Frequently Asked Questions

Regarding COVID-19 Vaccine

Where can I find reliable information on the vaccine?

Stick to reliable sources! The CDC continues to update their webpages as information becomes available. Start here.

How each vaccine works:

Overview of the types of vaccines in development here.

Select a topic or specific question to jump to the answer.

How long will the vaccine last? 

What's in them, and not in them? 

Have a question not listed above? Submit it here.

Should I get the vaccine?

 

When can I get the vaccine? 

 

Please refer to the following link.

Can I choose which vaccine I get? Should I wait for the one I want?

 

We do not advise any one vaccine over another. All are highly effective against severe COVID-19.

Will I need to pay for the vaccine? 

 

There will be no cost to you for the vaccine or administration, regardless of your insurance status. If you are insured, your medical insurance may be charged a fee for administering the vaccine, but there will be no cost for you personally. If you are uninsured, a fund created by the CARES Act will cover the cost of administering the vaccine at no cost to you. YOU WILL NOT RECEIVE A BILL FOR VACCINATION.

If I have already had COVID-19 and recovered, should I avoid getting the vaccine? 

 

You should still get the vaccine, although it is not as urgent and you may choose to wait until vaccine is more readily available.

If I'm allergic to eggs can I get the COVID-19 vaccine?

 

It depends on the vaccine. You will have no problem with the mRNA vaccines (Pfizer/BioNTech and Moderna) because they are not produced in eggs the way traditional vaccines (like the flu vaccine) are.

If I have a history of allergies, should I get the vaccine?

 

It depends. The CDC addressed this question (and others) in their clinical considerations for use of the Pfizer and Moderna vaccines with the following table: 

New Strains

 

Will the vaccine work against the UK and South African variants? 

 

Yes. Preliminary studies have shown that both the Pfizer/BioNTech and Moderna vaccines work against the UK (B.1.1.7) and South African (B.1.351) variants. This is not surprising. The immune system does not just look for the whole spike protein. Rather, your cells will make the protein and then chop it up into small pieces and present it to the immune system, which then makes antibodies against multiple pieces of the spike protein. So even if one or two areas have small changes, there will still be many other areas that are still “recognized” by antibodies. The mRNA vaccines provoke a WHOPPING immune response, so even if some of the antibodies are “off-target” there should still be plenty to provide protection against severe disease.

 

What do I need to know about the new strains? 

The strain of the virus that appears to have originated in southern Britain is up to 70% more transmissible. It also appears that it may infect children as easily as adults, which is a major concern for viral spread. It has a number of mutations, one of which is also found in a strain that seems to have taken over much of South Africa (90% of samples since mid-November). Your risk for catching COVID-19 will increase dramatically when these new strains take hold. 

 

How worried should I be about more mutations? 

Worrying does not help; what does help is changing your behavior in response to changes in the way the virus behaves. The more transmissible it becomes, the more careful you should be. COVID-19 mutations are happening all the time, albeit at a much slower rate than for the flu virus. This is evolution at work. Mutations that make a virus more contagious are very likely to spread and take over, as we saw with D614G which quickly became the dominant strain around the world. However, these mutations do not automatically (or generally) make a virus more virulent (causing more severe illness). Why? Because there is selection pressure (evolutionary advantage) for increased transmissibility, but not for increased illness severity. The most successful viruses spread easily but do not make their hosts extremely ill--a good example is the common cold. 

 

How long will the vaccine last? 

This depends on four things: The immune response of the individual, the mutation rate of the virus, the prevalence of the virus in the population, and the vaccination rate of the public

  • Immune response of the individual: The mRNA vaccines generally produce a very robust immune response in persons with normal immune systems. Statistically speaking, this is not a big issue. 

  • Mutation rate of the virus: No single mutation will allow the virus to escape the vaccine, but multiple mutations could. We cannot control the mutation rate of the virus, but it does not mutate as quickly as the flu so annual vaccination should not be necessary if the next two conditions do not favor the virus. 

  • Prevalence of the virus in the population; Mutations occur in every infection. More infections mean more chances of accumulating mutations that will allow the virus to become more infectious or/and more deadly or/and evade a vaccine. Note that these are not co-dependent features of a mutation. The N501Y mutation (in the UK and South African variants) makes the virus more infectious, and possibly more deadly according to scientists in the UK. Several strains of the UK variant have also picked up the E484 mutation seen in the Brazil variant. Addition of each advantageous mutation brings the virus one step closer to escaping immunity endowed by prior infection or vaccination. It is still many steps away, but it can only be avoided by reducing the amount of virus circulating. 

  • Vaccination rate of the public: This is the issue at hand

Why does the vaccination rate of the public matter?

 

For the same reason that you must take ALL of your antibiotic prescription rather than just until you feel better. The longer the virus circulates, the more chances it has to accumulate random mutations until it can escape the vaccine. One single mutation will not allow the virus to escape the vaccine, but an accumulation of mutations will. If a virus suddenly has no susceptible hosts, it will be eradicated. We must reduce the prevalence of the virus and reduce the chance of it escaping by vaccinating as many people as possible as quickly as possible. 

If I get the vaccine, will I test positive for COVID infection? That would be a problem for traveling. 

 

No, you will not test positive for active COVID infection after being vaccinated. The mRNA vaccines carry the genetic sequence (instructions) for your cells to make the spike (S) protein. The PCR/molecular tests look for sequences encoding a different protein (nucleocapsid protein, N), so even if you have the Pfizer/BioNTech or Moderna vaccine actively in your system, you will not test positive. The antigen tests detect the nucleocapsid protein, so no matter how much spike protein your cells make in response to the vaccine, you will not test positive. Antibody tests are not used to find active infection. 

 

Can an mRNA vaccine change my DNA

 

No. Your DNA is safe in the fortified nucleus of your cells and the vaccine mRNA will remain outside the nucleus in the cytoplasm. Getting into a cell is relatively easy, the nucleus is a fortress that requires special recognition, like password-protection and 2-factor authentication. RNA that does not belong in the nucleus does not get there.

Weren't trials too rushed to demonstrate safety? 

 

Adverse events generally occur within 1-2 months of vaccination, so COVID vaccines authorized by the FDA will have good safety profiles. Longer trials are always preferred, but ethics requires balancing the known harm of a raging pandemic against the possibility of a rare adverse event. 

Will there be side effects? 

 

You will probably feel your immune system responding to the vaccine - pain at the injection site and flu-like symptoms including aches and a low fever. You should not be alarmed by these symptoms. There is zero chance of getting COVID-19 from an mRNA vaccine. Please refer to the graphical guide to coronavirus for details on which vaccines contain live (but severely weakened) virus. The grading of adverse events is a little complicated, but if you are interested this presentation explains them. The severity of adverse events is graded 1-5. Grade 5 is death, grade 4 is life-threatening, grade 3 is medically significant and serious, but not life-threatening. Grade 3 events "limit daily activities" but generally do not require hospitalization. Note that ALL adverse events are reported, regardless of whether they are related to vaccination or not—getting struck by lightning is reported as an adverse event in a clinical trial. In the Pfizer/BioNTech phase 3 trials, no grade 4 or 5 events attributable to vaccination were reported. In the vaccine groups grade 3 events were site-injection soreness, fatigue, and fever. Moderna reported grade 3 events of fatigue, muscle and joint pain, headache, and redness at the injection site. These occurred in more than 2% of participants who received the vaccine and generally lasted less than 48 hours. 

What's in them, and not in them?

 

Do the mRNA vaccines contain antifreeze?

 

No. Antifreeze is ethylene glycol - one ethylene group (which you can think of as a single Lego block). The Pfizer/BioNTech and Moderna vaccines contain polyethylene glycol, also called PEG. The prefix “poly” means “many” so you can think of PEG as many Legos added sequentially to the first Lego. FYI, the laxative MiraLax is PEG 3500 (the number is a weight that corresponds to a certain number of ethyl groups). MiraLax is sold over-the-counter, consumed in huge quantities compared to what is in a vaccine, and is nontoxic. PEG is added to many injectable medications including some contraceptives and steroids; this practice is so frequent that industry has coined the term "PEGylation" to describe the process. The PEG in the vaccines is similarly well tolerated, although some people are allergic to it. 

 

Are there microchips in the vaccine?

No. Keep in mind that extremist groups are excellent pawns for foreign actors that would love to see the United Sates continue to struggle amid a pandemic. There is virtually zero evidence for this one. 

 

Is there aborted fetus in the vaccine?

See above.

 

What are the ingredients in the mRNA vaccines?

Here's a table provided by the CDC:

Adverse Events

 

Is there a fertility risk for women? I heard that the spike protein is similar to part of the placenta!

 

There is zero evidence and no reason to believe that the vaccine will interfere with fertility. In fact, 23 people became pregnant after receiving the Pfizer/BioNTech vaccine in their Phase 3 clinical trial, and no adverse events have been reported. A very small part of the spike protein is indeed similar to a protein in the placenta. HOWEVER, that part of the spike protein is not included in the mRNA vaccine so it will not be expressed by your cells when they receive the mRNA vaccine. That part of the protein has simply been left out. In any case, placental abnormalities observed in COVID-positive pregnancies are believed to be due to the clotting issues caused by the virus; no clotting abnormalities occurred in the Pfizer/BioNTech or Moderna vaccine trials.

 

Can I get Bell's Palsy from the vaccine? 

This is extremely unlikely. Yes, there were 4 cases of Bell’s Palsy amongst vaccine people who received the Pfizer/BioNTech vaccine in their Phase 3 trial. This falls well within the normal incidence of Bell’s Palsy in the general population (calculations below if you want to keep reading). As it happens, there were none in the control group. This is likely a statistical anomaly, which you see when your sample size is too small to collect sufficient data points for the signal you are trying to detect—Bell’s Palsy is not common and the number of participants in the Phase 3 trial was too small to accurately measure its occurrence. Statistical anomalies appear real when you look too closely at small data sets. For instance, if you flip a coin you will inevitably get runs of either heads or tails, but the numbers of heads vs. tails will even out if you flip the coin enough times. If a run of heads or tails occurs early in your experiment and you stop the experiment immediately after the run, it will appear to favor either heads or tails over the other. This is why something called “statistical power” is important when designing trials. An underpowered trial may not detect truly rare events. The incidence of Bell’s Palsy is somewhere around 15-30 cases per 100,000 people per year. Let’s use the middle of that range (22.5) and run the numbers. The Pfizer trial followed 65,000 people for three months so 22.5/100,000 x 65,000 = 15 cases expected per year in that population; over three months (1/4 of the year) one would expect to see 3.6 (or 4) cases of Bell’s Palsy. Q.E.D.

 

I had a seizure when I received the DTAP or TDaP vaccine as a child. Could the COVID vaccine give me a seizure?

Seizures have not occurred in the study population, so it is extraordinarily unlikely. Seizures are a known risk with the administration of the pertussis vaccines; although rare, your experience was not entirely unexpected. When the COVID vaccine is tested in the pediatric population, it is possible that a risk of seizures will be found but we just don’t know yet.

 

How are adverse events reported after administration, and for how long? 

The FDA and CDC manage a database called VAERS, the Vaccine Adverse Events Reporting System, to track the long-term safety of vaccines. Anyone who administers vaccines must agree to report serious adverse events to this system, but anyone (including patients) can file a report. The data is available to the public. You can see how the VAERS system works, including strengths and limitations, in this video. There is no time limit to safety monitoring of vaccines.

 

How will the health and safety of COVID vaccine recipients be monitored? 

Because the COVID vaccine is being offered under EUA rather than full approval, an active (voluntary) smart phone-based safety monitoring system will be implemented—V-SAFE, Vaccine Safety Assessment For Essential workers. If you are vaccinated in Phase 1, you will receive a text message or email daily for the first week and then weekly for 6 weeks, asking about any symptoms you may be experiencing. Adverse events will be reported to VAERS for you. In addition to V-SAFE and VAERS, additional monitoring systems will be used in a traditional manner and timeline (NHSN, VSD, CMS, BEST and Sentinel, etc.).

 

What will happen once an event is reported to VAERS?

  • Processing of VAERS reports related to COVID will be expedited as follows:

    • Reports of death (remember, if you get hit by a car or struck by lightning, it’s an adverse event that gets reported): 1 day

    • Reports classified as serious: 3 days

    • Reports classified as non-serious: 5 days

    • Active telephone follow-up will be conducted for anyone reporting a ‘clinically important’ adverse event during a V-SAFE health check

      • “Clinically important” = missing work, unable to perform normal daily activities, or getting care of any kind from a healthcare professional

  • An FDA scientist will review any event classified as serious, and attempts will be made to review medical records and other medical documentation.

  • CDC scientists will review VAERS reports for AESIs (Adverse Events of Special Interest).

The above information was updated 02/04/2021.

Interventional Pain Management

This website may contain general information relating to various medical conditions and their treatment. Such information is provided for information purposes only and is not meant to be a substitute for advice provided by a doctor or other qualified healthcare professional. Patients should not use the information contained herein for diagnosing a health or fitness problem or disease. Patients should always consult with a doctor or other healthcare professional for medical advice or information about diagnosis and treatment. 

Copyright © 2019. All Rights Reserved by Neuroversion