Eight questions to consider before taking COVID-19 vaccines

Published on Friday, January 1, 2021

By: Annie Oeth, aoeth@umc.edu

Mississippians will have the opportunity to roll up their sleeves for a COVID-19 vaccination this year.

Vaccines developed by Pfizer and BioNTech and by Moderna received emergency use authorization from the U.S. Centers for Disease Control and Prevention in December and have been made available first to Mississippians at greatest risk for contracting COVID-19. Health care workers and residents in long-term care homes were among the first vaccinated.

At the University of Mississippi Medical Center, employee vaccinations began Dec. 16 and continued as vaccine supply allowed. UMMC’s first allotment of the Pfizer-BioNTech vaccine - 3,900 doses - arrived packed in dry ice and was moved to ultra-cold freezer storage.

Vaccination locations and availability are expected to increase in 2021, along with questions from patients. UMMC experts answer the most common questions they’ve received about COVID-19 vaccine options. 

Are COVID-19 vaccinations safe and effective?

The short answer is yes.

Both the Pfizer-BioNTech and the Moderna vaccines contain messenger RNA, or mRNA, that prompts cells to create antibodies against the spiked protein of the coronavirus. These antibodies help fight against the virus upon exposure and reduce the risk of developing severe illness and death from the infection. The vaccine does not contain the coronavirus that causes COVID-19, so it cannot give anyone the illness.

Contrary to conspiracy theories, the vaccines do not contain microchips and do not change a person's DNA, said Dr. Bhagyashi Navalkele, medical director for infection prevention at UMMC.

Navalkele said she has faith in the vaccines’ clinical trials and their results. Of the Pfizer-BioNTech trial, she said, “It has shown that this vaccine is extremely effective – 95 percent by the second dose – and it’s extremely safe.

"This is our chance to bring an end to this pandemic safely. We can avoid all these deaths and severe disease if people decide to get the vaccine.”

Dr. Jason Parham, director of UMMC’s Division of Infectious Diseases, agrees.

“I do feel strongly that these are safe, effective vaccines, and we believe that vaccination is the way we get to the end of this pandemic,” he said.

Will these vaccines be effective against new variants of the virus that causes COVID-19?

The COVID-19 vaccine is going to be effective in developing immunity against variants of SARS-CoV-2, the virus that causes COVID-19, Navalkele said. Variants in viruses is a common phenomenon.

“The coronavirus causing COVID-19 has changed multiple times since its discovery, so this is not a surprise,” she said. “This new variant has shown to bind with higher affinity to host cells and spread faster. The more the virus can transmit among people, the more opportunity it gets to develop new variants.”

The good news, she said, is that the measures being taken to prevent the spread of SARS-CoV-2 also work in stopping the spread of variations of the virus.

“All the recommended preventative measures, such as maintaining a six-foot distance from others, wearing a mask around others and hand-washing, are still effective to be safe and prevent exposure to the virus and its variants.” 

Who can take the vaccines?

COVID-19 vaccinations have not been tested on those younger than 16, so they’re not available to children. Women of childbearing age can be vaccinated safely, Parham said.

“The Society of Maternal Fetal Medicine advises women who are pregnant or may become pregnant to get the vaccine. We’ve had some very bad outcomes in that age group. We have very safe vaccines and a very real threat.”

Other comorbidities, such as obesity, diabetes, hypertension, chronic respiratory and cardiac conditions, autoimmune diseases, and compromised immune systems, are reasons to consider vaccination.

“Those with underlying chronic medical conditions are at a higher risk for developing severe COVID-19 infection and death,” Navalkele said. “We encourage people with these conditions to get vaccinated if they have none of the other contraindications to vaccination.”

Those who should avoid taking the vaccine include those who have received doses of monoclonal antibodies or convalescent plasma to treat COVID-19 or who are currently sick with COVID-19 symptoms, undergoing testing for COVID-19 or under isolation for COVID-19 infection.

Once a person is no longer contagious, it is safe for him or her to receive the vaccine. Those who have had severe allergic reactions to other vaccines or injectable medications should talk with their health care providers before receiving a vaccination.

The vaccine does not have any effect on fertility for women in reproductive age groups. The CDC recommends those with Guillain-Barré syndrome, a type of muscle weakness and paralysis, or a history of Bell’s Palsy, a type of facial paralysis, due to previous non-COVID 19 vaccinations to receive the COVID-19 vaccine, Navalkele said.

“There has been no association between these paralyses and COVID-19 vaccine,” she said. “The benefits for protection against COVID-19 from vaccine far exceeds the risk of having COVID-19 infection and associated bad outcomes. These groups of people should consider discussing this with their health care providers prior to vaccination.” 

How were these COVID-19 vaccines developed so quickly?

It may seem as if these new COVID-19 vaccines became available rapidly, but the technology behind them was developed during the last decade, said Dr. Alan Jones, assistant vice chancellor for clinical affairs and COVID-19 clinical response leader at UMMC. Research into vaccines for MERS and SARS, which are also coronaviruses, started about 10 years ago, he said.

“This mRNA technology has been around for quite some time, but because these did not turn out to be pandemics, these vaccines did not advance to the finish line,” Jones said.

Jones, who received his COVID-19 vaccinations from the Mississippi Department of Health, said the vaccines will protect Mississippians from further illness and deaths.

"I feel 100 percent confident in saying these vaccines are safe and effective,” he said.

How do the vaccines differ?

Both mRNA-based vaccines have similarities, but one major difference is in the storage required, said Dr. Jonathan Wilson, chief administrative officer and incident manager for UMMC’s COVID-19 response efforts.

The Pfizer-BioNTech vaccine requires ultra-cold storage and shipment in dry ice. UMMC already had ultra-cold freezers in its research laboratories, so it made sense for the Medical Center to receive that vaccine, he said. Once moved from ultra-cold storage to refrigeration at 36 to 46 degrees, the vaccine has a shelf life of five days.

The Moderna vaccine does not require ultra-cold storage and can be refrigerated for 30 days.

“The plan is for the Moderna vaccine to go to locations that don’t have ultra-cold storage,” Wilson said. 

Why are two doses required?

Both vaccines require two doses. The Pfizer-BioNTech vaccine requires its doses 21 days apart, while the Moderna vaccine’s doses are 28 days apart.

The first dose offers some immunity to COVID-19. For example, the Pfizer-BioNTech vaccine is 52 percent effective about 12 days after the first dose, but 95 percent effective after both doses have been taken at the recommended times.

If the second dose is missed, it can be taken afterward without starting the vaccination process over, but Jones said that’s not recommended.

Do these vaccines have side effects?

In clinical trials, about 10 percent of those vaccinated experience side effects, most commonly injection site pain, headaches, fatigue and muscle aches.

“You could develop side effects from any medication you take,” Navalkele said, “and that is the same with these vaccines.”

In the more than 18,000 study participants who received the Pfizer-BioNTech vaccine, “there were few side effects, and those were all very mild and tolerable,” she said. “As of now, more than 1.8 million people around the world have received the Pfizer/BioNTech vaccine, and less than 10 severe allergic reactions have been reported.”

The side effects are usually mild and resolve within 1-2 days. Over-the-counter medications, such as acetaminophen, can help with symptoms.

If the vaccines are effective, why is it recommended that people continue to follow CDC guidelines on wearing masks, handwashing and social distancing?

While an increasing number of Mississippians are receiving COVID-19 vaccinations, Jones said it is important for everyone to continue to take precautions.

“In these next few months, it’s still important to continue to follow CDC guidelines regarding wearing face masks and social distancing,” he said. “These precautions are how we will get to the other side of this pandemic.”

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