Vaccination FAQ

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  • Vaccination: Virginia COVID Information Center General Information

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

    Establishing a centralized Virginia COVID Information Center will improve and expand upon existing Virginia Department of Health and local districts’ COVID-response capabilities and support equal access to all VA resident populations. With an increasing number of COVID inquiries from residents and workers across local health districts, it is imperative we centralize COVID support across the Commonwealth to improve our response in call volume and deliver consistent, accurate, and up-to-date information to all VA residents and workers. 

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

    The Virginia COVID information Center’s resources and the pre-registration tool can be accessed anytime online and by phone 7 days a week from 8am to 8pm ET at 1-877-VAX-IN-VA (1-877-829-4682).

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

    In order to reach the call center via Virginia Relay, including by TTY, please dial 7-1-1. Additional ASL functionality is currently being explored.

    Residents and workers will be asked vaccination pre-registration questions, such as date of birth, occupation, and high-risk medical conditions to determine eligibility. Eligibility and prioritization for vaccination scheduling will continue to be based on CDC guidance and vaccine availability.​

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

    Vaccination: Virginia COVID Information Center Pre-Registration

    No. Your information will be imported into the new centralized system.  ​You may be contacted and asked to confirm or update your pre-registration record within the new system over the coming weeks.  You will never be asked to send your personal, private information through text or email – and you should never give out your information to someone who calls you requesting it.

    You can check the pre-registration list online anytime. You will also receive regular updates confirming you are still on the list and will be contacted when it’s your turn to schedule your vaccination.

    No. Once you have pre-registered online, you will receive a reference code. If you gave an email address you will receive regular updates, to give you peace of mind that you are still on the list and your turn is coming!​

    You will be asked simple questions to determine when you are eligible for a vaccination such as your date of birth, your occupation, and any high-risk medical conditions you may have. You will be asked for contact information so you can be contacted for scheduling when it is your turn. State and local agencies will not ask for a social security number or payment, but some private providers may need your social security number to bill your insurance if you have it. However, your insurance status will never delay or prevent you from being vaccinated.

    All personal information collected during pre-registration will only be used to determine when you are eligible to receive a shot, and to follow up when it’s your turn to schedule vaccination. Information gathered by the Virginia COVID Information Center or on Virginia Department of Health websites will not be shared for any other purposes except as authorized or required by law. The Commonwealth of Virginia will never call, email, or text asking for your social security number or payment as it relates to vaccination. Your information will not be shared for any other purpose.

    You will be asked simple questions at pre-registration, such as date of birth, occupation, and high-risk medical conditions to determine eligibility. All personal information collected during pre-registration will only be used to determine vaccination eligibility, prioritization, and to follow-up with residents and workers when it’s their turn to schedule vaccination. VDH is working to ensure vaccine distribution is equitable and in alignment with CDC prioritization guidelines.

    Once you have pre-registered, you will receive a reference code. Then, if you gave an email address, you will receive regular emails to give you peace of mind that you are still on the list and your turn is coming up. ​

    Once you pre-register, you will receive a reference code.​ If you have already pre-registered through your local health district, we recommend you check the list.

    The reference code is a generated code that can be used as a “shortcut” to verify your status in the new pre-registration system at vaccinate.virginia.gov. It is intended as an easier alternative to searching by your name and phone number or email, but doesn’t have any special importance beyond convenience — if you are verified as being in the pre-registration list, you’re fully enrolled even if you don’t have a code. The information you provided which is used to track your eligibility is entirely separate from the reference code.

    Because priorities are calculated by a number of factors (including location and risk factors), we do not have a viewable list. You’ll be contacted by a vaccine provider in your area as soon as an appointment is available. In the meantime, we’ll provide regular updates by email or SMS to confirm that you’re in line.

    No, there’s nothing important about the reference code — it just makes the process of looking yourself up easier compared to entering your name and email or phone number. If you signed up through a local health district prior to 2/16/2021, you may not have a reference code, but can still look yourself up. 

    The only important thing is to verify that you’re registered. Please click on Check the List to confirm you are pre-registered. If you experience difficulties with the search function, check the spelling of your name and email address carefully and consider whether you may have used a different name, phone number, or email address in the past. Additionally, we continue to migrate data from local health department systems, which could delay your pre-registration from showing up in the search function. If you previously pre-registered, your status will not be affected and it is not necessary to pre-register again. If you have questions, please call 877-VAX-IN-VA.

    If you are already in the system, please do not submit another form because this might delay the process.

    If you gave an email address, you will receive regular emails to give you peace of mind that you are still on the list and your turn is coming up. ​

    When your turn comes, you will get a phone call or an email to schedule your appointment.​

    We are currently unable to give each person on the waiting list a specific number in line, due to the complexities involved with the many types of eligibility groups. This is based on CDC guidelines. ​

    Based on the limited supply of vaccines, Virginia is prioritizing those individuals most at risk of contracting COVID-19 and certain occupations, based on CDC guidelines. VDH is working to ensure vaccine distribution is equitable and in alignment with CDC prioritization guidelines. Rest assured, when your turn comes, you will be contacted for scheduling. ​

    When it is your turn to receive the COVID-19 vaccine, you will be contacted to schedule an appointment using the email or phone number provided during pre-registration. When contacted, you will be offered a specific date and location and asked to select an available time. Please complete the scheduling process as soon as possible. ​

    All Virginia employees must pre-register themselves for a COVID-19 vaccine at vaccinate.virginia.gov or by calling 877-VAX-IN-VA. The new Virginia Statewide Vaccine Pre-Registration System will allow individuals to identify themselves as frontline essential workers so that they may be contacted when they become eligible for a vaccine in their area. Employers will play a vital role in this effort by educating employees on how to pre-register and ensuring that they correctly provide their work address on the pre-registration form. Employers can also continue to work with their local health districts to coordinate vaccine clinics and facilitate the efficient vaccination of Virginia's employees. Informational materials on the new pre-registration system are available here

    With the launch of the new Virginia Statewide Vaccine Pre-Registration System, employees are being asked to pre-register themselves to ensure an efficient and equitable vaccine distribution. VDH is committed to ensuring certain workers are not at an advantage over others whose employers did not previously pre-register them for a vaccine. This new policy will not impact an employee's vaccine access or timeline. However, employees whose employer may have previously submitted their information to their local health district should first check if they are already in the statewide system at vaccinate.virginia.gov before attempting to pre-register. Employers will also still be expected to educate their employees on how to individually pre-register and ensure that they correctly provide their work address on the pre-registration form. Informational materials on the new pre-registration system are available here.

    Virginia’s primary allocation of COVID-19 vaccine is managed by local health districts, so most vaccination clinics will use the statewide pre-registration and scheduling systems because they are conducted by local health districts. Clinics conducted by hospitals, pharmacies, or physicians may use other signup and appointment systems. Department of Defense service members and staff; veterans receiving care in Veterans Affairs Medical Centers; and certain other federal employees and individuals may be vaccinated through separate processes.  As part of a federal retail pharmacy program, selected pharmacy locations in Virginia are offering the vaccine.

    If you receive the COVID-19 vaccine in Virginia, you will be automatically removed from the pre-registration list. If you receive the vaccine outside of Virginia or wish to be removed from the pre-registration list for any other reason, please call 1-877-VAX-IN-VA.

    Vaccination: Virginia COVID Information Center Scheduling​

    Because each person may have a different level of eligibility and each clinic has a limited number of appointments, it is unlikely that spouses, partners, or family members will be scheduled at the same time. If two people are invited to make appointments for the same clinic, they can choose times near each other if available.​

    No. You will be contacted to schedule your second dose appointment at the appropriate time, and you do not have to pre-register again. Some clinics will schedule your second dose appointment at the time of your first dose, and some will contact you a week or two before the second dose is due.​

    No. While there is more than one vaccine brand available, local health departments, healthcare providers, pharmacies, and clinics likely will have only one brand available. Vaccine supplies are limited, and you should take whichever COVID-19 vaccine is available to you. Each available brand of COVID-19 vaccine has been proven to protect against serious illness, hospitalization, and death from COVID-19.

    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 remain on the waiting list in case another opportunity becomes available with your desired vaccine. There is no guarantee that you will be able to receive the brand of vaccine you want.

    Vaccination: How To Get the COVID-19 Vaccine

    The vaccine is currently available for the following groups: 

    1a: Healthcare Personnel and Long-Term Care Residents

    1b: Frontline Essential Workers, People Aged 65 years and Older, People aged 16 through 64 years with a High Risk Medical Condition or Disability that Increases Their Risk of Severe Illness from COVID-19, and People Living in Correctional Facilities, Homeless Shelters and Migrant Labor Camps 

    Vaccine supply is limited, and there are not enough vaccines for everyone in Phase 1b at this time. Virginia is not likely to meet the demand for Phase 1b until April. It may be weeks or longer before vaccination appointments become available for those who have pre-registered. Vaccine providers across Virginia are working as quickly as possible to vaccinate people eligible for Phases 1a and 1b.

    At this time, there is no set date for the start of Phase 1c. During Phase 1c, vaccines will be offered to other essential workers. 

    Virginians not included in priority categories will be offered the COVID-19 vaccine when it is more widely available. Children under the age of 16 will be offered vaccines only after the vaccine is tested and authorized by FDA for use in children. 

    Pre-registration is available through vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). You are able to pre-register even if you are not eligible to receive the vaccine right now. After you pre-register, you will be contacted when it is your turn to receive a vaccine. Also, VDH has developed these online tools:

    • An interactive map to enable Virginians to determine which COVID-19 vaccine phase their local health district is in. 
    • An eligibility tool to enable Virginians to find out which vaccination phase they fall under.

    Only those in groups 1a and 1b are currently eligible to receive the vaccine. Where you receive the vaccine may depend on who you are. 

    Many healthcare personnel are being vaccinated at their workplaces. Healthcare personnel who cannot access the vaccine through their employer should pre-register at vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). You will be asked for information about your job when you pre-register. If you think your employer may have previously submitted your information to your local health district, check if you are already in the statewide system at vaccinate.virginia.gov before trying to pre-register.

    Residents of long-term care facilities are being vaccinated at their facilities through partnerships with CVS and Walgreens pharmacies. When these partnerships are completed, a VDH Long-Term Care Facility Vaccination Coordination Team under the VDH State Pharmacy will coordinate the on-going need for vaccinations at long-term care facilities.

    Essential workers may be most likely to receive the vaccine through employer-based vaccination clinics. Others will get it through their local health department or through arrangements with pharmacies and healthcare providers.  

    Anyone eligible for Phase 1b based on age or medical condition may be vaccinated at a healthcare provider’s office, the local health department, a pharmacy, urgent care, or healthcare system. 

    Many people not included in priority groups may be vaccinated at a healthcare provider’s office, the local health department, a pharmacy, urgent care, or healthcare system. 

    You can pre-register at vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). You are able to pre-register even if you are not eligible to receive the vaccine right now. After you pre-register, you will be contacted when it is your turn to receive the vaccine. The ability to schedule appointments will depend on the supply of vaccine available, and supply is limited right now.

    Yes, healthcare systems and local health departments are working collaboratively to vaccinate healthcare personnel.

    HEALTHCARE SYSTEMS are vaccinating their staff. Many are vaccinating non-health system staff as well.

    LOCAL HEALTH DEPARTMENTS are identifying healthcare providers who are not affiliated with a hospital or health system in order to offer them vaccines as quickly as possible. Phase 1a primary caregivers who do not have access to the vaccine through their health system or healthcare providers should complete a pre-registration form through vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). You will be asked about your job when you pre-register. Employees whose employer may have previously submitted their information to their local health district should first check if they are already in the statewide system at vaccinate.virginia.gov before attempting to pre-register.

     

    INFORMATION FOR HEALTHCARE EMPLOYERS 

    Employees are no longer being pre-registered through employers. Employees should complete their own pre-registration forms through vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). Employees whose employer may have previously submitted their information to their local health district should first check if they are already in the statewide system at vaccinate.virginia.gov before attempting to pre-register. Employers are still encouraged to raise awareness among employees of the importance of getting vaccinated and how to pre-register, and to work with local health districts when it would make sense to hold on-site clinics for employees who are already pre-registered and eligible.

    Healthcare Personnel include the following: 

    • Behavioral health providers
    • Community health workers
    • Dental assistants, hygienists, dentists
    • EMT/first responders serving as EMT extenders
    • Environmental services staff
    • Healthcare trainees
    • Home health workers
    • Human service providers
    • Infection control and quality assurance personnel
    • Laboratorians
    • Mortuary service providers (e.g. morticians/funeral home staff)
    • Nurses, nursing assistants
    • Optometrists
    • Personal care aides
    • Pharmacists, pharmacy techs and staff
    • Physicians, physician assistants
    • Public-facing public health workers
    • Radiological techs (and other diagnostic/therapeutic techs)
    • Respiratory, physical, speech and occupational techs
    • Social workers
    • Primary caregivers for persons with severe chronic medical conditions  or with intellectual or developmental disabilities requiring a high level of daily care 

    For more information on Phase 1a, please see here. 

    Virginia’s Phase 1b includes frontline essential workers, people aged 65 years and older, people living in correctional facilities, homeless shelters, and migrant labor camps, and people aged 16-64 years with a high-risk medical condition or disability that increases their risk of severe illness from COVID-19.

    Workers who are in sectors essential to the functioning of society, are at substantially higher risk of exposure to SARS-CoV-2, and cannot work remotely. Frontline Essential Workers include:

    • Police, Fire, and Hazmat
    • Corrections and homeless shelter workers
    • Childcare/Pre K-12 Teachers/Staff (Public and Private)
    • Food and Agriculture (including veterinarians)
    • Manufacturing
    • Grocery store workers
    • Public transit workers
    • Mail carriers (USPS and private)
    • Officials needed to maintain continuity of government (including judges and public-facing judicial workers)
    • Clergy/Faith Leaders
    • Janitorial/Cleaning staff

    For definitions of the occupational groups of the frontline essential workers listed above, see pages 9-16 of Guidance on the Essential Critical Infrastructure Workforce: Ensuring Community and National Resilience in COVID-19 Response.

    Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. Individuals with any underlying medical conditions (including those NOT on the list below) should consult with their healthcare provider about their own personal risk factors associated with illness from COVID-19. Healthcare providers may use clinical judgement to determine if a patient’s medical condition or disability warrants prioritization for vaccination.

    Adults of any age with the following conditions are at increased risk of severe illness from the virus that causes COVID-19:

    Based on what we know at this time, adults of any age with the following conditions might be at an increased risk for severe illness from the virus that causes COVID-19:

    For more information on this topic, please click here.

    No, proof of a high-risk medical condition or disability that increases risk of severe illness from COVID-19 is not needed.

    Yes. On page 10 of the Guidance on the Essential Critical Infrastructure Workforce: Ensuring Community and National Resilience in COVID-19 Response, convenience stores are included in the “Food and Agriculture” category of Phase 1b.

    Yes, all health districts in Virginia are now in Phase 1b. Phase 1a is ongoing while communities vaccinate people included in Phase 1b.

    Movement through phases is locality-specific, based on the needs or population in that locality. It also depends on the supply of vaccines available. Vaccine supply is limited, and demand is high. Virginia is not likely to meet the demand for Phase 1b until April.

    Pre-registration is available through vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). After you pre-register, you will be contacted when it is your turn to receive a vaccine. If you are eligible because of your job and think your employer may have previously submitted your information to your local health district, check if you are already in the statewide system at vaccinate.virginia.gov before trying to pre-register.

    Also, VDH has developed these online tools:

    • An interactive map to enable Virginians to determine which COVID-19 vaccine phase their local health district is in.
    • An eligibility tool to enable Virginians to find out which vaccination phase they fall under.

    During Phase 1b, roughly half of each local health district's allocation of doses should be used to vaccinate people aged 65 and older. Vaccine supply is limited, and demand is high. About half of Virginia residents are now eligible to receive the vaccine, and Virginia is not likely to meet the demand for Phase 1b until April.

    Many of the people who are included in Phase 1b because of their age will be offered the vaccine through their healthcare provider. Others in this category will be able to access vaccination through their local health department or through arrangements with healthcare systems and pharmacies.

    Virginia’s Phase 1c includes other essential workers not included in Phase 1b.

    In Phase 1b, frontline essential workers were included. Vaccination will be allocated to additional essential workers in Phase 1c. These workers are in sectors essential to the functioning of society and/or are at higher risk of exposure to SARS-CoV-2. Other Essential Workers include:

    • Energy
    • Water, Wastewater, and Waste Removal Workers (includes recycling removal workers)
    • Housing and Construction
    • Food Service
    • Transportation and Logistics
    • Institutions of Higher Education Faculty/Staff
    • Finance
    • Information Technology & Communication
    • Media
    • Legal Services
    • Public Safety (Engineers)
    • Other Public Health Workers

    Occupational definitions and further clarifications can be found within guidelines provided by Guidance issued by Cybersecurity and Infrastructure Security Agency (CISA).

    The exact timeline for vaccination of individuals in Phase 1c is not yet known, and more information will be communicated in the future.

    Vaccine supply is limited, and VDH is distributing vaccines to communities primarily based on population. Local health departments will announce when access continues to expand for those residing in the community. Individuals who have pre-registered for vaccination online at vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682) will be contacted when it is their turn to receive the vaccine. 

    VDH and vaccination partners continue to vaccinate healthcare personnel and long term care facility residents. Local health departments are identifying healthcare providers who are not affiliated with a hospital or health system and need to be vaccinated. Residents of long-term care facilities are being vaccinated at their facilities through partnerships with CVS and Walgreens pharmacies.

    Virginia residents and workers can pre-register to get a COVID-19 vaccine through our Statewide Vaccine Pre-registration System, even if they are not eligible to receive the vaccine right now. You can pre-register online 24/7 at vaccinate.virginia.gov. You can also pre-register by phone 7 days a week from 8:00 a.m. to 8:00 p.m. by calling 1-877-VAX-IN-VA (1-877-829-4682). Service is available in English and Spanish. Call-back service in 100+ languages. TTY service to assist people who are deaf, hard of hearing, or speech impaired. After you pre-register, you will be contacted when it is your turn to get the vaccine. 

    You only need to pre-register once, either at vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). If you have already pre-registered through your local health district, you were automatically added to the new statewide system and can check the list at vaccinate.virginia.gov to make sure you are in the system. If you are having trouble finding your name in the system, check the spelling of your name and email address carefully and consider whether you may have used a different name, phone number, or email address in the past. If you have questions, call 1-877-VAX-IN-VA (1-877-829-4682).

    Clergy members and faith leaders fall under Phase 1b

    Member of the clergy/faith leader refers to a person formally designated within a religious group or faith community/congregation that performs religious functions critical to the continuity of the faith community, congregation, or house of worship. A faith leader includes but is not limited to: Apostle, Bishop, Cardinal, Minister, Nun, Imam, Pastor, Priest, Punjaris, and/or Rabbi.

    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.

    No, government-issued identification is not required to receive a vaccination. You can not be turned away for lack of documentation.

    No. Proof of Virginia residency is not required.

    No. Any person living in the U.S., regardless of duration, is eligible to be vaccinated. Proof of U.S. Citizenship is not required.

    Yes. Persons living in Virginia who are eligible for the current phase of Virginia vaccination rollout (e.g. based on age, medical condition or occupation) can receive vaccination in Virginia.

    There is no policy that you may only receive a vaccine in your locality of residence. However, vaccines are allocated by population in the locality, so it is best to work with your local health department in the locality where you live

    Virginia is receiving weekly shipments of both the Pfizer-BioNTech and Moderna vaccines from the federal government and is using those doses to vaccinate people in Phases 1a and 1b. Shipments will increase in the coming months. Virginia expects to begin receiving doses of the Johnson & Johnson COVID-19 Vaccine in the first week of March. 

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

    Long-term care facility residents are being given vaccines on-site at their facilities by CVS and Walgreens teams. These pharmacies are partnering with the CDC to bring vaccines directly to the facilities so residents do not have to travel. When these partnerships are completed, a VDH Long-Term Care Facility Vaccination Coordination Team under the VDH State Pharmacy will coordinate the on-going need for vaccinations at long-term care facilities.

    Phase 1a healthcare workers will receive the vaccine at their places of employment.

    Phase 1a healthcare workers who cannot receive the vaccine at their place of employment should pre-register at vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). You will be asked for information about your job when you pre-register. If you think your employer may have previously submitted your information to your local health district, check if you are already in the statewide system at vaccinate.virginia.gov before trying to pre-register.

    Primary caregivers perform a role similar to that of a home health aide or personal care aide, which are included in Phase 1a.  Primary caregivers for persons with severe chronic medical conditions or with intellectual or developmental disabilities requiring a high level of daily care will be able to access a vaccine through their local health department, their healthcare provider, or arrangements with healthcare systems and pharmacies as part of Phase 1a.  

    Vaccine supply is limited, and demand is high.  Phase 1a is ongoing while communities vaccinate people included in Phase 1b. It may take several weeks or longer to vaccinate people included in Phase 1a. 

    Phase 1a primary caregivers who do not have access to the vaccine through their health system or healthcare provider should pre-register at vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682) . You will be asked to provide information about your role as a primary caregiver when you pre-register.

    There is not sufficient supply at this time to vaccinate everyone in Phase 1b at the same time. Local health districts will reach out to engage the Frontline Essential Worker groups in vaccination planning in the following order:

    1. Police, Fire, and Hazmat
    2. Corrections and homeless shelter workers
    3. Childcare/Pre K-12 Teachers/Staff (Public and Private) 
    4. Food and Agriculture (including veterinarians) 
    5. Manufacturing
    6. Grocery store workers
    7. Public transit workers
    8. Mail carriers (USPS and private)
    9. Officials needed to maintain continuity of government (including judges and public-facing judicial workers)
    10. Clergy/Faith Leaders
    11. Janitorial/Cleaning staff

     

    How Frontline Essential Workers Can Access Vaccination

    Local health departments, pharmacies, healthcare systems, and employer-based occupational health units are working collaboratively to vaccinate frontline essential workers. Frontline essential workers may be most likely to receive the vaccine through employer-based vaccination clinics.  Others will get it through their local health department or through arrangements with pharmacies and healthcare providers.  Information will be coming out from local health departments, employers, and healthcare providers about how and when you can receive your COVID-19 vaccine. The ability to schedule appointments will depend on the supply of vaccine available.

    How Persons Aged 65 years and Older And Persons Aged 16 through 64 Years with a High Risk Medical Condition or Disability Can Access Vaccination

    Many of the people who are included in Phase 1b because of their age and/or an underlying medical condition or disability will be offered the vaccine through their healthcare provider. Others in this category will be able to access vaccination through their local health department or through arrangements with healthcare systems and pharmacies.

    How Persons Living in Correctional Facilities, Homeless Shelters, and Migrant Labor Camps Can Access Vaccination

    The Department of Corrections, local and regional jails, and their occupational health programs will vaccinate staff and persons living in correctional facilities, with local health department assistance as needed. Those living in homeless shelters and migrant labor camps will receive the vaccine through their local health department or through arrangements with healthcare systems and pharmacies.

    Pre-registration is available through vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682). After you pre-register, you will be contacted when it is your turn to receive a vaccine. If you are eligible because of your job and think your employer may have previously submitted your information to your local health district, check if you are already in the statewide system at vaccinate.virginia.gov before trying to pre-register.

    To keep up to date on vaccination eligibility for individuals, VDH has developed these online tools:

    • An interactive map to enable Virginians to determine which COVID-19 vaccine phase their local health district is in.
    • An eligibility tool to enable Virginians to find out which vaccination phase they fall under.

     

    You are not eligible to receive the vaccine at this time if you are in Phase 1c, but you can pre-register now. Pre-registration is available through vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682).

    Because there is not sufficient supply at this time to vaccinate everyone in Phase 1c at the same time, local health districts will reach out to engage the Other Essential Worker groups in vaccination planning in the following order:

    1. Energy 
    2. Water, Wastewater, and Waste Removal Workers (includes recycling removal workers) 
    3. Housing and Construction 
    4. Food Service 
    5. Transportation and Logistics 
    6. Institutions of Higher Education Faculty/Staff 
    7. Finance 
    8. Information Technology & Communication
    9. Media 
    10. Legal Services
    11. Public Safety (Engineers) 
    12. Other Public Health Workers

    How Other Essential Workers Can Access Vaccination

    Local health departments, pharmacies, healthcare systems, and employer-based occupational health units are working collaboratively to vaccinate other essential workers. Other essential workers may be most likely to receive the vaccine through employer-based vaccination clinics. Others will get it through their local health department or through arrangements with pharmacies and healthcare providers.  Information will be coming out from local health departments, employers, and healthcare providers about how and when you can receive your COVID-19 vaccine. The ability to schedule appointments will depend on the supply of vaccine available.

    The doses Virginia receives from the federal government are allocated by VDH to local health districts, mostly based on population. Local health districts then work with volunteers, hospitals, healthcare providers, and pharmacies to provide these vaccines to people in their districts in an efficient and equitable way. Additional doses help support targeted equity initiatives. Other doses reach some residents of Virginia through separate federal allocations for employees of the U.S. Department of Defense and certain other agencies; the Indian Health Service; and a federal contract to vaccinate residents of long-term care facilities.

    For Phase 1b, local health departments are using  roughly half of available vaccines to vaccinate people aged 65 and older. The other half of available vaccines are being used to vaccinate frontline essential workers, people aged 16-64 with high-risk medical conditions or disabilities, and people in correctional facilities, homeless shelters, and migrant labor camps.  

    In the future, if there is a sufficient amount of vaccine to cover an entire priority group, it will be shipped directly to the designated vaccinators to administer to anyone who wants to be vaccinated.

    No, the dosing or schedules of COVID-19 vaccines should not be changed. The Food and Drug Administration (FDA) has emphasized that vaccine providers should continue to follow the authorized dosing and schedules for COVID-19 vaccines.

    The COVID-19 vaccines authorized for emergency use have shown high effectiveness when following the specified dosing and schedules in the emergency use authorizations.

    For additional information, see the FDA Statement on Following the Authorized Dosing Schedules for COVID-19 Vaccines.

    VDH released a COVID-19 vaccine dashboard with information including total vaccine doses received and administered. Locality and demographic information is also available. 

    The vaccine will be offered to everyone at no cost. Any fees will be covered either by insurance companies or by the U.S. Health Resources and Services Administration Provider Relief Fund. You will not have any out-of-pocket costs.

    No. There are currently three vaccine brands available in the United States, but each healthcare provider will likely 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 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.

    The COVID-19 vaccine will be offered to everyone at no cost regardless of health insurance. Availability will be based on risk level, not on income or insurance. Children under the age of 16 will be offered a COVID-19 vaccine only after the vaccines are tested and authorized for emergency use in children.

    The following federal entities (and their respective populations) that will receive a direct allocation of COVID-19 vaccine: 

    • Bureau of Prisons (BoP)
      • All BoP-managed facilities: facility staff and inmates
      •  Private contracted facilities and contracted residential reentry centers (RRCs) not included
    • Department of Defense (DoD)
      •  Active duty personnel and their dependents 
      • Retirees (does not include their dependents) 
      • U.S. Coast Guard (does not include their dependents) 
      •  DoD civilian and contractor employees (those who regularly receive care through DoD as well as those who don’t) 
      • To be determined: Reserves and National Guard (including those not activated)
    • Department of State (DoS)
      • All personnel under Chief of Mission eligible to receive care through DoS
      • Stateside civil service employees
    • Indian Health Service (IHS)
      • Tribal nations selecting IHS for vaccine allocation
      • Potentially includes IHS/Tribal/Urban facility staff and individuals served
    • Veterans Health Administration (VHA)
      • VA staff (including volunteers and trainees) and veterans regularly receiving care at VHA facilities
      • (State Veterans Homes not included)

    Federal employees can also access the vaccine through other entities available, if they are eligible for the vaccine.

    At this time, Virginia is receiving a limited supply of COVID-19 vaccines each week from the federal government. VDH is distributing these vaccines to communities in Virginia primarily based on population.

    Additional doses reach some residents of Virginia through separate federal allocations for employees of the U.S. Department of Defense and certain other agencies; the Indian Health Service; a federal contract with CVS and Walgreens to vaccinate residents of long-term care facilities; and to selected CVS locations in Virginia through the Federal Retail Pharmacy Program.

    The Federal Retail Pharmacy Program is a federal program that provides additional COVID-19 vaccines to certain retail pharmacies each week. These vaccines are provided in addition to the weekly supply of vaccines already being sent to Virginia by the federal government. 

    As part of the program, selected pharmacy locations in Virginia are now receiving doses each week. Participating locations include CVS, Food City, Giant, Kroger/Harris Teeter, Safeway, Walgreens, Walmart, and multiple independent community pharmacies. The Commonwealth is working with these pharmacies to ensure that as many appointments as possible are offered first to people age 65 and older who are currently on local health district waitlists, rather than accepting new signups from the general public. Unfortunately, CVS has been unable to find a way to do this within the technical limits of their appointment system. Anyone 65 or older can check cvs.com regularly as appointments become available.

    There is no charge to any U.S. resident for COVID-19 vaccine or for the vaccination appointment itself. No one can get their vaccine sooner by paying someone money. The Virginia Attorney General has recently 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).

    This depends on the setting. In general, people who have had a 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 SARS-CoV-2 during the vaccination visit.

    Exceptions to this are may 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 continues to sign up Virginia healthcare providers who want to provide the COVID-19 vaccine. These providers include hospitals, long-term care facilities, local health departments, pharmacies, health systems, outpatient centers and urgent care centers. Vaccine providers are being trained to correctly store, administer, and document available vaccines.

    When healthcare providers register to provide vaccines in Virginia, they identify the number of people they think they will vaccinate in each risk group (senior citizens, essential workers, people with serious medical conditions, etc.). VDH is using this information, along with CDC recommendations, to determine how and when vaccines should be distributed to each group.

    Vaccination: Why Get Vaccinated Against COVID-19

    We don’t know yet why some healthy people become seriously ill or die from COVID-19, while other people with COVID-19 only become mildly sick. There’s no way to know ahead of time how COVID-19 will affect you. However, once vaccinated, your body will build immunity to the virus so you are less likely to get sick. In fact, the COVID-19 vaccine will greatly reduce your chances of getting COVID-19 and will ensure that if you do get the virus, you will have only mild symptoms or none at all.

    All available COVID-19 vaccines are highly effective at preventing serious illness, hospitalization, and death. 

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

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

    Goal #2: A second goal for a COVID-19 vaccine is to be sure that the people who get vaccinated can’t pass a COVID-19 infection on to other people even if they are not having any symptoms themselves. For example, many 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.

    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, in which many people 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 COVID-19 to allow that disease to keep spreading.

    The vaccine will not be mandatory for Virginians and there are no legal penalties for refusing it, but we urge you to get it once it’s available. Once enough people are vaccinated against COVID-19, we can resume more of the everyday activities we enjoyed before the COVID-19 pandemic.

    No. The vaccine will not give you COVID-19 because the vaccine is not made from the live virus. The vaccine just teaches your body to build a protein that fights the virus. However, it can take a few weeks for the body to build immunity after any vaccination, so it’s possible to get COVID-19 from another person just before or just after being vaccinated, while your immunity is still developing.

    Sometimes the immune response from a vaccine can cause soreness at the injection site, a fever, headache or tiredness. This is normal and should go away after a few days.

    No. Vaccines currently being developed in the United States will not cause you to test positive on COVID-19 PCR and antigen tests. These types of tests detect active infection with the virus that causes COVID-19.

    After vaccination, you might test positive on a COVID-19 antibody test. This type of test shows previous exposure of your immune system to the virus that causes COVID-19, not current infection. We’re still learning about how COVID-19 vaccination might influence the interpretation of antibody test results.

    While the vaccine will help keep you from getting sick from COVID-19, scientists are not yet sure if a person who has been vaccinated can still give the virus to other people. That means it is important for everyone to get vaccinated and to continue wearing masks and following physical distancing recommendations.

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

    You should also receive a fact sheet with information specific to the vaccine that you received.

    All people recieving a COVID-19 shot should be monitored on site for some time, after receiving the shot.

    Remember to 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 you need a second vaccine dose. 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.

    Herd immunity is a form of indirect protection from an infectious disease that occurs when the majority of a population has become immune to infection, either through vaccination or previous infections. Once herd immunity is achieved, the infectious disease is less likely to spread. Those who did not get vaccinated will still be protected because the population in which they live is protected. This is especially important for people with certain medical conditions who might not be able to receive a vaccine.

    Herd immunity only works in very large groups -- tens of thousands of people -- because it keeps the virus from being able to find new hosts within the population. A small group, like a family or a school, cannot have herd immunity because there are still too many other people in the community who can spread the virus. That’s why a country can only have herd immunity when most of the population has been vaccinated.

    With COVID-19 and many other diseases, if you become sick, your body builds up antibodies that keep you from getting sick again from the same virus -- at least for a while. This is called “natural immunity.” A vaccine gives you the same type of natural immunity -- at least for a while. How much immunity and how long it lasts depends on the disease and on the person. For instance, most people who had measles as a child -- or who got the vaccine -- have immunity for life. COVID-19 and the COVID-19 vaccine are similar. However, we do not know for sure how long the immunity will last.

    After the immunity runs out, you will need another dose of COVID-19 vaccine. In some other types of vaccines, a second shot or “booster” gives immunity for a much longer time than the first dose. In others, like the flu vaccine, you need to get the vaccine every year.

    Yes, regardless of history (symptomatic or asymptomatic), they should get the vaccine.  In the clinical trial, there were patients with serologic evidence of previous infection.   Patients should be out of the isolation period and out of the active stage of infection when they get vaccinated.

    The one exception for vaccination might be for those people who had COVID-19 earlier but who have not recovered completely and are still having long-term effects. If you are still having long-term effects after COVID-19, you should discuss COVID-19 vaccination with your healthcare provider. 

    While there is otherwise no recommended minimum interval between infection and vaccination, current evidence suggests that reinfection is uncommon in the 90 days after initial infection. Thus, persons with documented COVID-19 in the preceding 90 days may delay vaccination until near the end of this period, if desired.

    There have been reports of people testing positive for COVID-19 after completing the vaccination series. Thus far all cases have been either mild or asymptomatic. Gene sequencing and investigation of these cases are underway. Breakthrough cases are rare, but they should be expected as COVID-19 vaccines do not provide 100% protection from getting the virus. 

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

    Vaccination: Development + Safety

    One of the reasons that these COVID-19 coronavirus vaccines could be produced and tested so quickly is that two previous coronaviruses, SARS that emerged in China in 2002 and MERS that emerged in the Middle East in 2012, taught us a lot about developing a safe and effective coronavirus vaccines. The COVID-19 vaccines have been produced faster than any other U.S. vaccines, but they have followed the very same process as any other vaccine, 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), trials start with Phases 1 and 2, when small groups of people are vaccinated and then monitored 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 U.S. vaccines is strictly controlled by the 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. And in fact, the United States currently has the safest, most effective vaccines in its history.

    The CDC and FDA monitor the safety of vaccines after authorization and approval to be sure they are safe and effective in the long term. After a vaccine is authorized or approved, as it is being used in widespread vaccine programs, it enters Phase 4 of vaccine research, where CDC and FDA continue to monitor its safety and long-term effects. 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. 

    All 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 are Black, Hispanic, Asian or Native American.

    The effectiveness of a vaccine (how well it works) is determined through studies that compare the proportion (percentage) of vaccinated people who got COVID-19 infection with the proportion (percentage) of people who didn’t get the vaccine (control group) and developed COVID-19 infection. If significantly fewer people in the vaccine group become infected compared to the control group, the vaccine is determined to be effective.

    Sometimes scientists can use a different measure to decide if a vaccine is working. For example, for a disease as serious and sometimes fatal as COVID-19, we might worry less about people having a mild COVID-19 infection and worry more about how well a vaccine can keep vaccinated people from needing to be in a hospital or in an intensive care unit.  Fortunately, all three current vaccines,  from Pfizer-BioNTech, Moderna,  and Johnson & Johnson (also known as Janssen Biotech) have done really well in keeping vaccinated people from needing to be in a hospital. 

    In order to show effectiveness, vaccine trials also looks at many factors, including age, race and ethnicity, gender, degree of exposure to COVID-19, and other risk factors. For example, healthcare workers are more likely to be exposed to the virus and are more likely to be exposed to large amounts of it. People with chronic illnesses like diabetes or asthma may be less likely to come into contact with the virus, but they are more likely to become seriously ill if they do get it.

    mRNA stands for messenger ribonucleic acid. mRNA does not get into the nucleus of your cells and it does not put germs into your body. Instead, it teaches your cells to make a non-infectious COVID-19 protein that then stimulates an immune response. That immune response produces antibodies that help keep you from becoming infected if the COVID-19 virus enters your body.  The two COVID-19 Vaccines that use mRNA will not change your DNA or cause any alteration of your body’s genetic material.   

    Viral vector vaccines use a modified version of a different virus as a vector to deliver instructions, in the form of genetic material (a gene), to a cell. The vaccine does not cause infection with either COVID-19 or the virus that is used as the vector.

    For COVID-19 vaccines, a modified virus delivers a SARS-CoV-2 gene that instructs our cells to make a SARS-CoV-2 antigen called the spike protein. This antigen triggers production of antibodies and a resulting immune response. The virus used in a viral vector vaccine poses no threat of causing illness in humans because it has been modified so it cannot reproduce and thus cannot cause disease in humans.

    As with the mRNA vaccines, the genetic material delivered by the viral vector vaccine does not integrate into a person’s DNA.

    The Johnson & Johnson (also known as Janssen Biotech) vaccine uses an adenovirus in it’s viral vector vaccine. Adenoviruses are often used for viral vector vaccines because they can induce a robust 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 approval or emergency use authorization) are those that meet these standards.

    An EUA is an “Emergency Use Authorization,” a process in the FDA that allows a drug or vaccine company to apply for use of a COVID-19 vaccine with a limited amount of effectiveness and safety data. This 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. 

    Before it allows an EUA, the FDA must decide that the known and possible benefits of the 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 for 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. 

    The first COVID-19 vaccines in the United States have been authorized as EUAs so they can be distributed quickly to as many people as possible. 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 up to a year of study.

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

    Common short term side effects at the injection site include: local arm pain and redness or swelling. Common systemic side effects include tiredness, headache, or muscle aches. A very small number have had transient nausea, chills, or a fever for a few days. A small number have experienced swollen lymph nodes. For the two mRNA vaccines, these expected side effects are more common in younger people than older people and more common after the 2nd vaccine dose than after the first dose, if part of a two dose series. 

    Some people have reported redness, swelling, and itching around the injection site beginning a few days after or into the second week after their first mRNA vaccine dose.  Some of these reactions have been quite large. It is not known if the persons who experience this unusual reaction will have a similar reaction after their second dose. However, these reactions are not felt to represent a risk for anaphylaxis upon receipt of the 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.

    These short term discomforts are the effects of your body developing immunity, and are normal. These discomforts do not mean that the vaccine has given you COVID-19. Even if you 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.

    Because COVID-19 vaccines are so new, information on possible long term side-effects is still being collected and studied. However, at this point, although CDC, FDA, and other groups are looking carefully, no permanent long term side effects of any of the three COVID-19 vaccines have been identified.

    No. There is no live virus in any of the current COVID-19 vaccines. 

    However, because there are still so many COVID-19-infected people in our communities, it is possible that a few COVID-19 vaccine recipients have already been exposed and infected with COVID-19 at the time they get the vaccine even if they are not yet showing symptoms of COVID-19 infection. If those exposed people later have symptoms of COVID-19 infection or test positive for it soon after vaccination, that does not mean they got COVID-19 from the vaccine.

    Medicines such as acetaminophen, ibuprofen, or naproxen or other medicines called “non-steroidal anti-inflammatory drugs” (NSAIDS) can help with the expected side effects (arm pain, fever) once 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 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. So when a COVID-19 vaccine is available to you, you are encouraged to get vaccinated to protect yourself 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 disease such as HIV/AIDS, cancer, 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 aware 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.
    • 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.
    • 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 with a neurologic disease history of having previously had either Guillain-Barre syndrome or Bell’s palsy can receive COVID-19 vaccine but need to be closely monitored for the re-development of one of those conditions.
    • Some people with a history of dermal filler use may develop swelling at or near the site of filler injection after receiving a dose of an mRNA COVID-19 vaccine. If it occurs, this problem can be treated by a healthcare provider and dermal filler use is not a contraindication to COVID-19 vaccination. However, such people should be advised to contact their health care provider if they experience 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.  

    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. 

    These severe allergic reactions (anaphylaxis) have occurred rarely after both of the currently available mRNA COVID-19 vaccines. Based on VAERS reports and reported doses administered, CDC data published on February 12th show that anaphylaxis occurred following vaccination with the current mRNA COVID-19 vaccines about 4 times for every million doses administered.

    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 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 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. 

    Polyethylene glycol (PEG) is an ingredient in both mRNA COVID-19 vaccines, and polysorbate 80 is an ingredient in Janssen COVID-19 vaccine. 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.

    Finally, each site where COVID-19 vaccines are given is required to have the medications on hand to treat any of the severe or milder 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

    People who have had recent COVID-19 disease should get COVID-19 vaccine only after they have recovered from their illness.  

    Children under the age of 16 or 18 (depending on which vaccine is available), should not receive the current vaccines as they have not been studied yet in this population. (Use of COVID-19 vaccines in older children and adolescents is now being studied.)

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

    Starting the COVID-19 vaccination series as soon as it becomes available to you is an important step. Given the lack of data on the safety and efficacy of mRNA COVID-19 vaccines administered at the same time as other vaccines, the COVID-19 vaccine series should be administered alone, with a minimum interval of 14 days before or after getting any other vaccines. However, if mRNA COVID-19 vaccines are inadvertently given within 14 days of another vaccine, doses do not need to be repeated for either vaccine.

    If you have concerns about close spacing of vaccines, you should discuss this issue with your doctor or other health care provider. 

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

    A complete list of this vaccine’s ingredients can be found here. 

    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, Latex

    The Pfizer-BioNTech vaccine is recommended for people aged 16 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. 

    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, 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.

    A complete list of this vaccine’s ingredients can be found on page 2 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.

    Available data suggest that some pregnant women who get infected with COVID-19 are at greater risk of having a severe form of COVID-19 than non-pregnant women. Pregnant women with some underlying conditions, such as diabetes or obesity, are at even greater risk, as is true in the non-pregnant population.

    The Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists, and the Virginia Department of Health (VDH) recommend that COVID-19 vaccines should NOT be withheld from pregnant or breast-feeding women or from other women who intend to get pregnant and who otherwise are in any of the priority categories for COVID-19 vaccination based on the CDC and its Advisory Committee on Immunization Practices (ACIP) recommendations

    While safety data on the use of COVID-19 vaccines in pregnancy are not yet available (and are now being collected), there are also no data suggesting that these COVID-19 vaccines should be withheld from people in these groups. 

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

     

    The Pfizer-BioNTech COVID-19 vaccine has not yet been studied in children less than 16 years old and the Moderna and Johnson & Johnson (also known as Janssen Biotech) COVID-19 vaccines have not yet been studied in children less than 18 years old, so vaccinating children below these ages is not yet recommended. 

    Although there is not yet an exact timeline for children to get vaccinated against COVID-19, additional studies looking at vaccine safety and effectiveness in older children and adolescents are now being done and recommendations for vaccinating children will be developed as soon as these studies are finished.

    A COVID-19 vaccine for pets is not available. A small number of pets worldwide, including cats and dogs, have been infected with SARS-CoV-2, mostly after close contact with people who have 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 vaccine 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 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 several 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 report possible vaccine side effects to VAERS. However, most of the VAERS monitoring is done by U.S. healthcare providers providing anonymous vaccine-related data from millions of patients. This system, which is already used to monitor all other current U.S. vaccines, alerts the CDC and FDA if healthcare systems begin recording complications that should not have been occurring after vaccines. VAERS cannot determine whether a vaccine caused any specific  side effect. 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.

    Several new variants of the SARS-CoV-2 virus that causes COVID-19 have been reported as being spread more easily than the strain we have been dealing with in the United States since March 2020. These enhanced transmission data have yet to be confirmed. In addition, whether the new variants cause milder or more severe illness is still unknown, as is whether the new variants might be less detectable by the currently available viral diagnostic tests such as PCR or antigen tests. 

    Meanwhile COVID-19 vaccine experts are studying these new variants to determine  whether the current COVID-19 vaccines are likely to remain effective against them, that is, whether the new variants are unlikely to reduce vaccine effectiveness. Initial data are reassuring in terms of the current COVID-19 vaccines’ ability to protect against the new variants. The Johnson & Johnson vaccine was tested in areas where variants of COVID-19 were predominant. The vaccine showed efficacy, though decreased, against these variants. 

    Additional information on the new virus variants is available from CDC here.  

    But regardless of the amount of protection that any of these vaccines can provide against the new viral variants, even vaccinated people should continue with their own personal prevention steps to help stop the spread of the virus: wearing masks, staying six feet apart, avoiding crowds and poorly ventilated spaces and frequently washing your hands.

    Vaccination: Side Effects After I Receive the COVID-19 Vaccine

    Although COVID-19 vaccination will help protect you from getting COVID-19 disease, you may have some local or systemic side effects from the vaccination, which are normal 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 arm pain at the injection site, fatigue, headache or other body aches, or chills or fever for a few days. These common side effects are also experienced after receiving other types of vaccines, such as the flu shot. These side effects do NOT mean that the vaccine has given you a COVID-19 infection. Rather, this means that the vaccine is causing your body’s immune system to react and create antibodies to fight off the virus in the future.

    Some people have reported redness, swelling, and itching around the injection site beginning a few days or into the second week after their first vaccine dose.  Some of these reactions have been quite large. It is not known if the persons who experience this will have a similar reaction after their second dose. However, these reactions are not felt to represent a risk for anaphylaxis upon receipt of the 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.

    These side effects may interfere with your ability to do daily activities, but they should go away in a few days.

    Remember to sign 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.

    If you have persistent pain or other discomfort, talk to your doctor about taking an over-the-counter medicine, such as ibuprofen or acetaminophen.

    To reduce pain and discomfort where you 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 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

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

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

    There have been some reports of immediate but non-severe allergic reactions within 4 hours after getting a COVID-19 vaccine such as hives, swelling, and wheezing. People who have such an immediate allergic reaction - even if it was not severe - after their first COVID-19 vaccine dose should probably NOT receive the second dose of the currently available COVID-19 vaccine. However, because COVID-19 is a potentially serious disease, deciding not to finish your vaccine series is a very important decision that should be discussed with your doctor or other healthcare provider.  

    In some cases, your doctor 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 big concern is making sure that you are not one of the rare 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., 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 provider or occupational health office. 

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

    No. Sometimes people who are afraid of or otherwise opposed to using vaccines raise this topic as a concern.  However, no fertility effects have been found for any current U.S. vaccine and there is no biologic reason to suspect that COVID-19 vaccines might have an effect on female or male fertility.

    Although there have been no formal studies of fertility issues yet, this topic will be monitored as part of the Phase 4 (long term) vaccine studies that are being done.

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

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

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

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

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

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

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

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

    Studies to answer this question are being done now.  

    For right now, because there is currently no information about how well you are protected from COVID-19 if you get one dose of each company’s vaccine instead of two vaccine doses of vaccine from the same company, CDC strongly recommends that the vaccine series should be completed with a second dose of the same vaccine. 

    However, if, because of unavoidable circumstances, doses of two different COVID-19 mRNA vaccines have been given, no additional doses of either vaccine are recommended.

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

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

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

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

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

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

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

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

    COVID-19 vaccines are not interchangeable, but in extremely rare situations, some people simply may not have documentation or know which brand of vaccine they got for their first dose.

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

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

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

    If you get a COVID-19 infection after the first dose of COVID-19 vaccine, your second COVID-19 vaccine dose should be deferred until you have recovered from the symptoms of COVID-19 disease AND until you have been allowed to discontinue isolation. If you do get COVID-19 disease after one dose of either the Pfizer or Moderna vaccine, you should report that to CDC on your v-safe phone app.

    Vaccination: After Being Fully Vaccinated with COVID-19 Vaccine

    “Fully vaccinated” means that (1) a person has received either two doses of the Pfizer-BioNTech COVID-19 vaccine OR two doses of the Moderna COVID-19 vaccine OR a single dose of the Johnson & Johnson (also known as Janssen Biotech) COVID-19 vaccine and (2) that at least 14 days have passed since the last dose was received.

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

    • Are fully vaccinated (i.e., ≥2 weeks following receipt of the second dose in a 2-dose series
    • Are within 3 months following receipt of the last dose in the series
    • Have remained asymptomatic since the current COVID-19 exposure
    • Are not inpatients or residents in healthcare settings (These individuals should continue to quarantine following an exposure to someone with suspected or confirmed COVID-19)

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

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

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

    We’re still not sure. Although available information suggests that current COVID-19 vaccines are very likely to keep you, the vaccinated person, from getting sick from COVID-19, the studies have not yet measured whether the vaccine can prevent a vaccinated person from spreading COVID-19 disease to others. That question is still being studied. That uncertainty is one reason why it is important to keep following the basic prevention measures to protect yourself and others such as wearing a mask, staying at least 6 feet away from others, avoiding crowds and poorly ventilated spaces, and washing your hands often.

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

    All doses administered will be entered into the Virginia Immunization Information System (VIIS)

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

    Stopping any pandemic requires using all the tools we have available.  Eventually, people who have received both of their vaccine shots, and have waited until they take effect, will likely be able to do things more safely than unvaccinated people--like having meals together or hugging their grandchildren.  Until the pandemic is defeated, we need to continue to follow the social distancing recommendations to help unvaccinated people stay safe and contribute to the goal of saving as many lives as possible. 

    At this time, the combination of getting vaccinated and following CDC's recommendations to protect yourself and others will offer the best protection from COVID-19.  This includes wearing a mask, staying at least six feet from others, and avoiding crowds.

    As more people in the Commonwealth are vaccinated, and experts learn more about how COVID-19 vaccination may help reduce the spread of the disease in communities, CDC and VDH will continue to use the latest science to update recommendations to protect people and communities.

    While vaccinated people can feel a bit safer than before they were vaccinated, those precautions should not change too much yet even around other vaccinated people. You should still practice masking, physical distancing, avoiding indoor spaces and taking extra care in handwashing. 

    There are several reasons for this recommendation: (1) while the current vaccines are very effective in preventing COVID-19 disease, that effectiveness is NOT 100%; some risk remains; (2) the recently reported and highly transmissible COVID-19 variants that were first identified in Africa and European Countries are already being reported in Virginia and the current vaccines’ ability to prevent infections by these new variants is not yet certain; (3) the vaccines’ ability to prevent transmission of COVID-19 from vaccinated people to others is also still uncertain; and (4) how long protection from the vaccine lasts is still uncertain, and a few COVID-19 infections have already been reported in vaccinated people.

    No, your travel will probably not be affected by a recent COVID-19 vaccination or its side effects. Once the expected short-term side effects of COVID-19 vaccination have worn off, most vaccine recipients should feel well enough to travel. 

    But remember that even after receiving both doses of a two dose vaccine series, it is still important to continue prevention behaviors such as wearing a mask, physical distancing, avoidance of crowds and poorly ventilated spaces, and routine hand washing or use of hand sanitizer.

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

    COVID-19 viral testing is increasingly required for pre-travel screening, especially on international flights. All passengers, including U.S. citizens, are now REQUIRED to have either a negative COVID-19 viral PCR or antigen test or documentation of recovery from COVID-19 before boarding a flight to return to the United States. Unfortunately, as of February 24, 2021, even proof of being fully vaccinated against COVID-19 will NOT substitute for having a negative viral test.

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

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

    On the other hand, one result of vaccination is the production of antibodies against one specific part of the virus that causes COVID-19. Some but not all available serologic (blood) tests for COVID-19 test for this antibody so having a COVID-19 vaccination may result in your having a positive COVID-19 antibody test later on. 

    We don’t know yet exactly how long the protection from these three vaccines will last. 

    It is possible that you might need to get a booster vaccine dose at some time in the future but at this moment, the need for eventual booster doses has not been demonstrated and no additional doses beyond the primary COVID-19 vaccination are now being recommended. 

    Studies of long term protection from these COVID-19 vaccines are underway and more information will be made available as soon as possible.

    No, you will not. COVID-19 vaccines will not give you a COVID-19 infection or allow you to spread it to others. However, it typically takes a few weeks for the body to build immunity after a vaccination so during that time, you could still get the virus from another person and spread COVID-19to those around you. That is why you should continue to practice safety measures to prevent the spread of COVID-19 by covering your mouth and nose with a mask, washing hands often, staying at least six feet away from others and avoiding crowds and poorly ventilated indoor spaces.

    For the vaccine to be most effective and for everyone in your household to protect themselves and each other, everyone who can be vaccinated, should receive it. 

    Children under 18 years old with the Moderna or Johnson & Johnson (also known as Janssen Biotech) vaccines, or under 16 years old with the Pfizer vaccine should not be vaccinated yet, as the studies of COVID-19 vaccination in  these populations have not been completed yet. At the moment, the best way to protect children in a household is to vaccinate all the adults in the household who can be vaccinated. However, because the vaccine is being given to people based on their individual COVID-19 risk priority, it may not be available right away for some of the adults in your household.

    As is true with influenza vaccines as well, the most important question about COVID-19 vaccines is how well they protect you from the more severe COVID-19 illness that leads to hospitalization, intensive care unit (ICU) admission, or death. All three of the current vaccines are highly effective in preventing those most serious outcomes

    The COVID-19 vaccines from Pfizer-BioNTec and from Moderna that are now being used are expected to prevent infection in more than 90% of people who get both doses. The ability of the Johnson & Johnson (also known as Janssen Biotech) vaccine to prevent milder forms of COVID-19 is a bit less (66.3%), although some of the research with that vaccine took place in countries where more vaccine-resistant variants were circulating. And in fact, the early data with all three of the current vaccines suggest that even if you do get infected with COVID-19 after getting both doses of the vaccine, the disease symptoms are likely to be milder than if you hadn’t been vaccinated.  

    And finally, getting only a single dose of one of the current two-dose COVID-19 vaccines will not provide the vaccine’s full protection.

    Several new variants (types) of the SARS-CoV-2 virus that causes COVID-19 have been reported as being spread more easily than the type of that virus we have been dealing with in the United States since March 2020. This information about faster spread is not yet confirmed. In addition, whether the new variants cause milder or more severe illness is still unknown, as is whether the new variants might be less detectable by the currently available viral diagnostic tests such as PCR or antigen tests. 

    Meanwhile COVID-19 vaccine experts are studying these new variants to determine whether the current COVID-19 vaccines are likely to remain effective against them, that is, whether the new variants are unlikely to reduce vaccine effectiveness. Initial data are reassuring in terms of the current COVID-19 vaccines’ ability to protect against the new variants. 

    Additional information on the new virus variants is available from CDC here.  

    But regardless of the amount of protection that any of these vaccines can provide against the new viral variants, even fully vaccinated people should continue with their own personal prevention steps: wearing masks, staying six feet apart, avoiding crowds and poorly ventilated spaces and frequently washing your hands.

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

    It is possible that some people who are vaccinated will still get a COVID-19 infection from other people. If this happens, they may have symptoms, but the symptoms will probably be milder (less severe) than if they had not been vaccinated. This partial protection issue is true of many vaccines, for example the flu vaccine, which keeps most people from getting the flu at all and makes it likely that those who do get it only have mild symptoms.

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

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

    This depends. The FDA has provided guidance on this topic. People who have been vaccinated against COVID-19 should not donate plasma unless: 

    1. You had symptoms of COVID-19 and a positive test result from a diagnostic test approved, cleared, or authorized by FDA AND
    2. received the COVID-19 vaccine after diagnosis of COVID-19, AND
    3. are within 6 months after complete resolution of COVID-19 symptoms.

    Vaccination: Healthcare Providers

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

     

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

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

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

    Data is published weekly on Wednesdays 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.

    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)
    • 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 fact sheet for healthcare providers administering the Pfizer-BioNTech COVID-19 Vaccine can be found here. (Revised February 25, 2021) 

    The fact sheet for healthcare providers administering the Moderna COVID-19 Vaccine can be found here.

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

    No. 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 first dose of mRNA COVID-19 vaccine was received but patient is unable to compete series with same or different mRNA vaccine (e.g., contraindication), a single dose of Janssen COVID-19 vaccine may be administered at minimum interval of 28 days from mRNA dose*. These individuals will be considered to have received valid, single-dose Janssen vaccination, not mixed 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 Janssen COVID-19 vaccine.*

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

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

    *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 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 with a history of an immediate allergic reaction of any severity to a vaccine or injectable therapy and persons with a history of anaphylaxis due to any cause should be observed for 30 minutes. 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.

    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.

     

    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 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. 

    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 efficacy of mRNA COVID-19 vaccines administered beyond this window. If the second dose is administered beyond these intervals, there is no need to restart the series.

    Additional information on vaccine administration can be found here

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

    No, currently available mRNA COVID-19 vaccines are not interchangeable with each other or with other COVID-19 vaccine products. The safety and efficacy of a mixed-product series have not been evaluated. Both doses of the series 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. 

    Recommendations may be updated as further information becomes available or other vaccine types (e.g., viral vector, protein subunit vaccines) are authorized. Additional information on vaccine administration 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 and Moderna. Consensus from FDA and CDC is that it is acceptable to use every full dose obtainable from each vial. 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.

    Given the lack of data on the safety and efficacy of COVID-19 vaccines administered simultaneously with other vaccines, the vaccine series should routinely be administered alone, with a minimum interval of 14 days before or after administration with any other vaccine. However, COVID-19 and other vaccines may be administered within a shorter period in situations where the benefits of vaccination are deemed to outweigh the potential unknown risks of vaccine coadministration (e.g., tetanus toxoid-containing vaccination as part of wound management, measles or hepatitis A vaccination during an outbreak) or to avoid barriers or delays to COVID-19 vaccination (e.g., in long-term care facility residents or healthcare personnel who received influenza or other vaccinations prior to/upon admission or onboarding). If COVID-19 vaccines are administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine. Further information can be found here.

    Currently, there are no data on the safety and efficacy of mRNA COVID-19 vaccines in persons who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment. Based on the estimated half-life of such therapies and evidence suggesting that reinfection is uncommon in the 90 days after initial infection, vaccination should be deferred for at least 90 days, as a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses. This recommendation applies to persons who receive passive antibody therapy before receiving any vaccine doses and those who receive passive antibody therapy after the first dose but before the second dose, in which case the second dose should be deferred for at least 90 days following receipt of the antibody therapy.

    For persons receiving antibody therapies not specific to COVID-19 treatment (e.g., intravenous immunoglobulin, RhoGAM), administration of mRNA 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. Thus, there is no recommended minimum interval between other antibody therapies (i.e., those that are not specific to COVID-19 treatment) and mRNA COVID-19 vaccination.  

    More information can be found here.

    Yes. CDC has released a summary table which provides descriptions of planned vaccine effectiveness evaluations they are conducting with partners. Table includes the research outcome, evaluation population, evaluation design, participating sites, and, where relevant, links to protocols that detail the evaluation designs.

    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.

    Vaccination: Long-Term Care Facilities

    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.

    Yes. According to CDC, healthcare personnel (HCP) refers to all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air. These HCP may include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons (e.g., clerical, dietary, environmental services, laundry, security, maintenance, engineering and facilities management, administrative, billing, and volunteer personnel) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted among HCP and patients. It will be at the discretion of the facilities as to who they would want to be vaccinated from their facility. However, all LTCF staff (i.e., employees, contractors, external hospice workers, etc.) that are to be vaccinated MUST be included in the total employee count provided by the facility to CVS or Walgreens, and must be included in the registration process. This is to ensure that the pharmacy team arrives at the facility with enough vaccine doses in hand to vaccinate all persons who are to be vaccinated. 

    No. Vaccination of persons with known current COVID-19 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. More information can be found here.

    CVS and Walgreens will be providing Pfizer-BioNTech vaccine to Virginia LTCFs initially. This may be a change from previous communications. The decision to allocate Pfizer-BioNTech vaccine was based on CDC ACIP recommendations that supported the use of Pfizer-BioNTech vaccine for this population, the ability of the pharmacies to maintain cold-chain storage, and the amount of Pfizer-BioNTech vaccine allocated to Virginia.

     

    CDC released some material that can be used to address vaccine hesitancy in your facility. Please find the material here. Acknowledging their fears and being transparent about the process goes a long way when addressing topics like these.

     

    Concern about LTCF staff getting systemic symptoms of COVID-19 post vaccination, causing them to miss work, has led some states and providers to consider staggering staff vaccinations. In the Pfizer-BioNTech trial, it was shown that about half of the people getting the vaccine experience fatigue or headache, but it was deemed mild to moderate severity in the vast majority, which should not limit their ability to work. However, some staff may feel sick enough that they can't work. Staggering staff may cause delays in vaccinating your staff and some may miss out on the CDC Pharmacy Partnership Program. This must be weighed against the concern over staffing shortages. Providers should plan for some staff to miss work 1-2 days after the vaccine clinic. Providers should review CDC guidance on post-vaccine consideration for healthcare workers for more information. This guidance discusses when employees must be excluded from work based on signs and symptoms post-vaccine and provides some ideas for staggering Staff.

    Unfortunately, the CVS and Walgreens providers can only conduct three vaccination events per facility, based on their contractual relationship with CDC. Additionally, increasing the number of vaccination events for each facility would cause significant delays in the progress of the vaccination campaign. However, for those entities that have SNFs and ALFs on the same campus, there will actually be six visits in total, allowing more flexibility for staggering staff vaccinations. Lastly, there will be other opportunities for staff to receive the vaccination in the near future (i.e., through their primary care provider or at a local pharmacy).

    After the initial phase of vaccinations, the facility can choose to continue to work with the pharmacy that provided their initial on-site clinics for additional doses or can choose to work with a pharmacy provider of their choice. Each person getting the COVID-19 vaccine will receive a vaccination record card to make sure they receive the correct vaccine for the second dose.

    People who receive the first dose of COVID-19 vaccine at a LTCF but are not onsite to receive the second dose may bring their vaccination record card to another provider in their area to complete the vaccine series. Initially when there are less providers who will be administering vaccine, this may require coordination with the local health department.  It is important that the same vaccine is administered for the second dose (e.g., Pfizer-BioNTech or Moderna). 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.

    Yes, the CVS and Walgreens vaccination teams will be trained to handle emergencies and will bring supplies such as epinephrine autoinjectors onsite to use in the event that this is necessary. Further information on preparing to handle anaphylaxis can be found here.

    Generally, no. Because Virginia was only allocated enough doses of vaccine to initiate Part A (nursing home) of the CDC Pharmacy Partnership Program for LTCFs, CVS and Walgreens will only vaccinate nursing homes/skilled nursing facilities (SNFs) at this time. Once Virginia has enough vaccine allocated to initiate Part B (assisted living facilities), there will be more flexibility in scheduling.

    Update (1/4/2021): Virginia has now activated Part B of the program, with a start date of Jan 11th. CVS and Walgreens have been given permission to start scheduling vaccination events for ALFs and other facilities enrolled in the program. Going forward, CVS and Walgreens will have the flexibility to schedule SNFs and ALFs on the same campuses on the same day.

    No. For now, CMS has not changed their testing requirements for LTCFs. Experts need to understand more about the protection that COVID-19 vaccines provide before deciding to change recommendations on steps everyone should take to slow the spread of the virus that causes COVID-19. Positive viral (nucleic acid or antigen) tests for SARS-CoV-2, if performed, should not be attributed to the COVID-19 vaccine, as vaccination does not influence the results of these tests. In the near future, these recommendations will likely change as LTCFs begin to complete the immunizations for their staff and residents, but VDH cannot provide a specific timeframe.

    Yes, pharmacists from CVS and Walgreens will be tested at least once a week or according to the CMS testing requirements for staff. Pharmacies will work with individual LTCFs on testing plans if the facility has more stringent testing requirements.

    Yes, pharmacists will be wearing full PPE when entering the room of residents on contact precautions. Pharmacies and facilities are expected to work together and pre-plan vaccination logistics. Pfizer-BioNTech vaccine that is being used by the federal pharmacy partners can be out for only 6 hours. It is imperative that facilities and pharmacies determine the best way to immunize all the staff and residents in limited time.

    If an employee only receives one dose of the vaccine as part of the three visits to the facility from CVS or Walgreens, the employee will need to obtain their second dose from another COVID-19 vaccine provider. VDH is working with pharmacies and healthcare providers to become enrolled in the Virginia COVID-19 Vaccine Campaign as vaccine providers. As more providers receive the vaccine, the information will be added to the VaccineFinder programEmployees will simply need to find a nearby provider and go get their second dose.  Everyone who is vaccinated will receive a Vaccine Card explaining which vaccine they received, and instructions for receiving their second dose. Further, all COVID-19 vaccines must be entered into one of the systems of record that is connected to the Virginia Immunization Information System (VIIS). As part of the provider registration process, all COVID-19 vaccine providers must be registered in VIIS, and this will allow them to look up COVID-19 vaccination records for any patient, regardless of where they received their first dose.

    Generally, no. At least not initially. The Virginia Incident Command Team is working to ensure equitable allocation of COVID-19 vaccines across the Commonwealth to ensure that all persons in Phase 1a are able to receive their vaccine as soon as possible. Allocating vaccine to a LTCF that has already been allocated vaccine as part of the CDC Pharmacy Partnership Program would prevent vaccine being allocated somewhere else where it is needed. However, there may be case-by-case exceptions where it makes sense to make special allocations to certain facilities. Enrolling as a COVID-19 vaccine provider with VDH would be burdensome for a LTCF to receive, store, administer and report all doses administered to VIIS.

    The CDC Pharmacy Partnership Program for Long-Term Care provides for three visits to each facility. CVS and Walgreens began to schedule these visits by calling facilities on December 14. The pharmacies will begin vaccinating at Virginia LTCFs on December 28.

    Update (1/4/2021): Virginia has now activated Part B of the program, with a start date of Jan 11th. CVS and Walgreens have been given permission to start scheduling vaccination events for ALFs and Other facilities enrolled in the program. Going forward, CVS and Walgreens will have the flexibility to schedule SNFs and ALFs on the same campuses on the same day.

    CVS and Walgreens will work directly with each LTCF to determine the most efficient way to vaccinate residents and staff. Vaccination of persons with known current SARS-CoV-2 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. More information can be found here.

    CVS and Walgreens staff will be tested weekly to determine if they are infected with COVID-19. They will also bring their own PPE, and will be adhering to protocols designed to prevent the spread of COVID-19 during their visits. If you have any specific infection control concerns, it is recommended that you coordinate with the vaccination team before their arrival. 

    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.

    CVS and Walgreens staff are trained to handle immediate anaphylactic reactions, but it is also recommended that LTCF staff monitor residents for other adverse reactions that may show up later.

    Yes. Vaccination of persons with known current SARS-CoV-2 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. While there is otherwise no recommended minimum interval between infection and vaccination, current evidence suggests that reinfection is uncommon in the 90 days after initial infection. Thus, persons with documented acute SARS-CoV-2 infection in the preceding 90 days may delay vaccination until near the end of this period, if desired. Additional information can be found here

    The CDC website has  general information about the CDC Pharmacy Partnership Program. The CDC has also created a LTCF Toolkit which provides information to help prepare staff and residents for vaccine, vaccine safety and monitoring, frequently asked questions, and additional resources/flyers. Additional information and resources, including consent forms from CVS and Walgreens, can be found on the VDH COVID-19 Vaccination website.

    The CDC Pharmacy Partnership for Long-Term Care (LTC) Program is further divided into Part A and Part B.  Part A includes all Skilled Nursing Facilities, while Part B includes all Assisted Living and Other facilities that were enrolled in the program.  Each state activates Part A and Part B based on vaccine allocations available from CDC.  As of Dec 14, 2020, Virginia had enough doses of vaccine allocated to activate Part A of this program, allowing vaccination events to occur in Skilled Nursing Facilities in Virginia beginning on Dec 28, 2020.  Both Part A and Part B are part of Phase 1a.  Phase 1a will take several weeks to complete.

    Update (01/04/2020): Virginia activated part B of the CDC Pharmacy Partnership for Long-Term Care Program. CVS and Walgreens can start conducting vaccination clinics in Assisted Living and other facilities as early as January 11th, 2021.  Both Part A and Part B are part of Phase 1a.  Phase 1a will take several weeks to complete.

    Part B of the Federal LTCF Pharmacy Partnership program provides for vaccination in assisted living facilities (ALF) and facilities including Continuing Care Retirement Communities (CCRC), personal care homes, residential care, adult family home, adult foster home, intellectual or developmental disabilities (IDD), HUD 202, and Veteran's homes. These facilities had an opportunity to sign up for the federal pharmacy program by Nov 6th. If a facility did not self-enroll in this program by Nov 6, 2020, this does not mean that the facility will not receive the vaccine. It only means that the facility will not be vaccinated through the federal pharmacy partnership program. If the facility has an affiliation with a pharmacy, the pharmacy can be enrolled as a COVID-19 vaccine provider and receive vaccines through the state allocation. Find more information here. Facilities may also work with their local health department to receive the COVID-19 vaccine.

    CVS and Walgreens have been instructed to avoid vaccine wastage to the greatest extent possible. They are also equipped and prepared to use the leftover vaccine at a different vaccination site or to vaccinate eligible individuals outside the facility. It is important for facilities to provide a precise number beforehand to the pharmacy to avoid vaccine wastage.

    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.

    a. 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.

    b. Healthcare providers are required by law to report to VAERS:

    i. Any adverse event listed in the VAERS Table of Reportable Events Following Vaccination that occurs within the specified time period after vaccination

    ii. An adverse event listed by the vaccine manufacturer as a contraindication to further doses of the vaccine

    c. Healthcare providers are strongly encouraged to report:

    i. 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

    ii. Vaccine administration errors

    d. 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.

    For facilities that are vaccinated via the federal pharmacy partnership, CVS and Walgreens uploads that information to a web-based platform. VDH is working with the pharmacies and CDC to reconcile data in this platform and will be able to provide more accurate information soon. The cumulative vaccine administered doses can be found on the VDH vaccine dashboard. You can also go to CVS and walgreens data sites to access statewide vaccine administered numbers and projections.

    A VDH Long-Term Care Facility Vaccination Coordination Team has been established under the VDH State Pharmacy to coordinate the current and on-going need for vaccinations at long-term care facilities; including skilled nursing facilities, assisted living facilities, independent living facilities, group homes, and other residential care settings.

    An intake process has been established in REDCap for facilities to report their vaccination needs.  The link to that form is shared with long term care associations and providers.  This form should be completed by a designated Point of Contact at the LTCF (not by individual residents).  Lastly, if a LTCF has an upcoming vaccination clinic already scheduled, they do not need to complete this survey.

    Vaccination: Flu vs. COVID-19

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

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

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

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

    The COVID-19 vaccine will help prevent you from getting COVID-19. COVID-19 vaccines started coming to Virginia in December 2020, but it will take a while before they are easily available to the public. 

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

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

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

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

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

    Page last updated: March 3, 2021