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All the COVID-19 Vaccine Side Effects, Explained

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All the COVID-19 Vaccine Side Effects, Explained

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With the Pfizer BioNTech BNT162b2 vaccine and Moderna's mRNA-1273 vaccine currently being administered to select groups, the buzz around the COVID-19 vaccine is palpable. Public response to the idea of a vaccine has also grown more favorable, with a national survey from PEW Research Center indicating that 60 percent of Americans would definitely or probably get a vaccine for the coronavirus, up from 51 percent in September.

Yet among many people who are in line to get the vaccine, those who aren't yet eligible, and those who are hesitant, there are questions about exactly what the side effects of those vaccines are, and how often they occur.

Collectively, the companies' clinical trials have tested more than 73,000 people and separately have produced vaccines with over 90 percent effectiveness. The vaccines teach your body to produce an immune response, and they do have the potential for short-term side effects.

What are the side effects and how often do they occur?

Natasha Bhuyan, MD, a practicing family physician based in Phoenix, AZ, says side effects from the COVID-19 vaccine were expected and they are short-lived (think a day or so).

"It is entirely normal to experience some side effects with any vaccination: arm soreness, fatigue, body aches, and even fever," explains Jay W. Lee, MD, MPH, a practicing family physician based in Orange County, CA.

Side effects seen in the Moderna vaccine trials

The company reported that during its Phase 3 trials it saw:

Fatigue, 9.7% of the time

Muscle aches (myalgia) 8.9%

Joint pain (arthralgia) 5.3%

Headaches 4.5%

Pain at the injection site 4.1%

Redness at the injection site 2%

Side effects seen in the Pfizer vaccine trials

Pfizer reported that during its Phase 3 trials, it saw:

While the Pfizer report above focused on events that produced severe reactions greater than 2 percent of the time, the CDC reports that other side effects include:

There were also four reported cases of Bell's palsy, which is the sudden weakness in facial muscles (think facial paralysis) on one side of the face, in each company's trial.

A lot of these side effects aren't really all that out of the ordinary. The seasonal flu shot, which injects the inactive virus into you to help boost immunity, for example, also has side effects, which, according to the Centers for Disease and Prevention (CDC) include soreness, redness, and/or swelling from the shot, headache, fever, nausea, muscle aches-many of which are similar to what participants in COVID-19 trials have experienced.

When these side effects occur, how long do they last?

For those who experience side effects, they don't last very long- about 48 hours.

For both vaccines, the side effects are most prominent after the booster shot. In an interview with CNN's Anderson Cooper, one woman who was a part of the Moderna vaccine trials noted having little effect from the first vaccine, but experienced more severe symptoms (muscle, joint and bone pain), lasting for about four hours, after the booster shot.

Again, most of these reactions are normal. They mean the vaccine is doing its job, creating antibodies that will not only help your body build protection against the disease (get the full story on how they work here), but train it to fight diseases much faster. Interestingly, though, younger adults reported experiencing side effects more than older adults.

What about the allergic reactions we've heard about?

Trials aside, the administration of the vaccines have seen allergic reactions for some. Among the first were three Alaskans. One had an anaphylactic reaction-a severe, potentially life-threatening allergic reaction-that included a rash on her face and torso, shortness of breath and an elevated heart rate and resulted in her being admitted to the ICU.

Another experienced eye puffiness, lightheadedness, and a scratchy throat, but after being treated with epinephrine, returned to normal. Both healthcare workers experienced these symptoms 10 minutes after receiving their shot.
Gallery: Sure Signs You've Already Had COVID, According to Expert (ETNT Health)

The last also had symptoms of an allergic reaction, which consisted of difficulty breathing, swelling of the tongue, and a hoarse voice. (Three British health care workers with a history of allergies who received the vaccine also developed anaphylactic symptoms.)

Morbidity and Mortality Weekly Report says that as of January 3, 21 cases of anaphylaxis were reported.

Who, with allergies, should ask their doctor before getting the vaccine

The recent reactions have now prompted the CDC to include language on its website about the potential for anaphylaxis as well the recommendation that folks with a history of it, regardless of the cause, be observed for 30 minutes post vaccine administration. (Everyone else should be observed for 15 minutes.) And per an FDA fact sheet, if a severe allergic reaction were to occur, signs would likely surface between minutes and an hour post vaccination.

The CDC recommends that people who have had severe allergic reactions to any ingredients of the vaccines not get vaccinated with the currently available COVID-19 vaccines, and that anyone who had an anaphylactic response to the first dose shouldn't get the second.

What was discovered about allergies during the trials

It should be noted that a document published by the FDA prior to Pfizer's EUA did highlight that 0.63 percent of participants experienced "hypersensitivity-related adverse events." A similar document released by the FDA prior to Moderna's EUA revealed that 1.5 percent of participants also experienced hypersensitivity, though "there were no anaphylactic or severe hypersensitivity reactions." In other words, the potential for allergic reactions was always there. Though, specifically in Pfizer's trials, it is reported that folks with a history of severe reaction to any vaccine as well as a severe allergic reaction to any part of the study interventions were not included.

What might be causing the allergic reactions

There are some reports that at a recent briefing, Peter Marks, MD, PhD, the director of the Center for Biologics Evaluation and Research (CBER) at the FDA speculated that there might be a link between allergic reactions and polyethylene glycol (PEG), which is a component, though in different forms, in both Pfizer's and Moderna's vaccines.

Also noteworthy: In an alleged email dated September 25 from Robert F. Kennedy, Jr. and Children's Health Defense to FDA Director Steven Hahn, MD, Marks and National Institute of Allergy and Infectious Diseases Director Anthony Fauci, MD as well as several senators and people in Congress concerning Moderna's COVID-19 vaccine, Kennedy wrote: "The use of PEG in drugs and vaccines is increasingly controversial due to well-documented incidence of adverse PEG-related immune reactions, including life-threatening anaphylaxis." He went on to write that "roughly seven to ten Americans may already be sensitized to PEG, which may result in reduced efficacy of the vaccine and an increase in adverse side effects."

According to Purvi Parikh, MD, an allergist and immunologist at NYU Langone, who is also a co-investigator on COVID vaccine trials, "allergic reactions are quite rare" in vaccines in general, pointing to a review study in the Journal of Clinical Allergy and Immunology which found that the rate of anaphylaxis was 1.31 per million vaccine doses. "Also, usually people are allergic to an ingredient rather than vaccine itself," she says, noting that new CDC recommendations cite that if there's a reaction, you should not take the second dose, and you should see an allergist for evaluation.

It's possible that the reactions weren't all allergic reactions

"We are not 100 percent certain all of these are allergic in nature," says Dr. Parikh, noting that in her study they excluded those with vaccine allergies, but did include those with other allergies. "Some may be vasovagal reactions [a sudden drop in heart rate and blood pressure leading to fainting] which are common with needles and benign usually or anxiety related as well."

Rashid A. Chotani, MD, an infectious disease and biodefense expert and medical director and senior scientist at IEM in Morrisville, NC and HealthCentral's resident epidemiologist, advises that "no one should say 'no' to the vaccine unless they have had serious allergic reactions to vaccines in the past and discuss if they have any issues with their primary care physician, as each case can be unique. The benefits definitely outweigh the risks which can in most cases be dealt with a simple epinephrine pen."

What to know about dermal fillers and the vaccine

The FDA's December briefing on the Moderna vaccine reported that two subjects with dermal fillers in the Phase 3 trail experienced facial swelling and a third had lip swelling. These people received their injections at different time periods prior to their Moderna vaccinations, ranging from two weeks to six months. (At this time there have been no reports of similar incidences with the Pfizer vaccine.)

They're among the 2.7 million people who received dermal fillers in 2019 (99,783 were men), according to the American Society of Plastic Surgeons.

Many experts think there's no need to furrow those smoothed-out brows over the vaccine/fillers association just yet, especially considering three adverse reactions in a trial of 30,000 plus people is only about.0001 percent, explains Sola Fasusi, MD, a Miami-based plastic surgeon. "That is an incredibly small percentage," he says.

It's a mild concern, rather than a major one, says Aisha Baron, MD, a board certified plastic and reconstructive surgeon and owner of Breast Body Beauty Plastic & Reconstructive Surgery in Marietta, Georgia. While experts are unsure of what exactly is causing these adverse reactions, there are theories. Vaccines are designed to teach the body to respond to foreign material, and some people's bodies may see the injectable as foreign, she says.

And it's not the first time there have been reactions to vaccines among people with fillers. Although all eyes are on COVID vaccines, it's important to understand that there have been similar issues linked to other vaccines, including the flu vaccine, says MH dermatology advisor Corey L. Hartman, MD. In fact, it was reported that the patient with lip swelling had a similar reactions after receiving the flu vaccine previously. "It seems to be mediated by a cytokine cascade that is specific to the patient and not to the vaccine," he says. Another interesting discovery: A 2019 study in Clinical, Cosmetic and Investigational Dermatology revealed that some people who'd had the flu or a flu-like illness had reactions-swelling, redness, and hardness-in the places on their bodies where they'd previously had hyaluronic acid fillers.

Sometimes this type of reaction even happens on its own when fillers are placed, Dr. Hartman explains. For people who had this filler site reaction in the Moderna vaccine trial, the issue either resolved itself, or patients were treated with antihistamines and/or steroids (common treatments). Dr. Fasusi agrees, mentioning that "all you can probably safely say at this point is that the reactions that we've seen with people who happen to have dermal fillers have been relatively mild and easily treatable."
Bottom line:

Try to avoid having filler treatments in or around the time you are vaccinated, says Dr. Fasusi.

Don't let dermal fillers stop you from receiving vaccines of any kind and vice versa, recommends the American Society for Dermatologic Surgery.

What's the chance there are side effects we don't know about yet?

While it is possible for side effects that were not seen in the trials to pop up, Dr. Parikh says that typically isn't common. Also important to remember, "though these cases are making the news, there are thousands who aren't having issues that do not make the news," she says. (FYI: It has been reported that an estimated 128,000 people -and that's on the low end-have received the vaccine so far.)

"This is the first time in human history that a mRNA vaccine or any vaccine has been fully developed during a raging pandemic; however, this technology is not entirely new," says Dr. Chotani, noting that mRNA research and science dates back to the nineties. "RNA vaccines use part of the virus' own genetic code to stimulate an immune response and can be developed in a laboratory using readily available materials. This means the process can be standardized and scaled up, making vaccine development faster than traditional methods which use weakened or dead virus."

The clinical trials have looked for side effects. Additionally, the CDC notes that "after a vaccine is authorized or approved for use, many vaccine safety monitoring systems watch for adverse events" (possible side effects). If an unexpected adverse event is seen, experts quickly study it further to assess whether it is a true safety concern."

There are also safety monitoring systems in place to track additional outcomes, including V-safe, a smartphone-based, after-vaccination health checker, and National Healthcare Safety Network (NHSN), an acute and long-term care facility monitoring system that reports to the Vaccine Adverse Event Reporting System or VAER.

"Overall, these vaccines have displayed an impressive safety profile," Dr. Bhuyan says. "While some people may still be reluctant to get a vaccine, I encourage them to talk to their family doctor if they have questions. Getting vaccinated is a selfless act that not only protects you, it protects your community." She goes on: "We know that vaccines help build a community of immunity and protects those who may not be able to get vaccinated themselves."

Try 200+ at home workout videos from Men's Health, Women's Health, Prevention, and more on All Out Studio free for 14 days!

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All the COVID-19 Vaccine Side Effects, Explained

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With the Pfizer BioNTech BNT162b2 vaccine and Moderna's mRNA-1273 vaccine currently being administered to select groups, the buzz around the COVID-19 vaccine is palpable. Public response to the idea of a vaccine has also grown more favorable, with a national survey from PEW Research Center indicating that 60 percent of Americans would definitely or probably get a vaccine for the coronavirus, up from 51 percent in September.

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Here’s What to Know About the COVID-19 Vaccine Side Effects

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Here’s What to Know About the COVID-19 Vaccine Side Effects

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The COVID-19 vaccine is here and doses are beginning to roll out across the country and the world. It'll take several months for inoculations to reach everyone based on current distribution plans but reactions to the vaccine will be followed closely, including side effects.

Having some side effects from receiving a vaccine isn't unusual. For example, it's not unusual for some people to experience mild side effects like headaches, muscle aches and soreness after receiving their annual flu shot.

Because of the speed with which it was developed and because it's a new vaccine, though, some have expressed concerns about the COVID-19 vaccine, specifically its side effects. We talked to critical care specialist Rachel Scheraga, MD, about those side effects, what causes them and why the vaccine is safe.

The vaccines

Currently, two vaccines have been given the green light for distribution: one developed by Pfizer, in conjunction with BioNTech, and one developed by Moderna. Both were found to be about 95% effective during trials.

Neither vaccine has been fully approved by the Food and Drug Administration (FDA), which would allow the vaccines to be sold to hospitals and health care providers. But both have been approved for emergency use authorization (EUA) by the FDA because of the current state of emergency (the ongoing pandemic).

But it's still important to keep in mind that we're still in the early stages of the process. With those EUA come tons of data - data that will continue to be collected as doses are distributed - that prove these vaccines are both safe and effective. And that includes side effects of the vaccines.

What are the known side effects of the vaccines?

As with many vaccines, there are some side effects but, says Dr. Scheraga, those side effects are relatively mild.

"The side effects have mainly been arm soreness, fatigue, muscle aches, headaches and some instances of fever and chills," she notes. She adds that between the two different vaccines the side effects are effectively the same.

She also says that the side effects are more commonly felt after the second dose rather than after the first. With the Pfizer/BioNTech vaccine, the second dose will come 21 days after the first while the second Moderna dose occurs 28 days later. "The data from the trials of the vaccines show that the side effects were more common after the second dose," she says.

So far, no additional widespread side effects have become known but, again, it's still early in the process, she points out. As these trials continue, the companies and health care providers will be on the lookout for anything else.

What causes these side effects?

According to Dr. Scheraga, the side effects have to do with how the COVID-19 vaccine works. Both the Pfizer/BioNTech and Moderna vaccines use the "messenger RNA" (or mRNA) approach. The strategy has been in development for years but this is the first time it's been used in a distributed vaccine.

In this case, the harmless "spike" protein of the virus in the mRNA vaccine triggers the secretion of antibodies and recruitment of memory immune cells in the bloodstream that will allow for protection if one gets infected with the virus at a later time, Dr. Scheraga says.

"This activation of the immune system is what leads to some of these non-specific symptoms," she adds.

Do the vaccine side effects mimic COVID-19 symptoms?

Dr. Scheraga notes that there are some overlapping features between the side effects and the symptoms of COVID-19. "Specifically, the fever and the muscle aches are some of the general side effects that mirror COVID-19 symptoms," she says.

It's important to keep an eye on the side effects you experience because, as she says, it's possible that these symptoms could be a result of COVID-19. "It's possible that if you contract the virus a few days before you receive your first dose, those symptoms could be indicative of COVID-19 infection instead of vaccine side effects."

But, she adds, there are a few ways to tell if it's just the side effects or something more serious. "Most times," she says, "the side effects are mild and usually fade within 24 hours. You shouldn't feel prolonged effects from the vaccine itself."

Everyone's reaction will be on a case-by-case basis, she says. "If you find those symptoms worsening or lingering longer than a day or two, you should contact your healthcare provider. They'll be able to direct you on the best next steps, including, potentially, a COVID-19 test."

No, you can't get COVID-19 from the vaccine

"The COVID-19 vaccine will not give you COVID-19," Dr. Scheraga says. "You're just getting a sequence of the protein spike of the virus. You're not getting either an active or inactive part of the virus."

She adds, "You're just getting what is needed from the virus so your immune cells can develop memory so that if you do contract COVID-19 after full vaccination, your immune system will be able to fight it off quickly so you don't get sick."

Are there any pre-existing medical conditions that could interfere with or intensify the side effects?

One question about the vaccine has been whether or not pregnant patients would experience any additional adverse reactions. So far, that's unknown because, as Dr. Scheraga says, "The initial clinical trials didn't include pregnant recipients so they're still investigating whether or not they can safely receive the vaccine."

Recent guidance developed by the Centers for Disease Control and Prevention (CDC) advises that if a pregnant patient is part of a group recommended to receive the vaccine, that patient would have the ultimate choice with the recommendation they consult their health care provider.

As with other vaccines, like a flu shot, the health care provider administering the vaccine will check with each recipient if they've experienced allergies with previous vaccines. Specifically, those reactions are generally caused by additives in the vaccine.

"Once you receive a dose, you'll be monitored for 15 minutes which is typically enough time to see any indication of a severe allergic reaction," Dr. Scheraga points out.

As of now, the CDC says that patients with a history of such reactions can receive the vaccine but they should have those incidents fully assessed by a health care provider to determine a fuller context around those incidents.

The CDC says, "These persons may still receive vaccination, but they should be counseled about the unknown risks of developing a severe allergic reaction and balance these risks against the benefits of vaccination."

In those instances, the CDC calls for a post-vaccination observation period of 30 minutes instead of 15 minutes.

Are the vaccines safe?

Ultimately, the bottom line is that, yes, says Dr. Scheraga, the COVID-19 vaccines are safe. She explains the mRNA platform has been a big advance in technology that was developed and worked on prior to the pandemic.

"There's a lot of concern because of the speed of development and it's a brand new platform," she says, "but it's not brand new technology. This platform has been under development for this kind of real-time distribution for a while."

A great deal of experimentation had already taken place, she notes, so that when the COVID-19 pandemic unfolded, it was a well-tested platform ready for implementation: "It's safe, effective and potentially life-changing."

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Here's What to Know About the COVID-19 Vaccine Side Effects

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The COVID-19 vaccine is here and doses are beginning to roll out across the country and the world. It'll take several months for inoculations to reach everyone based on current distribution plans but reactions to the vaccine will be followed closely, including side effects. Having some side effects from receiving a vaccine isn't unusual.

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Possible Side Effects After Getting a COVID-19 Vaccine

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Possible Side Effects After Getting a COVID-19 Vaccine

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Centers for Disease Control and Prevention

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Self-Checker

Important update: Healthcare facilities

CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more

Possible Side Effects After Getting a COVID-19 Vaccine

What You Need to Know

Side effects after getting a COVID-19 vaccine can vary from person to person.

Some people experience a little discomfort and can continue to go about their day. Others have side effects that affect their ability to do daily activities.

Side effects generally go away in a few days.

Even if you don't experience any side effects, your body is building protection against the virus that causes COVID-19.

Adverse events (serious health problems) are rare but can cause long-term health problems. They usually happen within six weeks of getting a vaccine.

Common Side Effects

Side effects after a COVID-19 vaccination tend to be mild, temporary, and like those experienced after routine vaccinations. They can vary across different age groups.

Common side effects can include:

Pain on the leg or arm where the shot was given

Swollen lymph nodes

Irritability or crying

Sleepiness

Loss of appetite

Side effects are more common after the second dose and can include:

Pain, swelling, and redness on the arm where the shot was given

Tiredness

Headache

Muscle or joint pain

Chills

Swollen lymph nodes

On the arm where you got the shot:

Throughout the rest of your body:

Tiredness

Headache

Muscle pain

Chills

Fever

Nausea

After a second shot or booster

Reactions reported after getting a booster shot are similar to those after the two-dose or single-dose primary shots. Most side effects were mild to moderate.

The most commonly reported side effects were:

Fever

Headache

Fatigue (tiredness)

Pain at the injection site

Helpful tips to relieve side effects

Adults

To relieve pain or swelling on the arm where you got the shot:

Apply a clean, cool, wet washcloth over the area.

Use or keep moving your arm.

Also, if possible, get some rest.

To reduce discomfort from fever:

Drink plenty of fluids,

Dress in comfortable clothes,

Talk to your doctor about taking over-the-counter (OTC) medicine, such as ibuprofen, acetaminophen, aspirin (only for people ages 18 years or older), or antihistamines.
It is not recommended to take these medicines before vaccination to try to prevent side effects as it is not known how OTC medicines might affect how well the vaccine works.

Children

Ask your child's healthcare provider for advice on using a non-aspirin pain reliever and learn about other steps you can take at home to comfort your child after vaccination.

Call a doctor or healthcare provider about a side effect if:

Redness or tenderness where the shot was given gets worse after 24 hours

Side effects are worrying or do not seem to be going away after a few days

Adverse Events after COVID-19 Vaccination Are Rare

Adverse events, including severe allergic reactions, after COVID-19 vaccination are rare but can happen. For this reason, everyone who receives a COVID-19 vaccine is monitored by their vaccination provider for at least 15 minutes.

After leaving a vaccination provider site, if you think you or your child might be having a severe allergic reaction, seek immediate medical care by calling 911.

Learn more about what you can do if you have an allergic reaction.

Reporting Side Effects and Adverse Events

Use v-safe or the Vaccine Adverse Event Reporting System (VAERS) to report your side effects:

V-safe, a smartphone-based tool, provides quick and confidential health check-ins via text messages and web surveys. It does this so you can quickly and easily share with CDC how you or your child feel after getting a COVID-19 vaccine.

Vaccine Adverse Event Reporting System can be used by you or your healthcare provider to report a side effect, adverse event, or reaction from COVID-19 vaccine.

Stay Up to Date with COVID-19 Vaccines and Boosters

When do you need to schedule your next shot?

Do you or your child need to get a booster?

Can you get a different vaccine product after your 1st dose?

Stay Up to Date

Resources

What to Expect after Getting a COVID-19 Vaccine

Fact sheet for healthcare workers to give after vaccination.

File Details: 199 KB, 1 page
View PDF

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What to Expect after Getting a COVID-19 Vaccine

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Self-Checker Important update: Healthcare facilities CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more Possible Side Effects After Getting a COVID-19 Vaccine Side effects after getting a COVID-19 vaccine can vary from person to person. Some people experience a little discomfort and can continue to go about their day.

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https://www.cdc.gov/aging/covid19-guidance.html#:~:text=The%20risk%20of%20severe%20illness,from%20COVID%2D19.

https://www.who.int/news-room/feature-stories/detail/the-moderna-covid-19-mrna-1273-vaccine-what-you-need-to-know#:~:text=As%20with%20all%20COVID%2D,be%20prioritized%20for%20vaccination.

https://www.health.harvard.edu/blog/wondering-about-covid-19-vaccines-if-youre-pregnant-or-breastfeeding-2021010721722

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What happens after the vaccine?
https://health.clevelandclinic.org/what-happens-when-you-get-the-covid-19-vaccine/
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html
https://www.healthline.com/health-news/how-your-life-will-and-wont-change-after-getting-the-covid-19-vaccine

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The World Health Organization (WHO) this week said that it does not recommend pregnant women receive the Moderna COVID-19 vaccine at this time.

"While pregnancy puts women at a higher risk of severe COVID-19, the use of this vaccine in pregnant women is currently not recommended," unless they are at a high risk of exposure to the novel disease, such as health care workers, the WHO said in a Tuesday informational post about the Moderna jab, the second such vaccine to receive emergency use approval in the U.S., followed by one created by Pfizer-BioNTech.

The WHO did not provide any additional details as to why it does not recommend the vaccine for pregnant women, but the Centers for Disease Control and Prevention (CDC) on its website notes that "only limited data are available on the safety of COVID-19 vaccines, including mRNA vaccines, administered during pregnancy."

"Limited data are currently available from animal developmental and reproductive toxicity studies. No safety concerns were demonstrated in rats that received [the] Moderna COVID-19 vaccine before or during pregnancy," the federal agency added, noting that "studies of the Pfizer-BioNTech vaccine are ongoing."
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The Moderna jab, as well as the one created by Pfizer, does not contain a live virus; they were created using groundbreaking mRNA technology.

mRNA vaccines "do not interact with a person's DNA because the mRNA does not enter the nucleus of the cell. Cells break down the mRNA quickly. Based on how mRNA vaccines work, experts believe they are unlikely to pose a specific risk for people who are pregnant," the CDC continues.

However, the agency continues, "the actual risks of mRNA vaccines to the pregnant person and her fetus are unknown because these vaccines have not been studied in pregnant women."

The WHO also noted that it does not recommend the Moderna jab or any other vaccine crated with mRNA technology for "individuals with a history of severe allergic reaction to any component of the vaccine."
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"While vaccination is recommended for older persons due to the high risk of severe COVID-19 and death," the WHO continued, "very frail older persons with an anticipated life expectancy of less than 3 months should be individually assessed."

The vaccine should also not be given to children at this time, it added.

"The vaccine should not be administered to persons younger than 18 years of age pending the results of further studies," per the WHO.

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Moderna COVID-19 vaccine 'not recommended' for pregnant women: WHO

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The World Health Organization (WHO) this week said that it does not recommend pregnant women receive the Moderna COVID-19 vaccine at this time.

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The W.H.O. and the C.D.C. provide differing views, and experts partly blame a lack of data because expectant mothers have been excluded from clinical trials.

A pregnant woman being vaccinated in Tel Aviv. The C.D.C. and the W.H.O. differ in their guidance for expectant mothers. Credit... Jack Guez/Agence France-Presse - Getty Images

Pregnant women looking for guidance on Covid-19 vaccines are facing the kind of confusion that has dogged the pandemic from the start: The world's leading public health organizations - the U.S. Centers for Disease Control and Prevention, and the World Health Organization - are offering contradictory advice.

Neither organization explicitly forbids or encourages immunizing pregnant women. But weighing the same limited studies, they provide different recommendations.

The C.D.C.'s advisory committee urged pregnant women to consult with their doctors before rolling up their sleeves - a decision applauded by several women's health organizations because it kept decision making in the hands of the expectant mothers.

The W.H.O. recommended that pregnant women not receive the vaccine, unless they were at high risk for Covid because of work exposures or chronic conditions. It issued guidance on the Moderna vaccine on Tuesday, stirring uncertainty among women and doctors on social media. (Earlier this month, it published similar guidance on the Pfizer-BioNTech vaccine.)

Several experts expressed dismay at the W.H.O.'s stance, saying the risks to pregnant women from Covid were far greater than any theoretical harm from the vaccines.

"There are no documented risks to the fetus, there's no theoretical risks, there's no risk in animal studies," from the vaccines, said Dr. Anne Lyerly, a bioethicist at the University of North Carolina, Chapel Hill. "The more that I think about it, the more disappointed and sad I feel about it."

The difference of opinion between the C.D.C. and the W.H.O. is not rooted in scientific evidence, but the lack of it: Pregnant women have been barred from participating in clinical trials of the vaccines, a decision in line with a long tradition of excluding pregnant women from biomedical research, but one that is now being challenged.

While the rationale is ostensibly to protect women and their unborn children, barring pregnant women from studies pushes the risk out of the carefully controlled environment of a clinical trial and into the real world. The practice has forced patients and providers to weigh sensitive, worrisome issues with little hard data about safety or effectiveness.

Vaccines are generally considered to be safe, and pregnant women have been urged to be immunized for influenza and other diseases since the 1960s, even in the absence of rigorous clinical trials to test them.

"As obstetricians we are often faced with difficult decisions about using interventions in pregnancy that have not been properly tested in pregnancy," said Dr. Denise Jamieson, an obstetrician at Emory University in Atlanta and a member of the Covid expert group at the American College of Obstetrics and Gynecologists. The college strongly advocated including pregnant and breastfeeding women in the vaccine trials.

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People waiting in line to receive a Covid vaccine at a walk-up vaccination site in Los Angeles. Credit... Mario Tama/Getty Images

"What many people miss is that there are risks to doing nothing," Dr. Jamieson said. "Not offering pregnant women the opportunity to be vaccinated and protect themselves, where there are known and severe risks of Covid amplified by pregnancy, is not a wise strategy."

The uncertainty isn't limited to Covid vaccines: Many if not most medications, including widely used drugs, have never been tested in pregnant women. It can take years or decades for adverse side effects to come to light in the absence of a study with a control group for comparison.

"This isn't a story about the W.H.O. or other people advising against vaccination in pregnancy," said Carleigh Krubiner, a policy fellow at the Center for Global Development and a principal investigator for the Pregnancy Research Ethics for Vaccines, Epidemics and New Technologies project (PREVENT). "It's a story about the failure to timely and appropriately include pregnant women in vaccination studies."

Saying she understood the commitment of the W.H.O. and other advisory bodies to rely on scientific studies, Dr. Krubiner added: "The reality is that we don't yet have the data on these vaccinations in pregnancy, and it's very difficult without that data to come out and give a full-throated recommendation in support."

The C.D.C. and the W.H.O. have offered dissonant advice many times over the course of the pandemic - most notably on the usefulness of masks and the possibility of the virus traveling by air indoors.

In a statement, the C.D.C. said on Thursday that based on how the Pfizer-BioNTech and Moderna vaccines work, "they are unlikely to pose a specific risk for pregnant women."

The C.D.C.'s recommendation may make sense for the United States, where women may easily be able to consult with their health care providers, said Joachim Hombach, a health adviser to the W.H.O. on immunizations. But the W.H.O. provides guidance to many low- and middle-income countries where women do not have access to doctors or nurses, he said.

The W.H.O.'s recommendation was also made "in the context of limited supply" of the vaccines, Dr. Hombach said. "I don't think the language is discouraging, but the language is stating the facts."

Pfizer did not include pregnant women in its initial clinical trials because it followed the policies outlined by the Food and Drug Administration to first conduct developmental and reproductive toxicity studies, said Jerica Pitts, a spokeswoman for the company. Pfizer and Moderna both provided results from toxicity studies in pregnant rats to the F.D.A. in December.

Pfizer plans to begin a clinical study in pregnant women in the first half of 2021, Ms. Pitts said. Moderna is establishing a registry to record outcomes in pregnant women who receive its vaccine, according to Colleen Hussey, a spokeswoman for the company.

Critics of the companies' decisions to exclude pregnant women from trials say the reproductive toxicity studies could have been carried out much earlier - as soon as promising vaccine candidates were identified. The companies should have added a protocol to enroll pregnant women once it was clear the vaccines' benefits outweighed potential harm, Dr. Krubiner said.

"It's hard to understand why that delay is happening and why it wasn't initiated sooner," she said. "The bigger issue is, we're going to have lost months by the time they start them."

Doses of Pfizer's vaccine at a site in Rohnert Park, Calif. Pfizer did not include pregnant women in its clinical trials, saying it followed F.D.A. guidelines. Credit... Jim Wilson/The New York Times

Akiko Iwasaki, an immunologist at Yale University who has advocated immunizations for pregnant women, questioned the underlying issue that prompted the W.H.O.'s decision.

"Whatever it is, I wish the W.H.O. would be more transparent in their reasons behind this recommendation," she said. "Women's lives depend on it."

The toxicity data released by Pfizer and Moderna in December found no harmful effects from the vaccines to pregnant rats - evidence cited by the W.H.O. in its guidance.

One extreme consequence of a conservative approach to vaccines played out during the Ebola epidemic in the Democratic Republic of Congo, when health workers offered a vaccine for the disease to all frontline workers and contacts of people confirmed to have it - except if they were pregnant or breastfeeding. Without the vaccine, 98 percent of pregnant women who were infected with the Ebola virus died.

The rules were changed following a public outcry but, by then, many pregnant women had died, Dr. Lyerly said.

Covid-19 has also proved to be dangerous to pregnant women. A large C.D.C. study published in November found that pregnant women with Covid who were symptomatic were significantly more likely to be hospitalized or to die when compared with nonpregnant women who also had Covid symptoms.

The evidence prompted agency officials to add pregnancy to the list of conditions that heighten the risk of severe disease and death from Covid.

The C.D.C. has set up a smartphone application called v-safe to solicit reports of side effects from immunized people. About 15,000 pregnant women have enrolled in the registry so far, the agency's immunization committee reported on Wednesday.

"I think that's our best chance of getting safety data rapidly," Dr. Jamieson said.

Britain initially starkly recommended against Covid vaccines for pregnant women, but has since revised its guidance to authorize inoculating pregnant women who are frontline workers or otherwise at high risk. "I'm hoping the W.H.O. will reconsider as well," Dr. Jamieson said.

Some experts said the recommendations are not as divergent as they may appear at first glance. "The C.D.C. is more inclined to say that pregnant women should have access to the vaccine, but should discuss their circumstances with their providers," said Dr. Ana Langer, a reproductive health expert who leads the Women and Health Initiative at Harvard's T.H. Chan School of Public Health. "The W.H.O.'s interim recommendation says that women who are at particularly high risk of exposure or getting Covid should get the vaccine. So where's the big difference here?"

Denise Grady contributed reporting.

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Pregnant Women Get Conflicting Advice on Covid-19 Vaccines

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The W.H.O. and the C.D.C. provide differing views, and experts partly blame a lack of data because expectant mothers have been excluded from clinical trials. Pregnant women looking for guidance on Covid-19 vaccines are facing the kind of confusion that has dogged the pandemic from the start: The world's leading public health organizations - the U.S.

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Summary

Are the symptoms of COVID-19 different in children? Do the new variants impact children differently? What can parents do to keep children safe from COVID-19. WHO's Dr Maria Van Kerkhove explains in Science in 5.

Science in 5 is WHO's conversations in science. Watch WHO experts explain science related to COVID-19.

Transcript

Vismita Gupta-Smith
We hear a lot about COVID-19 and symptoms in grownups and adults. How does COVID-19 impact children? Welcome to Science in 5. I'm Vismita Gupta-Smith and this is WHO's conversations in science. We're talking to Dr. Maria Van Kerkhove today about COVID-19 and children. Welcome, Maria.

Dr. Maria Van Kerkhove
Hi, Vismita. Thanks for having me.
Vismita Gupta-Smith
Maria, tell us about symptoms of COVID-19 in children. Are they any different from grownups, especially in the very young ones?

Dr. Maria Van Kerkhove
So, this is a really important question and we continue to learn about SARS-CoV-2 virus, the virus that causes COVID-19. There are different types of disease presentation based on the age of the person who is infected by this virus. Luckily, children and adolescents tend to have more mild disease compared to adults. Most people who are infected with the SARS-CoV-2 virus have respiratory symptoms. They start to feel a little bit unwell, they will have a fever, they may have a cough or a sore throat or sneeze. In some individuals, they may have gastrointestinal symptoms. Others may lose the sense of smell or the sense of taste. Especially in the youngest children, they tend to be more mild, which means they don't have as many symptoms as adults do. Some children may have gastrointestinal symptoms like diarrhoea or vomiting, but they tend to be more mild. And even most children tend to have asymptomatic infection, which means they don't have any symptoms at all.

Vismita Gupta-Smith
Maria, we're hearing a lot about these variants now; what are we seeing? In children, do these variants have different symptoms? Are they impacting children in a different way?
Dr. Maria Van Kerkhove
So, virus variants mean changes in the virus and we are detecting changes in the SARS-CoV-2 virus over time. This is expected. Many of these changes do not have any impact on the virus in terms of its ability to transmit or the disease that it causes. But some variants we call "variants of concern" and these viruses need more study. And scientists are looking at the way the virus transmits, the disease that it causes, and luckily so far, these variants do not tend to cause more severe disease across any age group. The disease presentation looks the same and the severity looks the same as the other SARS-CoV-2 viruses circulating. In terms of transmission, the virus variant that was identified in the United Kingdom, they noticed an increase in transmissibility across all age groups. This includes increased transmission among younger children as well. In the area where this virus variant was circulating, schools happened to have been open. And the virus that was circulating, also circulated among the students and the faculties in those schools that were open. So, there's much study that's still underway with these virus variants, but the studies in the United Kingdom, for example, do not indicate that the virus specifically targets young children, meaning that it's not infecting children more than would be likely of other viruses that are circulating in the area.
Vismita Gupta-Smith
Maria, we don't want to worry mothers, fathers, and caregivers. So, give us some tips about how to keep children, especially the little ones, safe.

Dr. Maria Van Kerkhove
The best way to keep children safe is about prevention. We want to prevent as many infections as we possibly can all over the world. And it's about doing it all. The comprehensive package of interventions that you hear us talk about all the time apply to children as well. Making sure children have clean hands and they wash their hands appropriately with soap and water and sing the songs so that they get enough bubbles and they make sure that those hands are really clean. Or use an alcohol-based rub. Make sure that they practice respiratory etiquette, where they sneeze into their elbow. Even my littlest one who's two years old now, will cough and sneeze into his elbow. But these are good habits to be forming for children as they get older. Making sure that if they're age appropriate and they follow the local guidance to wear a mask appropriately. With clean hands, make sure that the mask is put on over your ears, covers their nose and their mouth and that the children don't touch the outside of their masks. Make sure that they have clean hands. And then when they take it off, to clean their hands as well. Making sure that you as parents talk to your kids as best you can answering their questions. There's a lot of confusing information out there and it's scary. So, find the time to talk to them and answer their questions and alleviate their fear, and make sure that they get good information from you. And probably the most important thing that everybody can do is physical distancing. Outside of your immediate family, make sure that you keep your distance from others. That's the best way to prevent the spread of SARS-CoV-2.

Vismita Gupta-Smith
Thank you, Maria. So, parents remember you have a whole toolkit of precautionary measures; make that part of your daily routine and habit for your children. And, also please share this information and other science-based information with your networks of parents. Until next time then. Stay safe, stay healthy and stick with science.

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Are the symptoms of COVID-19 different in children? Do the new variants impact children differently? What can parents do to keep children safe from COVID-19. WHO's Dr Maria Van Kerkhove explains in Science in 5. Science in 5 is WHO's conversations in science. Watch WHO experts explain science related to COVID-19.

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How do we know that covid vacine is safe? 

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How do we know that covid vacine is safe? 

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1:
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html
2: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/is-the-covid19-vaccine-safe
3: https://www.bbc.com/news/health-55056016

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When can children get COVID-19 vaccine? Will it be safe?

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When can children get COVID-19 vaccine? Will it be safe?

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https://www.usatoday.com/story/news/health/2021/03/16/covid-19-vaccine-when-can-children-get-it-coronavirus/4714963001/

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Centers for Disease Control and Prevention

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Important update: Healthcare facilities

CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more

How Do I Find a COVID-19 Vaccine or Booster?

Find COVID-19 Vaccines or Boosters Near You

Find a COVID-19 vaccine or booster: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.

There are several ways you can look for vaccination providers near you in the United States.

Visit Vaccines.gov to find vaccination providers near you. In some states, information may be limited while more U. S. vaccination providers and pharmacies are being added. Learn more about COVID-19 Vaccination Locations on Vaccines.gov.

Text your ZIP code to 438829 or call 1-800-232-0233 to find vaccine locations near you in the United States.

Ask your doctor, pharmacist, or community health center if they provide vaccines.

Check your local pharmacy's website to see if vaccination appointments are available. Find out which pharmacies are participating in the Federal Retail Pharmacy Program.

Contact your state health departmentto find additional vaccination locations in the area.

Process for Finding a COVID-19 Vaccine Is Always the Same

Whether you want to schedule your first dose, or any other doses, the process to find a COVID-19 vaccine provider is always the same.

If you need help scheduling a vaccination after you've had your first shot, contact the location that set up your first appointment.

If you need to get another dose in a location that is different from where you received your previous shot (for example, if you moved to a different state or attend school in a different state) you can find a vaccine provider by following any of the recommendations above.

If you are having trouble or have questions about using a vaccination management or scheduling system, reach out to the organization that enrolled you in the system. This may be your state or local health department, employer, or vaccination provider.

Scheduling Vaccination Appointments

Most vaccination providers schedule vaccination appointments online. To schedule your COVID-19 vaccination appointment, visit vaccine providers online scheduling services. If you have a question about scheduling your vaccination appointment contact a vaccination provider directly.

CDC cannot schedule a vaccination appointment.

CDC cannot assist with verifying, rescheduling, or cancelling your vaccination appointment.

If you need to verify, reschedule, or cancel a COVID-19 vaccination appointment, contact the location that set up your appointment. If you need to schedule a second-dose, additional-dose, or booster-dose appointment and the location where you received your other dose(s) is no longer offering COVID-19 vaccine, you may be able to get an appointment at another location. Contact your state or local health department for help or look for other COVID-19 vaccination providers near you.

COVID-19 Vaccines Are Free to Anyone in the United States

COVID-19 vaccines are available for everyone ages 5 years and older at no cost. Vaccines were paid for with taxpayer dollars and will be given free of charge to all people living in the United States, regardless of health insurance or immigration status.

CDC does not require U.S. citizenship for individuals to receive a COVID-19 vaccine.

Jurisdictions (state, tribal, local, and territorial) cannot add U.S. citizenship requirements or require U.S. citizenship verification as a requirement for vaccination.

Be aware of scams

If anyone asks you to pay for access to a COVID-19 vaccine, you can bet it's a scam. Don't share your personal or financial information if someone calls, texts, or emails you promising access to a vaccine for an extra fee.
COVID-19 vaccination providers cannot:

Charge you for a vaccine

Charge you directly for any administration fees, copays, or coinsurance

Deny vaccination to anyone who does not have health insurance coverage, is underinsured, or is out of network

Charge an office visit or other fee to the recipient if the only service provided is a COVID-19 vaccination

Require additional services in order for a person to receive a COVID-19 vaccine; however, additional healthcare services can be provided at the same time and billed as appropriate

Safe, Easy, Free, and Nearby COVID-19 Vaccination

The federal government is providing the vaccine free of charge to all people living in the U.S., regardless of their immigration or health insurance status.
COVID-19 Vaccines Are Free

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Important update: Healthcare facilities CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more How Do I Find a COVID-19 Vaccine or Booster? Find a COVID-19 vaccine or booster: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.

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Sisolak: All Nevadans 16 and older will be eligible for the COVID-19 vaccine starting April 5

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Sisolak: All Nevadans 16 and older will be eligible for the COVID-19 vaccine starting April 5

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All Nevadans who want the COVID-19 vaccine will be eligible to get it in less than three weeks, Gov. Steve Sisolak announced on Wednesday.

The governor, at a press conference in Carson City, said that all Nevadans aged 16 and older will qualify to get the vaccine starting April 5. Those in that age group with pre-existing conditions - including cancer, diabetes and lung diseases, among many others - will be able to get it even sooner, beginning March 22.

Currently, only those 65 and older, those 55 and older with underlying conditions and certain essential workers are eligible for the vaccine in most of the state, though some counties have expanded vaccine eligibility further.

The Moderna and Janssen, formerly known as Johnson and Johnson, vaccines are authorized for use only in those 18 and older while the Pfizer vaccine can be used on those 16 and older. Clinical trials are underway to test the effectiveness of the vaccine in kids, including a study by Moderna looking at those aged six months to less than 12 years.

The governor's announcement comes just six days after President Joe Biden announced that he planned to direct all states to make all adults eligible for the COVID-19 vaccine by May 1.

"This vaccination campaign is essential to getting our country and state back to normal so that we can all hug our families, continue getting Nevadans back to work to go to restaurants, send our kids to school, play sports and get together again," Sisolak said

The governor attributed the state's confidence in the new vaccine distribution timeline to the ramp up in production and expected increases in allocations of the COVID-19 vaccine to the state. He also expressed hope that the expansion of vaccine eligibility would help others hesitant to get the shot become more comfortable as they see their family, friends and neighbors getting it.

Still, Sisolak cautioned that even as vaccine eligibility expands, not everyone who wants the vaccine will immediately be able to get it because of the fixed supply the state receives each week and urged Nevadans to remain patient. He also said the state will continue to "scale up" its efforts to ensure that all communities have equitable access to the vaccine and reduce barriers for those who are most vulnerable for severe illness from COVID-19.

"There continues to be a very targeted outreach to those communities that are disproportionately affected, so that entire process will still continue," said Candice McDaniel, health bureau chief in the Bureau of Child, Family, and Community Wellness.

As of Wednesday, more than 1 million doses of the COVID-19 vaccine have been administered across Nevada, and more than 21 percent of all Nevadans have either started or completed the vaccination process, according to Centers for Disease Control and Prevention Data.

Those with pre-existing conditions will continue to be directed to local retail pharmacies to receive the vaccine, as has been the case for those 55 and older with underlying conditions. State officials have said that pharmacies are better equipped than a mass vaccination site, such as Cashman Center in Las Vegas, to evaluate someone's medical history and decide whether they should be prioritized to receive the vaccine.

Underlying conditions that qualify someone to receive the vaccine early include cancer, chronic kidney disease, COPD and asthma, down syndrome, heart conditions, an immunocompromised state, pregnancy, sickle cell disease, Type 1 and Type 2 diabetes, smoking, hypertension and high blood pressure, cystic or pulmonary fibrosis, neurological conditions, liver disease and being overweight, among others. Providers are directed to use their clinical judgment to determine whether someone's condition qualifies them to receive the COVID-19 vaccine.

Even as vaccinations are expanded to everyone with pre-existing conditions, counties will continue to vaccinate essential workers. Since January, the state has been operating under a two-lane vaccine distribution structure that allows counties to work on vaccinating vulnerable members of the general population and essential workers at the same time.

Last week, the state announced that food service and hospitality workers - including tens of thousands of casino workers on the Las Vegas Strip - would be eligible for the vaccine in Clark County. Sisolak said it was "incredibly important" to prioritize those workers in the state's vaccination plan, though the state has received some criticism from union advocates for not opening up vaccines to those workers earlier.

"These are folks who cannot work from home and have been going to work every day since this pandemic started serving all of us," Sisolak said. "I've said it before and I want to repeat it here again today: Nevada will be the safest place to have a convention or come and visit. It will be safe for the tourists and business travelers. It will be safe for employees and it will be safe for their families."

Sisolak demurred on Wednesday when he was asked whether he plans to extend the state's eviction moratorium beyond the end of the month. He did, however, say that the state is working with the judicial branch to determine how to move forward.

"I've got a lot of options on the table right now," Sisolak said. "We're working night and day to come up with a plan for that and we should see something in the future."

The governor also responded to accusations from Las Vegas Carolyn Goodman on Wednesday that his decision to exercise his emergency powers during the pandemic was "tyranny," saying that he has relied on scientific data in making all of his decisions, including those to close schools and businesses - the latter happened exactly a year ago on Wednesday.

"They have not been easy decisions," Sisolak said. "We protected people as best we possibly can because that's my priority."
For more information check out The Nevada Independent's vaccine Q+A . You can also view your county's vaccine distribution plan on Immunize Nevada's website . For help making an appointment once your turn comes up, call the state's hotline at 800-401-0946.

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Sisolak: All Nevadans 16 and older will be eligible for the COVID-19 vaccine starting April 5

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All Nevadans who want the COVID-19 vaccine will be eligible to get it in less than three weeks, Gov. Steve Sisolak announced on Wednesday. The governor, at a press conference in Carson City, said that all Nevadans aged 16 and older will qualify to get the vaccine starting April 5.

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first baby born with antibodies after mom reveives vaccine 

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first baby born with antibodies after mom reveives vaccine 

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At 36 weeks pregnant, a South Florida frontline health care worker received her first shot of the Moderna COVID-19 . She gave birth three weeks later to a healthy baby girl - with COVID-19 antibodies.

Doctors believe the newborn marks the first known case of a baby born with coronavirus antibodies in the U.S., which may offer her some protection against the virus.

Dr. Paul Giblert and Dr. Chad Rudnick presented their findings in a preprint study, meaning it has not yet been peer-reviewed. They found that the antibodies were detected at the time of delivery, after analyzing blood from the baby's umbilical cord taken immediately after birth and before placenta delivery.

"We have demonstrated that SARS-CoV-2 IgG antibodies are detectable in a newborn's cord blood sample after only a single dose of the Moderna COVID-19 vaccine," they concluded. "Thus, there is potential for protection and infection risk reduction from Sars-CoV-2 with maternal vaccination."

The doctors emphasize, however, that more research is needed to verify the safety and efficacy of the coronavirus vaccines during pregnancy.

It was already known that mothers previously infected with COVID-19 can pass antibodies on to their newborns. Additionally, the passage of antibodies from mother to baby through the placenta is well documented in other vaccines, including that for influenza, so doctors were hopeful the same newborn protection would be possible after maternal vaccination against COVID-19.

"It really starts aligning the COVID vaccine with those vaccines that we already use in pregnant women like the flu vaccine," Dr. Neeta Ogden, an internal medicine specialist and immunologist, told CBSN on Wednesday. "We really need, and it is clear that we need, significant data on how safe it is in pregnant women."

Doctors say a Florida mother who received one dose of Moderna vaccine while pregnant has passed antibodies to her newborn.

Her child is believed to be the first baby known to be born with COVID-19 antibodies. pic.twitter.com/tZQFNx0S7i
- CBS News (@CBSNews) March 17, 2021

These early results may help give pregnant women more reason to consider getting the vaccine.

"This also is hopeful because it offers a level of protection to one of the most vulnerable populations, the newborn," Ogden said, emphasizing the need to further study in pregnant women during this pandemic.

Since we don't have COVID vaccines approved for children yet, she said, "If we can see this kind of safe maternal transmission of antibodies from the vaccine to newborns, I think that's really a great step in the right direction."

Other recent studies, also shared in preprint and not yet peer-reviewed, support the findings.

Massachusetts General Hospital recently studied 131 women - 84 pregnant, 31 breastfeeding and 16 non-pregnant - who all received the Pfizer or Moderna vaccines. They found equally strong immune responses in the pregnant and lactating women as the control group. Additionally, antibodies were present in the placenta and breastmilk of every sample taken.

"Maternal vaccine-generated antibodies were detected in the umbilical cord blood of all 10 babies who delivered during our study period," co-author Dr. Andrea Edlow, a maternal-fetal medicine specialist at Massachusetts General Hospital, told CBS News on Wednesday. "Our data suggest that receiving both shots of the mRNA vaccine leads to improved antibody transfer to newborns."

Another study out of Israel found antibodies in all 20 women tested who received both doses of the Pfizer vaccine, both during their third trimesters and in their newborns, also through placental transfer.

Last month, Pfizer announced that it had begun the first large-scale trial of its vaccine on pregnant women, which it expects to finish by the beginning of 2023. Its vaccine was approved for emergency use in the U.S. in December, and millions of people, including thousands of pregnant women, have taken it already.

Moderna, whose vaccine also received emergency use authorization in the U.S. in December, has not begun trials focusing on pregnancy, but has created a registry to track pregnant women who get its vaccine. Johnson & Johnson, which received emergency use authorization for its vaccine last month, said that it plans to include pregnant women and their infants in its studies as well as collect data on pregnant women via a registry.

Pregnant women were excluded from the original trials of Moderna and Pfizer's COVID-19 shots, a common practice in such studies.

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First baby in U.S. born with antibodies against COVID-19 after mom receives dose of Moderna vaccine while pregnant

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At 36 weeks pregnant, a South Florida frontline health care worker received her first shot of the Moderna COVID-19 . She gave birth three weeks later to a healthy baby girl - with COVID-19 antibodies. Doctors believe the newborn marks the first known case of a baby born with coronavirus antibodies in the U.S., which may offer her some protection against the virus.

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https://www.bbc.com/news/health-55056016

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why do adults get the vaccine first then kids.

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why do adults get the vaccine first then kids.

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Adult vaccination has begun, while clinical trials for a children's vaccine are underway

The world finally has a coronavirus vaccine for adults (two to be exact). And although this is fantastic news, experts say that children will also need to be vaccinated to get the pandemic under control. Still, clinical trials for a kid's vaccine are underway, and although it may take another year to receive the data and produce a vaccine, it's promising news.

Pediatric infectious disease specialist Frank Esper, MD, explains the ins and outs of developing a vaccine for children and why the first COVID-19 vaccines weren't approved for kids.

Why an adult vaccine came first

"Both adults and children will need to be vaccinated for things to return to some sort of normalcy," explains Dr. Esper. "Many vaccine manufacturers have now started research and clinical trials for a vaccine that is safe and effective for kids."

Kids weren't involved in the original adult clinical trials because the data tells us that severe illness from COVID-19 tends to happen to adults (especially in older adults). We're not seeing the same sort of response or sickness in children.

That's not to say that children are immune to COVID-19, because they aren't. But they tend to be more resilient and fare better if they get sick, notes Dr. Esper (although a very small number of kids have developed a serious inflammatory condition linked to coronavirus).

One of the reasons for focusing on an adult version first is because when children are involved in clinical trials, there is oftentimes more layers of protection to go through. For instance, the child and both parents typically have to agree to participate in the trial or study.

"Kids are a special and vulnerable population and we try to protect them because they can't make decisions for themselves," says Dr. Esper. "In clinical trials - whether for a vaccine or any type of treatment - we don't want to speed things up because it's a matter of protection and safety."

So the first priority was for an adult vaccine, not only because of the outcomes we're seeing, but because an adult vaccine was faster to create due to the potential risk and rigorous safety precautions needed for the development of a children's vaccine.

Children's immune systems are different than adults

Immune systems in kids can vary greatly depending on age. A 16-year-old is going to have a much different immune system than a 16-month-old. Because of this, additional data and research is needed when evaluating a vaccine for kids.

It's even true for the flu shot. Babies six months and older should get a flu shot every year, but some kids six months through eight years of age may need two doses for more protection. This is because of differing immune system responses at different ages.

"Children's immune systems are growing up just as they are," explains Dr. Esper. "We often split kids up by age groups and stages. We can't just say all kid's immune systems are the same at any given age."

For adults, we're often lumped together from age 18 to 65 and then 65 and over. With children, there is a much wider range in terms of stages and ages because they are still growing and developing. All of this has to be taken into consideration with a vaccine since kids at varying ages will likely respond differently.

Because of all the challenges with kid's immune systems and the protection and safety protocols in clinical trials, a COVID-19 vaccine for children will still take some time to develop. But, it's good news and a step in the right direction that clinical trials for a children's vaccine are underway.

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Why a COVID-19 Vaccine for Children May Take Longer

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Adult vaccination has begun, while clinical trials for a children's vaccine are underway The world finally has a coronavirus vaccine for adults (two to be exact). And although this is fantastic news, experts say that children will also need to be vaccinated to get the pandemic under control.

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COVID-19 vaccine near me: Digital tools to help you find vaccination locations

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COVID-19 vaccine near me: Digital tools to help you find vaccination locations

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As COVID-19 vaccines continue to be distributed across the country and its territories, more digital tools are becoming available to help Americans get their shots.

The U.S. is currently distributing vaccines made by Pfizer-BioNTech, Moderna and Johnson & Johnson in hospitals, pharmacies and other locations in all 50 states.

Many state health departments websites offer information about where eligible groups can get the vaccine in their state, as well as each state's vaccination plan. Big retail and pharmaceutical companies also have the information readily available on their websites. Tech giants, such as Apple and Facebook, have also developed digital tools to help users find locations offering vaccinations.

As language barriers thwart efforts to vaccinate Latino and other communities, government entities, as well as corporations and nonprofit groups, are publishing content in Spanish and other languages.
An illustrated guide: When can children get COVID-19 vaccine?:Will it be safe? Here's what experts want you to know What to expect before and after getting a COVID-19 vaccine
Roughly 22.2% of people in the US have received at least one COVID-19 shot as of Mar. 18, and around 12% of people are fully vaccinated, according to USA TODAY'S COVID-19 vaccine tracker.

Here's a list of online sources to help users find places where they can get a COVID-19 vaccine:

VaccineFinder

VaccineFinder is a free, online service where users can search for locations that offer vaccinations. The service is operated by epidemiologists and software developers at Boston Children's Hospital.

Apple Maps

Apple announced Tuesday it will display on its Apple Maps app places where users can go to get a COVID-19 vaccine. Apple product users can search for a nearby vaccination site by asking Siri or typing in the search bar within Maps.

Facebook

Facebook launched a tool in its COVID Information Center that shows when and where users can get vaccinated. The update also gives users a link to make an appointment. The tool is still rolling out.

CVS Pharmacy

CVS Pharmacy has a map in their COVID-19 page where users can select their state and find the nearest CVS offering vaccinations. Eligible users can schedule their first and second doses of the vaccine online.

Rite Aid

Users can visit the Rite Aid COVID-19 website to find out where they can get the vaccination against the virus. Visitors must click on their state to find out if they're eligible for the vaccine and can schedule their appointment at the nearest Rite Aid.

Albertsons

Albertsons is part of the federal program to receive vaccines from the CDC. Users can visit their website to locate the nearest Albertsons offering COVID-19 vaccinations. Visitors must enter their zip code and confirm they are eligible for vaccination.

Hy-Vee

Hy-Vee's pharmacy page offers a tool where users can enter their zip code and find the nearest Hy-Vee offering the vaccination against the COVID-19 virus. Due to limited vaccine supply, appointments may not be available at all locations, according to the web page.

Walgreens

The Walgreens COVID-19 vaccine locator tool helps residents in New Mexico and New Hampshire find a Walgreens providing vaccination against the coronavirus. Users must enter their zip code to find the nearest location.

Costco

Costco pharmacies are administering COVID-19 vaccines in locations in California, Mississippi, New York, Oregon, Puerto Rico, South Carolina, Vermont and Washington. Residents seeking the vaccine can visit Costco's COVID vaccine page and select their state and county, and book an appointment.

Kroger

Through Kroger's general vaccination website, users can can enter their zip code to locate the nearest Kroger location offering vaccination against COVID-19. The vaccine against the coronavirus is only available in select locations.
Follow Coral Murphy on Twitter @CoralMerfi
Walmart

Walmart designed an interactive map to show which locations are offering COVID-19 vaccinations. Users can zoom in on their state and find the nearest location.

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COVID-19 vaccine near me: Digital tools to help you find vaccination locations

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As COVID-19 vaccines continue to be distributed across the country and its territories, more digital tools are becoming available to help Americans get their shots. The U.S. is currently distributing vaccines made by Pfizer-BioNTech, Moderna and Johnson & Johnson in hospitals, pharmacies and other locations in all 50 states.

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https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/safety-of-vaccines.html

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Booking a Covid-19 Vaccine? More Tools and Tips, Plus Help From Apple, Facebook and Google

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Booking a Covid-19 Vaccine? More Tools and Tips, Plus Help From Apple, Facebook and Google

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Me: "Hey Siri, refresh the pharmacy websites until there's an available vaccine appointment within 50 miles, then book it as fast as robotically possible. If you can't do that, sound your loudest alarm to get my attention."

Siri: "I didn't get that. Can you try again?"

Alright, maybe I got a bit overzealous after Apple announced it is making it easier to find Covid-19 vaccines.

Can you blame me? As I detailed in a column a few weeks ago, in many states getting a vaccine appointment is an experience somewhere between Vegas poker and the Hunger Games. The combo of poorly designed websites and scarce appointments will make you wish you could simply stand on a line 15 miles long, on a freezing cold day, no snacks in sight.

The big tech companies now are pitching in to help with a small part of the struggle: finding the vaccine locations. Earlier this week, Apple and Facebook joined Google in offering some new tools:

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Booking a Covid-19 Vaccine? More Tools and Tips, Plus Help From Apple, Facebook and Google

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If you are trying to book a Covid-19 vaccine, the combo of poorly designed websites and scarce appointments might make you wish you could just stand on a long line in the freezing cold-but big tech companies are pitching in to help.

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https://www.uchicagomedicine.org/forefront/coronavirus-disease-covid-19/mrna-covid-19-vaccine-pregnancy-breastfeeding

https://www.baystatehealth.org/covid19/vaccine/pregnancy

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Now that COVID-19 vaccines are rolling out, pregnant and breastfeeding people have many questions around risks and benefits. At first, many of those receiving vaccines in US will be healthcare workers, although the circles for vaccine eligibility are widening.

The Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine agree that the new mRNA COVID-19 vaccines should be offered to pregnant and breastfeeding individuals who are eligible for vaccination. However, the World Health Organization (WHO) recommends against using mRNA vaccines in pregnant women unless the benefit to an individual outweighs potential vaccine risks. You can weigh benefits and risks with your doctor.

Here are answers to some basic questions you may have about getting a COVID-19 vaccine if you're pregnant or breastfeeding - or are considering a pregnancy. Keep in mind that information is evolving rapidly. Your obstetric provider or medical team can advise you more fully, based on your personal health risks, exposures to the virus that causes COVID-19, and preferences.

What do we know about how COVID-19 affects people who are pregnant?

COVID-19 is potentially dangerous for all people. Although the actual risk of severe illness and death among pregnant individuals is very low, it is higher when compared to nonpregnant individuals from the same age group. Those who are pregnant are at higher risk for being hospitalized in an intensive care unit and requiring a high level of care, including breathing support on a machine, and are at higher risk for dying if this happens.

If you're pregnant, you may also wonder about risks to the fetus if you get COVID-19. Research suggests that having COVID-19 might increase risk for premature birth, particularly for those with severe illness. So far, studies have not identified any birth defects associated with COVID-19. And while transmission of the virus from mother to baby during pregnancy is possible, it appears to be a rare event. You can read more about pregnancy and COVID-19 here.

What do we know about the safety of newly available mRNA COVID-19 vaccines in people who are pregnant?

The mRNA vaccine trials did not deliberately include pregnant or breastfeeding individuals, so our direct knowledge is currently limited. Some vaccine trial participants inadvertently became pregnant; 18 of these people received the vaccine. Further information may be available in coming months.

When studied during animal tests, the mRNA vaccines did not affect fertility or cause any problems with pregnancy. In humans, we know that other kinds of vaccines generally are safe for use in pregnancy - in fact, many are recommended.

It's also important to know that

The mRNA vaccines do not contain any virus particles.

Within hours or days our bodies eliminate mRNA particles used in the vaccine, so these particles are unlikely to reach or cross the placenta.

The immunity that a pregnant individual generates from vaccination can cross the placenta, and may help to keep the baby safe after birth.

What about vaccine side effects? One possible short-term side effect of the mRNA vaccine trials (occurring within one to two days of vaccination) is fever. About 1% to 3% of people have experienced fever after the first dose of mRNA vaccine, and about 15% to 17% after the second dose. These fevers are generally low and can be managed with acetaminophen, which is safe to take during pregnancy. Rarely, high, prolonged fevers in pregnancy may lead to birth defects.

For more information about common COVID vaccine side effects, click here.

What to consider about COVID-19 vaccines if you're pregnant

Eligibility for COVID vaccines varies from state to state. Healthcare workers with direct patient contact are typically in the first phase for vaccines, followed by other people at high risk for getting COVID or becoming very sick from it, such as first responders, essential workers, nursing home residents, people over age 75, and people with certain health conditions.

Assuming the mRNA vaccine is available to you during your pregnancy, you have several options to discuss with your health care provider.

Get vaccinated as soon as the vaccine is available to you. You might decide to do this if you have additional risk factors for severe complications from COVID-19 (such as high blood pressure or obesity), and/or multiple potential exposures to COVID-19 from your work, your family, or your community.

Wait until after you give birth to get the vaccine. You might choose to do this if pregnancy is your only risk factor for severe disease, and you are able to control your exposures by limiting interactions with people outside of your household and using protective measures (mask-wearing, handwashing, and physical distancing).

Consider ways to modify your exposures to COVID-19 and possibly defer getting the vaccine. Most people have some risk factors and some uncontrolled exposures. If this describes you, you still have options. You may decide to modify your exposures if possible and defer vaccination until the second trimester, when the natural risk of miscarriage is lower. Or you may choose to delay vaccination until after the baby is born.

Wait for a traditional vaccine similar to the flu shot or Tdap vaccines. These vaccines are in development but are not yet approved in the US. Experts know much more about using these types of vaccines in people who are pregnant. However, depending on your exposures to COVID-19 and your risk for getting seriously ill if you get infected, it may be wisest to have an mRNA vaccine.

If you are considering deferring the vaccine, ask whether vaccination will be available to you at a later date. The answer may vary depending on supplies of the COVID vaccines and vaccination programs where you live.

One more note about timing: The flu shot and Tdap (tetanus, diphtheria, pertussis) vaccines are routinely recommended during pregnancy. If you choose to receive the COVID-19 vaccine during pregnancy or the postpartum period, the CDC recommends scheduling it at least 14 days before or 14 days after any other vaccination. Talk to your obstetric provider about the best timing for the COVID-19 vaccine.

What to consider about COVID-19 vaccines if you're breastfeeding

Experts, including the WHO, believe it is most likely safe to get an mRNA COVID-19 vaccine if you're breastfeeding. Although breastfeeding people were not included in the vaccine trials, the mechanism of mRNA vaccines and experience from other vaccines suggest this is true.

It is important to know:

There is no virus in the mRNA vaccines. You cannot get COVID, or give your baby COVID, by being vaccinated. The components of the vaccine are not known to harm breastfed infants.

When you receive the vaccine, the small mRNA vaccine particles are used up by your muscle cells at the injection site and thus are unlikely to get into breast milk. Any small mRNA particles that reach the breast milk would likely be digested.

When a person gets vaccinated while breastfeeding, their immune system develops antibodies that protect against COVID-19. These antibodies can be passed through breast milk to the baby. Newborns of vaccinated mothers who breastfeed can benefit from these antibodies against COVID-19.

What to consider if you're thinking of becoming pregnant soon or in the future

If you are considering pregnancy soon, accepting the COVID-19 vaccine as soon as it is available to you is a great way to ensure that you - and your pregnancy - are protected.

COVID-19 vaccination is not believed to affect future fertility.

The bottom line

COVID-19 vaccination for people who are pregnant or breastfeeding has potential benefits, and raises some as yet unanswered questions. It helps to become as informed as you can when making your decision, but realize that information may be changing rapidly. We will be learning more about COVID vaccine safety during pregnancy and while breastfeeding from animal studies now underway, and from human studies that are enrolling participants.

Meanwhile, you can stay informed by checking trusted health websites, such as those listed above, and talking with your healthcare providers. Together you can balance the latest data on risks of COVID-19 in pregnancy, the safety of available vaccines, your individual risk factors and exposures, and most importantly, your values and preferences.

Additional resources

Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients. American College of Obstetricians and Gynecologists.

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Wondering about COVID-19 vaccines if you're pregnant or breastfeeding? - Harvard Health Blog

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If you are pregnant or are thinking about becoming pregnant, or have recently given birth and are breastfeeding, you may have questions about getting a COVID-19 vaccine. Get informed by consulting trusted health sources, and talk with your medical providers about your options.

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https://www.bbc.com/news/world-us-canada-55340244
https://www.bbc.com/news/health-56012529

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By Rachel Schraer
BBC Reality Check

Claims on social media that the Covid vaccine could affect female fertility are unfounded, experts have said.

Posts have incorrectly suggested the Pfizer vaccine could cause infertility in women, or cause their bodies to attack the placenta.

But there is no "plausible biological mechanism" by which the vaccine could affect your fertility, says Prof Lucy Chappell, a professor in obstetrics at King's College London and spokesperson for the Royal College of Obstetricians and Gynaecologists.

How does the vaccine work?

The vaccine works by sending a message to the body with a blueprint, allowing it to manufacture a small, harmless fragment of the coronavirus's distinctive "spike".

This prompts your immune system to kick into action, producing antibodies and white blood cells to fight off the virus - and recognising it if you encounter it again.

It can't give you the virus, and it has no way of affecting your own genetic information.

These "messenger particles" are extremely short-lived: they deliver their message and then they are destroyed. That's why the Pfizer vaccine in particular has to be stored so carefully - the genetic material it contains falls apart and becomes useless very easily.

Prof Nicola Stonehouse, a virologist at the University of Leeds, said there was no possible way she could think of that this could have an impact on reproductive health.

What does the evidence say?

Online, some people have pointed to a line in an earlier version of guidance published by the UK government stating it was "unknown" whether the Pfizer vaccine had an impact on fertility. This has since been updated to clarify that animal studies don't indicate any harmful effects on the reproductive system.

Part of the confusion here is down to how scientists describe things compared with how most of us would understand them in our daily lives.

When scientists say there is "no evidence" they mean there hasn't yet been a long-term study on this specific vaccine - but that doesn't mean there are no facts here at all or we're shooting in the dark.

In fact, Prof Chappell pointed out, there is lots of evidence from other non-live virus vaccines, including the flu jab, that they have no impact on fertility and are completely safe and recommended for use during pregnancy.

And getting the Covid virus itself - which the vaccine protects against - has the potential to affect fertility, so "you're much more likely to have fertility issues post-Covid than after the vaccine," Prof Stonehouse said.

False placenta claims

Some of the rumours have suggested the vaccine could threaten fertility because it contains proteins also used to make the placenta. Posts on social media have claimed this could lead the body to attack the placenta.

This is not true - the vaccine does contain a protein which slightly resembles one used in the development of the placenta but it's not similar enough to confuse the body.

Vaccines are designed around the most distinctive parts of the virus's spike to make sure it recognises only that.

The fact that the respective proteins bear a passing resemblance "doesn't mean anything", says Prof Chappell, since there are lots of similar proteins existing in different places in nature - it's their precise length and sequence that makes them distinctive.

Prof Chappell, who specialises in the health of pregnant women and people hoping to conceive, said she had "no concerns" about fertility and the Covid vaccine.

And the deputy chief medical officer for England, Jonathan Van-Tam, when answering questions from BBC viewers, said: "I have never heard of a vaccine that affects fertility."

He described the suggestion as "a nasty, pernicious scare story, but that's all it is".

What about during pregnancy?

During pregnancy women are understandably very concerned about their health and may be conscious of scandals such as the one surrounding thalidomide - a drug used for morning sickness, that affected thousands of babies, leaving many with impaired limb development.

But as a direct result of these experiences, our understanding and treatment of drugs during pregnancy is entirely different.

The advice on treatments during pregnancy is extremely cautious.

And pregnant women are generally not included in clinical trials - including those for the Covid vaccine.

Though vaccines are quite different from powerful drugs like thalidomide, most health services are erring on the side of caution.

They are generally not recommending pregnant women have the jab unless they are at particular risk from Covid.

That might be because they are highly exposed to the virus in their jobs, or at high risk of becoming very sick if they contracted Covid due to health conditions.

The UK government says: "The vaccines have not yet been tested in pregnancy, so until more information is available, those who are pregnant should not routinely have this vaccine."

Like all things in healthcare, there is an element of balancing risks.

Even something as simple as an over-the-counter painkiller carries a tiny risk of ulcers and internal bleeding. But the risk for most people is so small when used correctly, that it is outweighed by the benefits of treating relatively mild pain.

And the benefits of preventing an illness that we know can be life-threatening have been judged to be much greater than any theoretical risk of vaccination.

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Covid: Claims vaccinations harm fertility unfounded

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By Rachel Schraer BBC Reality Check Claims on social media that the Covid vaccine could affect female fertility are unfounded, experts have said. Posts have incorrectly suggested the Pfizer vaccine could cause infertility in women, or cause their bodies to attack the placenta.

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US Plans to Send 4 Million Vaccines to Mexico and Canada

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US Plans to Send 4 Million Vaccines to Mexico and Canada

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https://www.reuters.com/article/us-health-coronavirus-usa-mexico-exclusi/exclusive-u-s-plans-to-send-four-million-doses-of-astrazeneca-vaccine-to-mexico-canada-official-idUSKBN2BA22S

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WASHINGTON (Reuters) - The United States plans to send roughly 4 million doses of AstraZeneca's COVID-19 vaccine that it is not using to Mexico and Canada in loan deals with the two countries, an administration official told Reuters on Thursday.

Mexico will receive 2.5 million doses of the vaccine and Canada will receive 1.5 million doses, the official said.

"This virus has no borders," the official told Reuters on condition of anonymity. "We only put the virus behind us if we're helping our global partners."

The Biden administration has come under pressure from allies worldwide to share vaccine, particularly from AstraZeneca, which is authorized for use in other countries but not yet in the United States.

AstraZeneca has millions of doses made in a U.S. facility, and has said that it would have 30 million shots ready at the beginning of April. The company's shares rose slightly on the news.

The deal to share the vaccine, which is still being finalized, does not affect President Joe Biden's plans to have vaccine available for all adults in the United States by the end of May, the official said. The deal is likely to be announced publicly in the coming days.

Two officials said the vaccine would be delivered in "short order" once the deal was completed, but they declined to give a more specific timetable.

The "releasable" vaccines are ready to be used once they arrive. Under the deal, the United States will share doses with Mexico and Canada now with the understanding that they will pay the United States back with doses in return. The official said that would take place later this year.

The United States had no plans to share the vaccine with other countries at this time, he said.

"They are our neighbors, they are our partners," the official said about Mexico and Canada. Mexican President Andres Manuel Lopez Obrador had requested the vaccine previously.

Biden has said if the United States has a surplus of vaccine, it will share it with the rest of the world.

The official noted that the United States has pledged $4 billion to the COVAX vaccine facility that aims to deliver coronavirus vaccines to poor countries.

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pharmaceuticals & medical research (trbc level 2)

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Exclusive: U.S. plans to send four million doses of AstraZeneca vaccine to Mexico, Canada - official

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WASHINGTON (Reuters) - The United States plans to send roughly 4 million doses of AstraZeneca's COVID-19 vaccine that it is not using to Mexico and Canada in loan deals with the two countries, an administration official told Reuters on Thursday. Mexico will receive 2.5 million doses of the vaccine and Canada will receive 1.5 million doses, the official said.

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CDC
Possible Side Effects After Getting a COVID-19 Vaccine | CDC

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Centers for Disease Control and Prevention

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Self-Checker

Important update: Healthcare facilities

CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more

Possible Side Effects After Getting a COVID-19 Vaccine

What You Need to Know

Side effects after getting a COVID-19 vaccine can vary from person to person.

Some people experience a little discomfort and can continue to go about their day. Others have side effects that affect their ability to do daily activities.

Side effects generally go away in a few days.

Even if you don't experience any side effects, your body is building protection against the virus that causes COVID-19.

Adverse events (serious health problems) are rare but can cause long-term health problems. They usually happen within six weeks of getting a vaccine.

Common Side Effects

Side effects after a COVID-19 vaccination tend to be mild, temporary, and like those experienced after routine vaccinations. They can vary across different age groups.

Common side effects can include:

Pain on the leg or arm where the shot was given

Swollen lymph nodes

Irritability or crying

Sleepiness

Loss of appetite

Side effects are more common after the second dose and can include:

Pain, swelling, and redness on the arm where the shot was given

Tiredness

Headache

Muscle or joint pain

Chills

Swollen lymph nodes

On the arm where you got the shot:

Throughout the rest of your body:

Tiredness

Headache

Muscle pain

Chills

Fever

Nausea

After a second shot or booster

Reactions reported after getting a booster shot are similar to those after the two-dose or single-dose primary shots. Most side effects were mild to moderate.

The most commonly reported side effects were:

Fever

Headache

Fatigue (tiredness)

Pain at the injection site

Helpful tips to relieve side effects

Adults

To relieve pain or swelling on the arm where you got the shot:

Apply a clean, cool, wet washcloth over the area.

Use or keep moving your arm.

Also, if possible, get some rest.

To reduce discomfort from fever:

Drink plenty of fluids,

Dress in comfortable clothes,

Talk to your doctor about taking over-the-counter (OTC) medicine, such as ibuprofen, acetaminophen, aspirin (only for people ages 18 years or older), or antihistamines.
It is not recommended to take these medicines before vaccination to try to prevent side effects as it is not known how OTC medicines might affect how well the vaccine works.

Children

Ask your child's healthcare provider for advice on using a non-aspirin pain reliever and learn about other steps you can take at home to comfort your child after vaccination.

Call a doctor or healthcare provider about a side effect if:

Redness or tenderness where the shot was given gets worse after 24 hours

Side effects are worrying or do not seem to be going away after a few days

Adverse Events after COVID-19 Vaccination Are Rare

Adverse events, including severe allergic reactions, after COVID-19 vaccination are rare but can happen. For this reason, everyone who receives a COVID-19 vaccine is monitored by their vaccination provider for at least 15 minutes.

After leaving a vaccination provider site, if you think you or your child might be having a severe allergic reaction, seek immediate medical care by calling 911.

Learn more about what you can do if you have an allergic reaction.

Reporting Side Effects and Adverse Events

Use v-safe or the Vaccine Adverse Event Reporting System (VAERS) to report your side effects:

V-safe, a smartphone-based tool, provides quick and confidential health check-ins via text messages and web surveys. It does this so you can quickly and easily share with CDC how you or your child feel after getting a COVID-19 vaccine.

Vaccine Adverse Event Reporting System can be used by you or your healthcare provider to report a side effect, adverse event, or reaction from COVID-19 vaccine.

Stay Up to Date with COVID-19 Vaccines and Boosters

When do you need to schedule your next shot?

Do you or your child need to get a booster?

Can you get a different vaccine product after your 1st dose?

Stay Up to Date

Resources

What to Expect after Getting a COVID-19 Vaccine

Fact sheet for healthcare workers to give after vaccination.

File Details: 199 KB, 1 page
View PDF

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What to Expect after Getting a COVID-19 Vaccine

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Self-Checker Important update: Healthcare facilities CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more Possible Side Effects After Getting a COVID-19 Vaccine Side effects after getting a COVID-19 vaccine can vary from person to person. Some people experience a little discomfort and can continue to go about their day.

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Johns Hopkins Medical https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/is-the-covid19-vaccine-safe

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Featured Experts:

Yes. The two mRNA vaccines, Pfizer and Moderna, authorized by the U.S. Food and Drug Administration (FDA) and recommended by the Centers for Disease Control and Prevention (CDC), are very safe and very good at preventing serious or fatal cases of COVID-19. The risk of serious side effects associated with these vaccines is very small.

Lisa Maragakis, M.D., M.P.H., senior director of infection prevention, and Gabor Kelen, M.D., director of the Johns Hopkins Office of Critical Event Preparedness and Response, answer questions about the safety of the COVID-19 vaccines.

COVID-19 Vaccine Safety - What We Know

The Pfizer and Moderna vaccines are strongly recommended as safe and effective at preventing serious illness or death from COVID-19.

From December 2020 to December 2021, about 470 million doses of COVID-19 vaccine have been given in the U.S.

Roughly 12 months of data, including data from tens of thousands of participants in clinical trials, show that the vaccines are safe and effective at preventing serious disease or death due to COVID-19.

Additional shots and boosters are also authorized for those who meet the guidelines.

mRNA technology used in the Pfizer and Moderna vaccines has been in development for over 15 years.

The Pfizer and Moderna vaccines received full FDA approval, which means more data show how well that particular vaccine works.

Due to potential blood clots following administration of the Johnson & Johnson vaccine, the CDC updated its recommendations in December 2021. The CDC noted that the two mRNA vaccines, from Pfizer and Moderna, are preferred over the Johnson & Johnson vaccine.

Are there risks or safety concerns regarding the COVID vaccines?

To help catch risks or safety concerns, the CDC and FDA monitor possible safety issues with the COVID-19 vaccines. This ongoing work has led to revised recommendations for the Johnson & Johnson vaccine and information about rare side effects tied to the Pfizer and Moderna vaccines.

Johnson & Johnson/Janssen. In December 2021, the CDC updated its recommendations and stated that either of the two mRNA vaccines is preferred over the Johnson & Johnson (J&J) COVID-19 vaccine. The CDC explained that the Pfizer and Moderna vaccines are preferred due to a greater risk for developing rare but severe blood clots, called thrombosis with thrombocytopenia syndrome (TTS), following administration of the J&J vaccine. The CDC noted that there are some situations when a J&J vaccine may still be used, if the recipient understands the risks and benefits of the J&J vaccine. Read about side effects related to the rare blood clot.

At Johns Hopkins Medicine, we offer Pfizer and Moderna vaccines throughout our vaccine clinics.

Pfizer and Moderna. After observing rare occurrences of myocarditis following the second injection of the Pfizer and Moderna COVID-19 vaccines, the CDC released information for the public. Most of these myocarditis events happened in teens and young adults, and the majority of the cases were mild and cleared up on their own. Read about side effects related to myocarditis.

This review process continues to monitor vaccine safety. Potential risks of COVID-19 vaccines are reviewed and weighed against the benefits of protection that the vaccines offer as well as the known, serious risk of harm due to COVID-19.

What if I got a J&J vaccine? Should I worry about blood clots?

If you received a Johnson & Johnson vaccine more than three weeks ago, you do not need to watch for side effects related to blood clots.

If you received the J&J vaccine within the last three weeks, you should watch for possible symptoms of TTS and get medical help immediately if you have any of the following:

Severe or persistent headaches or blurred vision

Shortness of breath

Chest pain

Leg swelling

Persistent abdominal pain

Easy bruising or tiny blood spots under the skin near the injection site

Is there a risk of an allergic reaction to a COVID vaccine?

According to the CDC, anyone who has a severe allergy (e.g., anaphylaxis) to any of the mRNA vaccine ingredients should not receive this vaccine. The CDC says people with allergies to certain foods, insects, latex and other common allergens can safely receive the COVID-19 vaccine. Those with a history of severe allergic reaction (anaphylaxis) to injectables or other vaccines should discuss the vaccination with their doctor, who can evaluate and assess their risk.

The COVID-19 Vaccines: What you need to know | Las vacunas anticovid-19: información imprescindible

How was the COVID-19 vaccine developed so quickly?

The relatively quick development of these vaccines does not mean safety measures were skipped. There are several reasons why the COVID-19 vaccines were developed faster than other vaccines:

The technologies used to develop the COVID-19 vaccines have been in development for years to prepare for outbreaks of infectious viruses. The manufacturing processes were ready very early in the COVID-19 pandemic.

Countries shared genetic information when it was available about SARS-CoV-2, the coronavirus that causes COVID-19, which gave vaccine developers an early start at finding a vaccine.

The testing processes for the vaccines didn't skip any steps, but the vaccine developers conducted some stages of the process simultaneously to gather as much data as quickly as possible.

Governments gave money to vaccine developers in advance, so the companies had resources they needed.

Some types of COVID-19 vaccines were created using messenger RNA (mRNA), a new technology that allows a faster approach than the traditional way vaccines are made.

Social media enabled companies to reach out to and enroll study volunteers, and plenty of people wanted to help, so there were enough research participants to test the COVID-19 vaccines.

Because SARS-CoV-2 is so contagious and widespread, many volunteers who got the vaccines were exposed to the virus, and with so many exposures, it took a shorter time to see if the vaccines worked.

Companies began manufacturing vaccines ahead of their authorization or approval so some supplies would be ready if authorization occurred.

What steps are taken to help make sure the COVID-19 vaccines are safe?

Safety is always a top priority as federal agencies work with vaccine manufacturers and independent scientific organizations to develop, study, authorize and approve new vaccines. Here are some of the steps taken for COVID-19 vaccines, as well as other vaccines:

Careful testing. All vaccines go through clinical trials to test safety and effectiveness. For the COVID-19 vaccine, the FDA set high safety standards for vaccine developers to meet. This graphic from the National Institutes of Health shows the four phases a vaccine goes through before it is released to the public.

Authorization for emergency use. If a vaccine or medicine is needed to address an emergency situation such as the COVID-19 pandemic, once it is shown to be safe and effective, the FDA can grant it an emergency use authorization (EUA). An EUA allows a vaccine, treatment or medication to be used before the formal FDA approval.

Continuous monitoring for problems and side effects. Once a vaccine gets an EUA and is being given to people, the FDA and the CDC continue to watch carefully in case problems arise. Data on the vaccine's safety record accumulates over time, as more and more people who receive it report on their experience and any side effects. One important way to report adverse events after vaccination is through the Vaccine Adverse Event Reporting System.

Learn more from the CDC about the safety steps for the COVID-19 vaccine.

Demographics of the COVID-19 Vaccine Trials

Do I still have to wear a mask if I get a vaccine?

The CDC continues to monitor the spread of COVID-19 and makes recommendations for wearing face masks, both for those who are fully vaccinated as well as people who are not fully vaccinated.

The CDC also recommends that masks and physical distancing be required when going to a doctor's office, hospital or long-term care facility, including all Johns Hopkins hospitals, care centers and offices.

Johns Hopkins Medicine's mask safety guidelines have not changed, and we still require everyone to wear masks inside all of our facilities.

Can I get COVID-19 from the vaccine?

You cannot and will not get COVID-19 from any of the vaccines. The COVID-19 vaccines do not have any virus or other infectious material in them.

What about the safety of COVID-19 vaccination for diverse groups of people?

The FDA and other reviewers closely consider diverse populations and include them in the trials. The clinical trials for the first two COVID-19 vaccines included members of underrepresented minorities and older age groups, and people with conditions such as obesity, diabetes, and heart and respiratory conditions.

Does Johns Hopkins Medicine recommend that I get a COVID-19 vaccine?

Yes, we recommend that everyone who is eligible get vaccinated with one of the currently authorized mRNA COVID-19 vaccines: Pfizer or Moderna. We view both as highly effective in preventing serious disease, hospitalization and death from COVID-19 (including disease caused by the very contagious delta and omicron variants of the coronavirus), and we believe that their benefits outweigh their risks.

At Johns Hopkins Medicine, we offer Pfizer and Moderna vaccines throughout our vaccine clinics.

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Our experts answer some frequently asked questions about vaccine safety.