Covid-19 Vaccine Q&A: Chicago Physicians Weigh In

Covid-19 Vaccine Q&A: Chicago Physicians Weigh In

Even though the toll of Americans dying from Covid-19 continues to rise and Chicago specifically is seeing a surge in cases, hope is on the horizon. Scientists and public health officials expect that vaccines against the illness will eventually bring an end to the pandemic.

As of late March, the Food and Drug Administration (FDA) has approved three vaccines for use against Covid-19: the Pfizer and Moderna vaccines, which require two shots, and the Johnson & Johnson vaccine, which requires one shot.

As exciting as these new vaccines are, questions remain.

We spoke with several local physicians — Lakshmi Halasyamani, MD, chief medical officer at NorthShore University HealthSystem; John Segreti, an epidemiologist and medical director of infection control and prevention at Rush University Medical Center; and Mia Taormina, DO, an infectious disease physician at DuPage Medical Group — to get answers.

They urge anyone looking for reliable information about Covid-19 and the vaccines to consult their physician and to turn to official sources including the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and local health departments, such as the Illinois Department of Public Health and the Chicago Department of Public Health.

Q: If you’ve had Covid-19 already, do you need to get vaccinated?

“Yes,” Segreti says. “It is unknown how long the natural immunity to Covid-19 lasts, but it is estimated to last at least three months.”

You can receive a vaccine 14 days after you’ve had Covid-19, but it may be better to wait until you’re feeling better and are up to 90 days post-infection, some experts say. You should receive all vaccine doses, even if you contracted Covid-19 after the first dose of a two-shot series. “In the future, we may see that only a single dose of vaccine is needed in these individuals, so we will stay tuned in regard to any changes in guidelines,” Taormina says.

Q: Are Covid-19 vaccines not safe because their development was rushed?

“Vaccine development was not rushed,” Halasyamani says. “Vaccine development was safe, deliberate, and urgent, because of the tremendous toll Covid-19 has had and continues to have across the world. The processes used were methodical and relied on decades of scientific knowledge and progress.”

All Covid-19 vaccines currently used in the United States have been rigorously studied, and expert scientists have reviewed their efficacy data. The CDC and the FDA continue to monitor vaccine safety in real-time, which is a standard process for all vaccines and therapies.

Q: Do I need to wear a mask after getting vaccinated? 

“For the time being, you should continue to wear a mask in most situations, even after being vaccinated,” Segreti says. The other physicians also agree that it’s important to keep wearing masks when interacting with others who have not been vaccinated.

For people who’ve been fully vaccinated, the CDC has issued new guidance on their need for masks when visiting others who’ve also been fully vaccinated. It states that fully vaccinated people can visit other fully vaccinated people without wearing masks or maintaining social distance. A person is considered fully vaccinated two weeks after having received a second dose in a two-dose series and a first dose in one-dose vaccine.

Q: Can I still carry the virus and spread it after I’ve been vaccinated?

In short, no one knows for sure yet. However, Taormina prefers to play it safe. “While it is unlikely you will be a major spreader of disease if you have antibodies, we are still learning about transmission of Covid from vaccinated persons. Until we have more reassuring data, we have to still presume a vaccinated individual can spread this disease.”

Q: Is one vaccine better than the others?

“The available vaccines are all very good. Waiting for a particular vaccine when another may be available sooner would not be advised,” Taormina says. “You should get vaccinated when it is your turn with whichever vaccine is available first.”

Q: Do the vaccines give me the Covid-19 virus?

“None of the FDA-approved vaccines contain the live virus that causes Covid-19. As a result, you simply cannot get Covid-19 from the vaccine,” Halasyamani says.

Q: Are there situations where I should wait to get a vaccine?

“There are a few situations where you should wait to get the Covid-19 vaccine: If you are currently infected with Covid-19, if you have had a high-risk Covid exposure, if you have received specific treatments for severe Covid-19 infections, or if you have received another vaccine,” Halasyamani says.

“However, when making this decision, please consider your risk for Covid-19 infection,” she says. For example, you may not want to delay receiving the vaccine if you work with the public or in a community setting.

For these situations and others, such as if you are receiving immunosuppressive treatments, talk to your doctor to help you weigh the risks and benefits.

Q: Are severe reactions to Covid-19 vaccines common?

While people may experience temporary side effects from the vaccine, severe reactions are low. “Side effects like local tenderness, fatigue, and headache are common with the Covid vaccines,” Halasyamani says. “Overall, the risk of severe side effects like a severe allergic reaction is low.”

Recent data shows the risk of a severe allergic reaction to either the Pfizer or Moderna vaccine as 4.5 cases per one million doses administered. Prior to the Covid-19 vaccine, the risk of anaphylaxis — severe, potentially life-threatening allergic reactions — to vaccines was reported at 1 in every 1 million doses.

Q:  Why do some people react more strongly to the vaccine than others?

“We are still learning about this,” Taormina says. “It does seem that those who have recovered from Covid illness in recent months seem to have a more severe adverse reaction profile than others. This may be because the body already has been primed with these antibodies and vaccines act with a boosting effect. Fortunately, nearly all side effects are relatively mild, and those that aren’t are generally short-lived.”

Q: Should I not get the vaccine if I have seasonal allergies?

“Seasonal allergies or allergies to other medications or food do not prevent you from getting the vaccine. If you have a severe allergy to a food, venom, or medication, you may be monitored longer after receipt of the Covid vaccine,” Halasyamani says.

If you’ve had a reaction in the past to a food or medication that has required you to take epinephrine, you should plan to be observed for 30 minutes after receiving the vaccine to make sure you don’t have a reaction.

Individuals who are allergic to polyethylene glycol (the medication in Miralax and colonoscopy prep) should not get the mRNA (Moderna or Pfizer) vaccines, but they may be eligible for the Johnson & Johnson vaccine.

If you have a polysorbate-80 allergy, the CDC says  you should not get the Johnson & Johnson vaccine, but you may be eligible for the Moderna or Pfizer vaccines. Talk with your doctor to discuss your particular situation.

Q: When might children be able to be vaccinated?

“Pediatric vaccine trials are ongoing,” Segreti says. “We need information on the safety and efficacy of these vaccines before they will be approved for children. When that will be is not certain.”

On March 31, Pfizer-BioNTech announced that its clinical trial results for children ages 12 to 15 showed the vaccine was 100% effective and well tolerated in study participants. The phase 3 trial involved 2,260 participants, and researchers will monitor those who received the vaccine for two years after their second dose.

Q: Should pregnant people get vaccinated?

“Pregnant and lactating people should receive the vaccine,” Taormina says. “While there haven’t been specific studies on these individuals, we know that Covid illness can present some challenges in pregnancy. Available vaccines appear safe, and major obstetric [professional societies] agree that pregnant patients should receive Covid vaccine.”

Q:  Should nursing mothers be vaccinated?

“There is no evidence that the vaccine causes any problems for nursing mothers,” Segreti says. On the flip side, if a mother is vaccinated, it might help her baby. “There is evidence that the vaccine can potentially protect the baby because the immunoglobulin [a form of antibody] in the milk is transferred to breastfeeding babies,” he says.

Q: Is the vaccine mandatory?

“The vaccine is voluntary at this time,” Halasyamani says.

Q: Do I have to pay for a vaccine?

“You should not have to pay for vaccines anywhere,” Taormina says. “Vaccines are free.” If you are asked for insurance information, it is because there may be a billable, covered injection fee.

Q: Do the Covid-19 vaccines cause infertility?

“There is no evidence to suggest that getting vaccinated causes infertility,” Halasyamani says. “Also, there has been no decrease in fertility in individuals who had and recovered from Covid-19.”

Q: Have there been any other benefits of wearing masks and social distancing?

Mask wearing and social distancing have drastically cut down flu deaths this past year. Typically, there are 12,000 to 61,000 deaths per year in the U.S. due to the flu, but this season there have been under 600 deaths from flu since September 2020.

Taormina says, “It seems something as easy as wearing masks and not gathering in large groups certainly has benefits.”

Q: When will things go back to normal?

“This pandemic has forever changed us,” Taormina says. “While we are moving toward the necessary herd immunity so we can once again be able to move more freely around the country and internationally, mask wearing could be with us indefinitely, especially for those who are medically fragile or during peak viral seasons.”