COVID-19 VACCINE: FREQUENTLY ASKED QUESTIONS

WHO IS ELIGIBLE FOR A VACCINATION?

COVID-19 vaccination is now available to individuals ages 5 and older. Recommendations for vaccination of ages 5-11 with the Pfizer-BioNTech vaccine were issued by the CDC on November 2.

In addition to the primary dose/series of vaccines, boosters have now been authorized for those age 12 and older. See below for more information about boosters.

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 toward 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. 

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.

The Moderna and Janssen vaccines are currently available for use in ages 18 and older. The Pfizer-BioNTech vaccine is now available for use in ages 5 and older. Pfizer is currently the only vaccine authorized for use individuals under age 18.

For detailed information about each vaccine, including fact sheets, select the appropriate manufacturer:

Moderna Fact Sheet (ages 18 and older)

 

Janssen (Johnson & Johnson) Fact Sheet (ages 18 and older)

 

HOW IS THE VACCINE ADMINISTERED?

The Pfizer and Moderna vaccines are administered in multiple doses, given several weeks apart. The Janssen (Johnson & Johnson) vaccine is a single-dose vaccination. 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?

Booster shots are available to ages 12 and older, based on when primary vaccination was completed.

Moderna: The CDC recommends booster shots for everyone age 18 and older who completed the primary Moderna vaccination series at least five months ago.

Pfizer-BioNTech: The CDC recommends boosters of the Pfizer vaccine for everyone age 12 and older who completed the primary Pfizer vaccination series at least five months ago.

Johnson & Johnson: The CDC recommends boosters of the Johnson & Johnson vaccine for those who are 18 and older who were vaccinated two or more months ago. 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.

Individuals age 18 and older who are eligible for a booster dose may choose which vaccine they want to receive as a booster dose. The Pfizer vaccine is the only COVID vaccine authorized for those under age 18.

Individuals are encouraged to consult with their primary care physician regarding individual risk and benefit of receiving a booster. Those who elect to receive a booster based on the current recommendations should bring their vaccination record card showing dates of prior doses and manufacturer information to the vaccine location. 

Learn more about the latest CDC recommendations on boosters here.

who is eligible for a third primary dose of vaccine?

The use of an additional dose of Pfizer-BioNTech and Moderna vaccines have been recommended for those who are fully vaccinated and are immunocompromised, specifically, solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise. Key points to note about this recommendation include:

  • The recommendation for a third dose applies only to individuals that received an mRNA vaccine (Pfizer or Moderna). This does not include those who received the Janssen vaccine.
  • The recommendation includes ages 5 and older for Pfizer and 18 and older for Moderna. 
  • The recommendation is that the third dose be from the same vaccine manufacturer as the individual initially received; however, if the same vaccine is not available, the third dose could be either Moderna or Pfizer.
  • A third dose is recommended to occur at least 28 days after initial completion of the original two-dose series.

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 500 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 tranmissable than the original version of the virus. 

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) and, therefore, could begin experiencing symptoms of COVID-19 after taking the vaccine.

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 experienced allergic reactions. Out of an abundance of caution, it is recommend 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 toward 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.

HOW IS THE VACCINE STORED BEFORE USE?


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 was started 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.