COVID-19 Q&A: Vaccines, Variants and How to Get Back to Normal 

As we await our turn to get the COVID-19 vaccine, a panel of infectious disease experts from the UVM Health Network address some of the newest questions to arise.

Panelists: Tim Lahey, MD, MMSc, of UVM Medical Center; Beth Kirkpatrick, MD, of UVM Medical Center and director of UVM Larner College of Medicine’s Vaccine Testing Center; and Wouter Rietsema, MD, vice president, population health and information Services, UVM Health Network – Champlain Valley Physicians Hospital.

Now that more than 11 million people in the U.S. have received the COVID-19 vaccine, what are the most prevalent side effects we’re seeing? 

The main side effects seem to be sore arm, fatigue, muscle aches, a reaction at the injection site and chills. For most people, these symptoms last a few days, but for a small number of people they may last up to a week. – Dr. Beth Kirkpatrick

What about the risk of severe allergic reactions?

These reactions, including anaphylaxis, are very rare and only occur in a few people per million persons vaccinated.

There is a lot of work going on to understand when and how these new vaccines cause severe immediate reactions, including anaphylaxis. We are learning rapidly about how they can be prevented and safely managed. Individuals with a past history of a severe allergic reaction should speak to their health care provider before making an appointment to get a vaccine and be sure to also let the vaccination clinic know if this is a concern. All individuals vaccinated will be observed for at least 15 to 30 minutes after vaccination so that quick intervention can be taken in cases of these rare reactions to the vaccines. – Dr. Beth Kirkpatrick

Why do we still need to wear a mask and physically distance once we're vaccinated? 

The vaccine makes symptomatic disease less likely, reducing the risk of hospitalization and death, but we still don’t know if it prevents infection in the first place or prevents spreading the virus to others. As we learn more, it makes sense to still wear masks and otherwise follow proven ways of slowing transmission. In time we’ll know more and may have a chance to loosen the guidance. – Dr. Tim Lahey 

If I’m vaccinated and my friend has also been vaccinated, can we get together inside without masks? 

If we learn that vaccination prevents infection -- which is currently being studied intensively around the world -- then it may be okay for vaccinated people to socialize with other vaccinated people. It’ll be far longer until it is safe to join a big crowd. – Dr. Tim Lahey

Once our elderly loved ones are fully vaccinated, can we visit them inside their homes or nursing homes?

Because vaccines do not provide 100 percent protection, the idea of “safe” is not a yes/no idea. We need to think in terms of “safer.” If my parents are vaccinated, it is safer than if they are not. If I am vaccinated, it is safer still. If I have a negative rapid test, it is safer still. Each family will need to decide for itself how much safer it needs to be before we visit one another in our separate households. For nursing homes, this decision will be determined by each state. If effective rapid testing capability expands as is described in the new National Strategy for COVID-19, these tests could be used to screen visitors in the future. – Dr. Wouter Rietsema

Will the vaccines be effective against new variants, such as the ones we’re seeing from Brazil, South Africa and the United Kingdom?

It is thought that the vaccines will still protect against severe disease caused by most of these viral variants, but clearly this is a fast-moving area that scientists and public health professionals are watching very closely. The South African variant is causing the most concern and our best approach is to vaccinate as many people as quickly as possible since lack of transmission overall limits the spread of all COVID-19 viruses, variant and original, and limits future mutations. – Dr. Beth Kirkpatrick

What is different about the new variants of the virus? 

What we know for sure is that the B.1.1.7 variant is much, much easier to transmit. This variant is 10 to 50 times more transmissible, which means that many more people will get infected and that the number of hospitalizations or death [can increase] by the same factor. Early studies have given conflicting information about whether the new B.1.1.7 variant is more lethal. Some suggested not; some suggested case fatality rates were a bit higher. We’ll see what scientists decide when the data are clearer. – Dr. Tim Lahey

With new variants of COVID-19 potentially in our community, do we need to do anything different to prevent infection, like limiting our trips to stores? 

The most important way to stay safe from new COVID-19 variants are the same things we’ve been doing for months: Wearing masks, avoiding gathering with folks outside of our own households and getting a vaccine. I don’t think other activities like grocery shopping need to be restricted. Things could change, of course. If our caseloads went from the current moderately bad levels in Vermont and northern New York to levels closer to what they are seeing in Los Angeles (around 300,000 per million) and other hard-hit areas, that might prompt some changed habits. Just the presence of the variant may not result in higher caseloads depending on how successfully people are wearing masks, physical distancing and getting vaccines. Whenever I’m feeling tempted to bend the rules a little, particularly to have a meal with folks I love, I keep this in mind and try to use it to build a little more patience. – Dr. Tim Lahey

What’s going to be the quickest way for us all to get back to normal? 

The fastest road back to normal involves everyone in the community pitching in against the virus. That means consistently wearing facemasks when in public, avoiding gatherings with folks outside our households and getting the vaccine when you can. – Dr. Tim Lahey

Are other companies besides Pfizer/BioNTech and Moderna developing vaccines? 

Yes, there are vaccines finishing phase III trials and other vaccines are in the earlier development phases. The next COVID-19 vaccine that the U.S. Food and Drug Administration (FDA) will review will likely be a vaccine by Johnson & Johnson/Janssen, which is a single-dose vaccine; this review is expected in the next month or two. The one after that will probably be the AstraZeneca vaccine, a few weeks behind Johnson & Johnson/Janssen. Although they are different in design, the principle of how they protect someone from COVID-19 is the same as the other vaccines: They help the body develop immune responses to the virus’ “spike protein.” Following behind these two vaccines is a vaccine by Novovax, and others are further behind this one. The vaccine landscape will continue to evolve rapidly over 2021, which is overwhelmingly good news in our ability to control this pandemic. – Dr. Beth Kirkpatrick

I am seeing people wear two masks because of the COVID-19 variant. Do I need to wear two masks?

Currently, the CDC recommends wearing one mask. A two- or three-ply cloth mask should suffice for most situations. Health care providers routinely wear surgical procedure masks for most interactions, and N95’s only for high-risk clinical care. It is true that wearing two cloth masks or medical grade masks might enhance protection a little bit. It’s not clear that that is required everywhere, or just in the hardest hit areas. Also, the supply chain for PPE still has weaknesses, meaning it’s still important to make sure the highest risk health care providers have enough supply. This balancing act is being discussed currently by national public health leaders and we will update our recommendations if recommendations are changed. – Dr. Tim Lahey

How do I know if I’m eligible for the COVID-19 vaccine?

The University of Vermont Health Network is proud to be working with local partners and the states of New York and Vermont to distribute the COVID-19 vaccine. We are committed to sharing the most up-to-date information so that you understand more about who is eligible to receive the vaccine, when and where. Click here for New York-specific information; click here for Vermont-specific information.