Frequently Asked Questions About COVID Vaccines

Three vaccines have received emergency use authorization from the FDA: the Pfizer-BioNTech COVID-19 vaccine, Moderna COVID-19 vaccine and, most recently, Johnson & Johnson’s (Janssen) COVID-19 vaccine. MidMichigan Health administers the vaccine it receives based on supply. Currently this includes the Moderna and Pfizer vaccines.

Each vaccine uses a slightly different approach with the same goal: to induce an immune response in the body against SARS-CoV2, the virus that causes COVID-19.

The Pfizer and Moderna vaccines are both mRNA vaccines. This type of vaccine is not a live vaccine and does not contain the virus itself. Rather, it gives our cells instructions for how to make a harmless protein unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies recognize that the protein should not be there and build immune cells that will remember how to fight the virus that causes COVID-19 if we are infected in the future.

The Pfizer vaccine will require two shots, with the second shot received 21 days after the first.

The Pfizer vaccine contains:

• Messenger ribonucleic acid (mRNA) – the main, active ingredient that elicits an immune response and the production of antibodies
• Lipids (including ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3- phosphocholine, and cholesterol) – an outside coating or shell of fat that protects the mRNA from destruction as it is being stored, administered and delivered to cells
• Salts that are used to maintain proper levels of acidity (pH) - Potassium chloride; monobasic potassium phosphate; sodium chloride (salt); dibasic sodium phosphate dehydrate
• Sucrose – a sugar that stabilizes the suspension

The Moderna COVID-19 vaccine contains:

• Messenger ribonucleic acid (mRNA) – the main, active ingredient that elicits an immune response and the production of antibodies
• Lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG],cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC])- an outside coating or shell of fat that protects the mRNA from destruction as it is being stored, administered and delivered to cells
• Tromethamine,tromethamine hydrochloride, acetic acid, sodium acetate - used to maintain proper pH
• Sucrose – a sugar that stabilizes the suspension

The Johnson & Johnson COVID-19 vaccine contains:

• Recombinant, replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein - the active ingredient that enters human cells and elicits the immune response without replication.
• Citric acid monohydrate - an antioxidant that helps maintain stability of the active ingredient
• Trisodium citrate dihydrate - used to help control pH (acidity)
• Ethanol - used to keep the other ingredients dissolved and in solution form
• 2-hydroxypropyl-?-cyclodextrin (HBCD) - used to improve the solubility and stability of the active ingredient
• Polysorbate-80 - this is a common food additive used in several vaccines as an emulsifier (to hold other ingredients together). Compared with its use in foods, there is very little polysorbate-80 in vaccines.
• Sodium chloride - a salt used to control acidity and tonicity of the solution

Out of an abundance of caution, the FDA has paused the use of Johnson & Johnson (Janssen) vaccine as a result of six reported cases of a very rare type of blood clot (cerebral venous sinus thrombosis). The pause went into effect on Tuesday, April 13, until the Advisory Committee on Immunization Practices (ACIP) can further review these cases. The FDA is also set to review that analysis as it investigates the cases.

Who was impacted in these cases?

First, it’s important to note that these events are believed to be very rare, as only six cases are thus far discovered and over 6 million doses have been administered in the U.S. In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination. Treatment of this specific type of blood clot is different from the treatment that might typically be administered. Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given.

I received the Johnson & Johnson vaccine. Should I be concerned?

Right now, these adverse events appear to be extremely rare as only six cases have been discovered among the more than six million doses administered in the U.S. Those who have received the Johnson & Johnson vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider. Notably, if patients develop muscle aches, chills, or nausea and vomiting within 1-2 days after the vaccine, that is likely a known side effect of the vaccine and not related to a clot. But if these develop 4-5 days after the vaccine, you should be evaluated by your health care provider for a possible rare blood clot.

What are the main symptoms of this rare type of blood clot?

Signs and symptoms of a blood clot may include severe headache, vision changes, severe abdominal pain, or nausea and vomiting. Notably, if patients develop muscle aches, chills, or nausea and vomiting within 1-2 days after the vaccine, that is likely a known side effect of the vaccine and not related to a clot. But if these develop 4-5 days after the vaccine, patients should be evaluated for a possible rare blood clot.

I am scheduled to receive a COVID vaccine. Should I still get it?

COVID-19 is a serious public health crisis. Vaccines are a critical element to getting the pandemic under control. The Pfizer and Moderna vaccines are a different type of vaccine and continue to have a very safe rollout and patients should be encouraged to continue to receive these vaccines on schedule.

Do I need to reschedule my vaccine appointment?

MidMichigan Health has not been administering the Johnson & Johnson vaccine in our vaccine clinics so patients do not need to schedule or change their appointments.

Did MidMichigan administer the Johnson & Johnson vaccine prior to the pause in use?

MidMichigan Health has been predominantly administering the Moderna vaccine and the Pfizer vaccine, with only very limited supplies of the Johnson & Johnson vaccine. We have paused our administration of the Johnson & Johnson vaccine administration concordant with the CDC and FDA recommendations.

How many vaccines have been distributed nationwide?

As of April 12, more than 6.8 million doses of the Johnson & Johnson vaccine have been administered in the U.S. 

The key difference between the Johnson & Johnson vaccine and the Pfizer/BioNTech and Moderna vaccines is that the Johnson & Johnson vaccine requires only one dose. Both the Pfizer/BioNTech and Moderna vaccine require two doses.

Additionally, the Janssen vaccine uses an inactivated adenovirus (adenovirus 26; similar to the virus that causes the common cold) instead of the mRNA technology used in the Moderna and Pfizer/BioNTech vaccines. While Moderna and Pfizer both use the same technology, they contain slightly different mRNAs and different ingredients used to protect the mRNA, maintain the pH and stabilize the solution.

All three vaccines effectively prevent serious illness and death from COVID-19 and have similar potential side effects.

In clinical trials, after the second dose, the Pfizer and Moderna vaccines were shown to be about 95% effective at preventing illness caused by the coronavirus. .

MidMichigan Health is following the vaccination prioritization guidelines established by the Centers for Disease Control and Prevention (CDC) and the State of Michigan. Experts are working on how to distribute these limited vaccines in a fair, ethical, and transparent way, with an emphasis on keeping essential services functioning and protecting people at increased risk for severe cases. These prioritizations may change as more information on vaccine effectiveness and additional vaccination products become available. The timing of these phases is dependent on guidance from CDC and the Advisory Committee on Immunization Practices (ACIP), supply of vaccine from the manufacturer, how vaccine is allocated from the federal level to the states, and the capacity to administer the vaccine. The phases may also overlap.

To find out which of these phases you fall into, please refer to the detailed descriptions in Michigan’s Vaccination Interim Prioritization Guidance document.

• Phase 1A - Health care workers and residents of long-term care facilities
• Phase 1B - Specific groups of essential workers in critical infrastructure, plus all people age 75 and older.
• Phase 1C
  • Group A - All people age 65 and older.
  • Group B - People ages 16 and older at high risk for severe COVID-19 illness due to underlying medical conditions.
• Phase 2 - All individuals 16 years of age or older.

MidMichigan Health is committed to ensuring cost is not a barrier for you to receive the COVID 19 vaccine.

While the vaccine is free of charge, there will be a fee for the administration of the vaccine. We will work with your insurance carrier to make sure there is no out of pocket cost to you.

If you do not have insurance, please reach out to Patient Financial Services at (844) 832-1956 for assistance.

Please bring photo ID and wear a mask and a short-sleeved shirt on the day of your vaccination. The injection will be administered in your upper arm.

Yes, according to the CDC, patients should be offered the vaccine even if they have a prior history of COVID-19, with or without symptoms. Data from clinical trials suggest that vaccination is safe and likely efficacious in these people. Patients will need to wait at least 10 days after diagnosis and be symptom free and out of quarantine before receiving the vaccine. Current evidence suggests that people who have had COVID-19 may be protected for up to 90 days after their initial infection, so they may decide to wait until after this period, if desired.

Immunocompromised individuals may receive COVID-19 vaccination if they have no contraindications to vaccination. However, before signing up for the vaccine, they should consult their specialist to learn more about the safety and effectiveness in immunocompromised populations, as well as the potential for reduced immune response and any impacts the vaccine may have on their current medications. These patients must also continue to carefully follow all current guidance to protect themselves against COVID-19.

Currently, there are no data on the safety and efficacy of mRNA COVID-19 vaccines in people who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment. However, based on the estimated half-life of such therapies and evidence suggesting that reinfection is uncommon in the 90 days after initial infection, as a precautionary measure until additional information becomes available, there should be at least a 90 day waiting period after treatment before being vaccinated In addition, patients who have already received their first dose of the vaccine and who then received passive antibody therapy should delay their second dose until 90 days after the antibody therapy.

Given the lack of data on the safety and efficacy of mRNA COVID-19 vaccines administered simultaneously with other vaccines, the vaccine series should be administered alone, with a minimum interval of 14 days before or after administration with any other vaccine, (including vaccines such as Hepatitis B, Shingrix, Tetanus, seasonal flu, etc.) If mRNA COVID-19 vaccines are inadvertently administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine.

Because clinical trials didn’t include pregnant patients, there is no conclusive evidence related to vaccine safety and efficacy during pregnancy. However, pregnant patients are at higher risk of severe disease and worse outcomes from COVID-19 than non-pregnant peers and therefore would benefit from protection from the virus. Based on available information, expert organizations including the American College for Obstetricians and Gynecologists and Michigan Medicine’s Von Voigtlander Women’s Hospital strongly recommend that pregnant and nursing patients have access to the vaccine. They also clarify that it is not necessary to delay pregnancy after completing both doses of the COVID-19 vaccine.

The CDC also recommends that pregnant women take into account their personal risk of contracting COVID-19 based on their occupation or other activities, the risk of COVID-19 to the mother and the pregnancy, efficacy of the vaccine, and known side effects of the vaccine when deciding whether to be vaccinated. We advise patients to discuss the potential benefits and unknown risks specific to their individual situation with their healthcare provider.

The Academy of Breastfeeding Medicine does not recommend stopping breastfeeding for people who get the COVID-19 vaccine.

You may experience sore/enlarged lymph nodes in the armpit and neck after a COVID-19 vaccination. Although this is considered a normal reaction, it can show up on a mammogram. Therefore, if you are due for a routine screening mammogram, we recommend scheduling your mammogram before your first dose or 4-6 weeks after your second dose of the COVID vaccine. If you get offered a vaccine appointment, we recommend that you get the vaccine and then reschedule your mammogram if needed. View mammogram scheduling phone numbers.

There is no deferral time for eligible blood donors who are vaccinated with an inactivated or RNA based COVID-19 vaccine manufactured by Moderna or Pfizer.

Eligible blood donors who are vaccinated with a replication defective virus COVID-19 vaccine manufactured by AstraZeneca or Janssen/J&J must wait two weeks before giving blood.

Eligible blood donors who do not know what type of COVID-19 vaccine they received must wait four weeks before giving blood.

Individuals who have received a COVID-19 vaccine are not eligible to donate convalescent plasma.

For more information please refer to the Red Cross's Coronavirus and Blood Donation page.

Producing a vaccine against COVID-19 has been the top priority of scientists and governments around the world to help bring an end to the pandemic. With the coordinated and enormous investment of resources, development of these vaccines has been accelerated, all while maintaining standards for safety and efficacy.

Rather than eliminating steps from traditional vaccine development timelines, steps are proceeding simultaneously, such as scaling up manufacturing while safety and efficacy data are collected.

Before receiving approval for emergency use, pharmaceutical companies must provide evidence that their vaccines are safe. A team of experts from the Food and Drug Administration (FDA), ACIP and other agencies reviewed all available data on safety and efficacy before recommending them for use.

Side effects that have been reported with the Pfizer-BioNTech COVID-19 vaccine include:

• Injection site pain
• Tiredness
• Headache
• Muscle pain
• Chills
• Joint pain
• Fever

More people experienced these side effects after the second dose rather than the first one. For more information, visit the FDA website's Pfizer-BioNTech COVID-19 Vaccine page.

Based on our experience with other vaccines and early data from the COVID-19 vaccines, it is likely that people who are vaccinated will have enough immunity where they will not pass the virus to others if exposed, but this is not 100 percent certain.

Maybe you’ve heard a claim about the COVID vaccines on social media or from a friend or relative that is making you wary about getting vaccinated when it’s your turn.

Michigan Medicine has collected some of the most widespread rumors, claims, myths and worries about the COVID-19 vaccines, and checked them out with help from Michigan Medicine experts. Read the questions and answers on their blog post: “Not Sure About the COVID-19 Vaccine? Get the Facts, Then Decide.”

Health care professionals and researchers are still learning about COVID-19 and new information is discovered nearly every day that is helpful in the fight against this disease. Because COVID-19 is still a relatively new virus, it is difficult to know exactly how the virus affects the body long-term and how long immunity from natural infection lasts. Experts are working to learn more about both natural immunity and vaccine-induced immunity.

Therefore, it is also difficult to predict how long a vaccine will provide protection against the virus. As the vaccines are administered and new information is gathered, additional data about how long it will protect against the virus will be made available.

This is not known at this time. Scientists are continuing to collect data about long-term immunity to SARS-CoV2.

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, like 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 following the CDC’s recommendations for how to protect yourself and others will offer the best protection from getting and spreading COVID-19.

There is still more to learn 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. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision.

People are considered fully vaccinated:

• 2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or
• 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

After you’ve been fully vaccinated against COVID-19, you should keep taking precautions – like wearing a mask, staying 6 feet apart from others, and avoiding crowds and poorly ventilated spaces – in public places until we know more.

CDC summary of recent changes for those fully vaccinated

Yes. It is possible to still get the virus; however, the benefit of being vaccinated is any symptoms you do have will be much less and will prevent you from getting seriously ill or even hospitalized. COVID-19 vaccination works by teaching your immune system how to recognize and fight the virus that causes COVID-19, and this protects you from getting sick with COVID-19.

Studies so far suggest that current vaccines are effective against the variants but may not be as strong or long lasting. Therefore, it is important that everyone continue to practice physical distancing, wear masks, and follow proper hand hygiene methods to help limit the spread of COVID-19, even if you’ve received the vaccine.