Questions, answers on the new vaccines
Coronavirus vaccines are rolling out to health workers now and are expected to reach the arms of most of the rest of us by spring. Here are answers to some questions about the vaccines and the vaccination process.
Access to vaccines Who will get it first?
This is the expected order:
Health care workers and people in long- term care facilities. The 21 million health care workers and 3 million mostly older people in long- term care facilities are going first, starting this month.
front- lineessentialworkersandpeople 75 and older.
Other essential workers, adults with medical conditions and people over 65. The Centers for Disease Control and Prevention is recommending all remaining at- risk adults and the remaining 57 million workers in food and agriculture, manufacturing, law enforcement, education, transportation, corrections, emergency response and other sectors considered essential by the government, be prioritized for a third wave of vaccination at some point this winter. States again will have the final say on who is in this group.
All other adults. Adults in the general population are at the back of the line. They could start receiving the vaccine as early as April, said Dr. Anthony Fauci, the nation’s top infectious disease expert, although many people are likely to have to wait until at least May or June. The vaccine hasn’t been approved in children, so it may be several months, or possibly a year, before a vaccine is available for anyone under the age of 16.
— Abby Goodnough and Tara Parker- Pope
How will the vaccine get to nursing homes?
The pharmacy chains CVS and Walgreens have contracts with the federal government to send teams of pharmacists and support staff into thousands of longterm care facilities in the coming weeks to vaccinate all willing residents and staff members. CVS and Walgreens are both planning to administer their first vaccinations as early as this week. More than 40,000 facilities have chosen to work with CVS. Nearly 35,000 picked Walgreens. Each state has already picked, or will soon pick, either the Pfizer or the Moderna vaccine for its long- term care facilities that will be working with the pharmacies.
— Abby Goodnough and Tara Parker- Pope
How will the rest of us get vaccinated?
It’s quite likely that when the general public starts getting vaccinated in April, shots will be scheduled through doctors’ offices, CVS, Walgreens and other pharmacies — the same way people get flu shots. However, final plans will depend on what other vaccines besides Pfizer’s and Moderna’s have been approved.
— Abby Goodnough and Tara Parker- Pope
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 should still be given the vaccine at no charge.
Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a copayment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients, including those who are uninsured. Even so, health experts do worry that patients might stumble into loopholes that leave them vulnerable to surprise bills. This could happen to those who are charged a doctor visit fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules.
If you get your vaccine from a doctor’s office or urgent care clinic, talk to them about potential hidden charges. To be sure you won’t get a surprise bill, the best bet is to get your vaccine at a pharmacy once the shots become available.
— Sarah Kliff
If supply is limited, is there a risk it will run out before I get my second dose?
Nobody’s giving away your shot! If you are in the first group of people vaccinated, your booster shot will be set aside for you and won’t be given to someone else. Later when supplies are more plentiful, reserves probably won’t be necessary. Gen. Gustave F. Perna, the chief operating officer for Operation Warp Speed, the federal effort to speed a vaccine to market, has said that after the first doses are given, the doses earmarked for the second shot will be set aside to be given three weeks later. An additional 500,000 backup doses will also be held in reserve, in case they are unexpectedly needed.
“Eventually, we will become much more confident in our manufacturing, our distribution process, state handling, et cetera,” Perna said. “And then the requirement for reserve won’t be necessary.”
— Katie Thomas
How long will it take to work?
You won’t get the full protection from the Pfizer- Biontech vaccine until about a week after the second dose, based on clinical trial data. The researchers found that the vaccine’s protection started to emerge about 10 days after the first dose, but it reached only 52% efficacy, according to a report in The New England Journal of Medicine. A week after the second dose, the efficacy rose to 95%.
— Abby Goodnough and Tara Parker- Pope
Safety and side effects Will it hurt? What are the side effects?
The injection into your arm won’t feel different from any other vaccine, but the rate of short- lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of COVID- 19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25- 33% of patients, sometimes more, including headaches, chills and muscle pain.
While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long- lasting immunity.
— Abby Goodnough and Tara Parker- Pope
How do I know it’s safe?
Each company’s application to the Food and Drug Administration includes two months of follow- up safety data from Phase 3 of clinical trials conducted by universities and other independent bodies. In that phase, tens of thousands of volunteers got a vaccine and waited to see if they became infected, compared with others who received a placebo. By September, Pfizer’s trial had 44,000 participants; no serious safety concerns have been reported.
— Abby Goodnough
If I have allergies, should I be concerned?
People with severe allergies who have previously experienced anaphylaxis should talk to their doctors about how to safely get the vaccine and what precautions to take. Although severe reactions to vaccines are rare, two health care workers had anaphylaxis after receiving the vaccine on the first day it became available in Britain. Both workers, who had a history of severe reactions, were treated and have recovered. ( Anaphylaxis can be life- threatening, with impaired breathing and drops in blood pressure that usually occur within minutes or even seconds after exposure to a food, medicine or substance like latex.)
For now, British authorities have said the vaccine should not be given to anyone who has ever had an anaphylactic reaction. U. S. health experts have said such warnings are premature because severe reactions can be treated or prevented with medications. After the British cases, the FDA said it would require Pfizer to increase its monitoring for anaphylaxis and submit data on it once the vaccine comesintouse. Fewerthanonein1million recipients of other vaccines a year in the United States have an anaphylactic reaction, said Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia.
Among those who participated in the Pfizer trials, a very small number of people had allergic reactions. A document published by the FDA said 0.63% of participants who received the vaccine reported potential allergic reactions, compared with 0.51% of people who received a placebo. In Pfizer’s late- stage clinical trial, one of the 18,801 participants who received the vaccine had an anaphylactic reaction, according to safety data published by the FDA. None in the placebo group did.
— Denise Grady
Different types of patients I already had COVID- 19. Do I need a vaccine?
It’s safe, and probably even beneficial, for anyone who has had COVID to get the vaccine at some point, experts said. Although people who have contracted the virus do have immunity, it is too soon to know how long it lasts. So for now, it makes sense for them to get the shot. The question is when. Some members of the CDC advisory committee have suggested people who have had COVID in the past 90 days should be toward the back of the line. — Abby Goodnough and Apoorva
Mandavilli
What about women who are pregnant or breastfeeding?
Pregnant and breastfeeding women should consult with their obstetricians and pediatricians about whether to get the vaccine. The Pfizer vaccine has not been tested in pregnant women or in those who were breastfeeding, and federal health officials have not issued any specific guidance, other than allowing these women to be vaccinated if they choose.
In the initial rollout, it will mostly be pregnant health care workers who must weigh the benefits and possible risks. By the time the vaccine is available to pregnant essential workers or to women in the general population, there should be a lot more data available.
Some experts said the virus itself posed greater risks to pregnant women than the new vaccine. Since the 1960s, pregnant women have been urged to receive vaccines against influenza and other diseases. These women are generally cautioned against live vaccines, which contain weakened pathogens — but the Pfizer vaccine does not contain live virus.
— Apoorva Mandavilli
Does the vaccine affect fertility or miscarriage risk?
A false claim has been circulating online that the new vaccine will threaten women’s fertility by harming the placenta. Here’s why it’s not true.
The claim stems from the fact that the vaccines from Pfizer and Moderna cause our immune systems to make antibodies to something called a “spike” protein on the coronavirus. The false warnings about fertility are based on the claim that these antibodies could attack a similar protein that is made in the placenta during pregnancy, called syncytin. In reality, the spike protein and syncytin are similar only in one very small region; there’s no reason to believe antibodies that can grab onto spike proteins would lock onto syncytin.
Also, the human body generates its own supply of spike antibodies when it fights off the coronavirus, and there’s no sign that these antibodies attack the placenta. If they did, you would expect that women who got COVID- 19 would suffer miscarriages. But a number of studies show that COVID- 19 does not trigger miscarriages.
— Carl Zimmer
When will vaccines be available for children?
So far, no coronavirus vaccine has been approved for children. New vaccines are typically tested on adults before researchers begin trials on children, and coronavirus vaccine developers are following this protocol. In September, Pfizer and Biontech began studying their vaccine on children as young as 12. Moderna followed suit in December. If these trials yield good results, the companies will recruit younger children. The FDA will then have to review these results before the vaccines can get emergency authorization.
— Carl Zimmer
Life after vaccination What if I forget to take the second dose on time?
The Pfizer- Biontech and Moderna vaccines both have two doses, with the booster shot coming a few weeks after the first. Pfizer- Biontech’s second dose comes three weeks after the first, and Moderna’s comes four weeks later. The second dose provides a potent boost that gives people strong, long- lasting immunity.
If for some reason you fail to get the second shot precisely three weeks after the first, you don’t have to start over with another two- dose regimen. “The second dose can be picked up at any time after the first. No need to start the series over,” said Offit of the University of Pennsylvania, who is a member of the FDA’S vaccine advisory panel.
And while the two leading vaccines include a second dose, some future vaccine candidates may only require one dose. Johnson & Johnson, for example, is expecting data in January that will show whether its experimental vaccine works after a single dose. In case it doesn’t, the company has also started a separate trial using two doses.
— Carl Zimmer and Tara Parker- Pope
If I’ve been vaccinated, will I still need to wear a mask?
Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick.
The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with COVID- 19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask.
— Apoorva Mandavilli
Will my employer require vaccinations?
Employers do have the right to compel their workers to be vaccinated once a vaccine is formally approved. Many hospital systems, for example, require annual flu shots. But employees can seek exemptions based on medical reasons or religious beliefs. In such cases, employers are supposed to provide a “reasonable accommodation” — with a coronavirus vaccine, for example, workers might be allowed to work if they wear a mask, or work from home.
— Abby Goodnough
How will we know when the situation is getting better?
The test positivity rate in your community will be an indicator of how things are going. This number is the percentage of overall tests given in a community that come back positive. The lower the number, the fewer new cases and the less likely you are to cross paths with someone who has the virus. “The best number is zero,” Fauci said. “It’s never going to be zero, but anywhere close to that is great.”
— Tara Parker- Pope
When can we start safely doing normal things, like going to the movies or the theater?
Public health officials estimate that 70- 75% of the population needs to be vaccinated before people can start moving freely in society again. If things go well, life could get a lot better by late spring and early summer.
Given the surveys so far showing significant public reluctance to get vaccinated, however, it may take a while to see widespread community protection, Fauci said, “If it turns out that only 50% get vaccinated, then it’s going to take much, much longer to get back to the kind of normality that we’d like to see.”
— Tara Parker- Pope
Will I be required to provide proof of vaccination to travel?
In the coming weeks, major airlines including United, Jetblue and Lufthansa plan to introduce a health passport app, called Commonpass, that aims to verify passengers’ coronavirus test results — and perhaps soon, vaccinations. Commonpass notifies users of local travel rules — like having to provide proof of a negative virus test — and then aims to check that they have met them.
Although no plans are in place yet to require proof of vaccination for travel or otheractivities, electronicvaccinationcredentials could have a great effect on efforts to control the virus and restore the economy. They could prompt more employers and college campuses to reopen. Developers say they may also give some consumers peace of mind by creating an easy way for movie theaters, cruise ships and sports arenas to admit only those with documented virus vaccinations.— Natasha Singer
How long will the vaccine last? Will I need another one next year?
That is to be determined. It’s possible that coronavirus vaccinations will become an annual event, just like the flu shot. Or it may be that the benefits of the vaccine last longer than a year.
— Carl Zimmer