The COVID-19 pandemic continues to wreak havoc in the United States and throughout the world with cases, hospitalizations, and deaths reaching devastating and tragic levels each day. The current peak of infections is likely to continue to expand until mid-January. Fortunately, two COVID-19 vaccines have now been approved for use by the U.S. Food and Drug Administration and distribution to the states is underway. The Pfizer (ages 16 and up) and Moderna (ages 18 and up) vaccines received Emergency Use Authorization (EUA) on December 11 and December 18, respectively.
These vaccines provide the path forward to end the COVID-19 pandemic. In general, unless there is a specific reason to not get vaccinated, such as a known allergy to a component of the vaccine, our medical team at the Rocky Mountain MS Center at University of Colorado is recommending that all individuals get vaccinated. As always, with any intervention, if you have any questions, please be sure to check with your provider before taking any drug or vaccine. Several of our providers have started to get vaccinated.
The framework for vaccination prioritization and distribution timelines are being developed by each state. Priority is based on the principles of who is at highest risk of exposure, including health care workers taking care of COVID-19 patients; and who is at highest risk of a bad outcome if exposed, including older individuals living in nursing homes.
Everyone should continue to wear a mask, avoid in-person interactions, wash your hands, physically distance, and follow all CDC and state health and safety guidelines. Even after being vaccinated, it is important to continue to use these critical safety measures until a significant majority of Americans (70%+) have been infected and/or vaccinated. According to the CDC, the combination of getting vaccinated and continuing to follow these safety guidelines will offer the best protection from COVID-19 for yourself and others. Stopping the pandemic requires using all the tools we have available. These actions are important both for your health and for the health and safety of your family, friends, and fellow community members.
Below is a summary of vaccine information, including efficacy and safety data, additional vaccines undergoing clinical trials, and vaccination distribution plans. We will continue to update you with any new information or additional guidance.
Efficacy of Pfizer and Moderna Vaccines
Both the Pfizer and Moderna COVID-19 vaccines have demonstrated very high effectiveness of about 95%. For a point of reference, the annual Flu vaccine, depending on the year, is usually between 50% and 70% effective.
Safety of Pfizer and Moderna Vaccines
The vaccines have gone through rigorous review by multiple entities to ensure safety and efficacy. Clinical trials have evaluated the vaccines in many thousands of study participants to generate scientific data and other information for the FDA to determine their safety and effectiveness. The FDA and the Centers for Disease Control (CDC) have determined that the Pfizer and Moderna COVID-19 vaccines meet their safety and effectiveness standards for Emergency Use Approval. A diverse group of people volunteered to participate in every phase of the clinical trials, including populations disproportionately impacted by COVID-19 due to systemic inequities.
The clinical trials demonstrated similar safety and efficacy profiles in persons with underlying medical conditions, including those that place them at increased risk for severe COVID-19, compared to persons without comorbidities. MS and related conditions, by themselves, do not raise risk of bad outcomes with COVID-19. Some medications, such as rituximab (Rituxan) and ocrelizumab (Ocrevus) may slightly increase risk of a bad outcome if exposed to the virus that causes COVID-19. Overall, there is limited data for most medications.
Since the vaccines are not live viruses (in fact there is no virus in these vaccines), they likely do not present risk for those with MS and related neurological conditions. No specific neurological concerns related to the vaccines have been raised so far, although there have been a few cases of Bell’s Palsy in the Pfizer and Moderna trials, and a single case of a transverse myelitis with the AstraZeneca vaccine among the nearly 60,000 individuals treated so far through the vaccine clinical trials. Neither of these conditions has been clearly attributed to the vaccine vs. the placebo. And have not occurred at a rate above that expected in the entire population.
There is inadequate data of the effects of any of the vaccines in pregnant women. Pregnant and breastfeeding women will have the option to be vaccinated if they so choose. Present recommendation is to NOT get vaccinated if you have had a significant allergic reaction to any prior vaccination.
Potential Side Effects of the Vaccine
The most common reported side effects of the vaccines include fever, fatigue, headaches, muscle pain, chills, joint pain, and pain at the injection site, which are similar to those experienced when receiving the flu vaccine.
How Do the Pfizer and Moderna Vaccines Work?
Both the Pfizer and Moderna vaccines are messenger RNA (mRNA) vaccines. mRNA is a single-stranded RNA molecule that can lead to production of a certain protein found on the surface of the virus that causes COVID-19, called the spike protein. Our bodies recognize that the protein should not be there and build T-lymphocytes and B-lymphocytes that allow us to fight the virus if we become exposed or infected in the future. These vaccines do not contain live virus and cannot produce live virus in recipients.
Both the Pfizer and Moderna vaccines require two doses which are administered into the muscle. The two Pfizer doses are administered 3 weeks apart; the two Moderna doses are administered 4 weeks apart. It is very important that an individual receives both doses of either of the vaccines for maximal benefit. The only exception would be if there was a significant bad reaction with the first dose. These have been very rare.
Vaccine Distribution
Vaccines are currently being delivered to all 50 states. The quantity being delivered is based on the population of each state. Each state is developing prioritization and distribution plans for the vaccines. Colorado’s front-line health care workers began receiving vaccinations on December 14, 2020.
In Colorado, the state’s draft vaccine distribution plan has three phases which are detailed here: https://covid19.colorado.gov/vaccine-faq#Planning and we’ve also included CPDHE’s graphic below. Colorado’s draft plan is subject to change based on available data, science, and availability.
The current Phase 2 group includes “immunocompromised” individuals, but the term “immunocompromised” has not yet been defined. We will update you with further information as it becomes available.
The vaccines require special handling and procedures as they make their way out to the public. This affects the logistics of shipment and delivery of the vaccines, especially for the Pfizer vaccine, because it must be kept at extremely cold temperatures, ie dry ice or other very cold refrigeration, not only while in transit, but also while in storage at their destination.
If you are a patient at UCHealth, please watch for messages to your My Health Connection account (click here to access), and please register/aign up if you haven’t already done so. As UCHealth receives additional vaccine supplies and expands vaccinations in the coming weeks and months, they will send patients messages through this channel to sign up for an appointment. For additional questions about UCHealth’s vaccine information, please visit: https://www.uchealth.org/services/infectious-diseases/coronavirus-covid-19/covid-19-vaccine/
If you are 70 years or older, here is more specific information on how to contact providers to receive your vaccine: https://covid19.colorado.gov/for-coloradans/vaccine/vaccine-for-coloradans?fbclid=IwAR1ma8J4z2R0IoXao2_kjGmVvPxyoDFCQEF6BIHI4yTFDwS7a2vHRDzVwEg
Additional Vaccines Currently Undergoing Clinical Trials
Additional COVID-19 vaccinations are under development and undergoing clinical trials including Johnson & Johnson, Janssen and AstraZeneca. Janssen and AstraZeneca are vector vaccines. Vector vaccines contain a disabled virus —a different virus than the one that causes COVID-19 — which cannot multiply and infect other cells. This virus carries genetic material that gives our cells instructions to make a protein that is unique to the virus that causes COVID-19. Our bodies respond to the protein by building T-lymphocytes and B-lymphocytes to fight that virus if we are exposed or infected in the future. Efficacy and safety data regarding these and other additional vaccines will likely be available in the coming months. Studies in children also are ongoing.
Continue Following Ongoing Safety Guidance
Everyone, including individuals who receive a COVID-19 vaccination, should continue to follow all current guidance to protect themselves and others. According to the CDC and CDPHE, in order to slow the spread of disease, we should all continue to use basic public health guidance, like physical distancing and mask wearing, until a vaccine is widely available and used. Core safety guidelines to continue following include:
- Wearing a mask
- Staying at least 6 feet away from others
- Avoiding crowds
- Washing hands often
- Following CDC travel guidance
- Following quarantine guidance after an exposure to someone with COVID-19
- Following any applicable workplace or school guidance
FAQs: Answers to Other Frequently Asked Questions
For more information and Frequently Asked Questions about the COVID-19 vaccines, please see the following resouces:
- Colorado Department of Public Health and Environment (CDPHE) Vaccine FAQ webpage
- Overall COVID-19 information from CDPHE
- The CDC’s COVID-19 vaccine information page
- Vaccine information from UCHealth
- Specific information for those 70 years of age and older