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February 1, 2021

COVID-19 Vaccine FAQ

It’s natural to have some fear of the unknown. Knowledge is power over that fear. The COVID-19 pandemic has killed almost half a million mothers, fathers, sisters, brothers, sons and daughters in the United States. It’s important to put an end to the pandemic by doing your part to:

Find your spot to take your shot. – NC DHHS COVID-19

Almost all of us need to get the vaccine when it’s available in order to get us back to normal.  When my patients tell me that they don’t think they’ll die if they get COVID-19 so they’re not going to get the vaccine, I am compelled to ask  – “Maybe you won’t die if you get infected, but who are you willing to kill?”

Here are some commonly asked questions about the COVID-19 vaccine.

Can I get COVID-19 from the vaccine?

  • The currently available vaccines do not contain any part of the virus at all.

How do I know the vaccine is safe?

  • The U.S. Food and Drug Administration (FDA) makes sure all food and drugs are safe. The COVID-19 vaccines must pass clinical trials like other drugs and vaccines. The FDA checks the work and authorizes vaccines only if they are safe and effective. The FDA can get them to people faster through an Emergency Use Authorization. Like all vaccines, the FDA keeps checking safety through the Vaccine Adverse Events Reporting System (VAERS). Health care providers are required to report serious side effects, or if someone gets seriously ill with COVID-19. There is also a smartphone-based health checker called V-SAFE that uses text messaging and web surveys to do health check-ins after people receive a COVID-19 vaccination. People can report any problems they may have with a vaccine through V-SAFE.
  • The technology used to develop mRNA vaccines like the Pfizer and Moderna vaccines started in the early 1990’s. Scientist      figured out how to use this new technology to create safe vaccines around 2012. When the pandemic hit, scientist were ready to go.
  • Researchers have been studying and working with mRNA vaccines for decades. Interest has grown in these vaccines because they can be developed in a laboratory using readily available materials. This means the process can be standardized and scaled up, making vaccine development faster than traditional methods of making vaccines.
  • mRNA vaccines have been studied before for flu, Zika, rabies, and cytomegalovirus (CMV). As soon as the necessary information about the virus that causes COVID-19 was available, scientists began designing the mRNA instructions for cells to build the unique spike protein into an mRNA vaccine.

What are the side effects of the vaccine?

  • No serious side effects were reported in clinical trials. Temporary reactions after receiving the vaccine may include a sore arm, headache, or feeling tired and achy for a day or two. These temporary reactions were more common after the second vaccine dose. In most cases, these temporary reactions are normal, which are good signs that your body is building protection. You can take medicines like Tylenol or ibuprofen to help with these temporary reactions.  While extremely rare, there have been a few cases of severe allergic reaction to the Pfizer vaccine outside of the clinical trials, and vaccine providers are prepared with medicines if they need to treat these rare allergic reactions.

What about allergic reactions? What if I have an egg or latex allergy?

  • People who have had severe allergic reactions, also called anaphylaxis, to any ingredient in the Pfizerand Moderna vaccines should not receive that vaccine. People who have had this type of severe allergic reaction to any vaccine or treatment that is injected should talk with their health care provider about the risks and benefits of vaccination.
  • People with allergies to foods (such as eggs), animals, environmental triggers (such as pollen), latex, or medications taken by mouth, or who have family members with past severe allergic reactions, can be vaccinated with the Pfizer or Moderna vaccines. Severe allergic reactions to the vaccines have been very rare and mostly occurred in people who have had previous severe allergic reactions.
  • Vaccine providers will watch patients for 15-30 minutes after vaccination to ensure the patient’s safety. Additional information can be found here for the Pfizer and Moderna vaccines.

How much will the vaccine cost?

  • There is no cost. They are free to everyone, even if you don’t have health insurance. The federal government is covering the cost. Administration fees will also be covered for those who are uninsured and should be covered by all health insurance companies. No vaccine provider should be charging anyone to receive the vaccine. Patients who get the vaccine while having an appointment for another reason, such as a medical check-up, may be charged for the check-up depending on their insurance. Providers administering the vaccine to people without health insurance or whose insurance does not provide coverage of the vaccine can request reimbursement for the administration of the COVID-19 vaccine through the Provider Relief Fund, see https://www.hrsa.gov/CovidUninsuredClaim.

How effective is it?

  • Two vaccines from Pfizer-BioNTech and Moderna have proven to prevent COVID-19 illness with no safety concerns in the clinical trials. They are 95% effective.

How does the vaccine work?

  • The short explanation: The Pfizer and Moderna vaccines give your body instructions to make a kind of protein. This protein safely teaches your body into thinking the virus is attacking. Your body then strengthens itself to fight off the real COVID-19 if it ever tries to attack you. Your body gets rid of the small protein naturally and quickly.
  • A more detailed explanation: Most everyone has seen a picture of the virus with its distinctive “crown” around it. The crown is made of proteins called “spike proteins”. With mRNA vaccines, material from the virus isn’t used to stimulate the creation of antibodies, mRNA vaccines “tell” your body to manufacture part of the spike protein, which then results in your body making antibodies.
  • Want to know even more? The vaccine contains the genetic information for making the spike protein in a small sequence of amino acids called messenger RNA which is wrapped up in a protective fatty coat. The fatty coat is the reason the vaccines must be kept so cold. The coat melts quickly if the vaccine warms up and the mRNA easily be destroyed by your immune system after it is injected. This mRNA is a “one trick pony” so to speak – it only knows how to do one thing:  instruct the protein manufacturing complex in a cell to make a spike protein. When the vaccine is injected into your arm, special white blood cells called dendritic cells recognize it is “not you” and welcome the vaccine in to take a look. When the vaccine gets into the dendritic cells,  the coat comes off and is munched up by enzymes in the cell. The mRNA is exposed and goes to the protein building machine called the ribosomes and “instructs” the ribosomes to manufacture the spike protein. The mRNA doesn’t have much time to do this, because the dendritic cell’s enzymes break it down quickly.  The small strand of mRNA doesn’t have the right tools ever get into the nucleus of the cell where DNA resides.  mRNA can’t mess with your genetic code. After the spike proteins are manufactured, they do what they know to do, which is to the hang out on the surface of the white blood cell. Your body now makes antibodies against the spike protein. If you meet up with COVID-19 in the future, the newly formed antibodies are in town to fight it off.

Why do I still need to wear a mask after I take the vaccine?

  • Yes. Everyone should continue using the 3 Ws—wearing a mask, waiting 6 feet apart, washing your hands, and limiting gatherings—until most people are vaccinated. Receiving the COVID-19 shot and following the 3 Ws is everyone’s best protection from getting and spreading COVID-19.
  • Trials for the vaccine were done while masks were recommended to be worn by everyone. Vaccine recipients weren’t required to wear masks, but general “mitigation” practices like the 3-W’s were in place.  It’s not known how much the 3’W’s contributed to the 95% effectiveness.  We know that the flu vaccine seems much more effective this year, so mask wearing likely benefits vaccine effectiveness.

What are the chances I’ll get an allergic reaction from the vaccine?

I had COVID-19 already, do I still need to get vaccinated?

  • The vaccine works to protect you against a future infection. If you currently have COVID-19, you should wait until your symptoms have gone away before getting the vaccine. You don’t need a COVID-19 test before vaccination. It is safe to get vaccinated with the Pfizer or Moderna vaccine if you have been infected in the past. Additional information can be found here for the Pfizer and Moderna vaccines.

If I get the vaccine, will I still need to quarantine if I have close contact with someone who has COVID-19?

  • Experts are still deciding on whether people who are vaccinated still need to be quarantined if they have been in close contact with someone who has COVID-19. At this time, anyone who has been in close contact with someone who has COVID-19, besides people who have had COVID-19 in the past 3 months, should quarantine. 

Do I need to show an I.D. or sign a consent to get the vaccine?

  • North Carolina does not require an identification card, like a driver’s license, to be vaccinated. Some employers or health care providers could request ID, but it is not required by the state.
  • You can provide verbal consent. Written consent is not generally required, but some providers may require or request written consent.

If I’m pregnant or breastfeeding, is it safe to get the vaccine?

  • Pregnant and breastfeeding women may choose to receive the Pfizer or Moderna COVID-19 vaccines. Pregnant women can talk with their doctors before making the choice. You do not need to take a pregnancy test before you get your vaccine. Women who are breastfeeding may also choose to get vaccinated. The vaccine is not thought to be a risk to a baby who is breastfeeding. Additional information can be found here for the Pfizer and Moderna vaccines.

Yours in health,

Joanne M. Fruth, MD, MA, FAAFP

Avance Care Chief Medical Officer
Dr. Fruth is a family physician with a mission to promote the benefits of primary care and especially Family Medicine (#FMrevolution).  As Chief Medical Officer at Avance Care, Dr. Fruth uses her years of experience and passion for teaching to inspire other clinicians to make each primary care visit one which builds the foundation good health.

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