Frequently asked questions on the suitability of the COVID-19 Pfizer/BioNTech vaccine for you

1.Which COVID vaccine will I get?

There are currently two COVID-19 vaccines that are available in the UK and have been given authorisation for supply by the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), for use in the UK national COVID-19 vaccination programme, Pfizer BioNTech COVID vaccine and AstraZeneca COVID vaccine.

Both have been shown to be effective in clinical trials and have a good safety record, both vaccines are being distributed to clinics.

We are not able to advise you which will be given to you as it would depend on the vaccination clinic that you are booked into.

It is recommended that you should have whichever vaccine you are offered. Both the currently approved vaccines have been shown to be safe and to work well at preventing disease from the virus.

2. Can I have the COVID vaccine if I am taking other medicines?

Many medicines will not be a problem if taken alongside the COVID vaccine. Patients who are taking anticoagulants (blood thinners) such as warfarin, apixaban, edoxaban, rivaroxaban and dabigatran can receive the vaccine provided their treatment is stable and they do not have unexplained bruising or bleeding. Patients taking warfarin should take their yellow book with them to their vaccine appointment and will be able to receive the vaccine if they are up to date with their scheduled INR testing and their last result was below the upper limit of their target INR range.

3. Can I have the COVID vaccine if I have a bleeding disorder such as haemophilia?

Patients with a bleeding disorder such as haemophilia should inform the vaccination clinic of their disorder when they book, as the person vaccinating you will use a different size needle. You can still have the vaccine if you have a bleeding disorder. If you take medication for your bleeding disorder, you should arrange for the vaccine to be administered to you shortly after you have taken that medicine. If you have a bleeding disorder you are more likely to bruise after your vaccine.

4. What side effects can I expect after the vaccine?

Local reactions were commonly reported in the clinical trials for the COVID vaccine. This is similar to other vaccines you would have had previously. Over 8 out of every 10 people reported pain at the injection site during the clinical trials. This occurred within 7 days of the vaccine and resolved after a few days. Other reported side effects during the clinical trials included tiredness (6 out of every 10 people), headache (5 out of every 10 people), muscle aches (3 out of every 10 people), chills (3 out of every 10 people), joint pain (2 out of every 10 people), and a raised temperature (1 out of every 10 people). These symptoms were usually mild or moderate in intensity and resolved within a few days after vaccination. If you suffer from any of these symptoms you can take some analgesia such as paracetamol (which will also help to reduce your temperature if you have a raised temperature).

If you suffer any other adverse reaction to the COVID vaccine we would advise you to report this to the MHRA using the specially established Coronavirus Yellow Card reporting scheme (coronavirus-yellowcard.mhra.gov.uk/ or call 0800 731 6789).

There have been some reports of patients having an immediate allergic reaction to the COVID vaccine. This has led to the MHRA announcement that the Pfizer COVID vaccine is not suitable for some patients with a history of severe allergic reactions. See answer to the question below – I have allergies – can I have the COVID vaccine?

 5. I have allergies – Can I have the COVID vaccine?

Following the initial roll-out of the COVID vaccine the MHRA have updated their advice with regard to allergies.

The MHRA has advised that individuals with a history of anaphylaxis to food, an identified drug or vaccine, or an insect sting can receive any COVID vaccine, as long as they are not known to be allergic to any component (excipient) of the vaccine.

All recipients of the Pfizer BioNTech COVID vaccine should kept for observation and monitored for a minimum of 15 minutes. Facilities for management of anaphylaxis should be available at all vaccination sites.

The British Society for Allergy and Clinical Immunology (BSACI) has advised that:

  • individuals with a history of immediate onset-anaphylaxis to many types of drugs or an unexplained anaphylaxis should not be vaccinated with the Pfizer BioNTech vaccine. The AstraZeneca vaccine can be used as an alternative.
  • individuals with a localised urticarial (itchy) skin reaction (without systemic symptoms) to the first dose of a COVID vaccine should receive the second dose of vaccine with prolonged observation (30 minutes) in a setting with full resuscitation facilities (e.g. a hospital)
  • individuals with non-allergic reactions (vasovagal episodes, non-urticarial skin reaction or non-specific symptoms) to the first dose of a COVID vaccine can receive the second dose of vaccine in any vaccination setting

6. Can I have the vaccine if I am immunocompromised or have a reduced immune response?

The COVID vaccine does not contain any whole or live virus and so it is safe to receive the vaccine if you have a condition or are taking medicines that reduce your immune response.

7. Can I have the COVID vaccine if I have just had my flu vaccine?

It is advised that there should be at least 7 days between the COVID vaccine and any other vaccine (including the flu vaccine). Please bear this in mind when booking your COVID vaccine appointment.

8. I’ve had COVID infection previously – should I have the vaccine?

There is no evidence from clinical trials of any safety concerns from vaccinating individuals with a past history of COVID-19 infection. It is also not known how long antibodies made in response to natural infection persist and whether immunisation could offer more protection. If antibodies have already been made to the disease following natural infection, receiving COVID-19 vaccine would be expected to boost any pre-existing antibodies, which will further benefit you and your protection against future COVID-19 infection.

If you have had a recent positive COVID test, vaccination should be delayed to around 4 weeks after the onset of symptoms or 4 weeks from the confirmed positive COVID test if you did not experience any symptoms (asymptomatic).

9. I’m pregnant/ planning pregnancy/ breastfeeding. Can I have the COVID vaccine?

Although the currently available data do not indicate any safety concerns or harm to pregnancy, there is currently insufficient evidence to recommend the routine use of COVID-19 vaccines during pregnancy.

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that vaccination in pregnancy should be considered, where the risk of exposure to COVID infection is high and cannot be avoided, or where the woman has underlying conditions that put them at very high risk of serious complications of COVID-19.

Pregnant women in these clinical high-risk groups should discuss this with their doctor or nurse, and you may feel that it is better to go ahead and have the vaccine.

If you find out that you are pregnant after you have had your first dose, you should not have your second dose until after your pregnancy is complete, unless you are high-risk.

If you are trying to get pregnant, you do not need to avoid pregnancy after having the COVID vaccine.

There are no data on the safety of COVID vaccines in breastfeeding or on the breastfed infant. However, COVID vaccines are not thought to be a risk to the breastfeeding infant, and the benefits of breast-feeding are well known. Therefore, the JCVI has recommended that the women who are breastfeeding can have the COVID vaccine.

10. My first COVID vaccine dose made me feel unwell, should I still have the second dose?

It is important that you have both doses to give you the best protection against COVID-19. If you are still unwell for your next appointment, it is better to wait until you have recovered to have your vaccine, but you should try to have it as soon as possible. You should not attend a vaccine appointment if you are self-isolating, waiting for a COVID-19 test or unsure if you are fit and well.  Please contact the vaccination centre to let them know if you are not able to attend for your second dose.

11. I have had the first COVID vaccine dose, why do I have to wait so long for the second dose?

The COVID vaccine should be administered as 2 doses. It is recommended that the second dose of both the Pfizer BioTech and AstraZeneca vaccines are scheduled between 4 and 12 weeks after the first dose is given. This is so to allow more people to benefit from the protection provided from the first dose whilst the COVID vaccine is still being rolled out.

Questions about accessing the COVID vaccine

12. Is the COVID vaccine compulsory?

Whilst the COVID vaccine is not a compulsory vaccine, we would strongly recommend that you take up the offer of receiving the vaccine if you are eligible and it is appropriate for you to have it.

13. I am a clinically vulnerable patient, or a high-risk patient who was not on the Government shielded list – when will I be called to receive my COVID vaccine?

The full prioritisation list as advised by the Joint Committee on Vaccination and Immunisation (JCVI) showing the order of COVID vaccination is as follows (in order of priority).

People who are defined as clinically extremely vulnerable are considered to be at high risk of severe illness from COVID-19 and on the Government shielded list (https://www.gov.uk/government/publications/guidanceon-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-onshielding-and-protecting-extremely-vulnerable-persons-from-covid-19#cev).

Patients who were not on the Government shielded list but were still in a clinical high-risk group will be classified as priority 6.

The main risk groups have been identified as follows:

  • chronic respiratory disease, including chronic obstructive pulmonary disease (COPD), cystic fibrosis and severe asthma
  • chronic heart disease (and vascular disease)
  • chronic kidney disease
  • chronic liver disease
  • chronic neurological disease including epilepsy
  • Down’s syndrome
  • severe and profound learning disability
  • diabetes
  • solid organ, bone marrow and stem cell transplant recipients
  • people with specific cancers
  • immunosuppression due to disease or treatment
  • asplenia and splenic dysfunction
  • morbid obesity
  • severe mental illness

14. Does the COVID vaccine protect me from spreading the virus to others?

The vaccine cannot give you COVID-19 infection, and a full course will reduce your chance of becoming seriously ill. We do not yet know whether it will stop you from catching and passing on the virus, but we do expect it to reduce this risk. So, it is still important to follow the guidance in your local area to protect those around you.

To protect yourself and your family, friends and colleagues you still need to:

  • practice social distancing
  • wear a face mask
  • wash your hands carefully and frequently
  • follow the current guidance in your area

Any further questions?

If you have any further questions about the COVID vaccine that haven’t been answered here, please email us your question to epunft.askpharmacy@nhs.net and we will respond to you with the answer to your question.

If you would prefer a verbal answer rather than an email, please include your contact number when you email us your question. However, please note that we will be calling you from a withheld number to answer your question.

References

PHE Guidance. What to expect after your COVID-19 vaccination. https://www.gov.uk/government/publications/covid-19-vaccination-what-to-expect-after-vaccination/what-to-expect-after-your-covid-19-vaccination

Covid-19: the green book, chapter 14a. https://www.gov.uk/government/publications/covid-19-the-green-book-chapter-14a

COVID-19 vaccination programme. Information for healthcare practitioners. Republished December 2020. PHE. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/941236/COVID-19_vaccination_programme_guidance_for_healthcare_workers_December_2020_V2.pdf

COVID-19 vaccination: a guide for women of childbearing age, pregnant or breastfeeding. 31 December 2020. PHE

https://www.gov.uk/government/publications/covid-19-vaccination-women-of-childbearing-age-currently-pregnant-planning-a-pregnancy-or-breastfeeding/covid-19-vaccination-a-guide-for-women-of-childbearing-age-pregnant-planning-a-pregnancy-or-breastfeeding