EEH: What should I expect when I get the COVID-19 vaccine?

After nearly a year of mask-wearing, physical distancing from friends and family, and frequent handwashing and disinfecting, an effective vaccine has arrived.

The COVID-19 vaccine helps your body develop antibodies that make you less susceptible to the disease.

While it will take months to roll out to the general public and people should continue following public health precautions, the vaccine offers hope.

What can people expect when it’s their turn to get the vaccine? Which vaccines are available? When does protection against COVID-19 begin after vaccination?

How will people know when they’re eligible to receive the vaccine?

At this time, the COVID-19 vaccines are in limited supply so they will be administered in phases. The Centers for Disease Control and Prevention (CDC) has determined that healthcare workers and residents of long-term care facilities should receive the first phase of vaccines due to supply limitations. Government officials have estimated that the general public may start receiving the vaccine in the spring of 2021.

On Jan. 11, 2021, the state of Illinois authorized health departments that have substantially completed phase 1a of the vaccine distribution plan to move on to 1b, which opens vaccine eligibility to those 65 and older and those who are front-line essential workers. Phase 1b also includes essential workers such as first responders, teachers and other school personnel; grocery store employees, day care workers and U.S. postal workers.

Does everyone need more than one dose?

For the most recently available vaccines, yes. The Pfizer-BioNTech vaccine, which was approved for emergency use, requires two doses, separated by 21 days. The vaccine produced by Moderna (also approved for emergency use) also requires two doses, separated by 28 days. The first shot starts building protection and the second shot strengthens the immune response. Both doses are necessary to achieve each vaccine’s full effectiveness. The vaccines are not interchangeable, so individuals should complete the second dose with the same vaccine.

Will people need this vaccine every year?

Scientists are still studying this and will decide once the vaccine is distributed and more data is available.

Who will administer the vaccines?

When the vaccine becomes more widely available later in 2021, it will be distributed by large hospitals, pharmacies, mobile clinics, large employer health clinics, critical access hospitals and community health centers. Check with state and local health departments for more information.

Which vaccines are available?

Several vaccines are currently in development; all but one require two doses. A Pfizer-BioNTech vaccine was approved by the Food and Drug Administration (FDA) for emergency use on Dec. 11, 2020. The FDA approved a vaccine by Moderna for emergency use on Dec. 18, 2020. Both are mRNA vaccines — a new technology that involves synthetic messenger RNA.

How do the vaccines work?

The vaccine helps the body develop antibodies that makes it less susceptible to the disease. The Pfizer-BioNtech and Moderna vaccines are mRNA vaccines. They contain the portion of mRNA that encodes the spike protein, the button on the surface of the SARS-CoV2 virus. It is not a live virus, cannot replicate itself and is quickly destroyed in the cell shortly after translation. After injection, the protein teaches the body how to fight off the spike protein. The antibodies produced after vaccination are then able to fight off the spike protein that surrounds the SARS-CoV2 virus so it cannot bind to and invade human cells.

Are the vaccines safe?

Data gathered in large clinical trials conducted by the vaccine manufacturers have found the benefit of a vaccine for COVID-19 outweighs any known or potential harm that would come from being infected with the coronavirus. The FDA has studied the data and concluded that the Pfizer-BioNTech vaccine is safe for ages 16 or older, and the Moderna vaccine is safe for ages 18 or older. Right now, there is no specific information regarding whether these vaccines will be recommended for children or immune-compromised individuals. The CDC recommends that pregnant women consult with their doctor before getting the vaccine.

Which vaccine is the most effective?

Both the Pfizer-BioNTech and Moderna vaccines were more than 94 percent effective in preventing symptomatic coronavirus infection (Pfizer's is at 95 percent while Moderna's is 94.1 percent), and nearly 100 percent effective in preventing severe illness from COVID-19. In phase one and two trials, two doses of mRNA were given to hundreds of subjects and elicited neutralizing and binding antibodies in all participants. Antibody levels were higher than the 50th percentile of patients who had natural infection, in both young adults and the elderly. The vaccines were both effective for different races and genders, as well as for people with underlying medical conditions.

Can people choose which vaccine to get?

No. Which vaccine you receive depends on supply.

How long will it take after getting the shots to be protected from COVID-19?

Those who receive the two-dose vaccine will develop maximum immunity several weeks after the second dose. It normally takes about 2-3 weeks for cellular immunity to develop and several weeks for full antibody development.

Does the vaccine protect others?

The more people who get vaccinated, the fewer people will spread the virus, the less effectively the virus can transmit, and there’s a better chance for herd immunity. It’s not yet clear whether vaccinated people could still develop asymptomatic infections and be able to spread the virus to others.

Do people experience any side effects after getting the vaccine?

As with other vaccines, it is normal to experience some fatigue, muscle aches, headaches or low-grade fever following the vaccination. Side effects could also include pain, redness or swelling at the injection site, chills, joint pain, nausea and swollen lymph nodes. Side effects may be more frequent after the second dose and less common among older adults. The side effects are a sign the body is mounting a defense against the disease. The vaccine does not use live or weakened virus, so it cannot give you COVID-19.

Once someone’s had a vaccine, can they stop wearing masks?

No. People should continue to wear a mask after receiving the vaccine. The Pfizer and Moderna vaccines were around 95% effective in trials for preventing symptomatic and severe COVID-19. Experts don’t know the vaccine’s effect on asymptomatic infection or transmission of the virus. It will be several months before the overall risk of exposure is low because so many others have been immunized.

Until most of the population is vaccinated, wearing masks, distancing and handwashing are the only tools society has to stop the spread of COVID-19. People must stay vigilant until many have received the vaccine and COVID-19 is a rarity.

For more information, visit www.eehealth.org/coronavirus.