Vaccination FAQ

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

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

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

Everyone in Virginia 5 years or older is eligible.

The CDC provides additional support in their VAMS Vaccine Recipient Frequently Asked Account Set Up and Scheduling Questions.

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

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

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

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

No. Proof of Virginia residency is not required.

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

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

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

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

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

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

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

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

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

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

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

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

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

Yes, the 5–11 year old age group has been authorized by the FDA and recommended by CDC to receive the children’s Pfizer-BioNTech COVID-19 vaccine. These children can be scheduled for vaccination in Virginia, the same way that older children and adults are being scheduled.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Yes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Centers for Disease Control and Prevention (CDC) has a lot of information on this topic. To learn more:

• Frequently Asked Questions about COVID-19 Vaccination
• Vaccines
• Benefits of Getting a COVID-19 Vaccine
• Understanding How COVID-19 Vaccines Work
• There are Different COVID-19 Vaccines
• How CDC Is Making COVID-19 Vaccine Recommendations
• 8 Things to Know about Vaccine Planning
• Myths and Facts about COVID-19 Vaccines
• Who is Eligible for a COVID-19 Booster Shot?

For the latest information about COVID-19 vaccination in Virginia, click here.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

EUAs are issued when the FDA agrees that the current disease situation is so dangerous that there is not time to fully complete the usual long-term studies. Even in an emergency, however, the short-term studies and trials must show that the vaccine is effective and as safe as possible. Updates or amendments to an EUA, as happened in May 2021 to allow use of the Pfizer-BioNTech vaccine for 12–15 year olds and as happened again in October 2021 to allow use of that vaccine in 5–11 year olds, similarly require presentation of new data or other information to the FDA.

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

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

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

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

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

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

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

In August 2021, the U.S. Food and Drug Administration (FDA) granted full approval to Comirnaty (previously known as the Pfizer-BioNTech COVID-19 vaccine) for people aged 16 years and older. This was the first of three federal review steps. The next step was for the CDC Advisory Committee on Immunization Practices (ACIP) to discuss its updated recommendation for this vaccine. The final step, the CDC Director’s review and final approval of the ACIP recommendations, also occurred on that same day. The full recommendations were published soon after that as official CDC/HHS recommendations in the Morbidity and Mortality Weekly Report (MMWR). The vaccine also continues to be available under emergency use authorization (EUA) for individuals 5–15 years of age, for the administration of a primary dose in certain immunocompromised individuals, and for booster doses in certain categories of fully vaccinated people.

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

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

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

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

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

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

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

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

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

No, you cannot.

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

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

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

Yes.

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

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

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

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

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

• People with some autoimmune diseases are also able to be vaccinated but also need to be aware of the limited vaccine safety data for people in their category.

• People who have a history of myocarditis or pericarditis unrelated to mRNA COVID-19 vaccination may receive any FDA-authorized COVID-19 vaccine after the episode of myocarditis or pericarditis has completely resolved. It is unclear if people who developed myocarditis or pericarditis after a dose of an mRNA COVID-19 vaccine may be at increased risk of further adverse cardiac effects following a subsequent dose of the vaccine. Until additional safety data are available, experts recommend that people who developed myocarditis or pericarditis after a first dose of an mRNA COVID-19 vaccine defer receiving their second dose.

• People with a history of Guillain-Barre Syndrome (GBS) should receive any FDA-authorized COVID-19 vaccine. However, given the possible association between the Janssen (Johnson and Johnson) COVID-19 vaccine and an increased risk of GBS, a patient with a history of GBS and their clinical team should discuss the availability and possible use of one of the mRNA COVID-19 vaccines to offer protection against COVID-19.

• People with a history of having previously had Bell’s palsy should receive COVID-19 vaccine but need to be closely monitored for the re-development of this neurologic condition.

• Some people who have used dermal filler may develop swelling at or near the filler injection site soon after receiving an mRNA COVID-19 vaccine. Such people should contact their health care provider if they experience post-vaccination swelling at a dermal filler injection site.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Type of vaccine: mRNA

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

How given: injections in the muscle of the upper arm

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

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

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

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

Type of vaccine: mRNA

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

How given: Injection in the muscle of the upper arm

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

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

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

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

Type of vaccine: adenoviral vector for spike protein

Number of injections (shots): 1 injection

How given: Injection in the muscle of the upper arm

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

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

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

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

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

For younger children, clinical studies by Pfizer-BioNTech and Moderna have been going on now in an age-de-escalated manner. (5–11 year olds, then 2–4 year olds, and finally, children less than 2 years old.) 

Pfizer- BioNTech submitted data for vaccine response in younger children to the FDA in late September 2021. An FDA committee has recommended the vaccine for 5–11 year olds and CDC’s Director has now agreed with the recommendations of the CDC Advisory Committee on Immunization Practices (ACIP) that the Pfizer-BioNTech COVID-19 vaccine should be given to all children five years and older.  

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

The dose of the Pfizer-BioNTech vaccine for 5–11 year olds is 10 mcg, which is ⅓ of the adult dose. The dose of vaccine for those 6 months - 4 years old is expected to be 3 mcg, which is 1/10 of the adult dose.

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

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

Yes.

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

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

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

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

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

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

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

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

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

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

Yes.

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

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

Yes.  

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

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

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

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

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

Not yet.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Religious leaders across many different faiths have all endorsed getting the COVID-19 vaccine.

The Vatican released a document in support of COVID-19 vaccine use called “Note on the morality of using some anti-Covid-19 vaccines” on December 21, 2020. In this document, the Catholic Church affirms that getting vaccinated against COVID-19 is acceptable and morally justified.

The National Muslim Task Force on COVID-19 (NMTF) and the National Black Muslim COVID Coalition (NBMCC) released a joint statement on Ramadan 2021 and COVID-19 Vaccines on April 6, 2021. They report that the COVID-19 vaccines authorized for use in the United States (Pfizer-BioNTech, Moderna, and Johnson & Johnson) are effective and have been deemed permissible to use (halal) based on the majority of Islamic scholars. They also state that getting a COVID-19 vaccine during Ramadan does not invalidate the fast based on the opinion of most Islamic scholars.

The Assembly of Muslim Jurists of America also released a statement called “The Ruling On Getting The COVID-19 (Coronavirus) Vaccine” on December 13, 2020 that allows and recommends COVID-19 vaccination.

The Rabbinical Assembly released two statements supporting the use of COVID-19 vaccines, "Does halakhah require vaccination against dangerous diseases such as measles, rubella, polio and Covid-19?" (Approved on January 5, 2021) and "Vaccination and Ethical Questions Posed by COVID-19 Vaccines" (Approved on January 5, 2021), that have been passed by the The Committee on Jewish Law and Standards (CJLS). CJLS is the central authority on halakha (Jewish law and tradition) within conservative Judaism.

The Orthodox Union and the Rabbinical Council of America have issued a document called "COVID-19 Vaccine Guidance" strongly encouraging all those eligible to access the COVID-19 vaccination to do so.

No.

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

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

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

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

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

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

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

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

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

1) Local reactions, at or near the injection site

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

(3) Allergic reactions 

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

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

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

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

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

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

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

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

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

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

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

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

To reduce discomfort from fever:

• Drink plenty of fluids.
• Dress lightly.

When to call the doctor:

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

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

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

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

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

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

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

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

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

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

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

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

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

No, it has not. 

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

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

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

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

Probably yes, but with precautions.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Be on the lookout for any of the following symptoms:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Symptoms include:

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

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

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

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

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

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

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

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

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

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

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

Please see here for more information.

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

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

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

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

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

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

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

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

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

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

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

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

This request can be made through CDC-INFO by:

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

For more information, see here. 

No, you cannot. 

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

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

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

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

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

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

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

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

Key points include:

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

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

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

 Key points include:

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

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

Persons should be observed for 30 minutes if they have:

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

All other persons should be observed for 15 minutes.

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

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

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

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

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

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

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

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

• Understanding and Explaining mRNA COVID-19 Vaccines
• Understanding and Explaining Viral Vector COVID-19 Vaccines 

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

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

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

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

Additional information can be found here.

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

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

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

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

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

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

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

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

Additional information on vaccine administration can be found here. 

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

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

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

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

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

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

Additional information on vaccine administration can be found here. 

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

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

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

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

Yes.

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

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

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

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

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

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

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

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

More information can be found here.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 here.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Pfizer-BioNTech:

The volume for the booster dose is the same as that for the primary vaccine series, i.e., 0.3 mL, administered via the intramuscular route at least 6 months after completion of the 2-dose primary vaccine series. Since immunity wanes gradually over time, the booster may be given at an interval greater than 6 months after completion of the primary vaccine series.

Moderna:

The volume for the booster dose (0.25mL) is half the volume as that for the primary vaccine series (0.5 mL), administered via the intramuscular route at least 6 months after completion of the 2-dose primary vaccine series. Since immunity wanes gradually over time, the booster may be given at an interval greater than 6 months after completion of the primary vaccine series.

Johnson & Johnson (Janssen):

The volume for the booster dose is the same as that for the primary vaccine dose (0.5mL), administered at least 2 months after the primary dose.

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

1. •  An additional primary series mRNA dose is for the immunocompromised population after receiving the initial 2 doses of an mRNA series.
   • A booster is an additional dose of a vaccine given after the protection provided by the original dose(s) has begun to decrease over time. Typically, you would get a booster after the immunity from the initial dose(s) naturally starts to wane. The booster is designed to help people maintain their level of immunity for a longer period of time.

1. • The CDC has authorized Moderna and Pfizer-BioNTech to be administered to individuals who have received their primary two-dose series of an mRNA vaccine and are moderately to severely immunocompromised.

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

For more information, please visit the CDC website.

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

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

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

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

• All other persons aged 18 years and older

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

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

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

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

For more information, visit the CDC website.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 here. FAQs about VAERS reporting can be found here.

1. 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.
2. Healthcare providers are required by law to report to VAERS:
   1. Any adverse event listed in the VAERS Table of Reportable Events Following Vaccination that occurs within the specified time period after vaccination
   2. An adverse event listed by the vaccine manufacturer as a contraindication to further doses of the vaccine
3. Healthcare providers are strongly encouraged to report:
   1. 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
   2. Vaccine administration errors
4. 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.