Your Vaccination Guide
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How effective are the vaccines in preventing severe COVID-19 disease?
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All three vaccines (Pfizer, Moderna, and Johnson & Johnson) have demonstrated to be >90-95% effective at preventing severe disease once the patient is fully vaccinated.

Which vaccine is better? Which vaccine should I get?
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  • All three vaccines are extremely effective at preventing serious illness, hospitalization and death from SARS-CoV-2, even in the face of the delta variant. We have evidence that the mRNA vaccines, Pfizer and Moderna, and the Johnson and Johnson adenovirus vector vaccine are also still very good at preventing infection and transmission, though somewhat less so with the Delta variant that is currently dominant in the US. 
  • What this means is that all three vaccines are extremely effective in preventing one from getting seriously ill or dying from CoVID, so you should get whichever vaccine you have access to as soon as you can.
Are the vaccines safe? How many people were studied? Was that enough?
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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.

How can I find the vaccine?
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Everyone aged 16 years and older is eligible to receive a COVID vaccine. 

Additionally, as of May 10, 2021, the FDA extended emergency use authorization (EUA) to Pfizer’s COVID vaccine for adolescents ages 12 to 15.

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

What have been the main side effects people experienced from the vaccine?
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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

On April 23 2021, the FDA and CDC lifted the recommended pause on the Johnson & Johnson COVID-19 vaccine (which was found to cause rare blood clots) after a thorough safety review. 

Read this release for more information. 

How effective is each shot of the Pfizer and Moderna vaccines? How long do I need to wait between each shot?
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  • 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 the Delta variant emerged and their efficacies against Delta are being studied, though it does appear the vaccines’ ability to prevent infection is somewhat reduced in the face of the Delta variant. That said, these vaccines are all still excellent at preventing serious illness, hospitalization and death even from the Delta variant.  
  • For the Pfizer vaccine, you need to wait 21 days between doses. For the Moderna vaccine, it is 28 days between doses. As noted, the Johnson & Johnson vaccine is only one dose.
How effective are the vaccines in preventing people from spreading the virus when they have no symptoms?
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We know that the currently available COVID-19 vaccines are very good at preventing someone from getting symptoms from the virus, and data also suggests that they are very good at preventing people from spreading the virus to others even when they have no symptoms. That said, certainly, no vaccine is 100% effective, so there will still be a very small number of folks who are vaccinated and still get sick, or who pass it on without having any symptoms. This has been the case now with the Delta variant in circulation. 

Will I still have to wear a mask if I get the vaccine?
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In the face of the Delta variant and the widespread transmission the CDC recommends, as of 7/27/21, that if a fully vaccinated person lives in/is visiting an area where the transmission rates are “high” or “substantial”, 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, ribal or territorial laws, rules and regulations, including local business and workplace guidance.

  • Travel Exception: You will still be required to wear a mask on planes, buses, trains and other forms of public transportation traveling into, within or out of the United States, and in transportation hubs such as airports and train stations.

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 delta variant now so prominent across the US and spreading rapidly, 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.

If I am vaccinated, but have a known close contact exposure to someone with COVID, do I need to quarantine?
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No, at this time, you do not need to quarantine immediately after a close contact exposure if you are fully vaccinated, but CDC does recommend that you get tested in 3-5 days after the exposure, and to wear a mask in public indoor settings for 14 days or until you receive a negative test result.  You should monitor yourself for symptoms development for 14 days after the exposure. If any symptoms develop, or you test positive, you do need to isolate yourself as per CDC guidelines (minimum of 10 days).

How long is the vaccine good for/last in the body? If I get one of the mRNA vaccines, will I need a booster after the first 2 doses? What about a booster of the Johnson and Johnson vaccine?
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  • FDA has approved the use of a booster of Pfizer and Moderna for immunocompromised patients. It has also approved a booster of the PFIZER vaccine (not Moderna, yet) for certain populations:
    • those 65+ years old, those in long term care facilities,
    • those ages 50-64 w/underlying medical conditions
    • those ages 18-49 with underlying medical conditions based on individual benefit vs risk (ie. shared decision making with patient’s clinician), 
    • and for healthcare workers and other frontline workers. 
  • A booster will likely be needed at some point for those who received the single dose Johnson and Johnson vaccine, but it is not yet known at what interval; so, currently, boosters are not approved for those individuals who received Johnson and Johnson. 
  • Moderna and Pfizer are also studying variant specific boosters. 
How can we best distinguish expected vaccine side effects from symptoms of acute illness with COVID-19?
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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.

How do I prepare for my vaccine appointment?
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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.

I’m pregnant, breastfeeding, or trying to get pregnant. I know they didn’t study the vaccines in pregnant women so should I get it?
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  • It is true that pregnant and breastfeeding women were largely excluded from the initial trials, though new evidence demonstrating the safe use of the COVID-19 vaccines during pregnancy from tens of thousands of reporting individuals (data from v-safe, the v-safe pregnancy registry, and VAERS)  supports the safety of the vaccine in this population. 
  • With what is known about the way an mRNA vaccine works, it was never thought that the mRNA vaccines would have a detrimental effect on pregnancy or affect a breastfeeding infant.  
  • CDC, WHO, and the American College of Obstetricians and Gynecologists (ACOG) all  indicate that pregnancy and lactation (breastfeeding) are not considered reasons to avoid the vaccine. 
  • ACOG and the Society for Maternal-Fetal Medicine (SMFM) once again encourage their members to “enthusiastically”  recommend that all pregnant individuals be vaccinated in light of evidence demonstrating their safety during pregnancy, the current low vaccination rates, and concerning increase in cases.
Should I be concerned about the use of new technology (mRNA) to make the Pfizer and Moderna vaccines?
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No, you should not be concerned about the technology used to make the vaccines. Like all vaccines, COVID-19 vaccines have been tested for safety before being allowed to be used in the United States.  It’s also important to know that the mRNA technology used for the Pfizer and Moderna vaccines was not just created for the novel coronavirus. It has actually been studied and designed for more than a decade. So, researchers and vaccine experts already had experience with it.

The three available vaccines do not contain a live virus so they do not carry a risk of causing COVID-19 in anyone. Also, material from the mRNA vaccine never enters the center of the cell and does not affect the  person’s own DNA. Lastly, after our body uses the information in the mRNA it is broken down by our cells. Then the immune system makes protective antibodies to protect us against the virus.

Should I get an antibody test before getting the vaccine?
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Antibody testing is not currently recommended to assess the need for vaccination.

Should I get the vaccine if I already had COVID-19?
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Yes, even if you had COVID-19, you should still get the vaccine because it is not clear how long the immunity lasts after having had COVID-19. 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.

Should I worry about how fast these vaccines were created?
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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.

Should people with certain autoimmune diseases or other conditions avoid the vaccines?
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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.

Are there any long-term effects that we need to be watching out for in the upcoming year?
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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. 

Did they study the vaccine in kids? Can children get the vaccine? Are they safe?
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Though the vaccines were not studied in children in the initial clinical trials in 2020 and early 2021, these studies are ongoing now to assess vaccine safety and efficacy in children and adolescents. In fact, on May 10, 2021 the Pfizer COVID vaccine was the first to be given Emergency Use Authorization (EUA) by the FDA for use in those age 12 to 15.  After reviewing the data from Pfizer’s studies, the FDA concluded that their vaccine is safe and effective for this age group. 

Moderna and Johnson and Johnson are also continuing their studies in children and adolescents and it is anticipated that they, too, will receive authorization for use in adolescents in the coming months.

Will the vaccine protect me from the new variants?
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  • At this time, data indicates the current vaccines will still protect most people from the new coronavirus variants, including the UK variant (also called Alpha), the South African variant (Beta), the Brazil variant (Gamma), and the Indian variant (Delta) that are now spreading in the US.  
  • There are some new variants that seem to have originated in the US, as well, that researchers are still learning about and watching. 
  • These new variants are another reason why for those who are not fully vaccinated it’s important to continue to wear masks, social distance, and practice hand hygiene to prevent their spread. 
  • For updated news about new variants from the CDC: (https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html).
What do we know about the delta variant?
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  • The Delta variant that originated in India in December 2020 now makes up the majority of the SARS-CoV-2 variants circulating in the US currently. It has surpassed the Alpha variant in prevalence. 
  • It is clearly more transmissible than the original virus, and is spreading quickly, especially in areas with low vaccination rates. 
  • It is impacting children more than previous variants as this population is still largely unvaccinated.
  • It is also not clear at this time whether it is more virulent than the other variants, with some data suggesting it does cause more severe disease, while other data does not show this. 
  • The typical symptoms caused by the Delta variant are a little different from the original (wild-type) virus and the other variants in that it causes less coughing, shortness of breath, loss of taste and smell, and more sore throat, runny nose, fever, and headache. 
  • Infrequently, even those who have been fully vaccinated can get infected with the Delta variant, called a “breakthrough” infection, and transmit it to others, but the good news is that all three approved vaccines do protect against a breakthrough infection becoming serious and leading to hospitalization or death.
  • Hear a summary of what we know about the Delta Variant from Dr. Todd Thames.
How much does the vaccine cost?
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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 is the newest vaccine to be approved in the US. How does it work and is it available for use again?
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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 at specifically its ability to prevent serious illness overall. The Johnson & Johnson vaccine will work well to prevent COVID-19, and especially well to prevent serious illness from developing.

On April 23 2021, the FDA and CDC lifted the recommended pause on the Johnson & Johnson COVID-19 vaccine (which was found to cause rare blood clots) after a thorough safety review. 

The Advisory Committee on Immunization Practices (ACIP) – a group that advises the CDC on issues related to vaccination in the United States – reviewed all of the available data regarding the cases of blood clots that was reported after receiving the Johnson & Johnson vaccine. They determined that the number of cases were extremely small compared to the number of Johnson & Johnson vaccines that have been given. This means that the risk of blood clots is very low. For this reason, the vaccine is no longer paused and can continue to be distributed.  

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 for more information.

I have heard that only getting half doses of the vaccine, or only the first dose and not the second can help more people get the vaccine faster. Should I do this?
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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.

My parents are elderly and are not sure they should get the vaccine. Does it work in older adults? Did they study it in older adults?
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Yes, Pfizer, Moderna and Johnson & Johnson did study their vaccines in older people, a group who often don’t respond as strongly to vaccines. The success rate of vaccines is still very good at 94% for the Pfizer vaccine in people  55 and over and 86% for the Moderna vaccine in people  65 and older. For comparison, younger people had a 95% success rate for these vaccines. So, these two vaccines are still very useful for preventing COVID-19 in older people.

I’m partially vaccinated (received one of two doses of either Moderna or Pfizer). How protected am I after one dose?
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Evidence indicates that after the first dose of the mRNA vaccine, the efficacy is about 80%, which is very good. That said, after the second dose the efficacy is over 90%, so you are still highly encouraged to get the second dose for full protection. 

Is it OK to get the COVID-19 vaccine with other vaccines?
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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.  

Did they study the vaccine in people of color?
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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.

How effective is the AstraZeneca vaccine?
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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).

Is it safe to travel if I’ve been vaccinated?
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While the CDC still recommends against travel in general, they have updated their travel guidelines specifically for fully vaccinated travelers: 

  • Fully vaccinated people can resume domestic travel and do not need to get tested before or after travel or self-quarantine after travel.
  • Fully vaccinated people do not need to get tested before leaving the United States (unless required by the destination) or self-quarantine after arriving back in the United States.
  • Travelers still need to show a negative test result or documentation of recovery from COVID-19 before boarding a flight to the United States.
  • Travelers should still get tested 3-5 days after international travel.
  • Travelers do NOT need to self-quarantine after arriving in the United States.

What about Guillain-Barré syndrome (GBS) and these vaccines?
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  • As of July 12, 2021 100 cases of GBS have been reported to VAERS occurring about 2 weeks after vaccination with the Johnson and Johnson vaccine. (There have been ~12.5 million Johnson and Johnson vaccines administered in the US). These cases of GBS have been mostly in men, many 50 years and older.  As a result, FDA will issue a warning about the remote risk of the development of GBS after Johnson and Johnson vaccination, though the agency notes the benefits outweigh the risks, and the data is insufficient to establish causality.  
  • Persons with a history of GBS may receive a COVID-19 vaccine unless they have a contraindication (ie. a known allergy to the vaccine’s components.)
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Expert Answers to Your Vaccine Questions
Check out these up-to-date insights and answers to your COVID-19 vaccine questions from our Chief Medical Officer and senior medical experts.
Meet Our Doctors
Dr. Melody Msiska
Dr. Melody Msiska

Dr. Msiska is a Staff Physician and Telemedicine Service Lead at Grand Rounds Health. She oversees our team of top doctors, nurses and healthcare experts as they meet and care for patients from across the country in virtual visits. Whether by phone, app or computer, Dr. Msiska is passionate about using technology to make sure everyone has access to high-quality healthcare so they can get better faster and save time and money along the way.

Dr. Todd Thames
Dr. Todd Thames

Dr. Thames is a Senior Medical Director at Grand Rounds Health. He believes strongly in listening closely to patients to understand the many issues and experiences that affect their health. After decades of working in hospitals and the healthcare industry, Dr. Thames focuses his strengths in healthcare management, medical education and patient care on raising the standard of healthcare for Grand Rounds members.

Dr. Heather Hockenberry
Dr. Heather Hockenberry

Dr. Hockenbery is our Senior Staff Physician and Clinical Lead at Grand Rounds Health. She brings over a decade of direct patient care experience to her role as leader and mentor to our large medical team. Drawing on her vast knowledge of medicine and her one-on-one experience caring for patients from all walks of life, Dr. Hockenberry helps her team deliver the highest possible healthcare to all our Grand Rounds members.

Andrea Ballesteros, RN
Andrea Ballesteros, RN

Andrea Ballesteros comes to the Grand Rounds Health team after years of experience caring for patients in a hospital setting. As a Spanish-Speaking Bilingual Registered Nurse, she makes sure Grand Rounds members get the care and information they need in the language they understand. From connecting members to the right doctors for their conditions to supporting them through COVID-19 issues and behavioral health crisis, Andrea brings high-quality compassionate care to every member’s experience.

Trusted Sources
Where to turn for additional vaccine resources
CDC COVID-19 vaccination information
State by state vaccination plans
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