In an effort to answer as many of your pertinent questions as we can about the COVID vaccines, Western's Dr. David Hansen, Western's Associate Medical Director, will address common questions or misconceptions here each day. Have a question for Dr. Hansen? Email it to email@example.com, and don't forget to review Western's existing vaccine FAQ on its coronavirus website, here.
If I have already had COVID-19 and have recovered, do I still need to get vaccinated?
DH: Yes, you should be vaccinated regardless of whether you already had COVID-19, because experts do not yet know how long you are protected from getting sick again after recovering from the virus. Even if you have already recovered from COVID-19, it is possible — although rare — that you could be infected with the virus that causes COVID-19 again.
If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.
Answering your questions about the Johnson & Johnson vaccine
How do we know the J&J vaccine is really safe?
On April 13, the Centers for Disease Control and Prevention (CDC) and the Food & Drug Administration (FDA) recommended a pause in administering J&J vaccine. The pause was out of an abundance of caution after 6 women under the age of 50 developed a severe and rare blood clotting disorder, thrombosis with thrombocytopenia syndrome (TTS), within 6 to 13 days of receiving J&J vaccine. As of April 23, about 8 million doses of J&J vaccine have been administered in the United States and 15 cases of TTS have been confirmed. Of these 15 cases, 3 people died.
During the pause, medical and scientific teams at the FDA and CDC examined the data to assess the risk of TTS. The teams reviewed several sources of data and information, including the medical literature, reports from global regulatory partners and reports submitted to the Vaccine Adverse Event Reporting System.
Following a thorough safety review weighing the benefits and risks, the Advisory Committee on Immunization Practices (ACIP) voted to recommend the ongoing use of J&J vaccine under a revised EUA. ACIP recommended the Food and Drug Administration (FDA) include a warning statement and J&J include an information sheet at vaccination informing people about the increased risk of TTS.
The FDA and CDC are confident that the vaccine is safe and effective in preventing COVID-19, and that the benefits outweigh the risks.
Detecting these rare adverse events tells us that the systems in place to monitor the safety of all of our vaccines are working. The TTS reports were detected early, and the pause reflected the government’s commitment to transparency and safety. COVID-19 vaccines will continue to undergo the most intensive safety monitoring in U.S. history. The bottom line: You have a greater chance of being struck by lightning than in developing complications from the J&J vaccine; as of April 27, there have been almost 370,000 confirmed cases of COVID-19 in Washington state. Protect yourself and your loved ones today.
Are some people more susceptible to the blood clots?
Most people who developed the blood clots and low levels of platelets were females ages 18 through 49. However, with so few cases to study, it is difficult to know for sure if something is predisposing women in this age range to the clots.
Although it appears there is a relationship between the vaccine and the clots, anywhere from 2 to 14 people per million develop blood clots each year in this country. It could be that the individuals who developed the blood clots would have developed them regardless of whether they received the vaccine.
If I receive the J&J vaccine, is there anything I should look out for?
For three weeks after receiving the vaccine, you should be on the lookout for possible symptoms of a blood clot with low platelets. These include:
- Severe or persistent headaches or blurred vision
- Shortness of breath
- Chest pain
- Leg swelling
- Persistent abdominal pain
- Easy bruising or tiny blood spots under the skin beyond the injection site
Seek medical care right away if you develop one or more of these symptoms.
I have been vaccinated but my spouse or roommate just tested positive. Do I still need to quarantine? (updated)
DH: There have been many changes in guidelines since this question was last addressed. At the time, guidance around quarantine for those already vaccinated came from consultation with our local health department. These earlier recommendations were based on the high infection rates in Whatcom County. Now that we continue to see a decline in the positivity rate, the CDC guidelines will apply. These guidelines apply to any exposure – whether the COVID positive individual lives in your household or not.
Fully vaccinated people with COVID-19 symptoms:
- Although the risk that fully vaccinated people could become infected with COVID-19 is low, any fully vaccinated person who experiences symptoms consistent with COVID-19 should isolate themselves from others, be clinically evaluated for COVID-19, and tested for SARS-CoV-2 if indicated. The symptomatic fully vaccinated person should inform their healthcare provider of their vaccination status at the time of presentation to care.
Fully vaccinated people with no COVID-like symptoms following an exposure:
- Fully vaccinated people with no COVID-like symptoms do not need to quarantine or be tested following an exposure to someone with suspected or confirmed COVID-19, as their risk of infection is low.
- Fully vaccinated people who do not quarantine should still monitor for symptoms of COVID-19 for 14 days following an exposure. If they experience symptoms, they should isolate themselves from others, be clinically evaluated for COVID-19, including SARS-CoV-2 testing, if indicated, and inform their health care provider of their vaccination status at the time of presentation to care.
NOTE: People are considered fully vaccinated for COVID-19 two weeks or more after they have received the second dose in a two-dose series (Pfizer-BioNTech or Moderna), or 2 weeks or more after they have received a single-dose vaccine (Johnson and Johnson (J&J)/Janssen).
A deep dive into"Breakthrough Cases" - when people who are fully vaccinated still get COVID-19
There has recently been some news about “breakthrough cases” in Washington state and Whatcom County, with patients contracting and testing positive for the COVID-19 virus two weeks or more after they have been fully vaccinated.
What does this tell us about people’s immune response against the virus post-vaccination?
DH: A breakthrough case occurs when an individual has had a lower immune response from the vaccine. Each person’s ability to mount an immune response is unique and can be affected by multiple factors including age and general health status. This means a small percentage of fully vaccinated people can be expected to still get COVID-19. This can be expected with any vaccine.
In addition, after vaccination, the body’s immune defense system has been activated to fight multiple COVID-19 variants. However, if the immune system is presented with a new variant that it is unfamiliar with, a breakthrough case may occur. It is important to remember that every vaccine on the market right now prevents severe disease and death in most cases.
How common is it for this to happen?
As of April 2, out of one million fully vaccinated individuals in Washington state, epidemiologists report evidence of 102 breakthrough cases since Feb.1, which represents 0.01% of vaccinated people in Washington. Breakthrough cases have been identified in 18 counties. The majority of those in Washington state with confirmed vaccine breakthrough experienced only mild symptoms, if any. However, since February 1, eight people with vaccine breakthrough have been hospitalized.
Is this a normal phenomenon for other vaccines (such as measles, flu, etc.)?
Yes. Viruses that affect our respiratory system are quite adapt at modifying their genetic make-up. We see this phenomenon every year with the flu vaccine which is only 45-60% effective from year to year.
Do people who still contract the COVID-19 virus despite being fully vaccinated typically exhibit symptoms or experience stronger or weaker cases?
COVID-19 vaccines are very effective in preventing mild symptoms, severe disease, and hospitalizations due to COVID-19 disease. But it is still possible for a fully vaccinated person to get infected if they are exposed to the virus. These individuals may have no symptoms or mild symptoms, yet they can still spread the virus to others. That’s why even after getting vaccinated for COVID-19 we recommend continuing to wear a mask, keep your distance, avoid crowded settings, and wash your hands: this helps you to prevent exposure to the virus and unknowingly spreading it to others.
Is it safe to say the vaccine prevents hospitalizations, even among those who contract the virus post vaccination?
Yes. Because fully vaccinated people usually have some immunity against the disease, breakthrough cases usually have either no symptoms or mild symptoms.
What are the differences between the three types of vaccines currently available? (updated)
DH: Right now, both the Pfizer and Moderna vaccine have similar levels of efficacy and safety. The key differences for patients are that the Pfizer vaccine is approved for people aged 16 and up, whereas the Moderna vaccine is approved for people aged 18 and up. Additionally, the time you need to wait between the first and second dose is 21 days for Pfizer and 28 days for Moderna. While Pfizer and Moderna use mRNA, the more recently approved Johnson & Johnson vaccine uses a viral vector delivery system to stimulate an immune response. The Johnson & Johnson vaccine has demonstrated 72% efficacy in the United States, and while that is lower than the 95% efficacy rate of the mRNA vaccines, the J&J vaccine is of equal efficacy for preventing hospitalizations, serious illness, and death. It also requires a single dose, rather than two. Healthcare authorities advise people to get whichever vaccine is available to them when they are eligible, as each is an effective and important tool in protecting our communities and ending the pandemic.
If I am a student with an on-campus presence and have been vaccinated, do I still need to get tested regularly at Fraser Hall?
DH: Yes. There are three key reasons why testing will continue to be important:
- Although we know COVID-19 vaccines are effective at preventing COVID-19 disease, especially severe illness and death, we are still learning how effective the vaccines are against variants of the virus that causes COVID-19. Early data show the vaccines may work against some variants but could be less effective against others.
- We’re also still learning how well COVID-19 vaccines prevent disease transmission. Early data show that the vaccines may help keep people from spreading COVID-19, but we are learning more as more people get vaccinated.
- We’re still learning how long COVID-19 vaccines can protect people.
Until we know more about those questions, everyone — even people who’ve had their vaccines — should continue to wear masks, avoid crowds, socially distance and wash hands frequently.
Can I stop wearing a mask and social distancing once I’m vaccinated?
DH: There is new guidance from the CDC and WCHD on this topic. According to this latest guidance, once you are fully vaccinated (two weeks after your second dose of Moderna or Pfizer, or two weeks after your single-dose Johnson & Johnson vaccination), you can:
- Visit with other fully vaccinated people indoors without wearing masks or physical distancing
- Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
- Refrain from quarantine and testing following a known exposure if asymptomatic
For now, fully vaccinated people should continue to:
- Take precautions in public like wearing a well-fitted mask and physical distancing
- Wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
- Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from multiple households
More details and information on recommendations for fully vaccinated people is available at the CDC website, here.
A rumor spread recently about a local clinic offering vaccines to Western faculty members as part of the governor's new rule opening vaccines to K-12 employees. Is this true, and are WWU employees eligible?
DH: No. A Bellingham clinic did vaccinate a very small number of WWU employees on March 4 in error, and this unfortunately spread quickly via social media. Higher education employees are not currently one of the groups able to be vaccinated per the governor's order. The clinic in question is no longer accepting appointments or completing vaccinations for WWU employees as part of this mandate, and has asked the university to relay this message. Any Western employee currently "in phase" can, of course, get their vaccination done as normal. Click here to see the state's current vaccination phase.
With the recent expansion of vaccine eligibility to educators, does that include higher education instructors and staff?
DH: Western has consulted with Whatcom County Health Department officials, and their interpretation is that K-12 and licensed daycare have now been rolled to Phase 1B1, but that this does not include higher education instructors or staff.
We have been very careful to follow CDC, Department of Health and Governor Inslee’s guidelines throughout this pandemic including Washington’s COVID-19 vaccine phases. At this time, we would encourage anyone who meets the criteria for Phase 1B1 — now including K-12 and licensed daycare workers, in addition to those 65 and older and those 50 and older in multigenerational households — to contact their medical providers or to review https://vaccinefinder.org/ for vaccine sites.
We understand that changes to eligibility are causing confusion for some and that the wait for vaccines is a source of frustration for many, but we are hopeful that increases to supply will help more people get access in the coming weeks. We want to assure everyone that Western’s Incident Management Team is working with the Council of Presidents to get our higher education employees appropriately placed in the upcoming vaccination phases. Once we have that designation in hand, we will be able to create a definitive roll-out plan for our own vaccine effort on campus.
Do I really need the second dose?
DH: Some protection may be conferred after a single dose of the Pfizer-BioNTech and Moderna mRNA vaccines but this protection is far less than after two doses. The second dose acts as a booster which allows the immune system to better fight infection. All people should receive two doses of these vaccines.
How do I know the vaccine is safe?
DH: COVID-19 vaccines are safe and effective, and were evaluated in tens of thousands of participants in clinical trials and meet the FDA’s rigorous scientific standards for safety, effectiveness, and manufacturing quality. Over the past two months, 52 million doses of COVID-19 vaccine were administered in the United States. These vaccines will undergo the most intensive safety monitoring in U.S. history. This monitoring includes using both established and new safety monitoring systems to make sure that COVID-19 vaccines are safe.
Can I still get COVID-19 or transmit the virus to others after I am vaccinated?
DH: Although COVID vaccines do not completely prevent infection, they do prevent the infection from spreading within the body and from causing serious disease. The vaccine is not 100% effective and we still do not know if someone who was vaccinated can develop asymptomatic infection and transmit the virus.
Is it possible to contract coronavirus from the vaccine itself?
DH: No, it is not possible to get Covid-19 from vaccines. Vaccines against SARS-CoV-2 use inactivated virus, parts of the virus (e.g., the spike protein), or a gene from the virus. None of these can cause Covid-19.
If I'm a student and have been vaccinated, will I still have to participate in the COVID testing program?
DH: Yes. Even though the student has been vaccinated, they could still become an asymptomatic carrier and transmit the virus. Our surveillance testing program at Fraser Hall allows us to identify those asymptomatic carriers and isolate them so the virus is not transmitted to others.
Will I still have to wear a mask after I get vaccinated?
DH: Until we substantially reduce community transmission of SARS-CoV-2, and see hospitalizations and deaths dramatically decrease, we still need to wear masks and practice physical distancing even after vaccination. The vaccine is not 100% effective and we still do not know if someone who was vaccinated can develop asymptomatic infection and transmit the virus.