Experts Answer Six Top Questions About the COVID-19 Vaccine

Experts Answer Six Top Questions About the COVID-19 Vaccine

  • The Food and Drug Administration has approved the emergency use of the Pfizer-BioNTech COVID-19 vaccine, with its first doses being distributed this week.
  • Some Americans may be eligible to be vaccinated in January and February, after healthcare workers but before it’s rolled out to the public in late spring or early summer of 2021.
  • There are 15+ pharmacies, retailers, and supermarket chains that will offer COVID-19 vaccines to the public, with many offering appointments online.

    Your Questions, Answered:
    Who will be first? | Can I get a vaccine now? | Where can I find a vaccine? |How many shots will I need? | How much is it? | Are there side effects? | Should I speak to my doctor?

    December has brought record-day highs of novel coronavirus deaths and cases here in the United States. But the nation’s top medical officials have taken the first steps towards rolling out a much-needed vaccine to stem the outbreak. On Friday, officials at the Food and Drug Administration (FDA) authorized pharmaceutical manufacturer Pfizer to roll out its newly created vaccine for emergency use. The shot is being administered to some as early as this week — a press conference held after the FDA’s approval suggests more than 140 sites will receive shots on Monday — after the federal agency said that the «totality of the available data provides clear evidence» that the vaccine «may be effective in preventing COVID-19.»

    While new information is being released daily about the upcoming distribution of millions of doses of vaccine, one thing is certain — some Americans will receive a shot before others. And the general public probably won’t be able to walk into a local clinic, pharmacy, or hospital for a COVID-19 vaccine well into 2021. Many hope that Dr. Anthony Fauci, easily one of the White House Coronavirus Task Force’s most reassuring experts, is right about one of his latest estimates: «By the time we get to April, we would likely have taken care of all the high priority and then the general population… can walk into a CVS or to a Walgreens and get vaccinated,» he said during a public interview in late November.

    There are likely to be two (or more!) vaccines available to the public when spring rolls around, however. In the same interview, Dr. Fauci told the public that the federal government has contracted with multiple companies to make more than 600 million doses of the vaccine, as it looks like each American will need to receive two shots over the course of multiple weeks. But the New York Times reports that U.S. officials have only purchased 100 million doses from Pfizer, and have purchased other vaccines from companies like Moderna, which is trailing behind Pfizer in the FDA approval process (as well as AstraZeneca and Johnson & Johnson, who are even further behind).

    Much remains to be seen about all of the vaccines that may end up available to the American public, but the FDA’s approval of the Pfizer product has revealed a few key details. A 53-page FDA report suggests that Pfizer’s vaccine offers some protection against severe COVID-19 symptoms after just one shot, and could be upwards of 95% effective when two doses are administered. And other vaccine candidates are showing similar results: You can view the progress of each developing vaccine (and trial results) in an illustrated guide by the New York Times.

    But with the government rolling out vaccines to some individuals earlier, you might be wondering when it’ll be your turn to get a vaccine — and how you can secure one earlier if you’re eligible. Some of this information is covered by officials at the Centers for Disease Control and Prevention (CDC), but most insight is coming from experts who have experience in medical regulations. Below, a pair of leading infectious disease experts with experience in federal and international affairs share how much the vaccine will cost, what the vaccine will be like, and who will be first in line to receive it. Plus, we’re sharing a list of retailers who will offer it in your area.

    Much of this information may be found within questions answered by CDC officials. As more information about the upcoming COVID-19 vaccine is released, some of the details in this report may have changed since it was last updated. You can find up-to-date information on vaccines by visiting online resources published by the CDC and the World Health Organization, as well as consulting your local public health department.

    Who will be the first to receive a vaccine?

    While there isn’t a definite timeline set into place yet, federal officials are working with states to put out guidelines on who should receive a vaccine first — and the priority list may differ between regions. Robert Amler, M.D., former CDC officer and U.S. Health and Human Services regional administrator currently serving as vice president for government affairs at New York Medical College, says state officials will largely decide where the vaccine is deployed first. Here’s how priority may play out in most states, according to Dr. Amler:

    1. Frontline workers and healthcare providers: Anyone who is working in a hospital setting or an emergency clinic setting will likely receive vaccinations in December and early January. Depending on the state’s criteria, some workers who perform essential duties, including public service, may also receive a vaccine at this stage.
    2. Long-term healthcare providers: Namely those who care for high-risk individuals who are likely to develop severe COVID-19 symptoms, including the elderly and immunocompromised. These healthcare providers, in places like nursing homes through rehab clinics and even places like Veteran Affairs Hospitals, will also be vaccinated in the upcoming weeks.
    3. High-risk individuals: Likely, this will come down to health conditions that have been defined previously by CDC officials. Older individuals and those with preexisting health conditions (like diabetes, cancer, or cardiovascular issues, among others) may receive their vaccine earlier at the turn of the season, between late winter and early spring.
    4. Those at elevated risk: This is where each state may have vastly different plans, as needs vary by region. «There are certainly, within different states and within different counties and cities, subgroups — some of them racial, some of them ethnic, some of them socioeconomic — where people have been seen to have higher rates of disease and higher rates of complications,» explains Dr. Amler. He adds that these areas, especially those where high-density living or working conditions are a concern, may see open access to vaccines before other areas will.
    5. All others: Depending on whether there are any manufacturing delays or other logistical issues, most medical experts expect the vaccine to be made available to the general public in late spring or early summer 2021. «This projected timeline is going to get sharper and sharper, as the vaccine gets approved, as it begins to get distributed,» Dr. Amler adds.
      1. A preliminary report drafted by Johns Hopkins University suggests that the distribution of vaccines could end up being phased in in stages. Phase 1 would include frontline workers and first responders, as well as those at higher risk for severe symptoms. Phase 2 would include critical workers, like teachers and staff at educational institutions, and those at elevated risks, including the homeless, imprisoned, or other older adults not included in Phase 1.

        Phase 3 would potentially push out vaccines to children and young adults (more on that later), and Phase 4 would be a general roll out to the public. «Although the framework does not specifically identify racial or ethnic groups, there is recognition of the disproportionate impact of COVID-19 in African-American and Latinx communities due to systemic racism that yields higher rates of underlying diseases, living conditions that contribute to disease risk, and greater employment as essential workers,» the report concludes.

        How can I get a COVID-19 vaccine now?

        Depending on where you fall into the categories above, you may be wondering if you’re eligible to get a vaccine before others. The good news is that you won’t have to do any extra work to get access to an early vaccine if you are meant to have it, Dr. Amler explains. Since the federal government is working to distribute vaccines to states based on their need, local county and city health boards will end up distributing vaccines to hospitals, clinics, and larger medical practices, which may already have a list of patients who would benefit from an early vaccine. In this case, you’ll hear directly from your care provider that a vaccine is being made available to you before others.

        But not everyone has a care provider, and the government doesn’t know of each and every condition that all Americans have, which is why Dr. Amler says you’ll see lots of advertising and educational material about the vaccine soon. «This material can alert people to the fact that they may be eligible to get a vaccine sooner,» he explains. Many, many efforts are underway to attempt to convince more Americans to sign up for a vaccine, as anywhere between 40 and 65% surveyed said they have doubts about getting a shot, according to data compiled by the Pew Research Center. Notable leaders and celebrities are already committing to receiving vaccines, some publicly — former Presidents Barack Obama, Bill Clinton, and George W. Bush will publicize their vaccinations, per CNN.

        If you don’t already have an existing relationship with a healthcare provider, you can try reaching out to your area’s local health department in the new year to inquire about receiving a vaccine due to an underlying condition. But it’ll likely be easier to seek out a vaccine from a primary care doctor, as their institutions could be quicker in getting you in line for an early vaccine if they determine you qualify for one.

        Not sure if you should ask about an early vaccination? The New York Times has put together an illustrated guide to estimating your need for a vaccine compared to others in your local county.

        What will the vaccine actually be like?

        Early reports from the FDA suggest that most vaccines will require two different doses, with what’s known as a «booster» shot being administered weeks apart (for Pfizer products, it’ll be three weeks). Dr. Amler explains that consumers likely won’t have a choice in selecting where their vaccine is coming from in early 2021, but that they’ll need to receive two of the same vaccines; «You won’t be able to get a Pfizer shot first and then a Moderna shot three weeks later,» he says.

        It’s crucial that both doses are administered in order to offer the most protection. And even if you do successfully receive the entire vaccine, it doesn’t mean you can stop practicing social distancing or wearing a mask just yet. Believe it or not, it could be months, or an entire season, before the vaccine stems the spread of COVID-19, says Bojana Berić-Stojšić, M.D., Ph.D., CHES, an ambassador for the United Nations’ Society for Public Health Education and director of the master of the public health program at Fairleigh Dickinson University. «It will take some time for the mRNA vaccine to immunize enough people to reach what we know as ‘herd immunity,’ that would help stop the spread of the virus, locally and globally,» Dr. Berić-Stojšić shares.

        As of now, though, a rather large question remains unanswered — whether or not we’ll need to receive a new coronavirus vaccine annually, periodically, or if one vaccine will be enough for our entire lifespan. «Right now, the length of the immunity protection in the mRNA vaccine is unknown. It could be through our lifetime, but it may be a shorter period of protection, like the flu vaccine,» she adds. Like vaccines for pneumonia or tetanus, it’s more likely that we will need to be vaccinated again at some point.

        Where can I find a vaccine?

        Both Dr. Amler and Dr. Berić-Stojšić say that state health departments are finalizing plans for making the vaccine available to the public. Primarily, however, the vaccine will be available at hospitals and pharmacy clinics, and in some cases, even clinics embedded in places like shopping malls and grocery stores.

        In an interview with NBC, CEO of CVS Health Larry Merlo said that all of the company’s pharmacies will make the COVID-19 vaccine available when they have approval from the federal government. And in some cases, local clinics in your area may directly receive their supply of vaccines from pharmacies like CVS: Merlo said upwards of 31,000 different long-term care facilities have already asked for the pharmacy’s help. Similar to getting your flu shot, you’ll need to schedule an appointment to receive the vaccine, and clinicians will be reminding you of a next visit. «We’ll prompt them as they schedule their first vaccine to also schedule that booster, and much like we do today with refill reminders so that you stay current to your medications, we’ll be providing an awful lot of friendly nudges so that you don’t miss that first appointment and, equally important, that second appointment.»

        The Department of Health and Human Services has already announced a partnership with a string of national chains (some pharmacies, others retailers outright) that will carry the vaccine. Here’s every pharmacy, clinic, and retailer where you may be able to receive a COVID-19 vaccine, with more information on where you can learn more information or make an appointment:

        • Albertsons: This includes all the retailers that are part of Albertsons Companies, Inc, such as Osco, Safeway, Shaws, Vons, Lucky’s, and Acme, among others. You can sign up for availability alerts and an appointment here.
        • Costco: You can make an appointment online, and receive updates for when the vaccine is available in your nearest market.
        • CVS Pharmacy: Learn more about how CVS plans to distribute vaccines here.
        • H-E-B Markets: Grocery locations with pharmacy services will partner with state governments to distribute shots, with more details here.
        • Hy-Vee: The grocer chain is hiring 1,000 pharmacists to help distribute vaccines in its stores.
        • Meijer: You can make online appointments for different services, including vaccinations.
        • Stop and Shop: You’ll be able to receive a vaccine at any of this chain’s in-store pharmacies when supplies become available, including at sister chains across the Eastern seaboard, including Giant, Food Lion, and Hannaford.
        • Publix: This Southeastern grocery chain will also offer vaccines to customers, and you can locate a local pharmacy with access to vaccines online.
        • Kroger: A grocery giant, Kroger will offer vaccines in its in-store clinics, as well as provide shots at stores like Harris Teeter, Fred Meyer, City Market, Pick-n-Save, and Dillons, among others.
        • Rite Aid: The pharmacies may provide COVID-19 vaccines to high-risk individuals earlier than others, according to its website (where you can also make an appointment).
        • Walgreens: Sign up for updates in real time and make an appointment online before heading to your nearest pharmacy.
        • Walmart: You can read more about the company’s plans to roll out vaccines to nearly all of its stores across the nation, and when the time comes, make a pharmacy appointment here.
        • Wegmans: Learn more about getting a shot at this chain, as well as its sister stores, like ShopRite, Acme, and Weis Markets, among others.

          Per an NBC News analysis, around 99% of Americans live within 50 miles of these places — but another 20% of the population will need to travel at least five miles. If you’re a resident of Alaska, Hawaii, California, Arizona, or Montana who doesn’t have access to these chains within 50 miles (approximately 700,000 do not), you may seek a vaccine from your direct primary care provider or a hospital or clinic in your area if it’s closer.

          How much will the vaccine cost?

          The short answer: It will be free. «Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost,» the CDC shares.

          But some vaccine providers may charge a nominal fee for their services, which should be made clear to you before you make an appointment. «Over the decades, if there was free vaccine being sent out to private doctor’s offices, or private clinic, or even public clinics, the providers — although the vaccine charge was zero — were allowed to charge a nominal fee,» Dr. Amler explains. «It’s for the cost of providing the vaccine… putting an alcohol swab on your arm, and so forth.»

          Are there any side effects associated with COVID-19 vaccines?

          First thing’s first: If you have concerns about the safety of this brand new vaccine, that is totally normal. «You should ask as many questions as you need to, to being to get [your] arms around the benefit and the risk of the vaccine; the very large benefit, and the small, small risk,» Dr. Amler says. «The risk has to be way below the benefit of a vaccine to be recommended. And that’s why these final reviews are in place this very month, to make sure that we have the right product going out there.»

          In approving the vaccine for emergency use, officials at the FDA shared that their review of Pfizer’s product didn’t reveal any serious risks for the public. In a statement, officials shared that «potential benefits outweigh the known and potential risks» and that «a thorough evaluation of the available safety, effectiveness, and manufacturing quality» was completed before the product earned approval.

          Recent headlines drew attention to the possibility of an impact on those with allergies, as officials in the United Kingdom report two healthcare workers — who had previously established allergies and carry adrenaline auto-injectors currently — had allergic reactions to Pfizer’s vaccine. According to CNN, these individuals reported symptoms like breathlessness and skin rash, consistent with an «anaphylactoid reaction.» Both individuals have since recovered, but the incident is a good reminder that (as with most vaccines) anyone with allergies should discuss a new shot with their doctor first.

          In an interview with CNN, current FDA Commissioner Stephen Hahn told the public that vaccine administrators will be instructed to have emergency medication on-site if someone develops an immediate allergic reaction to the vaccine. But healthcare providers will also be aware of any common allergens found within the vaccine they are administering, and should notify their patients ahead of time of any possible complications.

          Even if you are itching for a shot, it wouldn’t be a bad idea to let your doctor know you’re planning to get one ASAP, Dr. Berić-Stojšić says. There may be other health factors that may require a special follow up with care providers beyond allergies, and transparency is best.

          Who should speak to their doctor before asking for a COVID-19 vaccine?

          There are a couple of groups of people who should not receive the vaccine without speaking to their primary care provider first. Dr. Berić-Stojšić explains the risk to both of these groups:

          1. Children: The FDA’s emergency release stipulates that patients must be 16 years old to receive a vaccine at this time, but Dr. Berić-Stojšić suggests that teenagers are likely being directed by their healthcare provider to sign up (or they should be). No one under the age of 18 should be seeking a vaccine without a recommendation just yet, as Pfizer is still in trials with children as young as 12, the Times reports. «It seems [a majority of kids] may have this cross-immunity from all the immunizations vaccines they are normally receiving, and they seem to be doing pretty well as a group in comparison to other demographics,» she adds.
          2. Those living with chronic disease: A vaccine may impact some of the treatments associated with chronic diseases, particularly most forms of cancer. Anyone who is undergoing a form of treatment (even for diabetes, which is a high-risk marker) should discuss the vaccine with their care provider first.
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