COVID-19 Vaccine FAQs for Healthcare Professionals

In general, all doses of the primary series and the additional primary dose should be completed with the same product. Make every effort to determine which vaccine product was administered as the first dose to ensure your patient completes the vaccine series with the same product. It is preferable to delay the second dose to administer the same product rather than administer a mixed series using a different product.

For people 18 years of age and older,  in exceptional situations, when the vaccine product given for the first dose cannot be determined or is no longer available, you may administer any available mRNA COVID-19 vaccine, with a minimum of 28 days between doses.

If a patient received the first dose of an mRNA COVID-19 vaccine but is unable to complete the series with either the same or a different mRNA COVID-19 vaccine (e.g., due to contraindication), you may consider administering a single dose of Janssen COVID-19 Vaccine, with a minimum of 28 days between doses. See contraindications and precautions for more information on use of Janssen COVID-19 Vaccine and additional precautions in people with a contraindication to mRNA COVID-19 vaccines.

Yes. In most situations, mRNA COVID-19 vaccines (Pfizer-BioNTech or Moderna) are preferred over the Janssen COVID-19 vaccine for primary and booster vaccination. Start the two-dose mRNA COVID-19 vaccine series even if there is uncertainty about how the patient will receive their second dose; setting alone should not be a reason to offer the Janssen COVID-19 vaccine.

Janssen COVID-19 Vaccine may be offered in some situations. For more information, see:

• Considerations for Janssen COVID-19 Vaccine
• Contraindications and precautions
• Janssen COVID-19 Vaccine FAQs

No. You should administer the second dose as close as possible to the recommended interval after the first dose. However, if the second dose is administered after this interval, there is no need to restart the series.

An 8-week interval may be optimal for some people, including males 12-39 years of age because of the small risk of myocarditis associated with mRNA COVID-19 vaccines. Vaccine effectiveness may also be increased with an interval longer than 4 weeks. Considerations can be found here.

Yes. You may administer a COVID-19 vaccine before, at the same visit, or after other vaccines without regard to timing (including live, attenuated vaccines). If a patient is due for more than one vaccine, providers are encouraged to offer all of the vaccines at the same visit. Coadministration of all recommended vaccines is important because it increases the probability that people will be fully vaccinated. It is also an important part of immunization practice if a healthcare provider is uncertain that a patient will return for additional doses of vaccine.

Learn more about coadministration with other vaccines.

Yes. Do not delay COVID-19 vaccination because of testing for TB infection. Testing for TB infection with one of the immune-based methods, either the TST or an IGRA, can be done before, after, or during the same encounter as COVID-19 vaccination.

Patients who have active TB disease or an illness that is being evaluated as active TB disease can receive a COVID-19 vaccine (note: the presence of a moderate or severe acute illness is a precaution to administration of all vaccines).

Everyone 12 years of age and older should receive a booster dose of COVID-19 vaccine.  For those 18 years of age and older, the booster dose can be Moderna, Pfizer-BioNTech, or Janssen; however, an mRNA COVID-19 vaccine is preferred over the Janssen COVID-19 Vaccine. For those 12 through 17 years of age, the booster dose must be the age-appropriate Pfizer-BioNTech COVID-19 Vaccine.

People who received:

• An mRNA primary series should receive a single booster dose at least 5 calendar months after completion of the primary series
• A Janssen primary series should receive a booster dose at least 2 months (8 weeks) after completing their primary series.

Currently, CDC does not recommend a booster dose in children aged 5–11 years. As more data become available, this recommendation may be updated.

Booster dose recommendations for people who were vaccinated outside the United States may be different.

Learn more about considerations for COVID-19 vaccine booster doses.

Yes. The 4-day grace period applies to the booster dose. A booster dose of a COVID-19 vaccine administered up to 4 days before the recommended date (4-day grace period) is considered valid. Use the grace period when retrospectively reviewing records to determine the validity of a dose. Do not use the grace period to schedule doses.

If a booster dose is administered earlier than the grace period (i.e., earlier than 4 days before the 5-month interval from an mRNA primary series or 4 days before the 2-month interval from a single-dose Janssen primary series), do not repeat the dose. This is considered a vaccine administration error. Determine how the error occurred and implement strategies to prevent it from happening again. Additionally, you are required to report COVID-19 vaccine administration errors to the Vaccine Adverse Event Reporting Systemexternal icon.

People 12 through 17 years of age who have completed a mRNA primary COVID-19 vaccine series can only receive Pfizer-BioNTech COVID-19 Vaccine as a booster dose at this time.

People 18 years of age and older who have completed a primary COVID-19 vaccine series with any FDA-approved or FDA-authorized product have the option to receive any age-appropriate FDA-approved or FDA-authorized COVID-19 booster product (Pfizer-BioNTech, Moderna [0.25 mL dose], or Janssen), even if they were 18 years of age or younger at the time of the primary series. An mRNA COVID-19 vaccine is preferred over the Janssen COVID-19 Vaccine.

Learn more about considerations for selecting which booster dose to receive and considerations for Janssen COVID-19 Vaccine.

Individuals can self-attest to their moderately to severely immunocompromised status and receive the additional dose wherever vaccines are offered. Vaccinators should not deny COVID-19 vaccination to a person due to lack of documentation. This will help prevent barriers to access for this vulnerable population receiving a needed additional dose. If immunocompromised individuals have questions about the additional dose, they should discuss with their healthcare provider whether getting an additional dose is appropriate for them.

If a booster dose is given at any time earlier than the recommended interval (i.e., earlier than 5 months after completion of the mRNA primary series or 2 months after completion of Janssen primary series), do not repeat the dose.

Administering booster doses prior to the 4-day grace period is considered vaccine administration error.  Determine how the error occurred and implement strategies to prevent it from happening again. Additionally, you are required to report COVID-19 vaccine administration errors to the Vaccine Adverse Event Reporting Systemexternal icon.

A patient can be vaccinated once symptoms resolve and if they have met the criteria to discontinue isolation. We do not have guidance for specific optimal time-period between infection and vaccination.

If the patient received antibody products (anti-SARS-CoV-2 monoclonal antibodies or convalescent plasma) as part of COVID-19 treatment, post-exposure prophylaxis, or pre-exposure prophylaxis can be vaccinated at any time; COVID-19 vaccination does not need to be delayed following receipt of monoclonal antibodies or convalescent plasma.

Antibody tests for COVID-19 look for the presence of antibodies made in response to a previous infection or vaccination. They are an indicator of the body’s efforts to fight off the SARS-CoV-2 virus. None of the currently authorized SARS-CoV-2 antibody testsexternal icon have been validated to evaluate specific immunity or protection from SARS-CoV-2 infection.

Antibody testing is NOT currently recommended to assess

• Immunity to COVID-19 following COVID-19 vaccination
• The need for vaccination in an unvaccinated person

There are several issues to consider when interpreting an antibody test for SARS-CoV-2 infection:

• Scientists have not yet established a serologic correlate of protection, which is the measurable threshold above which a person is protected against SARS-CoV-2 infection. This makes it difficult to interpret how laboratory results might translate to clinical protection.
• Antibody testing does not evaluate the cellular immune response, which may also play a role in vaccine-mediated protection.
• Vaccines trigger antibodies to specific viral protein targets. Currently authorized/approved COVID-19 vaccines induce antibodies to the spike protein but not to the nucleocapsid protein, which is likely detected only after a natural infection with SARS-CoV-2. Therefore, COVID-19-vaccinated people who have not had previous natural infection will receive a negative antibody test result if the antibody test is designed to detect nucleocapsid protein.
• Antibody tests have different levels of sensitivity (i.e., the true positive rate, or ability to identify people with antibodies to SARS-CoV-2) and specificity (i.e., the true negative rate, or ability to identify those without antibodies to SARS-CoV-2).

For assistance with patient counseling and education related to COVID-19 testing and vaccination, please see:

• Test for Past Infection [CDC]
• Using Antibody Tests for COVID-19: Information for Patients and Consumers [CDC]
• Antibody (Serology) Testing for COVID-19: Information for Patients and Consumers [FDA]external icon

For more detailed information, please see:

• Interim Guidelines for COVID-19 Antibody Testing [CDC]
• Serology/Antibody Tests: FAQs on Testing for SARS-CoV-2 [FDA]external icon
• Antibody Testing Is Not Currently Recommended to Assess Immunity After COVID-19 Vaccination: FDA Safety Communication [FDA]external icon

Yes. CDC recommends COVID-19 vaccination for all people 5 years of age and older with prior SARS-CoV-2 infection.

• Prior infection: Offer vaccination regardless of history of prior symptomatic or asymptomatic SARS-CoV-2 infection, including to people with prolonged post-COVID-19 symptoms and people who experienced a breakthrough infection.
• Current infection: Defer vaccination of people with known current SARS-CoV-2 infection until the person has recovered from acute illness (if the person has symptoms) and until criteria have been met for them to discontinue isolation. This recommendation applies to any vaccine, including the first and second doses of COVID-19 vaccine.

Learn more about COVID-19 vaccination and SARS-CoV-2 infection.

Yes. Most of the time, unvaccinated people who have been in close contact with someone who had COVID-19 should not seek vaccination until quarantine has ended.

However, vaccination can be considered in some instances to avoid missed opportunities. Examples include when people:

• Are likely to have repeated exposures (e.g., residing in a congregate or crowded setting or during community outbreaks)
• Will have limited access to vaccination after their quarantine period has ended
• Are unlikely to otherwise seek vaccination after their quarantine period has ended

In such situations, people can receive vaccination during quarantine as long as:

• They do not have symptoms consistent with COVID-19 or current SARS-CoV-2 infection, and
• Appropriate infection prevention and control procedures are employed

COVID-19 vaccines are not recommended for post-exposure prophylaxis to prevent SARS-CoV-2 infection. These people should be counseled that although COVID-19 vaccines are effective and will help protect them from future infection, the vaccine will not prevent them from getting COVID-19 from the current exposure.

Learn more about vaccinating people with a known COVID-19 exposure or during COVID-19 outbreaks.

Yes. a COVID-19 vaccination is recommended for everyone 5 years of age and older, including people with  underlying medical conditions. COVID-19 vaccines are especially important for people with underlying medical conditions associated with higher risk for severe COVID-19. Like all vaccine-eligible populations, mRNA COVID-19 vaccines are preferred over the Janssen COVID-19 vaccine for primary and booster vaccination.

Learn more about patient counseling for specific populations.

Yes. People with a history of an episode of an immune-mediated syndrome characterized by thrombosis and thrombocytopenia, such as HIT, should receive a currently FDA-approved or FDA-authorized mRNA COVID-19 vaccine and should not receive Janssen COVID-19 vaccine.

More information is available at: Clinical Care Considerations for COVID-19 Vaccination.

Yes. CDC recommends COVID-19 vaccination for all people who are pregnant, breastfeeding, trying to get pregnant now or who might become pregnant in the future. mRNA vaccines are recommended for all vaccine-eligible populations, including for people who are pregnant or lactating. Those who are considering receipt of the Janssen COVID-19 Vaccine should be counseled about the rare risk of TTS which can occur (typically within 2 weeks) after receipt of the Janssen COVID-19 Vaccine and need for a booster dose 2 months or more after the initial dose.

If a person becomes pregnant following the first dose of a COVID-19 vaccine that requires two doses (i.e., Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 Vaccine), the second dose should be administered as indicated for the person to be considered fully vaccinated.

Learn more about vaccination of pregnant or breastfeeding people and considerations for use of the Janssen COVID-19 Vaccine in certain populations.

CDC has a Prevaccination Checklist for COVID-19 Vaccinespdf icon that you can use to screen patients for contraindications and precautions for COVID-19 vaccines.

Yes. For COVID-19 vaccination for immunocompromised people, please refer to:

• Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States
• COVID-19 Vaccine Indications for Patients Who Are Immunocompromised
• How to Talk to Patients Who Are Immunocompromised

Additional information about the level of immune suppression associated with a range of medical conditions and treatments can be found in the General Best Practices Guidelines for Vaccination of People with Altered Immunocompetence, the CDC Yellow Book, and the 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Hostexternal icon. 

Contraindications to COVID-19 vaccination include:

• History of a severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the COVID-19 vaccine
• Known diagnosed allergy to a component of the COVID-19 vaccine (see Appendix C for a list of vaccine components)
• For the Janssen COVID-19 Vaccine, TTS following receipt of a previous Janssen Vaccine or other adenovirus vector-based COVID-19 vaccines (e.g., AstraZeneca’s COVID-19 Vaccine, which is not authorized or approved in the United States).

People with a contraindication to one type of COVID-19 vaccine (i.e., mRNA COVID-19 vaccines or Janssen COVID-19 Vaccine) should not receive additional doses of that type of COVID-19 vaccine. However, people with a contraindication to mRNA COVID-19 vaccines may be able to receive Janssen COVID-19 Vaccine, and vice versa, provided certain measures are taken.

Learn more about COVID-19 vaccine contraindications and precautions.

Precautions to any COVID-19 vaccine include:

• History of an immediate allergic reaction to any non-COVID-19 vaccine or injectable therapy (i.e., intramuscular, intravenous, or subcutaneous vaccines or therapies [excluding subcutaneous immunotherapy for allergies, i.e., “allergy shots”])
• People with a history of a non-severe, immediate (onset less than 4 hours) allergic reaction after a dose of one type of COVID-19 vaccine (i.e., mRNA or Janssen) have a precaution to the same type of COVID-19 vaccine.
• People with an allergy-related contraindication to one type of COVID-19 vaccine have a precaution to the other type of COVID-19 vaccine (e.g., people with a contraindication to an mRNA COVID-19 vaccine have a precaution to Janssen COVID-19 vaccine and vice versa).
• Moderate or severe acute illness, with or without fever
• For mRNA COVID-19 vaccines-history of myocarditis or pericarditis after a dose of an mRNA COVID-19 vaccine
• For Janssen COVID-19 vaccine-a history of GBS

When applicable, consider conducting a risk assessment or referral to an allergist-immunologist to help with vaccination decision-making.

Learn more about COVID-19 vaccine contraindications and precautions.

Yes. CDC recommends the following observation periods after COVID-19 vaccination:

• 30 minutes for people with:
  • Contraindication to a different type of COVID-19 vaccine (e.g., people with a contraindication to an mRNA COVID-19 vaccine have a precaution to Janssen COVID-19 vaccine and vice versa)
  • History of non-severe, immediately (onset less than 4 hours) allergic reaction after a previous dose of COVID-19 vaccine
  • History of an immediate allergic reaction of any severity to non-COVID-19 vaccines or injectable therapies
  • History of anaphylaxis due to any cause
• 15 minutes for all other people

As with other vaccines, you can vaccinate patients with a mild illness. A moderate or severe illness is a precaution to receiving any currently FDA-authorized or FDA-approved COVID-19 vaccine. It is not considered a contraindication. Generally, vaccination should be delayed until the acute illness has improved. However, if you and your patient believe the potential benefits of vaccination outweigh the potential risks, they may receive COVID-19 vaccine.

Learn more about contraindications and precautions.

PEG can be found in:

• Osmotic laxatives and oral bowel preparations for colonoscopy procedures
• Many medications as an inactive ingredient or excipient (e.g., certain injectable contraceptives, steroids)
• Some therapeutic medications (e.g., some chemotherapeutics)

Additionally, cross-reactive hypersensitivity can occur between PEG and polysorbates.

Screen patients for contraindications and precautions prior to vaccination. If a patient identifies a history of allergic reaction to a medication with which you are unfamiliar, you may consider using the following resources to determine if a specific medication contains PEG, a PEG derivative, or polysorbates:

• FDA package insert for the specific medication
• National Institutes of Health DailyMed databaseexternal icon
• CDC’s vaccine excipient summarypdf icon

Yes, the patient should get another dose if they have not yet completed:

• A primary series
• An additional primary dose (and are moderately to severely immunocompromised)
• A booster dose (and are eligible)

A side effect is not a contraindication to another dose of mRNA COVID-19 vaccine. Common side effects after vaccination may include:

• Injection site pain, redness, or swelling
• Tiredness
• Headache
• Muscle pain
• Chills
• Fever
• Nausea

For most people, side effects last no longer than 1–2 days. Encourage patients to enroll in v-safe to tell CDC about any side effects after getting a COVID-19 vaccine and to receive reminders if they need another dose.

People with a severe allergic reaction (e.g., anaphylaxis) to a previous dose of a COVID-19 vaccine should not receive additional doses of that type of COVID-19 vaccine. These people may be able to receive another type of COVID-19 vaccine (e.g., people with a contraindication to an mRNA COVID-19 vaccine have a precaution to Janssen COVID-19 vaccine and vice versa), but it is considered a precaution. In these cases, consider consultation with an allergist-immunologist to help determine if the patient can safely receive vaccination. Healthcare providers and health departments may also request a consultation from the Clinical Immunization Safety Assessment COVIDvax Project. Vaccination of these people should only be done in an appropriate setting under the supervision of a healthcare provider experienced in the management of severe allergic reactions.

People who experience an immediate (onset less than 4 hours), but non-severe, allergic reaction after a dose of one type of COVID-19 vaccine are considered to have a precaution for a subsequent dose of that same vaccine type. Consider referral to an allergist-immunologist for subsequent vaccination with the same vaccine type. Another option is to administer the other vaccine type with a 30-minute observation period in a usual vaccination setting.

See more information on:

• Contraindication and precautions
• Potential characteristics of allergic reactions

If the vaccine experienced problems during shipment (for example, damage or temperature excursion), contact:

• Directly distributed vaccine (Pfizer): 800-666-7248 (option 8) or CVGovernment@Pfizer.com.
• Centrally distributed vaccine (for example, Moderna): McKesson Specialty Customer Service at (833) 343-2703, Monday–Friday, 8 AM–8 PM Eastern Time.

If the vaccine experienced problems after it was received and placed into storage, contact the vaccine manufacturer for guidance on improper storage and handling.

For temperature excursions (out-of-range temperatures), take immediate action:

• Label the vaccine “Do Not Use” and store at the recommended temperature range until you receive manufacturer guidance.
• Document the date and length of time of the excursion, storage unit temperature, room temperature, and inventory affected.
• Record any other relevant information.
• Contact the manufacturer for guidance on whether to use affected vaccines and whether patients need to be recalled for revaccination.
• Document the event and action taken for record-keeping requirements.
• (Pfizer only) If advised to dispose of the vaccine, properly dispose of the vaccine as biohazard waste. Never return vaccines with thermal shipping containers back to the manufacturer.

An expiration date is a date, usually defined by the manufacturer, after which a product should not be used. In certain circumstances, usually determined by the manufacturer, an expiration date can be extended.

A beyond-use-date (BUD), by contrast, is a date/time that is generated when a product is transitioned between storage states (e.g., ultra-cold, freezer, refrigerator, room-temperature), when a product vial is punctured, or when some other transition occurs.  It is a new deadline after which the product should not be used.  This new deadline replaces but will never extend beyond the expiration date. When moving vaccine from one type of storage to another, puncturing a vial for use, and mixing vaccine with diluent, always label the vial with the BUD and staff initials.

CDC recommends transporting vaccine in vials. However, there may be instances when the only option is to transport predrawn vaccine in a syringe. U.S. Pharmacopeia includes guidance for transporting predrawn vaccine in syringes in the COVID-19 Vaccine Handling Guides: Operational Considerations for Healthcare Practitionersexternal icon.

No. While it is important to try to use every dose of vaccine possible, that should not be at the expense of missing an opportunity to vaccinate every eligible person when they are ready to get vaccinated. Strategies to ensure providers do not miss an opportunity to vaccinate every eligible person and limit wastage can be found here: Identification, Disposal, and Reporting of COVID-19 Vaccine Wastagepdf icon.

No. CDC recommends following these practices:

• Never combine or “pool” partial doses from two or more vials to obtain one or more doses of vaccine.
• Withdraw only the number of doses authorizedexternal icon for the specific vaccine.
• Discard the vaccine vial and remaining vaccine if the amount of vaccine left in the vial is not a full dose.

Although no one wants to waste vaccine, it is crucial for infection control and patient safety to administer vaccine properly. Combining vaccine doses from multiple vials can result in cross-contamination, potentially causing bacterial infection in patients.

No. You should not aspirate before giving any vaccine, including COVID-19 vaccines. Aspiration can increase pain because of the combined effects of a longer needle-dwelling time in the tissues and shearing action (wiggling) of the needle. A discussion of vaccine administration best practices can be found in the Vaccine Administration chapter of Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book).

No. These devices or a needle should not be left inserted into a medication vial septum for multiple uses. This provides a direct route for microorganisms to enter the vial and contaminate the fluid in these devices. Learn more about injection safety.

COVID-19 vaccines are administered by intramuscular injection. For all intramuscular injections, the needle should be long enough to reach the muscle mass and prevent vaccine from seeping into subcutaneous tissue. Ensuring the vaccine is given in the muscle is important to optimize immunogenicity and minimize adverse reactions at the injection site. If vaccine is given subcutaneously with the incorrect needle length, patients may experience more pain, irritation, and redness at the injection site.

Needle gauge and length recommendations vary for adolescents based on age, and for adults based on age, gender, and weight. CDC’s needle gauge and length chartpdf icon, included in the ancillary kits, outlines ACIP’s recommendations for needle length. Other vaccine administration and injection resources can be found in CDC’s Vaccine Administration Resource Library.

To reduce the risk of fake or counterfeit vaccines, dispose of vials and packaging as medical waste by placing vials in a sharps container and packaging in a red medical waste bag. If medical waste containers are in short supply, deface or safely crush packaging materials so they cannot be reintroduced or reproduced. After the products are sufficiently defaced or destroyed, dispose with regular waste.

The disposal process for unused COVID-19 vaccine and diluent may be different. For guidance, contact your jurisdiction’s immunization program.  If advised to dispose of the vaccine, properly dispose of the vaccine as biohazard waste. Never return unused or expired vaccines with the shipping containers back to the manufacturer. Additionally, promptly report any expired or unused vaccine. This helps CDC accurately monitor the amount of vaccine in the field.  Keep in mind that there are no negative consequences for reporting waste, and it will not negatively impact future allocations. CDC recognizes that unused expired vaccine is a normal part of any vaccination program, especially one of this scope and size.

Some interim recommendations for COVID-19 vaccine administration errors differ from ACIP’s General Best Practice Guidelines. Review vaccine administration errors and deviations for COVID-19 vaccines to learn about the interim recommendation for each type of error.

For all vaccine administration errors:

• Inform the recipient of the vaccine administration error.
• Consult with the state immunization program or immunization information system (IIS) to determine how the dose should be entered into the IIS, both as an administered dose and to account for inventory.
• Report the error to the Vaccine Adverse Event Reporting System (VAERS)external icon unless otherwise indicated in the Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Providers are required to report all COVID-19 vaccine administration errors—even those not associated with an adverse event—to VAERSexternal icon.
• Determine how the error occurred and implement strategies to prevent it from happening again. A discussion on strategies to prevent errors can be found in the Vaccine Administration chapter of Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book). Additional resources can be found on CDC’s vaccine administration web page, including a job aidpdf icon for preventing errors.

All vaccine recipients should have received a CDC vaccination card when they were initially vaccinated.

When scheduling appointments, remind patients to bring their COVID-19 vaccination record card. If patients do not bring their card, make every effort to verify vaccination history.

• If patients bring their vaccination card: Document the dose on their existing card. There are two additional spaces on the card.
• If patients are unable to locate or do not bring their vaccination card: Provide a new card to record the dose.

Remind all patients to bring their vaccination record card to their appointment, even if they laminated it. If your patient presents a laminated vaccination card at their appointment, you can:

• Add a label or sticker to the card that fits within the appropriate space
• Provide a new card, transfer the original information, and destroy the old card

No. Under Emergency Use Authorization, there is no VIS for an authorized vaccine. Instead, providers are legally required to provide the EUA Fact Sheet for Recipients and Caregivers to vaccine recipients or their guardians. There are two Fact Sheets for Pfizer-BioNTech based on age group; one covers ages 5 through 11 years and one covers ages 12 years and older. There is no VIS yet for the FDA-approved COMIRNATY vaccine.  The Fact Sheet for ages 12 years and older covers both the authorized Pfizer-BioNTech COVID-19 Vaccine and the FDA-licensed vaccine, COMIRNATY.

The Fact Sheet for Recipients and Caregivers includes:

• Basic information on COVID-19, symptoms, and what to discuss with a healthcare provider before vaccination
• Who should and should not receive the vaccine
• A statement that recipients have the choice to receive the vaccine
• Vaccine series information
• Potential and known risks and benefits of the vaccine, including common side effects
• Information on reporting side effects to VAERS
• An explanation of what an EUA is and why it is issued
• Any approved available alternatives for preventing COVID-19
• Additional resources

No. Although you are required to provide the vaccine-specific Fact Sheet for Recipients and Caregivers to vaccine recipients or their caregivers, you are not required to document that you did so. To help facilitate such documentation in electronic medical records/immunization information systems for vaccination providers who choose to do so, CDC is leveraging the existing vaccine information statement (VIS) Code Set infrastructure, barcoding, and URLs to provide the information needed for various systems. This is similar to the electronic system and workflow documentation of the VIS. The barcode at the bottom of the last page of the Fact Sheet for Recipients and Caregivers may be scanned to capture in electronic medical records/immunization information systems that the fact sheet was provided to the vaccine recipient or caregiver.

Report adverse events that occur in a recipient following COVID-19 vaccination to the Vaccine Adverse Event Reporting System (VAERS)external icon. Vaccination providers are required by the FDA to report:

• Vaccine administration errors
• Serious adverse events
• Cases of multisystem inflammatory syndrome
• Cases of COVID-19 that result in hospitalization or death following COVID-19 vaccination

Reporting is encouraged for any other clinically significant adverse event, even if it is uncertain whether the vaccine caused the event. Also, vaccine recipients can report adverse events that occur after vaccination. Information on how to submit a report to VAERS is available at https://vaers.hhs.govexternal icon or by calling 1-800-822-7967. For more information on VAERS, please refer to the VAERS FAQsexternal icon.

The VAERS reporting requirements for COVID-19 vaccines are different from those for routine vaccines licensed in the United States. Healthcare providers are strongly encouraged to report vaccine administration errors involving any licensed vaccine. However, healthcare providers are required to report COVID-19 vaccine administration errors to VAERSexternal icon.

Before vaccination, counsel patients about expected local and systemic side effects.

Common side effects include:

Local reactions:

• Pain
• Redness
• Swelling

Systemic reactions:

• Tiredness
• Headache
• Muscle pain
• Chills
• Fever
• Nausea

If receiving Janssen COVID-19 Vaccine, women ages 18–49 years old should be made aware of the rare but increased risk of blood clots with low platelets following vaccination and the availability of other COVID-19 vaccines where this risk has not been observed. Provide recipients or caregivers (as applicable) the EUA Fact Sheet for Recipients and Caregiversexternal icon.

If receiving an mRNA COVID-19 Vaccine (i.e., Pfizer or Moderna), recipients should be made aware of the rare but elevated risk for myocarditis and/or pericarditis, particularly in males ages 12–29 years.  The Advisory Committee on Immunization Practices concluded that the benefits of COVID-19 vaccination to individual persons and at the population level clearly outweighed the risks of myocarditis after vaccination. Provide recipients or caregivers (as applicable) the Pfizer Vaccine Information Fact Sheetexternal icon or the Moderna EUA Fact Sheetexternal icon for Recipients and Caregivers.

No. There is no evidence that any vaccine, including COVID-19 vaccines, cause fertility problems. People who are trying to become pregnant do not need to avoid pregnancy after COVID-19 vaccination. There is no recommendation for routine pregnancy testing before receipt of a COVID-19 vaccine. For more information, please visit Myths and Facts about COVID-19 Vaccines.

For more information, visit CDC’s When You’ve Been Fully Vaccinated webpage.

All staff supporting COVID-19 vaccination efforts should receive ongoing training as new COVID-19 vaccines become available and recommendations evolve. Review and complete training and core competencies by professional qualification. Additionally, for healthcare professionals new to vaccination, the COVID-19 Vaccination Training Programs and Reference Materials for Healthcare Professionalspdf icon provide a comprehensive list of suggested training and reference materials.

For more immunization training resources, see Resources for Health Care Providers and Immunization Education and Training.

Please contact CDC-INFO for further questions on COVID-19 vaccines.