By Dr Vivian Kominos
In December, two COVID-19 vaccines, Pfizer-BioNTech and Moderna, received emergency use authorization by the FDA. Unlike other vaccines, these do not contain a weak or inactive virus. The COVID-19 vaccines use messenger RNA (mRNA), a small piece of genetic material, that instructs our cells to make a spike protein that is found on Sars-CoV 2, the coronavirus that causes COVID-19. This spike protein is recognized by our cells as being foreign and causes activation of our immune system: antibodies and specialized cells are made against the spike protein. If Sars-CoV2 enters the body, our antibodies and immune cells prevent the virus from entering our cells. Although mRNA vaccines are new, the technology of mRNA has been studied for over a decade. Since mRNA is very specific, these vaccines are VERY effective in preventing COVID-19. Both vaccines have an equal efficacy of 95% at preventing COVID-19 after two shots. Pfizer vaccines are given 21 days apart and Moderna 28 days apart. Since these vaccines are new, many questions are commonly asked.
What is the difference between emergency use authorization (EUA) and an approved vaccine?
An EUA is given if the vaccine is effective and safe. The EUA does not cut corners when it comes to FDA’s review, but cuts out some of the paperwork and bureaucracy associated with approval. The COVID-19 vaccines have been evaluated by the Vaccines and Related Biological Products Advisory Committee that consists of independent experts on vaccine efficacy and safety from several scientific disciplines. This committee has no connections to the manufacturers or the FDA.
Can the vaccine cause an infection?
No. There is no virus in the vaccine. After the vaccine, the most common side effect is pain and swelling at the injection site and some may experience mild headache, body aches, or chills. This is a sign that the immune system is working. To lessen side effects move the arm frequently, drink plenty of fluids and get rest. If the symptoms don’t go away after a couple days, call your healthcare provider.
Will the mRNA become part of my genes/DNA?
No. mRNA never enters the nucleus of your cell and cannot alter or change your DNA. mRNA degrades quickly and lasts only a couple hours to days after injected.
How long does immunity from the vaccine last?
This is not known yet. To get the best immune response two shots are given. The first primes the immune system and the second shot acts as a booster. Immunity develops within 2 weeks after the second shot. For now, we do not know whether the vaccines provide long term immunity.
If I had COVID-19 should I get the vaccine?
Yes, but wait 90 days after your symptoms from COVID-19 resolve. Having COVID-19 gives you “natural” immunity, but we do not know how long this immunity lasts.
Can I get the COVID vaccine at the same time with other vaccines?
No, since this has not been studied and since we want the COVID vaccine to have maximum effectiveness. Separate it from other vaccines such as the flu vaccine by at least 2 weeks.
Is there anyone who should not get the vaccine?
Anyone who has had an anaphylactic (serious allergic) reaction to any component of the vaccine should not get the vaccine.
Can pregnant women or children get the vaccine?
The vaccine has not yet been studied in children or in pregnancy; however, pregnancy and lactation are not contraindications to the vaccine. Some women who were in the vaccine trials became pregnant and no adverse effects were reported. Speak to your healthcare provider.
How do I get scheduled for the vaccine?
New Jersey’s vaccination plan is following CDC recommendations: essentially those who are at greatest risk for a serious infection get vaccinated first. It may take several months before you qualify for the vaccine depending on occupation, age, and medical history. New Jersey has set up a dashboard where you can pre-register for the vaccine: https://covid19.nj.gov/pages/vaccine.
When I get vaccinated can I go back to a more normal life?
You can still catch COVID until you develop immunity after your second shot. And although the vaccine may prevent you from catching COVID-19, and prevent serious disease if you catch COVID-19, we don’t know if it prevents transmission. In other words, if you are exposed and carry Sars-CoV-2 in your nose or mouth, it is possible you might spread it to others. Therefore, you should continue to wear a mask and practice physical distancing until there is herd immunity. This will take many months since roughly 70-80% of the population needs to be immunized before we have herd immunity in the population.
To get additional information on New Jersey’s Vaccination Plan go to: https://www.nj.gov/health/cd/topics/covid2019_vaccination.shtml
Vivian A. Kominos, MD, FACC, ABOIM is an integrative cardiologist and wellness expert with a private practice in West Long Branch, NJ. She can be contacted at 732 395-3059. Learn more at www.drkominos.com.