Finally, most vaccines require growing the virus in eggs or cell cultures in a lab, which can take many mon

Finally, most vaccines require growing the virus in eggs or cell cultures in a lab, which can take many months. (Large quantities of flu vaccines take six months to make.) But mRNA vaccines only require manufacturing short mRNA strands based on the virus’s genetic sequencing. Once that genomic sequence became available in January, researchers could create those genetic strands in a few weeks, dramatically speeding up the process of actually manufacturing the vaccines.

Q: If another country has a proven vaccine first, can we use it?

If you are in that country and qualify for it under that country’s guidance, that’s up to you, but it won’t be possible to get any vaccines in the U.S. that have not undergone review by the FDA and received CDC recommendations.

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Safety
Q: How will I know if the vaccine is really safe?

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It’s not surprising that many people have questions or uncertainty about getting a Covid-19 vaccine. “It’s entirely reasonable to have doubts and concerns,” Greyson said. “We tell people to question interventions, especially new ones, and this is an intervention, and it’s a new one.”

Further, the speed at which these vaccines were developed is “amazing but understandably can be scary if we don’t understand how they were done faster,” Greyson said. “Usually when we talk about things going fast, they’re rushed, we skip steps. In this situation, that’s not the case, but that hasn’t been effectively communicated to the public.”

Here’s how we can know steps were not skipped with these vaccines: Every expert on the planet can review the data themselves. In addition to the two committees of independent experts who will review the vaccine data — VRBPAC at the FDA and ACIP at the CDC — all the clinical trial data submitted to the FDA and CDC will be made available to the public. Pfizer’s data went public December 8 — a whopping 92 pages of it. Other experts can read it and raise any red flags they come across. If you don’t know which experts to follow, Omer has a simple rule of thumb: “Do what Fauci says. He’s a shorthand for outside experts.”

Since other countries are reviewing data for the same vaccines, those who don’t feel confident about the FDA or CDC can look to regulatory agencies overseas for their verdicts on the vaccines’ safety.

Q: What kinds of side effects could the vaccine have?

All vaccines can have reactions and side effects. Side effects are unexpected responses to the vaccine that are uncomfortable or painful but are usually rare. Reactions, especially soreness, swelling, or redness at the injection site, are much more common and are expected to occur in some people after vaccination. Other reactions reported from Covid-19 vaccines include headache, nausea, muscle stiffness, soreness, and aches — all of which are common with many vaccines.

“These are not really side effects in the way that we think about them,” Brewer said. “These are routine reactions that your body has.”

Reactions typically occur because of the way vaccines work — by stimulating the immune system. Illness symptoms like coughing, sneezing, fever, runny nose, and watery eyes are actually the immune system’s response to a pathogen, trying to get rid of it. A fever occurs when the body heats up to help the immune system work more efficiently. Coughing and sneezing are the body’s attempts to literally eject intruders from your body.

Therefore, when these symptoms occur after a vaccine, it’s most often because the vaccine worked (though not necessarily always, as these reactions can occur in placebo groups as well). That is, the vaccine caught the immune system’s attention, and the immune system got to work defending against what it thinks is the real virus.

“The immune response needs a better public relations team because this is just what happens when you respond to a foreign protein, the SARS-CoV-2 spike protein,” that the vaccines cause your cells to produce, Offit said. “When you respond to a natural infection or you respond to an immunization, your immune system makes a series of proteins that cause side effects. That means you’re having a vigorous immune response.”

So while these reactions aren’t pleasant for many—and downright miserable for some—the good news is that they usually mean your immune system is working well. It’s also why many people feel tired or worn out for a few days after getting a vaccine: Your body used up a lot of energy fighting a serious threat (or so the immune system believed it to be).

Most people experienced only mild or moderate reactions, if any, from the Moderna vaccine, but the company hasn’t yet released its complete data on side effects, so it cannot be compared to the Pfizer vaccine right now. Moderna did report numbers for severe adverse events: about 2% developed high fevers (102ºF–104ºF) and severe chills. Other severe Moderna vaccine reactions included severe fatigue (10% of participants), muscle pain (9%), joint pain (5%), and headache (5%). Likely a much higher percentage experienced mild or moderate versions of those side effects, but we won’t know until the company releases the full data.

With the Pfizer vaccine, the younger participants were, the more commonly they reported similar reactions: fatigue, headache, muscle pain, chills, joint pain, and fever. Among the small data set of 100 adolescents aged 12–15, for example, 14% experienced a fever after the first dose, and 20% experienced one after the second dose, compared to 1% and 11% in older adults (over age 55). It‘s not necessarily surprising that older adults would experience fewer reactions than younger people since reactions usually result from how strongly the immune system responds; the older you get, the less efficiently your immune system responds to threats.

The most commonly reported adverse events with the Pfizer vaccine were headache (42% of participants with the first dose and 52% with the second) and fatigue (27% and 59%), which also occurred in the placebo group, though at lower rates. One common theme that occurred across all ages was a stronger reaction to the second Pfizer dose than the first. A majority of participants reported pain at the injection site with both doses. But more than half of participants of all ages felt fatigued after the second dose, and high numbers experienced headaches as well. In those aged 16–55, more than a third experienced chills and/or muscle pain, and the numbers were only slightly lower in those over age 55. A small proportion of participants (less than 1%) experienced severe fatigue, headache, muscle pain, joint pain, or fever with the first dose, and only slightly more (2% or less) had these severe reactions with the second dose, except 3.8% who had severe fatigue with the second dose.

The adverse reactions reported in the AstraZeneca vaccine trials are similar—fever, chills, fatigue, headache, muscle aches, nausea, joint pain, or generally feeling crummy—though complete phase 3 data are not available yet. One severe adverse event occurred in the AstraZeneca trial: a person developed transverse myelitis (an inflammation of the spinal cord) 2 weeks after getting the second dose, though researchers could not determine if it was related to the vaccine or not. The person recovered and remained in the trial. Not enough data from other vaccine candidates are available yet, but they’re likely to be similar unless an unexpected adverse event is found.

If you get a Covid-19 vaccine, odds are high that you’ll have a sore arm. In addition, some people will have severe swelling at the injection site, and others will feel knocked flat for a day or two, as though they’ve gotten sick, especially after the second dose of an mRNA vaccine. They haven’t gotten sick or been given Covid, but their immune system doesn’t realize that and has gone into overdrive to protect the body. It’s helpful to be prepared in case you’re among the unlucky ones who has a severe reaction, but know that it passes within 1–3 days. Some experts recommend that people plan for stronger reactions to the second dose by getting it on a Friday or taking off work the next day.

So far, none of the vaccines have shown more serious reactions or side effects than these in the trials, but two people in the United Kingdom did experience severe allergic reactions after receiving the Pfizer vaccine. (See the next question.) Researchers will continue to look for adverse events in trial participants for several years, and the CDC has several surveillance systems to look for and respond to vaccine safety concerns in the general public.