Your FAQs Answered About the COVID-19 Vaccine by Local Experts

With COVID-19 vaccines being distributed all over the world, there are many questions regarding the vaccine’s safety, effectiveness, etc. To help shed some further light on the subject, local residents, Jackie Johnston, PharmD, BCPS, a Clinical Pharmacist, and Clinical Professor and Caitlin Kulig, a Cardiology Clinical Pharmacist and Clinical Assistant Professor put together a document which they believe will answer some of the most common questions that they receive as clinicians regarding the COVID-19 vaccines — as well as some of their own experiences with the vaccine. They have also included their personal experiences with the vaccines, including side effects over 0-72 hours with both the first and second doses. Here’s everything you need to know about the COVID-19 vaccine:

clinical pharmacist explains covid-19 vaccine

About the Pfizer and Moderna COVID-19 vaccines: both mRNA vaccines.

Before we discuss the vaccines, let us take a step back. Our body creates thousands of different proteins, each with a specific mission and function. Messenger RNA, also known as mRNA, acts as an intermediary between DNA and protein. Think about the whole thing as a 3-step process: DNA -> mRNA -> protein. For our body to synthesize proteins, our body “translates” our DNA to mRNA which then can be translated into proteins.

Our body does this because DNA cannot leave a part of the cell known as the nucleus. Therefore, to get to the cytoplasm where this protein synthesis occurs, we need mRNA. Just like our bodies, viruses such as the COVID-19 also are composed of proteins. A protein present on the surface of the COVID-19 is known as a “spike protein”. The spike protein for COVID-19 is specific to the virus with the primary function being to allow COVID-19 to enter our healthy human cells to hijack our cell’s machinery to replicate. 

These mRNA vaccines, therefore, contain the mRNA sequence of the COVID-19 spike protein. Please note, the content of spike protein included in the vaccine is not virulent – meaning it cannot cause infection. Your body processes this mRNA sequence and manufacturers a portion of the spike protein. Once your body produces the spike protein, it wants to show it off. Your body’s immune system recognizes this spike protein as being “foreign” and creates antibodies.

Think of these antibodies as guards. Your body will create these antibodies and commit them to memory. By creating these antibodies, your body is well equipped for future encounters with COVID-19. If you then encounter the real COVID-19, your body will recognize that spike protein and attack the virus. It is also important to note that the vaccine cannot change your DNA. This is because, as mentioned above, mRNA cannot enter the nucleus of the cell where your genetic material {DNA} is stored.

After getting the vaccine, individuals may experience some side effects. The side effects represent your body’s immune system working hard to create this antibody defense. Think about it this way – imagine you are shown a photograph of something dangerous. The photograph itself cannot cause you harm, but instead, it allows you to prepare your defense in case you even encounter the danger seen in the photograph. The photograph in this scenario is the vaccine, and the dangerous thing is the actual coronavirus. 

Q: Are there any big differences between currently available vaccines {Pfizer or Moderna} in terms of efficacy?

Johnston + Kulig No, both vaccines have shown impressive data with regards to efficacy. The Pfizer vaccine demonstrated 95% efficacy and Moderna reported 94.1% efficacy. No cases of severe COVID-19 infection occurred in those who received the Moderna vaccine in clinical trials. One case of severe COVID-19 infection occurred in one out of 18,198 patients who received the Pfizer vaccine in clinical trials.

Q: Does the vaccine mean I do not need to wear a mask anymore?

J + K: Unfortunately, although you have received the vaccine you will still need to wear a mask. Although the vaccine may decrease COVID-19 transmission, especially asymptomatic transmission, we do not know how well it does this. The studies that evaluated the safety and efficacy of the vaccines did not specifically investigate reductions in transmission.

Q: Should you get vaccinated if you already had COVID-19?

J + K: Yes! The CDC currently recommends that those who had previous COVID-19 infection and have recovered should get the vaccine. Although those who have had COVID-19 developed a “natural immunity”, the degree and duration of immunity vary from person to person. Due to the possibility of re-infected, vaccination is recommended. 

The only caveat to consider is if an individual received convalescent plasma or monoclonal antibodies as part of their COVID-19 treatment. If those therapies were received, it is recommended to wait 90 days (={about 3 months} before the first dose of the vaccine. 

Q: How many doses of the vaccine will I need?

J + K: Both the Pfizer and Moderna vaccines require two doses: the Pfizer vaccine requiring three weeks and the Moderna vaccine requiring four weeks between doses.

Q: What side effects should a person expect?

K + F: The most reported side effects include percentages from Moderna study:

  • Headache {63%}
  • Fatigue {69%}
  • Fever {15%} 
  • Chills {44%}
  • Nausea/vomiting {20%}  
  • Injection site pain {92%}
  • Joint pain {45%}
  • Muscle pain {60%} 
  • Swollen lymph nodes
  • Anaphylaxis 

Early safety data has reported 21 cases of anaphylaxis to the Pfizer vaccine. Most anaphylaxis cases had symptom onset within 30 minutes of vaccination, and most persons with anaphylaxis had a history of allergies or allergic reactions, including some with previous anaphylaxis. 

Questions you may be asking yourself:

Q: Will I have side effects with both doses? 

J + K: While some individuals may experience no side effects, others may experience with one or both doses. More people have reported side effects to the second dose compared to the first dose.

Q: Is it true that the vaccine can cause Bell’s Palsy?

J + K: Cases of Bell’s palsy have been reported in participants in clinical trials. A total of 3 of 30,000 participants in the Moderna clinical trial and 4]four out of the 43,000 participants in the Pfizer clinical trial developed Bells’ Palsy. However, the Food and Drug Administration {FDA} does not consider these to be above the rate expected in the general population. They have not concluded these cases were caused by vaccination. Additionally, persons who have previously had Bell’s Palsy may still receive the vaccine.

Q: If I have a history of Guillain-Barre syndrome, can I still get the vaccine?

J + K: Yes, a history of GBS does not preclude you from receiving the mRNA COVID-19 vaccine. To date, there have been no cases of Guillain-Barre syndrome have been reported among participants in the mRNA COVID-19 vaccine clinical trials. 

Q:  What is the timeline of side effects?

J + K: Between both the Pfizer and Moderna studies, most patients reported symptom onset between day 0 {day of vaccination} and day 2 following vaccination. Of those who develop symptoms, the duration of symptoms may vary between individuals. Symptoms may persist for 1-3 days after vaccination, with longer durations reported following the second vaccine dose. It is important to note that symptoms may persist up to 7 days, or longer, in some individuals.  

Side effect reporting

J + K: All individuals who receive the COVID-19 vaccination should register with V-safe. V-safe is a smartphone-based tool, using text messaging and web surveys, to complete health check-ins after you receive the vaccine. V-safe allows an individual to report any side effects to the vaccine to the CDC. You may be contacted by the CDC for more information on your side effects. Additionally, V-safe will remind you to get your second dose when appropriate. 

Our personal experiences with the vaccine:

Jackie Johnston, PharmD, BCPS – Critical Care Clinical Pharmacist and Clinical Assistant Professor

  • Vaccine: Pfizer
  • COVID-19 status: no history of COVID-19 
  • Dose 1: 
      • Pain with vaccine administration: none
      • Vaccine day: mild arm soreness/injection site pain
      • Post-Vaccine day 1: 
        • Mild headache
        • Arm muscle pain/soreness 
        • Post-Vaccine day 2: no symptoms 
  • Dose 2: 
      • Pain with vaccine administration: none
      • Vaccine day: mild arm soreness/injection site pain
      • Post-Vaccine day 1: 
        • Arm muscle pain/soreness
        • Mild fatigue 
      • Post-Vaccine day 2: no symptoms

Would I get the vaccine again?

100% Yes! My vaccine symptoms were mild and responded well to common therapies {I.e. Advil or Tylenol for the headache}. By getting the vaccine, I am protecting myself and others from COVID-19. 

Caitlin Kulig, PharmD – Cardiology Clinical Pharmacist and Clinical Assistant Professor 

  • Vaccine: Pfizer
  • COVID status: a history of COVID-19 {2 months prior}
  • Dose 1: 
    • Pain with vaccine administration: none
    • Vaccine day: mild arm soreness/injection site pain
    • Post-Vaccine day 1: 
      • Flu-like symptoms: mild fever {100.4F}, generalized fatigue, and chills
      • Arm muscle pain/soreness 
    • Post-Vaccine day 2: no symptoms 
  • Dose 2: 
        • Pain with vaccine administration: none
        • Vaccine day: mild arm soreness/injection site pain
        • Post-Vaccine day 1: 
          • Arm muscle pain/soreness
          • Mild fatigue 
        • Post-Vaccine day 2: no symptoms

Would I get the vaccine again?

In a heartbeat. I would recommend trying to get the vaccine on the day before you are off from work, if possible. While I did have some symptoms after the vaccine, it did not compare to how I felt when I had COVID-19. My COVID-19 infection left me in bed for weeks and unable to exercise for over 2 months without experiencing shortness of breath. By getting the vaccine I am also protecting myself, my loved ones, and others that I will not even meet. 

Maria Fernandez, AGNP-C, MSN, CCRN

  • Vaccine: Pfizer
  • COVID status: no history of COVID-19 
  • Dose 1:
      • Arm muscle pain/soreness 
  • Dose 2:
      • Arm muscle pain/soreness 
      • Moderate headache
      • Severe fatigue  

Would I get the vaccine again?

Without hesitation! As an intensive care unit nurse, I have seen firsthand the devastation from COVID-19. I have seen too many people die from the virus; both young and old. Imagine having to use your cellphone to Facetime family members so they can say goodbye. We were not ready for something like COVID-19. It exposed the vulnerability and lack of resources in health care, including trained health care professionals. As a caregiver, COVID-19 has been heartbreaking. I want to be there to protect my loved ones, my patients, and my community. 

For more FAQ regarding the COVID-19 Vaccine, please see here

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Written by:

Dr. Cait Kulig is a Clinical Assistant Professor at the Ernest Mario School of Pharmacy at Rutgers and a Cardiology Clinical Pharmacist. Her clinical role is primarily based in the cardiology/cardiothoracic intensive care unit, as well as in a cardiology outpatient clinic at St. Joseph’s University Medical Center in Paterson, NJ. Dr. Jackie Johnston is a Clinical Assistant Professor at the Ernest Mario School of Pharmacy, at Rutgers and a Critical Care Pharmacist. Her clinical role is in a combined surgical/trauma/neurological intensive care unit at St. Joseph’s University Medical Center in Paterson, NJ.