For Covid-19 information in Native Hawaiian and Pacific Islander languages, please check here: IN-LANGUAGE RESOURCES | NHPI COVID-19 Resources (nhpicovidhawaii.net)
For more translated Covid-19 information, including vaccination, check here: Resources – Hawai‘i DOH: Info & Resources for Managing COVID-19 (hawaiicovid19.com)
Can my family and I get the Covid-19 vaccine at KPHC
- Yes! KPHC is currently administering the Moderna vaccine to all patients 18 and older and the Pfizer vaccine for all patients 12-17 years old.
- We are currently administering the vaccine by appointment only for established and new KPHC patients. We are usually able to accommodate same day appointments. Call us at 843-7282 or 792-4513 to schedule vaccination.
- If you have questions about vaccination or other covid-19-related questions or to schedule for Covid testing, call our Covid nurse line at 381-7009
- If you are not a KPHC patient, please speak with your PCP or go to www.hawaiicovid19.com for more information on where to get the vaccine
- If you do not have a primary care provider or medical clinic, call us at 848-1438 (915 N. King St), 843-7552 (710 N. King St.) or 792-5560 (89 S. King St., Downtown Honolulu) to set up a visit with a primary care provider.
Will my child be able to get vaccinated against Covid-19?
- KPHC has the Pfizer vaccine available now for children aged 12-17 years old. For 18 and above we are administering the Moderna vaccine.
- No Covid-19 vaccines are currently approved for children below 11 year old or younger. We are hoping that these age groups will be approved by the end of 2021 or early 2022.
- It is important that adults caring for children be vaccinated so they can keep from getting infected and possibly passing the infection to their children.
I got the first dose at a different location, can KPHC give me my second dose?
- It is important that you receive the same vaccine for the second dose as you did for the first. Depending on which vaccine you received, we may or may not be able to accommodate your request. We currently administer Moderna and Pfizer vaccines vaccine at KPHC.
- The location where you got your first dose, should have provided you with an appointment for your second dose.
- If you are unable to get back to your original vaccination site, call us at 843-7282 or 792-4513 to schedule for your second dose of Moderna or Pfizer.
I don’t want to get vaccinated with my priority group, can I get vaccinated later?
Yes, however, depending on demand and supply, you may have to wait longer for vaccination. Our recommendation is to get vaccinated as soon as the vaccine is available to you.
Is there a difference between the Pfizer, Moderna and Johnson&Johnson vaccines, can I choose which one I want?
- The Pfizer and Moderna vaccines are the same type of vaccine and are very similar in their effectiveness and side effects. Both vaccines are very effective in preventing Covid-19 infections and preventing hospitalizations and death due to Covid-19. Both vaccines require two doses for full effectiveness. Both vaccines have a very low risk of a condition called myocarditis that may occur in teens and young adults after vaccination. This condition is a mild and temporary inflammation of the heart muscle. See below for more information on myocarditis.
- The Johnson&Johnson/Janssen vaccine is a different type of vaccine. KPHC does not carry the J&J vaccine. It only requires 1 dose. It is also very effective at preventing infections and especially effective at preventing hospitalizations and severe cases of Covid-19. There is a very rare risk of blood clots after the J&J vaccine, especially in women under age 50. We recommend to discuss which vaccine may be best for you with your healthcare provider. The J&J vaccine does offer the single-shot advantage and provides full vaccination protection sooner that other vaccines which may be important for travel plans or for patients waiting for full vaccination status before starting immunosuppressive treatments or chemotherapy.
- KPHC currently has the Moderna and Pfizer vaccines available, we may carry additional brands of Covid vaccines as they become available.
- If you prefer the J&J vaccine, please check with www.hawaiicovid19.com for more information on where J&J may be available.
I got one dose Pfizer or Moderna, do I really need the second one?
- Yes, one dose does provide some protection, but it is unclear how effective one dose is or for how long the protection from one dose may last. A second dose is strongly encouraged to provide the level of protection seen in the vaccine trials.
- Early studies on vaccine effectiveness against the Delta variant shows that 1 dose of vaccine may only prove 30-40% protection but 2 doses bring protection closer to 90%.
I already been infected with Covid-19, do I still need to get vaccinated?
- Yes, vaccination is still recommended. We don’t know how long immunity after an infection lasts. Some early studies have shown that mild infections may lead to less long-term immunity. Other studies have shown that those with prior infection who get vaccinated may have enhanced protection against Covid variants. The immunity from vaccines appears to be stronger and last longer than the immunity after an infection.
- If you were infected within the last 90 days before the vaccine is available to you, you are probably ok to wait, however it is not required that you wait. Once you are finished with your isolation period after infection, you can get vaccinated.
I’ve had a bad reaction to a vaccine before, am I still able to get vaccinated?
- If your reaction was mild to moderate, you can still get vaccinated. If you had a serious allergic (anaphylactic) reaction to a vaccine, discuss with your doctor or nurse before you get vaccinated or before your second dose. You may not be able to get vaccinated at this time, or you may be advised to wait until other covid-19 vaccine options are available.
- Before you are vaccinated, you will be asked about any allergies you might have to food or medicines. Please let your nurse or vaccine administrator know about any allergic reactions you have had.
- If you were diagnosed with myocarditis after the first dose of either the Pfizer or Moderna vaccines, let your vaccine provider or PCP know before you get your second dose.
I have bad egg, shrimp, peanut or bee sting allergies, am I still able to get vaccinated?
Yes, you will be asked to stay around after vaccination for 30 minutes to monitor for any allergic reactions.
I am pregnant, or I think I might be pregnant, or breast feeding, can I still get vaccinated?
- Yes, vaccination is recommended for pregnant women. Studies show that vaccinated pregnant women pass protective antibodies to their infant through their umbilical cord before birth and through their breast milk after birth.
- Studies show that there is no increased risk of miscarriage after vaccination
- Covid-19 infection is known to increase risk of injury to pregnant women and their children, so vaccinating may be a safer choice for you. If you think you might be pregnant, optional pregnancy testing is available at our clinic.
I don’t have insurance, will I have to pay for vaccination?
- No, there is no charge associated with the vaccine. You will not be asked to pay any out-of-pocket costs for the vaccine at this time, whether you have insurance or not.
- If anyone calls, messages or emails you offering you vaccines for sale or asking for any personal or credit card information, DO NOT give any information. Go to www.hawaiicovid19.com for official state vaccine information.
I had a transplant and I’m on immunosuppression. Is the vaccine available and safe for me?
- Yes, if you are immunosuppressed, the vaccine is still recommended.
- If you are receiving Methotrexate, Cyclophosphamide or Janus Kinase Inhibitor medication or high dose steroid medications, please contact your care provider or specialist to discuss safe vaccination recommendations.
- The Covid-19 vaccines available are not “live” vaccines, so you cannot get or spread Covid-19 after vaccination.
- On Aug 12, 2021 the FDA approved an Emergency Use Authorization revision recommending a third dose of Moderna or Pfizer for individuals with specific immunosuppressive conditions. We will have more specific guidance soon and will be contacting all of our patients with these conditions to schedule their third dose.
I don’t have an immunosuppressed condition, but I want to get a booster dose. Can I get it now?
- A third dose of mRNA vaccines (Moderna and Pfizer) are only recommended and approved for specific immunosuppressed individuals. We are unable to give a third dose or booster dose to any other individuals at this time. It is important to follow guidance of the FDA and CDC to ensure we are providing doses that provide the most benefit with the lowest risk for adverse events.
- Mixing doses for instance giving a dose of Pfizer after Moderna or J&J is not recommended.
Is it possible for the vaccine to give me Covid-19?
No, the vaccines do not contain the Covid-19 virus and it does not contain any way for your body to create the covid-19 virus after vaccination.
Does the Covid-19 vaccine affect my DNA?
No, the mRNA in the Pfizer and Moderna vaccines does not contact your DNA and cannot alter your DNA. The mRNA is quickly broken down by your cell’s normal metabolism.
Am I going to need a booster shot in the future?
- Like most viruses that infect people, the Covid-19 virus is changing and mutating over time. The more infections that happen, the more chances the virus has to change. Some of these changes may make the virus harder to prevent with the current vaccines. It is very likely that we will all need to have booster doses of vaccine at sometime within the next year or two.
- At this time (Aug 12 2021), the CDC is not recommending booster vaccines for the general population, only for individuals with specific immunosuppressive conditions. These conditions have a higher risk of not generating a good antibody response to two doses of mRNA vaccines. A third dose significantly improves their immune response. Research is ongoing. We expect to have more information on clinical trials of booster doses available in the fall of 2021
- If a major Covid-19 variant is spreading that is not prevented by the available vaccines or if there is a significant increase in cases among vaccinated people, a booster vaccine is likely to be recommended
- The current vaccines have been in clinical trials for about 1 year and in real-world use for about 8 months. Over the next several months to years we will know more about the duration of effectiveness of the vaccines.
Am I going to feel sick after vaccination?
- Almost all side effects or reactions are brief and mild lasting 1-2 days
- most people (80-90%) experience soreness at the injection site,
- about half (50%) of people experience headache and fatigue (feeling tired),
- about a quarter (25%) had muscle aches, chills and/or joint pain,
- about 10% or less had fever, nausea, diarrhea and/or swelling at injection site.
- about 1% or less had lymph node swelling
- Some people may experience a rash at the injection site several days to a week or more after vaccination.
- About 1 out of every 500 people who get vaccinated may have an adverse event such as a non-severe allergic reaction or persisting vomiting lasting for 1-2 days
- About 1 out of every 250,000-500,000 people who get vaccinated may have a severe allergic reaction (anaphylaxis).
- For teenagers and young adults about 1 out of every 100,000 receiving their first dose and 4 to 5 out 100,000 receiving their second dose of Pfizer or Moderna may have develop inflammation of their heart muscle called myocarditis.This is more likely to occur in males rather than females. (see below for more information). Based on Hawaii’s population, if all of Hawai’i’s teens and young adults got vaccinated, we would expect to see a state-wide total 1 or 2 cases of myocarditis after the first dose and 5 to 6 cases of myocarditis after the second dose.
- Other rare adverse events may emerge over time, the CDC and other government agencies are monitoring national reporting databases and electronic medical records and watching international reports to identify concerning effects as soon as possible.
- Elderly vaccine recipients tend to have less severe side effects from the Covid-19 vaccine
- Teenagers and younger adults may have a slightly high incidence of fainting after vaccination. This may be due to anxiety around the vaccine and occurs with other vaccines as well. Make sure you have eaten and are well hydrated before going for vaccination and you should be sitting down when you get vaccinated and during the 15 to 30 minute observation period after vaccination.
- The second dose of the vaccine is more likely than the first dose to cause some systemic symptoms such as fever, tiredness, headache and/or chills, but this is usually brief, lasting 1 to 2 days.
- Side effects and reactions are not a sign of illness, they are a sign of your immune system responding to the vaccine and helping your body to be ready to quickly stop future infections.
What about the reports of serious allergic reactions to the vaccine.
- The overall risk of having an anaphylaxis reaction after a Covid-19 vaccine is about 1 in 250,000 to 500,000 doses. Most people who experienced anaphylaxis after their covid vaccine had a history of prior allergic reactions.
- If you have never had a severe allergic reaction, your risk of anaphylaxis is much lower.
- If you had a severe reaction to the first dose of vaccine you should not get a second dose of either the Pfizer or Moderna vaccine or any other Covid-19 vaccine until you have discussed your risks thoroughly with your care provider.
- If you had a mild to moderate reaction to the first dose, you may get the second dose but should consult with your medical care provider
- If you have a history of immediate allergic reaction after other injections or vaccines, discuss with your medical provider if you should get either mRNA vaccine.
- If you have had a severe reaction to other triggers such as bee stings, peanuts, latex or shellfish, you can still get vaccinated but will be asked to stay for at least 30 minutes of observation after injection. The Covid vaccine does not contain latex or any egg proteins.
- If you have had a severe allergic reaction to polysorbate or to polyethylene glycol (PEG), the active ingredient in Miralax and other laxatives and in some lubricants and creams, you should not get either of the mRNA vaccines. There will likely be other Covid vaccine options available to you in the coming months.
What about blood clots after the Johnson&Johnson/Janssen vaccine?
Johnson&Johnson/Janssen vaccine has reports of rare bleeding disorder events that occurred in about 1 per million vaccine recipients. The J&J vaccine has been approved to restart, with added precautions regarding education of risks, especially to women under the age of 50. For more information on the J&J vaccine, visit Janssen COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers 04232021 (fda.gov)
What about the reports of myocarditis after vaccinations in teenagers
What is myocarditis and how common is it?
- Myocarditis is inflammation of the muscle of the heart. Pericarditis is inflammation of the outside lining of the heart.
- Myocarditis and pericarditis are rare, affecting 1 to 2 of every 100,000 children per year and up to 10-22 per 100,000 people of all ages after viral infections per year.
What causes myocarditis?
- Most cases of myocarditis are idiopathic, meaning there is not a single clear cause. Myocarditis can be caused by a variety of viruses (including coronaviruses), parasites, bacteria and fungi. It can also be triggered by toxic substances such as cocaine and rarely by some common medications such as cephalosporins and sulfa drugs.
- Many diseases such as Lupus, Inflammatory Bowel Disease and Diabetes also can cause myocarditis.
- Covid-19 infections can also sometimes cause myocarditis.
What are the signs of myocarditis?
- Chest pain, shortness of breath and palpitations (feeling like your heart is skipping beats or fluttering)
- Abnormal ECG and abnormal inflammation blood tests (troponin)
- Abnormal Echo or MRI of the heart
- Pericarditis may also have an abnormal heart sound called a rub heard by stethoscope
Is myocarditis/pericarditis serious?
- The seriousness of myocarditis and pericarditis depends on the underlying cause and severity.
- Myocarditis caused by some viruses or chronic illnesses can be very serious and dangerous.
- Myocarditis after vaccination is generally much milder and is caused by an immune reaction to the vaccine. The inflammation is temporary and like other types of inflammation, will generally resolve after a few days.
- Those affected are likely to be temporarily hospitalized for close monitoring and advised to avoid strenuous activity for a period of time afterward.
How is it treated?
- Most cases respond to rest, supportive care and may need anti-inflammatory medications or medications temporarily for irregular heart beat or to support heart function.
- Rare severe cases may require more complex care. Most myocarditis or pericarditis patients, even those with mild symptoms, are admitted to the hospital for supportive care and monitoring.
How is myocarditis connected to Covid-19 vaccinations?
In early June 2021, reports were published out of Israel and the US identifying rare cases of myocarditis after Covid-19 vaccination. Most cases appeared to be associated with the second dose of mRNA vaccine (Pfizer and Moderna), appeared to occur more commonly in adolescent and young adult males, and 95% appeared to be mild. A CDC evaluation of available data in June 2021 confirmed that there is likely a link between the mRNA vaccines and very rare, but mild cases of myocarditis.
CDC Covid-19 vaccine myocarditis risk
- Myocarditis risk in Unvaccinated
- About 1 to 2 out of every 100,000 teenagers per year are diagnosed with myocarditis, males are at a slightly higher risk than females. Most of these cases are due to unknown causes or due to viruses or medications or drugs.
- Newborns sometimes develop myocarditis due to exposures while in the womb or due to infections before their immune system is fully developed.
- Myocarditis estimated risk after vaccination
- Teenage girls have a risk of myocarditis of less than 1 per 100,000 doses of vaccine. The risk is slightly higher after the second dose.
- Teenage boys have a risk of myocarditis of about 1 per 100,000 after the first dose and 5 to 6 episodes for 100,000 after the second dose
- Hawai’i estimates
- Hawai’i has about 56,000 residents between 12 and 17 years old: If 100% of this age group got vaccinated against Covid-19, we would expect 0-1 cases of vaccine-associated myocarditis after the first dose and 3-4 cases after the second dose.
- Hawai’i has about 65,000 residents between 18 and 24 years old: If 100% of this age group got vaccinated, we would expect 0-1 cases of vaccine-associated myocarditis after first dose and 2-3 cases after the second dose.
If my teenager does not get vaccinated, what is their risk of getting Covid-19?
- Individual risk of infection depends on many factors, including living situation and participation in high-risk activities such as attending large gatherings, parties or other social events and mask use. As Hawai’i opens up more and as restrictions and mask use drops and in-person school resumes in the fall, the risk of infection will increase for everyone.
- For 12-29 year olds
- There have been 7.7 million confirmed Covid-19 infections in US in this age group
- This age group accounts for 33% of US cases in May, 2021
- There have been 2,767 Covid-19 related deaths in this age group since the beginning of the pandemic and 300 Covid-19 related deaths in this age group since April 2021
- In Hawai’i
- Children and young adults account for 37% of total cases, about 13,000 cases
- For 0-18 years olds Hawai’i there have been over 6,600 cases, 77 hospitalizations and 1 death, as of Aug 12, 2021.
- For 18-29 years olds, there have been 213 hospitalizations and 6 deaths in Hawai’i.
- There are over 300,000 Hawaii residents between 12-29 years old.
- As of early August 2021, about 47.8% of the 12-17 year age group and 54.4% of 18-29 year olds have been fully vaccinated. That means there are still about 150,000 12-29 year olds who have not been vaccinated, many of whom are returning to school and increasing social activities as the state opens up to more activities.
Are there long-term risks of Covid-19 in kids and teenagers?
● Most kids and young adults infected with Covid-19 do well, they tend to have less and milder symptoms and have a higher survival rate than older infected persons, but that risk is not zero and kids and young adults with co-morbidities are at a much higher risk of severe infections. There are, however, serious post-infection risks.
● The most serious post-infection complication is children after Covid-19 is a condition called MIS-C, a severe inflammatory condition that can arise in children about a month after infection that includes high fevers, rashes, eye and mucus membrane inflammation and potential heart damage and dangerous blood clots
o MIS-C affects about 1 in every 3-4,000 children infected with Covid-19, many initial infections were asymptomatic
o 60-70% are admitted to the ICU
o 1-2% die
o Those that recover can have lifelong cardiac complications or other complications such as amputations from blood clots
o MIS-A is similar to MIS-C mostly affecting young adults and up to 50% of cases have cardiac involvement
● Prolonged symptoms: Covid-19 can cause long-term and sometimes permanent damage to the heart and lungs. Up to 60% of Covid-19 infections can lead to long-term cardiac symptoms. Even young adults can become long-haul Covid patients. Up to 1/2 of adolescents and young adults still have symptoms 1 month after infection
So yes or no to adolescent vaccination against Covid-19?
- Yes!, Covid-19 Vaccinations in adolescents
- Are extremely effective at preventing infections and hospitalizations
- mRNA Vaccines are showing strong efficacy against emerging variants, including the delta variant
- prevent hospitalizations
- prevent deaths due to Covid-19 and MIS-C
- prevent long-term Covid-19 complications,
- prevent MIS-C incidents that have very high cardiac risks that can be permanent
- prevent the spread of infections in schools and homes,
- prevent clusters that may spread to more vulnerable populations,
- prevent missed school days for kids and missed work days for caregivers,
- prevent mandatory quarantine of contacts,
- prevent opportunities for variants to develop
- allow for quicker return to healthy and safe socialization and group activities and improve mental health environments
- As the state reopens and full in-person school resumes in the fall, kids will have more interactions and more opportunities for infection. Without adequate vaccination, cases will increasingly spread within this age group and while they may be less impacted than older populations, they will inevitably have increased hospitalizations, long-term and possibly permanent issues and deaths and contribute to community spread and variant development
- Covid-19 is here to stay (FYI the flu virus that caused the 1918 pandemic is also still around and its descendants are responsible for the flu that we live and die with). Eventually Covid-19 or some future version of it will reach every hard to reach spot in the world. Even if you are low risk now, you might find yourself in a cluster or at high risk in a year or two, so your vaccine today might save you or those around you years from now.
- But what about the myocarditis?
- If every adolescent and young adult in Hawai’i were to get vaccinated, we would expect 1 to 2 cases of myocarditis after the first dose and 5 to 7 cases after the second dose. These episodes would be self-limited, similar to other post-vaccination side effects, and most if not all would fully recover within a few days to weeks.
What about other vaccines, should I wait for J&J or the Novavax vaccine
There have been rare myocarditis cases also reported after J&J vaccination, but because it has been used so much less than the Pfizer and Moderna vaccines, it is not clear if it has the same occurrence rate. The myocarditis events are due to the immune system cross reacting to the spike protein that the vaccines encode for. All the vaccines available and coming up either use the spike protein directly (Novavax), use a viral vectors to induce your cells to make the spike protein (J&J and Astra-Zeneca) or use mRNA to induce your cells to make the spike protein (Pfizer and Moderna). Covid-19 itself can cause myocarditis. So waiting or switching vaccines after 1 dose is not recommended and may not reduce the risk of myocarditis.
If I have myocarditis after my first dose of vaccine should I still get the second dose?
If you have any symptoms of myocarditis after vaccination, you should inform your care provider immediately for evaluation. You should have a discussion with your care team and provider before getting your second dose.