Your Questions Answered
- Is it safe for my child to go to summer camp this year?
Summer camp is a great way for children to socialize, learn new skills and engage in healthy physical activity. For parents concerned about their children attending camp this year due to COVID-19, here is the latest guidance. The U.S. Centers for Disease Control and Prevention says that children who are fully vaccinated can safely attend summer camp and they do not need to wear masks or engage in other COVID precautions such as social distancing, except where required by state and local laws and regulations. Camp organizers should be supportive if a vaccinated child wishes to continue wearing a mask. At camps where some children may not be vaccinated, the CDC advises that vaccinated children still don’t need to wear masks, but unvaccinated children are “strongly encouraged” to wear masks, especially indoors and in crowded area outdoors. Vaccines are currently available to all children 12 years old or older. Camp organizations are advised to hold as many events as possible outdoors, maintain maximum ventilation during indoor activities and to regularly clean and sanitize high-traffic areas to reduce potential spread of a virus.
- Will the COVID-19 vaccine protect me if I am immunocompromised?
For millions of Americans with compromised immune systems, the protections provided by the COVID-19 vaccines are not a sure thing, providing another reason for unvaccinated individuals to get vaccinated or at the very least, continue wearing masks.
Immunocompromised individuals – those with certain medical conditions such as blood cancers or who have received an organ transplant - currently make up between 3-4 percent of the U.S. population. Early research shows that many of these individuals, once vaccinated, are generating few of the protective antibodies needed to fight COVID-19. Their weakened vaccine response may be due to certain immunosuppressive drugs and steroid regimens associated with their condition. A study published in JAMA in May 2021, found that 46 percent of 658 organ transplant patients who were vaccinated did not mount an antibody response after two doses of the Pfizer-BioNTech or Moderna vaccines.
But the possibility of a muted vaccine response should not deter individuals from getting a COVID-19 vaccine. The U.S. Centers for Disease Control and Prevention (CDC) has stated that because COVID-19 vaccines in the U.S. do not contain any live coronavirus, they can be safely administered to immunocompromised people” and “immunocompromised people can receive COVID-19 vaccination.”
People with autoimmune conditions such as rheumatoid arthritis and systemic lupus also may receive any FDA-authorized COVID-19 vaccine, according to the CDC.
Because people who have compromised immune systems, those taking immunosuppressive drugs, and others with certain underlying medical conditions are at higher risk of getting severe COVID-19, the CDC advises that they speak with their health care provider about getting vaccinated.
The CDC provides specific COVID-19 vaccine considerations for people with certain underlying medical conditions, including those with compromised immune systems, on its website.
COVID-19 Booster Shot Explored
Looking forward, researchers are currently exploring whether COVID-19 vaccine booster shots may increase antibody generation in individuals who are immunocompromised.
- There are many of us who cannot take or do not want to take the COVID-19 vaccine. Are there therapeutics available to treat people who become infected with COVID-19?
According to the Centers for Disease Control and Prevention (CDC), “The spectrum of medical therapies to treat coronavirus disease 2019 (COVID-19) is growing and evolving rapidly, including both drugs approved by U.S. Food and Drug Administration (FDA) and drugs made available under FDA emergency use authorization (EUA).” The National Institutes of Health (NIH) has updated information on these approved therapeutics as well as treatment guidelines for clinicians. For those choosing not to receive a COVID-19 vaccine, the CDC strongly recommends continuing to wear masks, practicing physical distancing, and good hygiene, including thorough hand washing.
Note: On June 17, 2021, the Biden administration announced it was investing $3 billion for the development of pills to fight the coronavirus. If all goes well in clinical trials, some of the most promising pills could be available by the end of the year, according to the New York Times.
- I am 72 years old and experienced mild symptoms of COVID-19 last year. On several occasions since then, I have experienced audio hallucinations and on one occasion a visual hallucination. Could this be related to COVID-19?
- If you are experiencing a specific health problem that is concerning to you, it is important you contact your health care provider right away. Some people who have had COVID-19 continue to experience symptoms months after their initial diagnosis. These so-called “COVID long-haulers” have reported symptoms such as brain fog, dizziness, fatigue and headaches. The best thing to do is to contact your health care provider. This article from the American Medical Association explains more. If you are experiencing any of the COVID-19 emergency warning signs – trouble breathing, persistent pain or pressure in your chest, new confusion, inability to wake or stay awake, and pale, gray, or blue-colored skin, lips or nail beds (depending on skin tone), the Centers for Disease Control and Prevention (CDC) recommends that you seek emergency medical care right away.
- I hear that there is a microchip in the COVID-19 vaccine that can be used as a tracking device once it is delivered into my body. Is this true?
- There are absolutely no microchips in the COVID-19 vaccines. This rumor is believed to have started due to a misunderstanding about state electronic vaccine records. These digital records are kept by individual physicians on computer rather than on paper as part of the routine modernization of recordkeeping. Electronic patient medical records also allow health care providers to share information about a patient more easily when they are undergoing specialized treatment or in an emergency. But there are no electronic components in the COVID-19 vaccines or in any vaccines.
- My mom received a first dose of the Sinovac COVID-19 vaccine in Mexico and now is reluctant to get the second dose of that vaccine. She would rather receive the Johnson & Johnson vaccine. Is it safe to get multiple types of vaccines?
Yes. The CDC says that revaccination with an FDA- or WHO-authorized vaccine (like Johnson & Jonhson’s) may occur in cases where someone initially received a vaccine without those designations (like Sinovac).
Here is the CDC’s current guidance as of May 14, 2021:
People vaccinated with COVID-19 vaccines not authorized in the United States:
Some people may have received a COVID-19 vaccine that is not currently authorized in the United States. No data are available on the safety or efficacy of receiving a COVID-19 vaccine currently authorized in the United States after receipt of a non-FDA-authorized COVID-19 vaccine. However, in some circumstances people who received a COVID-19 vaccine not currently authorized in the United States may be offered revaccination with an FDA-authorized vaccine:
- COVID-19 vaccines not authorized by FDA but authorized for emergency use by WHO
- People who completed a COVID-19 vaccination series with a vaccine that has been authorized for emergency use by the World Health Organization (WHO) do not need any additional doses with an FDA-authorized COVID-19 vaccine.
- People who are partially vaccinated with a COVID-19 vaccine series authorized for emergency use by WHO may be offered an FDA-authorized COVID-19 vaccine series.
- COVID-19 vaccines not authorized by FDA or not authorized for emergency use by WHO
- People who completed or partially completed a COVID-19 vaccine series with a vaccine that is not authorized by FDA or not authorized for emergency use by WHO may be offered an FDA-authorized COVID-19 vaccine series.
Administration of an FDA-authorized COVID-19 vaccine in these people should comply with all conditions of use specified under the EUA for the vaccine being used. The minimum interval between the last dose of a non-FDA authorized vaccine and an FDA-authorized COVID-19 vaccine is 28 days.
NOTE: The CDC advises that individuals who begin a multi-dose vaccine treatment as required for both the Pfizer-BioNTech and Moderna vaccines, should complete that course of treatment with the same vaccine. CDC guidelines state COVID-19 vaccines are not interchangeable. The Pfizer and Moderna vaccines rely on mRNA vaccine technology and they are designed to be most successful when a second dose is administered several weeks after the first (Pfizer 21 days, Moderna 28 days). The Johnson & Johnson vaccine uses a different vaccine technology that requires only one dose.
- COVID-19 vaccines not authorized by FDA but authorized for emergency use by WHO
- Will we need a SARS-CoV2 vaccine booster? If so when?
According to the CDC: “The need for and timing for COVID-19 booster doses have not been established. No additional doses are recommended at this time.”
We asked Yale School of Public Health Assistant Professor Jason Schwartz, Ph.D., for his thoughts on the matter. Here is what he had to say. Dr. Schwartz is affiliated with the Department of Health Policy and Management, an assistant professor in the History of Medicine, and an assistant professor in the Institution for Social and Policy Studies at Yale.
Jason Schwartz: We know a tremendous amount about the currently available vaccines, evidence that has led us to be confident and enthusiastic about their safety and effectiveness. But as more and more vaccines are administered, we continue to learn more about them, as is the case with every medical and public health intervention that is implemented. The effectiveness of the COVID-19 vaccines has exceeded nearly all expectations, but no vaccine is 100% effective, and there have been extremely rare cases in which vaccinated individuals have subsequently tested positive for COVID-19. But those cases were generally mild, and they’ll become even less frequent as vaccination rates continue to increase.We don’t yet know precisely how long protection lasts following vaccination, but it’s thought to be at least six months – and likely considerably longer. That duration is being carefully monitored in case booster doses are needed for COVID-19 vaccines, as they are for other diseases.
- Can the vaccine prevent against the long-term effects of COVID as we've been hearing/seeing?
- While we have no data on this, it is inconceivable that reducing clinical disease and reducing viral loads via immunization will not reduce “long haul” COVID-19 residual disease.
- Isn’t it too early to see long term effects of the vaccines?
- Yes, but the nature of the vaccines is so precise in just generating antibodies to the spike protein of the virus that it is hard to imagine some mystery condition 5-10 years hence. The long-term effects of COVID-19 are also unknown, but we have enough information even now that it may not be a happy story.
- Could you please define vaccine efficacy according to vaccine protocols?
- There are multiple outcomes in each trial, typically some variation of these: COVID-19 infection and COVID-19 severe disease. Vaccine efficacy is calculated by comparing the incidence (proportion of persons within the time period who reach the defined endpoints of infection or disease) in the vaccine group with the incidence in the unvaccinated group. An example can help: a 95% vaccine efficacy means that instead of 10,000 COVID-19 cases in an unvaccinated population of 1 million (assuming 1% would get COVID-19 and 99% would not get it), there would be 500 cases (99.95% of the vaccinated population would be disease-free compared to 99% of the unvaccinated population).
- We know two people who have contracted COVID after being fully vaccinated, so can you explain the quarantine rules (it essentially being eliminated post vaccination) since someone vaccinated can still spread COVID even if they aren’t likely to get as sick.
- The data so far suggests that vaccinated persons are not likely to transmit virus, but the studies are small to date. 95% efficacy is not 100% so inevitably some vaccinees will get COVID-19. However, viral loads will be blunted and they will not get seriously ill.
- How long is a typical long-term study for these vaccines?
- These vaccinees will be studied for years, I think. But the “post-marketing surveillance” demanded for new products by the FDA brings in safety data and will also assess how fast (or whether) immune responses wane with time. This can be done in many more persons that those who were in the clinical trials.
- The COVID-19 vaccines were made at “warp speed.” Have they been around long enough to really know if they are safe?
- The COVID-19 vaccines approved for use have been extensively tested. Those tests have been independently verified by hundreds of scientists. Due to the public health emergency created by COVID-19, scientists around the world joined together in sharing critical information that resulted in the new vaccines being developed at unprecedented speed. But no steps were bypassed or overlooked. These vaccines went through the same rigorous review required of any new vaccine.
- Will the vaccine give me COVID-19?
- Pfizer/BioNTech’s and Moderna’s mRNA vaccines do not contain live SARS-CoV-2 coronavirus, so they cannot infect you with COVID-19. The Johnson & Johnson vaccine uses a modified adenovirus to carry the genetic code your body needs to fight COVID-19. Adenoviruses are mostly known to cause mild cold-like symptoms, but scientists altered the adenovirus used in the vaccine so that it won’t cause any disease.
- Will the vaccine change my DNA?
- The messenger RNA used in the Pfizer and Moderna vaccines does enter your cells, but it stops there. It doesn’t enter the nucleus of your cells that contain all of your DNA. And just like in Mission: Impossible, the mRNA is destroyed by the cell after it receives its instructions.