Anju Goel, MD, MPH, is a board-certified physician who specializes in public health, communicable disease, diabetes, and health policy.
A vaccine is a major component of preventing COVID-19. In an unprecedented effort to curb the pandemic, scientists from around the world have come together to condense a 10-year research and development timeline into roughly 10 months. There are over 200 vaccines in development, and dozens are in clinical trials. In the United States, three vaccines have received emergency use authorization from the Food and Drug Administration (FDA).
To move at such a rapid pace, researchers explored new vaccine platforms, like mRNA. Manufacturers produced batches of vaccines without waiting for final clinical trial results in order to have them immediately ready if proven safe and effective. In spite of the speed, safeguards like data and safety monitoring boards remained in place throughout the process. A vaccine is only FDA-authorized once it is proven to be safe.
Learn the Basics of Getting Vaccinated
In the U.S., there are currently three vaccines with Food and Drug Administration (FDA) emergency use authorization: the Pfizer-BioNtech vaccine, the Moderna vaccine, and the Johnson & Johnson vaccine. There are large-scale Phase 3 clinical trials in progress or being planned for two additional COVID-19 vaccines in the U.S.: AstraZeneca’s vaccine and Novavax’s vaccine.
The available COVID-19 vaccines underwent extensive safety and regulatory processes. In order for the vaccines to receive FDA emergency use authorization, each clinical trial was subjected to review from a panel of scientists who are independent of the companies developing the vaccines. These scientists are members of data and safety monitoring boards (DSMB) that review clinical trials of drugs and vaccines. DSMBs have vetted drugs and vaccines for decades.
The COVID-19 vaccine will be distributed in phases. The first phase prioritizes healthcare workers, residents of assisted living facilities, essential workers, older adults, and adults with certain medical conditions. Phase 1 distribution has already begun. Phase 2 will prioritize schools, correctional facilities, homeless shelters, and more. Phase 3 will include children and young adults. Ultimately, state and county health departments currently determine who is eligible to receive the COVID-19 vaccine, so eligibility may vary. However, President Biden announced that all adults in the U.S. will be eligible to register for a vaccine no later than May 1.
The best place to start is your county’s health department website. Vaccines are being distributed locally, and eligibility to sign up may vary. Some counties have vaccine registration portals available, while others are only providing information and phone numbers at this time. Many states are encouraging residents to go to their local county health departments for specific information about making an appointment. You can also search for pharmacies and providers that offer vaccination on Vaccinefinder.org.
Public health officials say to expect largely mild side effects. You may feel pain and redness at the injection site, fatigue, a headache, joint and muscle aches, and/or a fever. Some less common side effects can include swollen lymph nodes (especially in the armpit) and swelling at the injection site. A very rare symptom may include a temporary weakness or paralysis of the facial muscles called Bell’s Palsy.
Even if you’ve previously been infected with COVID-19 and recovered, experts recommend getting vaccinated. Your natural immune response may not be strong enough to protect you from future infections. If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine, according to the CDC. And if you currently have an active case of COVID-19, wait until after the isolation period is over to make your appointment to prevent spreading the virus at the vaccine site.
While the vaccines were not tested on pregnant women or those who were breastfeeding, federal health officials are allowing pregnant women to receive the vaccine if they choose. Pregnancy is considered a risk factor for severe COVID-19 illness by the CDC. The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant and breastfeeding individuals who fall into COVID-19 vaccine priority groups should be able to receive the shot. Federal officials are leaving this decision up to the individual, and recommend you seek advice from your healthcare provider.
New research found that both the Pfizer and Moderna COVID-19 vaccines will protect against the U.K. and South African variants of the virus. The Johnson & Johnson vaccine is also thought to provide some level of protection against variants, though research is ongoing. Moderna, Pfizer, and Johnson & Johnson are all developing booster shots that may help increase immunity against virus variants. Scientists say the virus would have to mutate extensively to escape the vaccine response. They believe the vaccines will still be protective against new strains that are not significantly different from the original virus.
In order to ensure the vaccine is as effective as possible, some experts are recommending against taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) before or after you get injected in an effort to prevent or soothe side effects. NSAIDS include well-known pain relievers such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). A recent study found that NSAIDS dampen the production of protective antibodies against the virus. If you can’t tolerate symptoms post-vaccine, experts recommend using acetaminophen (Tylenol) over an NSAID. If you take NSAIDS long-term for chronic conditions, you should continue following your prescription.
While your body likely will build some immunity to the virus shortly after receiving the single-dose COVID-19 vaccine or the first dose of a two-shot regimen, you won’t be fully protected. To reach full protective immunity, current research suggests you will have to wait two weeks after your second dose for the Pfizer and Moderna vaccines or two weeks after your single dose of the Johnson & Johnson vaccine.
Experts believe immunity from the virus will likely last at least a year, and Moderna reports its vaccine will provide immunity for at least that period of time. It’s possible you may have to receive the shot annually like a flu shot in order to boost waning immunity. But more research needs to be done before experts can know for sure.
If you’ve been fully vaccinated and are two weeks past the date of your second shot—or your first shot in the case of the Johnson & Johnson vaccine—the CDC says you may begin to loosen safety precautions in certain situations. According to CDC guidance, you can gather indoors with other fully vaccinated people without wearing a mask or distancing, as well as with unvaccinated people from one other household. However, you should still refrain from gathering with unvaccinated individuals that are at high risk for severe COVID-19 or someone who is in regular contact with someone at high risk. Outside of these small gatherings, guidance remains largely the same. You should still wear a mask and maintain social distance in public, avoid medium and large gatherings, and refrain from non-essential travel.
Experts still aren’t sure if the COVID-19 vaccines can prevent transmission of the virus. Early data from Israel shows that the Pfizer vaccine may be effective at preventing transmission of the virus. Johnson & Johnson data also suggests that the vaccine may curb asymptomatic transmission. While the CDC has released guidance stating that people who are fully vaccinated against COVID-19 don’t need to quarantine or test after being exposed to the virus if asymptomatic, experts haven’t taken a hard and fast stance in regards to transmission.
Experts are recommending you practice safety precautions like wearing masks and staying away from large gatherings until herd immunity is achieved, or a larger portion of the population—at least 70% based on some of Dr. Fauci’s estimates—is vaccinated. More research needs to be done to learn about the duration of COVID-19 immunity and whether transmission is possible after vaccination.
Experts believe it’s unlikely the government will institute a COVID-19 vaccine mandate to protect public health. Instead, the government will likely release recommendations and national standards for the vaccine. Vaccination requirements may be implemented through employers and schools—both of which have instituted vaccine requirements in the past.
Explore interactive models that show how the human body responds to a COVID-19 vaccine, and what the body of a vaccinated person would do if exposed to the SARS-CoV-2 virus.
United States Food and Drug Administration. COVID-19 Vaccines. Updated February 27, 2021.
Pronker ES, Weenen TC, Commandeur H, Claassen EH, Osterhaus AD. Risk in vaccine research and development quantified. PLoS ONE. 2013;8(3):e57755. doi:10.1371/journal.pone.0057755