COVID-19 VACCINE: FREQUENTLY ASKED QUESTIONS

WHO IS ELIGIBLE FOR A VACCINATION?

Adults age 18 and older may be administered a vaccine manufactured by Pfizer-BioNTech, Moderna or Johnson & Johnson. On December 16, 2021, the CDC recommended Pfizer and Moderna should be considered the preferred vaccines, citing increasing evidence of a rare blood clot disorder associated with the Johnson & Johnson vaccine. The risk was greatest among women aged 30-49, estimated at 1 in 100,000. The Johnson & Johnson vaccine is not being removed from the market; however, it is recommended that you consult with your medical provider prior to having this vaccine administered.

Vaccination for those age 6 months to 17 years may vary based on age and manufacturer.

On June 17, 2022, the U.S. Food and Drug Administration authorized emergency use of the Moderna COVID-19 Vaccine and the Pfizer-BioNTech COVID-19 Vaccine for the prevention of COVID-19 to include use in children down to 6 months of age. 

• For the Moderna COVID-19 Vaccine, the FDA amended the emergency use authorization (EUA) to include use of the vaccine in individuals 6 months through 17 years of age. The vaccine had been authorized for use in adults 18 years of age and older.
• For the Pfizer-BioNTech COVID-19 Vaccine, the FDA amended the EUA to include use of the vaccine in individuals 6 months through 4 years of age. The vaccine had been authorized for use in individuals 5 years of age and older. 

For additional detail, click here.

what vaccines are available?

Three vaccines have been authorized for use in the United States: Pfizer-BioNTech, Moderna and Janssen.

The Pfizer-BioNTech and Moderna vaccines both use messenger RNA (mRNA) technology, which uses the cells of one’s own body to boost an immune response towards a protein found on the virus cell wall. Antibodies toward this “spike protein” will then disable the SARS-CoV-2 virus if exposed in the future. These vaccines are not produced using live virus; therefore, you cannot be infected with the COVID-19 (SARS-CoV-2) virus from the vaccination. Both vaccines are two-shot doses, with the Pfizer second dose given approximately 21 days later and the Moderna second dose approximately 28 days later.

The Janssen (Johnson & Johnson) vaccine does not use mRNA. It uses the more common approach to vaccine development (adenovirus vector vaccine) by employing a harmless cold virus to deliver a gene that carries the blueprint for the spike protein found on the surface of the coronavirus. Once it enters, the cells are triggered to make the spike protein on their own surface and the immune system notices these foreign proteins and makes antibodies that will protect the person if exposed to COVID-19. The Janssen (Johnson & Johnson) vaccine is a single-dose vaccine. 

HOW IS THE VACCINE ADMINISTERED?

All vaccines are administered via injection in the muscle of the upper arm, much like flu vaccination. You will be required to remain for observation for 15 minutes following your injection.

Who is eligible for a booster of the COVID vaccine?

For detail regarding dose recommendations for adolescents and adults who are moderately to severely immunocompromised, see CDC Recommendations.

The term immunosuppressed is defined as:

• Active or recent treatment for solid tumor and hematologic malignancies
• Receipt of solid-organ or recent hematopoietic stem cell transplant
• Severe primary immunodeficiency disorder
• Advanced or untreated HIV
• Active treatment with corticosteroids (20 mg/day or higher), alkylating agents, antimetabolites, TNF blockers, and other biologics that are immunosuppressive
• Considerations for other medical conditions such as asplenia

Patients who are not certain whether they qualify for a third dose vaccine based on the criteria stated above should contact their physician for guidance.

ARE THESE VACCINES SAFE?

Medication safety and efficacy is reviewed by the FDA prior to emergency use authorization (EUA). Vaccine trials for all three manufacturers with EUA approval contained more than 21,000 individuals. To date, more than 590 million doses of COVID vaccines have been administered in the United States.

WHAT ARE THE SIDE EFFECTS?

Studies indicated that a small percentage of people who received the vaccines had short-lived fatigue and headache. Chills, muscle aches and pain at the injection site were other minor symptoms. Rare allergic reactions have been reported in individuals with a history of severe allergic reactions to other drugs/foods/vaccines.

On December 16, 2021, the CDC recommended Pfizer and Moderna should be considered the preferred vaccines, citing increasing evidence of a rare blood clot disorder associated with the Johnson & Johnson vaccine. The risk was greatest among women aged 30-49, estimated at 1 in 100,000. The Johnson & Johnson vaccine is not being removed from the market; however, it is recommended that you consult with your medical provider prior to having this vaccine administered.

WHAT are variants?

A virus constantly changes through mutation, resulting in a variant of the original virus. Public health experts track changes in viruses to determine whether variants have the ability to spread more quickly or to cause more severe illness and how the changed virus responds to testing and treatment.

Since COVID-19 was first identified, several variants of the virus have emerged. The Delta and Omicron variants were both identified in 2021 as being much more transmissable than the original version of the virus. The BA.2 omicron subvariant accounted for more than half of all new cases in the U.S. by late March 2022.

what if i am planning a trip?

The CDC recommends delaying travel until you are able to get fully vaccinated (two weeks after the second dose of the Pfizer or Moderna vaccine or the single dose of the Janssen vaccine). If you are planning an international trip, a cruise or other travel, it is especially important to become fully vaccinated. Some destinations or services may require vaccination before departure, so check before making reservations. Learn more about travel recommendations related to COVID-19 here.

I HAVE HAD COVID-19 IN THE PAST. SHOULD I CONSIDER TAKING THIS VACCINE?

Yes, you should consider vaccination. However, if you are currently infected with COVID-19, you should wait to get vaccinated until after your illness has resolved and you have met the criteria to discontinue isolation. 

I HAVE HAD MONOCLONAL ANTIBODY TREATMENT. SHOULD I CONSIDER TAKING a VACCINE?

Yes, but you must wait 90 days post monoclonal antibody treatment. You must also wait 90 days if you have had convalescent plasma treatment.

DO THE VACCINE SIDE EFFECTS DIFFER FOR THOSE WHO HAVE HAD COVID-19?

Individuals who have had COVID-19 may experience fever, fatigue and body aches after vaccination. 

WHAT SHOULD I DO AFTER RECEIVING THE VACCINE?

It is recommended that those receiving the vaccine should monitor for any symptoms following vaccination. It is normal to feel slightly fatigued, particularly after the second dose, as your body’s immune response is triggered. However, if you experience symptoms such as low-grade fever, loss of taste and smell, cough, etc., it is likely that you may have been exposed to COVID-19 either before the vaccine was administered or before it resulted in immunity. It is recommended that you monitor your symptoms at home. If symptoms persist after 24 hours, you should contact your physician or visit an urgent care or emergency department depending upon the severity of your condition.

WHY HAVE SOME PEOPLE TESTED POSITIVE FOR COVID-19 AFTER THEIR INITIAL VACCINE DOSE?

Because the COVID-19 vaccine does not contain live virus, it is not possible to contract COVID-19 from the vaccine; however, we must keep in mind that an individual could have been exposed to COVID-19 prior to taking the vaccination or before vaccine immunity takes affect (two weeks after full vaccination).

IS THERE ANYONE WHO SHOULD NOT BE VACCINATED?

We encourage you to discuss vaccination with your primary care provider; however, a small number of individuals have experienced allergic reactions. Out of an abundance of caution, it is recommended that individuals with severe drug/food allergy history (e.g. anaphylactic, use of epi pens) should consider deferring vaccination until more data is available. See next two questions regarding pregnant and lactating individuals and those treated with monoclonal antibody or convalescent plasma.

IF I AM PREGNANT, SHOULD I TAKE THE VACCINE?

The CDC recommends COVID vaccination for people who are pregnant, trying to get pregnant or might become pregnant in the future. If you have questions about getting vaccinated, talk to your doctor who can help you make an informed decision. 

SHOULD THOSE TREATED WITH MONOCLONAL ANTIBODY INFUSION OR CONVALESCENT PLASMA BE VACCINATED?

Currently, there are no data on the safety and efficacy of COVID-19 vaccines in those who received monoclonal antibodies or convalescent plasma. Based on the estimated half-life of such therapies as well as evidence suggesting that reinfection is uncommon in the 90 days after initial infection, it is recommended that vaccination be deferred for at least 90 days, as a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses.

SHOULD I TAKE THE COVID-19 VACCINE IF I RECENTLY RECIEVED ANOTHER VACCINATION?

Per the CDC, you can get a COVID vaccine at the same time as a flu vaccine. For guidance regarding other types of vaccination, consult with your primary care physician.

DOES THE VACCINE CONTAIN LIVE VIRUS?

The Pfizer and Moderna vaccines use messenger RNA (mRNA) technology. This technology uses the cells of one’s own body to boost an immune response towards a protein found on the virus cell wall. Antibodies toward this “spike protein” will then disable the SARS-CoV-2 virus if exposed in the future. The Janssen (Johnson & Johnson) uses a more traditional approach to vaccine development (adenovirus), using a harmless cold virus to boost an immune response to the spike protein and triggering the development of antibodies. This means that the vaccines are not produced using live COVID-19 virus; therefore, you cannot be infected with the SARS-CoV-2 virus from the vaccination.

SHOULD THE SPEED IN WHICH THIS VACCINE WAS DEVELOPED BE A CONCERN?

The Pfizer and Moderna vaccines were able to be developed quickly due to scientists studying the SARS1 and MERS outbreaks, new techniques and early isolation of SARS-CoV-2. SARS1 occurred in 2002 and vaccine development began at that time. SARS1 and COVID-19 structures are more than 70% identical. MERS occurred around 2012 and provided more information on vaccine development. MERS and COVID-19 structures are approximately 50% identical. As such, new vaccine development techniques were discovered prior to the start of the COVID-19 outbreak. Scientists isolated SARS-CoV-2 in early January 2020, allowing structure analysis to begin.

For additional information, visit the CDC Frequently Asked Questions about COVID-19 Vaccination page.

To learn more about Tennessee Department of Health vaccination, click here.