By Dr. George Terwilliger, Grace Cottage Hospital Chief Medical Officer
Should I get vaccinated for COVID-19?
Absolutely! We strongly recommend you get vaccinated, protecting you from a serious case of COVID-19, possibly saving your life. You will also be protecting your family and everyone you have contact with from being exposed to a potentially deadly disease. The pandemic has killed millions across the world and over 500,000 in the U.S. alone. Mass vaccination is the only way to stop the deaths.
Getting the Vaccine
Why is access to the vaccine strictly controlled?
The primary goal of vaccination is to prevent death. Given that the vaccine supply is limited, efforts are being made to equitably distribute vaccine in a way that will minimize COVID deaths. Health-care workers and first responders were among the first to be vaccinated in order to preserve the health-care and emergency response system. The elderly and those with particular disease and risk factors are at far higher risk for severe COVID, so they are also being given early access to the vaccine.
How will I learn when it’s my turn?
Grace Cottage has vaccinated hundreds of staff, community health care workers, those with high risk medical conditions, and older Vermonters. Refer to the graph below for when you are eligible. Registration must be done through the state. For more information go to this website: healthvermont.gov/myvaccine or call 855-722-7878.
Can my child get vaccinated for COVID-19?
So far, the vaccine is authorized only for adults and older teens. Studies are underway to determine safety and effectiveness in children.
I live much of the year in Vermont but my legal residence is out of state. Can I get my vaccine here or in my home state?
People who live in one place and receive care in another should take their first opportunity to receive the vaccine. In general, only Vermont residents are eligible to receive COVID-19 vaccinations in Vermont. If you are a resident of another state and have a primary care provider in Vermont, you are not eligible to get a vaccine in Vermont. You will need to get the vaccine in your home state. The exceptions are:
- You work in an occupation or setting in Vermont that is currently eligible.
- You moved to Vermont within the last 6 months with the intention of becoming a resident and are in an age group, occupation or other group that is currently eligible
Is the vaccine free?
You should not have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you don’t have insurance, you will be given the vaccine at no charge. Recent legislation bars insurers from applying any cost sharing, such as a co-payment or deductible.
Is there a risk VT will run out of the vaccine before I get my second dose?
Health officials are confident that everyone who needs a second dose of the Moderna or Pfizer vaccines will get it. A third vaccine by Johnson & Johnson that requires only a single dose has recently been approved and is now available at some locations in VT (not Grace Cottage as yet) which will assist in getting everyone a shot who wants one.
Can I choose which vaccine I get?
Not easily. Most vaccination centers in VT are allowed to dispense only one vaccine product, either Moderna, Pfizer, or Johnson & Johnson, in an effort to keep things simple. In terms of effectiveness, and side-effects, these three vaccines are very similar. Currently, Moderna’s vaccine it the vaccine available at Grace Cottage. You should get whichever vaccine is first available to you; the longer you wait for the vaccine, the longer you risk getting COVID-19.
Why do I have to wait around after getting the shot?
Everyone who gets the vaccine will be asked to stay for a 15 minute observation. This will allow health workers to monitor you for any signs of an allergic reaction, which are rare. A person with a history of severe allergies may be asked to stay longer. Make sure you bring a good two-layer mask to your vaccination appointment. Everyone should stay masked and keep their distance from others as much as possible. Even though you just received the vaccine, you won’t be fully protected until about a week after your last shot.
Will I receive proof of vaccination?
You will be given a vaccination card that tells you exactly when, where, and which COVID-19 vaccine you were given. Take a picture or copy the card so you have a permanent record of it. You may need to provide proof of vaccination for an employer, travel, college, or your doctor.
Vaccine Safety and Side Effects
Are there any side-effects from the COVID-19 vaccines?
In many people, yes. While these vaccines are extremely safe, minor side effects (injection-site soreness, mild headache, fatigue, fever, and “brain fog”) are common, but only last a day or two. These side effects show that the vaccine is working as it prepares the body to fight the virus. Serious side effects are extremely rare, mostly being allergic reactions that are effectively treated with common medications. Anyone who has had a severe allergic reaction to polysorbate or polyethylene glycol (PEG), a component of both vaccines, should not receive either Pfizer’s or Moderna’s product.
Is it true that the side effects after the second shot are worse than the first shot?
In many people, yes. The side effects can be more pronounced after the second dose of vaccine because the body is already primed by the first dose to attack the viral spike protein. People have reported bad headaches, upset stomach, chills, itching, and severe fatigue that sends them to bed for a day, feeling like they have the flu. For many, the symptoms last a day; for others they might last two or three days. In a few people, a rash can develop a few days later that goes away on its own and does not generally mean you should avoid further vaccinations. Call your doctor if you have questions or concerns.
Is it true that taking a pain reliever after getting a COVID-19 vaccine could diminish its effectiveness?
It is safe to take a pain reliever or fever reducer like acetaminophen or ibuprofen to relieve discomfort after you get vaccinated. However, you shouldn’t try to prevent discomfort by taking a pain reliever before getting the shot. It is possible taking medications such as acetaminophen or ibuprofen before receiving a vaccine might reduce your immune response to the vaccine. However, this shouldn’t happen once your immune system has revved up and is causing uncomfortable symptoms.
If I don’t get any side effects from the vaccine, does that mean it’s not working?
During clinical trials, it was found that people have varied reactions to the vaccines. Many people experience only mild or no symptoms at all after getting the shot. In the trials, roughly half of the participants did not have any particular side effects, yet the overall effectiveness of the vaccine was 95 percent. Clearly, a lack of side effects does not mean a vaccine isn’t working. We know that older people tend to report fewer side effects than younger people, possibly because immune systems become less exuberant with age. Fortunately, in the Pfizer and Moderna vaccine trials, older people still showed excellent immunity to COVID-19 after becoming vaccinated. If you don’t have side effects from your shot, call yourself lucky.
If I have allergies, should I be concerned about the vaccine?
While severe allergic reactions, called anaphylaxis, have occurred in the minutes following an injection with the new vaccines, it’s an extremely rare event. The rate of anaphylaxis has been 5 cases per million doses, much less than with many commonly used drugs. For example, the risk of anaphylaxis from penicillin is about 60 times more likely than with the COVID-19 vaccine — about 300 cases per million cases of therapy— but that doesn’t stop doctors from prescribing them. All the patients who experienced severe reactions to the vaccines were treated and have recovered. Most of them had a history of anaphylaxis or allergies, but some patients had no known allergies.
Grace Cottage, like every other vaccination site, is required to have epinephrine and other emergency supplies in case a patient has an allergic reaction. If you have a history of anaphylaxis, you’ll be monitored for 30 minutes after the shot, instead of the standard 15 minutes.
If you had anaphylaxis to your first dose of Covid vaccine, you should not get a second dose. People who have had allergic reactions to either of two ingredients — polyethylene glycol or polysorbate — are also being warned not to receive a vaccine.
How were the COVID-19 vaccines developed so quickly when previous vaccines took many years to develop?
Pandemic conditions motivated governments, researchers, and pharmaceutical companies to quickly dedicate massive resources to the task of creating safe effective vaccines. Rapid development does not mean safety measures were skipped. It was possible to expedite the clinical trials without compromising safety due to several factors:
- The first two vaccines available were created using the new mRNA technology, which allows faster and safer vaccine development.
- Funding was no obstacle and thousands of scientists contributed to the effort.
- The testing processes didn’t skip any steps, but vaccine developers conducted some stages simultaneously to gather as much data as quickly as possible.
- The process was aided by the unprecedented participation of tens of thousands of people eager to help with the fight against COVID-19, who quickly signed up to participate in vaccine trials.
- Because of the rapid spread of COVID-19, observing the effectiveness of the vaccines based on naturally-occurring infections was more rapid than it would be with less prevalent illnesses.
- Companies began manufacturing vaccines ahead of their FDA authorization so they would be ready to ship immediately upon approval.
Why do experts believe the COVID-19 vaccines are safe?
In one trial alone, over 40,000 people took this vaccine under test conditions with very strict monitoring and follow-up over several months. Although many recipients reported mild reactions like pain at the injection site, tiredness and headache, only 4 people had more serious side effects that might have had some connection to the vaccines.
Because the vaccines are so new, how can we be sure there aren’t any, as yet undiscovered, long-term side effects?
In vaccine research, there have been rare, serious side-effects found such as Guillain-Barre syndrome, seizures, and sudden, unexplained death. However, these serious side-effects have always occurred within 6 months of receiving the vaccine. At this point, serious side-effects have been very rare. It is very unlikely that a new side-effect will be found that will affect any significant number of people.
Can the vaccine give you COVID?
No. It is impossible to get COVID from the vaccine because the virus is not in the vaccine. Some people who received the vaccine experienced fatigue, soreness, inflammation, or headache, symptoms similar to those experienced by those with COVID, but these were a result of the vaccine teaching their bodies to respond to the virus, if infected.
Can Moderna’s or Pfizer’s mRNA vaccines change my DNA?
No. mRNA stands for messenger ribonucleic acid and refers to instructions to your cells for how to make a protein or even just a piece of a protein. mRNA is not able to alter or modify a person’s genetic makeup (DNA). The mRNA from a COVID-19 vaccine never enters the nucleus of the cell, which is where our DNA is kept. Also, mRNA is very fragile and is quickly degraded. This means the mRNA does not affect or interact with our DNA in any way.
COVID-19 mRNA vaccines instructs our immune cells to make a harmless piece of what is called the “spike protein” found on the surface of the virus that causes COVID-19. This “spike protein” is then displayed on the surface of these immune cells, triggering an immune response. After the protein piece is made, the cell eliminates these instructions.
At the end of the process, our bodies have learned how to protect against future infection. The benefit of mRNA vaccines, like all vaccines, is that those vaccinated gain this protection without ever having to risk the serious consequences of getting sick with COVID-19.
Understanding the Vaccine
How effective are COVID-19 vaccines?
Pfizer’s and Moderna’s vaccines are astoundingly effective. They are both approximately 95% effective in preventing symptomatic COVID-19 and completely eliminate death or the need for hospitalization. This effectiveness applies across adult age groups, racial and ethnic groups, and both sexes. Vaccine trials in children have not been completed, so vaccination for children is not yet approved. It takes about 2 weeks for the vaccine to start building immunity. Two shots are needed for maximum protection.
Do the vaccines work against the new COVID-19 variants that have emerged?
The short answer is yes, but the full answer is complicated. This coronavirus, as expected, is evolving by acquiring new mutations that could eventually reduce vaccine effectiveness. This process is happening as the virus has spread unchecked in many parts of the world. Each new infection gives the coronavirus more chances to mutate, creating new variants.
The variants found in Britain, S. Africa, and Brazil appear to be more transmissible than the original form. While there is no convincing evidence that they are more lethal, these variants do show some resistance against natural and vaccine-acquired antibodies. Despite this, Moderna, Pfizer-BioNTech, and Johnson & Johnson vaccines all remain highly effective at protecting against severe illness and death, even for these strains. As long as the authorized vaccines continue to work against the variants, all efforts should be made to inoculate as many people as possible and to prevent the coronavirus from evolving into more impervious forms.
As Dr. Fauci said in January: “We need to get as many people vaccinated with the current vaccine that we have as we possibly can … and prepare for the potential eventuality that we might have to update this vaccine sometime in the future.” The mRNA technology used in both the Pfizer-BioNTech and Moderna vaccines allows them to be reformulated much faster than vaccines made with more traditional methods, allowing rapid deployment of booster shots if needed.
Is it better to get natural immunity to COVID-19 rather than immunity from a vaccine?
No. While COVID-19 infection does give some immunity, it is a dangerous option, causing serious illness in many, with debilitating symptoms that can last for months. It kills at least 1-2% of those who get it. Also, experts think immunity from the disease itself may not be long-lasting. Vaccination is the best protection; it is very safe and provides the best immunity.
I hear that the chances of surviving COVID are 99% for a young, healthy person. Why should I get the vaccine?
If that were true, that means there’s a 1% chance of dying, not good odds. In the U.S., with a population of 328 million, that could mean 3,280,000 deaths if everyone got infected – unacceptable. Worse, the death rate is far higher than 1% for the elderly and those with medical problems. Those who survive COVID, perhaps most, suffer weeks of symptoms with prolonged recovery. Some who survived COVID early in the pandemic are still disabled by this so-called “long COVID.” The risks from vaccination are miniscule, far safer than getting COVID. Without vaccines, the pandemic would continue for years, eventually killing millions in the U.S. alone.
If the vaccine doesn’t completely eliminate my chances of getting or spreading COVID -19, what’s the point of getting the vaccine?
While it is possible some vaccinated people could get asymptomatic infection, their ability to transmit it to others, according to emerging data, is at a much lowered rate. Remember, the main purpose of getting the vaccine is to prevent illness and death for those who receive it. If most of us get the vaccine, the pandemic will end quickly.
Is it safe to get the vaccine if I have a weakened immune system?
Yes. A weakened immune system can result from AIDS, cancer, or immunosuppressive medications. It is safe and especially important for people with weakened immune systems to get the currently-available vaccines as soon as you are able.
Is it safe to get the vaccine if I have a bleeding disorder or if I am on a blood thinner?
Yes. While you will be more likely to get a bruise or bleed a little from the shot, the vaccine is safe for those with bleeding disorders and those taking blood thinners.
Is it safe to get a COVID-19 vaccine if I have an underlying medical condition?
Yes. COVID-19 deaths are more common in those with many medical conditions, making vaccination especially important for those with underlying health problems such as cancer, kidney disease, lung disease, heart disease, severe obesity, and diabetes, as these increase the risk of getting very sick from COVID-19.
Can I get the vaccine if I am pregnant, nursing, or may become pregnant?
Based on current knowledge, pregnancy increases the risk for severe illness from COVID-19. Also, there may be increased risk of adverse pregnancy outcomes, such as preterm birth. Therefore, pregnant women have been given early access to the vaccines. While the vaccines currently available have not been tested in pregnant or breastfeeding women, the American College of Obstetricians and Gynecologists recommends COVID-19 vaccines for these individuals. The World Health Organization says: “Based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.”
Can I get the COVID vaccine if I recently received another vaccine?
Because there is no research on this issue, the manufacturers ask that COVID-19 vaccines be routinely administered alone, and not within 14 days before or after any other vaccination. However, COVID-19 and other vaccines may be administered at shorter intervals if the benefits of vaccination are judged to outweigh any unknown potential risks of vaccine co-administration. It is also acceptable to get the COVID vaccine earlier than 14 days after another vaccine was given to avoid delays in getting the COVID vaccine. If COVID-19 vaccines are administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine.
Should I get vaccinated even if I have had COVID?
It is recommended that even people who have had COVID-19 should receive the vaccine. The immunity gained from having COVID-19, called natural immunity, is variable. For those recovered from COVID-19, the vaccine would be like a booster shot.
Once I get the vaccine, can I go back to normal life?
Not immediately. Stopping a pandemic requires using all tools available. This is especially important with the emergence of new coronavirus strains that appear to be more contagious and which the vaccines may not fully protect against. We must continue all preventative measures for the near future. Vaccines take time to start working and do not provide perfect protection. It will be some time before all community members are vaccinated, so we should do everything possible to stop the virus from spreading. Remember – face masks, six-foot spaces, and avoid crowds.
Why are some people hesitant to get the vaccine?
- Some people oppose the vaccine for ideological reasons. COVID-19 and the response to it have become politicized.
- Many of those not intending to be vaccinated against COVID-19 are committed vaccination opponents and some believe in conspiracy theories.
- Some people understand the need for a COVID-19 vaccine but have safety concerns. However, as discussed above, it is far safer to get the vaccine than to risk a COVID-19 infection.
- People of color, immigrants, LGBTQ individuals, homeless or low-income people, people with disabilities and other marginalized populations traditionally face obstacles and inequalities in healthcare, and this situation has been exacerbated by the COVID-19 pandemic. They may also have collective histories of experience with medical malpractice that affect current trust.
- Some people intend to become “free-riders,” letting others have the vaccine while they receive the benefits of a hoped-for herd immunity without getting the vaccine.
- Some young and healthy individuals believe they will not be harmed by COVID-19. Unfortunately this belief is misplaced, because even survivors of COVID-19 may suffer long-term health consequences.
Fortunately, many people who have vaccine hesitancy eventually do take it.
I’ve heard that some health-care workers have refused to get vaccinated. Why?
Health-care workers may be heroic but they are still human and can be swayed by the same fears and misinformation as everyone else. However, at Grace Cottage, over 93% of our staff have been vaccinated against COVID-19, which is a powerful testament to their focus on the best medical information and their concern for the safety of their patients, family, friends and community.