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FAQ: What you should know about getting the COVID-19 vaccine in Arizona

This story will be updated as we learn more about how the vaccine will be distributed in Arizona.

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Q: Do I need to be concerned about the Johnson & Johnson vaccine?

A: On April 13, the CDC and FDA recommended pausing use of the Johnson & Johnson vaccine amid concerns that it's connected to a "rare and severe" kind of blood clot. Six cases were reported. More than 6.8 million doses of the vaccine have been administered in the U.S. About 122,000 of those were in Arizona.

What is happening with Johnson & Johnson COVID-19 vaccine in Arizona

All six cases were in women between the ages of 18 and 48, with symptoms showing up six to 13 days after they got their shots.

With the Johnson & Johnson COVID-19 now under investigation for a potential connection to potentially dangerous blood clots, many people who got that shot are wondering if they need to be concerned. Dr. Michael White of Valleywise joined Javier Soto this morning to explain what happens now and what people need to know.

Q: What are the symptoms of this blood clot?

A: If you develop a severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination, you should contact your health care provider, the CDC and FDA say.

If you've recently had the J&J vaccine, watch for these rare symptoms, CDC says

Q: This doesn't happen with the Pfizer or Moderna shots?

A: The Pfizer and Moderna vaccines are mRNA vaccines, which are very different from Johnson & Johnson's viral vector vaccine. No clotting issues have been reported with either.

Q: I've heard "mRNA vaccine" a lot. What does that mean?

A: First, although it has to do with genetics, an mRNA vaccine does not change your DNA. Second, mRNA vaccines are not new.

Messenger RNA teaches our bodies to create what's called a spike protein to trigger an immune response and then it disappears. The spike protein is on the surface of the virus that causes COVID-19. As part of the immune response, our bodies recognize that the spike protein is an invader and builds antibodies. It's the same thing that happens if you get infected with the coronavirus.

The vaccines you've had before now put a weakened or inactive germ into your body to get it to make antibodies. Flu and polio shots use inactivated virus. The measles, mumps, rubella (MMR) vaccine uses weakened virus.

The challenge with traditional vaccines is that the virus has to be grown, which can be a time-consuming process. The production process for an mRNA vaccine is much faster because it's created from a DNA template on a computer.

Q: Can I get a shot without an appointment?

A. No. You must register and schedule an appointment at a specific location.

Q: How do I do that?

It depends on where you plan to get your vaccination. You can use the ADHS Vaccine Finder tool to find a location that will work for you. Once you choose a place, you will need to register online. For vaccination sites run by the state or a county, you will register using the ADHS Vaccine Patient Portal. It's a good idea to set up your free account ahead of time. This will make the scheduling process fasters.

Guide: How to book an appointment to get your COVID-19 vaccine

If you're going to a clinic at a health care facility, a pharmacy, or some other location, they will have their own website for scheduling. Those links are including in the ADHS Vaccine Finder.

🡕 ADHS Vaccine Finder | 🡕 ADHS Patient Portal

News groups of appointments at state- and county-run facilities open every Friday at 11 a.m. Appointments also become available throughout the day -- every day -- when people cancel or simply do not show up.

Q: What happens if I just go to a vaccine site without an appointment?

A: Staff there will explain what you need to do to properly register and guide you to an exit.

Q: My 16- and/or 17-year-old wants to get the vaccine. Can I send them on their own or with a sibling or friend?

A: No. A parent or guardian must accompany a minor getting a vaccine. Also, the Pfizer vaccine is the only one approved for people 16 and older, so keep that in mind when you make their appointment.

Q: Is the vaccine safe?

A: While there have been some cases in which patients had an allergic reaction to its vaccine, Pfizer says it appears to be safe. 

Dr. Cara Christ, the directors of the Arizona Department of Health Services, said when people get the vaccine, they will need to stay put with their provider for about 15 minutes to make sure they do not have an adverse reaction. 

Neither Pfizer nor Moderna reported any serious side effects during their clinical trials. The most common side effects, according to the manufacturers, are not unusual with vaccines.

  • Pain at injection site
  • Muscle aches
  • Fatigue
  • Chills
  • Fever
  • Headaches
  • Swollen lymph nodes (Moderna)

While the testing process was accelerated, Teri Lukin, MS, FNP-BC, NC-BC says no phases or clinical trials were skipped. Since the FDA approved the Pfizer and Moderna vaccines for emergency use in late December, millions of doses have been administered. "If there were serious safety concerns, we would have mostly likely seen them emerge already," she explained.

"We need to let everybody know that the vaccine is safe, effective, and it's for everyone's benefit," Christ said.

The Centers for Disease Control and Prevention says the flu-like side effects are a sign that your body is doing what it's supposed to and building protection against the virus.

There are several things, however, that cannot be known yet, including what, if any, long-term effects the vaccine might have.

It's also not clear if the vaccine can prevent transmission of the coronavirus that causes COVID-19 or if it only prevents people from getting sick.

COVID-19 vaccine may protect you, but whether it prevents transmission is unknown

Q: I had COVID-19. Do I still need to get the vaccine?

A: Yes, eventually. If you had COVID-19, you already have some immunity that could last for up to seven months. The CDC is asking those who have had COVID-19 to wait on their vaccinations until those who have no immunity have gotten their shots.

Q: What are some of the side effects of the vaccine? Are there long-term effects?

A: The most common side effects of the COVID-19 vaccine include swelling, redness, and soreness at the injection site, which is the same as with most other vaccines. Lukin said massage at the injection site, a cool compress, and taking Tylenol or ibuprofen can help ease the discomfort. Do not, however, take ibuprofen before you get your shot. Some studies show that it can decrease the efficacy of the vaccine. "It's totally fine to take it afterward," Lukin said.

Doctors advise against taking over-the-counter painkillers before COVID-19 shot

In addition to a sore arm, chills, fatigue, body aches, and even a fever, can be expected, as well. They're called systemic side effect "Although those mimic the symptoms of COVID-19, it is not. You are not getting a 'mild case' of it," Lukin explained.

Systemic side effects mean your body is doing what it is supposed to -- creating antibodies to fight off the virus. 

Lukin also noted that those systemic side effects seem to be more common in young people who have active immune systems. They also tend to show up more after the second dose.

While we don't yet know the long-term effects of the vaccine because the data specific to these vaccines simply does not exist yet, Lukin said mRNA vaccines have been used for quite some time in animal kingdom without long-term effects. That and the fact that very few other vaccines have long-term effects "gives us a lot of reassurance" about what we might see down the road, according to Lukin.

"One thing we do know for sure is that COVID-19 can have long-term effects," she explained. As many as one-third of COVID-19 patients deal with what's called "long COVID." "They can have symptoms for months afterwards," she said. "We know that there can be very serious long-term effects from the illness. I think you need to balance that with not knowing what the possible long-term effects of the vaccine are."

Q: What about these new strains of the coronavirus? Will these vaccines work?

A: Yes, the current vaccines appear to be highly effective against the variant strains that we're seeing. "It might not be 100% effective," Lukin said. "The efficacy doesn't decline significantly."

She also said that because these are mRNA vaccines, an updated vaccine could be created in about 90 days.

Q: Where can I get the vaccine?

A: There are hundreds of locations all over the state. Use the ADHS Vaccine Finder tool to find a location that will work for you.

Q: How many shots do I have to get?

A: It depends on which vaccine you get.

Two doses are required for the Pfizer and Moderna vaccines. The second dose comes 21 or 28 days after the first, depending on which vaccine you get. Whichever version you get, your second dose must be the same as the first. So, if you got the Pfizer vaccine for your first dose, your second shot must also be the Pfizer vaccine. They are not mix and match.

The Johnson & Johnson (Janssen) vaccine is the only sing-shot option approved by the FDA.

Where you can get Johnson & Johnson and other COVID-19 vaccines in Arizona

Q: What if I can't get the second Pfizer or Moderna shot in time?

A: It should not be an issue. Your second appointment will be scheduled right after you get your first dose.

That said, don't panic but get that second dose as soon as you can. Studies show that you can delay for up to six weeks and still get the full benefit. If you go longer than that, there might be a slight decrease in efficacy.

Q: Am I protected after the first shot?

A: Yes and no.

"While some protection will be obtained two weeks after the first dose, full protection will not be achieved until one to two weeks after the second dose," Dr. Christ said. "That second dose is very important."

Q: Do I have to go to the same place for my second shot?

A: No. You do, however, have to be sure you get the vaccine from the same manufacturer. If your first dose was Pfizer, your second dose must also be Pfizer. The vaccines are not "mix and match." 

Q: I'm not a resident of Arizona. Can I still get vaccinated here?

A:  Yes. "Individuals will be taken in order based on their priority population not based on residency status," according to Maricopa County' COVID-19 vaccine webpage. "Identification, such as a driver's license or employer ID badge, may be required to verify eligibility for the phase they are registering."

That said, health officials strongly encourage people to get their second shot at the same place they got the first one. If that's not possible, you will get a vaccination record noting which vaccine you got and when. This is important because the two versions of the vaccine are not interchangeable, and the timing of the second shot is essential for each vaccine to work properly.

Q: How many vaccines have been administered? Where is my county in the process?

A: ADHS posts the current numbers on its Find Vaccine webpage. It also includes links and phone numbers for vaccination sites by county.

Q: Will this vaccine be a yearly thing like the flu shot? Will I need periodic boosters?

A: There's no certain answer to that yet, but medical experts seem to be leaning toward an annual shot like the flu vaccine. Viruses mutate over time and vaccines have to be adjusted to be as effective as possible against current strains. It's probably not a one-vaccine-fixes-everything-forever approach.

Medical researchers are still learning about the body's responses to the coronavirus and how the antibodies to it work. There's still quite a bit that's unknown.

"It's very unlikely that it's going to be two [doses] and done," Lukin said. "There probably will need to be boosters. The hope is that once we get to herd immunity -- which is about 80% -- the virus will just have no place to go and it will start to fade away. ... It is likely that there will be repeated vaccines. It's just too early to tell how often and how many." 

Q: What's herd immunity?

A: Unlike bacteria, viruses can't live on their own. They need a host. "What we're hoping to do is just not have any hosts available for them," Lukin explained. 

Herd immunity happens when a percentage of a given population is immune to a disease, making the person-to-person spread of the germ less likely. If there's nobody to get sick or pass along the disease, the virus has nowhere to go. "As a result, the whole community becomes protected — not just those who are immune," according to MayoClinic.org. Herd immunity is generally created by a combination of vaccinations and natural infections. 

Medical experts says between 70% and 80% of a community needs to be immune to the coronavirus that causes COVID-19 to have herd immunity. That percentage, however, depends on the virus. The measles, for example, is highly contagious. Mayo Clinic says 94% of the population has to be immune to stop the spread.

It's possible to reach herd immunity, then lose it. Repeatedly. Here's what you can do to help prevent that from happening

Q: Can my employer require me to get the vaccine? If I don't do it, can I be fired?

A: The short answer is possibly.

If you have an underlying medical condition, you might be exempt under the Americans with Disabilities Act. Title VII of the Civil Rights Act provides similar protection for people with "sincerely held" religious beliefs against vaccines.

If you are exempt, you and your employer would need to work together to come up with "reasonable accommodations." What that looks like varies. It could be remote work or it could be using personal protective equipment (PPE) at the workplace.

Absent those two exceptions, you will be taking a risk against your employer's mandate. Employers have the right to enforce their requirements.

"If your employer requires it, and you don't do it, then it is likely you'll lose your job," said attorney Logan Elia with Rose Law Group.

Employers can require COVID-19 vaccine with few exceptions, attorney says
What to know if your employer wants you to get vaccinated for COVID-19

Q: Once I get the shot, I won't get sick, right?

A: Nothing in life is certain except death and taxes, but Pfizer says its vaccine is 95% percent effective at preventing COVID-19. Moderna puts its vaccine's efficacy at 94.5%.

It takes time for your body to build immunity, at least a couple of weeks. So, if you're exposed to the virus right before or right after being vaccinated, your body will not have had time to build up its defenses. 

🔗 Yes, you can still get infected with Covid-19 after being vaccinated. Here's why

It's also important to remember that no vaccine is 100% effective. You should still take precautions.

If you do develop the disease, you probably will not get as sick as you might have otherwise. You might even be asymptomatic.

Also, it's still not clear if people who have been vaccinated can transmit the coronavirus to others.

Q: Will I still have to wear a mask and socially distance after getting the vaccine?

A: Medical experts say yes. While Pfizer says its vaccine is effective at preventing people from getting COVID-19, it's not clear yet if it has any effect on transmitting the virus. So, even if you do not get sick, you could still be contagious.

"It will be important for everyone to continue taking precautions, even after being vaccinated, to ensure that we are protecting our loved ones and those around us," according to Dr. Christ.

COVID-19 vaccine may protect you, but whether it prevents transmission is unknown

Medical experts worldwide have made it clear that masks are not just to protect the wearer but also to protect everyone around them.

"It's possible that someone could get the vaccine but could still be an asymptomatic carrier," said CNN Medical Analyst Dr. Leana Wen, an emergency physician. "They may not show symptoms, but they have the virus in their nasal passageway so that if they're speaking, breathing, sneezing and so on, they can still transmit it to others."

Q: I'm pregnant. Should I get the vaccine?

A: "There are no clinical trials yet conducted in children or pregnant women," Dr. Christ said. "As we get more information, will be adding more information about kids and pregnant women."

Q: What about my children? Can they get the vaccine?

A: The short answer is no. The FDA has approved the Pfizer vaccine for people 16 and older. Both Moderna and Johnson & Johnson are for people 18 and older. Both Pfizer and Moderna are looking at how their respective vaccines work in younger teens, but no trials have been completed yet.

Q: There are three versions of the vaccine? What's the difference?

A: For Pfizer and Moderna, the two-does mRNA vaccines, the three biggest differences are the storage requirements, whether the vaccine needs to be diluted before being administered, and the dosage amount and timing, according to the FDA and pharmaceutical experts.

The Pfizer vaccine must be stored at subfreezing temperatures -- -94 degrees. Transporting the Pfizer vaccine requires a complex "cold chain," including expensive ultra-cold freezers and dry ice. Also, it only lasts in the refrigerator for five days. Moderna's vaccine is a little more flexible.

It can be stored in regular freezers and has a refrigerated shelf life of 30 days. That means it's more easily transported and stored, and will be more widely available.

Dr. Art explains the how the two vaccines are different

Pfizer's vaccine must be diluted. It's given as two 100-microgram shots given 21 days apart.

Moderna's vaccine does not require dilutions. It's two 30-microgram doses given 28 days apart.

The third vaccine, the single-dose version by Johnsons & Johnson (Janssen), is a viral vector vaccine. That means is uses a weakened or inactive version of another virus to deliver instructions to the body to make the spike protein that in turn triggers the creation of antibodies. 

On April 13, the CDC and FDA recommended pausing use of the Johnson & Johnson vaccine amid concerns that it's connected to a "rare and severe" kind of blood clot. Six cases were reported. More than. 6.8 million doses of the vaccine have been administered in the U.S. About 122,000 of those were in Arizona.

What is happening with Johnson & Johnson COVID-19 vaccine in Arizona

Q: Can I choose which version of the vaccine I get?

Yes, in a way. You can choose where you go for your vaccine based on which version is offered. State-run facilities, for example, offer the Pfizer vaccine. What you cannot do is request a specific vaccine once you're at a vaccination site. They have what they have. The ADHS Vaccine Finder tool lists which vaccine is offered at every site. If you want a specific vaccine, pay attention to where you make an appointment.

Q: I've heard that the vaccines use cells from aborted fetuses. Is that true?

A: No. Both the Pfizer and Moderna vaccines are synthetic. They take advantage of a new approach to vaccines by using messenger RNA (mRNA). Traditional vaccines use a weakened or inactive virus to trigger an immune response. The mRNA vaccines do not work that way. "Instead, they teach our cells how to make a protein -- or even just a piece of a protein -- that triggers an immune response inside our bodies," explains the CDC. 

Diocese of Phoenix says only 2 COVID-19 vaccines are 'morally acceptable'

The main claim regarding the use of cell lines from aborted fetuses involves the AstraZeneca vaccine, which has not been FDA-approved yet. The Associated Press, among others, fact-checked the claim that researchers used cells from the lung tissue of a fetus aborted in the '60s in the production of its vaccine. While those cells, called MRC-5 cells, have been used in the creation of vaccines, AstraZeneca confirmed to AP that it does not utilize those cells in its COVID-19 vaccine. It did, however, use another cell line in its vaccine development -- clones of kidney cells from a fetus aborted in 1973. They were used in the production of the vaccine but are not in the vaccine, according to an expert in the field.

“What’s important for the public to know even if they are opposed to the use of fetal cells for therapies, these medicines that are being made and vaccines do not contain any aspect of the cells in them,” Dr. Deepak Srivastava told the AP. “The cells are used as factories for production. They are widely used in many aspects in biomedical science because they are so effective.”

Q: How much is vaccine going to cost me?

A: It's free to you. If a website asks you for credit card information when you're making an appointment to get a shot, it's probably a scam.

Trying to get a COVID-19 vaccination appointment online? Read this first

Q: Is getting the vaccine mandatory?

A: Not by the government. Your employer, however, might require it.

Q: Can I donate convalescent plasma after getting the vaccine?

A: No. 

People vaccinated can't donate convalescent plasma after; donations are needed now

CNN and AP contributed to this article.

 

Copyright 2020 KPHO/KTVK (KPHO Broadcasting Corporation). All rights reserved.

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