Vaccination FAQ

Note: This information is based on currently available evidence, resources, information, emergency use authorization, and expert opinion, and is subject to change.

  • Vaccination: Virginia COVID Information Center General Information

    The Virginia COVID Information Center is a dedicated interagency effort across the Commonwealth of Virginia to provide Virginia residents and workers with an integrated, comprehensive solution for timely and accurate COVID-19 general information, in alignment with CDC guidelines, and simplify vaccination scheduling services for all Virginia residents and workers. ​

    All Virginia workers and residents 5 years and older are eligible for scheduling, vaccination, and general COVID inquiry services. This includes all undocumented immigrants. The Information Center’s sole objective in collecting your information is to help you get vaccinated. Information gathered by the Virginia COVID Information Center or on Virginia Department of Health websites will not be shared for any other purposes except as authorized or required by law. The Commonwealth of Virginia will never call, email, or text asking for your social security number or payment as it relates to vaccination.

    The Virginia COVID information Center’s resources can be accessed anytime online and by phone Monday through Friday, from 8 a.m. to 6 p.m  ET at 1-877-VAX-IN-VA (1-877-829-4682).

    There are Spanish and English-speaking agents, as well as additional language services in over 100 languages to assist those residents and workers who speak other languages.

    In order to reach the call center via Virginia Relay, including by TTY, please dial 7-1-1. 

    ASL users have two ways to connect: by videophone at 1-877-VAX-IN-VA (1-877-829-4682) or by clicking the “ASL Now” button at vaccinate.virginia.gov.

    The centralized Virginia COVID Information Center will be the first line of contact for residents and workers with COVID questions and vaccine scheduling needs. While easing the initial call volume from the local health district, the Information Center agents will also have the ability to redirect callers to their local health departments as necessary for COVID contact tracing, COVID testing, and all non-COVID health support.​

    Vaccination: How To Get the COVID-19 Vaccine

    To find an appointment, visit vaccinate.virginia.gov, call 877-VAX-IN-VA (877-829-4682), or text your zip code to GETVAX (438829) for English or VACUNA (822862) for Spanish. 

    At vaccinate.virginia.gov, you can access the “Search by Location” feature which allows you to enter the street address where you usually live. You will then be provided options for making an appointment. Most clinics offer walk-in service in addition to scheduled appointments.

    Information on how to stay safe while you are waiting for your COVID-19 vaccine can be found here

    Everyone in Virginia 5 years or older is eligible.

    No, photo identification is not required for vaccination. It is important however, to have some way to confirm your identity (i.e. name, date of birth) so we can confirm that we are vaccinating the right person. 

    VDH recommends that vaccine providers refrain from enforcing any residency requirements by asking for identification or documentation from individuals.

    No, government-issued identification is not required to receive a vaccination.

    VDH recommends that vaccine providers refrain from enforcing any residency requirements by asking for identification or documentation from individuals.

    No. Proof of Virginia residency is not required.

    VDH encourages vaccine providers to vaccinate individuals regardless of in-state or local residency.

    No. Any person age 5 years or older and living in the U.S., regardless of how long, is eligible to be vaccinated. Proof of U.S. Citizenship is not required. 

    Yes. Persons in Virginia age 5 years or older can get vaccinated in Virginia. 

    VDH recommends that vaccine providers refrain from enforcing any residency requirements by asking for identification or documentation from individuals.

    Yes, you can receive a vaccine in a locality (city or county) different from the one you live in. 

    VDH encourages vaccine providers to vaccinate individuals regardless of in-state or local residency.

    The Pfizer-BioNTech, Moderna, and Johnson & Johnson (Janssen) vaccines are available in Virginia.

    Several other drug companies are participating in Phase 3 trials at this time, and other vaccines may be available in the future.

    Most clinics offer walk-in service in addition to scheduled appointments. Visit vaccinate.virginia.gov or call 877-VAX-IN-VA (877-829-4682) to find a vaccine. The website includes a simple address search to help you find the most convenient ways to get vaccinated.

     

    Yes. You have the option to choose which vaccine brand you would like to receive if you are scheduling through Vaccines.gov, as the website allows you to filter by vaccine brand. Call center agents can also help you find a location that has your preferred brand of COVID-19 vaccine.

    To cancel or change your vaccination appointment, you will need to reach out to the agency that contacted you about scheduling your appointment. The agencies that may have contacted you include, but are not limited to, the Virginia COVID Information Center (VCIC) or your Local Health District.

    You can identify the agency that scheduled your appointment by referencing the communication they used to contact you; this could be through an email, a text message, or a phone call and may provide additional instructions on appointment management. To help locate this communication, we encourage you to search key words such as “vaccination” or “appointment” in your email or text messages. 

    You must reach out to the Local Health District or agency that scheduled your appointment. For example, if you scheduled your appointment through the Vaccinate Virginia program which uses the Vaccine Appointment Scheduling Engine (VASE), you can call 877-VAX-IN-VA (877-829-4682). Please check the communication(s) you received for your appointment – this should help you find the local government, local health department, or other agency managing your appointment.

    Yes, the 511 year old age group has been authorized by the FDA and recommended by CDC to receive the children’s Pfizer-BioNTech COVID-19 vaccine. These children can be scheduled for vaccination in Virginia, the same way that older children and adults are being scheduled.

    In general, the scheduling arrangements, allergy precautions, other pre-vaccination precautions, vaccine side effects, safety data, and vaccine effectiveness in this age group are similar to those in older children and young adults. Please note: the vaccine formulation for this age group is different from the one for adolescents and adults. 

    Parents and guardians can enroll adolescents (ages 5 and older) in the v-safe after vaccination health checker and complete health check-ins on their behalf after COVID-19 vaccination.

    If you are contacted to schedule an appointment for a vaccine and you do not want the brand of vaccine you are offered, you can choose instead to go to Vaccines.gov to search for a vaccination appointment with a preferred brand near you. You can also call 877-VAX-IN-VA (877-829-4682), and a call center agent can help you find a location that has your preferred brand of COVID-19 vaccine.

    If you have additional questions, please contact your vaccination provider or reach out to the agency that contacted you to schedule your vaccination appointment. The agencies that may have contacted you include, but are not limited to, the Virginia COVID Information Center (VCIC) or your Local Health District.

    You can identify the agency that scheduled your appointment by referencing the communication they used to contact you; this could be through an email, a text message, or a phone call and may provide additional instructions on appointment management. To help locate this communication, we encourage you to search keywords such as “vaccination” or “appointment” in your email or text messages.

    As of November 22, more than 87% of all adults in Virginia have received at least one dose and more than 64% of the entire population is fully vaccinated. We have seen great response, and we expect that to continue now that COVID-19 vaccines are available to everyone 5 and older.  

    This map provides COVID-19 vaccine hesitancy estimates in your community.

    We will continue the focus on equity and reaching our vulnerable populations. Those efforts include targeted advertising in multiple languages, working with community partners to schedule vaccination clinics with walk-in options, and deploying mobile vaccination units. Please visit the VDH Health Equity Dashboard.

    As of November 5, more than 83% of all adults in Virginia have received at least one dose and more than 63% of the entire population is fully vaccinated. We have seen great response, and we expect that to continue now that COVID-19 vaccines are available to everyone 5 and older.  

    This map provides COVID-19 vaccine hesitancy estimates in your community.

    VDH maintains a COVID-19 Vaccine Summary dashboard with information including total vaccine doses received and administered. Locality, demographic, and federal dose information is also available. 

    VDH also has a dashboard to show COVID-19 cases by vaccination status and to track COVID-19 vaccine breakthrough cases. The VDH COVID-19 Cases by Vaccination Status dashboard includes information on the number of COVID-19 cases, hospitalizations and deaths by vaccination status. The dashboard also includes data to track COVID-19 vaccine breakthrough cases, hospitalizations, and deaths. Vaccine breakthrough means someone who is fully vaccinated develops COVID-19. 

    The COVID-19 vaccine “must be provided to vaccine recipients with no out-of-pocket costs,” according to the Department of Health and Human Services (HHS). While the federal government is picking up the cost of the vaccine doses people across the country are getting, some healthcare providers can get paid for administering the vaccines. For those with health insurance, this cost is typically billed to the insurance company. Even if you do not have health insurance you can still get a COVID-19 vaccine for free. Providers who administer a COVID-19 vaccine to someone who is uninsured or who has limited Medicare benefits that do not cover vaccines, will be reimbursed as part of a provider relief fund created as part of the CARES Act coronavirus legislation.

    No. More than one vaccine brand is available in the United States, but your vaccine provider might have only one brand. Vaccines will be offered to everyone at no cost, regardless of whether or not they have insurance.

    No. While there is currently more than one vaccine brand available to Americans, local health departments, healthcare providers, pharmacies, and clinics will likely have only one brand. Vaccine supplies are limited, and you should take whichever COVID-19 vaccine is available to you. In general, side effects and effectiveness for the currently available vaccines are very similar.

    The COVID-19 vaccine is offered to everyone at no cost regardless of health insurance. Children under the age of 5 years will be offered a COVID-19 vaccine only after the vaccines are tested and authorized for emergency use in children. 

    The flu vaccine and routine childhood vaccines are provided free or low-cost by many  public providers in underserved areas. Refer to the VDH website for more information.

    There is no charge to anyone for COVID-19 vaccine or for the vaccination appointment itself. The Virginia Attorney General has provided a warning and detailed advice for avoiding COVID-19 vaccine scams or other COVID-19 scams here.

    The Commonwealth of Virginia will never call, email, or text asking for someone's social security number or immigration status in connection with vaccination. Virginians who have any questions or concerns or believe they may have been the victim of a COVID vaccine related scam should reach out to Attorney General Herring’s Consumer Protection Section

    The Federal Bureau of Investigation (FBI) is also warning the public about several emerging fraud schemes related to COVID-19 vaccines. If you believe you have been the victim of a COVID-19 fraud, immediately report it to the FBI (ic3.gov, tips.fbi.gov, or 1-800-CALL-FBI) or HHS OIG (tips.hhs.gov or 1-800-HHS-TIPS).

    Any offers related to the sale or use of COVID vaccines, not from a medical provider, should be considered suspicious and reported to the state or local health department. You can also submit the information to the US Department of Health and Human Services, Office of the Inspector General at 1-800-HHS-TIPS or www.oig.hhs.gov; or submit a tip to the Federal Bureau of Investigation at: www.tips.fbi.gov

    Non-medical companies or private persons are not authorized to provide, sell, or administer vaccines.

    This depends on the setting. In general, people who have had a recent known COVID-19 exposure should not seek vaccination until their quarantine period has ended. This is to avoid potentially exposing healthcare personnel and other persons to the virus that causes COVID-19 during the vaccination visit.

    Exceptions to this are made in the following settings: people living in congregate healthcare settings (e.g., long-term care facilities) and residents of other congregate settings (e.g., correctional and detention facilities, homeless shelters). Additional guidance on this topic can be found here.

    VDH is supporting Virginia healthcare providers who are currently offering COVID-19 vaccines. VDH continues to sign up healthcare providers who want to offer COVID-19 vaccines. These providers include hospitals, long-term care facilities, local health departments, pharmacies, health systems, outpatient centers and urgent care centers. Vaccine providers are trained to correctly store, administer, and document available vaccines. Other efforts include targeted advertising in multiple languages, working with community partners to schedule vaccination clinics with walk-in options, and deploying mobile vaccination units.

    All COVID-19 vaccination sites in Virginia are ADA compliant. If you need special accommodations when going to get your or your child’s vaccination, please reach out to your local health department. To schedule an appointment for the COVID-19 vaccine visit vaccinate.virginia.gov/ or call 1-877-VAX-IN VA (1-877-829-4682) Monday through Friday from 8:00 am - 6:00 pm ET.

    You can also utilize the Disability Information and Access Line (DIAL). For additional information about DIAL, visit acl.gov/dial. You can contact DIAL at 888-677-1199 Monday-Friday from 9 a.m. to 8 p.m. (Eastern)  or email DIAL@n4a.org.

    A few tips for the day of your or your child’s appointment include the following: 

    • Consider having a snack and drink in hand. 
    • Make sure to take any regular medications on your regular schedule the day of your vaccine appointment.
    • It is important to maintain your same health routine on the day you or your child are getting vaccinated.
    • Bring your vaccination card if you have received previous COVID-19 vaccine doses.
    • Consider dressing lightly, or with layers that can be easily removed if you get too hot.

    Virginia is offering mobile vaccination units capable of vaccinating up to 300 people per day to support local health department efforts across the state. 

    These mobile units offer the one-dose Johnson & Johnson vaccine. The one-dose vaccine allows for greater flexibility in that the mobile unit does not have to return to a particular area for second-dose shots. 

    These units are being used primarily in rural, underserved areas to help fill access gaps and smaller urban areas. Site selection is based on needs, data-driven and in support of local health district requests. Local health districts are working with local and state agency partners to determine where to deploy the units.

    Vaccination: Why Get Vaccinated Against COVID-19

    COVID-19 vaccines are important to us as individuals and as a society.

    There’s no way to know ahead of time how getting COVID-19 disease could affect you. For example, we still don’t know yet why some healthy people become seriously ill or die from COVID-19, while other healthy people with COVID-19 only become mildly sick. Individuals with mild or even asymptomatic disease can suffer from Long COVID.  However, once vaccinated, your body will build immunity to the virus so you are less likely to get infected, to get sick, and to transmit COVID-19 to others. In fact, the COVID-19 vaccine will greatly reduce your chances of getting COVID-19 disease at all and will make it very likely that even if you do get the virus, you will have only mild symptoms or none at all.

    All available COVID-19 vaccines are highly effective, including among children 5 years and older, for preventing serious illness, hospitalization, and death. 

    It is difficult to predict the course of the pandemic, therefore even if community and state case counts decrease, there is always a risk of a future resurange of cases. 

    Experts continue to conduct more studies about the effect of COVID-19 vaccination on its ability to keep people, including children, from spreading the SARS-CoV-2 virus that causes COVID-19.

    As more people get vaccinated, we can slowly return to doing the things we enjoy. 

    Additional information about why COVID-19 vaccines are important can be found here.

    Goal #1: The most important goal of a COVID-19 vaccine series, including any recommended vaccine booster doses, is to safely protect the vaccinated person over a long period. It should either protect vaccinated people completely, keeping them from getting infected at all or make sure that if they get infected, their COVID-19 infection is less severe than it would have been if they had not been vaccinated. 

    “Breakthrough” COVID-19 infections can occur in fully vaccinated people but they remain rare, although some recent information suggests that immunity may begin waning (decreasing) over time, especially in older people. Such waning immunity will increase the need for vaccine booster doses.

    However, because COVID-19 vaccine series along with any recommended booster doses continue to be highly effective at preventing serious COVID-19 illness, this goal has been met.

    Goal #2: A second goal for a COVID-19 vaccine is to be sure that the people who get fully vaccinated become less likely to pass a COVID-19 infection on to other people even if they are not having any symptoms themselves. For example, many unvaccinated people who get COVID-19 infections have no symptoms at all, but they can still transmit and spread COVID-19 to people that they come in contact with. 

    Because several studies indicate that, even if they do get infected, people fully vaccinated with COVID-19 vaccines are less likely to transmit COVID-19 to others, this goal has been met. This benefit even includes fully vaccinated people who get breakthrough infections with the Delta variant of COVID-19. 

    Goal #3: A third goal for a COVID-19 vaccine is to provide an opportunity for an entire population to develop long-lasting “herd immunity” or “population immunity”, in which many people in the population are protected against COVID-19, either because they have been vaccinated or, for some, because they had COVID-19 disease and then recovered. If the number of people in a population with those kinds of immunity and protection becomes high enough, there won’t be enough unprotected people left who can still get infected with and transmit COVID-19 to allow the disease to keep spreading.

    NOTE: People who are partially protected because they previously had COVID-19 disease can further improve their protection by getting COVID-19 vaccinated. Studies have shown that among people who had COVID-19 disease earlier, those who later got fully vaccinated had much lower risks of getting re-infected with COVID-19 than those who remained unvaccinated.

    Although we have still not reached the point of “herd immunity”, we have reached a point where most of the severe COVID-19 illness and nearly all of the COVID-19 deaths are occurring in people who have not been fully vaccinated. Therefore, COVID-19 vaccines are already accomplishing much of this goal among fully vaccinated people.

    Broadly speaking, the vaccine will not be required for all Virginians and there are no legal penalties for refusing it, but we urge you to get it as soon as you are eligible. Once enough people are fully vaccinated against COVID-19, we can resume more of the everyday activities we enjoyed before the COVID-19 pandemic.

    Some employers, such as Virginia's state agencies, have begun mandating COVID-19 vaccination. 

    Some Virginia colleges and universities are requiring COVID-19 vaccination for students and staff. 

    Some K–12 school systems in Virginia are mandating COVID-19 vaccination for their employees.

    There are no plans at the moment to mandate that K–12 public school children receive COVID-19 vaccine. (The General Assembly would need to approve that step as an amendment to Virginia’s immunization code.)

    No. 

    Vaccines currently being used or developed in the United States will NOT cause positive results on COVID-19 viral PCR and antigen tests. These types of tests detect active infection with the virus that causes COVID-19 and the current COVID-19 vaccines do NOT contain the actual virus that causes COVID-19.

    However, after vaccination, you or your vaccinated child might test positive on some but not all types of COVID-19 antibody (serology) tests. These other tests do NOT indicate current infection but rather show previous exposure of your immune system to the virus that causes COVID-19. We’re still learning about how COVID-19 vaccination might influence the interpretation of these antibody test results. Please note: Routine COVID-19 antibody testing after vaccination is not recommended.

    Yes. Since vaccine breakthrough cases continue to be rare, in addition to protecting you, getting fully vaccinated will also provide some protection to your family, household members and other contacts.

    In fact, fully vaccinated people with breakthrough infections can spread the virus to others. However, because fully vaccinated people appear to spread the virus for a shorter time, they are therefore less likely to spread the virus compared to unvaccinated individuals. 

    It is important for every eligible person to get fully vaccinated themselves as soon as possible and to continue wearing masks and following physical distancing recommendations in public settings.

    For more information on what you, your family, and friends can do safely after being fully vaccinated, click here.

    When you or your child gets vaccinated for COVID-19, you will be provided with a signed card that contains the name of the vaccine manufacturer, the vaccine lot number, and the date and location of where you were vaccinated. Please keep this card in a safe place.

    You should also receive or have access to a fact sheet with information specific to the brand of vaccine that you or your child received. 

    All people receiving a COVID-19 vaccination should be monitored on site for at least 15 minutes after receiving the shot. Anyone who has had severe allergic reactions in the past or who has had any allergic reaction within 4 hours of receiving any vaccine or other injection in the past should be monitored onsite for at least 30 minutes. 

    Ask your healthcare provider about how to register for v-safe. V-safe allows you to use your smartphone to tell CDC about any side effects after getting the COVID-19 vaccine. You’ll also get reminders if a second vaccine dose is needed. You can also choose to enroll in the VaxText text messaging service. By texting ENROLL to 1-833-VaxText (829-8398), vaccine recipients can opt in to receive a weekly text reminder for their second dose of COVID-19 vaccine or a reminder for when they are overdue for their second dose, in English or Spanish.

    Visit CDC’s Getting Your COVID-19 Vaccine and Stay Safer Getting Your COVID-19 Vaccine for more on what to expect during and after your visit.

    Herd immunity is a form of population immunity, which is an indirect protection from an infectious disease that occurs when the majority of a population has become immune to infection, either through vaccination or from previous infections. If and when herd immunity against COVID-19 is achieved in any population, that disease is less likely to spread in that population. Many of those who did not get fully vaccinated will still be protected because the population in which they live is at least partly protected. This type of protection is especially important for people with certain medical conditions who might not be able to receive a vaccine themselves.

    This type of immunity can sometimes even be effective in families or in other small populations. A recently published study from Sweden shows that having more people in a household who were immune, either from vaccine or from prior COVID-19 infection, meant that transmission risks for others in the household were lower. For example, if four people were immune in a five person family, the risk of infection in the fifth family member was reduced by 97%! A description of this study is here

    Vaccinating a very high percentage of the population is the best and safest way to get to herd immunity. However, even after a population gets to herd immunity, some people can still get infected and the risk of COVID-19 outbreaks will continue to be higher in areas where fewer people are fully vaccinated. Continuing other basic prevention measures will still be essential in higher risk situations or settings. 

    Yes.

    The “natural immunity” provided by having COVID-19 disease alone provides good protection from reinfection for a short time after the illness. However, several studies have shown that compared to the “natural immunity” in people who had COVID-19 illness before but have NOT been vaccinated yet, the immunity provided by COVID-19 vaccination in people who also had COVID-19 illness before is both stronger (that is, provides higher antibody levels) and broader (that is, it can better protect against some of the new variant strains.)  Recent information from Kentucky that can be seen here indicates that among people who had previously had COVID-19 disease, those who did not get COVID-19 vaccine after their COVID-19 disease were more than twice as likely to get COVID-19 disease again compared to those who had been vaccinated after their original COVID-19 disease.

    Examination of data from another recent COVID-19 outbreak found that, among 28 people who had had COVID-19 disease before that outbreak, those who had remained unvaccinated afterwards had a 57% infection rate (4 of 7) in the current outbreak vs.a much lower 5% infection rate (1 of 20) among those people who had been fully vaccinated after their earlier COVID-19 disease. 

    Therefore, as variants of COVID-19 continue to appear and to spread more widely, COVID-19 vaccination becomes even more important for those previously infected with COVID-19. The recently identified variant SARS-CoV-2 viruses such as the Delta variant are both much more infectious and less likely to be prevented by antibodies against earlier forms of the virus. Fortunately, in terms of preventing severe forms of COVID-19, the available vaccines continue to work well against all variants that have been identified so far. 

    While there is no recommended minimum interval between infection and vaccination, current evidence suggests that the risk of reinfection is low in the first 2-3 months after initial infection but after that, reinfection risk may increase over time due to waning immunity.

    In summary, full COVID-19 vaccination is recommended for everyone who previously had a COVID-19 infection. In addition, booster doses of COVID-19 vaccine are now being recommended for many groups in the population. As long as the individual has no vaccine contra-indication, is not symptomatic or in an isolation period, they can and should get fully vaccinated and should get a vaccine booster dose when it is recommended for them. 

    For additional information, please see this CDC discussion of SARS-CoV-2 Infection-induced and Vaccine-induced Immunity.

    CDC recommends that people 2 years old and older who are not fully vaccinated wear a mask when they are in indoor public settings or when they are around people who don’t live in their household. Masks are federally required for all those 2 years and older when they are using public transportation or in terminals (airports, train or bus stations, etc) for public transportation. 

    On August 12, 2021, State Health Commissioner Dr. M. Norman Oliver reissued a Public Health Order requiring all students, teachers, staff, and visitors in Virginia’s K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. Although the Order does not apply to outdoor settings in those schools, VDH recommends (but does not require) those who are not fully vaccinated wear masks in any crowded outdoor settings or during outdoor activities that involve sustained close contact with other people. FAQs on the Commissioner’s Public Health Order can be found here

    In addition, please be aware that physical distancing is NOT a substitute for wearing a mask. Masks should still be worn in addition to staying at least 6 feet apart, especially when indoors in poorly ventilated places and around people who don’t live in your household.

    Finally, anyone who is unvaccinated or only partially vaccinated should complete their full vaccination series.

    The latest mask requirements and recommendations in Virginia can be found here.

    There have been some individual reports that people who have any of the collection of symptoms now known as Long COVID note an improvement of their symptoms after they receive COVID-19 vaccine. In addition, the risk of “Long COVID” after vaccine breakthrough infections is much lower than in unvaccinated people who get COVID-19.

    The potential benefit of vaccines on Long COVID is now being studied carefully and results will hopefully be available soon. 

    More information on Long COVID and other long-term effects of SARS-CoV-2 infection and COVID-19 illness can be found here.

    Finally, the risk of LONG COVID and the various other long-term effects of COVID-19 infection and disease are important reasons to get fully vaccinated against COVID-19. 

    At the top of all VDH web pages, there is a Google Translate button that says 'Select Language.' Clicking on this button translates web page content into 100+ different languages immediately. From there, you can go to the main page at: https://www.vdh.virginia.gov/covid-19-vaccine/ where you can learn more about COVID-19 vaccines.

    En la parte superior de todas las páginas web de VDH, hay un botón del Traductor de Google que dice 'Select Language.' (Seleccionar idioma). Al hacer clic en este botón, el contenido de la página web se traduce inmediatamente a más de 100 idiomas diferentes. Desde allí, puede ir a la página principal en: https://www.vdh.virginia.gov/covid-19-vaccine/ donde puede obtener más información sobre las vacunas contra COVID-19.

    El sitio web vdh.virginia.gov ofrece la opción "Traductor de Google" para ayudarlo a leer el sitio web de vdh.virginia.gov en otros idiomas además de inglés. Google Translate no puede traducir todos los tipos de documentos y es posible que no proporcione una traducción exacta.

    في الجزء العلوي من جميع صفحات موقع الويب الخاص بـ VDH، يوجد زر "تحديد اللغة" لترجمة جوجل "Google Translate"، يؤدي النقر على هذا الزر إلى ترجمة محتوى صفحة الويب على الفور إلى أكثر من 100 لغة مختلفة. من هناك، يمكنك الانتقال إلى الصفحة الرئيسية على: /https://www.vdh.virginia.gov/covid-19-vaccine حيث يمكنك معرفة المزيد عن لقاحات COVID-19.

    يقدم موقع vdh.virginia.gov خيار ترجمة جوجل أو "Google Translate" لمساعدتكم على تصفح موقع vdh.virginia.gov بلغات أخرى غير الإنجليزية. لا يمكن لـ Google Translate ترجمة جميع أنواع المستندات، وقد لا توفر ترجمة دقيقة.

    모든 VDH 웹 페이지의 상단에 '언어 선택(Select Language)'이라는 Google 번역 버튼이 있습니다.' 이 버튼을 클릭하면 즉시 웹 페이지 콘텐츠가 100가지 이상의 다른 언어로 변환됩니다. 거기에서 https://www.vdh.virginia.gov/covid-19-vaccine/의 메인 페이지로 이동합니다. 그곳에서 COVID-19 백신에 대해 자세히 확인하실 수 있습니다.

    vdh.virginia.gov 웹사이트가 제공하는 "구글 번역(Google Translate)" 옵션을 통해 vdh.virginia.gov 웹사이트를 영어 이외의 언어로 읽을 수 있는 도움을 받을 수 있습니다. 구글 번역(Google Translate)은 모든 유형의 문서를 번역 할 수 없으며 정확한 번역을 제공하지 않을 수 있습니다.

    Sa kabuuan ng lahat ng mga web page ng VDH, may Google Translate button na nagsasabing 'Piliin ang Wika.' Ang pag-click sa button na ito ay nagsasalin ng content ng web page sa 100+ na iba't ibang wika agad. Mula rito, maaari kang magpunta sa main page sa: https://www.vdh.virginia.gov/covid-19-vaccine/ kung saan matututunan mo ang tungkol sa mga bakuna ng COVID-19.

    Ang website ngvdh.virginia.gov ay ibinibigay ang “Google Translate” na opsyon para alalayan ka sa pagbabasa sa website ng vdh.virginia.gov sa iba pang wika maliban sa Ingles. Ang Google Translate ay hindi kayang isalin ang lahat ng uri ng mga dokumento, at maaaring hindi makapagbigay ng eksaktong pagsasalin.

    在任何 VDH 网页的顶部,都有一个 Google 翻译按钮,上面写着“选择语言”。点击此按钮即可将网页内容翻译成 100 多种不同的语言。您可以从翻译页面转到 COVID-19 疫苗主页:https://www.vdh.virginia.gov/covid-19-vaccine/,进一步了解有关 COVID-19 疫苗的更多信息。

    vdh.virginia.gov网站提供"谷歌翻译"选项,以帮助您阅读vdh.virginia.gov网站上非英语语言的内容。Google翻译无法翻译所有类型的文档,也可能无法提供准确的翻译。

    Vaccination: Vaccine Development + Safety

    One of the reasons that these COVID-19 coronavirus vaccines were produced and tested so quickly in 2020 is that vaccine research for two previous coronavirus diseases, SARS that emerged in China in 2002 and MERS that emerged in the Middle East in 2012, taught us a lot about developing safe and effective coronavirus vaccines. In addition, we also learned a lot about developing new mRNA vaccines from the recent research into new rabies and influenza vaccines. mRNA vaccines are an idea that is decades in the making. Information about the use of mRNA in the development of vaccines can be found here

    In addition, although the COVID-19 vaccines were developed faster than any other U.S. vaccines, that increased speed of development was also made possible by making new funding and other resources available, by creating new partnerships between government and private-sector organizations, and by reducing non-scientific bureaucratic obstacles. In fact, development of these new vaccines has followed the same effectiveness and safety review processes as other vaccines, including studying tens of thousands of participants of different ages, races and ethnicities for each vaccine. 

    For every vaccine used in the United States (including COVID-19 vaccine), trials start with Phases 1 and 2, when small groups of people are vaccinated and then monitored for immune response and for safety. Then, in Phase 3, tens of thousands of people are vaccinated to be sure the vaccine is both safe and effective for all types of people. 

    Development of vaccines for use in the United States is strictly controlled by the U.S. Food and Drug Administration (FDA). After the FDA authorizes or approves a vaccine, an independent immunization committee at the Centers for Disease Control and Prevention (CDC) decides whether to recommend it and for whom. In all stages of the process, the most important factor is safety. Vaccines must meet the highest standards of safety and have minimal side effects, because they are given to healthy people to prevent disease. The United States currently has the safest, most effective vaccines in its history. 

    The CDC and FDA monitor the safety of vaccines even after authorization and approval to be sure they are safe and effective in the long-term. These long-term studies to monitor the safety and effectiveness of vaccines as they are being widely used for the public are considered to be Phase 4 of vaccine research. These long-term studies, which include people at high risk for COVID-19, will help identify any common side effects or other safety concerns and will help clarify how long protection lasts after vaccination.

    VDH shares the goal of ensuring safe vaccines and has the safety of the Commonwealth and its citizens as its number one priority. VDH works closely with the CDC to review all vaccines to be sure its recommendations are based on sound science. 

    Finally, although the concern about rapid vaccine development may have been a reasonable concern in 2020 and in early 2021, we now have much more field experience with these vaccines. The U.S. COVID-19 vaccine program is by far the most carefully monitored vaccine program in this country’s history. As of November 17, more than 444 million doses of COVID-19 vaccine have now been given in the United States and have been successfully preventing SARS-CoV-2 infections, severe COVID-19 disease, and COVID-19 deaths in this country for almost a year. During that period, serious adverse effects of COVID-19 vaccine have been identified only rarely in the five different federal surveillance systems studying COVID-19 vaccine side effects. 

    Pfizer-BioNTech and Moderna, the developers of the first two COVID-19 vaccines to be used in this country, have now collected enough safety and effectiveness data to allow them to apply to FDA for full approval for their vaccines. Now,the Pfizer-BioNTech COVID-19 vaccine has been fully approved and licensed for individuals 16 years and up, and the FDA is in the process of considering the Moderna application.

    All initial Phase 3 vaccine trials had at least 30,000 participants each and included people from various races, ethnicities, age groups, and genders. Pfizer-BioNTech, Moderna, and Johnson & Johnson (also known as Janssen Biotech), the companies currently providing COVID-19 vaccines in the United States, report that at least 30% of their trial participants were Black, Hispanic, Asian or Native American.

    As of the end of November 2021, the health of all the vaccine recipients in the early studies has been carefully monitored for nearly a year.

    The supplementary studies of Pfizer-BioNTech vaccines in adolescents that led to the May 2021 recommendation to reduce the age eligibility for that vaccine to 12 years or older included over 2400 adolescents. The supplementary studies of Pfizer-BioNTech vaccines in younger children that led to the November 2021 recommendation to reduce the age eligibility for that vaccine to 5 years or older included over 3000 children from 5–11 years old.

    One way that the effectiveness of a vaccine (how well it works) is determined is through studies that compare the proportion (percentage) of vaccinated people who get COVID-19 infection with the proportion (percentage) of unvaccinated people (control group) who develop COVID-19 infection. A comparison of that kind calculates the vaccine effectiveness (VE) against infection. If significantly fewer people in the vaccine group become infected compared to the unvaccinated control group, the vaccine is determined to be effective in preventing infection.

    For COVID-19, a serious and sometimes fatal disease, most public health experts are now focusing on even more important outcome measures to decide if a COVID-19 vaccine is working effectively. For example, we should probably worry less about people having an asymptomatic or mild COVID-19 infection and should worry a lot more about how well a vaccine can keep vaccinated people from needing to be in a hospital or to keep them from dying. Fortunately, all three current vaccines, from Pfizer-BioNTech, Moderna, and Johnson & Johnson (also known as Janssen Biotech) have done really well in their large Phase 3 studies and in daily use since then in effectively preventing deaths among those receiving the vaccine. They have also done really well in the original studies and since then in keeping vaccinated people from needing to be in a hospital.

    For example, a study looking at vaccine effectiveness among U.S. veterans hospitalized at five Veterans Affairs Medical Centers, between February 1–August 6, 2021 (a time period with Delta variant circulation), was 87%. Vaccine effectiveness (VE) in preventing COVID-19–related hospitalization was 80% among adults aged ≥65 years compared with 95% among adults aged 18–64 years.

    Another report, titled Interim Estimates of COVID-19 Vaccine Effectiveness Against COVID-19–Associated Emergency Department or Urgent Care Clinic Encounters and Hospitalizations Among Adults During SARS-CoV-2 B.1.617.2 (Delta) Variant Predominance — Nine States, June–August 2021 showed that overall, VE against COVID-19 hospitalization was 86%. VE was lower among adults aged ≥75 years (76%) than among those aged 18–74 years (89%).

    Finally, Virginia has recently added a new dashboard, COVID-19 Cases in Virginia by Vaccination Status, on the VDH Data web page. Among the important information shown there is the fact that, as of mid November 2021, nearly all COVID-19 deaths in Virginia are now occurring in people who were not fully vaccinated.

    The COVID-19 vaccines from Pfizer-BioNTech and Moderna use mRNA to cause an immune response. mRNA stands for messenger ribonucleic acid. The vaccines’ mRNA teaches your cells to make a specific non-infectious COVID-19 protein that then stimulates your immune system to respond against COVID-19. That immune response produces antibodies that help keep you from becoming infected if the COVID-19 virus later enters your body.

    The mRNA in the COVID-19 vaccines does NOT get into the nucleus of your cells and it does not put germs into your body. The two COVID-19 vaccines that use mRNA will not change your DNA or your body’s other genetic material in any way. Finally, these mRNA COVID-19 vaccines do not inject spike proteins into your body.

    Viral vector vaccines use a modified version of a different virus - but not the SARS-CoV-2 virus that causes COVID-19 - as a way to insert in human cells a SARS-CoV-2 protein antigen called the spike protein. This spike protein antigen triggers production of antibodies against it and the resulting immune response then targets that spike protein. The specific virus used in this viral vector vaccine poses no threat of causing human infection or disease because it has been modified so it cannot reproduce.

    The Johnson & Johnson (also known as Janssen Biotech) vaccine uses a virus called an adenovirus in its viral vector COVID-19 vaccine. Adenoviruses are often used for viral vector vaccines because they can induce a strong immune response. The adenovirus genome has been well studied by scientists.

    Viral vector vaccines for COVID-19 are being held to the same rigorous safety and effectiveness standards as all other types of vaccines in the United States. The only COVID-19 vaccines the U.S. Food and Drug Administration (FDA) will make available for use in the United States (by emergency use authorization or full approval) are those that meet these standards.

    It is important to know that, as with the mRNA vaccines, the genetic material carried by viral vector vaccines is not DNA itself and does not become part of - or otherwise change -  a person’s DNA.

    An EUA is an “Emergency Use Authorization,” a process in the FDA that allows a vaccine company or drug company to apply for emergency use of a COVID-19 vaccine (or COVID-19 treatment drug or a COVID-19 test) with only a limited amount of effectiveness and safety data. This temporary limit means that the vaccine can become available for use in an emergency like the current COVID-19 pandemic more quickly than the usual approval and licensing process would allow. 

    However, before it allows an EUA, the FDA and its outside advisory group must decide that the known and possible benefits of the proposed vaccine outweigh the risks of authorizing (allowing) its use in that kind of emergency before it has been studied long term.

    EUAs are issued when the FDA agrees that the current disease situation is so dangerous that there is not time to fully complete the usual long-term studies. Even in an emergency, however, the short-term studies and trials must show that the vaccine is effective and as safe as possible. Updates or amendments to an EUA, as happened in May 2021 to allow use of the Pfizer-BioNTech vaccine for 1215 year olds and as happened again in October 2021 to allow use of that vaccine in 511 year olds, similarly require presentation of new data or other information to the FDA.

    The first COVID-19 vaccines in the United States were initially authorized as EUAs so they could be distributed quickly to as many people as possible. (While vaccines are being used under an EUA, the rest of the data needed for their eventual full approval is still being collected and monitored.)

    The vaccine companies will still need to obtain the regular biological license application (BLA) approval later to continue marketing the vaccines, but a BLA approval requires a more detailed evaluation. Both Pfizer-BioNTech and Moderna have applied to the FDA for full approval for their COVID-19 vaccines and full approval has now been granted by the FDA for use of the Pfizer-BioNTech vaccine in people at least 16 years old. Full approval for the Moderna vaccine for those at least 18 years old is pending. 

    Information describing a COVID-19 vaccine’s path from initial research to an EUA - and eventually to a BLA - can be found on the FDA’s website here.

    FDA full approval for a vaccine requires the agency’s standard and rigorous process for reviewing medical products, including vaccines, drugs and medical devices. The FDA’s review process for a vaccine relies upon the submission of a Biologics License Application (BLA) by the manufacturer. A BLA is a comprehensive submission that is submitted to the agency and that must meet very specific requirements

    For the COVID-19 vaccines, a BLA builds on the early data and information that previously supported the EUA, such as preclinical and clinical data and information, as well as details of the manufacturing process and inspections at the sites at which the vaccine is made. However, to ensure the safety of vaccines, the BLA generally requires a far longer period of time for observing and examining both the effectiveness and side effects of the vaccine. The FDA’s review of a BLA is among the most comprehensive medical product reviews in the world. It involves FDA conducting its own analyses of the information in the BLA to make sure the vaccines are safe and effective and meet their standards for approval. FDA will also again inspect the facilities that are involved in the manufacturing of the product.

    FDA has stated that they recognize that full approval of a COVID-19 vaccine may encourage more people to get the vaccine. The agency has prioritized review of the COVID-19 vaccines, however they are also committed to following the rigorous processes. In August 2021, the FDA fully approved the Pfizer- BioNTech vaccine which is being marketed as Comirnaty, for use in those at least 16 years old. At this time, Moderna has also submitted an application for full approval of its COVID-19 vaccine for those at least 18 years old, and the FDA is currently reviewing that data.

    The Pfizer-BioNTech COVID-19 vaccine will now be marketed as Comirnaty, following FDA approval. Comirnaty is identical to the Pfizer-BioNTech vaccine that was first authorized for emergency use by the FDA in December 2020.

    In August 2021, the U.S. Food and Drug Administration (FDA) granted full approval to Comirnaty (previously known as the Pfizer-BioNTech COVID-19 vaccine) for people aged 16 years and older. This was the first of three federal review steps. The next step was for the CDC Advisory Committee on Immunization Practices (ACIP) to discuss its updated recommendation for this vaccine. The final step, the CDC Director’s review and final approval of the ACIP recommendations, also occurred on that same day. The full recommendations were published soon after that as official CDC/HHS recommendations in the Morbidity and Mortality Weekly Report (MMWR). The vaccine also continues to be available under emergency use authorization (EUA) for individuals 515 years of age, for the administration of a primary dose in certain immunocompromised individuals, and for booster doses in certain categories of fully vaccinated people.

    Full approval means the vaccine can also be used in non-emergency settings.

    The current Pfizer-BioNTech vaccine (recently approved by the FDA to be marketed as Comirnaty was found to be 91% effective at preventing COVID-19 disease over a six month period. 

    The most commonly reported side effects were pain, redness and swelling at the injection site, fatigue, headache, muscle or joint pain, chills, and fever. 

    FDA conducted rigorous post-authorization safety surveillance regarding cases of myocarditis and pericarditis. Available short term data suggest that most individuals fully recovered, however some patients did require intensive care support. The risk was found to be highest in males 12 through 29 years of age. The myocarditis risk among vaccine recipients was also found to be much lower than the risk of myocarditis during and after actual COVID-19 disease.

    Pfizer’s application for FDA full approval was for use in individuals age 16 years and older. The FDA had previously issued the EUA for the Pfizer COVID-19 vaccine in December 2020, at which time this vaccine was authorized for emergency use in individuals age 16 years and older. Several months later, in May 2021, and based on extensive effectiveness and safety data from clinical trials of adolescents, the EUA was expanded to include those 12 through 15 years old. Finally, the EUA was further expanded in October 2021 to include children at least five years old. 

    Pfizer plans to request full approval for these younger age groups once it has collected and analyzed four to six months of safety data from these groups of clinical trial participants. The EUA remains in place for individuals aged 5 through 15 years old, and the CDC continues to recommend that all adults, adolescents, and children age 5 years  and older become fully vaccinated with a COVID-19 vaccine.

    All three available COVID-19 vaccines are safe and effective. Please speak with your healthcare provider if you have questions about which vaccine may be best for you. 

    The Pfizer COVID-19 vaccine was the first vaccine to receive emergency authorization, which is why it was the first to have enough data to receive full approval from the FDA. The Moderna and Johnson & Johnson vaccines will continue to be safely administered through emergency use authorization as the FDA reviews data about their real-world use. It is likely that both of those other vaccines will be fully approved soon after their six month safety data are analysed and submitted 

    As of October 13, 2021, Moderna has also submitted an application for full approval of its COVID-19 vaccine, and the FDA is currently reviewing that data.

    No, you cannot.

    First, since there is no live virus in any of the current COVID-19 vaccines, you cannot get a COVID-19 infection from the vaccination itself. 

    However, in some situations, you could still get new COVID-19 symptoms soon after getting the vaccine.

    Because of the highly infectious Delta variant and because there are still so many COVID-19-infected people in our communities, it is possible that a few COVID-19 vaccine recipients might have already been exposed to and infected with COVID-19 just before they got a first dose of vaccine even if they were not yet showing any COVID-19 symptoms. If those pre-exposed people later get symptoms of COVID-19 infection or test positive for it soon after vaccination, that does NOT mean that their COVID-19 came from the vaccine. Rather, that means that they got COVID-19 from their exposure to one or more infected people before they themselves were fully vaccinated and not from the vaccine.

    Yes.

    If you have an underlying medical condition such as diabetes, asthma or obesity, you may be at higher risk for severe COVID-19 disease so your need for the vaccine is even greater. You are strongly encouraged to get fully vaccinated to protect yourself and any unvaccinated family members and other contacts from serious COVID-19 illness. 

    Several groups of people have special COVID-19 vaccine concerns:

    • People with weakened immune systems are at greater risk for severe COVID-19 disease. Categories of patients with weakened immune systems include patients with conditions such as HIV/AIDS, leukemia or other cancers, bone marrow or organ transplant, genetic immune deficiencies, or patients taking steroids or other medicines designed to suppress the immune system. Such patients can receive COVID-19 vaccine if they have no other contraindications but they should be made aware by their vaccinator that because their immune system may be weaker than normal, they may have a weaker immune response to the vaccine and may thus still be less protected against COVID-19 infection. People with such conditions should discuss COVID-19 disease and COVID-19 vaccine with their doctor. 

    Even after vaccination, such patients should pay extra attention to the continuing need for all of the other COVID-19 prevention measures such as mask-wearing, avoidance of crowds and poorly ventilated spaces, physical distancing and handwashing. 

    As an additional way of minimizing their chances of exposure to COVID-19, people with weakened immune systems should also encourage their household members, friends, caregivers, and other close contacts to become fully vaccinated. 

    • People with some autoimmune diseases are also able to be vaccinated but also need to be aware of the limited vaccine safety data for people in their category.
    • People who have a history of myocarditis or pericarditis unrelated to mRNA COVID-19 vaccination may receive any FDA-authorized COVID-19 vaccine after the episode of myocarditis or pericarditis has completely resolved. It is unclear if people who developed myocarditis or pericarditis after a dose of an mRNA COVID-19 vaccine may be at increased risk of further adverse cardiac effects following a subsequent dose of the vaccine. Until additional safety data are available, experts recommend that people who developed myocarditis or pericarditis after a first dose of an mRNA COVID-19 vaccine defer receiving their second dose.
    • People with a history of Guillain-Barre Syndrome (GBS) should receive any FDA-authorized COVID-19 vaccine. However, given the possible association between the Janssen (Johnson and Johnson) COVID-19 vaccine and an increased risk of GBS, a patient with a history of GBS and their clinical team should discuss the availability and possible use of one of the mRNA COVID-19 vaccines to offer protection against COVID-19.
    • People with a history of having previously had Bell’s palsy should receive COVID-19 vaccine but need to be closely monitored for the re-development of this neurologic condition.
    • Some people who have used dermal filler may develop swelling at or near the filler injection site soon after receiving an mRNA COVID-19 vaccine. Such people should contact their health care provider if they experience post-vaccination swelling at a dermal filler injection site.

    People with a history of any of these conditions or situations should discuss COVID-19 vaccination with their healthcare provider. 

    Additional information on COVID-19 vaccination for people with these conditions can be found on the CDC website here.  

    People who have had recent COVID-19 disease should not get COVID-19 vaccine until they have recovered from their illness and are out of their isolation period.

    Children under the age of 5 years (for the Pfizer-BioNTech vaccine) or under the age of  18 years (for the Moderna and Janssen /Johnson & Johnson vaccines), should not receive the current vaccines as the data from studies in children below these ages are still being collected or in some cases, are still being analyzed by FDA.  

    People who had COVID-19 disease earlier and who were treated with convalescent plasma or monoclonal antibody should only get the COVID-19 vaccine after at least 90 days have passed since their last plasma or antibody treatment.  

    People who have ever had an anaphylactic reaction (anaphylaxis) to an injection or medication, you should discuss COVID-19 vaccination with your healthcare provider. 

    People who have ever had a severe allergic reaction to any of the ingredients in a COVID-19 vaccine should not get that specific vaccine. In that case, your healthcare provider may want to refer you to a specialist in allergies and immunology to provide more specific care or advice.

    People who have ever had an immediate allergic reaction to polyethylene glycol (PEG)  should not get an mRNA COVID-19 vaccine. Polyethylene glycol (PEG) is an ingredient in both mRNA COVID-19 vaccines. You should discuss this with your healthcare provider, as you still may be able to get the Johnson & Johnson vaccine.  

    People who have ever had an immediate allergic reaction to polysorbate should not get the Johnson & Johnson (Janssen) COVID-19 vaccine. Polysorbate 80 is an ingredient in the Johnson & Johnson vaccine. You should discuss this with your healthcare provider, as you still may be able to get one of the mRNA COVID-19 vaccines. (NOTE: PEG and polysorbate 80 are structurally related, and cross-reactive hypersensitivity between these compounds may occur.) 

    People who have ever had a severe allergic reaction in the past to other vaccines or injectable medications should ask their doctor or other healthcare provider about getting a COVID-19 vaccine. That person will help you decide if it is safe for you to get vaccinated.  

    If you have ANY concerns about getting a COVID-19 vaccine, talk to your doctor or other healthcare provider.

    If you have an underlying medical condition such as diabetes, asthma or obesity, you may be at higher risk for severe COVID-19 disease so your need for the vaccine is even greater. You are strongly encouraged to get vaccinated to protect yourself and any unvaccinated contacts from serious COVID-19 illness. 

    Several groups of people have special COVID-19 vaccine concerns:

    • People with weakened immune systems are at greater risk for severe COVID-19 disease. Categories of patients with weakened immune systems include patients with conditions such as HIV/AIDS, leukemia or other cancers, bone marrow or organ transplant, genetic immune deficiencies, or patients taking steroids or other medicines designed to suppress the immune system. Such patients can receive COVID-19 vaccine if they have no other contraindications but they should be made aware by their vaccinator that there is only limited safety data available and that, because their immune system may be weaker than normal, they may have a weaker immune response to the vaccine and may thus be less protected against COVID-19 infection. People with such conditions should discuss COVID-19 vaccine with their doctor.
      • Even after vaccination, such patients should pay extra attention to the continuing need for all of the other COVID-19 prevention measures such as mask-wearing, avoidance of crowds and poorly ventilated spaces, physical distancing and handwashing.
      • As an additional way of minimizing their chances of exposure to COVID-19, people with weakened immune systems should also encourage their household members, caregivers, and other close contacts to become fully vaccinated.
    • People with some autoimmune diseases are also able to be vaccinated but also need to be aware of the limited safety data for people in their category.
    • People who have a history of myocarditis or pericarditis unrelated to mRNA COVID-19 vaccination may receive any FDA-authorized COVID-19 vaccine after the episode of myocarditis or pericarditis has completely resolved. It is unclear if people who developed myocarditis or pericarditis after a first dose of an mRNA COVID-19 vaccine may be at increased risk of further adverse cardiac effects following a second dose of the vaccine. Until additional safety data are available, experts recommend that people who develop myocarditis or pericarditis after a first dose of an mRNA COVID-19 vaccine defer receiving the second dose.
    • People with a history of having previously had Bell’s palsy can receive COVID-19 vaccine but need to be closely monitored for the re-development of this conditions.
    • Some people who have used dermal filler may develop swelling at or near the site of filler injection after receiving an mRNA COVID-19 vaccine. Such people should contact their health care provider if they experience post-vaccination swelling at a dermal filler injection site.  

    People with a history of any of these conditions or situations should discuss COVID-19 vaccination with their healthcare provider. 

    Additional information on COVID-19 vaccination for people with these conditions can be found on the CDC website here. 

    Information on the Pfizer-BioNTech COVID-19 Vaccine can be found here.

    A complete list of this vaccine’s ingredients can be found here. (Last updated October 29, 2021) 

    Type of vaccine: mRNA

    Number of injections (shots): 2 injections, 21 days apart

    How given: injections in the muscle of the upper arm

    This vaccine does not contain: eggs, preservatives, gelatin, or latex

    The Pfizer-BioNTech vaccine is recommended for people aged five (5) years and older.

    Information on the Moderna COVID-19 Vaccine can be found here.

    A complete list of this vaccine’s ingredients can be found here. (Last updated October 20, 2021)

    Type of vaccine: mRNA

    Number of injections (shots): 2 injections, 28 days apart

    How given: Injection in the muscle of the upper arm

    This vaccine does not contain: eggs, preservatives, gelatin, or latex

    The Moderna COVID-19 vaccine is recommended for people aged 18 years and older.

    Information on the Janssen COVID-19 Vaccine can be found here. (Last updated October 20, 2021) 

    A complete list of this vaccine’s ingredients can be found in the fact sheet here. 

    Type of vaccine: adenoviral vector for spike protein

    Number of injections (shots): 1 injection

    How given: Injection in the muscle of the upper arm

    This vaccine does not contain: eggs, preservatives, gelatin, or latex

    The Johnson & Johnson (also known as Janssen Biotech) COVID-19 vaccine is recommended for people aged 18 years and older.

    At least two additional COVID-19 vaccines, one manufactured by Astra-Zeneca and one by Novavax, could possibly become available in the United States in the near future. Some informal data provided by these companies suggests that these vaccines would also be effective against the more severe aspects of COVID-19 disease.

    However, since neither company has yet applied for the required Emergency Use Authorization (EUA) from the FDA and since their data have not formally been presented to or reviewed by the relevant FDA advisory committee, the timing of their respective availability still remains uncertain.

    The Pfizer-BioNTech vaccine is currently available and FDA authorized for those ages 5 years and up. 

    For younger children, clinical studies by Pfizer-BioNTech and Moderna have been going on now in an age-de-escalated manner. (511 year olds, then 24 year olds, and finally, children less than 2 years old.) 

    Pfizer- BioNTech submitted data for vaccine response in younger children to the FDA in late September 2021. An FDA committee has recommended the vaccine for 511 year olds and CDC’s Director has now agreed with the recommendations of the CDC Advisory Committee on Immunization Practices (ACIP) that the Pfizer-BioNTech COVID-19 vaccine should be given to all children five years and older.  

    Moderna submitted their pediatric vaccine efficacy and safety data to the FDA at the end of October. 

    The dose of the Pfizer-BioNTech vaccine for 511 year olds is 10 mcg, which is ⅓ of the adult dose. The dose of vaccine for those 6 months - 4 years old is expected to be 3 mcg, which is 1/10 of the adult dose.

    Having these Pfizer-BioNTech data available for 6 month - 4 year old children is just the first step.  COVID-19 vaccine use in these younger children will then need to be authorized by the FDA, then recommended for use by CDC’s Advisory Committee on Immunization Practices (ACIP), and finally, approved by the CDC Director, to become available to the public for use. If FDA deems this is an emergency situation for children, they could issue an EUA very soon after the data have been considered by the FDA advisory group. In June 2021, Moderna submitted data for expansion of their vaccine EUA, to include 12 to 17 year olds. FDA and ACIP review of these new data still needs to be completed. 

    Please see the recent statement titled “FDA Will Follow The Science On COVID-19 Vaccines For Young Children”.

    Yes.

    Currently and recently pregnant people are more likely than non-pregnant people to get severely ill if they get  COVID-19.  Pregnant women with some underlying health conditions, such as diabetes or obesity, are at even greater risk, as is true in the non-pregnant population. In addition, having COVID-19 disease while pregnant has been associated with stillbirths, preterm birth, and other adverse outcomes of pregnancy.

    Preventing these extra COVID-19 risks in pregnant women is an important public health goal. Getting COVID-19 vaccine during pregnancy can protect you and your fetus from severe illness from COVID-19.

    The Centers for Disease Control and Prevention (CDC), the Virginia Department of Health (VDH), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal Fetal Medicine (SMFM) all recommend that COVID-19 vaccines should be given to pregnant or breast-feeding women or other women who intend to get pregnant and who otherwise are eligible for COVID-19 vaccination based on recommendations from the CDC and its Advisory Committee on Immunization Practices (ACIP). In addition, CDC and ACOG agree in strongly recommending booster doses of COVID-19 vaccine for anyone who received a two dose series of either the Pfizer-BioNTech vaccine or the Moderna vaccine at least six months before and for anyone who received the Johnson and Johnson (Janssen) vaccine at least two months earlier. The most recently updated ACOG recommendations can be found here and a joint message about COVID-19 vaccination from ACOG and SMFM can be found here.

    At least four studies here, here, here, and here show that COVID-19 mRNA vaccines are safe and effective in pregnancy, with the potential to benefit both mother and baby.

    CDC and the Food and Drug Administration (FDA) have several safety monitoring systems in place to collect and study information about vaccination during pregnancy and continue to closely monitor that information. 

    Results from CDC’s v-safe voluntary after-vaccination health check system, with public data that is updated weekly, show that a large number of women who received COVID-19 vaccines have reported pregnancies, with no specific safety issues identified. 

    In addition, CDC established a specific v-safe COVID-19 Vaccine Pregnancy Registry to learn more about these issues and initial data from this registry show similar vaccine side effects for pregnant and non-pregnant individuals. The most up to date numbers are available here. Based on birth outcomes of the first 275 completed pregnancies, rates of complications are not significantly different from those of unvaccinated pregnant women.

    To emphasize the risk of COVID-19 illness in pregnancy and the need for COVID-19 vaccine, a recent report described 15 COVID-19-associated deaths of pregnant women in a single state over a 19 month period ending in early October 2021. All 15 women were unvaccinated.

    Pregnant women who are considering a COVID-19 vaccination can discuss the potential risk and benefits of COVID-19 vaccines with their doctor or nurse-midwife.

    More detailed and more technical descriptions and analyses of all pregnancy-related COVID-19 data reported to CDC up to February 28, 2021 can be found here and here.

    Yes.

    Pregnant and recently pregnant people (including at least 42 days following end of pregnancy) are considered in the same group as other people with underlying medical conditions

    Therefore, pregnant individuals should receive a booster shot of either mRNA vaccine (from Pfizer-BioNTech or Moderna) at least 6 months after completing their Pfizer-BioNTech or Moderna primary vaccine series or at least two months after their single Janssen (Johnson and Johnson) vaccine dose, based on their individual risk and benefit. Learn more.

    Yes.  

    The American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics, and the CDC agree that breastfeeding (lactating) women should be offered COVID-19 vaccine(s) if they otherwise meet the criteria for receiving that vaccine. Although breastfeeding women were not studied in the Phase 3 COVID-19 vaccine research to date, the current three COVID-19 vaccines used in the United States do not contain any virus that replicates/reproduces inside host cells and they are therefore not thought to pose any risk to the breast-fed infants of vaccinated mothers.

    As recently highlighted by CDC, women fully vaccinated with COVID-19 vaccine do not need to take special COVID-19 precautions when they are breastfeeding or expressing milk.

    And in fact several recent studies show that protective COVID-19 antibodies can be passed from a mother to her infant through breast milk, suggesting that breast-fed infants of vaccinated mothers may gain some temporary protection against COVID-19 as well.  

    In addition, a July 2021 study of milk samples from recently vaccinated breastfeeding mothers found no trace of vaccine mRNA in any of the 13 milk samples.

    The most recent CDC information on COVID-19 and breastfeeding, including receiving COVID-19 vaccine while breastfeeding and access to lactation services, is available here and here.    

    Not yet.

    Although animal vaccines against COVID-19 are being studied, a COVID-19 vaccine for pets is not available now. A small number of pets worldwide, including cats and dogs, have been infected with SARS-CoV-2, mostly after close contact with people who had COVID-19. Some pets did not show any signs of illness, and most of those pets that did get sick all had mild disease that could be taken care of at home. 

    Although people can give COVID-19 to household pets and other animals, there is no evidence that animals play a major role in spreading COVID-19 to people. For these reasons, there is no COVID-19 vaccine for pets. If your pet is sick or you think your pet might have the virus, call your veterinarian to discuss your pet’s health. 

    Vaccines must meet the highest standards of safety and have minimal side effects because they generally are given to healthy people to prevent disease. Vaccines are strictly regulated by the FDA. The CDC and FDA are committed to assuring the safety of vaccines through detailed studies both before and after they are licensed. The United States currently has the safest, most effective vaccines in its history. 

    And in fact all people now getting COVID-19 vaccines will continue to be monitored for long-term side effects and to be sure the vaccine continues to be effective in the coming months and years.

    The Virginia Department of Health (VDH) shares the CDC and FDA goal of ensuring safe vaccines. VDH has the safety of the Commonwealth and its citizens as its number one priority. VDH works closely with CDC to conduct active surveillance and review of vaccines to ensure the recommendations the agency follows are of sound science. 

    CDC and FDA continuously monitor the safety of vaccines after they are put into use. 

    If CDC and FDA identify a problem with a vaccine, the agencies inform health officials, health care providers, and the public. These agencies use at least five different systems to monitor vaccine safety:

    • The Vaccine Adverse Event Reporting System (VAERS): an early warning system that helps CDC and FDA monitor problems following vaccination.  Anyone can and should report possible vaccine side effects to VAERS. However, most of the VAERS monitoring is done by U.S. healthcare providers providing anonymous data from millions of patients being vaccinated. This system, which is already used to monitor all other current U.S. vaccines, alerts the CDC and FDA if healthcare systems begin reporting unusual patterns of adverse effect information about complications that should not have been occurring after vaccines.

    NOTE: VAERS is set up as a system to collect as much data as possible about events that may or may not turn out to be side effects of vaccines. That data is then examined closely to verify the events and to then identify any clusters or groups of unexpected post-vaccine events. Because the data submitted to - and made publicly available by - VAERS has not yet been verified, the VAERS system clearly cannot determine whether a vaccine caused any specific side effect. Therefore, drawing conclusions from publicly available but unverified VAERS data alone without the follow-up investigations is scientifically inappropriate because it is likely to lead to erroneous conclusions. An excellent but slightly technical description of how VAERS works can be found here. VDH participates in VAERS.

    • The Vaccine Safety Datalink (VSD): a collaboration between CDC and nine health care organizations around the United States, which allows ongoing monitoring and proactive searches of vaccine-related data.
    • The Clinical Immunization Safety Assessment (CISA) Project: a partnership between CDC and several medical centers that conducts clinical research on vaccine-associated health risks.
    • V-safe is a new cell phone-based CDC system that individual COVID-19 vaccine recipients can use to notify CDC if they develop any side effects. Each vaccinated person can and should download a v-safe app onto their cell phone as soon as they receive the vaccine.  Instructions on how to download and use v-safe will be given out when you get the vaccine. As an extra benefit, v-safe will remind you about getting your second vaccine dose.  

    Additional vaccine safety monitoring systems, such as the use of National Healthcare Safety Network (NHSN) data, and continued monitoring through clinical trials will also be utilized to ensure the safety of COVID-19 vaccines. Finally, every healthcare provider who is administering COVID-19 vaccines is required to report all serious health events occurring soon after vaccination to the VAERS system.

    NOTE: Since all these different systems are being used to identify, study, and respond to adverse effects of COVID-19 vaccination, COVID-19 vaccines are the most closely monitored vaccines ever used in the United States.

    FDA REQUIRES all vaccine providers to report EVERY death that occurs after a COVID-19 vaccination to the VAERS reporting system. These death reports are REQUIRED even if it seems clear that the death was not related to the vaccine. The details of every death are investigated by CDC and FDA physicians as soon as these are reported.

    Given the absolute requirement to report EVERY death in a vaccine recipient, regardless of its apparent cause, reports of deaths and other adverse events to VAERS following vaccination do not automatically mean that a vaccine caused these problems. In fact, drawing any conclusions from the numbers of reported but unverified deaths in the VAERS system is scientifically inappropriate.

    COVID-19 vaccines are being given to hundreds of millions of people in the United States. Many of these vaccine recipients have pre-existing illnesses or are elderly and in frail condition and are thus already at higher risk of death regardless of receiving or not receiving a COVID-19 vaccine. Therefore, a very small percentage of people receiving COVID-19 vaccine are likely to die from natural causes soon after being vaccinated. As discussed here, “VAERS data must be interpreted with caution due to the inherent limitations of passive surveillance. VAERS is primarily a safety signal detection and hypothesis generating system. Generally, VAERS data cannot be used to determine if a vaccine caused an adverse event. VAERS data interpreted alone or out of context will lead to erroneous conclusions about cause and effect as well as the risk of adverse events occurring following vaccination.” More than 430 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through November 1, 2021. During that time, VAERS received 9367 (0.0022%) reports of death among people who had “recently” received a COVID-19 vaccine. 

    Every death that occurs after COVID-19 vaccination is investigated. An ongoing review of available clinical information, including death certificates, autopsy, and medical records, has not established any causal link between any of these deaths and COVID-19 vaccines. The single exception is that recent reports indicate a plausible causal relationship between the J&J/Janssen COVID-19 Vaccine and TTS, a rare and serious adverse event—blood clots with low platelets—which has caused deaths. Get the latest safety information on the J&J/Janssen vaccine here. 

    Additional information on investigation of deaths reported after COVID-19 vaccination can be found here.  

    No. The three current COVID-19 vaccines do NOT contain any fetal tissue. 

    Neither Moderna nor Pfizer-BioNTech used any fetal tissue in the research, development, or production of their vaccines; however, after the successful research and development of these two vaccines, both companies used a widely-used fetal cell line (HEK-293) in the process of confirming that their vaccines worked. Fetal tissue was used in the research and development of the Johnson & Johnson (Janssen) vaccine but it is NOT contained in the vaccine itself.

    NOTE: Fetal tissue is often used late in the development of many vaccines and drugs. In fact, fetal tissue was used in the development of drugs such as Regeneron, ibuprofen (e.g., Advil), remdesivir, hydroxychloroquine, and ivermectin.  A thoughtful discussion of this issue is available here.

    To more directly address this issue, the Vatican developed and released a document called “Note on the morality of using some anti-Covid-19 vaccines.” This document, which discusses concerns about fetal tissue use in the development of COVID-19 vaccines, was developed at the request of Pope Francis, was approved by him (as noted in its text), and was published in December 2020.

    No.

    The Pfizer-BioNTech, Moderna, and Johnson & Johnson (Janssen) COVID-19 vaccines do not contain any human or animal products (including pork products), preservatives, or adjuvants. For the complete list of ingredients in each vaccine, see Pfizer-BioNTech, Moderna, and Johnson & Johnson (Janssen).

    An individual is considered a vaccine breakthrough COVID-19 case, if they initially test positive for SARS-COV-2 at least 14 days after completing a well-documented COVID-19 vaccine series (that, depending on the vaccine brand, may be 2 doses or just 1 dose.)

    • Vaccine breakthrough cases are expected especially before population immunity reaches sufficient levels to further decrease transmission. In addition, breakthrough cases may be expected if and when vaccine-induced immunity wanes over time. COVID-19 vaccines are effective and are a critical tool to bring the pandemic under control. However, no vaccines are 100% effective at preventing illness in vaccinated people. There will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from COVID-19. More specifically, even if a vaccine is 95% effective, we would still expect 5% of fully vaccinated individuals to become infected despite receiving the shots. 
    • More than 196 million people in the United States have been fully vaccinated as of November 20, 2021. Like with other vaccines that are not 100% effective, vaccine breakthrough cases will occur, even though the vaccines are working as expected. Asymptomatic infections among vaccinated people will also occur.
    • There is some evidence that vaccination may make illness less severe for those who are vaccinated and still get sick; and also reduce the risk of further transmission. A few links to such studies are here, here, and here

    Current data suggest that COVID-19 vaccines authorized for use in the United States offer protection against the Delta variant as well as against the other SARS-CoV-2 variants currently circulating in very small numbers in the United States. However, variant viruses will also cause some vaccine breakthrough cases.

    Virginia added an important new dashboard, COVID-19 Cases by Vaccination Status, on the VDH Data web page.

    Between 1/17/21 and 11/13/21, unvaccinated people in Virginia developed COVID-19 at a rate 4.7 times that of fully vaccinated people. 

    Between 1/17/21 and 11/13/21, unvaccinated people in Virginia were hospitalized for COVID-19 at a rate 4.4 times that of fully vaccinated people. 

    Between 1/17/21 and 11/13/21, unvaccinated people in Virginia died of COVID-19 at a rate 4.4 times that of fully vaccinated people.

    Vaccination: Side Effects and Adverse Events After COVID-19 Vaccine

    Short term vaccine side effects fall into one of three categories: 

    1) Local reactions, at or near the injection site

    (2) Systemic reactions (such as fever, chills, headache, or muscle aches)

    (3) Allergic reactions 

    This discussion addresses the local and systemic side effects. (Allergic side effects are addressed in a later question and response.) Although COVID-19 vaccination will help protect you from getting COVID-19 disease, you may have some short term local or systemic side effects from the vaccination, which are normal (and expected) signs that your body is building protection against COVID-19. 

    While we do not yet know all of the possible vaccine side effects, some vaccinated people have had local reactions such as pain or redness or tenderness at the injection site.  In terms of systemic side effects, a small number of vaccine recipients have had transient symptoms such as fatigue, nausea, chills, fever, headache or other body aches for a few days. These local or systemic side effects do NOT mean that the vaccine has given you a COVID-19 infection. Rather, these expected side effects mean that the vaccine is causing your body’s immune system to react and create antibodies to fight off the virus that causes COVID-19 if you are exposed in the future.

    A small number of vaccine recipients have experienced swollen lymph nodes. For the two mRNA vaccines, these expected side effects are more common in younger people than older people and with the two-dose vaccine series, they are more common after the 2nd dose than after the first dose. 

    Less commonly, some people have reported redness, swelling, and itching around the injection site beginning a few days or in the second week after their first vaccine dose. Although these reactions get better within a few days, some of them have been quite large. However, these local reactions, which are now called “COVID arm” are not considered to be allergic reactions and are not felt to represent a risk for anaphylaxis upon receipt of the second dose. In fact, a few of those people who experienced this reaction have had a similar reaction after their second dose. Thus, individuals with such delayed injection site reactions after the first mRNA COVID-19 vaccine dose should receive the second dose using the same vaccine product as the first dose and at the recommended interval, and preferably in the opposite arm. More information about these uncommon “COVID arm” reactions can be found here.

    As happens occasionally with other vaccines such as influenza vaccine, fainting soon after injection has also been noted among a small number of COVID-19 vaccine recipients, especially among adolescents and other young adults. This kind of short term reaction after the first injection of a two-dose COVID-19 vaccine series is also not a reason to avoid the second dose.

    For those older children (12 years and older) currently authorized to receive COVID-19 vaccines, the side effects seen after vaccination in the recent research studies were similar to those seen in older adolescents and young adults. For children 5 11 years of age, side effects seen after vaccination were similar or less than those seen in older adolescents and young adults.

    Finally, even if you or your child experience discomfort after the first dose of mRNA COVID-19 vaccine, it is very important that you still receive the second dose a few weeks later for the vaccine to be effective.

    Some of the expected side effects could interfere with your - or your child’s - ability to do daily activities, but they should go away in a few days.

    Medicines such as acetaminophen, ibuprofen, or naproxen or other medicines called “non-steroidal anti-inflammatory drugs” (NSAIDS) can help with the common side effects (for example, arm pain or fever) after those side effects start to occur. However, these drugs should not be taken before your COVID-19 vaccine doses since information on their possible impact on the body's ability to create immunity to COVID-19 infection is not yet available. 

    If you or your child have persistent injection site pain, short term fever, or other discomfort, talk to your healthcare provider about taking one of these over-the-counter medicines.

    To reduce pain and discomfort where you or your child got the shot: 

    • Apply a clean, cool, wet washcloth over the area
    • Use or exercise your arm.

    To reduce discomfort from fever:

    • Drink plenty of fluids.
    • Dress lightly.

    When to call the doctor:

    In most cases, discomfort from arm pain or swelling where you or your child got the shot or from fever, headache, fatigue, etc., will not last more than a few days after a COVID-19 vaccine dose. Contact your doctor or healthcare provider:

    • If the redness or tenderness where you got the shot increases after 24 hours
    • If your side effects are worrying you or do not seem to be going away after a few days

    Remember to sign yourself and your vaccinated child up for v-safe, where you can use your smartphone to tell CDC about any side effects after getting the COVID-19 vaccine. You’ll also get reminders from V-Safe about your second vaccine dose.

    Side effects or adverse events can be reported either in v-safe or VAERS

    Healthcare personnel, experiencing certain symptoms may need to remain out of work, as outlined here. 

    Residents of long term care facilities who experience certain symptoms may need to take additional precautions or measures as outlined here.  

    COVID-19 vaccines are important tools to save lives and to get this pandemic under control and all three currently authorized vaccines are safe and effective.

    Information on possible adverse events continues to be collected and studied by CDC, FDA, and other groups, using multiple systems to collect the data.

    One serious adverse effect that has been identified is a rare blood clotting problem  thrombosis with thrombocytopenia syndrome (TTS) that has occurred in a very small number of people vaccinated with the Johnson & Johnson (Janssen) vaccine. When that problem was first noted in early April 2021, use of that vaccine was stopped for almost two weeks while it was further studied. After deciding that the vaccine’s known and potential benefits outweighed its known and potential risks, the FDA and CDC recommended resuming its use in the United States. As of October 13, 2021, more than 15 million doses of the J&J/Janssen COVID-19 Vaccine have been given in the United States. CDC and FDA identified 47 confirmed reports of people who got the J&J/Janssen COVID-19 Vaccine and later developed TTS. For women 50 years and older and for men of all ages, this adverse event is even more rare. Women younger than 50 years old should be made aware of the rare but increased risk of TTS.

    To date, only two confirmed cases of TTS in people who received an mRNA COVID-19 vaccination (Moderna) have been reported to VAERS. Based on available data, this number is not greater than the background rate of this problem and there is not an increased risk for TTS after mRNA COVID-19 vaccination.  For additional information on this topic, see here.  

    As of October 27, 2021, VAERS has received about 1800 reports of myocarditis or pericarditis among people ages 30 and younger who received COVID-19 vaccine. CDC has confirmed about 1000 of these cases so far. Most patients responded well to rest and quickly recovered. The relationship of these rare events to COVID-19 vaccine is still being investigated. More information on this topic can be found here

    CDC and FDA are monitoring reports of Guillain-Barré Syndrome (GBS) in people who have received the J&J/Janssen COVID-19 Vaccine. GBS is a rare disorder where the body’s immune system damages nerve cells, causing muscle weakness and sometimes paralysis. Most people fully recover from GBS, but some have permanent nerve damage. After more than 15 million J&J/Janssen COVID-19 Vaccine doses administered, there have been around 233 preliminary reports of GBS identified in VAERS as of October 13, 2021. These cases have largely been reported about 2 weeks after vaccination and mostly in men, many 50 years and older. CDC will continue to monitor for and evaluate reports of GBS occurring after COVID-19 vaccination and will share more information as it becomes available.

    Given the ongoing risk of serious complications, hospitalizations, and even deaths from COVID-19 illness, and given the rarity of serious adverse effects, CDC and VDH continue to strongly recommend COVID-19 vaccination for anyone five (5) years of age or older.

    No, it has not. 

    One issue that has been raised as a possible concern with most new vaccines is Antibody-Dependent Enhancement (ADE)

    ADE is defined by the occurrence of enhanced (stronger-than-expected) disease symptoms in a person the second time they have contact with a virus. (The first contact could have been during a natural illness or from a vaccine.) Over the past 60 years, ADE has been seen three times after use of new vaccines. These episodes occurred when previously vaccinated people who got the disease in question had much stronger and very different symptoms than they would have had if they had not been vaccinated before they got infected. All three of the earlier vaccines that caused ADE were immediately kept off the market.

    We know that ADE is NOT an issue with COVID-19 or with COVID-19 vaccines because no sign of ADE was seen during or since the closely monitored Phase 2 and Phase 3 field studies in which more than 20,000 people received the new vaccines. In addition, at this point, hundreds of millions of people have received COVID-19 vaccine doses and although vaccines are not perfect in disease prevention and although breakthrough COVID-19 infections sometimes occur after full vaccination, none of those people with breakthrough infections had stronger-than-expected (“enhanced”) disease symptoms. In fact, most people with breakthrough COVID-19 infections have generally either been asymptomatic or had surprisingly mild symptoms. This point is in contrast to the unfortunate experiences of previously unvaccinated people who get infected with the SARS-CoV-2 virus that causes COVID-19. Unvaccinated people now account for nearly all of the COVID-19 patients in U.S. hospital intensive care units and a very large majority of COVID-19 deaths.

    A recent less-technical discussion of ADE and COVID-19 vaccines can be found here.

    Probably yes, but with precautions.

    There have been some reports of immediate but non-severe allergic reactions such as hives, swelling, and wheezing within 4 hours after getting a COVID-19 vaccine. Available data support that people who had an immediate (onset <4 hours after vaccination), but non-severe, allergic reaction after a dose of one type of COVID-19 vaccine (i.e., mRNA COVID-19 vaccines or Janssen COVID-19 Vaccine) are considered to have a precaution for receipt of a subsequent dose of that same vaccine type. These individuals should be observed for 30 minutes following vaccination.   

    In some cases, your healthcare provider may want to refer you to a specialist in allergies and immunology to help make a final decision. You may be able to get the Johnson & Johnson vaccine instead.

    This depends on what signs and symptoms you are experiencing. The concern is making sure that you are not one of the unusual people who was exposed to COVID-19 just before you got vaccinated and that you now have an actual COVID-19 infection.

    • In general, you can return to work if you are afebrile and signs and symptoms are limited only to those observed following COVID-19 vaccination (i.e., you do not have other signs and symptoms of COVID-19 including cough, shortness of breath, sore throat, or loss of taste or smell). If symptoms persist for more than 2 days, you should not work, should be further evaluated, and a viral test for SARS-CoV-2 should be considered.
    • For example, if you had an immediate hypersensitivity reaction (e.g., urticaria, anaphylaxis) or localized symptoms (e.g., pain, swelling, or redness at the injection site) alone but that reaction has now resolved completely, then you may go to work following normal protocols. 
    • However, if you have signs and symptoms unlikely to be from the COVID-19 vaccine (e.g., cough, shortness of breath, rhinorrhea, sore throat, loss of taste or smell that could be from a COVID-19 infection), you should not go to work until you are evaluated for possible causes, including SARS-CoV-2 infection, as appropriate. Criteria for returning to work will depend on the suspected or confirmed diagnosis. 
    • If you have signs and symptoms that may be from either COVID-19 vaccination, SARS-CoV-2 infection, or another infection (e.g., fever, fatigue, headache, chills, myalgia, arthralgia), you should consult your own healthcare provider or occupational health office. 

    For more information about post-vaccine considerations for healthcare workers, see here.  

    No. Such effects have not been seen and are unlikely to occur. 

    Sometimes people who are concerned about vaccines or vaccination raise a wide range of various reproduction and fertility questions as part of their concerns.  

    First, there is no genetic material in any of the current COVID-19 vaccines so there is no risk of a COVID-19 vaccine changing the DNA of any vaccine recipient or that person’s children.

    Reports have been published about temporary post-vaccination changes in women’s menstrual cycles. However, short-term changes in menstrual cycles can occur associated with almost any stress, infection, dietary changes, or sleep problems. A still unpublished survey noted heavier periods in some women, especially those who were older, had given birth, or were Hispanic. None of the survey results suggested an impact on fertility. A discussion of these preliminary survey results can be found here. Not surprisingly, similar reports about changes in duration and flow of menstrual cycles were noted after COVID-19 illness.

    Also, people now using hormonal birth control (pills, patch, ring, implant, etc.) can receive any of the current COVID-19 vaccines.

    One recent study found no increase in the risk of miscarriages in the pregnancies of fully vaccinated women. 

    As noted elsewhere, there is no reason to withhold COVID 19 vaccine from women who are pregnant, post-partum, and/or breastfeeding. Currently and recently pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people. Pregnant women with some underlying health conditions, such as diabetes or obesity, are at even greater risk, as is true in the non-pregnant population. In addition, having COVID-19 while pregnant has been associated with preterm birth and other adverse outcomes of pregnancy. Preventing these extra COVID-19 risks in pregnant women is an important public health goal. Getting a COVID-19 vaccine prior to or during pregnancy can protect you and your fetus from severe COVID-19 illness. 

    In summary, no negative fertility effects have been found for any current U.S. COVID-19 vaccine and there is no biologic reason to suspect that COVID-19 vaccines might have an effect on female or male fertility. 

    A recent detailed review of the safety of COVID-19 vaccines in terms of fertility and sexual function was published in the Scientific American magazine.  

    For people who are considering COVID-19 vaccination at the same time they are considering having a baby, additional useful information can be found here.  

    There have been rare reports of people receiving COVID-19 vaccine, who suffered severe allergic reactions, also known as anaphylaxis. An allergic reaction is considered severe if it requires hospitalization, or the use of an EpiPen (epinephrine) injection for treatment. 

    Anaphylaxis after COVID-19 vaccination is rare and has occurred approximately 2-5 times for every million people vaccinated in the United States. 

    NOTE: Severe allergic reactions, including anaphylaxis, can occur after any vaccination. 

    If you have ever had a severe allergic reaction to any of the ingredients in a COVID-19 vaccine, you should not get that specific vaccine. In that case, your doctor may want to refer you to a specialist in allergies and immunology to provide more specific care or advice.

    If you have ever had an immediate allergic reaction to polyethylene glycol (PEG), you should not get an mRNA COVID-19 vaccine. Polyethylene glycol (PEG) is an ingredient in both mRNA COVID-19 vaccines. You should discuss this with your healthcare provider, as you still may be able to get the Johnson & Johnson vaccine.  

    If you have ever had an immediate allergic reaction to polysorbate, you should not get the Johnson & Johnson (Janssen) COVID-19 vaccine. Polysorbate 80 is an ingredient in the Johnson & Johnson vaccine. You should discuss this with your healthcare provider, as you still may be able to get one of the mRNA COVID-19 vaccines. 

    PEG and polysorbate are structurally related, and cross-reactive hypersensitivity between these compounds may occur. 

    If you have ever had a severe allergic reaction in the past to other vaccines or injectable medications, you should ask your doctor or other healthcare provider if you should get a COVID-19 vaccine. That person will help you decide if it is safe for you to get vaccinated.  And in fact, If you have ANY concerns about getting a COVID-19 vaccine, talk to your doctor or other healthcare provider. 

    People with a history of allergic reactions not related to vaccines or injectable medications—such as allergies to foods, pet dander, venom, pollen, or latex—are not likely to have a severe reaction to COVID-19 vaccines and may still get vaccinated. People with a history of allergies to oral antibiotics or other oral medications or a family history of severe allergic reaction may also still get vaccinated.

    Also, in Virginia, each COVID-19 vaccinator has also been trained specifically to recognize and treat anaphylaxis. Finally, each site in Virginia where COVID-19 vaccines are given is required to have the medications on hand to treat anaphylaxis or any other severe or mild allergic reactions to COVID-19 vaccines. If you get a COVID-19 vaccine and you think you might be having a severe allergic reaction after leaving the vaccination site, seek immediate medical care by calling 911. 

    For the most up to date information on allergic reactions to COVID-19 vaccines, see COVID-19 Vaccines and Severe Allergic Reactions on the CDC web site. 

    Information on the Pfizer-BioNTech COVID-19 Vaccine can be found here. Information about the Moderna vaccine can be found here. Information about Johnson & Johnson’s Janssen COVID-19 vaccine can be found here.

    Out of more than 15 million people who received the J&J vaccine through October 13, 2021, 47 female recipients were identified who developed a type of blood clot called thrombosis with thrombocytopenia syndrome (TTS); a few have been fatal. Thrombosis means blood clot and thrombocytopenia means low levels of platelets.

    In April 2021, The Advisory Committee on Immunization Practices (ACIP) met to review additional information about cases of TTS and update recommendations for use of the J&J COVID-19 vaccine. After studying the reported cases of TTS and considering the risks and benefits of using the J&J vaccine, ACIP recommended lifting the pause on J&J vaccinations. 

    At that time, CDC and FDA determined that the use of the J&J COVID-19 Vaccine should be resumed in the United States. The FDA and CDC have confidence that this vaccine is safe and effective in preventing COVID-19.The FDA has determined that the available data show that the vaccine’s known and potential benefits far outweigh its known and potential risks in individuals 18 years of age and older. At this time, the available data suggest that the chance of TTS occurring is very low, but the FDA and CDC will remain vigilant in continuing to investigate this risk. Vaccine recipients should review the Fact Sheet for Recipients and Caregivers, which have been revised to include information about the risk of this syndrome, which has occurred in a very small number of people who have received the Janssen COVID-19 Vaccine.

    CDC provides additional J&J/Janssen vaccine information here and specific questions and answers about that vaccine here.

    To date there have been relatively few cases of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart muscle) reported after vaccination with an mRNA vaccine.

    • Cases have been reported to VAERS:
      • Mostly in male adolescents and young adults
      • More often after getting the second dose of one of these two COVID-19 vaccines than after the first dose
        • Early data suggest that the myocarditis risk after vaccine booster doses is lower than after second doses.
        • Although the risk of myocarditis after a booster dose of Moderna COVID-19 vaccine is unknown, accumulating evidence suggest a higher risk for myocarditis following Moderna compared to Pfizer-BioNTech  primary series vaccination. It’s important to note that Moderna’s booster dose is half that of the primary series.
      • Typically within several days after COVID-19 vaccination

    Most patients who received care responded well to medicine and rest and quickly felt better.

    Be on the lookout for any of the following symptoms:

    • Chest pain
    • Shortness of breath
    • Feelings of having a fast-beating, fluttering, or pounding heart

    Seek medical care if you think you or your child have any of these symptoms within a week after COVID-19 vaccination.

    If you have any health problems after vaccination, report them to the Vaccine Adverse Event Reporting System (VAERS).

    For more information, read Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination

    NOTE: Myocarditis has been reported far more frequently among people with COVID-19 disease than among COVID-19 vaccine recipients

    CDC and VDH continue to recommend full COVID-19 vaccination for everyone 5 years of age and older, given the greater risk of COVID-19 illness and related, possibly severe complications.

    You will need your smartphone and information about the COVID-19 vaccine that you or your child received. This information can be found on the vaccination record card you received at the time of your vaccination; if you cannot find your vaccination record card, please contact your healthcare provider.

    For instructions on how to register for v-safe, please click here.

    Vaccination: After Receiving the First Dose of a Two-dose COVID-19 Vaccine Series

    That depends on which vaccine you are receiving. Although the Johnson & Johnson (also called Janssen Biotech) COVID-19 vaccine only requires a single dose for a primary vaccination, the COVID-19 mRNA vaccines from Pfizer-BioNTech and Moderna both require two doses in their primary vaccination series. When you get your first dose of a two-dose series, your vaccine provider will let you know about the second dose and will either arrange an appointment or will help provide a way to remind you when it’s time to return for that second dose. 

    In addition, the CDC’s “v-safe” software will provide a reminder about the needed 2nd dose.  For instructions on how to register for v-safe, please click here. 

    Finally, remember that even if you have some mild side effects from the first vaccine dose of a two-dose series, it is very important to finish the vaccination series to be sure that you get complete protection against COVID-19. 

    The two doses of Pfizer-BioNTech vaccine are recommended to be given three weeks (21 days) apart and the two doses of Moderna vaccine four weeks (28 days) apart. You should not get the second dose earlier. However, if that kind of appointment scheduling is not possible, the second dose for each vaccine may be scheduled as late as 6 weeks (42 days) after the first dose.

    Although there are currently limited data on how much protection from COVID-19 you get if your vaccine doses are given more than six weeks apart, if the second dose has to be given more than six weeks after the first dose, the vaccine series does NOT need to be restarted.   

    There are a number of reasons why someone may miss an appointment for the second COVID-19 shot that is part of a two dose series. If you miss your second dose for any reason, you should get it as soon as possible. The second dose for each mRNA vaccine may be scheduled up to 6 weeks (42 days) after the first dose. You no longer need to get a second dose at the same place where you received the first dose.  

    If you have difficulty getting a second dose appointment, you can email 2ndvaxdose@vdh.virginia.gov for help.

    If you do receive your second shot of COVID-19 vaccine earlier or later than recommended, you do not have to restart the vaccine series. (This guidance might be updated as more information becomes available.)

    If you or your child are scheduled for COVID-19 vaccination but are exposed to someone infected with the SARS-CoV-2 virus, you should self-quarantine and reschedule your vaccination appointment after the quarantine period has ended in order to avoid the risk of exposing vaccinators and others to the virus.

    If it turns out that you develop COVID-19 symptoms and are diagnosed with a SARS-CoV-2 infection and COVID-19 illness, you should defer vaccination until after recovery and after the end of your isolation period to avoid the risk of exposing vaccinators to the virus.

    In general, primary series and additional primary doses should be with the same vaccine product. In exceptional situations in which the mRNA vaccine product given for the first dose of the primary series cannot be determined or is not available, any available mRNA COVID-19 vaccine may be administered at a minimum interval of 28 days between doses to complete the mRNA COVID-19 vaccination series. In situations where the same mRNA vaccine product is temporarily unavailable, it is preferable to delay the second dose to receive the same product than to receive a mixed primary series using a different product. If two doses of different mRNA COVID-19 vaccine products are administered in these situations (or administered inadvertently), the primary series is considered complete and no subsequent doses of either product are recommended to complete the primary series. In limited, exceptional situations where an individual received the first dose of an mRNA COVID-19 vaccine but is unable to complete the series with either the same or different mRNA COVID-19 vaccine (e.g., due to contraindication), a single dose of Janssen COVID-19 vaccine may be considered at a minimum interval of 28 days from the mRNA COVID-19 vaccine dose.

    If you have a vaccine-related contraindication to getting the second mRNA COVID-19 vaccine dose, you may be able to get the Johnson & Johnson (Janssen) vaccine as a second dose. This is a discussion that should be had with your healthcare provider.

    COVID-19 vaccines are not currently considered to be interchangeable in the primary vaccine series, but in rare situations, some people simply may not have brought their vaccination record card or other documentation or know which brand of vaccine they got for their first dose.

    Every effort should be made to determine which brand of vaccine was received as the first dose in order to ensure completion of the vaccine series with the same brand, but individuals will not be turned away if they do not have proof. In exceptional situations, like when the first-dose vaccine brand cannot be determined, any available mRNA COVID-19 vaccine may be administered with a minimum interval of 28 days between doses to complete the mRNA COVID-19 vaccination series.

    Strategies for determining date and brand of vaccine used for the first dose include: 

    • Checking the individual's COVID-19 vaccination record card
    • Checking the Virginia Immunization Information System (VIIS) 
    • Checking VaxTextSM if the individual enrolled in this service
    • Checking any available medical records

    Yes, at least temporarily postponed. 

    After you receive a vaccine dose in your arm muscle, the lymph nodes under your upper arm and armpit often swell up as your body begins processing the new vaccine. However, this is an intended and expected effect.

    Lymph nodes throughout the body are parts of the human immune system, the system that is intended to be stimulated by the vaccine. Lymph nodes are sites where many of the antibodies that eventually result in vaccine recipients being protected from COVID-19 are produced. Along with other lymph nodes, the lymph nodes under the arm that received the vaccine are likely to get a lot larger for a time as they begin responding to the vaccine components. .

    Since lymph nodes under the arms are also places that cancer cells would spread to in people who develop breast cancer, one of the places that doctors always look for signs of breast cancer when you have a screening mammogram is that same group of lymph nodes under the arms. 

    The caution about having a mammogram soon after a COVID-19 vaccination is to avoid having those lymph nodes (that may be enlarged as part of an expected response to the COVID-19 vaccine) be mistaken in the mammogram for a sign of the spread of breast cancer.  

    By waiting 4-6 weeks after a COVID-19 injection to have a screening mammogram, you allow the lymph nodes to complete their initial vaccine response and begin going back to their normal size and appearance. By waiting for your mammogram, you reduce the risk of that kind of mistake happening. 

    When you eventually have your mammogram, be sure to tell the technician that you recently had a COVID-19 vaccine, including which arm that you had it in.

    Please note: If the purpose of your mammogram is to investigate an already existing breast symptom such as a breast lump, then you should have the mammogram first, before your next COVID-19 vaccine dose.

    Yes.

    It is clear that having COVID-19 disease provides strong protection for several months after the illness but the total length of this protection is still uncertain. In addition, there have been some suggestions that people who had COVID-19 disease at some earlier time might only need a single dose of COVID-19 vaccine to be fully vaccinated, the idea being that the earlier COVID-19 illness could act as an equivalent to the first dose of vaccine. 

    However, COVID-19 remains a dangerous and sometimes fatal illness. Several studies of people who have already had COVID-19 disease have indicated that people who are fully vaccinated after having COVID-19 are more protected against getting COVID-19 again than those who had COVID-19 disease without later vaccination. At the moment, VDH and CDC continue to recommend that people who have had COVID-19 disease maximize their protection from getting infected again by becoming fully vaccinated.  

    There is evidence that neutralizing antibody and memory B cell response after a single dose of mRNA COVID-19 vaccine following previous infection with SARS-CoV-2 results in a higher antibody titer that is approximately equivalent to a two-dose vaccine regimen in individuals who were not previously infected. Whether the actual disease protection (vaccine effectiveness) from this higher single dose antibody titer after previous infection with SARS-CoV-2 lasts as long as protection from a two-dose vaccine series is still being investigated. Therefore, for complete protection, 2 mRNA COVID-19 doses are needed.

    If you get a COVID-19 infection after the first dose of COVID-19 vaccine, your second COVID-19 vaccine dose should be deferred until you have recovered from the symptoms of COVID-19 disease AND until you are allowed to discontinue isolation.

    Data from clinical trials show that the currently authorized COVID-19 vaccines can and should be given to people with evidence of a prior SARS-CoV-2 infection and that they are effective in increasing vaccine recipients’ immunity even further.

    Currently, there are no data on the safety and efficacy of COVID-19 vaccines in people who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment. If you received either one as part of your COVID-19 infection treatment, your COVID-19 vaccination should be deferred for at least 90 days after your last dose of antibodies or plasma.

    Vaccination: After Being Fully Vaccinated with COVID-19 Vaccine

    As of late November 2021, CDC has not announced a plan to update the definition of fully vaccinated to incorporate the concept of booster doses. “Fully vaccinated” still means that (1) a person has received two doses of either the Pfizer-BioNTech COVID-19 vaccine OR the Moderna COVID-19 vaccine OR a single dose of the Johnson & Johnson (also known as Janssen) COVID-19 vaccine AND (2) that at least 14 days have passed since the last dose was received. 

    However, anyone who completed a COVID-19 vaccination series with an mRNA vaccine is now allowed to get a booster dose with any FDA-authorized COVID-19 vaccine once 6 months has elapsed since their 2nd dose. People 50 years old and older are now recommended to get a booster dose. People who received the Johnson and Johnson (Janssen) vaccine should get a vaccine booster dose once two months has elapsed since their initial dose. 

    PLEASE NOTE: Even if they meet this current definition of “fully vaccinated”, people who have immune systems that are likely to be weakened because of a disease condition they have (e.g., leukemia), because they are receiving a medication that intentionally suppresses the immune system (e.g., organ transplant recipients or people with severe allergies), or because they were born with a condition associated with weaker immune systems (e.g., Down’s Syndrome) should be aware that they may have had a reduced immune response to COVID-19 vaccine and that they may NOT be fully protected against COVID-19. Such people should receive an additional primary vaccine dose and should also continue following all of the current COVID-19 prevention guidance (masking, distancing, avoidance of crowds and poorly ventilated indoor spaces) to protect themselves against COVID-19 and should discuss their situation with their healthcare provider. 

    Finally, even after immunocompromised people have received an additional primary vaccine dose, they should continue to follow the prevention guidance detailed above until advised otherwise by their healthcare provider. 

    Additional information for such people can be found here.

    The Delta variant, which is now the main variant of the SARS-CoV-2 virus circulating in Virginia, is significantly more contagious (infectious) than the original COVID-19 virus or any of the other variants seen since then. Until more people are vaccinated, wearing masks remains an important tool to help even fully vaccinated people stop the spread of COVID-19. VDH recommends you follow CDC guidance to mask in areas of substantial to high transmission. This means you are in a place where the spread of COVID-19 is happening more often. Check here to see if you are in one of those areas.

    In addition, if you’ve been fully vaccinated:

    • There are some settings where there are still formal mask requirements, under some federal, state, local, tribal, or territorial laws, rules, and requirements as well as and local business and workplace guidance.
    • Per a federal order, you must wear masks when using public transportation (airplanes, ships, ferries, trains, subways, buses (including school buses), taxis, and rideshares, as well as in indoor transportation hubs, such as airports and stations).
    • On August 12, 2021, State Health Commissioner Dr. M. Norman Oliver reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. 
    • You should wear a mask in all other indoor child care settings outside of your home.  
    • You should wear a mask in healthcare settings, like a hospital or doctor’s office.
    • You should wear a mask if you live, work, or visit a correctional facility, homeless shelter, halfway house or other crowded living situation.
    • You should wear a mask if you take medication or have a condition that weakens the immune system, unless your healthcare provider advises otherwise.
    • You might also choose to wear a mask regardless of the level of transmission, particularly if you or someone in your household has a weakened immune system or is at increased risk for severe disease, or if you live with someone, including a child, who is not fully vaccinated.
    • If you’ve had close contact with someone who has COVID-19, you should get tested 5–7 days after your exposure, even if you don’t have symptoms. You should also wear a mask indoors in public for 14 days following exposure or until your test result is negative.
      • You should isolate yourself for 10 days if your test result is positive.
    • You should still watch out for symptoms of COVID-19, especially if you’ve been around someone who is sick. If you have symptoms of COVID-19, you should get tested and stay home and away from others. If your test is positive, isolate at home for 10 days. If you travel in the United States, you do not need to get tested before or after travel or self-quarantine after travel.
    • Fully vaccinated international travelers, regardless of citizenship, arriving in the United States are still required to get tested no more than 3 days before travel by air into the United States (or show documentation of recovery from COVID-19 in the past 3 months) and should still also get tested 3-5 days after their trip.

    Even when not required or recommended, people who are fully vaccinated should continue to wear masks whenever they are more comfortable doing so.

    Fully vaccinated persons with an exposure to someone with suspected or confirmed COVID-19 are not required to quarantine if they meet all three of the following criteria:

    • Are fully vaccinated (that is, at least 2 weeks after the second dose of Pfizer-BioNTech or Moderna vaccine or at least two weeks after receiving the Janssen (also called Johnson & Johnson) vaccine) -AND- 
    • Have remained asymptomatic since the current COVID-19 exposure -AND-
    • Are not inpatients or residents in healthcare or other congregate settings (If you ARE an inpatient or resident in one of these settings, you should continue to quarantine following any exposure to someone with suspected or confirmed COVID-19.)

    Persons who do not meet all three of the above criteria should continue to follow current quarantine guidance after exposure to someone with suspected or confirmed COVID-19.

    In addition, fully vaccinated persons who do not need to quarantine should still get tested 57 days after your exposure, even if you don’t have symptoms. You should also wear a mask indoors in public for 14 days following exposure or until your test result is negative.

    NOTE: If your test result is positive, you should self-isolate for 10 days.

    Finally, fully vaccinated persons who do not need to quarantine should still watch for symptoms of COVID-19 for at least 14 days following an exposure. If they experience symptoms, they should be evaluated by their healthcare provider for COVID-19, including SARS-CoV-2 testing, if indicated.

    For additional considerations regarding quarantine or work restrictions for fully vaccinated healthcare personnel, patients, or residents in healthcare settings (including nursing homes), please see here.

    The data show that the United States and Virginia are still in a COVID-19 surge due to the Delta variant. 

    A recent article published by the CDC, shows that the amount of virus present in the nasopharynx of vaccinated people infected with the Delta variant was very high and was in fact the same as that of unvaccinated people who were infected. This information is concerning, as it shows that some fully vaccinated people could and do infect others. Studies also show that the viral load from infection with the Delta variant can be as much as a 1000 times higher than the previous Alpha variant. Studies suggest the Delta variant is 40% to 60% more transmissible than the Alpha variant. (And remember that the Alpha variant itself was 50% more transmissible than the original SARS-CoV-2 viral “strain”.) We are still studying whether the Delta variant causes more severe illness. 

    However, although fully vaccinated people who get breakthrough infections can spread COVID-19 to others, such infected but fully vaccinated people seem to be contagious for a shorter time than infected unvaccinated people. The most recent information on the risks of the Delta variant can be found here

    In addition, all three COVID-19 vaccines are still doing what they are primarily meant to do in the sense that a primary goal of COVID-19  vaccination is preventing severe illness, hospitalizations, and deaths. Although effectiveness of the current vaccines against mild or asymptomatic infection with the Delta variant is slightly less, full COVID-19 vaccination is still effectively preventing severe outcomes. Most COVID-19 hospitalizations and most deaths from COVID-19 are occuring in unvaccinated individuals. The CDC has regularly updated its guidance as more information became available regarding the effectiveness of the vaccines, along with the current status of the pandemic in the United States. 

    From a UK study published in the New England Journal of Medicine, two doses of the Pfizer-BioNTech was 88% effective against the delta variant and 93.7% against the alpha variant. 

    Importantly, “vaccine breakthrough cases” continue to be rare.  Please note: people with weakened immune systems, including people who take immunosuppressive medications, may not be protected even if fully vaccinated.

    Yes, there are several other ways to help.

    Many of us have frequent contact with others who are fully vaccinated for COVID-19, but who may not be as well protected by those vaccines. This group includes anyone whose immune system is suppressed by a disease (e.g., cancer) or genetic condition (e.g., Down’s Syndrome) or because they are taking medicines to suppress their immune systems (e.g., organ transplant recipients).  It is also important to remember that some people cannot be vaccinated because they are either too young or they are allergic to one or more vaccine components. All of these people are still vulnerable to COVID-19 and deserve COVID-19 prevention support from their friends, family, caregivers, neighbors, co-workers, etc.

    Because they can still get an uncommon but still contagious breakthrough COVID-19 infection, fully vaccinated people can help protect these vulnerable people by continuing to wear masks and maintaining adequate distance when around them. In addition to masking, unvaccinated people who are vaccine-eligible can get vaccinated. In addition to these familiar COVID-19 prevention strategies, you can also help educate other people in your family, neighborhood and community about the people among us who are still susceptible to COVID-19. The best way to keep them protected is for all of us to continue to do our part to stop the spread of COVID-19.

    For additional information, please see CDC considerations for Families with Vaccinated and Unvaccinated Members

    Vaccine registration requires that you provide your name and date of birth. The registration process will also ask for the following information: race, ethnicity, sex, phone number, and address, including county/zip code of residence. You will also be asked questions to see if you have a medical condition that places you in any group that is at increased risk of severe illness from COVID-19. NOTE: Information gathered will only be used for vaccination purposes. Your information is safe and protected when provided through the call center or the Virginia Department of Health pre-registration system.  

    Information about all COVID-19 vaccine doses administered in the state will be entered into the Virginia Immunization Information System (VIIS)

    The State of Virginia sends information on recipient birth year, sex, race, ethnicity, and zip code to the CDC.  Your name and address will not be sent.

    As of November 21, 2021, neither the Federal government nor Virginia’s state government requires COVID-19 vaccination or proof of vaccination for the general population. 

    However, vaccine mandates are being considered or put in place for some groups within the Federal and Virginia State governments. In addition, many individual businesses, employers, educational organizations, and other private organizations in Virginia are allowed to require vaccination or proof of vaccination from employees, customers, students, and/or other participants if they choose to do so. Also, some other countries are now considering requiring proof of vaccination before allowing U.S. and other travelers to enter the country and, in some cases, to enter certain organizations and buildings within the country.

    The vaccination record provided by the portal includes your name, your date of birth, the date of each COVID-19 vaccination you received in Virginia; the manufacturer, description, and lot number; and the name of the provider who administered it. No other personal information is returned.

    The vaccination record provided by the portal includes only COVID-19 vaccinations entered in the Virginia Immunization Information System by providers, and may not include vaccinations administered outside Virginia or by federal government agencies such as the Department of Defense (for military facilities) or the Department of Veterans Affairs.

    If you would like a record of other vaccinations, you may submit your request online. You can also contact the VIIS Help Desk at (866) 375-9795. The Help Desk will be staffed from 8:30 am until 5:00 pm, Monday through Friday. For other questions, please email vaccinerecord@vdh.virginia.gov or call 877-VAX-IN-VA (877-829-4682).

    Adequately controlling this COVID-19 disease pandemic requires using all the disease prevention tools we have available.

    Fortunately, fully vaccinated people who have waited at least 14 days from their last dose and who, if eligible, have gotten their booster dose, are now able to resume some of the activities that they did prior to the pandemic.

    Especially because of the Delta variant of the SARS-CoV-2 virus, which spreads far more efficiently than earlier versions of that virus, those people who are not yet fully vaccinated should continue all current prevention measures, and get fully vaccinated as soon as possible, and get a booster dose if recommended. 

    Yes. 

    People who have been fully vaccinated against COVID-19 - and who have received a  booster dose if eligible - can travel relatively safely within the United States. But remember that during travel even after being fully vaccinated and boosted, when you are in public spaces, it is still important to continue prevention behaviors such as wearing a mask, staying at least 6 feet from people not traveling with you, avoiding crowds and poorly ventilated spaces, and routine hand washing or use of hand sanitizer.

    In fact, use of a mask is REQUIRED by the federal government on planes, trains, buses and other forms of public transport traveling into, within, or leaving the United States and in indoor parts of transport hubs such as train and bus stations and airports.

    NOTE: Outdoor areas of train or bus stations or airports are exempted from the mask requirement.

    After your travel, be sure to self-monitor for symptoms of COVID-19 and, if any of those symptoms develop, you should self-isolate and arrange to be tested for COVID-19.

    Additional information on domestic (U.S.) travel recommendations for fully vaccinated people can be found on the CDC website here

    Domestic travel recommendations for anyone NOT fully vaccinated against COVID-19 have NOT changed. Travel recommendations for people who are not fully vaccinated can be found on the CDC website here.

    And finally, receiving a COVID-19 vaccine will NOT affect future results of any viral PCR or rapid antigen testing you may need to rule out a current or recent COVID-19 infection.

    For additional VDH travel information, please click here.

    Yes, but as of now, being fully vaccinated and/or boosted against COVID-19 does NOT yet overcome all the challenges of traveling outside the United States.

    In fact, COVID-19 viral testing is increasingly required for pre-travel screening on international flights. In addition, some other countries are now considering requiring proof of vaccination before allowing travelers to enter. For ANY travel to other countries, you should check closely with both your airline and the national testing and vaccination requirements of the country or countries that you will be visiting.

    In terms of coming back to the United States, all arriving passengers, including U.S. citizens, are now REQUIRED to have either a negative COVID-19 viral PCR or antigen test or documentation of recovery from COVID-19 in the past 90 days. The timing of the test will depend on vaccination status:

    • Fully vaccinated air travelers, regardless of citizenship, are required to show proof of vaccination (if 18 years old or older) and a pre-departure negative test taken no more than 3 days before travel to the U.S.
    • Passengers who are not fully vaccinated are required to show a pre-departure negative test taken no more than 1 day before departure for the U.S.

    NOTE: As of late November 2021, proof of being fully vaccinated against COVID-19 will NOT substitute for having a negative viral PCR or antigen test before returning to the United States.

    For additional information, please click here.

    That depends on the test. 

    In terms of screening you for a current or very recent COVID-19 infection, having a COVID-19 vaccination will NOT affect the results of any later viral testing such as COVID-19 PCR or antigen testing that you may need to diagnose a COVID-19 infection. 

    On the other hand, one result of vaccination for most people is the production of antibodies against the specific spike protein part of the virus that causes COVID-19. Some but not all available serologic (blood) tests used to identify an earlier COVID-19 illness are based on this specific type of antibody so having a COVID-19 vaccination may result in your having a positive COVID-19 antibody (serology) test later on. However, because not all serology tests will test for the anti-spike protein antibody, serology testing is NOT recommended to confirm protection after COVID-19 vaccination.

    Many studies of how long the protection from these COVID-19 vaccines lasts have recently been completed and others are still being done.

    Because immunity against COVID-19 appears to be waning, booster doses with any FDA-authorized or approved COVID-19 vaccine have now been recommended starting six months after being fully vaccinated with an mRNA vaccine (from Pfizer-BioNTech and Moderna) or starting two months after being vaccinated with the Janssen (Johnson and Johnson) vaccine. 

    Booster doses can “boost” one’s level of immune protection significantly. That’s why a booster will be needed to maximize and extend their protection.

    Everyone 18 years and older is now eligible for a booster shot. Specifically, healthy people who were not previously recommended for a booster shot may now receive one if they received a primary mRNA (Pfizer or Moderna) COVID-19  vaccine series. In addition, all people 50 years and older are recommended to get a booster shot. Recommendations for Johnson & Johnson’s Janssen COVID-19 vaccine remain the same:  Everyone 18 years and older who received a J&J/Janssen vaccine at least two months ago should get a booster shot. 

    Please see the VDH booster FAQs for more details on these recommendations

    As of September 29, 2021, COVID-19 vaccine booster shots are available for the following mRNA (Pfizer-BioNTech or Moderna) vaccine recipients who completed their initial series at least 6 months ago:

    Any people in these same groups who had their Johnson and Johnson (Janssen) vaccine dose at least two (2) months ago are also eligible for a booster dose with any FDA-authorized or approved COVID-19 vaccine.

    Please see the VDH booster FAQs for more details on these recommendations.

    No, you will not. 

    COVID-19 vaccines do not contain a live virus and will not give you or your child a COVID-19 infection or allow you to spread COVID-19 to others. 

    However, it typically takes a few weeks for the body to build immunity after a vaccination, especially after the first dose of a two-dose vaccine series, so during that time before your second dose, when you are only partially immune, you could still get a COVID-19 infection from another person and then spread COVID-19 to those around you. That is why, until you are fully vaccinated you should continue to practice safety measures to prevent the spread of COVID-19 by covering your mouth and nose with a mask, washing hands often, staying at least six feet away from others and avoiding crowds and poorly ventilated indoor spaces.

    For COVID-19 vaccine to be most effective and for everyone in your household to protect themselves and each other as much as possible, everyone who is eligible should be fully vaccinated as soon as possible (and “boosted” as they become eligible later).

    As of now, children 5-17 years old can only be vaccinated with the Pfizer-BioNTech vaccine. The Moderna or Johnson & Johnson (also known as Janssen Biotech) vaccines can only be used in adults 18 years and older. Some additional studies of COVID-19 vaccination in younger age groups are underway but the FDA has not yet authorized use of these vaccines in younger children. 

    At the moment, the best way to protect younger children in a household is to vaccinate all the adults and older children in the household who can be vaccinated and to minimize any unvaccinated children’s contact with other unvaccinated children or adults. For additional protection, eligible individuals should also get a booster dose. 

    No vaccine works 100% of the time and some people who are fully vaccinated against COVID-19 are likely to get what are called “vaccine breakthrough” infections. In most cases, these people do not have any symptoms or have only mild symptoms. Although they may still be able to spread the virus to others, their infections might also be shorter in duration. 

    However, just because a small proportion or fraction of fully vaccinated people become infected does NOT mean the vaccines are not working. The most important purpose of the COVID-19 vaccines for individuals is to protect you from severe COVID-19 symptoms that can lead to hospitalization, intensive care unit (ICU) admission, or death. All three of the current COVID-19 vaccines are highly effective in preventing those most serious outcomes of COVID-19 disease, even with the Delta variant. 

    There is recent evidence that vaccine protection against mild or moderate COVID-19 decreases over time. There is also concern that protection against severe disease, hospitalization, and death could also weaken in the same way in the months ahead, especially among people who are at higher risk for severe illness or were vaccinated during the earlier phases of the vaccination rollout. That is why public health officials are now recommending a booster vaccine dose to people at least six (6) months after receiving the second dose of an mRNA (Pfizer-BioNTech or Moderna) vaccine or at least two (2) months after receiving the Johnson and Johnson vaccine. The booster dose, which can “boost” one’s level of immune protection, will help maximize and extend protection for fully vaccinated persons. 

    Please see the VDH booster FAQs for more details on these recommendations

    NOTE: Getting only a single dose of one of the current two-dose (Pfizer-BioNTech or Moderna) mRNA COVID-19 vaccines will not provide that vaccine’s full protection.

    Probably yes, at least for the moment. 

    Vaccine experts are continually studying the Delta variant and any other new variants of the SARS-CoV-2 virus that comes along to determine whether the current COVID-19 vaccines are likely to remain effective against them. Current data are reassuring in terms of the current vaccines’ ability to protect against the most severe forms of infections from the common new variants, including the Delta variant. Vaccine effectiveness against developing a COVID-19 illness with mild or no symptoms appears to be slightly decreased against the Delta variant. However, most importantly, all current vaccines used in the United States are still effective in preventing serious illness, hospitalization, or deaths from the Delta virus or other new variants.  

    In addition to any impact on vaccine effectiveness, the Delta variant is truly unique in that it spreads much more efficiently, i.e., more easily and more rapidly) than any of the earlier variants we have been dealing with in the United States since March 2020. However, it also appears at the moment that the Delta variant does NOT cause more severe illness than earlier variants and that it is NOT any less detectable by the currently available viral diagnostic tests such as PCR or antigen tests.. Still, each of these important issues is being studied in more detail.

    Additional information on the Delta variant (also called B.1.617.2)  is available from CDC here and in a more technical version here. Information on protection by vaccines from the Delta variant is also available from Moderna here and from Janssen (Johnson & Johnson) here. VDH information on virus variants can be found here

    But regardless of the amount of protection that any of these vaccines and boosters can provide against the Delta or other new viral variants, even fully vaccinated people , including those who have already received boosters, might consider continuing with their own personal prevention steps when outside their own personal spaces: wearing masks, staying at least six feet apart, avoiding crowds and poorly ventilated spaces, and frequently washing your hands.

    No.

    Commercial serology (antibody) testing to confirm immunity after vaccination is not currently recommended by CDC or by VDH. One important reason (beyond its cost) is that some of the currently marketed serology test kits use a different technology than others and may not be able to detect the spike (S) protein antibodies that are the most important antibodies produced by the mRNA COVID-19 vaccination process. Using such serology blood test kits could provide a false negative test result that would not reflect your actual protection provided by the COVID-19 vaccine.

    This caution about the risk of false negative results of post-vaccine antibody testing is also true for the recently authorized Symbiotica SARS-CoV-2 home antibody test kit.  

    Your COVID-19 vaccination will not interfere with the accuracy of your TB test. According to the CDC, inactive vaccines will not interfere with results of either a TB skin test or a TB blood test (also known as an IGRA). TB testing can be done before or at the same time as mRNA COVID-19 vaccination, or otherwise delayed for at least 4 weeks after the completion of mRNA COVID-19 vaccination, if possible, but generally should not be cancelled.

    More information on this topic can be found on the CDC website here.

    People who were vaccinated outside the United States with a currently FDA-approved or FDA-authorized COVID-19 vaccine or a WHO-EUL COVID-19 vaccine and who have received all the recommended doses are considered fully vaccinated and do not need any subsequent primary series doses. As of November 10, 2021, this category includes five additional COVID-19 vaccines, manufactured by AstraZeneca, the Serum Institute of India, Sinopharm/BIBP, Sinovac, and Bharat Biotech.

    People who completed a primary vaccine series outside the United States and received FDA-approved, FDA-authorized, or WHO-EUL COVID-19 vaccines as a mixed dose regimen are considered fully vaccinated as per CDC guidance. They do not need to restart a COVID-19 vaccine primary series in the United States. This does not imply that these non-U.S. vaccine primary series regimens are approved or authorized by FDA or are recommended by CDC or ACIP. 

    People who received the first dose of a 2-dose FDA-approved or FDA-authorized mRNA COVID-19 vaccine do not need to restart the vaccine series in the United States. They should receive the second dose as close to the recommended time as possible and are considered fully vaccinated upon completion of the 2-dose primary series.

    People who were vaccinated in countries where only a single mRNA COVID-19 vaccine dose is administered are not considered fully vaccinated in the United States. They should be offered an age-appropriate second dose of an mRNA vaccine to complete the 2-dose primary series.

    The following people who received a COVID-19 vaccine that is not currently FDA-approved or FDA-authorized in the United States may be offered a complete FDA-approved or FDA-authorized COVID-19 vaccine primary series as follows:

    • People who have received only the first dose of a 2-dose COVID-19 primary series listed for emergency use by WHO
    • People who received all or some of the recommended doses of a COVID-19 vaccine primary series that is not listed for emergency use by WHO.

    The minimum interval between receipt of the non-FDA-approved/authorized vaccine and initiation of the FDA-approved/authorized COVID-19 vaccine primary series is at least 28 days.

    Additional guidance can be found here.

    Although your insurance company can be billed for the process of your COVID-19 vaccination, you cannot be personally billed for COVID-19 vaccinations. If you receive a bill, you should first speak to the person or facility that sent it. If they don’t cancel it, contact the HHS Office of Inspector General Hotline at 1-800-HHS-TIPS or visit https://TIPS.HHS.GOV to file a complaint.

    If you are uninsured and receive a bill related to COVID-19 testing or treatment, ask your provider to bill the HRSA COVID-19 Uninsured Program instead of you. 

    For additional information, see here. 

    The Virginia Department of Health is aware of an email scam occuring asking individuals to “validate their COVID-19 status.” The email uses VDH logos and graphics, but it is not from VDH. VDH graphics and materials will link to VDH or LHD websites.  Individuals should check the URL to ensure that it's legitimate.  If you have any questions about such emails, please contact VDH directly via email at questions@vdh.virginia.gov.

    Yes. Current FDA guidance is that people who received any of the three current COVID-19 vaccines from Pfizer-BioNTech, Moderna, or Janssen (Johnson & Johnson) are still eligible to donate blood, blood plasma, or platelets as long as the vaccinated people are free of post-vaccine symptoms and are otherwise feeling well.

    The only requirement is that the name of the vaccine’s manufacturer will be needed at the blood or plasma donation site. Blood donors are encouraged to bring the vaccine card that they received at the time of their vaccination.

    This depends. People who have been vaccinated against COVID-19 can donate COVID-19 plasma only if you meet all three of these criteria:

    1. You had symptoms of COVID-19 disease and a positive test result from a diagnostic test approved or authorized by FDA, AND
    2. You received the COVID-19 vaccine after your diagnosis of COVID-19, AND
    3. You are within 6 months after complete resolution of your COVID-19 symptoms.
    4. See page 6 of the current FDA guidance for more information on this topic.

    Vaccination: Healthcare Providers

    VDH is asking providers to report all vaccination administrations to the Virginia Immunization Information System (VIIS). This is very important for ensuring that there is an established reporting and data feedback loop for the COVID-19 vaccine.

     

    Healthcare providers who are interested in providing the COVID-19 vaccine may complete a Provider Intent form on the VDH website. VDH staff will contact providers once they have submitted their intent form to discuss the next steps to enroll as a COVID-19 vaccine provider.

    Further information specific to enrollment as a vaccine provider in Virginia can be found here and general information from CDC can be found here.

    Yes. The Virginia Department of Health publishes a list of individual healthcare providers/practices that are currently partnering with VDH to administer the COVID-19 vaccine. This is NOT a list of locations where the public may access the COVID-19 vaccine and does not indicate the number of doses available for public distribution. Many organizations and local health departments partner to deliver vaccines at community events, and some providers are coordinating with VDH to serve specific populations, such as long-term care facilities.

    Data is published weekly on Wednesday mornings (beginning February 17, 2021), and is meant to reflect data through the previous Sunday. These data do not indicate the current inventory available at these locations, and may not align exactly with the daily totals on the main VDH dashboard. Vaccine administrations may take up to 72 hours to be reported. In some cases, administration data may reflect the location where a patient's medical records were updated instead of the physical location the dose was administered. Doses may also be used to support a community event in a different locality, which may result in apparent discrepancies.

    Clinicians should maintain a high index of suspicion for symptoms that might represent serious thrombotic events or thrombocytopenia in patients who have recently received the J&J/Janssen COVID-19 vaccine, including severe headache, backache, new neurologic symptoms, severe abdominal pain, shortness of breath, leg swelling, petechiae (tiny red spots on the skin), or new or easy bruising.

    Obtain platelet counts and screen for evidence of immune thrombotic thrombocytopenia.

    In patients with a thrombotic event and thrombocytopenia after the J&J/Janssen COVID-19 vaccine, evaluate initially with a screening PF4 enzyme-linked immunosorbent (ELISA) assay as would be performed for autoimmune heparin-induced thrombocytopenia (HIT). Consultation with a hematologist is strongly recommended.

    Do not treat patients with thrombotic events and thrombocytopenia following receipt of J&J/Janssen COVID-19 vaccine with heparin, unless HIT testing is negative.

    If HIT testing is positive or unable to be performed in a patient with thrombotic events and thrombocytopenia following receipt of J&J/Janssen COVID-19 vaccine, non-heparin anticoagulants and high-dose intravenous immune globulin should be strongly considered.

    See the updated clinician fact sheet here and the CDC “Talking to Patients” handout.

    Refer to the American Society of Hematology guidance: Vaccine-induced Immune Thrombotic Thrombocytopenia: Frequently Asked Questions.

    Read the official CDC health alert on April 13, Cases of Cerebral Venous Sinus Thrombosis with Thrombocytopenia after Receipt of the Johnson & Johnson COVID-19 Vaccine, which includes details about how to assess and care for a patient that presents with thrombosis or thrombocytopenia.

    Report adverse events to VAERS, including serious and life-threatening adverse events and deaths in patients following receipt of COVID-19 vaccines as required under the Emergency Use Authorizations for COVID-19 vaccines.

    Since April 2021, increased cases of myocarditis and pericarditis have been reported in the United States after mRNA COVID-19 vaccination (Pfizer-BioNTech and Moderna), particularly in adolescents and young adults. There has not been a similar reporting pattern observed after receipt of Johnson & Johnson’s Janssen COVID-19 vaccine.

    In most cases, patients who presented for medical care have responded well to medications and rest and had prompt improvement of symptoms. Reported cases have occurred predominantly in male adolescents and young adults 16 years of age and older. Onset was typically within several days after mRNA COVID-19 vaccination, and cases have occurred more often after the second dose than the first dose. CDC and its partners are investigating these reports of myocarditis and pericarditis following mRNA COVID-19 vaccination.

    CDC continues to recommend COVID-19 vaccination for everyone 5 years of age and older given the risk of COVID-19 illness and related, possibly severe complications, such as long-term health problems, hospitalization, and even death.

    On June 25, the FDA updated its patient and provider fact sheets for the Pfizer- BioNTech and Moderna COVID-19 vaccines to include a warning about this rare potential complication.

    CDC provides clinical considerations here and here. It is unclear if people who developed myocarditis or pericarditis after a first or second dose of an mRNA COVID-19 vaccine may be at increased risk of further adverse cardiac effects following a second or third dose of the vaccine. Until additional safety data are available, experts recommend that people who develop myocarditis or pericarditis after any dose of an mRNA COVID-19 vaccine defer receiving additional doses. People with a history of myocarditis or pericarditis who choose to receive additional doses of an mRNA COVID-19 vaccine should wait at least until their episode of myocarditis or pericarditis has completely resolved. People who have a history of myocarditis or pericarditis unrelated to mRNA COVID-19 vaccination may receive any FDA-authorized COVID-19 vaccine after the episode of myocarditis or pericarditis has completely resolved. 

    Out of nearly 26 million booster shots administered in the U.S. so far, there have been 54 preliminary cases of myocarditis reported to the Vaccine Adverse Event Reporting System (VAERS) following Pfizer or Moderna vaccination and are under investigation. No cases of myocarditis or pericarditis were reported following booster vaccination in Pfizer-BioNTech’s Phase 3 clinical trial. In addition, data from Israel show the rates of myocarditis after a booster shot of Pfizer  COVID-19 vaccine appear to fall between the rates seen after dose 1 and dose 2. Although the risk of myocarditis after a booster dose of Moderna COVID-19 vaccine is unknown,  accumulating evidence suggest a higher risk for myocarditis following Moderna compared to Pfizer primary series vaccination. It’s important to note that Moderna’s booster dose is half that of the primary series. Current recommendations also allow eligible adults to get a different booster from their primary vaccine series.

    Guillain-Barré syndrome (GBS) is a neurological disorder in which the body’s immune system damages nerve cells, causing muscle weakness and sometimes paralysis. After more than 14.9 million J&J/Janssen COVID-19 Vaccine doses administered, there have been around 244 preliminary reports of GBS identified in VAERS as of October 27, 2021. These cases have largely been reported about 2 weeks after vaccination and mostly in men, many 50 years and older.

    Symptoms include:

    • Weakness or tingling sensations, especially in the legs or arms, that worsens and spreads to other parts of the body
    • Difficulty walking
    • Difficulty with facial movements, including speaking, chewing, or swallowing
    • Double vision or inability to move eyes
    • Difficulty with bladder control or bowel function

    Available data do not show a similar pattern of GBS after mRNA vaccines (Pfizer-BioNTech and Moderna). Additional data are being collected and analyzed. In addition, the fact sheets (HCPs, Recipients and Caregivers) for Johnson & Johnson’s Janssen vaccine were updated to include information on GBS. However, given the risk of serious complications and even deaths from COVID-19 illness (that are now occurring mainly in unimmunized people), CDC and VDH continue to strongly recommend COVID-19 vaccination for anyone 5 years of age or older who does not have a specific contra-indication.

    Healthcare providers should promptly report any suspected case of GBS in a person who has recently received a COVID-19 vaccine to the VAERS system.

    Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe condition in children and adolescents infected with SARS-CoV-2. Multisystem inflammatory syndrome in adults (MIS-A) appears to be even rarer and is less well characterized than in children. The mechanisms of MIS-C and MIS-A are not well understood but include a dysregulated immune response to SARS-CoV-2 infection. The risk of recurrence of the same dysregulated immune response following reinfection with SARS-CoV-2 among people with a history of MIS-C or MIS-A is unknown. It is also unknown if some persons with a history of MIS-C or MIS-A may be at risk for an MIS-like illness following vaccination with COVID-19 vaccine.

    Children with MIS-C have high antibody titers to SARS-CoV-2, however, it is unknown if this correlates with protection against reinfection and for how long protective antibody levels persist.

    Given the lack of data on the safety of COVID-19 vaccines in people with a history of MIS-C or MIS-A, a conversation between the patient, their guardian(s), and their clinical team or a specialist (e.g., specialist in infectious diseases, rheumatology, or cardiology) is strongly encouraged to assist with decisions about the use of COVID-19 vaccines.

    Given the widespread transmission of SARS-CoV-2 across the United States and increases in hospitalizations of children and adolescents, several experts consider the benefits of COVID-19 vaccination for children and adolescents (i.e., a reduced risk of severe disease including potential recurrence of MIS-C after reinfection) to outweigh a theoretical risk of an MIS-like illness or the risks of myocarditis following COVID-19 vaccination for people who meet all of the following criteria:

    • Clinical recovery has been achieved, including return to normal cardiac function;
    • It has been ≥90 days since their diagnosis of MIS-C;
    • They are in an area of high or substantial community transmission of SARS-CoV-2 or otherwise have an increased risk for SARS-CoV-2 exposure and transmission; and
    • Onset of MIS-C occurred before any COVID-19 vaccination.

    COVID-19 vaccination may also be considered for people with a history of MIS-C who do not meet all the above criteria or for people with a history of MIS-A. Experts view clinical recovery, including return to normal cardiac function, as an important factor when considering COVID-19 vaccination. Additional factors when considering individual benefits and risks may include:

    • An increased personal risk of severe COVID-19 (e.g., age, underlying conditions)
    • Timing of immunomodulatory therapies (ACIP’s general best practice guidelines for immunization can be consulted for more information)
    • People diagnosed with MIS-C or MIS-A after COVID-19 vaccination

    In the rare instance of a person developing MIS-C, MIS-A, or a similar clinical illness after receipt of a COVID-19 vaccine, referral to a specialist in infectious diseases, rheumatology, or cardiology should be considered. Because MIS-C and MIS-A are conditions known to occur with SARS-CoV-2 infection, these individuals should be assessed for laboratory evidence of current or prior SARS-CoV-2 infection. Healthcare and public health professionals should also consider requesting a consultation from the Clinical Immunization Safety Assessment COVIDvax project. In addition, all illnesses consistent with MIS-C or MIS-A occurring in persons who received any COVID-19 vaccine should be reported to VAERS.

    Please see here for more information.

    CDC has developed several self-study web modules for healthcare providers. These can be found here, and include the following:

    • COVID-19 Vaccine Training: General Overview of Immunization Best Practices for Healthcare Providers (15 minutes)
    • Janssen COVID-19 Vaccine (Johnson & Johnson): What Healthcare Professionals Need to Know (30 minutes)
    • Moderna COVID-19 Vaccine: What Healthcare Professionals Need to Know (30 minutes)
    • Pfizer-BioNTech COVID-19 Vaccine: What Healthcare Professionals Need to Know (30 minutes)

    Each of these courses includes continuing medical education (CME) credits.

    Additional resources include the CDC website “Clinical Considerations for COVID-19 Vaccination” and the CDC “COVID-19 Vaccination” homepage. 

    The New England Journal of Medicine provides additional Covid-19 Vaccine Frequently Asked Questions for clinicians

    The American College of Obstetricians and Gynecologists provides COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care

    The American Academy of Pediatrics provides COVID-19 Frequently Asked Questions related to children.

    The CDC provides FAQs for COVID-19 Vaccine Indications for Patients Who Are Immunocompromised as well as General COVID-19 Vaccine FAQs for Healthcare Professionals. 

    The fact sheets for healthcare providers administering the Pfizer-BioNTech COVID-19 Vaccines can be found here. (Revised November 19, 2021) The EUI factsheet for providers can be found here. The link to the prescribing information (PI) for Comirnaty is here: www.fda.gov/media/151707/download.

    The fact sheet for healthcare providers administering the Moderna COVID-19 Vaccine can be found here. (Revised November 19, 2021) 

    The fact sheet for healthcare providers administering the Johnson & Johnson (also known as Janssen) COVID-19 Vaccine can be found here. (Revised November 19, 2021) 

    Healthcare providers or health departments in the United States can request a consultation from CISA COVIDvax for a complex COVID-19 vaccine safety question that is (1) about an individual patient residing in the United States or vaccine safety issue and (2) not readily addressed by CDC or Advisory Committee on Immunization Practices (ACIP) guidelines.

    This request can be made through CDC-INFO by:

    • Calling 800-CDC-INFO (800-232-4636), or
    • Submitting a request via CDC-INFO webform

    For more information, see here. 

    No, you cannot. 

    Instructions from Moderna about their current COVID-19 vaccine indicate that the vaccine should NOT be refrozen once it is thawed. Moderna COVID-19 vaccine vials that have been thawed and then refrozen should be considered spoiled and should be discarded. Discarded vaccine doses or vials should be reported according to the relevant VDH requirements. The VDH COVID Vaccine Wastage Form can be found here

    No. Expired COVID-19 vaccine is much less likely to protect recipients. Moderna COVID-19 vaccine vials expire no later than six hours after they were first used and must be discarded then. Discarded vaccine doses or vials should be reported according to the relevant VDH requirements. The VDH COVID Vaccine Wastage Form can be found here.

    Yes. If the first dose of mRNA COVID-19 vaccine was received but the patient is unable to complete the series with an mRNA vaccine (e.g., due to a listed contraindication), a single dose of Janssen COVID-19 vaccine may be administered at a minimum interval of 28 days from the mRNA dose*. These individuals will be considered to have received a valid, single-dose Janssen vaccination, not mixed a vaccination series (mRNA/viral vector).

    Persons with a contraindication to mRNA COVID-19 vaccines (including due to a known allergy to PEG) have a precaution to the Janssen COVID-19 vaccine.*

    The same precaution applies if a person has a contraindication to getting the Janssen COVID-19 vaccine. Persons with a contraindication to the Janssen COVID-19 vaccine (including due to a known allergy to polysorbate) have a precaution to mRNA COVID-19 vaccines.*

    Persons with a contraindication to one mRNA vaccine should not receive doses of either mRNA vaccine (PfizerBioNTech or Moderna).

    *In these patients, vaccination should be undertaken in an appropriate setting under the supervision of a health care provider experienced in the management of severe allergic reactions. Consider referral to an allergist-immunologist.

    Detailed information from CDC on how to address vaccine administration errors can be found here.

    Key points include:

    • Inform the recipient of the vaccine administration error.
    • Consult with the state immunization program and/or Immunization Information System (IIS) to determine how the dose should be entered into the IIS, both as an administered dose and to account for inventory. The Virginia IIS homepage can be found here
    • Report the error to the Vaccine Adverse Event Reporting System (VAERS), unless otherwise indicated in the table. Providers are required to report all COVID-19 vaccine administration errors—even those not associated with an adverse event — to the VAERS. To file an electronic report, please see the VAERS website.

    Determine how the error occurred and implement strategies to prevent it from happening again. A discussion on strategies to prevent errors can be found in the Vaccine Administration chapter of the Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book). Additional resources can be found on CDC’s vaccine administration web page, including a job aid for preventing errors.

    CDC provides detailed information on preparing to handle anaphylaxis after COVID-19 vaccine administration here.

     Key points include:

    • Healthcare personnel who are trained and qualified to recognize the signs and symptoms of anaphylaxis, as well as administer intramuscular epinephrine, should be available at the vaccination location at all times.
    • Vaccination locations that anticipate vaccinating large numbers of persons should plan adequate staffing and supplies (including epinephrine) for the assessment and management of anaphylaxis.
    • A full list of medications and supplies to have on hand can be found here.
    • COVID-19 vaccination locations should have at least 3 doses of epinephrine available at all times, and the ability to quickly obtain additional doses to replace supplies after epinephrine is administered to a patient. Persons with a history of anaphylaxis who carry an epinephrine auto-injector could be reminded to bring it to their vaccination appointment.

    CDC recommends an observation period following vaccination with COVID-19 vaccines.

    Persons should be observed for 30 minutes if they have:

    • A history of an immediate allergic reaction of any severity to a vaccine or injectable therapy
    • A history of anaphylaxis due to any cause
    • A contraindication to a different type of COVID-19 vaccine (for example, people with a contraindication to mRNA COVID-19 vaccines who receive Janssen viral vector vaccine should be observed for 30 minutes following Janssen vaccination).

    All other persons should be observed for 15 minutes.

    For more information on allergic reactions related to the COVID-19 vaccines, please see the CDC website here.

    Syncope (fainting) may occur in association with any injectable vaccine.

    Procedures should be in place to prevent falling injuries and manage syncopal reactions following COVID-19 vaccination.

    All people are recommended to be observed following COVID-19 vaccination for at least 15 minutes; patients should be seated or lying down during the observation period to decrease the risk for injury should they faint. If syncope develops, patients should be observed until symptoms resolve.

    Yes. CDC has specific guidance for healthcare providers who may be vaccinating homebound persons or persons in small group settings here.

    Yes. The Center for Inclusive Design and Innovation (CIDI) at Georgia Tech has created COVID-19 resources in alternative formats based upon CDC's guidance. Their work is supported by a grant from the CDC Foundation with technical assistance from the Center for Disease Control and Prevention (CDC). These accessible resources for COVID-19 for individuals with disabilities may be found here.

    Yes. Pfizer-BioNTech states that ‘the thermal shipping container, including the temperature-monitoring device, must be returned to the supplier to help Pfizer-BioNTech fulfill its commitment to reusable resources’. The first step in preparing to return the container is to open the thermal shipping container and leave it at room temperature in a well-ventilated area to discard the dry ice. Details about how to return the container are available here.

    CDC has resources that healthcare providers can use to share information on the history and safety of both mRNA and viral vector COVID-19 vaccines. These resources can be found here:

    Additionally, CDC has dedicated resources for building vaccine confidence here.

    V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after patients receive a COVID-19 vaccination. Through v-safe, patients can quickly tell CDC if they have any side effects after getting the COVID-19 vaccine. Depending on their answers, someone from the CDC may call to check on them. V-safe will remind patients to get the second COVID-19 vaccine dose if they need one. 

    Vaccination providers are asked to recommend the use of v-safe to all COVID-19 vaccine recipients. V-safe information sheets and posters are available under “Patient Education” on our website. 

    The VaxText text messaging resource is a free, no cost to the provider or patient, service you can offer to vaccine recipients if you do not already have a text or email reminder system in place. By texting ENROLL to 1-833-VaxText (829-8398), vaccine recipients can opt in to receive a weekly text reminder for their second dose of COVID-19 vaccine or a reminder for when they are overdue for their second dose, in English or Spanish.

    Additional information can be found here.

    The mRNA COVID-19 vaccine series consist of two doses administered intramuscularly:

    • Pfizer-BioNTech (30 µg, 0.3 ml each): 3 weeks (21 days) apart
    • Moderna (100 µg, 0.5 ml): 1 month (28 days) apart

    Persons should not be scheduled to receive the second dose earlier than recommended (i.e., 3 weeks [Pfizer-BioNTech] or 4 weeks [Moderna]). However, second doses administered within a grace period of 4 days earlier than the recommended date for the second dose are still considered valid. Doses inadvertently administered earlier than the grace period do not need to be repeated, but should be reported to VAERS as a vaccine administration error. For detailed information about the grace period, please see here.

    The second dose should be administered as close to the recommended interval as possible. However, if it is not feasible to adhere to the recommended interval, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be scheduled for administration up to 6 weeks (42 days) after the first dose. There are currently limited data on the efficacy of mRNA COVID-19 vaccines administered beyond this window. However, if the second dose is administered beyond these intervals, there is no need to restart the series.

    For certain immunocompromised individuals, an additional primary dose should be administered. The additional mRNA COVID-19 vaccine dose should be the same vaccine product as the initial 2-dose mRNA COVID-19 primary vaccine series (Pfizer-BioNTech or Moderna). If the mRNA COVID-19 vaccine product given for the first two doses is not available, the other mRNA COVID-19 vaccine product may be administered. Until additional data are available, the additional dose of an mRNA COVID-19 vaccine should be administered at least 28 days after completion of the initial 2-dose mRNA COVID-19 primary vaccine series, based on expert opinion. 

    For individuals 18 years of age and older, a booster dose is recommended. The booster dose of COVID-19 vaccine should be given no earlier than 6 months after completion of an mRNA 2-dose primary vaccine series or 2 months after the Janssen (J&J) vaccine. Since immunity wanes gradually over time, the booster may be given at an interval greater than 6 months after completion of the primary vaccine series. Booster doses administered within a grace period of 4 days earlier than the recommended date for the are still considered valid. A booster dose following administration of the J&J COVID-19 vaccine can be given after at least two months. 

    For those recommended to receive a booster, people have the option to receive any of the FDA-approved or FDA-authorized COVID-19 booster products (Pfizer-BioNTech, Moderna [half dose], or Janssen). People may consider the benefits and risks of each product and discuss with their healthcare provider which product is most appropriate for them. More information can be found here

    VDH has developed a “Child, Adolescent, and Adult COVID-19 Vaccine Dosage and Scheduling Table” for easy reference, which may be found on the VDH Healthcare Professionals website.

    Additional information on vaccine administration can be found here

    Vaccine administration errors should be reported to the Vaccine Adverse Event Reporting System (VAERS).

    All doses of the primary series and the additional primary dose (for moderately and severely immunocompromised people), if indicated, should be completed with the same product.

    Every effort should be made to determine which vaccine product was received as the first dose, in order to ensure completion of the vaccine series with the same product. In exceptional situations in which the first-dose vaccine product cannot be determined or is no longer available, any available mRNA COVID-19 vaccine may be administered at a minimum interval of 28 days between doses to complete the mRNA COVID-19 vaccination series. If two doses of different mRNA COVID-19 vaccine products are administered in these situations (or inadvertently), no additional doses of either product are recommended at this time. 

    The safety and efficacy of Janssen COVID-19 vaccine administered after an mRNA COVID-19 vaccine has not been established. However, in limited, exceptional situations where a patient received the first dose of an mRNA COVID-19 vaccine but is unable to complete the series with either the same or different mRNA COVID-19 vaccine (e.g., due to contraindication), a single dose of Janssen COVID-19 vaccine may be considered at a minimum interval of 28 days from the mRNA COVID-19 vaccine dose. Patients who receive Janssen COVID-19 vaccine after a dose of an mRNA COVID-19 vaccine should be considered to have received a valid, single-dose Janssen vaccination—not a mixed vaccination series.

    For individuals aged 18 years or older who are recommended to receive a booster dose, people have the option to receive any of the FDA-approved or FDA-authorized COVID-19 booster products (Pfizer-BioNTech, Moderna [half dose], or Janssen). People may consider the benefits and risks of each product and discuss with their healthcare provider which product is most appropriate for them.

    Clinical trial data show that homologous COVID-19 booster doses (utilizing the same vaccine product for the primary series and booster dose) increase the immune response against SARS-CoV-2 and have an acceptable safety profile for all FDA-approved or FDA-authorized COVID-19 vaccine boosters. One study of heterologous (mix-and-match) booster dosing showed that all three of the FDA-approved or FDA-authorized vaccine boosters doses led to a strong serologic response in groups primed by all three vaccines. For a given COVID-19 primary vaccine series, heterologous boosters elicited similar or higher serologic responses as compared to their respective homologous booster responses.

    Additional information on vaccine administration can be found here

    Information for individuals who received incomplete or full vaccination in another country with a non-FDA authorized vaccine can be found here

    Vaccine administration errors should be reported to the Vaccine Adverse Event Reporting System (VAERS).

    FDA and CDC have confirmed that some providers are reporting the ability to obtain additional doses within the multidose COVID-19 vaccine vials manufactured by both Pfizer-BioNTech and Moderna. Consensus from FDA and CDC is that it is acceptable to use every full dose obtainable from each vial, with one exception for Moderna vials (see next paragraph). However, since these are preservative free vials, it is critical to note that any further remaining liquid that does not constitute a full dose should not be pooled from multiple vials to create an additional dose.

    For Moderna Vials: When extracting only primary series doses (0.5 mL), depending on the syringes and needles used, a maximum of 11 doses (range: 10-11 doses) may be extracted from the vial containing 5.5 mL or a maximum of 15 doses (range: 13-15 doses) may be extracted from the vial containing 7.5 mL. When extracting only booster doses (0.25 mL) or a combination of primary series (0.5 mL) and booster doses (0.25 mL), the maximum number of doses that may be extracted from either vial presentation should not exceed 20 doses. Do not puncture the vial stopper more than 20 times. If the amount of vaccine remaining in the vial cannot provide a full dose of 0.5 mL or 0.25 mL, discard the vial and contents. Do not pool excess vaccine from multiple vials.Full prescriber information from the FDA may be found here (dated October 20, 2021).

    Yes.

    Due to the novelty of the COVID-19 vaccines, the previous recommendation was to administer COVID-19 vaccines alone, with a minimum interval of 14 days before or after administration of any other vaccine to better understand any adverse reactions. However, substantial data have now been collected regarding the safety of COVID-19 vaccines currently authorized by FDA for use under EUA. Extensive experience with non-COVID-19 vaccines has demonstrated that immunogenicity and adverse event profiles are generally similar when vaccines are administered simultaneously as when they are administered alone. COVID-19 vaccines (i.e. primary series, third doses, and booster doses) and other vaccines may now be administered without regard to timing. This includes simultaneous administration of COVID-19 and other vaccines on the same day, as well as co-administration within 14 days. Co-administered vaccines should be administered in different arms. 

    It is unknown whether reactogenicity, that is, the generation of vaccine side effects, is increased with coadministration, including with other vaccines known to be more reactogenic, such as adjuvanted vaccines.

    When deciding whether to co-administer with COVID-19 vaccines, providers could consider whether the patient is behind or at risk of becoming behind on recommended vaccines and the reactogenicity profile of the vaccines.

    Currently, there are limited data available on the safety and effectiveness of COVID-19 vaccines in people who received passive antibody products (anti-SARS-CoV-2 monoclonal antibodies or convalescent plasma) as part of COVID-19 treatment or post-exposure prophylaxis. Based on the estimated half-life of such products and the anticipated period of protection against infection or reinfection, COVID-19 vaccination should be temporarily deferred as a precautionary measure during the time period specified below after receiving passive antibody products to avoid potential interference of the product with vaccine-induced immune responses:

    • Passive antibody product used for post-exposure prophylaxis: defer COVID-19 vaccination for 30 days
    • Passive antibody product used for COVID-19 treatment: defer COVID-19 vaccination for 90 days

    However, if passive antibody products and a COVID-19 vaccine dose are administered within these recommended deferral periods (30 or 90 days), the vaccine dose does not need to be repeated.

    For people receiving antibody products not specific to COVID-19 treatment (e.g., intravenous immunoglobulin, RhoGAM), administration of COVID-19 vaccines either simultaneously with or at any interval before or after receipt of an antibody-containing product is unlikely to substantially impair development of a protective antibody response to SARS-CoV-2. Thus, there is no recommended minimum interval between antibody therapies not specific to COVID-19 treatment and COVID-19 vaccination.

    Vaccines other than COVID-19 vaccines, including inactivated and live vaccines, may be administered without regard to timing of anti-SARS-CoV-2 monoclonal antibodies. Vaccines for diseases other than COVID-19 can be administered without regard to timing following receipt of convalescent plasma except for measles- or varicella-containing vaccines, which should be administered at least 7 months after receipt of convalescent plasma.

    More information can be found here.

    Yes. A number of ongoing real-world effectiveness studies have been conducted. This is an area under continuous research. CDC’s Science Brief: COVID-19 Vaccines and Vaccination provides a summary of studies regarding vaccine effectiveness. These studies look at the different vaccine brands, various populations, different clinical outcomes, transmission risk, and response to variants.

    The COVID-19 Prevention Network provides information on enrolling in clinical trials. Please click here for more information. The COVID-19 Prevention Network (CoVPN) was formed by the National Institute of Allergy and Infectious Diseases (NIAID) at the U.S. National Institutes of Health.

    Some people in the United States have completed a COVID-19 vaccination series as part of a clinical trial with sites in the United States involving a COVID-19 vaccine that is currently neither approved nor authorized by FDA.

    CDC provides guidance on this topic, including additional and booster dose guidance,  here. CDC also provides guidance for people vaccinated as part of a clinical trial outside the United States. The emergency use instruction fact sheet for clinicians can be found here.

    Moderna: To find the expiration date for any vial of Moderna COVID‑19 vaccine, locate the lot number, printed on the carton and vial. Enter the lot number on the Moderna website by entering the lot number that is printed on the box. You can also scan the QR code located on the outer carton. 

    Pfizer: Vials stored in an ultracold storage unit can be used until the last day of the month printed on the tray and each vial.

    Janssen: The expiration date can be acquired three ways. For complete instructions, visit the Janssen website

    • Scan the QR code on the outer carton
    • Call 1-800-565-4008
    • Visit vaxcheck.jnj

    An additional dose of an mRNA COVID-19 vaccine after an initial 2-dose primary mRNA COVID-19 vaccine series should be considered for people with moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments. These conditions and treatments include but are not limited to: 

    • Active treatment for solid tumor and hematologic malignancies 
    • Receipt of solid-organ transplant and taking immunosuppressive therapy 
    • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of  transplantation or taking immunosuppression therapy) 
    • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome,  Wiskott-Aldrich syndrome) 
    • Advanced or untreated HIV infection 
    • Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or  equivalent per day), alkylating agents, antimetabolites, transplant-related  immunosuppressive drugs, cancer chemotherapeutic agents classified as  severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory. 

    Additional information about the level of immunosuppression associated with a range of medical conditions and treatments can be found in general best practices for vaccination  of people with altered immunocompetence, the CDC Yellow Book, and the Infectious  Diseases Society of America policy statement, 2013 IDSA Clinical Practice Guideline for  Vaccination of the Immunocompromised Host.

    The dosage size for the additional primary dose is the same as previous doses. The additional primary dose should be the same mRNA vaccine as the primary series. However, an alternative mRNA vaccine can be used if the primary series product is not available.

    Yes. HCT and CAR-T-cell recipients who received doses of COVID-19 vaccine prior to receiving an HCT or CAR-T-cell therapy should be revaccinated with a primary vaccine series at least 3 months (12 weeks) after transplant or CAR-T-cell therapy.

    An additional primary dose of an mRNA COVID-19 vaccine (if revaccinated with a 2-dose mRNA COVID-19 vaccine primary series) is recommended as part of revaccination for persons who continue to have moderate or severe immune compromise. The additional primary dose of an mRNA COVID-19 vaccine should be administered at least 28 days after the second dose. A patient’s clinical team is best positioned to determine the degree of immune compromise and appropriate timing of vaccination.

    No. Individuals can self-attest, or self-report, that they are eligible for an additional primary dose of an mRNA vaccine (with moderate or severe immunocompromising condition) or a booster dose. Eligible persons should be able to receive this additional or booster dose wherever vaccines are offered.

    Vaccine providers should ask patients questions to confirm eligibility for vaccination,  including the person’s age and previous COVID-19 vaccination history.

    Vase+, VAMS and PrepMod will all have this ability but they may not immediately have  the most up-to-date vaccine fact sheet link in their system. Both additional primary doses and booster doses will be recorded as third doses in these systems. Any additional health  screening questions may not be added yet. 

    Recommended vaccination schedules vary depending on the disease and the vaccine product used. For COVID-19, a primary vaccine series is defined as either:

    • Two doses of an mRNA vaccine (Pfizer-BioNTech or Moderna) separated by the recommended number of 21 or 28 days; or
    • One dose of the Johnson & Johnson (J&J) vaccine.

    A booster dose is a COVID-19 vaccine dose administered to someone who initially had a sufficient immune response to their primary vaccine series, but this immune response is expected to have weakened over time. 

    CDC now recommends that people aged 18 years and older receive a booster vaccine at least 6 months (for Pfizer-BioNTech or Moderna) after completing their primary series. More information can be found here and here.

    CDC also recommends that everyone aged ≥18 years who received a Janssen (J&J) primary series should receive a single COVID-19 vaccine booster ≥2 months after their Janssen primary dose. Currently, a booster dose is not recommended in people aged <18 years. More information can be found here

    An additional primary series dose is a COVID-19 vaccine dose administered to someone with a moderately or severely weakened immune system because their initial immune response after completing the primary vaccine series may have been insufficient to provide them with strong protection. This additional dose for immunocompromised people is NOT a traditional vaccine booster dose. Rather, this third dose is considered a necessary part of the primary series for those with significant immune compromise.

    People who have a moderately or severely weakened immune system who received 2 doses of the Pfizer-BioNTech or Moderna vaccine are now eligible to get an additional primary dose of the Pfizer-BioNTech or Moderna vaccine. For those with significant immune compromise who received the J&J vaccine, it is not authorized for use as an additional primary dose, and people who received a single-dose Janssen primary vaccine should not receive an additional primary dose.

    HCT and CAR-T-cell recipients who received doses of COVID-19 vaccine prior to receiving an HCT or CAR-T-cell therapy should be revaccinated with a primary vaccine series at least 3 months (12 weeks) after transplant or CAR-T-cell therapy.

    An additional primary dose of an mRNA COVID-19 vaccine (if revaccinated with a 2-dose mRNA COVID-19 vaccine primary series) is recommended as part of revaccination for persons who continue to have moderate or severe immune compromise. The additional primary dose of an mRNA COVID-19 vaccine should be administered at least 28 days after the second dose. A patient’s clinical team is best positioned to determine the degree of immune compromise and appropriate timing of vaccination.

    VDH has developed a “Child, Adolescent, and Adult COVID-19 Vaccine Dosage and Scheduling Table” for easy reference, which may be found on the VDH Healthcare Professionals website.

    CDC now recommends that people aged 18 years and older receive a booster shot of Pfizer-BioNTech or Moderna COVID-19 Vaccine at least 6 months after completing their primary series. 

    Individuals aged 18 years and older who received the Johnson & Johnson (Janssen) COVID-19 vaccine may receive a booster 2 months after their initial dose. 

    Detailed information about booster doses may be found here. VDH has developed a “Child, Adolescent, and Adult COVID-19 Vaccine Dosage and Scheduling Table” for easy reference, which may be found on the VDH Healthcare Professionals website.

    Booster doses of the Pfizer-BioNTech, Moderna, and Johnson & Johnson (Janssen) vaccines have been authorized by the FDA, approved by the ACIP, and CDC has published interim recommendations. These booster doses may now be administered at any time, provided the individual qualifies for a booster dose and completed their primary series of their mRNA vaccine (Pfizer-BioNTech or Moderna) at least 6 months ago or their Johnson &Johnson (Janssen) vaccine at least 2 months ago. 

    For groups recommended to receive a booster, people have the option to receive any of the FDA-approved or FDA-authorized COVID-19 booster products (Pfizer-BioNTech, Moderna [half dose], or Janssen). People may consider the benefits and risks of each product and discuss with their healthcare provider which product is most appropriate for them.  Further considerations regarding booster doses may be found here.

    Vaccination: Long-Term Care Facilities

      •  An additional primary series mRNA dose is for the immunocompromised population after receiving the initial 2 doses of an mRNA series.
      • A booster is an additional dose of a vaccine given after the protection provided by the original dose(s) has begun to decrease over time. Typically, you would get a booster after the immunity from the initial dose(s) naturally starts to wane. The booster is designed to help people maintain their level of immunity for a longer period of time.
      • The CDC has authorized Moderna and Pfizer-BioNTech to be administered to individuals who have received their primary two-dose series of an mRNA vaccine and are moderately to severely immunocompromised.

    The CDC has authorized that all COVID-19 vaccines are now booster authorized. The CDC has also authorized that all COVID-19 vaccines are interchangeable for booster doses across all three vaccine types (Pfizer, Moderna, and J&J). 

    For more information, please visit the CDC website.

    Any of the COVID-19 vaccines can be used for booster vaccination, regardless of the vaccine product used for primary vaccination. When a heterologous or “mix and match” booster dose is administered, the eligible population and dosing intervals are those of the vaccine used for primary vaccination.

    For the mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna) recipients, the following recipients of an mRNA primary series should receive a single COVID-19 booster dose (Pfizer-BioNTech, Moderna, or Janssen) at least 6 months following completion of the primary series:

    • People aged 50 years and older
    • Residents aged 18 years and older in long-term care

    The following recipients of an mRNA primary series may receive a single COVID-19 booster dose (Pfizer-BioNTech, Moderna, or Janssen) after at least 6 months following completion of their primary series based on their individual benefits and risks:

    • All other persons aged 18 years and older

    These booster dose recommendations also apply to people who received two doses of different mRNA COVID-19 vaccine products for their primary series.

    Moderately or severely immunocompromised people aged ≥18 years who received a 2-dose mRNA primary series and an additional primary dose (3 total mRNA COVID-19 vaccine doses) are eligible for a single COVID-19 booster dose (Pfizer-BioNTech, Moderna, or Janssen).

    For the Janssen COVID-19 Vaccine recipients, people aged ≥18 years who received a single dose Janssen primary series should receive a single COVID-19 booster dose (Pfizer-BioNTech, Moderna, or Janssen) at least 2 months following  completion of their Janssen primary series.

    Currently, CDC does not recommend a booster dose in children aged 5–17 years. As more data becomes available, this recommendation may be updated.

    For more information, visit the CDC website.

    As of Friday, October 22, CDC booster recommendations were updated to include LTCF staff and residents for all three types of the COVID-19 vaccine (Pfizer, Moderna, and J&J).

    Residents or patients in congregate healthcare settings (e.g., long-term care facilities) may be vaccinated. In these settings, exposure to and transmission of SARS-CoV-2 can occur repeatedly for long periods of time, and healthcare personnel and other staff are already in close contact with residents.

    LTCF Staff aged 18–64 years who are at increased risk for SARS-CoV-2 exposure and transmission because of occupational or institutional setting are eligible to receive a booster.

    Eligible individuals can receive a booster dose of Pfizer-BioNTech or Moderna at least 6 months after completing their primary series (2nd dose). Individuals who had initially received the J&J vaccine can receive their booster dose at least 2 months (8 weeks) after receiving the first dose.

    Yes, individuals may receive a booster that is not the same type as their primary series vaccine. See example scenarios below:

    1. Individuals who had received Moderna 1st and 2nd doses can choose to receive Pfizer or J&J as their booster dose
    2. Individuals who had received Pfizer 1st and 2nd doses can choose to receive Moderna or J&J as their booster dose
    3. Individuals who received the J&J one dose vaccine can choose to receive Pfizer or Moderna as their booster dose

    As of Tuesday, November 2nd, 2021, a new COVID-19 Pfizer vaccine has been approved by CDC/ACIP for individuals aged 5 to 11 years old.

    If a long-term care facility has 5 to 11 year old patients, the facility is advised to work with a pharmacy partner or the LHD to confirm access to the new pediatric vaccine.

    The Federal pharmacy partnership program will not be reinstated by CDC for COVID-19  booster assistance. However, CDC has partnered with various pharmacies to ensure LTCFs are able to access the COVID-19 vaccine. For more information, visit the CDC pharmacy partner contact information page here.

    • Consider identifying a pharmacy to contract with, if your current pharmacy is not able to meet your needs.
    • If LTCFs are unable to partner with a local pharmacy, facilities are encouraged to consider enrolling as a vaccine provider to be able to order and administer vaccines to staff and residents themselves. For more information, visit the VDH Provider Enrollment Process Flow & Checklist.
    • LTCFs may also submit an off-site clinic request with pharmacies who may be able to assist facilities with their vaccination needs. For more information, visit the CDC pharmacy partner contact information page here.

    Contact your local health department for additional support, if needed. More information can be found on the Toolkit for Long-Term Care Facilities to Sustain COVID-19 Vaccine Access.

    Influenza vaccines and COVID-19 vaccines can be coadministered without regard to timing. If these vaccines are co-administered, it is recommended to use different injection sites. Please refer to the full CDC guidance.

    LTCFs are able to order and administer vaccines through VaxMaX if the facility is enrolled  as a vaccine provider. More information on how to enroll as a vaccine provider, visit the VDH Provider Enrollment Process Flow & Checklist.

    Patient education can be found here. These resources can be used to help educate patients and staff who remain vaccine hesitant. 

    COVID-19 Staff Vaccination toolkit for LTCFs can be found on the VDH LTC taskforce page under Education & Training Resources.

    CDC provides guidance on post vaccine considerations for residents. Data thus far show that most systemic post-vaccination signs and symptoms are mild to moderate in severity, occur within the first three days of vaccination (the day of vaccination and following two days, with most occurring the day after vaccination), resolve within 1-2 days of onset, and are more frequent and severe following the second dose and among younger persons compared to those who are older (>55 years). Cough, shortness of breath, rhinorrhea, sore throat, or loss of taste or smell are not consistent with post-vaccination symptoms, and instead may be symptoms of SARS-CoV-2 or another infection.

     

    Staff who are fully vaccinated need not be routinely tested. Facilities in communities with moderate transmission should test unvaccinated staff once per week. Facilities in communities with substantial or high transmission should test unvaccinated staff twice per week. If a new case is identified in the facility, residents and staff who are close contacts should be tested regardless of their vaccination status. Please refer to the amended CMS guidance document to learn more about testing requirements for unvaccinated staff.

    Vaccination: Employers

    A vaccinated workforce confers a host of benefits for both employers and employees. The vaccines greatly reduce the chances of an individual getting COVID-19 and will ensure if the employee gets the virus, they will have only mild symptoms or none at all. This translates into healthier employees, higher productivity and morale, plus reduced absences due to illness.

    Present them with the facts about the benefits of vaccination, as well as available resources about how to get vaccinated in the community if you are not coordinating an onsite clinic. Combat misinformation and provide support wherever possible. Be flexible in your human resources policies, allowing staff to take paid time off to get the vaccines if you are not able to provide an opportunity through your workplace during their working hours. Refer staff to vaccinate.virginia.gov, where they can schedule a vaccine appointment. Promote vaccination by posting signs or sharing flyers that advertise the benefits of getting vaccinated or locations that are offering COVID-19 vaccine in the workplace or community.  Warn your employees about vaccination scams

    The CDC has developed an Essential Workers COVID-19 Vaccine Toolkit with information to help employers educate employees about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns.

    A Virginia-specific public information toolkit is also available to assist community partners with graphics, talking points, frequently asked questions, and other materials on the COVID-19 vaccines. 

    The U.S. Surgeon General released a community toolkit for Addressing Health Misinformation. The toolkit can be found here.

    Inform employees about the high rates of efficacy these vaccines provide.  All three of these vaccines provide excellent protection against the most severe forms of COVID-19 that are linked to a need for hospitalization and to death. Also, make sure your employees know about the significant government oversight ensuring all approved COVID-19 vaccinations are as safe as possible. Remind your staff that millions of people have already been vaccinated across the nation.   

    Employees should understand what potential side effects they might experience after receiving the vaccines, as well as the importance of getting both doses of the vaccine if it is a 2-dose series (e.g., Moderna or Pfizer-BioNTech vaccines). They will receive a vaccination record card allowing them to keep track of what vaccine they are given and how many doses they need. Most side effects should be minor and are simply the body’s response to building immunity to the virus.

    No employer is required by law to provide employees with the COVID-19 vaccines. However, Virginia’s employers have the opportunity to play a key role in the largest vaccination effort in history by encouraging their employees to get vaccinated. Getting as many people vaccinated as possible will help the Commonwealth end the COVID-19 pandemic and safely reopen the economy. Employers are also encouraged to work collaboratively with their local health district to support the efficient vaccination of their employees when possible.

    To find an appointment, employees should visit vaccinate.virginia.gov or call 877-VAX-IN-VA (877-829-4682). 

    Yes. 

    Large employers with the medical infrastructure and capacity to vaccinate their own employees may be eligible to receive an allocation of vaccine doses from their local health department when doses become available. Healthcare providers affiliated with an employer must enroll as a CDC vaccine provider and complete the necessary paperwork. They may then work with their local health department to hold on-site clinics for employees.

    Yes. It may be possible for an employer to contract with a healthcare staffing group to administer vaccines to their employees. The healthcare group must have enrolled as a CDC vaccine provider and completed the necessary paperwork.

    Yes. If you are able to offer vaccination at your workplace, consider providing vaccinations to all eligible individuals, regardless of their status as a contract or temporary employee. What is most important is to encourage everyone at the work site to be vaccinated, no matter what their work arrangement is.

    The Centers for Disease Control and Prevention (CDC) has provided guidance on how to avoid worker shortages due to vaccine side effects. Data from COVID-19 vaccine trials indicate most side effects are mild, but employers may consider staggering employee vaccination schedules. Side effects are more frequent and severe after the second dose, when part of a two-dose series.

    The vaccines are offered to everyone, including employees, at no cost. Any administrative fees must be covered either by insurance companies or by the U.S. Health Resources and Services Administration Provider Relief Fund. Employers are not authorized to charge employees any out-of-pocket fees for access to the vaccines. 

    No. The COVID-19 vaccines will not be made mandatory for all Virginians, and there are no legal penalties for not being vaccinated, but the Virginia Department of Health is urging individuals to get fully vaccinated once vaccines are available to them. Once enough people are vaccinated against COVID-19, we can resume more of the everyday activities we enjoyed before the COVID-19 pandemic. Please note, at this time many colleges and universities are requiring vaccination for students and staff in the upcoming academic year.

    The Equal Employment Opportunity Commission (EEOC) has issued guidance on this and the applicability of various laws to COVID-19 vaccinations in the workplace. Private employers should seek legal counsel for additional details.

    The Equal Employment Opportunity Commission (EEOC) has issued guidance on this and the applicability of various laws to COVID-19 vaccinations in the workplace. Private employers should seek legal counsel for additional details.

    The Equal Employment Opportunity Commission (EEOC) has issued guidance on this and the applicability of various laws to COVID-19 vaccinations in the workplace. Private employers should seek legal counsel for additional details.

    Virginia’s permanent COVID-19 workplace safety and health rules took effect on January 27, 2021, after Governor Northam approved the standard adopted by the Virginia Department of Labor and Industry’s (DOLI) Safety and Health Codes Board. The standards mandate appropriate personal protective equipment, sanitation, social distancing, infectious disease preparedness and response plans, record keeping, training, and hazard communications in workplaces across the Commonwealth. DOLI has published the Virginia Standard For Infectious Disease Prevention Of COVID-19

    Employers are required to comply with the standards for as long as they are in effect, regardless of if all or some of their employees have been vaccinated.

    Employees who work in certain business sectors—including restaurants, retail, fitness, personal care, and entertainment—must continue to wear masks unless fully vaccinated, consistent with CDC guidelines.

    Businesses are generally free to adopt their own mask requirements. Employees of some workplaces may still be required by state regulations to wear masks, even if fully vaccinated. For more information, employers should refer to the Virginia Department of Labor and Industry’s Standard and Frequently Asked Questions.

    The Equal Employment Opportunity Commission (EEOC) has issued guidance on this and the applicability of various laws to COVID-19 vaccinations in the workplace. In short, private employers should seek legal counsel for additional details

    Employers should seek legal counsel for guidance on requiring vaccination for in person events or for return to work. Generally speaking, the COVID-19 vaccine will not be made mandatory for all Virginians. However, the Virginia Department of Health does urge individuals to get vaccinated once it’s available to them. Once enough people are vaccinated against COVID-19, we can resume more of the everyday activities we enjoyed before the COVID-19 pandemic.

    The Equal Employment Opportunity Commission (EEOC) has issued guidance on this and the applicability of various laws to COVID-19 vaccinations in the workplace. In short, private employers should seek legal counsel for additional details. The Virginia Department of Health does urge individuals to get vaccinated once it’s available to them. Once enough people are vaccinated against COVID-19, we can resume more of the everyday activities we enjoyed before the COVID-19 pandemic.

    Vaccination: Children

    As of 11/22/21, more than 18% of children 5 to 11 have received at least one dose of COVID-19 vaccine in Virginia. Children (those less than 18 years of age) account for a significant proportion (>20%) of COVID-19 cases in Virginia. Children aged 5–11 years have the highest case rates of COVID-19 in Virginia of any childhood age group. Although children and adolescents may have less severe acute illness than adult populations, they are still at risk of becoming sick, hospitalized, or in some cases, dying. Although many hospitalized children have underlying conditions, one-third do not. Children who become infected may also develop long-term illness, such as multisystem inflammatory syndrome in children (MIS-C) or long COVID. MIS-C is a condition where different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Long COVID is when individuals develop symptoms such as fatigue, chest pain, headaches, or shortness of breath that last for weeks or months, and may not appear until several weeks after infection. Long COVID can occur even in cases of asymptomatic or mild COVID-19 disease. A number of children have developed myocarditis from COVID-19 infection. Finally, unvaccinated children are more likely to spread the SARS-CoV-2 virus to other people if they get infected.

    Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history. We are fortunate to have such a safe and effective vaccine to protect us. Having the ability to vaccinate children aged 5–11 years will provide additional protection for this population. Equally important, it can help our students stay in school, and minimize interruptions such as having to quarantine after an exposure. Vaccination can also decrease the likelihood of COVID-19 transmission, which makes our communities safer.

    You can now make an appointment for your 5–11 year old to get the Pfizer-BioNTech COVID-19 vaccine. 

    Virginia will have enough supply of the Pfizer-BioNTech (5–11 year old) vaccine for all Virginians ages 511 years old. However due to the nature of vaccinating this population, we do anticipate appointments with a primary care provider may be preferred by parents and therefore access to this vaccine may be more limited initially. There are many options for children to receive the Pfizer-BioNTech (5–11 year old) vaccine, including pediatrician and family practice offices, retail pharmacies, federally qualified health centers (FQHC), and Community Vaccination Centers (CVCs).

    High demand for the Pfizer-BioNTech (5–11 year old) vaccine in some parts of Virginia may make it hard to get an appointment at certain locations at first. More appointments will open up each week. Parents and guardians should check vaccinate.virginia.gov regularly to see updated appointment availability, especially if they are unable to make an appointment at their preferred location.

    Appointments for vaccines for 5–11 year olds may be limited initially.

    To look for an appointment, check with your child’s healthcare provider to see if they are providing COVID-19 vaccines for this age group, visit vaccinate.virginia.gov, or call 877-VAX-IN-VA (877-829-4682). Many healthcare providers have vaccines, but some do not. You can find other locations such as retail pharmacies, community events, and community vaccination centers at vaccinate.virginia.gov.

    Children 5–11 will need 2 doses of the Pfizer-BioNTech vaccine separated 21 days apart. Your child should get their second dose 21 days after their first dose or soon after. However, their second dose may be given up to 6 weeks (42 days) after the first dose, if necessary. It is important that your child receive both doses.

    Sites run by the Virginia Department of Health require the parent or guardian to verbally confirm a minor’s date of birth; however, other providers may require additional proof of age.

    You should check with the facility that is offering the vaccination about requirements for proof of age.

    For minors getting vaccinated at VDH-sponsored or VDH-supported community events and health department clinics: The parent or guardian does not have to be present at the time of vaccination, but someone acting in loco parentis must accompany the minor.

    For minors getting vaccinated at VDH sponsored or supported school vaccination events: Clinics occurring during the school day while school is in session and fully staffed do require parental consent but do not require the presence of a parent, guardian, or someone acting in loco parentis.

    You should check with the facility that is offering the vaccination about consent and who needs to accompany the adolescent.

    Yes. It is recommended that your child become fully vaccinated against COVID-19 for complete protection. It is safe for your child with previous COVID-19 illness to get vaccinated.

    Even if your child already had COVID-19, they will benefit from vaccination. In someone who has “natural immunity” from a previous infection, vaccination adds protection that is both stronger and broader. Several studies clearly indicated that people vaccinated after having COVID-19 disease had lower risk of COVID-19 re-infection than people not vaccinated after COVID-19 disease.

    The Pfizer-BioNTech COVID-19 vaccine for 5–11 year olds works the same way as the Pfizer-BioNTech COVID-19 for adults. However, the formulation is different.  Not only is it a lower dose, but the dilution requirements and storage conditions are also different. It is important that your child receive the specific vaccine formulated for children.

    COVID-19 vaccine dosing is based on your child’s age, and not their weight or size.

    Side effects seen in children after vaccination against COVID-19 are similar to those seen in adolescents and young adults. Reported side effects following vaccination are less frequent in children aged 5–11 years compared with young adults aged 16–25 years.

    Reported local side effects include pain, or redness, or tenderness at the injection site. Possible systemic effects include fatigue, nausea, diarrhea, chills, fever, swollen lymph nodes, headache or other body aches for a few days. These expected side effects mean that the vaccine is causing the body’s immune system to react and create antibodies to fight off the virus that causes COVID-19 if they are exposed in the future. Side effects are typically mild and go away within a few days. 

    As happens occasionally with other vaccines such as the influenza vaccine, fainting soon after injection has also been noted among a small number of COVID-19 vaccine recipients, especially among adolescents and other young adults.

    Some of the expected side effects could interfere with your child’s ability to do daily activities, but they should go away in a few days.

    Medicines such as acetaminophen or ibuprofen can help with the common side effects (for example, arm pain or fever) after those side effects start to occur. These medications should only be taken after, and not before, your child’s COVID-19 vaccine dose. If your child has persistent injection site pain, short term fever, or other discomfort, talk to your child’s healthcare provider about taking one of these over-the-counter medicines.

    Contact your child’s healthcare provider:

    • If the redness or tenderness where your child got the shot increases after 24 hours. 
    • If their side effects are worrying you or do not seem to be going away after a few days. 

    Remember to sign your vaccinated child up for v-safe (vsafe.cdc.gov), where you can use your smartphone to tell CDC about any side effects after they get the COVID-19 vaccine. You’ll also get reminders from v-safe about their second vaccine dose.

    You will need your smartphone and information about the COVID-19 vaccine that your child received. This information can be found on the vaccination record card they receive at the time of vaccination; if you cannot find their vaccination record card, please contact your healthcare provider. COVID-19 vaccination records in the Virginia Immunization Information Systems (VIIS) are also available through the COVID-19 Vaccination Record Request Portal. You can access the portal by visiting vaccinate.virginia.gov

    For instructions on how to register your child for v-safe, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/v-safe-register-dependents.html.

    Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of the heart. In both cases, the body’s immune system causes inflammation in response to an infection or some other trigger. Cases of myocarditis and pericarditis in adolescents and young adults have been reported more often after getting the second dose than after the first dose of one of the two mRNA COVID-19 vaccines, Pfizer or Moderna. These reports are rare and the known and potential benefits of COVID-19 vaccination outweigh the known and potential risks, including the possible risk of myocarditis or pericarditis

    In addition, myocarditis is far more common and more severe after COVID-19 illness than after COVID-19 vaccination. According to a CDC MMWR, in children less than 16 years of age, patients with COVID-19 had more than 35 times the risk for myocarditis compared with patients who did not have COVID-19. 

    Learn more about myocarditis and pericarditis. Seek medical care if you or your child have symptoms of these conditions within a week after COVID-19 vaccination.

    COVID-19 vaccination records in the Virginia Immunization Information Systems (VIIS) are available through the COVID-19 Vaccination Record Request Portal. To access the portal, visit vaccinate.virginia.gov

     

    Enter your child’s name, date of birth, and ZIP code. If there is a match, the system will send a verification code to the phone number associated with their vaccination record, through either a text message or an automated voice call. This prevents other people from accessing their record. Once you enter the verification code, you can view, save, and print your child’s Vaccination Record with QR code. With iOS 15, you can securely store verifiable versions of your child’s COVID-19 test results and immunization records in the Health app on your iPhone or iPod touch.

     

    Vaccine doses given to children at a federal facility (such as a military treatment facility) are not reported to VIIS. Please contact the facility that provided the vaccine for instructions on how to obtain a copy of their record.

    No, children aged 5–11 years are not required to get vaccinated; however, vaccination is strongly recommended for all eligible individuals, including children aged 5–11 years.

    Children should receive the vaccine dosage and formulation based on their age on the day of vaccination with each dose. If a child turns 12 years old between their first and second dose, they should receive the age-appropriate 30 µg Pfizer COVID-19 Vaccine formulation for their second dose to complete their series. However, the FDA authorization allows children who will turn from 11 years to 12 years of age between their first and second dose in the primary regimen to receive, for either dose, either: (1) the Pfizer COVID-19 Vaccine formulation for children aged 5–11 years (each 0.2 ml dose containing 10 µg); or (2) the Pfizer COVID-19 Vaccine formulation authorized for use in individuals 12 years of age and older (each 0.3 mL dose containing 30 mcg). If such dosing occurred, the child is considered fully vaccinated. This is not considered an error.

    There are no plans to mandate that K-12 school children receive a COVID-19 vaccine at this time. The General Assembly would need to approve that requirement through Virginia’s immunization code.

    People with a history of MIS-C may choose to be vaccinated. This is a discussion that should be had with your child’s healthcare team. 

    The risk of SARS-CoV-2 reinfection is low in the first few months after initial infection but may increase with time due to waning immunity. Thus, people with a history of MIS-C or MIS-A should consider delaying vaccination until they have recovered from illness and for 90 days after the date of diagnosis of MIS-C recognizing that the risk of reinfection and, therefore, the benefit from vaccination, might increase with time following initial infection.

    Several experts consider the benefits of COVID-19 vaccination for children and adolescents to outweigh a theoretical risk of an MIS-like illness or the risks of myocarditis following COVID-19 vaccination for people who meet all of the following criteria:

    • Clinical recovery has been achieved, including return to normal cardiac function;
    • It has been ≥90 days since their diagnosis of MIS-C;
    • They are in an area of high or substantial community transmission of SARS-CoV-2 or otherwise have an increased risk for SARS-CoV-2 exposure and transmission; and
    • Onset of MIS-C occurred before any COVID-19 vaccination.

    COVID-19 vaccination may also be considered for people with a history of MIS-C who do not meet all the above criteria or for people with a history of MIS-A. Experts view clinical recovery, including return to normal cardiac function, as an important factor when considering COVID-19 vaccination. Additional factors when considering individual benefits and risks may include:

    1. An increased personal risk of severe COVID-19 (e.g., age, underlying conditions)
    2. Timing of immunomodulatory therapies (ACIP’s general best practice guidelines for immunization can be consulted for more information)

    No.

    There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems—problems trying to get pregnant or in carrying a pregnancy to term. NOTE: Getting the actual COVID-19 illness while pregnant does increase the risk of severe illness in the pregnant woman and the risk of premature delivery.

    Like with all vaccines, scientists are studying COVID-19 vaccines carefully for side effects now and will report any additional findings as they become available.

    The risk of children getting severely ill from COVID-19 has been lower than in unvaccinated older people, but it is not zero. In addition, recent data indicate that the Delta variant of the SARS-CoV- virus that causes COVID-19 has a greater impact on younger people than the earlier variants.

    Children who have COVID-19 have a risk of becoming sick, hospitalized, or in some cases, dying. Children may also develop long-term illness, such as multisystem inflammatory syndrome in children (MIS-C) or long COVID. Long COVID is when individuals develop symptoms such as fatigue, chest pain, headaches, or shortness of breath that last for weeks or months, and may not appear until several weeks after infection. In contrast, the vaccine has been proven to be safe and effective in children ages 5 years and up. 

    Getting children vaccinated can help protect them as individuals from becoming seriously ill or developing long term complications. Equally important, it can also help our schools become safer for everyone and reduce transmission and infection in our communities. By vaccinating children, we can also help protect those who may still be vulnerable including immunocompromised individuals who may not have complete protection from the vaccine and younger children who are not yet eligible for the vaccine.

    Yes. Masks will continue to be required in public and private K-12 settings, given low rates of vaccination among children. 

    On August 12, 2021, State Health Commissioner Dr. M. Norman Oliver reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. The Order does not apply to outdoor school settings. VDH recommends those who are not fully vaccinated wear masks in crowded outdoor settings or during outdoor activities that involve sustained close contact with other people, but it is not a requirement. FAQs on the mask order can be found here.

    Vaccination: People with Weakened Immune Systems

    Yes. As many as 2.7% of the adult U.S. population have some variety of weakened immune systems.

    Many people with weakened immune systems are at greater risk from SARS-CoV-2 virus infection and severe COVID-19 disease. Such people include: 

    1. those who have a weakened immune system because of a disease they were born with (e.g., Down’s Syndrome) or that they became ill with (e.g., HIV) later on;
    2. those whose immune systems are weaker because of a medicine they are taking to prevent rejection of a solid organ transplant (e.g., kidney or liver transplant) or from medicine or radiation needed to control a disease such as rheumatoid arthritis or cancer.

    People with weakened immune systems are also at higher risk from COVID-19 because they may not be able to gain the full protection of being fully vaccinated with COVID-19 vaccine. 

    Finally, people with weakened immune systems can also sometimes stay ill with – and can continue to spread - COVID-19 disease and SARS-CoV-2 virus  for prolonged periods, thereby increasing the risk of exposing others to the virus. 

    Yes, as long as they don’t have any other specific reasons not to receive COVID-19 vaccine. A list and discussion of the very few specific reasons not to receive COVID-19 vaccine can be found here.

    In general, people with weakened immune systems have not experienced severe health issues after receiving COVID-19 vaccines.

    For a few people with weakened immune systems, the timing of their vaccination becomes more important as a result of their condition. Please discuss specific concerns with your healthcare provider. People with weakened immune systems should continue to take all COVID-19 precautions recommended for unvaccinated people (e.g., masking, physical distancing) until advised otherwise by their healthcare provider.

    The American College of Rheumatology has guidelines around vaccination timing for people with autoimmune and inflammatory conditions. They also provide recommendations for which medications should be paused when patients get the vaccine.

    The International Organization for the Study of Inflammatory Bowel Disease has issued guidance here. 

    The Leukemia and Lymphoma Society has released FAQs here.

    Finally, the American Society of Transplantation and other transplantation groups have issued a guidance statement that can be found here.

    Some people with weakened immune systems will be protected by COVID-19 vaccines but the exact amount of that protection is not yet clear.

    People with weakened immune systems should be offered the COVID-19 vaccine, as long as they don’t have any specific reasons not to receive COVID-19 vaccine. A list and discussion of the very few specific reasons not to receive COVID-19 vaccine can be found here

    An additional (third) dose of a COVID-19 mRNA vaccine is now recommended for people with weakened immune systems.

    However, even after being fully vaccinated AND then receiving the additional (third) vaccine dose, people with weakened immune systems may still have an inadequate immune response to the vaccine and may thus be less protected against COVID-19 infection. People with such conditions should discuss COVID-19 vaccine and other ways of avoiding SARS-CoV-2 infection with their healthcare provider. 

    Despite this potential inadequacy, many of those same people may still benefit to some degree from COVID-19 vaccination; even if their immune response to a vaccine is weaker than if they had a normal immune system, even a small benefit from the vaccine could be helpful in preventing severe COVID-19.  

    Even after vaccination, such patients should pay extra attention to the continuing need for all of the other COVID-19 prevention measures such as mask-wearing, avoidance of crowds and poorly ventilated spaces, physical distancing and handwashing.   

    You should wait at least 28 days after receiving the second mRNA vaccine dose before receiving the third (additional) dose.

    mRNA vaccines are readily available throughout Virginia, and vaccine providers are making third doses available as soon as they can adapt their processes.

    Individuals who are moderately or severely immunocompromised and who have received two doses of the Pfizer-BioNTech or Moderna vaccines more than 28 days ago are eligible to receive an additional primary (third) dose. Individuals should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.

    No. Proof of medical condition is not required to receive a third (additional) dose. However, individuals may need to state that they have a moderate or severe immunocompromising condition. You should bring photo identification to confirm your identity as well as your CDC vaccination card, so that this additional dose can be added.

    Moderately and severely immunocompromised people aged ≥18 years who received a single dose J&J COVID-19 vaccine primary series should receive a single COVID-19 booster vaccine (Pfizer-BioNTech, Moderna or J&J) at least 2 months (8 weeks) after receiving their initial Janssen primary dose. If the Moderna vaccine is used in this circumstance, the booster dose and dose volume should be used (50µg in 0.25ml).

    Whether they have received and additional (third) dose of COVID-19 vaccine or not, all immunocompromised individuals who are fully vaccinated should continue to follow  standard public health COVID-19 prevention recommendations (e.g., masking; distancing; staying at least 6 feet from others; avoiding crowds, large gatherings, or indoor spaces with poor ventilation (air flow).

    In addition, to provide them with an extra layer of protection, they or their family members should ask and encourage all of their household members, friends, caretakers, work colleagues, and other close contacts to be fully vaccinated against COVID-19.

    Not officially. As before, people are considered fully vaccinated:

    • 2 weeks after their second dose in a 2-dose series, such as the Pfizer-BioNTech or Moderna vaccines, or
    • 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

    If you don’t meet these requirements, regardless of your age, you are NOT fully vaccinated.

    However, CDC now recommends that people with moderately to severely compromised immune systems should receive an additional (third) dose of mRNA COVID-19 vaccine after the initial two dose series. These individuals should continue to follow standard public health COVID-19 prevention recommendations (e.g., wearing a mask, physical distancing, avoiding crowds, and avoiding spaces with poor air flow) after receiving this additional dose.

    People who were vaccinated outside the United States and completed a 2-dose mRNA COVID-19 vaccine (including a mixed mRNA primary series) may receive an additional mRNA dose (Pfizer-BioNTech or Moderna) at least 28 days after receiving the second mRNA vaccine dose if they are moderately or severely immunocompromised.

    At this time, CDC has no recommendation regarding an additional primary dose or a booster dose for people who were vaccinated outside the United States with a WHO-EUL COVID-19 vaccine that is not FDA-authorized or approved.

    Additional guidance can be found here.

    No.

    At this time, antibody testing to document the immune response after COVID-19 vaccination of people with weakened immunity is not recommended by the CDC, FDA, or VDH.

    First, our bodies produce several different types of antibodies against the SARS-CoV-2 virus that causes COVID-19. Some of the COVID-19 serology tests that are available do NOT measure the SARS-CoV-2 spike antibody which is the only antibody that the body produces after COVID-19 vaccination. Thus a negative serology test after vaccination, if it is not measuring the vaccine-generated COVID-19 spike antibody, could be a false negative.

    Second, the antibody response after COVID-19 vaccination is only one part of the expected response of the body’s immune system. The other critical part of the immune system is called cellular immunity (or T-cell immunity) and it is still not clear which part of the immune system is most important for responding to COVID-19.

    Several studies have indicated that the cellular immune system responds well to COVID-19 vaccination and it is entirely possible that even if your body does not make antibodies well after COVID-19 vaccination, your cellular immune system may be responding well to the vaccine. (This result has even been seen in people with weakened immunity who did not produce COVID-19 antibodies after vaccination.) Thus a negative serology/antibody test by itself is not a certain indicator that your immune system is not responding at all to the vaccine.

    It is possible that, once the uncertainty about the meaning of the immune system measurements is removed, measuring the immune system’s response after COVID-19 vaccination of people with weakened immune systems may eventually become a standard procedure. However, that is not the case right now.

    Guidelines from the American Society of Transplantation “strongly caution against concluding that low antibody response rate to SARS-CoV-2 vaccination will lead to reduced clinical effectiveness until more information is available.” Read the full statement here.

    Vaccination: Booster Doses

    A booster dose is a COVID-19 vaccine dose administered to someone who initially had  good protection from the primary vaccine series, but this protection has weakened over time. 

    Booster doses are recommended for all individuals who received the Pfizer or Moderna COVID-19 vaccine primary series at least six (6) months ago and for all individuals who received the J&J COVID-19 vaccine at least two (2) months ago. Information on accessing a COVID-19 booster dose can be found at vaccinate.virginia.gov.

    An additional (third) primary series dose is a COVID-19 vaccine dose administered to someone with a moderately or severely weakened immune system because their initial immune response after completing the primary vaccine series may have been insufficient to provide them with strong protection. 

    People who have a moderately or severely weakened immune system who received two (2) doses of the Pfizer or Moderna vaccine are eligible to get an additional (third) primary dose of the Pfizer or Moderna vaccine. 

    Those with significant immune compromise who received the J&J vaccine are eligible for a booster dose of J&J or a booster dose of an mRNA vaccine. They are not eligible at this time to receive an additional primary dose. This is an important point because the dose sizes for boosters and additional primary doses of Moderna vaccine are different.

    For COVID-19, a primary vaccine series is defined as either:

    • Two doses of an mRNA vaccine (Pfizer or Moderna) separated by the recommended number of 21 or 28 days, respectively; or
    • One dose of the Johnson & Johnson (J&J) vaccine.

    The following individuals should receive a single COVID-19 booster dose (can choose: Pfizer, Moderna, or Janssen) at least 6 months after completing the primary vaccination series:

    The following individuals may receive a single COVID-19 booster dose (can choose: Pfizer, Moderna, or Janssen) at least 6 months after completing their primary series based on their individual benefits and risks:

    • All other persons aged 18 years and older

    Yes. 

    All individuals 18 years of age and older who received the Johnson & Johnson single dose COVID-19 vaccine, should receive a booster dose at least two (2) months after their primary dose. 

    This booster can be a dose of either the Moderna, Pfizer, or Johnson & Johnson vaccine.

    The risks that come with a decrease in protection from COVID-19 vaccines over time are larger for adults 50 years of age and older or adults 18 year of age and older who live in a long term care facility. This is why the recommendation for these individuals is stronger. People in the “may” category should consider their individual risks and benefits when making the decision of whether to get a booster shot. This  recommendation may change in the future as more data become available. However, almost all individuals 18 years of age and older will benefit from getting a booster dose, especially heading into the winter and before the holidays. Booster doses restore protection to levels seen soon after completing the initial series. This is beneficial to the person getting vaccinated, as well as to the people they come in contact with.

    You can choose which vaccine you receive as a booster. 

    Some factors to consider include: 

    • Availability of booster product
    • Risk profile of vaccine boosters, including rare events

    Consider consulting your healthcare provider for additional guidance.

    People who received a single dose of the Janssen (J&J) vaccine can receive an mRNA COVID-19 booster (Moderna or Pfizer) dose at least 2 months after completing their primary dose. 

    People who received an mRNA primary series (Moderna or Pfizer) can receive the alternative mRNA COVID-19 booster or a J&J COVID-19 booster dose at least 6 months after completing the primary mRNA vaccine series.

    Yes. You can get a booster dose before, on the same day, or after getting the flu shot.

    The following individuals who are otherwise eligible for a booster have contraindications:

    • Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the COVID-19 vaccine  
    • Immediate allergic reaction of any severity to a previous dose or known (diagnosed) allergy to a component of the vaccine 
    •  Known polysorbate allergy is a contraindication to Johnson & Johnson COVID-19 and a precaution to mRNA COVID-19 vaccination
      • People with a contraindication to the mRNA COVID-19 vaccines (including a known allergy to polyethylene glycol [PEG]) have a precaution to J&J COVID-19 vaccine.

    The following are additional considerations for specific known adverse events. For complete recommendations, please refer to the CDC clinical considerations that will be updated soon. Talk to a healthcare provider if you have questions about getting a booster dose. 

    • For people who developed myocarditis or pericarditis after mRNA vaccine, deferral of COVID-19 booster dose is recommended at least until clinical syndrome has completely resolved. 
      • The risk of myocarditis or pericarditis is highest in male adolescents and young adults, after an mRNA dose. 
    • For people who developed thrombosis with thrombocytopenia syndrome (TTS) after J&J primary vaccine, a booster dose of J&J vaccine is not recommended.
      • The risk of TTS is highest in women younger than 50 years old.
    • For people who had Guillain-Barré Syndrome (GBS) after J&J primary vaccine, they should speak to their healthcare provider for additional guidance.  

    People who were vaccinated outside the United States and completed a primary vaccination series comprised of an FDA-authorized or FDA-approved COVID-19 vaccine (i.e., a single dose Janssen Vaccine or a 2-dose mRNA vaccine [including a mixed mRNA primary series]) may receive a booster dose (Pfizer-BioNTech, Moderna, or Janssen) if they are eligible.

    People vaccinated outside the United States who received a vaccine authorized or recommended by FDA or emergency use listed (EUL) by WHO are considered fully vaccinated if they completed the primary series or a heterologous (mix and match) series with a combination of FDA-authorized, FDA-approved, or WHO-EUL vaccines. The updated recommendations are for an additional dose as part of the primary series (if the person is moderately or severely immunocompromised and aged 12 years or older) and a booster dose (if the person is aged 18 years or older and with either a high-risk condition or high-risk exposure) for people who received an WHO-EUL vaccine not approved or authorized by FDA. However, they should specifically receive the FDA-approved Pfizer-BioNTech COVID-19 vaccine (30 µg formulation [purple cap]) as their additional or booster dose. 

    People vaccinated in clinical trials within or outside the United States who received an WHO-EUL vaccine or a vaccine for which a U.S. data and safety monitoring board or equivalent has independently confirmed efficacy are considered fully vaccinated. This includes the Novavax COVID-19 vaccine and the Moderna COVID-19 vaccine in children 6-17 year olds. These individuals are eligible for an additional dose and a booster dose if they meet other eligibility criteria. If they do not plan to receive the additional dose or booster dose through the clinical trial, they should be given the FDA-approved Pfizer-BioNTech COVID-19 vaccine (30 µg formulation [purple cap] as their additional or booster dose. Clinical trial participants who have questions about whether they should receive an additional dose or booster dose outside of a clinical trial are advised to speak with a healthcare provider.

    Additional information can be found here.

    Vaccine providers can begin administering booster vaccines based on the updated CDC recommendations already issued; however, appointment scheduling capabilities may not be available for all providers. Please be patient as providers adjust to this change.

     

    Immunity wanes gradually, but remains strong against severe illness. Therefore, although the booster vaccine doses are being recommended, there is no need to get a booster exactly at two (2) months (for J&J) or six (6) months (for Moderna and Pfizer) after completion of the primary regimen.

    If you are eligible, you can receive a booster dose of COVID-19 vaccine wherever COVID-19 vaccines are available. Options include community vaccination clinics, your healthcare provider, or a pharmacy. Visit vaccinate.virginia.gov to find an appointment. Thank you for your patience while all providers respond to increased demand for appointments.

    No. COVID-19 vaccines continue to work well to prevent severe illness, hospitalization, and death, even against the Delta variant. However, public health experts are starting to see some vaccine “breakthrough infections” that indicate reduced protection, especially among certain populations, against mild and moderate COVID-19 disease.

    If you are between the ages of 18 and 49, and are uncertain about your individual benefits and risks of receiving a booster dose of the Moderna or Pfizer COVID-19 vaccine, you should speak to your healthcare provider. 

    If you are uncertain if you should get a different brand as a booster, consider also consulting your healthcare provider.

    Yes. The Pfizer COVID-19 vaccine booster dose is the same product, and is given at the same dose as the primary series. 

    In this “mix and match” scenario, the dose of the Moderna COVID-19 booster dose is  0.25 mL (50 mcg). This is half of the Moderna primary series dose. This dose can be given to eligible individuals at least 2 months after completion of the J&J primary vaccination.

    No. Although a driver’s license or other sort of valid identification card will be required to establish your identity, proof of prior vaccination is not required.

    Side effects, which are expected with vaccination, have so far been mostly mild or moderate, and short lived. For both Pfizer-BioNTech and Moderna, side effects were reported less frequently following a booster dose than the second dose of the primary series. Fatigue and pain at the injection site were the most commonly reported side effects, and overall. Lymphadenopathy (swelling of lymph nodes) was more common after the booster dose than after the second dose. 

    For most people who have completed their primary series, the benefits of getting a booster shot outweigh the known and potential risks. As with the primary series, serious side effects are rare, but may occur. The risks of myocarditis and pericarditis after a third dose of mRNA vaccines may vary by age and sex and is unknown at this time. Until additional safety data are available, experts recommend that people who develop myocarditis or pericarditis after a dose of an mRNA COVID-19 vaccine defer receiving a subsequent dose. For people who developed thrombosis with thrombocytopenia syndrome (TTS) after J&J primary vaccine, a booster dose of J&J vaccine is not recommended. The risk of TTS is highest in women younger than 50 years old.

    Individuals who receive a booster dose should remember to sign up for v-safe after vaccination health checkerand complete health check-ins after COVID-19 vaccination.

    For the moment, the definition of fully vaccinated remains the same. People are considered fully vaccinated: 

    • 2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or
    • 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

    This definition applies to all people, including those who receive an additional (third) dose as recommended for moderate to severely immunocompromised people and those who receive a booster shot.

    The COVID-19 vaccines available in the United States continue to be highly effective at preventing severe disease, hospitalization, and death. This effectiveness includes protection against the widely circulating Delta variant. 

    However, recent evidence (here and here) shows that the COVID-19 vaccines provide protection against mild and moderate COVID-19 disease that is slowly decreasing over time in certain people. 

    There is a concern that protection against severe COVID-19 disease, hospitalization, and death could also slowly weaken in the months ahead, especially among people who are at higher risk for severe illness or were vaccinated during the earlier phases of the vaccination rollout. Booster vaccine doses appear to be able to “boost” one’s level of immune protection significantly.

    You should plan to bring a form of personal identification (e.g., driver’s license) and your CDC immunization card with information on your previous doses of COVID-19 vaccine received.

    COVID-19 vaccination records in the Virginia Immunization Information Systems (VIIS) are available through the COVID-19 Vaccination Record Request Portal.

    Yes. Moderately and severely immunocompromised people aged ≥18 years who completed an mRNA COVID-19 vaccine primary series and received an additional (third) mRNA vaccine dose may receive a single COVID-19 booster dose (Pfizer-BioNTech, Moderna or Janssen) at least 6 months after completing their third mRNA vaccine dose. In such situations, people who are moderately and severely immunocompromised may therefore receive a total of four COVID-19 vaccine doses.

    Vaccination: Flu vs. COVID-19

    Annual flu seasons begin in the Fall, often in October, and ends in February or March.

    It’s important to get a flu vaccine before the beginning of flu season later this year to make sure you don’t get the flu when doctors’ offices and hospitals are already crowded with COVID-19 patients. By getting a flu vaccine, you can help keep yourself healthy and give healthcare workers time to focus on COVID-19.

    It is possible to catch both the flu and COVID-19 at the same time.

    Yes. COVID-19 vaccines and other vaccines may now be administered without regard to timing. This includes getting a COVID-19 vaccine and other vaccines on the same day, as well as coadministration within 14 days. 

    You can get a flu shot from your healthcare provider or just about any pharmacy. Some public providers offer the flu vaccine for free. Visit the VDH website to find out where you can get your flu shot.

    Many public providers offer flu vaccines for adults and children in underserved areas. Refer to the VDH website for more information.

    Getting a flu shot is the best way to protect yourself from the flu. Flu can cause serious illness, especially in older adults and infants. While the flu vaccine won’t prevent COVID-19, it is one thing we all can do to stay healthy every winter. The flu vaccine will be available at pharmacies and doctor’s offices and should be taken every year in the fall or winter.

    The COVID-19 vaccine will help prevent you from getting COVID-19. All three available COVID-19 vaccines are safe and effective, especially against severe illness, hospitalization, and death.

    No. Each of these diseases are caused by different viruses. While the flu vaccine won't protect you from COVID-19, it will protect you from getting sick from the flu. Flu is a serious virus that causes deaths every year, especially among older adults and infants. Most people older than six months should get the flu vaccine every year.

    Yes! Being pregnant puts you at a higher risk for serious illness caused by the flu. The flu shot can also protect the newborn since antibodies are passed to the child before birth. If you are pregnant, let the provider know, so you receive an inactivated flu vaccine.

    If you think you have symptoms of COVID-19, get tested as soon as possible. You can check your symptoms online at www.vdh.virginia.gov/COVIDcheck and find out where you can be tested.

    If you do have COVID-19 symptoms, wait 14 days from the time your symptoms end before getting a flu vaccine.

    There is no evidence that it’s dangerous to get a flu vaccine while you have COVID-19, but you could spread the coronavirus to healthcare workers and other patients, so stay home until you have not had symptoms for 14 days.

    Vaccination: Records

    COVID-19 vaccination records in the Virginia Immunization Information Systems (VIIS) are available through the COVID-19 Vaccination Record Request Portal

    Enter your name, date of birth, and ZIP code. If there is a match, the system will send a verification code to the phone number associated with your vaccination record, through either a text message or an automated voice call. This prevents other people from accessing your record. Once you enter the verification code, you can view, save, and print your Vaccination Record with QR code. With iOS 15, you can securely store verifiable versions of your COVID-19 test results and immunization records in the Health app on your iPhone or iPod touch.

    The request portal is also accessible via Virginia’s free COVIDWISE app, along with information about vaccines and other frequently asked questions. In the app, tap “Virtual VDH” for these options.

    Vaccine providers in Virginia submit vaccination records to the Virginia Immunization Information System (VIIS), but they may have provided information that's incomplete, out of date, or incorrect. So, it's likely we have your record if you were vaccinated in Virginia, even if it’s not available through the request portal. For example, your name or phone number may have been entered incorrectly or may have changed. If you can’t find your record, first try the search again without entering a ZIP code. If the record still isn’t found, you can contact your vaccine provider to update their vaccination record or call 877-VAX-IN-VA (877-829-4682) for help. Call center hours are Monday through Friday from 8 a.m. to 6 p.m. ET.

    Some doses administered outside Virginia to Virginia residents may be in VIIS. Doses administered directly by federal agencies such as the Department of Defense or Department of Veterans Affairs are not reported to VIIS.

    If you would like a record of other vaccinations (besides COVID-19), you may submit your request online

    If the information on your vaccination record is incorrect (e.g., missing dose, wrong date or incorrect brand), you should contact your vaccine provider to update their record or call 877-VAX-IN-VA (877-829-4682) for help. Call center hours are Monday through Friday from 8 a.m. to 6 p.m. ET.

    Virginia’s COVID-19 vaccination records include QR codes – a type of barcode that can be scanned with smartphones. QR codes – short for “quick response” – are commonly used in retail, logistics, and other sectors. The technology allows anyone to show proof of vaccination with a digital or printed QR code instead of a paper card, and without the need for an app. As more and more employers and businesses respond to calls by President Biden and Governor Northam to require that employees and customers be vaccinated, QR codes will help improve the consistency and security of vaccination information while protecting individual privacy.

    A person vaccinated in Virginia can visit vaccinate.virginia.gov to obtain their free vaccination record with QR code, which can then be saved to a phone gallery, printed on paper, or stored in a compatible account, such as Google Pay, CommonHealth, or Apple Health.

    QR codes contain the same information as paper records, but in a format that offers greater security and efficiency. Because the QR code is digitally signed by the Virginia Department of Health, it cannot be altered or forged. Information from QR codes is only available if and when the individual chooses to share it.

    There are a number of ways you can save your QR code: 

    1. Print it
    2. Screenshot it and store it in your photo album
    3. Save it 
      1. To your computer
      2. To your smartphone as a file (iPhone/Android)
      3. To your Google Pay Wallet
      4. To your Apple Health account (requires iOS 15)

    For help with securely storing verifiable versions of your COVID-19 test results and immunization records in the Health app on your iPhone or iPod touch, please visit https://support.apple.com/en-us/HT212752.

    You are not required by the Virginia Department of Health to obtain a Vaccination Record with QR Code, or to use it for any particular purpose. Your record, and the QR code within it, are options provided to you to document your vaccinations and provide proof to those with whom you choose to share it. 

    The information listed on the QR code is the information shown on paper vaccination records or cards, which includes name, date of birth, vaccination date, vaccine manufacturer, lot number, and provider for each dose of vaccine received. The QR code does not include social security number, immigration status, or other information not found on paper vaccination records.

    Because the QR code is digitally signed by the Virginia Department of Health, it cannot be altered or forged.

    Your vaccination history is stored directly within the QR code, which you control. It’s completely up to you to decide whether and when to show someone else your QR code.

    This COVID-19 Vaccination Record with QR Code can only be scanned by apps or websites that agree to the privacy protections required by the SMART Health framework, such as the SMART Health Verifier App.

    You can obtain your COVID-19 Vaccination Record with QR Code at vaccinate.virginia.gov on your smartphone, or tablet or computer browser. There is also a link to the COVID-19 Vaccination Record Request Portal in the free COVIDWISE app (tap “Virtual VDH” at the bottom).  You can also call 877-VAX-IN-VA (877-829-4682) for help (call center hours are Monday through Friday from 8 a.m. to 6 p.m. ET.) 

    Vaccination Records with QR Codes are available to anyone whose vaccination record is in the Virginia Immunization Information System (VIIS) and includes a working phone number.

    You should only show any vaccination record to a person, business, or organization you want to know your vaccination information, and only after they tell you what they intend to do with your data and if they will keep it.

    Clinics vary in the length of time it takes to submit dose information to the Virginia Immunization Information System. Records are usually updated within 24-72 hours after a dose is administered.

    Your COVID-19 Vaccination Record does not automatically update. If you receive an additional dose of the COVID-19 vaccine, visit the COVID-19 Vaccination Record Request Portal again at vaccinate.virginia.gov to obtain your updated Vaccination Record with QR Code. 

    Businesses and employers that choose to verify an individual’s vaccination status via QR code can download the free SMART Health Card Verifier App to do so.

    Businesses and employers validating vaccination records are encouraged to require a second form of government identification (e.g. government issued driver’s license) to compare to the name and date of birth on the vaccination record.

    No. The purpose of this system is to allow you to access your own vaccination record and to have options for presenting it if and when you choose to do so.

    The Smart Health Verifier App may be used by businesses to verify an individual's COVID-19 Vaccination Record with QR Code. Individuals do not need to test their own QR code with the Smart Health Verifier App. If an individual would like to test their COVID-19 Vaccination Record with QR Code using the Smart Health Verifier App on their smartphone, it is recommended the individual print the record from a computer or smartphone prior to scanning it with the Verifier App because it is likely that the computer screen resolution of the individual may not allow the QR Code to be read by the Verifier App. Also, the Verifier App does not allow the COVID-19 Vaccination Record with QR Code to be uploaded. The Verifier App is only for verification purposes. Please call 877-VAX-IN-VA (877-829-4682), Monday through Friday from 8 a.m. to 6 p.m. ET with any additional questions.

    Page last updated: November 23, 2021