*Coronavirus FAQs: Can I Drink Between Vaccine Doses? What Is 'Vaccine
Efficacy'*

Sheila Mulrooney Eldred

People are wondering if alcohol in between vaccine doses might have an
impact on your body's reaction to the vaccination.

*I have started hearing that vaccine recipients should abstain from alcohol
between the first and second doses of the COVID vaccine. Is this a thing?*

It's true that chronic, heavy drinking and binge drinking can suppress your
immune system, says Richard Kennedy
<https://www.mayo.edu/research/faculty/kennedy-richard-b-ph-d/bio-00027442>,
professor of medicine at the Mayo Clinic in Rochester, Minn., and
co-director of the Vaccine Research Group. And there are plenty of health
reasons not to drink alcohol, he adds. But an occasional drink here and
there — including a celebratory toast after your second shot? "That won't
have an effect," he says.

*What, exactly, does it mean that a vaccine is, for example, 92%
efficacious? Does it mean there's an 8% chance of my getting COVID-19? If
so, why would anyone want to get a vaccine that's only 60 or 65%
efficacious?*

*I find the subject of vaccine efficacy very confusing!*

Don't worry: If you find it confusing, you're probably on the right track!
Efficacy rates (and effectiveness rates and point estimates and confidence
intervals) should appear at least a little confusing to most
non-biostatisticians. The concepts rely on statistical thinking that many
aren't familiar with, says Brianne Barker,
<https://www.drew.edu/communications-department/2018/02/13/brianne-barker/>
a virologist at Drew University.

The tendency to oversimplify has led many people to the same — mistaken —
conclusion that an efficacy rate of 92 percent would mean that of 100
vaccinated people, 8 of them would get sick during a pandemic.

But that's not the case. Fortunately, a vaccine with a 92 percent efficacy
rate actually means your chances of getting the disease is much, much less
than 8 percent*.* It means that if you were exposed to the disease, your
chances of getting infected would be 92 percent less if you were vaccinated
than if you weren't.

If you want to geek out on the exact math on how much your chances of
getting COVID drops after a vaccine, you'd have to know what the
probability of getting sick is, Barker says. "And that varies based on the
population that you look at."

Say you originally had a 10% chance of getting sick without being
vaccinated. If you got that vaccine with an efficacy rate of 92%, your
chance of getting sick would drop from 10% to less than 1% — 0.8%, to be
exact.

In reality, the trials found that the probability of getting sick in the
placebo groups was much less than 10%. In the Pfizer trial, for example, it
was 0.79% — or less than one per 100 people. Participants who got the real
vaccine had just a .04 percent chance of getting COVID ... that's 4 in *10,000
*people.
<https://www.npr.org/sections/goatsandsoda/2021/03/12/976538684/coronavirus-faqs-can-i-drink-between-vaccine-doses-what-is-vaccine-efficacy?utm_source=pocket-newtab-intl-en#_msocom_6>
<https://www.npr.org/sections/goatsandsoda/2021/03/12/976538684/coronavirus-faqs-can-i-drink-between-vaccine-doses-what-is-vaccine-efficacy?utm_source=pocket-newtab-intl-en#_msocom_7>

While efficacy rates should, theoretically, make comparisons among
different vaccines possible, a number of variables have made it more like
"comparing an efficacy rate of 70 percent to purple," says Richard Kennedy
<https://www.mayo.edu/research/faculty/kennedy-richard-b-ph-d/bio-00027442>,
co-director of the Vaccine Research Group.

"You're laughing because that's a ludicrous comparison," he says. But to
truly make an apples-to-apples comparison, he says, you'd have to run the
vaccines head-to-head in the same clinical trial. As it was, the
characteristics of the participants in the various trials were different
(Johnson & Johnson enrolled more people at higher risk, for example),
variants were circulating during some trials and not others, and each trial
defined the disease differently. (For example, Moderna defined a COVID-19
infection as a positive PCR test plus two symptoms from one group or one
symptom from another group. Pfizer defined it as a positive PCR test plus
one symptom.)

"The devil really is in the details," he says.
<https://www.npr.org/sections/goatsandsoda/2021/03/12/976538684/coronavirus-faqs-can-i-drink-between-vaccine-doses-what-is-vaccine-efficacy?utm_source=pocket-newtab-intl-en#_msocom_8>

*Can I get the Johnson & Johnson vaccine and then sign up for Pfizer or
Moderna? *

Theoretically, that should be fine, Barker and Kennedy agree. In real life,
it's unlikely to happen — "it's hard enough to get one in the first place,"
Barker says, and "having already received one shot of Johnson & Johnson,
you'd be considered fully vaccinated and probably no one is going to let
you get another one because you're taking it away from someone who needs
it," Kennedy says.

However, your body would likely handle the mixing and matching just fine,
since all of the vaccines have the same antigen, Kennedy explains. The
antigen is the component that your immune response recognizes — in this
case, the spike protein. It's akin to the flu vaccine, he says. We get
influenza vaccines every year, often with similar strains, without worrying
about which company made it. When antigens are different, however, your
body usually develops weaker antibodies.

"Another thing to consider is what will happen if we need booster doses in
6 months, 2 years, whenever," he says. "I doubt that we will have the
resources or ability to only provide the same vaccine that you originally
received."

*And can people who have an allergic reaction to their first Pfizer or
Moderna shot follow up with Johnson & Johnson?*

Again, this may work in theory, Kennedy says, but until vaccines are more
widely available it may not be possible. In the meantime, be reassured that
your first dose may provide pretty good protection. After all, the Pfizer
and Moderna vaccines weren't studied as single doses, so the efficacy rate
after a month or two could be higher than you think, he points out.
--

With best wishes

S Chander

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