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Note: This information is based on currently available evidence, resources, information, emergency use authorization, and expert opinion, and is subject to change.
Vaccination: How To Get the COVID-19 Vaccine
Where can I get a COVID-19 vaccination? (Last reviewed 3/6/23)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.
The website includes a simple address search to help you find the most convenient ways to get vaccinated.
The call center is available Monday through Friday, from 8 a.m. to 5 p.m ET. 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.
For individuals with access and functional Needs, you can reach the call center via Virginia Relay, including by TTY, by dialing 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.
Is photo identification required for COVID-19 vaccination? (Last reviewed 2/27/23)No, government-issued photo identification is not required for vaccination. It is important however, to have some way to confirm your or your child's identity (i.e. name, date of birth) so we can confirm that we are vaccinating the right person.
Where can I find data on the COVID-19 vaccines used in Virginia? (Last reviewed 2/27/23)VDH maintains a COVID-19 Vaccine Summary dashboard with demographic information also available.
Why am I being asked for my insurance information if the COVID-19 vaccine is free? (Last reviewed 2/27/23)The COVID-19 vaccine “must be provided to vaccine recipients with no out-of-pocket costs,” according to the U.S. Department of Health and Human Services (HHS). While the federal government is picking up the cost of the vaccine doses people across the country are getting, some healthcare providers and clinics can get paid for administering the vaccines. For those people with health insurance, this cost is typically billed to the insurance company. Even if you do not have health insurance, you can still get a COVID-19 vaccine for free.
How do I or my eligible children get the vaccine if we are disabled? (Last reviewed 2/27/23)All COVID-19 vaccination sites in Virginia are ADA-compliant. If you need special accommodations when going to get your or your child’s vaccination, please reach out to your local health department. To schedule an appointment for the COVID-19 vaccine visit vaccinate.virginia.gov/ or call 1-877-VAX-IN VA (1-877-829-4682) Monday through Friday from 8:00 am - 5:00 pm ET.
You can also utilize the Disability Information and Access Line (DIAL). For additional information about DIAL, visit acl.gov/dial. You can contact DIAL at 888-677-1199 Monday-Friday from 9 a.m. to 8 p.m. (Eastern) or email DIAL@n4a.org.
Vaccination: Why Get Vaccinated Against COVID-19
Why should we get vaccinated against COVID-19? (Last reviewed 2/28/23)It is difficult to predict the course of the COVID-19 pandemic. There is always a risk of a future resurgence with new variants or subvariants of COVID-19.
There’s no way to know ahead of time how getting COVID-19 disease could affect you. For example, we still don’t know why some healthy but unvaccinated people become seriously ill or die from COVID-19, while other healthy people only become mildly sick. In addition, people with mild or even asymptomatic disease can also develop and continue suffering from Long COVID. However, once vaccinated, your body will start building immunity to the virus so you are less likely to get infected, less likely to get seriously ill, less likely to transmit COVID-19 to others, and less likely to get Long COVID. Staying up to date with regard to COVID-19 vaccination, especially with the new bilateral COVID-19 booster will reduce your chances of getting COVID-19 disease and will make it more likely that even if you do get the virus, you will have only mild symptoms or none at all. For 2021 and 2020, COVID-19 was the third leading cause of death after heart disease and cancer.
All available COVID-19 vaccines are highly effective, including among children 5 years and older, for preventing serious illness, hospitalization, and death. Based on results of antibody studies, we expect the same to be true for children 6 months to five years old.
Can Long COVID be prevented or treated by COVID-19 vaccination? (Last reviewed 2/27/23)Both older and more recent studies suggest that the risk of developing “Long COVID” after vaccine breakthrough infections is much lower than in unvaccinated people who get COVID-19.
In addition, some people who already had Long COVID after an earlier infection noted an improvement of their symptoms after they received COVID-19 vaccine. The potential benefits of COVID-19 vaccines on Long COVID are now being studied carefully and results will hopefully be available soon.
More information on Long COVID and other long-term effects of SARS-CoV-2 infection and COVID-19 illness can be found on the CDC webpage.
How do I learn more about COVID-19 vaccines if I speak a different language? (Last reviewed 2/8/23)At the top of all VDH web pages is a Google Translate button that says 'Select Language.' Clicking on this button translates web page content into 100+ different languages immediately. From there, you can go to the main page at: https://www.vdh.virginia.gov/covid-19-vaccine/ where you can learn more about COVID-19 vaccines.
The vdh.virginia.gov website is providing the “Google Translate” option to assist you in reading the vdh.virginia.gov website in languages other than English. Google Translate cannot translate all types of documents, and may not provide an exact translation.
¿Cómo puedo obtener más información sobre las vacunas contra COVID-19 si hablo un idioma diferente? (Última actualización 2/8/23)En la parte superior de todas las páginas web de VDH, hay un botón del Traductor de Google que dice 'Select Language.' (Seleccionar idioma). Al hacer clic en este botón, el contenido de la página web se traduce inmediatamente a más de 100 idiomas diferentes. Desde allí, puede ir a la página principal en: https://www.vdh.virginia.gov/covid-19-vaccine/ donde puede obtener más información sobre las vacunas contra COVID-19.
El sitio web vdh.virginia.gov ofrece la opción "Traductor de Google" para ayudarlo a leer el sitio web de vdh.virginia.gov en otros idiomas además de inglés. Google Translate no puede traducir todos los tipos de documentos y es posible que no proporcione una traducción exacta.
. كيف يمكنني معرفة المزيد عن لقاحات COVID-19 إذا كنت أتحدث لغة مختلفة؟ (آخر تحديث 18/3/21)في الجزء العلوي من جميع صفحات موقع الويب الخاص بـ VDH، يوجد زر "تحديد اللغة" لترجمة جوجل "Google Translate"، يؤدي النقر على هذا الزر إلى ترجمة محتوى صفحة الويب على الفور إلى أكثر من 100 لغة مختلفة. من هناك، يمكنك الانتقال إلى الصفحة الرئيسية على: /https://www.vdh.virginia.gov/covid-19-vaccine حيث يمكنك معرفة المزيد عن لقاحات COVID-19.
يقدم موقع vdh.virginia.gov خيار ترجمة جوجل أو "Google Translate" لمساعدتكم على تصفح موقع vdh.virginia.gov بلغات أخرى غير الإنجليزية. لا يمكن لـ Google Translate ترجمة جميع أنواع المستندات، وقد لا توفر ترجمة دقيقة.
다른 언어를 사용하는 경우 COVID-19 백신에 대해 자세히 알아보려면 어떻게 해야 합니까? (최신 업데이트 21년 3월 18일)모든 VDH 웹 페이지의 상단에 '언어 선택(Select Language)'이라는 Google 번역 버튼이 있습니다.' 이 버튼을 클릭하면 즉시 웹 페이지 콘텐츠가 100가지 이상의 다른 언어로 변환됩니다. 거기에서 https://www.vdh.virginia.gov/covid-19-vaccine/의 메인 페이지로 이동합니다. 그곳에서 COVID-19 백신에 대해 자세히 확인하실 수 있습니다.
vdh.virginia.gov 웹사이트가 제공하는 "구글 번역(Google Translate)" 옵션을 통해 vdh.virginia.gov 웹사이트를 영어 이외의 언어로 읽을 수 있는 도움을 받을 수 있습니다. 구글 번역(Google Translate)은 모든 유형의 문서를 번역 할 수 없으며 정확한 번역을 제공하지 않을 수 있습니다.
Paano ko malalaman ang higit pa tungkol sa mga bakuna ng COVID-19 kung magsasalita ako ng ibang lahi? (Huling binago noong 3/18/21)Sa kabuuan ng lahat ng mga web page ng VDH, may Google Translate button na nagsasabing 'Piliin ang Wika.' Ang pag-click sa button na ito ay nagsasalin ng content ng web page sa 100+ na iba't ibang wika agad. Mula rito, maaari kang magpunta sa main page sa: https://www.vdh.virginia.gov/covid-19-vaccine/ kung saan matututunan mo ang tungkol sa mga bakuna ng COVID-19.
Ang website ngvdh.virginia.gov ay ibinibigay ang “Google Translate” na opsyon para alalayan ka sa pagbabasa sa website ng vdh.virginia.gov sa iba pang wika maliban sa Ingles. Ang Google Translate ay hindi kayang isalin ang lahat ng uri ng mga dokumento, at maaaring hindi makapagbigay ng eksaktong pagsasalin.
如果我说的是另一种语言,如何了解有关新冠(COVID-19)疫苗的更多信息?(最后更新日期:2021 年 3 月 18 日)在任何 VDH 网页的顶部,都有一个 Google 翻译按钮,上面写着“选择语言”。点击此按钮即可将网页内容翻译成 100 多种不同的语言。您可以从翻译页面转到 COVID-19 疫苗主页:https://www.vdh.virginia.gov/covid-19-vaccine/,进一步了解有关 COVID-19 疫苗的更多信息。
vdh.virginia.gov网站提供"谷歌翻译"选项,以帮助您阅读vdh.virginia.gov网站上非英语语言的内容。Google翻译无法翻译所有类型的文档,也可能无法提供准确的翻译。
Vaccination: Vaccine Development + Safety
How was the safety and efficacy of the updated (bivalent) COVID-19 boosters tested? (Last updated 2/27/23)The updated COVID-19 vaccines are also called “bivalent” boosters because they are made from two different variants of the SARS-CoV-2 virus that causes COVID-19.
The safety of the bivalent Moderna and Pfizer booster doses was shown using data from human clinical trials using Omicron BA.1 bivalent vaccines. The BA.1 bivalent vaccine side effects were similar to side effects seen after the primary series and original booster doses. No new safety concerns were identified.
The efficacy of the bivalent Moderna and Pfizer booster doses was shown by meeting pre-specified immunogenicity objectives in terms of serum antibody levels.
Clinical trials are currently underway for the bivalent BA.4/BA.5 Moderna and Pfizer-BioNTech COVID-19 Vaccines.
On November 4, Pfizer and BioNTech announced updated clinical data for their Omicron BA.4/BA.5-adapted bivalent booster, showing substantially higher immune response in adults compared to the original COVID-19 vaccine.
- The bivalent booster produced about 4-fold higher antibody titers against Omicron BA.4/BA.5 sublineages compared to the original COVID-19 vaccine in individuals older than 55 years of age.
- A month after getting a bivalent booster dose, Omicron BA.4/BA.5 antibody titers increased 13.2-fold from pre-booster levels in adults older than 55 years of age and 9.5-fold in adults 18 to 55 years of age, compared to a 2.9-fold increase in adults older than 55 years or age who received the original booster vaccine.
- Safety and side effects of the bivalent booster remain similar to the original COVID-19 vaccine.
In November 2023, Moderna announced that both of its bivalent booster vaccines against Omicron variants (one that targets BA.1 and the other targeting BA.4/5) produce a better antibody response than its original vaccine when used as a booster.
- In a Phase 2/3 study, a booster dose of bivalent vaccine produced high antibody response against Omicron BA.4/BA.5 variants when compared to the same dose of monovalent booster in 511 participants who had previously been vaccinated and boosted.
- Both bivalent vaccines also showed robust neutralizing activity against Omicron subvariant BQ.1.1.
- The frequency of side effects with the bivalent boosters were similar to or lower than that of either a second or third dose of the original vaccine.
- No new safety concerns were identified after three months of follow-up.
What is mRNA, and how does it work to provide protection? (Last reviewed 3/2/23)mRNA stands for messenger ribonucleic acid.
The COVID-19 vaccines from Pfizer-BioNTech and Moderna use mRNA to cause a two-stage immune response. First, the vaccines’ mRNA teaches your cells to make a specific non-infectious COVID-19 protein. Then this new protein stimulates your immune system to respond against COVID-19. That immune response produces antibodies and other forms of immunity that help keep you from becoming infected if you are later exposed to COVID-19.
The mRNA in the COVID-19 vaccines does NOT get into the nucleus of your cells or put germs into your body. These two mRNA COVID-19 vaccines will not change your DNA or your body’s other genetic material in any way.These mRNA COVID-19 vaccines do not inject spike proteins into your body.
Additional information about the development of mRNA vaccines is available.
What is the current status of the Johnson and Johnson (Janssen) viral vector COVID-19 vaccine? (Last reviewed 2/27/23)The FDA has limited the use of the J&J COVID-19 vaccine due to safety issues. The J&J COVID-19 vaccine should only be given to individuals 18 years and older for whom mRNA COVID-19 vaccines are not accessible or clinically appropriate and who would otherwise not receive a vaccine. People who are starting their vaccine series should get either Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines or the new non-mRNA Novavax COVID-19 vaccine. People who are getting a booster dose should get the bivalent version of either the Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines.
What is known about the recently available Novavax COVID-19 vaccine? (Last reviewed 3/6/23)The Novavax COVID-19 vaccine is a standard “adjuvanted” protein (and non-mRNA) COVID-19 vaccine that has been in development for more than a year. This vaccine uses a more traditional approach, by injecting the spike proteins of the coronavirus, stimulating the immune system to respond directly to those proteins. Its primary vaccination series includes two doses intended to be given from 3-8 weeks apart to people 12 years and older. Each dose also includes an “adjuvant,” a substance that amplifies the immune system’s response to the vaccine. Adjuvants have already been in use for many years in a number of U.S. vaccines such as hepatitis A, hepatitis B, and TDaP (tetanus, diphtheria and pertussis / whooping cough).
Preliminary Novavax clinical trial data indicate an overall 90% effectiveness in preventing infection with pre-Omicron variants of SARS-CoV-2 (including 79% effectiveness in people 65 years and older) and near 100% overall effectiveness in preventing moderate-to-severe COVID-19 disease, hospitalization, and death.
What is an FDA Emergency Use Authorization (EUA) for a vaccine? (Last reviewed 3/6/23)An EUA is an “Emergency Use Authorization,” a process in the FDA that allows a vaccine company or drug company to apply for emergency use of a COVID-19 vaccine (or COVID-19 treatment drug or a COVID-19 test) with only a limited amount of effectiveness and safety data. This temporary emergency limit means that the vaccine can become available for use in an emergency like the current COVID-19 pandemic more quickly than the usual approval and licensing process would allow.
However, before it allows an EUA, the FDA and its outside advisory group must decide that the known and possible benefits of the proposed vaccine outweigh the risks of authorizing its use.
Information describing a COVID-19 vaccine’s path from initial research to an EUA - and eventually to a biological license application (BLA) - can be found on the FDA’s website.
How is a vaccine’s full FDA approval and licensing different from an FDA Emergency Use Authorization (EUA)? (Last reviewed 3/6/23)The FDA’s full approval for a vaccine requires the agency’s standard and rigorous process for reviewing medical products, including vaccines, drugs, test kits, and other medical devices. That review process for a vaccine relies upon the manufacturer’s submission of a Biologics License Application (BLA), a comprehensive submission that is submitted to the agency and that must meet very specific requirements.
For COVID-19 vaccines, a BLA uses the early information that previously supported the EUA, such as preclinical and clinical data, as well as details of the manufacturing process. However, to ensure the safety of vaccines, the BLA generally requires a far longer period of time for observing and examining both vaccine safety and vaccine effectiveness. This BLA review is among the most comprehensive medical product reviews in the world. It involves the FDA and its external advisory committee conducting their own analyses of the information in the BLA. FDA will also again inspect the facilities that are involved in the manufacturing of the product.
The FDA has now fully approved the Pfizer- BioNTech vaccine which is being marketed as Comirnaty, for use in those at least 16 years old. In addition, the FDA has fully approved the Moderna vaccine, which is being marketed as Spikevax, for use in those at least 18 years old.
Full approval by the FDA also means the vaccine can also be used in non-emergency settings.
Where can I find information on the Pfizer- BioNTech COVID-19 vaccine? (Last reviewed 3/6/23)Information on the Pfizer-BioNTech COVID-19 Vaccine is available on the CDC website.
A complete list of this vaccine’s ingredients can be found in the fact sheet.
Type of vaccine: mRNA
How given: injections in the muscle of the upper arm
This vaccine does not contain: eggs, preservatives, gelatin, or latex
The Pfizer-BioNTech vaccine is recommended for people aged 6 months and older.
Where can I find information about the Moderna COVID-19 vaccine? (Last reviewed 3/6/23)Information on the Moderna COVID-19 Vaccine can be found on the CDC website.
A complete list of this vaccine’s ingredients can be found in the fact sheet.
Type of vaccine: mRNA
How given: Injection in the muscle of the upper arm
This vaccine does not contain: eggs, preservatives, gelatin, or latex
The Moderna COVID-19 vaccine is recommended for people aged 6 months and older.
Where can I find information about the Johnson & Johnson (also known as J&J and Janssen Biotech) COVID-19 vaccine? (Last reviewed 3/6/23)Information on the Janssen COVID-19 Vaccine can be found on the CDC website. (Last updated May 5, 2022)
A complete list of this vaccine’s ingredients can be found in the fact sheet.
Type of vaccine: adenoviral vector for spike protein
How given: Injection in the muscle of the upper arm
This vaccine does not contain: eggs, preservatives, gelatin, or latex
The Johnson & Johnson (also known as Janssen Biotech) COVID-19 vaccine is recommended for people aged 18 years and older.
The FDA has limited the use of the J&J COVID-19 vaccine due to safety issues. The J&J COVID-19 vaccine should only be given to individuals 18 years and older whom mRNA COVID-19 vaccines are not accessible or clinically appropriate and/or who would otherwise not receive a vaccine. Please see the Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety page for more information.
Where can I find information about the Novavax COVID-19 vaccine? (Last reviewed 2/8/23)Information on the Novavax COVID-19 vaccine can be found on the CDC website.
A complete list of this vaccine’s ingredients can be found in the fact sheet.
Type of vaccine: protein vaccine with adjuvant (also known as “adjuvanted protein” vaccine)
The Novavax COVID-19 vaccine does not contain: eggs, preservatives, gelatin, or latex.
How given: upper arm muscle
Age range: 12 years and older
Can I get another vaccine at the same time as getting a COVID-19 shot? (Last reviewed 2/28/23)Yes. COVID-19 vaccines and other vaccines may be administered to all age groups without regard to timing. This includes getting a COVID-19 vaccine and other vaccines on the same day, as well as co-administration within 14 days. This includes the Flu, Pneumococcal, Tdap, orthopox (Mpox), and Shingles vaccine.
Should pregnant or breast-feeding individuals get a COVID-19 vaccine? (Last reviewed 2/28/23)Yes. Getting COVID-19 vaccine during pregnancy can protect you and your fetus and infant from severe illness from COVID-19.
Currently and recently pregnant people are more likely than non-pregnant people to get severely ill if they get COVID-19. Pregnant women with some underlying health conditions, such as diabetes or obesity, are at even greater risk. Having COVID-19 disease while pregnant has been associated with stillbirths, preterm birth, low birth weight babies, and other adverse outcomes of pregnancy. A study showed that infants whose mothers received two doses of COVID-19 vaccine during pregnancy were 61% less likely to be hospitalized in their first six months of life compared to infants of unvaccinated mothers.
The CDC, VDH, the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal Fetal Medicine (SMFM) all recommend that pregnant or breast-feeding women or other women who intend to get pregnant and who otherwise are eligible for COVID-19 vaccination should be COVID-19 vaccinated and then stay up to date with vaccination. The most recently updated ACOG recommendations are available and a joint message about COVID-19 vaccination from ACOG and SMFM is also available.
CDC and the Food and Drug Administration (FDA) have several vaccine safety monitoring systems in place to collect and study information about vaccination during pregnancy and continue to closely monitor that information. Results from CDC’s v-safe voluntary after-vaccination health check system, with public data that is updated weekly, show that a large number of women who received COVID-19 vaccines have had pregnancies, with no vaccine-specific safety issues identified.
In addition, CDC has established a specific v-safe COVID-19 Vaccine Pregnancy Registry to learn more about these issues and initial data from this registry show similar vaccine side effects for pregnant and non-pregnant individuals. The most up to date numbers are available.
How is COVID-19 vaccine safety being monitored? (Last reviewed 2/8/23)The safety monitoring of COVID-19 vaccines has been described as “the most comprehensive of any vaccine in US history.”
CDC and FDA continuously monitor the safety of vaccines.These agencies use at least five different systems to monitor vaccine safety:
- The Vaccine Adverse Event Reporting System (VAERS): VAERS is an early warning system that helps CDC and FDA identify potential problems following vaccination. Anyone can and should report possible vaccine side effects to VAERS. However, most of the VAERS monitoring is done by U.S. healthcare providers providing anonymous data from hundreds of millions of patients being vaccinated. This system alerts the CDC and FDA if healthcare systems begin reporting unusual patterns of adverse effect information about events that occur after vaccinations.
NOTE: every healthcare provider who administers COVID-19 vaccines is required to report all serious health events occurring soon after vaccination to the VAERS system even if it seems clear that the death was not related to the vaccine. VAERS is therefore set up as an early warning system to collect as much data as possible about any and all events that may or may not turn out to be side effects of vaccines. Those data are then examined closely to verify the events and to identify any clusters or groups of unexpected serious or severe post-vaccine events. Because the data submitted to - and made publicly available by - VAERS has not yet been verified, the VAERS system clearly cannot determine whether a vaccine caused any specific side effect. VAERS is NOT - and is NOT INTENDED TO BE - a reliable source of information on vaccine side effects. Therefore, drawing conclusions from these publicly available but unverified VAERS screening data alone without the follow-up investigations is scientifically and ethically inappropriate because it is likely to lead to erroneous conclusions.
A description of how VAERS works is available.
- The Vaccine Safety Datalink (VSD): a collaboration between CDC and nine health care organizations around the United States, which allows ongoing monitoring and proactive searches of vaccine-related data.
- The Clinical Immunization Safety Assessment (CISA) Project: a partnership between CDC and several medical centers that conducts clinical research on vaccine-associated health risks.
- V-safe is a cell phone-based CDC system that individual COVID-19 vaccine recipients can use to notify CDC if they develop any side effects. Each vaccinated person should download a v-safe app onto their cell phone as soon as they receive the vaccine. Instructions on how to download and use v-safe will be given out when you get the vaccine. v-safe will also remind you about getting your second vaccine dose.
Additional vaccine safety monitoring systems, such as the use of National Healthcare Safety Network (NHSN) data, and continued monitoring through clinical trials are also utilized to ensure the safety of COVID-19 vaccines.
What is known about deaths that are reported to occur after COVID-19 vaccination? (Last reviewed 3/7/23)FDA REQUIRES EVERY VACCINE PROVIDER to report EVERY death that occurs after a COVID-19 vaccination to the VAERS reporting system. These death reports by vaccine providers are REQUIRED even if it seems clear that the death was not related to the vaccine. The details of every death are investigated by CDC and FDA staff as soon as possible after these are reported.
Given the absolute requirement to report EVERY death in a vaccine recipient, regardless of its apparent cause, reports of deaths and other adverse events to VAERS following vaccination can not be interpreted to mean that a vaccine caused these problems. In fact, drawing ANY conclusions from the numbers of reported but unverified deaths in the VAERS system is scientifically inappropriate.
COVID-19 vaccines are being given to hundreds of millions of people in the United States. Many COVID-19 vaccine recipients have pre-existing illnesses or are elderly and frail and are thus already at higher risk of death whether or not they get vaccinated. Therefore, a small percentage of people receiving COVID-19 vaccine are likely to die from natural causes soon after being vaccinated. As discussed in the article, “VAERS data must be interpreted with caution due to the inherent limitations of passive surveillance. VAERS is primarily a safety signal detection and hypothesis generating system. Generally, VAERS data cannot be used to determine if a vaccine caused an adverse event. VAERS data interpreted alone or out of context will lead to erroneous conclusions about cause and effect as well as the risk of adverse events occurring following vaccination.”
Every death that occurs after COVID-19 vaccination is investigated. With a single exception, an ongoing review of available clinical information, including death certificates, autopsy, and medical records, has not established any causal link between any of these deaths and COVID-19 vaccines.
NOTE: The single exception noted is that reports have indicated a plausible causal relationship between the J&J/Janssen COVID-19 Vaccine and TTS, a rare and serious adverse event—blood clots with a low platelet count—which has caused less than a dozen deaths. Get the latest safety information on the J&J/Janssen vaccine here.
Additional information on investigation of deaths reported after COVID-19 vaccination can be found on the CDC website.
Vaccination: Side Effects and Adverse Events After COVID-19 Vaccine
What are common short term side effects of the current COVID-19 vaccines (including the bivalent boosters)? (Last reviewed 3/7/23)Short term vaccine side effects fall into one of three categories:
(1) Local reactions, at or near the injection site
(2) Systemic reactions (such as fever, chills, headache, or muscle aches)
(3) Allergic reactions
This FAQ response addresses the local and systemic side effects. Allergic side effects are addressed in a later question and response. Although COVID-19 vaccination will help protect you from getting COVID-19 disease, you may have some short term local or systemic side effects from the vaccination, which are normal signs that your body is building protection against COVID-19.
Some vaccinated adults and children have had local reactions such as pain, redness, or tenderness at the injection site. A small number of vaccine recipients have had transient systemic side effects such as fatigue, nausea, chills, fever, headache or other body aches for a few days. These local or systemic side effects do NOT mean that the vaccine has given you a COVID-19 infection. Rather, these expected side effects mean that the vaccine is causing your body’s immune system to react and create antibodies to fight off the virus that causes COVID-19 if you are exposed in the future.
Some vaccine recipients have experienced swollen glands (lymph nodes). For the two mRNA vaccines, these expected side effects are more common in younger people than older people and are more common after the second dose than after the first dose.
Less commonly, a few people have reported redness, swelling, and itching around the injection site beginning a few days or in the second week after their first vaccine dose. However, these local reactions are not considered to be allergic reactions and are not a risk for anaphylaxis when getting a second dose. Individuals with such delayed injection site reactions after the first mRNA COVID-19 vaccine dose should get 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 is available about these uncommon “COVID arm” reactions.
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 or three-dose COVID-19 vaccine series is also not a reason to avoid the second dose or any later booster doses when eligible.
For young children, the side effects seen after vaccination were similar to those seen in older children.
Finally, even if you or your child experience one or more of these expected short term side effects after the first dose of mRNA COVID-19 vaccine, it is very important that you still receive the second primary series dose a few weeks later - as well as all recommended booster doses - for the vaccination process to be effective.
What should I do if I or any of my vaccinated children get any of these common COVID-19 vaccine reactions? Are there medicines we can take to prevent or minimize any of these side effects? (Last reviewed 2/27/23)Some of the expected side effects could interfere with your - or your child’s - ability to do daily activities, but they should go away in a few days.
Age appropriate medicines such as acetaminophen, ibuprofen, or naproxen or other medicines called “non-steroidal anti-inflammatory drugs” (NSAIDS) can help with the common side effects (for example, arm pain or fever) after those side effects start to occur. However, these drugs should not be taken before your COVID-19 vaccine doses since information on their possible impact on the body's ability to create immunity to COVID-19 infection is not yet available.
If you or your child have persistent injection site pain, short term fever, or other discomfort, talk to your healthcare provider about taking one of these over-the-counter medicines.
To reduce pain and discomfort where you or your child got the shot:
- Apply a clean, cool, wet washcloth over the area and use or exercise the arm.
To reduce discomfort from fever, dress lightly, and drink plenty of fluids.
When to call the doctor:
In most cases, discomfort from arm pain or swelling where you or your child got the shot or from fever, headache, fatigue, etc., will not last more than a few days after a COVID-19 vaccine dose. Contact your doctor or healthcare provider:
- If the redness or tenderness where you got the shot increases after 24 hours
- If your side effects are worrying you or do not seem to be going away after a few days
Remember to sign yourself and your vaccinated child up for v-safe, where you can use your smartphone to tell CDC about any side effects after getting the COVID-19 vaccine. You’ll also get reminders from V-Safe about your second vaccine dose.
Side effects or adverse events can be reported to CDC either in v-safe or VAERS.
How can I find out about serious adverse events reported after COVID-19 vaccinations? (Last reviewed 3/8/23)Information on possible vaccine adverse events (side effects) continues to be collected and studied by CDC, FDA, and other groups, using multiple systems to collect the data.
One serious but rare adverse effect that has been identified is a blood clotting problem that has occurred in a very small number of people vaccinated with the Johnson & Johnson (J&J) (Janssen) vaccine. It occurs at a rate of less than four (4) cases per million Janssen vaccine doses and has resulted in a small number of deaths. When that problem was first noted in early April 2021, use of that vaccine was stopped while it was further studied. After deciding that the vaccine’s known and potential COVID-19 prevention benefits outweighed its known and potential risks, the FDA and CDC recommended resuming its use in the United States.
However, because of a later risk-benefit analysis of post-vaccination blood clotting disorders, the FDA has now limited the use of the J&J COVID-19 vaccine to individuals 18 years and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate and who would otherwise not receive a COVID-19 vaccine. For more information, visit Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety.
To date, very few blood clotting problems in people who received an mRNA COVID-19 vaccination (Moderna or Pfizer) have been reported to VAERS. Based on available data, this number is not greater than the background rate of this problem and there is not an increased risk of this kind of problem after mRNA COVID-19 vaccination.
There have been rare reports of myocarditis or pericarditis among people ages 30 and younger who received COVID-19 vaccine. Most patients responded well to rest and quickly recovered. More information on this topic can be found on CDC’s Myocarditis and Pericarditis After mRNA COVID-19 Vaccination webpage.
CDC and FDA are monitoring reports of Guillain-Barré Syndrome (GBS) in people who have received the J&J/Janssen COVID-19 Vaccine. GBS is a rare disorder where the body’s immune system damages nerve cells, causing muscle weakness and sometimes paralysis. Most people fully recover from GBS, but some have permanent nerve damage. These cases have largely been reported about 2 weeks after vaccination and mostly in men, many 50 years and older.
Given the ongoing risk of serious complications, hospitalizations, and even deaths (including deaths of children) from COVID-19 illness, and given the rarity of serious adverse effects, CDC and VDH continue to strongly recommend being up to date, including with the bivalent COVID-19 vaccine booster, on COVID-19 vaccination.
For additional information about rare, but serious side effects, visit the CDC page at Selected Adverse Events Reported after COVID-19 Vaccination.
Is COVID-19 vaccine likely to have an important impact on reproduction? (Last reviewed 2/27/23)No. Significant effects on reproduction have NOT been seen and are unlikely to occur after COVID-19 vaccination.
Sometimes people who are concerned about vaccines or vaccination raise a wide range of various reproduction and fertility questions as part of their concerns.
First, there is no genetic material in any of the current COVID-19 vaccines so there is no risk of a COVID-19 vaccine changing the DNA of any vaccine recipient or that person’s children.
Studies have been published about temporary post-vaccination changes in women’s menstrual cycles. However, short-term changes in menstrual cycles can occur associated with almost any stress, infection, weight changes, dietary changes (including a diet high in soy), excess exercise, or sleep problems. A review of the vaccine-menstrual cycle study data and a summary of the overall vaccine-menstrual cycle question are both available. None of these studies suggested any impact on fertility and, not surprisingly, similar reports about changes in duration and flow of menstrual cycles have been noted after COVID-19 illness.
Also, people now using hormonal birth control (pills, patch, ring, implant, etc.) can receive any of the current COVID-19 vaccines.
One recent study found no increase in the risk of miscarriages in the pregnancies of fully vaccinated women.
As noted elsewhere, there is no reason to withhold COVID 19 vaccine from women who are intending to get pregnant, are currently pregnant, are post-partum, and/or are breastfeeding. Getting a COVID-19 vaccine prior to or during pregnancy can protect you, your fetus, and your infant from severe COVID-19 illness.
In summary, no negative fertility effects have been found for any current U.S. COVID-19 vaccine and there is no biologic reason to suspect that COVID-19 vaccines might have an effect on female or male fertility.
A review of the safety of COVID-19 vaccines in terms of fertility and sexual function was published in the Scientific American magazine.
For people who are considering COVID-19 vaccination at the same time they are considering having a baby, additional useful information can be found on CDC’s COVID-19 Vaccines While Pregnant or Breastfeeding webpage.
How do I register myself or my child for V-safe? (Last reviewed 2/27/23)You will need your smartphone and information about the COVID-19 vaccine that you or your child received. This information can be found on the vaccination record card you received at the time of your vaccination; if you cannot find your vaccination record card, please contact your healthcare provider.
For instructions on how to register for v-safe, please visit the CDC’s V-safe After Vaccination Health Checker webpage.
Vaccination: Staying Up to Date with COVID-19 Vaccinations
When should I or my child get the second dose of a two-dose or three-dose primary series of a COVID-19 vaccine? (Last reviewed 2/27/23)The first two doses of Pfizer-BioNTech or Novavax vaccine should be given at least three weeks (21 days) apart and the first two doses of Moderna vaccine at least four weeks (28 days) apart. There is no maximum amount of time between doses for any of these three vaccines, but do not get following doses earlier than the recommended date.
An extended interval between doses is an option for individuals 6 months of age and older based on an individual’s risks and benefits. A longer (up to 8-week) interval may be optimal for some people, especially for males ages 12 to 39 years, to reduce the risk if side effects. However, the 21 or 28 day interval between the first and second doses remains the recommended interval for: people who are moderately to severely immunocompromised; adults ages 65 years and older; and others who need rapid protection due to increased concern about community transmission or risk of severe disease. Talk to your healthcare or vaccine provider about the timing of the second shot that is right for you or your child.
Detailed information on COVID-19 vaccination recommendations for both people with normal immune systems and for immunocompromised people is available on the CDC COVID-19 vaccination website.
For currently available COVID-19 vaccines, what is the difference between being “Up to Date” and being “fully vaccinated”? (Last reviewed 2/27/23)Being Up to Date with COVID-19 vaccination provides the best available medical protection against COVID-19 AND goes several steps beyond being fully vaccinated to include receiving the most recent booster dose recommended.
Being “fully vaccinated” only means that (1) a person has received two doses (or three doses of Pfizer vaccine at 6mo– 4yrs) of the original series of either the Pfizer-BioNTech mRNA COVID-19 vaccine OR the Moderna mRNA COVID-19 vaccine OR the Novavax COVID-19 vaccine OR that the person has received a single dose of the Johnson & Johnson (also known as Janssen) COVID-19 vaccine AND (2) that at least 14 days have passed since the last vaccine dose was received.
However, being “fully vaccinated” will NOT provide as much COVID-19 protection as being “Up to Date”. Everyone aged 5 years and older who has received their initial vaccine primary series is eligible for a bivalent vaccine booster dose. In addition, children 6 months to 5 years old who received the Moderna vaccine series should also receive an updated bivalent booster dose.
Detailed information on COVID-19 vaccination recommendations for both people with normal immune systems and for immunocompromised people is available on the CDC COVID-19 vaccination website.
Will being up to date against COVID-19 reduce the risk that we could infect others if we get infected with COVID-19? (Last reviewed 2/27/23)Yes. Although people up to date with COVID-19 vaccination who get breakthrough infections with the Omicron variant can sometimes spread COVID-19 to others, such people seem to be contagious for a shorter time than infected but unvaccinated people.
This Nature magazine article discusses the disease transmission benefits of a booster dose. After being boosted, “[people] who had received a single booster were 38% less likely to spread a Delta variant infection to their household members, and 22% less likely to pass on an Omicron variant infection than were those who had had just two shots.”
Where can I find travel guidance, for travel outside the United States? (Last reviewed 3/6/23)For airline travel to other countries, COVID-19 viral testing is sometimes required for pre-travel screening on international airline flights. Some countries are requiring proof of vaccination before allowing travelers to enter certain facilities (e.g., restaurants). Before ANY travel to other countries, you should check closely with both your airline and with the national COVID-19 testing and COVID-19 vaccination requirements of the country or countries that you will be visiting.
For airline travel from other countries to the United States, with a single exception that is specific for travel from China, Hong Kong, or Macau, CDC no longer requires any arriving passengers, including U.S. citizens. to show any proof of a negative COVID-19 viral PCR or antigen test.
However, as of Jan. 5, 2023, new requirements apply to travelers two years of age and older who are traveling from China, Hong Kong and Macau. According to CDC, “These passengers, regardless of citizenship or vaccination status, are required to show a negative COVID-19 test result taken no more than 2 days before their flight departs. Those who had COVID-19 in the 90 days before their travel to the United States can instead show documentation of recovery from COVID-19.” Special measures also apply to travelers arriving in the U.S from Vancouver, Toronto, or Seoul (South Korea) who have been in China within the 10 days prior to their U.S. arrival.
For cruise ship travel, CDC recommends that you make sure you are up to date with your COVID-19 vaccines before travel.
For additional information, please visit the VDH’s Travelers FAQs e or the CDC International Travelers’ web page.
Should I have a COVID-19 serology (antibody) test to be sure that the COVID-19 vaccine is working to protect me? (Last reviewed 2/27/23)No.
Serology (antibody) testing to confirm immunity after vaccination is not currently recommended by CDC or by VDH. One important reason is that some of the currently marketed serology test kits use a different technology than others and may not be able to detect the spike (S) protein antibodies that are the most important antibodies produced by the mRNA COVID-19 vaccination process. Using such serology blood test kits could provide a false negative test result that would not reflect your actual protection provided by the COVID-19 vaccine.
NOTE: This recommendation against routine COVID-19 serology (antibody) testing also applies to any immunocompromised people after their COVID-19 vaccination series.
Is there guidance available for people vaccinated with COVID-19 vaccines not authorized in the United States? (Last reviewed 2/27/23)Yes. CDC guidance is available and is based on the vaccine(s) received for the primary series, whether the primary series was completed, and whether a booster dose was received.
Age-appropriate Moderna, Novavax, and Pfizer-BioNTech COVID-19 vaccine products can be used in people ages 6 months and older to initiate or complete the primary series. Age-appropriate Moderna and Pfizer-BioNTech COVID-19 vaccines can be used in people ages 5 years and older for bivalent booster vaccination. Bivalent vaccines are available for eligible children aged 6 months through 5 years. See Appendix B on the CDC Interim Clinical Considerations website for details.
For a current emergency use list of WHO-Emergency Use Listing (EUL) COVID-19 vaccines, see the WHO page “COVID-19 vaccines WHO EUL issued.”
What’s the difference between a COVID-19 vaccine booster dose and an additional primary series vaccine dose? (Last reviewed 3/6/23)A vaccine booster dose is a COVID-19 vaccine dose administered to someone who initially had good protection from the primary vaccine series or from an earlier booster dose, but in whom this protection may have weakened over time. Having the most recently recommended COVID-19 vaccine booster dose ensures that you are staying up to date with vaccination. As of the review date noted above, the currently recommended booster dose is the updated bivalent Pfizer or Moderna COVID-19 vaccine booster.
Information on accessing a COVID-19 booster dose can be found at vaccinate.virginia.gov.
An additional primary series dose is an extra COVID-19 vaccine dose administered to someone with a moderately or severely weakened immune system because their initial immune response after completing the primary vaccine series may have been insufficient to provide them with strong protection.
- A 3-dose primary series is recommended for people ages 5 years and older who are moderately or severely immunocompromised at the time of vaccination. The same mRNA vaccine product should be used for all three doses of the primary series. The 3rd (additional) dose is administered at least 4 weeks after the second dose.
- For moderately or severely immunocompromised people ages 18 years and older who received a primary Janssen vaccination, a second (additional) dose using an mRNA COVID-19 vaccine is recommended at least 4 weeks later.
Those people who receive an additional dose because they are immunocompromised will also be eligible for a recommended vaccine booster dose (when they also meet the age and time requirements for a booster). As of the review date noted above, the currently recommended booster dose is the updated bivalent Pfizer-BioNTech or Moderna COVID-19 vaccine booster.
PLEASE NOTE: The FDA has limited the use of the Johnson and Johnson (J&J) COVID-19 vaccine for individuals 18 years and older whom mRNA COVID-19 vaccines are not accessible or clinically appropriate and who would otherwise not receive a COVID-19 vaccine. People who are starting their COVID-19 vaccine series should get either Pfizer or Moderna mRNA COVID-19 vaccines or should get Novavax vaccine. Booster doses should be given with the updated (bivalent) Pfizer-BioNTech or Moderna vaccine. Because of an updated risk-benefit analysis of post-vaccination blood clotting disorders, CDC recommendations now state that, in most situations, Pfizer-BioNTech, Moderna, or Novavax COVID-19 vaccines are now preferred over the Johnson and Johnson (Janssen) COVID-19 vaccine. Please see Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety.
See the CDC COVID-19 Vaccination Schedule or COVID-19 Vaccine Schedule (Immunocompromised).
Do booster dose recommendations mean that the COVID-19 vaccines are not working? (Last reviewed 2/27/23)No. All COVID-19 vaccines work well to prevent severe illness, hospitalization, and death. However, similar to the annual flu shot, COVID-19 booster shots are needed to restore protection that might have waned (decreased) since the previous vaccine dose. The current bivalent boosters are a better match for the forms of Omicron variants that are spreading recently. Therefore, CDC and VDH recommend staying up to date with COVID-19 vaccinations for maximum protection.
Do I need to show proof of prior vaccination, to get a COVID-19 booster dose in Virginia? (Last reviewed 2/27/23)No. Although a driver’s license or other sort of valid identification card will be required to establish your identity, proof of prior vaccination is not required. However, bringing your CDC vaccination card to the vaccination site will allow the booster dose to be added to your card.
Vaccination: Natural Immunity
What is hybrid immunity? (Last reviewed 2/27/23)To maximize protection from future COVID-19 infections and reinfections, you should always stay up to date with COVID-19 vaccinations.
For COVID-19, hybrid immunity is a combination of (1) the immunity from being up to date with COVID-19 vaccination plus (2) the immunity from a natural COVID-19 illness.
The hybrid immunity coming from this combination of natural infection and COVID-19 vaccination provides a higher, stronger, and more consistent level of protection from COVID-19 than either infection alone or vaccination alone. Several studies have found that people who had that combination of hybrid immunity from both COVID-19 infection AND COVID-19 vaccination had even lower disease risks than people who had immunity from only COVID-19 disease or from only COVID-19 vaccination. Recent studies that include hybrid immunity data on Omicron variants are available.
After a natural SARS-CoV-2 infection, how long can I wait to get a COVID-19 vaccine booster dose? (Last reviewed 2/27/23)You can wait up to three (3) months after a natural infection. This waiting period is based on data indicating that high levels of anti-COVID-19 antibody and protection persist at least until that point. Increased time between illness and vaccination booster appears to result in a better immune response.
Vaccination: Healthcare Providers
How should healthcare providers administering the COVID-19 vaccine report this information back to VDH? (Last reviewed 2/8/23)VDH is asking providers to report all vaccination administrations to the Virginia Immunization Information System (VIIS). These reports are very important for ensuring that there is an established reporting and data feedback loop for the COVID-19 vaccine.
I work in a doctor’s office, pharmacy, or other healthcare office. Can I administer the COVID-19 vaccine at my practice? (Last reviewed 2/8/23)Yes. Healthcare providers who are interested in providing the COVID-19 vaccine may complete a Provider Intent form on the Virginia Electronic Registration for Immunization Programs (VERIP) website. VDH staff will contact providers once they have submitted their intent form to discuss the next steps to enroll as a COVID-19 vaccine provider.
Further information specific to enrollment as a vaccine provider in Virginia and general information from CDC are available.
As a healthcare provider, how can I learn more about the vaccines and administering them? (Last reviewed 2/8/23)CDC has self-study web modules for healthcare providers that can be found at Vaccine Courses, Broadcasts, Webcasts and Self Study Training and include a general overview of COVID-19 Immunization Best Practices (15 minutes) and a set of modules on what healthcare providers need to know about each of the current COVID-19 vaccines. Each of these courses includes continuing medical education (CME) credits.
Additional resources include the CDC website “Clinical Considerations for COVID-19 Vaccination,” the CDC “COVID-19 Vaccination” homepage for healthcare professionals, and COVID-19 Vaccine Product Information.
Immunize.org provides FAQs on their “Ask the Experts” page.
The American College of Obstetricians and Gynecologists provides COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care.
The American Academy of Pediatrics provides COVID-19 Vaccine Resources and COVID-19 Frequently Asked Questions related to children.
Fact sheets for healthcare providers administering COVID-19 vaccines may be found on the FDA website:
How can healthcare providers or health departments request a consultation for a complex COVID-19 vaccine safety question? (Last reviewed 2/8/23)U.S. Healthcare providers or health departments can request a consultation from CDC’s Clinical Immunization Safety Assessment (CISA) COVIDvax project for any complex COVID-19 vaccine safety question that is (1) about an individual patient residing in the United States or vaccine safety issue and (2) not readily addressed by CDC or Advisory Committee on Immunization Practices (ACIP) guidelines.
This request can be made through CDC-INFO by:
- Calling 800-CDC-INFO (800-232-4636), or
- Submitting a request via CDC-INFO webform
For more information, visit the CDC’s Clinical Immunization Safety Assessment (CISA) Project webpage.
How should healthcare providers report vaccine administration errors? (Last reviewed 2/8/23)CDC provides information on how to address vaccine administration errors. Additional resources can be found on CDC’s vaccine administration web page.
Key points include:
- Inform the recipient of the vaccine administration error.
- Consult with the state immunization program and/or Immunization Information System (IIS) to determine how the dose should be entered into the IIS. The Virginia IIS homepage is available.
Report the error to the Vaccine Adverse Event Reporting System (VAERS). Determine how the error occurred and implement strategies to prevent it from happening again.
Do vaccine providers need to document proof of a qualifying condition before administering an additional primary dose of an mRNA vaccine? (Last reviewed 2/8/23)No. Individuals can self-attest, or self-report, that they are eligible for an additional primary dose of an mRNA vaccine (with moderate or severe immunocompromising condition). Eligible persons should be able to receive this additional primary dose wherever vaccines are offered in Virginia.
Vaccine providers should ask patients questions to confirm eligibility for vaccination, including the person’s age and previous COVID-19 vaccination history.
How will additional primary vaccine doses and booster doses be recorded? (Last reviewed 2/8/23)Vase+, VAMS and PrepMod will all have the ability to record additional doses. Both additional primary doses and first booster doses will be recorded as third doses in these systems. Both second boosters (and first boosters for certain immunocompromised individuals) will be recorded as fourth doses in these systems. Second boosters for certain immunocompromised individuals will be recorded as a fifth dose. Additional boosters, such as the bivalent booster authorized in Fall 2022, will be recorded in the same pattern.
Non-immunocompromised Individual Immunocompromised Individual Recorded in Vase+, VAMS, and PrepMod as: Primary Series #1 Primary Series #1 First Dose Primary Series #2 Primary Series #2 Second Dose Booster #1 Primary Series #3 Third Dose Booster #2 Booster #1 Fourth Dose Booster #2 Fifth Dose Vaccination: Long-Term Care Facilities
How does my long-term care facility (LTCF) obtain the bivalent vaccine? (Last reviewed 3/7/23)LTCFs are recommended to use their regular facility-pharmacy operations to acquire the COVID-19 vaccine for their residents and/or staff. LTCFs should maintain open and constant communication with their contracted pharmacy providers to discuss meeting COVID-19 vaccine needs moving forward, including boosters. If your LTCF does not have a contracted pharmacy partner, see FAQs below for how to access vaccine.
What is VDH doing to help connect LTCFs to the new bivalent vaccines? (Last reviewed 3/7/23)The VDH Pharmacy Team is working to improve access to boosters in LTC settings. The team is working to identify facilities that need assistance in securing COVID-19 bivalent boosters. Facilities that order and offer vaccination by other means should utilize their standard channels. Facilities that otherwise do not have access to COVID-19 bivalent boosters and require assistance with obtaining vaccine may reach out to COVIDPharmacySupport@vdh.virginia.gov.
Will CVS and Walgreens be offering booster vaccines to LTCFs as previously provided through the Federal pharmacy partnership program? (Last reviewed 3/7/23)The Federal pharmacy partnership program will not be reinstated by CDC for COVID-19 booster assistance. However, CDC has partnered with various pharmacies to ensure LTCFs are able to access the COVID-19 vaccine. For more information, visit the CDC pharmacy partner contact information page. If you require further assistance in coordinating boosters for your facility, please contact your local health district or email COVIDPharmacySupport@vdh.virginia.gov.
How can a LTCF access COVID-19 vaccine for their residents and staff if the facility does not have a pharmacy agreement in place? (Last reviewed 3/7/23)- Facilities are encouraged to consider enrolling as a vaccine provider to be able to order and administer vaccines to staff and residents themselves. This will allow facilities to vaccinate residents and staff in a more timely manner. For more information, visit the VDH Provider Enrollment Process Flow & Checklist.
- If enrolling as a vaccine provider is not an option, you can consider identifying a pharmacy to contract with.
- LTCFs may also submit an off-site clinic request with pharmacies who may be able to assist facilities with their vaccination needs. For more information, visit the CDC pharmacy partner contact information page.
If you require further assistance in coordinating COVID-19 vaccines for your facility, please contact your local health district or email COVIDPharmacySupport@vdh.virginia.gov.
Am I able to order and receive vaccines to administer at my facility? (Last reviewed 3/7/23)LTCFs are able to order and administer vaccines through VaxMaX if the facility is enrolled as a vaccine provider. For more information on how to enroll as a vaccine provider, visit the VDH Provider Enrollment Process Flow & Checklist.
How do I encourage my LTCF staff to get vaccinated? (Last reviewed on 3/7/23)Patient education about the COVID-19 vaccine can be found on the VDH website. These resources can be used to help educate LTCF residents and staff who remain vaccine hesitant.
Who is responsible for reporting possible vaccine-related adverse events to VAERS? The LTCF or the pharmacy who administered the vaccine? (Last reviewed 3/7/23)If the adverse event occurs while the pharmacy team is on site, then they will report the adverse event to VAERS. If it occurs after the pharmacy team has left, then the facility should report the event to VAERS. Both the pharmacy and the LTCF facility can report adverse events to VAERS; there is no double reporting jeopardy in the VAERS system. Information about how to report to VAERS can be found on their website. FAQs about VAERS reporting are also available.
- VAERS accepts reports from anyone. Patients, parents, caregivers and healthcare providers (HCP) are encouraged to report adverse events after vaccination to VAERS even if it is not clear that the vaccine caused the adverse event.
- Healthcare providers are required by law to report to VAERS:
- Any adverse event listed in the VAERS Table of Reportable Events Following Vaccination that occurs within the specified time period after vaccination
- An adverse event listed by the vaccine manufacturer as a contraindication to further doses of the vaccine
- Healthcare providers are strongly encouraged to report:
- Any adverse event that occurs after the administration of a vaccine licensed in the United States, whether or not it is clear that a vaccine caused the adverse event
- Vaccine administration errors
- Vaccine manufacturers are required to report to VAERS all adverse events that come to their attention.
Facilities should also encourage staff to report their post vaccination symptoms to v-safe. Any adverse event reported to v-safe will trigger a phone call from the VAERS team. The LTCF can also report these symptoms to the pharmacy when they come back for the second or third clinic. The EUA fact sheet shared with vaccinated individuals contains information about post vaccination adverse event reporting.
If a facility is experiencing a COVID-19 outbreak, can a planned COVID-19 or other vaccine booster clinic proceed as scheduled? (Last reviewed 3/7/23)There are multiple factors to be considered before deciding whether to conduct a vaccine clinic during an active COVID-19 outbreak.
- Individuals with active COVID-19 infection are not recommended to receive a vaccination.
- If the outbreak is under control and is restricted to one unit/area of the facility, the clinic can be conducted by following the recommendations from CDC infection prevention guidance (under “indoor visitation during an outbreak response”).
- If the facility’s current outbreak response plan includes expanding routine COVID-19 testing, it is prudent to reschedule the vaccine clinic to a later date.
- The facility should notify the booster clinic providers about the outbreak situation.
How will the VDH Office of Licensure and Certification (OLC) be surveying nursing homes with respect to the current COVID-19 vaccination up to date definition? (Last updated 3/7/23)As of 10/24/2022, the Centers for Medicare and Medicaid Services (CMS) released an update regarding the COVID-19 vaccination definition and how LTC facilities should respond to infection control.
As outlined in §483.80(i) COVID-19 Vaccination of facility staff. The facility must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID-19. For purposes of this section, staff are considered fully vaccinated if it has been 2 weeks or more since they completed a primary vaccination series for COVID-19. The completion of a primary vaccination series for COVID-19 is defined here as the administration of a single-dose vaccine, or the administration of all required doses of a multi-dose vaccine. The surveyors utilize a set of detailed guidelines outlined by CMS to complete the surveys. These guidelines have not changed and are used at each survey.
Vaccination: Children
Do minors need parental/guardian consent to receive a COVID-19 vaccine in Virginia? (Last reviewed 3/6/23)Yes. Minors (those less than 18 years old) in the Commonwealth of Virginia may not consent to their own immunizations to prevent disease. There are some exceptions to this restriction. For example, any minor who is or has been married is considered to be an adult for the purpose of giving consent to their own surgical and medical treatment.
The Commonwealth does allow someone acting “in loco parentis” per:§ 32.1-46, which covers vaccination in accordance with the Immunization schedule developed by and published by the Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). In an effort to maintain consistency with similar approaches to vaccination, a minor may present for COVID-19 vaccination with either a parent, guardian, or someone standing in loco parentis.
Will I be required to provide proof of age at my child’s COVID-19 vaccination appointment? (Last reviewed 2/27/23)Sites run by the Virginia Department of Health require the parent or guardian to verbally confirm a minor’s date of birth; however, other providers may require additional proof of age.
You should check with the facility that is offering the vaccination about requirements for proof of age.
What side effects are common in the youngest children (6 months through 5 years) after vaccination? (Last reviewed 2/27/23)The most common reported local side effect was pain or tenderness at the injection site. The most common reported systemic side effect was fatigue for older children and irritability and drowsiness for younger children. Side effects were usually mild in severity and resolved within a few days. Fever occurred after vaccination in some children.
How do I register my child for V-safe? (Last reviewed 2/27/23)You will need both your smartphone and information about the COVID-19 vaccine that your child received. This information can be found on the vaccination record card they receive at the time of vaccination; if you cannot find their vaccination record card, please contact your healthcare provider. COVID-19 vaccination records in the Virginia Immunization Information Systems (VIIS) are also available through the COVID-19 Vaccination Record Request Portal. You can access the portal by visiting vaccinate.virginia.gov.
For instructions on how to register your child for v-safe, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/v-safe-register-dependents.html.
I am concerned about my child’s risk of myocarditis and pericarditis from COVID-19 vaccination. Why should I consider vaccinating my child? (Last reviewed 2/27/23)First, parents should be aware that myocarditis and other heart problems are much more common and more severe after COVID-19 illness than after COVID-19 vaccination. According to a CDC MMWR, young men (ages 18-29 years old) had 7-8 times the risk of heart complications after SARS-CoV-2/COVID-19 infection compared to after COVID-19 vaccination.
Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of the heart. In both cases, the body’s immune system causes inflammation in response to an infection or some other trigger. Cases of myocarditis and pericarditis in adolescents and young adults have been reported more often after getting the second dose than after the first dose of one of the two mRNA COVID-19 vaccines, Pfizer or Moderna. These reports are rare and the known and potential benefits of COVID-19 vaccination outweigh the known and potential risks, including the possible risk of myocarditis or pericarditis.
Talk to your healthcare provider about the possibility of an extended interval between the first and second vaccine doses. An 8-week interval may be optimal for some people, especially males ages 12 to 39 years, since it may result in a lower risk of myocarditis. However, the 21 or 28 day interval between doses remains the recommended interval for: children who are moderately to severely immunocompromised and for others who need rapid protection due to increased concern about community transmission or risk of severe disease.
Learn more about myocarditis and pericarditis. Seek medical care if you or your child have symptoms of these conditions after COVID-19 illness or after COVID-19 vaccination.
My child is on the cusp (edge) of an age group for which a different COVID-19 vaccine formulation is recommended. Where can I find guidance on which dose they should receive? (Last reviewed 3/6/23)People should receive the recommended age-appropriate vaccine dosage based on their age on the day of vaccination. If a person moves from a younger age group to an older age group during the primary series or between the primary series and receipt of the booster dose(s), they should receive the vaccine product and dosage for the older age group for all subsequent doses. COVID-19 vaccine dosing is based on your child’s age, and not their weight or size.
For guidance on Pfizer vaccines, see the Pfizer-BioNTech COVID-19 Vaccine for Children who Transition from a Younger to Older Age Group document.
For guidance on Moderna vaccines, see the Moderna COVID-19 Vaccine for Children who Transition from a Younger to Older Age Group document.
Should my child get the 2-dose Moderna series for children 6 months through 5 years or the 3-dose Pfizer series for children 6 months through 4 years? (Last reviewed 2/27/23)Both vaccines are safe and effective. Parents of eligible children can choose to get either vaccine. The CDC and VDH do not recommend one over the other. Parents and caregivers should get their child vaccinated with the COVID-19 vaccine that is available to them and that they feel comfortable with. Certain locations will only carry one brand of vaccine.
Will Virginia public schools require my child to get vaccinated against COVID-19? (Last reviewed 2/27/23)Although children 6 months and older are eligible for COVID-19 vaccination, 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.
Why should I get my child vaccinated? (Last updated 3/8/23)Although the rates of serious problems with COVID-19 are lower in children than in adults, children who have COVID-19 do have a small risk of becoming sick, hospitalized, or in some cases, dying. Children with diabetes and obesity are likely to experience severe COVID-19. Children may also develop long-term illness, such as multisystem inflammatory syndrome in children (MIS-C) or long COVID.
Among children 1–4 years of age in the United States, COVID-19 was the 5th most common cause of death in 2020 - 2022. One in four infants and young children hospitalized with COVID-19 require ICU admission. More than half of the hospitalized children in the United States with a COVID-19 infection aged 6 months–4 years old had no underlying conditions.
CDC data from April 2022 shows that during the Omicron surge, hospitalization rates from COVID-19 in children aged 5–11 years were approximately twice as high among unvaccinated as among vaccinated children. Thirty percent of hospitalized children had no underlying medical conditions.
The COVID-19 vaccine is safe and effective at preventing severe illness and death.
More than 9 million children aged 5–11 years have received a COVID-19 vaccine so far in the United States.
COVID-19 vaccination can help our children stay in school or other childcare settings and decrease the likelihood of COVID-19 transmission.
Vaccination: People with Weakened Immune Systems
Is an additional primary series dose of a COVID-19 vaccine recommended for people with weakened immune systems? (Last reviewed 2/27/23)Yes, an additional primary series dose is recommended for many but not all immunocompromised people.
After completing their primary vaccine series, moderately or severely immunocompromised people should get an additional primary series shot.
- The additional dose should be administered at least 28 days after the second dose of either the Pfizer, Moderna, or Novavax vaccine; or at least 28 days after the single initial dose of the Johnson & Johnson vaccine.
- The single exception is for children from six (6) months to five (5) years old who received the three-dose Pfizer-BioNTech primary vaccine series. Their third primary series vaccine dose also counts as the additional dose for immunosuppressed people.
- The additional primary series dose should be with the same mRNA vaccine as the primary series.
- For J&J (Janssen) vaccine recipients, the additional dose should be any mRNA COVID-19 vaccine.
However, even those people with weakened immune systems who receive an additional dose of an mRNA vaccine still might not have strong protection against COVID-19 after vaccination. These individuals should speak to their healthcare provider about planning for additional prevention measures. They should also have a plan of action in place if they become ill with COVID-19 like symptoms, including having a plan for testing, and the need for early treatment if infected. In areas where the COVID-19 Community Level is high or medium, people at increased risk should wear a mask or respirator that provides them with greater protection, like an N95 or KN95, and may choose to avoid nonessential indoor activities.
- Their household members, friends, and other close contacts who are vaccine-eligible should get up to date on COVID-19 vaccination, including with the updated bivalent vaccine booster, to help provide maximal protection to their immunocompromised loved ones and colleagues.
The American College of Rheumatology has guidelines around vaccination timing for people with autoimmune and inflammatory conditions as well as recommendations for which medications should be paused when patients get the vaccine. Other guidance is available from the International Organization for the Study of Inflammatory Bowel Disease, and the American Society of Transplantation and other transplantation groups. The Leukemia and Lymphoma Society has released a set of COVID-19 FAQs.
Finally, immunocompromised individuals should receive all the recommended COVID-19 vaccine booster doses when eligible (including the bivalent booster). See the CDC COVID-19 Vaccine Schedule (Immunocompromised) .
Will I need to show proof that I have a moderate or severe immunocompromising condition to get the additional dose? (Last reviewed 2/27/23)No. Proof of medical condition is not required to receive a third (additional) dose. However, individuals may need to state that they have a moderate or severe immunocompromising condition. You should also bring photo identification to confirm your identity as well as your CDC vaccination card, so that this additional dose can be added.
Vaccination: Records
How do I obtain a copy of my or my child’s COVID-19 vaccine record? (Last reviewed 3/7/23)COVID-19 vaccination records in the Virginia Immunization Information Systems (VIIS) are available through the COVID-19 Vaccination Record Request Portal.
This portal can be used to obtain a record of your COVID-19 vaccinations if you have misplaced the vaccine card you received at a vaccination clinic; if your first, second, third and booster doses were written on different cards; or if you would like to give a copy of your record to someone else.
Enter your name, date of birth, and ZIP code. If there is a match, the system will send a verification code to the phone number associated with your vaccination record, through either a text message or an automated voice call. This prevents other people from accessing your record. Once you enter the verification code, you can view, save, and print your Vaccination Record with QR (short for "Quick Response") code. With iOS 15 or 16, you can securely store verifiable versions of your COVID-19 test results and immunization records in the Health app on your iPhone or iPod touch.
The request portal is also accessible via Virginia’s free COVIDWISE app, along with information about vaccines and other frequently asked questions. In the app, tap “Virtual VDH” for these options.
What if I cannot find a COVID-19 Vaccination Record? (Last reviewed 2/8/23)Vaccine providers in Virginia submit vaccination records to the Virginia Immunization Information System (VIIS), but they may have provided information that's incomplete, out of date, or incorrect. So, it's likely we have your record if you were vaccinated in Virginia, even if it’s not available through the request portal. For example, your name or phone number may have been entered incorrectly or may have changed. If you can’t find your record, first try the search again without entering a ZIP code. If the record still isn’t found, you can contact your vaccine provider to update their vaccination record or call 877-VAX-IN-VA (877-829-4682) for help (Mon-Fri 8 a.m. to 5 p.m).
Some doses administered outside Virginia to Virginia residents may be in VIIS. Doses administered directly by federal agencies such as the Department of Defense or Department of Veterans Affairs are not reported to VIIS.
If you would like a record of other vaccinations (besides COVID-19), you may submit your request online.
What if my COVID-19 Vaccination Record is incorrect? (Last reviewed 3/7/23)If the information on your vaccination record is incorrect (e.g., missing dose, wrong date or incorrect brand), you should contact your vaccine provider to update their record or call 877-VAX-IN-VA (877-829-4682) for help (Mon-Fri 8 a.m. to 5 p.m).
What is the VDH COVID-19 Vaccination Record with QR Code? (Last reviewed 2/28/23)Virginia’s COVID-19 vaccination records include QR codes – a type of barcode that can be scanned with smartphones. QR codes are commonly used in retail, logistics, and other sectors. The technology allows anyone to show proof of vaccination with a digital or printed QR code instead of a paper card, and without the need for an app.
A person vaccinated in Virginia can visit vaccinate.virginia.gov to obtain their free vaccination record with QR code, which can then be saved to a cell phone gallery, printed on paper, or stored in a compatible account, such as Google Pay, CommonHealth, or Apple Health.
The COVID-19 Vaccination Record with QR Code will be available to you from the COVID-19 Vaccination Record Request Portal.
The QR code can also be scanned by a tablet or smartphone with the SMART Health Verifier App. This will display to the reader your name, date of birth, vaccine date(s), and vaccine type.
Vaccination records with QR codes contain the same information as paper records, but in a format that offers greater security and efficiency. Because the QR code is digitally signed by the Virginia Department of Health, it cannot be altered or forged. Information from QR codes is only available if and when the individual chooses to share it.
There are a number of ways you can save your QR code:
- Print it
- Screenshot it and store it in your photo album
- Save it
- To your computer
- To your smartphone as a file (iPhone/Android)
- To your Google Pay Wallet
- To your Apple Health account (requires iOS 15)
For help with securely storing verifiable versions of your COVID-19 test results and immunization records in the Health app on your iPhone or iPod touch, please visit https://support.apple.com/en-us/HT212752.
Vaccination records, including Vaccination Record with QR Code, are also accessible via Virginia’s free COVIDWISE app, along with information about vaccines and other frequently asked questions.
What information is in my COVID-19 Vaccination Record with QR Code? (Last reviewed 2/27/23)The vaccination record provided by the portal includes your name, date of birth, date of each COVID-19 vaccination you received; the manufacturer, description, and lot number; and the provider who administered it. No other personal information is sent.
Because the Vaccination Record with QR Code is digitally signed by the Virginia Department of Health, it cannot be altered or forged.
Am I required to get a COVID-19 Vaccination Record with QR code? (Last reviewed 2/27/23)You are not required by the Virginia Department of Health to obtain a Vaccination Record with QR Code, or to use it for any particular purpose. Your record, and the QR code within it, are options provided to you to document your vaccinations and provide proof to those with whom you choose to share it.
How does the COVID-19 Vaccination Record with QR code protect my privacy? (Last reviewed 2/27/23)The information listed on the QR code is the information shown on paper vaccination records or cards, which includes name, date of birth, vaccination date, vaccine manufacturer, lot number, and provider for each dose of vaccine received. The QR code does not include social security number, immigration status, or other information not found on paper vaccination records.
Because the QR code is digitally signed by the Virginia Department of Health, it cannot be altered or forged.
Your vaccination history is stored directly within the QR code, which you control. It’s completely up to you to decide whether and when to show someone else your QR code.
This COVID-19 Vaccination Record with QR Code can only be scanned by apps or websites that agree to the privacy protections required by the SMART Health framework, such as the SMART Health Verifier App.
How can I obtain a COVID-19 Vaccination Record with QR code for myself or my child? What about records of vaccinations other than COVID-19? (Last reviewed 3/7/23)You can obtain your COVID-19 Vaccination Record with QR Code at vaccinate.virginia.gov on your smartphone, or tablet or computer browser. There is also a link to the COVID-19 Vaccination Record Request Portal in the free COVIDWISE app (tap “Virtual VDH” at the bottom). You can also call 877-VAX-IN-VA (877-829-4682) for help (Mon-Fri 8 a.m. to 5 p.m.)
Vaccination Records with QR Codes are available to anyone whose vaccination record is in the Virginia Immunization Information System (VIIS) and includes a working phone number.
If you would like your full immunization record (i.e., COVID-19 and non-COVID-19 immunizations), you may submit your request online. At this time, all full immunization records will not include a QR code.
Am I required to show my vaccination record to anyone? (Last reviewed 2/28/23)Individual businesses, employers, and other private organizations are usually allowed to require vaccination or proof of vaccination for employees, customers, and/or other participants if they choose to do so.
You should only show any vaccination record to a person, business, or organization you want to know your vaccination information, and only after they tell you what they intend to do with your data and if they will keep it.
I just received a COVID-19 vaccination dose. When will this show up in my COVID-19 Vaccination Record with QR code? (Last reviewed 3/7/23)Clinics and doctors’ offices vary in how long it takes them to submit vaccine dose information to the Virginia Immunization Information System (VIIS). VIIS records are usually updated within one-to-three workdays after a dose is administered.
However your copy of your COVID-19 Vaccination Record with QR code does not automatically update. If you receive an additional dose of the COVID-19 vaccine, you will need to visit the COVID-19 Vaccination Record Request Portal again at vaccinate.virginia.gov to obtain your updated Vaccination Record with QR Code.
How can businesses and employers use the COVID-19 Vaccination Record with QR Code to verify the vaccination status of their patrons or employees? (Last reviewed 3/7/23)Businesses and employers that choose to verify an individual’s vaccination status via QR code can download the free SMART Health Card Verifier App to do so.
Businesses and employers validating vaccination records are encouraged to require a second form of government identification (e.g. government issued driver’s license) to compare to the name and date of birth on the vaccination record.
Can I verify or test the QR code of my COVID-19 Vaccination Record myself? ? (Last reviewed 3/7/23)If you would like to test the QR code of your COVID-19 Vaccination Record using a Smart Health Verifier App on your smartphone, you should first print a paper copy of your QR record before scanning it with the Verifier App because it is likely that the small resolution of a computer or phone screen will not allow that App to accurately read the QR code.
Please call 877-VAX-IN-VA (877-829-4682), Mon-Fri 8 a.m. to 5 p.m with any additional questions.
Page last updated: March 9, 2023