Q. What are my options for the COVID-19 vaccine?
A. There are three vaccines that have received an Emergency Use Authorization (EUA) by the U.S. Food and Drug Administration (FDA): the Pfizer vaccine, the Moderna vaccine, and the Janssen/Johnson & Johnson (J&J) vaccine. The Pfizer and Moderna vaccine are both mRNA vaccines. The J&J vaccine is a viral vector vaccine. DC Health recommends that you take the first vaccine available to you.
Q. How well do the COVID-19 vaccines work?
A. Clinical trials have shown the Pfizer and the Moderna vaccines to be about 95% effective at preventing COVID-19 illness. The J&J vaccine is about 85% effective at preventing severe COVID-19. Please note that the vaccines were tested at different times and in different places, and the J&J vaccine was tested when there were more people infected with variant strains of the virus that causes COVID-19. This means that it’s hard to compare the numbers against each other. The bottom line is, they are all very effective! Another important thing to know is that if people catch COVID-19 despite being vaccinated, they will not get as sick. The vaccines are extremely effective at preventing people from needing to be hospitalized or dying from COVID-19.
Q. How many doses of the vaccine do I have to get?
- One dose for the J&J vaccine.
- Two doses for the Pfizer and Moderna vaccines. For the two-dose vaccines:
- The first shot helps the immune system recognize the virus, and the second shot strengthens the immune response. You need both to get the best protection.
- The recommended time period between the first and second doses is 21 days for the Pfizer vaccine and 28 days for the Moderna vaccine.
- It is important to get both doses of the same vaccine and not to mix-and-match, or the vaccine might not work as well.
Q. How long does the COVID-19 vaccine take to start working? Do I get some protection after the first dose of the two-dose vaccine?
You are considered fully vaccinated 2 weeks after finishing your vaccine series (2 weeks after getting your one dose of the J&J vaccine or 2 weeks after the second dose of the Pfizer or Moderna vaccines). You will get some protection after the first dose of the Pfizer or Moderna vaccine, but it is important to get your second dose for full protection.
Q. What are the side effects of the COVID-19 vaccines?
A. Common side effects of the COVID-19 vaccines are pain at the injection site, swollen glands in the armpit area of the vaccinated arm, fever, feeling tired, headache, chills, muscle aches and joint pains. Experiencing any of these common side effects shows that the vaccine is working as intended and stimulating an immune response from your body.
There is a rare side effect associated with the J&J vaccine called Thrombosis Thrombocytopenia Syndrome (TTS), an illness with blood clots plus low numbers of platelets (the cells that make our blood clot). It is unusual to have blood clots and low platelets occur together. TTS has mainly occurred in women younger than 50 (7 cases per million vaccines given), within about 2 weeks after receiving the vaccine. Public health officials at the U.S. Centers for Disease Control and Prevention (CDC) and the FDA quickly responded to reports of this illness and the vaccine was put on hold so the cases could be investigated and healthcare providers could be informed how to appropriately treat the condition. At the end of the investigation, vaccine safety officials determined that it was safe to restart use of the vaccine, since the good the vaccine does outweighs the risk of this very rare side effect. People who get the J&J vaccine should be aware of this serious side effect and seek medical attention urgently if they develop any symptoms of TTS including: severe headache, confusion, vision changes, severe abdominal pain, nausea/vomiting, back pain, shortness of breath, unexplained leg pain, easy bruising, or small red spots on your skin. If you develop any of these symptoms tell your healthcare provider that you recently received the J&J vaccine so they can get the right tests and treatments ordered quickly.
In addition, a small number of cases of myocarditis (a heart inflammation) and pericarditis (inflammation of the sac around the heart) have occurred in teens and young adults, especially males, after the second dose of the Pfizer and Moderna vaccines. It is not yet clear if the vaccine caused these illnesses, but this is being investigated. Myocarditis and pericarditis can have many other causes. Fortunately, most young people who developed these conditions recovered completely without any lasting heart damage. Symptoms of myocarditis and pericarditis are: chest pain, shortness of breath, or feelings of having a racing or fluttering heart.
Q. Are the vaccines safe? I’ve heard the process was rushed and important steps were skipped.
A. While the COVID-19 vaccines were developed in record time, they are still being held to the same safety standards as all prior vaccines. The COVID-19 vaccines are undergoing the most intense safety monitoring of any vaccine in US history. People who received the vaccines in the clinical trials (about 120,000 people) continue to be monitored for any negative effects. Now that millions of Americans have been vaccinated, we’ve added to our knowledge with real world experience and data through reports to the Vaccine Adverse Events Reporting System (VAERS) and other reporting systems. This thorough safety monitoring will ensure that public health officials can detect even very rare side effects of the COVID-19 vaccines.
Q. Do I need to get vaccinated if I’ve already had COVID-19?
A. Yes. It is not yet certain how long or how well a past COVID-19 infection protects someone from getting infected again. The vaccine also provides a strong boost to any immunity you may already have from a past COVID-19 infection. Since re-infection with COVID-19 is uncommon in the 90 days following an infection, you may choose to delay getting vaccinated until after 90 days has passed, but do not have to (unless you received monoclonal antibodies).
Q. Can the vaccine give me COVID-19 or cause me to test positive for COVID-19?
A. No. The COVID-19 vaccines do not contain any of the live virus that causes COVID-19, only the code for one of its viral proteins. However, it typically takes a few weeks for the body to build immunity after vaccination. That means it’s possible you could be infected with the virus that causes COVID-19 just before or just after vaccination and get sick. If you develop cough, shortness of breath, runny nose, sore throat, or loss of taste or smell after getting the vaccine, you should not assume these symptoms are from the vaccine, and should take steps to isolate yourself and call your healthcare provider.
Q. Can pregnant women get the vaccine?
A. Yes. There is no evidence that the vaccine causes any problems with pregnancy. Pregnant women were not included in the early COVID-19 vaccine studies, but some women enrolled in the clinical trials got the vaccine before they knew they were pregnant, and some became pregnant during the study period. In these instances, the vaccine was effective and no negative effects have occurred. Also, tens of thousands of pregnant women have now received the vaccine since it became available to the public and no safety or effectiveness concerns have been identified. Clinical trials evaluating the COVID-19 vaccine in pregnant women are going in progress.
Pregnant women are at higher risk for complications from COVID-19 such as preterm birth. U.S. Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians (ACOG) have recommended that pregnant women be vaccinated. Pregnant women should consult with their obstetric health care provider if they have more questions about getting the vaccine.
Q. Can breastfeeding women get the vaccine?
A. Yes. Although the vaccine has not been specifically studied in breastfeeding women, it is felt to be safe. The COVID-19 virus is not transmitted through breastmilk, so it is expected that vaccination would not be a concern either.
Q. If I’m trying to get pregnant, can I get the vaccine? Should I delay getting pregnant until after I’ve been vaccinated?
A. Yes, you can get the vaccine if you are trying to get pregnant. It is not necessary to delay pregnancy until after you have been vaccinated.
Q. Can children get the vaccine, and do they need to?
A. Yes. Children aged 12 and up are eligible for the COVID-19 vaccines. Children's National is offering COVID-19 vaccine to all DC residents ages 12-22. Call 202-476-1022 during business hours to schedule an appointment.
While children may not be as likely to get severely ill with COVID-19, there are now more teens that have been hospitalized for COVID-19 than there were during the H1N1 flu pandemic. Children in this age group are also at risk for developing multisystem inflammatory syndrome in children (MIS-C), which can cause some children who are affected to require intensive care, and may affect heart function. COVID-19 is now also one of the top 10 causes of death in the 12-17 year old age group. Getting kids vaccinated is important both to protect themselves, and to decrease risk that they may spread it to others if they don’t get vaccinated.
Q. How much will the COVID-19 vaccine cost?
A. The vaccine is free. Some doctors may charge an administration fee which may be covered by your health insurance. You should not be charged any out-of-pocket fees when you get your vaccine.
Q. Who should NOT get the COVID-19 vaccine?
- Anyone with a previous severe or immediate allergic reaction (e.g. anaphylaxis) to the first COVID-19 mRNA vaccine dose, any of the vaccine ingredients, or polysorbate. For a list of vaccine ingredients see:
- Children 11 and younger (it has not yet been fully tested on this age group)
- People currently ill with COVID-19 and are isolating, people with symptoms who are isolating, or people who have been exposed to COVID-19 and are quarantining. This is to protect the staff and other patients in the vaccine clinic. You can get your vaccine once your isolation or quarantine is completed.
After Getting the Vaccine
Q. Once I get vaccinated, will I receive any sort of documentation to show that I have received the COVID-19 vaccine?
A. You will receive a COVID-19 Vaccination Record Card after getting your vaccine. If you are getting a two-dose vaccine, the card will remind you of when you will need to return for your second dose. You will need to bring the card with you when you return for the second dose so that it can be documented on the card.
Keep your vaccination card in case you need it for future use. Consider taking a picture of your vaccination card after your second shot appointment as a backup copy.
Q. What happens if my second dose gets delayed?
A. You should get the second shot as close to the recommended interval as possible (21 days for the Pfizer vaccine and 28 days for the Moderna vaccine). If for some reason you are late getting your second shot, get the second shot as soon as you can. Don’t wait any longer than 6 weeks to get your second shot. Also, do not get your second dose earlier than what is recommended (up to 4 days earlier is acceptable). We are still learning if the vaccine works as well if it is taken outside of the currently recommended time periods.
Q. Can I stop taking precautions like wearing a mask and social distancing after I get the vaccine?
A. Yes, fully vaccinated people are protected and can resume most activities safely without masking or social distancing. Fully vaccinated people only need to wear a mask where it is required. You may choose to wear a face mask to further reduce your risk in areas with low vaccination rates and high COVID-19 rates. Please see Guidance for Fully Vaccinated People at coronavirus.dc.gov/healthguidance for more information.
Q. If I am exposed to COVID-19 after I am vaccinated, do I still have to quarantine?
A. Fully vaccinated people who were in close contact with someone with COVID-19 are NOT required to quarantine as long as they do not have any symptoms of COVID-19. However, they should still monitor themselves for symptoms for 14 days after the exposure date, and isolate and call their healthcare provider if symptoms develop.
Q. Can a person sick with COVID-19 receive the vaccine?
A. No. They should wait to get the vaccine until they are feeling better and have completed their isolation period so that they don’t expose healthcare providers and other people.
Q. When will children younger than 12 be able to get the COVID-19 vaccine?
A. We don’t know for sure. Trials studying the safety and effectiveness of the Pfizer vaccine in children younger than 12 are currently in progress.
Q. Should people with chronic medical conditions get the vaccine?
A. Yes. COVID-19 vaccination is especially important for people with chronic health problems, such as heart disease, diabetes, and lung disease. People with chronic health conditions are more likely to get very sick from COVID-19.
Q. Should people who are immunocompromised get the vaccine?
A. CDC recommends that immunocompromised people should get the vaccine. There is not much data so far about effectiveness of the vaccine in people who have problems with their immune system. It is possible that the vaccine may not work as well in this segment of the population. On the other hand, immunocompromised people are at increased risk for severe COVID-19 infection. Immunocompromised people should discuss whether they should get the vaccine with their healthcare provider.
Q. Who needs an additional COVID-19 vaccine?
A. CDC is recommending that moderately to severely immunocompromised people receive an additional dose. This includes people who have:
- 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
People should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them. Take your vaccination card with you to your additional dose appointment so your provider can fill in the information about your additional dose.
Q. What should immunocompromised people who received the J&J/Janssen vaccine do?
A. The FDA’s recent EUA amendment only applies to mRNA COVID-19 vaccines, as does CDC’s recommendation.
Data has demonstrated that immunocompromised people who have low or no protection following two doses of mRNA COVID-19 vaccines may have an improved response after an additional dose of the same vaccine. There is not enough data at this time to determine whether immunocompromised people who received the Johnson & Johnson’s Janssen COVID-19 vaccine also have an improved antibody response following an additional dose of the same vaccine.
Q. Will I need to get a COVID-19 vaccine every year like the flu vaccine?
A. It is still too early to know. Ongoing studies should answer this question.
Q. Can I get a COVID-19 vaccine at the same time as another vaccine?
A. Yes. It is safe to get the COVID-19 vaccine as the same time as other vaccines.
Access to the Vaccine
Q. How can I get the vaccine in DC?
A. It is easy to get the vaccine now! All DC residents 12 and older are eligible to receive the COVID-19 vaccine. The District currently offers 11 high-capacity, walk-up, no appointment needed vaccination sites. (Walk-up sites are for first doses. When you receive your first dose, you will still make an appointment to get your second dose.) The walk-up sites are in addition to the pharmacies, clinics, and health care providers that are also administering the vaccines citywide. These sites have their own scheduling systems. See locations and hours here.
Q. How do the COVID-19 vaccines work? Do they all work the same?
A. The mRNA vaccines (Pfizer and Moderna) work differently than the J&J vaccine which is a viral vector vaccine.
How the mRNA vaccines work: mRNA is the blueprint living things use to make proteins. Viruses and humans both use mRNA. The vaccine contains the mRNA code for the COVID-19 virus spike protein. The spike protein is what the virus uses to attach to and infect human cells. The vaccine causes human cells to produce some spike protein, which tricks the immune system into thinking a person is infected with the real virus. This causes the body to make an immune response. Then, if the person gets exposed to the real virus, the immune system kills the virus and the person does not get sick.
How the viral vector (J&J) vaccine works: This vaccine works by using a different virus called an adenovirus that has been weakened so it cannot replicate. The adenovirus carries the spike protein code and, similar to the mRNA virus, it instructs human cells to make some spike protein to cause the body to make an immune response.
Q. What is herd immunity and why is it important in relation to COVID-19?
A. Herd immunity (also known as population immunity) occurs when a high enough percentage of a population is immune to a certain infection. When a population reaches herd immunity, if someone gets the infection, the microbe has difficulty finding new people to infect, and epidemics will die out. The amount of the population that needs to be immune to reach herd immunity varies for every infection. It is not yet known what percentage of people would need to be immune to COVID-19 to reach herd immunity. Getting as many people vaccinated as possible is the safest and best way to get to herd immunity and stop the COVID-19 pandemic.
Q. Will the vaccines work on the variant strains of COVID-19?
A. Based on current information, the vaccines do seem to work against the variant strains of COVID-19. Scientists are monitoring the variants closely and DC Health will keep you informed as more information becomes available.
Q. Can the vaccines change my DNA?
A. No, they cannot. The mRNA in the Pfizer and Moderna vaccines does not enter the nucleus of human cells where DNA is stored. The mRNA is naturally broken down within the cell after a short period of time.
The J&J vaccine does contain DNA encoding a gene from the COVID-19 virus, and does enter the nucleus of the human cell, but it does not contain the machinery to change human DNA.
Q. Can the COVID-19 vaccine make you infertile or affect puberty?
A. No. There is no evidence that the COVID-19 vaccine causes infertility. They do not affect hormone levels or move to other parts of the body, so there is no reason to expect that COVID-19 vaccines would have lon or short-term effects on those systems.
Q. Are the vaccines produced using fetal cells?
A. The Pfizer and Moderna vaccines are not produced using fetal cells. The J&J vaccine is grown in cells originally isolated from fetal tissue. The source fetal tissue from which cells were derived is decades old and no new fetal tissue was needed to produce the vaccine.
Q. Do the vaccines contain preservatives, like thimerosal?
A. No. The ingredients of the vaccine can be found here: cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#Appendix-C .