COVID-19 Vaccine Discussion Guide

Our public opinion research in North Carolina and research conducted across the United States consistently shows that medical professionals are the most trusted source for information and answers related to COVID19 vaccines. Clear, concise and compelling information from medical professionals has made a real difference in providing people with the confidence to get vaccinated. But as our COVID-19 vaccine rollout continues, there will continue to be groups of people who feel they need more information to make an informed decision and are taking a wait and see approach before making what they feel is an important decision. That’s where you come in. Your recommendation, as a trusted source of information, will help patients with questions make a quicker and more informed decision about getting a COVID-19 vaccine.

Right now, keeping our communities safe from COVID-19 is one of the primary goals of health care providers. We must commit to advancing equity and protecting and promoting the health of all patients. This document outlines ways to support your patients in making informed decisions about the COVID-19 vaccines. The intention is to help you answer patients’ questions, provide them with accurate information, and honor and respond to their needs. 

General Tips for Leading a COVID-19 Vaccine Conversation:

  1. Emphasize connection over content. Building trust is as important as building immunity and will help us make it safely through the pandemic.
  2. Share the floor. These conversations should be driven by your patients. Invite your patients and their families to ask their questions, instead of dominating the discussion with your knowledge.
  3. Validate questions. Let patients know that they are not alone in holding a particular belief or fear, even if that question or fear is not one that you share.
  4. Be honest about vaccine side effects. If you do not know the answer to a question, do not make up an answer. Be honest and open about the information you do have—and let people know there are trusted sources for more information, including YourSpotYourShot.nc.gov.
  5. Be willing to accept “no.” You can demonstrate you care for those who choose to not vaccinate by focusing on other ways they can stay safe, such as practicing the 3 Ws.
  6. Honor concerns about discrimination and distrust. For communities of color, distrust in the health care system is a response to historic injustices and modern-day experiences of racism. Recognize that many people have good reason to be worried.
  7. Be ready to help navigate. If you are unable to offer vaccines in your clinic, remember that the logistics of finding, making, and getting to an appointment can often be the biggest barriers to getting one. Help connect your patients as directly as possible to a vaccine opportunity.

Step 1. Starting the conversation

Every patient visit or encounter is an opportunity to start or continue the discussion about COVID-19 vaccines. All providers, including primary care providers, dentists, physical therapists, urgent care providers, specialists, and healers, are trusted messengers.

The decision to be vaccinated is personal. Your goal is for each patient to have the information they need to make an informed decision. Patients desire health care interactions where their experiences are heard and validated, making it important to lead conversations with listening.

Try using open-ended questions to understand what each person thinks and feels about COVID-19 vaccination (see below for examples). Offer your strong recommendation and be clear that they have a choice:

  • I highly recommend that everyone get the COVID-19 vaccine. I’ve been vaccinated. Have you been vaccinated yet?
  • How are you feeling about the COVID-19 vaccines?
  • Is there anything you want to know? o What kinds of things are you hearing about the vaccines?
  • Can you tell me what is worrying you?
  • How can I support you in making your decision?

Step 2. Be ready to explain how COVID-19 vaccines work. 

A person’s baseline knowledge impacts what they need to know to make an informed decision. You can provide straightforward explanations that honor each person’s level of knowledge and addresses what they want to know. Be prepared to answer some basic questions about how the vaccines work such as:

  • What is a virus?
  • What is the vaccine doing once it is in my body?
  • What is mRNA? o What is a viral vector?
  • Can I catch COVID-19 from the vaccine?
  • Is it possible to still get COVID-19 after being vaccinated?
  • If the virus changes or mutates, will the vaccines still work?

Try to use plain language and avoid medical jargon. When possible, use familiar examples and comparisons. Reframe your explanations if patients seem lost or confused and invite follow-up questions. Information to answer these questions is at the end of this discussion guide. 

Step 3. Prepare to answer common question

Suggested answers for building confidence

Below are some options you could use to continue the conversation when patients have questions or express that they may not want to get vaccinated. In every case, invite them to reach out to you any time they have more questions, or if you offer vaccination, when they decide they want to get vaccinated. 

Why have you made that decision? What would it take for you to feel comfortable getting vaccinated? Do you have any questions about the vaccines? Would you like to talk about what you can do to protect yourself right now and where getting vaccinated fits into that? I will probably ask you about vaccination again next time I see you in case you have new questions or are ready to think about it again. 

That can be a reasonable choice. I am worried though about the risk that you could get sick with COVID-19 in the meantime. What is making you want to wait? Is there anything that would help you feel more confident about getting vaccinated? When do you think you will be ready to think about it again? 

I recommend you go ahead with vaccination even though you had COVID-19. There is a good chance you will have some protection against getting COVID-19 for a few months after being sick. However, we do not know how long that protection lasts, how this is impacted by the different variants, and people can get COVID-19 more than once. Getting vaccinated is recommended even if you had COVID-19 to help prevent you from getting it again. Also, the vaccines may help boost any natural protection you have. 

Products such as monoclonal antibodies are an important advancement in COVID-19 treatments but they are not a substitute for COVID-19 vaccines. These treatments may decrease the risk of severe disease, hospitalization and death but they will not prevent infection. COVID-19 vaccines are safe, effective, free and widely available. 

What are your own thoughts? Are there questions I can answer for you? If you decide you want to get vaccinated, what might help your family feel more confident? 

Suggested answers for questions about vaccine safety and development 

Identify: Are there specific concerns? What have they heard? Are they afraid of the vaccines?

Three vaccines are available: The Pfizer-BioNTech and Moderna vaccines are two doses, and the Johnson & Johnson (Janssen) is one dose. In addition to the primary doses, all three of these vaccines have been authorized for use as booster shots in all adults 18 or older, and Pfizer may be used as a booster dose in adolescents ages 16-17. All of them provide significant protection against COVID-19 and protect against virusrelated hospitalization and death. There were no serious safety concerns in any of the clinical trials. The U.S. Food and Drug Administration (FDA) makes sure all food and drugs, including vaccines, are safe. The FDA authorizes vaccines only if they are safe and effective. Because vaccines are given to millions of healthy people to prevent serious diseases, they’re held to very high safety standards, and their safety is constantly monitored with multiple vaccine safety monitoring systems.

These vaccine safety monitoring systems can pick up even very rare occurrences of adverse events. For example, in mid-April, a pause in administering the Johnson & Johnson vaccine was made out of abundance of caution after there were initially six reported cases of a rare type of blood clot in individuals after vaccination. Through their review, the FDA and CDC determined that blood clotting with low platelets (called thrombosis with thrombocytopenia syndrome – TTS) from the Johnson & Johnson vaccine is rare and that the benefits of the vaccine in preventing serious illness, hospitalization and death far outweighed the risk— resulting in the recommendation to resume the use of the Johnson & Johnson vaccine. However, the CDC now recommends the Moderna and Pfizer COVID-19 vaccines as the best choice for most people as there is good vaccine supply across the nation. Although the Johnson & Johnson vaccine is available, people with a history of thrombosis with thrombocytopenia (TTS) should not receive the Johnson & Johnson vaccine.

The U.S. Food and Drug Administration (FDA) makes sure all food and drugs are safe. The COVID-19 vaccines must pass clinical trials like other drugs and vaccines. The FDA checks the work and authorizes vaccines only if they are safe and effective. Because vaccines are given to millions of healthy people to prevent serious diseases, they’re held to very high safety standards. In addition, the Centers for Disease Control and Prevention are actively engaged with the FDA in monitoring vaccine safety through numerous safety monitoring systems, including the Vaccine Adverse Event Reporting System (VAERS).

Development of the vaccines involved an unprecedented number of resources to make the vaccine available as quickly as possible. Scientists built on many years of research from other vaccines, including research on vaccines for other coronaviruses. Coronaviruses are a family of viruses that can cause illnesses, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS). The coronavirus identified in 2019, commonly known as COVID-19, was caused by SARS-CoV-2 leading to this pandemic of respiratory illness.

Deeper Dive: The FDA can get vaccines to people faster through an Emergency Use Authorization (EUA). After the FDA has authorized a vaccine, the Centers for Disease Control and Prevention’s (CDC) independent advisory committee reviews the data before advising the CDC on recommending a vaccine for use. Like all vaccines, the FDA and CDC keep checking safety through the Vaccine Adverse Events Reporting System (VAERS). Health care providers are required to report serious side effects, or if someone gets seriously ill with COVID-19. There is also a smartphone app called V-SAFE that uses text messaging and web surveys to do health check-ins after people receive a COVID-19 vaccination. People can also report any problems they may have with a vaccine through V-SAFE.

They did not skip any steps. The studies followed the same steps as studies for any other vaccine. The reason the vaccines were given Emergency Use Authorization (EUA) instead of FDA approval has to do with the ability to get the vaccines to the public quickly. Like all vaccines, the COVID-19 vaccines were first tested in smaller studies to establish that there were no immediate safety concerns, and that they were likely to protect against COVID-19. Then, large studies were organized with tens of thousands of people to confirm the vaccines worked and to look further for safety concerns. The studies had to meet criteria showing that the vaccines worked. There also had to be at least two months of follow-up safety data before the FDA would consider authorization. Even after a vaccine is authorized, safety monitoring continues. 

All available vaccines in the United States have been under an EUA. Rigorous clinical trials among thousands of people have proven that vaccines are safe and effective. Over 200 million Americans have been safely fully vaccinated against COVID-19. The U.S. Food and Drug Administration (FDA) approved the Pfizer-BioNTech COVID-19 vaccine, which Pfizer is calling Comirnaty, for the prevention of COVID-19 disease in individuals 16 years of age and older. This is the only fully FDA approved COVID-19 vaccine at this time. The Pfizer adult vaccine will continue to be available under EUA for teens 12 to 15, for the administration of a third dose in certain immunocompromised individuals, and for a booster dose in 16 and 17 year olds. The FDA also issued an EUA for a lower dose of the Pfizer-BioNTech COVID-19 vaccine for children ages 5-11, and the Centers for Disease Control and Prevention (CDC) recommended all children in this age group get the vaccine to protect against serious illness and help keep them healthy. FDA approval of Pfizer for these younger populations will require additional time as the vaccine was not authorized for such use until more recently. 

Suggested answers to support informed decision making

Identify: Are they curious about the science? Are they concerned the vaccine will change something in their body? What have they heard? Is there a vaccine they want? 

You cannot get COVID-19 from the vaccines. All the currently authorized vaccines give your body temporary instructions to make a protein. The two-dose vaccines use mRNA technology, while the one-dose vaccine uses DNA technology to provide these instructions. This protein safely teaches your body to make germ-fighting antibodies against the COVID-19 virus. These germ-fighting antibodies are then ready to fight off the real COVID-19 if it ever tries to attack you. Your body naturally breaks down everything in the vaccine. There is no COVID-19 virus in the vaccine, and none of the vaccines can change your DNA.

The Centers for Disease Control and Prevention recommends the Moderna and Pfizer COVID-19 vaccines as the best choice for most people for preventing infection from COVID-19. There is ample supply of both vaccines in North Carolina and across the country. The CDC emphasized that receiving any vaccine, including the Johnson & Johnson vaccine, is better than being unvaccinated. People who prefer to receive the Johnson & Johnson COVID-19 vaccine will continue to have access to it, as will people who cannot receive an mRNA vaccine. However, people with a history of thrombosis with thrombocytopenia, a condition defined as blood clotting with low platelets, should not receive the Johnson & Johnson vaccine.

Deeper Dive: The Pfizer, Moderna, and Johnson & Johnson vaccines were built on decades of previous work on similar vaccines. The vaccines were tested at different times and different places; Johnson & Johnson clinical trials were conducted later and in other countries, including Brazil and South Africa with high rates of COVID-19 variants. All the vaccines have proven effective in preventing the spread of COVID-19, reducing serious illness, and preventing hospitalization and death from COVID-19.

Yes. The vaccine works to protect you against a future infection and individuals who have been infected can get reinfected. People who have been infected with COVID-19 and recovered have some protection against the virus, called natural immunity. Current evidence suggests that reinfection is uncommon in the 90 days after initial infection. However, experts do not know for sure how long this protection lasts, how this is impacted by the different variants, and the risk of severe illness and death from COVID-19 far outweighs any benefits of natural immunity. People can be confident that the protection they get from the vaccine is very strong, reliable and predictable. You don’t need a COVID-19 test before vaccination. It is safe to get vaccinated with any of the available vaccines if you have been infected in the past.

Deeper Dive: If you were treated for COVID-19 symptoms with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine. 

We know that the vaccines can protect people from COVID-19 illness for at least two to six months. We’ll know even more about how long the immunity from the vaccines lasts as people have been vaccinated for a longer period. With the spread of the Delta variant and more recent studies, boosters were recommended to strengthen and extend protections against COVID-19. With additional data, we will know if COVID- 19 vaccines will need to be given yearly, like the flu shot.

If you are moderately or severely immunocompromised, you are eligible to receive an additional primary dose to help you build an improved immune response. The third dose just needs to be at least 28 days after you finished the initial two doses for Pfizer or Moderna. For Pfizer this applies to immunocompromised persons ages 12 or older and for Moderna ages 18 or older. It is recommended that persons 16 and older who received an additional dose, also get vaccinated with an age-appropriate booster at the appropriate time.

People who received their first COVID-19 vaccines outside of the U.S. with a brand not currently authorized can now receive a Pfizer booster/additional dose when they are eligible. The Johnson & Johnson vaccine has not received approval for an additional dose at this time. An immunocompromised condition is something you would have to self-attest to, but your provider can help you make an informed decision.

An additional dose is intended for those who did not build the necessary immune response with the standard vaccine dose (in this case, two doses for Pfizer and Moderna vaccines) while a booster dose is administered when the initial immune response to a primary series has weakened over time. A booster is now recommended for all individuals 16 years and older.

The Pfizer-BioNTech COVID-19 adult vaccine can be given to teens ages 12 and up, under FDA EUA. Additionally, children between the ages of 5 and 11 are eligible to receive the lower-dose Pfizer-BioNTech COVID-19 pediatric vaccine under FDA EUA. Like the Pfizer-BioNTech COVID-19 adult vaccine, the PfizerBioNTech COVID-19 pediatric vaccine can be administered at any health care location offering COVID-19 vaccines including pharmacies without a prescription.

Moderna and J&J COVID-19 vaccines are not currently authorized for individuals under 18 for a primary series, additional dose, or booster dose. Pfizer and Moderna are both currently conducting clinical trials in children as young as 6 months of age. Johnson & Johnson is currently conducting a clinical trial in adolescents ages 12 to 17.

Deeper Dive:
Consent: Health care providers are required to obtain written consent from a parent or legal guardian of a minor prior to administration of any vaccine that has been granted emergency use authorization and is not yet fully approved by the United States Food and Drug Administration to an individual under 18 years of age. This applies specifically to children ages 5 to 11, teens ages 12 to 15 receiving a Pfizer-BioNTech COVID-19 vaccine or additional dose, or teens 16-17 receiving a Pfizer booster dose. Because the Pfizer-BioNTech COVID-19 adult vaccine was FDA approved for those 16 years of age and older receiving their primary series (first and second doses), consent is not required for those ages 16 and 17 receiving a first or second dose.

Additional dose: If a child is 12 years and older, is moderately to severely immunocompromised, and has completed their Pfizer-BioNTech COVID-19 primary series they should plan to get an additional dose 28 days after receiving their second shot. Written consent from parent or a legal guardian is required for youth 12-17 years of age receiving an additional dose if immunocompromised at this time. Persons 16 and older who received an additional dose, should also get vaccinated with an age-appropriate booster at the appropriate time

Booster dose: Individuals 16 and 17 years of age are eligible to receive a Pfizer-BioNTech COVID-19 single booster dose at least six months after completion of a primary vaccination with the Pfizer-BioNTech COVID19 Vaccine. Written parental consent is required as this is under Emergency Use Authorization.

The main difference between the adult and pediatric version of the Pfizer BioNTech COVID-19 vaccine is that the vaccine for children 5-11 is one-third the amount given to people 12 and older. The pediatric vaccine still requires two doses. At this time, the 5-11 version of the vaccine is not offered as an additional or booster dose, as it has not been authorized by the FDA or CDC for these uses. 

Yes. There were no safety concerns or serious side effects noted in the clinical trials, which began in March 2021. The first phase of the trial initially enrolled 4,500 children ages six months to 11 years in more than 90 clinical trial sites. This is comparable to the number included in many similar clinical trials with children. Trials included volunteers from different races and ethnicities, including Black and Hispanic/Latinx volunteers around the world. 77% percent of clinical trial participants were white, 6% were Black, 8% Asian, 17% Hispanic/Latino and 7% multiracial. Additionally, the vaccine was found to be effective in this age group: it produced similar immune responses in children 5-11 as in older kids and adults ages 16 to 25. As always, keep in mind that the Food and Drug Administration (FDA) reviews trials to determine if vaccines are safe—an independent, scientific committee checks the work. Vaccines are authorized and the Centers for Disease Control and Prevention (CDC) recommends their use.

Deeper Dive: There have been rare reports of myocarditis occurring after COVID-19 vaccination with Moderna or Pfizer vaccines. Myocarditis is the inflammation of the heart muscle and pericarditis is the inflammation of the lining outside the heart. In both cases, the body’s immune system is causing inflammation because of an infection or some other trigger. While myocarditis can be serious, these postvaccination cases are frequently mild and get better without any treatment and are seen more often in adolescents and young adults, after the second dose of either Pfizer or Moderna and within a week of vaccination. No cases of myocarditis were seen in children 5 to 11 in the clinical trials and the FDA and CDC are continuing to monitor. The risk for both myocarditis and pericarditis are much higher from becoming infected with COVID-19 than from the vaccines. 

Yes, the pediatric vaccine is offered at no cost—just like COVID-19 vaccines for adults – even if you don't have insurance and regardless of your immigration status. Children ages 5-11 get a smaller dose of the Pfizer vaccine, so it may not be available everywhere. Call ahead to make sure.

The vaccine can help our children get back to fuller lives with healthier and happier experiences both in and outside of the classroom. Children are vulnerable to the virus like everyone else, and COVID-19 cases in children can result in hospitalization, deaths, MIS-C (inflammatory syndromes) and long-term complications, such as “long COVID” where symptoms can last for months. During the most recent surge, pediatric cases of COVID-19 rose by about 240% in the United States. But now we have a lower dose Pfizer COVID-19 vaccine available for children ages 5 to 11 that is safe and effective in protecting against COVID-19. It is also free even if they don’t have insurance and regardless of immigration status. Kids 5-11 can be vaccinated at any location that has the smaller dose of Pfizer available, so find a location near you at myspot.nc.gov

 It is normal for a virus to mutate (change) over time and for new variants to occur. Several variants of the virus that causes COVID-19 have been identified. Some of these variants seem to spread more easily and quickly than others and may cause more severe disease. This can lead to an increase in COVID-19 cases, hospitalizations and deaths. The presence of these variants makes it even more important to get vaccinated. Scientists are working to learn more about these variants and how they affect vaccines.

Deeper Dive: During Summer 2021, the Delta variant arose as the primary strain of COVID-19 in the U.S. The COVID-19 vaccines authorized in the United States continued to be remarkably effective in reducing risk of severe disease, hospitalization, and death, even against the widely circulating Delta variant. Health experts are now warning that the highly contagious COVID-19 variant, Omicron, is expected to cause the greatest surge in COVID-19 infections to date in the coming months. Early evidence suggests that Omicron is two to three times as contagious than the Delta variant, making it four to six times as contagious as the original COVID-19 virus. It is critical that unvaccinated and partially vaccinated people get fully vaccinated. For those already fully vaccinated, protection against Omicron increases greatly after a booster dose. The Centers for Disease Control and Prevention and the North Carolina Department of Health and Human Services urge people to get vaccinated with an mRNA vaccine (Pfizer or Moderna) as soon as possible and to get a booster as soon as they are eligible to help prevent serious illness, hospitalization and death.

Data has shown boosters can provide continued protection, especially as the Omicron variant sweeps through the United States. The Food and Drug Administration (FDA) as well as the Centers for Disease Control and Prevention (CDC) have authorized use of COVID-19 booster shots available for all individuals ages 16 and over.

You should get a booster shot if you are ages 16 years and older. At this time, only the Pfizer-BioNTech COVID-19 vaccine (with written parental consent) is authorized for the use of a single booster dose for administration to individuals 16 and 17 years of age.

When to get a booster:

  • At least 6 months after completing a Moderna or Pfizer primary mRNA COVID-19 vaccination series
  • Two months after completion of a primary vaccination series of the Janssen vaccine

Individuals are now able to receive any brand of COVID-19 vaccine for their booster shot. Some people may have a preference for the vaccine type that they originally received, and others may prefer to get a different booster. Limited preliminary evidence suggests that booster doses of one of the two mRNA vaccines – Moderna or Pfizer-BioNTech – more effectively raise antibody levels than a booster dose of the Johnson & Johnson vaccine. While individuals are able to receive any brand of COVID-19 vaccine for their booster shot, the CDC has recommended Moderna and Pfizer COVID-19 vaccines as the preferred choice for both initial series and boosters.

Moderately and severely immunocompromised individuals 16 years of age and older who received an additional dose of Pfizer or Moderna are eligible to receive a single age-appropriate booster dose at least 6 months after the third additional dose. The CDC has recommended Moderna and Pfizer COVID19 vaccines as the preferred choice.

Suggested answers about vaccine side effects

Identify: What side effects are they concerned about? Is there a specific vaccine or side effect that they are worried about? Do they think the vaccine will cause something worse than COVID-19?

No serious side effects were reported in clinical trials. Temporary reactions after receiving the vaccine may include a sore arm, headache, feeling tired and achy for a day or two, or in some cases, fever. In most cases, these temporary reactions are normal and good signs that your body is building protection! You can take medicines like Tylenol or ibuprofen after receiving your shot to help with these temporary reactions. 

Temporary side effects for kids 5-11 are like those for older kids and adults. Your child may experience a temporarily sore arm, headache and being tired or achy for a day or so. An extremely rare side effect of the vaccine seen is myocarditis, or heart muscle inflammation. Myocarditis has been seen in some older adolescent and young males, with mostly mild cases. People usually recover on their own or need minimal treatment. No cases of myocarditis were seen in children age 5-11 in the clinical trials. Ongoing safety surveillance will continue in order to determine if this rare occurrence is a risk to younger children

A small number of people have experienced anaphylaxis, a serious allergic reaction that requires emergency treatment. So far, reports of anaphylaxis are uncommon. For every one million people who receive the Pfizer or Moderna vaccines, fewer than five people experience a severe allergic reaction. In the clinical trials for the Johnson & Johnson vaccine, severe allergic reactions were very uncommon as well. Patients will be observed after vaccination in case they develop a side effect that requires medical attention. 

While it is extremely rare, there have been 54 cases (out of about 17 million doses) of thrombosis with thrombocytopenia (TTS), associated with the Johnson and Johnson vaccine, which is a condition defined by blood clots with low platelets. The Centers for Disease Control and Prevention recommends that the Pfizer or Moderna COVID-19 vaccine is the best choice for most people for preventing severe illness and hospitalization from COVID-19. However, receiving any vaccine, including the Johnson & Johnson vaccine, is better than being unvaccinated. If you develop shortness of breath, chest pain, leg swelling, persistent abdominal pain, severe or persistent headaches or blurred vision, easy bruising or tiny blood spots under the skin beyond the site of injection within 3 weeks of vaccination with the Johnson & Johnson vaccine, seek medical attention right away. There are no safety concerns for people who were previously vaccinated and did not experience TTS.

The FDA reported that there have been very rare cases of Guillain-Barre Syndrome after receiving the Johnson & Johnson COVID-19 vaccine with 100 preliminary cases out of more than 12.8 million (mostly in males, many aged 50 years and older). GBS is a neurological disorder usually triggered by a respiratory or gastrointestinal infection that most people fully recover from. The body’s immune system damages nerve cells, causing muscle weakness and sometimes paralysis in severe cases. With nearly all COVID-19 hospitalizations and deaths occurring in unvaccinated people, the risk of COVID-19 infection is greater than the extremely low risk of a severe adverse events after COVID-19 vaccination and everyone eligible should get vaccinated and receive a booster when it is time.

Since April 2021 there have been over one thousand (1000+) reports of inflammation of the heart— known as myocarditis. Although, one thousand seems like a large number, incidence of myocarditis is incredibly rare given the hundreds of millions of doses administered. These cases generally occur after the second dose of mRNA vaccine (Pfizer or Moderna), in male adolescents ages 16 years and older, and symptoms present typically within several days after vaccination. Most patients who received care responded favorably and recovered quickly. These are rare, temporary side effects and no deaths have been reported. Patients can usually return to their normal daily activities after their symptoms improve. Heart inflammation happens more often and is more severe in teens who contract COVID-19 than those who get vaccinated. The CDC continues to recommend COVID-19 vaccines for everyone 5 years and older. 

What should you do when myths/misinformation is raised during a presentation?

Don't repeat the myth. Repeating the my can backfire and result in its amplification.

Do ask questions. Why might that not be true? Why might someone want you to believe that?

Lead with the facts. Focus more on the relevant, truthful information rather than the myth.

Keep it Simple. Repeat validated information in a way that is easy to understand.

Responding to misinformation

Identify: Are there specific concerns? What have they heard, and from whom? Is religion a factor? 

With misinformation about vaccines circulating widely in some communities, we know that it can be frustrating and challenging to address misinformation. However, the goal of these conversations is to invite people to engage with us. Ask patients to share anything concerning that they have heard about the vaccine. Address inaccurate information without dismissing their concerns. We encourage anyone counseling patients on COVID-19 vaccines to use these tips, practice patience when answering questions, and to refrain from dominating the conversation with facts.

No. The American College of Obstetricians and Gynecologists (ACOG) recommends vaccination for all eligible people, including those who may want to get pregnant. There have been no safety data to suggest that the vaccines impact the ability of a woman to get pregnant. Similarly, the Society for Male Reproduction and Urology recommends that men who desire fertility should be encouraged to get vaccinated. The American Society for Reproductive Medicine has also stated that there is no evidence of fertility loss due to COVID-19 vaccines.

Deeper Dive: Patients scheduled for reproductive services, such as oocyte retrieval, embryo transfer, and intrauterine insemination, should avoid getting the vaccine for 3 days prior to and after the procedure. This recommendation is not because vaccination is unsafe, but to make sure that doctors can confidently monitor pre-procedural and post-procedural symptoms. 

COVID-19 vaccination is recommended for all people aged 5 years and older, including people who are pregnant, breastfeeding, or trying to get pregnant now or might become pregnant in the future. Pregnant and recently pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people. Getting a COVID-19 vaccine during pregnancy can protect you from severe illness from COVID-19. In a new analysis from the v-safe pregnancy registry, scientists did not find an increased risk of miscarriage among people who received the vaccine before 20 weeks. Previous findings from three safety monitoring systems did not find any safety concerns for pregnant individuals, or their babies, when vaccinated late in pregnancy. The growing evidence about the safety and efficacy of COVID-19 vaccines during pregnancy suggest receiving the vaccine outweighs potential risks of not receiving and contracting COVID-19 during pregnancy, which has the potential to create severe illness and pregnancy complications.

None of the vaccines contain fetal cells or fetal tissues. Fetal cells were used in research to develop all three vaccines. Vaccines commonly use fetal cells in development. The Pfizer and Moderna vaccines do not require the use of any fetal cells to produce the vaccines. In order to produce the vaccine, the Johnson and Johnson vaccine uses fetal cells that were isolated over 30 years ago.

No, nothing in the vaccine can be tracked and the vaccine is naturally broken down by your body after it finishes making you stronger.

Suggested answers for helping patients navigate to a vaccine

Identify: Are they having difficulty finding a vaccine provider? What resources do they need?

If vaccine is not available in your clinic, you can direct patients to the Vaccine Finder tool, an easy-touse online tool to help individuals find their spot to get a vaccination in NC, including vaccine provider locations and contact information.

North Carolina uses a secure data system called the COVID-19 Vaccine Management System (CVMS) to make sure you get your second shot at the right time. When you get your first shot, you will be asked to make an appointment for your second dose. You will also be given a card with information about which vaccine you got for your first dose and the date of that shot. Keep the card in a safe spot and take a picture of it just in case it gets misplaced. You may also receive an email notification with a reminder for the second shot. With increased vaccine supply across North Carolina, you no longer have to receive the second dose at the same site that you received the first dose and eligible individuals can go to any available provider for their booster shot. 

Identify: Are they afraid of being turned away? Are there concerns over payment? Are they worried about repercussions related to immigration status? 

North Carolina does not require a government-issued identification card, like a driver’s license, to be vaccinated. Vaccine providers may ask you to pre-register, to fill out a form on-site with your name, address and date of birth, or ask for a bill or other document with your name and address on it. For people with health insurance, vaccine providers may ask for photo-identification or health insurance care in order to bill correctly, but lack of government issued ID or lack of health insurance will not prevent you from receiving a vaccine.

Deeper Dive: Vaccines are available to anyone in North Carolina, regardless of their immigration status. None of the information collected by vaccine providers is sent to ICE. To follow state law, North Carolina submits year of birth (not date of birth), the first 3 digits of the vaccine's recipient's zip code (as long as that zip code includes more than 20,000 people), as well as the date of submission of the vaccination record to the CDC, but no information that can be identify an individual.

 

Suggested answers to appeal to positive emotions

Identify: Are they excited to return to normalcy? Do they want to travel or visit family? What are they looking forward to most? Do they want their kids and teens to be safer in school? 

The COVID-19 vaccines are very good at protecting people from severe COVID-19 illness, hospitalization and death. Getting vaccinated is much safer than getting sick with COVID-19. It protects you, your family and others. The more people who are vaccinated, the more likely we can get back to the people and places we love. 

Fully vaccinated people can participate in many of the activities that they did before the pandemic; for some of these activities, they should wear a mask. Although infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant, preliminary evidence suggests that fully vaccinated people who do become infected with the Delta variant can spread the virus to others. People who are fully vaccinated should:

  • Wear a mask in all indoor public spaces if you live in area of high or substantial levels transmission as defined by the CDC until more people are vaccinated and viral transmission decreases.
  • Wear a face covering in all K-12 schools, child care, indoor settings with a large number of children or child- focused activities (e.g, children’s museums), public transportation, healthcare settings, high density congregate settings (e.g., correction and detention facilities, homeless shelters, migrant farm camps), and large crowded indoor venues (e.g., arenas, stadiums).
  • Get tested if you have any symptoms of COVID-19. After an exposure to COVID-19, you should get tested 3-5 days after exposure and wear a mask around others until you get a negative test result

Yes. It is incredibly important that everyone in North Carolina do their part to help get as many people vaccinated as possible. This is especially important as we face more highly contagious variants, along with increasing cases and hospitalizations. The more people who are vaccinated, the faster we will end the pandemic and the more confident each one of us can be that we and our loved ones are protected as we get back to the people and places we love. To protect those who cannot be vaccinated due to age or medical conditions, we need everyone who can safely get vaccinated to do so.

Step 4. Make getting vaccinated easy

Here is information to help you support patients in getting vaccinated and answer their questions about the process:

  1. Alleviate concerns: Inform patients that COVID-19 vaccination is provided at no cost and is available regardless of immigration status and health insurance.
  2. Become a vaccine provider. If your practice is not already set up to administer COVID-19 vaccines, register to become a vaccine provider through the COVID-19 Vaccine Management System (CVMS) and learn more about North Carolina’s COVID-19 vaccine program.
  3. Make it simple to get an appointment:
  • If you offer a COVID-19 vaccine, have staff available to answer phones or have a clear message on voicemail. Be proactive in reaching out to patients so they know what to do.
  • If you do not offer vaccination, you and your staff can help your patients get an appointment by going to vaccines.gov to find a nearby vaccine provider.
  • Provide patients with the information they need to schedule their own appointment:
    • Help patients navigate to the vaccines.gov website to locate a vaccine provider near them. o Share information about the NC COVID-19 hotline (1-888-675-4567) to answer questions and provide assistance.
    • Let patients know that they can call their local transit agency to get a free ride to their vaccine appointment
    • For homebound patients, connect them to the homebound vaccine provider in their county.
  • Use our communication toolkit to provide information that is appropriate to your patient population, such as telephone, text, mail, email

Additional Resource:

Carolina Complete Health members age 5 years and older can receive a $75 My Health Pays® reward when they receive a COVID-19 vaccination. View more information