COVID-19 Vaccine Information

• Been receiving active cancer treatment for tumors or cancers of the blood
• Received an organ transplant and are taking medicine to suppress the immune system
• Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
• Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
• Advanced or untreated HIV infection
• Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response

The CDC and California Department of Public Health do not recommend using an antibody test or any other tests to determine protection from the virus at this time. There is significant variability from one antibody test to another, and we do not know enough about what antibody levels mean in terms of protection from COVID-19 and its variants.

No. COVID-19 vaccines are working well to prevent severe illness, hospitalization, and death. However, the protection from vaccines or prior natural infection wanes over time and the best way to minimize the risk of infection which can lead to serious illness and hospitalization is by getting vaccinated and boosted when eligible.

Yes, you can “mix and match” COVID-19 vaccines for your booster dose. The U.S. Food and Drug Administration and CDC/ACIP indicated that people can get boosters that are different from the vaccine they originally received. Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine.  So if you got Pfizer six months ago, you could get a booster from Moderna or Johnson & Johnson, as long as you are eligible otherwise.

No, even with a booster dose, precautions are still important to keep everyone safe. COVID-19 vaccines are not 100% effective, and some groups are not yet eligible for the vaccine. Taking precautions such as wearing a face mask in indoor public settings, and social distancing helps to protect them from contracting COVID-19 and becoming seriously ill.

• The original strain from Wuhan, and
• The current predominant subvariant of Omicron, BA.5.  The spike protein on the surface of both Omicron’s BA.4 and BA.5 subvariants is exactly the same. So, this booster should protect people against both.

• Moderna: 6 years and older
• Pfizer: 5 years and older

Of note, the bivalent booster recommendation replaces previous booster recommendations for people ages 12 years and older. This means that everyone ages 5 years and older who are eligible for a booster dose will now only be eligible for ONE booster dose.

No. You’ll need to wait until two months have passed since your last booster shot.

If you were very ill, you’ll need to wait at least until the worst of your symptoms have resolved, and you have met the criteria to leave isolation. Immunologists indicate that patients with recent COVID-19 infections should consider waiting three or four months instead of two (counting from the time they first showed symptoms or tested positive) to get a booster shot.

The original monovalent vaccines are no longer authorized to be used as a booster dose in people ages 5 and older (Pfizer) or 6 and older (Moderna) now that the reformulated (bivalent) booster vaccines have been approved.  However, the CDC’s ACIP indicated that the monovalent vaccines are still to be used as primary series doses since the amount of mRNA in the primary vaccine formulation is higher (more antigenic) than in the bivalent booster formulation.

No. The Centers for Disease Control and Prevention (CDC) notes there’s still no need to stagger these vaccinations. If you’re due for both, you can get your flu shot and your COVID-19 booster at the same time on the same day. You can even get them in the same arm, if you want to cut down on the amount of soreness you experience.

Based upon recent history, public health officials are expecting another wave of COVID-19 infections this fall as immunity from the prior vaccines or prior illness wanes, more contagious omicron subvariants spread, and people spend more time indoors as the weather turns colder and families gather for the holidays. The CDC and the FDA anticipate that the new bivalent boosters will provide more durable protection against infection, mild illness and severe disease. As a result, anyone who is eligible should be encouraged to get a bivalent booster.  

Yes. It’s OK to mix and match as long as you’re eligible for the vaccine you prefer.  

Yes. Those who take EVUSHELD antibody therapy to protect themselves from severe COVID-19 infection can receive the bivalent booster, if eligible. Those who receive a vaccine dose (primary or booster) should wait at least two weeks before getting the EVUSHELD injection, according to the Centers for Disease Control and Prevention’s advisory group.  However, if you received EVUSHELD there is no minimum interval time frame required from receiving EVUSHELD to receiving a COVID-19 vaccine or booster.  

The third dose should be the bivalent booster dose given two months after the last monovalent dose.  People who are or who become moderately or severely immunocompromised should follow the COVID-19 vaccination schedule according to their age and immune status at the time of eligibility for that dose. For example, people who become moderately or severely immunocompromised after completing a 2-dose mRNA primary series do not need additional primary doses; however, they should follow the schedule for people who are moderately or severely immunocompromised for the booster dose. Click this link from the CDC which outlines the updated COVID-19 vaccine schedule. 

At this time, there are no changes to the vaccine schedules for children age 6 months through 11 years. Some experts have indicated that the bivalent booster formulation will likely be authorized within the next three to six months for children under age 12, or potentially even sooner. Manufacturers are using the exact same processes to make the bivalent boosters as they did to make the originals. So, while the change in proteins included is an important one, it’s still relatively small from the point of view of the body’s developing a new adverse reaction to it.

• All Sansum Clinic COVID-19 information can be found at https://covid19.sansumclinic.org/.
• To ensure you receive our periodic COVID-19 email updates from the Sansum Clinic CEO, please make sure you are signed up for MyChart, so we have your email address.
  
   
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Sansum Clinic is currently administering the Pfizer/BioNTech, Moderna and Novavax vaccines .  Pfizer and Moderna are the only vaccines currently approved for people age 6 months and older.

Getting vaccinated is one of many steps you can take to protect yourself and others from COVID-19. Protection from COVID-19 is critically important because for some people, COVID-19 can cause severe illness or death. There is no way to know how COVID-19 will affect you. If you get COVID-19, you could spread the disease to family, friends and others around you. Getting a COVID-19 vaccine can help protect you by creating an antibody response in your body without your having to become sick with COVID-19. 

All COVID-19 vaccines currently available in the US have been shown to be highly effective at preventing COVID-19 and may also help keep you from getting seriously ill even if you do get COVID-19. Getting vaccinated may also protect people around you, particularly people at increased risk for severe illness from COVID-19.

The FDA has confidently said that the Pfizer/BioNTech, Moderna and Janssen vaccines are safe. The Pfizer/BioNTech vaccine has full FDA approval .  The Moderna and Janssen vaccines have an emergency use authorization from the FDA. People who receive the vaccine will be monitored to check for safety, and participants in the original clinical trials will be followed for two years.

The currently approved COVID-19 vaccines were tested in large clinical trials to make sure they meet efficacy and safety standards. Many people were recruited to participate in these trials to see how the vaccine offers protection to people of different ages, races, and ethnicities, as well as those with different medical conditions.

All of the authorized vaccines work by helping your body produce antibodies. Antibodies are proteins that help fight infections from viruses, bacteria and other germs. Mild symptoms are common as when the body produces antibodies, and are not a sign of infection.
The most common side effects reported 24-48 hours after the vaccine, include:

• Pain at the injection site
• Fatigue
• Headache
• Muscle pain
• Chills
• Joint pain
• Mild fever

Drink plenty of fluids to reduce discomfort from the above symptoms. To reduce pain and discomfort where you got the shot, apply a clean cool wet cloth over the area and try to use or exercise your arm. You can also take over the counter medications for pain, like acetaminophen or ibuprofen (e.g., Advil). If you are unsure if you can safely take an over the counter medication, check with your healthcare provider. Side effects are generally mild and go away after a day or two. For the Pfizer and Moderna vaccines, they are likely to be more pronounced after the second shot.

As with any vaccine, there is a low chance of allergic reaction. If you have a history of severe allergic reaction to other vaccines, please talk to your doctor about whether you should receive the COVID-19 vaccine. 

When to call the doctor —> in most cases, discomfort from fever or pain is normal. Contact your doctor or healthcare provider:

If the redness or tenderness where you got the shot increases after 24 hours

If your side effects are worrying you or do not seem to be going away after a few days

If you get a COVID-19 vaccination and you think you might be having a severe allergic reaction after leaving the vaccination site, seek immediate medical care by calling 911. 

We encourage all patients to enroll in the CDC’s V-Safe program, which will send you a text for six days to see how you are feeling after getting the vaccine, then once a week for six weeks. The program will also send you a reminder text about your second dose. Visit https://vsafe.cdc.gov/ for more information

You are not contagious if you develop side effects from the authorized COVID-19 vaccines. None of the authorized COVID-19 vaccines contain the live virus that causes COVID-19.

Stopping a pandemic requires using all the tools available. After you receive the vaccine, you should continue to follow all safety measures like mask-wearing, social distancing and hand washing.

If you experienced mild side effects (pain or swelling at the injection site, fever, chills, fatigue or headache within 24-48 hours of vaccination), you should get a second dose.

However, if you have had anaphylactic reaction to the first dose of vaccine, you should not get the second dose. Please talk to your healthcare provider if you have any questions or concerns.

We encourage all patients to enroll in the CDC’s V-Safe program, which will send you a text for six days to see how you are feeling after getting the vaccine, then once a week for six weeks. Visit https://vsafe.cdc.gov/ for more information.

As with the initial COVID-19 vaccines, there may be some mild side effects, such as pain and redness surrounding the injection site, fatigue, muscle soreness, headache, or fever, which may last 24-48 hours. The very rare risk of the blood clotting disorder with the Johnson & Johnson COVID-19 vaccine occurring primarily in females 18-49, thrombosis with thrombocytopenia syndrome, is a rare adverse event, occurring in ~ 7 cases per one million people vaccinated. If you receive the Johnson & Johnson vaccine and experience any sign of a blood clot or low platelets, including severe headaches, abdominal pain, leg pain, shortness of breath, or easy bruising or tiny blood spots under the skin beyond the site of injection, contact your doctor or seek medical care immediately.

You should not get the vaccine if you have had a severe allergic reaction to any ingredient in the vaccine, or if you had a severe allergic reaction to a previous dose of the vaccine.

You can find the ingredients and fact sheets for the Pfizer-BioNTech, and Moderna vaccines here.

If you have an immediate allergic reaction after getting the first dose of a two-dose COVID-19 vaccine, don’t get the second dose. Talk to your health care provider if you have questions about receiving the vaccine.

You must be 6 months of age and older to receive the Pfizer/BioNTech and Moderna vaccines, and 18 years of age and older to receive the Janssen vaccine.

Current evidence shows that people whose immune systems are compromised may be more at risk for severe COVID-19. The most recent COVID-19 vaccine guidelines from the Centers for Disease Control and Prevention (CDC) state that people who are immunocompromised may receive the vaccine if they do not have any contraindications to vaccination. If you are immunocompromised or are on a medicine that affects your immune system, you should speak with your healthcare provider about the risks and benefits of vaccination, including the potential for a decreased response to the vaccine.

Taking into account both the risks and benefits of our patients receiving one of the two vaccines, based on our current knowledge, Sansum OB/GYN department supports the recommendations of the American College of Obstetricians and Gynecologists (ACOG), Society for maternal Fetal medicine (SMFM), and American Society for Reproductive Medicine (ASRM), that all patients planning to conceive, currently pregnant or who are lactating have access to the vaccine. We recommend that you discuss your personal situation, including vaccine availability and your risk of COVID-19, directly with your OB/GYN provider so that they can help you make the best decision for you.

If you have a history of severe allergic reactions not related to vaccines or injectable medications, you may still get a COVID-19 vaccine, and you should be monitored for 30 minutes after getting the vaccine (compared to the standard 15 minutes for someone without a history of allergic reaction). If you’ve had an immediate allergic reaction to other vaccines or injectable medications, ask your doctor if you should get a COVID-19 vaccine. If you’ve ever had an immediate allergic reaction to any ingredient in a COVID-19 vaccine, the Centers for Disease Control and Prevention recommends not getting that specific vaccine. Also, people who are allergic to polyethylene glycol (PEG) should not get an mRNA COVID-19 vaccine. PEG is an ingredient in some other vaccines and multiple FDA approved medications including bowel preparations, like Miralax. You can find the ingredients and fact sheets for the Pfizer-BioNTech and Moderna vaccines here.

If you have an immediate allergic/anaphylactic reaction after getting the first dose of aCOVID-19 vaccine, don’t get the second dose. This guidance pertains to both the Pfizer and Moderna vaccine. If you experience an immediate allergic reaction to either vaccine, you should not get a second dose of either manufacturer’s vaccine.

Yes, you should still get the COVID-19 vaccine if you have already recovered. We recommend that you delay getting vaccinated for 90 days after most recent positive test result. There is a concern that you may have a stronger reaction to the vaccine if you get vaccinated soon after having COVID-19, because your immune system is likely already “primed” as a result of the natural infection, and adding vaccine on top of that could result in a more vigorous immune response (e.g., potentially more side effects). Additionally, current evidence suggests that reinfection with the virus that causes COVID-19 is uncommon in the 90 days after initial infection due to the natural immunity that you likely now have as a result of making antibodies to the virus on your own.

Vaccination of persons with known current SARS-CoV-2 infection 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 persons who develop SARS-CoV-2 infection before receiving any vaccine doses as well as those who develop SARS-CoV-2 infection after the first dose but before receipt of the second dose.

Yes. If you recently received monoclonal antibody therapy or convalescent plasma to treat a COVID-19 infection, you should defer your vaccination for at least 90 days from when you last received that treatment.