December 23, 2020

Coronavirus (COVID-19): COVID Vaccine FAQ

by Dr. Brian Hollett


Vaccination against the COVID-19 virus is now approved in the US. Though it will take time to rollout to our entire population, this is a momentous scientific achievement that cannot be understated. In the history of medicine, rarely has a vaccine been developed in less than five years.  The following Frequently Asked Questions (FAQ) post has been arranged with the aim of giving further clarity about this development and what it means for you.


The following content relies heavily on information released by experts in the field of infectious disease (FDA, CDC, John’s Hopkins, Dr. Robert Citronberg, and others). In this post we share a curation of the great work of others.


Do the vaccines work?

Yes, and then some. Both the Pfizer and Moderna vaccines prevented COVID-19 in 90-95% of participants, which historically speaking is unprecedented (the influenza vaccine is ~40-60% effective). Anything more than 50% would have been an astounding scientific accomplishment.

Please remember that the first types of COVID-19 vaccines to become available require two doses administered three or four weeks apart (for Pfizer and Moderna respectively).


Because the vaccine was developed in such a short period of time were corners cut on safety?

The rapid development of COVID-19 vaccines is possibly the greatest scientific marvel of our time. Most vaccines take 4-6 years or longer to develop. Almost 44,000 volunteers were enrolled in the Pfizer Phase 3 trial and more than 30,000 people were enrolled in the Moderna Phase 3 trial. After the volunteers were studied for at least two months, no serious safety concerns were reported by either company. Both trials had fully independent safety monitoring boards; and, full safety data are being reviewed by the FDA and expert panels. Historically, most serious side effects become apparent early (usually under 40 days) after receiving a vaccine. Still, there will be intense short- and long-term monitoring of individuals who receive the vaccine.


Could there be long-term side effects of the vaccine?

There could be, but the vast majority of vaccine side effects occur in the first few weeks following immunization. Both companies, and others that release vaccines later, will monitor participants for possible long-term side effects of their vaccines.


Since mRNA is genetic material, will the vaccine alter my DNA?

No. The mRNA from the vaccine first triggers your cells to make the spike protein of the coronavirus and then your immune system makes antibodies against it. So, basically, your body makes antibodies without ever having been exposed to the actual virus.  The mRNA never enters the nuclei of the cells and does not interact with your DNA.


Can I get COVID-19 from the vaccine?

Absolutely not. None of the vaccines in development use whole virus and as such the disease cannot be transmitted through vaccination.


Will I need to get a vaccine every year, like the flu shot?

At this time, the answer is unknown and will require additional study. It is hopeful that the immunity conferred by the vaccine will last many years if not for life, but it is possible that booster shots will be required in the future. At this time, we know that it gives at least 2 months of immunity (this time period is coeval with the duration of the phase 3 study).


If I am young and healthy, why should I bother with the vaccine?

Although young healthy people are less likely to become seriously ill or die from COVID-19, it is still possible. It does not make sense to take the risk of serious illness when an effective and safe vaccine is available.


If I have already had COVID-19, should I still get the vaccine?

Yes. The duration of natural immunity is unknown. Some  who experienced mild illness from coronavirus infection may not have developed adequate immunity at all and therefore may be at risk for reinfection. If you have recently had COVID-19, you may be lower on the priority list for receiving the vaccine, but you should definitely take it when it becomes available to you.


Who should get the vaccine first?

Right now, the top priority groups for the vaccine are frontline healthcare workers (especially those who take care of COVID-19 patients) and residents and staff of long-term care facilities. As the supply of vaccine increases, more groups, including essential workers, will be able to be immunized.


I heard two early vaccine recipients in the UK had severe anaphylactic (allergic) reactions. Based on this, who should hold off on taking the vaccine for the time being and what safety precautions are being taken?

Those who have had a severe allergic reaction to any vaccine should not receive the Pfizer vaccine at this time.  All those receiving the vaccine will observed for 15 minutes after vaccination to monitor for the occurrence of immediate adverse reactions. People with a history of anaphylaxis will be observed for 30 minutes. It is advised that those with a history of severe allergic reaction to any vaccine or injectable therapy have an Epi-Pen (or equivalent) and carry it with them in the period immediately following vaccination.


Can kids get the vaccine?

It is likely when the vaccines are released more broadly that they will only be licensed for adults. Both Pfizer and Moderna are currently studying kids 12 and in vaccine trials, so it is possible that the vaccines will be licensed for those kids sometime in 2021.


How long will it take to immunize the entire population?

It will depend on the supply of vaccines that are available, but it will likely take around six months to provide a vaccine to everyone in this country who wants one.


What if I decide not to get these initial vaccines, will I have future opportunities to receive a COVID vaccine?

Yes. Both Moderna and Pfizer are ramping up production and we believe there will be plentiful supply by early spring 2021. The US has purchased 100 million doses from each company, Pfizer and Moderna. AstraZeneca/Oxford recently completed their vaccine trials. There are several other vaccines that use more conventional technology nearing the end of phase three testing. We do not have information about their safety or efficacy yet. There are several other companies that are initiating phase III testing of candidate vaccines. The goal however, is for the U.S. to reach herd immunity as soon as possible through widespread vaccination.


Once I take the vaccine, do I need to continue to wear a mask and social distance?

Yes! Even if you receive the vaccine, it is conceivable that you can transmit the virus to others without becoming sick yourself. It is unlikely there will be any recommendations to lift the restrictions we are currently living under until herd immunity of the population is achieved.


When will life return to normal?

This is probably the most common question we receive, and the answer depends entirely on how many people choose to receive the vaccine. If we can reach 70% immunization by summer 2021, there is a strong chance that life will start to return to normal (e.g. sporting events, concerts, travel) in the second half of the year. The longer it takes to achieve herd immunity, the longer it will take to return to normal. At the current rate of new daily infections, it would still take three to five years for our society to reach herd immunity without widespread vaccination.

In the coming weeks, we will continue to share information about progress and new developments in addressing the pandemic.

In good health,

Dr. Brian Hollett and Dr. Ari Levy


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