By Dr. George Terwilliger, Grace Cottage Hospital Chief Medical Officer
Getting the Vaccine
Should I get vaccinated for COVID-19?
Absolutely! It is thought that almost everyone will eventually be exposed to this coronavirus and get some form of COVID-19. The immunization is exceptionally good at protecting against a serious case of COVID-19. That is why VT, with its best-in-the-nation vaccination uptake, has essentially the lowest COVID death and hospitalization rates in the country. COVID has killed nearly a million people in the U.S. alone. Mass vaccination is the only way to stop further deaths.
Eligibility for the COVID-19 Vaccination
The COVID vaccination is now authorized for use in all people ages six months old and above.
Given the complexity and dynamic nature of this issue, it is best to refer to the state website for more information: healthvermont.gov/myvaccine or call 802-863-7240.
Use this website and phone number to find out where to get a vaccine or booster shot.
Why do I have to wait around after getting the shot?
Everyone who gets the vaccine will be asked to stay for a 15 – 30 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. Even though you have just received the vaccine, you won’t be fully protected until about two weeks 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, headaches, upset stomach, fatigue, chills, fever, itching, and “brain fog”) are common. For some, these symptoms may feel like a mild case of the flu. For most, the symptoms last a day; for others they might last two or three days. These side effects show that the vaccine is working as it prepares the body to fight the virus. 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.
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.
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 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 Moderna and Pfizer 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.
If you had anaphylaxis to your first dose of Pfizer or Moderna 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 Pfizer or Moderna. However, you can get a second dose of a COVID vaccine by getting the Novavax or J&J 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, Pfizer and Moderna, 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-19?
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 instruct 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 at preventing serious disease and death. This effectiveness applies across age groups, racial and ethnic groups, and both sexes. It takes about 2 weeks for the vaccine to start building immunity. Two shots are needed for maximum protection, followed by a booster shot 5 months later, if you got the Pfizer or Moderna vaccine; a second shot is recommended if your first shot was J&J (second shot can be your choice of J&J, Pfizer, or Moderna).
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.
New COVID-19 variants 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, 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.
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 some vaccinated people will get asymptomatic or mild infections, their ability to transmit it to others, according to emerging data, is at a 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 more 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. Also, you should get a third dose of Pfizer or Moderna or a booster if your first shot was J&J to achieve full immunity.
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. The CDC and the American College of Obstetricians and Gynecologists recommend COVID-19 vaccines for these individuals.
Can I get the COVID vaccine if I recently received another vaccine?
Can I get the COVID vaccine in addition to other vaccines such as the flu shot?
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.
Why are some people hesitant to get the vaccine?
- Some people oppose the vaccine for ideological reasons. COVID-19 and the response to it has 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 their current level of 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 94% 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.