Communicating About COVID-19 Vaccination
(Updated January 14, 2021)
COVID-19 vaccines currently available for use either have an Emergency Use Authorization (EUA; in the U.S.) or an Interim Order (Canada). See our chart, COVID-19 Vaccines, for a comparison of available COVID-19 vaccines. The chart below answers common questions your patients may have about COVID-19 vaccination and includes talking points and strategies to address COVID-19 vaccine misconceptions.
Question |
Answer/Pertinent Information |
COVID-19 vaccines are being approved more rapidly than other vaccines. How can you reassure patients about this expedited approval process? |
The COVID vaccine has been developed at a more rapid pace than what is normally seen with other vaccines. But this does NOT mean safety steps have been skipped.34 The vaccine development process has been expedited because of the pandemic (e.g., early funding to ramp up manufacturing, overlapping phases of trials).34
COVID-19 vaccines are going through the same RIGOROUS approval process as other approved vaccines. Data are reviewed/analyzed by independent experts (i.e., not scientists employed by the manufacturer). The independent reviewer recommendations are then presented to the approving agency (e.g., FDA, Health Canada).50 Reassure patients that COVID-19 vaccine safety is a top priority.21,27 COVID-19 vaccines are being studied through phased testing to ensure safety and efficacy before they are made available to the public.
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Some of the COVID vaccines are utilizing new types of technology. How can you reassure patients these newer vaccines are safe? |
Many COVID-19 vaccines are a new type of vaccine (e.g., messenger ribonucleic acid [mRNA], viral vectors).22,35
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What are some talking points to use with patients who may be hesitant to get vaccinated for COVID-19? |
Remind patients about the benefits of COVID-19 vaccination. Vaccination may:16
Explain that the COVID-19 vaccine is one important tool in the toolbox to end the pandemic.16
Encourage vaccination as the safer path toward immunity.
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What are the expected short-term adverse effects with COVID-19 vaccination? |
Be transparent that patients may experience short-term adverse effects after vaccination (i.e., don’t sugarcoat or downplay these adverse effects). For other two-dose vaccines, this has been a well-received strategy in ensuring patients returned for their second dose (e.g., Shingrix vaccine).52
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What can patients do to minimize expected vaccine adverse effects? |
Help patients reduce and prepare for adverse effects. For example:
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Have there been serious or unusual adverse effects from COVID-19 vaccination? |
Serious adverse effects from COVID-19 vaccination seem extremely rare. But it takes time and large numbers of people getting vaccinated before we may know more about possible adverse effects. Safety monitoring will continue even after a COVID-19 vaccine is approved.4
There have been reports of severe allergic reactions including possible anaphylaxis, with the Pfizer/BioNTech COVID-19 vaccine.44,47,58 Anaphylaxis is a known, but rare side effect with any vaccine.44
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What are long-term safety concerns with COVID-19 vaccination? |
More time and data are needed to assess long-term safety of the COVID-19 vaccines. |
What are strategies to encourage patients to return for the second dose of their COVID-19 vaccination? |
Stress the importance of completing the vaccination series with the same vaccine (COVID-19 vaccines are NOT interchangeable),36 if more than one dose is needed (most COVID-19 vaccines currently in development require two doses separated by a few weeks).2
Help patients understand why two doses are used for many vaccines, including most of the COVID-19 vaccines.
Consider these tips to improve the likelihood patients will return for second doses:
See our toolbox, Medication Adherence Strategies, for other adherence ideas. |
What happens if the second COVID-19 vaccine dose is not given on schedule (too soon or too late)? |
To get the most benefit from vaccination, adhere to recommended intervals between doses when possible.53
For COVID-19 vaccines, it is too soon to know how early or late second doses will impact immunity.
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How long does it take to develop immunity after COVID-19 vaccination and how long does immunity last? |
It usually takes a few weeks after any vaccination to develop immunity.35 See our chart, Vaccines for COVID-19, for specific timing to develop immunity for each of the available COVID-19 vaccines.
We still don’t know how long immunity after vaccination will last.12,34 Explain that we only have data for as long as the trials have been going on.9 Once we have more data about how long vaccine-induced immunity lasts, it will be possible to determine how often patients may need to be vaccinated against COVID-19 to maintain immunity.12 |
Can a COVID-19 vaccine cause a COVID-19 infection? |
No.34 None of the COVID-19 vaccines currently in development use the live SARS-CoV-2 virus.6 |
Will COVID-19 vaccination lead to a positive COVID-19 test? |
COVID-19 vaccination may lead to a positive test for COVID-19 antibodies (serology tests).6 COVID-19 vaccination will NOT lead to a positive test for active COVID-19 infection (molecular or polymerase chain reaction [PCR] tests and/or antigen tests).6 |
If vaccine supplies are limited, who will be prioritized for vaccination? |
Vaccination may occur in multiple phases. Sub-prioritization within the phases may be needed when vaccine supplies are limited. For example:14,25,29
Per ACIP, there are currently four priority groups for COVID-19 vaccination if supply is limited. These priority groups include healthcare workers essential/critical workers (e.g., law enforcement, first responders, educators, grocery store workers, food manufacturers); people with certain underlying medical conditions that put them at risk for severe COVID-19 illness (e.g., cancer, chronic obstructive pulmonary disease [COPD], heart failure, severe obesity, type 2 diabetes); and people age 65 years and older.13 |
What do we know about COVID-19 vaccines during pregnancy? |
There are currently little to no data available about the safety or efficacy of COVID-19 vaccines during pregnancy.1,8,29 The medication and vaccine approval process typically assesses safety and efficacy in healthy women of childbearing age, before testing them in pregnant patients.30 Though pregnant patients were excluded from initial trials, information about vaccine effects and possible adverse effects are being collected (and will be evaluated) in patients that became pregnant during clinical trials.1,8 Data emerge every day about COVID-19. Stay informed, use shared decision making, and think about the following when COVID-19 vaccination is being considered during pregnancy:30
Gynecology and obstetrics experts, as well as the CDC, support offering mRNA COVID-19 vaccines to pregnant and lactating patients. As more data become available, updates to these recommendations will be made.49,56,59 |
What do we know about safety and efficacy of COVID-19 in immunocompromised patients? |
Patients who are immunocompromised were not included in early COVID-19 vaccine trials. We know that people who are immunocompromised are at risk for severe illness from COVID-19.37 We also know that people who are immunocompromised may have a lesser response to vaccinations compared to patients who are immunocompetent.40 Per the CDC, it is acceptable to offer an mRNA COVID-19 vaccine to patients with immunocompromising conditions.49 Be sure to counsel these patients about the lack of data and the potential for a reduced immune resonese.49 For patients who opt not to receive the vaccine, counsel patients to continue to follow recommendations to reduce risk of infection (e.g., social distancing, hand washing) and wait until we have more vaccine data in these patient populations.39,49 |
Can COVID-19 vaccines be given with other vaccines? |
There are no data available about safety or efficacy of coadministration of a COVID-19 vaccine and other vaccines.31 Initially, it may be best to separate vaccinations. This way adverse effects can be monitored and specifically linked to individual vaccines. For mRNA COVID-19 vaccines, give alone or with a minimum of 14 days before or after other vaccines.49 |
Should someone who has COVID-19 or who was previously infected get vaccinated? |
More data are needed to know if people who had COVID-19 will benefit from a COVID-19 vaccine.6 People may be advised to get vaccinated because COVID-19 is a significant health risk and there have been cases of reinfection. Explain it is not harmful to get a COVID-19 vaccine if you have had COVID-19 in the past. Previous COVID-19 infection (with or without symptoms) is NOT a contraindication to COVID-19 vaccination.29 It may be reasonable for people with past COVID-19 infections to delay COVID-19 vaccination until closer to 90 days after infection (especially when vaccine supply is limited), as reinfection during this timeframe is rare.29,49 Defer vaccination with an mRNA COVID-19 vaccine until patients have recovered from the acute illness.49 There is NOT clear guidance on whether or not to give other COVID-19 vaccines being studied to someone currently infected with COVID-19. In general, for most vaccines moderate to severe illness is considered a precaution against vaccination, while vaccination during a mild illness (with or without fever) is not a precaution.43 |
How will U.S. pharmacists bill for COVID-19 vaccinations? |
There will be no charge to patients for the COVID-19 vaccine (funded by the government). However, there may be an administration fee for vaccination.2
For COVID-19 vaccines that require two doses, use submission clarification code (SCC) of:24
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Are safety precautions (e.g., masks, social distancing) still necessary after COVID-19 vaccination? |
Yes.34 Until more is known about “real world” protection provided by COVID-19 vaccines, advise patients to:2
It is too soon to know if COVID-19 vaccines will stop a person from spreading the virus, even people who are asymptomatic. For example, it may be possible that if someone was vaccinated and then exposed to the virus, though they might not get sick, they could still spread the virus to others.9 Implementation of safety precautions may change over time as we learn more about the protection provided by COVID-19 vaccination. The number of people who get vaccinated and virus spread in local communities may also play a role in determining this.2 |
- For more information about the V-SAFE monitoring system go to https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-09/COVID-03-Shimabukuro.pdf.
- Operation Warp Speed is comprised of Department of Health and Human Services (HHS), including the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Biomedical Advanced Research and Development Authority (BARDA), and the Department of Defense (DoD).
Prepared by the Editors of Therapeutic Research Center (370101); Last modified January 14, 2021.
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Cite this document as follows: Clinical Resource, Communicating About COVID-19 Vaccination. Pharmacist’s Letter/Prescriber’s Letter. January 2021.