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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 (VCIC) General Information
What are the COVID information Center’s hours of operation? (Last updated 6/29/21)The Virginia COVID information Center’s (VCIC'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).
What languages are offered to VCIC users? (Last updated 3/3/21)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.
How can the VCIC support those with Access and Functional Needs? (Last updated 4/7/21)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.
Vaccination: How To Get the COVID-19 Vaccine
Where can I get a COVID-19 vaccination? (Last updated 6/22/21)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 (including Community Vaccination Centers) offer walk-in service in addition to scheduled appointments.
Who is eligible to receive a COVID-19 vaccine? (Last updated 11/10/21)Everyone in Virginia 5 years or older is eligible.
Is photo identification required for COVID-19 vaccination? (Last updated 5/7/21)No, government-issued 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.
Do I still need an appointment to receive a COVID-19 vaccination? (Last updated 12/15/21)Many clinics offer walk-in service in addition to scheduled appointments.
Community Vaccination Centers in Virginia have walk-in services, but appointments are preferred.
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.
How do I look up, manage, reschedule, or cancel my vaccination appointment scheduled by the Virginia COVID Information Center (VCIC)? (Last updated 4/13/21)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.
How can I confirm my vaccine appointment? (Last updated 4/12/21)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.
Where can I find information regarding the COVID-19 vaccines used in Virginia? (Last updated 7/13/21)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.
Why am I being asked for my insurance information if the COVID-19 vaccine is free? (Last updated 3/24/22)The COVID-19 vaccine “must be provided to vaccine recipients with no out-of-pocket costs,” according to the U.S. 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 and clinics can get paid for administering the vaccines. For those people 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.
I have to quarantine because of close contact with a person diagnosed with COVID-19. Can I still get vaccinated against COVID-19? (Last updated 3/3/21)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)
How do I or my eligible children get the vaccine if we are disabled? (Last updated 6/29/21)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.
How can we prepare for a COVID-19 vaccine appointment? (Last updated 11/18/21)A few tips for the day of your or your child’s appointment include the following:
- Plan on 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.
- 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 (if received). COVID-19 vaccination records in the Virginia Immunization Information Systems (VIIS) are available through the COVID-19 Vaccination Record Request Portal.
- Consider dressing lightly, or with layers that can be easily removed if you get too hot.
Additional information is available.
Vaccination: Why Get Vaccinated Against COVID-19
Why should we get vaccinated against COVID-19? (Last updated 1/21/22)It is difficult to predict the course of the COVID-19 pandemic. Even if community and state case counts are decreasing, there is always a risk of a future resurgence with a new variant of COVID-19.
On a personal level, there’s no way to know ahead of time how getting COVID-19 disease could affect you. For example, we still don’t know why some healthy but unvaccinated people become seriously ill or die from COVID-19, while other healthy people only become mildly sick. In addition, people with mild or even asymptomatic disease can also suffer from Long COVID. However, once vaccinated, your body will start building immunity to the virus so you are less likely to get infected, less likely to get seriously ill, and less likely to transmit COVID-19 to others. Staying up to date with regard to COVID-19 vaccination will 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. For 2021 and 2020, COVID-19 was the third leading cause of death after heart disease and cancer.
All available COVID-19 vaccines are highly effective, including among children 5 years and older, for preventing serious illness, hospitalization, and death.
Can Long Covid be prevented or treated by COVID-19 vaccination? (Last updated 5/9/22)Both older and more recent studies suggest that the risk of developing “Long COVID” after vaccine breakthrough infections is much lower than in unvaccinated people who get COVID-19.
In addition, some people who already had Long COVID after an earlier infection noted an improvement of their symptoms after they received COVID-19 vaccine. The potential benefits of COVID-19 vaccines on Long COVID are 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 on the CDC page.
Where can I find out more about the different COVID-19 vaccines and about COVID-19 vaccination? (Last updated 2/14/22)The Centers for Disease Control and Prevention (CDC) has a lot of information on this topic. To learn more, see:
- Frequently Asked Questions about COVID-19 Vaccination
- Vaccines
- Understanding How COVID-19 Vaccines Work
- There are Different COVID-19 Vaccines
- Who is Eligible for a COVID-19 Booster Shot?
The latest information about COVID-19 vaccination in Virginia can be found on the VDH website.How do I learn more about COVID-19 vaccines if I speak a different language? (Last updated 3/18/21)At the top of all VDH web pages 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.
The vdh.virginia.gov website is providing the “Google Translate” option to assist you in reading the vdh.virginia.gov website in languages other than English. Google Translate cannot translate all types of documents, and may not provide an exact translation.
¿Cómo puedo obtener más información sobre las vacunas contra COVID-19 si hablo un idioma diferente? (Última actualización 3/18/21)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.
. كيف يمكنني معرفة المزيد عن لقاحات COVID-19 إذا كنت أتحدث لغة مختلفة؟ (آخر تحديث 18/3/21)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.
다른 언어를 사용하는 경우 COVID-19 백신에 대해 자세히 알아보려면 어떻게 해야 합니까? (최신 업데이트 21년 3월 18일)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.
Paano ko malalaman ang higit pa tungkol sa mga bakuna ng COVID-19 kung magsasalita ako ng ibang lahi? (Huling binago noong 3/18/21)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.
如果我说的是另一种语言,如何了解有关新冠(COVID-19)疫苗的更多信息?(最后更新日期:2021 年 3 月 18 日)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
COVID-19 vaccines were originally developed faster than most other vaccines. How do I know they are safe and effective? (Last updated 5/9/22)The U.S. COVID-19 vaccination program is by far the most carefully monitored vaccination program in this country’s history.
Development of these new COVID-19 vaccines in 2020 followed the same effectiveness and safety review processes as other current vaccines, including studying tens of thousands of participants of different ages, races and ethnicities for each vaccine to be sure the vaccines are both safe and effective for all types of people.
Rapid vaccine 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 bureaucratic obstacles.
Since the vaccine rollout began, serious adverse effects of COVID-19 vaccine have been identified only rarely in the five different federally-sponsored surveillance systems studying COVID-19 vaccine side effects and most severe COVID-19 disease is continuing to occur in unvaccinated people.
Development of U.S. vaccines is strictly controlled by the U.S. Food and Drug Administration (FDA). After the FDA authorizes or approves a vaccine, the Advisory Committee on Immunization Practices (ACIP), an independent committee supporting the Centers for Disease Control and Prevention (CDC), decides whether to recommend it and for whom. The CDC and FDA monitor long-term vaccine safety and efficacy even after vaccines’ authorization and approval to help identify any unusual side effects or other safety concerns and to help clarify how long protection lasts after vaccination.
The mRNA COVID-19 Vaccines produced by Pfizer (for individuals 16 years and up) and Moderna (for individuals 18 years and up) have both been fully approved and licensed.
What is mRNA, and how does it work to provide protection? (Last updated 10/13/21)mRNA stands for messenger ribonucleic acid.
The COVID-19 vaccines from Pfizer-BioNTech and Moderna use mRNA to cause a two-stage immune response. First, the vaccines’ mRNA teaches your cells to make a specific non-infectious COVID-19 protein. Then this new protein stimulates your immune system to respond against COVID-19. That immune response produces antibodies and other forms of immunity that help keep you from becoming infected if you are later exposed to COVID-19.
The mRNA in the COVID-19 vaccines does NOT get into the nucleus of your cells or put germs into your body. These two mRNA COVID-19 vaccines will not change your DNA or your body’s other genetic material in any way.These mRNA COVID-19 vaccines do not inject spike proteins into your body.
Additional information about the development of mRNA vaccines is available.
What are viral vector COVID-19 vaccines? (Last updated 5/9/22)Viral vector COVID-19 vaccines use a modified version of a virus called an adenovirus - but not the SARS-CoV-2 virus that causes COVID-19 - as a way to insert in human cells a SARS-CoV-2 protein called the spike protein. This spike protein antigen triggers production of antibodies against itself and the resulting immune response then targets any viral spike proteins that are around, including those that would be on the outside of the SARS-CoV-2 virus if you get exposed. The specific virus used in this vaccine poses no threat of causing human infection or disease because it has been modified so it cannot reproduce.
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.
The Johnson & Johnson (also known as Janssen Biotech) vaccine uses adenovirus in its viral vector COVID-19 vaccine.
NOTE: The FDA has limited the use of the J&J COVID-19 vaccine due to safety issues. The J&J COVID-19 vaccine should only be given to individuals 18 years and older whom mRNA COVID-19 vaccines are not accessible or clinically appropriate and who would otherwise not receive a vaccine. People who are starting their vaccine series or getting a booster dose should get either Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines
What is an FDA Emergency Use Authorization (EUA) for a vaccine? (Last updated 11/8/21)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 emergency 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 its use.
Information describing a COVID-19 vaccine’s path from initial research to an EUA - and eventually to a biological license application (BLA) - can be found on the FDA’s website.
How is a vaccine’s full FDA approval and licensing different from an FDA Emergency Use Authorization (EUA)? (Last updated 1/31/22)The FDA’s full approval for a vaccine requires the agency’s standard and rigorous process for reviewing medical products, including vaccines, drugs, test kits, and other medical devices. That review process for a vaccine relies upon the manufacturer’s submission of a Biologics License Application (BLA), a comprehensive submission that is submitted to the agency and that must meet very specific requirements.
For COVID-19 vaccines, a BLA uses the early information that previously supported the EUA, such as preclinical and clinical data, as well as details of the manufacturing process. However, to ensure the safety of vaccines, the BLA generally requires a far longer period of time for observing and examining both vaccine safety and vaccine effectiveness. This BLA review is among the most comprehensive medical product reviews in the world. It involves the FDA and its external advisory committee conducting their own analyses of the information in the BLA. FDA will also again inspect the facilities that are involved in the manufacturing of the product.
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. In January 2021, the FDA fully approved the Moderna vaccine, which is being marketed as Spikevax, for use in those at least 18 years old.
Full approval by the FDA means the vaccine can also be used in non-emergency settings.
Who should NOT get a current COVID-19 vaccine right away? (Last updated 5/10/22)Anyone who recently had 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 should not receive any of the current vaccines as the data from studies in children below these ages have not yet been reviewed.
The following are contraindications to vaccination:
- History of a severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the COVID-19 vaccine.
- History of a known diagnosed allergy to a component of the COVID-19 vaccine
- For the Janssen COVID-19 Vaccine, TTS following receipt of a previous Janssen COVID-19 Vaccine (or other COVID-19 vaccines not currently authorized in the United States that are based on adenovirus vectors). Additionally, people with a history of an episode of immune-mediated syndrome characterized by thrombosis and thrombocytopenia, such as spontaneous or classic HIT, should not receive Janssen COVID-19 Vaccine.
NOTE: The FDA has limited the use of the J&J (Janssen) COVID-19 vaccine due to safety issues. The J&J COVID-19 vaccine should only be given to adults 18 years and older for whom mRNA COVID-19 vaccines are not accessible or clinically appropriate or who do not want to take mRNA vaccines and who would otherwise not receive a vaccine. CDC and VDH now authorize people who are starting their vaccine series or getting a booster dose to get either Pfizer-BioNTech or Moderna mRNA COVID-19 vaccine.
Individuals who have a contraindication or a precaution to COVID-19 vaccination should speak to their healthcare provider regarding their options.
For complete recommendations on vaccine contraindications and precautions, visit Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States.
Where can I find information on the Pfizer- BioNTech COVID-19 vaccine? (Last updated 3/30/22)Information on the Pfizer-BioNTech COVID-19 Vaccine is available on the CDC website.
A complete list of this vaccine’s ingredients can be found in the fact sheet. (Last updated 3/29/2022)
Type of vaccine: mRNA
Number of injections (shots): 2 injections, at least 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.
Where can I find information about the Moderna COVID-19 vaccine? (Last updated 3/30/22)Information on the Moderna COVID-19 Vaccine can be found on the CDC website.
A complete list of this vaccine’s ingredients can be found in the fact sheet. (Last updated 3/29/2022)
Type of vaccine: mRNA
Number of injections (shots): 2 injections, at least 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.
Where can I find information about the Johnson & Johnson (also known as Janssen Biotech) COVID-19 vaccine? (Last updated 5/9/22)Information on the Janssen COVID-19 Vaccine can be found on the CDC website. (Last updated May 5, 2022)
A complete list of this vaccine’s ingredients can be found in the fact sheet.
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.
The FDA has limited the use of the J&J COVID-19 vaccine due to safety issues. The J&J COVID-19 vaccine should only be given to individuals 18 years and older whom mRNA COVID-19 vaccines are not accessible or clinically appropriate and/or who would otherwise not receive a vaccine. Please see the Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety page for more information.
When will COVID-19 vaccines become available for younger children? (Last updated 5/9/22)Moderna has announced that it seeks emergency use authorization from the FDA of a two-dose primary series of its COVID-19 vaccine for children ages 6 months to under 6 years. According to media reports, Pfizer is unlikely to officially seek FDA authorization until June for children ages 6 months to 4 years. It is expected that these children will need three doses of the Pfizer vaccine.
Additionally, Moderna has initiated a submission to the FDA for emergency use authorization of their COVID-19 vaccine in children 6 to under 12 years of age and is updating their submission to the FDA for emergency use authorization of their COVID-19 vaccine in adolescents ages 12 to 17 years with additional follow-up data.
The FDA has held the dates of June 8, 21 and 22 to discuss the Moderna and Pfizer COVID-19 vaccines for younger populations.
COVID-19 vaccine use for younger age groups will first need to be reviewed by the FDA’s external scientific advisory committee, then 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. The exact timeline for this process is uncertain at this time.
Please see the previous statement titled “FDA Will Follow The Science On COVID-19 Vaccines For Young Children” to learn more about the process.
Can I get another vaccine at the same time as getting a COVID-19 shot? (Last updated 3/31/22)Yes. COVID-19 vaccines and other vaccines may 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. This includes the Flu, Pneumococcal, Tdap, and Shingles vaccine.
Should pregnant or breast-feeding individuals get a COVID-19 vaccine? (Last updated 3/1/22)Yes. Getting COVID-19 vaccine during pregnancy can protect you and your fetus and infant from severe illness from COVID-19.
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. Having COVID-19 disease while pregnant has been associated with stillbirths, preterm birth, low birth weight babies, and other adverse outcomes of pregnancy. A study showed that infants whose mothers received two doses of COVID-19 vaccine during pregnancy were 61% less likely to be hospitalized in their first six months of life compared to infants of unvaccinated mothers.
The CDC, VDH, the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal Fetal Medicine (SMFM) all recommend that pregnant or breast-feeding women or other women who intend to get pregnant and who otherwise are eligible for COVID-19 vaccination should be COVID-19 vaccinated and then stay up to date with vaccination. The most recently updated ACOG recommendations are available and a joint message about COVID-19 vaccination from ACOG and SMFM is also available.
CDC and the Food and Drug Administration (FDA) have several vaccine 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 had pregnancies, with no vaccine-specific safety issues identified.
In addition, CDC has 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.
How is COVID-19 vaccine safety being monitored? (Last updated 3/10/22)The safety monitoring of COVID-19 vaccines has been described as “the most comprehensive of any vaccine in US history.”
CDC and FDA continuously monitor the safety of vaccines.These agencies use at least five different systems to monitor vaccine safety:
- The Vaccine Adverse Event Reporting System (VAERS): VAERS is an early warning system that helps CDC and FDA identify potential 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 hundreds of millions of patients being vaccinated. This system alerts the CDC and FDA if healthcare systems begin reporting unusual patterns of adverse effect information about events that occur after vaccinations.
NOTE: every healthcare provider who administers COVID-19 vaccines is required to report all serious health events occurring soon after vaccination to the VAERS system. VAERS is therefore set up as an early warning system to collect as much data as possible about any and all events that may or may not turn out to be side effects of vaccines. Those data are then examined closely to verify the events and to identify any clusters or groups of unexpected serious or severe 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. VAERS is NOT - and is NOT INTENDED TO BE - a reliable source of information on vaccine side effects. Therefore, drawing conclusions from these publicly available but unverified VAERS screening data alone without the follow-up investigations is scientifically inappropriate because it is likely to lead to erroneous conclusions.
A description of how VAERS works is available.
- 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 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 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. v-safe will also 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 are also utilized to ensure the safety of COVID-19 vaccines.
What is known about deaths that are reported to occur after COVID-19 vaccination? (Last updated 1/29/22)FDA REQUIRES EVERY VACCINE PROVIDER to report EVERY death that occurs after a COVID-19 vaccination to the VAERS reporting system. These death reports by vaccine providers 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 possible after 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 should not be interpreted to 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 COVID-19 vaccine recipients have pre-existing illnesses or are elderly and frail and are thus already at higher risk of death whether or not they get vaccinated. Therefore, a 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.”
Every death that occurs after COVID-19 vaccination is investigated. With a single exception, 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.
NOTE: The single exception is that reports have indicated 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 less than a dozen 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 on the CDC website.
Vaccination: Side Effects and Adverse Events After COVID-19 Vaccine
What are common side short term effects of the current COVID-19 vaccines? (Last updated 7/14/21)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 FAQ response 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.
Some vaccinated adults and children have had local reactions such as pain or redness or tenderness at the injection site. A small number of vaccine recipients have had transient systemic side effects 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 are more common after the 2nd dose than after the first dose.
Less commonly, a few 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 are not considered to be allergic reactions and are not felt to represent a risk for anaphylaxis upon receipt of the second dose. 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 are available.
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 or any later booster doses when eligible.
For those children five (5) 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.
Finally, even if you or your child experience one or more of these expected short term side effects 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 initial vaccine series to be effective.
What should I do if I or any of my vaccinated children get any of these common COVID-19 vaccine reactions? Are there medicines we can take to prevent or minimize any of these side effects? (Last updated 7/14/21)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 and use or exercise the arm.
To reduce discomfort from fever, dress lightly, and drink plenty of fluids.
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.
Residents of long term care facilities who experience certain symptoms may need to take additional precautions or measures.
How can I find out about any known longer term or serious adverse events reported after COVID-19 vaccinations? (Last updated 5/9/22)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 called thrombosis with thrombocytopenia syndrome (TTS) that has occurred in a very small number of people vaccinated with the Johnson & Johnson (Janssen) vaccine. It occurs at a rate of about 3.83 cases per million Janssen doses and has resulted in deaths. 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.
However, because of a later risk-benefit analysis of post-vaccination TTS and other blood clotting disorders, the FDA has limited the use of the J&J COVID-19 vaccine. The J&J COVID-19 vaccine should only be given to individuals 18 years and older whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate and who would otherwise not receive a COVID-19 vaccine. For more information, visit Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety.
To date, very few 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, visit the CDC webpage
There have been rare reports of myocarditis or pericarditis among people ages 30 and younger who received COVID-19 vaccine. Most patients responded well to rest and quickly recovered. More information on this topic can be found on CDC’s Myocarditis and Pericarditis After mRNA COVID-19 Vaccination webpage.
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. These cases have largely been reported about 2 weeks after vaccination and mostly in men, many 50 years and older.
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.
For additional information, you can also visit the CDC page at Selected Adverse Events Reported after COVID-19 Vaccination
Has the adverse effect of Antibody-Dependent Enhancement ever been noted with current COVID-19 vaccines? (Last updated 1/12/22)No, Antibody-Dependent Enhancement (ADE) has not been noted during the development or extensive use of COVID-19 vaccines.
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 types of 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 has been 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 more than a year ago. In addition, at this point in 2022, many 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 in people who are up to date with vaccination, none of those people with breakthrough infections had stronger-than-expected (“enhanced”) disease symptoms. This point is in contrast to the unfortunate experiences of previously unvaccinated people, who 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 discussion of ADE and COVID-19 vaccines is available.
Is COVID-19 vaccine likely to have an important impact on reproduction? (Last updated 8/17/21)No. Such effects on reproduction have NOT been seen and are unlikely to occur after COVID-19 vaccination.
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.
Studies 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, weight changes, dietary changes (including a diet high in soy), excess exercise, or sleep problems. A recent review of the vaccine-menstrual cycle study data and a recent summary of the overall vaccine-menstrual cycle question are both available. None of these studies suggested any impact on fertility and, not surprisingly, similar reports about changes in duration and flow of menstrual cycles have been 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 intending to get pregnant, are currently pregnant, are post-partum, and/or are breastfeeding. Getting a COVID-19 vaccine prior to or during pregnancy can protect you, your fetus, and your infant 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 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 on CDC’s COVID-19 Vaccines While Pregnant or Breastfeeding webpage.
How do I register myself or my child for v-safe? (Last updated 12/22/20)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 visit the CDC’s V-safe After Vaccination Health Checker webpage.
Vaccination: After Receiving the First Dose of a Two-dose COVID-19 Vaccine Series
When should we get the second dose of a two-dose primary series of COVID-19 vaccine? (Last updated 3/11/22)The two doses of Pfizer-BioNTech vaccine should be given at least three weeks (21 days) apart and the two doses of Moderna vaccine at least four weeks (28 days) apart. There is no maximum amount of time between the first and second doses for either vaccine, but do not get the second dose earlier than recommended.
An extended interval is an option for individuals 12 years of age and older based on an individual’s risks and benefits. An 8-week interval may be optimal for some people ages 12 years and older, especially for males ages 12 to 39 years. However, the 21 or 28 day interval between the first and second doses remains the recommended interval for: people who are moderately to severely immunocompromised; adults ages 65 years and older; and others who need rapid protection due to increased concern about community transmission or risk of severe disease. Talk to your healthcare or vaccine provider about the timing of the second shot that is right for you.
What should I do if I or my child has an exposure to a person with COVID-19 illness between the first and second mRNA vaccine doses? (Last updated 5/13/21)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 for the recommended period and reschedule your vaccination appointment after your quarantine has ended in order to avoid the risk of exposing vaccinators and others to the virus or to COVID-19.
If I or my child develop test-confirmed COVID-19 disease after my first dose of a two-dose COVID-19 vaccine series, how does that affect when we get a second dose? (Last updated 2/14/22)If you get a confirmed COVID-19 infection after the first dose of COVID-19 vaccine, your second COVID-19 vaccine dose should be delayed until after your recovery and after the end of your isolation period to avoid the risk of exposing vaccinators to the virus.
COVID-19 vaccination second doses do not need to be delayed following receipt of monoclonal antibodies or convalescent plasma.
Should routine screening mammograms be postponed after getting a dose of COVID-19 vaccine?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 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.
If someone had COVID-19 disease before getting the first dose of COVID-19 vaccine, do they still need to get the second dose of a two dose vaccine series? (Last Updated 2/11/22)Several studies of people who have already had COVID-19 disease have indicated that people who become up to date with COVID-19 vaccination either before or after having COVID-19 disease are more protected against getting COVID-19 again than those who had COVID-19 disease without being up to date with vaccination.
VDH and CDC continue to recommend that people who may have natural immunity after having had COVID-19 disease maximize their protection from getting infected again by becoming up to date with COVID-19 vaccination.
For complete protection, you will need to become up to date with two (2) mRNA COVID-19 vaccine doses and any eligible booster doses.
Vaccination: Staying Up to Date with COVID-19 Vaccinations
For currently available COVID-19 vaccines, what is the difference between being “Up to Date” and being “fully vaccinated”? (Last updated 1/20/22)“Fully vaccinated” still means that (1) a person has received two doses of the original series of either the Pfizer-BioNTech mRNA COVID-19 vaccine OR the Moderna mRNA COVID-19 vaccine OR that the person has received 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 vaccine dose was received.
However, being Up to Date goes a step beyond being Fully Vaccinated to include any person who has received ALL of their recommended COVID-19 vaccine doses, including both the primary vaccine series and any booster dose(s) as soon as they are eligible.
Anyone 12 years of age and older who completed a COVID-19 vaccination series with an mRNA vaccine is now recommended to get a booster dose with any FDA-authorized COVID-19 vaccine once five (5) months have passed since their 2nd primary series dose. People who received the single-dose Johnson and Johnson (Janssen) vaccine should get a vaccine booster dose once two (2) months have passed since their initial dose.
According to a CDC note about the Omicron variant of the SARS-CoV-2 virus, “Data from South Africa and the United Kingdom demonstrate that vaccine effectiveness against [Omicron] infection for two doses of an mRNA vaccine is approximately 35%. A COVID-19 vaccine booster dose restores vaccine effectiveness against infection to 75%.”
To maximize protection against the Omicron variant of COVID-19, even if someone has already met the earlier definition of “fully vaccinated”, for optimal protection, they should still stay up to date on recommended COVID-19 booster vaccinations.
What additional precautions should my children and I continue to take once we are up to date with COVID-19 vaccination? (Last updated 2/28/22)Regardless of community transmission levels, VDH recommends everyone to stay up to date on their COVID-19 vaccines, including boosters, and to increase ventilation in indoor spaces.
Knowing the COVID-19 Community Level in your area will help you know what additional prevention measures to take.
Mask guidance:
- People with symptoms, a positive test, or exposure to someone with COVID-19 should wear a mask.
- In areas where the COVID-19 Community Level is
- Low: Wear a mask based on your personal preference and your level of risk of developing severe illness.
- Medium: Wear a mask based on your personal preference, your level of risk, and the risk of the people you live or spend time with.
- High:
- Everyone, regardless of vaccination status, should wear a mask indoors in public in areas where the COVID-19 Community Levels is high.
- People at increased risk should wear a mask or respirator that provides them with greater protection, like an N95 or KN95.
- People with weakened immune systems or who are at increased risk for severe illness should talk to their healthcare provider about what extra precautions, like masks, they may need.
- People may choose to mask at any time.
Testing guidance:
- At all COVID-19 Community Levels, get tested if you have COVID-19 symptoms or after you are exposed to someone with COVID-19.
- People with weakened immune systems or who are at increased risk for severe illness should talk to their healthcare provider about testing recommendations, regardless of the COVID-19 Community Level.
- At Medium or High Levels: If you have household or social contact with someone at high risk for severe disease, you should consider self-testing to detect infection before contact.
People with weakened immune systems or otherwise at increased risk for severe illness:
- These individuals should talk to their healthcare provider about what extra precautions they may need, including masking, testing, or early treatment recommendations.
- Treatments work best when started early, so rapid access to testing is critical for people at increased risk, in addition to other layers of prevention.
- At high COVID-19 Community Levels, people should avoid non-essential indoor activities.
What do we know about the breakthrough cases of COVID-19 (Last updated 4/25/22)Since no vaccine is100% effective at preventing infection, some vaccine breakthrough cases are expected. (Even if a vaccine is 95% effective, we would still expect 5% of fully vaccinated individuals to be susceptible to infection despite being vaccinated).
Breakthrough cases are expected when vaccine-induced immunity levels decrease over time. Breakthrough cases can also be expected when a new variant (e.g. the Omicron variant or the BA.2 sub-variant of Omicron) displays resistance to the antibody and cellular immunity provided by prior COVID-19 vaccination.
Such breakthrough COVID-19 cases can still result in losing some time away from school or work. In addition, Long COVID can still occur after breakthrough cases (although less often than after COVID-19 in unvaccinated people).
However, current evidence shows clearly that being up to date with COVID-19 vaccination accomplishes the primary goals of vaccination by making the illness of breakthrough cases less severe for those who are up to date and still get infected (including by the Omicron variant or the BA.2 sub-variant) and that vaccination will also reduce - but not eliminate entirely - the risk of spreading COVID-19 to others.
Study links:
Decreased SARS-CoV-2 viral load following vaccination
Initial real world evidence for lower viral load of individuals who have been vaccinated by BNT162b2
From a January 2022 CDC MMWR - adults who were unvaccinated had five (5) times the risk of infection with the Omicron variant compared with adults who were fully vaccinated with a booster.
This Nature article discusses the benefit of a booster dose. After being boosted, “household members were about 32% less likely to get infected with Delta and 12% less likely to become infected with Omicron than if they had received just two doses. People who had received a booster were 38% less likely to spread a Delta infection to their household members, and 22% less likely to pass on an Omicron infection than were those who had had just two shots.”
Virginia added aCOVID-19 Cases by Vaccination Status dashboard on the VDH Data web page.
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Will being up to date against COVID-19 reduce the risk that we could infect others if we get infected with COVID-19? (Last updated 3/29/22)Yes. Although people up to date with COVID-19 vaccination who get breakthrough infections with the Omicron variant can sometimes spread COVID-19 to others, such people seem to be contagious for a shorter time than infected but unvaccinated people. The most recent information on the spread of the Omicron variant can be found on the CDC’s Omicron Variant: What You Need to Know webpage.
Although effectiveness of the current COVID-19 vaccines against mild or asymptomatic Omicron or BA.2 variant breakthrough infection is slightly less, being up to date with COVID-19 vaccination is still effectively preventing severe illness, hospitalizations, and deaths. As has been the case for more than a year, most COVID-19 hospitalizations and most COVID-19 deaths are occurring in unvaccinated individuals.
Are there additional ways to protect vulnerable friends and family? (Last updated 4/15/22)Yes, there are several other ways to help protect others.
In areas where the COVID-19 Community Level is medium, people who live with or have social contact with someone who is at increased risk should consider wearing a mask when indoors with them, and also may choose to test themselves for infection before they get together. Other strategies include improving ventilation in indoor spaces and maintaining adequate distance when around them.
For additional information, please see CDC considerations for Families with Vaccinated and Unvaccinated Members.
Where can I find travel guidance, for travel outside the United States? (Last updated 2/28/22)For cruise ship travel, CDC recommends that you make sure you are up to date with your COVID-19 vaccines before travel.
For airline travel to other countries, COVID-19 viral testing is typically required for pre-travel screening on international airline flights. Some countries are requiring proof of vaccination before allowing travelers to enter certain facilities (e.g., restaurants). Before ANY travel to other countries, you should check closely with both your airline and with the national testing and vaccination requirements of the country or countries that you will be visiting.
For travel from other countries to the United States, all arriving passengers two (2) years and older, including U.S. citizens, and regardless of vaccination status, are REQUIRED to show a negative COVID-19 viral PCR or antigen test taken no more than 1 day before departure for the U.S., or the combination of (1) documentation of having recovered from COVID-19 in the past 90 days (i.e., their positive COVID-19 viral test result on a sample taken no more than 90 days before the flight’s departure) AND (2) a letter from a licensed healthcare provider or public health official stating that you were cleared to travel).
NOTE: Proof of being up to date with COVID-19 vaccination will not substitute for having a negative viral PCR or antigen test before returning to the United States.
For additional information, please visit the VDH’s Travelers webpage.
I am up to date with COVID-19 vaccination. Will that vaccination series protect me against the Omicron variant and the BA.2 sub-variant? (Last updated 3/28/22)The Omicron variant is up to three times more infectious than the Delta variant and the BA.2 sub-variant of Omicron is even more contagious than the Omicron variant.
However, being up to date with vaccination, including recommended booster doses, helps provide optimal protection against both the Omicron variant and the BA.2 sub-variant.
According to the CDC, “Data from South Africa and the United Kingdom demonstrate that vaccine effectiveness against [an Omicron variant ] infection for two doses of an mRNA vaccine is approximately 35%. A COVID-19 vaccine booster dose restores vaccine effectiveness against infection to 75%.“
Therefore, although vaccine effectiveness against developing a COVID-19 illness with mild or no symptoms appears to be decreased against the Omicron variant and the BA.2 sub-variant, protection of people up-to-date with COVID-19 vaccine will remain high for preventing serious illness, hospitalization, or deaths.
Frequently updated information from CDC on the Omicron variant (also called B.1.1.529) is available at Omicron Variant: What You Need to Know.
Individuals should also follow the guidance in the CDC COVID-19 Community Levels.
I had my recommended booster dose of a current mRNA COVID-19 vaccine a few weeks ago. Should I have a serology (antibody) test to be sure that the vaccine is working to protect me? (Last updated 1/30/22)No.
Serology (antibody) testing to confirm immunity after vaccination is not currently recommended by CDC or by VDH. One important reason 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.
Will COVID-19 vaccination interfere with my TB testing? (Last updated 3/28/22)Your COVID-19 vaccination will not interfere with the accuracy of your TB test. According to the CDC, inactive (non-live) 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 canceled.
More information on this topic can be found on the CDC website.
Is there guidance available for people vaccinated with COVID-19 vaccines not authorized in the United States? (Last updated 2/15/22)Yes. CDC guidance is available and is based on the vaccine(s) received for the primary series, whether the primary series was completed, and whether a booster dose was received.
To complete up to date vaccination of individuals who received all FDA-approved or -authorized COVID-19 vaccines, Pfizer-BioNTech COVID-19 Vaccine can be used in individuals ages 5 years and older and Moderna COVID-19 Vaccine can be used in individuals 18 years and older.
For individuals who received at least one COVID-19 vaccine that was not FDA-approved or -authorized, Pfizer-BioNTech COVID-19 Vaccine can be used in individuals ages 12 years and older and Moderna COVID-19 Vaccine can be used in individuals 18 years and older to bring them up to date with COVID-19 vaccination.
For a current list of WHO-EUL COVID-19 vaccines, see the WHO page “COVID-19 vaccines WHO EUL issued.”
I received a bill for the COVID-19 vaccination I received. What should I do? (Last updated 4/12/22)Although your insurance company can be billed for the process of administering your COVID-19 vaccination, you are not responsible for paying for your (or your child’s) COVID-19 vaccines or vaccinations. If you receive a bill, you should first speak to the person or facility that sent it.
Until recently, if you were uninsured and received a bill related to COVID-19 vaccination, you could have asked your healthcare provider to bill the HRSA COVID-19 Uninsured Program instead of you. However on April 5, 2022, the HRSA Uninsured Program stopped accepting vaccination claims due to a lack of sufficient funds.
However, CDC is still requiring all COVID-19 vaccinators to provide COVID-19 at no out-of-pocket costs to patients.
I received an email about COVID-19 vaccination appearing to come from the Virginia Department of Health but it seems suspicious. What should I do? (Last updated 10/29/21)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.
Will I be able to donate plasma for COVID-19 antibodies, after getting the COVID-19 vaccine? (Last updated 1/17/2022)This depends. People who have been vaccinated against COVID-19 can donate COVID-19 plasma only if you meet all three of these criteria:
- You had symptoms of COVID-19 disease and a positive test result from a diagnostic test approved or authorized by FDA, AND
- You received the COVID-19 vaccine after your diagnosis of COVID-19, AND
- You are within 6 months after complete resolution of your COVID-19 symptoms.
See page 6 of the January 2022 FDA guidance for more information on this topic.
Does the allowance for second boosters for some individuals change the definition of “up to date”? (Last updated 4/1/22)No, the definition of up to date remains the same. A person is up to date when they have received all recommended doses in their primary series of COVID-19 vaccine, and a booster dose when eligible. Getting a second booster dose is not needed to be considered up to date at this time.
Vaccination: Booster Doses
What’s the difference between a vaccine booster dose and an additional primary series COVID-19 vaccine dose? Which one will I need? (Last updated 4/12/22)A booster dose is a COVID-19 vaccine dose administered to someone who initially had good protection from the primary vaccine series or from a first booster dose, but in whom this protection may have weakened over time.
Standard (first) booster doses are recommended for all individuals 12 years and older. The recommended interval for the booster dose is based on the vaccine type received for the primary series. In most people, the interval is:
- At least 5 months after mRNA 2-dose primary vaccination series or
- At least 2 months after Janssen single dose primary vaccination
Information on accessing a COVID-19 booster dose can be found at vaccinate.virginia.gov.
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.
- A 3-dose primary series is recommended for people ages 5 years and older who are moderately or severely immunocompromised at the time of vaccination. The same mRNA vaccine product should be used for all three doses of the primary series. The 3rd dose is administered at least 4 weeks after the second dose.
- For moderately or severely immunocompromised people ages 18 years and older who received a primary Janssen vaccination, a second (additional) dose using an mRNA COVID-19 vaccine is recommended at least 4 weeks later.
Those people who receive an additional dose will also be eligible for a standard vaccine booster dose (if they also meet the age and time requirements for a booster) and for a second booster dose when they are eligible.
For COVID-19, a primary vaccine series is still defined as either:
- Two doses of an mRNA vaccine (Pfizer or Moderna) separated by at least the recommended minimum number of 21 or 28 days, respectively; or
- One dose of the Johnson & Johnson (J&J) vaccine.
PLEASE NOTE: Because of an updated risk-benefit analysis of post-vaccination blood clotting disorders, CDC recommendations now state that, in most situations, Pfizer-BioNTech or Moderna COVID-19 vaccines are now preferred over the Johnson and Johnson (Janssen) COVID-19 vaccine. Please see Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety.
When are you considered “up to date” for COVID-19 vaccines? (Last updated 4/11/22)Individuals are considered up to date on their COVID-19 vaccines as soon as they have completed the recommended primary series and when eligible, have also received a booster dose. Second boosters (for those who are eligible) are not needed at this time to meet the definition of “up to date”.
When should I get a vaccine booster dose? (Last updated 5/9/22)The timing of a vaccine booster dose depends on (1) which vaccine you received as the primary vaccination, (2) the competence of the immune system of the potential booster recipient, and (3) whether you have had a recent COVID-19 infection.
After a Pfizer-BioNTech or Moderna mRNA vaccine series: Everyone ages 12 years and older should receive a single COVID-19 booster dose) 5 months after completing the primary mRNA vaccination series.
Adults ages 50 years and older who are not moderately or severely immunocompromised may choose to receive a second booster dose using an mRNA COVID-19 vaccine at least 4 months after the first booster dose.
People ages 12 years and older who are moderately or severely immunocompromised may choose to receive a second booster dose at least 4 months after the first booster dose.
At this time, only the Pfizer COVID-19 vaccine is authorized and recommended as a booster for individuals 12 to 17 years old.
After Johnson & Johnson (Janssen) vaccine: 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.
People ages 18–49 years who are not moderately or severely immunocompromised and who received Janssen COVID-19 Vaccine as both their primary series dose and booster dose may receive a second booster dose using an mRNA COVID-19 vaccine at least 4 months after the first Janssen booster dose.
Adults ages 50 years and older who are not moderately or severely immunocompromised may choose to receive a second booster dose using an mRNA COVID-19 vaccine at least 4 months after the first booster dose.
Because their risk of reinfection is low in the first months after a SARS-CoV-2 infection and COVID-19 illness, people who have had a recent natural infection can consider delaying their first or second booster until 3 months have passed since that illness. Increased time between illness and vaccination booster appears to result in a better immune response.
The FDA has limited the use of the J&J COVID-19 vaccine due to safety issues. The J&J COVID-19 vaccine should only be given to individuals 18 years and older whom mRNA COVID-19 vaccines are not accessible or clinically appropriate and who would otherwise not receive a vaccine. CDC recommends that, in most situations, Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines are preferred over the Johnson and Johnson (Janssen) COVID-19 vaccine. For additional information, please see Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety.
Should I wait for an Omicron-specific vaccine booster dose? (Last updated 4/25/22)No. Although vaccine manufacturers have stated that they are working on Omicron specific vaccines, even if successfully completed, that process will take at least several months more. Although the protection provided against infections from the Omicron variant infection or from its BA.2 subvariant is slightly less than against the Delta variant, booster doses with current mRNA COVID-19 vaccines protect well against serious illness, hospitalization, and death from the Omicron variants.
The best current way to protect yourself and your family from the Omicron variant is (1) to stay up to date on your COVID-19 vaccinations and (2) to continue practicing other recommended prevention measures.
Are there contraindications or precautions with getting a COVID-19 vaccine booster dose? (Last updated 2/15/22)The following conditions in individuals who are otherwise eligible for a COVID-19 vaccine booster dose are contraindications:
- History of a severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the COVID-19 vaccine
- History of a known diagnosed allergy to a component of the COVID-19 vaccine
The following are COVID-19 vaccine precautions (requiring extra care at the time of vaccination):
- History of an immediate allergic reaction to any vaccine other than COVID-19 vaccine or to any injectable therapy (i.e., intramuscular, intravenous, or subcutaneous vaccines or therapies [excluding “allergy shots”])
- People with a history of a non-severe, immediate (onset less than 4 hours later) allergic reaction after a dose of one type of COVID-19 vaccine (i.e., mRNA or Janssen) have a precaution to the same type of COVID-19 vaccine
- People with an allergy-related contraindication to one type of COVID-19 vaccine have a precaution to the other type of COVID-19 vaccine (e.g., people with a contraindication to an mRNA COVID-19 vaccine have a precaution to Janssen COVID-19 vaccine and vice versa).
- Moderate or severe illness, with or without fever
- For mRNA COVID-19 vaccines, history of myocarditis or pericarditis after a dose of an mRNA COVID-19 vaccine
For complete recommendations, please refer to the CDC clinical considerations. Talk to a healthcare provider if you have questions about getting a booster dose.
I was vaccinated abroad with a World Health Organization (WHO)-authorized COVID-19 vaccine. Should I get a booster dose? (Last updated 2/15/22)The recommendations for people vaccinated outside of the United States depend on the vaccine(s) received for the primary series, whether the primary series was completed, and whether any booster dose was already received.
Please refer to the CDC guidance on this topic.
For individuals who received any FDA-approved or FDA-authorized COVID-19 vaccines as an initial dose, Pfizer COVID-19 vaccine can be used in individuals ages 5 years and older and Moderna COVID-19 vaccine can be used in individuals 18 years and older to complete a primary vaccination series and for booster doses when eligible.
For individuals who completed a series of a COVID-19 vaccine that was not FDA-approved or -authorized, but that is WHO-authorized, Pfizer COVID-19 vaccine can be used in individuals ages 12 years and older and Moderna COVID-19 vaccine can be used in individuals 18 years and older to provide a booster dose five months after their most recent vaccine dose.
Do booster dose recommendations mean that the COVID-19 vaccines are not working? (Last updated 3/28/22)No. The current booster dose recommendations mean that COVID-19 vaccines are working as expected. Many vaccines used in the United States produce levels of antibody and cellular immunity that wane (decrease) over time and their successful long term use requires booster vaccine doses at various times. Some examples include flu (influenza), pertussis (whooping cough), tetanus, and diphtheria. Regular boosters are part of the long term planning for preventing these diseases.
COVID-19 vaccines continue to work well to prevent severe illness, hospitalization, and death.
Do I need to show proof of prior vaccination, to get a booster dose? (Last updated 9/24/21)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. However, bringing your CDC vaccination card to the vaccination will allow the booster dose to be added.
Does the availability of booster doses change the definition of “fully vaccinated”? (Last updated 1/14/22)No.
The CDC definition of fully vaccinated remains the same. People are considered fully vaccinated:
- 2 weeks after their second dose in a 2-dose series ofthe Pfizer or Moderna vaccines, OR
- 2 weeks after a single dose of the Johnson & Johnson’s Janssen vaccine
This definition applies to all people, including those who receive an additional (third) mRNA vaccine dose as recommended for moderate to severely immunocompromised people and those who receive a booster shot.
However, because it is essential for maximum protection against COVID-19, individuals should stay up to date with additional or a booster dose after their primary COVID-19 vaccination series.
Why would I need a vaccine booster dose? (Last updated 1/14/22)The COVID-19 vaccines available in the United States continue to be highly effective at preventing severe disease, hospitalization, and death.
However, there is a concern that the protection against severe COVID-19 disease, hospitalization, and death that are benefits of the primary vaccine series could weaken over time in the months ahead. Booster vaccine doses given after the primary vaccine series appear to be able to “boost” one’s level of immune protection significantly. This boost is now especially important with the threat of the Omicron variant and the BA.2 sub-variant. It is essential that for maximum protection, individuals should stay up to date with their COVID-19 vaccinations, including boosters.
If I am immunocompromised and received an additional vaccine dose, can I get a COVID-19 booster dose? (Last updated 5/10/22)Yes. Moderately and severely immunocompromised people aged ≥12 years who:
- Received 2 mRNA COVID-19 vaccine doses should receive a third mRNA primary dose (at least 28 days after their second dose) followed by a booster dose (at least 3 months after completing their third primary dose), for a total of four vaccine doses
- Received a Janssen COVID-19 Vaccine primary dose should receive one additional mRNA dose (at least 28 days after their primary dose) and one booster dose (at least 2 months after completing their additional dose), for a total of three vaccine doses.
People ages 12 years and older who are moderately or severely immunocompromised may choose to receive a second booster dose at least 4 months after the first booster dose. This would be a fifth dose for people who completed an mRNA primary series and a fourth dose for people who completed the J&J (Janssen) initial shot.
Teens 12–17 years old may only get a Pfizer-BioNTech COVID-19 vaccine booster.
Note: The FDA has limited the use of the J&J COVID-19 vaccine due to safety issues. The J&J COVID-19 vaccine should only be given to individuals 18 years and older whom mRNA COVID-19 vaccines are not accessible or clinically appropriate and who would otherwise not receive a vaccine. People who are starting their vaccine series or getting a booster dose should get either Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines. For more information, please see Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety and CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines.
What is the current option for a second COVID-19 vaccine booster? (Last updated 4/25/22)Protection from COVID-19 vaccination can decrease over time. Since overall immune responses appear to increase with each subsequent vaccine dose, one way to respond to a decrease in immunity against infections with the Omicron variant or other variants might be to give a second booster dose.
Public health organizations and vaccine manufacturers have been carefully watching emerging data to ensure vaccine protection remains strong against severe COVID-19 illness. Individuals who are up to date with their COVID-19 vaccinations, including booster doses, continue to have strong protection against severe illness. The current booster dose recommendation for staying up to date is especially important to get the greatest protection against the Omicron variant.
FDA’s advisory committee met on April 6 to discuss the use of COVID-19 vaccine booster doses and the process for COVID-19 vaccine strain selection to address current and emerging variants. The committee is expected to meet again in late spring or early summer to consider updated booster formulations for this fall.
Meanwhile, people 50 years old and older and immunocompromised individuals 12 and older are now allowed to have another (second) COVID-19 vaccine booster dose. The booster dose policy is being changed because recent data shows that second booster doses are very effective in both restoring antibody levels and further reducing infection rates. These benefits are important for individuals at higher risk for severe COVID-19 illness.
CDC’s most recent guidance on the eligibility for and timing of a second COVID-19 vaccine booster is available.
Vaccination: Natural Immunity
Is the immune response from staying up to date with COVID-19 vaccinations different from the initial immune response generated by natural infection? (Last updated 4/25/22)For COVID-19 vaccination, we have antibody, vaccine safety, and vaccine effectiveness data and we also have vaccine boosters of proven effectiveness (including against the Omicron variant) to address decreasing immunity over time. Vaccination can ensure the optimal degree of population protection against the Omicron variant and against other future variants of the SARS-CoV-2 virus.
A CDC study shows that even among persons with previous COVID-19 infection, receipt of a COVID-19 mRNA vaccine provided protection against subsequent COVID-19 hospitalization. The highest level of protection was provided by a booster vaccine dose.
Before the Omicron variant, both natural immunity and immunity from COVID-19 vaccine appeared adequate to prevent another infection for at least several months and to ensure that those infections that occurred were milder than initial natural infections might be. However, with Omicron (a more infectious variant), booster doses are essential for optimal protection.
The Omicron variant and its BA.2 sub-variant still have the ability to at least partially evade both (1) the antibodies produced after natural infection with a prior variant and (2) the antibodies produced after current COVID-19 vaccines.
However, with Omicron infections, the other part of the immune system, the cell-mediated (T-cell) immunity helps to provide some of the observed protection against the severity of COVID-19 re-infection seen after both vaccination and after natural infection.
Vaccination is the safest way to get consistent protection against severe illness, hospitalization, and death. Being up to date on COVID-19 vaccinations, including being boosted when eligible, provides protection against severe outcomes caused by the variants. Natural infection alone can provide some protection, though less against Omicron compared to previous variants. With an initial natural infection, there is also added risk of developing complications with infection or Long-covid. The risk of Long-covid is lower if an individual is up to date with COVID-19 vaccination.
For more information visit the CDC site.
What is hybrid immunity? (Last updated 4/12/22)To maximize protection from future COVID-19 infections and reinfections, you should always stay up to date with COVID-19 vaccinations.
For COVID-19, hybrid immunity is a combination of (1) the immunity from being up to date with COVID-19 vaccination and (2) the immunity from a natural COVID-19 illness.
The hybrid immunity coming from this combination provides a higher, stronger, and more consistent level of protection from COVID-19 than either infection alone or vaccination alone. Several studies have found that (a) people vaccinated after having natural infection had much lower re-infection risks than people who did not get vaccinated after a natural infection and (b) that people who had that combination of hybrid immunity from both COVID-19 infection AND COVID-19 vaccination had even lower disease risks than people who had immunity from only the disease or from only vaccination. In addition, two recent CDC studies support this observation: (link and link).
After a natural infection, how long can I wait to get a booster dose ? (Last updated 4/27/22)You can wait up to three (3) months after a natural infection. This waiting period is based on data indicating that high levels of anti-COVID-19 antibody and protection persist at least until that point. Increased time between illness and vaccination booster appears to result in a better immune response.
Should I seek out infection with the Omicron variant or its BA.2 subvariant to try to obtain hybrid immunity? (Last updated 4/12/22)No.
Although infection with the Omicron variant appears to be relatively milder when compared to previous variants, it is still not considered to be a mild infection. Some individuals, particularly unvaccinated individuals, can and do become severely ill from Omicron infection and can require hospitalization or can develop debilitating Long COVID symptoms. Infected individuals can also contribute to community transmission.
How many doses of COVID-19 vaccine will I need to be fully protected by hybrid immunity? (Last updated 4/12/22)No one knows for certain yet. Although initial studies of hybrid immunity from India and from Israel found good results after a single dose of COVID-19 vaccine, they did not account for the possible risks of immunity decreasing over time or for waning due to the arrival of new variants. Because of these risks, both VDH and CDC recommend staying up to date with COVID-19 vaccination even if you have had COVID-19 in the past.
If I get a breakthrough infection after I have gotten fully vaccinated, how well will I be protected by hybrid immunity?(Last updated 2/10/22)Having a breakthrough COVID-19 infection after being vaccinated against COVID-19 also leads to a hybrid immunity that is more protective against severe forms of COVID-19 than what you would have had after having either natural infection alone or COVID-19 vaccination alone. Also, it appears that as far as getting hybrid immunity from a combination of natural infection and vaccination, the sequence of infection and vaccination does not matter.
Vaccination: Healthcare Providers
How should healthcare providers administering the COVID-19 vaccine report this information back to VDH? (Last updated 1/5/21)VDH is asking providers to report all vaccination administrations to the Virginia Immunization Information System (VIIS). These reports are very important for ensuring that there is an established reporting and data feedback loop for the COVID-19 vaccine.
I work in a doctor’s office, pharmacy, or other healthcare office. Can I administer the COVID-19 vaccine at my practice? (Last updated 12/22/20)Yes. 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 and general information from CDC are available.
Where can clinicians learn more about adverse events after vaccination and other clinical considerations? (Last updated 5/9/22)Clinicians can utilize the following resources:
- Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States
- Clinical Considerations Second COVID-19 Vaccine Booster Dose
- COVID-19 ACIP Vaccine Recommendations
- COVID-19 Vaccine FAQs for Healthcare Professionals
- COVID-19 Vaccination Clinical & Professional Resources
J&J thrombosis with thrombocytopenia resources:
- Clinician fact sheet: Janssen
- American Society of Hematology guidance: Vaccine-induced Immune Thrombotic Thrombocytopenia: Frequently Asked Questions.
Myocarditis and pericarditis resources:
- CDC Clinical Considerations: Myocarditis after mRNA COVID-19 Vaccines
- Clinician fact sheets: Pfizer- BioNTech and Moderna COVID-19 vaccines
Report all adverse events occurring soon after COVID19 vaccination to VAERS, including serious and life-threatening adverse events. In particular, report any deaths in patients following receipt of COVID-19 vaccines even if you do not think the death was related to the vaccination process, as required under the Emergency Use Authorizations for COVID-19 vaccines.
MIS-C and MIS-A resources:
As a healthcare provider, how can I learn more about the vaccines and administering them? (Last updated 2/15/22)CDC has self-study web modules for healthcare providers that can be found at Vaccine Courses, Broadcasts, Webcasts and Self Study Training and include a general overview of COVID-19 Immunization Best Practices (15 minutes) and a set of modules on what healthcare providers need to know about each of the current COVID-19 vaccines. 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.
Information on administering a second booster dose can be found in the CDC fact sheet: Clinical Considerations: Second COVID-19 Vaccine Booster Dose.
Immunize.org provides FAQs on their “Ask the Experts” page.
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 most recent fact sheets for healthcare providers administering the Pfizer-BioNTech COVID-19 Vaccines can be found on the FDA website. The link to the prescribing information (PI) for Comirnaty is here: www.fda.gov/media/151707/download.
The most recent fact sheets for healthcare providers administering the Moderna COVID-19 Vaccines can be found on the FDA website. The link to the prescribing information (PI) for Spikevax is here: https://www.fda.gov/media/155675/download.
The most recent FDA-approved fact sheet for healthcare providers administering the Johnson & Johnson (also known as Janssen) COVID-19 Vaccine is available. (Revised January 31, 2022)
Resources for vaccinating immunocompromised individuals:
- Best practices for vaccination of people with altered immunocompetence
- CDC Yellow Book, Chapter 5
- 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host.
- What to Tell Immunocompromised Patients about COVID-19 Vaccines
- How Effective are COVID-19 Vaccines in Immunocompromised People
How can healthcare providers or health departments request a consultation for a complex COVID-19 vaccine safety question? (Last updated 5/13/21)U.S. Healthcare providers or health departments can request a consultation from CDC’s Clinical Immunization Safety Assessment (CISA) COVIDvax project for any 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, visit the CDC’s Clinical Immunization Safety Assessment (CISA) Project webpage.
What is the difference between the purple cap Pfizer COVID-19 vaccine and the gray cap Pfizer vaccine (Last updated 1/6/22)?Pfizer is transitioning all COVID-19 vaccines from the purple cap vials to the gray cap vials. As of January 4th, 2022, the only available Pfizer vaccine for federal (U.S. government) ordering comes in gray cap vials, which is indicated for individuals ages 12 years and older. The vaccine in the gray cap Pfizer vials does not need to be diluted prior to administration. This is different from the purple cap vials. Storage and handling of the gray cap Pfizer vaccine are also different from the purple cap vaccine. Please see CDC’s website on Pfizer-BioNTech COVID-19 Vaccines by Age and Cap Color for more information.
How should healthcare providers report vaccine administration errors? (Last updated 2/12/21)CDC provides detailed information on how to address vaccine administration errors. Additional resources can be found on CDC’s vaccine administration web page, including a job aid for preventing errors.
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. The Virginia IIS homepage is available.
- Report the error to the Vaccine Adverse Event Reporting System (VAERS), unless otherwise indicated in the table. Determine how the error occurred and implement strategies to prevent it from happening again.
How do I find the expiration date of the different COVID-19 Vaccine Brands? (Last updated 4/13/22)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 ultra low temperature (ULT) conditions can be used 9 months after the manufactured date listed. Example: the manufacture date listed is 2/22 the vaccine could be administered through 10/31/2022.
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
Do I need to return the Pfizer-BioNTech vaccine shipping container after I have used the contents and discarded the dry ice? (Last updated 6/16/21)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.” Details about how to prepare and return the container are available.
Do vaccine providers need to document proof of a qualifying condition before administering an additional primary dose of an mRNA vaccine? (Last updated 9/29/21)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). 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.
How will additional primary vaccine doses and booster doses be recorded? (Last updated 9/29/21)Vase+, VAMS and PrepMod will all have this ability to record additional doses, 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.
Can we vaccinate someone using an unopened Moderna vaccine vial that was thawed yesterday, was not used, and then was put back in the freezer overnight? (Last updated 4/18/22)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 and should then be reported according to the relevant VDH requirements. The VDH COVID Vaccine Wastage Form is available.
Am I able to continue to order the J&J (Janssen) Vaccine in my health district? (Last updated 5/9/22)Yes, the Johnson & Johnson /Janssen (J&J) COVID-19 Vaccine is available for centralized ordering through the VaxMaX portal.
Can I administer an additional primary dose of an mRNA vaccine or a booster dose to someone who is not currently recommended to receive this additional dose? (Last updated 11/22/21)No. Healthcare providers who choose to administer COVID-19 vaccines must enroll as providers in the vaccination program and comply with provider requirements. As part of the provider agreement, the provider must administer COVID-19 vaccines in accordance with all program requirements and recommendations, including those of CDC, the Advisory Committee on Immunization Practices, and the U.S. Food and Drug Administration.
Providers who administer COVID-19 vaccines in a way that is not advised by the federal agencies or “off label” are violating the agreement. These noncompliant providers might be unenrolled in the COVID-19 vaccination program or restricted from further vaccine doses. Healthcare providers who administer COVID-19 vaccines outside of recommendations, or “off-label”, may not be covered under the Public Readiness and Emergency Preparedness Act (PREP) Act or the COVID-19 PREP Act declaration. Therefore, these healthcare providers may not have immunity from liability claims. Administration fees for such administration of the COVID-19 vaccine, may not be reimbursable by payers.
To review the most recent recommendations for who can receive an additional primary dose or booster dose, please see the CDC website.
Vaccination: Long-Term Care Facilities
Will CVS and Walgreens be offering booster vaccines to LTCFs as previously provided through the Federal pharmacy partnership program? (Last updated 9/28/21)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.
How can a LTCF access COVID-19 vaccine for their residents and staff if the facility does not have a pharmacy agreement in place? (Last updated 9/28/21)- 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.
How do I request vaccine support from the health department? (Last updated 3/20/22)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.
Am I able to order and receive vaccines to administer at my facility? (Last updated 9/28/21)LTCFs are able to order and administer vaccines through VaxMaX if the facility is enrolled as a vaccine provider. For more information on how to enroll as a vaccine provider, visit the VDH Provider Enrollment Process Flow & Checklist.
How do I encourage my staff to get vaccinated? (Last updated on 9/14/21)Patient education can be found on the VDH website. 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.
Where can I find guidance on how to evaluate residents of long-term care facilities that may have symptoms after vaccination? (Last updated 12/28/20)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.
How do resident and staff vaccinations impact the current CMS testing requirements? (Last updated 9/14/21)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.
Who is responsible for reporting possible vaccine-related adverse events to VAERS? The LTCF or the pharmacy who administered the vaccine? (Last updated 1/14/21)If the adverse event occurs while the pharmacy team is on site, then they will report the adverse event to VAERS. If it occurs after the pharmacy team has left, then the facility should report the event to VAERS. Both the pharmacy and the LTCF facility can report adverse events to VAERS; there is no double reporting jeopardy in the VAERS system. Information about how to report to VAERS can be found on their website. FAQs about VAERS reporting are also available.
- VAERS accepts reports from anyone. Patients, parents, caregivers and healthcare providers (HCP) are encouraged to report adverse events after vaccination to VAERS even if it is not clear that the vaccine caused the adverse event.
- Healthcare providers are required by law to report to VAERS:
- Any adverse event listed in the VAERS Table of Reportable Events Following Vaccination that occurs within the specified time period after vaccination
- An adverse event listed by the vaccine manufacturer as a contraindication to further doses of the vaccine
- Healthcare providers are strongly encouraged to report:
- Any adverse event that occurs after the administration of a vaccine licensed in the United States, whether or not it is clear that a vaccine caused the adverse event
- Vaccine administration errors
- Vaccine manufacturers are required to report to VAERS all adverse events that come to their attention.
Facilities should also encourage staff to report their post vaccination symptoms to v-safe. Any adverse event reported to v-safe will trigger a phone call from the VAERS team. The LTCF can also report these symptoms to the pharmacy when they come back for the second or third clinic. The EUA fact sheet shared with vaccinated individuals contains information about post vaccination adverse event reporting.
If a facility is experiencing an outbreak, can a planned booster clinic proceed as scheduled? (Last updated 2/8/22)There are multiple factors to be considered before deciding whether to conduct a vaccine clinic during an active outbreak.
- Individuals with active COVID-19 infection are not recommended to receive a vaccination.
- If the outbreak is under control and is restricted to one unit/area of the facility, the clinic can be conducted by following the recommendations from CDC long-term care infection prevention guidance (under “indoor visitation during an outbreak response”).
- If the facility’s current outbreak response plan includes expanding routine testing, it is prudent to reschedule the vaccine clinic to a later date.
- The facility should notify the booster clinic providers about the outbreak situation.
Vaccination: Employers
Can I require my employees to get the COVID-19 vaccines as a condition of employment? (Last updated 3/26/21)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.
Do employees still need to wear masks at work? (Last Updated 3/30/22)Employees and employers should refer to the VDH mask page for current mask recommendations.
Can a company, organization, association require a vaccination to attend ‘in person’ events or return to work? (Last updated 5/18/21)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.
Vaccination: Children
How many vaccine doses will my child need to be protected? (Last updated 3/30/22)Children 5–17 years old will need two (2) doses of the Pfizer-BioNTech vaccine separated by at least 21 days apart. An extended interval is an option for individuals 12 years of age and older based on an individual’s risks and benefits (including the risk of myocarditis). An 8-week interval may be optimal for some people ages 12 years and older, especially for males ages 12 to 39 years. However, the 21 or 28 day interval between the first and second doses remains the recommended interval for: children who are moderately to severely immunocompromised and others who need rapid protection due to increased concern about community transmission or risk of severe disease.
After receiving the two doses, it is important that children stay up to date on COVID-19 vaccines by receiving booster doses when eligible in order to maintain adequate protection.
People aged 5+ who are moderately or severely immunocompromised should get a third (additional) primary dose of Pfizer COVID-19 vaccine, 28 days after their 2nd dose.
Everyone ages 12+ should get a Pfizer booster dose at least 5 months (or at least 3 months if immunocompromised) after the last dose in their primary series.
People ages 12 years and older who are moderately or severely immunocompromised may choose to receive a second booster dose at least 4 months after the first booster dose. This would be a fifth dose for people who completed an mRNA primary series and a fourth dose for people who completed the J&J (Janssen) initial shot.
Do minors need parental/guardian consent to receive a COVID-19 vaccine? (Last updated 11/3/21)Yes. Minors (those less than 18 years old) in the Commonwealth of Virginia may not consent to their own immunizations to prevent disease. There are some exceptions to this restriction. For example, any minor who is or has been married is considered to be an adult for the purpose of giving consent to their own surgical and medical treatment.
The Commonwealth does allow someone acting “in loco parentis” per:§ 32.1-46, which covers vaccination in accordance with the Immunization schedule developed by and published by the Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). In an effort to maintain consistency with similar approaches to vaccination, a minor may present for COVID-19 vaccination with either a parent, guardian, or someone standing in loco parentis.
Will I be required to provide proof of age at my child’s COVID-19 vaccination appointment? (Last updated 11/3/21)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.
COVID-19 vaccine dosing is based on your child’s age, and not their weight or size.
What side effects are common in pre-teen and younger children after vaccination? (Last updated 11/10/21)Side effects seen in younger 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.
Detailed comments on expected vaccine side effects are available in the Vaccine FAQs section on Side Effects and Adverse Events After COVID-19 Vaccine.
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.
What should I do if my vaccinated children get any of the common COVID-19 vaccine side effects? (Last updated 11/3/21)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.
Detailed information on expected vaccine side effects are available in the Vaccine FAQs section on Side Effects and Adverse Events After COVID-19 Vaccine.
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.
How do I register my child for v-safe? (Last updated 11/17/21)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.
I am concerned about my child’s risk of myocarditis and pericarditis from vaccination. Why should I consider vaccinating my child? (Last updated 4/11/22)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 and other heart problems are more common and more severe after COVID-19 illness than after COVID-19 vaccination. According to a recent CDC MMWR, young men (ages 18-29 years old) had 7-8X the risk of heart complications after infection compared to after vaccination.
If your child is 12 years of age or older, talk to their healthcare provider about an extended interval between the first and second vaccine doses. An 8-week interval may be optimal, and is now allowed, for people ages 12 years and older. Males ages 12 to 39 years, may especially benefit, with a lower risk of myocarditis. However, the 21 or 28 day interval between doses remains the recommended interval for: children who are moderately to severely immunocompromised and for others who need rapid protection due to increased concern about community transmission or risk of severe disease.
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.
My child is 11 years old and will turn 12 by the time they receive their 2nd Pfizer vaccine dose. What dose should they receive for the 2nd dose? (Last updated 11/10/21)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.
Will Virginia public schools require my child to get vaccinated? (Last updated 7/21/21)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.
Do additional data support that COVID-19 vaccines protect children and adolescents? (Last updated 3/11/22)COVID-19 vaccines protect children 12–18 years old against severe outcomes of COVID-19 infection. A recent study of adolescents hospitalized with COVID-19 found that only 4% of them had been up to date in their COVID-19 vaccination status. In a comparison of this group with hospitalized adolescents who did not have COVID-19, the effectiveness of vaccines in preventing hospitalization was found to be 94%. Vaccine effectiveness in preventing adolescent COVID-19 admission to an ICU was 98%, and its effectiveness in preventing adolescent death from COVID-19 was 100%.
In a March 2022 CDC report, data show that two doses of Pfizer-BioNTech COVID-19 vaccine reduced the risk of Omicron infection by 31% among children aged 5–11 years and by 59% among persons aged 12–15 years. Fully vaccinated participants with Omicron infection spent an average of one half day less sick in bed than did unvaccinated participants with Omicron infection.
A preprint study conducted in New York, shows that vaccine effectiveness against COVID-19 cases dropped (waned) quickly, but especially in younger children (5–11 years). Yet the study showed that vaccine protection against severe COVID-19 outcomes remained especially high in adolescents.
Given the low risk of COVID-19 to children, why not wait for more data to get my child vaccinated? (Last updated 4/20/22)The risk of children getting severely ill from COVID-19 was lower in the past than in unvaccinated older people, but it is not zero.
Children who have COVID-19 have a risk of becoming sick, hospitalized, or in some cases, dying. Children with diabetes and obesity are likely to experience severe COVID-19. 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.
CDC data from April 2022 shows that during the Omicron surge, hospitalization rates from COVID-19 in children aged 5–11 years were approximately twice as high among unvaccinated as among vaccinated children. Thirty percent of hospitalized children had no underlying medical conditions.
The COVID-19 vaccine is safe and effective at preventing severe illness and death. More than 9 million children aged 5–11 years have received a COVID-19 vaccine so far in the United States. COVID-19 vaccination can help our students stay in school, minimize interruptions (such as having to quarantine after an exposure), and decrease the likelihood of COVID-19 transmission.
Vaccination: People with Weakened Immune Systems
Are people with weakened immune systems at higher risk from COVID-19 disease? (Last updated 6/3/21)Yes. As many as 2.7% (almost 10 million people) 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:
- those who have a weakened immune system because of a disease they were born with (e.g., Down’s Syndrome or primary immunodeficiency) or that they became ill with (e.g., HIV infection or blood cancer) later on;
- 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 or even up to date with COVID-19 vaccine.
People with weakened immune systems can also sometimes stay infected 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.
Is an additional primary dose of a COVID-19 vaccine recommended for people with weakened immune systems? (Last updated 4/25/22)Yes.
After completing the primary vaccine series, some moderately or severely immunocompromised people should get an additional primary series shot.
- The additional dose should be administered at least 28 days after the second dose of either the Pfizer or Moderna vaccine; or at least 28 days after the single initial dose of the Johnson & Johnson vaccine.
- The additional dose should be the same mRNA vaccine as the primary series. For J&J (Janssen) vaccine recipients, the additional dose should be any mRNA COVID-19 vaccine.
However, even those people with weakened immune systems who receive an additional dose of an mRNA vaccine still might not have strong protection against COVID-19 after vaccination. These individuals should speak to their healthcare provider about additional prevention measures, including having a plan for testing, or the need for early treatment if infected. In areas where the COVID-19 Community Level is high or medium, people at increased risk should wear a mask or respirator that provides them with greater protection, like an N95 or KN95 and may choose to avoid nonessential indoor activities.
- Their household members, friends, and other close contacts who are vaccine-eligible should get up to date on COVID-19 vaccination to help provide maximal protection to their immunocompromised loved ones and colleagues.
- The individuals who received mRNA COVID-19 vaccine doses should also get a standard booster dose (at least 3 months after completing their third primary dose), for a total of four vaccine doses
- The individuals who received a Janssen COVID-19 Vaccine primary dose followed by one additional mRNA dose, should receive one booster dose (at least 2 months after completing their additional dose), for a total of three vaccine doses.
- If a second booster dose is later considered, it should be given no earlier than four (4) months after the first (standard) booster dose.
People ages 12 years and older who are moderately or severely immunocompromised may choose to receive a second booster dose at least 4 months after the first booster dose. This would be a fifth dose for people who completed an mRNA primary series and a fourth dose for people who completed the J&J (Janssen) initial shot.
The American College of Rheumatology has guidelines around vaccination timing for people with autoimmune and inflammatory conditions as well as recommendations for which medications should be paused when patients get the vaccine. Other guidance is available from the International Organization for the Study of Inflammatory Bowel Disease, and the American Society of Transplantation and other transplantation groups. The Leukemia and Lymphoma Society has released a set of COVID-19 FAQs.
If I received one or more of my COVID-19 vaccine doses while receiving cancer chemotherapy or radiation, should I be revaccinated? (Last updated 3/15/22)You should discuss your personal protection and your COVID-19 vaccination situation with your healthcare provider. Any revaccination or additional vaccination decided on should be done with an mRNA vaccine.
Will I need to show proof that I have a moderate or severe immunocompromising condition to get the additional dose? (Last updated 8/27/21)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 also bring photo identification to confirm your identity as well as your CDC vaccination card, so that this additional dose can be added.
I am significantly immunocompromised but received the Johnson & Johnson (Janssen) vaccine. Am I eligible for additional doses of vaccine? (Last updated 2/14/22)Yes.
Moderately and severely immunocompromised people aged ≥18 years who received a single dose J&J COVID-19 vaccine primary series should receive a second primary dose (of an additional mRNA vaccine) at least 28 days after the 1st J&J dose. Then, they should also receive a COVID-19 booster vaccine (Pfizer-BioNTech, Moderna or J&J) at least 2 months (8 weeks) after receiving their second primary dose.
Certain scenarios:
- If an individual already received two doses of the Janssen COVID-19 Vaccine, they should receive a third dose (additional mRNA vaccine) at least 2 months after the 2nd dose.
- If an individual already received one dose of Janssen COVID-19 Vaccine and one dose of an mRNA COVID-19 Vaccine (given as a standard booster dose), they should receive a third dose (additional mRNA vaccine) at least 2 months after the 2nd dose.
- If an individual already received one dose of Janssen COVID-19 Vaccine and one dose of an mRNA COVID-19 Vaccine (given as additional dose), they should receive a booster dose of any COVID-19 vaccine 2 months after the 2nd dose.
Also, people ages 12 years and older who are moderately or severely immunocompromised may choose to receive a second booster dose no earlier than four (4) months after the first booster dose. This should be an mRNA booster.
Additional guidance can be found in the CDC clinical considerations.
Please note: The FDA has limited the use of the J&J COVID-19 vaccine due to safety issues. The J&J COVID-19 vaccine should only be given to individuals 18 years and older for whom mRNA COVID-19 vaccines are not accessible or clinically appropriate and who would otherwise not receive a vaccine.
I was vaccinated abroad. Can I get an additional COVID-19 vaccine dose in the United States if I am immunocompromised? (Last updated 2/14/22)People who were vaccinated outside the United States and completed a COVID-19 vaccination that is FDA-approved or FDA-authorized and who are moderately or severely immunocompromised and who:
- Received 2 mRNA COVID-19 vaccine doses should receive a third mRNA primary dose followed by a booster dose, for a total of four vaccine doses
- Received a Janssen COVID-19 Vaccine primary dose should receive one additional mRNA dose and one booster dose, for a total of three vaccine doses.
People ages 12 years and older who are moderately or severely immunocompromised and who completed a COVID-19 vaccination listed for emergency use by WHO but not approved or authorized by FDA should also receive:
- A single dose of an mRNA COVID-19 vaccine at least 28 days after receiving the last dose of the non-FDA-approved or -non-FDA-authorized primary series.
- An mRNA booster dose at least 3 months after their last primary series dose, for a total of four vaccine doses.
Additional guidance can be found on the CDC website.
A decision about receiving an additional dose or booster dose should be discussed with your healthcare provider.
I have a weakened immune system because of medicines I am taking after my organ transplant. After I am fully vaccinated, or receive a third (additional) dose or booster dose, should I have my COVID-19 antibodies measured with a serology test to make sure that I have responded to the COVID-19 vaccine? (Last updated 4/12/22)No.
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.
Our bodies produce several different types of antibodies against the SARS-CoV-2 virus that causes COVID-19. Some of the available COVID-19 serology tests do NOT measure the SARS-CoV-2 spike antibody which is the only antibody that the body produces after COVID-19 vaccination. A negative serology test after vaccination, if it is not measuring the correct (vaccine-generated spike) antibody, could be a false negative.
Several studies have indicated that the cellular immune system, another critical part of your immune system, usually 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 immunity may be responding well to the vaccine. A negative antibody test by itself is not a certain indicator that your immune system is not responding at all to the vaccine.
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.”
Vaccination: Records
How do I obtain a copy of my or my child’s COVID-19 vaccine record? (Last updated 10/6/21)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.
What if the COVID-19 Vaccination Record with QR Code is not found? (Last updated 9/14/21)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.
What if the COVID-19 Vaccination Record is incorrect? (Last updated 9/14/21)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.
What is the COVID-19 Vaccination Record with QR Code? (Last updated 9/14/21)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 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.
What should I do with my COVID-19 Vaccination Record with QR Code? (Last updated 10/13/21)There are a number of ways you can save your QR code:
- Print it
- Screenshot it and store it in your photo album
- Save it
- To your computer
- To your smartphone as a file (iPhone/Android)
- To your Google Pay Wallet
- 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.
Am I required to get a COVID-19 Vaccination Record with QR code? (Last updated 9/14/21)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.
What information is contained in the COVID-19 Vaccination Record with QR code? (Last updated 9/14/21)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.
How does the COVID-19 Vaccination Record with QR code protect my privacy? (Last updated 9/14/21)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.
How can I obtain the COVID-19 Vaccination Record QR code for myself or my child? (Last updated 9/14/21)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.
What happens to my information after I present my vaccination record to someone? (Last updated 9/14/21)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.
I just got vaccinated against COVID-19. When will this be available in my COVID-19 Vaccination Record with QR code? (Last updated 9/14/21)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.
I received an additional dose of COVID-19 vaccine. Will this show up in my COVID-19 Vaccination Record with QR code? (Last updated 9/14/21)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.
How can businesses and employers use the COVID-19 Vaccination Record with QR Code to verify the vaccination status of their patrons or employees? (Last updated 9/14/21)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.
Is the record system intended to be a vaccine passport? (Last updated 9/14/21)No. The purpose of this system is to allow you to access your own vaccination record and to have options for presenting it to others if and when you choose to do so.
How do I test the COVID-19 Vaccination Record with QR Code on my own? (Last updated 9/21/21)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: May 10, 2022