I’m nervous about having an allergic reaction.

“During December 14–23, 2020, after administration of 1,893,360 first doses of Pfizer-BioNTech COVID-19 vaccine (1,177,527 doses in females, 648,327 doses in males, and 67,506 doses missing sex), reports of 4,393 (0.2%) adverse events after receipt of the vaccine had been submitted to VAERS. Among these, 175 case reports were identified for further review as possible cases of severe allergic reaction, including anaphylaxis, based on descriptions of signs and symptoms; 21 of these reports met the Brighton Collaboration case definition criteria for anaphylaxis, corresponding to an initial estimated rate of 11.1 cases per million doses administered. All reports were Brighton levels 1 or 2 (Table 1). The median age of persons with anaphylaxis was 40 years (range = 27–60 years), and 19 (90%) cases occurred in females. The median interval from vaccine receipt to symptom onset was 13 minutes (range = 2–150 minutes); 15 (71%) patients had onset within 15 minutes, three (14%) within 15 to 30 minutes, and three (14%) after 30 minutes (Figure). In 19 of 21 (90%) reports, patients were treated with epinephrine as part of therapy; one patient received subcutaneous epinephrine and the remaining 18 were confirmed or presumed to have received intramuscular epinephrine based on the report. Four (19%) patients were hospitalized (including three in intensive care), and 17 (81%) were treated in an emergency department; 20 (95%) are known to have been discharged home or had recovered at the time of report to VAERS. No deaths from anaphylaxis were reported after receipt of Pfizer-BioNTech COVID-19 vaccine. Seventeen (81%) of 21 patients with anaphylaxis had a documented history of allergies or allergic reactions, including to drugs or medical products, foods, and insect stings; seven (33%) patients had experienced an episode of anaphylaxis in the past, including one after receipt of a rabies vaccine and another after receipt of an influenza A(H1N1) vaccine (Table 2). No geographic clustering of anaphylaxis cases was observed, and the cases occurred after receipt of doses from multiple vaccine lots. At the time of this report, investigators have been unable to obtain sufficient information to confirm or rule out anaphylaxis in seven cases despite follow-up efforts; these cases remain under investigation.”

I heard the COVID vaccine can cause infertility.

“Other types of vaccines also don’t impact fertility. In fact, doctors routinely recommend vaccinations to women who are trying to conceive, as well as pregnant women, because pregnant women and newborns may be more susceptible to illness.

Learn more about what pregnant and breastfeeding women should consider before getting the COVID-19 vaccine.

Some research suggests that COVID-19 itself – the virus, not the vaccine – may impact sperm quality, which could contribute to problems with infertility in some people. Vaccination against COVID-19 may help to protect male fertility, although more research is needed.”

I’m pregnant or breastfeeding, can I get the vaccine?

“The first thing you should be aware of is that the virus itself likely poses a greater risk to pregnant or breastfeeding women than the vaccine. Based on this and what we know about other vaccines and pregnancy or breastfeeding, the Food and Drug Administration noted within Pfizer-BioNTech’s Emergency Use Authorization (EUA) that these women may opt in for immunization, if they choose.

Many health care associations, including the Society of Maternal Fetal-Medicine (SMFM) and the American College of Obstetricians and Gynecologists (ACOG), have emphasized the importance of pregnant and breastfeeding women being able to choose to get vaccinated, especially those who work in health care. ACOG expects that the safety of the vaccine in pregnant women would be similar to that observed in non-pregnant women.

“Historically, vaccines have been given to pregnant and breastfeeding women and have been deemed appropriate and safe to do so,” says Thomas Bader, M.D., OB/GYN and vice president of medical quality for Hackensack Meridian Health. “The general concern about vaccines and pregnancy or women who are breastfeeding is the use of ‘live virus’ vaccines but the Pfizer-BioNTech and Moderna COVID-19 vaccines are not ‘live virus’ vaccines, they are mRNA vaccines.”

Will the mRNA vaccine alter my DNA?

“When your immune system recognizes that new protein as a foreign invader, it mounts an immune response to fight off what it interprets as an infection, and you develop antibodies specific to SARs-CoV-2. Your body eliminates the protein and the mRNA, but those antibodies stick around to help protect your from future COVID-19 infection. (It’s important to note that mRNA does not alter your DNA, per the CDC.)

mRNA isn’t the same as DNA, and it can’t combine with our DNA to change our genetic code. However, mRNA isn’t same as DNA, and it can’t combine with our DNA to change our genetic code. It is also relatively fragile, and will only hang around inside a cell for about 72 hours before being degraded.

Some viruses like HIV can integrate their genetic material into the DNA of their hosts, but this isn’t true of all viruses, and HIV can only do so with the help of specialized enzymes that it carries with it. MRNA vaccines don’t carry these enzymes, so there is no risk of the genetic material they contain altering our DNA. The RNA vaccines being developed for COVID-19 all provide instructions for making the same viral protein: the coronavirus ‘spike’ protein used by the virus to gain entry to our cells. Preclinical studies indicated that it was highly immunogenic, meaning that if our immune cells encounter this protein, they will mount a strong response, which should protect recipients against future COVID-19 disease. Once our cells have manufactured the viral protein, it is displayed on their surfaces, where passing immune cells can spot it and respond.

To produce an mRNA vaccine, scientists create a synthetic version of mRNA encoding the spike protein. This is packaged inside fatty parcels, to make it easier for the mRNA to cross the outer membranes of cells, which are also made of fatty material.

Once inside the cell, the mRNA comes into contact with protein making-machinery, which is located in the jelly-like cytoplasm filling the cell. It doesn’t enter the nucleus, which is where our chromosomes are stored.”

I’m worried about the side effects, especially with the second dose.

“Two major coronavirus vaccine candidates from Pfizer and Moderna have been granted Emergency Use Authorization from the FDA after being tested in more than 73,000 people in stage 3 clinical trials. While there are minor reported side effects, a vaccine wouldn’t be approved by public health experts unless they felt confident it’s as safe as possible. There are still some unknowns, but the COVID-19 vaccine does not contain live or inactive virus and will in no way give you COVID-19.

Getting the vaccine has several benefits, Dr. Adalja says. The big one? We can safely establish herd immunity, so the population at large can be protected from the virus if a threshold of vaccination is reached. It’s a tall order, as experts estimate that roughly 70% of people in the U.S. (200 million) need to be vaccinated to reach this level of protection for COVID-19 specifically. This is especially important for vulnerable, high-risk groups, like the elderly and immunocompromised.

Experts also say getting vaccinated will help protect you personally from contracting COVID-19 or from having severe complications of the virus if you do happen to contract it.

When the vaccine is available to you, it’s crucial that you get it. “At this point, one in 200 people who get COVID die,” Dr. Watkins says. “The benefit greatly outweighs the risks.”

Do vaccines contain heavy metals and other toxins?

“ No, vaccines do not contain toxic levels of mercury, aluminum, formaldehyde and other chemicals. While some vaccines use these and other chemicals to enhance their effectiveness, they are used at levels below what is found naturally in the body or environment. For example, the average newborn has 50 to 70 times more naturally produced formaldehyde in their body than what is found in a single dose of the vaccine used to prevent diphtheria and tetanus.

Another example is thimerosal, a chemical used to prevent contamination in multi-dose vials of vaccines. Thimerosal uses ethyl mercury, rather than methyl mercury, which is the form that causes mercury poisoning. Because it is used in such small amounts and is processed differently by the body, ethyl mercury is also less likely to build up in the body.”

Moderna Vaccine Briefing Document

This document contains extensive information about the ingredients, clinical trials, and administration of the Moderna vaccine.

Pfizer Vaccine Fact Sheet

This document includes information about the vaccine administration, ingredients, and how to submit a report should you have any concerns about your experience with the vaccine.