03/05/2021

Your COVID-19 Vaccine Questions -- Answered

Keep up-to-date with the latest information on COVID-19

Here Dr. John Mendoza, Wentworth-Douglass Hospital’s Infectious Disease Specialist, answers Frequently Asked Questions about COVID-19 Vaccination.  Please note we will continue to update this information as appropriate and will include information from Mass General Brigham and the Centers for Disease Control and Prevention.

What is the Delta variant and why is it concerning?

The Delta variant is more than two times more contagious than previous strains of COVID-19 and is currently leading to a dramatic rise in cases nationwide, similar to rates not seen since before the vaccines were widely available. 

Studies also suggest the Delta variant causes more severe illness and is more likely to lead to hospitalization.

If I am vaccinated, can I still contract the Delta variant?

Yes, you can. This is called a breakthrough infection. While the vaccines are highly effective against COVID-19, they are not 100% effective. However, studies have shown people who are vaccinated are far less likely to show severe symptoms or require hospitalization. 

I'm vaccinated. Can I spread the Delta variant to others if I'm infected?

Yes. Unlike previous strains of COVID-19, the Delta variant appears to produce the same high amount of virus in vaccinated and unvaccinated people. However, fully vaccinated people are likely infectious for a shorter period of time than unvaccinated people.  

When will the vaccine be available to me?

Currently, anyone in New Hampshire 12 and older is now eligible for the COVID-19 vaccine. Children 12-18 are eligible for Pfizer, while anyone 18 and older can receive Moderna or Johnson & Johnson's Janssen vaccine. 

How can I sign up for a vaccine?

You can visit www.vaccines.nh.gov to find vaccines near you. As of July 1, 2021, all state-run vaccine sites closed. However, there are more than 400 locations statewide that provide COVID-19 vaccines, many of them are walk-in and don't require an appointment.

If you are a Mass General Brigham patient, visit Mass General Brigham's open scheduling page here to find out where you can receive your vaccine. 

If you have additional questions about New Hampshire’s Vaccination Plan visit the state’s website at nh.gov/covid19/.

How many shots will I need?

Two of the available COVID-19 vaccines, Moderna and Pfizer, need two shots to be effective. For these vaccines, a second shot, three or four weeks after your first shot, is needed to get the best protection the vaccine has to offer against serious disease.

How do I know if I need a third booster shot?

Recently, the CDC voted to authorize a booster shot for the Moderna and Pfizer vaccines for people with moderately to severely compromised immune systems. CDC does not recommend additional doses or booster shots for any other population at this time.

If you have questions about whether you qualify for a third COVID-19 vaccine, you are advised to reach out to your doctor.

Which COVID-19 vaccine should I receive?

We encourage patients to receive whichever COVID-19 vaccine is available to you first.  

All available vaccines are in the 70-95% effectiveness range at preventing infection, and reducing serious illness causing the need for hospitalization or death. This means that a person who received any vaccine who actually gets COVID-19 is much less likely to have a serious illness.

It is important not to wait to get vaccinated in hopes you will receive a specific manufacturer's product. Delaying vaccination in favor of one product over another will actually put you at greater risk for serious illness and death from COVID-19 during the time you are awaiting a vaccine.

Additionally, the other benefits including controlling the pandemic, opening up society and the economy, and resuming “normal activities” will be further delayed if people wait for a specific product.

What are the benefits of COVID-19 vaccination?

What should I expect after I get the vaccine?

Some people do get side effects after receiving the vaccine. For both the Pfizer and Moderna vaccines, most mild side effects resolve within a day or so.

• The most commonly reported symptoms from the Pfizer vaccine have been pain at the site of vaccination, fatigue, headache, muscle pain, joint pain and chills.
   
• The most commonly reported symptoms from the Moderna vaccine have been pain at the injection site, tiredness, headache, muscle pain, chills, joint pain, swollen lymph nodes in the same arm as the injection, nausea and vomiting, and fever.

Can children get the vaccine?

Currently the Pfizer vaccine is approved for youth ages 12 and older. The Moderna vaccine is approved for individuals 18 and older. 

How do we know the vaccine works?

The COVID-19 vaccine has proven to be extremely effective. According to Phase 3 trials, the Pfizer vaccine is 95% effective 7 days after the second dose. The Moderna vaccine is 94% effective 14 days after the second dose. These results were consistent across gender, age, race and ethnicity.

How long will immunity last after I get vaccinated? Will I need to be vaccinated every year?

We do not know this yet. The clinical trials will continue to monitor participants to see how long protection lasts. We will provide updated information as it becomes available.

Can we stop wearing masks and socially distancing after getting vaccinated?

No, not yet. We know that the vaccine protects you from getting sick, but we do not know if it stops you from giving it to other people. Since not everyone will get the vaccine right away, we must be careful to protect others. Even if you get the vaccine, you should still wear a mask, practice social distancing and frequently wash your hands. Infection control experts will let us know when it is safe to modify or stop these safety measures.

Why do we need to get the vaccine if we’re wearing masks and socially distancing?

We need to use all of the tools available to us to stop the pandemic. Together, the COVID-19 vaccine and simple everyday actions like mask wearing and social distancing will offer the best protection from COVID-19. And even though the vaccines are 90% to 95% effective, you don’t know how effective it will be for you. About 5% to 10% of people immunized may still get the virus. You should do everything you can to reduce your risk of getting the virus and passing it to others.

Can people get COVID-19 from a vaccine?

No. The vaccine doesn’t contain the whole or live virus and, therefore, can’t cause COVID-19.

I already had COVID-19. Should I get vaccinated?

Yes, when it becomes available to you, you can still get the vaccine if you have had COVID-19 and have recovered. If you are actively sick with COVID-10 or have symptoms that could be from COVID-19 – cough, fever, loss of smell/taste, muscle aches, runny nose, shortness of breath and/or sore throat - you should not get the vaccine.

Can I get a COVID-19 vaccine with other vaccines?

When possible, you should avoid getting other vaccines for 14 days before or after you get the COVID-19 vaccine. If you get a COVID-19 vaccine within 14 days of another vaccine, you do not have to get it again.

Should I be concerned about allergic reactions to the COVID-19 vaccine?

There have been some reports of people having allergic reactions after getting the vaccine. A small number of people had a severe allergic reaction called anaphylaxis. Based on this, the U.S. Food and Drug Administration and the CDC recommend that people with a history of anaphylaxis to any of the ingredients in the COVID-19 vaccine should NOT get the vaccine. People with other food or medication allergies can receive the vaccine.

In general, most patients allergic to one vaccine can receive other vaccinations safely. If you have a history of severe allergic reactions to vaccines, injectable therapies, or any component of the COVID-19 vaccine you are going to receive, you should talk with your primary care provider of allergist (if you have one). Your provider can help you decide if it is safe to get vaccinated.

Who is paying for the COVID-19 vaccine?

Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. Vaccination providers may charge an administration fee, however, for giving the shot. This fee can be reimbursed by your public or private insurance company, or, for uninsured patients, by the Health Resources and Services Administration’s Provider Relief Fund.

What do I do while waiting for the vaccine?

It’s important to continue to socially distance with anyone not from your household, wash your hands frequently and wear a cloth face covering whenever you’re with someone from outside your household.

What are the symptoms of COVID-19?

Common symptoms of COVID-19 include fever or chills, cough, sore throat, congestion or runny nose, shortness of breath or difficulty breathing, fatigue, muscle or body aches, new loss of taste and/or smell, nausea or vomiting, diarrhea, and headaches.

What if I think I might have COVID-19?

If you develop a fever, symptoms of respiratory illness, such as a cough or shortness of breath, flu-like symptoms, or loss of taste or smell you should call your healthcare provider. Anyone with even mild symptoms of COVID-19 is encouraged to get tested.

Learn more about Wentworth-Douglass Hospital's COVID-19 updates at wdhospital.org/covid-19.
Immunocompromised patients

I am immunocompromised. Should I get the COVID-19 vaccine?

The CDC has stated that people who are immunocompromised may receive the COVID-19 vaccines, as long as they have had no issues with getting vaccines in the past.

Please note, the COVID19 vaccines are not live vaccines; live vaccines are often not recommended for immunocompromised patients.

Patients who are immunocompromised include:

• Living with HIV
• On immunosuppressive therapies like steroids (prednisone) for a long time
• On immunosuppressive therapies for prevention of organ transplant rejection
• On immune altering medications like biologic therapies (often injectable). These are used for treatment of autoimmune diseases such as Crohn’s disease, rheumatoid arthritis, lupus, and others.

It is not known how effective the COVID-19 vaccines will be for you. You may have less of an immune response to the vaccine. Even if you get the vaccine, you should still wear a mask, practice social distancing, and wash your hands. This is true for everyone getting vaccines now. Infection control experts will let us know when it is safe to modify or stop these safety measures. For now, we do not know if you may need long-term boosters or revaccination. We may not be doing repeat vaccination until everyone is vaccinated.

Should my immunosuppression medications be altered when I get the vaccine?

In general, we are not recommending altering the immunosuppression before or after vaccination. In specific cases, your provider may recommend changes. If you have questions, consider discussing this during your next medical visit.

Can I get the COVID-19 vaccine if I have had an organ transplant?

You can get the vaccine. It’s possible that the vaccine may be less effective in providing protection for you. It may be best to wait to get vaccinated at least three months after your transplant if possible, in order to improve the immune response to the vaccine (when your immune suppression may be less). There is no preference for the Pfizer-BioNTech or Moderna vaccines. Your transplant provider will tell you if you need transplant labs after vaccination.

I am waiting for organ transplantation. Should I get the vaccine?

In general, vaccines work better before organ transplant, before the immunosuppression is started. If possible, we would recommend that you get the vaccine before transplant. We do not currently have mechanisms now to expedite that.

Pregnancy and breastfeeding

I am pregnant. Should I get the COVID-19 vaccine?

Vaccination, especially with vaccines that do not contain live virus, are considered a safe and routine part of prenatal care. For example, the flu shot is not only offered during pregnancy but recommended.  

COVID-19 vaccination is recommended for all people 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.

There is growing evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy suggesting that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy.

There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.

With the help of your OB/GYN, you can discuss what is the best option for you. This will be based on your risk for exposure to the virus and how sick you might get if you do get the virus.

If I decide to get the vaccine during pregnancy does it matter when I get vaccinated?

The decision about when you get vaccinated should be made together with your OB/GYN. This should consider your risk of exposure to the virus and what your chance of getting very sick might be if you do get the virus. There is no data to suggest that the COVID-19 vaccines cause miscarriage.

I heard that some people had reactions after vaccination. Are these dangerous in pregnancy?

Symptoms including fever, muscle aches, joint pains, fatigue, and headache are common side effects of the vaccine (particularly after the second dose). Most mild side effects resolve within a day or two and are not believed to be dangerous. If you are worried about side effects from the vaccine and your pregnancy, talk to your OB/GYN before getting the vaccine.

I am breastfeeding. Should I get the vaccine?

When the vaccine is available for patients, it will be offered to breastfeeding individuals. At this time, there is no data regarding the safety of this new vaccine on breastfed infants of mothers who were vaccinated. However, any vaccine that makes it into the breast milk is likely to be quickly inactivated when the milk is digested. In addition, some of your COVID-19 immunity can pass to the baby through the breastmilk after you receive the vaccine.

What if I become pregnant between the first dose of the vaccine and the second shot?

You can choose to either get the second dose during pregnancy or wait to get the second dose until after you have had your baby. Many individuals who have already had the first dose may choose to get the second dose so they will become immune during pregnancy.

FAQ information updated 8/17/2021