What to expect before and after getting a COVID-19 vaccine, an illustrated guide

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The Biden administration continues to ramp up vaccinations, and people are receiving about 2 million doses of the COVID-19 vaccine per day.

On March 2, the president pledged enough vaccine for every adult in the USA by May, thanks to a deal brokered between pharmaceutical giants Merck and Johnson & Johnson.

As the pace of vaccinations grows and officials expect more vaccines on the way, Americans wonder what to expect from a COVID-19 vaccine appointment and what to do after getting vaccinated?

In a White House briefing Monday, the Centers for Disease Control and Prevention released guidelines for individuals who received their full course of the COVID-19 vaccine.

What should you do before getting the COVID-19 vaccine?

Congratulations! You will soon be a part of the nearly 18% of Americans vaccinated against the coronavirus. What’s next?

What do I need to bring to my COVID-19 vaccine appointment?

Each state has its own registration process and may require different documents for the COVID-19 vaccine appointment, such as a form of identification or proof of registration. Before showing up to the appointment, visit the local health department website if you're unsure of what documents are needed.

The procedure for getting a COVID-19 vaccine is similar to a regular vaccine, such as an influenza shot. The difference is health professionals will keep you there for 15 to 30 minutes after to monitor you for any serious adverse effects.

The CDC reported a few cases of anaphylaxis in people with a history of allergic reactions; however, these cases are extremely rare and almost always occur within 30 minutes of getting vaccinated. It’s important to inform health professionals at the vaccination site if you have a history of anaphylaxis or severe allergic reactions.

How long does it take for the side effects of the COVID-19 vaccine to show?

After getting vaccinated, most people report mild to moderate side effects within three days, including headache, fatigue, chills, body aches, low-grade fever and redness or swelling at the injection site. These side effects should last for only a day or two but may affect your ability to do daily activities such as going to work or hitting the gym.

Physicians emphasize the side effects are normal and also a sign the body is reacting properly to the vaccine.

“Just because you’re sore doesn’t mean that (the vaccine) didn’t work or wasn’t effective. It just means that your body responded the way it’s supposed to,” said Melanie Swift, an occupational medicine physician helping lead the COVID-19 vaccination plan at the Mayo Clinic.

How long do I wait between covid-19 vaccine doses?

People who receive the Pfizer-BioNTech vaccine must wait at least 21 days before getting their second dose. Those who receive the Moderna vaccine must wait at least 28 days.

The CDC recommends getting the second shot as close to the three-week or one-month interval as possible. However, the agency updated guidance in January to say the second dose of a two-shot vaccine can be administered up to six weeks after the first, if necessary.

This guidance pertains only to the vaccines that require two shots, which were developed by Pfizer-BioNTech and Moderna.

The recently authorized Johnson & Johnson vaccine may cause fewer side effects than the other two vaccines. About 50% of trial participants reported injection-site pain compared with nearly 80% for the Pfizer-BioNTech and Moderna vaccines.

For the second dose appointment, make sure to bring all the necessary documents from the first appointment, as well as the vaccination card that should have been given after the first dose.

The vaccination card should detail the vaccine received (Pfizer-BioNTech or Moderna), the date and the arm injected (right or left). If you lost this card or didn’t receive it at the first appointment, don’t fret! The state should have an electronic record of that information.

If your information can’t be found in the state’s Immunization Information System and you can’t remember which vaccine you received at the first appointment, the CDC updated guidelines in January to recommend getting whatever vaccine is available as a second dose instead of restarting the vaccination series.

Most people report stronger side effects after the second dose because it's a booster shot and elicits a stronger immune response. To minimize discomfort, doctors recommend taking pain relievers such as acetaminophen or ibuprofen. They advise against taking these medications before getting vaccinated in anticipation of these side effects.

Some experts say taking a Tylenol or Advil before getting vaccinated could blunt the effectiveness of the COVID-19 vaccine. Dr. Colleen Kelley, an associate professor at Emory University School of Medicine, speculated this could be caused by reducing inflammation triggered by the immune system.

“The immune system generates a response through controlled inflammation. (Pain relievers) can reduce the production of inflammatory mediators,” she said. “So this is the potential mechanism for a reduced immune response to vaccination if you take these medications.”

She said “it’s perfectly fine” to take pain relievers after vaccination.

Vaccines from Moderna and Pfizer-BioNTech were shown in large clinical trials last fall to be more than 94% effective. The J&J vaccine was found in its large trial to be 72% effective in the USA but less effective in South Africa and Latin America, where variants circulated.

Although the J&J vaccine appears to be less effective than the two other vaccines authorized by the FDA, health experts say all the vaccines are equally effective where it counts.

“They’re reducing symptomatic severe disease that leads to hospitalization and deaths,” said Anna Legreid Dopp, senior director of the clinical guidelines and quality improvements at the American Society of Health-System Pharmacists. “It’s those two things that will reduce the societal burden overall and the strain on the health care system on a whole.”

How long before the vaccine is effective?

This protection doesn’t happen overnight. It typically takes a few weeks for the body to build immunity, which means it’s still possible to get sick just after vaccination.

The CDC said it can take 10 to 14 days after the second shot of the Pfizer and Moderna vaccines or the one-dose J&J vaccine for someone to develop the full immunity. This doesn't mean a person can set aside all public health measures two weeks after getting fully vaccinated.

Can you catch COVID-19 after getting the vaccine and infect others?

Though studies show the vaccines are effective against symptomatic disease, researchers are still learning their effect on asymptomatic infection, which means vaccinated people may transmit the virus without getting sick.

“You can conceivably get infected, get no symptoms and still have virus in your nasal pharynx,” Anthony Fauci said during a CNN town hall in January.

You're more likely to catch the coronavirus within the two weeks after vaccination because that's when you're least protected. But you also have a small chance of becoming ill when you're fully immunized since the vaccines are 72-95% effective depending on which vaccine you get. But it will most likely be a mild or moderate form of the disease since the vaccines are almost 100% effective against severe disease

Though Americans shouldn't discard public health safety measures right after getting vaccinated, the CDC said there are some freedoms fully immunized people can enjoy.

“We’ve been through a lot this past year, and with more and more people getting vaccinated each day, we are starting to turn a corner,” CDC Director Rochelle Walensky said in a White House briefing Monday. “As more Americans are vaccinated, a growing body of evidence now tells us that there are some activities that fully vaccinated people can resume at low risk to themselves.”

When can I see my friends and travel?

The CDC said fully vaccinated people don't need to wear a mask or socially distance inside a home when visiting other vaccinated people or an unvaccinated person from one household who is at low risk for severe COVID-19 disease.

A person who is fully vaccinated should still wear a mask and socially distance in a home with someone who is unvaccinated and over 65 or has an underlying medical condition that raises the risk of getting severely ill with COVID-19.

In a situation where vaccinated people gather with unvaccinated people from multiple households, everyone should wear a mask and follow social distancing protocols. The CDC recommends gathering outdoors or in a well-ventilated space.

Regardless of vaccination status, the CDC recommends avoiding medium to large gatherings. The agency defers to states that may have guidance restricting the size of gatherings.

If a fully vaccinated person attends an event or large gathering, the CDC said, he or she should follow prevention measures that reduce COVID-19 spread, such as wearing a mask, social distancing and frequent hand-washing.

Traveling is one of the fastest ways viruses spread.

The CDC maintains Americans should refrain from traveling, referring to the organization's travel guidance last updated Feb. 16.

"Because of the risk of getting and spreading COVID-19 during travel, fully vaccinated people should still take all CDC-recommended precautions before, during, and after travel," read a CDC statement provided to USA TODAY by spokesperson Caitlin Shockey.

If a person must travel, the CDC recommends waiting at least two weeks after getting fully vaccinated and taking the following steps to reduce the risk of COVID-19 transmission:

  • Check travel restrictions before you go.

  • Get tested with a viral test one to three days before travel. Keep a copy of your test results while traveling in case someone asks for them.

  • Wear a mask, avoid crowds and stay at least 6 feet from anyone who did not travel with you.

  • Wash your hands often.

  • Bring supplies such as masks and hand sanitizer.

  • Avoid touching your eyes, nose and mouth.

  • Get tested again after traveling.

What's the point of getting the vaccine if I still can't do anything?

Though there are still some restrictions for vaccinated individuals, health experts urge Americans not to get discouraged.

In the White House briefing Monday, Walensky said the guidelines could change as researchers learn more about COVID-19 as a disease, Americans get vaccinated and "disease dynamics" change.

Updated guidance will be based on scientific evidence, she said, and balance the risk of vaccinated Americans, unvaccinated Americans and overall community transmission.

"Its important to note that this is initial guidance. "The science of COVID-19 is complex, and our understanding of the virus continues to rapidly evolve," Walensky said. "The recommendations issued today are just a first step."

Even with safety measures still in place, health experts said, Americans should get vaccinated to protect themselves from getting severely ill from COVID-19, which could lead to hospitalization or even death.

According to clinical trials, the Pfizer-BioNTech vaccine was 100% effective against severe disease, and the J&J was 86% effective against severe disease in the USA.

Getting vaccinated not only protects the individual and reduces strain on the health care system but also helps the country inch closer to herd immunity. Experts said at least 65% of people, and probably closer to 85%, must be vaccinated to reach herd immunity.

Fauci said the country may achieve herd immunity by the fall, reaching a degree of normality by the end of 2021. Experts said the vaccine is only one part of that equation, and it’s important to continue wearing masks and maintaining social distance until coronavirus circulation is low.

Contributing Karen Weintraub and Morgan Hines; Illustrations by Veronica Bravo and Janet Loehrke

This article originally appeared on USA TODAY: What to expect when you get your COVID vaccination