DFA COVID Vaccine FAQ Toolkit

Doctors for America
22 min readDec 16, 2020

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For a more readable version with the most updated information, & an interactive map featuring photos health workers who have been vaccinated across America, please visit our new website:

http://bit.ly/CovidVaxFAQ

We have made this toolkit of the most commonly asked questions we have received from patients and health care workers; and attempted to summarize answers in language that could easily be used with the general population.

We do not plan to go into detail on specific health conditions, as many of those organizations have their own recommendations out or forthcoming. However, we will touch on common questions and link to specific resources!

You can use this in any way you would like!

You can “build a Vaccine Handout,” pulling questions/answers from specific areas, tailored for your patients, colleagues, family, friends, coworkers, place of worship, school, daycare, etc.

Or you can share the link directly. Here’s a shortened version: bit.ly/DFACovidVaccineFAQ

We will also attempt a simple one-page vaccine handout (to be uploaded shortly). This will be a very high-level general informational handout.

AND: if you have questions you think should be included or suggestions on how to make this better (or you just want to help us!), please:

  • Email info@drsforamerica.org (Subject line: COVID Response Team)
  • Message one of us on Twitter!
  • Join the Doctors for America Slack Channel by clicking https://bit.ly/JoinDFASlack. We want to build the DFA community and very much want to hear from you.

In solidarity,

Meena Bewtra @DrsMeena

Farheen Qurashi @FarheenQurashi

Justin Lowenthal @jilowenthal

The Doctors for America (DFA) COVID Response Committee Leadership

Last updated: 12/31/2020 at 18:18 pm E.T. (Please visit http://bit.ly/CovidVaxFAQ for subsequent updates.)

Table of Contents (to guide your scrolling):

General Questions:

  1. How do I get the vaccine?
  2. Why should I get the vaccine?
  3. What is “herd immunity”?
  4. Why is the vaccine taking so long to be developed and given out?
  5. What is “vaccine hesitancy”?
  6. If I get the vaccine, will my risk of COVID19 be decreased?
  7. After I’m vaccinated, can I go to crowded indoor spaces?
  8. Once I’m fully vaccinated, can I stop wearing masks, washing hands, and social distancing?
  9. If I get the vaccine and still get COVID, will I get less sick?
  10. Once I am fully vaccinated, will I be able to pass on the virus to others?
  11. What level of immunity can the elderly and immunosuppressed expect to get from the vaccine?
  12. How long will this immunity last?
  13. If there is a delay in the distribution chain, how will it affect my vaccination efficacy if I have to wait longer between my first and second dose?
  14. Am I at a great risk of infection after my first dose but before my second dose of the vaccine?
  15. If someone has already had COVID, do they need to get the vaccine?
  16. What will the vaccine cost?
  17. Are there any negative interactions between the flu vaccine and the COVID vaccine?
  18. I am due to get another vaccine; can I get it at the same time as my COVID vaccine?
  19. Now that we have two vaccines (Pfizer and Moderna), which one should I get?
  20. Can I get one dose of one vaccine and the second dose from a different vaccine?
  21. Are these various vaccines the same or different enough that we should get both?
  22. I received convalescent plasma or a monoclonal antibody therapy for COVID; can I still get the vaccine?
  23. I don’t trust the vaccine because I don’t think my community (people who look like me) were represented.

Safety:

  1. Are RNA vaccines safe? We’ve never had one before!
  2. It’s really unbelievable that we will have a vaccine against a new virus so soon, right?
  3. I have heard that people with allergies cannot get the vaccines?
  4. Are there any underlying health conditions where it is recommended that people shouldn’t get the COVID vaccine?
  5. Is there anyone who should NOT get the vaccine due to safety concerns?
  6. Is this a live vaccine? I’m worried about getting the vaccine and passing COVID to someone else.
  7. Are there any human or animal parts in the vaccine?
  8. I have heard that you get really sick when you get this vaccine?
  9. I am immunosuppressed and/or have a high-risk medical problem: is it safe for me to get the COVID vaccine?
  10. I have heard that if I’ve had COVID and get the vaccine, it could lead to too many antibodies which could predispose you to autoimmune disorders. Is there any concern or truth to that?
  11. I have an autoimmune disorder; will I have a flare when I get the vaccine?
  12. Is it true that vaccines including COVID vaccines contain metals?

Timeline:

  1. When can I get the vaccine?
  2. Can I choose the type of vaccine I get?
  3. The vaccine priority groups are unfair — can I skip the line?
  4. How will I know when I can get the vaccine?
  5. Where can I find out when and where I can get the vaccine?
  6. What about people who were in a clinical trial and got placebo-can they get the vaccine?

Special Populations:

  1. What about getting this vaccine for pregnant or lactating women?
  2. I have heard that mRNA vaccines cause infertility?
  3. If I get my COVID19 vaccine while I am pregnant, will protective antibodies cross the placenta during pregnancy?
  4. Is it safe to get the vaccine while breastfeeding? Are protective antibodies from the vaccine spread in breast milk?
  5. What about children?

GENERAL QUESTIONS:

Q: How do I get the vaccine?

Answer: The vaccine is an injection or shot. You will need two shots for both of the EUA approved vaccines. The Pfizer vaccine is given 21 days apart. The Moderna vaccine is given 28 days apart.

You are not fully vaccinated until you receive both doses (two shots).

If you miss the 21/28-day window, you do NOT need to start all over again.

Q: Why should I get the vaccine?

Answer: The shot will help protect you from being infected with SARS-CoV-2 (the infection that causes COVID-19) and, even if you get infected, it will help prevent you from developing symptoms of severe COVID-19.

Getting the vaccine reduces your risk of becoming ill, seriously ill, or dying from COVID-19. The vaccine may also decrease the chance you could pass the virus on to someone else (see below).

When enough people receive the vaccine, we will reach what’s called herd immunity. Herd immunity will help protect everyone from COVID-19.

However, before we reach that point, we will still need to keep doing all the things we were already doing to protect ourselves: wash hands frequently, social distance, and wear masks.

Q: What is “herd immunity”?

Answer: Herd immunity occurs when a majority of the population (the “herd”) is vaccinated. When enough people are immune through vaccination, the disease is unable to spread. With nowhere to go, the virus dies out. It is then far less likely that anyone, immunized or not, will become infected with the virus. Usually, about 70%-90% of people must be vaccinated to reach herd immunity. Because these vaccines will take time to be distributed, we will need patience because it will take many months to reach this point with COVID-19.

To be clear: herd immunity is not the idea that a majority of people get sick with COVID-19 and recover. Herd immunity only applies to the COVID vaccine.

Q: Why is the vaccine taking so long to be developed and given out?

Answer: This vaccine has been developed very quickly compared to other vaccines. This is due to the urgency of the global pandemic. However, it has been created in a way that allowed it to be safe and to be studied so that people around the world can be confident in taking it

The next step is distribution. Distribution has some challenges, including shipping, storing (some vaccines need to be kept at remarkably cold temperatures!), and administration. The millions of doses that are needed still need to be manufactured.

Finally, there will be people who do not want to receive the vaccine for various reasons — or who do not want to receive it at first but do end up receiving it later. This delay is a barrier in achieving “herd immunity,” and it may take time and patience to reach a level of 70–80% of the population becoming vaccinated

Q: What is “vaccine hesitancy”?

Answer: This is when a person is “hesitant” about receiving the vaccine. This can be due to many factors, such as concern about the safety and development of this specific vaccine, lack of confidence in vaccines as a whole, or a lack of education about vaccination.

This is why it’s important for all of us to talk to each other, discuss concerns, and address them as honestly as possible.

Q: If I get the vaccine, will my risk of COVID19 be decreased?

Answer: Yes! These vaccines are effective and have been shown to significantly reduce your risk of getting sick with COVID-19. The risk decreases very quickly. Results from the Pfizer vaccine have shown that within 10 days of receiving the 1st shot, your risk of COVID significantly decreases. This is the same regardless of sex, race, age, or weight.

But that first dose is only 52% effective on its own. That’s why you need to get that second dose to get to the 95% effectiveness that everyone is talking about.

AND: you will still need to continue precautions for awhile longer. No vaccine protects 100% of the time. People will still have to minimize risk by wearing a mask, social distancing and washing hands.

Q: After I’m vaccinated, can I go to crowded indoor spaces?

Answer: No. First, the vaccine immunity takes at least 2–3 weeks after ALL doses. Also, the vaccine is not 100%. You will still need to social distance and wear a mask until we reach herd immunity.

Q: Once I’m fully vaccinated, can I stop wearing masks, washing hands, and social distancing?

Answer: No. We are still collecting data on how well the vaccines will prevent the spread of coronavirus. Some vaccinated people may get infected without developing symptoms and silently spread the disease to others. You must continue to practice social distancing, wear a mask, and wash your hands frequently. While vaccines are effective, they are not a 100% guarantee, and it will take at least several months for us to reach a point of herd immunity.

Q: If I get the vaccine and still get COVID, will I get less sick?

Answer: Yes. The vaccine has been shown to decrease severe COVID-19 in those who do come in contact with the SARS-CoV-2 virus. This is incredibly important, as we know a lot of long-term damage occurs when people are sicker with COVID-19. Being vaccinated helps keep people with COVID-19 out of hospitals, which protects our health care institutions for everyone

Q: Once I am fully vaccinated, will I be able to pass on the virus to others?

Answer: This is still being studied. The Oxford-AstraZeneca and the Moderna vaccines looked at asymptomatic transmission of the virus (meaning having active virus that could be spread but having no symptoms) and found that it was significantly decreased with their vaccines.

However, we do know that not everyone responds to these vaccines; and some vaccinated people still could get infected and not have symptoms. Those people can still spread the disease to others.

Bottom line: until we reach a point of “herd immunity” or get more data on this, you still need to wear a mask, social distance and wash your hands frequently to protect yourself and others.

Q: What level of immunity can the elderly and immunosuppressed expect to get from the vaccine?

Answer: The clinical trials for both Pfizer and Moderna thus far indicate no difference in efficacy by age with the vaccine.

It is unclear at this time what the effect of various immunosuppressant medications will be on the vaccine.

Q: How long will this immunity last?

Answer: At this time, we are not entirely sure how long it will last. Please stay tuned and we will update with more information as it comes!

Q: If there is a delay in the distribution chain, how will it affect my vaccination efficacy if I have to wait longer between my first and second dose?

Answer: this is a really great question and one many are already discussing given vaccine shortages. Currently it is recommended that you receive the two doses of the Pfizer vaccine 21 days apart. If you miss the 21 day window, you do NOT need to start all over again.

We do not know how this will affect efficacy at this time but will keep updating with recommendations from scientists and public health advocates based efficacy data we have!

Q: Am I at a great risk of infection after my first dose but before my second dose of the vaccine?

Answer: No! In fact, what is really great is that the Pfizer vaccine has been shown to cause a 52% efficacy with the first dose alone — and within 10 days of the dose! That is really incredible!

Still — you do not get that 90+% efficacy until you get the second dose; so please make sure to follow-up with your second dose; and always wear a mask, maintain social distancing and wash your hands!

Q: If someone has already had COVID, do they need to get the vaccine?

Answer: This is a great question! Currently people can — and should — receive the vaccine regardless of their prior history of infection.

It is NOT recommended that you need to test for active or prior infection before getting the vacccine

Given that it appears that many people who have had COVID have immunity for at ~90 days, people who have been infected can wait until a 90-day period has passed to receive the vaccine (but they do not have to wait).

If you are actively infected with COVID, you should wait until you have recovered from your acute infection and your quarantine period is over. This is so that we protect those giving the vaccines and others at the sites where vaccinations will be happening.

If you have been exposed to someone who had COVID, you should wait until your quarantine period is over — again to protect those giving the vaccines and others at the sites were vaccinations are happening.

Q: What will the vaccine cost?

Answer: That is a great question! Currently it is estimated it will cost (depending on the vaccine and insurer) anywhere from $3 to $38 per dose for the vaccines. This is the administrative fee for giving the shot and may be reimbursable by public/private insurance.

Q: Are there any negative interactions between the flu vaccine and the COVID vaccine?

Answer: No-there did not appear to be any negative interactions (remember, the clinical trials ran through flu season, so many participants received both). We do know that getting both the flu and COVID illnesses at the same time appears to be associated with a significantly increased risk of death, so we recommend obtaining BOTH vaccines! But you should space them apart by at least 14 days.

Q: I am due to get another vaccine; can I get it at the same time as my COVID vaccine?

Answer: Currently, for the Pfizer vaccine, it is recommended that the COVID vaccine should be administered at least 14 days before/after any other vaccine so potential reactions are not confused with reactions to other vaccines.

Q: Now that we have two vaccines (Pfizer and Moderna), which one should I get?

Answer: We are so glad you want to get vaccinated! Please get whichever is available to you first. Both the efficacy and safety data of the Pfizer and Moderna vaccines were very comparable (neither was “better” than the other). Due to supply and/or logistical issues, one may be available to you before the other.

Q: Can I get one dose of one vaccine and the second dose from a different vaccine?

Answer: Currently the vaccine trials only evaluated the efficacy of two doses of their own vaccine. The safety and efficacy was not tested for obtaining doses from different vaccines.

Q: Are these various vaccines the same or different enough that we should get both?

Answer: No — you do not need to get both vaccines! Both of the vaccines approved by emergency use authorization (EUA), the Pfizer and the Moderna vaccines, work in the same way: they are mRNA vaccines that target the spike protein of the virus (the protein that allows the virus to enter the body’s cells). Both have very similar efficacies and very similar side effect profiles.

So you should only get one of the vaccines — especially because we currently have limited supplies of them! But it is also recommended that you stick with the type of vaccine you get: so if you get your first dose of a Pfizer vaccine, you should also get the Pfizer vaccine for the second dose (for example). This is because both the safety and efficacy were evaluated only within each type.

Q: I received convalescent plasma or a monoclonal antibody therapy for COVID; can I still get the vaccine?

Answer: At this time there is not enough data to know if there is any change in vaccine effectiveness in people who have received monoclonal antibodies or convalescent plasma. Please stay tuned for any updates to this!

Q: I don’t trust the vaccine because I don’t think my community (people who look like me) were represented.

Answer: That is a really good concern. COVID19 has affected certain communities far more than others, and it is really important to ask if those communities have been part of this vaccine development as well as the safety reviews for these vaccines. In addition, we recognize that medicine historically has not treated underrepresented communities equally, and this creates legitimate distrust of the system.

In regards to the COVID-19 vaccine, scientists and advocates from very diverse backgrounds have been part of the leadership of these vaccines as well as reviewing and making guidelines and decisions regarding them. For example, Dr. Kizzmekia Corbett, who works for the National Institutes of Health, is an African-American woman who helped develop the Moderna vaccine. The safety monitoring and review boards for both the Pfizer and Moderna vaccines included scientists, physicians and advocates from diverse backgrounds representing numerous groups from all parts of the country. These hearings were also open to the public so that they could be as transparent as possible.

We fully recognize this may not be enough, but we hope that it gives some measure of comfort knowing that representation has occurred at all levels, from vaccine development through the independent safety reviews. COVID19 has been devastating and these vaccines represent the first real hope we’ve had to combat this pandemic.

SAFETY

Q: Are RNA vaccines safe? We’ve never had one before!

Answer: Great question! Please see this quick video above.

RNA are like post-it notes (or, for the younger crowd, Snapchat messages that expire!). At any moment, a human cell has 5000+ different RNA messages. They are read by the cells and then destroyed within minutes to hours.

Because they are temporary, they do NOT become a permanent part of your body. In fact, they do not enter the nucleus of the cell and they never interact with a person’s DNA.

These temporary RNA messages instruct the cells of the body to make proteins. In the case of the mRNA COVID-19 vaccine, they message for one single coronavirus protein: the spike protein. This is the protein that the virus needs to enter the cells. So by developing antibodies to block it, you prevent COVID!

Now: remember — it takes 25 different proteins to make a coronavirus. So your body is NOT making a coronavirus with the RNA vaccine!

It is also important to remember that tens of thousands of people have already received this vaccine and have been watched for several months now. All of this data has been reviewed by independent safety boards across the world. Safety review boards are NOT controlled by the company that makes the vaccine. The end result is a lot of safety data. In all of these reviews, no serious concerns have been found. Rather, the vaccines have shown incredible efficacy.

Q: It’s really unbelievable that we will have a vaccine against a new virus so soon, right?

Answer: Yes! It’s an incredible scientific achievement that we were able to develop these vaccines! But realize — scientists have been studying coronaviruses since the early 2000s when SARS (Severe Acute Respiratory Syndrome) broke out. Some scientists have been working on a vaccine since then. Research on the technology behind the new COVID-19 vaccine has been underway for the past 30 years. During this pandemic, scientists across the world have been working on a single virus with significant resources. In the US, we had Operation Warp Speed, a federal partnership between the Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), Biomedical Advanced Research and Development Authority (BARDA), Department of Defense (DOD), and private companies to develop, manufacture, and distribute 300 million doses of the COVID-19 vaccine. It was incredibly fortunate that they picked the spike protein of SARS-CoV-2 to focus on, as it turned out this was the right protein to target!

These vaccines have been tested in clinical trials enrolling tens of thousands of people, just like other vaccines. The timeline was accelerated, but steps were not skipped. You can see the FDA briefing materials that provide a comprehensive overview of the safety and efficacy data.

Q: I have heard that people with allergies cannot get the vaccines?

Answer: So far, there have been less than 20 severe allergic reactions that have been reported with the Pfizer and Moderna vaccines. It is important to remember that this is out of >1 million people worldwide who have been vaccinated. In all cases, people have successfully been treated for the allergic reaction. These events are being evaluated to determine exactly what reactions have occurred and what (if any) allergies these people have had.

The CDC is currently recommended a 15-minute monitored waiting period after the vaccine; but if you have had a serious of severe anaphylaxis, they are recommending you have 30 minute monitored waiting period after your vaccine.

Additional recommendations will be forthcoming or change, so check back here!

Q: Are there any underlying health conditions where it is recommended that people shouldn’t get the COVID vaccine?

Answer: No! Currently there are no underlying medical conditions that preclude you from getting the vaccine. That is because getting COVID is so much worse, especially for people with underlying chronic conditions.

If you do have a significant allergy history, or believe you are allergic to any of the ingredients in the vaccine, you should let your provider know. You may be monitored more closely following the vaccine.

Q: Is there anyone who should NOT get the vaccine due to safety concerns?

Answer: Great question! The only people who should NOT get the vaccine are those with a history of severe reactions to the vaccine ingredients. Those ingredients are listed on page 2 of this document: https://www.fda.gov/media/144414/download

We do strongly recommend you also discuss your allergy concerns with your doctor!

Q: Is this a live vaccine? I’m worried about getting the vaccine and passing COVID to someone else.

Answer: None of the vaccines are live vaccines. If you obtain these vaccines, you will not be able to pass COVID to someone else.

Q: Are there any human or animal parts in the vaccine?

Answer: mRNA vaccines contain no human or animal in them — they are just made with a few salts, sugar, water, a lipid capsule and mRNA.

Q: I have heard that you get really sick when you get this vaccine?

Answer: It appears that people who get the COVID vaccines are more likely to get some mild flu-like symptoms: sore arm, muscle aches, fatigue, GI discomfort, etc. This appears to happen a bit more with this vaccine than with (for example) the flu vaccine; and it appears to be more common after the second dose of the vaccine, and can last up to 24–36 hours.

But please remember: this is a GOOD thing! It means your body is responding to the vaccine and building up the defense you need to protect you from COVID! (Think of it like working out — you have to get a little sore to build up that muscle!)

It is absolutely fine to take Tylenol or ibuprofen (Motrin, Advil) to treat these symptoms if they occur; but it is currently NOT recommended to take those medications to prevent these symptoms before they start because it is unclear at this time if they will interfere with the antibody response and vaccine effectiveness.

And don’t worry if you don’t have these symptoms — some people do, some people do not!

Q: I am immunosuppressed and/or have a high-risk medical problem: is it safe for me to get the COVID vaccine?

Answer: YES! The CDC is ABSOLUTELY recommending that people who are immunosuppressed or have high-risk medical problems get vaccinated. Please remember: this is NOT a live vaccine; and it does not enter the nucleus of the cell. As a result, for these patients, the vaccine poses a far less risk than getting infected with COVID19!

Q: I have heard that if I’ve had COVID and get the vaccine, it could lead to too many antibodies which could predispose you to autoimmune disorders. Is there any concern or truth to that?

Answer: This is not true. It is recommended that even if you have had COVID in the past you get vaccinated. We have not seen an increased number of autoimmune flares with either the vaccine or with COVID.

Q: I have an autoimmune disorder; will I have a flare when I get the vaccine?

Answer: People with autoimmune diseases are not expected to have “flares” after receiving the vaccine — this was not seen in any of the data reviewed from the Pfizer vaccine; and also is not seen in active COVID-19 infections

Q: Is it true that vaccines including COVID vaccines contain metals?

Answer: Yes vaccines can contain metals; and so do blueberries, eggs and bananas! Metals are part of nature. Your body needs certain types of metals for appropriate function; and your body can handle these micro doses of metals and excrete them appropriately — including those in the foods you eat AND in vaccines.

TIMELINE

Q: When can I get the vaccine?

Answer: First — thank you for your enthusiasm to get vaccinated! You are part of the solution!

Please understand: there is a limited number of doses; and a great deal of infrastructure to get these vaccines to people across the country. It’s not just about getting that first dose — it’s critically important that people get the second dose as well! So we need to implement the infrastructure to schedule that second vaccine, send reminders, and keep track of who has gotten what — and that’s not easy with millions of people! Luckily, pharmacies are working with hospitals (as part of Operation Warp Speed) to help distribute these vaccines

The CDC and the American Committee on Immunization Practices and Protocols have been making recommendations for which groups of people should be vaccinated first based on who is at risk of spreading COVID-19 and who is at risk of dying from the disease. As you can probably guess, health care workers (doctors, nurses, technicians, staff, etc) are in the first tier. The second tier includes older adults(75 years+) and frontline essential workers (first responders, educational workers, daycare workers, food and agriculture workers, manufacturers, correctional facility staff, postal workers, public transit workers, etc).

However, every state has independent control to make their own state-specific prioritization protocol. So there will be variations by state. States have been notified about the amount of vaccine they have been given and are working on their protocols.

As more vaccine becomes available, it will move down the prioritization list and go out to the general population.

But even then, you may not be at the top of the “general population” list! People who live with the diseases that we know are associated with worse outcomes from COVID-19 (such as diabetes, lung disease, etc) may get priority.

This is not necessarily a bad thing! Consider: the more people who get vaccinated, the better for EVERYONE. First — this means your health care staff and other people around you are less likely to make you sick. Second, there is the idea of herd immunity: because this vaccine is so effective, the more people who get vaccinated, the safer EVERYONE is who hasn’t been able to get the vaccine first.

Q: Can I choose the type of vaccine I get?

Answer: That’s an excellent question. It does not seem likely that you will be forced to get one type of COVID vaccine versus another. However, there may be availability issues for a certain type of vaccine in a certain area.

Q: The vaccine priority groups are unfair — can I skip the line?

Answer: No, but there’s a good reason. Vaccinating those at highest risk protects ALL of us by reducing the number of cases among those most likely to be infected. This means as soon as you are eligible, you can get vaccinated — but not before.

Q. How will I know when I can get the vaccine?

Answer: The CDC has made recommendations for prioritization of the vaccine; but each state can make their own prioritization, so look to your state guidelines for when and where it will be available.

Q. Where can I find out when and where I can get the vaccine?

Answer: every state is working on their prioritization and state-wide distribution plans and will be conveying that information.

Q. What about people who were in a clinical trial and got placebo-can they get the vaccine?

Answer: This is a really great question. You should contact the vaccine study directly.

SPECIAL POPULATIONS

Q: What about getting this vaccine for pregnant or lactating women?

Answer: There are ethical problems with including pregnant women in a Phase 1 or Phase 2 study. For that reason, we have not tested the vaccine on pregnant women. However, the EUA for the Pfizer vaccine DID allow women who are pregnant or breastfeeding to opt to obtain the vaccine. This should be discussed with their primary care or OB/Gyn physician.

If a woman is considering pregnancy, it is recommended that they become fully vaccinated before becoming pregnant if they can.

Preliminary analysis from the Moderna vaccine indicates no effects on reproductive health; please do stay tuned for additional information and please also discuss with your primary care or OB/Gyn physician.

If a woman opts not to obtain the vaccine, they should do all the same things we are already doing — mask wearing, social distancing, washing hands. As a reminder: we know that COVID can be harmful to a pregnant woman and her fetus.

Because a COVID-19 vaccine is not going to be available to the general population for several months, many women may deliver their babies before they are eligible for the vaccine. It is therefore important that those around them also practice all the same precautions we have been doing (mask wearing, social distancing, washing hands); and (especially if the woman opts not to get vaccinated) consider obtaining the vaccine when it is available to them. This is similar to what we do for infants aged 0–6 months who cannot get the flu vaccine. We ask everyone who comes in contact with them make sure they are vaccinated to protect that non-vaccinated person!

Q: I have heard that mRNA vaccines cause infertility?

Answer: This is simply not true! In fact, in the Pfizer trial, 12 women in the vaccine arm became pregnant despite signing a pledge to use 2 forms of birth control or abstinence!

Q: If I get my COVID19 vaccine while I am pregnant, will protective antibodies cross the placenta during pregnancy?

Answer: We currently do not know the answer to this. Please check back as more data becomes available on these vaccines!

Q: Is it safe to get the vaccine while breastfeeding? Are protective antibodies from the vaccine spread in breast milk?

Answer: We do not know the answers to these questions for the COVID vaccine yet. But there is some data we do have that can be helpful.

Early studies in women with COVID19 have shown that these women can safely breastfeed their infants and protective antibodies have been found in the milk.

Most vaccines currently are safe during breastfeeding. The exceptions are the smallpox and yellow fever vaccines, both of which are live vaccines. Both EUA-approved COVID19 vaccines are not live vaccines.

Here is a link to the official American College of Obstetricians and Gynecologists recommendations:

https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19

And here is a very user-friendly decision tool for pregnant/breastfeeding women made by UMass/Baystate:

https://drive.google.com/file/d/1amyuWed4XkO5dwyfCKmu72RzaAoNf8u-/view?usp=sharing

Q: What about children?

Answer: The EUA for the Pfizer vaccine allows children 16 years and older to obtain the vaccine.

Only one vaccine (Pfizer) allowed children as young as 12 to get the vaccine — and there were not a lot of them.

This great article with an interview with Dr. Sallie Permar, Chairwoman and Pediatrician-in-Chief at the Weill Cornell Medical School and NYP Pediatrics, explains why studying children is so important — they are not “little adults.” Their immune systems work differently. So we will need to do trials to find out the correct doses for them.

The good news is that we already have great lessons from the existing trials — so these pediatric trials likely don’t have to be as long or as big!

However, we should get these trials done as soon as possible — because we want our children to go back to school as soon as safely possible.

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