KPHC COVID-19 Vaccination Info and FAQ

• KPHC has the Pfizer vaccine available now for children aged 5-17 years old. For 18 and above we are administering the Pfizer or Moderna vaccines. KPHC is not currently administering the J&J vaccine.
• No Covid-19 vaccines are currently approved for children 0-4 years old. Please check www.hawaiicovid19.com for the latest news on vaccine approvals.
• 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.

• 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.
• KPHC does not currently administer the J&J/Janssen vaccine

• Our recommendation is to get vaccinated as soon as you and your family are eligible.
• If you are considering vaccination, please do so now rather than waiting. Covid-19 will be spreading through Hawai’i for possibly years to come and it will eventually reach all of us. Being vaccinated is the most effective way to keep you and those who are close to you or who work with you from getting infected and especially from being hospitalized, on a ventilator or dying from Covid-19.
• If you have questions about the vaccine, please contact us and we will do our best to answer your questions to give you the information you might need to make the best decision for yourself and your family.

• The Pfizer and Moderna vaccines are the same type of vaccine and are very similar in their effectiveness and potential adverse events. Both vaccines are very effective in preventing Covid-19 infections and in preventing hospitalizations and deaths due to Covid-19. 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 usually mild and temporary inflammation of the heart muscle.
• The Johnson&Johnson/Janssen vaccine is a different type of vaccine. KPHC does not carry the J&J vaccine at this time. 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 adult women under age 50.
• If you are undecided, 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 a shorter interval to getting the booster dose, so it provides full vaccination protection sooner that other vaccines. The Moderna and Pfizer vaccines may provide slightly higher protection against covid-19 infections compared to the J&J vaccine. All three vaccines provide excellent protection against severe Covid-19. The CDC currently recommends the mRNA vaccines (Moderna or Pfizer) as preferable to the J&J vaccine due to higher efficacy and lower risk of serious adverse events.
• 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.

• Yes, one dose of Pfizer or Moderna vaccine does not provide significant protection against Covid-19 infection. Two doses provides improved protection against the original Covid-19 strain and Delta. With the rise of the Omicron variant, a booster dose of either Pfizer or Moderna provides very good protection against serious infection.
• Vaccine protection is not immediate, your body has to respond to the vaccine to stimulate your immune system. Waiting until you are exposed or feeling sick is too late for the vaccine to provide protection for that infection.  Completing your vaccines at least 2 weeks before exposure provides the best protection.

• 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.
• Once you are finished with your recommended isolation period (5-10 days for asymptomatic or mild to moderate infections. 10-20 days if you are immunosuppressed or had a more severe or critical Covid-19 infection) you can get vaccinated.
• If you had heart inflammation due to your Covid-19 infection, check with your medical care provider before getting vaccinated.

• If your reaction was mild to moderate, you can still get vaccinated. If you had a serious allergic (anaphylactic) reaction to a vaccine or to one of the ingredients in the vaccines, 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 had a serious adverse event or were diagnosed with myocarditis after the first dose of either the Pfizer or Moderna vaccines, let your vaccine provider or medical care provider know before you get your second dose.

Yes, your risk of an allergic reaction to the vaccine is low. You will be asked to stay around after vaccination for 30 minutes to monitor for any allergic reactions.

• Yes, vaccination is STRONGLY 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 INFECTIONS are known to increase the 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.

• No, there is no charge associated with the vaccine at this time, but this may change at any time. 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 financial or credit card information, DO NOT give any information. Go to www.hawaiicovid19.com for official state vaccine information.

• Yes, if you are immunosuppressed, the vaccine is still recommended and there is no evidence of increased adverse events after vaccination.
• The Covid-19 vaccines available are not “live” vaccines, so you cannot get or spread Covid-19 after vaccination.
• 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 vaccination recommendations.
• If you have moderate to severe immunocompromising condition, you may not have developed a strong protective immune response to 2 doses of an mRNA vaccine (Pfizer or Moderna) or 1 dose of the J&J vaccine. An additional/third dose of mRNA vaccine or second dose of J&J vaccine about a month after completing your primary series is recommended If you meet any of the following
  • on treatment for solid tumors or blood cancer like leukemia,
  • on immunosuppression after an organ transplant,
  • had a stem cell transplant within the last 2 years,
  • on immunosuppression treatment or high-dose steroids for other conditions,
  • have a moderate to severe immunocompromising disease,
  • or if you have advanced or untreated HIV
  • Your care provider may recommend an additional dose if you have other conditions that may suppress your immune system
• See below for more information on covid-19 vaccine additional doses and boosters.

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.

• 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.
• The mRNA in the vaccine is similar to a small part of the RNA in the virus that causes Covid-19 and almost all of the vaccine mRNA stays in the muscle area where it is injected.
• A single Covid-19 infection results in far more viral genetic material moving throughout your body. A covid-19 infection can result in from 1 billion to 100 billion individual viral particles in your body, each with a full viral RNA.
• So, natural Covid-19 infection is much more likely to cause severe illness, death or long-term disability, and it will result in a far greater amount of foreign RNA spreading throughout your body and the duration of your post-infection immunity may not last very long. Vaccination is very unlikely to cause any serious adverse events, will introduce far less RNA into your body than an infection, that RNA will almost entirely stay in the area of your injection and will be broken down soon after, and will result in more sustained immune protection from severe Covid-19 disease.

• Almost all adverse reactions to the vaccines are brief and mild, usually lasting 1-2 days. The second dose of vaccine is more likely to cause some temporary adverse events. The booster dose has a slightly lower rate of adverse events.
  • 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.
• 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.
• 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.
• Rarely some people may experience more serious adverse events after vaccination. See below for more information.
• An infection with Covid-19 is much more likely to cause serious medical complications, some of which may be long-term or even permanent or deadly. Covid-19 will eventually reach all of us, vaccination is a much safer option than waiting to get infected.

• Johnson&Johnson/Janssen vaccine has reports of rare bleeding disorder events that occurred in about 1 per million vaccine recipients, especially in adult females under 50 years of age. For more information on the J&J vaccine, visit Janssen COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers (fda.gov)

Johnson&Johnson/Janssen vaccine has reports of rare bleeding disorder events that occurred in about 1 per million vaccine recipients, especially in adult females under 50 years of age. For more information on the J&J vaccine, visit Janssen COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers (fda.gov)

• Myocarditis is inflammation of the muscle of the heart. Pericarditis is inflammation of the outside lining of the heart.
• Myocarditis can be caused by a variety of viruses (including non-Covid-19 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 are known to cause myocarditis, both during the acute infection and in patients who develop a serious inflammatory reaction a month after a Covid-19 infection, Called MIS-C or MIS-A
• The mRNA covid-19 vaccines (Pfizer or Moderna) can rarely cause myocarditis, especially in older teenagers and young adult males.

In the Spring of 2022, the CDC recommended a longer interval between the 2 doses of mRNA vaccines for teens and young adults of 8 weeks rather than the previous 3 weeks.

• This change reduces the risk of post-vaccine myocarditis.

• Chest pain, shortness of breath and palpitations (feeling like your heart is skipping beats or fluttering)

• The seriousness of myocarditis and pericarditis depends on the underlying cause and severity.
• Myocarditis caused by some viruses, including Covid-19, or chronic illnesses can be very serious and dangerous.  About 4-7% of people who get myocarditis due to virus infection or chronic disease die and another 4-9% will require a transplant.
• Myocarditis after vaccination is generally much milder and is caused by an immune reaction to the vaccine, not because of infection or damage to the heart. The inflammation is temporary and like other types of inflammation, will generally resolve after a few days.

• Most cases respond to rest, and supportive care and may need anti-inflammatory medications or medications temporarily for an irregular heartbeat or to support heart function.
• Most myocarditis or pericarditis patients, even those with mild symptoms, are admitted to the hospital for supportive care and monitoring. Rare severe cases may require more complex care.

• 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.
• Covid-19 can cause complications that occur after the acute infection has resolved. The most serious post-infection complication in 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
  • MIS-C affects about 1 in every 3-4,000 children infected with Covid-19, many initial infections were asymptomatic
  • 60-70% are admitted to the ICU
  • 1-2% die
  • Those that recover can have lifelong cardiac complications or other complications such as amputations from blood clots
  • MIS-A is similar to MIS-C mostly affecting young adults and up to 50% of cases have heart 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

• Yes!, Covid-19 Vaccinations in children and teens
  • effective at preventing infections
  • 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 improves mental wellness
  • 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.

• Yes.
• Clinical trials for 5-11 year olds showed that most vaccine reactions were mild and brief. Systemic reactions occurred less often and were less severe in 5-11 year olds compared to 16-25 year olds.
• Among 5-11 year old, after the second dose
  • 70% of kids had pain at the injection site
  • 20% of kids had redness
  • 15% had swelling
  • 6.5% had fever
  • 40% had fatigue
  • 30% had headache
  • 10% had chills or muscle pain
  • 5% or less had diarrhea, joint pains or vomiting
• There were no reports of anaphylaxis, no reports of myocarditis and no reports of Bell’s Palsy after vaccinations in the 5-11yo trials. The risk of myocarditis after vaccination is lower that the risk of myocarditis from a covid-19 infection.
• Millions of doses of Covid-19 vaccine doses have been administered to 12-15 years old children in the US with no safety concerns.
• No treatment or vaccine is 100% without any risk of adverse events. It is important to be informed about the risks and benefits of any preventive intervention or medical treatment, so decisions can be made with the best available understanding.

• Yes.
• Clinical studies showed the vaccine to have a 90.7% efficacy at preventing infection. True efficacy probably ranges from 70-97%. Infection prevention against Omicron is lower, however the vaccine is showing efficacy at preventing severe illness and hospitalization in children.
• It is still possible for a fully vaccinated person to become infected, but the risk of infection is lower and the risk of severe illness after vaccination is also very, very low.

• Children are as likely to get infected as adults. Social distancing, hand hygiene  and consistent mask use may be more difficult for younger children. Vaccination is very effective at protecting children.
• In the last week of December, 2021, 325,000 Covid infections occurred in children and teens.
• Children can spread infections. Children in poorly ventilated spaces such as at home or in classrooms or playgroups without consistent mask use are much more likely to become infected and to spread infection. Vaccinated children are less likely to spread Covid-19 to others in their home and at school.
• Children can still have very severe infections and can die from Covid-19. Since the beginning of the pandemic, through Jan 12, 2022
  • Over 1,000 children and teens have died from Covid-19
  • By comparison, the flu has killed 7 kids over the last 2 years
  • Unvaccinated teenagers are 10x as likely to be hospitalized compared to vaccinated
  • Over 5,000 cases of MIS-C, a severe inflammatory condition that occurs in 1 out of every 3-4,000 pediatric Covid infections had been reported in the US through October 2021, with 46 deaths.
• It is important to remember that the above numbers occurred with mitigation efforts in place; masks, social distancing, lockdowns, testing, isolation and quarantine requirements. Had those efforts not been in place, cases, hospitalizations and deaths would have been much higher and still could worsen without vaccinations as mitigation efforts are removed.
• Children can have long-haul Covid. About 7-8% of children who develop Covid-19 infections continue to have symptoms 3 months after their acute infection, including: fatigue, headaches, insomnia, difficulty concentrating, joint pains and cough. Infected children also have a high risk of myocarditis that may last for months and possibly longer.
• Vaccination of kids will help reduce the risk and spread of new covid variants. Every infection allows for millions of new viruses to grow, each new virus has the potential to mutate into a new variant. As we saw with the delta variant, new variants have the potential to change the course of the pandemic.
• Compared to the flu, children hospitalized for Covid-19 are more likely to have a longer hospitalization, more likely to be in the ICU and require mechanical ventilation. Over the last 2 years, Covid-19 has killed over 1,000 children and teens, Flu has killed 7 kids over the same time period. Death rates for children hospitalized with Covid-19 are similar to those for Influenza.
• Prior pediatric vaccination programs have been very effective.
  • Vaccines save the lives of children, save the lives of those children when they become adults, save lives of sexual partners and prevent diseases from passing to newborns. Vaccinations are a cornerstone of public health and have proven effective and safe over decades.

• Multisystem Inflammatory Syndrome in Children, a hyperinflammation condition that occurs in about 1 out of every 3,200 infected children
• MIS-C causes inflammation and impairment of multiple organ systems in the body, the heart in particular can become severely inflamed and potentially permanently damaged.
• Typically occurs about 1 month after an acute Covid-19 infection
• 60-70% of MIS-C cases are admitted to the ICU and 1-2% die
• There have been over 5,000 MIS-C cases and 46 deaths in the US  as of Oct 2021
• Average age is 9 years old

• For some mild diseases, such as Roseola and Fifth disease, natural infection is generally safe and the risk of vaccination outweighs the benefit, so vaccines are not recommended or even available.
• Covid -19 is not a mild disease. It is not like the flu. Consider that in a typical year before Covid, the flu kills between 40-200 U.S. children every year. After the Covid-19 mitigation efforts were in place (masks, social distancing, lockdowns and gathering restrictions, etc), flu cases dropped dramatically and in the 2020-21 flu season there was only 1 reported pediatric death in the U.S. During that same time, despite the same mitigation environment, Covid-19 infected millions of kids, leading to the deaths of over 700 children 0-17 years old.
• Just among 5-11 year olds in the US, through Oct 2021, Covid-19 caused
  • 1.9 million cases
  • 8,300 hospitalizations
  • 2,316 MIS-C cases (1 case per 3,200 Covid cases, 1-2% mortality)
  • 94 deaths
• Not vaccinating children while allowing mitigation efforts to stop, would cause far more cases with many more hospitalizations, deaths and long-term or life-long disability. These vaccines are safe and while there will be rare serious adverse events, the vaccines will prevent deaths and suffering in this age group.
• It is our responsibility as adults to protect our children, children have the right to access treatments that can prevent life-threatening illnesses.

• Yes, vaccination is recommended after recovery from infection
• Milder infections may result in shorter immunity after infection. Vaccination can provide more substantial and durable immunity.
• It is very difficult to predict how protected a person is after infection. We have had multiple cases of reinfection in adults and children. We recently had a child with reinfection and hospitalization 3 months after the initial mild infection.
• Antibody responses after vaccination are more consistent after vaccination compared after infection

• Covid-19 vaccination after MIS-C should be considered in consultation with your child’s doctor once all of the following criteria are met
  • Clinically recovered with normal cardiac function
  • At least 90 days since their MIS-C diagnosis
  • The child is in an area of high community spread of Covid-19 or otherwise, have a higher risk of exposure or transmission
  • MIS-C occurred prior to any Covid-19 vaccination
• Vaccination after MIS-C may be considered without meeting all of the above criteria in specific high-risk situations as long as cardiac function has normalized in consultation with your care provider.

• Antibody level testing is not recommended. Antibody levels may not correlate with protection from infection. Antibody tests check for only one part of your immune protection. You may still have excellent protection from infection even though you might have a negative antibody test.
• Other infections can sometimes cause false-positive Covid-19 antibody tests.

• The dose recommended for the age at the time of vaccination is recommended. In this case the first dose would be the 0.2ml of the 5-11yo (orange cap) formulation and the second dose would be 0.3ml of the 12+ formulation (purple cap).
• If both doses given are the 5-11yo formulation, it is not necessary to repeat the dose.

It is best to go ahead and vaccinate as soon as possible. Waiting for a higher dose is not likely to provide a benefit. The lower dose in younger kids has been shown to generate an immune response similar to that of the higher dose in older kids

No, the Covid-19 vaccine is not a required vaccination for public schools at this time.

Yes, there is no requirement to separate or delay other vaccines.

• The mRNA in the Pfizer and Moderna vaccines is a copy of a small portion (about 10%) of RNA of the virus that causes Covid-19. This small piece of mRNA allows your muscle cells at the injection site to make proteins that are identical to one of the proteins in the Covid-19 virus, the spike protein in this case. These proteins cause your body to make an immune response that can stop a future infection before it can cause infection or severe illness. The mRNA in the vaccine is only able to make this one, single protein. The vaccine mRNA does not make any of the other proteins that the Covid-19 virus requires to grow and spread.
• The vaccine mRNA and proteins never enter the nucleus of your cells and do not combine with or change your DNA.
• Just like the mRNA that your body makes naturally, the vaccine mRNA quickly breaks down and becomes inactive.
• By comparison, an infection with Covid-19 will flood your airway with between 1 billion and 100 billion virus particles and each virus contains much longer and more complex RNA that instructs the virus on how to overwhelm the infected cell with massive amounts of virus.
• We will all eventually be exposed to Covid-19 and are likely to become infected. The small amount of mRNA in the vaccine that will almost entirely stay in the muscle where it is injected, can prevent the billions of complex and invasive RNA strands from spreading throughout your body, potentially impacting the function of every body organ.

• Anyone 18+ years old who completed two doses of Pfizer or Moderna at least 5 months ago or J&J at least 2 months ago can receive a booster with any of the three available Covid-19 vaccines, Pfizer, Moderna or J&J
• Anyone 12+ years old who completed two doses of Pfizer at least 5 months ago should can receive a booster of Pfizer vaccine.
• If you are at least 12 years old and have a moderate to severe immunocompromising condition AND if you completed 2 doses of the Pfizer or Moderna vaccines, it is recommended that you receive an additional/third dose of vaccine at least 28 days after your 2nd dose. If you received the J&J vaccine, you are eligible for a booster dose after 2 months. A third dose of J&J is not recommended at this time.
  • Conditions approved for the third dose are: On treatment for tumors or blood cancer, on immunosuppression after transplant, had a stem cell transplant within last 2 years, on immunosuppression treatment or high-dose steroids, have a moderate to severe immunocompromising disease, advanced or untreated HIV

The third dose is not considered a booster, it is an additional primary course dose and is recommended for people with specific immunocompromising conditions that put them at risk for not developing an immune response to the 2-dose vaccine series. It is given 28 days after your second dose of vaccine and is approved for both Moderna and Pfizer recipients.

• If you have one of the conditions listed above and it has been at least 28 days since you got your second dose of Moderna or Pfizer vaccine, you should get a third dose now.
• If you got J&J as your single dose and it has been at least 2 months since your vaccine, you should get a booster with either J&J, Pfizer or Moderna vaccine

• If you received J&J/Janssen as your primary vaccine, you are eligible for a booster 2 months after your single primary dose. If it has been more than 2 months, that is ok, you can get your booster at any time after the 2-month minimum.
• If you received Moderna or Pfizer as your primary series, the booster should be given at least 5 months after you got your second dose of Pfizer. If it has been more than 5 months since you finished your first set of shots that is Ok, you can still get the booster any time after the 5-month minimum.

Yes, heterologous, or mixed vaccine type/brand for your booster is OK

• In general the recommendation is to stay with the same vaccine you received for your primary series, however National Institutes of Health studies have shown the mixing and matching vaccines for boosters resulted in a strong immune responses for all combinations.
• Boosting with one of the mRNA vaccines (Moderna of Pfizer) appeared to generate a higher antibody response compared to booster doses using the J&J vaccine.
• Data shows that if you received the Moderna or Pfizer vaccines you are probably going to have a slightly better immune response to receiving the same vaccine. If you received the J&J vaccine, you are likely to have a better antibody response to a booster with one of the mRNA vaccines.
• Known risk factors such as thrombotic event risks in younger women with the J&J vaccine or myocarditis in younger males with the mRNA vaccines should be considered when you are deciding on which vaccine you may want to choose.

Studies show that a lower dose provides an effective immune boost and has less adverse events compared to a full-dose booster. If you received Pfizer or J&J and choose a Moderna booster, you will still receive a half-dose compared to the primary series. This is shown to generate a good immune response.

• No, in the studies done on boosters, the local (redness, swelling and pain) and systemic (fever, headaches, fatigue) reactions occur LESS frequently than they do with the primary vaccination series. And the reactions tend to be less severe.
• The risk of severe events such as myocarditis or thombotic events is not increased with boosters compared to the primary vaccine series based on current information.

No. The booster dose is not mandated at this time. If you received 2 doses of either Moderna or Pfizer or a single dose of J&J, you are considered fully vaccinated.

• No. The current vaccines continue to be very effective, especially against hospitalizations. With Omicron, the effectiveness of the vaccines against mild to moderate infections is reduced, however the booster does appear to provide strong immunity against both infection and against severe or critical Covid-19 infections.

• Studies in the US and in other countries have shown that vaccine efficacy declines about 6 months after vaccination, leading to increased infections and hospitalizations in vaccinated persons who are in close contact with someone with Covid-19. Especially with Omicron infections. Efficacy is still good, especially against hospitalization and death.
• Booster doses appear to provide a big immune boost against Omicron infections and severe illness.
• Booster doses may reduce asymptomatic and milder infections as well and prevent spread of infection by vaccinated people, helping slow the pandemic and reduce hospitalizations.

• Booster studies in the US show a significantly lower risk of local and systemic adverse events after the booster compared to the primary vaccine series and those events tended to be less severe. There was no increase in serious adverse events with the boosters compared to the primary series of all vaccines.

No, the boosters are the same vaccines as the primary series. The only difference is for dosing of the Moderna booster, which is a half-dose compared to the primary series. The vaccines have been very effective against severe disease and hospitalizations and deaths due to the delta variant, so a modified vaccine is not necessary at this time.

• Not really. Antibody tests only measure one part of your immune response to vaccination, called humoral immunity. There is a second type of immune response called cellular immunity that is an important part of your protection that is not easy to measure. Antibody levels do correlate with protection from infection, but cellular immunity also provides significant protection, especially against severe illness. So even if you have no antibodies on an antibody test, you are likely still protected by your cellular immunity.
• Some antibody tests check for antibodies to a different part of the virus than the vaccine triggers, so a positive antibody test may indicate a prior infection, but not vaccine protection.
• Antibody tests also may not be sensitive enough to detect protective antibodies levels, leading to false-negative tests or they may detect antibodies for coronaviruses other than Covid-19, leading to false-positive results.

• In March 2022, the FDA and CDC approved a second booster shot of mRNA vaccines for anyone 50 and older, for anyone who has a high-risk immunocompromising condition, or anyone who received 1n mRNA booster after a J&J primary series.
• If you are 65+ years old or have a moderate to severe immunocompromising condition, we strongly recommend this second booster shot. For others 50-64 without high-risk conditions, the 2^nd booster is available. If you are in a high-risk environment for exposure or with a high risk of spreading covid to others at high risk, then the 2^nd booster is recommended.

• It isn’t clear at this point. The annual flu shot is necessary because protection from the flu shot tends to decrease over the course of a year or so, and because the flu virus changes year to year, so last year’s flu shot may not work against this year’s flu.
• If the Covid-19 virus stays fairly stable and if the current vaccine works against future variants and if the immune protection from the shot seems to last for a long while, then an annual Covid-19 shot won’t be necessary. If the Covid-19 virus changes its spike protein too much allowing the virus to sneak past our immunity or if a new variant arises that the vaccine does not work well against, or if we start seeing a lot of breakthrough infections with severe illness then an annual Covid-19 shot may be recommended.

• A covid-19 infection does provide some protection from a subsequent infection, but it is not clear how long that protection will last and we have seen several repeat infections among KPHC patients and staff. Studies comparing post-infection immunity to post-vaccination immunity show that the vaccine may provide 2x better immunity than infection alone and vaccine protection may last longer than post-infection protection.
• A prior breakthrough infection is not a contraindication to a booster dose and if you are at high risk of severe illness, a booster dose may provide you with significantly increased longer-lasting protection.

• The booster dose will increase your antibody levels and will likely reduce your risk of getting infected and your risk of spreading Covid-19 to others, but how much protection and how long that protection will last are still not clear at this time.

The most effective protection would be for the high-risk person to receive a booster dose, and for everyone else in the home or social circle to get fully vaccinated and booster doses when they are eligible.

• If you experienced an immediate allergic reaction after your prior dose of Pfizer vaccine, you should not receive the booster.
• If you experienced expected local or systemic reactions to a prior dose such as pain, fever, redness, nausea after vaccination, you can still receive the booster.
• If you experienced myocarditis after a prior dose of Pfizer vaccine, you can receive the booster as long and your inflammation has completely resolved. Consultation with your care provider or cardiologist is recommended. If you have a history of myocarditis or pericarditis unrelated to the vaccine, check with your care provider or cardiologist before getting your booster.
• If you experienced Guillain-Barre Syndrome or Bell’s Palsy after a prior dose of vaccine, you can still receive the booster.

Yes, it is no longer recommended that you wait for 90 days after you completed your plasma or antibody treatment before receiving your booster dose. You can receive it at any time that you would normally be eligible.