Vaccine Information for Health Care Professionals

Who is eligible for a COVID-19 vaccine now?

Anyone age 12 and older is eligible to be vaccinated! Make an appointment or find a walk-in clinic.

In addition to Health Department communications, we work with partners like health care practices, community organizations, pharmacies, employers, and local news media to announce updates in eligibility, vaccine access, and other important vaccine information.

How are these decisions made?

The National Academies of Sciences, Engineering, and Medicine established a framework for equitable allocation of a COVID-19 vaccine. The Advisory Committee on Immunization Practices (ACIP) has considered this framework and made recommendations for who should receive the vaccine in which phases. The Health Department works with State leadership to make these difficult choices after considering recommendations from the Advisory Committee on Immunization Practices, CDC, and Vermont’s Vaccine Implementation Advisory Committee. Based on our data, we know that focusing next on providing vaccines to people based on their age and whether they have certain high-risk health conditions will help us save lives.

Read about the ways we are working toward equity

Three COVID-19 vaccines have received Emergency Use Authorization from the U.S. Food and Drug Administration (FDA).

• The Pfizer-BioNTech vaccine received an EUA on December 11, 2020 and a second for people 12-15 years on May 10, 2021.
• The Moderna vaccine received an EUA on December 18, 2020. 
• The Janssen Biotech, Inc. (Johnson & Johnson) vaccine received an EUA on February 27, 2021.

See a vaccine comparison chart with key details for each vaccine from the Association of State and Territorial Health Officials (ASTHO)

About the Pfizer-BioNTech vaccine

Doses to be Fully Vaccinated
The Pfizer-BioNTech vaccine requires 2 doses about 21 days apart. It takes 14 days after your second dose to be protected from COVID-19.

How It Works
mRNA vaccines are introduced into the body to tell the body to make a harmless piece of “spike protein.” Your immune system sees the spike protein doesn’t belong in your body and starts building an immune response. This means that the next time you come in contact with the virus that causes COVID-19, your body knows how to fight it off. Scientists have been researching this type of vaccine for decades.

For more information on the development and approval of the COVID-19 mRNA vaccines visit the CDC Understanding and Explaining mRNA COVID-19 Vaccines.

How Well It Works
In clinical trials, the Pfizer-BioNTech vaccine was 95% effective at preventing COVID-19 after two doses. It was equally effective among people of different races, ethnicities, genders and health conditions. The level of protection against the current variants of the virus are being tested.

Side Effects
Some participants in clinical trials showed a strong immune response, which often leads lead to some side effects. The second dose may result in a stronger immune response than the first dose. Side effects are normal and show that your body is building immunity to COVID-19.

Common side effects reported by some trial participants were:

• Pain at the injection site (84.1%)
• Fatigue (62.9%)
• Headache (55.1%)
• Chills (31.9%)
• Joint Pain (23.6%)
• Fever (14.2%)

Recommended for:

• People of all races, ethnicities, and ages, 12 and older, including older adults
• People with medical conditions
• People who are pregnant and breastfeeding
• People with weakened immune systems
• People who had COVID-19 infection and have recovered

Not recommended for:
Children 11 years and younger. The Pfizer-BioNTech started clinical trials with children under 12 years old in March 2021.

Ingredients
Similar to other vaccine ingredients: mRNA protein, fats, salts, and sugars. It contains polyethylene glycol and polysorbate. The vaccine does not have any fetal tissue, animal products, eggs, gelatin, latex, microchips, or preservatives.

Resources

• Pfizer-BioNTech vaccine EUA received December 11, 2020 (FDA)
• Pfizer-BioNTEch Frequently Asked Questions (FDA)

About the Moderna Vaccine

Doses to be Fully Vaccinated
The Moderna vaccine requires two doses about 28 days apart. It takes 14 days after your second dose to be protected from COVID-19.

How it Works
mRNA vaccines are introduced into the body to tell the body to make a harmless piece of “spike protein.” Your immune system sees the spike protein doesn’t belong in your body and starts building an immune response. This means that the next time you come in contact with the virus that causes COVID-19, your body knows how to fight it off. Scientists have been researching this type of vaccine for decades.

For more information on the development and approval of the COVID-19 mRNA vaccines visit the CDC Understanding and Explaining mRNA COVID-19 Vaccines.

How Well It Works
In clinical trials, the Moderna vaccine was 94% effective at preventing COVID-19 after two doses. It was highly effective among people of different races, ethnicities, ages, genders and medical conditions. The level of protection against the current variants of the virus are being tested.

Side Effects
Some participants in clinical trials showed a strong immune response, which often leads lead to some side effects. The second dose may result in a stronger immune response than the first shot. Side effects are normal and show that your body is building immunity to COVID-19.

Common side effects reported by some trial participants were:

• Pain at the injection site (92%)
• Fatigue (70%)
• Headache (64.7%)
• Muscle pain (61.5%)
• Joint pain (46.4%)
• Chills (45.4%)
• Nausea/Vomiting (23%)
• Fever (15.5%)

Recommended for:

• People of all races, ethnicities, and ages, 18 and older, including older adults
• People with medical conditions
• People who are pregnant and breastfeeding
• People with weakened immune systems
• People who had COVID-19 infection and have recovered

Not recommended for:
Children 17 years and younger. Moderna is currently running clinical vaccine trials with adolescents aged 12 to 17. They also started a separate trial with children under 12 years old in March 2021.

Ingredients
Similar to other vaccine ingredients: mRNA protein, fats, salts, and sugars. It contains polyethylene glycol and polysorbate. The vaccine does not have any fetal tissue, animal products, eggs, gelatin, latex, microchips, or preservatives.

Resources

• Moderna vaccine EUA received December 18, 2020 (FDA)
• Moderna Frequently Asked Questions (FDA)

About the Janssen (Johnson & Johnson) Vaccine

Doses to be Fully Vaccinated
The Janssen vaccine requires one dose. It takes about 14 days after you get your vaccine to be protected.

How It Works
Vector vaccines use a modified virus like a cold virus that can’t make copies of itself or infect you. The vector virus tells your body to make harmless pieces of “spike proteins.” Your immune system sees the spike protein doesn’t belong in your body and starts building an immune response. This means that the next time you come in contact with the COVID-19 virus your body knows how to fight it off. Scientists have been researching this type of vaccine for decades. This type of vaccine was recently approved to prevent Ebola.

How Well It Works
In U.S. clinical trials, the Janssen vaccine was 72% effective against moderate illness, was 85% effective against severe COVID-19 and 100% effective against hospitalization and death. These tests were done while the variants were circulating, so these efficacy rates take variants into account.

Side Effects
The FDA reports milder side effects than those found in the two-dose mRNA vaccines. Common side effects reported in clinical trials were:

• Pain at the injection site (48.6%)
• Tiredness (38.2%
• Headache (38.9)
• Muscle pain (33.2%)
• Nausea (14.2%)

As vaccinations are being administered across the country, a small number of people had a rare and severe type of blood clot up to 2 weeks after vaccination. This side effect is extremely rare. People who get a severe headache, abdominal pain, leg pain or shortness of breath within three weeks of receiving the Johnson & Johnson vaccine should immediately contact their health care provider.

Recommended for:

• People of all races, ethnicities, and ages, 18 and older, including older adults.
• People with medical conditions.
• People who are pregnant and breastfeeding
• People with weakened immune systems
• People who had COVID-19 infection and have recovered

Not recommended for:
Children. Johnson & Johnson is running clinical vaccine trials with adolescents aged 12 to 17

Ingredients
Similar to other vaccine ingredients: modified cold virus, proteins, fats, and salts. It contains polysorbate. The vaccine does not have any fetal tissue, animal products, eggs, gelatin, latex, microchips or preservatives.

Resources

• Janssen (Johnson & Johnson) EUA received February 27, 2021 (FDA)
• Janssen (Johnson & Johnson) Frequently Asked Questions (FDA)

Other Vaccines

The CDC has an up-to-date list of vaccine types, authorized vaccines and vaccines in phase 3 clinical trials on the Different COVID-19 Vaccines webpage.

As new COVID-19 vaccines are approved, the CDC compiles resources on the U.S. COVID-19 Vaccine Product Information page. 

To manage and administer vaccines through your primary care office, you should enroll. 

• Even if your location is associated with a hospital currently receiving the COVID-19 vaccines, failure to enroll will be a barrier to administration through your office.
• If your location is an FQHC, enrollment in the Vermont COVID-19 Program is required before a HRSA allocation may be stored at your location.

We don't know when the COVID-19 vaccine will be provided through the Vermont Vaccine Program as other state-supplied vaccines are, so enrollment is highly encouraged.

Resources

• Vaccine Enrollment FAQs
• Vaccine Enrollment Process Guide

Receiving the COVID-19 Vaccine

If you would like to administer the COVID-19 vaccine in your office, please email AHS.VDHImmunizationProgram@vermont.gov.  

Independent Primary Care

The Immunization Program is working with independent primary care offices at all stages of readiness to provide COVID-19 vaccine, including newly enrolled and those that have not yet undergone the enrollment process. 

Hospital Associated Primary Care

Conversations continue with hospital umbrella organizations around plans and preferences to administer vaccines directly out of their primary care offices. Only after a hospital group agrees to a process will the offer be extended to their associated locations. Find options for hospital groups in COVID-19 Vaccination Options for Hospital-Based Umbrella PCPs. See also Hospitals as COVID-19 Vaccine Hubs for requirements and restrictions.

Federally Qualified Health Centers (FQHC’s)

FQHC’s are eligible for the federal Health Center COVID-19 Vaccine Program. Many are already serving their locations through federal allocations.  FQHCs interested in receiving the COVID-19 vaccine from the State should contact the Immunization Program.

Other Providers

Other providers outside of primary care interested in offering the COVID-19 vaccine to their communities should reach out to the Immunization Program. Eligible facilities include but are not limited to emergency medical services, home health care providers, pharmacies, urgent care facilities, specialty practices (ex: ob/gyn, pediatrics), substance use treatment and recovery centers, college health centers, and others. 

Health Resources & Services Administration (HRSA) and the CDC have launched a program that directly allocates a limited supply of COVID-19 vaccine to select HRSA-funded health centers in Vermont. HRSA-funded health centers are community-based and patient-directed organizations that deliver affordable, accessible, quality, and cost-effective primary health care to medically underserved communities and disproportionately affected populations.

Managing Your HRSA and State Supplied Vaccine: Handling two stocks of vaccine can be complicated. If you are one of the locations participating in this program, the Immunization Program created this 1-page reference document to assist in the process.

See which health centers in Vermont are participating and learn more about the program:

• CDC Health Center COVID-19 Vaccine Program
• HRSA Ensuring Equity in COVID-19 Vaccine Distribution
• Health Center COVID-19 Vaccine Program Participants in Vermont

Once enrolled, you will receive information primarily by email. It will be sent to the vaccine coordinator and back-up for your facility, as listed on your COVID-19 Enrollment form. They will ensure staff are aware of which vaccine or vaccines you will receive, delivery timing, and number of vaccine doses you can expect. 

Sign up for the Vaccine Inventory Management System (VIMS) if you are not already a user. A full reconciliation of inventory is required in Vaccine Inventory Management System (VIMS) after every clinic. Inventory adjustments for wastage or expiration should happen the day they occur.

• VIMS User Guide for COVID-19 Vaccine Inventory Management (Updated)
• VIMS Reconciliation Quick Guide 
• VIMS Reconcilliation Process Tutorial
• VIMS Vaccine Adjustments Tutorial
• VIMS Vaccine Adjustments Quick Guide
• Vaccine Ordering and VIMS web page
• Hospital COVID-19 Vaccine Transfer Guide

Get ordering information for other vaccines

Part of making sure safe and effective vaccine is administered to patients is ensuring proper storage and handling of vaccines. The Health Department offers training guides, tools and resources to help.

Vaccine Program Training Guide: All providers enrolled in the Vermont COVID-19 Vaccine Program need to read this guide before administering vaccine. In this guide you will find:

• CDC training modules
• Storage and Handling resources
• Ordering and Inventory Management resources
• Reporting requirements
• Resources to help in training staff on proper vaccine administration.
• CDC Toolkits on communication to patients about the COVID-19 vaccine
• Vaccine specific resources

Receipt and Management of COVID-19 Vaccine: You may receive the COVID-19 vaccine through your umbrella organization, transferred from the depot, or directly from the distributor.  Each method varies in storage requirements, inventory management, and communication structure, outlined in this guidance document. 

Temperature Monitoring

The Health Department provides enrolled locations with a temperature monitoring device compliant with CDC requirements. SensoScientific devices are cloud-based, and LogTag devices require a software download. Third Party temperature monitoring is permitted only if it complies with the CDC requirements.

Please refer to the monitoring resources on the Health Department Immunization Vaccine Storage and Handling webpage.

Temperature Excursions Protocol: Enrolled facilities must follow this protocol. This provides Pfizer-BioNTech and Moderna storage parameters and gives steps to take whenever a vaccine has a period of being out-of-range. Never assume vaccine viability. Always contact the Immunization Program before taking any steps to change the vaccine temperature.

Any questions about temperature monitoring or vaccine storage and handling please reach out to the Immunization Program at ahs.vdhimmunizationprogram@vermont.gov, 1-800-640-4374.

Off-site Vaccine Clinics

COVID-19 Vaccine Storage and Handling for Off-site Clinics: When administering COVID-19 vaccine away from a monitored storage unit, the vaccine is at greater risk of temperature fluctuations which puts the efficacy and safety at risk. Anyone participating in or planning an off-site COVID-19 clinic should review the guide for off-site clinics well in advance of the clinic date to ensure all preparations are made.

Read the Addendum for vaccine storage and handling for off-site clinics in warm weather.

Pre-Clinic Activities: This CDC page offers information on supplies, training, and clinic layout to prevent infections and more.

Minimizing Waste Policy: This Department of Health policy will help sites minimize waste while ensuring equity and alignment with the State of Vermont's phased roll-out of vaccinations.

Off-site Hourly Vaccine Temperature log: This form helps the facility to continuously monitor vaccine temperatures. Use this document to track the time the vaccine leaves and returns to monitored storage, and the hourly temperatures throughout the clinic as read on the provided LogTag device.

If your clinic is using VAMS (Vaccine Administration Management System) please direct questions to ahs.vdhophpvams@vermont.gov, 1-802-863-7428 (8:00-4:30 M-F).

Vaccine Carrier Borrowing Program

The Immunization Program has qualified vaccine carriers available to assist practices in conducting offsite clinics safely and confidently.  Vaccine Carriers are requested from the Immunization Program for temporary use and returned when no longer needed. The Vaccine Depot will deliver your vaccine carrier with a manufacturer user guide and a digital data logger.  See the Vaccine Carrier Borrowing Program Guide for more information. 
 
It is an expectation that practices take advantage of this program and plan accordingly. Previous guidance provided through the CDC Packing Vaccine for Transport during Emergencies is now ONLY appropriate for the short transfer of vaccine between monitored units.  For prolonged storage during clinics, please request a cooler from the Immunization Program.  

Vaccine Resources

Beyond Use Date (BUD) labels: These help with the complicated timing of COVID-19 vaccine administration.

• Pfizer-BioNTech BUD Guidance and Labels
• Moderna BUD Guidance and Labels

Storage and Handling Summary: includes details on vaccine storage and handling in a concise printable sheet.

• Pfizer-BioNTech
• Moderna
• Janssen (Johnson & Johnson)

Get storage and handling information for other vaccines

As vaccines are approved, more information will be coming about administering specific vaccines, including storage, side effects patients might have and reporting adverse reactions.

Authorized Age Groups

Under the EUAs, the following age groups are authorized to receive vaccination:

• Pfizer-BioNTech: ages ≥12 years
• Moderna: ages ≥18 year
• Jannsen: ages  ≥18 year

Children and adolescents outside of these authorized age groups should not receive COVID-19 vaccination at this time.

Third dose of mRNA vaccines for people who are immunocompromised

CDC now recommends that people whose immune systems are compromised moderately to severely should receive an additional dose of mRNA COVID-19 vaccine after the initial 2 doses. Federal health officials were acting on studies demonstrating that immunosuppressed people are more likely to get severely ill from COVID-19, are at higher risk for prolonged infection, are more likely to transmit the virus, and experience lower vaccine effectiveness. Widespread vaccination is a critical tool to help stop the pandemic 

• CDC Recommendations for immunocompromised people
• Taking to your patients who are immunocompromised

People who received AstraZeneca vaccine, may choose to receive the Pfizer or Moderna vaccine

• Read the letter from Dr. Levine

Administering COVID-19 Vaccines

The mRNA COVID-19 vaccine series consist of two doses administered intramuscularly:

• Pfizer-BioNTech (30 µg, 0.3 ml each): three weeks (21 days) apart
• Moderna (100 µg, 0.5 ml): one month (28 days) apart

Second doses administered within a grace period of ≤4 days from the recommended date for the second dose are considered valid. However, doses administered earlier do not need to be repeated. The second dose should be administered as close to the recommended interval as possible. However, there is no maximum interval between the first and second dose for either vaccine.

Janssen is a single dose vaccine administered intramuscularly.

• Janssen (500 µg, 0.5 ml): single dose

Clinical Considerations

Always refer to CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States for information on:

• Interchangeability of COVID-19 vaccines
• Coadministration with other vaccines
• Considerations for special populations
• Past SARS-CoV-2 infection or exposure
• Precautions or contraindications

Anaphylaxis

Anaphylaxis, an acute and potentially life-threatening allergic reaction, has been reported following COVID-19 vaccination.  Those administering COVID-19 vaccines should review the CDC’s Interim Considerations: Preparing for the Potential Management of Anaphylaxis After COVID-19 Vaccination.

Resources

General

• On-site Clear Mask Use Guidelines
• COVID-19: Vaccine Patient Information: A Health Department handout to give patients after they receive their first dose of Moderna or Pfizer-BioNTech. This does not replace the EUA dcoument that replaces the VIS sheet.
  Arabic | Burmese | French | Kirundi | Nepali | Somali | Spanish | Swahili | Vietnamese | Large Print-English
• Pre-vaccination screening form (CDC)
  Arabic | Burmese | French | Kirundi | Nepali | Somali | Spanish | Swahili | Vietnamese
• COVID-19 Vermont Vaccine Program FAQs: A list of commonly asked questions tailored to health care professional working with COVID-19 vaccine or discussing vaccination with their patients.
• CDC Preparing to Provide COVID-19 Vaccines to your Patients: Guidance on how to discuss COVID-19 vaccination with your patients in a variety of contexts.
• CDC COVID-19 Vaccination Toolkits: Audience specific toolkits containing educational materials and resources.
• CDC COVID-19 Vaccination Planning: A landing page to make big-pidcture topics such as partner requirements, operational guidance and federal partnerships.

Pfizer-BioNTech vaccine

• Initial Pfizer-BioNTech COVID-19 Vaccine Recommendations (Health Department, Health Alert)
• Interim Recommendation for Use of Pfizer-BioNTech COVID-19 in Adolescents Aged 12-15 Years (Health Department, Health Alert)
• FDA's COVID-19 Vaccine page has the EUA Factsheet for providers (which replaces the package insert normally found with vaccines) and the EUA Factsheet for recipients (which replaces the Vaccine Information Sheet)
• EUA factsheet for recipients in Arabic, Burmese, French, Kirundi, Nepali, Somali, Spanish, Swahili, Vietnamese
• CDC Provided Pfizer-BioNTech COVID-19 Vaccine Resources contains an overview of vaccine storage, handling, and administration including, instructions and resources on how to thaw, prepare, and administer the vaccine. Sign up to receive email updates when information changes.

Moderna Vaccine

• Guidance on Prioritization of Vaccination in Phase 1A and Moderna COVID-19 Vaccine Recommendations (Health Department, Health Alert)
• Moderna EUA Factsheet for providers replaces the package insert normally found with vaccines.
• Moderna EUA Factsheet for recipients replaces the vaccine information sheet that is given to recipients before receiving a vaccine. This fact sheet must be given to all vaccine recipients before a vaccine is administered. 
• EUA factsheet for recipients in Arabic, Burmese, French, Kirundi, Nepali, Somali, Spanish, Swahili, Vietnamese
• CDC provided Moderna COVID-19 Vaccine Resources: contains overviews of vaccine storage, handling, and administration. You can also sign up to receive an email when information changes. 

Janssen (Johnson & Johnson) Vaccine

• Recommendations for the Use of the Janssen COVID-19 Vaccine (Health Department, Health Alert)
• Janssen EUA Factsheet for providers replaces the package insert normally found with vaccines.
• Janssen EUA Factsheet for recipients replaces the vaccine information sheet that is given to recipients before receiving a vaccine. This fact sheet must be given to all vaccine recipients before a vaccine is administered. 
• EUA Factsheet for recipients in Burmese, Chinese, Spanish, Tagalog, Vietnamese
• Janssen COVID-19 Vaccine Resources (CDC): contains overviews of vaccine storage, handling, and administration. You can also sign up to receive an email when information changes. 

Side Effects

Some participants in clinical trials for both leading vaccine candidates elicited a strong immune response leading to side effects. The second shot may result in a stronger immune response than the first shot. This is a normal way that your body builds immunity to COVID-19. Encourage enrollment in v-safe, and report any adverse events to VAERS. Find a list of side effects reported in clinical trials in Vaccines Available section above.

A small number of people vaccinated people have developed a rare type of blood clot with trhombocytopenia after receiving the Johnson & Johnson/Janssen COVID-19 vaccine. Clinicians should be prepared to recognize and manage symptoms. When these specific types of blood clots are observed following vaccination, treatment is different from the treatment that might typically be administered for blood clots. Read the full Health Alert about CVST and Johnson & Johnson.

V-safe

V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after a patient receives a COVID-19 vaccination. Enrolling to receive electronic health check-ins is a manual process where a patient registers online through a website or QR code. More information on V-safe can be found on www.cdc.gov/vsafe. Available in English, Spanish, Simplified Chinese and Korean.

Healthcare providers should give a one-page enrollment sheet to patients at the time of vaccination and counsel patients on the importance of enrolling in V-safe. Please contact the Immunization Program by calling 802-863-7240, if your vaccination clinics need V-safe information sheets or posters. Information sheets and posters are available in English, Vietnamese, Spanish, Simplified Chinese and Korean from the CDC. The information sheets are also translated into the following languages:
Arabic | Burmese | French | Kirundi | Nepali | Somali | Spanish | Swahili | Vietnamese

VAERS

Health care providers are required by Vermont law to report any adverse events that happen after vaccination to VAERS. To report an adverse event, go to https://vaers.hhs.gov/ and fill out the VAERS online form or downloadable PDF.

Anyone can make a VAERS report, including a patient or a guardian. All adverse events should be reported as soon as possible and duplicate reporting is allowed. Please submit to VAERS even if you are unsure if a report should be filed.

VAERS is a passive system that accepts reports from everyone, and all ages, races, states/jurisdictions, and those with or without co-morbidities. VAERS accepts all reports of adverse events regardless of the plausibility of the vaccine causing the event or the clinical seriousness of the event.

With such a new virus and vaccine, there are many things that are still unknown. Talking to your patients now can help them make an informed decision about being vaccinated. Here are some tools to help you prepare for these conversations. 

• From Concern to Confidence: How Physicians Can Build Trust in COVID-19 Vaccines
• Talking to Patients About COVID-19 Vaccines
• Making a Strong Recommendation for COVID-19 Vaccination
• Answering patient’s questions
• Read the CDC's Frequently Asked Questions for more answers.
• Understanding and Explaining mRNA COVID-19 Vaccines
• Understanding and Explaining Viral Vector COVID-19 Vaccines
• COVID-19 Vaccine Information for Specific Groups
• Pediatric Healthcare Professionals COVID-19 Vaccination Toolkit

The COVID-19 Vaccine Communication Card is a tool to make sure patients who are deaf and hard of hearing or need to communicate visually can easily understand and be understood by vaccine clinic staff.

Tips for Using Visual Communication Cards with people who are English language learners, Deaf, hard-of-hearing or Deaf-blind.

Things you should know about the COVID-19 vaccine: A Health Department handout answering frequently asked questions.

Arabic | Burmese | French | Kirundi | Nepali | Somali | Spanish | Swahili | Vietnamese

• Vaccine Facts
• Pfizer-BioNTech Factsheets in several languages
• Moderna Factsheets in several languages
• Johnson & Johnson Factsheet

About Taking Prevention Steps After Vaccination

Patients receiving the COVID-19 vaccine series should be advised to continue taking all prevention steps until they are fully-vaccinated. Once someone is fully vaccinated, they do not need to wear a mask or stay 6 feet apart.