COVID-19 Vaccine Information

A booster is an extra dose of vaccine to make sure the body’s immune system remembers how to fight against a disease long after the initial vaccination. With the emergence of the Delta variant and Omicron variants, some people who were fully vaccinated (had received two doses of the Pfizer or Moderna, or one dose of the Johnson & Johnson) became ill with COVID-19. This is called a “breakthrough infection”. In most of these cases, people with breakthrough infections had received their initial vaccinations longer ago or were at higher risk of infection. Although most breakthrough infections are mild, any infection can spread COVID-19 to others. Part of the reason these variants caused breakthrough infections is because of changes to the shape of the spike protein on the COVID-19 virus that vaccines target. The initial vaccinations still do a good job protecting against severe illness from new COVID-19 variants, but booster vaccines several months after initial vaccination dramatically reduce the risk of these breakthrough infections and serious illness from them by refreshing the immune system’s memory so it can recognize these slightly different-looking strains of COVID-19.

Read more about booster doses, who should get one, and when at the CDC’s Booster Q&A.

No, boosters are not made differently than the original vaccine. However, the Moderna booster is half of the dose of the original Moderna vaccine.

For most adults, the CDC recommends a Pfizer or Moderna vaccine initially with a second dose in 3-8 weeks for Pfizer and 4-8 weeks for Moderna. Booster doses are recommended 5 months after the second dose of Moderna or Pfizer. People who initially received Johnson & Johnson vaccine are recommended for a booster with Moderna or Pfizer two months after their initial vaccination. People who initially received the Johnson & Johnson vaccine AND received a Johnson & Johnson booster may receive a second booster with Moderna or Pfizer vaccine. This is because Moderna and Pfizer vaccines have been shown to offer better protection. Mixing and matching between the primary series and the booster dose brand is okay.

The CDC also has special instructions for adults and children with weaker immune systems.  These individuals are recommended for a 3-dose primary series of Moderna and Pfizer and up to 2 boosters afterwards.

People with immune systems that are less strong can benefit from an extra dose of Moderna or Pfizer vaccine to teach their immune systems to recognize and fight against COVID-19.  Unlike boosters, third doses act to help create an initial immune response to COVID-19 rather than to act as a reminder about COVID-19 for a healthy immune system. For people with a weaker immune system, this extra dose is given as soon as 28 days after the second dose rather than 5 months after the second dose in the case of boosters. People who recommended for a three-dose primary series because of weaker immune systems can also get two boosters.

The FDA has authorized a third dose of Moderna and Pfizer vaccines against COVID-19 for people with severely compromised immune systems. The extra dose must be given more than 28 days after the second dose was received. Persons who are immunocompromised who received a Johnson & Johnson vaccination initially should receive 1 dose of Moderna or Pfizer vaccine at least 28 days after and then a Moderna or Pfizer booster in 2 months, with an option for a second booster of Moderna or Pfizer 4 months after the first.

The FDA has defined severely immunocompromised as, “solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise.” The CDC lists the following conditions as severely immunocompromising:

• Advanced or untreated HIV infection
• Active treatment for solid tumors and blood cancers
• Solid-organ transplant patients taking immunosuppressive therapy
• Persons who have had a stem cell transplant within past 2 years or who are taking immunosuppressive therapy
• Moderate or severe primary immunodeficiency
• Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), immunosuppressive chemotherapy, and other immunosuppressive medications and biologics
• Additional considerations: chronic medical conditions may be associated with varying degrees of decreased immune function. Please reach out to your clinical team should you have further questions.

Virtual and Telephone visits are available for Callen-Lorde Patients to discuss individual level of immunocompromise and determine eligibility for this new recommendation. Please call 212.271.7200 to discuss.

There is evidence that the Moderna and Pfizer vaccines offer better protection than the Johnson & Johnson vaccine. Currently, only Moderna and Pfizer have full FDA approval as a primary series. The Johnson & Johnson vaccine can still be given in special cases. Persons who initially received a Johnson & Johnson vaccine can receive a booster dose of Moderna or Pfizer 2 months after their initial vaccination.

Today, there are three vaccines approved for use in the United States: Moderna, Pfizer, and Johnson & Johnson (also known as Janssen), though there may be more that come on the market. Moderna and Pfizer each require two shots, and the Johnson & Johnson vaccine only requires one.  You can schedule an appointment online or call 212.271.7200. Vaccination appointments can also be found outside of Callen-Lorde and throughout NYC using vaccinefinder.nyc.gov.

All three vaccines were built on technology that has been studied for decades, and scientists from across the world worked together to quickly develop safe and effective vaccines.

The Moderna and Pfizer vaccines use a technique called “mRNA” or “messenger RNA” that teach your body how to build spike proteins like the one found on the outside of the virus that causes COVID-19. Once the vaccine is injected, your cells produce copies of the spike protein and your immune system learns how to defend against COVID-19.  Scientists have been working on making mRNA vaccines for over 30 years, but because mRNA is very delicate it has taken awhile. These are the first commercially available mRNA vaccines.

The Johnson & Johnson vaccine uses a “viral vector” technique with a different type of virus, an adenovirus, that has been modified to carry a code for making the spike protein.  Once this is introduced into the body, the body’s cells decode the viral vector’s instructions and makes mRNA that tells the body to make spike protein.  After that, the body’s immune system makes defenses against COVID-19.  This technology is commonly used for vaccines and the viral vector used in the Johnson & Johnson vaccine has successfully been used in an Ebola vaccine several years ago.  Several international COVID-19 vaccines, such as Sputnik V and AstraZeneca/Oxford vaccines also use viral vector technology.

Vaccination strongly reduces the risk of hospitalization and death from all strains of COVID-19.

This is the most important reason to consider getting vaccinated. Scientists have also found that being up-to-date with recommendations for vaccination or booster dramatically reduces the risk of mild, moderate, and asymptomatic COVID-19 infections. This helps prevent the spread of COVID-19 in communities. However, it is still possible for vaccinated people to get mild, moderate, or asymptomatic COVID-19. These cases are known as “breakthough infections”.

The data we have so far suggests that people have good protection at least 6 months after their primary vaccination series. Boosters are recommended to offer ongoing protection, especially in those at highest risk of severe illness from COVID-19.

The vaccinations currently available in the US seem to offer good protection against severe disease from all of the circulating domestic COVID-19 variants of concern, but increasing breakthrough cases are seen with the emerging Omicron variant. We know that because Omicron has many changes to the spike protein that vaccines target, boosters are important to help the immune system fight Omicron. Boosters are especially important for people who were vaccinated longer ago, have weaker immune systems, and/or are 50+ years of age.

Yes. Both vaccination and boosting help protect against getting COVID-19 again and reduce the risk of severe illness should you get COVID-19 again.

No, people who currently have COVID-19 infections and anyone with a moderate to severe illness (such as a fever over 100°F) should wait until they are feeling better and have completed isolation before getting vaccinated.  This prevents them from infecting other people at their vaccination site. Furthermore, it takes two weeks after vaccination to have good protection—a vaccine will not help if you are already infected.  People who are sick with COVID-19 should reach out to their medical provider, preferably for a virtual visit if possible rather than in-person, for treatment.

It is possible, but in general, antibody tests are not recommended as they are not an indicator of whether or not you are protected from COVID-19.

The most common side effects are soreness at the injection site, tiredness, headache, muscle pain, nausea, chills, joint pain, redness or swelling on the arm where the injection was given, and fever.  While side effects may be uncomfortable and inconvenient, they are a normal immune response as your body learns how to recognize and defend against COVID-19.  These side effects usually don’t last more than 24-48 hours, and many people may not have any side effects from vaccination at all.

Yes! You cannot catch COVID-19 or a cold from any of the vaccines because they do not contain a live virus. However, this does not mean you may not experience side effects.  Although dangerous complications like allergic reactions can happen, people are watched for at least 15 minutes after vaccination to make sure they are safe.  Dangerous reactions are very rare, and are estimated to occur in less than 1 per 100,000 vaccinations.

The vaccines are safe for…

• People living with HIV
• People with cancer receiving treatment
• People with kidney disease
• People with lung disease
• People with a neurological disease
• People with heart disease and hypertension
• People with liver disease
• People who are pregnant
• People with sickle cell disease
• People who have had organ transplants
• People who have a history of stroke
• People with a substance use disorder
• People who smoke
• People with more than one of the above conditions

If you have had a severe allergic reaction to a vaccine before, you should talk to your healthcare provider before getting a vaccine for COVID-19. However, the vaccines for COVID-19 do not contain other common allergens like eggs, latex, or gelatin.

Temporary swelling at the site of filler injections is rare but has been reported with the Moderna and Pfizer vaccines (not with the Johnson & Johnson vaccine). People with a history of filler injections are still recommended to get whichever vaccine they can as soon as they are eligible. If swelling happens they should reach out to their medical provider

No. The vaccine does not affect ability to become pregnant.

Excelsior Pass is a New York State-based safety screening tool that can offer proof of vaccination or recent negative COVID-19 test as an app or printout with a QR code that can be scanned to verify the information.  Two weeks after completing a vaccination series individuals vaccinated in New York State can access Excelsior Pass here: https://epass.ny.gov/home. If there is an issue with accessing an Excelsior Pass for a fully vaccinated person, they should reach out to the site where they received their vaccination.

Please note that Callen-Lorde does not replace COVID vaccination cards but will issue an official CIR or EHR immunization record. Please visit My Vaccine Record to search for and download a copy of your immunizations. You can use your mobile phone number, email address, or IDNYC number to search for your immunization record in the application.