What is an mRNA vaccine and how does it work?
Most vaccines (or immunizations) work by injecting a weakened form of a disease germ into your body. This is usually done with a shot in the arm or leg. Your body detects these germs and makes antibodies to fight them. Those protective antibodies then stay in your body for a long time. In many cases, they stay for the rest of your life.
A messenger ribonucleic acid (mRNA) vaccine is a different kind of vaccine. It works by giving your cells instructions that tell them to make a special protein called a “spike protein.” Your body’s immune cells respond to this spike protein just like they would to a weakened disease germ from a regular vaccine. They make antibodies to fight it. The spike protein instructions in the COVID-19 mRNA vaccine help your body make antibodies that prevent the virus that causes COVID-19 (called SARS-CoV-2) from entering your cells and causing disease. This keeps you from getting sick.
The instructions from the mRNA vaccine don’t interact with your DNA in any way. In fact, once the instructions are copied, your body quickly breaks down the mRNA and removes it from your system.
How does the Johnson & Johnson COVID-19 vaccine work?
The Johnson and Johnson vaccine uses a modified adenovirus to introduce DNA for the spike protein into cells. Adenoviruses typically cause the common cold, but the virus in the vaccine has been modified so it can’t replicate, make copies of itself, or cause disease. This modified virus is simply a vehicle (like a car or bus) that transports the DNA for the spike protein into cells where it is dropped off in the nucleus and instructs the cell to make the protein. The viral DNA does not interact or change your DNA, so it is very safe. This technology has been studied for decades and has been used in other vaccines with no safety concerns.
Can any of the vaccines cause COVID-19?
No. None of the vaccines are live and they do not replicate so they do not cause disease. The mRNA vaccine doesn’t actually contain the virus that causes COVID-19 and the Johnson and Johnson vaccine uses a different virus that does not cause COVID-19. The viral vector for this vaccine has been modified so it is not able to replicate, or make copies of itself, so it can’t cause disease.
What vaccines are available?
Three vaccines for COVID-19 have been authorized for emergency use in the United States. The U.S. Food and Drug Administration (FDA) has given emergency use authorization (also called EUA) to mRNA vaccines developed by Pfizer-BioNTech, Moderna, and Johnson and Johnson (Janssen). The Centers for Disease Control and Prevention (CDC) has recommended the Pfizer-BioNTech vaccine for people 12 and older and the Moderna and Johnson and Johnson vaccines for people 18 and older.
What is the difference between emergency use authorization and approval by the FDA?
FDA emergency use authorization is used for a medicine or vaccine when limited long-term data is available, but the benefits have been shown to outweigh the risks. EUAs can only be used during a public health emergency, such as the COVID-19 pandemic. Vaccines authorized with an EUA will continue to be studied. Additional safety monitoring and education are also required.
Why should I get a COVID-19 vaccine?
Clinical trials for the vaccines showed that they are all effective they at preventing severe COVID-19 disease, hospitalizations, and death due to COVID-19. By getting vaccinated, you are reducing your risk of serious illness and severe complications, hospitalization, and even death. You are also helping prevent the health care system from being even more overwhelmed.
How much does it cost to get the vaccine?
The federal government is providing the COVID-19 vaccines to the American public free of charge. This includes people who have insurance, including Medicare, Medicare Advantage, group or individual health insurance plans, and high-deductible health plans. It also includes people who don’t have health insurance.
During the public health emergency, insurance companies are required to cover the cost of giving the COVID-19 vaccines with no copay, deductible, or coinsurance for the patient. (Note that grandfathered health plans are allowed to opt out of covering the cost of giving the COVID-19 vaccine.) You do not have to pay to get the COVID-19 vaccines, even if you get it from a vaccine provider that isn’t in your insurance network.
How many doses are needed?
Both mRNA vaccines require 2 doses, delivered by a syringe (a shot). The shots are scheduled 3-4 weeks apart, depending on which vaccine you receive. Even though the vaccines are similar, you should get the same vaccine both times. The Johnson and Johnson vaccine is given as a single dose (shot).
On August 12, 2021, the FDA recommended an additional dose of either mRNA COVID-19 vaccine (Pfizer/BioNTech or Moderna) be given to certain individuals who are severely immunocompromised. The additional dose is only authorized for solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise. Other fully vaccinated individuals do not need an additional vaccine dose right now.
What are the side effects of the vaccines?
The vaccines can cause mild symptoms in some people. This happens because the spike protein instructions tell the immune cells to make antibodies. The most common reactions to the vaccine are pain at the injection site, fever, fatigue, headache, and muscle aches. These side effects are very common with other vaccines, including the flu shot. They are a sign that the body is responding the way it should to a vaccine
In rigorous clinical trials, the vaccines showed no serious safety concerns or severe side effects. However, the CDC and the FDA will monitor for side effects as the vaccine is distributed to the public. There have been a small number of people who had a severe allergic reaction (anaphylaxis) to one of the vaccines, but this is rare, and most people will not have any issues. But you will be asked about any history of reactions to vaccines or other injections just to be safe. If you have concerns or questions about any side effects after getting the vaccine, check with your family doctor.
How long does immunity last?
We still don’t know how long immunity lasts after you get a COVID-19 vaccine. We also don’t know how long immunity lasts after natural infection with the virus that causes COVID-19. There are some reports of lower levels of protective antibodies as soon as 3 months after infection. A few cases of reinfection have also been reported. We do know that being infected with seasonal coronaviruses (a source for the common cold) does not give very long-lasting immunity. This is part of the reason seasonal colds are so common every year.
Do I still need to wear a mask and physically distance if I get the vaccine?
Yes, the vaccine protects you from getting very sick by keeping the SARS-CoV-2 virus from entering your cells and causing COVID-19. But the vaccine does not keep you from getting the virus and possibly spreading it. Also, it takes a few weeks after the second dose of the vaccine to get the best protection.
On July 27, 2021, the CDC recommended that everyone wear a mask and practice physical distancing to prevent the spread of COVID-19, including the highly contagious delta variant, until more people have been vaccinated and developed immunity. Even then, more data will be needed to see how long immunity lasts.
Should I get the vaccine if I’ve already had COVID-19?
Yes, as long as you are not currently sick. We know that natural immunity to the virus that causes COVID-19 decreases over time. There’s not enough information from the COVID-19 vaccine studies to show how immunity from the vaccine compares to natural immunity. It’s likely the vaccine will boost your immunity and keep you protected longer.
Who can’t get the vaccine?
A vaccine is currently not available for children under the age of 12. Some people should talk with their family doctor before getting the COVID-19 vaccine. This includes people who have severe reactions to injected medicines and people who are immunocompromised.
As with other vaccines, people who have an allergy to any part of the vaccine should not get the shot. People who have a fever or other symptoms may not be able to get the vaccine until they’re better.
How do I report side effects after getting the vaccine?
If you have side effects (also called adverse events) after getting the COVID-19 vaccine, you should report them to the Vaccine Adverse Event Reporting System (VAERS). Talk with your family doctor if you have questions about what might be considered a side effect related to the vaccine.
The CDC will also be using a new smartphone-based tool called v-safe to send text messages to encourage people to report any side effects. Information on v-safe will be given to everyone who gets the COVID-19 vaccine. You will also get a card that tells you which vaccine and dose you were given and provides other information about the vaccine. You must opt in to get v-safe text messages on your smartphone.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.