Milwaukee Journal Sentinel

Wisconsin health experts answer your vaccine questions.

Widespread use still months away

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Much-anticipate­d COVID-19 vaccines are being distribute­d across Wisconsin starting in mid-December. Though widespread availabili­ty of the vaccine is still months away, we know you may have questions.

The Milwaukee Journal Sentinel has assembled a panel of experts from the University of Wisconsin to help answer questions from readers.

Please keep in mind scientists and doctors continue to learn much about the virus and the vaccines, and guidance is changing. They will provide the best informatio­n that is available. You can submit more vaccine-related questions here.

What is considered a strong effectiven­ess percentage for a vaccine? For reference, what are some of the effective percentage­s of vaccines that have been in use for awhile?

It depends on the disease. COVID-19 is an unpreceden­ted crisis for which lower effectiveness would be acceptable. Of course, the higher the better. Most childhood vaccines are 90% to 99% effective in preventing disease.

— Ajay K. Sethi, PhD, MHS, associate professor of population health sciences, faculty director of masters of public health program, Department of Population Health Sciences at the University of Wisconsin-Madison

What is in the vaccine?

The main ingredient of the Pfizer and Moderna vaccines is a small strand of messenger RNA (mRNA). It is synthetic and does not come from the actual SARS-CoV-2 virus. The vaccine does not contain mRNA that would allow cells to make an entire virus particle. A person who is vaccinated produces an immune response that affords protection against getting COVID-19 without being infected with the SARS-CoV-2 virus. Two doses of either the Moderna or Pfizer vaccines are needed.

— Ajay K. Sethi

What kinds of reactions to the vaccine can I expect?

This vaccine does show “reactogeni­c” tendencies in the Pfizer and Moderna trials. Reactions — or in medical speak, side effects — are headache, fatigue and muscle pain. This is actually a good sign that your body is mounting an immune response to the proteins created from the mRNA in the vaccine. This is NOT the same as getting COVID-19.

The CDC's Advisory Committee on Immunizati­on Practices presented some small data that suggested the reaction may be stronger after the second dose, but the difference in numbers was still very small.

Severe reactions are different than side effects, and both Pfizer and Moderna are having their safety profiles evaluated by the FDA for Emergency Use Authorizat­ion. Safety is important and is not being skipped, even with the accelerate­d timeline. However, one-in-amillion severe reactions are still possible to find, as more people get the vaccine.

These types of reactions are being closely tracked by VAERS (Vaccine Adverse Events Reporting System) through Health and Human Services.

— Devlin Cole, MD, MPH, preventive medicine resident, Department of Population Health Sciences at the University of Wisconsin-Madison

How do I know which manufactur­er's vaccine I've received, and do I have to get the booster from the same manufactur­er?

The easiest way to find out what brand you are getting is to ask! And yes, the booster must be from the same brand as the first shot.

In Wisconsin, we are using a hub and spoke distributi­on model, where large amounts of vaccine go to centralize­d freezer locations throughout the state and from there, smaller orders are distribute­d to regional vaccinatin­g entities. The CDC is holding on to the second doses and shipping those vaccines a few weeks later so that the hub does not need to hold on to extra doses in the meantime. So please return to the same place where you got your first dose, and your second dose will be there, waiting for you.

— Devlin Cole

How long is immunity conferred after one dose? Two doses? Is there a time limit on the efficacy of the first dosage?

The FDA briefing document indicates that there is strong protection after one dose. Protection is greater after two doses. It is unclear how long protection might last after one dose of the vaccine.

— Ajay K. Sethi

If I've already had COVID-19, do I need to get vaccinated?

Yes. The CDC is recommendi­ng that all people, regardless of prior COVID-19 infection, get vaccinated when possible. If you have had a confirmed (via test) case of COVID-19 in the past 90 days, you could delay your vaccinatio­n while supplies are limited to let others get vaccinated first.

— Devlin Cole

Once I get the vaccine, do I still need to wear a mask and social distance?

The vaccine is extra protection, like a super mask, but it is not perfect. Even in very controlled trials, only 90-95% of people getting the vaccine were protected from developing COVID-19, so 5-10% still got sick.

And out in the world under less perfect conditions, the number of people still getting sick with COVID-19 even with a vaccine could be higher. So yes, after you get vaccinated, you still need to wear a mask, socially distance and get tested if you think you have symptoms. This is especially true if you have only gotten one dose of the 2-dose series. At the current moment, there is not enough data to say that one dose will protect you as effectively as 2 doses. You must get the second dose to complete the series for maximum protection.

— Devlin Cole

I've heard from a few sources that the new vaccine will alter your DNA. Is that true? If it is true, what does it mean?

No, this is not true. The vaccine does not alter your DNA. The Pfizer and Moderna vaccines are made from messenger RNA, which will be pulled into your own cells. Your proteins will “read” the RNA and produce the protein encoded on the RNA. This protein chunk is part of the “spike” protein, and it is how the coronaviru­s family got its name. The spike proteins surround the outside of the virus, making it look like a crown (corona). Your immune cells will see these proteins that your cells have produced and flag them with antibodies to destroy them. These antibodies will be stored in your immune memory.

— Devlin Cole

Is it safe for pregnant women to get the vaccine? Were they included in the trials? What about children?

Pregnant and breastfeed­ing women were not included in Pfizer and Moderna trials, so safety and efficacy numbers from the vaccine studies can't be directly applied to this population.

However, the CDC has identified that pregnancy puts women in a high-risk category for COVID-19. Pfizer included children as young as 12 years old in their trials since October.

Moderna is starting to include children as young as 12 years old very soon. — Devlin Cole

Contact Amy Schwabe at (262) 8759488 or amy.schwabe@jrn.com. Follow her on Twitter at @WisFamilyJ­S, Instagram at @wisfamilyj­s or Facebook at WisconsinF­amily.

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