COVID-19 Vaccine FAQs for Healthcare Professionals

Vaccination Schedule and Use

All doses of the primary series and additional primary dose should be completed with the same product.  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. 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).

Booster Doses

Everyone 18 years of age and older should receive a booster dose of COVID-19 vaccine.

People who received:

  • An mRNA primary series should receive a single booster dose at least 6 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 5–17 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. See the question below for more information: “My patient was vaccinated outside the United States. Do they need any more doses of COVID-19 vaccine?”

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 6-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.

The dosage for the booster dose is

  • Janssen COVID-19 Vaccine: 0.5 mL
  • Moderna COVID-19 Vaccine: 0.25 mL (this is half the volume of a primary series dose)
  • Pfizer-BioNTech COVID-19 Vaccine: 0.3 mL (12 years of age and older formulation; purple cap)

People 18 years of age and older who received a primary series of any FDA-approved or FDA-authorized COVID-19 vaccine product have the option to receive any of the FDA-approved or FDA-authorized COVID-19 booster products (Pfizer-BioNTech 12 years of age and older formulation [purple cap]), Moderna [0.25 mL dose], or Janssen). Discuss the risks and benefits and which product may be most appropriate with individual patients.

Clinical trial data using homologous (the same) or heterologous boosters (“mix and match”) show that both increase immune response.

The frequency and type of local and systemic symptoms after a booster dose are generally similar to those experienced after a primary series. The rare risks of serious adverse events after a booster dose are also expected to be similar to those experienced after a primary series. These include:

  • Myocarditis and pericarditis: Based on data after receipt of an mRNA COVID-19 primary series, the group at the highest risk for myocarditis and pericarditis is males aged 12-29 years. Accumulating evidence from multiple sources suggests a higher risk for myocarditis following primary vaccination with Moderna compared to Pfizer-BioNTech. There are currently no data comparing the risk for myocarditis after a booster dose of Pfizer-BioNTech COVID-19 Vaccine versus a booster dose of Moderna COVID-19 Vaccine.
  • Guillain-Barre Syndrome: Based on data after receipt of a Janssen COVID-19 primary dose, the group at the highest risk for GBS is men 50-64 years.
  • Thrombosis with thrombocytopenia syndrome (TTS): The group at highest risk for TTS is women ages 18–49. These women should be made aware of the increased risk for TTS and the availability of mRNA COVID-19 vaccines for a booster dose. People who developed TTS after their single-dose Janssen primary series should not receive a Janssen booster dose.

Learn more about considerations for selecting which booster dose to receive.

Recommendations vary by the COVID-19 vaccine product administered for the primary series. For people who completed a primary series of an FDA-approved or FDA-authorized COVID-19 vaccine:

mRNA COVID-19 vaccine primary series:

People 12 years of age and older who are moderately or severely immunocompromised should receive an additional primary dose of the same mRNA vaccine received for the primary series at least 28 days after the completion of the primary series.

These people should receive a booster dose at least 6 months after completing their additional primary dose if they are 18 years of age or older.

The booster dose can be any FDA-approved or FDA-authorized COVID-19 vaccine, even if it is a different product than the primary series.

Janssen COVID-19 Vaccine primary series:

All people, including those who are moderately or severely immunocompromised, who received a Janssen COVID-19 vaccine primary series should receive a booster dose at least 2 months (8 weeks) after completion of a Janssen COVID-19 Vaccine primary series.

The booster dose can be any FDA-approved or FDA-authorized COVID-19 vaccine, even if it is a different product than the primary series.

If a booster dose is given at any time earlier than the recommended interval (i.e., earlier than 6 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.

Yes. People 18 years of age and older who experience COVID-19 after being fully vaccinated can receive a booster dose. People with known current SARS-CoV-2 infection should defer vaccination at least until they have recovered from the acute illness (if they had symptoms) and have met criteria to discontinue isolation. Current evidence about the optimal timing between SARS-CoV-2 infection and vaccination is insufficient to inform guidance.

Vaccine Indications

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:

For more detailed information, please see:

Yes. CDC recommends COVID-19 vaccination for all people with prior SARS-CoV-2 infection. However, the timing of the vaccination depends on when a person had SARS-CoV-2 infection and/or when they received treatment.

People with a 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.

People with a 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.

For people who previously received passive antibody therapy as part of COVID-19 treatment, defer vaccination for at least 90 days after receipt of passive antibody therapy (monoclonal antibodies or convalescent plasma). This recommendation applies to people who receive passive antibody therapy before receiving any COVID-19 vaccine dose and between doses.

You may administer routine vaccines, including influenza vaccine, any time before, at the same time, or after administration of monoclonal antibodies for treatment of COVID-19. COVID-19 monoclonal products contain only antibodies to SARS-CoV-2 and therefore do not interfere with the immune response to routine live or non-live vaccines.

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

No, your patient may be vaccinated without waiting 90 days. Although people who have received passive antibody therapy as treatment for COVID-19 should wait at least 90 days before vaccination, there is no minimum interval between antibody therapies not specific to COVID-19 treatment and COVID-19 vaccination.

If the first dose of an mRNA COVID-19 vaccine is inadvertently administered before the recommended 90 days has passed, defer the second dose of the mRNA COVID-19 vaccine for at least 90 days after receipt of passive antibody therapy. Ensure the recommended interval has elapsed from the first dose (i.e., 21 days for Pfizer-BioNTech and 28 days for Moderna).

Yes. You may administer any currently FDA-authorized or approved COVID-19 vaccine to people with underlying medical conditions; the Advisory Committee on Immunization Practices (ACIP) does not state a product preference. This includes people with:

  • Immunocompromising conditions or people who take immunosuppressive medication or therapies (learn more about considerations for an additional primary dose for immunocompromised people)
  • Autoimmune conditions
  • A history of Guillain-Barré syndrome
  • A history of Bell’s palsy
  • A history of dermal filler use

Learn more about vaccinating patients with underlying medical conditions.

Yes. For people with a history of an episode of immune-mediated syndrome characterized by thrombosis and thrombocytopenia (e.g., heparin-induced thrombocytopenia):

  • Offer Moderna COVID-19 Vaccine or Pfizer-BioNTech COVID-19 Vaccine if it has been 90 days or fewer since their illness resolved
  • Offer any FDA-authorized or FDA-approved COVID-19 vaccine after 90 days

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. This population can receive any of the currently FDA-authorized or FDA-approved COVID-19 vaccines; the Advisory Committee on Immunization Practices does not state a product preference. However, you should talk to pregnant, breastfeeding, and postpartum people younger than 50 years old who choose to receive Janssen COVID-19 Vaccine about:

  • The rare but increased risk of thrombosis with thrombocytopenia syndrome (TTS) after receipt of this vaccine
  • The availability of other FDA-authorized or approved COVID-19 vaccines (i.e., mRNA vaccines) for which the risk of TTS has not been observed

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.

Vaccine Contraindications and Precautions

Contraindications to COVID-19 vaccination include:

  • 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)

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)
  • Moderate or severe acute illness

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 a 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).

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:

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:

Vaccine Storage and Handling

CDC requires vaccination providers participating in the COVID-19 Vaccination Program to use a specific type of TMD called a “digital data logger” (DDL) to monitor temperatures. A DDL provides the most accurate storage unit temperature information, including details on how long a unit has been operating outside the recommended temperature range (referred to as a “temperature excursion”). DDLs using a buffered temperature probe provide the most accurate way to measure actual vaccine temperatures. Always use DDLs with a current and valid Certificate of Calibration Testing.

Note that not all DDLs can measure ultra-cold temperatures. For accurate ultra-cold temperature monitoring, it is essential to use an air-probe or a probe designed specifically for ultra-cold temperatures with the DDL.

For the Pfizer-BioNTech COVID-19 vaccine, there are additional considerations for using a TMD with the thermal shipping container. Refer to the Pfizer-BioNTech COVID-19 Vaccine Storage and Handling Summarypdf icon and Pfizer-BioNTech COVID-19 Vaccine web page for more information.

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.

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.

Vaccine Administration

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:

Some people may have received a COVID-19 vaccine outside of the United States.

People who were vaccinated outside the United States with Pfizer-BioNTech, Moderna, or Janssen COVID-19 vaccines:

  • Are considered fully vaccinated if they received all recommended doses of a single or 2-dose primary series.
  • Do not need to restart the series if they received the first dose of a 2-dose mRNA COVID-19 vaccine series. Administer a second dose as close to the recommended time as possible.
  • Should receive an additional primary dose if 12 years of age or older and moderately or severely immunocompromised, following the same guidance for people vaccinated in the United States.
  • Should receive a booster dose if 18 years of age or older, following the same guidance for people vaccinated in the United States.

People who completed all of the recommended doses of a World Health Organization Emergency Use Listing (WHO-EUL) COVID-19 vaccine that is not FDA-approved or FDA-authorized, and people who completed a heterologous (mix and match) series composed of any combination of FDA-approved, FDA-authorized, or WHO-EUL COVID-19 vaccines:

  • Are considered fully vaccinated.
  • Should receive an additional primary dose of Pfizer-BioNTech COVID-19 Vaccine at least 28 days after completion of the second dose of the primary series, if moderately or severely immunocompromised and at least 12 years of age.
  • Should receive a single booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after completing the primary series (i.e., after the last dose of the initial primary series or after the additional primary dose for immunocompromised people), if 18 years of age or older.

People who received only the first dose of a multidose WHO-EUL COVID-19 primary series that is not FDA-approved or FDA-authorized, or who received all or some of the recommended doses of a COVID-19 vaccine primary series that is not listed for emergency use by WHO:

  • Should be offered primary vaccination with Pfizer-BioNTech, Moderna, or Janssen COVID-19 Vaccine, with a minimum interval of at least 28 days since receipt of the last dose of vaccine.
  • Are considered fully vaccinated after completion of primary vaccination and are not recommended to receive an additional primary dose or booster dose at this time.

Learn more about guidance for people who received COVID-19 vaccine outside the United States.

Vaccination Documentation

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

The patient should request their vaccination card from the provider who administered the vaccination. They might also be able to check the immunization information system (IIS) in the jurisdiction they were vaccinated, or reach out to the state immunization program or state, tribal, local, or territorial health department to get their records from the IIS.

Vaccination providers enrolled in the COVID-19 Vaccination Program are required to:

  • Document vaccine administration in their medical record systems within 24 hours of administration.
  • Report administration data to the relevant system (i.e., Immunization Information Systems) for the jurisdiction as soon as practicable and no later than 72 hours after administration. See data reporting requirements.
  • Report inventory daily using Vaccines.gov. In some jurisdictions, providers may report vaccine inventory to the jurisdiction’s IIS for the jurisdiction to upload into Vaccines.gov. If you have questions about the process for your jurisdiction, please contact your jurisdiction’s immunization program.
  • Report the following to VAERSexternal icon:
    • Vaccine administration errors
    • Serious adverse events
    • Multisystem inflammatory syndrome
    • Cases of COVID-19 that result in hospitalization or death after the recipient has received COVID-19 vaccine

There are additional requirements for COVID-19 vaccination providers besides documentation (e.g., providing the Fact Sheet for Recipients and Caregivers to vaccine recipients). Please refer to your COVID-19 vaccination provider agreement for all provider requirements.

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.

Vaccine Safety and Efficacy

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, impact menstrual cycles or future fertility. 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.

Other

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.

For clinical questions on the following specific COVID-19 vaccines, see:

Page last reviewed: December 8, 2021