Here we provide information about the Pfizer COVID-19 vaccines to the Lurie Children’s community. Our understanding of vaccines continues to evolve. We will continue to provide additional information as we learn more about the vaccine and answer questions as we receive them.
Updates in this version include:
Quarantine and travel guidance if fully vaccinated
Updated process for referring parents/primary caregivers of patients with complex home health needs
Process for vaccine referral
For additional information, please see these resources:
The fact sheet from Pfizer for those who receive this vaccine
Below is additional information to frequently asked questions, and those marked with an asterisk (*) are new or modified with updated information.
COVID-19 Vaccine Background and Distribution
An mRNA vaccine is a new technology that uses your own cells to produce tiny pieces of a SARS-CoV-2 protein. Those tiny pieces then trigger your immune system to develop protection against the dangerous parts of the virus. This protection prevents COVID-19 after exposure to the real SARS-CoV-2 virus. These vaccines CANNOT cause COVID-19.
We continue to offer vaccine to Lurie Children’s healthcare workers and staff, as well as our contractors, students, and affiliated community healthcare workers, as part of tier 1A. We will address the community public health needs by vaccinating individuals in tier 1B, which includes a subset of essential frontline workers (i.e., K-12 teachers and support staff in Chicago schools and daycares). Tier 1A/B will also include a small subset of our patient families (see below). Expanded Tier 1B and Tier 1C includes patients 16-65 years old with high-risk medical conditions. The timeline for moving to tier 1C is not known at this time but expected to be in late winter or early spring.
We have now started a process for referring spouses, parents (including in-laws), and grandparents (including in-laws) of faculty and staff for vaccine at Lurie Children’s. Per CDPH guidance, we are limited to offering vaccine only to those meeting tier 1B criteria (i.e., at least 65 years old) AND who live in Chicago. The process for referring spouses, parents (including in-laws), and grandparents (including in-laws) who are at least 65 years-old and who live in Chicago can be found here on the portal.
Although children are not included in tier 1B, to ensure we are not wasting any doses of vaccine that we have left over during days when we are vaccinating healthcare workers, CDPH has approved us to give COVID-19 vaccine to high-risk patients 16-64 years old but only when there is a supply of unused vaccine that would otherwise be wasted. Children younger than age 16 years are not authorized to be vaccinated at this time. Clinic nurses will identify patients based on the high-risk registry and contact the medical team on service to determine if vaccination is appropriate; this may include contacting the attending of record. Nursing will work with patients to schedule the 2nd dose prior to discharge.
Oncology patients (with acceptable cell counts as determined by medical team and without impending chemotherapy scheduled)
Solid organ transplant recipients (at least 6 months after transplant and at discretion of medical team)
Stem cell transplant (at least 1 year after transplant and at discretion of medical team)
Children on other forms of chronic immunosuppression (steroid, TNF blockade or other; at the discretion of their medical team)
Pediatric obesity (BMI > or = 95%ile)
Important issues to consider when recommending patients for vaccine are:
The presence of medications or other factors that could interfere with generation of an effective immune response
Ability to tolerate potential side effects associated with 1st or 2nd dose of vaccine
Patients admitted with an acute illness should defer vaccine until their condition is improving and fever has resolved
Patients should be able to be monitored for allergic reaction for at least 15 minutes following the injection, and at least 30 mins if they have a history of severe allergic reactions to any substance
Vaccine should be deferred if currently infected and under isolation or quarantine for COVID-19 infection or exposure, respectively
Providers should familiarize themselves with other clinical considerations for COVID-19 vaccination here
On February 25th, the IL governor advised moving to expanded tier 1B, which includes individuals 16 years old and older with highest risk conditions. However, Chicago and collar county health departments have not expanded to high-risk patients 16 years old and older because of limited supply. Commercial entities may be offering vaccine to high-risk patients, although they typically only stock Moderna, which is available only to those 18 years and older.
We expect emergency use authorization to be expanded to children 12 years old and older in the near future. Lurie Children’s expects to become a site for clinical trials for children younger than 12 years old. A registry has been formed to receive information about clinical trial enrollment as it becomes available and can be found here.
Thanks to the tireless advocacy efforts of child health professionals here at Lurie Children’s and elsewhere, tier 1A/B will also include a small subset of our patient families. Parents, including foster parents, and other primary caregivers eligible for COVID-19 vaccine are defined as: “caregivers of medically fragile children or adults who live at home but require a level of ongoing medical care typically provided by a rehabilitation hospital or skilled nursing facility.” Essentially this population of children are those who would otherwise be hospitalized, admitted to a skilled nursing facility, or residing in a long-term care facility if the parent or other primary caregiver was not able to provide that skilled nursing care.
Examples of eligible patients that include, but are not limited to:
Those who have received a waiver through the Division of Specialized Care for Children (DSCC)
Technology-dependent children, such as those who require a ventilator or other type of respiratory support, other devices such as peritoneal dialysis, or feeding pumps for administration of nutrition
Individuals with severe disabilities, such as but not limited to cerebral palsy, Down Syndrome, or epilepsy, whose disability requires home healthcare needs
Families meeting these criteria can be referred to the Chicago Department of Public Health (if residing in Chicago) or the health department of the county of residence to claim vaccine eligibility as a home healthcare provider. A letter from their healthcare provider will be needed to confirm eligibility. Additionally, Lurie Children’s has identified many groups of patients meeting these criteria and send invitations to them for vaccination here at Lurie Children’s. If you would like to refer a parent who qualifies, please complete a referral request here on the portal.
COVID-19 Vaccine Safety, Effectiveness, and Administration
Yes, this vaccine was found to be safe during the four-month period that research subjects were followed thus far. Longer term safety evaluation is ongoing. In a large clinical trial, serious side effects were very rare and no different between those that got vaccine and those that received saline (placebo group). However, because the vaccine tricks your body into thinking it has an infection and triggers an immune response to protect you, that immune response can lead to side effects. Mild-to-moderate pain at the site of injection is common after getting the vaccine, occurring in 75-85% of vaccine recipients, similar to other common vaccines such as the Shingles vaccine. Headache, fever, chills, and body aches are less common, occurring in about 10-20% of vaccine recipients. Side effects are typically short lived, more common after the second dose, and more common and in younger people (younger than 55 years old). Side effects are described in more detail by the CDC. If you have concerns about receiving this vaccine, or if you have any underlying medical conditions, please consult with your personal medical provider.
Allergic reactions of any type occurred in 0.6% of those receiving the vaccine and 0.5% in those receiving saline (placebo). One side effect, Bell’s Palsy, was seen in 0.01% of patients who got the vaccine, which is less than the general population. The FDA has plans to monitor for this. Sometimes very rare side effects cannot be recognized even in large clinical trials. This is true for all medications and vaccines after they receive approval or authorization from the FDA. Vaccine safety will be rigorously monitored, and if any very rare events are noted, we will share that with the Lurie Children’s community immediately. We are aware of reports of allergic reactions, and we are prepared to monitor for and respond to these rare events should they occur.
At this time, subjects in large clinical trials have been observed for at least four months from vaccine administration, and the side effects described above are those identified within four months of receiving vaccine. Currently, side effects beyond four months are unknown but long-term side effects from vaccines in general are typically exceedingly uncommon.
Because some pain or fever-reducing medicines can interfere with the immune response to vaccines, is it advised to not take pain medicine before the vaccine. If you experience pain or fever after the vaccine, you can take pain or fever-reducing medicines per the over-the-counter instructions or advice from your personal medical provider.
Regardless if you have had the vaccine, if you have symptoms consistent with COVID-19, or if you are experiencing other concerning side effects, please call the NM employee COVID-19 hotline as you would currently. The NM employee COVID-19 hotline will help determine if COVID-19 testing is needed and when you can return to work.
This vaccine is extremely effective when two doses are given 3 weeks apart. After the second dose, compared to those who did not get the vaccine, the vaccine prevented 95% of symptomatic COVID-19 infections in the four months after being vaccinated. This means you are 95% less likely to get symptomatic COVID-19 than you would have been if you did not get the vaccine. Importantly, this effectiveness was seen in adults irrespective of age, sex, race, ethnicity, weight, and medical condition, including previous history of COVID-19. The study was not able to determine if the vaccine prevents hospitalization and death, but a vaccine that effectively prevents symptomatic COVID-19 is expected to also prevent those complications from COVID-19.
All viruses mutate over time as mistakes in their RNA are naturally introduced when they replicate. SARSCoV-2 actually mutates much less rapidly than many other viruses. Not surprisingly, we are finding variants of virus with mutation. Most variants make viruses less fit to cause disease or do not change them significantly, but rarely the virus can become more fit. Concerns have been raised that some variants may be transmitted more frequently or that vaccine may not be quite as effective against them. Much more research needs to be done, and scientists and public health officials are watching very closely. So far, it seems that vaccines provide at least some protection against all known variants. Fortunately, if this changes, the mRNA vaccine technology allows vaccine makers to quickly change the vaccine formulation to make it more effective. The best way to prevent more variants is to prevent as many infections as possible through vaccination.
We do not yet know if the vaccine prevents asymptomatic COVID-19 infections or transmission of SARS-CoV2 in the absence of symptoms. Research is ongoing in this area, and we anticipate to learn more about this soon.
Because the trial recently concluded, we do not know how long the protection lasts but we will learn more as the clinical trial subjects are followed for two years.
During a public health emergency, products to diagnose, treat, and prevent infection can be given emergency use authorization (EUA) by the FDA. In this case, initial data is rigorously reviewed to determine that it is first and foremost safe, and then determined that it has high likelihood of helping patients. An EUA lasts for one year and has to be renewed each year. Safety evaluation is not compromised when issuing an FDA. In the case of a pandemic, the bar for effectiveness may not be as high as full approval if the disease in question has significant potential to harm people in the community. This is true for COVID-19. Regardless, this vaccine was shown to be tremendously effective for preventing COVID-19 for at least four months after getting the vaccine. In the case of this vaccine, the clinical trial will be ongoing for two years to understand long-term safety and effectiveness, at which time full FDA approval may be granted.
To maximize protection against COVID-19, you need a second dose of the Pfizer vaccine approximately 3 weeks later. The second dose should be given as close to 21 days as possible after the first dose, but no sooner than 17 days after the first dose.
In general, it is strongly recommended that you get the same type of vaccine for the second dose (e.g., if Pfizer the first time, get Pfizer the second time). If this is not possible because of a vaccine shortage or other unusual extenuating circumstances, you can get a different mRNA vaccine (e.g., if Pfizer the first time, but Moderna the second time) but in this case the second dose should be given no sooner than 28 days later.
We understand that some employees and staff have appointments or employment at multiple medical centers, including NMH. If you are offered vaccine through another medical center, we encourage you to take advantage of the most immediately available option. You will be expected to receive the second dose at the location where you receive the first dose. Please email employee health at firstname.lastname@example.org with proof of vaccine if you are vaccinated elsewhere.
If you decline the vaccine initially, you can always change your mind and be scheduled later based on vaccine availability.
We are confident that we can continue to maintain a safe healthcare environment while vaccine supply improves over the next several weeks to months. The following are strategies that reduce risk of COVID-19: masking; physical distancing; hand hygiene; remaining compliant with Lurie Children’s infection prevention and PPE guidance; avoiding high-risk travel and large gatherings; avoiding coming to work sick and seeking testing when sick.
COVID-19 Vaccine in Special Patient Populations
This vaccine was not yet tested in pregnant or lactating women so we do not know for sure. The vaccine is being tested in pregnant animals, and data will be available soon. Future studies in pregnant women are planned. Pregnant and lactating women routinely receive vaccines safely. This vaccine does not cross the placenta. Pregnant women have an increased risk of severe COVID-19. Pregnant and lactating women will be eligible to receive this vaccine from Lurie Children’s but should first discuss this with their obstetrician and/or primary care provider. Women of child bearing age do not need a negative pregnancy test before getting the vaccine.
We do not know for sure because this vaccine was not tested in a large number of people with autoimmune diseases or weak immune systems, such as those with HIV, cancer, or those taking medicines that weaken their immune system. However, this is not a live vaccine so it cannot cause COVID-19 even if your immune system is weak. Those with a weak immune system might have an increased risk of severe COVID-19 infection and will be eligible to receive this vaccine from Lurie Children’s but should first discuss this with their healthcare provider.
Anaphylaxis to COVID-19 vaccines occurs approximately once for every 100,000 doses of vaccine given. If you have a history of anaphylaxis to any vaccine ingredients (described in the Pfizer fact sheet), then you should not receive this vaccine. In consultation with our Allergy-Immunology experts, a history of anaphylaxis to any of the ingredients would be very rare. The most likely ingredient to which an allergy will occur is polyethylene glycol. If you have common allergies to medications, foods, inhalants, insects and latex are no more likely than the general public to have an allergic reaction to the COVID-19 vaccine. However, if you have a history of severe allergy to any vaccine or medication, you should first discuss the COVID-19 vaccine with personal medical provider.
To date, no cases of Guillain-Barré syndrome (GBS) have been reported following vaccination with a COVID-19 mRNA vaccine. Therefore, individuals with GBS can receive the vaccine. One side effect, Bell’s Palsy, was seen in 0.01% of patients who got the vaccine in the Pfizer clinical trial, which is less than the general population. The FDA has plans to monitor for this, but at this time, those with a history of Bell’s Palsy can get the vaccine.
If you have dermal fillers, you may be at higher risk of swelling at the dermal filler site after the vaccine. If you have a history of dermal fillers, you should first discuss the COVID-19 vaccine with personal medical provider.
To make sure you do not have a bad reaction to the vaccine, we recommend you be observed by the vaccine team for at least 15 minutes if you are pregnant or breastfeeding, have a weak immune system, have a family history of anaphylaxis, or if you have had a non-severe allergy to any item in the past. If you have a history of severe allergic reactions of any kind, such as anaphylaxis, we recommend you to be observed for 30 minutes.
COVID-19 vaccine has not been tested in combination with other vaccines, so we do not know if they interfere with each other. Therefore, you should not get other vaccines within 2 weeks before or after the COVID-19 vaccine.
As we learn more about this vaccine, clinical information and information about special populations will be posted by the CDC here.
COVID-19 Vaccine in those with history of COVID-19 Infection, Exposure, or Vaccine Clinical Trial
It is possible that the vaccine will provide additional protection that natural infection does not. Therefore, even if you had COVID-19 and/or have detectable antibodies against SARS-CoV-2, we still recommend getting the vaccine. In general, we recommend getting the vaccine when you are no longer infectious, which is usually 10 days after infection, but up to 20 days for some patients with severe infection or weak immune system. It is thought that natural infection protects you for up to 90 days after infection. While you may choose to wait 90 days to get the vaccine, it is safe to get it before that 90-day period. This guidance also applies if you develop COVID-19 between the first and second dose; you should wait until you are no longer infectious before you get the second dose, even if it is after 3 weeks from the first dose.
We do not recommend getting antibodies tested prior to the vaccine. Even if you had COVID-19 and/or have detectable antibodies against SARS-CoV-2, we still recommend the vaccine.
If you have symptoms of COVID-19, you should not get the vaccine until COVID-19 has been ruled out. If you do have COVID-19, you should wait until you are no longer infectious, which is usually 10 days after infection, but up to 20 days for some patients with severe infection or weak immune system. This guidance also applies if you develop COVID-19 between the first and second dose; you should wait until you are no longer infectious before you get the second dose, even if it is after 3 weeks from the first dose.
If you have been recently exposed to someone with COVID-19, you should wait 14 days until after the exposure. If you do not have symptoms of COVID-19 at that time, you can then receive the COVID-19 vaccine. This guidance also applies if you are exposed to COVID-19 between the first and second dose; you should wait until after the 14-day incubation period before you get the second dose, even if it is after 3 weeks from the first dose.
If you received treatment for COVID-19 with monoclonal antibodies, you should wait 90 days before receiving the vaccine.
All clinical trials allow you to take steps to learn about new alternatives should they come available. When you are eligible to receive vaccine at Lurie Children’s, we advise you to discuss with the clinical trial study team of “unblinding” yourself to find out if you received vaccine or something that does not protect against COVID-19 (like saline, also known as placebo). If you received placebo, we recommend you to receive the vaccine from Lurie Children’s.
Life After the COVID-19 Vaccine
Yes, even if vaccinated, universal masking and infection control policies for patient care will continue to be in place. You should also avoid group gatherings. This is because it is not yet known if the vaccine prevents asymptomatic infection. Because the vaccine is not 100% effective, you should still avoid working when sick and get tested if you have symptoms of COVID-19. However, we anticipate that as more people get the vaccine that COVID-19 activity will decrease, eventually allowing us to discontinue universal masking and return to normal social activities.
We anticipate that as more people get the vaccine that COVID-19 activity will decrease and policies will change. However, at this time, we recommend all individuals follow policies for travel and quarantine after exposures that are based on health department guidance.
No, there will not be any additional blood draws or confirmation of immunity following the vaccine.
Avoiding Vaccine Misinformation
Unfortunately, there are a lot of people, both intentionally and unintentionally, sharing incorrect information about vaccines online. In general, please try to focus your attention on reliable sources, such as the CDC, the FDA, local health departments, your medical providers, and Lurie Children’s experts. Here is a website that provides more information about reliable medical information.
The COVID-19 pandemic required an urgent response to developing a vaccine. However, the Pfizer vaccine was subject to the same thorough safety evaluation as any other vaccine. A large phase 3 clinical trial was completed in more than 40,000 adolescents and adults. The FDA applied the same rigorous safety evaluation to this vaccine as to others. Here is more information from the FDA on this topic. Further, CDPH convened a workgroup to address this and confirmed the expected rigorous safety and efficacy evaluation process was appropriately performed.
No, mRNA viruses do not change your own DNA.
This is not true for the type of vaccine we will administer at Lurie Children’s. An unrelated vaccine in Australia resulted in false positive tests for HIV, and this trial has been suspended for this reason.