A volunteer receives an experimental vaccine as part of a study at NIH. More than 43,000 volunteers took part in the Pfizer trial for the Covid-19 vaccine. Credit: National Institutes of Health

None of the information provided is medical advice, and individuals should consult their providers with medical questions.

Getting the vaccine

Who received the first vaccinations in North Carolina?

Health care workers and first responders at high risk of interaction with COVID-19-positive patients were the first population to receive the vaccine.

Staff and residents of long-term care facilities were also in the initial phase of vaccine rollout. Distribution to long-term facility staff and residents is managed by the federal government through a partnership with CVS and Walgreens. The retail pharmacies operate vaccination clinics at long-term care facilities throughout the state.

Has the plan for vaccination distribution changed? Where is my place in line?

Yes. Initially, after health care staff and long-term care residents and staff, the NC vaccine distribution plan prioritized people with two or more of the chronic conditions, as defined by the CDC, that increase risk of disease severity. 

On Dec. 20, a CDC advisory panel recommended prioritizing essential workers and individuals 75 and older, and the state changed its plan. On Jan. 11, 2021, the federal government, through Operation Warp Speed, announced changes to prioritization.

On Jan. 14, 2021, North Carolina officials announced the latest plan which puts people 65 and older next in line after healthcare workers. The next group includes frontline essential workers. The state has not yet released guidance on how frontline essential worker designations will be made or enforced.

After frontline essential workers, the plan provides vaccines for people 16-64 with high-risk medical conditions; incarcerated individuals and those in congregate settings such as migrant farm camps or homeless shelters; and essential workers not yet vaccinated.

Where is the vaccine be available in North Carolina and how do I get an appointment?

A list of providers may be found at Find Your Spot.

As the state receives more shipments of vaccines, it will become available at more providers. After the initial distribution to specific hospitals and health departments, the Department of Health and Human Services expects to send doses to private providers and community clinics.

This map shows the current allocations and administrations by county.

How much vaccine has been shipped to the state so far? How much is sitting in NC warehouses or otherwise waiting to be distributed to medical providers?

Each week, the federal government allocates doses of the Pfizer and Moderna vaccines to be shipped to North Carolina. A portion of the allocation is designated for the CVS/Walgreens distribution to long-term care facilities, a process managed by the federal government. The following table shows the weekly allocation:

WeekPfizer dosesModerna dosesAllocation of Moderna doses
to long-term care facilities
Week 1: December 14, 202085,8000 (not yet authorized)0
Week 2: December 21, 202061,425175,90096,900
Week 3: December 28, 202078,00060,80034,500
Week 4: January 4, 2021143,325
(85,800 second doses)
59,50034,500
Week 5: January 11, 2021126,850
(61,425 second doses)
62,2000
Week 6: January 18, 2021DHHS has not yet released numbersDHHS has not yet released numbers

What are the side effects? 

“The most common solicited adverse reactions were injection site reactions (84.1%), fatigue (62.9%), headache (55.1%), muscle pain (38.3%), chills (31.9%), joint pain (23.6%), fever (14.2%); severe adverse reactions occurred in 0.0% to 4.6% of participants,” according to information Pfizer submitted to the FDA. 

Because individuals may experience mild or moderate side effects, some hospitals are staggering vaccine distribution for health care workers to avoid staff shortages. “We don’t want everyone to feel crummy all at the same time and have to call out and then folks have staffing challenges,” N.C. Department of Health and Human Services Secretary Dr. Mandy Cohen said.

Why does my appointment take 30 mins to an hour?

In addition to wait times, recipients may be asked to wait 15-30 minutes to be monitored for any possible reactions.

What is the recommendation for people who have already had COVID-19? 

The N.C. Department of Health and Human Services does not yet have enough information to advise individuals who have already contracted coronavirus. 

“We don’t know enough to say if having had COVID-19 creates natural immunity or how long that may last. Early data suggests that natural immunity from COVID-19 may not last very long, but more studies are needed to better understand,” a department statement said. 

A small number of Pfizer trial participants had prior evidence of infection before the vaccine. Their safety data in the trial looks “basically the same” as the noninfected participants, Dr. William Gruber, senior vice president of vaccine clinical research and development for Pfizer, told the FDA panel. “Clearly, these individuals did not fare worse from the vaccine.”

Is there any immunity after the first dose? How long after getting the second dose will I develop immunity? 

The science is not certain, but there appears to be some immunity after the first dose of the Pfizer vaccine. “A trend of potential efficacy following a single dose is observed in the data, however, a conclusion is limited because almost all participants received a second dose,” Pfizer reported to the FDA. 

Nonetheless, officials strongly recommend getting the second dose for maximum effect. “You get optimal immunity anywhere from seven to 10 days after the second dose,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN. 

How many doses will I have to get? Will I get a reminder if I need a second dose?

Pfizer and Moderna vaccines both require two doses. Providers in North Carolina will record contact data at the first dose so they can remind individuals to get the second dose. 

Another vaccine in development from Johnson & Johnson’s Janssen Pharmaceuticals requires only one dose. The Janssen vaccine is not an mRNA vaccine and does not require ultracold storage.

Must someone be a citizen to receive the vaccine?

No. All residents are eligible for the vaccine, and no proof of residency is required.

How much will the vaccine cost in North Carolina? Do I need insurance?

There is no cost for the vaccine in North Carolina and no proof of insurance is required.

What if I need transportation to a vaccine appointment?

The North Carolina Department of Transportation and the North Carolina Department of Health and Human Services provided funding to offset costs for local transit authorities to transport individuals to and from vaccine appointments. Find your local transit authority here.

Should children get the COVID-19 vaccine? 

The Emergency Use Authorization for Pfizer’s vaccine was for individuals 16 years old or older. Pfizer is studying the vaccine in 12- to 15-year-olds and Moderna is starting to test adolescents, but no vaccine is yet authorized for children. 

After the vaccine:

Can you still be a carrier and transmit the virus if you have had the vaccine? 

The short answer is the scientists do not know yet if people can transmit the virus even if they have been vaccinated.

Even if it doesn’t completely prevent you from transmitting to another person, it may lessen the likelihood. “If it doesn’t protect you against infection, it’s likely that the degree of immunity that you have is going to diminish the level of virus in your nasal pharynx. And even though you might be infected, it is likely not proven yet, but likely that it would be very less likely that you are going to transmit it,” Fauci told CNN. 

How long does immunity last? Will I have to get a vaccination annually?

Scientists do not yet know the duration of the vaccine. It is possible that repeat doses may be needed. 

If I get a vaccine, do officials think I still need to wear a mask? 

Yes. Because it will take some time for herd immunity to be reached and because viral spread continues to be rampant in North Carolina, people should continue to wear masks, Cohen said. 

Where will adverse responses be reported?

The CDC and FDA run a system whereby individuals can report adverse effects, the Vaccinate Adverse Events Reporting System, or VAERS. Health care providers are required to report certain events, but anyone who experiences an adverse reaction may submit their information to the system. The CDC and FDA use the information to assess any patterns in reaction as well as any particular clusters of adverse events.

About the vaccine

Who is making the vaccines? 

Multiple vaccines are in development, but none have been approved for use in the United States. Two manufacturers — Moderna and Pfizer — filed applications with the Food and Drug Administration that permitted the companies to move forward with distribution of the vaccines to the states. 

What is an Emergency Use Authorization (EUA) and who decides it?

Federal law permits the FDA commissioner to allow unapproved medical products to be used in emergencies where there are “no adequate, approved and available alternatives.” Because the pandemic is a global emergency, the FDA considers authorizations for COVID-19 vaccines. 

Pfizer submitted an application for Emergency Use Authorization in November. On Dec. 10, an FDA panel considered the application and voted in favor of the application. The EUA was approved Dec. 11.

The FDA panel voted in favor of the Moderna drug on Dec. 17 and the EUA was approved Dec. 18.

What happens after the Emergency Use Authorization?

After an Emergency Use Authorization is granted, another body at the Centers for Disease Control and Prevention (the Advisory Committee on Immunization), considered whether the vaccines should be used for particular populations.

The CDC committee voted in an emergency hearing on December 12 to recommend the Pfizer vaccine for Americans 16 years-old or older, and CDC director Robert Redfield signed the recommendations. The committee met a week later to consider the Moderna vaccine and issued interim recommendations for use in individuals 18 and over.

How effective are the vaccines?

Pfizer’s vaccine provides 95% efficacy against COVID-19 at the one-week mark after the second dose, the company reported to the FDA. 

What do we know about the safety of the proposed vaccines?

An independent data monitoring committee found Pfizer’s drug met its safety requirements during the trial of more than 43,000 participants. Reactions were “mostly mild to moderate, and with less frequency and severity in adults >55 yrs than in younger adults,” according to the data Pfizer submitted.  “There were no other specific safety concerns identified in subgroup analyses by age, race, ethnicity, medical comorbidities or prior SARS-CoV-2 infection.”

Moderna also presented safety data to the FDA. The manufacturers are continuing to follow trial patients for longer-term safety concerns. 

Is there a difference between the Moderna vaccine and the Pfizer vaccine?

Both vaccines are mRNA vaccines, or messenger RNA vaccines, which “teach our cells how to make a protein — or even just a piece of a protein — that triggers an immune response inside our bodies,” a CDC resource explains.

“That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies.” 

Both vaccines require two doses. The Pfizer vaccine requires 21 days in between the first and second doses while the Moderna vaccine requires 28 days between doses. 

But in terms of efficacy, Fauci told CNN, “since these vaccines are almost identical, I don’t think it makes any difference,” he said. “They’re both mRNA vaccines. They both have 94% to 95% efficacy, and they both have almost 100% efficacy against serious disease.”

The Pfizer vaccine requires storage in ultracold freezers at minus 70 degrees Celsius while the Moderna vaccine requires standard freezer storage.

Do providers have enough of the other supplies required for immunizations (needles, gloves, etc.)? 

Though some states are experiencing shortages of some supplies, North Carolina has ample supplies, Cohen said.

Editor’s note: This article was initially posted at 4 p.m. on Dec. 11 but has been updated several times, most recently on Jan. 22, 2021.

Laura Lee

Laura Lee is the News Editor at Carolina Public Press. Contact her at llee@carolinapublicpress.org.

Leave a comment

Your email address will not be published. Required fields are marked *