You asked, and we answered. Here are the answers to the Immunization Ambassadors and MyIRMobile community’s most pressing questions about the COVID-19 vaccine.

1. How does the vaccine actually work?

According to the Centers for Disease Control and Prevention (CDC), the COVID-19 vaccine works in the following ways:

• COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness. Different types of vaccines work in different ways to offer protection, but with all types of vaccines, the body is left with a supply of “memory” T-lymphocytes as well as B-lymphocytes that will remember how to fight that virus in the future.

• It typically takes a few weeks for the body to produce T-lymphocytes and B-lymphocytes after vaccination. Therefore, it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get sick because the vaccine did not have enough time to provide protection. 

• Sometimes after vaccination, the process of building immunity can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity.

2. Do current COVID-19 vaccines protect against new variants of the virus that causes COVID-19? 

At the time of this writing, there is not enough evidence to say whether or not COVID-19 vaccines that currently have Emergency Use Authorization (EUA) in the U.S. fully protect against all new COVID-19 variants. Viruses in general constantly change through mutation, and new variants of viruses are expected to occur over time. As of this writing, three new known variants are circulating globally—B.1.1.7 in the U.K., 1.351 in South Africa, and P.1 in Brazil. While these variants appear to spread more easily than others, there is currently no evidence that they cause more severe illness or an increased risk of death. Public health officials and scientists worldwide are studying these variants in order to better understand them and better control their speed. The best way to protect yourself and your community against all variants of COVID-19 is to comply with public health mitigation strategies—like getting the COVID-19 vaccine when you are able to, practicing social distancing, wearing masks, washing your hands and using hand sanitizer frequently, and quarantining and/or isolating. 

3. When can I get the vaccine? 

Unfortunately, not everyone will be able to get the COVID-19 vaccine right away due to limited supplies—as well as due to the logistical challenges that distributing a new vaccine of this scale comes with. That’s why distribution of the vaccine will be done in phases, with priority groups being granted access to the vaccine before the general public. Vaccine rollout plans and distribution can also vary state to state and county to county.

The Advisory Committee on Immunization Practices (ACIP)—a U.S. federal advisory group made up of medical and public health experts—developed a multi-phased approach for its recommendation on who should receive the vaccination first. The initial phase of the ACIP’s plan launched in December, 2020, when the COVID-19 vaccine first became available to select healthcare personnel in the U.S.. 

The ACIP recommends that the first group to receive access to the COVID-19 vaccine should be healthcare personnel as well as adult residents of long-term care facilities. The second group the ACIP recommended that should receive the vaccine is people age 75 and older and frontline essential workers (including first responders, teachers, public transit employees and grocery store workers). The ACIP suggested this be followed by a third priority group consisting of people ages 65 to 74 and people ages 16 to 64 who are considered high risk for developing severe COVID-19 symptoms should they catch the illness due to underlying medical conditions (such as people with type 2 diabetes and severe obesity). The third priority group also includes all other essential workers (including food service workers and construction workers). After the third and final priority group—and whenever doses become available—the vaccine should become available for the rest of the general public. 

While we don’t yet know an exact date when the vaccine will become available for each priority group or the general public, the recent announcement of a purchase of 200 million additional vaccine doses by the Biden administration makes it likely that the general public will have the opportunity to get vaccinated by the end of summer, 2021. 

However, we are learning more about the COVID-19 vaccine, and how/when it will be distributed, every day, and are likely to have more answers regarding this question in the coming weeks or months. 

4. Why do we have to get two injections? How do we keep track of this and how important is it to get the second part on time?

Both the Pfizer and Moderna COVID-19 vaccines require two doses, although single dose vaccines are being researched and developed. Due to the way that mRNA vaccines work—including the Pfizer and Moderna vaccines in particular—it’s important to get two shots because the first shot helps your body recognize viruses such as SARS-CoV-2 (the virus that causes COVID-19) and prepares your immune system to develop an immune response, while the second shot strengthens that immune response, which in return makes your body more prepared to fight infection. 

MyIRMobile (www.myirmobile.com) is a great resource for accessing your immunization records and for vaccination scheduling. Upon receiving your first dose, you should receive a CDC vaccination card that tells you what COVID-19 vaccination you received, the date you received it, and the date of your next shot. Most vaccine administrators schedule a time and date you should return to receive the second dose during your appointment for the first dose. 

5. What if I have an allergic reaction? Why do some people have allergic reactions to the vaccine? 

While it is possible to have an allergic reaction to the COVID-19 vaccine, it is rare—especially with the mRNA vaccines that have been approved for Emergency Authorization Use (EUA) in the U.S. This is why after receiving a dose of the vaccine, patients are monitored by vaccine administers for at least 15 minutes. 

Even with the small risk of allergic reactions, most people with a history of severe allergies are still able to safely get the COVID-19 vaccine—including those who are allergic to certain foods, pollen, bee stings and oral medications. If you have a history of severe allergies, you should tell the person administering your vaccine, so they can monitor you for 30 minutes after receiving a dose as opposed to the usual 15 minutes. 

It’s especially important to talk to your doctor about potential risks of getting a COVID-19 vaccine if you have a history of allergic reactions to vaccines and/or injectable medications. If you are allergic to any of the ingredients in the COVID-19 vaccines, including polyethylene glycol (PEG) and polysorbate, it is not recommended to get the vaccine. If you have an allergic reaction within the first 30 minutes after receiving the first dose of the COVID-19 vaccine, you should not get a second dose. 

As with any vaccine or medication, it’s important to disclose any possible risks, allergies and other medical conditions that could cause a reaction with your doctor and vaccine administrator in advance. If you do find yourself having an allergic reaction to the COVID-19 vaccine, immediately call 911. 

6. Will you experience any COVID-19 side effects after getting the vaccine? What about other potential side effects? 

The answer to this question is not one-size-fits-all, since side effects can vary depending not only on the vaccine administered, but also the individual who received the vaccine. Rest assured, this is common with vaccines. It’s estimated that 10-15% of people who receive the COVID-19 vaccine will have noticeable side effects—though adverse reactions are rare. Side effects are also an indicator that your body is building protection against SARS-CoV-2, the virus that causes COVID-19. While side effects can vary in length—or not appear at all—they typically appear within the first three days after getting the vaccine and last one to two days. After receiving the vaccine, it’s likely you’ll be monitored for 15 minutes to see if a reaction occurs. 

Possible Mild Side Effects of the COVID-19 Vaccine Include:

• Pain, redness or swelling where the shot was given
• Fever
• Fatigue
• Headache
• Muscle pain
• Chills
• Joint pain

It is especially important to continue to limit exposure to COVID-19 after getting the vaccine, as it will take a few weeks for your body to build immunity after getting both doses of the COVID-19 vaccine—leaving you susceptible to illness from SARS-CoV-2 in the meantime. 

7. What is mRNA?

First and foremost, we want to dispel a popular rumor circulating the internet and social media—mRNA does not alter your DNA. So what is mRNA then? And what does it do?  

According to Harvard Health Publishing (Harvard Medical School), “mRNA, or messenger RNA, is genetic material that contains instructions for making proteins. mRNA vaccines for COVID-19 contain man-made mRNA. Inside the body, the mRNA enters human cells and instructs them to produce the “spike” protein found on the surface of the COVID-19 virus. Soon after a cell makes the spike protein, the cell breaks down the mRNA into harmless pieces. At no point does the mRNA enter the cell’s nucleus, which is where our genetic material (DNA) lives. The immune system recognizes the spike protein as an invader and produces antibodies against it. If the antibodies later encounter the actual virus, they are ready to recognize and destroy it before it causes illness.” 

Since mRNA is not SARS-CoV-2 itself, which is the virus that causes COVID-19, it cannot and does not cause COVID-19. Merely, it trains the body to fight off SARS-CoV-2, should exposure occur.

8. Do we know how long the vaccine will be effective for?

As of now, we don’t have enough information to decisively say how long protection and immunity from the COVID-19 vaccine lasts. That’s because research is ongoing for the various COVID-19 vaccines in development, as well as COVID-19 vaccines that have been granted Emergency Use Authorization (such as Moderna and Pfizer’s coronavirus vaccines). What we do know is that the COVID-19 vaccine does prevent you from getting sick with COVID-19 by teaching your immune system how to both recognize and fight SARS-CoV-2, the virus that causes COVID-19. 

Ultimately, any protection against COVID-19 is better than no protection—since there is no way to predict for sure how the illness will impact you, or someone else you may infect. Furthermore, historically, vaccines are the best and safest way to achieve herd immunity and end epidemics and pandemics (case in point: the polio and measles epidemics). It’s important to continue recommended COVID-19 pandemic best practices—washing your hands often, using hand sanitizer, social distancing and wearing masks—as it is still possible to pass COVID-19 on to others, even after developing immunity from getting both doses of the COVID-19 vaccine. 

9. Why did people develop Bell’s palsy after a clinical trial for Pfizer’s COVID-19 vaccine? 

While an article published by the Daily Mail on December 8, 2020, claimed that four volunteers for a Pfizer COVID-19 vaccination clinical trial developed Bell’s palsy (a form of temporary facial paralysis) after getting the shot, the link between Pfizer’s COVID-19 vaccine and Bell’s palsy has since been debunked by the FDA, which found that there was no known link between the volunteers that developed Bell’s palsy and the shots administered during the clinical trial. 

According to an article published on December 15, 2020, by USA Today, “The annual incidence rate for Bell’s palsy within the general population is around 23 cases per 100,000 people or 15-20 per 100,000 people, according to some population studies. Translating that to the trial’s four cases out of 38,000 trial participants, it computes to 11 cases per 100,000 people.” 

Thus, the number of cases (four) of Bell’s palsy seen in the trial’s participants is actually less than the statistical average for cases of Bell’s palsy. It’s still unknown what caused Bell’s palsy in the trial’s volunteers, however there are certain conditions that can put people at higher risk for developing Bell’s palsy—including pregnancy, hypertension and diabetes. 

The same USA TODAY article also states the following: “Although herpes is a lifelong infection, Bell’s palsy is completely treatable with anti-inflammatory drugs like corticosteroids and, in some severe cases, antiviral therapy as well. Approximately 80% to 90% of patients recover fully within six weeks to three months. Recurrence for Bell’s palsy is estimated at 5% to 15%.”

In addition, the images used in the Daily Mail article were not actually from Pfizer’s COVID-19 trial, and were instead from various other studies and sources and were taken prior to the 2020 COVID-19 vaccine study. 

10. How many versions of the vaccine will there be from different companies and how will they differ?

At the time of this writing, there are currently two vaccines (the Pfizer-BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine) that have Emergency Use Authorization in the U.S. and are recommended for preventing COVID-19, as well as three other vaccines in Phase 3 clinical trials (as of December 28, 2020, in the U.S.). However, even more COVID-19 vaccines are being developed globally. Among the coronavirus vaccines in Phase 3 in the U.S. are AstraZeneca’s COVID-19 vaccine, Janssen’s COVID-19 vaccine and Novavax’s COVID-19 vaccine​. Both the Moderna and Pfizer COVID-19 vaccines consist of two doses, and work in a similar fashion, as both are mRNA vaccines. However, a key difference between the two is the recommended time in between each dose. Each dose of the Moderna vaccine should be taken 28 days apart, while the recommended time between doses for the Pfizer vaccine is 21 days. The Pfizer vaccine is also recommended for those ages 16 and up, while the Moderna vaccine is recommended for those ages 18 and up. 

11. Are there any individuals who are advised against getting the vaccine, and who?

At the time of this writing, the Pfizer vaccine is only recommended for people ages 16 and up, while the Moderna vaccine is only recommended for people ages 18 and up. Individuals with a history of allergic reactions to vaccines and/or injectable medications should discuss the risks and benefits of the COVID-19 vaccine with their doctor prior to receiving the vaccine. It is not recommended for those allergic to ingredients in the vaccine to get it—including those who are allergic polyethylene glycol (PEG) and polysorbate, which are in both the Pfizer and Moderna vaccines. Pregnant women who are in an authorized vaccine group should discuss with their doctor if getting the COVID-19 vaccine is the right decision for them. As with any vaccine, it’s important to discuss any allergies or medical conditions that could cause a reaction with your doctor before getting the COVID-19 vaccine. 

12. Is the vaccine equally effective across racial groups?

According to an article by the Los Angeles Times, the Moderna vaccine was 100% effective for Black, Latinx and Asian American study participants, as well as in people with mixed racial backgrounds in Moderna’s Phase 3 trial. In Pfizer’s Phase 3 trial, the vaccine was 100% effective for Black study participants, 74.4% effective in Asian American study participants, 100% effective in Native American and Pacific Islander study participants, and 94.5% effective for Latinx study participants, which was slightly below the 94.7% effectiveness rate for white study participants. Among participants with multiracial backgrounds, the Pfizer vaccine was only 10.4% effective, with one case of COVID-19 occurring among those in the trial who got the vaccine and one case occurring among those who got the placebo.

13. Can pregnant women get the COVID-19 vaccine? Will it cause birth defects?

There is no evidence that approved COVID-19 vaccines cause birth defects, and mRNA vaccines are not generally considered a risk to a breastfeeding infant or lactating mother. Based on current knowledge of mRNA vaccines, both the Pfizer and Morderna vaccines are unlikely to pose a risk to a pregnant person or fetus because mRNA vaccines are not live vaccines and degrade quickly by normal cellular processes, therefore they do not enter the nucleus of the cell. However, more research is needed on the safety and efficacy of approved COVID-19 vaccines in pregnant women.

As there is currently limited data available on the safety of COVID-19 vaccines, including mRNA vaccines, in pregnant or lactating people, the CDC recommends discussing the COVID-19 vaccine with your doctor if you are pregnant or nursing/lactating before getting the vaccine. 

Sources (listed in order of questions):

1. Centers for Disease Control and Prevention (CDC) 
2. Centers for Disease Control and Prevention (CDC) 
3. http://www.covidvaccinefacts.org; USA TODAY 
4. http://www.goodrx.com; Centers for Disease Control and Prevention (CDC) 
5. Harvard Health Publishing (Harvard Medical School)
6. www.covidvaccinefacts.org; Centers for Disease Control and Prevention (CDC)
7. Harvard Health Publishing (Harvard Medical School)
8. U.S. Food & Drug Administration (FDA); Centers for Disease Control and Prevention (CDC)
9. U.S. Food & Drug Administration (FDA); USA TODAY
10. Centers for Disease Control and Prevention (CDC)
11. Harvard Health Publishing (Harvard Medical School), Centers for Disease Control and Prevention (CDC)
12. Los Angeles Times
13. Centers for Disease Control and Prevention (CDC)