House Call: Answering patients’ 10 questions about COVID-19 vaccinations

Throughout history, vaccines have helped us overcome terrible diseases like polio and smallpox.

But while it took Jonas Salk more than seven years to develop the polio vaccine, U.S. scientists and industry worked tirelessly to develop a pathway out of the COVID-19 pandemic in less than a year.

When our great-grandchildren read about this pandemic, the facts about this remarkable scientific breakthrough will be a truly inspiring tale.

As a health care provider, I was fortunate to have been able to receive COVID-19 vaccination early.

Even though eligible, however, many of my patients remain anxious and fearful about receiving the vaccine. I’ve been fielding many questions about the shots I received, side effects, risks and safety, and, unfortunately, many have held off on getting vaccinated due to those concerns and fears.

Last month, all Washington residents ages 16 and older became eligible for the Pfizer COVID-19 vaccine. This week, the Food and Drug Administration approved use of that vaccine for children ages 12 to 15, another big step in the fight against COVID-19.

As many of you are deciding whether to get vaccinated, I’d like to use this month’s column to answer the 10 most common questions that patients have asked me about the safety and efficacy of the COVID-19 vaccine and, I hope, reassure those who are still in doubt that vaccination is absolutely the right thing to do for a whole host of reasons.

How does the vaccine work?

Like most vaccines, the COVID-19 vaccines were created to prevent a virus from attacking the body. Each vaccine is designed to make your immune system recognize the virus and learn how to fight it. What’s new and different about the COVID-19 vaccines is the use of mRNA technology. Researchers have identified the proteins that allow COVID-19 to attack the body and the instructions to make these proteins.

The vaccine uses messenger RNA to teach your body to make a simple protein that stimulates the body’s immune system to manufacture antibodies and other specific defenses against the COVID-19 virus. The immune protection given by the vaccine has been shown to be sustained and transferable, even among the newer virus variants that have appeared.

Is the vaccine safe?

Yes. All COVID-19 vaccines were tested in large populations, so there’s significant data that the vaccines are effective and safe. For example, the Pfizer vaccine was tested in 44,000 people, and, throughout the world, many millions have been vaccinated without any known long-term side effects.

All COVID-19 vaccines are held to the same rigorous safety and effectiveness standards as vaccines for other diseases. The data shows these vaccines are highly effective, with Pfizer and Moderna vaccines proving to be 95% and 94% effective, respectively, at preventing COVID-19. The mortality reduction is especially impressive and holds true across all vaccines tested.

What about the Johnson & Johnson vaccine?

After a temporary pause, the FDA and CDC have reaffirmed their approval of the Johnson & Johnson vaccine. The Johnson & Johnson vaccine was initially paused because doctors discovered a rare side effect that causes blood clots primarily in female patients.

Additional research, however, found the side effect only occurred in 15 people out of more than 8 million doses administered. If you have a history of strokes or low platelet counts, you might want to speak to your doctor about what vaccine to receive even though the likelihood of you being impacted by this side effect is about 1 in 1 million.

COVID-19 is a deadly disease that kills 1 of every 100 people it infects. Vaccination gives you a much higher chance of survival if you encounter the disease. There is no comparison of the relative risk.

Why should I get more than one shot?

For the two-dose vaccines, receiving one dose does provide you with protection, though we do not know the full extent of the protection or how long it might last.

Receiving only one dose is not as useful as receiving the full second dose. Given the spread of the virus and the serious health risk it poses, the second dose is strongly recommended.

Why is it important that as many people as possible get vaccinated?

Getting vaccinated protects more than just yourself – it also means you are less likely to spread COVID-19 to your family and friends. For example, if 80% of a population is immune to a virus, 4 of 5 people who encounter someone with the disease won’t get sick (and won’t spread the disease any further).

Measles, mumps, polio and chickenpox are examples of infectious diseases that were once common but are now rare in the U.S. because vaccines helped to establish widespread immunity. We have a social responsibility to avoid spreading the virus to our neighbors, grocery store workers and everyone else around us.

As more people gain immunity from vaccines or from recovering from COVID-19, the virus will spread less and less. When you are deciding whether to get the COVID-19 vaccine, it’s important to remember that what we do affects everyone we interact with, not just ourselves.

Are there other benefits to vaccination?

As vaccines become more available, being vaccinated could help you travel, attend sporting events and see friends at restaurants. Many businesses, such as airlines, colleges and bars, are considering requiring proof of vaccination for their patrons.

When motivating younger patients, I always tell them that getting vaccinated will make it easier for them to get jobs and participate in sports. Most important, vaccination keeps your grandparents and parents safe from infection. If you become a super-spreader, you will have to live with impacts on your family and co-workers for the rest of your life.

Finally, some people who become sick with COVID-19 end up with long-term effects. These “long-haulers” suffer from heart issues, persistent fatigue and confusion. Even if you feel you are not at risk from dying of COVID-19, the disease could stick with you and cause problems for the long haul.

Are there any side effects to vaccination?

After vaccination, many patients experience a sore arm at the site of the injection. Some patients report that their second shots can cause minor flulike symptoms such as aches, fatigue, chills or a low-grade temperature.

I tell my patients that these reactions are a sign that the immune system is working. Side effects are generally short-lived and can be managed with Tylenol and rest. The relative risk of vaccine side effects pales in comparison to the risk of death from getting COVID-19.

When will my children be able to get the vaccine?

Because adults have been shown to get sicker from COVID-19 than children, the first vaccines were developed for adults. The FDA approved Pfizer COVID-19 vaccines for children ages 12-15 this week, and providers are preparing to expand to this additional age group. So far, only the Pfizer vaccine is used for patients younger than 18.

Where can I get vaccinated?

You can visit the Washington Department of Health website to find a free vaccination appointment near you at vaccinelocator.doh.wa.gov. Many pharmacies such as CVS and Walgreens offer free vaccinations. Kaiser Permanente offers free vaccination to members and nonmembers alike at Riverfront Medical Center.

You can also attend a mass vaccination site. The Spokane Arena is offering free vaccinations by appointment on Tuesdays, Thursdays, Fridays and Saturdays. You can sign up for an appointment here.

Finally, your regular health care provider can either administer a vaccine or help you find a place to get vaccinated. Just reach out to your doctor, and they will be more than happy to help you get your shots.

Do I still need to take precautions after vaccination?

Until roughly 80% of the population acquires immunity, it is still important to follow COVID-19 safety guidelines. This includes regular handwashing and social distancing indoors when possible.

In Spokane County, 36% of adults have received at least one dose of the vaccine, and 22% have been fully vaccinated. After vaccination, you should still wear a mask when you enter an enclosed space such as a restaurant or grocery store, and always follow all local health department guidelines.

While the COVID-19 vaccination provides a high level of protection, there is still a small chance you could catch the disease. I recommend wearing a mask in situations that have proven to be super-spreader events like attending indoor religious services where people are singing and indoor weddings.

The good news is once enough people are vaccinated, you will no longer need to wear masks in public – another reason to encourage your friends and family to get vaccinated. I for one am looking forward to the day we no longer have to wear masks.

Vaccination is the best way to prevent ourselves and our families from getting COVID-19. With the vaccine widely available, I encourage you to protect yourself and your community by getting vaccinated.

Dr. Jeff Markin is a family medicine physician practicing at Kaiser Permanente’s Veradale Medical Center.