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Health Team

Answers to your questions about the COVID-19 vaccine

Posted January 22, 2021 11:38 a.m. EST
Updated September 24, 2021 4:09 p.m. EDT

Medical professionals from the North Carolina Healthcare Association will take your questions about the COVID vaccines, boosters, safety and side effects Wednesday, Sept. 29 from 4 to 7:30 p.m.

YOU ASKED, THEY ANSWERED

Choose a question from the list for the answer.

OUR EXPERTS

Dr. Elizabeth Tilson is North Carolina state health director and chief medical officer. Additional questions and answers are from the North Carolina Department of Health and Human Services FAQ.

Dr. David Wohl is an infectious disease specialist at UNC's School of Medicine, involved in the Moderna vaccine trial as well as treatments for COVID.

Dr. Geeta Swamy is an OBGYN and vice chair for research at Duke School of Medicine and was involved in the Pfizer vaccine studies there. Additional questions and answers are from the Duke Health COVID-19 FAQ.

Dr. Robert W. Frenck Jr. is professor of pediatrics at Cincinnati Children's Hospital Medical Center, director of the Gamble Center for Vaccine Research and the immunization program medical director of the Ohio American Academy of Pediatrics.

What’s in the vaccine?

You cannot get COVID-19 from the vaccine. The Pfizer and Moderna vaccines give your body instructions to make a harmless piece of the “spike protein." This protein safely teaches your body that the virus is attacking. Your body then strengthens itself to fight off the real COVID-19 if it ever tries to attack you. Your body gets rid of the small protein naturally and quickly. There is no live virus, and no egg, gelatin, latex or preservatives in the vaccine.

The Johnson & Johnson COVID-19 vaccine uses a harmless inactivated cold virus as the carrier for the genetic material that codes for a piece of the “spike protein” of COVID-19 to help the body build an immune response against the coronavirus that causes COVID-19.

Is the vaccine safe?

Almost 200 million Americans have been safely vaccinated against COVID-19.

Two vaccines from Pfizer-BioNTech and Moderna have been proven to prevent COVID-19 illness with no safety concerns in the clinical trials. They are 95% effective.

The U.S. Food and Drug Administration (FDA) makes sure all food and drugs are safe.

The COVID-19 vaccines must pass clinical trials like other drugs and vaccines. The FDA checks the work and authorizes vaccines only if they are safe and effective.

With all vaccines, the FDA keeps checking safety through the Vaccine Adverse Events Reporting System (VAERS). Health care providers are required to report serious side effects, or if someone gets seriously ill with COVID-19. There is also a smartphone-based health checker called V-SAFE that uses text messaging and web surveys to do health check-ins after people receive a COVID-19 vaccination. People can report any problems they may have with a vaccine through V-SAFE.

Who can get a vaccine booster?

The CDC recommends a booster shot for those who got the Pfizer vaccine more than six months ago who are:

  • 65 years and older
  • residents in long-term care settings
  • 18–64 years with underlying medical conditions*
  • 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting

The medical conditions that put people at greater risk of severe illness or death from COVID-19 are:

  • cancer
  • chronic kidney disease
  • chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension
  • dementia or other neurological conditions
  • diabetes (type 1 or 2)
  • Down syndrome
  • heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)
  • HIV infection
  • having a weakened immune system
  • liver disease
  • overweight or obese
  • pregnancy
  • sickle cell disease or thalassemia
  • being a current or former smoker
  • recipient of a solid organ or blood stem cell transplant
  • stroke or cerebrovascular disease, which affects blood flow to the brain
  • substance use disorder (such as alcohol, opioid, or cocaine use disorder)

How many people are being injured or dying from the coronavirus vaccine?

Frenck: I know of no one who has died from the vaccine. The rates of serious side effects, such as myocardial and blood clots, are incredibly rare, in the range of 1-2 per 100,000 or less.

The U.S. Food and Drug Administration requires health care providers to report anybody who died after getting a COVID-19 vaccinations (even months after their shot) to the Vaccine Adverse Event Reporting System (VAERS). These deaths are not necessarily linked to the vaccine. According to the Centers for Disease Control and Prevention, reviews of available clinical information has thus far not established a causal link between any deaths and COVID-19 vaccines.

More than 175 million Americans received a coronavirus vaccine between Dec. 14 and Aug. 30. During that time, VAERS received 7,218 reports of death (.002 percent) among people who received a shot.

Some reports suggest a plausible causal relationship between the J&J/Janssen COVID-19 vaccine and TTS, a rare blood clotting syndrome that can be fatal. A CDC report from May identified 28 confirmed TTS cases after the J&J vaccine (.000003 percent of the 8.73 million doses given out at the time). Of those, three people died.

Who can get the vaccine?

County health departments, hospital groups, primary care physicians and many pharmacies provide the vaccine free of charge.

No government ID or insurance is required. Everyone can be vaccinated, regardless of their immigration status.

State search: Find your spot to get your shot

You can also call the COVID-19 Vaccine Help Center 1-888-675-4567. It's a free call.

Will I need a booster shot?

The Food and Drug Administration and the Centers for Disease Control and Prevention recommend a third shot – a booster – for those who got either Pfizer or Moderna vaccine. Research is still being done on a booster for the Johnson & Johnson vaccine, and the CDC hasn't approved people trying to mix vaccines to get a booster.

People with weakened immune systems are eligible for that third shot now in most North Carolina counties. Included are:

  • Cancer patients undergoing active treatment for tumors or cancers of the blood.
  • Organ transplant recipients who are taking medicine to suppress their immune systems.
  • Anyone with moderate or severe primary immunodeficiency.
  • Anyone with advanced or an untreated HIV infection.
  • Anyone receiving high-dose corticosteroid or other drugs that may suppress their immune response.

For the rest of the general public, a booster is recommended eight months after the second shot.

Coronavirus vaccinations in NC

Is one vaccine better than the others?

No. Both the Moderna and Pfizer vaccines use mRNA, a sort of genetic text message, to make our cells produce a spike on the surface of the virus. Our body then makes antibodies to that spike so if we ever get infected with the COVID-19 virus those antibodies will be around and attack it. The mRNA is the same in both of the vaccines and both looked remarkably similar in two different huge studies – including protection from COVID-19 and side effects. Therefore, there is no major difference between Moderna and Pfizer vaccines, no matter what the internet or your cousin’s friend says.

The Johnson & Johnson vaccine is different than the Moderna and Pfizer vaccines. It uses another virus called an adenovirus to deliver a genetic message to our cells to make the virus spike. In a big study of this vaccine, the protection from COVID-19 was lower than reported previously with Moderna and Pfizer.

Now, to be fair, half the people in the Johnson & Johnson study live in South Africa or Latin America and there were more of those variants of the virus that seem to be less able to be protected against. Also, the protection with the Johnson & Johnson vaccine against hospitalization and death was 100%, so far. Hard to beat that.

Overall, all three vaccines look terrific at preventing severe COVID-19.

Are there side effects?

No serious side effects were reported in clinical trials.

Temporary reactions after receiving the vaccine may include a sore arm, headache, or feeling tired and achy for a day or two. These temporary reactions were more common after the second vaccine dose. In most cases, these temporary reactions are normal, which are good signs that your body is building protection.

You can take medicines like Tylenol or ibuprofen to help with these temporary reactions.

While extremely rare, there have been a few cases of severe allergic reaction to the vaccines outside of the clinical trials, and vaccine providers are prepared with medicines if they need to treat these rare allergic reactions.

The CDC reports blood clots are occurring at a rate of about seven per one million vaccinated women between 18 and 49 years old.

Where can we find the ingredients list for each shot?

Each COVID vaccine that has been approved by the FDA under the Emergency Use Authorization has Fact Sheet for Recipients and Caregivers, meaning for people receiving the vaccine and health care providers administering the vaccine. The Fact Sheets are on the FDA’s website but can easily be found online. There is a section in each Fact Sheet that describes the ingredients of each vaccine.

Does the vaccine give you immunity from COVID-19 or does it just make the virus symptoms less severe?

The vaccines have been demonstrated to prevent becoming sick with COVID-19, especially getting really sick.

The Johnson & Johnson vaccine trial looked for signs of infection in the participants regardless of whether they had symptoms or not and found that fewer of those who got the vaccine had ended up infected than those who got the placebo. This is great evidence that the J&J vaccine (and likely the other two vaccines) protects not only from becoming sick but from infection too. While this is sorted out, it is best to be careful as it is unclear whether some vaccinated people can become infected for a brief period during which they can infect others.

How quickly am I protected?

The vaccine does not provide full protection until 1-2 weeks after the second dose. The Pfizer and Moderna vaccines require two shots a set number of days apart. You need two doses to build up strong immunity against COVID-19. The second shot will come about 3-4 weeks after the first. It is important to get two doses of the same vaccine.

While other countries may take a different approach to vaccinations, the FDA and CDC continue to recommend that everyone get two shots. Currently there is not enough data to suggest that one shot offers enough protection against COVID-19. With two shots, both the Pfizer and Moderna vaccine are 95% effective in preventing COVID-19.

How long does protection last?

Pfizer, Moderna and Janssen (J&J) are continuing to follow study participants for longer to see how long the vaccine offers protection and will continue to provide the data to FDA and CDC so that recommendations can be made in a timely manner.

How often are vaccines supposed to be taken?

Unfortunately we don’t yet know how long the vaccine will be effective against preventing COVID19 infection. Pfizer, Moderna and Janssen (J&J) are continuing to follow study participants from the original trials to see how long the vaccine offers protection and will continue to provide the data to FDA and CDC so that recommendations can be made in a timely manner. There is a very good chance that we will have to get booster vaccine doses at some point, but the frequency or number of doses needed is not yet known.

If I had COVID, do I still need the vaccine?

People who have been infected with COVID-19 and recovered have some protection against the virus, called natural immunity. Natural immunity can be strong and long-lasting for some people, but weaker and shorter-lasting for others.

People can be confident that the protection they get from the vaccine is very strong and that it lasts for at least six months, and likely longer as scientists continue to monitor the vaccines. Vaccines may also better protect you against certain variants of the COVID-19 virus. Getting vaccinated against COVID-19 is the best way to protect yourself and those around you from getting COVID-19.

A person can get vaccinated once they are out of isolation.

If you were treated for COVID-19 symptoms with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.

Can I go unmasked once I am vaccinated?

Continue practicing the 3 Ws – wearing a mask, waiting 6 feet apart, washing your hands – as well as limiting gatherings.

The vaccine is very effective at keeping people from becoming ill from COVID-19, though scientists are still studying how often vaccinated individuals can become infected with so-called "breakthrough" cases, where they get the COVID-19 virus or pass the virus to others.

Although infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant, preliminary evidence suggests that fully vaccinated people who do become infected with the Delta variant can spread the virus to others.

Vaccinated people need to still think of themselves as potential virus spreaders.

Who should NOT get the vaccine?

Children will not receive vaccines until clinical trials are completed to ensure the vaccines are safe and work to prevent COVID-19 illness in children. The Pfizer vaccine is approved under an Emergency Use Authorization for those ages 12 and up.

Pregnant and breastfeeding women may choose to receive the Pfizer or Moderna COVID-19 vaccines. Pregnant women can talk with their doctors before making the choice.

You do not need to take a pregnancy test before you get your vaccine.

Women who are breastfeeding may also choose to get vaccinated. The vaccine is not thought to be a risk to a baby who is breastfeeding. The CDC has additional information for the Pfizer and Moderna vaccines.

People who have had severe allergic reactions, also called anaphylaxis, to any ingredient in the Pfizer and Moderna vaccines should not receive that vaccine. People who have had this type of severe allergic reaction to any vaccine or treatment that is injected should talk with their health care provider about the risks and benefits of vaccination. People with allergies to foods, animals, environmental triggers (such as pollen), latex, or medications taken by mouth, or who have family members with past severe allergic reactions, can be vaccinated with the Pfizer or Moderna vaccines. Severe allergic reactions to the vaccines have been very rare and mostly occurred in people who have had previous severe allergic reactions.

Vaccine providers will watch patients for 15-30 minutes after vaccination to ensure the patient’s safety. Additional information can be found here for the Pfizer and Moderna vaccines.

Are COVID-19 vaccines recommended for pregnant and nursing mothers?

Pregnant people are at increased risk of severe illness and complications from COVID-19 including death.

Based on the how the vaccines work, there is no evidence to suggest that any of the COVID-19 vaccines would cause harm to a pregnant or breastfeeding woman or her fetus or infant. Therefore, the CDC, FDA, American College of Obstetrics & Gynecology, Society for Maternal-Fetal Medicine, and Academy for Breastfeeding Medicine all recommend that pregnant and breastfeeding people be allowed to receive COVID-19 vaccines if they choose to do so.

Can COVID vaccines cause problems with fertility or getting pregnant?

COVID-19 vaccination is recommended for all people 12 years of age and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.

There is no need to wait or avoid getting pregnant if you are planning to get vaccinated. Those seeking fertility treatment can also get vaccinated. There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men. Recent reports have shown that breastfeeding women who have received COVID-19 mRNA vaccines have antibodies in their breastmilk, which could help protect their babies.

The risks of COVID-19 virus are greater for pregnant women compared to people who are not pregnant. Pregnant women with COVID-19 have a higher risk of being hospitalized and needing care in the ICU. Pregnant women with COVID-19 are at increased risk for preterm birth (delivering the baby earlier than 37 weeks) and might be at increased risk for other poor outcomes related to pregnancy compared to pregnant people without COVID-19, such a pregnancy loss.

Are the vaccines safe for people with autoimmune diseases?

Some people with autoimmune conditions were certainly in the clinical trials of the three vaccines, and there have not been reports of any safety issues in these people. The risk of COVID-19 (about 1% risk of death, on average plus long hauler problems) would likely favor vaccination for most with autoimmune issues. Getting advice from your healthcare provider and autoimmune specialist would be a good idea.

Can you take the shot when you're on blood thinners?

Yes, the needle and volume of the vaccines are such that there is not a problem for those on blood thinners.

What is herd immunity?

The CDC defines herd immunity as a situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community.

How many need to get the vaccine for herd immunity?

The percent of the population that needs a vaccine for herd immunity varies by how contagious the disease is. Because COVID-19 is a new disease, we do not know what percent of the population needs to get the vaccine for herd immunity.

Current estimates are that at least 70% of the population would need to get the vaccine for herd immunity, but the CDC and other experts are studying herd immunity and will provide more information as it is available.


The North Carolina Department of Health and Human Services has additional questions and answers, including details about vaccine development, shipping and storage.

For other questions and answers., call the North Carolina COVID-19 vaccine help line at 888-675-4567 Monday through Friday from 7 a.m. until 7 p.m., and on Saturday and Sunday from 8 a.m. until 4 p.m.

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