COVID-19 Vaccine

No. On Jan. 11, 2020, scientists published the full genetic code for this virus which allowed development of the vaccine. These vaccines technologies are not new—the many years of research in this area and focused support of the process allowed the rapid development of the COVID-19 vaccine to occur.

It is highly unlikely that you will have a choice between vaccines at a particular clinic. Local authorities distribute vaccine supply to best meet the needs of this national emergency. Clinics administer whichever of the vaccines they are provided. Most clinics are receiving and administering only one brand of vaccine at a time. Brand of vaccine being administered can vary between clinic locations and from one day to the next. Please remember that all three vaccines are highly effective in preventing serious COVID-19 illness and death, and that the best vaccine is the one you have the first opportunity to receive. It is your choice to accept or decline any vaccine offered to you.

No, they are not interchangeable. If you receive one of the two-dose mRNA vaccines (Pfizer or Moderna), you should receive the same brand of vaccine for both doses. Every effort should be made to ensure this, but the CDC provides guidance for situations where this may not be possible. The single does Janssen (Johnson & Johnson) vaccine should not be used to replace a dose of the two-dose mRNA vaccines.

The mRNA vaccines require two doses and are injected into the shoulder muscle just like the influenza vaccine. The Pfizer vaccine doses are given 21 days apart; the Moderna vaccine doses are given 28 days apart. The second dose should be received as close to the recommended interval as possible. However, according to the CDC, if it is not feasible to adhere to the recommended interval, the second dose of the Pfizer and Moderna COVID-19 vaccines may be received up to 6 weeks (42 days) after the first dose. There are currently limited data on efficacy of mRNA COVID-19 vaccines administered beyond this window of time. If the second dose is administered beyond these intervals, there is no need to restart the series. The Janssen (J&J) vaccine is a single dose vaccine.

The government is providing vaccine doses to people across the country at no cost. There may be charges to administer the vaccine.

Both the CDC and the state of Nebraska have comprehensive vaccine plans. These plans guide institutions on how to prioritize initial vaccine supplies. Plans are evolving and can be found on local Health Department websites.

No. A flu vaccine will not protect you from getting COVID-19, but it can prevent you from getting both influenza (flu) and COVID-19 at the same time. This can keep you from having a more severe illness. Getting a flu vaccine this year is more important than ever.

The protection someone gains from having an infection (called natural immunity) varies depending on the disease, and it varies from person to person. Since this virus is new, we don’t know how long natural immunity might last. Early evidence—based on some people—suggests that natural immunity may not last very long, so the vaccine is still needed. Data from clinical trials indicate that these vaccines are safe in people who have had a prior COVID-19 infection or positive testing.

Because convalescent plasma or monoclonal antibody therapy for COVID-19 illness may reduce vaccine response, patients who received these therapies should wait 90 days to receive the vaccine. Other types of antibody therapies are not thought to affect COVID-19 vaccine efficacy.

No. The mRNA vaccines do not contain the live virus. The Janssen (Johnson & Johnson) vaccine uses an inactivated adenovirus to deliver immunity instructions to your cells. This inactivated adenovirus is similar to a cold virus but cannot replicate itself or cause adenovirus infection. None of the vaccines are able to infect you with COVID-19 or adenovirus.

No. The way these vaccines work does NOT alter our DNA. With the Pfizer and Moderna vaccines, mRNA technology was chosen because it is faster to produce very large amounts of vaccine than other traditional methods. mRNA is not able to alter or modify a person’s genetic makeup (DNA) in any way. The Janssen (Johnson & Johnson) vaccine works differently but also has no effect on our DNA. These vaccines work with the body’s natural defenses to safely develop protection (immunity) to disease.

No, but it is possible that a recipient of the vaccine may have positive antibody tests.

In clinical trials, participants experienced symptoms such as:

• Pain and redness at the injection site
• Muscle and joint aches
• Fever
• Headache
• Swollen glands
• Fatigue
• Chills

In most cases these side effects were mild to moderate, but it is possible they will affect activities of daily living. When they did occur, symptoms most commonly appeared within the first three days and resolved within one to three days after that.

The ingredients in the three vaccines with Emergency Use Authorization (EUA) are:

Observational data demonstrate that pregnant people with COVID-19 have an increased risk of severe illness, including illness resulting in intensive care admission, mechanical ventilation, extracorporeal membrane oxygenation, or death, though the absolute risk for these outcomes is low. Additionally, they might be at an increased risk of adverse pregnancy outcomes, such as preeclampsia, coagulopathy, and preterm birth.

Data on the safety of COVID-19 vaccines in pregnant people are limited. No female reproduction or fetal, embryonal, or postnatal development safety concerns were demonstrated in animals that received Pfizer-BioNTech, Moderna, or Janssen COVID-19 vaccines before or during gestation. In addition, the adenovirus vector platform used in the Janssen COVID-19 vaccine has also been used for other Janssen vaccine development programs that have included pregnant people vaccinated during any trimester, including in a large-scale Ebola vaccination trial. No adverse pregnancy-related outcomes—including infant outcomes—were determined to be related to the vaccine in these trials.

Based on current knowledge, experts believe that COVID-19 vaccines are unlikely to pose a risk to the pregnant person or fetus because the currently authorized COVID-19 vaccines are non-replicating vaccines and cannot cause infection in either the mother or the fetus. No evidence exists of risk to the fetus from vaccinating pregnant women with non-replicating vaccines in general. However, the potential risks of COVID-19 vaccines to the pregnant person and the fetus are unknown because these vaccines have not been studied in pregnant people. Clinical trials to evaluate the safety and efficacy of COVID-19 vaccines in pregnant people are underway or planned. Vaccine manufacturers are also following outcomes in people in the clinical trials who became pregnant.

Pregnant people may choose to receive a COVID-19 vaccine. A conversation between the patient and their clinical team may assist with decisions about the use of a COVID-19 vaccine, though a conversation with a healthcare provider is not required before vaccination. When making a decision, pregnant people and their healthcare providers should consider the level of COVID-19 community transmission, the patient’s personal risk of contracting COVID-19, the risks of COVID-19 to the patient and potential risks to the fetus, the efficacy of the vaccine, the side effects of the vaccine, and the limited data about the vaccine during pregnancy. Pregnant people who choose to receive COVID-19 vaccine are encouraged to enroll in v-safe. A v-safe pregnancy registry has been established to follow outcomes among pregnant people who are vaccinated. Based on self-reported information, no specific safety signals have been observed among pregnant vaccine recipients included in the v-safe registry. However longitudinal follow-up is needed to fully evaluate pregnancy and birth outcomes.

Side effects can occur with COVID-19 vaccine use in pregnant people, similar to those expected among non-pregnant people. Acetaminophen can be offered as an option for pregnant people experiencing fever (which has been associated with adverse pregnancy outcomes) or other post-vaccination symptoms.

There is no recommendation for routine pregnancy testing before receipt of a COVID-19 vaccine. Those who are trying to become pregnant do not need to avoid pregnancy after COVID-19 vaccination. There is no evidence that any of the COVID-19 vaccines affect future fertility.

Health Expert Blog by Sean Kenney, MD, Center for Maternal & Fetal Care:

Should Pregnant Women Get the COVID-19 Vaccine?

Corwin Friesen, MD, Bryan Women's Care Physicians and Whitney, RN, and Expecting Mother, Explain Why COVID-19 Vaccine is Important for Expecting Mothers

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• Start video, then click on CC (this turns on closed captioning)
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There is no data on the safety of COVID-19 vaccines in lactating people or the effects of COVID-19 vaccines on breastfed infant or milk production. Because non-live vaccines pose no risk for lactating people or their infants, COVID-19 vaccines are not thought to be a risk. Therefore, lactating people may choose to be vaccinated.

There is no data showing that the vaccine affects fertility. You may see rumors suggesting this, but it has never been shown. Women who were trying to conceive were excluded from the study. We know that most adverse effects from vaccines appear within two months of receiving the vaccine and most people in the study were followed for at least two months. The following statement comes from the CDC: "Those who are trying to become pregnant do not need to avoid pregnancy after mRNA COVID-19 vaccination." Please discuss with your health care provider if you have additional concerns.

People with HIV infection or other immunocompromising conditions or people who take immunosuppressive medications or therapies might be at increased risk for severe COVID-19. No data are available to establish COVID-19 vaccine safety and efficacy in these groups. However, the currently authorized COVID-19 vaccines are not live vaccines and therefore can be safely administered to immunocompromised people. People with stable HIV infection were included in the COVID-19 vaccine clinical trials, though data remain limited.

Immunocompromised people can receive COVID-19 vaccination. Data are currently insufficient to inform optimal timing of COVID-19 vaccination among people who are planning to receive immunosuppressive therapies. However, based on general best practices for vaccination of immunocompromised people, ideally COVID-19 vaccination should be completed at least two weeks before initiation of immunosuppressive therapies. When it is not possible to administer a complete COVID-19 vaccine series (i.e., two doses of an mRNA vaccine or a single dose of Janssen COVID-19 vaccine) in advance, people on immunosuppressive therapy can still receive COVID-19 vaccination. Decisions to delay immunosuppressive therapy to complete COVID-19 vaccination should consider the person’s risks related to their underlying condition.

Antibody testing is not recommended to assess for immunity to SARS-CoV-2 following COVID-19 vaccination. At this time, revaccination is not recommended after people who received COVID-19 vaccines during chemotherapy or treatment with other immunosuppressive drugs regain immune competence. Recommendations on re-vaccination or additional doses of COVID-19 vaccines may be updated when additional information is available.

People should be counseled about the unknown vaccine safety profile and effectiveness in immunocompromised populations, the potential for reduced immune responses, and the need to continue to follow current guidance to protect themselves against COVID-19.

Persons with autoimmune conditions were not excluded from clinical trials, but there is no data specifically available on the safety and efficacy of mRNA COVID-19 vaccines in these populations. Patients with these conditions who have no contraindications to vaccination may receive the vaccine.

No cases of Guillain-Barré syndrome (GBS) were reported following vaccination among participants in the mRNA (Pfizer-BioNTech and Moderna) COVID-19 vaccines clinical trials. One case of GBS was reported in a participant in the vaccine group in the Janssen (Johnson & Johnson) vaccine clinical trial, compared to one GBS case among those who received a placebo. With few exceptions, ACIP's general best practice guidelines for immunization do not include history of GBS as a contraindication or precaution to vaccination. People with a history of GBS may receive COVID-19 vaccination. Any occurrence of GBS following COVID-19 vaccination should be report to VAERS.

There were cases of Bell’s palsy among patients in the clinical trials, but the rate of occurrence was not higher than in the general population. They were not considered to be caused by vaccination. Persons with a history of Bell’s palsy may receive an mRNA COVID-19 vaccine unless they have other contraindications.

There is a small chance that the vaccine could cause a severe allergic reaction.

Patients who should not receive the vaccine include those with a history of:

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose of a COVID-19 vaccine or any of its components
• Immediate allergic reaction of any severity to a previous dose of a COVID-19 vaccine. or any of its components with symptoms such as feeling of impending doom, urticaria/hives, itching, flushing, swelling of the face, mouth or throat, confusion, disorientation, dizziness, weakness, loss of consciousness, shortness of breath, respiratory distress, wheezing, stridor, bronchospasm, hypoxia or anaphylaxis, drop in blood pressure or increased heart rate, nausea, vomiting, abdominal cramps, diarrhea. (Not all side effects represent an allergic reaction -- your health care provider can help discern between allergic reactions and other types of vaccine side effects.)

For patients with a history of any immediate allergic reaction to other vaccines or injectable therapies, consider deferring vaccination and/or referral to allergist-immunologist for risk assessment.

There are no warnings under the EUAs against vaccinating patients with other allergies (e.g. food, pets, insect venom, environmental, latex, eggs, gelatin or oral meds) or only a family history of allergies. CDC notes that a history of mild allergic reactions to vaccines or injectable therapies is not a contraindication or precaution to being vaccinated with the COVID-19 vaccines.

If you have had severe or immediate allergic reactions to other vaccines or injectable therapies, or have concerns about potential allergic response to this vaccine, you should discuss risks and benefits with your health care provider.

Dermal fillers are various types of products injected under the skin to plump tissue for cosmetic reasons. Rarely, people receiving the mRNA COVID-19 vaccine have experienced swelling near the area of a filler injection (usually face or lips). If this happens, it appears to be temporary and can resolve with treatment. This should not prevent you from being vaccinated unless you have other medical reasons that you should not receive these vaccines. If you do develop swelling of this type after vaccination, contact your health care provider.

CDC states “Given the lack of data on the safety and efficacy of mRNA COVID-19 vaccines administered simultaneously with other vaccines, the vaccine series should be administered alone, with a minimum interval of 14 days before or after administration with any other vaccines. If mRNA COVID-19 vaccines are inadvertently administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine.”

Herd immunity happens when a virus can’t spread because it keeps encountering people who are already protected against infection. Once a large portion of the population is no longer at risk, any new outbreak should halt. Experts estimate that in the U.S., about 70 to 80 percent of the entire population—more than 200 million people—must recover from COVID-19 to stop the pandemic from getting worse.

But, that level of infection will lead to large numbers of patients with serious long-term complications and millions of deaths. This is why the vaccine is so important. Our health care system cannot accommodate that many patients—we are overwhelmed now. When you get the vaccine, you help create herd immunity because the virus can’t spread due to the protection the vaccine provides.

This is not recommended, since the impact on vaccine efficacy is unknown at this time. However, if you experience discomfort from side effects after the vaccination, you may take an over-the-counter pain reliever.

Yes, the injection is given in the muscle of the shoulder, just like the annual flu shot.

Yes, we all need to continue the same effective practices of wearing a mask, washing our hands and social distancing for the foreseeable future. We are in a long battle with a fierce enemy and we can’t let up, but hope from the vaccine is here.

The full effect of the vaccine can be expected for most people within 10-14 days after the second vaccination dose is given.

It is not yet known how long immunity to COVID-19 lasts, either in a person who recovered from the disease or one who got vaccinated. It is possible that vaccines will require additional booster doses at some point after the first two doses.

According to the Nebraska Community Blood Bank, there is no waiting period to donate blood or plasma after receiving the Pfizer or Moderna vaccine. If you receive the Johnson & Johnson or Astra Zeneca vaccine (when available), a 14-day waiting period is required prior to donation of blood or plasma. You are not able to donate convalescent plasma if you are vaccinated.