11 Things to Know About the COVID-19 Vaccines

The recent rollout of two newly authorized COVID-19 vaccines is a bright light at the end of what has been a very dark year while the world lives with the coronavirus pandemic.

Front line health care workers and nursing home residents started receiving the vaccine a couple of weeks ago, during the first phase of the rollout. Vaccinations for essential workers—firefighters, therapists, teachers—began in some parts of the country this week. If all goes well, the general public should start getting their shots sometime in the next few months.

The vaccines were developed under an accelerated process that has a lot of folks concerned, even though both are about 95 percent effective at preventing severe COVID illness. In fact, polls taken earlier this month still show nearly 50 percent of people are hesitant about lining up for their vaccination.

This has been especially debated in the Black community, which has been particularly hard hit by coronavirus.

“The virus has exposed the longstanding systemic health and social inequities in the Black and Latino communities. The Black community is burdened with the highest death rates,” said Janice Underwood, chief diversity, equity and inclusion officer for Virginia. “We must ensure trust and accurate information in this vaccine for everyone.”

The inequities plaguing the Black community is why Dr. Valerie Fitzhugh signed up to be a volunteer in a vaccine clinical trial.

“I know that communities of color, and in particular, my community, the Black community, has myriad reasons to not trust medicine, and to not trust this vaccine. My ancestors have been experimented on and have been hurt by doctors in the name of science,” said Fitzhugh, associate chair of pathology at Rutgers University. “For me, this was the most profound reason to join a trial; I wanted to be able to show my community that the vaccine is safe, and that this is a step we can all take to help curb the spread of #COVID19. I took the chance so Black people would be represented in this study. For me that was the most important thing.”

Here’s what we know: If a vaccine stays in a bottle, not in someone’s arm, it is not effective at all, and COVID-19 continues to disrupt our lives.
This is what else we know about the vaccines:

1. The vaccines use a new technology. The two vaccines—one developed by Pfizer and BioNTech, the other by Moderna—use the same mRNA technology. Both vaccines have a singular mission: Get into the cell, deliver instructions and then self-destruct. The instructions are a small piece of genetic code, the mRNA, for the coronavirus’ spike protein. Our body’s immune system recognizes that protein as an attack and ramps up to fight it. The vaccine tricks the body into reacting to a harmless set of instructions so if you encounter the virus again, your body already knows how to fight it.
There’s more than mRNA in the vaccines, but unlike rumors suggest, the vaccine does not contain tracking devices, microchips, fetal tissue or any live virus. And it won’t give you COVID-19. The vaccine contains a fatty coating to protect the mRNA (which is sensitive to heat and light), salts to maintain proper pH and a stabilizing sugar.

2. Both vaccines require a second dose. The 95 percent effective rate is achieved only if people take both doses of the dual-injection immunization three weeks to a month apart.

3. The vaccine is considered safe. Many pharmaceutical companies invested significant resources into quickly developing a vaccine for COVID-19 because of the global impact of the pandemic. The emergency situation warranted the quick response but that doesn’t mean companies bypassed safety protocols or performed inadequate testing. When the Food and Drug Administration authorized the Pfizer and Moderna vaccines, it determined their benefits outweighed their risks.

“Some people thought development happened too fast, but that isn’t really the case. The science of vaccine development has changed. This vaccine utilizes mRNA. We knew the genetic makeup back in January. As soon as we knew the genetic makeup, we were able to develop mRNA in a matter of days,” said Norm Oliver, M.D.., the state health commissioner for the Virginia Department of Health. “The vaccines were tested in a  broad layer of people between the Pfizer and Moderna trials, including African Americans. It was 95 percent effective for both of those vaccines. The 5 percent who got the virus had only mild virus. They went through multiple checks—FDA, vaccine advisory committees, health equity, faith leaders—before they were pronounced safe.”

4. There are potential side effects. There are short-term mild or moderate vaccine reactions that resolve without complication or injury. In clinical trial participants, the side effects were similar to other vaccines: pain at the injection site, fatigue, headache, muscle pain, fever and chills.

Fitzhugh said she experienced all of these side effects. “The day after the second injection [a Saturday], I had a terrible headache and I was very tired. I gave in and took a nap. I pulled a huge blanket over me because I was cold, despite the house being 75 degrees! And I slept for nearly two hours. When I woke up, I was shivering. I had chills. I took my temperature: 101.5F. I had a fever,” she said. Her fatigue and headache lasted another day, the injection site arm pain for several days, but Fitzhugh was able to go to work the following Monday with no problems.

Experts say the benefit of getting the vaccine is not contracting or dying from COVID-19. Or, as Virginia’s Oliver said bluntly: “The vaccine’s side effects are minor; the effects of COVID-19 are deadly.”

Of course, other side effects could pop up over time. There’s not enough data yet to know if the vaccines pose an elevated risk to pregnant or breastfeeding women or to immunocompromised people, such as those living with HIV. And we know nothing about the effects in children younger than 16, who were not included in the clinical trials for the Pfizer and Moderna vaccines—and for whom those vaccines are not authorized.

5. Some people have had an allergic reaction to the vaccine. Shortly after the vaccination process began in the United Kingdom, there were news reports of two people having severe allergic reactions after getting the shot. There have been a handful of reported allergic reactions in the U.S., too, but this number is small compared to the thousands who have been vaccinated. Still, the Centers for Disease Control and Prevention recommend people receiving the vaccine be observed for up to 30 minutes afterward. The CDC has also created an app called v-safe that patients can opt-in to report any side effects.

6. Immunizations are being rolled out in phases. As we mentioned, health care workers and residents of nursing homes and other long-term care facilities were in phases 1 and 1a. Forty million doses of both vaccines should immunize the bulk of them. Next in line is phase 1b, essential workers (firefighters; teachers; U.S. Postal Service employees; corrections workers; public transit workers; grocery store employees; and those working in manufacturing, food service and agriculture) and people older than 75 years of age. The third phase, phase 1c, will be people ages 65-74 and those younger than 65 with certain medical conditions that put them at high risk, followed by phase 2, the rest of the population. It is estimated that everyone should be vaccinated by late spring, though it is more likely complete roll out may take until summer or fall. There are already some distribution bottlenecks. It is possible two more vaccines could receive FDA approval early in 2021. And there are currently 1,627 clinical trials under way around the globe for vaccines and treatments for COVID-19.

7. After getting a vaccine, you’ll still need to wear a mask and practice social distancing. Unfortunately, we’ll need to continue our stay-safe measures, especially early on, before a lot of people have been vaccinated. Though the Moderna and Pfizer vaccines are 95 percent effective, you still have a 5 percent chance of getting sick if you are exposed to someone who hasn’t been vaccinated, or someone who has been but is still transmitting the virus. You’ll also want to continue to protect others, since you could be shedding virus despite the vaccination.

8. You should still get vaccinatedeven if you’ve already had COVID-19. We don’t know how long exposure to the virus protects you from reinfection. Public health officials say protection probably lasts at least a few months, but it’s a good idea to get vaccinated when your group is up, especially if it’s been many months since you tested positive.

9. Consumers won’t have a choice about which vaccine they get. “We don’t have the luxury to choose right now because we don’t have enough doses, but that may quickly change,” said Onyema Ogbuagu, a Yale Medicine infectious diseases specialist and the principal investigator of the COVID-19 vaccine studies supported by the Yale Center for Clinical Investigation at Yale School of Medicine, in partnership with the Yale New Haven Health System. “If supply improves, you can imagine a scenario where policies would favor the more highly effective vaccines above the others. But at this point, it’s really whatever we can get.”

10. The virus is mutating. Reports out of England suggest the coronavirus that causes COVID-19 is changing, but, according to the experts, this isn’t cause for alarm. “The prevailing view is that the mutations should not compromise the effect of vaccines,” Ogbuagu said. “It appears that some of those mutations may have made the virus more contagious, which makes it easier to spread from person to person; that’s an observation that has been made. Based on current observations, we don’t think the changes would jeopardize vaccines.”

11. The vaccine is free. “The vaccine will be 100 percent free,” said Stephanie Wheawill, of the Office of Epidemiology in the Virginia Department of Health. “Those who are administering the vaccine may be able to bill insurance, but there will be no out-of-pocket costs for anyone.”