Getting the vaccine
How do I get the vaccine?
Should people who have had COVID-19 get the vaccine?
For the most part, yes (see below for exceptions). The Centers for Disease Control and Prevention recommend that everyone be offered the vaccine, regardless of whether they have been infected. It is unclear how long natural immunity lasts after someone recovers from an infection.
There is guidance on exceptions from the CDC on the following:
Those with known current COVID-19 infection: Vaccination should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. This recommendation applies to people who develop a COVID-19 infection before receiving any vaccine doses, as well as those who develop an infection after the first dose but before receipt of the second one.
Those with known COVID-19 exposure: Vaccination is unlikely to be effective in preventing disease after an exposure — because the median incubation period of COVID-19 is four to five days, it is unlikely that the first dose of the vaccine would provide an adequate immune response within the incubation period for effective post-exposure prophylaxis (that is, vaccination to prevent the development of COVID-19). People in the community or outpatient setting who have had a known COVID-19 exposure should not seek vaccination until their quarantine period has ended to avoid potentially exposing health care personnel and other persons during the vaccination visit.
Those who have received passive antibody therapy (that is, who have received monoclonal antibodies or convalescent plasma from individuals who have recovered from an infection): Based on the estimated half-life of such therapies as well as evidence suggesting that reinfection is uncommon in the 90 days after initial infection, vaccination should be deferred for at least 90 days, as a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses. This recommendation applies to people who receive passive antibody therapy before receiving any vaccine doses as well as those who receive passive antibody therapy after the first dose but before the second dose, in which case the second dose should be deferred for at least 90 days following receipt of the antibody therapy.
There is no recommended minimum interval between other antibody therapies not specific to COVID-19 treatment (e.g., intravenous immunoglobulin, RhoGAM) and vaccination.
If I’m not feeling well the day of my scheduled vaccination? Can I still get the vaccination?
No. Please stay home and reschedule when you are well. It’s important to protect the health of the distribution-site staff, as well as other people receiving the vaccine.
Can you mix the types of vaccine — get the first dose of one kind and the second of the other?
No. Your second vaccination needs to be the same vaccine brand as your first (Moderna or Pfizer-BioNTech).
What if I have a history of anaphylaxis with other vaccines or medications?
You will need to be observed for 30 minutes after your vaccine dose, rather than the standard 15 minutes.
What if I have a weakened immune system or am on blood thinners?
Consult with your health care provider. If you are on blood thinners, you will need to wait 30 minutes under observation at the vaccination site after receiving your vaccine.
What if I’m pregnant or breastfeeding?
Consult with your OB/GYN and/or pediatrician before receiving any COVID-19 vaccine.
What does the vaccine cost?
Gov. Doug Ducey has issued an executive order making the vaccine free for everyone, with or without insurance. This includes winter visitors, part-time residents and undocumented individuals.
Do I have to have health insurance?
No. If you have health insurance, you will be asked to enter your information during the vaccine registration.
Can I use work time to get a COVID-19 vaccine?
Yes — time to take the vaccine is considered working time. Employees should try to take it during working hours. Time away from work should be coordinated with and approved by the supervisor with as much notice as possible.
Time should be recorded as regular working time for hourly employees even if it is taken on a weekend and results in overtime. FFCRA pay codes should not be used to account for time to take a vaccine.
For assistance with time reporting questions, contact OHR Partners.
Are there any age limitations to those who can get the vaccine?
Vaccines need to be tested in various populations before they're approved for use in those groups. People ages 16 and older were included in the initial Pfizer-BioNTech study, while people 18 and up were in the original Johnson & Johnson and Moderna studies. Combined, the clinical trials of the three vaccines included more than 110,000 people after preliminary, small-scale trials to ensure safety. Both studies included people from a variety of racial and ethnic backgrounds. On May 10, 2021, the FDA announced that it had approved emergency-use authorization for the Pfizer vaccine for children ages 12-15.
There is no upper age limit. The clinical trials included older adults for both vaccines. Currently, the three vaccines have 12-, 16- and 18-year-olds (depending on the vaccine) as the lower age line. There will be more testing in younger people, but for now those are the ages for vaccine guidance.
Do I need to provide a record of my COVID-19 vaccinations?
Yes. ASU does not have access to ADHS records regarding who received the vaccine. To assist in our efforts to manage COVID-19 vaccinations in the ASU community, we are asking those individuals who have been vaccinated to upload their vaccination records; the information is kept secure. Employees can do so here; students can do so through the Health Portal.
I am traveling out of the country. How do I get the vaccine before I leave?
Can international students get vaccinated while in the U.S.? Is it recommended they get the vaccines here?
International students can get the vaccine while in the U.S. when they are eligible according to the phased approach. It is recommended that they get the vaccine as soon as they are able to according to phase eligibility.
Do international students have to get both shots in the U.S.?
No. They should bring verification of vaccination with them so that the vaccination site knows which shot they need. You cannot mix vaccine brands, however. ASU cannot guarantee that if someone gets a certain vaccine elsewhere that the same brand will be available here.
Are vaccines different in the U.S. than in international students' home countries?
The U.S. will only distribute vaccines that have been approved as effective and have received emergency-use designation. Other countries may be using the same or different vaccines, as there are numerous available globally.
How it works
How does the COVID-19 vaccine work?
The SARS-CoV-2 virus is covered in a crown, or corona, of spike proteins that give coronaviruses their name. The viruses use these spike proteins to gain access to human cells.
The vaccines turn spike proteins against the virus, by teaching our bodies to recognize them as intruders and protect us from infection.
There are currently two types of COVID-19 vaccines authorized for use in the U.S. — adenovirus and messenger RNA (mRNA) vaccines. Both types of vaccines use the virus’s genetic instructions for building these spike proteins to provoke an immune response.
The Johnson & Johnson vaccine requires a single dose, administered by injection in the upper arm.
The Johnson & Johnson shot contains an adenovirus, a common virus that usually causes cold- or flu-like symptoms. This virus, however, has been reprogrammed so that it can’t replicate or make you sick. Instead, it carries DNA with instructions for the coronavirus’s spike protein.
The adenovirus is absorbed into cells where it injects its DNA into the nucleus. The cell copies the instructions for the spike protein into a messenger RNA molecule. The cell uses this mRNA like a blueprint to start building spike proteins. The spike proteins make their way to the outside of the cell, where your body recognizes them as intruders and mobilizes an immune response.
The Pfizer-BioNTech and Moderna vaccines work in a similar way, but they skip the adenovirus step. Instead of having your cells build the mRNA from DNA, they give your cells the mRNA directly. These vaccines require two doses taken three to four weeks apart, given by injection into the upper arm.
In both types of vaccines, the genetic instructions are destroyed after use, like a self-destructing “Mission Impossible” message. However, the antibodies created by your immune system remain. If you’re exposed to the coronavirus in the future, your body will recognize the spike protein trying to access your cells and deploy antibodies in defense.
Will the COVID-19 vaccine have side effects?
Possibly. Reported side effects of the COVID-19 vaccines may include fever, chills, fatigue and headache, and pain and swelling where you received the injection. But those side effects aren’t cause for concern.
These symptoms are normal signs that your body is building protection against the virus and are an expected response to a vaccine. People with side effects lasting for more than two days should consult with a medical provider.
A very small number of people have had allergic reactions to the vaccine; the Centers for Disease Control and Prevention website has guidance and details on the safeguards in place. Most allergic reactions that have happened have been immediate, which is why staff members keep you at the vaccination site for 15 minutes after you receive it to monitor for any reaction.
If you have a history of allergic responses to food or medications, please consult with a health care provider. Seasonal allergies have not been named a concern with the vaccine.
What if I had an allergic reaction to my first COVID-19 vaccine dose?
Consult with your doctor before receiving your second dose.
Can I use sick leave if I encounter side effects?
Yes, employees who have side effects can use sick leave.
Will I have to get a vaccination every year, like we do with flu shots?
The short answer is we don’t know yet, but probably not.
The longer answer — in the words of Dr. Joshua LaBaer — is that vaccines act like circulating mugshots of criminals, so that police can share the images to surveillance systems. The flu virus has developed systems of changing disguises — mostly through mutations and swapping in and out different coat proteins. We have to update the flu vaccine each year to share the three most common disguises that the flu virus is currently using. The SARS-CoV-2 virus does not appear to use any of those tricks; it does not change coat proteins and always appears to look the same to the immune system. So it doesn’t look like we will need to update the vaccines as often as the flu.
That said, it is also true that different vaccines seem to last longer in our immune systems than others. Some vaccines are good after one vaccination, others need to be updated every 10 years and still others need boosters even more often. We simply don’t yet know how long these vaccines will last. It will probably vary depending on the specific vaccine.
What do we know about the long-term effects of the COVID-19 vaccine?
No long-term side effects have been reported for either the Moderna or Pfizer-BioNTech vaccines. The first people who got the vaccine in the spring, during the earliest phase of clinical trials, have not shown any serious long-term effects.
It's worth noting that most side effects from vaccines show up within a couple of months — not a decade later.
We also do not yet know the long-term effects of COVID-19 itself, a virus that has been with us for only a year.
What is in the COVID-19 vaccine?
The Pfizer-BioNTech and Moderna vaccines contain messenger RNA (mRNA), lipids and saline solutions. The single active ingredient — mRNA — is contained within a protective bubble of lipids. The saline solutions in the two vaccines are used commonly in medications and vaccines and serve to keep the pH and salt levels of the mixture close to those in the human body. Both vaccines are essentially genetic material wrapped in a bubble of fat suspended in salt water.
The full ingredients of the Moderna COVID-19 vaccine are: messenger ribonucleic acid (mRNA), four lipids: SM-102; polyethylene glycol (PEG) 2000 dimyristoyl glycerol (DMG); cholesterol; 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC); and the saline solutions comprised of tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose.
The full ingredients of the Pfizer-BioNTech COVID-19 vaccine are: messenger ribonucleic acid (mRNA), four lipids: (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; and a saline solution of potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose.
The Johnson & Johnson vaccine contains a modified adenovirus with coronavirus DNA, as well as various stabilizers, alcohol for sterilization, an anticoagulant, an emulsifier to hold the ingredients together and salt.
The full ingredients of the Johnson & Johnson vaccine are: recombinant, replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein, citric acid monohydrate, trisodium citrate dihydrate, ethanol, 2-hydroxypropyl-β-cyclodextrin (HBCD), polysorbate-80 and sodium chloride.
What is PEG, and is it in the vaccines?
Polyethylene glycol, or PEG, is a petroleum-derived compound that’s found in everything from medicine and food to cosmetics and industrial products. PEG is in both the Pfizer-BioNTech and Moderna vaccines, where it’s used as a stabilizing agent for the mRNA.
“It’s used in the vaccines to make sure the active component doesn't fall apart, dry up, degrade or become unusable until it gets delivered to the body,” says Biodesign Institute Executive Director Josh LaBaer. “It’s used in all kinds of substances that we take all the time. Generally speaking, the vast majority of people have no problem with polyethylene glycol, but there are individuals that have allergic reactions to PEG.”
The Johnson & Johnson vaccine does not contain PEG, but it does contain polysorbate. A small number of people are allergic to polysorbate.
If you have a history of severe allergic reactions, check the CDC guidelines to see if you should receive a COVID-19 vaccine.
Does the flu vaccine protect against COVID-19?
No. The flu shot does not protect against COVID-19.
Health experts urge people to get their annual flu shot in addition to the COVID-19 vaccine. Especially with so many hospitals at capacity, it's best to do everything possible to prevent either illness.
Does the COVID-19 vaccine prevent people from getting the virus?
The vast majority of people who get vaccinated will be protected from getting severe, COVID-19 illness, and most people will be protected from getting sick at all.
Johnson & Johnson reports their vaccine to be 66% effective in preventing moderate to severe cases of COVID-19 and 85% effective in preventing severe forms of COVID-19. The Pfizer-BioNTech and Moderna vaccines have reported efficacy of 95% and 94.1%.
“That's very high and totally reasonable for the kinds of vaccines that we licensed in the United States regularly,” says Anna Muldoon, who holds a master’s degree in public health and is a PhD student in the School for the Future of Innovation and Society. “But there is no such thing as a 100% guarantee.”
The small number of people who do get infected are likely to have a milder case than they would have without the vaccine.
“You may still get COVID-19 even after the vaccine, but it will protect you from having a serious case,” adds Heather Ross, a clinical assistant professor in ASU’s Edson College of Nursing and Health Innovation and School for the Future of Innovation in Society. “Because the clinical trials were designed to look for symptomatic illness, you could still get the virus, but have no symptoms and not know at all. We just don't know that yet, because that's not what the clinical trials were designed to measure.”
For this reason, people who have been vaccinated should continue to wear masks and social distance around unvaccinated individuals.
Does the COVID-19 vaccine change your DNA?
While the vaccines contain genetic material (mRNA), they have no effect on our DNA. These messenger RNA vaccines, or mRNA, simply deliver instructions to our immune cells to make a single protein from the coronavirus. Once the protein is created, those instructions are broken down and the protein piece is displayed on the surface of a cell. Our immune systems recognize that it doesn’t belong and make antibodies in defense, mirroring the natural immune response to an infection.
The mRNA does not remain in the body. It’s disposed of once it delivers its instructions and does not impact our DNA.
Will the COVID-19 vaccines protect me from new strains of the virus?
It is unknown if the COVID-19 vaccines will protect against new strains of SARS-CoV-2. Preliminary research suggests that the Pfizer-BioNTech vaccine will provide protection against the more infectious strain first detected in the United Kingdom.
Pfizer-BioNTech and Moderna vaccines prompt the body to create antibodies tailored to the virus’s spike protein, and new strains of the coronavirus are exhibiting changes to that region.
Scientists don’t think those changes will be enough to prevent the vaccine from working. “What we might see, though, is instead of being 95% effective, maybe the vaccines are 80% effective or 70% effective against the new strains,” says Bertram Jacobs, a professor of virology with ASU’s School of Life Sciences and a researcher in the Biodesign Institute's Center for Immunotherapy, Vaccines and Virotherapy.
While diminished efficacy is a concern, Jacobs says both the Pfizer-BioNTech and Moderna vaccines can be quickly adapted to protect against emerging strains.
“It is worth noting that even though the vaccines have not yet been formally tested on the variants, they are still proving effective when measured in geographical areas that have high rates of variants,” adds Biodesign Institute Executive Director Josh LaBaer, pointing to the Johnson & Johnson clinical trial in South Africa.
In the trial, 92% of sequenced cases were the more infectious South African variant of the virus, though the vaccine proved effective in preventing moderate to severe COVID-19 73% of the time at 14 days and 82% at 28 days.
“My guess is that the vaccines are going to be effective for a long time,” says LaBaer. “I'm hopeful, because this is not like the flu virus, which constantly changes its look and its antigens. This virus doesn't change that fast, and the vaccines seem to be pretty broadly effective.”
After the vaccine
Continued safety protocols
Do I need to keep getting regular COVID-19 tests after I'm vaccinated?
Yes, if you have symptoms or have been exposed to someone who tested positive. Vaccination is not a golden ticket to never worry about the coronavirus again. The risk of infection is reduced, but not eliminated. And until a greater proportion of the population is vaccinated, testing is a way of making sure people aren't asymptomatically carrying the virus.
Biodesign Institute Executive Director Josh LaBaer, who has been vaccinated, gets tested when the situation calls for it.
“If I'm going to be near somebody who hasn't been vaccinated or I travel, or I’m heading to an in-person meeting, I'll get tested,” he says.
Looking for testing options? Learn about the different types of COVID-19 tests.
Will my vaccination impact the result of my ASU saliva test?
It’s important to continue to get tested. If you’ve recently received a COVID-19 vaccine, this will not affect your COVID saliva test result. You will still receive an accurate test result.
The saliva test measures the virus itself — its genetic material, its RNA — and does not have anything to do with the immune system. So nothing about the vaccination would affect that kind of test. If someone is currently infected with virus, whether or not they have been vaccinated, ASU's saliva test will work.
If people close to me get vaccinated, why do I need to get a vaccine?
Getting vaccinated helps us reach herd immunity, which refers to when most of a population is immune to a disease — either through vaccination or previous infection. It provides indirect protection to those who aren’t immune. The percentage of immune people in a population needed to reach herd immunity varies for different diseases and is unknown for COVID-19.
In addition, it is not currently known if the vaccine eliminates asymptomatic infection and transmission. That means those close to you who get vaccinated might still be able to pass along the coronavirus to you, even if it doesn't affect them.
Is natural herd immunity better than herd immunity by vaccination?
“Natural herd immunity” is a theoretical case of herd immunity achieved through naturally occurring infections rather than vaccines. It has never been achieved in recorded medicine, according to health experts.
The COVID-19 vaccine seems like it arrived very fast. How were scientists able to develop it so quickly?
One big reason the vaccines were developed so quickly is their underlying technology. The first vaccines authorized for use, Pfizer-BioNtech and Moderna, use messenger RNA, or mRNA, which has been studied and worked on for decades. mRNA vaccines can be made with using readily available materials in laboratories, meaning their production process can be easily standardized and scaled, hastening development.
The Johnson & Johnson vaccine is also based on decades of research. The company previously produced an adenovirus-based Ebola vaccine, which was approved for general use by the European Commission in July 2020.
In addition, lack of funding and unknown/unstable demand are two crucial factors that impact how long it can take for a vaccine to reach the market. In the case of COVID-19, the demand is overwhelming and the funding is being provided to ensure public health.
The widespread nature of COVID-19 also allowed scientists to quickly test and develop their vaccines. To test the efficacy of a vaccine, it needs to be given to some people and not given to others. Those two groups are then followed to see who gets sick and who doesn’t. Normally a study might have to wait years for enough people in a trial to get exposed to an illness, but because COVID-19 is so prevalent, many people in the clinical trials did get exposed and get sick.
Were the clinical trials large and long enough to ensure safety?
Yes. While vaccine development and trials moved quickly, it was for good reason. The emergency situation warranted an emergency response, and a number of steps normally done back-to-back were layered on top of one another. One example: The manufacturing of the vaccines because before it was known whether they’d be effective — a financial risk had they turned out not to be, but essential for getting the vaccine supply out quickly.
To get the emergency-use authorization, manufacturers had to follow at least half the study participants for at least two months after completing their vaccinations to make sure they were safe and effective. Furthermore, the safety of the vaccines shown in clinical trials is being reflected in the general population. It has been given to millions of people at this point, and the number of adverse events that have been observed is very low.
The CDC recently released a safety report examining adverse reactions to the BioNTech and Moderna vaccines from Dec. 14, 2020–Jan. 13, 2021.