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Everything You Need to Know About the COVID-19 Vaccine

As of this week, more than 187 million doses of the COVID-19 vaccine have been administered across the United States. Currently, the FDA has authorized three vaccines for emergency use: one made by ​​​​Pfizer-BioNTech, one made by Moderna, and one made by Johnson & Johnson. (On April 13, federal health agencies called for a pause on administering Johnson & Johnson’s vaccine in order to take a closer look at a rare blood-clotting disorder that affected six women who received the vaccine. Learn more about the pause here.)

Vaccine administration began in mid-December, originally limited to specific groups like health care workers and nursing home residents. Experts are continuing to test existing vaccines and roll out new options, while individual states are trying to get a handle on how to safely and quickly administer vaccines to residents.

Experts say that so far, there’s not much to worry about in terms of vaccine effectiveness. “We have a vaccine that so far looks very effective and so far looks quite safe,” says Martin Hirsch, MD, professor of medicine at the Harvard Medical School and professor of infectious diseases and immunology at the Harvard School of Public Health. “We can’t make promises that something won’t happen at some point. But the best we can do is say that the risk-benefit ratio today strongly favors use of the vaccine. I’m certainly looking forward to getting my vaccine.”

So! Even though there might not be a set date for when you will get the vaccine, Cosmo is here to make sure you have all the necessary info about getting pricked when the time comes. Here are all the answers to your vaccine-related questions.

Real talk: Which vaccine is the best?

Trick question! The first vaccine you can get is the best because all the ones approved in the U.S. are highly effective.

If you really want to get into what makes each vaccine different, here’s a quick science-backed crash course: The Pfizer-BioNTech and Moderna vaccines, which were approved by the FDA in December, use mRNA technology. Both of their large-scale clinical trials have shown that they are more than 94 percent effective at preventing severe disease and death, and they both require two doses to be given over the course of three or four weeks. (According to a new study, the Pfizer vaccine is also 94 percent effective at preventing asymptomatic transmission, which is when people with no symptoms at all have the disease and spread it to others. This matters because one study found that asymptomatic transmission was behind 59 percent of new COVID-19 cases.)

Many vaccines are “live” vaccines (think: the MMR shot or the flu shot). These contain live, weakened versions of a disease that the body recognizes and builds up an immune defense against. But…twist! The COVID-19 ​​​​Pfizer-BioNTech and Moderna vaccines do not contain the live virus. Instead, they work using mRNA technology. When you see pictures of COVID-19 cells, you can spot those telltale “spikes” surrounding the cell. “These famous spikes are used by the virus to enter our cells, mostly in those in our airways—nose, throat, and lungs,” says Noam Tau, MD, a physician and researcher at Israel’s Sheba Medical Center who studies vaccine safety. “These spikes are also the ‘face’ of the virus, which our body recognizes when it creates an immune response.”

So how does an mRNA COVID-19 vaccine work? Essentially, Dr. Tau says, you can think of it like an “instruction booklet” on how to build those COVID-19-like spikes. “The body then takes the instruction book and inserts it into our cells, which creates a whole lot of spikes,” he explains. “These spikes, of course, are not capable of causing any disease and only help teach our immune system how to protect itself against COVID-19. The spike instruction book is then destroyed, and none of it should be left in our cells within a short period of time after the vaccine.”

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The Johnson & Johnson vaccine requires only one dose—does that mean it offers less protection?

Nope! Johnson & Johnson’s vaccine was authorized for emergency use on February 27 and is what’s called a “viral vector vaccine.” It uses a modified virus—in this case, a modified adenovirus, which is the virus behind the common cold—to deliver “important instructions to our cells,” the CDC says. “For COVID-19 viral vector vaccines, the vector (not the virus that causes COVID-19 but a different, harmless virus) will enter a cell in our body and then use the cell’s machinery to produce a harmless piece of the virus that causes COVID-19.” Keyword here: “harmless.”

Current studies show that the Johnson & Johnson vaccine, which requires just one dose and can be kept refrigerated at 36°F to 46°F for up to three months, is 66 percent effective overall at preventing moderate to severe COVID-19 and 85 percent effective overall in preventing severe disease.

As mentioned above, the vaccine is currently on pause while health officials examine a rare blood-clotting disorder. Dr. Anthony Fauci said that close to 7 million people have received the Johnson & Johnson vaccination, and the reported problems “are less than one in a million.” He said that the pause will likely last “days to weeks,” not “weeks to months.”

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Are there side effects?

Dr. Hirsch says that some people in the vaccine trials reported minor side effects like a sore arm or swelling around the injection site. These types of side effects are common with a bunch of vaccines. For example, plenty of people get a sore arm after the flu shot.

“Just because a vaccine has side effects doesn’t mean it’s not safe.”

Another concern is that some people with major allergies have reported anaphylactic-type responses to the vaccine. “If people are allergic to any of the components of the vaccine, they should discuss this with their physicians and decide whether they want to get the vaccine or not,” Dr. Hirsch says. “But there are no prohibitions against those individuals actually getting the vaccines.” You may also experience symptoms like headache, fever, or chills.

But here’s the big takeaway: “Just because a vaccine has side effects doesn’t mean it’s not safe,” says Abisola Olulade, MD, a family medicine physician with Sharp Healthcare in San Diego. “In fact, a lot of the vaccine side effects that we see, such as arm soreness, headache, fever, and chills, are signs that your immune system is responding well to the vaccine and working to build protection against the infection.” Plus, she says, most side effects go away within a day or two.

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Is there anyone who shouldn’t take the vaccine?

There are a number of populations that the mRNA vaccines haven’t been fully tested on yet—namely kids under 16, pregnant women, and lactating women. Moderna recently began a trial testing their vaccine in children ranging from 6 months to 11 years old.

If you’re pregnant or lactating, the choice is up to you, and it’s kind of confusing. “The potential risks to a pregnant individual and the fetus are unknown,” the American College of Obstetricians and Gynecologists says.

To put it another way, Dr. Hirsch says, “It is not expected to cause problems in these populations—but we just don’t have data in such individuals.” When the vaccine is widely available, pregnant and lactating folks can talk to their physician or ob-gyn about the potential risks and benefits.

Also, people who have “had a severe allergic reaction (anaphylaxis) or an immediate allergic reaction” to vaccine ingredients shouldn’t get one. The CDC has a whole page of info on this, and you can speak to your doctor for more information.

Do the vaccines work against these new variants?

Ah, yes, those new variants of the disease we’ve been hearing about. Experts say that the vaccines we already have may not be fully effective against new COVID-19 variants, but they’ll almost certainly help prevent hospitalization and death from the disease.

“The main variant that’s the most concerning to the population is the South African variant,” says Jarod Fox, MD, an infectious disease specialist and chairman of the Orlando Health Medical Group Infectious Disease. “Pretty much across the board, all of the vaccines show a pretty significant decrease in efficacy—but not to the point that they don’t work at all.”

Going forward, it’s possible that so-called “booster shots” could be developed to protect against certain variants. “The good thing about most of these candidates, especially the ones that are based on the mRNA or DNA, is that it’s pretty easy to tweak them for the different variants,” Dr. Fox says. “So if a booster is required, they can quickly get them out to the public.”

When should I expect to get the vaccine?

Here’s the thing: It really depends. The Advisory Committee on Immunization Practices recommends that health care personnel, residents of long-term care homes, and essential workers get the vaccine first—followed by people over the age of 75, people over the age of 65, and people with medical conditions that increase their risk of getting severe COVID-19. But it’s up to individual states to determine rollout schedules and priority groups, and there aren’t enough doses available for everyone to get vaccinated at once.

President Biden recently announced that all adults should be eligible to receive a vaccine by May 1, but your actual timeline for getting an appointment might vary depending on vaccine supply and your state government.

Will I have to pay to get vaccinated?

According to the CDC, “Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. However, vaccination providers can charge an administration fee for giving someone the shot.” Insurance companies can cover this fee, as can the Health Resources and Services Administration’s Provider Relief Fund for people who don’t have health insurance. Bottom line? The CDC says: “No one can be denied a vaccine if they are unable to pay the vaccine administration fee.”

I’ve heard alarming rumors about the vaccines—are any of them true?

There are a lot of scary, totally out-there myths going around about the vaccines that are 100 percent bogus. Just to clear up a few things:

    The Mayo Clinic has some great info about COVID-19 vaccine myths specifically, so definitely check out that page if you have any worries.

    What if I’m nervous about getting the vaccine?

    Well, you’re not alone. “Historically, the introduction of every new vaccine has been met with nervousness, panic, paranoia, conspiracy theory, and a lack of faith in the effectiveness of the vaccine,” says Ramin Ahmadi, MD, MPH, chief medical officer for Graduate Medical Education Global LLC and a former assistant professor of medicine at Yale School of Medicine. “This skepticism is why the history of vaccines is highlighted by scientists and doctors who vaccinated themselves and their children with their own discovery. Vaccines have saved us throughout our modern history from many deadly diseases and will continue to do that.”

    To build public trust in the vaccine, health care workers and public figures—including Barack Obama, Bill Clinton, and George W. Bush—have pledged to get the COVID-19 vaccine publicly or on live TV. Experts also say consumers can do their own research—Dr. Lillibridge recommends reading the FDA website or talking to a physician if you can.

    Overall, doctors say, they strongly recommend getting inoculated. “The risks of COVID-19 far outweigh the risks of vaccines,” says Dr. Olulade. “One has a long and proven safety track record—vaccines in general—and one has a proven deadly, destructive track record—COVID-19. Patients always tell me that it’s a risk-benefit ratio for them. I tell them that when you think about it from that standpoint, then the vaccine wins—all the time, hands down, and it’s a simple choice for me.”

    What can I do once I’m vaccinated?

    Once you’re fully vaccinated (which is two weeks after your second shot, or two weeks after a single-dose vaccine), the CDC says it’s still important to be careful in public places. Because we still don’t know everything about how COVID-19 spreads, you should keep wearing a mask and stay at least six feet away from strangers.

    Now for the good news—fully vaccinated folks can hang out indoors and maskless with other fully vaccinated folks and gather indoors with unvaccinated people from one other household. Yep, that means if your parents or grandparents are fully vaxxed, members of your household can visit with them inside—and hugging is allowed.

    Keep in mind, guidelines and recommendations from the CDC will likely continue to evolve as we learn more about transmission.

    Is there anything I can do to help other people get the vaccine?

    Depending on where you live, vaccine appointments can be really hard to get—even more so for folks who aren’t super tech savvy. If you have some time to spare, see if your area has a local “vaccine angels” group on Facebook or NextDoor, where you can help eligible people sign up for an appointment.

    Another issue some people are facing: It can be really hard to get to vaccine appointments if you don’t drive or don’t have access to a car. Lyft just launched a “fund a ride” program, where some users are eligible for free or discounted rides to their vaccine appointments and others can donate to make those rides possible. If you’re a Hilton Honors, Delta SkyMiles, or Chase Ultimate Rewards member, linking your account to Lyft and making a donation can get you various bonus miles or points—check out all the details here.

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