Answering Patients’ Questions
Some patients won’t have questions about coronavirus disease 2019 (COVID-19) vaccination when you give your strong recommendation and use language that assumes patients will get vaccinated when doses are widely available. If a patient questions your recommendation about COVID-19 vaccination, this does not necessarily mean they will not accept a COVID-19 vaccine. This is a new vaccine, and some questions are to be expected. Your patients consider you their most trusted source of information when it comes to vaccines, and sometimes they simply want your answers to their questions.
This page outlines some topics patients ask about most vaccines and tips for how to answer their questions.
The federal government, under the umbrella of Operation Warp Speedexternal icon, has been working since the start of the pandemic to make a COVID-19 vaccine available as soon as possible. This accelerated timeline is unprecedented and has raised concerns for some people that safety may be sacrificed in favor of speed. However, as with all vaccines, safety is a top priority.
Patients may ask: How do we really know if COVID-19 vaccines are safe? To respond, you can explain how:
- The Food and Drug Administration (FDA) carefully reviews all safety data from clinical trials and an authorizes emergency vaccine use only when the expected benefits outweigh potential risks.
- The Advisory Committee on Immunization Practices (ACIP) reviews all safety data before recommending any COVID-19 vaccine for use. Learn how ACIP makes vaccine recommendations.
- FDA and CDC will continue to monitor the safety of COVID-19 vaccines, to make sure even very rare side effects are identified.
COVID-19 vaccines were tested in large clinical trials to make sure they meet safety standards. Many people were recruited to participate in these trials to see how the vaccines offers protection to people of different ages, races, and ethnicities, as well as those with different medical conditions.
Because some people with COVID-19 can have very mild symptoms, some may see natural infection as preferable to receiving a new vaccine. Others may be concerned that getting a COVID-19 vaccine could make a later illness worse. Help your patients understand the risks and benefits so they can be confident choosing to get vaccinated.
Patients may ask: Is the vaccine that helpful? I heard getting COVID-19 gives you better and longer immunity than the protection a vaccine can give. Can it actually make my illness worse if I do end up getting COVID-19? To respond, you can:
- Explain the potential serious risk COVID-19 infection poses to them and their loved ones if they get the illness or spread it to others. Remind them of the potential for long-term health issues after recovery from COVID-19 disease.
- Explain that scientists are still learning more about the virus that causes COVID-19. And it is not known whether getting COVID-19 disease will protect everyone against getting it again, or, if it does, how long that protection might last.
- Describe how the vaccine was tested in large clinical trials and what is currently known about its safety and effectiveness.
Be transparent that the vaccine is not a perfect fix. Patients will still need to practice other precautions like wearing a mask, social distancing, handwashing and other hygiene measures until public health officials say otherwise.
“Both this disease and the vaccine are new. We don’t know how long protection lasts for those who get infected or those who are vaccinated. What we do know is that COVID-19 has caused very serious illness and death for a lot of people. If you get COVID-19, you also risk giving it to loved ones who may get very sick. Getting a COVID-19 vaccine is a safer choice.”
Some COVID-19 vaccines may be more reactogenic than vaccines that people are familiar with. Information about specific side effects of the COVID-19 vaccine will be available when it is approved. It is important to set this expectation with your patient, in case they experience a strong reaction.
Patients may ask: How much will the shot hurt? Can it cause you to get very sick? To respond, you can:
- Explain what the most common side effects from vaccination are and how severe they may be.
- Provide a comparison if it is appropriate for the patient (for example, pain after receiving Shingrix for older adults who have received it).
- Make sure patients know that a fever is a potential side effect and when they should seek medical care.
- Let them know that symptoms typically go away on their own within a week. Also let them know when they should seek medical care if their symptoms don’t go away.
- Explain that the vaccine cannot give someone COVID-19.
- Explain that side effects are a sign that the immune system is working.
“Most people do not have serious problems after being vaccinated. We will understand more about mild side effects of the COVID-19 vaccine before we start to use it. However, your arm may be sore, red, or warm to the touch. These symptoms usually go away on their own within a week. Some people report getting a headache or fever when getting a vaccine. These side effects are a sign that your immune system is doing exactly what it is supposed to do. It is working and building up protection to disease.”
Due to the relative speed with which these vaccines were developed, patients’ concerns about long-term side effects are reasonable and to be expected.
Patients may ask: How do we know that these vaccines are safe when they are so new? Couldn’t they cause problems that we don’t know about yet? What about long-term problems? To respond, you can:
- Explain how FDA and CDC are continuing to monitor safety, to make sure even long-term side effects are identified.
- Reassure patients that COVID-19 vaccines will be continuously monitored for safety after authorization, and ACIP will take action to address any safety problems detected.
- Compare the potential serious risk of COVID-19 infection to what is currently known about the safety of COVID-19 vaccines.
COVID-19 vaccines are being tested in large clinical trials to assess their safety. However, it does take time, and more people getting vaccinated before we learn about very rare or long-term side effects. That is why safety monitoring will continue. CDC has an independent group of experts that reviews all the safety data as it comes in and provides regular safety updates. If a safety issue is detected, immediate action will take place to determine if the issue is related to the COVID-19 vaccine and determine the best course of action.
All but one of the COVID-19 vaccines currently in phase 3 clinical trials use two shots. The same vaccine brand must be used for both shots.
Patients may ask: How many shots am I going to need? To respond, you can:
- Explain that two shots are generally needed to provide the best protection against COVID-19 and that the shots are given several weeks apart. The first shot primes the immune system, helping it recognize the virus, and the second shot strengthens the immune response.
- When applicable, explain the dosing options available in your office and advise the patient that they can set up an appointment before they leave to come back for a second dose.
Nearly all COVID-19 vaccines being studied in the United States require two shots. The first shot starts building protection, but everyone has to come back a few weeks later for the second one to get the most protection the vaccine can offer.
If you have additional questions from patients, reference Frequently Asked Questions about COVID-19 Vaccination for regularly updated answers to common questions.