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Updated on Jan 10, 2021
As the COVID-19 vaccine is introduced, many people have questions about development, safety, access, cost, and other common concerns. This page provides information about what scientists do and do not know yet about the vaccines, drawing from the World Health Organization, the United States Centers for Disease Control and Prevention, and other trusted sources. Some of this language is used word for word, and other language is paraphrased. We would like to acknowledge the hard work of these organizations in compiling this information.
Getting vaccinated is one of many steps you can take to protect yourself and others from COVID-19. Other recommendations including the use of face masks, distancing and washing hands should continue to be followed to reduce your chance of being exposed to the virus or spreading it to others.
If you cannot find the information you are looking for on this page, you are invited to submit your own questions and our team will look into the answers.
Vaccine Development
How does the COVID-19 vaccine work?
There are currently multiple COVID-19 vaccines being developed, tested and approved. They are all meant to teach the body’s immune system to safely recognize and block the coronavirus. The various types include:
- mRNA vaccines, which contain synthetic mRNA, which is information used to make a coronavirus spike protein. This protein alone cannot cause COVID-19. Our cell uses this mRNA to make the viral protein which then causes our immune system to make antibodies to fight the virus when it is encountered.
- Inactivated or weakened virus vaccines, which use a form of the virus that has been inactivated or weakened so it doesn’t cause disease, but still generates an immune response.
- Protein-based vaccines, which use harmless fragments of proteins or protein shells that mimic the COVID-19 virus to generate an immune response, without causing COVID-19.
- Viral vector vaccines, which use a genetically engineered virus to carry the genetic code (such as DNA) to generate a protein that prompts an immune response, without causing COVID-19.
For more information: https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work
What are mRNA vaccines and how do they work?
Messenger RNA vaccines—also called mRNA vaccines—are some of the first COVID-19 vaccines (Moderna and Pfizer-BioNTech) authorized for use in the United States. mRNA vaccines are a new type of vaccine to protect against infectious diseases.
The immune system helps the body fight infections. To trigger a protective, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines. Instead, they teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. The antibodies produced as a result are helpful to detect and launch an attack against the real viruses.
Why was the COVID-19 vaccine developed so much faster than other vaccines?
The vaccine process is happening faster because vaccine research and development, clinical trials, manufacturing, and plans for distribution are taking place at the same time. This method removes delays that occur when these processes are carried out one after the other. Operation Warp Speed also accelerated the development by investing in and coordinating the various steps. Steps to ensure safety are not being eliminated.
Vaccine Safety
How are vaccines tested?
Possible vaccines go through an intensive testing process. Testing includes careful examination of the vaccine and its ingredients. These tests evaluate the safety of the vaccine and how well it prevents a disease. Tests are first done in research labs, and then if the vaccine looks effective and safe, researchers can apply to do clinical trials. Clinical trials typically involve several thousand healthy volunteer participants in three phases with increasing numbers of participants in each phase. Trials in all phases have to follow strict safety regulations that are set by national regulatory authorities that prioritize participant safety. When vaccine manufacturers apply for approval for their vaccine, the results of all the clinical trials are considered.
How do we know the vaccine is safe?
The most commonly used vaccines we have today have been in use for decades, with millions of people receiving them safely every year. As with all these successful vaccines, COVID-19 vaccines have also undergone extensive and rigorous testing before being approved. Scientists around the world have been working since early 2020 to develop the current possible COVID-19 vaccines and go through all of the testing processes to ensure they are safe. The vaccine safety is also monitored after the vaccines have been introduced which is called post-market surveillance. This ensures that the vaccines will continue to meet the same quality, safety and performance requirements as when they were initially introduced in the market.
Are there side effects to receiving the vaccine?
COVID-19 vaccination will help protect you from getting COVID-19. You may have some side effects, which are normal signs that your body is building protection. Common side effects include pain and swelling at the site of injection, and flu-like symptoms such as fever, chills, tiredness and headache. These should go away in a few days.
It has been seen that some people can develop allergic reactions after getting the COVID-19 vaccine. If you have ever had a severe allergic reactions to other vaccines or injectables, it is recommended that you speak to your doctor before getting vaccinated.
Is it safe for me to get the vaccine if I have a health condition such as diabetes, high cholesterol, obesity, or heart disease?
Currently approved COVID-19 vaccines may be administered to people with underlying medical conditions if they have not had a severe allergic reactions to other vaccines or injectables.
People with a weakened immune system due to other illnesses or medication, may receive the COVID-19 vaccine. However, they should be aware of the limited safety data on the mRNA COVID-19 vaccines.
Is it safe for me to get the vaccine if I am pregnant or breastfeeding?
There is limited data on the safety of getting vaccinated against COVID-19 among people who are pregnant and breastfeeding, though scientists are planning to study this further. The CDC recommends talking with your healthcare provider about the vaccine if you are pregnant or breastfeeding.
For more information, please visit: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html
Vaccine Access and Cost
Will I have to pay for the vaccine? What if I do not have health insurance?
Vaccines will be provided at no cost. However, providers can charge an administration fee. This fee can be covered by public or private insurance or by the Health Resources and Serviced Administration’s Provider Relief Fund, for those who are uninsured.
For more information on how to avoid surprise bills for the COVID-19 vaccine, visit: https://www.nytimes.com/2020/12/17/upshot/vaccines-surprise-bills.html
Will there be enough vaccine for everyone?
The initial supply of the vaccine in the United States will be limited. For this reason, vaccination will be done in phases. Each state will broadly follow federal guidelines but will have its own policies for prioritizing who gets vaccinated first. Healthcare workers and residents of long-term care facilities will be the first to be vaccinated. The goal is to get everyone vaccinated as supply becomes available. Even as the vaccine is becoming available, it is important to continue to follow the general recommendations including the use of face masks, distancing and washing hands.
Who will receive the COVID-19 vaccine first?
In the United States, healthcare personnel (clinical staff members, nursing or medical assistants, and support staff members, food, environmental and administrative service workers) are the first to receive the vaccine. Residents of long-term care facilities will also be receiving the vaccine.
Common Concerns
Are both/all of the vaccines the same? Will I have a choice between them?
The Pfizer and Moderna vaccines are both about 95% effective. The currently approved vaccines are both mRNA vaccines and work similarly. Other vaccines under development and review have different mechanisms of action. The Pfizer vaccine needs to be kept at extremely cold temperatures, while the Moderna vaccine can be kept in a normal freezer. The two doses of the Pfizer vaccine are given 21 days apart and the vaccine is authorized for people ages 16 and up. The two doses of the Moderna vaccine are given 28 days apart and the vaccine is authorized for people ages 18 and up.
Whether you will have a choice of vaccine depends on a number of factors, including the supply in your area at the time you’re vaccinated and whether certain vaccines are found to be more effective in certain populations, such as older adults. The Pfizer and Moderna vaccines are the only two vaccines currently approved in the United States.
Why do I need to get two doses of the vaccine?
The first dose helps your body recognize the virus and gets your immune system ready to protect from future infection, while the second dose strengthens that immune response. This makes your body more prepared to fight infection.
Can I get COVID-19 from the vaccine?
No, the different types of vaccines have different materials in them that will signal our bodies to produce the proteins or antibodies to protect us from the virus. NONE of these vaccines contain the active virus.
The immune response that is initiated in the body might lead to symptoms, such as fever. This does not mean the person is infected with the virus. Learn more from the CDC about how COVID-19 vaccines work.
It typically takes a few weeks for the body to build immunity after vaccination. That means it’s possible a person could be infected with the virus that causes COVID-19 just before or just after vaccination and get sick. This is because the vaccine has not had enough time to provide protection.
Will I be required to get the vaccine in order to go to work or school?
While the vaccine will not be made mandatory nationwide or statewide, employers and schools can require people who will be working and learning in their buildings to receive the COVID-19 vaccine. COVID-19 would not be the first vaccine to be mandated in certain spaces. Many healthcare employers require the annual flu vaccine and most schools require students to receive the recommended childhood vaccines. A COVID-19 vaccine could also be required for international travel. Check with your individual employer, school, airline, or other institution for specific information on their policies.
If I have already had COVID-19 and recovered, do I still need to get the COVID-19 vaccine when it becomes available?
There is not enough information currently available to say if or for how long after infection someone is protected from getting COVID-19 again. Early evidence suggests that this protection may not last very long, but it seems to vary by individuals. Those who have recovered from COVID-19 or who are in recovery should talk to their doctors about whether they should be vaccinated and when vaccination can occur.
If I currently have COVID-19, should I get the vaccine now?
If someone currently has active symptoms of COVID-19, it is recommended that they wait to get vaccinated until they have recovered and met the criteria for ending isolation.
Will a COVID-19 vaccine need to be given every year?
While testing has ensured that the COVID-19 vaccine is safe and effective at preventing illness in the short-term, we currently do not know how long its protection will last. It is possible that protection will last for many years, but it is also possible that a COVID-19 vaccine will need to be given again in future years. Repeat vaccination could be necessary if the vaccine’s protection decreases over time or if the virus that causes COVID-19 changes over time, such as the virus that causes the seasonal flu.
Will getting a flu vaccine protect me against COVID-19?
A flu vaccine will NOT protect you from getting COVID-19, but it can prevent you from getting influenza (flu) at the same time as COVID-19. This can keep you from having a more severe illness. While it’s not possible to say with certainty what will happen in the winter, it’s likely that flu viruses and the virus that causes COVID-19 will both be spreading during that time. That means that getting a flu vaccine is more important this year than ever to protect your health and prevent hospitals from becoming overcrowded with flu patients and COVID-19 patients.
Do I need to wear a mask and avoid close contact with others if I have received two doses of the vaccine?
Yes. While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to us to help stop this pandemic. These tools include covering your mouth and nose with a mask, washing hands often, and staying at least 6 feet away from others. Together, the COVID-19 vaccine and everyone following the COVID-19 safety guidelines will offer the best protection from getting and spreading COVID-19. Experts need to understand more about the protection that COVID-19 vaccines provide before deciding to change recommendations on steps everyone should take to slow the spread of the virus that causes COVID-19.
What are the ingredients in vaccines?
Today’s vaccines use only ingredients that are safe and effective. Each ingredient in a vaccine serves a specific purpose. For example, vaccine ingredients may:
- Help provide immunity (protection) against a specific disease
- Help keep the vaccine safe and long lasting
- Be used during the production of the vaccine
Ingredients provide immunity-
Vaccines include ingredients to help your immune system respond and build immunity to a specific disease. For example:
- Antigens are very small amounts of weak or dead germs that can cause diseases. They help your immune system learn how to fight off infections faster and more effectively. The flu virus is an example of an antigen.
- Adjuvants, which are in some vaccines, are substances that help your immune system respond more strongly to a vaccine. This increases your immunity against the disease. Aluminum is an example of an adjuvant.
- Messenger ribonucleic acid (mRNA), in some new COVID-19 vaccines, is the active component that generates an immune response in the recipient. The mRNA instructs the body to create a copy of the COVID-19 virus protein, which generates an immune response against the virus. The Pfizer and Moderna COVID vaccines are examples of mRNA vaccines.
Ingredients keep vaccines safe and long lasting-
Some ingredients help make sure a vaccine continues to work like it’s supposed to and that it stays free of outside germs and bacteria. For example:
- Preservatives protect the vaccine from outside bacteria or fungus. Today, preservatives are usually only used in vials (containers) of vaccines that have more than 1 dose. That’s because every time an individual dose is taken from the vial, it’s possible for harmful germs to get inside. Most vaccines are also available in single-dose vials and do not have preservatives in them.
- Stabilizers, like sugar or gelatin, help the active ingredients in vaccines continue to work while the vaccine is made, stored, and moved. Stabilizers keep the active ingredients in vaccines from changing because of something like a shift in temperature where the vaccine is being stored.
Ingredients used during the production of vaccines-
Some ingredients that are needed to produce the vaccine are no longer needed for the vaccine to work in a person. These ingredients are taken out after production so only tiny amounts are left in the final product. The very small amounts of these ingredients that remain in the final product aren’t harmful. Examples of ingredients used in some vaccines include:
- Cell culture (growth) material, like eggs, to help grow the vaccine antigens.
- Inactivating (germ-killing) ingredients, like formaldehyde, to weaken or kill viruses, bacteria, or toxins in the vaccine.
- Antibiotics, like neomycin, to help keep outside germs and bacteria from growing in the vaccine.
Detailed ingredients of the Pfizer and Moderna COVID-19 vaccines can be found on their Emergency use authorization documents released by the FDA.
The claim that these vaccines contain a microchip or tracker is FALSE. The claim that these vaccines contain mercury is also FALSE.
For more information about the ingredients and possible allergens, please ask your provider before getting the vaccine.
For more information: https://www.vaccines.gov/basics/vaccine_ingredients
Does the COVID-19 vaccine contain aluminum?
The Pfizer and the Moderna vaccines do NOT contain aluminum.
A very small amount of aluminum is used as an ingredient in some vaccines because it helps our immune system to respond more strongly to the vaccine. For decades, vaccines that include aluminum have been tested for safety — these studies have shown that using aluminum in vaccines is safe.
Please follow the links below for more information:
Vaccines.gov (U.S. Department of Health & Human Services)
The United States Center for Disease Control and Prevention
New York Times COVID-19 Vaccine Resources
This material was curated by Viswanath Lab of Harvard Chan School of Public Health and the Dana-Farber Cancer Institute (DFCI) with the help of the Health Communication Core of Dana-Farber/Harvard Cancer Center (DF/HCC). These are not the official views of Harvard Chan or DFCI. For any questions, comments or suggestions reach out to rpinnamaneni@hsph.harvard.edu.