Hope has arrived in the form of three vaccines for COVID-19. The world was told vaccine development could take years, yet human innovation and global collaboration allowed us to access one in under a year. For the first time in my life, the public watched the development of a vaccine from start to finish. More and more people are getting access to vaccination, and herd immunity is right around the corner. Historically, vaccine distribution is driven by nursing. Since we are the most trusted profession, we need to ensure we can dispel the myths while also answering community members' questions. To date, over 120 million single doses have been administered in the US. While that is a sizable number, we still have many doses to go. To help nurses and other healthcare workers respond to questions, we went to the CDC to identify the top five things you need to know as a healthcare worker about the COVID-19 vaccines.
Know the Choices
Currently, there are three vaccines available to the public: Moderna, Pfizer, and Johnson & Johnson (also known as Janssen). Moderna and Pfizer are both mRNA vaccines, and Johnson & Johnson's vaccine is a viral vector. All three vaccines are effective, and people should know they don't need to wait for the availability of one specific type of vaccine. When it is your turn to be vaccinated, get the vaccine; there's no need to concern yourself with the brand offered. We will discuss in more detail the differences in the vaccines when we discuss reasons for vaccine hesitancy. Here is the breakdown of the three vaccines.
- Type: mRNA vaccine
- Number of shots: 2 separated by 28 days
- Does not contain preservatives, thimerosal (a safe form of mercury sometimes used in vaccines to prevent bacteria and fungi from growing), antibiotics, or adjuvants (ingredients used in some vaccines to create a stronger immune response).
- Efficacy: 94.5%
- Type: mRNA vaccine
- Number of shots: 2 separated by 21 days
- Does not contain preservatives, eggs, or latex.
- Efficacy: 95%
- Type: viral vector
- Number of shots: 1
- Does not contain preservatives, eggs, or latex.
- Efficacy: 85%
Common Reasons for Vaccine Hesitancy
Despite the obvious perks of getting the COVID-19 vaccine (staying well, stopping a pandemic, saving lives), many are still hesitant to get vaccinated. We've listed a few common reasons some people are reluctant to receive any of the COVID-19 vaccines and the facts you can share with patients, friends, and family members to help them make an educated decision.
I don't want to get sick.
It's important to remind patients that vaccines do not make them sick. Vaccines trigger an immune response which creates antibodies. Antibodies, known as "searchers and destroyers," are the proteins that fight off trespassers by binding to the invading pathogen and marking it for destruction. Often, you will feel body aches, malaise and may even have a fever while your body creates antibodies. This does not mean you are sick. It only means the body is doing what it is supposed to: gaining protection from disease. Your body is developing an immune response like it would if you were sick but without the actual condition's associated risks.
I've heard COVID-19 vaccines can alter my DNA.
First, let's review how messenger RNA (mRNA) and viral vector vaccines work. Unlike many vaccines that place a weakened or inactive pathogen into our bodies, messenger RNA and viral vector vaccines work by teaching our cells how to make a protein that will trigger an immune response. An mRNA vaccine sends a message to your cells in a capsule that instructs the body to make a spike protein specific to SARS-CoV-2. This spike protein triggers an immune response, thereby creating antibodies to fight future exposure. A viral vector vaccine uses a modified and harmless version of another virus to deliver the same message. The Johnson & Johnson vaccine uses the adenovirus as a vector. Once the virus enters a cell, it uses that cell's machinery to create the spike protein. Both mRNA and viral vector vaccines teach your cells to generate a spike protein specific to the novel coronavirus; they just use two different delivery modes. It's important to note that neither a messenger RNA nor a viral vector ever enters a cell's nucleus, which is where genetic material is housed. So neither vaccine alters a person's DNA.
COVID-19 vaccines were made way too fast.
While mRNA and viral vector vaccines are new, they are not unfamiliar. Scientists and researchers have studied both vaccine delivery systems for over 30 years, during which they have overcome many obstacles to make these vaccination methods safe. Messenger RNA and viral vector methods are currently being tested for other pathogens like Ebola, Zika, and influenza. Both processes are easily replicable and faster than traditional vaccine development. And most importantly, both are safe.
Vaccine safety is the top priority, while broad vaccine distribution is essential. There are two safety reporting systems of which healthcare workers and patients should be aware.
First is the V-safe After Vaccination Health Checker. This is a secure, online tool that helps the CDC with ongoing vaccination-safety monitoring. After your patients receive their first vaccine, they can access V-safe through any smartphone. Registration takes minutes, and they only need to enter their name, date of birth, sex, race, cell number, and zip code. Once registered, participants will select the type of vaccine they received and the date they received it. They will then answer a few quick questions regarding how they currently feel and any specific symptoms. The CDC uses this data to monitor participants' real-time health statuses, and they can investigate medical problems further if warranted. This is an excellent way for all community members to contribute to vaccine safety and efficacy and a great way to pass the time during the observation period after your vaccine.
Second is the Vaccine Adverse Event Reporting System or VAERS. VAERS is a national reporting system overseen by the CDC and FDA. It allows both entities to identify safety problems with all vaccines. Anyone can submit a report to VAERS, and healthcare providers are required to disclose specific adverse events. They are encouraged to register any reaction they deem as clinically significant whether they can confirm it's related to a vaccine or not. After submitting a report, you will receive confirmation of receipt, and someone will contact you if follow-up information is warranted. Regarding the COVID-19 vaccine, the following items should be reported:
- Vaccine administration errors.
- Serious adverse events regardless of cause (for example, death, life-threatening event, hospitalization).
- Cases of multi-system inflammatory disease.
- Cases of COVID-19 resulting in death.
For more information on reporting requirements, click here.
I'm Vaccinated, Now What?
Many people wonder what freedoms complete vaccination affords them. The CDC recently released guidelines that will help those vaccinated know what we can and can't do. So what's changed?
You are fully vaccinated two weeks after your second dose of the Moderna or Pfizer vaccine and two weeks after one dose of the Johnson & Johnson vaccine. Once you've reached that milestone, feel free to doff your mask in the following situations:
- When you are indoors with other fully vaccinated people.
- When you are indoors with unvaccinated people in a single household, unless one of the members has an increased risk for severe illness or death from COVID-19.
Do you remember the days of self-quarantine and testing if you were exposed to an individual with COVID-19? If you are fully vaccinated, there is no need to self-quarantine or get tested (unless you live in a group home or correctional facility).
Now that we know what's changed, here is a list of things that have not changed.
- Continue to wear masks in public.
- Continue to wear masks when you are around unvaccinated people.
- Continue to wear a mask when you are around someone with an increased risk of severe illness or death from COVID or who lives with someone with an increased risk of severe illness or death from COVID.
- Avoid medium and large-sized gatherings.
- Delay domestic and international travel. If you can't delay travel, make sure you are following CDC guidelines.
- Watch for symptoms.
- Follow your workplace guidelines.
While day-to-day life isn't 100% back to normal, getting vaccinated allows you to enjoy some of the pleasures we've avoided for this last year.
What We Still Don't Know
While we know that being vaccinated prevents disease, specifically severe illness and hospitalization, it is essential to consider what the healthcare and science communities are still learning. We don't know how effective vaccines are against variants that are continuing to pop up worldwide. We also don't know how well vaccines prevent someone from spreading COVID-19, even if they are fully vaccinated. Make an effort to check in with the CDC weekly for updates. And when you aren't sure, always rely on known infection-prevention measures. Wear a mask, wash your hands, and socially distance yourself.
It's hard to believe we've been living with COVID-19 for over a year. And what is even harder to believe is there are three vaccines available to help us move past the pandemic. We aren't out of the proverbial woods yet, but we are close. But it doesn't matter if a vaccine is created if people aren't willing to take it. Nurses and other healthcare workers play an integral role in educating the public about the safety and efficacy of COVID-19 vaccines and guidelines they should follow after they are fully vaccinated. Your job isn't to convince someone to take the vaccine or judge those who are hesitant. Your job is to provide the most updated information so that patients and the community make the most informed decisions possible.