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Vaccine Frequently Asked Questions (FAQs)


Vaccine Prioritization

UPDATED APRIL 5: Who is eligible to receive the vaccine?

As of Monday, April 5, vaccine eligibility in Pima County is open to everyone 16 years and older. Only the Pfizer vaccine has been approved for 16 and 17 year olds. Pfizer is available at the state-run site on the University of Arizona campus, at Banner-South, and potentially at local pharmacies.

Those under 18 need an accompanying parent or guardian to complete consent forms. The only exception is if an accompanying adult brings a notarized letter stating that the parent allows the accompanying adult to complete the consent forms.

For additional registration information and news, please visit the COVID-19 vaccine information page.

Vaccine Allocation and Distribution

UPDATED JAN. 26: What are the latest vaccination numbers for the County?

It all began when Pima County received 11,000 doses of the Pfizer vaccine in the week beginning Dec. 14, and then 15,400 Moderna vaccines arrived on Dec. 22 and were delivered directly to approved community hospitals and clinics. The state updates its data dashboard daily -- click on "vaccine administration" to find results statewide and by county.

UPDATED MARCH 2: How many doses will I need?

It depends on which vaccine you receive.

The Pfizer and Moderna vaccines are two-dose vaccines, given three weeks apart for Pfizer and four weeks apart for Moderna. The CDC advises the second dose be given as close to the recommended interval as possible, but if not feasible, the second doses for both vaccines may be administered up to 6 weeks following the first.

Getting both vaccine doses is important so that your body develops enough antibodies to fight COVID-19 if you are exposed. Getting more than one dose for a vaccine is not unusual. In fact, it's the norm. Many routine vaccinations require more than one dose for maximum protection.

The Johnson & Johnson vaccine is a single-dose vaccine.

Source:
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States CDC, updated regularly
Johnson & Johnson COVID-19 Vaccine Authorized by U.S. FDA for Emergency USE - First Single-Shot Vaccine in Fight Against Global Pandemic Johnson & Johnson, 2/27/21

UPDATED JAN. 28: What is the recommended interval between the first and second doses for the mRNA vaccines?

The Pfizer vaccine doses are given 21 days apart, and the Moderna vaccine doses are given 28 days apart. The CDC recommends adhering as closely as possible to this dosing schedule, but allows a “grace period” for second doses of both products to be administered up to 4 days earlier.

In situations in which it is impossible to follow this interval, the CDC indicates the second dose may be administered up to six weeks (42 days) after the first dose. Data on effectiveness of second doses administered after six weeks is limited. Current guidance indicates the series does not need to be restarted if the second dose is given beyond this window.

Source:
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States CDC, 1/21/21.

UPDATED JAN. 9: Can non-residents (snowbirds, students) get the vaccine in Arizona?

Yes. Non-residents will be vaccinated along with residents according to the Arizona vaccine priority phase into which they fall.

UPDATED April 12: Will I have a choice of which COVID-19 vaccine I receive?

Different points of distribution may have different vaccines. Please check pima.gov/covid19vaccine for a list of County pods and which vaccine is being delivered at that site. You can also find links on that page to search for availability at local pharmacies.

UPDATED FEB 25: Can veterans sign up via Southern Arizona VA Health Care?

Yes. The Southern Arizona VA Health Care System (SAVAHCS) started vaccinating Veterans 85 and older on Jan. 11. They are currently distributing COVID-19 vaccines to Veterans 65 and older.

Veterans, who are eligible based upon Centers for Disease Control (CDC) risk criteria, are being contacted directly by VA staff to schedule a COVID-19 vaccine appointment. They are also using an automated text and telephone program that connects Veterans to SAVAHCS staff to schedule an appointment.

If a Veteran expresses interest in receiving a COVID 19 vaccine, they can register at the following web link: https://www.va.gov/health-care/covid-19-vaccine/

UPDATED MARCH 10: Can children get vaccinated for COVID-19?

The Emergency Use Authorizations for the current vaccines allow vaccination for the following age groups:
  • Pfizer – age 16 years and older
  • Moderna – age 18 years and older
  • Johnson & Johnson – 18 years and older

UPDATED JAN 8: How can health care providers sign up to be vaccinators in Pima County?

The Arizona Department of Health Services has a Pandemic Vaccine Provider Onboard link for vaccination providers to start the process. More information about the registration process is available via this PDF.

  • Onboarding is for providers who have cold storage, staff for administration and are willing to meet data reporting requirements set by ADHS
  • Onboarding must be fully completed to receive vaccine
  • For assistance with the tool or to check status reach out to ASIISHelpDesk@azdhs.gov
Check out the CDC Storage and Handling Toolkit for more information about storing and handling vaccine.

Vaccine Volunteer Efforts

UPDATED JAN. 18: I am an active or retired health professional. Can I volunteer to help with the vaccine effort?

Yes, you can and we need you!

As Pima County accelerates the COVID-19 vaccine rollout and expands regional vaccination centers, we need volunteers like you to help staff the effort to get our community vaccinated and protected against the virus.

Doctors, veterinarians, dentists, nurses, nurse practitioners, chiropractors, physician assistants, and behavioral health professionals can all help make a difference. Medical personnel interested in volunteering should register through the Medical Reserve Corps of Southern Arizona (MRCSA). Apply directly via their online application, and an MRCSA coordinator will contact you.

UPDATED JAN. 18: Can I volunteer to help the vaccination effort even if I don’t have an active medical license?

Yes, you can!

You don’t have to administer shots to support the vaccine rollout. Pima County has partnered with the Arizona Emergency System for Advance Registration of Volunteer Health Professionals (AZ-ESAR-VHP) to offer volunteer opportunities.

To volunteer, visit their online platform, click on the big blue “Register Now” button, select “Add Organizations” and choose Pima County. They will then notify you regarding opportunities via the email address you provide.

Another option to help is by giving blood, if you’re in a position to be able to do so. The American Red Cross is reporting a shortage in blood donations, and you can schedule an appointment here.

UPDATED JAN. 28: If I volunteer at one of the vaccine points of distribution, will I get a vaccine?

Volunteers at our vaccination points of distribution (PODs) are not guaranteed their first vaccine during their term of service. Due to the logistics of volunteer scheduling and the fact that these PODs will be in operation for months, we are asking for a time commitment of 36 hours from volunteers to help us increase efficiency.

With the help of the generosity from the Pima County community, volunteers have been able to complete about 10,380 hours of service, no matter rain or shine. The Pima County Health Department is thankful for all of the hard work that our volunteers have done and will continue to do.

Vaccine Safety

Is the vaccine safe?

Yes. While it was developed faster than other vaccines, it went through the same safety trials as any other common vaccines, and is overwhelmingly safe. Talk to your doctor if you have concerns about whether you should be vaccinated.

Crystal Rambaud, the Pima County Health Department Manager for Vaccine Preventable Diseases: "I know there are a lot of concerns about safety due to the really rapid timeline surrounding this vaccine. What I would say to that is they did not skip any of the steps for the approval, it went through the same rigorous testing and safety trials that we see all of our other widely accepted vaccines go through. I feel that this vaccine is safe, it's been indicated that it's safe. So we really hope that the community can feel confident about this vaccine.”

Pima County Health Director Dr. Theresa Cullen notes that the attention to detail in the clinical trials and the review of data went through a standard process. "The acceleration was in the manufacturing phase," she said.

UPDATED APR. 13: Why has the Johnson & Johnson COVID-19 vaccine been paused?

On April 13, 2021, the CDC and the FDA issued a joint statement recommending a pause in the use of the Johnson & Johnson vaccine following six U.S. cases of a rare, severe type of blood clot in people receiving the vaccine. All six cases were in women aged 18-48, and symptoms occurred 6-13 days after vaccination. This type of blood clot is called cerebral venous sinus thrombosis (CVST), and was seen in combination with low levels of blood platelets (thrombocytopenia).

Right now, these blood clots appear to be extremely rare, with only 6 cases reported out of the 6.8 million Johnson & Johnson doses administered.

People who received the vaccine over a month ago are at low risk. People who received the vaccine recently-within the last 3 weeks- should watch for symptoms such as:
  • Severe headache
  • Abdominal pain
  • Leg pain
  • Shortness of breath
People experiencing these symptoms should contact a medical provider.

Health care providers are asked to report adverse events to the Vaccine Adverse Event Reporting System.

This pause was issued out of an abundance of caution to give the CDC and FDA time to investigate these cases more closely. The FDA and CDC are sharing guidance with the health care community on how best to recognize and treat patients appropriately. Providers should report any adverse events they may observe in patients who have received this vaccine.

The CDC is monitoring this situation closely. The Advisory Committee on Immunization Practices (ACIP) will meet April 14 to analyze the evidence and provide further guidance. The FDA will review that analysis also. More information will be released as it becomes available.

These adverse effects have NOT been observed with the Pfizer or Moderna COVID-19 vaccines.

UPDATED MAR. 2: What is an Emergency Use Authorization?

The FDA describes it this way: “During a public health emergency, the FDA can use its Emergency Use Authorization (EUA) authority to allow the use of unapproved medical products, or unapproved uses of approved medical products, to diagnose, treat, or prevent serious or life-threatening diseases when certain criteria are met, including that there are no adequate, approved, and available alternatives.

Before the FDA can issue an EUA, the Secretary of Health and Human Services must make a declaration of emergency or threat justifying authorization of emergency use for a product. This chart summarizes the process for EUA issuance.”

For a vaccine to be granted an EUA, manufacturers must submit clinical data generated from rigorous studies from tens of thousands of study participants to ensure safety, quality and that that the benefits outweigh the risks.

The FDA has issued EUAs for COVID-19 vaccines made by  PfizerModerna, and Johnson & Johnson

Sources:
Emergency Use Authorization for Vaccines Explained FDA, 11/20/20. FAQs on Emergency Use Authorizations (EUAs) for Medical Devices During the COVID-19 Pandemic FDA, 8/18/20.

UPDATED FEB. 24: What are the benefits of getting a COVID-19 vaccine?

Getting vaccinated will help keep you from getting COVID-19
  • Vaccination may help keep you from getting seriously ill even if you do get COVID.
  • Getting vaccinated yourself may also protect those around you, particularly people at increased risk for severe illness from COVID-19.
Vaccination is a safer way to help build immunity
  • COVID-19 can have serious, life-threatening complications, sometimes with persistent, debilitating symptoms and there is no way to predict how it will affect you. If you get sick, you could also spread the virus to your friends, family and others around you.
  • Getting COVID-19 may offer some natural immunity, but experts don’t know how long this protection lasts. The risk of severe illness and death from the virus far outweighs any benefits of natural immunity.
  • Vaccination will help protect you by creating an immune response without having to experience the illness and its risks.
Vaccination will be an important tool to help stop the pandemic
  • Stopping a pandemic requires using all the tools available. Wearing masks, handwashing and physical distancing are all important strategies to help reduce your chance of being exposed to the virus or spreading it to others, but these alone are not enough.
  • The combination of getting vaccinated and following the CDC’s recommendations on protecting yourself and others offers the best protection against the virus.
Sources:
Benefits of Getting a COVID-19 Vaccine CDC, updated regularly.
How to Protect Yourself & Others CDC, updated regularly.
Key Things to Know About COVID-19 Vaccines CDC, updated regularly.

UPDATED MARCH 2: What should I expect after getting the vaccine -- are there side effects?

Common side effects may include pain and swelling at the injection site. You may get fever, chills, tiredness or a headache. These side effects may affect your ability to do daily activities, but they should go away in a few days. These are all indications that your body is building protection against the virus.

Even if you get some side effects after the first shot, it is important that you get the second shot (unless your doctor advises you otherwise), because Pfizer and Moderna COVID-19 vaccines require two doses to achieve optimal protection. Johnson & Johnson requires only one.

The CDC has a printable factsheet for vaccine providers to offer recipients in English and Spanish. It includes information on how vaccine recipients can register for v-safe to report additional side effects.

Current safeguards recommended for recipients and providers of COVID-19 vaccines:
  • All people who get a COVID-19 vaccine should be monitored on-site. People with a history of severe allergic reactions should be monitored for 30 minutes after getting the vaccine. All other people should be monitored for 15 minutes after getting the vaccine.
  • Vaccination providers should have appropriate medications and equipment — such as epinephrine, antihistamines, stethoscopes, blood pressure cuffs, and timing devices to check your pulse — at all COVID-19 vaccination sites.
  • If you experience a severe allergic reaction after getting a COVID-19 vaccine, vaccination providers should provide rapid care and call for emergency medical services. You should continue to be monitored in a medical facility for at least several hours.
The CDC has additional recommendations for vaccine providers to safeguard against allergic reactions.

Sources:
What to Expect after Getting a COVID-19 Vaccine CDC, updated 1/11/21.
COVID-19 Vaccines and Allergic Reactions CDC, updated 1/22/21.
Interim considerations: preparing for the potential management of anaphylaxis after COVID-19 vaccination CDC, 12/31/20.

UPDATED MARCH 2: How do I report an adverse reaction to the vaccine?

If you are a patient, please let your health care provider know about your symptoms first. We strongly urge both urge health care providers and patients to report any adverse reactions via the Vaccine Adverse Event Reporting System.

Additionally, at the time of vaccination, you will be given a vaccine record card with information about how to register and use the text-based tool v-safe. Registration is completely voluntary and provides personalized check-ins, surveys, and a reminder to let you know when it is time to get your second shot (for Pfizer or Moderna vaccines). Depending upon your responses, someone from the CDC may call to check on you.

Sources:
V-safe After Vaccination Health Checker CDC, updated 2/6/21.
Vaccine Adverse Event Reporting System, HHS.

UPDATED MARCH 1: What is "COVID arm?"

Some people report having a red, itchy, swollen, or painful rash appearing on the arm where they received the vaccine. Sometimes the rashes are large, warm or painful. These rashes, referred to as “COVID arm” are neither serious nor life-threatening. They may occur a day or two following vaccination, but can also happen up to a week later. These rashes generally resolve within a few days after they appear.

It’s a sign that your immune system is reacting to what it views as an infectious invader.

Dr. Stappenbeck, Chairman of the Department of Inflammation and Immunity at the Cleveland Clinic explains, “What we essentially think is going on with COVID arm is that your immune cells are reacting to muscle cells that have taken up the messenger RNA vaccine. The immune cells can be a little over-exuberant because they view the SARS-CoV2 spike protein produced by the vaccine as an infection that they need to fight off.”

For those who get COVID arm, using a cold compress or ice can be used to ease inflammation, and a taking a pain reliever like acetaminophen may help with any soreness, or antihistamines for itchiness.

You won’t necessarily get it again, and there is no evidence to suggest that it increases the risk of severe allergic reactions. “If you’re worried about possibly having a sore arm after your second dose, get it in the opposite arm to make things a little easier,” says Dr. Stappenbeck.

Sources:
Should You Be Worried About COVID Arm? Cleveland Clinic, 2/17/21.
What to Do if You Have an Allergic Reaction After Getting A COVID-19 Vaccine CDC, 2/25/21.

UPDATED FEB. 24: I didn’t get any side effects after the COVID-19 vaccine-does that mean it’s not working?

No, this doesn’t mean your vaccination isn’t working.

Tara Parker-Pope, award-winning consumer health writer for The New York Times explains a lack of vaccine side effects this way:
"Just as some people experience side effects from medications and some don’t, people have varied reactions to vaccines. While we tend to hear only about the unpleasant reactions after the vaccine, a lot of people experience only mild discomfort or no symptoms at all after getting the shot.

“In the Pfizer trial, for instance, about half the participants developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, including headaches, chills and muscle pain. That means that half or more of the participants did not have those side effects, and yet the overall efficacy of the vaccine was 95 percent, suggesting that a lack of side effects does not mean a vaccine isn’t working.

"We also know that older people tended to report fewer side effects than younger people, probably because aging immune systems aren’t as strong. As people age, bodily defenses against pathogens weaken, and the response to vaccines also falters. But in the Pfizer and COVID vaccine trials, older people still produced adequate levels of antibodies, indicating a strong immune response after the vaccine. If you don’t have side effects after your shot, be glad you are one of the lucky ones and don’t worry.”

Source:
Answers to All Your Questions About Getting Vaccinated for Covid-19 The New York Times, updated regularly.

Can the COVID vaccine give me COVID?

No. There are no vaccines near approval that use live virus, and a COVID-19 vaccine will not cause you to test positive for COVID-19. The goal of the vaccine is to provide your body with the tools it needs to fight the COVID-19 virus if you were to get infected.

UPDATED MARCH 2: Will getting the vaccine cause me to test false positive on any of the COVID-19 tests (e.g., PCR test, antigen test or antibody test)?

None of the authorized vaccines or those being researched in the U.S. cause a positive result on either the PCR or antigen viral tests. This is because these tests check for current infection, not immunity. Because there is no coronavirus in the vaccines, only instructions for the immune system to build proteins to fight it, it cannot cause you to become infected or test positive.

After vaccination you may however, test positive on some serology (antibody) tests, because these check for antibodies built up as part of your immune system, which is exactly what the vaccine does!

The New York Times offers helpful descriptions of how the Pfizer, Moderna, and Johnson & Johnson vaccines work.

Sources:
Myths and Facts about COVID-19 Vaccines, CDC, 2/3/21.

UPDATED JAN. 15: Is natural immunity from getting sick with COVID-19 better than the passive immunity gained from the vaccine?

Vaccine immunity is actually preferable to immunity gained via illness from COVID-19 for several reasons.

It’s optimal not to have to suffer through the disease and its associated risks. We’re still learning about the potentially serious and persistent effects or COVID-19, and it is unknown who may suffer them or how long they may last.

We know how to safely treat and resolve any rare allergic reactions that may arise from the vaccine far better than we know how to treat and resolve the body’s often unpredictable reactions to illness from COVID-19.

Additionally, “The natural immune response after a mild case appears to be short lived, and much shorter than what is expected from the vaccine,” notes Dr. Dean Blumberg, Chief of Pediatric Infectious Diseases at UC Davis Children’s Hospital.

Dr. Bill Moss, with Johns Hopkins Bloomberg School of Public Health points out “People who have a mild or asymptomatic infection could also have a lower immunity level. There’s already some evidence for this idea. We also know that in animal and monkey models, a certain level and type of antibody response correlates with immunity and protection – so a more severe infection might lead to a higher immunity level.”

But again, why take the risk and suffer through a severe and potentially fatal infection?

Sources:
Can I get it twice? Herd immunity, vaccines and covid-19 a Q&A with Dr. Bill Moss Johns Hopkins University Medicine, 1/2021.
The real facts about common COVID-19 vaccine myths UC Davis Health, 12/21/20.
Long-Term Effects of COVID-19 CDC, updated 11/13/20.

UPDATED MARCH 10: Do fully vaccinated people still need to quarantine after exposure to someone with suspected or confirmed COVID-19?

According to the CDC, people who are fully vaccinated (this means ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine) do not need to quarantine or be tested following exposure to someone with suspected or confirmed COVID-19. Their risk of infection is thought to be low.

They still need to watch for the development of COVID-like symptoms for 14 days after an exposure, however. A fully vaccinated person who starts to experience symptoms should isolate from others and notify their health care provider for evaluation and possible testing for COVID-19. They should also advise their health care provider of their vaccination status at the time of care.

Fully vaccinated residents of congregate settings (i.e. correctional/detention facilities, group homes) with exposure to a known or suspected case of COVID-19 should still continue to quarantine for 2 weeks and be tested, due to greater transmission risk, population turnover, and physical distancing challenges.

These CDC recommendations may change as the science evolves and more is learned about how well the vaccines prevent transmission, their effectiveness against variants, and for how long the vaccines may offer protection.

UPDATED FEB. 24: Should I get the vaccine if I am pregnant?

There is limited data on the safety of COVID-19 vaccines in pregnancy. 

The CDC currently states “experts believe that mRNA vaccines are unlikely to pose a risk to the pregnant person or the fetus because mRNA vaccines are not live vaccines. However, the potential risks of mRNA vaccines to the pregnant person and the fetus are unknown because these vaccines have not been studied in pregnant people.” Those who are pregnant and considering COVID-19 vaccination are encouraged to consult with their healthcare provider. 

Pregnancy puts one at risk for severe illness and death from COVID-19, the CDC warns, and the virus may also increase the chance of adverse pregnancy outcomes, including preterm birth. It is especially important for those who are pregnant to take steps to protect themselves from getting the virus. These include mask wearing, avoiding close contact with others and handwashing. The CDC offers additional guidance on staying safe from COVID-19 during pregnancy.

Sources:
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States CDC, updated regularly.
Pregnancy, Breastfeeding, and Caring for Newborns CDC, 12/28/20.

UPDATED FEB. 24: Should I get the vaccine if I’m breastfeeding?

No safety data exist on COVID-19 vaccines in people who are lactating, or on the effects of mRNA vaccines on the breastfed infant or on milk production or excretion. mRNA vaccines are not thought to be a risk to the breastfeeding infant. 

The Academy of Breastfeeding Medicine states that during breastfeeding, “it is unlikely that the vaccine lipid would enter the blood stream and reach breast tissue,” and that “if it does, it is even less likely that either the intact nanoparticle or mRNA transfer into milk. In the unlikely event that mRNA is present in milk, it would be expected to be digested by the child and would be unlikely to have any biological effects.”

Sources:
Considerations for COVID-19 Vaccination in Lactation Academy of Breastfeeding Medicine, 12/14/20.
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States CDC, updated regularly.

UPDATED MARCH 10: Can people with severe allergies get vaccinated?

It depends upon what they are allergic to and the type of allergic reaction they had.

People with allergies not related to vaccines or injectable therapies, such as food, latex, venom, pet or environmental allergies, may still get the COVID-19 vaccines. People allergic to oral medications or those with family histories of severe allergic reactions may also get vaccinated.

Anyone who has had a severe allergic reaction, or an immediate allergic reaction (even if it wasn’t severe) to any ingredient in a currently available mRNA vaccine or to any ingredient in the Johnson & Johnson vaccine should NOT receive that particular type of vaccine.

The CDC advises that people allergic to polyethylene glycol, or PEG (an ingredient found in the mRNA vaccines) ask their physician if they may receive the Johnson & Johnson vaccine instead. Those allergic to polysorbate (an ingredient in the Johnson & Johnson vaccine) should ask their physician if they may receive an mRNA vaccine instead.

Anyone who has had an immediate allergic reaction, whether severe or not, to a vaccine or other injectable therapy should ask their physician if it is safe for them to get vaccinated. One’s own physician is always in the best position to address specific questions and to offer strategic guidance tailored to one’s own personal health situation.

Please make your vaccine provider aware of any history of severe allergic reaction or any immediate allergic reactions to vaccines or injectable therapies. People with these histories will be monitored for at least 30 minutes following vaccination.

Precautions and contraindications to any of the currently approved vaccines are regularly updated and outlined in detail on the CDC’s website. They also offer guidance to vaccine providers on preparing for and managing severe allergic reactions.

Source:
Information about COVID-19 Vaccines for People with Allergies CDC, updated regularly.

UPDATED MARCH 10: Can immunocompromised people get vaccinated?

Barring contraindications to vaccination (such as an allergy to the vaccine or its components), someone who is immunocompromised can get vaccinated. Those with immunocompromising conditions, HIV and those on immunosuppressant medications may be at higher risk than others for severe outcomes from COVID-19.

Data are not available to establish COVID-19 vaccine safety and efficacy in immunocompromised individuals, however the currently authorized vaccines are not live vaccines and therefore can be safely administered to immunocompromised people. People with stable HIV infection were included in the COVID-19 vaccine clinical trials, though data remain limited. There are no data available regarding safety or efficacy of COVID-19 vaccines in people with autoimmune conditions, but these groups may receive any authorized COVID-19 vaccine. Data continue to evolve for organ transplant recipients but experts generally agree that these individuals should be vaccinated because of higher risk from severe outcomes should they contract COVID-19.

People planning to receive treatment with immunosuppressive therapy should ideally complete their COVID-19 vaccination at least 2 weeks before the therapy starts. For additional considerations regarding the timing of this therapy and COVID-19 vaccination, clinicians should refer to the CDC’s most updated clinical guidance.

Someone who is immunocompromised may mount a less protective immune response to the vaccine than someone with a normal immune system. Leading infectious disease expert Dr. Anthony Fauci recommends that these individuals still get vaccinated. “Some degree of immunity is better than no degree of immunity,” he said.

UPDATED FEB. 10: Should people receiving chemotherapy get the COVID-19 vaccine?

Clinical trials for the COVID-19 vaccines did not include people receiving chemotherapy or those with weakened immune systems, so it is still unknown how safe or effective these vaccines are in these populations.

According to data from the American Cancer Society, “It’s generally recommended that vaccines not be given during chemo or radiation treatments. (An exception to this is the flu shot.) This is mainly because vaccines need a healthy immune system response to work, and you may not get a good response if your immune system is suppressed by your cancer treatment. Some types of immunotherapy might affect the immune system as well.”

We expect more information will become available in the next few months. In the meantime, consultation with the treating physician is the best strategy to balance potential the unknown safety profile and potential limited immunological response to the vaccine in chemotherapy patients with the risks of potential serious outcomes from COVID-19 disease.

Sources:
COVID-19 Vaccines in People with Cancer American Cancer Society, 12/21/20.
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States CDC, 1/21/21.
Optimal Timing for COVID-19 Vaccination in Oncology Patients Receiving Chemotherapy Clinical Oncology, Dec 24, 2020.

UPDATED FEB. 10: Should people who did receive a COVID-19 vaccination during chemotherapy or immunosuppressive medications get re-vaccinated?

We anticipate more information will become available in the coming months. In the meantime, the CDC does not currently recommend re-vaccination for persons who have regained immune competence following chemotherapy or immunosuppressive medications.

Source:
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States CDC, 1/21/21.

UPDATED MARCH 10: Are the vaccines interchangeable?

The CDC advises that the COVID-19 vaccines are NOT interchangeable, advising that the safety and efficacy of a mixed product series has not been evaluated, thus every effort should be made to ensure 2 dose regimens are completed using the same product.

Vaccine recipients can help by keeping their vaccination card and presenting it when they show up for any second appointments, and/or signing up for VaxText, a free text messaging platform that sends vaccine information plus any needed reminders. Vaccine providers should record all vaccine information into the patient’s record and into the immunization information system, and make any necessary second appointments.

For exceptional, rare situations in which the first-dose vaccine product cannot be determined or is unavailable, or for situations in which administration of the Johnson & Johnson vaccine might be considered following an mRNA vaccine, the CDC offers clinical guidance.


Vaccine Variants

UPDATED MARCH 11: Will the vaccines work against the new COVID-19 variants?

Health experts at the CDC and globally are working to learn more about these circulating variants, and to understand more about how they might affect current COVID-19 vaccines and treatments.

“It is unlikely that, overnight, a variant is going to emerge that is capable of completely evading the vaccine,” says Dr. Angela Rasmussen, virologist at Georgetown University’s Center for Global Health Science and Security. The hope is that even if a vaccine is not a complete match against a variant, that it will provide at least partial protection, so that someone might have a less severe form of illness. Also, the technology used to make the vaccines can also be adapted to viral mutations in variants, sometimes in as little as six weeks.

And the body does not make just one antibody in response to the vaccine, it creates multiple and different antibodies which can attack different areas on the coronavirus’ spike protein. That way, if one part of the virus mutates, antibodies can still attack it in other areas. 

The more actions everybody takes to minimize opportunities for the virus to spread and infect others, the more we reduce chances for it to develop additional variants. Wearing a well-fitted mask, handwashing, physical distancing and staying home when sick, all remain effective strategies. Once you have been fully vaccinated, continuing to take steps to protect yourself and others will help end the pandemic sooner and get us back to our day-to-day activities.  

Sources:
New Variants of the Virus that Causes COVID-19 CDC, updated regularly.
Will vaccines work on new variants? New Scientist, 1/23/21.


General Questions

What will the vaccine cost?

The vaccine is free for everybody, regardless of insurance status. For those that have insurance, a small administration fee may be billed.

If I get the vaccine, can life go back to “normal?”

Not just yet. Millions of Americans will not yet have access to the vaccine, and they can still spread COVID. Most vaccines are not 100 percent effective at stopping transmission, although the COVID-19 vaccine is around 95 percent effective. Until more people are vaccinated or recover from COVID, masking, distancing, and hand washing are still good practices as we transition back to "normal."

Kaiser Health: 5 reasons to wear a mask even after you're vaccinated

UPDATED APR. 15: I'm vaccinated, but my children haven't/can't. What social activities can we do?

Until COVID-19 vaccines are approved for children (experts speculate this may happen later this year or in early 2022), vaccinated parents may wonder how to weigh and manage the level of risk certain social activities might carry for their unvaccinated children.

It is best to consult with your child’s pediatrician for specific recommendations. They can help evaluate risks and make decisions tailored to your child’s personal health situation. No answers exist that cover every situation, as risk factors can vary in each instance. While nothing is zero risk, there are ways to reduce the relative risk for unvaccinated children to help them participate in certain activities. In general, risk is lower for outdoor activities, small group sizes, and mask wearing and physically distancing if indoors. Talking with the other parents about their pandemic safety approach is important to manage everyone’s expectations and ensure everyone is on the same page.

The following are general guidelines:
  • Grandparent visits: The CDC says that fully vaccinated people can visit another single household in which not everyone has been vaccinated, as long as those who aren’t vaccinated are not at high risk for severe illness with COVID-19. So for example, vaccinated grandparents could visit their children and unvaccinated grandchildren from one household, eat with them, and hug them without needing to wear masks, as long as none of the unvaccinated family members are at risk of severe COVID-19. 
  • Visiting with other families of vaccinated parents and unvaccinated children: When more than one household is involved, the risk for the unvaccinated increases. The CDC currently recommends masking and physical distancing anytime more than one household is gathering. Outdoor visits are best, and members of different families should stay 6 feet apart from other families. Children playing within 6 feet of each other should wear masks. If the visit moves indoors, everyone should wear masks and stay 6 feet apart. 
  • Restaurants: Eating indoors at restaurants remains risky for anyone who is unvaccinated. Takeout orders, followed by outdoor dining is the lowest risk with children. For parents who want to eat indoors with their children, they can choose restaurants following strict safety precautions with good ventilation and physical distancing between tables. Because the vaccines are being proven effective, and the CDC suggests they may also prevent symptomatic spread, making it unlikely that parents dining out by themselves will bring the virus home to their children. 
  • Play dates, birthday parties: Keeping parties or playdates small, with just one or two friends and doing something outside helps reduce the risk. Ideally, everyone should wear masks and keep 6 feet apart from each other.

UPDATED APRIL 15: What do we know about the Johnson & Johnson vaccine?

Unlike the Pfizer and Moderna vaccines that use single strands of genetic material called mRNA inside a special lipid coating, the Johnson & Johnson vaccine works by using double strands of DNA protected inside an adenovirus. Adenoviruses are common viruses like those which cause colds and flu-like illnesses. The virus used in this vaccine was modified, so that when it enters a cell it cannot replicate or cause disease. Just like the Pfizer and Moderna vaccines, this vaccine also stimulates the body’s immune response to create antibodies against the spike proteins of the virus that causes COVID-19.

The Johnson & Johnson vaccine has the advantage of being a single-shot dose, which may make it easier and more attractive for many people. It can also be kept under regular refrigeration making it simpler to ship and store, which may result in more widespread availability.

FDA analysis supports the Johnson & Johnson vaccine for Emergency Use Authorization (EUA). In a study of about 40,000 people (half of whom received the vaccine, the other half a placebo) in the U.S., Latin America and South Africa, the vaccine was found to be 72 percent effective in the U.S. and 66 percent effective overall in preventing moderate to severe COVID-19 disease.

Side effects reported in clinical trials were mild or moderate, most commonly pain at the vaccine site, headache, fatigue and muscle pain.

In Johnson & Johnson’s large clinical trial, no-one receiving the vaccine needed hospitalization or died from COVID-19 once the vaccine took full effect (28 days after immunization). Dr. Ashish Jha, dean of Brown University’s school of public health points out that "What you care about is hospitalizations and deaths. Johnson & Johnson appears to be just as good as Moderna and Pfizer at preventing those," he said.

On April 13, 2021, the CDC and the FDA issued a joint statement recommending a pause in the use of the Johnson & Johnson vaccine following 6 US cases of a rare, severe type of blood clot in people receiving the vaccine. The CDC and FDA are reviewing the evidence and updated information is anticipated as it becomes available.

Sources:
How the Johnson & Johnson Vaccine Works New York Times, 2/24/21.
FDA Analysis Of Johnson & Johnson COVID-19 Vaccine Finds It Safe, Effective NPR, 2/24/21.
FDA Briefing Document Janssen Ad26.COV2.S Vaccine for the Prevention of COVID-19 FDA, 2/26/21.
Johnson & Johnson Announces Single-Shot Janssen COVID-19 Vaccine Candidate Met Primary Endpoints in Interim Analysis of its Phase 3 ENSEMBLE Trial Johnson & Johnson, 1/29/21.

UPDATED MARCH 11: How long should I wait to get vaccinated if I currently have COVID-19, or if I develop COVID-19 between vaccinations?

Anyone who is currently sick with COVID-19 should wait to get vaccinated until after they have recovered from the acute phase of the illness (if they had symptoms) and have met criteria to discontinue isolation. This applies to those who develop COVID-19 before receiving any vaccine doses as well as to those who develop infection between the first and the second doses (if receiving a dual-dose vaccine). 

Because evidence suggests that the risk of reinfection is low in the first few months following illness, those with recent confirmed COVID-19 may wish to temporarily delay vaccination while vaccine supplies remain limited. However, the CDC does not specify a minimum waiting time between a previous infection and getting vaccinated.

Sources:
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States CDC, updated regularly.

UPDATED FEB. 10: If I just received another vaccine, do I have to wait to get the COVID-19 vaccine?

There is no safety or efficacy data for simultaneous administration of the mRNA COVID-19 vaccines with any other vaccines. Therefore, current CDC guidelines recommend administering the COVID-19 vaccine series alone, with a minimum waiting time of 14 days after any other vaccines.

However, CDC advises allowing a shorter time period between COVID-19 vaccines and other vaccines in which the benefits of vaccine co-administration outweigh the potential unknown risks (such as giving tetanus vaccine for wound management, or measles or hepatitis A vaccination for outbreak management), or to avoid delays of COVID-19 vaccination for people who may already have received prior influenza or other immunizations (such as for healthcare workers or long-term care facility residents).

CDC notes that “If mRNA COVID-19 vaccines are administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine.”

Source:Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States CDC, updated 2/10/21.

UPDATED MARCH 11: If I was treated with monoclonal antibody therapy for COVID-19, should I get vaccinated?

Yes, although you should consider a delay for 90 days. 

CDC recommendations state “Based on the estimated half-life of such therapies and evidence suggesting that reinfection is uncommon in the 90 days after initial infection, vaccination should be deferred for at least 90 days. This is a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses.”

People who received passive antibody treatment for COVID-19 after having already received the first dose of an mRNA vaccine are advised to wait 90 days after getting the therapy before getting the second vaccine dose. It is not necessary to repeat any COVID-29 vaccine doses administered within 90 days of passive antibody therapy.

No waiting period is needed for people receiving passive antibody therapies unrelated to COVID-19 treatment (such as RhoGAM, or IVIG) because these are unlikely to impair vaccine antibody response. 

UPDATED FEB. 24: Once I’m vaccinated, do I still need to worry about infecting others?

We don’t yet know. More research is needed.

Clinical trials determined the vaccines authorized in the U.S. to be protective against development of symptomatic as well as severe COVID-19 disease. However, we don’t yet know whether being vaccinated prevents viral transmission to others.  Therefore, even though the vaccine can prevent you from getting symptoms from the virus, you may still be able to spread it to those around you.

Even after you get the vaccine, please continue to follow the steps to protect yourself recommended by the Pima County Health Department and the CDC by masking, distancing and hand washing. 

Also, the CDC issued an order on January 29, 2021, requiring that masks be worn by all travelers on public transportation including airplanes, trains, buses, taxis and ride shares, regardless of vaccine status.

Sources:
Coronavirus Resource Center Harvard Medical School, 1/29/21.
How to protect yourself and others CDC, 1/30/21.
Requirement for Face Masks on Public Transportation Conveyances and at Transportation Hubs CDC, 1/29/21.

UPDATED MARCH 11: Do I need a vaccine if I've already recovered from COVID-19?

Yes, vaccination is recommended and beneficial for people who have already had COVID-19. 

Current evidence suggests that while reinfection with the virus appears uncommon in the 90 days following initial infection, medical experts do not yet know how long this natural protective immunity lasts. COVID-19 infection or reinfection can have serious, life-threatening complications, and health experts agree that vaccination is a safer way to build immunity to the virus. People who have been fully vaccinated can also start doing some of the things they had stopped doing because of the pandemic.

Knowledge is expected to evolve as researchers worldwide and at the CDC continue to study the immunity produced by the COVID-19 vaccines. 

If I have an active case of COVID, can the vaccine be used as a treatment?

Individuals with an active case of COVID-19 need to wait until recovery before receiving the vaccine, according to Pima County Health Director Dr. Theresa Cullen.

UPDATED DEC. 22: Can my employer require me to get vaccinated?

Yes. According to the Equal Employment Opportunity Commission (EEOC), employers may require employees to take the COVID-19 vaccine, subject to certain legally protected exceptions for disability and sincerely held religious beliefs.

Employers may ask employees to show proof of receipt of a COVID-19 vaccination.

If an employer requires the vaccine, or contracts with a vendor to provide the vaccine, then the pre-vaccination medical screening questions are subject to ADA standards for disability-related inquiries (i.e., must be job-related and consistent with business necessity); if voluntary, or if the employee receives the vaccine from a third party that does not have a contract with the employer, then these ADA restrictions do not apply.

Should I get the flu vaccine?

Yes! As the flu season approaches our health care system could be overburdened with the on-going pandemic. Even a mild flu season, combined with a COVID surge could rapidly overwhelm out health care and hospital system. The flu vaccine has proven safe and effective. While it is recommended to get the flu vaccine in September or October, it is still not too late, although you should not get the flu vaccine at the same time as the COVID-19 vaccine.

How effective is the vaccine in people over 65?

The vaccine seems highly effective in older adults. In testing, older adults also tended to have less risk of side effects from the vaccine. 

How long does the immunity last?

We don’t know yet. The drug trials were very recently completed, and we need more data to determine how long people retain immunity.

UPDATED APRIL 15: How many vaccines have been approved?

Of the dozens in development, three vaccines have received emergency use authorization (EUA) in the United States.

In December 2020, the FDA issued EUAs for vaccines from Pfizer and Moderna. In February 2021, the FDA issued an EUA for Johnson & Johnson.

The CDC and the Infectious Diseases Society of America maintain regularly-updated websites with information for clinicians and the public about the Pfizer, Moderna, and Johnson & Johnson vaccines.

On April 13, 2021, the CDC and the FDA issued a joint statement recommending a pause in the use of the Johnson & Johnson vaccine following 6 US cases of a rare, severe type of blood clot in people receiving the vaccine. The CDC and FDA are reviewing the evidence and updated information is anticipated as it becomes available.

The first two vaccines are mRNA vaccines – what does that mean?

mRNA vaccines take advantage of the process that cells use to make proteins in order to trigger an immune response and build immunity to COVID-19. In contrast, most vaccines use weakened or inactivated versions or components of the disease-causing pathogen to stimulate the body’s immune response to create antibodies.

mRNA vaccines have strands of genetic material called mRNA inside a special coating. That coating protects the mRNA from enzymes in the body that would otherwise break it down. It also helps the mRNA enter the muscle cells near the vaccination site.

mRNA can most easily be described as instructions for the cell on how to make a piece of the “spike protein” that is unique to the virus that causes COVID-19. Since only part of the protein is made, it does not do any harm to the person vaccinated but provides immunity.

After the piece of the spike protein is made, the cell breaks down the mRNA strand and disposes of them using enzymes in the cell. It is important to note that the mRNA strand never enters the cell’s nucleus or affects genetic material. mRNA vaccines do not alter or modify someone’s genetic makeup.

Once displayed on the cell surface, the protein or antigen causes the immune system to begin producing antibodies and activating T-cells to fight off what it thinks is an infection. These antibodies are specific to the COVID-19 virus, which means the immune system is primed to protect against future infection.

Keep track of the progress of all the vaccines undergoing testing at the New York Times' Coronavius Vaccine Tracker.

UPDATED DEC. 21: How can I protect myself from scams?

While the newly-approved COVID-19 vaccine offers hope of controlling the pandemic, scammers see the vaccine as an opportunity to steal from hopeful consumers.

The FBI and the Department of Health and Human Services’ (HHS) Office of Inspector General have been issuing alerts about the increase in coronavirus fraud. Scammers aren’t just using email or telemarketing calls. They are also coming at people via messages on social media platforms, and they’re even performing door-to-door visits, HHS says.

Vaccine scam flyer

Do I need to delay my mammogram after getting the vaccine?

The COVID-19 vaccines often elicit a very prominent immune response which can result in tender, swollen lymph nodes under the arm. Called “axillary adenopathy,” it signals inflammation, which is the body’s normal response to vaccination. Recently, it has been increasingly confused with cancer on regular screening mammograms, MRIs or ultrasound exams when a patient has recently had their COVID-19 vaccine.

False positives due to adenopathy from the vaccines have resulted in undue alarm and sometimes additional unnecessary testing. In response, the Society of Breast Imaging published guidelines for scheduling mammograms in a way to help avoid this. They recommend that if possible, and when it does not unduly delay care, patients and their providers consider scheduling breast screening exams before receipt of the first dose of a COVID-19 vaccine, or wait 4-6 weeks following the second dose of vaccine (if using a two-shot series) before being screened.

Anyone experiencing a suspicious lump is still encouraged to consult with their healthcare provider.

UPDATED APRIL 5: What are fully vaccinated people able to do?

Fully vaccinated people may resume certain activities that they might have stopped doing because of the pandemic.

People are considered fully vaccinated 2 weeks after receiving the second dose of a 2-dose vaccine series (such as Pfizer or Moderna), or 2 weeks after a single dose vaccine (such as (Johnson & Johnson).

The CDC advises that fully vaccinated people can:
  • Visit with other fully vaccinated people indoors without wearing masks or physical distancing 
  • Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
  • Refrain from quarantine and testing following a known exposure if asymptomatic 
  • Resume domestic travel and refrain from testing before or after travel or self-quarantine after travel. 
  • Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States.
Until more is known about how vaccines might affect the spread of COVID-19, in public spaces, everyone, including fully vaccinated people should continue to follow recommended precautions to protect themselves and others, including mask wearing, handwashing, physical distancing, and getting tested if symptomatic.

These recommendations may expand or change, as the science evolves and we learn more about how long the vaccines protect and how they affect prevention and transmission.

For additional details, visit the CDC’s When You’ve Been Fully Vaccinated webpage. To learn more about traveling locally or internationally, visit the Pima County Health Department’s Travel and COVID-19 page, and the CDC’s travel page.

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