Protecting India against COVID-19 through Vaccines: Answers to Frequently Asked Questions
Nidhi Rohatgi, MD and Aruna Subramanian, MD
Dr. Nidhi Rohatgi (twitter: @nrohatgi2) practices General Medicine at Stanford University in California, United States and Dr. Aruna Subramanian (twitter: @ArunaSubraman12) is an Infectious Disease Specialist at Stanford University.
As COVID-19 surges in India and there are global efforts towards vaccinating everyone, we want to share how these vaccines work and why should we take them. These are general considerations for educational purposes and do not replace the recommendations and clinical judgment of the local doctors.
1) How do vaccines work?
Normally, when germs enter the body, our body creates a response to fight against them. Our body creates antibodies to stop the virus from growing in our body and protect us from future infection. Usually, we first have to get infected with the germs for this to happen and go through the symptoms of infection. If our body is not strong enough, then the germs can hurt us or even cause death. While our body is fighting against germs, we can spread those germs to others around us.
If we take a vaccine, we are exposing the body to small parts of the virus that cannot cause infection inside us. Then our body can create these antibodies ahead of time to stop the virus from growing in our body. Our body saves these antibodies in our body. If the virus tries to enter our body, these antibodies protect us, and the germs cannot hurt us at all or can hurt us much less.
— It is important to get the vaccine even if you had COVID-19, since the antibodies our body makes after getting the vaccine are more protective and may last longer than those made after COVID-19 infection.
2) Why should you get the vaccine for COVID-19?
a. Getting a vaccine for COVID-19 is protective against severe disease and dramatically decreases the chances of dying from COVID-19. All available vaccines have been extremely effective for this.
b. Getting a vaccine does not completely protect us from getting COVID-19.
c. It may take 2–3 weeks after you get the vaccine for immunity to develop and you to be protected from the virus.
d. Get the first available vaccine that is approved by your local doctors.
e. Even if you have had COVID-19 before, getting the vaccine provides additional protection from the disease in future.
f. It is unknown how long the protection from any of the vaccines will last, but so far, the benefits have been long-lasting.
g. None of the COVID-19 vaccines have been specifically studied in pregnant women, but so far there is no indication that it is not safe for pregnancy. Studies have shown that women can give protective antibodies to their babies through breast feeding if they have been vaccinated.
3) What age groups are the COVID-19 vaccines approved for?
a. Covishield, Covaxin, and Sputnik-V vaccines are approved in India for people aged 18 years and over.
b. Pfizer COVID-19 vaccine is approved for age 12 years and over.
c. Moderna and J&J COVID-19 vaccines are approved for ages 18 years and older, but these are not yet available in India.
4) If you got COVID-19, when can you take COVID-19 vaccine?
If you are currently infected with COVID-19, then you can take the vaccine:
(a) After your symptoms have resolved AND
(b) You are cleared from being in quarantine (10–14 days from the end of symptoms of COVID-19 to avoid spreading infection to others)
However, if you received any medications in the hospital for COVID-19 (e.g., monoclonal antibodies), then discuss the timing of vaccine with your local doctor as you will likely have to wait for 90 days from the last dose of that medication.
5) What if you get COVID-19 after getting the vaccine?
The vaccine can still protect you from getting severe illness or death even if you get COVID-19 after getting the vaccine.
i. If you only received the first dose of vaccine and then got COVID-19, you should still try to take the second dose as follows:
1. You do not need any blood tests (such as C-reactive protein or Interleukin-6) or a test for COVID-19 (RT-PCR or rapid test) prior to getting the second dose of vaccine.
2. Covaxin: Can take 4–6 weeks after the first dose
3. Covishield / Astra-Zeneca: Can take 4–8 weeks after the first dose. There is preliminary data that up to 12 weeks is okay.
4. Sputnik-V: Can take 3 weeks after the first dose
5. Pfizer vaccine: Take at least 3 weeks after the first dose
6. Moderna: Take at least 28 days after the first dose
7. You should get both doses using the same vaccine.
a. There are ongoing studies of combining vaccines, but no definite results from these studies are known at this time.
ii. So far, data shows that both Covaxin and Covishield are effective against variants that are present in India. It is likely the other vaccines are very effective against these variants as well, and this is being studied.
6) Will you test positive for COVID-19 because of the vaccine? Will the COVID-19 vaccine change your DNA?
— None of the COVID-19 vaccines use the live version of the SARS-CoV-2 virus and cannot cause COVID-19 infection in us.
— You will not test positive for COVID-19 infection because of the vaccine
— None of the COVID-19 vaccines change your DNA.
7) What are the side effects of taking COVID-19 vaccines?
People typically experience arm pain, headache, low grade fevers, cold symptoms, body ache for a couple of days after taking the vaccine.
Extremely rarely, anaphylaxis (severe allergy) or blood clots can occur. The rates of severe allergic reactions are much lower than what is seen with common antibiotics, and the rate of blood clots is significantly lower than what is seen during actual COVID-19 infection. Hence, getting the vaccine is tremendously safer than getting COVID-19.
8) What can you do to reduce the chance of more common side effects of COVID-19 vaccine?
· Along with rest and fluids, take pain or fever relief medicines as needed after the vaccine.
· The benefits of the vaccine are much more than any extremely rare severe side effects.
9) What happens in your body after you take the COVID-19 vaccine?
· Normally, our body knows it is being attacked by SARS-CoV-2 virus when it detects the spikes on the surface of the SARS-CoV-2 virus. These spikes are made up of proteins.
· When the COVID-19 vaccine is injected in our body:
o Our body detects the spike protein from SARS-CoV-2
o Our body then gets fooled into thinking that it is being attacked by SARS-CoV-2 virus.
o So, the body starts making antibodies against SARS-CoV-2
o This army of antibodies protect us when the actual SARS-CoV-2 germs try to enter our body
10) How do Covishield or Astra-Zeneca, J&J, and Sputnik-V vaccines work?
· Covishield or Astra-Zeneca vaccines, J&J vaccine, and the Sputnik-V vaccine use another virus called adenovirus to deliver the vaccine. Adenovirus is a common cold causing virus, but this virus has been changed in such a way that it cannot cause infection in our body.
· Adenovirus does not have the spike proteins that our body uses to detect that it is being attacked by SARS-CoV-2 virus
· For creating these vaccines, the adenovirus is changed in such a way that it can use the cells in our own body to make these spike proteins.
· Covishield or the Astra-Zeneca vaccines are 70% effective in preventing mild illness from SARS-CoV-2 but all COVID-19 vaccines have been fully effective for protecting against severe infection or death from COVID-19
· Sputnik-V is 90% effective in preventing mild illness from SARS-CoV-2 but all COVID-19 vaccines have been fully effective for protecting against severe infection or death from COVID-19.
· J&J vaccine was 66–85% effective in preventing mild to severe disease, but fully effective against preventing hospitalization and death. The J&J vaccine can be given as 1 shot.
· Covishield or the Astra-Zeneca vaccines and the Sputnik-V vaccine are given as two shots. The second shot contains similar ingredients as the first shot. The second shot helps boost the antibody levels and gives stronger protection against COVID-19.
11) How does the Covaxin vaccine work?
· For creating Covaxin, the SARS-CoV-2 virus is first killed using heat or chemicals. This killed SARS-CoV-2 cannot grow inside our body or cause COVID-19 infection
· The killed SARS-CoV-2 virus used for making Covaxin still has the spike proteins. Because the SARS-CoV-2 virus is killed already, the killed SARS-CoV-2 virus cannot grow inside our body or hurt us.
· Covaxin is 80% effective in protecting against mild SARS-CoV-2 but all COVID-19 vaccines have been fully effective for protecting against severe infection or death from COVID-19
· Covaxin is given as two shots. The second shot contains the same ingredients as the first shot. The second shot helps boost the antibody levels and gives stronger protection against COVID-19.
12) How do Pfizer and Moderna vaccines work?
· Pfizer and Moderna COVID-19 vaccines are RNA vaccines. RNA is something that tells our body to make proteins. These vaccines don’t change our genes.
· Pfizer and Moderna COVID-19 vaccines contain a piece of RNA. This piece of RNA can tell our body to make spike proteins.
· These vaccines are 94–95% effective against mild infection, and close to 100% effective against hospitalization and death.
