The top COVID-19 vaccines, safety concerns, and health updates—all in one place.
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With more than 297 million coronavirus infections—including 57 million cases and over 830,549 deaths in the U.S.—since the start of the pandemic, the race to distribute a COVID-19 vaccine to Americans is on.

To date, three vaccines are rolling out in America. Pfizer is approved for everyone ages 5 and up; younger children may get the go-ahead this year (Pfizer has full FDA approval for those 16 and older). Moderna and Johnson & Johnson can currently be given to anyone 18 and older. All available vaccines have been shown to reduce the risk of severe illness, hospitalization, and death from COVID-19.

With all of the recent vaccine news, parents are wondering when, exactly, things will go back to "normal"—and what a vaccine could mean for their family. Here, the latest on vaccine development, safety concerns, what happens once you've been fully vaccinated, and everything you need to know about COVID-19 vaccines.

Vaccine Safety and Regulations

The FDA has strict regulations that must be met before a vaccine can be distributed to the general public. To ensure the safety and effectiveness of a vaccine, it must go through three phases:

  • Phase 1: Early stage clinical trials on 20-100 healthy volunteers to test the safety profile, dose effects, and any adverse effects. If no serious side effects are discovered, the vaccine can move to phase 2.
  • Phase 2: Testing on hundreds of volunteers to determine any short-term side effects or dose effects on different categories of people. If deemed safe, the vaccine can move on to final trials.
  • Phase 3: Hundreds or thousands of volunteers are tested to evaluate the vaccine's effectiveness. This is where the FDA discovers if the vaccine prevents disease when compared to a placebo test and allows researchers to learn more about its safety and any common side effects.

Once this rigorous testing is complete and a vaccine is distributed to the public, phase 4—where the widespread effectiveness or long-term effects are tested on a greater population—will begin. To be considered effective, the FDA says that a vaccine should protect 50 percent of recipients.

"This unprecedented period has called for innovation, speed, and efficiency in vaccine production," says Mobola Kukoyi, M.D., MPH, an emergency physician at Carle Foundation Hospital in Urbana, Illinois who has seen both pediatric and adult COVID-19 cases in the emergency room. "Understandably, this comes with a concern for safety. However, given the different regulatory checkpoints in the phases outlined above, a product is only approved if it meets specific guidelines. My advice to all would be to follow the science."

Vaccine Front-Runners

With dozens of vaccines under development worldwide, a handful have shown promise. These are the ones to know about:

1. Pfizer

On December 11, 2020, Pfizer—working with German company BioNTech and Chinese drugmaker Fosun Pharma—was approved for emergency use in the U.S. On August 23, 2021, it became the first COVID-19 vaccine to receive full FDA approval in America. The full approval applies to those 16 and up.

Children ages 5 to 15 can currently get Pfizer under emergency use authorization; 5- to 11-year-olds receive a lower dose of the vaccine. Pediatric clinical trials showed over 90 perfect effectiveness in kids with no major red flags.

Pfizer is also including those 6 months and up in trials. That said, results indicated the vaccine didn't produce a sufficient immune response in 2- to 4-year-olds, so Pfizer is testing a third low-dose shot in this age group, given two months after the second shot. Emergency use authorization for those under 5 will depend on the results of these trials.

2. Moderna

Partnering with the National Institute of Allergy and Infectious Diseases (NAIAD), Moderna, a biotech company in Cambridge, Massachusetts, created the first vaccine to reach phase 3 testing. On December 18, 2020, Moderna became the second drugmaker to receive approval from the FDA for rollout for people ages 18 and up.

After receiving this emergency approval, Moderna started enrolling kids 12 and up in new trials and is now including children between 6 months and 12 years old. They recently announced that its vaccine is highly effective in adolescents ages 12 to 17, and they plan to apply for emergency use authorization for this age group soon.

In October 2021, Sweden paused Moderna distribution for anyone born in 1991 or later. And Denmark did the same for those 18 and younger. The countries cited an increased risk of rare side effects, such as myocarditis and pericarditis (inflammation of the heart), in young people.

3. Johnson & Johnson

The single-dose Johnson & Johnson vaccine has also been approved for emergency use authorization from the FDA.

On April 13, use of Johnson & Johnson's COVID-19 vaccine was paused after several women developed blood clots. Nearly 7 million people had received the vaccine in the U.S. at that time, and the FDA and CDC called for this pause out of an abundance of caution. After looking into the blood clot cases, the vaccine was restarted with a warning label about the rare clotting disorder. As of December 2021, nine people have died from these rare blood clots.

In July 2021, the FDA attached a different warning to the Johnson & Johnson vaccine, saying it could cause an increased risk of a neurological condition called Guillain–Barré syndrome. Indeed, according to The New York Times, people who received the Johnson & Johnson vaccine have a three to five times higher chance of developing the condition than the general population.

The CDC now recommends Pfizer or Moderna over the Johnson & Johnson vaccine.

4. AstraZeneca

In collaboration with the United Kingdom's University of Oxford, British-Swedish pharmaceutical giant AstraZeneca was awarded $1.2 billion to get 300 million doses of its vaccine contender ready for the U.S. AstraZeneca said on March 22 that it would apply for emergency use authorization by the FDA in the coming weeks, but new concerns over outdated information included with the vaccine's results caused setbacks.

5. Novavax

After a successful round of safe early clinical trials, Novavax, a Maryland-based company, has another vaccine to watch. Preliminary studies on monkeys and humans showed the production of virus antibodies, as well as killer T-cells, which can kill cells with the virus. Novavax has already begun phase 3 testing in the U.S..

FAQs

Is the testing moving too fast?

"The speed which this vaccine was brought to market was unprecedented," says Kevin Kathrotia, M.D., neonatologist and COO of Millennium Neonatology in Charlotte, North Carolina who has cared for babies whose mothers have tested positive for COVID-19. "This is a testament to the herculean effort of scientists and doctors at multiple companies, research facilities, and some of the world's greatest universities." 

And while things are moving faster than usual—it usually takes years to develop a vaccine, and COVID-19 vaccines are set to be distributed within 24 hours of FDA approval—Dr. Kathrotia says that we should trust the clinical trial process and the fact that a drug brought to market is safe and works.

Who should get a COVID-19 vaccine?

After undergoing a strategic rollout to the public—with doses available first to health care workers, high-risk adults, and residents of long-term care facilities—states began broadening eligibility. Now all American age 5 and up are eligible to receive a COVID-19 vaccine.

Is it safe for children?

Parents can rest assured that vaccines approved by the FDA are safe for children. On March 31, Pfizer announced that its vaccine is effective in preventing illness in young teens and, on May 10, received emergency use authorization for 12- to 15-year-olds. Pfizer also received for emergency approval for kids ages 5 to 11 last fall, and younger children might get the go-ahead soon. Pediatric trials showed more than 90 percent effectiveness with no red flags.

Note: The CDC has reported rare cases of myocarditis and pericarditis (inflammation of the heart) in people under 30 years old who received Pfizer of Moderna. Most cases—which come with symptoms like heart palpitations, chest pain, and shortness of breath—have occurred in males after their second dose, and they usually resolve with treatment. The CDC is investigating further, and the FDA urged an expansion of pediatric trials to further evaluate this rare side effect, but the organizations still recommend that everyone 5 and up get vaccinated.

Is it safe for pregnant women?

Organizations like the CDC and the American College of Obstetricians and Gynecologists recommend that pregnant women receive the COVID-19 vaccine, as the benefits of vaccination outweigh any possible risks.

More good news: A baby in Florida and a baby in Colorado have been born with COVID antibodies after their mothers received the vaccine during pregnancy. Early studies also point to protective antibodies being passed through the breast milk of those who have been vaccinated.

Is it safe for people with allergies?

Early Pfizer vaccine distribution in the U.K. sparked warnings that those with severe allergies should not receive the vaccine, but Americans with allergies have received the OK to get it—though they'll have to discuss with their doctors first and be monitored following vaccination.

"People that do report those types of anaphylactic reactions to other vaccines or injectables — they can still get the vaccine, but they should be counseled about the unknown risks of developing a severe allergic reaction and balance these risks against the benefit of vaccination," said Sarah Mbaeyi, a medical officer with the CDC's National Center for Immunization and Respiratory Diseases.

If you or your child have a history of allergic reactions, you should speak with your doctor before getting vaccinated.

How will I know if my family should get the COVID-19 vaccine?

According to the CDC, getting vaccinated may keep you from becoming seriously ill if you do get COVID-19. It may also keep those around you from becoming sick. Health experts agree that families should let the vaccine data speak for itself once testing is complete. The FDA and government officials will share ongoing vaccination guidance, but you should check with local health officials and your doctor about your family's vaccine plan.

What's the deal with booster shots?

As the Delta and Omicron variants spread across America, experts are seeing waning immunity from the COVID-19 vaccines. That's why booster shots have been approved for anyone 12 years and older.

If you received Pfizer of Moderna, you can get a booster five months after completing your primary vaccination series, according to the CDC. If you received Johnson & Johnson, it's recommended that you get a booster at least 2 months after your initial shot.

What's more, certain immunocompromised children ages 5 to 11 are eligible for an additional dose 28 days after their second shot.

So which booster shot should you get? "You may choose which COVID-19 vaccine you receive as a booster shot," says the CDC. "Some people may prefer the vaccine type that they originally received, and others may prefer to get a different booster. CDC's recommendations now allow for this type of mix and match dosing for booster shots." 

OK, I'm vaccinated—now what?

Finally some good news: New guidance from the CDC suggests that people who have been fully vaccinated can start to safely enjoy some of the things they've put on hold during the pandemic.

You're considered fully vaccinated two weeks after receiving the second dose of the Pfizer or Moderna vaccines or two weeks after receiving the single shot from Johnson & Johnson. Booster shots may soon change that definition, however. Here's what you can do once that happens:

  • The CDC recommends vaccinated people wear masks in public indoor spaces "in an area of substantial or high transmission." Wearing a mask is also important "if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated." You'll also still need to wear masks on public transportation (like trains, buses, and planes) and in health care settings. Students and faculty should also mask in schools, regardless of whether they're vaccinated.
  • Resume domestic travel. You also don't need to get a COVID-19 test (unless required by your destination) or self-quarantine before or after travel.
  • Travel internationally without testing, unless your destination requires it. That said, "If you plan to travel internationally, you will need to get a COVID-19 viral test (regardless of vaccination status or citizenship) no more than 1 day before you travel by air into the United States. You must show your negative result to the airline before you board your flight," says the CDC.