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Compare this to the risks of a real COVID-19 infection, which we know is quite serious. Even young, healthy people can get serious illnesses and die. A third of patients who recover from COVID-19 may have “long-lasting” symptoms, such as profound fatigue, neurological effects, and autoimmune syndromes.
If I have already contracted the COVID infection, should I still receive the vaccine?
Yes. The CDC recommends vaccination for those who have already had a confirmed COVID-19 infection. We have reason to think that the immunity from the vaccine is stronger and may outlast “natural” immunity. Those who received the Moderna vaccine, for example, had much higher levels of antibodies than those who had been infected.
When can I get the vaccine?
The CDC has developed recommendations for different groups based on risk. Currently, healthcare workers and residents of long-term care facilities are receiving doses. The following groups are other essential workers; those with high-risk medical conditions; and those over 65 years of age. It is estimated that the general population will receive the vaccines in March or April. Details of how these groups will receive the vaccines are still being worked out.
If I got infected or vaccinated, can I stop wearing the mask?
No. We do not yet know whether natural immunity or vaccines reduce viral transmission. We know that reinfection is rare and that those with immunity are much less likely to get sick. But we don’t know if people with immunity still catch the virus and pass it on to other people without knowing it. We will have to keep masking and distancing until this is understood or until the transmission is low.
If I am pregnant or breastfeeding, should I get vaccinated?
Pregnant and breastfeeding people were excluded from vaccine trials, so we don’t know for sure how they will be affected. The guidelines suggest that the vaccine must still be offered to pregnant women who can make a shared decision with their provider. Right now, pregnant people are at a higher risk for severe COVID illness than the general population, but the risks from the vaccine are expected to be low. For lactation, it is unlikely that the components of the vaccine can pass through milk.
Why are some people afraid of getting the vaccine?
Vaccine vacillation exists on a spectrum from conspiratorial “anti-vaccine” cottage industries to reasonable uncertainty about a new vaccine. There are decades of solid science behind the vaccine, but there are still many unknowns. Currently there is widespread institutional mistrust and misinformation. Many communities have very good reason to distrust, given the prolonged mistreatment by medical institutions. It is not unreasonable to hesitate. For us to get to the other side of this pandemic, we must listen to where people are coming from, understand and address concerns, and provide transparent education. This trust is built over time.
The science and coordination that accelerated these effective vaccines is unprecedented in history. It is a marvel and an achievement. As we did with laboratory and clinical trials, we must now accelerate the science of implementation, including equitable access and public education.
Dharushana Muthulingam, MD, MS is an infectious disease physician and public health researcher in St. Louis, MO
