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Q&A: Addressing Resident Concerns Surrounding COVID-19 Vaccines--Part 1

With the recent news surrounding the advancement of numerous COVID-19 vaccine candidates, the public has raised many concerns about the safety, effectiveness, and other aspects of these vaccines. With the recent rise in disinformation being disseminated regarding the COVID-19 Pandemic, it is our responsibility as members of the healthcare community to provide accurate information to address the questions and concerns of our residents as the vaccines become available and are distributed. When addressing our residents, it is important to reassure them while setting appropriate expectations for vaccine performance. Here are some common questions that residents may ask you and some appropriate ways of addressing those questions. How effective is the vaccine? Will it prevent me from getting hospitalized from COVID-19? The projected effectiveness depends on the specific vaccine that is to be administered to the resident. As only interim reports on Phase 1-2 trials are currently available, the true efficacy of vaccines at this stage is difficult to assess due to the smaller number of enrolled individuals and the purpose of early stage trials which mainly focus on overall safety and immune responses. As trial data is released from the current Phase 3 studies, we will have a better understanding of the efficacy of these vaccines. For example, Pfizer’s vaccine is on track to be soon released, and they have announced that their vaccine is about 95% effective. Similarly, Moderna has announced that their vaccine demonstrates an efficacy of 94.1%. These are reassuring statistics but should be taken with some caution until full data has been released and analyzed. Many of these trials mainly assess overall disease prevention and do not examine the prevention of hospitalization associated with COVID. However, a decrease in the amount of overall infections is related to lower hospitalization rates and cases of severe disease. Will I be able to get a vaccine? The availability of each vaccine is dependent on the particular vaccine and the company’s manufacturing and distribution capabilities. Many of the vaccines that may be soon available for use under the emergency use authorization are produced by larger pharmaceutical companies such as Pfizer and Johnson & Johnson, which have large manufacturing capabilities. It is important to note that many vaccines have cold-storage requirements, which may impede vaccine distribution to health centers. For example, the Pfizer vaccine requires a storage temperature of -70 degrees Celsius. It is important to share with residents that although there may be difficulties with vaccine supply upon initial release of certain vaccines, residents are at high priority for vaccination per CDC recommendations due to their advanced age and common presence of comorbid conditions. How will I feel after taking the vaccine? Will the vaccine make me more sick? What are the side effects? Side effects related to the administration of COVID-19 vaccine vary depending on the vaccine used, but there are typical side effects that are commonly seen with vaccinations of any type. Common side effects that can occur include: injection site pain and redness, muscle pain, joint pain, headache, and fatigue. It is important to note that some vaccines may also cause fever. Among the majority of the vaccines in late stage trials, many of the reported side have been mild to moderate and will dissipate within a few days of administration. If the resident experiences any severe side effects, they should immediately be seen by a healthcare provider. It is important to emphasize that side effects vary by vaccine and will be available for review on the vaccine-specific FDA package insert as it is released. Do I really need to take both doses of the vaccine? The majority of the vaccines in the late trial phase require two injections separated by a period of 2-4 weeks. This schedule has been designed to optimally increase the immune response to potential COVID infections in patients. In the available clinical trial data, immune responses are typically lower in patients after their first injection in comparison to their second injection. Although a majority of Phase 3 trials do not specifically test the efficacy of single vaccine injections, it may be safe to assume from Phase 1-2 trial data that single dose vaccines are less effective than the same vaccine administered over two doses. To summarize, if the vaccine is intended to be administered over two doses, it is important to receive both doses as only a single dose may not guarantee effectiveness of the vaccine.

Prepared in collaboration with graduate students from Keck Graduate Institute (Claremont, CA): Kaljit Atwal, Paola Montes, Joseph Nguyen, Alice Wen


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