The production and now distribution of the first COVID vaccines are the first steps in finally conquering this pandemic. The vaccines are a truly remarkable scientific accomplishment and the pharmaceutical companies that have developed the several versions deserve great credit for the tremendous work they’ve done to achieve it. While research into using messenger RNA (mRNA) as a basis for a vaccine has gone on for years, this is the first application that has been developed and offered to the global population.

The spread of COVID-19 has been relentless, and the rapid vaccine development was essential if we were to save as many lives as possible. However, it has made people wonder if the speed was accomplished by skipping safety measures and putting us all at risk for serious unknown consequences. Was it rushed or was the industry really ready to do it? The politicization of the process has additionally led some people to assess the vaccine by whether their candidate supports it rather than the science behind it. 

All the evidence points to a rigorous development process built on a foundation of research that said an mRNA vaccine will work and it can be done rapidly. About 50 different vaccine preparations were winnowed down to the few that are going through FDA approval. Over 40,000 people participated as subjects in the clinical trials, which were conducted in the normal three-phase process. If the effectiveness had been poor or if serious side effects had been frequent, development and refinement would still be going on. The exceptionally high effectiveness of 94-95%, based on the percentage of people who developed protective levels of antibodies, and the minor nature of most observed side effects made it possible to offer the vaccine in a short timeframe.

Can I get COVID from the vaccine?

It is literally not possible to get COVID from the vaccine. An mRNA vaccine doesn’t contain the virus. Its RNA sequence instructs our cells to manufacture just the “spike” protein that occurs on the surface of the virus. Our immune system recognizes it as a foreign protein and produces antibodies that attach to it. This makes the virus identifiable and susceptible to destruction by immune cells. But there is no possibility that the protein can lead to growing the complete virus any more than acquiring the front grill for a new Ferrari will grow you the whole car. 

If I take the vaccine, when will I be protected?

The clinical trials showed that antibodies begin to develop after the first shot. However, a second dose of the vaccine 3 or 4 weeks later is necessary to develop adequate antibody levels to achieve the 94-95% effectiveness. Antibody levels reach a plateau about a week after the second dose.

How long will the immunity last?

It’s impossible to say at present since the vaccine is only months old. Levels of antibodies were stable after 3 months, which suggests long-term protection. Some vaccines confer permanent immunity, but others may require “booster” doses years later.

I hear there are side effects.

There can be. Side effects are apparently more common than we usually experience with the seasonal flu vaccine. They are generally mild and are usually gone in about 30 hours. They include:

• Pain, redness, or swelling where the shot was given
• Fever
• Fatigue
• Headache
• Muscle pain
• Chills
• Joint pain

You may have read that two people in England who had other severe allergies experienced severe reactions to the COVID vaccine. It is recommended that people who have had severe allergic reactions such as throat swelling or shortness of breath should not receive the vaccine.

Some of these sound similar to COVID. How can I tell the difference?

The symptoms are also characteristic of colds and flu. If they go away in 24-30 hours, they were almost certainly due to the vaccine. However, if you have been exposed to COVID in the previous 2 weeks, it is possible for you to develop the infection after you receive the vaccine but before you have developed antibodies. If you additionally feel short of breath or lose your sense of smell and taste, or if symptoms persist more than 48 hours, you should be seen by a medical professional and be tested.

I’m African-American. Can I trust the vaccine?

Given the history of unethical treatment of Black people in some medical research even by the U.S. government, many African-Americans and other minorities are mistrustful of all clinical trials. However, it was extremely important to have strong minority participation by Black and Hispanic people in the vaccine trials, since mortality from COVID-19 is significantly higher in those populations. Through major efforts by the pharmaceutical companies and organizations like the National Medical Association, Black enrollment in the vaccine trials reached 10% of the total and Hispanic participation nearly 20%. No differences in effectiveness or incidence of side effects were found among these or any other minority participants.

If I’ve had COVID-19, do I need the vaccine?

The vaccine is still recommended for those who have had the illness. The persistence of antibodies has been variable after recovery, with some people showing no COVID antibodies a couple months later. A small percentage of people have experienced a second episode of COVID-19.

Once I’m a week past my second shot can I stop wearing a mask?

Wearing a mask and social distancing remain important even after the vaccine. It is possible that the virus can be present in the nasal and respiratory droplets of an immune person who has been exposed to someone with the infection. That individual should be protected but may infect others who are not immune. And remember that 95% effectiveness means that 5% of vaccinated people won’t become immune.

What is “herd immunity” and when will those who declined the vaccine be protected?

Herd immunity is a handy phrase but something of a misnomer. When a large majority of a population has become immune to a disease through vaccination or through surviving it, the chance of non-immune people being exposed to infected people is greatly diminished. Public health officials estimate that perhaps 90% of the population must be immune to COVID-19 to show this decreased risk. 

However, people who are not immune remain susceptible if they are exposed to the disease. If they become infected the risk of severity is still present. So it is not true immunity; it is simply a much lower risk than when everyone was susceptible. In addition, some communities or regions will have a lower percentage of immune people, which can lead to regional outbreaks as it does with measles. 

In conclusion…

Everyone will have to weigh the risks of receiving the vaccine against the risk of acquiring COVID and becoming severely ill. For the vast majority of us, the disease is a much bigger threat than that of the vaccine. Many people do have a relatively mild course, but even among those, 15-20% show lingering effects like fatigue, neurologic symptoms, decreased cardiac health, and depression. If you happen to be hit hard, it is a devastating illness and survival is not certain. I don’t normally interject my personal health decisions into this blog, but in this case it’s important for people to know if those who promote the vaccine are taking it. I was fortunate to be offered the vaccine and have taken the first dose, with the second due in a few weeks.

About Dr. Joseph Moser

Dr. Joseph Moser is the Chief Medical Officer at University of Maryland Charles Regional Medical Center. He has over 40 years of experience in the healthcare field and now oversees all of UM Charles Regional Medical Center’s doctors on staff.