COVID-19 Vaccine After-Care

COVID-19 Vaccine After-Care Instructions & Reporting Framework

Potential COVID19 Vaccine Side EffectsSuggested Techniques/Tips to Manage COVID19 Vaccine Side EffectsReporting Requirements
Tier 1: General Side EffectsGeneral side effects:
*redness and/or swelling at the injection site
*Low grade fever
*Muscle and joint pain
*Overall lethargy (tiredness) *Headache  

Additional Vaccine Specific Side Effects:  
Moderna COVID-19 Vaccine:
*Nausea and/ or vomiting *Enlarged lymph nodes (swollen glands) in your underarm.  

Pfizer-BioNTech COVID-19 Vaccine:

*Applying an ice pack or cold damp cloth where the vaccine was given, may help with soreness.  
*Tylenol (Acetaminophen) or Advil (Ibuprofen) may help with pain or fever.  
*Monitor the nausea/vomiting/diarrhea. You may need to consult the family physician if it lasts longer than 24 hours as you don’t want the individual to become dehydrated.  

*Enlarged Lymph nodes may be painful. Tylenol or Advil may also help but remember to contact the family physician to get more direction if you are concerned.
See the Appendix 1 for Acetaminophen Protocol as a guideline to administration.            
*Complete Incident Report for additional symptoms – Level 1 and notify Supervisor/manager.  

*Communicate side effects through Communication Binder, Personal Log-Book, MAR sheet and PRN monitoring log  

*Update Vaccination Notes on ISIS.
Tier 2: Serious Side EffectsSerious side effects after receiving the vaccine are rare. Any of the following adverse reactions can develop within three days of receiving the vaccine:
*swelling of the face or mouth
*trouble breathing
*very pale color and serious drowsiness
*high fever (over 40°C)
*convulsions or seizures (more than usual or presenting differently for those that have a seizure disorder like Epilepsy)other serious symptoms (e.g., “pins and needles” or numbness).  

At this time there is no directive for the use of Benadryl (diphenhydramine) in the aftercare of the COVID-19 vaccine.

In the event of an emergency please seek medical attention by a healthcare professional and alert the Health Team.
*Complete Incident Report – Level 2 for seeking medical attention or Level 3 for 911/ hospitalization and notify Supervisor/manager/on-call and email CLTO Health team at    

*Complete SOR for Incident Reports Level 3

*Complete an AEFI Reporting Form.  
-Send it to your local public health unit.  

See AEFI Reporting Fact Sheet for more information.    

Appendix 1: Acetaminophen (Tylenol) General use guidelines

(Not to replace existing PRN protocol for pain & fever as signed off by a healthcare professional)

  • Individuals need to be given Acetaminophen for either pain and/or fever. This is usually ordered by the Family Physician and remains as a medical directive (PRN) order on the MAR sheet.
  • Temperatures should be checked using a Tympanic (Ear) Thermometer as it is most effective, less intrusive, and quick.

To know when this medication is to be given there are some signs and symptoms that must be present as follows:

  • If the individual is feeling unwell, then a body temperature check should be done to see whether they have a fever as that is a good indicator that their body may be fighting some type of infection.
  • If the individual has a low-grade fever between 37.5ºC (99.5ºF) and 38ºC (100.4ºF) then the temperature must be taken every 4 hours, but Acetaminophen does not have to be administered.
  • However, if the individual is feeling generally unwell, Acetaminophen can be administered as they may be feeling some discomfort that cannot be explained.
  • Once there is a body temperature of over 38ºC (100.4ºF) Acetaminophen MUST be given as per the MAR sheet (from doctor’s orders) and continue to check the Temperature every 4 hours.
  • If the fever persists for more than 3 days with little improvement or worsening of other symptoms such as a raspy chesty cough, thick greenish discharge from the nose and/or mouth (when coughing) or just general malaise, then medical attention is needed. 
  • Once there is no fever for 24 hours then the temperature can be taken in the morning and at bedtime for 2 more days and then stopped.

Remember that Acetaminophen can be administered whenever there is pain due to trauma such as from falls or other types of injuries, but medical attention should be sought if there is a serious concern.