Vaccination FAQ

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

  • Vaccination: Virginia COVID Information Center General Information

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

    All Virginia workers and residents 12 years and older are eligible for scheduling, vaccination, and general COVID inquiry services. This includes all undocumented immigrants. The Information Center’s sole objective in collecting your information is to help you get vaccinated. Information gathered by the Virginia COVID Information Center or on Virginia Department of Health websites will not be shared for any other purposes except as authorized or required by law. The Commonwealth of Virginia will never call, email, or text asking for your social security number or payment as it relates to vaccination.

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

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

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

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

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

    Vaccination: How To Get the COVID-19 Vaccine

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

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

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

    Everyone in Virginia 12 years or older is eligible.

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

    At vaccinate.virginia.gov, you can access the “Search by Location” feature, which allows you to enter the street address where you usually live. You will then be provided options for making an appointment.

    Many clinics offer walk-in service in addition to scheduled appointments.

    We expect that everyone who wants to be vaccinated will be able to get their first shot by the end of May.

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

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

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

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

    Proof of Virginia residency is not required.

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

    No. Any person age 12 or older and living in the U.S., regardless of how long, is eligible to be vaccinated. Proof of U.S. Citizenship is not required. 

    Yes. Persons in Virginia age 12 or older can get vaccinated in Virginia. 

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

    There is no policy that you may only receive a vaccine in the locality (city or county) where you live. 

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

    Virginia is receiving weekly shipments of the Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines from the federal government. 

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

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

     

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

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

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

    You must reach out to the local health department, Local Health District, or agency that scheduled your appointment. For example, if you scheduled your appointment through the Vaccinate Virginia program which uses the Vaccine Appointment Scheduling Engine (VASE), you can call 1-877-VAX-IN-VA. Please check the communication(s) you received for your appointment – this should help you find the local government, local health department, or other agency managing your appointment.

    Yes, the 12-15 year old age group has been authorized by the FDA and recommended by CDC’s Advisory Committee on Immunization Practices (ACIP) to receive the Pfizer-BioNTech COVID-19 vaccine. The children can be scheduled for vaccination in Virginia, the same way that older children and adults are being scheduled.

    In general, the scheduling arrangements, allergy precautions, other pre-vaccination precautions, vaccine side effects, safety data, and vaccine effectiveness in this age group are similar to those in older children and young adults.

    Parents and guardians can enroll adolescents (ages 12 and older) in the v-safe after vaccination health checker and complete health check-ins on their behalf after COVID-19 vaccination. 

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

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

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

    Virginia has made significant progress in its vaccine rollout. As of June 8, more than 68.2% of all adults in Virginia have received at least one dose and more than 46% of the entire population is fully vaccinated. We have seen great response, and we expect that to continue now that COVID-19 vaccines are available to everyone 12 and older.  

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

    We will continue the focus on equity and reaching our vulnerable populations. Those efforts include targeted advertising in multiple languages, working with community partners to schedule vaccination clinics, opening large, state-run Community Vaccination Centers in targeted areas, and deploying mobile vaccination units.

     

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

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

    No. More than one vaccine brand is available in the United States, but 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 COVID-19 vaccine is offered to everyone at no cost regardless of health insurance. Children under the age of 12 will be offered a COVID-19 vaccine only after the vaccines are tested and authorized for emergency use in children. 

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

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

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

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

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

    VDH is supporting Virginia healthcare providers who are currently providing COVID-19 vaccines. VDH continues to sign up healthcare providers who want to provide  COVID-19 vaccines. These providers include hospitals, long-term care facilities, local health departments, pharmacies, health systems, outpatient centers and urgent care centers. Vaccine providers are trained to correctly store, administer, and document available vaccines.

    Community Vaccination Centers (CVCs), are larger-scale sites capable of vaccinating hundreds to thousands of people per day. CVCs are organized by the Virginia Department of Emergency Management (VDEM) and the Virginia Department of Health (VDH) in consultation with local health districts and local governments; funded by the Federal Emergency Management Agency (FEMA); and operated by turnkey contractors.

     

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

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

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

     

    Virginia is offering mobile vaccination units capable of vaccinating up to 250 people per day to support local health department efforts across the state. 

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

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

    All units are ADA-accessible and provide language services. 

    Vaccination: Why Get Vaccinated Against COVID-19

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

    We don’t know yet why some healthy people become seriously ill or die from COVID-19, while other healthy people with COVID-19 only become mildly sick. 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, including among older children, 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, including children from spreading the virus that causes COVID-19.

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

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

    Goal #1: The most important goal of a COVID-19 vaccine is to safely protect the vaccinated person 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 the disease to keep spreading.

    Broadly speaking, the vaccine will not be required for all Virginians and there are no legal penalties for refusing it, but we urge you to get it 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.

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

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

     

    No. The vaccine will not give you COVID-19 because the vaccine is not made from the live virus. However, it can take a few weeks for the body to build full 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 used or developed in the United States will not cause positive results on COVID-19 viral PCR and antigen tests. These types of tests detect active infection with the virus that causes COVID-19 and the current COVID-19 vaccines do NOT contain the actual virus that causes COVID-19.

    After vaccination, you or your vaccinated child might test positive on some but not all types of COVID-19 antibody tests. These tests show 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 these antibody test results. Please note: routine antibody testing after vaccination is not recommended.

    Fully vaccinated people are less likely to get an asymptomatic COVID-19 infection that can be spread to others. Thus, in addition to protecting you, getting vaccinated will provide some protection to your family and household members and other contacts.

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

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

    When you or your child gets vaccinated for COVID-19, you will be provided 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 or have access to a fact sheet with information specific to the vaccine that you or your child received. 

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

    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 a second vaccine dose is needed. You can also choose to enroll in the VaxText text messaging service. By texting ENROLL to 1-833-VaxText (829-8398), vaccine recipients can opt in to receive a weekly text reminder for their second dose of COVID-19 vaccine or a reminder for when they are overdue for their second dose, in English or Spanish.

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

    Herd immunity is a form of 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.

    Vaccinating a lot of people is the best way to get this immunity. Some people can still get sick even with herd immunity. The risk of outbreaks is higher in areas where fewer people get the vaccine.

    How long the protection will last after being fully vaccinated with a current COVID-19 vaccine is still not known.

    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 antibody 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 measles vaccine -- have immunity to measles for life. In some other types of vaccines, another shot or “booster” gives immunity for a much longer time than the original vaccination. In other vaccines, like the flu vaccine, you need to get a new dose of the vaccine every year.

    COVID-19 disease and the COVID-19 vaccination are similar in that they both result in immunity in most people. However, at this moment, we do not know for sure how long the immunity will last after either COVID-19 disease or after COVID-19 vaccination. If that COVID-19 immunity begins to run out, you will need another dose of COVID-19 vaccine.

    Yes- vaccination can be offered for those who previously had a COVID-19 infection. As long as the individual is not symptomatic, and also out of the isolation period, they can get the vaccine. 

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

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

    • Vaccine breakthrough cases are expected especially before population immunity reaches sufficient levels to further decrease transmission. COVID-19 vaccines are effective and are a critical tool to bring the pandemic under control. However, no vaccines are 100% effective at preventing illness in vaccinated people. There will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from COVID-19. More specifically, if a vaccine is thought to be 95% effective, we would expect 5% of fully vaccinated individuals to still become infected despite receiving the shots. 
    • More than 123 million people in the United States have been fully vaccinated as of May 17, 2021. Like with other vaccines, vaccine breakthrough cases will occur, even though the vaccines are working as expected. Asymptomatic infections among vaccinated people will also occur.
    • There is some evidence that vaccination may make illness less severe for those who are vaccinated and still get sick; and also reduce the risk of further transmission. A few links to such studies are here, here, and here

     

    Current data suggest that COVID-19 vaccines authorized for use in the United States offer protection against most SARS-CoV-2 variants currently circulating in the United States. However, variants will cause some vaccine breakthrough cases.

    CDC recommends that people 2 years old and older who are not fully vaccinated wear a mask when they are in indoor public settings or when they are around people who don’t live in their household. Masks are federally required for those 2 and older when they are using public transportation or in terminals (airports, train or bus stations, etc.) for public transportation. In Virginia, per Executive Order 72, masks will be required for those aged 5 and older, regardless of vaccination status, at public and private K-12 schools and for employees in certain business sectors. 

    A mask is NOT a substitute for physical distancing. Masks should still be worn in addition to staying at least 6 feet apart, especially when indoors around people who don’t live in your household.

    There have been some individual reports that people who have any of the collection of symptoms now known as Long COVID note an improvement of their symptoms after they receive COVID-19 vaccine.

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

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

    Finally, the threat of the various long term effects of COVID-19 infection and disease is an important reason to get a COVID-19 vaccine. 

    Companies across the United States are offering rewards to their vaccinated customers and employees. Click here for a list of these incentives currently being offered. 

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

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

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

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

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

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

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

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

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

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

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

    Vaccination: Development + Safety

    One of the reasons that these COVID-19 coronavirus vaccines could be produced and tested so quickly is that two previous coronavirus diseases, SARS that emerged in China in 2002 and MERS that emerged in the Middle East in 2012, taught us a lot about developing safe and effective coronavirus vaccines. Although the COVID-19 vaccines have been developed faster than any other U.S. vaccines, that increased speed of development was made possible by making new resources available, by creating new partnerships between government and private-sector organizations, and by reducing non-scientific bureaucratic obstacles. In fact, development of these new vaccines has followed the same effectiveness and safety review processes as other vaccines, including studying tens of thousands of participants of different ages, races and ethnicities for each vaccine.

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

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

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

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

    The supplementary adolescent studies of Pfizer-BioNTech vaccines that led to the recommendation to reduce the age eligibility for that vaccine to 12 years or older included over 2400 additional adolescents.

    One way that the effectiveness of a vaccine (how well it works) is determined is through studies that compare the proportion (percentage) of vaccinated people who get COVID-19 infection with the proportion (percentage) of people who don’t get the vaccine (control group) and develop 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 in preventing infection.

    For COVID-19, a serious and sometimes fatal disease, many public health experts are also using a slightly different outcome measure to decide if a vaccine is working effectively. For example, 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 keep them from dying. Fortunately, all three current vaccines, from Pfizer-BioNTech, Moderna, and Johnson & Johnson (also known as Janssen Biotech) did really well in their large Phase 3 studies in almost totally preventing deaths among those receiving the vaccine. They also did really well in keeping vaccinated people from needing to be in a hospital. In fact, a recent follow-up study from 24 hospitals in 14 U.S. states found that Pfizer-BioNTech and Moderna vaccines given to people aged 65 and older were able to reduce COVID-19-associated hospitalization by 94%. 

    In order to show effectiveness for many groups of people, vaccine trials also look 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. 

    A number of real-world effectiveness studies confirm that the vaccines provide protection against COVID-19. Studies have been conducted among health care personnel (showing protection against symptomatic illness), among adults aged ≥65 years (showing protection against COVID-19 hospitalization), among health care personnel, first responders, and other essential and frontline workers (showing protection against COVID-10 regardless of symptom status), and among residents of skilled nursing facilities experiencing COVID-19 outbreaks (showing protection, and even some protection with partial vaccination). The CDC summarizes the information and the associated real-world effectiveness studies here. 

    The COVID-19 vaccines from Pfizer-BioNTech and Moderna use mRNA to cause an immune response. 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 your immune system to respond. That immune response produces antibodies that help keep you from becoming infected if the COVID-19 virus later 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 - but NOT the SARS-CoV-2 virus - as a way to deliver to human cells a SARS-CoV-2 antigen called the spike protein. This spike protein antigen triggers production of antibodies against it and the resulting immune response then targets that spike protein. The virus used in this viral vector vaccine poses no threat of causing human infection or disease because it has been modified so it cannot reproduce.

    As with the mRNA vaccines, the genetic material carried by viral vector vaccines does not become part of - or otherwise change -  a person’s DNA.

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

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

    An EUA is an “Emergency Use Authorization,” a process in the FDA that allows a vaccine company or drug 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 and its outside advisory group  must decide that the known and possible benefits of the proposed vaccine outweigh the risks of authorizing (allowing) its use in that kind of emergency before it has been studied long term.

    EUAs are issued when the FDA agrees that the current disease situation is so dangerous that there is not time 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. Updates or amendments to an EUA, as happened in May 2021 to allow  use of the Pfizer-BioNTech vaccine for 12-15 year olds, similarly require presentation of the updated data or other information to the FDA.

    The first COVID-19 vaccines in the United States were initially authorized as EUAs so they could be distributed quickly to as many people as possible. The vaccine companies will still need to obtain the regular biological license application (BLA) approval later to continue marketing the vaccines, but a BLA approval requires a more detailed evaluation. Press reports suggest that both Pfizer-BioNTech and Moderna will soon be applying for full FDA approval for their COVID-19 vaccines although as of June 2, 2021, there is no mention of that process on the FDA website.  

    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 of vaccine recipients 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 with the two-dose vaccine series, they are more common after the 2nd dose than after the first dose. 

    Less commonly, some people have reported redness, swelling, and itching around the injection site beginning a few days after or into the second week after their first mRNA vaccine dose.  Some of these reactions in the upper arm have been quite large. A few persons who experience this unusual reaction (now called “COVID Arm”) 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 and expected. 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.

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

    For those older children recently authorized to receive COVID-19 vaccines, the side effects seen after vaccination in the recent research studies were similar to those seen in older adolescents and young adults.

    Medicines such as acetaminophen, ibuprofen, or naproxen or other medicines called “non-steroidal anti-inflammatory drugs” (NSAIDS) can help with the common side effects (for example, arm pain or fever) 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.

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

     

    Because COVID-19 vaccines are so new, information on possible long term side-effects is still being collected and studied by CDC, FDA, and other groups, using multiple systems to collect the data. One adverse effect that has been identified is a rare blood clotting problem that occurred in 15 women among nearly 8 million people vaccinated with the Janssen (Johnson and Johnson) vaccine. When that problem was first noted in early April 2021, use of that vaccine was stopped for almost two weeks while it was further studied. After deciding that the vaccine’s known and potential benefits outweigh its known and potential risks, the FDA and CDC recommended resuming its use in the United States. Women younger than 50 years old should be made aware of the rare but increased risk of thrombosis with thrombocytopenia syndrome (TTS).

     

    That rare blood clotting problem has not been seen with the Pfizer-BioNTech and Moderna vaccines.

    For additional information on this topic, see here.

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

    However, in some situations, you could still get new COVID symptoms soon after getting the vaccine. Because there are still so many COVID-19-infected people in our communities, it is possible that a few COVID-19 vaccine recipients had already been exposed to and infected with COVID-19 by the time they got the vaccine even if they were not yet showing any COVID-19 symptoms. If those pre-exposed people later had symptoms of COVID-19 infection or tested positive for it soon after vaccination, that does NOT mean that their COVID-19 came from the vaccine. Rather, that means that they got COVID-19 from their pre-vaccination exposure to one or more infected people and not from the vaccine.

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

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

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

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

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

    • People with some autoimmune diseases are also able to be vaccinated but also need to be aware of the limited safety data for people in their category.
    • People 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. 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 May 27, 2021 indicate that anaphylaxis occurs following vaccination with the current COVID-19 vaccines about 2 to 5 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 specific care or advice.

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

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

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

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

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

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

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

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

    People who have had recent COVID-19 disease should not get COVID-19 vaccine until they have recovered from their illness.  

    Children under the age of 12 years (for the Pfizer-BioNTach vaccine) or under the age of  18 years (for the Moderna and Janssen /Johnson & Johnson vaccines), should not receive the current vaccines as they have not been studied yet below these ages. (Use of these COVID-19 vaccines in adolescents and younger children is now being studied.)

    People who had COVID-19 disease earlier and who were treated with convalescent plasma or monoclonal antibody should not get the COVID-19 vaccine until at least 90 days have passed since their last plasma or antibody treatment.  

    COVID-19 and other vaccines may now be administered without regard to timing of other vaccines. This includes simultaneous administration of COVID-19 and other vaccines on the same day, as well as co-administration within 14 days.

    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 12 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. (Last updated April 23, 2021)

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

    Type of vaccine: adenoviral vector for spike protein

    Number of injections (shots): 1 injection

    How given: Injection in the muscle of the upper arm

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

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

    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 health conditions, such as diabetes or obesity, are at even greater risk, as is true in the non-pregnant population. In addition, having COVID-19 while pregnant has been associated with preterm birth and other adverse outcomes of pregnancy. Preventing these extra COVID-19 risks in pregnant women is an important public health goal. 

    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.

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

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

    Results from CDC’s v-safe voluntary after-vaccination health check system showed that as of May 31, 2021, more than 121,000 women who received COVID-19 vaccines have reported pregnancies, with no specific safety issues identified. 

    CDC established a specific v-safe COVID-19 Vaccine Pregnancy Registry to learn more about these issues and Initial data from this registry, which as of June 7, 2021 includes data from more than 5000 women, show similar vaccine side effects for pregnant and non-pregnant individuals. Based on birth outcomes of the first 275 completed pregnancies, rates of complications are not significantly different from those of unvaccinated pregnant women.

    Pregnant 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.

    A more detailed and far more technical description and analysis of all pregnancy-related COVID-19 data reported to CDC up to February 28, 2021 can be found here.

    Yes.  

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

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

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

    Although animal vaccines against COVID-19 are being studied, a COVID-19 vaccine for pets is not available now. A small number of pets worldwide, including cats and dogs, have been infected with SARS-CoV-2, mostly after close contact with people who 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.

    COVID-19 vaccines are being given to hundreds of millions of people in the United States. Many of these vaccine recipients are older and thus already at higher risk of death from pre-existing illnesses or other natural causes regardless of receiving or not receiving a COVID-19 vaccine.

    FDA requires vaccine providers to report ANY deaths that occur after a COVID-19 vaccination to the VAERS reporting system. Every death is investigated by CDC and FDA physicians as soon as these are reported.

    As of late May, 2021, over 285 million COVID-19 vaccine doses have been given out in the United States and 4863 deaths (0.0017%) among vaccine recipients have been reported and each death has been investigated. As noted by CDC, “A review of available clinical information including death certificates, autopsy, and medical records revealed no evidence that vaccination contributed to patient deaths. However, recent reports indicate a plausible causal relationship between the J&J/Janssen COVID-19 Vaccine and a rare and serious adverse event—blood clots with low platelets—which has caused a small number of deaths.  Get the latest safety information on the J&J/Janssen vaccine here. CDC and FDA will continue to investigate reports of adverse events, including deaths, reported to VAERS.”

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

    No.

    None of the three current COVID-19 vaccines contain any fetal tissue. 

    Neither Moderna nor Pfizer-BioNTech used any fetal tissue in the research, development, or production of their vaccines; however, after the development of these two vaccines, both companies used a fetal cell line in the process of confirming that their vaccines worked. Fetal tissue was used in the research and development of the Johnson and Johnson (Janssen) vaccine. 

    To help address this issue, the Vatican developed and released a document called “Note on the morality of using some anti-Covid-19 vaccines.” This document, which discusses concerns about fetal tissue use in the development of COVID-19 vaccines, was developed at the request of Pope Francis, was approved by him (as noted in its text), and was published on December 17, 2020.

    Out of 7.98 million people who received the J&J vaccine as of April 21, 2021, 15 female recipients were identified who developed a type of blood clot called thrombosis with thrombocytopenia syndrome (TTS); some have been fatal. Thrombosis means blood clot and thrombocytopenia means low levels of platelets.

    On April 23, 2021, The Advisory Committee on Immunization Practices (ACIP) met to review additional information about cases of TTS and update recommendations for use of the J&J COVID-19 vaccine. After studying the reported cases of TTS and considering the risks and benefits of using the J&J vaccine, ACIP recommended lifting the pause on J&J vaccinations.

    On April 23, 2021, CDC and FDA determined that the use of the J&J COVID-19 Vaccine should be resumed in the United States. The FDA and CDC have confidence that this vaccine is safe and effective in preventing COVID-19.The FDA has determined that the available data show that the vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years of age and older. At this time, the available data suggest that the chance of TTS occurring is very low, but the FDA and CDC will remain vigilant in continuing to investigate this risk. Vaccine recipients should review the Fact Sheet for Recipients and Caregivers, which have been revised to include information about the risk of this syndrome, which has occurred in a very small number of people who have received the Janssen COVID-19 Vaccine.

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

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

    Vaccination: Side Effects After Receiving the COVID-19 Vaccine

    Vaccine side effects fall into one of three categories: 1) Local reactions (at or near the injection site); (2) Systemic reactions (such as fever, chills, or muscle aches); and (3) Allergic reactions. 

    This response addresses the local and systemic side effects. Allergic side effects are addressed in a later response. 

    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 (and expected) signs that your body is building protection against COVID-19. 

    While we do not yet know all of the possible vaccine side effects, some vaccinated people have had 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 that causes COVID-19 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. However, these local reactions, which are now called “COVID arm” are not considered to be allergic reactions and are not felt to represent a risk for anaphylaxis upon receipt of the second dose. In fact, a few of those people who experienced this reaction have had a similar reaction after their second dose. Thus, individuals with such delayed injection site reactions after the first mRNA COVID-19 vaccine dose should receive the second dose using the same vaccine product as the first dose and at the recommended interval, and preferably in the opposite arm. More information about these uncommon “COVID arm” reactions can be found here.

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

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

    If you have persistent injection site 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

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

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

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

    Probably not but be sure to discuss this kind of important decision with your healthcare provider.

    There have been some reports of immediate but non-severe allergic reactions such as hives, swelling, and wheezing within 4 hours after getting a COVID-19 vaccine. Anyone having 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 vaccines. However, because COVID-19 is a potentially serious disease, deciding not to finish a COVID-19 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. 

    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. Such effects are unlikely. 

    Sometimes people who are concerned about vaccines raise a wide range of various reproduction and fertility topics as part of their concern.  

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

    Next, COVID-19 vaccine experts are not aware of ANY information indicating that these vaccines have a specific effect on menstrual cycles.

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

    As noted elsewhere, there is no reason to withhold COVID 19 vaccine from women who are pregnant, post-partum, and/or breastfeeding  

    More specifically, there are no scientific data to substantiate the myth that antibodies produced by the COVID-19 vaccines target - and affect - syncytin-1, a protein in the placenta of pregnant women.   

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

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

    • Cases reported to VAERS have occurred:
      • Mostly in male adolescents and young adults age 16 years or older
      • More often after getting the second dose of one of these two COVID-19 vaccines than after the first dose
      • Typically within several days after COVID-19 vaccination

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

    Be on the lookout for any of the following symptoms:

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

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

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

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

    CDC and VDH continue to recommend COVID-19 vaccination for everyone 12 years of age and older, given the greater risk of COVID-19 illness and related, possibly severe complications.

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

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

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

    That depends on which vaccine you are receiving. Although the Johnson & Johnson (also called Janssen Biotech) COVID-19 vaccine only requires a single dose, 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 either arrange an appointment or will help provide a way to remind you when it’s time to return for that second dose.

    In addition, the CDC’s “v-safe” software will provide a reminder about the needed 2nd dose.  For 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 to be sure that you get complete protection against COVID-19.

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

    Although there are currently limited data on how much protection from COVID-19 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.   

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

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

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

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

    If you are then diagnosed with a SARS-CoV-2 infection, you should defer vaccination until after recovery and after the end of the isolation period to avoid the risk of exposing vaccinators to the virus.

    Studies to answer this question are being done right now.  

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

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

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

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

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

    You can obtain a copy of your - or your child’s - immunization record by making a request here. A VIIS representative will contact you within 24 to 48 hours to discuss your request. You can also contact the VIIS Help Desk at (866) 375-9795. The Help Desk will be staffed from 8:30 am until 5:00 pm, Monday through Friday.

    Other Strategies can be used to obtain a record of COVID-19 vaccination: 

    • Check your email to see if your vaccination site provided you with documentation. 
    • Check to see if you have a login for a patient portal where you can access this information. 

    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 may be enlarged as part of an expected response to the COVID-19 vaccine) be mistaken in the mammogram for a sign of the spread of breast cancer.

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

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

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

    Definitely yes.

    There have been some suggestions that people who had a real COVID-19 infection at some earlier time might only need a single dose of COVID-19 vaccine to be fully vaccinated, the idea being that the earlier COVID-19 illness could act as an equivalent to the first dose of vaccine.

    However, COVID-19 remains a dangerous and sometimes fatal illness. Until enough information is collected to thoroughly answer this question, VDH and CDC continue to recommend that both doses of a two-dose COVID-19 vaccine series are necessary for someone to be considered as fully vaccinated.

    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 discontinuing isolation is allowed.

    Data from clinical trials show that the currently authorized COVID-19 vaccines can be given safely to people with evidence of a prior SARS-CoV-2 infection.

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

    Vaccination: After Being Fully Vaccinated with COVID-19 Vaccine

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

    People who completed a COVID-19 vaccination series with any vaccine that has been authorized for emergency use by the World Health Organization (WHO) do not need any additional doses with an FDA-authorized COVID-19 vaccine.

    PLEASE NOTE: Even if they meet this definition of “fully vaccinated,” people who have immune systems that are likely to be weakened because of a disease condition they have (e.g., leukemia) or because they are receiving a medication that intentionally suppresses the immune system (e.g., organ transplant recipients or people with severe allergies) should be aware that they may have a reduced immune response to COVID-19 vaccine. Those people should also be advised to continue following the current COVID-19 prevention guidance (masking, distancing, avoidance of crowds and poorly ventilated indoor spaces) to protect themselves against COVID-19. Additional information for such people can be found here

    If you’ve been fully vaccinated:

    • You can resume most activities that you did prior to the pandemic.
    • You can resume most activities without wearing a mask or staying 6 feet apart. Exceptions include public transit, schools, correctional facilities, homeless shelters, and healthcare facilities including skilled nursing facilities (nursing homes). .
      • If you’ve been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms.
      • However, if you live or work in a correctional or detention facility, a homeless shelter, or a healthcare facility (including a nursing home) and are around someone who has COVID-19, you should still get tested, even if you don’t have symptoms.

    People who have a condition or are taking medications that weaken the immune system are advised to talk to their healthcare provider to discuss their activities; because such people may not respond to COVID-19 vaccine as well as other people, they may need to keep taking all precautions to prevent COVID-19 even if they are fully vaccinated.

    For now, if you’ve been fully vaccinated:

    • You will still need to follow guidance at your workplace, school, and local businesses.
    • If you travel, you should still take steps to protect yourself and others. You will still be required to wear a mask on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in U.S. transportation hubs such as airports and train and bus stations. Fully vaccinated international travelers arriving in the United States are still required to get tested within 3 days of their flight (or show documentation of recovery from COVID-19 in the past 3 months) and should still get tested 3-5 days after their trip.
    • You should still watch out for symptoms of COVID-19, especially if you’ve been around someone who is sick. If you have symptoms of COVID-19, you should get tested and stay home and away from others.
    • People who have a condition or are taking medications that weaken the immune system, should talk to their healthcare provider to discuss their activities. Even after being fully vaccinated, they may still need to keep taking all precautions to prevent COVID-19.

    Effective at midnight on May 15, 2021, masks are no longer required by Executive Order 72 for fully vaccinated individuals in most indoor settings. Exceptions include public transit, healthcare facilities, schools, correctional facilities, and homeless shelters. A growing body of evidence suggests that fully vaccinated people are less likely to have asymptomatic infection and less likely to spread the SARS-CoV-2 virus.

    Anyone who is not yet vaccinated or is partially vaccinated should wear masks and physically distance in public settings and when around people who don’t live in their household.

    People who have a condition or are taking medications that weaken the immune system are advised to talk to their healthcare provider to discuss their activities; they may need to keep taking all precautions to prevent COVID-19 even if they are fully vaccinated.

    Probably not. 

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

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

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

    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 (including nursing homes), please see here.

    Probably yes. 

    The CDC has regularly updated mask guidance as more information became available regarding the effectiveness of the vaccines, along with the current status of the pandemic in the United States. New cases, hospitalizations, and deaths have decreased significantly over the past few weeks as more individuals have become fully vaccinated.  

    A study released on May 14 by the CDC showed that real-world use of the Moderna and Pfizer vaccines are highly effective at preventing Covid-19 disease in healthcare personnel. Another study released on March 29 by the CDC, and another conducted in Israel also showed that the vaccines were highly effective against SARS-CoV-2 infections, regardless of symptom status. Another study released in Nature Medicine showed that vaccination can reduce viral load in vaccine breakthrough COVID-19 cases, thereby reducing the risk of further transmission. 

    There is a small chance that fully vaccinated people can still catch and spread Covid-19, however the science shows us that these “breakthrough cases” are not only rare, but when they do occur, illness is most likely less severe and less contagious to others. Some individuals, depending on their medical risk factors, may choose to continue all prevention measures.

    Yes, there are other ways to help.

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

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

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

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

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

    Stopping any disease pandemic requires using all the tools we have available.

    Fortunately, fully vaccinated people who have waited at least 14 days from their last dose are now able to resume most activities that they did prior to the pandemic.

    Those who are not fully vaccinated should continue current prevention measures, and get vaccinated as soon as possible.

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

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

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

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

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

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

    Yes, but as of June 7, 2021, being fully vaccinated against COVID-19 does NOT yet improve the administrative challenges of your travel outside the United States. 

    In fact, COVID-19 viral testing is increasingly required for pre-travel screening on international flights. For travel to other countries, you should check closely with both your airline and the national testing requirements of the country or countries that you will be visiting.

    In terms of coming back to the United States, all arriving passengers, including U.S. citizens, are now REQUIRED to have either a negative COVID-19 viral PCR or antigen test or documentation of recovery from COVID-19 before boarding a flight to return to the United States. 

    As of June 7, 2021, even proof of being fully vaccinated against COVID-19 will NOT substitute for having a negative viral PCR or antigen test before returning to the United States.

    That depends. 

    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 for most people is the production of antibodies against the specific spike protein part of the virus that causes COVID-19. Some but not all available serologic (blood) tests for COVID-19 are based on this type of antibody so having a COVID-19 vaccination may result in your having a positive COVID-19 antibody (serology) test later on. 

    Immunity against some viral disease wanes (becomes less) over long periods. For COVID-19, 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 COVID-19 vaccine dose at some time in the future but as of early June 2021, the need for eventual booster doses has not been demonstrated and no additional doses beyond the primary COVID-19 vaccination are now being recommended. 

    However, studies of how long the protection from these COVID-19 vaccines lasts are underway and more information and recommendations will be made public as soon as possible.

    No, you will not. 

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

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

    For COVID-19 vaccine to be most effective and for everyone in your household to protect themselves and each other, everyone who can be vaccinated should receive it as soon as possible.

    As of now, children 12-17 years old can only be vaccinated with the Pfizer-BioNTech vaccine. The Moderna or Johnson & Johnson (also known as Janssen Biotech) vaccines can only be used in adults 18 years and older. Some additional studies of COVID-19 vaccination in younger age groups are underway but the FDA has not yet authorized use of these vaccines in younger children. 

    At the moment, the best way to protect children in a household is to vaccinate all the adults and children in the household who can be vaccinated and to minimize other children’s contact with unvaccinated people.

    As is also true of influenza vaccines, the most important characteristic of the current COVID-19 vaccines is how well they protect you and others from the more severe COVID-19 symptoms that lead to hospitalization, intensive care unit (ICU) admission, or death. All three of the current COVID-19 vaccines are highly and equally effective in preventing those most serious outcomes of COVID-19 disease. This strong effectiveness against severe disease also seems to be true for 12-15 year olds who are being fully vaccinated with the Pfizer-BioNTech vaccine.

    In terms of milder illness, the COVID-19 vaccines from Pfizer-BioNTech and from Moderna that are now being used are expected to prevent milder 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%), although some of the research with that vaccine was done later than with the Pfizer-BioNTech and Moderna vaccines and in countries where more vaccine-resistant variants were already 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 being fully vaccinated, the disease symptoms are likely to be milder than if you hadn’t been vaccinated. In addition, it now seems that the few vaccinated people who get breakthrough COVID-19 infections have less virus in their nose and throat, meaning that they are also much less likely to infect other people.   

    And finally, getting only a single dose of one of the current two-dose (Pfizer-BioNTech or Moderna) mRNA COVID-19 vaccines will not provide the vaccine’s full protection.

    It is possible that some people who are fully vaccinated will still get a breakthrough COVID-19 infection from other people. If this happens, they may have some 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 flu will only have mild symptoms.

    Probably yes, at least for the moment. 

    Vaccine experts are continually studying these new variants of the SARS-CoV-2 virus to determine whether the current COVID-19 vaccines are likely to remain effective against them. As of June 2, 2021, data are reassuring in terms of the current vaccines’ ability to protect against the most common new variants. Available vaccines showed either unchanged effectiveness or only slightly lower effectiveness against some of the variants but in all cases so far, the vaccines were still effective in preventing serious illness or deaths from the new variants.  

    In addition to their impact on vaccine effectiveness, several new variants 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. If true, this will result in higher numbers of new COVID-19 cases than we would have otherwise. In addition, whether the new variants cause milder or more severe illness or whether the new variants might be less detectable by the currently available viral diagnostic tests such as PCR or antigen tests is still unknown. Each of these issues is currently being studied.

    Additional information on the new virus variants is available from CDC here and in a more technical version here. VDH information on variants can be found 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 recommended by CDC and by VDH when out in public: wearing masks, staying at least six feet apart, avoiding crowds and poorly ventilated spaces, and frequently washing your hands.

    Probably not.

    Commercial serology (antibody) testing to confirm immunity 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) proteins 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.

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

    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.

    No data are available on the safety or efficacy of receiving a COVID-19 vaccine currently authorized in the United States after receiving a non-FDA-authorized COVID-19 vaccine. However, in some circumstances people who received a COVID-19 vaccine not currently authorized in the United States may be offered revaccination with an FDA-authorized vaccine:

    • After receiving COVID-19 vaccines not authorized by FDA but authorized for emergency use by WHO. As of May 5, 2021, this category includes two COVID-19 vaccines, one manufactured by AstraZeneca and one manufactured by the Serum Institute of India
      • People who completed a COVID-19 vaccination series with one of these vaccines that has been authorized for emergency use by the World Health Organization (WHO) do not need any additional doses with an FDA-authorized COVID-19 vaccine.
      • People who are partially vaccinated with a COVID-19 vaccine series authorized for emergency use by WHO but not by FDA may be offered an FDA-authorized COVID-19 vaccine series.
    • After receiving COVID-19 vaccines not authorized by FDA or not authorized for emergency use by WHO
      • People who completed or partially completed a COVID-19 vaccine series with any other vaccine that is not authorized by FDA and not authorized for emergency use by WHO may be offered a full FDA-authorized COVID-19 vaccine series.

    Administration of an FDA-authorized COVID-19 vaccine in these people should comply with all conditions of use specified under the EUA for the vaccine being used. The minimum interval between the last dose of a non-FDA authorized vaccine and an FDA-authorized COVID-19 vaccine is 28 days.

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

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

    For additional information, see here. 

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

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

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

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

              See page 6 of the current FDA guidance for more information on this topic. 

    Vaccination: Healthcare Providers

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

     

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    CDC continues to recommend COVID-19 vaccination for everyone 12 years of age and older given the risk of COVID-19 illness and related, possibly severe complications, such as long-term health problems, hospitalization, and even death.

    Clinical considerations can be found here

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

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

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

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

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

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

    The fact sheet for healthcare providers administering the Moderna COVID-19 Vaccine can be found here. (Revised March 31, 2021) 

    The fact sheet for healthcare providers administering the Johnson and Johnson (also known as Janssen) COVID-19 Vaccine can be found here. (Revised April 23, 2021)  

    Governor Northam recently signed House Bill 2333 and Senate Bill 1445, which expand the pool of health care providers eligible to administer the COVID-19 vaccine in Virginia. 

    Health care providers who are now authorized to administer the COVID-19 vaccine in Virginia include but are not limited to dentists, dental hygienists, veterinarians, optometrists, and health professions students enrolled in an accredited Virginia program. 

    Eligible health care providers may register to volunteer as a COVID-19 vaccinator through either the Virginia Medical Reserve Corps (MRC) or the Virginia Volunteer Vaccinator Registry (VVVR).

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

    This request can be made through CDC-INFO by:

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

    For more information, see here.

    No, you cannot. 

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

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

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

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

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

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

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

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

    Key points include:

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

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

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

     Key points include:

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

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

    Persons should be observed for 30 minutes if they have:

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

    All other persons should be observed for 15 minutes.

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

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

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

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

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

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

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

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

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

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

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

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

    Additional information can be found here.

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

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

    Persons should not be scheduled to receive the second dose earlier than recommended (i.e., 3 weeks [Pfizer-BioNTech] or 4 weeks [Moderna]). However, second doses administered within a grace period of 4 days earlier than the recommended date for the second dose are still considered valid. Doses inadvertently administered earlier than the grace period do not need to be repeated. 

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

    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 yet. 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. 

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

    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

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

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

    FDA and CDC have confirmed that some providers are reporting the ability to obtain additional doses within the multidose COVID-19 vaccine vials manufactured by both Pfizer 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.

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

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

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

    Currently, there are 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 first 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.

     

    CDC released some ‘vaccine confidence” 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.

     

    Ongoing vaccination needs within these LCTFs exist for multiple reasons including first doses offered at the final CVS/Walgreens clinic (requiring a follow-up second dose from another provider), staff or resident turnover, and facilities who were not originally included in the CVS/Walgreens Federal Pharmacy Partnership Program. 

    To meet this ongoing need, The Virginia Department of Health (VDH) has developed the LTCFs Vaccine toolkit. The facilities can refer to this document if they have ongoing COVID vaccine needs.

    Under the state pharmacy partnership, several LTC pharmacies have been onboarded as vaccine providers with VDH. Facilities are encouraged to reach out to their regular pharmacy first and request vaccines.

    Yes, CMS has changed their testing requirements for nursing homes. Latest CMS guidance indicates, staff who are fully vaccinated need not be routinely tested. Please refer to the amended CMS guidance document to learn more about testing requirements for unvaccinated staff.

    If the adverse event occurs while the pharmacy team is on site, then they will report the adverse event to VAERS.  If it occurs after the pharmacy team has left, then the facility should report the event to VAERS.  Both the pharmacy and the LTCF facility can report adverse events to VAERS; there is no double reporting jeopardy in the VAERS system. Information about how to report to VAERS can be found here. FAQs about VAERS reporting can be found here.

    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.

    Please refer to the LTCF vaccine toolkit. The facilities can refer to this document when they need access to additional COVID-19 vaccine.

    Vaccination: Employers

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

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

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

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

    Inform employees about the high rates of efficacy these vaccines provide. Against the initial strains of the COVID-19 virus, the Moderna vaccines provide 94 percent efficacy, while the Pfizer-BioNTech vaccines provide 95 percent. Johnson & Johnson’s Janssen COVID-19 vaccine requires one dose and provides 66.3 percent efficacy.  Also, make sure your employees know about the significant government oversight ensuring all approved COVID-19 vaccinations are as safe as possible. Remind your staff that millions of people have already been vaccinated across the nation. 

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

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

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

    Yes. 

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

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

    Yes. If you are able to offer vaccination at your workplace, consider providing vaccinations to all eligible individuals, regardless of their status as a contract or temporary employee. What is most important is to encourage everyone at the work site to be vaccinated, no matter what their work arrangement is. The Centers for Disease Control and Prevention (CDC) has also provided guidance for employers on how to include contractors and temporary employees in a workplace vaccination plan.

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

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

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

    Yes. Side effects can be reported with the v-Safe app that can be downloaded onto their phone. V-Safe will notify them when they are due for their second dose, if they have not received it already. V-safe cannot schedule COVID-19 vaccination appointments.

    Yes. The COVID-19 vaccines can still benefit someone who has been sick and has recovered from COVID-19 by strengthening their immunity against reinfection. Scientists are still determining how long protection lasts after getting infected with COVID-19 so getting the vaccine is another layer of protection for those whose natural immunity might have worn off.  People who currently have COVID-19 should wait to get a COVID-19 vaccine until their isolation period is over (until they are no longer infectious to others) and their symptoms have resolved. Individuals who are having long-term effects after COVID-19 should discuss COVID-19 vaccination with their healthcare provider. 

    While there is otherwise no recommended minimum interval between infection and vaccination, current evidence suggests that reinfection is uncommon in the months after initial infection. 

    People who were treated for COVID-19 with monoclonal antibodies or convalescent plasma should wait 90 days before getting a COVID-19 vaccine. 

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

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

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

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

    Employers are required to comply with the standards for as long as they are in effect, regardless of if all or some of their employees have been vaccinated. This is also the case for the requirements outlined by the Governor’s applicable Executive Orders. Within 14 days of the expiration of the Governor’s COVID-19 State of Emergency and Commissioner of Health’s COVID-19 Declaration of Public Emergency, the Safety and Health Codes Board will conduct a meeting to determine whether there is a continued need for the standard.

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

    However, even fully vaccinated employees may still be required to wear masks at work because businesses in Virginia can require masks in their establishments if they choose to.

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

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

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

    Employers must continue to comply with the requirements outlined in Governor Northam’s Forward Virginia Plan and applicable Executive Orders, regardless of if all or some of their employees have been vaccinated.

    Vaccination: Children

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

    It is recommended that you check with the facility that is offering the vaccination about requirements for proof of age.

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

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

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

    No, there is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems—problems trying to get pregnant. Like with all vaccines, scientists are studying COVID-19 vaccines carefully for side effects now and will report findings as they become available.

    No, there is no reason to believe that the COVID-19 vaccines will affect your child’s growth and development- including puberty, fertility, or brain development. 

    The risk of children getting severely ill from COVID-19 is low, but it is not zero. Children who have COVID-19 have a risk of becoming sick, hospitalized, or in some cases, dying. Children may also develop long term illness, such as multisystem inflammatory syndrome in children (MIS-C) or long COVID. Long COVID is when individuals develop symptoms such as fatigue, chest pain, headaches, or shortness of breath that last for weeks or months, and may not appear until several weeks after infection. In contrast, the vaccine has been proven to be safe and effective in children ages 12 years and up. 

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

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

    Vaccination: People with Weakened Immune Systems

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

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

    People with weakened immune systems can also sometimes stay ill with – and can spread - COVID-19 for prolonged periods, thereby increasing the risk of exposing others to the virus. 

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

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

    For a few immunocompromised people, the timing of their vaccination becomes more important as a result of their condition. Please discuss specific concerns with your healthcare provider. 

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

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

    The Leukemia and Lymphoma Society has released FAQs here. 

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

    Because their immune system may be weaker than normal, these individuals may have a weaker immune response to the vaccine and may thus be less protected against COVID-19 infection. People with such conditions should discuss COVID-19 vaccine with their doctor. 

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

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

    Even after being fully vaccinated with COVID-19 vaccine, people with weakened immune systems should continue masking, distancing, avoiding crowds, avoiding poorly ventilated indoor spaces and careful handwashing.

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

    Probably not. For a couple of reasons, the CDC and others do not recommend routine serology testing to document the immune response after vaccination of people with weakened immunity.

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

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

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

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

    Page last updated: June 3, 2021