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Covid-19 Vaccination Q&A

Jewish Foundation for Group Homes (JFGH) is monitoring federal, state and local policy as regards COVID-19 vaccinations. We are pleased to offer the following Q&A in order to answer your questions, dispel any rumors or myths, present facts, and address issues and concerns. Nothing here is intended as medical advice or recommendations, and everyone should consult with their doctor or other licensed healthcare professional when seeking healthcare advice or information. We have and will continue to review data and facts, peer-reviewed scientific research, and official governmental reports and guidance as they inform our COVID-19 protocols and our planning for the vaccination.

If you have additional questions that are not satisfactorily answered or questions that are not addressed at all here, please direct them to vaccinationQ&A@jfgh.org.

Questions & Answers

1. Have people supported by JFGH been vaccinated?

Yes, as of 19 March, 91% of all people receiving supports have received both vaccine doses. The few remaining people are working on their vaccination plans, with our support.

2. Have JFGH staff been vaccinated?

Yes, by the beginning of April, more than 84% of all staff have been fully vaccinated. Many more have received at least their first dose.

As part of JFGH’s Infectious Disease policy and procedures, the COVID-19 vaccination is required. (There are medical exemptions, which will be considered on a case by case basis. As a matter of agency policy, being free of infectious disease is an essential function of our work.)

3. What do we know about the vaccines?

After carefully reviewing FDA technical reports and the Vaccines and Related Biological Products Advisory Committee reports from 10 December 2020 (Pfizer/BioNTech) 17 December 2020 (Moderna), and most recently, 26 February 2021 (Johnson & Johnson), as well as related peer-reviewed research, we know quite a lot.

For the Pfizer/BioNTech vaccine, information is available from the FDA HERE. Information from the FDA on the Moderna vaccine can be found HERE. And, for Johnson & Johnson (also known as Janssen, a pharmaceutical company of J&J), FDA information is HERE.

If you are interested in reading the Emergency Use Authorization Review Memoranda on these three vaccines, the links to each are shown below.

Pfizer/BioNTech Emergency Use Authorization
Moderna Emergency Use Authorization 
Johnson & Johnson (Janssen) Emergency Use Authorization

We have also reviewed information with our Medical Advisory Panel, and have spent time consulting with the American Academy on Developmental Medicine and Dentistry, as well as a number of national organizations, to review reporting on side effects and efficacy.

4. What are the differences in the vaccines?

The most recently authorized vaccine is the Johnson & Johnson (J&J)/Janssen vaccine. Unlike both the Pfizer/BioNTech vaccines, which are administered via two intramuscular injections (i.e., shots), the J&J/Janssen vaccine is administered via a single intramuscular injection.

In addition, the J&J/Janssen vaccine uses a different technology to trigger the body’s immune system to develop antibodies. Whereas the Pfizer/BioNTech and Moderna vaccines use mRNA technology to deliver what is essentially a manmade message to trigger the body’s response (see additional information on mRNA vaccine technology from the CDC HERE), the J&J/Janssen vaccine uses dead, non-replicable adenovirus (respiratory—essentially, the common cold) to trigger the body’s natural immune system. This engineered adenovirus will NOT cause you to get sick. Instead, it basically tricks the body’s immune system, just like the mRNA technology does, into developing antibodies that, if the body ever does encounter the SARS virus that causes COVID-19, it’s prepared and has the tools to fight back.

The J&J/Janssen vaccine, in clinical trials, achieved 66.9% efficacy. This compares to 95% and 94.5% for Pfizer/BioNTech and Moderna, respectively.

5. Are they safe?

Yes. There are side effects, like there are with virtually any vaccine or medication. The vast majority of side effects are both minor and temporary; however, there are serious side effects about which we all need to stay aware and vigilant. In recent news reports, a lot of attention is being paid to significant allergic reactions to the vaccines called anaphylaxis, which can be life threatening. The number of these cases is exceptionally small, and amounts to less than 1% of the total number of vaccinations administered.

6. What are side effects?

Most common side effects are pain/soreness, swelling and/or redness at the injection site, headache and fatigue. Some have reported chills or developing a low-grade fever, feeling achy—what appears, by description, to look like COVID-19—and diarrhea.

Serious side effects in the clinical trials were experienced by 0.6% of the vaccine group, and included myocardial infarction, atrial fibrillation, and sudden drops in blood pressure resulting in fainting (all heart issues), appendicitis and, as outlined above, anaphylaxis (allergic reaction).
NOTE: It is not clear in the clinical trials whether these side effects were caused by the vaccine or were the result of other factors.

Arrangements are being made, as part of JFGH’s planning, to allow for up to 30 minutes immediately following vaccination for monitoring for any of these or other side effects by a trained healthcare professional.

The Centers for Disease Control and Prevention (CDC) has recently published this infographic that speaks to side effects:

7. Will they work?

Yes. As above, the Pfizer/BioNTech and Moderna vaccines demonstrated efficacy of 95% and 94.5%, respectively, in clinical trials. J&J/Janssen report a 66.9% vaccine efficacy in clinical trials. From the Emergency Use Authorizations linked above:

 

 

 

 

 


We also note that the effectiveness—in the language from the clinical trials and subsequent reporting, the efficacy—was essentially unchanged across groups defined by age categories or the presence of co-existing conditions. We believe this is essential information when considering any potential increases in risk or changes in efficacy specifically for people with IDD.

8. Will the vaccines work with the new variants/mutations that are emerging?

Yes. Research on the efficacy (effectiveness) of the vaccine suggests that these mutations are neutralized by the current vaccines. However, there is also emerging data that suggests that the vaccines are not as effective against certain variants. And, there is news reports suggesting the potential need for a booster of some kind to protect against known variants.

We know that as the virus continues to replicate itself through community spread, it may mutate beyond the full reach of a person’s immune response. Ironically, global and community spread of the virus increases the pace of mutations, and the race to get people vaccinated en masse is a race against community spread! (Thus: Wear your mask. Wash your hands. Keep your physical/social distance!)

9. Can I get the COVID-19 virus from the COVID-19 vaccine?

No. None of the three vaccines contain live severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, and therefore you cannot contract COVID-19. Instead, the vaccine consists of manmade genetic material or non-replicable adenovirus (non-COVID respiratory virus) that instructs the body’s natural immune system on how to identify the COVID-19 virus and how to attack it and prevent it from entering your cells and replicating.

10. Can I get sick with COVID-19 even though I’ve gotten the vaccine?

Yes. There are three potential ways of contracting COVID-19 after being vaccinated. First, while all three FDA-authorized vaccines are effective, there is a small chance that the vaccine won’t work on a very small number of people. We note that no vaccine is 100% effective, so this is a fairly standard and extraordinarily small chance the vaccine won’t work. Second, because two of the vaccines require two doses, between 21 and 28 days apart, there is a chance someone could contract COVID-19 between doses. And third, it’s possible—improbable, but possible—that someone could contract COVID-19 after receiving both doses of the vaccine if there has been inadequate time after the second of the two doses for the body to fully develop the antibodies the vaccines are designed to trigger. It’s not altogether clear how long the body needs to develop immunity once the vaccination is fully delivered, but estimates are two to “a few” weeks. To this end, we continue to urge everyone to wear your masks, wash your hands well and frequently, and continue to practice physical distancing even after becoming vaccinated.

11. Can vaccinated people still test positive for COVID-19?

Yes, it is possible. But, being vaccinated should result in enough antibodies to reduce the ability of the virus to replicate. And, research suggests the while it’s also possible to become sick with COVID-19 after having been fully vaccinated (see #10, above), antibodies developed as a result of the vaccine are likely to make symptoms from a COVID-19 infection far less severe and life threatening.

12. Can I “shed” or spread the virus after I receive either dose 1 or the entire vaccine?

We don’t know, but it appears the answer is yes. It is possible that you can be carrying the virus during or after dose 1 or dose 2, and the vaccines themselves do not prevent shedding. It is essential that everyone continue to wear masks, wash hands and practice physical/social distancing for the foreseeable future, even for those people who have been fully vaccinated.

13. If someone JFGH supports refuses to be vaccinated or the vaccine is medically contraindicated, what will JFGH do?

Working with that person or those people, we will consult with primary care physicians and members of the persons’ support teams to address their needs, allay fears and concerns, and make certain that are making fully informed healthcare choices.

14. When do things go back to normal?

JFGH will continue to monitor vaccination rollout data in Maryland and Virginia carefully. At 7 April, only 20.2% of Marylanders, 19.8% of Virginians and 16% of folks living in DC have received full vaccination doses. Many of us have heard of ‘herd immunity’, and we look forward to a time when, most simply, there aren’t enough humans to host continued spread. But, this is quite a long way away in and around the communities in which folks supported by JFGH live, learn, work and play.

To achieve herd immunity, as few as 60% and, per Dr. Anthony Fauci, as many as 90% of people (this excludes kids who are under age 16, for whom there is no current vaccine) need to be fully vaccinated.

15. How do JFGH protocols differ from CDC recommendations we hear on the news?

As we have since the start of the crisis, JFGH monitors CDC guidelines regularly. In addition, we are closely and routinely monitoring direction and guidance from any/all of the following sources:

Centers for Medicare and Medicaid Services (CMS)

National Institutes of Health

Maryland Department of Health

Maryland Developmental Disabilities Administration

Virginia Department of Behavioral Health & Developmental Services

County departments of health (Montgomery, MD, and Fairfax and Loudoun, VA)

On occasion, guidelines conflict. Recently, for example, JFGH received direction from the MD Dept of Health that appeared to conflict with CDC guidelines on allowable activities for people who are fully vaccinated. In these circumstances, we tend to rely on the more stringent standard, consistent with our conservative approach to health and safety since the beginning of the crisis.

We are also constantly reviewing emerging, peer-reviewed research to inform our approach to the crisis. And, of course, we continue to rely heavily on now-widely available datasets as we assess progress in the community toward full vaccination.

16. What do we do next?

At the moment, nothing. As you may know, we have begun easing some—but not all—of our safety protocols, seeking balance between recognizing our vaccination status as well as the realities of current community vaccination status. In the meantime, we continue to work on our Safe Return to Work (SWARM) protocols to anticipate a gradual transition to our ‘new’ normal. Please check in regularly for updates to this COVID-19 Vaccination Q&A. And, e-mail any questions you have to vaccinationq&a@jfgh.org

 

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