COVID-19 vaccines: Get the facts

Vaccines to prevent coronavirus disease 2019 (COVID-19) are perhaps the best hope for ending the pandemic. But as the U.S. Food and Drug Administration (FDA) continues approving or authorizing emergency use of COVID-19 vaccines, you likely have questions. Find out about the benefits of the COVID-19 vaccines, how they work, the possible side effects and the importance of continuing to take infection prevention steps.

A COVID-19 vaccine might:

• Prevent you from getting COVID-19 or from becoming seriously ill or dying due to COVID-19
• Prevent you from spreading the virus that causes COVID-19 to others
• Add to the number of people in the community who are protected from getting COVID-19 — making it harder for the disease to spread and contributing to herd immunity
• Prevent the virus that causes COVID-19 from spreading and replicating, which allows it to mutate and possibly become more resistant to vaccines

Getting COVID-19 offers some natural protection or immunity from reinfection with the virus that causes COVID-19. But it's not clear how long this protection lasts. Because reinfection is possible and COVID-19 can cause severe medical complications, it's recommended that people who have already had COVID-19 get a COVID-19 vaccine.

In addition, COVID-19 vaccination might offer better protection than getting sick with COVID-19. A recent study showed that unvaccinated people who already had COVID-19 are more than twice as likely as fully vaccinated people to be reinfected with COVID-19.

Recent research also suggests that people who got COVID-19 in 2020 and then received mRNA vaccines produce very high levels of antibodies that are likely effective against current and, possibly, future variants. Some scientists call this hybrid immunity. Further research is needed.

If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, wait 90 days before getting a COVID-19 vaccine.

Currently, several COVID-19 vaccines are in clinical trials. The FDA continues to review the results of these trials before approving or authorizing COVID-19 vaccines for use. But because there is an urgent need for COVID-19 vaccines and the FDA's vaccine approval process can take months to years, the FDA first gave emergency use authorization to COVID-19 vaccines based on less data than is normally required. The data must show that the vaccines are safe and effective before the FDA can give emergency use authorization or approval. Vaccines with FDA emergency use authorization or approval include:

• Pfizer-BioNTech COVID-19 vaccine. The FDA has approved the Pfizer-BioNTech COVID-19 vaccine, now called Comirnaty, to prevent COVID-19 in people age 16 and older. The FDA approved Comirnaty after data found the vaccine is safe and effective. The Pfizer-BioNTech COVID-19 vaccine is 91% effective in preventing the COVID-19 virus with symptoms in people age 16 and older.

  The vaccine is still under an emergency use authorization for children ages 12 through 15. The vaccine is 100% effective in preventing COVID-19 in children ages 12 through 15. It requires two injections given 21 days apart. The second dose can be given up to six weeks after the first dose, if needed.

• Moderna COVID-19 vaccine. The Moderna COVID-19 vaccine is 94% effective in preventing COVID-19 with symptoms. This vaccine is authorized for people age 18 and older. It requires two injections given 28 days apart. The second dose can be given up to six weeks after the first dose, if needed.
• Janssen/Johnson & Johnson COVID-19 vaccine. In clinical trials, this vaccine was 66% effective in preventing the COVID-19 virus with symptoms — as of 14 days after vaccination. The vaccine also was 85% effective at preventing severe disease with COVID-19 — at least 28 days after vaccination. This vaccine is authorized for people age 18 and older. It requires one injection. The FDA and the Centers for Disease Control and Prevention (CDC) have recommended that use of this vaccine continue in the U.S. because the benefits outweigh the risks. If you are given this vaccine, you should be educated about the possible risks and symptoms of a blood clotting problem.

Both the Pfizer-BioNTech and the Moderna COVID-19 vaccines use messenger RNA (mRNA). Coronaviruses have a spikelike structure on their surface called an S protein. COVID-19 mRNA vaccines give cells instructions for how to make a harmless piece of an S protein. After vaccination, your cells begin making the protein pieces and displaying them on cell surfaces. Your immune system will recognize the protein and begin building an immune response and making antibodies.

The Janssen/Johnson & Johnson COVID-19 vaccine is a vector vaccine. In this type of vaccine, material from the COVID-19 virus is inserted into a different kind of weakened live virus, such as an adenovirus. When the weakened virus (viral vector) gets into your cells, it delivers material from the COVID-19 virus that gives your cells instructions to make copies of the S protein. Once your cells display the S proteins on their surfaces, your immune system responds by creating antibodies and defensive white blood cells. If you become infected with the virus that causes COVID-19, the antibodies will fight the virus.

Viral vector vaccines can't cause you to become infected with the COVID-19 virus or the viral vector virus. Also, the material that's delivered doesn't become part of your DNA.

No. The COVID-19 vaccines currently being developed in the U.S. don't use the live virus that causes COVID-19. As a result, the COVID-19 vaccines can't cause you to become sick with COVID-19 or shed any vaccine components.

Keep in mind that it will take a few weeks for your body to build immunity after getting a COVID-19 vaccination. As a result, it's possible that you could become infected with the virus that causes COVID-19 just before or after being vaccinated.

A COVID-19 vaccine can cause mild side effects after the first or second dose, including:

• Pain, redness or swelling where the shot was given
• Fever
• Fatigue
• Headache
• Muscle pain
• Chills
• Joint pain
• Nausea and vomiting
• Feeling unwell
• Swollen lymph nodes

You'll be monitored for 15 minutes after getting a COVID-19 vaccine to see if you have an allergic reaction. Most side effects go away in a few days. Side effects after the second dose might be more intense. Many people have no side effects.

A COVID-19 vaccine may cause side effects similar to signs and symptoms of COVID-19. If you've been exposed to COVID-19 and you develop symptoms more than three days after getting vaccinated or the symptoms last more than two days, self-isolate and get tested.

Because COVID-19 vaccines clinical trials only started in the summer of 2020, it’s not yet clear if these vaccines will have long-term side effects. However, vaccines rarely cause long-term side effects.

If you're concerned, in the U.S., safety data on COVID-19 vaccines will be reported to a national program called the Vaccine Adverse Event Reporting System. This data is available to the public. The CDC has also created v-safe, a smartphone-based tool that allows users to report COVID-19 vaccine side effects.

If you have additional questions or concerns about your symptoms, talk to your doctor.

In the U.S., there has been an increase in reported cases of myocarditis and pericarditis after mRNA COVID-19 vaccination, particularly in male adolescents and young adults age 16 and older. Myocarditis is the inflammation of the heart muscle, while pericarditis is the inflammation of the lining outside the heart. These reports are rare. The CDC is investigating to see if there is any relationship to COVID-19 vaccination.

Of the cases reported, the problem happened more often after the second dose of the COVID-19 vaccine and typically within several days after COVID-19 vaccination. Most of the people who received care felt better after receiving medicine and resting. Symptoms to watch for include:

• Chest pain
• Shortness of breath
• Feelings of having a fast-beating, fluttering or pounding heart

If you or your child has any of these symptoms within a week of getting a COVID-19 vaccine, seek medical care.

Some people who received the Janssen/Johnson & Johnson COVID-19 vaccine have developed Guillain-Barre syndrome. This is a rare disorder in which your body’s immune system attacks your nerves. The chances of this happening are very low.

Symptoms most often appeared within 42 days of vaccination. Seek immediate medical care after getting the Janssen/Johnson & Johnson COVID-19 vaccine if you have:

• Weakness or tingling sensations, especially in the legs or arms, that worsens and spreads to other body parts
• Difficulty walking
• Difficulty with facial movements, including speaking, chewing or swallowing
• Double vision or inability to move eyes
• Difficulty with bladder control or bowel function

Use of the Janssen/Johnson & Johnson COVID-19 vaccine might increase the risk of a rare and serious blood clotting disorder. Nearly all of those affected have been women ages 18 to 49, with the disorder happening at a rate of 7 for every 1 million vaccinated women in this age group. For women age 50 and older and men of all ages, the disorder is even more rare.

The FDA and the CDC have recommended that use of the vaccine in the U.S. can continue because the benefits outweigh the risks. (36) Evidence of these blood clots haven’t been reported in the Pfizer-BioNTech or Moderna COVID-19 vaccines.

Serious side effects of the Janssen/Johnson & Johnson COVID-19 vaccine can occur within three weeks of vaccination and require emergency care. Possible symptoms include:

• Shortness of breath
• Persistent stomach pain
• Severe or persistent headaches or blurred vision
• Chest pain
• Leg swelling
• Easy bruising or tiny red spots on the skin beyond the injection site

Mild to moderate headaches and muscle aches are common in the first three days after vaccination and don't require emergency care.

In the U.S., the delta (B.1.617.2) variant is now the most common COVID-19 variant. It is nearly twice as contagious as earlier variants and might cause more severe illness.

While research suggests that COVID-19 vaccines are slightly less effective against the variants, the vaccines still appear to provide protection against severe COVID-19. For example:

• Early research from the U.K. suggests that, after full vaccination, the Pfizer-BioNTech COVID-19 vaccine is 88% effective at preventing symptomatic COVID-19. The vaccine is also 96% effective at preventing severe disease with COVID-19 caused by the delta variant.
• Early research from Canada suggests that, after one dose, the Moderna COVID-19 vaccine is 72% effective at preventing symptomatic COVID-19 caused by the delta variant. One dose of the vaccine is also 96% effective at preventing severe disease with COVID-19 caused by the delta variant.
• The Janssen/Johnson & Johnson COVID-19 vaccine is 85% effective at preventing severe disease with COVID-19 caused by the delta variant, according to data released by Johnson & Johnson.

In the U.S., the federal government is providing COVID-19 vaccines free of charge to all residents, regardless of immigration status or health insurance coverage. The COVID-19 vaccines are free whether offered by a clinic, retail pharmacy or other location.

Yes, if you have an existing health condition you can get a COVID-19 vaccine — as long as you haven't had an allergic reaction to a first dose of a COVID-19 vaccine or any of its ingredients. But there is limited information about the safety of the COVID-19 vaccines in people who have weakened immune systems or autoimmune conditions.

COVID-19 vaccines also might not fully protect people from COVID-19 who have a weakened immune system that is caused by HIV, certain conditions or medications. It might be necessary to continue taking precautions.

It isn’t recommended that you take an over-the-counter medication before getting a COVID-19 vaccine to prevent possible discomfort. It’s not clear how these medications might impact the effectiveness of the vaccines. However, it’s OK to take this kind of medication after getting a COVID-19 vaccine, as long as you have no other medical reason that would prevent you from taking it.

There is no COVID-19 vaccine yet for children under age 12. Clinical trials involving younger children are in progress.

You might be having an allergic reaction to a COVID-19 vaccine if you experience these signs within four hours of getting vaccinated:

• Hives
• Swelling of the lips, eyes or tongue
• Wheezing

If you have any signs of an allergic reaction, get help right away. Tell your doctor about your reaction, even if it went away on its own or you didn’t get emergency care. This reaction might mean you are allergic to the vaccine. You might not be able to get a second dose of the same vaccine. However, you might be able to get a different vaccine for your second dose.

If you have a history of severe allergic reactions not related to vaccines or injectable medications, you may still get a COVID-19 vaccine. You should be monitored for 30 minutes after getting the vaccine.

If you've had an immediate allergic reaction to other vaccines or injectable medications, ask your doctor if you should get a COVID-19 vaccine. If you’ve ever had an immediate or severe allergic reaction to any ingredient in a COVID-19 vaccine, the CDC recommends not getting that specific vaccine.

If you have an immediate or severe allergic reaction after getting the first dose of a COVID-19 vaccine, don't get the second dose. However, you might be able to get a different vaccine for your second dose.

If you are pregnant or breastfeeding, it's recommended that you get a COVID-19 vaccine. Getting a COVID-19 vaccine can protect you from severe illness due to COVID-19. Vaccination can also help pregnant women build antibodies that might protect their babies.

COVID-19 vaccines don't cause infection with the virus that causes COVID-19, including in pregnant women or their babies. None of the COVID-19 vaccines contain the live virus that causes COVID-19.

While further research is needed, early findings suggests that getting an mRNA COVID-19 vaccine during pregnancy poses no serious risks for pregnant women who were vaccinated or their babies. The findings are based on data from the CDC’s coronavirus vaccine safety monitoring system. Also, keep in mind that mRNA COVID-19 vaccines don't alter your DNA.

In addition, vaccines that use the same viral vector as the Janssen/Johnson & Johnson COVID-19 vaccine have been given to pregnant women in each trimester of pregnancy in clinical trials. No harmful effects were found.

If you have concerns, talk to your health care provider about the risks and benefits of getting a COVID-19 vaccine.

It's recommended that you get a COVID-19 vaccine if you are trying to get pregnant or might become pregnant in the future. There is no evidence that any COVID-19 vaccines cause fertility problems.

A small number of women have reported experiencing temporary menstrual changes after getting a COVID-19 vaccine. A small study has also shown that some women experienced temporary menstrual changes after getting COVID-19. It's not clear if getting COVID-19 or a COVID-19 vaccine causes these changes. Further research is needed.

Keep in mind that many things can affect menstrual cycles, including infections, stress, sleep problems and changes in diet or exercise.

The FDA has given the Pfizer-BioNTech COVID-19 vaccine emergency use authorization for children ages 12 through 15.

The Pfizer-BioNTech COVID-19 vaccine requires two injections given 21 days apart. The second dose can be given up to six weeks after the first dose, if needed.

Research has shown that the Pfizer-BioNTech COVID-19 vaccine is 100% effective in preventing COVID-19 in children ages 12 through 15. Previous research has shown that the vaccine is 95% effective in preventing COVID-19 with symptoms in people age 16 and older.

A COVID-19 vaccine can prevent your child from getting and spreading the virus that causes COVID-19. If your child gets COVID-19, a COVID-19 vaccine could prevent him or her from becoming severely ill.

Getting a COVID-19 vaccine may also allow your child to start doing things that he or she might not have been able to do because of the pandemic.

The FDA reviewed a study of more than 2,200 U.S. children ages 12 through 15. Of this group, about half were given the Pfizer-BioNTech COVID-19 vaccine. The other children were given an inactive (placebo) shot.

A week after the second dose was given, research showed no cases of COVID-19 in the 1,005 children given the Pfizer-BioNTech vaccine. Among 978 children given the placebo, there were 16 cases of COVID-19. None of the children had previously been diagnosed with COVID-19. The results suggest that the vaccine is 100% effective at preventing the COVID-19 virus in this age group.

A portion of the children given the vaccine were also monitored for at least two months after being given the second dose.

You are considered fully vaccinated 2 weeks after you get a second dose of an mRNA COVID-19 vaccine or 2 weeks after you get a single dose of the Janssen/Johnson & Johnson COVID-19 vaccine. After you are fully vaccinated, you can more safely return to doing activities that you might not have been able to do because of the pandemic. You can also stop wearing a mask or social distancing in any setting, except where required by a rule or law. However, if you are in an area with a high number of new COVID-19 cases in the last week, the CDC recommends wearing a mask indoors in public and outdoors in crowded areas or when you are in close contact with unvaccinated people. If you are fully vaccinated and have a condition or are taking medications that weaken your immune system, you may need to keep wearing a mask.

You also will still be required to wear a mask on planes, buses, trains and other public transportation traveling to, within, or out of the U.S., as well as in places such as airports and train stations.

If you are traveling in the U.S., you don’t need to get tested before or after your trip or quarantine after you return. If you are traveling outside of the U.S., you don’t need to get tested before you leave the U.S. unless your destination requires it. You still need to show a negative test result or proof that you’ve recovered from COVID-19 in the past 3 months before boarding an international flight to the U.S. It’s also recommended that you get tested 3 to 5 days after international travel. However, quarantining isn't needed.

If you’ve been fully vaccinated and you’ve had close contact with someone who has the COVID-19 virus, get tested 3 to 5 days afterward. And if you are a resident or employee of a correctional or detention facility or a homeless shelter and are around someone who has COVID-19, you should still get tested even if you don’t have symptoms of COVID-19.

COVID-19 vaccination will protect most people from getting sick with COVID-19.

A small percentage of fully vaccinated people will still get COVID-19 if they are exposed to the virus that causes COVID-19. These are called vaccine breakthrough infections.

People with vaccine breakthrough infections may spread COVID-19 to others. However, it appears that vaccinated people spread COVID-19 for a shorter period than do unvaccinated people.

Vaccination also might make illness less severe. If you are fully vaccinated, the overall risk of hospitalization and death due to COVID-19 is much lower than among unvaccinated people with similar risk factors.

An additional dose of a COVID-19 vaccine is recommended for people who are fully vaccinated and might not have had a strong enough immune response. In contrast, a booster dose is recommended for people whose immune response weakened over time.

The CDC recommends additional doses and booster doses of COVID-19 vaccines in specific instances:

• Additional dose. The CDC recommends a third dose of an mRNA COVID-19 vaccine for some people with weakened immune systems, such as those who have had an organ transplant. People with weakened immune systems might not develop enough immunity after vaccination with two doses of an mRNA COVID-19 vaccine. An additional dose might improve their protection against COVID-19.

  The third dose should be given at least 28 days after a second dose of an mRNA COVID-19 vaccine. The additional dose should be the same brand as the other two mRNA COVID-19 vaccine doses you were given. If the brand given isn’t known, either brand of mRNA COVID-19 vaccine can be given as a third dose.

• Booster dose. The CDC recommends a booster dose of the Pfizer-BioNTech COVID-19 vaccine for people age 65 and older, residents in long-term care settings and people ages 50 to 64 who have underlying medical conditions, such as cancer, diabetes and heart disease. A booster dose of the Pfizer-BioNTech COVID-19 vaccine is also available to people ages 18 to 49 with underlying medical conditions and people ages 18 to 64 who have a job that puts them at increased risk of being exposed to COVID-19.

  The booster dose should be given at least 6 months after the second dose of the Pfizer-BioNTech COVID-19 vaccine.

There isn’t enough research to determine if people with weakened immune systems who got a Janssen/Johnson & Johnson COVID-19 vaccine also have an improved response after getting an additional dose of the same vaccine. The CDC also hasn’t made recommendations about booster doses for people who got the Moderna or Janssen/Johnson & Johnson COVID-19 vaccine.