A Primer on the COVID-19 Vaccines

By: Andrew P. Smith

Published: December 23, 2020

A Primer on the COVID-19 Vaccines

To date, two COVID-19 vaccines have been authorized for emergency use by the FDA. Produced by Pfizer and Moderna, the vaccines are in full distribution throughout the world; however they differ slightly in certain respects. Below is a brief primer on the two vaccines, along with post-vaccination considerations for health care personnel and residents of long-term care (LTC) facilities.

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Neither the FDA nor the vaccine manufacturers know how long either vaccine will provide protection from COVID-19 because there is no such data available. It is also unknown whether the vaccines are effective at reducing the severity of COVID-19.

The FDA recommends even those who have already had COVID-19 get one of the vaccines because data suggest that people who have had the disease can be at risk for reinfection.

The manufacturers, FDA, CDC, and other federal agencies will conduct safety monitoring of the vaccines as they are distributed. If safety concerns with the vaccines arise while the emergency use authorization is in effect, the FDA can revoke it and halt distribution.

Post-Vaccine Considerations for Health Care Personnel

Because COVID-like symptoms could occur following receipt of the vaccine, the CDC says it is possible health care personnel could be unnecessarily excluded from work if vaccination symptoms are mistakenly identified as COVID-19 symptoms. Conversely, the CDC believes there is a risk COVID-positive health care personnel could be allowed to work, as COVID-19 symptoms could mistakenly be identified as those associated with the vaccine.

In order to reduce disruptions in care due to this risk, the CDC has released guidance for health care personnel to evaluate and manage post-vaccination symptoms to accurately differentiate them from symptoms of COVID-19.

Located here, the guidance offers tips on recognizing COVID-19 symptoms in those who have been recently vaccinated (e.g., cough, shortness of breath, rhinorrhea, sore throat, loss of taste or smell) and suggested approaches.

Post-Vaccine Considerations for Long-Term Care Residents

The CDC has similar concerns for long-term care residents. In addition to continuing to follow the Infection Prevention and Control Recommendations previously issued, the CDC now recommends additional approaches to evaluating and managing post-vaccination signs and symptoms for residents of LTC facilities.

Located here, the CDC recommends residents with symptoms that may be from the vaccine or the virus itself be restricted to their current room and closely monitored until fever (if present) resolves and symptoms improve. According to the CDC, if the resident’s symptoms resolve within 2 days, precautions can be discontinued. Fever, if present, should have resolved for at least 24 hours before discontinuing precautions.

Importantly, the CDC advises that most systemic post-vaccination signs and symptoms are mild to moderate in severity, occur within the first three days of vaccination, resolve within 1-2 days of onset, and are more frequent and severe following the second dose and among younger persons compared to those who are older (>55 years). Cough, shortness of breath, rhinorrhea, sore throat, or loss of taste or smell are not consistent with post-vaccination symptoms, and instead may be symptoms of SARS-CoV-2 or another infection.

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