Address New Questions About COVID-19 Vaccines

You'll get more questions about COVID-19 vaccinations.

Vaccine choice. Urge eligible patients to get immunized ASAP with ANY COVID-19 vaccine...Pfizer-BioNTech's or Moderna's mRNA product or Johnson & Johnson/Janssen's viral vector option.

Emphasize the "best" vaccine to get is the one that's available.

Educate that all 3 vaccines have at least 85% efficacy at preventing severe COVID-19...such as cases leading to ICU admissions or death. Plus efficacy seems similar for younger and older adults.

Explain that these are not live vaccines...and can be given to immunocompromised patients and pregnant or breastfeeding moms.

Asymptomatic spread and variants. Growing data suggest these vaccines decrease asymptomatic COVID-19 cases and transmission.

And expect evidence to continue to emerge about how vaccine efficacy holds up against viral variants.

For now, advise to keep wearing a mask in public after immunization. But CDC says it's okay not to wear one, even indoors, with other fully vaccinated people...those who are at least 2 weeks after their final dose.

Adverse effects. These are similar overall for the 3 vaccines.

Patients may hear about "COVID arm"...a large, red, itchy reaction around the injection site a week or so after mRNA COVID-19 vaccination.

Reassure that this is uncommon and NOT a reason to avoid the second dose. Consider giving the second dose in the opposite arm.

Dispensing. Be aware, some hospitals are making use of extra doses from vaccine clinics by offering them to admitted patients.

Help develop a process at your facility. For example, identify inpatients due for their second mRNA vaccine dose...which product they got for the first dose...and how to document administration.

Try to avoid delays. Doses of mRNA vaccines are only good for 6 hours at room temp or in the fridge...from the time Pfizer-BioNTech vials are DILUTED or Moderna vials are PUNCTURED.

And for the Janssen vaccine, doses are good for 6 hours in the fridge...or 2 hours at room temp.

Use our chart, COVID-19 Vaccines, for more on beyond-use dating, storage, dosing, etc...and details on the AstraZeneca vaccine.

Find answers to other FAQs in our chart, Communicating About COVID-19 Vaccination...including information to address ethical concerns.

Key References

  • www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html (3-30-21)
  • www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html (3-30-21)
  • N Engl J Med Published online Mar 3, 2021; doi:10.1056/NEJMc2102131
  • www.usp.org/covid-19/vaccine-handling-toolkit (3-30-21)
Hospital Pharmacist's Letter. April 2021, No. 370401



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