Dear Nurses, Your COVID Vaccine Experience Matters

Erin F. Blau, DNP, MPH, RN; Stephen Perez, PhD, RN, ACRN


April 14, 2021

Editorial Collaboration

Medscape &

As members of the largest and most trusted healthcare profession, we nurses play important roles personally and professionally in the ongoing COVID-19 vaccine rollout. But recent data show that many nurses still question whether COVID-19 vaccination is right for them, and whether the vaccines are safe and effective.

By identifying and addressing our own questions and concerns, we can feel confident in our decision to get vaccinated, serve as role models for other nurses who may have similar concerns, and feel prepared to answer questions from our patients, friends, and family members.

Here, we answer the five most common questions nurses have about COVID-19 vaccines.

Nurses are one of the very first groups to get vaccinated, so how can we be sure the vaccines are really safe?

COVID-19 vaccines are safe and effective. More than 128 million doses have already been given in the United States. These vaccines are undergoing the most intensive safety monitoring in US history. This monitoring uses both existing and new reporting systems to track for any adverse events and make sure COVID-19 vaccines are safe.

The monitoring program results are reassuring. No unexpected patterns of reactions or other safety concerns have been identified during early vaccine safety monitoring. Data show that the most common side effects after COVID-19 vaccination are mild, such as pain, redness, or swelling at the injection site; fatigue; headache; muscle pain; chills; fever; or nausea. These side effects usually go away on their own within a few days. Serious adverse events are very rare.

The vaccines were developed so quickly. How can we be sure that all the necessary steps were taken in their development and approval?

Because of the urgent need to develop a safe and effective vaccine, scientists used a process called Emergency Use Authorization (EUA) to provide more timely access to the vaccines. This mechanism has been used in the past for anthrax, Ebola, enterovirus, H7N9 influenza, and Middle East respiratory syndrome.

Before being authorized for emergency use, COVID-19 vaccines underwent the same rigorous evaluation as those vaccines. People from many different races, ages, genders, and ethnicities participated in large clinical trials in the United States and globally to determine how well the COVID-19 vaccines work in diverse populations. The US Food and Drug Administration (FDA) granted EUAs for the COVID-19 vaccines that were shown during clinical trials to be effective at preventing serious illness, hospitalization, and death from COVID-19.

The amount of money, time, and effort dedicated to developing these vaccines was unprecedented. Scientists used these resources to build on existing research and technology and move through the vaccine development process without skipping any steps.

For more information on how vaccines are developed and approved, see Vaccine Development - 101 from the FDA.

What about severe side effects, such as anaphylaxis? What are the long-term side effects?

Severe allergic reactions, including anaphylaxis, can occur after any vaccination; anaphylaxis after COVID-19 vaccination is rare. On the basis of reports to the Vaccine Adverse Event Reporting System, anaphylaxis occurred in 5 of every 1 million people vaccinated in the United States.

If anaphylaxis does occur, vaccination providers have medication that effectively and immediately treats the reaction. As a precaution, people receiving COVID-19 vaccines are asked to stay for 15-30 minutes after being vaccinated so they can be observed and provided treatment in the rare case it is needed. More about the management of anaphylaxis after COVID-19 vaccination can be found here: Interim Considerations: Preparing for the Potential Management of Anaphylaxis after COVID-19 Vaccination.

Many people have reported mild, short-term side effects after getting a COVID-19 vaccine. These are normal signs that the person's body is building protection. Common side effects include pain, redness, and swelling at the injection site, and systemic side effects, such as tiredness, headache, muscle pain, chills, fever, and nausea. These side effects may affect a person's ability to do daily activities, but they should go away in a few days. Some people have no side effects.

COVID-19 vaccines are being tested in large clinical trials to assess their safety. However, it does take time and more people getting vaccinated before we learn about very rare or long-term side effects. This is why safety monitoring will continue. The Centers for Disease Control and Prevention (CDC) has an independent group of experts that reviews all safety data as they come in and provides regular safety updates. If a safety issue is detected, CDC will act immediately to determine whether the issue is related to the COVID-19 vaccine and decide the best course of action.

Millions of people in the United States have received a COVID-19 vaccination, in addition to the clinical trials that started in mid-2020. No serious long-term effects have been identified.

Will this vaccine affect fertility? If I am pregnant or breastfeeding now, can I still get a vaccine?

If you are trying to become pregnant now or plan to try in the future, you may receive a COVID-19 vaccine when one is available to you. There is no evidence that any vaccine, including COVID-19 vaccines, causes fertility problems. If you are trying to become pregnant, you do not need to avoid pregnancy after receiving a COVID-19 vaccine. As with all vaccines, scientists are studying COVID-19 vaccines carefully for side effects now and will report findings as they become available.

If you are pregnant, you may choose to receive a COVID-19 vaccine when one is available to you. A conversation with your healthcare provider may help you decide whether to get vaccinated, although this is not required. On the basis of how these vaccines work in the body, experts believe they are unlikely to pose a specific risk for people who are pregnant. However, currently data on the safety of COVID-19 vaccines in pregnant people are limited because these vaccines have not been widely studied in pregnant people. Currently authorized COVID-19 vaccines do not contain the live virus that causes COVID-19; thus, they cannot give someone COVID-19. There is no evidence that COVID-19 vaccination causes any problems with pregnancy, including the development of the placenta.

Although the overall risk for severe illness is low, pregnant people with COVID-19 disease have an increased risk for severe illness, including illness that results in intensive care unit admission, mechanical ventilation, and death, compared with nonpregnant people. In addition, pregnant people with COVID-19 might be at increased risk for adverse pregnancy outcomes, such as preterm birth, compared with pregnant women without COVID-19.

CDC has established the v-safe COVID-19 Vaccine Pregnancy Registry to learn more about pregnancy and COVID-19 vaccination. The registry is collecting health information from people who received COVID-19 vaccination in the periconception period or during pregnancy. Tens of thousands of pregnant people have received the vaccine, and no serious safety issues have been seen. Click here for more information on COVID-19 vaccines and pregnancy.

Breastfeeding is an important consideration, and vaccines rarely pose a safety concern. The COVID-19 vaccines authorized now are nonreplicating vaccines, meaning they can create an immune response but do not reproduce inside host cells. Because nonreplicating vaccines pose no risk to lactating people or their infants, COVID-19 vaccines are also thought not to be a risk to the breastfeeding infant. Therefore, lactating people may choose to be vaccinated.

I've already had COVID-19. Why do I need to get a vaccine? Isn't my dose better used for someone else?

You should be vaccinated regardless of whether you already had COVID-19. Experts do not yet know how long you are protected from getting sick again after recovering from COVID-19. Even if you have already recovered from COVID-19, it is possible — although rare — that you could be infected again with the virus that causes COVID-19. The risk for severe illness and death from COVID-19 far outweighs any benefits of natural immunity. Learn more about why getting vaccinated is a safer way to build protection than getting infected.

As a nurse, you are critical to caring for people who have COVID-19, and you also play an important role in halting its spread. You are among the first to receive the vaccine because it is an essential tool that can prevent you from becoming ill and, along with other important measures, can help protect your patients, family, and community from being exposed to and getting sick with COVID-19.

As we learn more about COVID-19 vaccines, we should share our experience to empower our patients, coworkers, and community. If you initially felt hesitant but ultimately decided to get the vaccine, celebrate your decision to get vaccinated and make it visible! Share a social media post about what influenced your decision. Inspire others to get vaccinated by posting a picture of you getting the vaccine or sharing your experience with coworkers in one-on-one discussions. Be a willing listener to those who may have concerns about COVID-19 vaccines and offer your own experience as a way to provide education and combat misinformation, using this guide to talk to patients, family, and friends. If you still have questions, visit CDC'S webpage for frequently asked questions about COVID-19 vaccination to help find answers.

Our experience matters, and it can build the confidence our fellow nurses, patients, and loved ones have in COVID-19 vaccines.

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