None of the Covid-19 vaccines under development can give you Covid-19 or lead you to “shed” the virus and give

Q: Can someone get Covid-19 from the vaccine itself or shed the virus and give it to someone else after getting the vaccine?

None of the Covid-19 vaccines under development can give you Covid-19 or lead you to “shed” the virus and give it to others. In fact, none of the vaccines being developed for the U.S. even contain the complete SARS-CoV-2 virus in them, so it’s impossible for them to cause a Covid infection.

Q: My friend is saying crazy things about the vaccine that sound disturbing. How can I find out if they’re true?

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As has been seen since the start of the pandemic, misinformation, disinformation, and conspiracy theories continue growing out of control. No doubt there will be plenty of bad information floating about on Covid-19 vaccines, and indeed, plenty is already out there. (No, there is no microchip tracker in the vaccine, it does not contain fetal cells, and it will not give you Covid.) Places to go for accurate information include the CDC (which already has a FAQ about Covid vaccines), the FDA, major hospital websites such as Children’s Hospital of Philadelphia’s Vaccine Education Center, and reliable fact-checker websites.

It’s also helpful to begin regularly practicing a technique called SIFT, coined by Mike Caulfield at Washington State University. When you come across a piece of new information and you’re not sure if it’s true:

Stop
Investigate the source
Find better/other coverage in other news sources
Trace claims, quotes, and media to their source
This method, described further at Caulfield’s website, will help you sift truth from fiction online.

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Q: Who will get a vaccine first?

The CDC’s Advisory Committee on Immunization Practices (ACIP) developed four principles to guide their decisions on who should first receive the vaccine: “1) maximize benefits and minimize harms, 2) promote justice, 3) mitigate health inequities, and 4) promote transparency.” But the CDC is still figuring out how translating these ideals into practical plans will occur. Priority also depends on the goal: reduce deaths first, or slow transmission first?

“If your goal is to maximize the preservation of human life, then you would bias the vaccine toward older Americans,” former FDA commissioner Scott Gottlieb, MD, told the New York Times. “If your goal is to reduce the rate of infection, then you would prioritize essential workers. So it depends what impact you’re trying to achieve.”

All experts agree that the first group to receive vaccines should be high-risk health workers and first responders since they’re directly in daily contact with Covid-19 patients and they’re essential for caring for those patients. The CDC estimates there are 21 million health care personnel, which appears to include lab technicians, cafeteria workers, janitors, administrative staff, and everyone else essential to the operation of a health care facility.

The other three high-priority groups designated by the CDC are essential workers, adults with high-risk medical conditions (based on the CDC’s list), and adults aged 65 and older, including those living in long-term care facilities. But each of these groups is large — 87 million essential workers, over 100 million adults with high-risk conditions, and 53 million older adults (though the populations do overlap one another, such as a 67-year-old grocery cashier with high blood pressure) — and ACIP has not finalized preferential order yet.

The U.K. chose to first vaccinate older adults in long-term care facilities, a group currently included in “phase 1a” by ACIP as well. But a couple of ACIP members at the November 23 meeting called for better data on adults in group homes because of the many challenges and possible risks of vaccinating this population, especially when this population was not included in any of the trials and the side effects may be intense for frailer adults. (The U.K.’s vaccination program may very well provide that data.) The committee unanimously agreed, however, that essential workers should be vaccinated next, in phase 1b, ahead of older adults and adults with high-risk medical conditions. Doing so not only helps reduce transmission but also addresses concerns about health inequities since essential workers include a disproportionately higher number of low-wage workers and Black and Latinx workers.

But who is essential? That will be left primarily up to the states, for good reason. For example, Charo said, snow plowers are essential in Wisconsin while air conditioning repair workers are essential in Arizona. Expect to see intense debates over who counts as essential, especially when it comes to public school teachers.

Eventually, we will reach what Omer called the “Oprah approach: You get a vaccine! You get a vaccine! You get a vaccine!”

Q: How will I know when it’s my turn to get the vaccine and how and where to get it?

When you specifically will get a vaccine will depend on your age, underlying conditions, and occupation, as outlined by the CDC. But how will you know it’s your turn? That will depend on what system your state has developed to notify residents.

“Ideally, immunization information systems would help the public preregister for vaccination so they could understand and monitor where they are in the prioritization queue as well as when to begin watching for an email or call to make an appointment,” Cox said. Such a system could also include a contactless electronic consent form, safety information about the vaccine, which vaccine they’re receiving, and when to return if they need a second dose. It’s not clear, though, how many states or counties might be able to pull a system like that together as quickly as needed. It will largely depend on existing infrastructure and systems.