This FAQ was updated on 3/9/2021 (unless otherwise noted within a given section or question).  COVID-19 is an evolving topic and information may change.

This is a compilation of questions asked during the February 5, 2021 webinar, COVID-19 Vaccine: What You Need to Know; the March 5, 2021 webinar, The COVID Vaccine: Personal & Professional Perspectives Within African American and Latino Communities; as well as other questions the community has reached out to us about.

Responses are from Dr. Amanda Westlake, Infectious Disease Specialist and Primary Care Provider at Baystate Mason Square Neighborhood Health Center; Dr. Paul Pirraglia, Chief of General Medicine and Community Health at Baystate Health; and our own staff.

Vaccine & Safety

  • Was the vaccine produced too quickly?
    • Probably not.  The technology (M RNA vaccines) that allowed quicker production has been around for a number of years.  This was a very appropriate application of that technology.  While the time from development to release was rapid relative to past vaccinations, the need for speed to try to stop the pandemic demanded a faster turn which includes the Emergency Use Authorizations (EUA’s) granted by the FDA for all COVID vaccines in use in the US. 
  • The vaccine was created so quickly, is it really safe to take it? How do we know?
    • ​​​​​​Yes.  The vaccine was created rapidly because all scientists in the world were working simultaneously to respond to this global health crisis.  No shortcuts were taken in the clinical trials that included ~40,000 participants that showed the vaccines are both safe and have efficacy >95%.  They were able to be brought to the public so soon after clinical trials because the federal government funded manufacturing. 
  • How large are the clinical trials - 100 people, 1000 people, 5000 people???  Please define large.  I believe in vaccinations.  I can't wait to get mine.  But worried people need to hear a real number not just the word "large".
    • For Pfizer: 21,720 people received vaccine & 21,728  people received placebo.  For Moderna: 15,181 people received vaccine & 15,170 received the placebo

  • What is the difference between the Pfizer and Moderna vaccines? Is one safer or more effective than the other?

    • They are equivalent from a safety and efficacy standpoint.  The only difference from an operations standpoint is that the Pfizer doses are administered 3 weeks apart, whereas Moderna are 4 weeks apart. 

  • Once the first dose of the vaccine is taken, how protected is someone from contracting Covid-19? What will happen if someone only takes the first dosage of the vaccine and does not take the second dosage? Will they no longer be protected?

    • Partial protection from the first dose begins at ~12 days after first dose.  By the time of the 2nd dose, people have >80% protection, and by 2 weeks after the second dose there is >95% protection.

    • The first dose confers the majority of the protection.  The second dose is a booster that increases the level of protection and increases the duration of protection.  This is the reason that some public health experts are recommending delaying the second dose for up to 3 mos in order to get the first dose to the greatest number of people in the shortest period of time. 

  • Once both dosages of the vaccine have been taken, how protected are people and how long does the protection last?

    • Beginning 14 days after the 2nd dose protection is >95%

    • The duration of protection – based on natural infection or vaccine – is not yet definitively known, mostly because the virus has only been circulating for a year.  Best available evidence points to a duration of protection for at least 6-9 mos.

  • After being fully vaccinated (taking both dosages) will another booster be necessary later down the road?

    • Unclear at this point.  If variants (ie, versions of the virus that contain mutations) such as the South Africa, UK and Brazil variants a) become widespread in the US and b) result in lower vaccine efficacy, it is possible that we will need a booster to “outwit” the variants.

  • There have been reports of deaths as a result of persons having received the vaccine, can anyone speak to these assertions?
    • The reported rate of deaths among those vaccinated between 12/14/2020 and 3/1/2021 was 0.0018% (1381 out of 76 million).  This is  very rare.  There is no pattern that suggests a safety concern with the vaccine.  To provide a comparison, there are 12.4 traffic fatalities per 100,000 people per year in the US—that translates to 0.0124% per year which means on average the risk of death in a traffic accident in a year is almost 7 times higher than a death related to COVID vaccination in the 3 months of observation.
  • What about J&J vaccine?  If I received it should I be concerned? (UPDATED 4/28/21)

    • The rate of the concerning side effect (called a cerebral venous sinus thrombosis which is a clot in the brain) is very rare.  Only 8 of these clots occurred among 7 million people who received the vaccination, so if you did receive the vaccination, the likelihood of you having this side effect is very small.  These clots occurred within 3 weeks of the vaccination.  The side effects to be concerned about are new onset of severe headache, abdominal pain, leg pain, shortness of breath, backache, new neurologic symptoms such as weakness in the limbs or sudden changes in vision, swelling in the leg, tiny red spots on the skin, new or easy bruising. It is really important to note the risk of getting COVID then developing clots related to COVID infection is substantively higher than the risk for the clot associated with the J&J vaccination.

  • I heard about the J&J vaccine being pulled. Should I be concerned about Pfizer and Moderna vaccines? (UPDATED 4/28/21)

    • There have been no reports suggesting similar concerns with the Pfizer and Moderna vaccines.  This is not surprising as these vaccines are produced differently and work differently than the J&J vaccination. ​​

How to get vaccine

  • How do you sign up for a vaccine? (UPDATED 5/17/2021)
    • There are several ways to sign up for a vaccine, and many locations are now accepting walk-ins.  ​​​​​​
  • For drive-thru vaccination clinics, is there observation time?
    • The advised observation time is 15 minutes.
  • What about vaccinations for home-bound residents? (UPDATED 5/28/21)
    • As of May 24, any individual who has trouble getting to a vaccine site is eligible for the homebound program. Individuals can call (833) 983-0485 to register for an in-home vaccination. The registration phone line is open Monday through Friday from 9 AM to 5 PM and has representatives who speak English and Spanish, as well as translation services available in 100+ languages.
  • Can you get shots in two different states?
    • This not advised—states track vaccinations
  • Can you choose the vaccine?
    • If the supply and arrangements favor it, you might.  Mostly it is limited to what is available so choice may not be an option.
  • Will the state be opening more localized vaccine sites? ​​​​​​

​​​​​​Who/When to Get Vaccine?

  • How long after getting another vaccine (e.g. flu, shingles) should I wait before I get COVID vaccine?
    • CDC recommends 14 days, with the rationale that you don’t want to confuse side effects from the COVID vaccine with side effects from any other vaccine (particularly shingles, which can make people feel pretty sick).  Pragmatically: get the COVID vaccine whenever it is available to you, regardless of when you got other vaccines.
  • Can pregnant women get vaccinated?
    • Yes.  The clinical trials of Pfizer and Moderna excluded pregnant women and therefore we don’t have specific efficacy and safety data in this population.  Animal studies have show no adverse effects on developing fetus from mRNA vaccines.  Studies are being conducted in real time of safety (e.g. through V-SAFE/CDC) on pregnant women who are receiving vaccine now.  There is not a compelling medical reason to believe that the mRNA vaccine would be either dangerous or less effective in a pregnant woman.   
  • Can I get vaccine if a received passive antibody therapy or other treatment for COVID?
    • Yes, but passive antibody therapy (monoclonals) is expected to impair your body’s ability to produce an immune response to vaccine for 90 days.  So those who got monoclonal antibodies should wait 90 days until they get vaccinated. 
    • Other COVID therapies (remdesivir, dexamethasone) have no bearing on vaccine efficacy – folks can get elect to get COVID vaccine as soon as recovered from COVID illness.
    • The duration of immunity following COVID infection is presumed to be 6+ months.  So there is no rush to get vaccine for those who have been recently infected – they are protected. 
  • Should I get vaccinated if I already had COVID? If so, how long after?
    • The duration of immunity following COVID infection is presumed to be 6+ months.  So there is no rush to get vaccine for those who have been recently infected – they are protected.  However, folks who have had COVID can elect to get vaccine as soon as it is available to them. 
  • If someone has an underlying health condition or is immuno-compromised, is it safe for them to take the vaccine?
    • Comorbidities: The clinical trials of the vaccines included a large proportion of people with underlying conditions such as diabetes, heart disease, lung disease.  It was safe and effective these people.  
    • Immunocompromise: Clinical trials excluded people with severe immunocompromise (receiving chemotherapy, AIDS, etc) so we don’t have definitive data.  These folks are at higher risk for severe COVID disease, so we recommend that they get COVID vaccine ASAP, knowing that immunocompromise may make it less effective. 
  • Can you get both vaccines?  (e.g. Pfizer for 1st dose, Moderna for 2nd)
    • Mixing vaccines is not recommended (just because of lack of data).
  • Do we have any idea when this will be offered to children? Is it safe for children? Or do we just not know yet? UPDATED 5/17/21
    • Pfizer vaccine authorized for age 12+, Moderna for 18+. Studies in children ongoing. Children are clearly at lowest risk for severe disease for COVID, so less urgency.
  • Would there be a problem for people undergoing chemotherapy and getting the vaccine
    • Chemotherapy lowers someone's immune response, so people on chemo may not mount as effective an immune response as people who are not on chemo. ​Otherwise said: people on chemo should definitely get vaccine, discuss the optimal timing of vaccine administration (vis a vis their chemo treatment), but may not get as much protection.  Some protection is better than none and people on chemo are at high risk of severe disease.
  • Can the vaccine be given in a location other than the arm (gluteus maximus, for example), for person who has lymphedema in both arms?
    • Yes, as long as it is administered intramuscularly.
  • My mother was told she should wait 90 days to get vaccinated after having the virus. Is this true?
    • Mostly no.  She may have been told this because she probably would have some degree of immunity from her infection that would probably last at least 90 days so perhaps less urgent, though the recommendation is still to get vaccinated.  If she got a monoclonal antibody treatment for COVID, she should wait 90 days. 

Allergies

  • I have a peanut allergy. Can I take vaccine?
    • Yes. Food allergies are NOT a reason not to get COVID vaccine.  There is no cross-reaction with ingredients in the vaccine. ​​​​​​
  • Can someone arrange to get vaccine in a medical center if risk of allergy?
    • Yes. 

  • What are the vaccine ingredients?
    • Unlike other vaccines, there are NO preservatives in the current mRNA (Pfizer and Moderna vaccines).  The main ingredient that is of concern from an allergy standpoint is polyethylene glycol (the active ingredient in Miralax – a laxative – and in bowel preparations for colonoscopy). 

Side Effects

  • What can someone expect after taking the 1st vaccine? How will they feel? What reactions may they have? ​​​​​​
    • Almost everyone will have arm pain.  Other reactions are less likely. 
  • What can someone expect after taking the 2nd vaccine? How will they feel? What reactions may they have?
    • Most people will have some symptoms – your immune system has already been primed by the first dose and is ready to rock!  These symptoms are normal and indicate that your immune system is doing what it needs to do.
    • Common symptoms: arm pain and fatigue (in most), headache, muscle aches and fever (in ~half).  Symptoms are often prominent enough that you might have to stay home from work/school/usual activities but resolve within 48-72h. 
  • Can I get COVID-19 infection from the vaccine?
    • No.  Unlike other vaccines which are killed (“attenuated”) forms of a virus, the COVID vaccines do NOT include the virus itself and therefore can’t result in infection. 
  • Will vaccines cause fertility issues?
    • There is NO credible evidence to support this claim. 
  • Are there any interactions with medications?
    • Not really.  Only in the sense that if you are receiving a medication that impairs the immune response (eg for rheumatoid arthritis, inflammatory bowel disease or cancer), you should try to time getting the vaccine when your immune system is at its strongest (so it can respond the best to the vaccine).    
  • If you have COVID but are asymptomatic and get vaccine, what will happen?
    • If COVID infection has already been established at the time vaccine is administered, the infection will proceed as it normally would have.
  • ​Is there a plan in place to assist elderly people who live alone (have no helper with them at the vaccine site), to follow up after the second shot to make sure they are not having serious issues?
    • In general, people feel more ill (fatigue, HA, muscle pains, fever) in the 48h following the 2nd dose than following the first dose. Interestingly, older people have FEWER side effects from the vaccine than younger people. However, we should partner with primary care to follow-up on folks after 2nd dose.
  • What are the long term side-effects of the vaccine?
    • This is unknown as the vaccine is new. 

Effectiveness

  • How long do vaccines last? 
    • Unclear at this time, as neither the virus nor the vaccines have been around long enough to definitively state duration of protection.
    • Best available evidence is that immunity from natural infection lasts at least 6mos. 
    • The answer will depend in part on what happens with variants (e.g., vaccine immunity could be reduced if vaccine-resistant variants become widespread).
  • Staff are still resistant because we don’t know how long the vaccine is effective.  Will we have to get boosters?

    • There is no answer to this question yet, but the thinking is that it is likely booster vaccinations will be needed.

  • ​​​​​​​​​​​​​​​​​Herd immunity? When will it be reached?

    • The million dollar question.  Probably somewhere north of 70% of the population immune from natural infection and vaccine. 
  • Can you share your perspectives about "Herd Community"? Have to be realistic about the fact that many will still not get vaccinated EVER.
    • Herd immunity is when a majority of people (estimated to be above mid-80% or so, depends on how easily the disease spreads) have been vaccinated or have immunity due to prior infection that a disease will not typically spread widely in the population (that is, there will only be scattered cases rather than clusters of outbreaks or widespread infection).  This is exactly why there is such interest in having enough vaccine and encouraging people to take the vaccine to get enough people vaccinated that the virus does not spread widely across the population the way it has been.  It is also why the new variants that spread easier are a worry—the percentage to get to herd immunity goes up if the disease spreads easier.​​​​​​​
  • Once someone is vaccinated, can they still transmit the virus to others who have not yet been vaccinated?
    • We don't yet have data to definitively answer that question. Initial data - and experience from prior vaccines - points to the likelihood that vaccinated persons will NOT transmit virus. That is, vaccine is likely to be good not only in preventing symptomatic infection but also in asymptomatic infection.
    • It is not definitively known to what degree mRNA vaccines prevent asymptomatic transmission. It is known that they are >95% effective in preventing symptomatic infection and that preliminary data suggest that they also prevent transmission (asymptomatic infection).
    • The main endpoint in the trials was symptomatic infection (ie, clinical disease) rather than infection (ie asymptomatic shedding of virus). However, the Moderna trial did do surveillance for asymptomatic infection and showed efficacy in preventing transmission.
  • Are vaccines effective against the new strains?
    • Modern and Pfizer weren’t tested at a time when the variants were circulating, so we don’t know.  Johnson & Johnson, Novavax, and Janssen all showed lower effectiveness in South Africa – suggesting that vaccines are less effective against the South African variant. 
  • Does blood type have anything to do with vaccine effectiveness?
    • No.
  • After vaccination, will COVID antibody test be impacted? 
    • Most of the antibody tests available currently test only for antibody induced by natural infection (antibody to nucleocapsid protein), not antibody induced by vaccine (antibody to spike protein).  So you will probably not test positive by antibody after vaccine alone.  This is changing, though – you need to find out what the specific antibody test your lab uses tests for. 
  • Once I get the vaccine, how and where can I obtain an antibody test to verify that I am in the 95% that have immunity with the vaccine?
    • Such antibody tests are neither recommended nor widely available. 
  • How long after the second dose can I consider myself fully protected? What is known about the prevalence of the resistant or more contagious COVID strains in our area?
    • 95% protection occurs 14 days after 2nd dose of mRNA vaccines (Moderna/Pfizer)
    • In general, the US has limited lab capacity to do the type of virologic surveillance that is needed to detect the variants.  The UK variant has been detected in 33 states, but this is likely an under-representation based on under-surveillance.
  • What % of effectiveness is the first shot of Pfizer or Moderna vaccine?
    • ​​​​​​​​​​​​​​Protection starts to kick in at 12 days after the first dose. By the time of the second dose, protection is 80% or higher. By 14 days after 2nd dose, protection is >95%​​​

​​​​​​​

Vaccine Requirements for Work

UPDATED 4/15/2021

  • Is it true that when a vaccine is under EUA an employer can't "require" employee vaccination?
    • Yes, a vaccine that is not full approved by the FDA cannot be mandated by an employer.
  • What are cleaning contagion protocols?
    • The virus that causes COVID-19 can land on surfaces. It’s possible for people to become infected if they touch those surfaces and then touch their nose, mouth, or eyes. In most situations, the risk of infection from touching a surface is low. The most reliable way to prevent infection from surfaces is to regularly wash hands or use hand sanitizer. Cleaning and disinfecting surfaces can also reduce the risk of infection.  Always follow standard practices and appropriate regulations specific to your type of facility for minimum standards for cleaning and disinfection.  Read CDC Guidance on cleaning and disinfecting your facility. ​​​​​​
  • What are appropriate protocols for office staff? If everyone is fully vaccinated, can you take your mask off?
    • Even if all employees are fully vaccinated, in work settings, employees should continue to wear masks.  Per CDC, employers should continue to follow the Guidance for Businesses and Employers Responding to COVID-19. This includes wearing well-fitting masks, making sure employees are staying at least 6 feet (about 2 arm lengths) apart from each other, avoiding crowds and poorly ventilated spaces, and washing hands often.  Read more.
  • My office is fully vaccinated, but the CDC says don't take your mask off and don’t gather for Easter. Yet, Six Flags is going to open. What are the right decisions? The guidelines are confusing.
  • Volunteers at my organization are eligible though many don't have digital access or are cognitively impaired. What are resources to help people who are not able to navigate online systems?
  • How should employers address staff side effects from the vaccine?
    • ​​​​​​​​​​​​​​CDC recommends that employers consider staggering employee vaccination to avoid worker shortages due to vaccine side effects.  They also encourage employers to provide flexible leave polices for those who may have post-vaccination symptoms. Learn more.
    • The CDC offers guidance on how to distinguish between post-vaccination signs and symptoms of COVID-19.  Learn more.
  • ​​​​​​​​​​Will the COVID-19 Vaccine be mandated eventually?
    • The CDC offers the following guidance on vaccine mandates & exemptions.
      • COVID-19 vaccines are not mandated under Emergency Use Authorizations (EUAs). The Food and Drug Administration (FDA) does not mandate vaccination. However, whether a state, local government, or employer, for example, may require or mandate COVID-19 vaccination is a matter of state or other applicable law.
      • Employer Vaccine Mandates and Proof of Vaccination. Whether an employer may require or mandate COVID-19 vaccination is a matter of state or other applicable law. If an employer requires employees to provide proof that they have received a COVID-19 vaccination from a pharmacy or their own healthcare provider, the employer cannot mandate that the employee provide any medical information as part of the proof.  Two types of exemptions to get vaccinated can be implemented: medical exemptions & religious exemptions.
      • Employers offering vaccination to workers should keep a record of the offer to vaccinate and the employee’s decision to accept or decline vaccination.​​​​​​​
  • How do you disclose if you have been vaccinated? What are the social ques and rules?
    • ​​​​​​​​​​​​​​If an employer requires employees to provide proof that they have received a COVID-19 vaccination from a pharmacy or their own healthcare provider, the employer cannot mandate that the employee provide any medical information as part of the proof.
    • There is a difference between asking if someone was vaccinated and asking someone why they were not vaccinated.  EEOC offers the following guidance: Simply requesting proof of receipt of a COVID-19 vaccination is not likely to elicit information about a disability and, therefore, is not a disability-related inquiry.  However, subsequent employer questions, such as asking why an individual did not receive a vaccination, may elicit information about a disability and would be subject to the pertinent ADA standard that they be “job-related and consistent with business necessity.”  If an employer requires employees to provide proof that they have received a COVID-19 vaccination from a pharmacy or their own health care provider, the employer may want to warn the employee not to provide any medical information as part of the proof in order to avoid implicating the ADA.  Additional guidance: U.S. Equal Employment Opportunity Commission, What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws

​​​​​​​​​​​​​​Considerations for Fully Vaccinated Individuals​​​​​

UPDATED 4/15/2021​

  • Are there any changes to what would be determined a contact? If someone is vaccinated, does that person still need to quarantine?
    • A close contact is someone who has been within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before the illness onset (or for asymptomatic patients, 2 days prior to test specimen collection) until they meet criteria for discontinuing home isolation.
    • If you have symptoms, whether you are vaccinated or not, you should isolate.  This is typically 10 days after the date your infection is confirmed. Learn more.
    • If you are fully vaccinated (2 weeks after final dose of vaccine), you do not need to quarantine or get tested after being around someone who has COVID-19 unless you have symptomsRead guidance for fully vaccinated individuals. However, if you live in a group setting (like a correctional or detention facility or group home) and are around someone who has COVID-19, you should still stay away from others for 14 days and get tested, even if you don’t have symptoms.
    • If you are not fully vaccinated and you were exposed to someone with COVID but haven’t shown any symptoms or had a positive COVID-19 test, it is best to quarantine for 14 days; however, if after 10 days after your exposure, you have no symptoms, you can end quarantine.   You can end your quarantine after 7 days if you get tested and are negative for the virus.  Read more guidance from MA.​​​​​​​
  • If a fully vaccinated individual experiences symptoms, should they still wait for a negative COVID-19 test?
  • If a fully vaccinated individual was exposed to COVID-19, but does not have any symptoms, do they still need to quarantine?
    • If fully vaccinated (2 weeks after final dose), you do not need to quarantine UNLESS you have symptoms.​​​​​​​
  • I have received vaccine. Do I still need to wear a mask? (UPDATED 5/28/21)
    • Effective May 29 in Massachusetts, fully vaccinated individuals (2 weeks after final dose of vaccine) do not need to wear masks, unless they are in specific settings: On public and private transportation; Inside K-12 public schools, collaboratives, approved special education schools; Inside childcare programs; In health care facilities and provider offices; In congregate care settings; In health care and rehabilitative day services and programs. ​​​​​​​Learn more.
    • CDC released updated guidance for fully vaccinated individuals on May 13, 2021.