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COVID-19 Vaccine Resource Library

We have built this COVID-19 Vaccine Resource Library as a single source of information, from many sources, with the goal of what to expect in the coming months and year.

COVID-19 Vaccine Information from King County

This information is available in several languages, including:

Amharic | Arabic | Chinese,Simplified | Chinese,Traditional | French | Khmer | Korean | Marshallese | Oromo | Russian | Samoan | Somali | Spanish | Tigrinya | Tongan | Ukrainian | Vietnamese

COVID-19 Vaccine Information from Snohomish County

This information is available in several languages, including:

Amharic | Arabic | Chinese | Japanese | Khmer | Korean | Marshallese | Punjabi | Russian | Tagalog | Ukrainian | Vietnamese

COVID-19 Vaccine Information from CDC

From the Department of Health:

Videos

EvergreenHealth's Medical Director of Infectious Disease, Dr. Francis Riedo, offers information about the vaccine(s) and clinical trials:

COVID-19 vaccine Q&A

Who should/will get the vaccine?

What is the final Advisory Committee on Immunization Practices (ACIP) recommendation for who should receive the vaccine?
The Advisory Committee on Immunization Practices (ACIP) recommends the intervention. The Pfizer-BioNTech COVID-19 vaccine is recommended for persons 12 years of age and older in the U.S. population under the FDA’s Emergency Use Authorization. Moderna and Johnson & Johnson are currently approved for persons 18 years of age and older.

Should pregnant or breastfeeding women receive the vaccine?
We recommend pregnant women consult with their healthcare provider and/or OB to determine if the COVID-19 vaccination is right for them. The CDC and the ACIP have provided information to assist pregnant people with their decision to receive the COVID-19 vaccine.

Will those who have been ill with COVID-19 still receive the vaccine? Do they not already have antibodies?
The CDC is stating that COVID-19 vaccines are safe and likely efficacious in people with evidence of prior COVID-19 infection, and should be offered regardless of history of prior symptomatic or asymptomatic COVID-19 infection. This is based on the fact that it is not entirely clear how protective immunity from natural infection is nor for how long. Based on the CDC’s recommendations we are planning to offer vaccines to those who have had prior COVID-19 illness. Note: it is recommended that individuals with active COVID-19 have vaccination deferred until they have recovered from the acute illness and have met criteria to discontinue isolation.

Will this vaccine have any age restrictions?
Currently the vaccines are for 12 and above (for Pfizer) and 18 and above (for Moderna and Johnson & Johnson).

When will the vaccine be available to everyone?
The vaccine is currently available to all who are eligible (12+ for Pfizer; 18+ for Moderna and Johnson & Johnson).

Do I (or my child) need to hold off on other vaccines prior to/after being vaccinated for COVID-19?
People can now get the COVID-19 vaccine within 14 days of other vaccines, including on the same day. Because of this change, children’s required school vaccinations or other recommended vaccines do not need to be scheduled separately from COVID-19 vaccination. This will support timely catch-up on any missing childhood and adolescent immunizations and reduced missed opportunities to ensure children are fully vaccinated.

Safety

What are the typical side effects?
We’ve had tetanus shots, flu shots, shingles vaccination (for some of us) – the side effects for this vaccine are similar. You may get a sore arm. You might get a headache or muscle aches. Perhaps even a low-grade fever or some fatigue. Vaccines generate an immune response – this is part of your body’s innate immune response.

According to the companies, no serious safety concerns have been reported in either the Pfizer or the Moderna trial. The side-effects include:

Pfizer vaccine: pain at the injection site; as well as fatigue, chills, and fever

Moderna vaccine: pain at the injection site; muscle aches and headaches

Johnson & Johnson: pain, redness of the skin and swelling at the injection site; headache, fatigue, muscle aches, nausea and fever

Unfortunately, these side effects can mimic COVID-19 symptoms. We just need to be very mindful that if these symptoms come on at the same time as our vaccine – it is highly likely to be the vaccine and not COVID-19. They are transient, are an expected side effect and can be seen as a sign that your immune system is working.

Are side effects typically more likely for certain patient demographics? Side effects from the vaccine are likely to affect younger populations. That's because the younger you are, the more robust your body’s immune response will be. While annoying, side effects are not a bad thing – they are your body’s way of letting you know the vaccine is doing what it is supposed to do.

What is Phase 1 testing for a vaccine? Phase 1 consists of a small number of individuals who are asked to volunteer – around 30-40 individuals. It is purely a safety trial. The sole purpose of phase 1 is to find out if we administer a vaccine, are there immediate and serious side effects.

What is Phase 2 testing for a vaccine? Phase 2 continues to monitor safety but is also directed at immunogenicity – this is actually the measurement of antibody production in the participant. Phase 2 trials are also often dose ranging trials to determine the optimal dose both in terms of antibody production but also to minimize side effects. You want to make sure that if you give a vaccine, it will generate an antibody response in that individual.

What is Phase 3 testing for a vaccine? Once you have decided on the appropriate dose, have confirmed safety, and have determined the vaccine actually generates a response, you want to test it for efficacy. Both the Pfizer and the Moderna vaccines went into phase 3 testing on July 27, 2020. The goal in any Phase 3 trial is to enroll a large number of individuals. In this vaccine Phase 3 testing, half are given the vaccine candidate and half are given a placebo (saline injection). Analyzing the number of individuals who contract the infection in the placebo group and in the vaccinated group helps determine how effective the vaccine is in actually preventing infection.

Wasn’t this timeline rushed? The target was met rapidly – but not rushed in a way that would cut corners. The rapidity happened for many reasons. In vaccine studies, Phase 1 and Phase 2 are made up of very small numbers of people. Because Phase 1 was showing such success, Phase 2 did overlap with Phase 1 – so that sped up the timeline a bit. When a vaccine enters Phase 3 trials, MANY people are studied (for example, Pfizer enrolled over 40,000 people in Phase 3). In Phase 3, you need to get to a point where a certain prespecified number of individuals become infected. With many diseases, Phase 3 can take years! With the COVID vaccines, the timeline was compressed because of the large prevalence of COVID-19 across the country. This allowed the study to reach the prespecified number of infections very quickly. 

What is Messenger RNA or mRNA? The use of messenger RNA (mRNA) is a novel technology that has turned out to be highly effective at generating an antibody response. Vaccines work by training the body to recognize and respond to the proteins or sugars produced by disease-causing organisms, such as a virus or bacteria. Traditional vaccines are made up of inactivated (killed) bacteria or viruses that cause infections. More recently vaccines are made of proteins or polysaccharide (sugar) molecules that coat the virus. These are introduced into the body to provoke the immune system into mounting a response. mRNA vaccines, in contrast, use the body’s cellular machinery to produce the viral proteins which then lead to an antibody response. They work by using mRNA, or messenger RNA, which is the molecule that essentially puts DNA instructions into action. Inside a cell, mRNA is used as a template to build a protein. To produce an mRNA vaccine, scientists produce a synthetic version of the mRNA that a virus uses to build its infectious proteins. This mRNA is delivered into the human body, whose cells read it as instructions to build that viral protein, and therefore create some of the virus’s molecules themselves. These proteins are solitary, so they do not assemble to form a virus. The immune system then detects these viral proteins and starts to produce a defensive response to them. Once the job of the mRNA is complete it disappears and does not become part of your cellular structure or DNA.

Is the Johnson & Johnson vaccine an mRNA vaccine too? The Johnson & Johnson COVID-19 vaccine is a vector vaccine. In this type of vaccine, genetic material from the COVID-19 virus is inserted into a different kind of weakened live virus. When the weakened virus gets into your cells, it delivers genetic material from the COVID-19 virus that gives your cells instructions to make copies of the S protein. Once your cells display the S proteins on their surfaces, your immune system responds by creating antibodies and defensive white blood cells. If you become infected with the COVID-19 virus, the antibodies will fight the virus. Viral vector vaccines can't cause you to become infected with the COVID-19 virus. Also, the genetic material that's delivered doesn't become part of your DNA.

Efficacy

How effective are these vaccines?
The Pfizer vaccine has an efficacy rate of 95%. The Moderna vaccine has an efficacy rate of 94.5%. The Johnson & Johnson vaccine has an efficacy rate of 72% in the United States. Most important all three FDA-authorized vaccines work equally well — close to 100% — at preventing hospitalization and death. In the Johnson & Johnson clinical trials, none were hospitalized, none died and in fact, none were even sick enough to require medical intervention.

How many doses is the Johnson & Johnson vaccine? The Johnson & Johnson vaccine schedule is a single dose.

Do you have to get two doses of Moderna or Pfizer? What if you only get one dose? Those receiving the vaccine must receive two doses to be fully immunized and protected. Everyone must get the second dose. Additionally, you must get your first and second dose from the same brand. The first dose primes the immune response – it’s the second dose that pushes the level of antibodies into a protective level. Having a single dose will not provide protective antibody concentrations. You need both doses of the vaccine.

What is the duration between 1st and 2nd vaccine doses? For the Moderna vaccine, it is as close to 28 days as possible - per the CDC, ideally 28 to 42 days. For the Pfizer vaccine, it is as close to 21 days as possible - per the CDC, ideally 21 to 42 days. Johnson & Johnson is a single dose vaccine.

How soon after the second dose will the vaccine be considered effective? It appears that at 7-14 days post second dose (after the single dose for Johnson & Johnson), there is an adequate level of protection against COVID-19.

Do we know how long the vaccine is effective? It is unknown at this time.

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