No doubt you’ve seen the pictures or heard the news: COVID-19 vaccines are here. Sandra Lindsay, a critical care nurse at the Long Island Jewish Medical Center in Queens, NY, became the first person in the U.S. to receive a COVID-19 vaccine outside of a clinical trial. After the FDA approved the Pfizer-BioNTech vaccine for emergency use on Dec. 11, Lindsay got inoculated on live TV on Dec. 14.
While this is incredible news, the vaccines aren't widely available yet—and we don't know when they will be. An emergency use authorization (EUA) isn't the same thing as full-on FDA approval. That means the vaccine is currently only available to limited groups, like healthcare workers and nursing home residents.
The first person vaccinated in NYC is a Black woman receiving the vaccine from another Black woman against a virus that has disproportionately killed Black Americans due to systemic racism.
Thank you nurse Sandra Lindsay and the clinician vaccinating her! https://t.co/vIe5E2FPF5
— uché blackstock, md (@uche_blackstock) December 14, 2020
Experts are extremely hopeful that continued testing will go smoothly, and say that so far, there"s not much to worry about in terms of effectiveness. "We have a vaccine that so far looks very effective, and so far, looks quite safe," says Dr. Martin Hirsch, M.D., 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's no 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.
First up, two of the major vaccines in play are what science folks call "mRNA vaccines." But how do they work?
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 vaccines that are in play right now 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 Dr. Noam Tau, 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 vaccine work? Essentially, Dr. Tau says, you can think of it like an "instruction booklet" on how to build those COVID-like spikes. "The body then takes the instruction book and inserts it into our cells which create 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."
A little extra razzle dazzle is that the spikes stick out on the cell surface (“transmembrane-anchored”).
Many infographics show them being pushed out of the cell which is slightly unfactual. https://t.co/qb0MGYziPH
— KizzyPhD (@KizzyPhD) December 16, 2020
Who makes these mRNA vaccines?
The two mRNA vaccines closest to public release come from Pfizer-BioNTech (that’s the one that received the EUA on Dec. 11) and Moderna, which received the EUA on Dec. 15. There are a bunch of similarities between the two: They are both injected into muscles, their large-scale clinical trials have shown that they are over 94% effective, and they both require two doses to be given over the course of three or four weeks.
The major difference we know about so far is how they're stored. The Pfizer-BioNTech needs to be stored in a freezer at –94°F, whereas the Moderna vaccine can actually be refrigerated for up to 30 days or stored for six months at –4°F.
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.
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 Dr. Abisola Olulade, M.D., a family medicine physician with Sharp Healthcare in San Diego, California. "In fact, a lot of the vaccine side effects that we see such as arm soreness, headache, fever, and chills are a sign 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.
Boston health care workers dancing on the sidewalk to celebrate the arrival of the first covid-19 vaccine. pic.twitter.com/7Aw61484xR
— Anaridis Rodriguez (@Anaridis) December 14, 2020
Is there anyone who shouldn’t take the vaccine?
There are a number of populations that the mRNA vaccines haven’t been tested on yet—namely kids under 16, pregnant women, and lactating women. Moderna recently announced their plans to run a trial using adolescents aged 12 to 17.
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 (ACOG) 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.
Why did some countries—ahem, the U.K.—start vaccinating people before others?
Different countries have different approval processes for vaccinations, which helps explain why the U.K. approved using the Pfizer-BioNTech vaccine about a week before the U.S. did. The FDA only oversees drugs used in the United States, and the approval process is really thorough to ensure that medicines are safe for public use before they’re released.
"The approval of the vaccines for emergency use authorization doesn't end the safety process—it just says the vaccine is now safe enough to begin immunizing people," explains Dr. Scott Lillibridge, M.D., International Medical Corps' Director of Emergency Response. "So, the scrutiny will continue intensely, in some cases for an additional two years, on all these vaccines."
When should I expect to get the vaccine?
Here’s the thing: We don’t really know. The Advisory Committee on Immunization Practices (ACIP) released a report on Dec. 3 suggesting that "health care personnel and residents of long-term care facilities" should receive the vaccine first. That said, individual states will determine rollout schedules and priority groups, and there aren’t enough doses available for everyone to get vaccinated at once. The CDC estimates that adults will get vaccinated sometime in 2021, but we just don’t know the specifics yet—young, healthy, low-risk adults may have to wait a while to ensure that vulnerable groups get their shots first.
Will I have to pay to get vaccinated?
We don't have all the details yet, but experts say they expect the vaccine to be free for most people. A piece of legislation that was passed in March 2020 requires Medicaid and most private insurance plans to provide the vaccine gratis, but we'll know more about the specifics when the vaccine is available to the general public.
What about those myths I keep hearing about?
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:
No, you won’t be injected with the COVID-19 virus. The Pfizer-BioNTech and Moderna vaccines use mRNA technology, not the live or inactivated virus.
No, Bill Gates is not implanting a chip in you.
No, getting the vaccine is not more dangerous than actually getting COVID-19
The Mayo Clinic has some great info about COVID 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 Dr. Ramin Ahmadi, MD, MPH, the 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 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. 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."
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