Five frequently asked questions and answers about the COVID vaccines

Navigating the various COVID vaccines, doses, side effects, and more

Today's expression: Feature not a bug
Explore more: Lesson #357
April 22, 2021:

Which vaccine should I get? How many doses do I need? Will there be side effects? Allergic reactions? What about protection from all of the new variants? As the world launches its vaccination efforts, we are answering five frequently asked COVID vaccine questions. Plus, learn “a feature, not a bug.”

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Five questions and answers about COVID vaccines

Lesson summary

Here we go again for another Plain English lesson, this time number 357. I’m Jeff; JR is the producer; and the full lesson is available at PlainEnglish.com/357.

Coming up today: five questions and answers about the Covid vaccines, including side effects, shot timing, and more. I got my first dose of the Pfizer vaccine and I’m waiting for my second dose. JR is fully vaccinated with the Moderna vaccine; he was a few weeks ahead of me.

Before we start, I do want to recognize that we have listeners all over the world and everyone is going to be in a different spot with respect to the vaccine. We have listeners in Israel, which has led the world in vaccination; we have listeners in Europe and America, which are in the middle of the rollout; and we have listeners in Japan, which is off to a slow start, and Brazil, which is also off to a slow start and battling a vicious new wave. Some places are competently administering the vaccine; other places, not so much. Wherever you are in the timeline, here are five questions and answers about the vaccines.

Five questions and answers about the Covid vaccines

Vaccination is continuing around the world—unevenly, to be sure, but it is continuing. Most countries prioritized the elderly, front-line workers, and the most vulnerable health-wise. When your turn comes, or as you start thinking about your turn, you might have a few questions about the vaccine and its side effects. So I put together a list of common questions and answers. And even if you know the answers, it’ll be good to hear them in English.

So, first question: How many shots do you need and when does the second dose come?

It depends on which vaccine you get. The Pfizer and Moderna vaccines are both two-dose vaccines. The second Pfizer dose comes three weeks after the first; the second Moderna dose comes four weeks later. What if you can’t get it exactly 21, or 28, days later? Don’t panic. The companies say you should definitely not get the second dose early. But if you need to get it a few days later, that’s okay too. The companies say you should try to get the second dose as close as possible to the recommended date, but if your second dose comes up to six weeks later, that would also be okay.

The Sinovac vaccine is also two doses. They originally recommended it 14 days after the first dose, but studies found that a three-week gap is even more effective. In short, follow whatever the current guidelines are—there haven’t been enough studies to say exactly when is the best day, so try to get closest to the current recommendation but it’s not the worst thing in the world if you get it a little later.

The Johnson & Johnson vaccine is one dose only.

Next question: What are the side effects?

Different people react differently to the vaccines, but it’s possible to make some general statements. Most people have some side effects, but there’s a wide range. The strongest side effects come from the second dose of a vaccine made with mRNA technology—specifically Pfizer and Moderna. More people report getting side effects, and more severe side effects, from the second dose.

The worst outcomes are usually a feeling flu-like symptoms for about a day. Some people describe having a “brain fog” and others just feel like they were run over by a truck—that was JR’s description after getting the Moderna vaccine. But not everyone has side effects that strong and they pass within a day or two.

The side effects mean that the vaccine is working. The vaccines are intended to provoke your immune system into mounting a response to an invader. The invader is innocent; our brains know that, but our bodies don’t. When you feel side effects, it’s because your body is gearing up to fight an intruder. In this way, the side effects of the vaccine are a feature, not a bug .

So does that mean you want to get side effects? Not really. The absence of serious side effects is nothing to be worried about. About a quarter of people who got the mRNA vaccines report no side effects overall, and the vaccines are 95 percent effective.

Regardless of which vaccine you get, you can probably expect some degree of pain, redness, and swelling where the injection happened. They are poking a hole in your arm, after all. But the localized side effects tend to be mild.

More generalized symptoms from the mRNA and other vaccines include fatigue, headache, and muscle soreness. Experts say you should drink a lot of water to help make these symptoms more manageable.

Third question: what about allergic reactions?

About two to five people per million experience a severe allergic reaction to the vaccine. The good news is that this almost always happens within 30 minutes of getting your dose. Vaccine sites should ask you to stay in observation for 15 to 30 minutes after receiving the shot to make sure you’re not going to have an allergic reaction. Vaccine sites have epinephrine on hand in case there are any severe allergic reactions.

Next up: Will vaccines protect against all variants?

This one is a maybe. There are a few major variants, described by where they were first identified. The variant from the UK spreads more quickly than the original virus. The vaccines appear to work against this variant. Unfortunately, the variants originating in South Africa and Brazil appear more resistant.

Vaccinated individuals still have some protection against even these variants. Even if the vaccine doesn’t give full protection, it is expected to give partial protection and give protection against the most serious cases. And drugmakers can prepare booster shots to add protection against specific variants later.

Finally: what to do after getting the vaccines?

Save your records! Each country does it differently, but in the United States the official record of whether you have been vaccinated is a small piece of paper that they give you after your shot. Take a picture of it. If you need a second dose, schedule your second dose for the recommended interval.

Many countries have some side effect trackers. You should consider doing those. This will help drugmakers and governments measure side effects across larger numbers of people. This is a contribution to our general knowledge of the vaccine and, in my opinion, contributing is the least we can do for the privilege of getting the vaccine.

And last, wait. Even after the second dose, you’re not considered fully protected until after about another 14 days.

You’ll want to still respect any local rules about masks or social distancing. There are two reasons for this: first, simply for the peace of mind of others around you. And second, the vaccines are effective—75 percent, 95 percent effective. But even 95 percent is not the same as 100 percent. Until enough people in your area are vaccinated, you still have a 1 in 25 chance of catching COVID and therefore spreading it to others. So until enough people in the population get the vaccine, even vaccinated people should still take precautions.

One last thing: gratitude

The last thing I would recommend is to take some time and be thankful. Be thankful that we live in 2021. Covid was bad. It was—it is—terrible. Governments around the world have handled it badly, I think, my own included. Not everyone is getting a vaccine fast enough. Many many people will have to wait a long time to get it.

But this whole ordeal could have been so much worse. The development of a vaccine after less than a year is nothing short of a miracle. So whatever complaints you have about how your local or national government has handled the virus, lockdowns, vaccines; and however much or little you were affected economically; do take some time after getting that first shot to be grateful that we live in such a scientifically advanced age.

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Expression: Feature not a bug