As of 01/16/2021
What is an mRNA Vaccine?
How does it work?
Messenger RNA (mRNA) vaccines use technology that has been studied for more than a decade. The vaccine injects genetic material inside a coating into the body. The coating acts to protect the mRNA from enzymes that break it down in the body as well as helps it enter cells called macrophages and dendritic cells in the lymph nodes. The mRNA serves as instructions for these cells to make a part of the “spike protein” that is considered characteristic of SARS-CoV-2.
Only a part of this particular protein is made; therefore, there is no harm being done to the person vaccinated while the body’s immune system creates antibodies against the spike protein. This is done by taking a bit of the processed protein and displaying it onto the antigen-presenting cells’ (macrophages and dendritic cells) surfaces. In turn, the immune system recognizes these spikes are foreign and begins producing antibodies and activating fighter cells called T cells to fight off what it thinks is an “infection”.
Once the body begins to protect itself against the spike proteins, the antibodies become more and more specific to the SARS-CoV-2 virus, allowing the immune system to be better equipped to protect against future SARS-CoV-2 infections.
Do mRNA vaccines alter genes or cause infection?
It is important to note that once the spike protein is made, the cells in your body use enzymes to break down the mRNA strand. The mRNA does not affect an individual’s genetic material as it never even enters a cell’s nucleus. Therefore, mRNA vaccines do not modify or alter an individual’s genetic makeup. Additionally, mRNA vaccines are not live vaccines and do not contain an infectious element. Consequently, there is no risk of the vaccine causing disease in the individual.
For more information please refer to “Making an Informed Decision” below!
Why should we use an mRNA vaccine?
- Safer – mRNA vaccines use a non-infectious element
- Scalable – mRNA vaccines are easily developed in labs using DNA templates, shortening the manufacturing time and making vaccine development faster than it is for typical vaccines
- Generalizable – one vaccine has the potential to target multiple diseases
What companies have been developing these vaccines?
One of the very first vaccines to complete phase 3 testing for SARS-CoV-2 have been mRNA vaccines. Two of these vaccines – Pfizer/BioNTech and Moderna – have now been authorized by the FDA for emergency use. These vaccines are claimed to be 94-95% effective against the coronavirus.
General Vaccine Distribution Information
- Data on how many vaccines have already been distributed has been changing rapidly. To view daily vaccination rates by state, click here, and to view daily vaccination rates by country, click here.
- The CDC proposed a phased approach to the vaccine distribution:
- Proposed phase 1a: Healthcare personnel (~21M), Long-Term Care Facility residents.
- CDC defines Healthcare Personnel: “paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances; contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air.”
- Proposed phase 1b: Other Essential workers (Education, food service, firefighters, police, corrections officers, etc. ~66M).
- Proposed phase 1c: Adults ≥65 years old (~53M), High-Risk Medical Conditions (Obesity, Diabetes, Heart Conditions, Cancer, etc. >100M). [Another CDC proposal included these two in phase 1b – nothing is finalized yet].
- Proposed phase 2: general population (it was estimated that we get to phase 2 after about 20 weeks – but it depends on how fast vaccines can be manufactured and shipped).
- Proposed phase 1a: Healthcare personnel (~21M), Long-Term Care Facility residents.
- Although this plan above is proposed by the CDC, it is still only tentative and depends on the state. For example, in New York state they are already beginning to give vaccines to those ≥75 years old, in addition to healthcare workers and long term care facilities.
DMV Vaccine-Specific Distribution Updates
- Update: the DC Health opened up vaccination to those aged 65 and older. There are 4,309 vaccination appointments now available for DC residents ≥65 years of age and/or health care workers who live in wards 1, 4, 5, 7 and 8. you can register for an appointment here or by calling the District’s hotline at 855-363-0333, Monday – Friday from 8am-7pm and Saturday from 8am-4pm.
- If appointments are not currently available, DC Health asks eligible residents to sign up here for an alert via email or text message when the next appointments are available.
- On Monday, January 18, at 9:00am, an additional 1,436 appointments will become available to any DC resident who is 65 and older or any individual who works in a healthcare setting in DC.
- The goal in the next few weeks is to be able expand the vaccinations to offer it to (in this order):
- Essential workers (public safety workers, grocery store workers, workers in PreK-12 education settings, and childcare settings)
- DC residents with chronic medical conditions and other essential workers.
- General population
- The full DC vaccination plan can be found here, the executive summary can be found here, and the COVID Vaccine section of the DC website can be found here.
- As of January 11th, 2021, MD is in Phase 1a.
- Individuals residing in MD should refer to the following page to find out which phase they are eligible for and which phase their county by clicking here.
- The COVID Vaccine section of the Maryland department of health website can be found here with an FAQs section here.
- According to Maryland’s website, they propose a variation of the CDC’s phased approach which can be found here.
- Phase 1a (current phase): front line hospital staff and healthcare workers, nursing home residents and staff, law enforcement, firefighters, EMS, all licensed and registered and certified health care providers, correctional health care staff and officers, front line judiciary staff.
- Phase 1b: assisted living, adults ≥75 years old, education and government.
- Phase 1c: adults age 65-74, essential workers in lab services, agriculture, manufacturing, postal service, etc.
- Phase 2: Adults age 16-64 at increased risk of severe COVID-19 illness due to comorbidity, essential workers in critical utilities (transportation, food services, etc.).
- Phase 3: general population.
- As of January 11th, 2021, VA is in Phase 1a-1b
- Individuals residing in VA should refer to the following page to find out which phase they are eligible for and which phase their county by clicking here.
- The full Virginia vaccination plan can be found here, the executive summary can be found here, and the COVID Vaccine section of the Virginia department of health website can be found here with an FAQs section here.
- Virginia will be working in a variation of the three phased approach outlined by the CDC (discussed above).
- Phase 1a (current phase): healthcare personnel, residents of long-term care facilities.
- Phase 1b (current phase): frontline essential workers, adults ≥75 years old, correctional facility residents, homeless shelters, migrant labor camps.
- Phase 1c: other essential workers, adults age 65-74, adults age 16-64 with underlying medical conditions.
- Phase 2: general population
Making an Informed Decision
Although getting the COVID-19 vaccine is not required, any hesitation or concerns about the vaccine should be addressed with your healthcare provider. There is a lot of misinformation circulating about the vaccine, so discussing it with an informed healthcare provider and researching the validity of information can help. Regardless of your decision, you will be supported. Here is some additional information to consider:
According to the CDC and Pfizer-BioNTech research, their vaccine is 95.0% effective following two doses in health adults. If you get the vaccine, it is very important to get both doses (three weeks apart for Pfizer), as the efficacy after only one dose was estimated at only 52.4%.
In clinical trials, participants had some mild reactions that are also common amongst many other vaccines such as the flu shot, such as soreness in the injected arm or feeling fatigued. Data from phase 2/3 clinical trials showed that 74.5% vaccinated persons (non-placebo) developed pain at the injection site, 6% had either redness or swelling at the injection site, and 20% had a systemic symptom (fever, fatigue, headache, chills, muscle pain, joint pain). These reactions are all normal signs of the body’s immune system building up resistance to COVID-19. In addition, 0.63% of the vaccinated group had hypersensitivity-related adverse effects (compared to 0.51% in the placebo group).
None of the COVID-19 vaccines in development or in use are live vaccines, therefore just like the flu vaccine, it is NOT possible to get COVID-19 from the vaccine.
Contraindications & Precautions
Contraindication = A reason to not pursue medical intervention due to potential harm
You should not get the vaccine if you have a history of a severe allergic reaction (anaphylaxis) to any of the ingredients in the Pfizer-BioNTech COVID-19 vaccine. The CDC considers a severe allergic reaction to any other vaccine or injectable therapy to be a precaution but not a contraindication to getting the COVID-19 vaccine, and should discuss with a healthcare provider.
Common Concerns about the Vaccine
- We know many individuals are nervous about how quickly the vaccine was rolled out and are worried about possible long term effects. This is a valid fear, however, the safety of this vaccine was studied extensively, and it would not have been approved by the FDA and recommended by ACIP and the CDC if it wasn’t shown to be safe. In addition, mRNA vaccines may be newly in use, but they have been researched extensively before (for the flu, Zika, Rabies, Cytomegalovirus, etc.) and have been shown to be safe. In addition, it is extremely rare that any other vaccine on the market has any long term side effects, whereas the COVID-19 virus itself has already shown to have long term effects. It is important as you weigh the risks and benefits of the vaccine to include the risks of getting COVID-19 if you do not get the vaccine.
- Other resources to help you make an informed decision
- ACIP’s Recommendation for the COVID-19 vaccine
- CDC’s Pfizer-BioNTech Vaccine information
- CDC’s FAQs and other information about the vaccine
- Pfizer-BioNTech’s Emergency Use Authorization (EUA) information
- U.S. Food & Drug (FDA)’s information about vaccines
- CDC’s Grading of recommendations, assessment, development, and evaluation of Pfizer-BioNTech Vaccine
- Infectious Disease Society (IDSA) information
- How the CDC is making vaccine recommendations
- See our “Latest Research” section
Commonly Asked Questions
When Will I Get The Vaccine?
Both Pfizer and Moderna are increasing their productions after approval. There could be up to 50 million doses from Pfizer and 20 million doses from Moderna by the end of 2020. It is expected that there will be 1.3 billion doses available from Pfizer and 500 million to 1 billion doses available from Moderna in 2021. It is expected that all the adults in the US will have access to the vaccine by June of 2021.
Since the number of doses is limited currently, it has been up to the states to prioritize who will be first in line to receive the vaccine. The state and local health care providers will communicate with the public with more information about who can get immunized first and the process for it. The CDC’s guidelines for Pfizer/BioNTech’s and Moderna’s vaccines have been linked below. However, refer to “Find Your Place in the Vaccine Line: NYT” tool to find more information regarding when you will receive the vaccine.
CDC’s Authorization for Pfizer-BioNTech: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccine
CDC’s Recommendations for Pfizer-BioNTech: https://www.cdc.gov/mmwr/volumes/69/wr/mm6950e2.htm
CDC’s Authorization for Moderna: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/moderna-covid-19-vaccineSource: https://www.cnet.com/health/covid-19-vaccine-hidden-costs-where-to-get-it-vaccination-cards-more/
How is the mRNA vaccine different from a traditional vaccine?
Vaccines work by teaching the immune system to recognize the virus and vigorously attack it if exposed to it again. Traditional vaccines typically use a weakened form of the virus. Vaccines for polio or measles work this way. On the other hand, mRNA vaccines contain genetic instructions to make only a specific structure of the virus (spike proteins for SARS-CoV-2).
Can I choose the vaccine brand that I receive?
This may depend on where you live and how many doses are being made available in your area. One of the primary reasons for this is because the Pfizer vaccine must be kept in extremely cold, dry-ice temperatures. Some medical centers near you may not have the medical-grade ultracold freezers available and can default to carrying the Moderna vaccine which can be stored in 36 to 46 degrees Fahrenheit. It is important to keep in mind that you must receive the second dose of the vaccine from the same brand that was given for the first dose.
What is the COVID-19 vaccination card?
Once you get the vaccine, you will receive a card with information about the brand of vaccine and when to go back for the second shot. However, this card will not be used as a vaccine “passport”. In other words, it is not an official certificate of immunity against COVID and cannot be used as a free pass to return to work, enter public places, or travel.
What are known side effects of the vaccine?
Data from the phase 2 and 3 clinical trials indicates that vaccinated persons could develop pain at the injection site, redness, swelling, or sometimes systemic symptoms. However, it is important to note that these reactions are all normal signs that the body’s immune system is building up resistance to COVID-19. It is also not possible to get COVID from the vaccine.
Refer to “Making an Informed Decision” for More Information
Do I have to pay to get the vaccine?
Regardless of your health insurance status, the COVID-19 vaccine is free for all Americans. However, you could still be charged an administration fee from providers for giving the shot. This can be claimed with your insurance company under approved preventative care as per ACA guidelines.
Where is the vaccine currently being given?
The COVID vaccine will be available in the same places that the flu vaccine is typically offered in. This includes clinics, hospitals, doctors’ offices, and pharmacies. Schools and community centers may also be sites for vaccination in order to accommodate more people.
Are kids eligible to receive the vaccine?
As of right now, kids will not be able to receive the vaccine. This is because the clinical trials have primarily tested the vaccine in adults. It is expected that kids under the age of 18 can get the vaccine in the later half of 2021, after sufficient clinical data has been published.
What is herd immunity and why is it important?
The concept of herd immunity may be applicable in the case for those who are ineligible to receive the vaccine or for those who do not want to take the vaccine. The concept states that if a high enough proportion of the population is immunized, the spread of the disease from person to person is unlikely and therefore, the whole community including those who are un-immunized become protected.
Refer to “Are kids eligible to receive the vaccine?”
How many times do I need to get the vaccine?
The two currently approved vaccines in the U.S. – Pfizer and Moderna – work with a two-dose schedule. After you are injected with the vaccine, you will need to come in again in 3-4 weeks for the second dose. Second dose for Pfizer is after 21 days; Moderna, 28 days.
Myths vs. Facts
Myth: The COIVD-19 vaccine is not safe because it was developed too quickly and was rushed.
Fact: The Food and Drug Administration (FDA) has some of the strictest safety regulations in the world, and they carefully reviewed all safety data from the clinical trials before approving it for emergency use. In addition, the Advisory Committee on Immunization Practices (ACIP) reviewed all safety data before recommending the vaccines for use. In addition, even though these are the first approved mRNA vaccines, the technology itself has been studied for three decades.
Myth: There are severe side effects of the COVID-19 vaccines.
Fact: The most common side effects of the vaccines are similar to any other vaccine you may have received, including the yearly flu shot. Pain at the site of injection, muscle pain in the arm that was injected, and cold or flu like symptoms (fever, fatigue, headache). The latter symptoms are signs that your immune system is doing exactly what it is supposed to do to build up protection to COVID-19. Most individuals do not have severe side effects, the only one that has been reported so far has been allergic reactions, which has only occurred to a few individuals out of the millions that have been vaccinated so far. There are many safeguards in place in case this unlikely scenario were to happen, and if you have had reactions to other vaccines in the past, the CDC has recommendations on how to proceed.
Myth: I have already had COVID-19 so I don’t need to get the vaccine when it becomes available to me.
Fact: There is not enough information that is available to know how long an individual has immunity after being infected with COVID-19 and recovering (natural immunity). Therefore it is recommended that everyone get the COVID-19 vaccine, even if you have already had COVID-19 previously. Since the vaccines are very harmless, the benefits of getting the vaccine outweigh the risks. However, according to the CDC, you should wait to get the vaccine until after the illness has resolved and you have met criteria to discontinue isolation. In addition, according to current evidence, reinfection with COVID-19 within 90 days of infection is uncommon, therefore you may be able to wait to get the vaccine until 90 days after your infection resolves, but this is not necessary.
Myth: You can get COVID-19 from the vaccine.
Fact: This is false. The only vaccines where it is possible to get the disease are live attenuated (live virus/bacteria that has been weakened) vaccines. Even with these vaccines, it is rare to get the disease from them unless you have a weakened immune system. None of the COVID-19 vaccines contain the live virus, therefore it is impossible to get the COVID-19 disease from the vaccine. The vaccine only contains the mRNA material that tells your body how to fight off the virus if it were to come in contact with it. You may experience symptoms of your body doing it’s job to build up immunity (fever, headache, fatigue), but this is not an infection with the virus.
Myth: COVID-19 vaccines will alter my DNA
Fact: The two COVID-19 vaccines that are approved are messenger RNA (mRNA) vaccines. mRNA is similar to DNA and contains instructions for all cells (human and non-human) to make proteins. By introducing mRNA from the COVID-19 virus (not the virus itself), our body learns how to make the specific viral proteins. Once it learns this, the original contents of the vaccine (mRNA) is degraded. The cells then display the newly made proteins on their surface for our immune system to recognize and make antibodies against. Since those antibodies are made now, once your body is introduced to the COVID-19 virus later on, your body will already know how to make the antibodies for it and you will not get sick. The mRNA never enters the nucleus of the cell where our own DNA is kept, and the cell breaks down and gets rid of the mRNA soon after it is finished making proteins from it. More information can be found on the CDC’s website.
Myth: Once I receive the vaccine I can stop wearing a mask and stop social distancing.
Fact: This is incorrect. It is important that until the very end of this pandemic we continue to use all the tools that are available to us in order to stop the pandemic. The vaccines are very effective (94-95%) but none of them are 100% effective, therefore it is imperative that we continue to be diligent about covering your mouth and nose with a mask, washing hands often, and staying at least 6 feet away from others that you do not live with. In addition, just because the vaccine is available, there is not going to be the flip of a switch and the vaccine will be over, it will take time to get enough people to be vaccinated. 60-70% of the population must become immunized to have herd immunity. More information from the CDC on how to protect yourself can be found here.
Myth: COVID-19 has a high survival rate, so I don’t need to get a vaccine.
Fact: The mortality rate is 1%, although this may sound low, it is actually 10 times more lethal that the seasonal flu (of which we have a vaccine for) and 1% of the United States population is still over 3.3 million individuals, which is a very significant number. In addition, mortality rates can vary by age, sex, and underlying health conditions. Also, the COVID-19 virus damages the lungs, heart, brain, and more, so it causes many long-term health problems. Not only will the vaccine prevent unnecessary deaths, but it will prevent more individuals from experiencing these long term effects that are not included in the mortality rate.
Myth: The vaccine was developed with a microchip in it to control the population.
Fact: There is no microchip or “nanotransducer” or anything else similar to that in the vaccine. The vaccine will not track people or gather personal information from any recipients. The ingredient list for Pfizer can be found here, and for Moderna can be found here.
This myth stated after comments were made by Bill Gates about a digital certificate of vaccine records. He was only referring to keeping track of who got the vaccine, nothing related to a microchip, and this has not and will not be implemented in any manner.
Myth: If I am allergic to eggs I cannot get the COVID-19 vaccine.
Fact: Although some vaccines do have egg as an ingredient, neither of the approved vaccines (Pfizer and Moderna) have eggs in them. The ingredient list for Pfizer can be found here, and for Moderna can be found here.
Myth: The COVID-19 vaccines were developed using fetal tissue.
Fact: Current mRNA COVID-19 vaccines (Pfizer and Moderna), along with others that are still being studied currently do not require the use of fetal cell cultures in the production process. The ingredient list and information about the production for Pfizer can be found here, and for Moderna can be found here.
Myth: We don’t know what’s in these vaccines.
Fact: Both Pfizer and Moderna have published their ingredient lists for their vaccines, and they can be found here and here respectively. In addition to the mRNA main ingredient, both vaccines contain lipids (fat) to help deliver the mRNA to your cells, sucrose (sugar) and a few other common ingredients such as salts that help maintain the pH and stability of the vaccine.
Myth: The COVID-19 vaccines cause infertility or miscarriage.
Fact: The COVID-19 vaccines have not at all been linked to infertility or miscarriage. The etiology of this myth is from information that antibodies to the spike protein of COVID-19 will bind to placental proteins and prevent or terminate pregnancy, originated from an individual with anti-vaccine views. This is not scientifically plausible. No other vaccine or viral infection has been shown to cause infertility or miscarriage. In addition, when an individual has the COVID-19 virus, the body also makes antibodies to the same spike protein, and if this were possible then we would have seen reports of miscarriage from those recovering from the COVID-19 virus itself, which is not the case.