According to the CDC, it is safe to do the following two weeks after your final shot:

• Resume activities that you did before the pandemic; however, to prevent the spread of COVID and its variants, you should continue wearing masks if you are at high risk, or if your community is at a high Community Level, but can take your mask off when outside

• Resume domestic travel without having to test before or after travel or self-quarantine after travel

• Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States

• Refrain from testing following a known exposure, if asymptomatic, with some exceptions for specific settings

• Refrain from quarantine following a known exposure if asymptomatic

• Refrain from routine screening testing if feasible

CEO’s Legal and Compliance team is keeping an up to date list of resources from state and local departments of health in jurisdictions with CEO sites. This resource is also linked on the homepage of the CEO Covid 19 Resource Site.

COVID-19 vaccines are being provided for free, both for people with and without health insurance. If you have health insurance, your provider may ask for your insurance information; however, you will not be charged for the shot. 

CEO's Mask Policy is currently in effect. Our policy allows fully vaccinated individuals to remove their mask when they are around other staff members. Unvaccinated staff and participants must continue to wear a mask, and all staff must wear a mask if participants are present or could enter unannounced. 

Some businesses and locations around the country still have mask policies, so regardless of vaccination status, the CDC is asking that you still comply with all mask guidelines set by businesses, workplaces, and local laws. Wearing a mask on all planes, buses, trains, and other forms of public transportation, and in U.S. transportation hubs (airports and stations) is required. 

Yes - Both of our medical insurance carriers, Aetna and Kaiser Permanente, offer telemedicine services that allow you to connect with a certified doctor from the comfort of your home.  

Due to the fast arrival of the vaccine, there has been a lot of conflicting information about its safety and effectiveness. It’s okay if you have questions! It is important that you get the most accurate, fact-based information from medical experts and doctors and now you can connect with your medical care team without having to leave your house. Both Aetna and KP members can access telemedicine services online or from a mobile app. Telemedicine services are included in your health plan, you simply pay your copay as you would for any routine visit.

For more information about how to access telemedicine services, visit the links below:

Aetna Members

Kaiser Permanente Members (CA Only)

There are many factors that combined to allow the COVID-19 vaccine to be developed quickly and safely:

• Researchers got a head start on developing a vaccine because the virus that causes COVID-19 is similar to other existing viruses. 

• Research about the new virus was shared almost immediately with scientists all over the world, which allowed work to begin on a vaccine right away.

• Some researchers were able to run phase one and two trials at the same time. See this helpful explainer from the New York Times on the phases of vaccine development. 

• The studies on COVID-19 included a larger number of people than other recent vaccine trials, meaning that they could get results from enough people faster than usual.

  • Moderna had 40,000 participants and Pfizer had 30,000. You can see publicly available data about the breakdown of the Pfizer study here and the Moderna study here (scroll down to Table 1).

• The federal government allowed manufacturing of the most promising vaccines to begin while the studies were ongoing. Though the government risked money if they weren’t effective, the Moderna and Pfizer vaccines were able to be distributed as soon as they were approved. And fortunately, the gamble paid off: both have 95% effectiveness rates.

It’s important to note that all vaccine developers are required to go through each stage of the development process and meet all safety and efficacy (how well something works) standards.

It’s true that some vaccine trials can take up to ten years to complete, while the Moderna and Pfizer trials were completed in ten months. 

What is easily misunderstood, is that the COVID-19 vaccine actually went through the same amount of total testing time as any other vaccine. The factors that accelerated the process were largely not related to testing time, and were about avoiding bureaucratic delays:

• Researchers did not have trouble recruiting trial participants, even with mandates that the trial groups had to over-represent people of color disparately impacted by COVID.

  • The Moderna Trial was delayed in August 2020 because they needed to increase the representation of people of color in the trials. This is why the Pfizer vaccine was approved first. 

• Researchers collaborated much more than usual because COVID-19 is a world-wide threat. While researchers often act in competition, everyone had access to the same information about the vaccine

• There was much greater government funding for COVID Vaccine Trials than usual.

• Drugs and vaccines have to be approved by the Food and Drug Administration (FDA) to ensure that only safe and effective products are available to the American public. In situations when there is good scientific reason to believe that a drug is safe and is likely to treat or prevent disease, the FDA may authorize its use even if definitive proof of the efficacy of the drug is not known, especially for diseases that cause high mortality.

• In the case of the COVID-19 vaccines, the FDA has issued EUAs to Moderna and Pfizer-BioNTech because their vaccines have been shown to be safe and effective against the virus, and there is an urgent need to get people vaccinated as quickly as possible.

• People can have allergic reactions to any medication or biological product such as a vaccine. Most allergic reactions occur shortly after a vaccine is administered, which is why the CDC recommends that persons with a history of anaphylaxis (due to any cause) are observed for 30 minutes after vaccination, while all other persons are observed for 15 minutes after vaccination. The Centers for Disease Control and Prevention recommends anyone with an allergy to "any component" of the vaccine not get the vaccine.

Severe allergic reactions to the COVID vaccines are extremely rare (occurring at a rate of 11.1 to 1 million shots, or 0.001% of cases, according to the CDC) and no one has died of anaphylaxis from the vaccine. 

• Although the large phase 3 trials of the Pfizer-BioNTech and Moderna Covid-19 vaccines did not include people who are pregnant, eligible people who are pregnant may be vaccinated. The two mRNA vaccines are not contraindicated during pregnancy, meaning there is not a symptom or condition that makes receiving this particular treatment inadvisable. People who are pregnant should consider the risks of Covid-19, which may be more severe in pregnant people, and the uncertain risk of vaccination. More information on the safety and efficacy of Covid-19 vaccines in people who are pregnant will become available over time. 

• People in the Pfizer vaccine got pregnant during the trial, indicating little risk of danger due to pregnancy or impact on fertility (received info from Mo C. - should flesh out more).

• The CDC has this resource page for those looking for more information on receiving COVID-19 vaccine while pregnant or breastfeeding.

The Pfizer/BioNTech vaccine is now eligible for everyone 5 years and older, and everyone 16 years and older can get the booster shot. More research is being conducted on COVID vaccines for those younger than 5, but as of today, this is not yet available.

No. None of the vaccines being studied are made up of materials that can cause disease. For example, the first vaccines approved by the FDA (from Moderna and Pfizer-BioNTech) use a small, harmless part of the virus’s genetic material called ‘mRNA’. This is not the virus. mRNA vaccines teach your body to create virus proteins. Your immune system develops antibodies against these proteins that will help you fight the virus that causes COVID-19 if you are exposed to it.

It varies, but nearly all side effects are minor. 

The most common side effects after vaccination include pain and/or swelling in the affected arm, and potentially fever, chills, fatigue, and/or headaches. Many people report feeling no side effects, and others report them lasting for a number of hours up to a day or two.

In rare cases, some people have had severe allergic reactions that can cause trouble breathing or swelling. It's just like when someone with a severe peanut allergy is exposed and needs an EpiPen, or has to go to the hospital. Because these reactions almost always occur 15-30 minutes after vaccination, medical professionals monitor this closely at the vaccination site.

Only a very small percentage of people who have received mRNA vaccines have experienced anaphylaxis: the CDC reports just 21 cases in the first 1.9 million Pfizer shots administered (.001% of people). Nobody has died from an allergic reaction from either shot.

You can read more about allergic reactions here and here. If you have any questions about potential allergies to the mRNA vaccine ingredients, please consult with your physician.

The Pfizer-BioNTech and Moderna vaccines are both mRNA vaccines. An mRNA vaccine uses a piece of messenger RNA — a set of instructions that tells a cell to make a specific protein. For COVID-19, this is the spike protein that is found on the surface of the viral envelope. The mRNA used in the vaccine does not enter the cell’s nucleus and consequently has no interaction with a cell’s DNA. It is also not a full virus and cannot replicate itself. The mRNA is rapidly broken down by the cell once the instructions have been transmitted, so it does not cause mutations or cellular defects, and has not been associated with infertility. Once the spike protein is made, it is put on the surface of the cell, where it is seen by the immune cells and causes them to become activated and respond. The result is the production of neutralizing antibodies. If a person who is immunized becomes infected with the virus, the neutralizing antibodies will bind to the virus and prevent it from entering cells and causing disease.

When scientists calculate the efficacy rate of a vaccine, they compare how many people in each of the two vaccine trial groups -- those who received the vaccine and those who received a placebo -- became infected with COVID. The efficacy rate of the vaccine is how much less likely someone is to get a symptomatic case of COVID if they received the vaccine compared to if they received a placebo. Looking at the Pfizer vaccine trial results is helpful in explaining this: 

# of people in group

Placebo: 21,830

Vaccinated: 21,830

# of people infected

Placebo: 162

Vaccined: 8

Moderate infection rate

Placebo: 0.74%

Vaccinated: 0.04%

# of severe infections

Placebo: 30

Vaccinated: 0

Severe infection rate

Placebo: 0.1374%

Vaccinated: 0.00%

To explain the math: the Pfizer trial showed that 162 people who did not receive the vaccine and 8 people who received the vaccine caught symptomatic cases of COVID. When divided by the total number of people in each group, the Pfizer scientists were able to determine the overall risk of moderate symptomatic infection for each group -- 0.74% for the placebo group and 0.04% for the vaccinated group. They then compared these two risk rates to see how much less likely someone who received the vaccine is to get a symptomatic case of COVID than someone who got a placebo: the vaccinated group’s infection risk is 0.7% lower than the placebo group (0.74% minus 0.04%). Divide that difference by the placebo group’s infection risk (0.7% divided by 0.74%) and you’ll get the efficacy rate: 0.946 or 94.6%. This means that the vaccine group’s chance of catching a symptomatic case of COVID is reduced by about 95%. 

To sum up: A 95% efficacy rate does not mean that 5% of people who get the vaccine will catch COVID; it means that someone who gets the vaccine is 95% less likely to develop a symptomatic case of COVID than someone who is not vaccinated.  

It’s also important to note that both the Pfizer and Moderna vaccine trials were completely effective against preventing the most severe cases of COVID. As you’ll see in the last two columns, zero vaccinated people in any of the trials were hospitalized or died of COVID-19 after the vaccines had fully taken effect (making severe infection rate 0%).

This is the million dollar question. Researchers are optimistic that the answer is no, but are still working to back this up. 

To answer this question, it’s important to understand the difference between being infected with the virus and becoming sick from COVID-19. Becoming “infected” means that the virus has entered and stayed in your system long enough for it to be detectable or for you to spread it to others. Becoming sick from COVID-19 means that you have been infected and that the virus is staying in your body long enough to cause symptoms.

As stated in other FAQs, we know that both the Pfizer and Moderna vaccines are highly effective (95%!) at stopping folks from becoming sick from COVID-19, both from mild cases or severe cases. 

But researchers don’t know if the vaccines stop people from being infected long enough to spread the virus to others.  

However, just because the research has not yet provided a clear answer does not mean that the vaccines do not work. Early research suggests the vaccines at least partly reduce transmission (we’ll share morein an FAQ next week) and there should be more data within the next couple of months. And in the increasingly unlikely event that vaccines don’t stop transmission, they will still help those who are vaccinated clear the infection without getting sick and needing treatment or hospitalization.

Answer 1: It takes two shots and five to six weeks for your body to build 95% protection from COVID-19. 

From the clinical trial data, we know that people reach 95% protection (see our last FAQ!) two weeks after their second shot (three to four weeks apart). That means people should assume it takes both shots and five to six weeks total for 95% protection. It takes time for your immune system to learn to fight the virus. The side effects that many individuals experience (see our 2/11 FAQ) are normal and mean that the body is building protection against the COVID-19 virus. The vaccines cannot make you sick with COVID-19. 

Answer 2: An early study from Israel suggests the Pfizer vaccine could be 85% effective after one shot, though it is not clear exactly when.

Israel currently has one of the highest vaccination rates in the world and has been able to study the impact of higher levels of vaccination over time. The early evidence is extremely promising. Yet there is much we still don’t know, such as: how long after the first shot 85% protection is reached, whether this will be true for individuals of all ages, or whether researchers are as optimistic about the first shot of the Moderna vaccine. 

As we continue to learn more, it’s important for everyone to practice all social distancing and safety precautions, especially until two weeks after your second shot. And be on the lookout for continued guidance about protection after full vaccination.

It teaches your body to build Coronavirus spike proteins, just like the mRNA vaccines, but through a slightly different process.

The Johnson & Johnson vaccine (also called the Janssen vaccine) delivers the blueprint to build spike proteins, like Pfizer and Moderna vaccines, but through a slightly different "delivery system." As Dr. Akiyama and Dr. Gadir explained during our town hall discussions, the Pfizer and Moderna vaccines are mRNA vaccines: they use a snippet of Coronavirus messenger RNA containing the code for the Coronavirus’s spike protein to teach your immune system how to defend against COVID-19. 

On the other hand, the Johnson & Johnson vaccine is a viral vector vaccine. Instead of mRNA, this vaccine uses a deactivated virus –not the virus that causes COVID-19 – called an adenovirus. The adenovirus, which causes mild cold or flu symptoms in people, was modified by Johnson & Johnson to include DNA that codes for the spike protein on the Coronavirus. Similar to the mRNA vaccine, the adenovirus injects the genetic material for the spike protein into your cells which the cells read to make copies of the spike protein. Also, like the mRNA vaccine, this triggers an immune reaction: essentially teaching your body how to respond to the Coronavirus before it arrives. 

The mild/moderate case efficacy rate of the Johnson & Johnson vaccine is 66% – slightly lower than the Pfizer and Moderna vaccines. However, the Johnson and Johnson vaccine has a 84.5% efficacy rate against the most severe cases of COVID-19 and 100% effective against death from COVID-19. Also, unlike the Pfizer and Moderna vaccines, the Johnson & Johnson vaccine only requires a single dose and may be less likely to produce the side effects that require monitoring after the injection than the Pfizer-BioNTech and Moderna vaccines.

Short answer: Yes!

Long answer: Yes! Medical experts emphasize that all three of the vaccines have proven successful at stopping serious illness, hospitalizations, and death. The Johnson and Johnson vaccine trials had a slightly lower efficacy rate for preventing moderate cases of COVID-19 (66%) than Moderna and Pfizer (94-95%). However, it was very successful in stopping serious illness (85%), and 100% effective in preventing hospitalizations or death. However, at this time the J&J booster shot is not recommended above the Pfizer & Moderna boosters, as it has a lower protection rate.

A few quotes from experts on the subject:

• Dr. Marina Del Rios, emergency medicine specialist at the University of Illinois-Chicago, said, “Part of my messaging in the community has been that the vaccines on the market are equally efficacious and equally safe. The best vaccine you can get is the one that you can get a hold of first, and getting vaccinated earlier, sooner rather than later, protects us from getting sick ourselves and also our community, which has been so terribly devastated by this virus.”

• "They're all in the same ballpark in terms of effectiveness," said Dr. William Schaffner from the Vanderbilt University School of Medicine. 

• Lisa Lee, a Virginia Tech infectious disease epidemiologist and a public health ethicist says having a third Covid vaccine option, “substantially reduces the time it takes the US to reach herd immunity.” Herd Immunity is when enough people are immune that everyone is less at risk of infection.

Additionally, the Johnson and Johnson vaccine also has some major advantages since it does not need to be stored at freezing temperature like the Pfizer and Moderna vaccines. And, the Johnson and Johnson vaccine is only one shot, so that in itself may be appealing to some! 

As the Johnson and Johnson vaccine become more available, we will share more information about where you can find appointments to receive any of the three approved vaccines.

Resources:

• Why you shouldn't turn down the Johnson & Johnson vaccine to wait for the others

• Pfizer, Moderna, Johnson & Johnson: Which COVID Vaccine is Best?

• Johnson & Johnson Vaccine is Approved: Here’s Why Experts Say You Should Take What You Can Get

We don't know exactly, but it will require the vast majority.

If you missed it on Tuesday - Herd immunity means that enough people have either been vaccinated or previously infected so that the virus doesn’t spread. 

As we discussed, the nationwide percentage required for herd immunity is very different for each disease:

• Because the COVID-19 virus (and it’s variants) are very contagious, and because we still don’t know how much asymptomatic infection occurs, the % of people with protection may need to be higher for herd immunity.

• We still don’t know how many people have protection from previously having COVID-19 (and for how long).

• Vaccination rates will be really different across the country, meaning that high COVID spread will continue in some communities longer than others.

All of these uncertainties mean that experts estimate it may require around 80-90% of the population to either have been vaccinated OR to be protected from COVID-19 via previous infection. Since there will be overlap between these two groups, herd immunity will require the vast majority of adults to be vaccinated.

The good news is also that the currently available vaccines have a high efficacy rate: Moderna and Pfizer at 94-95%, and Johnson and Johnson at 66%. The biggest thing that we can all due to help reach herd immunity is get vaccinated. We really are all in this together. 

• The Pfizer and Moderna vaccines both use “messenger RNA” (also called mRNA) to teach the cells in your body to recognize the outside part of the virus that causes COVID-19. That way, if you are exposed to the virus, your immune system will stop it from making you sick.

• The COVID-19 vaccine does not change your DNA. mRNA is not the same as DNA, and it cannot combine with your DNA to change your genetic code.

The Moderna and Pfizer-BioNTech vaccines both require two shots. The first shot of the mRNA vaccines starts building protection; the second shot a few weeks later is needed to get the most protection the vaccine has to offer.

Everyone 16 years and older are recommended to get a booster shot 5 months after their second dose of the Moderna or Pfizer vaccine, or 2 months after their J&J vaccine. All 3 vaccine providers have a booster, but the Moderna or Pfizer are recommended. You do not need to get a booster from the same provider that you originally got your vaccine, so either booster will work. COVID vaccines are still working to prevent severe illness, hospitalization, and death. However, public health experts are starting to see reduced protection over time against mild and moderate disease, especially among certain populations. 

Receiving the first dose of the 2-shot vaccines (the Moderna and Pfizer-BioNTech vaccines) does confer a limited amount of protection; however, the second shot is needed to get the most protection the vaccine has to offer.

You should get your second shot as close to the recommended 3-week or 1-month interval as possible. However, there is no maximum interval between the first and second doses for either vaccine. You should not get the second dose earlier than the recommended interval.

The Pfizer-BioNTech and Moderna vaccines are not interchangeable and the safety and efficacy of combinations of vaccines have not been evaluated. However, the Centers for Disease Control and Prevention recently stated that, in exceptional situations in which the first-dose vaccine product cannot be determined or is no longer available, any available mRNA Covid-19 vaccine may be administered to complete the mRNA Covid-19 vaccination series.

When you get a vaccine, usually there is a lag time between when you get the vaccine and when you are protected against the virus. It’s just the time it takes for your immune system to respond. In the case of the two dose vaccines, the whole process typically takes about 28 days and is complete soon after you get the second shot. Because of this, it is especially important to continue to take precautions such as physical distancing and masking even after the vaccine.

Currently booster shots are available 5 months after your 2 shot vaccine. However, we do not yet know how long protection lasts following vaccination but it will be critically important to measure long-term protection (at least two years) in the phase 3 trials and by following people who have been vaccinated outside of the trials. We are still learning about the duration of protection following infection with COVID and it is too early to tell how long protection will last. There have already been cases where individuals have been shown to be infected twice but most often the second illness was mild or without any symptoms. This is what we would expect with an immune response that protects against disease but not infection.

Yes! It is very important to get the influenza vaccine, particularly this season when both influenza viruses and COVID-19 can infect people. We still do not know how these two viruses will interact but people can get infected with both viruses and this will likely cause more severe disease and possibly death. Reducing the number of people who get severe influenza and require hospitalization will also help ensure that the health care system, hospitals and intensive care units will not be overwhelmed.

Yes. The Centers for Disease Control and Prevention recommends that people who have had Covid-19 should still be vaccinated because of the severe health risks associated with Covid-19 and the fact that reinfection is possible. People who were treated for Covid-19 with monoclonal antibodies or convalescent plasma should wait 90 days before getting a Covid-19 vaccine.

Recent studies suggest that both vaccines are effective against these variants but may be slightly less protective against the South African variant. However, much remains to be learned. Both vaccine manufacturers are working on modified vaccines to better protect against the South African COVID-19 variant.

We've accumulated a list of verified sources for you:

https://amend.us/covidvaccinefaq/

https://coronavirus.jhu.edu/vaccines/vaccines-faq

https://www.nejm.org/covid-vaccine/faq

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

https://covid19vaccine.health.ny.gov/frequently-asked-questions-0

https://www.aafp.org/dam/AAFP/documents/patient_care/public_health/COVID19-Vaccine-FAQs.pdf

https://amend.us/covidvaccinefaq/

https://www.nytimes.com/2021/01/29/health/Covid-vaccine-explainer.html

https://www.huffpost.com/entry/how-long-before-coronavirus-vaccine-works_l_5fd6c66fc5b6218b42ea3760