Your Vaccination Guide

The Food and Drug Administration (FDA) sets tough standards that must be met before they will allow for an emergency use authorization (EUA) for a vaccine, which it granted to the Pfizer and Moderna vaccine in December 2020 and the Johnson & Johnson vaccine in February 2021. (NOTE: as of August 2021, the Pfizer mRNA vaccine has been granted FULL authorization by the FDA due to abundant evidence of its safety and efficacy).

The Centers for Disease Control and Prevention (CDC) also reviews vaccine studies along with a group of doctors and other vaccine experts who don’t work for the government. These groups found that the vaccines are safe. Safety information will continue to be gathered as more and more vaccinations are given.

Pfizer, Moderna and Johnson & Johnson all tested their vaccines on large groups of people. The Pfizer SARS-CoV-2 vaccine studies had 43,448 people, and the Moderna SARS-CoV-2 vaccine study had more than 30,000 people. The Johnson & Johnson vaccine clinical trials enrolled 45,000 people.

• All three vaccines are extremely effective at preventing serious illness, hospitalization and death from SARS-CoV-2, even in the face of the Omicron variants. We have evidence that the mRNA vaccines, Pfizer and Moderna, and the Johnson and Johnson adenovirus vector vaccine also can prevent infection, though less so in the face of the Omicron variant . 
• What this means is that all three vaccines are extremely effective in preventing one from getting seriously ill or dying from CoVID. That said, the Johnson and Johnson vaccine has fallen out of favor due to side effects (especially problems with blood clots that are not associated with the mRNA vaccines) so you should get one of the mRNA vaccines from Pfizer and Moderna if at all possible.
• The Johnson & Johnson vaccine should be reserved for those very few who are unable to take the mRNA vaccines, or for whom these are not available. 

Everyone aged 5 years and older is eligible to receive the Pfizer COVID vaccine. The Moderna and Johnson and Johnson vaccines are authorized for age 18 and older. 

VaccineFinder.Org is a free resource to find locations with vaccine availability near you.

In most cases, post-vaccine symptoms are reported to include: 

• Pain at injection site 
• Fatigue
• Headache
• Muscle pain
• Chills 
• Joint pain
• Fever
• Injection site swelling
• Injection site redness

• Studies indicate the efficacy after the first dose of the mRNA COVID-19 vaccines from Pfizer and Moderna is about 80%. After two doses the efficacy reaches over 90%. The Johnson & Johnson vaccine is only one dose, and has an efficacy of 66% overall, and 72% in the US arm of their trials. Note: these studies were done before Omicron variant emerged. Their ability to prevent infection from this variant and its subvariants is reduced, though all three of these vaccines remain excellent at preventing serious illness, hospitalization, and death even from the Omicron variant.  
• Full vaccination for the Pfizer vaccine is 2 doses 21 days apart, and fore the Moderna vaccine, it is 28 days between the two doses. Johnson & Johnson vaccine is only one dose.
• Boosters are also now available for certain groups.

We know that the currently available COVID-19 vaccines are very good at preventing someone from getting severe symptoms from the virus and dying, though, in the face of the Omicron variant, they are not as effective at preventing the spread of the virus to others, even when they have no symptoms.

In the face of the Omicron variants and widespread transmission, the CDC recommends that if a fully vaccinated person lives in/is visiting an area where the transmission rates are “high” that they wear a mask while in indoor public spaces.  (Check here for your county transmission rates)

If you reside in or are visiting an area with low transmission rates (less than 50 cases/100,000 people) you can can resume activities that you did prior to the pandemic without wearing a mask or physically distancing, except where required by federal, state, local, tribal or territorial laws, rules and regulations, including local business and workplace guidance.

People who have a condition or are taking medications that weaken the immune system, should talk to their healthcare provider to discuss their activities and may need to continue to take precautions to prevent COVID-19, including wearing a mask.

With the highly infectious Omicron variant now so prominent across the US  some cities and counties with high transmission rates are returning to mask mandates. These mandates should be followed even if vaccinated in an attempt to counter this spread.

No, as long as you do not develop symptoms and you have completed the full vaccine series of an mRNA vaccine (Pfizer, Moderna) within the last 5 months, or Johnson and Johnson in the last 2 months or if you’ve had a booster, a close contact exposure means you should wear a mask for 10 days when around people. You should get tested 5 days after the exposure.

Under emergency use authorization from the FDA (EUA), all adult patients can now access boosters of Pfizer, Moderna, and Johnson and Johnson, and are recommended to do so in the face of the Omicron variant and its subvariants.  Please refer to this CDC link for details on the boosters.

Also approved was heterologous boosting, which means individuals can also choose which vaccine they receive as a booster – they are not required to stick with the one they got initially.

If patients have symptoms of injection site pain/tenderness, fatigue, fever, muscle/body aches, etc. within hours to a couple days after receiving the injection, then these are very likely related to the vaccine and not COVID-19. If there are other more specific symptoms like a runny nose, coughing, chest pain, loss of taste/smell, vomiting, or diarrhea then it could be COVID-19, or some other virus, and not likely caused by the vaccine. If this occurs, you should isolate yourself per CDC guidelines and get tested for COVID-19.

In preparation for your vaccine appointment, be sure to take your driver's license / ID card, and your insurance card with you along with the vaccination form filled out.  Be sure to wear a short-sleeve shirt, or a shirt with sleeves loose enough to easily pull it up and allow access to your upper arm.  It is not recommended that you take any Tylenol or Ibuprofen prior to the vaccine, but these can be taken afterwards if needed for minor aches and pains that might occur.

• It is true that pregnant and breastfeeding women were largely excluded from the initial clinical trials, though now that the vaccines have been in use since December 2020, data from tens of thousands of reporting pregnant individuals (via v-safe, the v-safe pregnancy registry, and VAERS)  support the safety of the vaccine in this population. Moreover, studies also show that getting vaccinated while pregnant not only protects the woman against severe COVID and death, but confers immunity to the newborn, as well. 
• CDC, WHO, and the American College of Obstetricians and Gynecologists (ACOG) all indicate that vaccination in pregnancy is important to protect pregnant women who are at higher risk of severe outcomes should they get COVID.  
• Boosters may also be given in pregnancy if the person meets the requirements.

Antibody testing is not currently recommended to assess the need for vaccination.

No, there is no reason to worry about the safety of the vaccine. The factors that led to the quick turnaround of the vaccines. There are many reasons the safe vaccines could be made so quickly. First, the technology used to make the mRNA vaccines has been studied and created for more than a decade. Second, making a vaccine with the mRNA technology (the Pfizer and Moderna products) is also much simpler and faster than the other forms, such as those used to make the flu vaccine. So there is a shorter manufacturing time. The Johnson & Johnson vaccine uses a process already in use for other, non-COVID-19 vaccines. Third, the US government helped fund the studies and vaccine creation, so that helped speed up the process as well. Lastly, the pandemic made the need for the vaccine a top priority for people. So getting enough people to take part in the studies was quick and easy.

• No, having an autoimmune condition is not not a reason to avoid the vaccine. The vaccine is approved for people with autoimmune diseases and weakened immune systems from health conditions or a medication.  To understand the risks and benefits, people with these conditions should consult with their care provider before getting the vaccine.
• Those ages 5 and older with moderate to severe immune compromise, from a health condition or from medication, should have a primary series of 3 mRNA vaccines (Pfizer or Moderna) injections, with the 3rd in the series to be given 28 days after the second. 
• Boosters should also be given to those ages 5+ who are immunocompromised. 

There are no long-term effects to watch out for. But scientists will continue to watch for side effects that people report after getting the vaccine through an app on their smartphones or computers, and information they share with their vaccine providers. 

• Yes, the vaccines have been shown to be safe in children, as they are in adults.
• Both the Pfizer and Moderna vaccines now have FDA Emergency Use Authorization for use in children ages 6 months and up. Pfizer’s vaccine is given as a three dose series, and Moderna’s is two doses.
• The Johnson and Johnson vaccines are not authorized for those under 18 years of age.  
• The side effects are similar to what has been seen before in older kids and adults, generally mild with a sore arm being the most common. 
• Many pediatricians across the country have been authorized to give the vaccine in their office, so call your pediatrician or family practice doctor to see if they have the vaccine for this age range.

• At this time, the current vaccines do protect most people from serious illness, hospitalization, and death from the coronavirus variant Omicron and its subvariants that are now dominant in the US.  
• For updated news about new variants from the CDC: (https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html).

• The Omicron variant originated in South Africa in late 2021 and now it’s subvariants are the dominant variants circulating in the US. 
• It spreads more easily than the original SARS-CoV-2 virus and than Delta variant. Anyone with Omicron infection can spread the virus to others, even if they are vaccinated or don’t have symptoms, but the majority of people are not getting very ill, in general.
• Current vaccines are protecting against severe illness, hospitalizations, and deaths, however, which is great news and what we hoped the vaccines would do.

COVID-19 vaccine is free. The health care provider may choose to charge an administration fee for distributing the vaccine, if this occurs the fee will be covered by your insurance company. For uninsured patients, the government will cover the administration fee. No one can be denied a vaccine if they are unable to pay the vaccine administration fee.

• The Johnson & Johnson vaccine differs from the currently available COVID-19 vaccines from Pfizer and Moderna in a few ways. First, it is given in a single dose. Additionally, this vaccine uses a common cold virus, to introduce the spike proteins of COVID-19 into our cells, thereby evoking an immune response. It is important to understand that this is an altered form of the common cold virus that cannot cause any harm or multiply, so no one will get sick from it. This common cold virus has been used in this same way for other vaccines, as well, with no problems. Another difference between this vaccine and the vaccines from Pfizer and Moderna is that it does not require such cold temperatures to transport and store unlike the mRNA vaccines. This makes the Johnson and Johnson vaccine less complicated for hospitals, clinics, and pharmacies to handle.

• The results from Johnson & Johnson large clinical trials indicate that the vaccine has an efficacy of 72% in the United States arm of the trial, and 85% when they looked specifically at its ability to prevent serious illness overall. That said, its efficacy is not holding up so well in the face of the Omicron variant, and this vaccine has also fallen out of favor due to the rare but very serious risk of blood clots, especially in women under 50. So, the CDC now recommends that if an mRNA vaccine is available, and the patient is able to get it (no contraindications) they should opt for that rather than the Johnson & Johnson product. 

• If you have received the Johnson & Johnson vaccine, you are advised to monitor for severe headache, abdominal pain, leg pain, or shortness of breath occurring within three weeks after vaccination, and should contact your local health care provider for evaluation right away if such symptoms occur.

• If you received the Johnson & Johnson vaccine and have not developed any of the side effects associated with signs of blood clots, as noted above, within three weeks after vaccination, the risk of an adverse reaction is unlikely. Read this release from CDC for more information.

No. It is not recommended that we change the schedule of getting both vaccine shots from what was studied. The current recommendation is for a full dose of the vaccine to be given, and then again 3 weeks later for the Pfizer vaccine, and 4 weeks later for the Moderna vaccine.

Yes, COVID-19 vaccines and other vaccines may now be administered without regard to timing, including simultaneous administration of COVID-19 vaccines and other vaccines on the same day, as well as coadministration within 14 days. 

For the mRNA vaccine from Pfizer, 10% of U.S. people in the study were Black, 13% were Hispanic, 6% were Asian, and less than 2% were Native American. Over all the studies Pfizer did worldwide, not just in the US, 10% of the people  were Black, 26% were Hispanic, 5% were Asian, and less than 1% were Native American. 

In the Moderna vaccine studies, roughly 20% of the people were Hispanic, 10% were Black, and 4% were Asian. Information on the number of American Indians in the study was not provided.

Among U.S. participants in Johnson & Johnson phase 3 trial, 74% were white, 15% were Hispanic, 13% were Black, 6% were Asian, and 1% were Native American.

Currently AstraZeneca is not approved for utilization in the United States. AstraZeneca reports that the vaccine is 76% effective overall after the second dose. This is above the standard set by the U.S. FDA for a vaccine to be considered useful (50% efficacy).

While the CDC still recommends wearing masks during travel on public transportation, they have updated their travel guidelines, and masks are no longer mandatory. Please refer to these above CDC guidelines.

• Guillain-Barré Syndrome (GBS) in people who have received the Johnson and Johnson COVID-19 vaccine is rare. 
• GBS has largely been reported in men ages 50 years and older.
• Based on a recent analysis of data from the Vaccine Safety Datalink, the rate of GBS within the first 21 days following Johnson and Johnson COVID-19 vaccination was found to be 21 times higher than after either the Pfizer or Moderna vaccines. 
• After the first 42 days, the rate of GBS was 11 times higher following Johnson and Johnson COVID-19 vaccination. 
• The analysis found no increased risk of GBS after Pfizer or Moderna vaccination. 
• CDC and FDA will continue to monitor this.

Yes, even if you had COVID-19, you should still get the vaccine and booster when eligible because immunity after having had COVID-19 is unpredictable and wanes more quickly, studies show. If you have had COVID-19 within the last month, please contact your local health provider or our health team to determine when you should get the vaccine.