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VERIFY: COVID-19 vaccine Q&A as first doses are distributed

Our KGW VERIFY team set out to answer some frequently asked questions about the COVID-19 vaccine.

PORTLAND, Oregon — Ready and available vaccines for COVID-19 are here and have been administered to healthcare workers in Oregon and Washington. The biopharmaceutical companies Pfizer and Moderna both recently announced that their coronavirus vaccines have around 95% efficacy.

The Pfizer vaccine is being distributed nationwide after it gained emergency use authorization from the U.S. Food and Drug Administration (FDA). Moderna will go through the same FDA review process this week.

As these vaccines are being produced in record time, and much is still unknown about their long-term effects, many questions remain unanswered. Our KGW VERIFY team set out to answer some frequently asked questions about the COVID-19 vaccine.

Q: How many vaccine doses has the U.S. secured? 

A: As of Dec. 16, the U.S. currently has secured 300 million doses of the vaccine from Pfizer and Moderna. This is only enough to inoculate 150 million people — or less than half the nation — by the end of June.

In the summer, Pfizer agreed to provide the U.S. 100 million doses by the end of March. The company urged the Trump administration to pre-order more doses, but the government turned them down, not wanting to favor one manufacturer.

Seeing the high efficacy of the Pfizer vaccine, the U.S. recently asked the company to make enough doses for another 50 million Americans, but they said other countries had secured their vaccines until the middle of next year. 

Now, according to New York Times reporting, the U.S. is working to free up supplies of raw materials so Pfizer can produce tens of millions of additional doses for Americans in the first half of next year. Negotiations are ongoing.

Moderna, the other leading vaccine manufacturer, agreed last summer to provide the U.S. with 100 million doses by the end of March and has now pledged to send another 100 million by the end of June.

Q: When will Oregonians get the vaccine?

A: Oregon has received a total of more than 187,000 doses of the Pfizer and Moderna vaccines as of Dec. 30. Since both vaccines require two doses, this is enough to inoculate more than 93,500 people.

The number of vaccines a state gets depends on its population. The federal government has not told Oregon how many doses the state will receive in January and the months to come. 

These first vaccines are being distributed first to health care workers, emergency service providers and long-term care facility residents and caretakers. Next in line are essential workers, people over 65 and others disproportionately affected by the virus.

The vaccines are not expected to reach the general population until the end of March at the earliest, though OHA was unable to estimate any specific dates at this time.

Q: How will I find out when I can get the vaccine?

A: In Oregon, vaccine provider websites will have updated information about who can get the vaccine, according to Jonathan Modie with the OHA.

“We also are publicizing when provider sites receive vaccine shipments and will be encouraging people to reach out to their providers to ask to get vaccinated,” Modie said.

Vaccine providers include pharmacies, doctor’s offices, clinics and health centers, among others. Vaccine supply is extremely limited for the time being, so certain critical populations, such as health care workers, will be prioritized depending on their risk of exposure to the virus. 

Once doses of the vaccine become more plentiful, however, the general public in Oregon will be notified by vaccine provider websites that the vaccine is available to be administered. OHA will continue reporting when shipments are being sent out for Oregon distribution.

Q: Can employers force you to get the vaccine?

A: Employers are legally allowed to have vaccine mandates with some exceptions. 

In Oregon, employees have the ability to seek medical, religious or philosophical exemptions to vaccine mandates. While all states allow medical exemptions, Oregon is one of 15 states that allows philosophical and religious exemptions.

Experts say that vaccine mandates are most likely to be implemented in hospitals, where flu shots are already mandated. This has not happened yet, largely because the Pfizer vaccine has only received emergency use approval.

In other workplaces, employers may be more likely to encourage their workers to get immunized, rather than issue a mandate, for liability reasons.

Q: How long does the COVID-19 vaccine last once administered?

A: Natural immunity to COVID-19, meaning the protection an individual gains from already having been infected, varies from person to person, and evidence shows that it may not last very long.

The Centers for Disease Control and Prevention (CDC) states on its website, “Regarding vaccination, we won’t know how long immunity lasts until we have a vaccine and more data on how well it works.”

While knowledge about vaccine-induced immunity is still not thorough, scientists and researchers are hard at work to fill in the gaps about the vaccine’s duration and effectiveness.

It's possible that the vaccines will not provide long-lasting protection, and people will need to get a "booster" shot in the future to maintain immunity.

Q: Can kids get the vaccine?

A: While the Pfizer vaccine has been approved for emergency use in the U.S., and the Moderna vaccine is on track for the same authorization, it will likely be a longer wait for people under 18. 

Infectious disease expert Dr. Anthony Fauci recently announced that once vaccines hit the market, they will not initially be available to children because few children have participated in clinical trials for the vaccine. Children’s immune systems are different from adults, and as such there might be discrepancies in vaccine effectiveness between the two age groups. 

The New York Times reported that it may take upwards to a year from now to get a COVID-19 vaccine ready for children. Before that happens clinical trials with children must be implemented and the child vaccine protocol must be approved by the FDA.

This means, in order to establish herd immunity, 70% of the adult population must be vaccinated.  

Q: Why did the U.K. get emergency authorization first?

A: On Dec. 2, the U.K. became the first Western country to authorize the COVID-19 vaccine for emergency use. Britain was one of the European countries worst hit by the coronavirus. 

Britain’s emergency authorization approval came after review by health authorities although some European regulators cast doubt on the thoroughness of the review, says The New York Times. 

This announcement has sparked some confusion and feelings of impatience amongst the American public as more lives are lost due to the virus. The FDA is working meticulously to authorize the COVID-19 vaccines safely and responsibly. 

Q: If I’ve already contracted COVID-19, how long should I wait to get the vaccine?

A: So far, experts advise that individuals who have gotten sick with COVID-19 in the past should still get the vaccine due to risk of reinfection. The CDC website states that experts do not know how long natural immunity after recovering from the virus lasts. 

Natural immunity varies from person to person. As such, the CDC says there is no agreed upon waiting period before getting the vaccine after initial infection as of yet. The CDC will keep the public informed as more information becomes available. 

Q: Can a person receive the COVID-19 vaccine while they are sick?

A: It is not recommended to get the vaccine while you are sick.

Jonathan Modie, an OHA spokesperson, said that while it is safe to receive the COVID-19 vaccine during mild illness, it is “better that you recover from your illness, with no symptoms, before getting vaccines to keep from spreading your illness to health care workers who are administering the vaccine.”

Q: What are the side effects of the COVID-19 vaccine?

A: On Nov. 18, Pfizer issued a press release detailing information about its COVID-19 vaccine. While there is no evidence of long-term side effects, notable short-term side effects include fatigue, headache and other flu-like symptoms.

Studies show that side effects can be more severe after the second dose, and some patients may need to take a day or two off from work. 

Flu-like side effects are a sign that the vaccine is working. The Centers for Disease Control and Prevention (CDC) has developed a smartphone-based tool that uses texts and web surveys to provide personalized health check-ins after you receive a COVID-10 vaccine.

Patients can report an adverse event here.

Q: Is the vaccine working if I don't have side effects?

A: Though side effects are a sign of the vaccine working, studies show that not everyone has the same response to the Pfizer vaccine.

The most common side effect is pain around the injection site, which was reported by 84% of trial participants who received the vaccine. 

Roughly 63% of subjects that received the vaccine experienced fatigue, about 55% had headaches and about 38% had muscle pain. 

Though the majority of people have mild to modest side effects, there is a small percentage of the population that will not experience this and this does not mean the vaccine is not working.

Q: Is the vaccine safe for people with severe allergies? 

A: The CDC announced on Dec. 13 that people who have experienced severe reactions to prior vaccines can still get the Pfizer vaccine for COVID-19, but they should discuss the risks with their doctors and be monitored for 30 minutes afterward.

This recommendation differs from that of British authorities, who said vaccines should not be given to people who have had an anaphylactic reaction to a food, medicine or vaccine.

Since the U.K. became the first Western to authorize use of Pfizer’s COVID-19 vaccine, it has been reported that two health care workers who received the vaccine suffered from serious allergic reactions. The cause of these reactions has yet to be determined.

Unlike some vaccines, both the Pfizer/BioNTech and Moderna vaccines do not have preservatives or egg products, which have triggered allergic reactions from other types of vaccines in the past. 

People with allergies to any food, latex, pollen or other substances do not need to take special precautions and are recommended to receive the Pfizer vaccine.

Q: What are the vaccines made of?

A: Both the Pfizer and Moderna vaccines rely on messenger RNA (mRNA) rather than the “live” virus that causes COVID-19. This is a type of molecule that transports copies of genetic instructions that cells use to build proteins. 

In this case, the mRNA instructs cells to construct the coronavirus’ “spike” protein, which the virus typically uses to infect cells. Then, the immune system rushes to create a defense system against this weapon and thus build immunity against the virus.

According to reporting from the Financial Times, Moderna’s vaccine uses 100 micrograms of RNA per dose, while Pfizer’s use only 30 micrograms, making them easier to produce and less expensive. 

Both vaccines use “lipid nanoparticles” to encase and protect the genetic instructions. The vaccines also contain salts that keep the acidity of the vaccine close to a human body and common sugar to keep the nanoparticles from sticking together.

Q: Are the vaccines from Pfizer and Moderna interchangeable?

A: While the Pfizer and Moderna vaccines have similar ingredients, they are not interchangeable.

The CDC published an extensive COVID-19 Vaccination Program Interim Playbook that states, “different COVID-19 vaccine products will not be interchangeable,” meaning both of a vaccine recipient’s doses must be from the same manufacturer.

Q: How long do I have to wait between getting the first and second dose?

A: Pfizer and Moderna's vaccines each require two doses to be about 95% effective.

For Pfizer, the doses should be delivered 21 days apart, or three weeks. For Moderna, doses should be delivered 28 days apart, or four weeks.

Q: Do the Pfizer and Moderna vaccine doses need to be given exactly 21 and 28 days apart respectively? 

A: It's recommended to get as close to this time frame as possible.

According to OHA's Modie, "If the second dose (of the Pfizer vaccine) isn’t given by 21 days after the first dose, it should be given at the earliest opportunity to ensure your body can develop a full immune response, but no doses will need to be repeated."

One should not wait much longer after the recommended time to get the second dose due to risk of not developing a full immune response to the virus. It is not yet known whether Moderna’s vaccine will allow for a similar range of time in which the second dose can be given.

Q: Are the first and second doses of each vaccine the same?

A: Yes, the contents of the first and second doses of each respective vaccine are the same, though they function differently in the body.

“The first dose is there to train the immune system,” said Mark Slifka, a professor and vaccine researcher at Oregon Health and Science University (OHSU). “You really need that second dose to boost the immune system to its highest peak levels to give you the most durable immunity.”

The population may even need a third “booster” dose of the vaccine later on, Slifka said, but researchers have yet to conclude how long the two-dose vaccine will provide immunity.

Q: Can you just get one dose if supplies run out?

A: In order for the vaccine to be about 95% effective, patients need to take two doses. 

For Pfizer, according to documents published by the FDA, the vaccine does offer strong protection (about 53% efficacy) against COVID-19 within about 10 days after the first dose. 

But it is unclear how long this protection will last, underscoring the importance of getting the second dose that brings the efficacy rate to near 95% after seven days of inoculation.

The Oregon Health Authority (OHA) has said that it will make sure that everyone who gets a first dose gets a second dose. The state health agency is confident that it will receive more allocations from the federal government.

Worst-case scenario, some first dose allocations could be moved to the second round, but OHA officials say this is unlikely.

Q: What happens if the COVID-19 vaccines accidentally warm up?

A: The vaccines are temperature sensitive. As such, they must be stored and handled correctly to ensure shelf life and efficacy. In the process of vaccine distribution there will be a cold chain with well trained staff and reliable equipment, says the CDC Vaccination Program Interim Playbook. 

The COVID-19 vaccine must be handled and stored at a cold temperature until the vaccine is administered with Moderna’s kept at minus 20 celsius, and Pfizer’s at minus 70 celsius. The Vaccination Playbook adds, 

“If COVID-19 vaccines are exposed to temperature excursions at any time, the temperature excursion should be documented and reported according to the jurisdiction immunization program’s procedures. The vaccines that were exposed to out-of-range temperatures must be labeled 'do not use.'"

Q: Will a prisoner in Oregon be able to get a COVID-19 vaccine before the general population?

A: According to Oregon's draft COVID-19 Vaccination Plan, incarcerated peoples will be one of several critical populations to receive the emergency authorized vaccine. This, however, is subject to change as the plan evolves and more information is gathered about the vaccine. 

Section 4 of Oregon’s COVID-19 vaccination plan describes the state’s plan in administering vaccines to critical populations. People who are incarcerated in correctional facilities are included in this list of critical populations as well as groups like long-term care facility residents, healthcare personnel, people 65 and older and people experiencing houselessness.

Critical populations are at greater risk of not only contracting COVID-19 but also having serious health complications as a result of the virus. Under the conditions in which they live, prisoners are unable to maintain social distancing and often do not have adequate access to medical care. As such, incarcerated individuals are at high risk during this pandemic. 

According to a study by the National Commission on COVID-19 and Criminal Justice (NCCCJ) incarcerated people are four times more likely to contract COVID-19 than individuals in the general population. The NCCCJ also reported that the national mortality rate in prisons from COVID-19 is double that of the general population. This disproportionately affects black and brown people who are incarcerated at higher rates than their white counterparts. 

Q: Will the vaccine remain at the minus 70 Celsius when injected? 

A: No, the vaccine will be thawed before it is injected. It will be the same temperature as any other vaccine by the time it is drawn into the syringe, according to Mark Slifka, a professor and vaccine researcher at Oregon Health and Science University (OHSU). 

“The vaccine has to be stored under the super-cold temperatures only for its long-term storage,” he said via email. “However, on the day of vaccination (within six hours of when the shot is going to be administered), the vaccine is taken out of the freezer, mixed with saline to dilute it to the right concentration and is then is stored in the refrigerator or at room temperature for up to 6 hours before use.”

Q: If one spouse qualifies for a vaccine (i.e. they are a nurse of doctor), would the other spouse who does not fit qualification criteria also get the vaccine?

A: Short answer: no. 

Because there is currently a very limited quantity of the vaccines for distribution, only those in vulnerable populations such as healthcare workers, people over 65 and essential workers will receive the vaccine in the first phases. This means that spouses and family members of those receiving vaccines will not qualify to receive the vaccine unless they also belong to a priority group.

Q: Do I have to continue wearing a mask after receiving the vaccine?

A: Short answer: yes. 

The CDC website states that one should still wear a mask after vaccination. The CDC recommends that, during the pandemic, people should continue wearing masks that cover their mouth and nose when in contact with others outside of their household. 

The CDC adds, “While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to us to help stop this pandemic, like covering your mouth and nose with a mask, washing hands often, and staying at least 6 feet away from others.”

More needs to be understood about the protection the COVID-19 vaccine provides before mask mandates can be changed. 

Q: Can people who are pregnant or breastfeeding receive the vaccine?

A: No pregnant or breastfeeding people have been included in COVID-19 vaccine trials. As such, not much is known about the health effects of the vaccine on those specific populations. The CDC has not yet endorsed the use of the vaccine on pregnant people, but pregnant and breastfeeding people can opt to receive the vaccine - there are no rules barring them from getting vaccinated. The decision is up to them. There are currently no reported added risks of receiving the vaccine while pregnant. 

Q: How will I find out when I would be able to go and get the vaccine?

A: We spoke to Jonathan Modie at OHA who commented,

 “Vaccine provider sites will let their patients know, but we also are working to publicize those provider sites when they become available. We also are publicizing when provider sites receive vaccine shipments and will be encouraging people to reach out to their providers to ask to get vaccinated.”

Vaccine providers include pharmacies, doctor’s offices, clinics, health centers, etc... Vaccine supply is extremely limited for the time being, so certain critical populations, such as health care workers, will be prioritized depending on their risk of exposure to the virus. Once doses of the vaccine become more plentiful, however, the general public in Oregon will be notified by vaccine provider websites that the vaccine is available to be administered. OHA will continue reporting when shipments are being sent out for Oregon distribution. 

Q: Is the vaccine covered by Medicare?

A: The Medicare website says, yes, once a COVID-19 vaccine becomes available it will be covered by Medicare.

Q: Will the covid-19 vaccines need to be repeated annually like the flu shots?

A: Again, the CDC website clearly states, “Regarding vaccination, we won’t know how long immunity lasts until we have a vaccine and more data on how well it works.”

Q: Do I have to pay to receive the COVID-19 vaccine?

A: Doses of the COVID-19 vaccine are being bought with taxpayer dollars. The vaccines will be administered to the American people at no cost, says the CDC. However, some vaccination providers can charge a vaccine administration fee that can be reimbursed by insurance. Those who are uninsured can use the Health Resources and Services Administration’s Provider Relief Fund.

Knowledge about COVID-19 vaccines is still growing, and scientists and researchers are hard at work to fill in the gaps about the vaccine’s duration, effectiveness, and distribution.

Do you have something you want us to VERIFY? Let us know. Email us at VERIFY@kgw.com