To date, more than 89 million cases of Covid-19 have been confirmed worldwide, with more than 1.9 million global deaths. In the United States, there have been more than 22 million cases and more than 372,000 death from Covid-19 so far.
The rapid roll-out of multiple Covid-19 vaccines brought both hope that an end to this pandemic might be in sight and fear, among many, that vaccines produced as part of Operation Warp Speed could be rushed, and unsafe, in either the short- or long-term. Currently, there are two Covid-19 vaccines available in the United States. One is made by Pfizer and the other by Moderna. I have addressed both the short-term and long-term safety data of these two mRNA vaccines in previous articles, as well as an overview of how the Pfizer and Moderna mRNA vaccines work.
The Pfizer and Moderna vaccines are administered in two doses. As of 9 AM on January 8, 2021, more than 6.6 million people in the United States have received their first dose of either the Pfizer or Moderna vaccines. For comparison, this is approximately the number of people living in the cities of Los Angeles and Chicago combined. To date, both vaccines are considered safe overall, in terms of the ongoing clinical trials and the experiences in the vaccinated population. However, many still have questions about whether they should get a Covid-19 vaccine.
A Gallup survey performed in November 2020 found that 63% of Americans would be willing to get a Covid-19 vaccine if available. However, Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, has said that 75-85% of the population needs to be vaccinated in order to bring the pandemic under control. Some are questioning whether they should have the vaccine due to natural reservations about something relatively new, but rampant misinformation is also to blame.
This article is part of a series on Covid-19 vaccines and will address specific questions about who may be a candidate for the Pfizer or Moderna vaccines currently available.
I tested positive for Covid in November, so I’m not sure that I need a vaccine.
Current data suggest that it is rare for people who previously tested positive for Covid-19 to be reinfected within 90 days. However, it is safe for people who have recovered from Covid-19 to get the vaccine, and it is recommended that everyone is offered the vaccine, regardless of their previous history of Covid-19. There have been multiple documented cases of people being reinfected with Covid-19, so it does make sense for Covid-19 survivors to get the vaccine.
I have two children, ages 14 and 16. Can they take the vaccine?
The Pfizer clinical trial included participants age 16 and older, so your 16-year-old will be a candidate for the Pfizer vaccine when the roll-out for that age group occurs, but there is not yet FDA clearance for participants younger than 16 years of age. So, unless your 14-year-old is part of a clinical trial, this child is not a candidate for either vaccine right now.
I’m allergic to some of the ingredients of the vaccine. Should I get the vaccine anyway?
No. If you have allergies to any of the ingredients in a vaccine, you should not get the vaccine. You can find the ingredients of both the Pfizer and Moderna vaccines in Appendix B at the end of this document. Review this with your physician, and if you are allergic to a component found in only one vaccine, then you should not get this vaccine and should try to get the other instead. If you have questions about the ingredients, contact a pharmacist or your allergist.
I’m not allergic to any of the ingredients listed for either vaccine, but I’m allergic to a lot of other things. Should I avoid this vaccine?
Not necessarily. Approximately 1 in 100,000 people who have taken the Pfizer Covid-19 vaccine have developed anaphylaxis (a serious allergic reaction), so this is a rare finding. We don’t yet have similar data on the Moderna vaccine. Most people who had this type of reaction had it within minutes of getting the vaccine and responded to treatment (epinephrine). Although frightening and potentially deadly without intervention, this reaction is a treatable condition with no permanent side effects. This is why it is recommended that those who receive a Covid-19 vaccine be monitored for at least 15 minutes after vaccination. The CDC reports state that allergic reactions, including severe allergic reactions, to food, animals, venom, or environmental allergens, are not a contraindication or precaution to vaccination with either mRNA Covid-19 vaccine. The mRNA vaccines do not contain eggs or gelatin, and the vial stoppers are not made with natural rubber latex.
I am pregnant or breastfeeding. Should I avoid this vaccine?
Participants who were pregnant or breastfeeding were not included in either the Pfizer or Moderna trials. However, because the mRNA vaccine does not include a live portion of the virus, it is thought that these vaccines are unlikely to pose a risk to the pregnant person or the fetus. In contrast, we do know that pregnant people who get Covid-19 may be at increased risk for severe illness and death. Therefore, if a pregnant person is offered the vaccine, the pregnancy is not a contraindication. People who are breastfeeding should be offered the vaccine when they meet roll-out criteria. The American College of Obstetricians and Gynecologists has information for pregnant and breastfeeding people making these decisions.
I am a cancer survivor and take medications related to my diagnosis. Should I still have the vaccine?
Cancer survivors were included in the vaccine clinical trials, and having cancer is not a contraindication for these vaccines. Some cancer survivors may be at increased risk to have a poor outcome if they are infected with Covid-19 because their immune systems may be compromised, which makes them good candidates for these vaccines. Speak to your oncologist and primary care physician to see if you should consider this vaccine.
Would a history of autoimmune conditions or compromised immunity mean I cannot get this vaccine?
Not necessarily. People with these conditions were not excluded from these clinical trials. Although we do not yet have safety data on each of these subgroups, the risks of the vaccine must be weighed against the potential increased risk for severe symptomatic Covid-19 that people with these conditions may experience if they are infected with the virus. The effectiveness of the vaccines in people who cannot mount the necessary immune response needed to provide protection, due to having one of these conditions, is also unknown.
Is there one vaccine I should choose over another?
Unless you are allergic to one of the ingredients (see Appendix B at the end) found in just one of the available vaccines, no, there is no reason at this time to choose one mRNA vaccine over the other. Both the Pfizer and Moderna vaccines have been shown to be safe and effective. Take the one offered to you first.
There are currently more than 50 Covid-19 vaccine candidates in trials around the world. It is likely that within the next few months several new vaccines will be available in the United States. It is important that we evaluate each of those vaccines independently as each person decides if they will take the vaccine when offered to them in hopes of ending this global pandemic.