Excellent 8 Minute Animated Video from Dr. Zafar 1 Page - What to Expect, from CDC, Spanish

CDC Video - What to Expect CDC Fast Facts

ODH Myth vs. Facts Vaccine Town Hall

Pfizer Fact Sheet Plain Language FAQ [DDS]

Moderna Fact Sheet

Kaiser Family Foundation Poll

ODH Communications Toolkit
pg 5 has persuasive language table based on deBaumont COVIDpoll results

CDC Social Media Toolkit

How Vaccine Safety Is Ensured general to all vaccines

About the ACIP Advisory Committee on Immunization Practices

FDA info on Emergency Use Authorization

FDA's EUA Video

Emergency Use Authorization Process

Moral Considerations:
For the Moderna and Pfizer vaccines, stem cell lines derived from aborted fetuses were used evaluation of the vaccine but are not used in current production. For the Johnson and Johnson vaccine, fetal derived stem cell lines are used in development, testing AND current production. The Vatican has declared it morally acceptable to get the vaccine.

CDC's Interim Considerations

Contraindications:

• allergic reaction to  vaccine or components, to poly-ethylene glycol

Precautions:

If any history of allergic reaction to any vaccine or injectable OR any anaphylaxis ever

Then:

• reasonable to differ until consult with allergist, but depends on individual risk/benefit

• administer in a setting where immediate help is available

• DO NOT pre-medicate with antihistamines

• Observe 30 minutes after administration

Allergy & Anaphylaxis:

Allergy Triage Chart

Ingredients

American Academy of Allergy, Asthma, and Immunology agrees with the CDC recommendations.

CDC Video on Allergic Reactions Contraindications, Precautions (1h)

CDC Anaphylaxis - Pfizer
21 cases from 1.89 million recipients
CDC Moderna Anaphylaxis
10 cases from 4 million recipients

Preparing for potential anaphylaxis

Lab evaluation after severe reaction

NON-Contraindications:

These are NOT reasons to avoid or delay vaccination:

• Hx of Guillan-Barre

• Hx of Bell's Palsy

• any food allergies including eggs

• pet, insect, bee venom allergies

• latex allergy

• hx of facial fillers, per Aesthetic Society 

Timing:

Should space 14 days before and after any other vaccine.

If acute tetanus vaccination is needed give it and COVID vaccine as previously planned.

Mixing Vaccine Products:

Ok to mix and match for booster.

Pfizer Vaccine: NEJM Publication, 1 page summary, IDSA Summary

Moderna Vaccine: NEJM Publication, 1 page summary, IDSA summary

Johnson and Johnson Vaccine: Interim Analysis, publication pending; IDSA summary

V-Safe Sign up

Vaccine safety tracking via text message
1 week of daily surveys
reminder to get 2nd dose
info sheet

VAERS

Vaccine Adverse Event Reporting System
Anyone can report an adverse event associated with a vaccine to the CDC.
Physicians are required to report certain events.

Therapeutic Immunosuppression

Excluded from trials, so no specific data, but not a live vaccine so immunosuppression is not a contraindication or precaution.

American College of Rheumatology has no formal recs yet, but they anticipate recommending to immunosuppressed patients.

For cancer patients actively getting chemotherapy, radiation, or immunotherapy, the American Cancer Society recommends discussing the timing of the vaccine with the Oncologist in order to optimize effectiveness. The American Society of Clinical Oncologists agrees.

For transplant patients, the American Society of Transplantation stated that transplant recipients and candidates should get the vaccine though timing relative to surgery is important. The International Society for Heart and Lung Transplantation also supported vaccination. Given unknown effect on rejection, the American Society of Transplant Surgeons was more equivocal: "these two vaccines are the safest alternatives for the transplant population at this time, but come with unknown consequences for our patients". 

No revaccination if immunosuppression ends (for now, this may evolve).

Important to continue precautions after vaccination.

HIV

Patients with HIV were included in the trials.

Per IDSA and CDC, they CAN get the vaccine.

Important to continue precautions after vaccination.

Pregnant/Lactating

Pregnant women were not included in the trials, so no specific data. Also, no data on safety with breastfeeding.

There is no live virus and no adjuvant; mRNA is short lived in the body.

Pregnant women are at an increased risk if they get COVID, especially if they have comorbidities or are from minority groups.

WHO recommends Pfizer and Moderna for pregnant women

CDC agrees with the ACOG Practice Advisory and the Society of Maternal Fetal Medicine:

Pregnant and lactating patients CAN get the vaccine

No special consultation or doctor visit needed prior to vaccination

No pregnancy testing for women needed prior to vaccination

"the theoretical risk of fetal harm from mRNA vaccines is very low"

SUPPORT the patient's decision if they decline the vaccine

COVID Exposed or Infected

CDC Guidance:

Recovered COVID patients not included in the trial, so no data.

Also no specific data for recipients of convalescent plasma, antibodies or any other COVID treatment.

Unclear if there is benefit or harm from vaccine, but they are not excluded from getting it.

The vaccine is not thought to be effective post-exposure prophylaxis.

WAIT to vaccinate until recovered and out of quarantine if currently symptomatic or exposed. Exception: if very likely to have additional exposures (i.e. in a SNF where there is an outbreak) and they are not symptomatic the patient can get vaccine.