What you should know about the COVID-19 Vaccine
Vaccines are an important tool to help communities fight the spread of COVID-19 and help people stay healthy. Research has shown that people who are not fully vaccinated “were 4.5 times more likely than vaccinated individuals to become infected, 10 times more likely to be hospitalized, and 11 times more likely to die from the coronavirus.”1 Vaccines interrupt the ability of the virus that causes COVID-19 to move between people and mutate, so it is important for everyone to get vaccinated as medically appropriate.
We strongly encourage all CarePlus members to consider getting the COVID-19 vaccine when they are eligible. Talk to your doctor about what is best for you.
Once fully vaccinated, the CDC confirms that, “You can participate in many of the activities that you did before the pandemic.” Review the CDC’s updated guidance on mask usage here (link opens in new window).
Until you are vaccinated, to help yourself and others, it is important to continue following the advice of health professionals in order to minimize the chances of catching or spreading the disease. According to the Centers for Disease Control and Prevention (CDC), wearing masks, practicing social distancing, and washing your hands remain the best protections against the virus.
SOURCE: (1) CDC (link opens in new window)
ALERT: The Delta variant, a more contagious strain of COVID-19, is now circulating widely in the US. Data suggests that “the national proportion of cases attributed to the Delta variant to be greater than 98%”.1
However, recent studies2 have shown that the vaccines available in the United States are effective against variants currently circulating, including Delta
SOURCE: (1) CDC: Covid Data Tracker| Sars-COV-2 Variants (link opens in new window)
SOURCE: (2) CDC: Science Brief: COVID-19 Vaccines and Vaccination (cdc.gov) (link opens in new window)
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What vaccines are available for COVID-19?
- The Pfizer-BioNTech vaccine (also known as Comirnaty) is the first COVID-19 vaccine to receive full FDA approval for individuals 16 years of age and older. The vaccine is also available under emergency use authorization (EUA) for individuals 12 through 15 years of age.
- The Moderna vaccine is available under EUA for ages 18 and over.
- The Johnson & Johnson vaccine is available under EUA for ages 18 and over.
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Are the COVID-19 vaccines safe and effective?
Yes. In order to receive Emergency Use Authorization (EAU) from the FDA, vaccines must pass rigorous safety and efficacy trials. According to the CDC, “Clinical trials of all vaccines must first show they are safe and effective before any vaccine can be authorized or approved for use, including COVID-19 vaccines.”
According to the FDA, to support their recent approval decision of the Comirnaty/Pfizer-BioNTech COVID-19 vaccine, they have reviewed updated data from the clinical trial which supported the EUA and included a longer duration of follow-up in a larger clinical trial population.
“Specifically, in the FDA’s review for approval, the agency analyzed effectiveness data from approximately 20,000 vaccine and 20,000 placebo recipients ages 16 and older who did not have evidence of the COVID-19 virus infection within a week of receiving the second dose. The safety of Comirnaty was evaluated in approximately 22,000 people who received the vaccine and 22,000 people who received a placebo 16 years of age and older.
Based on results from the clinical trial, the vaccine was 91% effective in preventing COVID-19 disease.
More than half of the clinical trial participants were followed for safety outcomes for at least four months after the second dose. Overall, approximately 12,000 recipients have been followed for at least 6 months.”
To learn more, read this FDA news release on the FDA evaluation of safety and effectiveness data for Pfizer-BioNTech/Comirnaty approval(link opens in new window) .
Safety: According to the CDC, “Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history.” Learn how federal partners are working together to ensure the safety of COVID-19 vaccines (link opens in new window).
With regard to the Johnson & Johnson COVID-19 vaccine, the CDC and FDA recommend “women younger than 50 years old especially should be aware of the rare risk of blood clots with low platelets after vaccination, and that other COVID-19 vaccines are available where this risk has not been seen.” If you received a Johnson & Johnson vaccine, here is what you need to know (link opens in new window).
Additionally, the FDA has issued a release (link opens in new window) and updated the label (link opens in new window) on the Johnson & Johnson COVID-19 vaccine warning that “reports of adverse events following use of the Janssen COVID-19 Vaccine under emergency use authorization suggest an increased risk of Guillain-Barré Syndrome (GBS) during the 42 days following vaccination”. GBS is a rare neurological disorder in which the body’s immune system damages nerve cells, causing muscle weakness, or in the most severe cases, paralysis. However, the FDA’s release states it has evaluated the available information for the Johnson & Johnson COVID-19 vaccine and “continues to find the known and potential benefits clearly outweigh the known and potential risks”.
Efficacy: The CDC states that, “All COVID-19 vaccines currently available in the United States have been shown to be highly effective at preventing COVID-19. According to the CDC, both the Pfizer and Moderna vaccines are reported to be about 94% to 95% effective in preventing COVID-19. The Johnson & Johnson vaccine is reported to be about 72% effective at preventing COVID-19 in trials conducted in the U.S., 85% effective at preventing severe disease and was 100% effective in preventing hospitalization and death. Learn more about the different COVID-19 vaccines(link opens in new window).”
Read more about the benefits of getting the COVID-19 Vaccine from the CDC here (link opens in new window)
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Who is eligible to get the vaccine?
According to the CDC, “COVID-19 vaccination is recommended for all people aged 12 years and older, including people who are pregnant, breastfeeding, 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 can protect you from severe illness from COVID-19”. The Pfizer vaccine is currently the only COVID-19 vaccine available under emergency use authorization (EUA) for those age 12 through 15 and 17.
The CDC also recommends that:
- people aged 65 years and older and residents in long-term care settings, and people aged 50–64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 Vaccine at least 6 months after completing their Pfizer-BioNTech primary series
- people aged 18–49 years with underlying medical conditions, and people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot based on their individual benefits and risks.
People should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.
To learn more, read these details on the CDC’s booster recommendations(link opens in new window). For the latest information about COVID-19 vaccines, visit the CDC’s website(link opens in new window).
SOURCE: (1) CDC (link opens in new window)
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Is one vaccine better than another?
Fortunately, all vaccines that are out on the market and approved for use have been rigorously reviewed for both efficacy and safety.
As the CDC has reported, the Pfizer and Moderna vaccines did show higher effectiveness at preventing overall incidence of COVID-19 illness in their trials than the Johnson & Johnson vaccine. However, it is important to note that the Johnson & Johnson vaccine was tested during a time with more contagious and virulent disease variants than the ones that existed during the Moderna and Pfizer trials. Despite those conditions, the J&J vaccine significantly reduced all COVID-19 infections, and was 100% effective in preventing hospitalization and death from COVID-19 during the trial.
Note that the CDC and FDA released a statement on the Johnson & Johnson COVID-19 vaccine stating that, “women younger than 50 years old should be aware of the rare risk of blood clots with low platelets after vaccination, and that other COVID-19 vaccines are available where this risk has not been seen.” If you received a Johnson & Johnson vaccine, here is what you need to know (link opens in new window).
Sources:
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Pfizer-BioNTech.html(link opens in new window)
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html(link opens in new window)
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/janssen.html(link opens in new window)
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Where can I get the vaccine?
Vaccine supply is increasing rapidly and securing appointments has become less challenging. There are several places to look to receive the vaccine:
For more information, visit How Do I Get a COVID-19 Vaccine | CDC (link opens in new window).
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Should I be concerned about scams when I’m looking for the vaccine?
Wherever you get the vaccine, it is important to confirm the source is safe and reputable to avoid becoming a victim of fraud. A recent warning from the Federal Bureau of Investigation (FBI) provides information on potential indicators of COVID-19 vaccine related fraud and tips on how to avoid it. View the FBI’s warning(link opens in new window).
If you are a victim of a scam or attempted fraud involving COVID-19, you can:
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What should I bring and do when I go to get my vaccination?
Remember to bring a government-issued ID with you when you get your vaccination. Because age is an important criterion for eligibility in most states, many vaccine providers are requiring a government-issued ID showing date of birth as proof of age.
CarePlus members should remember to bring your Medicare card and your CarePlus member ID card when you get your vaccine in case the vaccine provider requests it.
While the federal government is covering the cost of the vaccine for all Americans, some providers may charge a fee for administering the vaccine. There won’t be any cost to you, but having your card will ensure the provider can receive reimbursement for administering the vaccine to you. For more information on costs, see the “Will I be able to get the COVID-19 vaccine at no cost to me” FAQ below.
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Are there any side effects from the vaccine?
It is possible that you will experience some side effects after receiving the COVID-19 vaccine. According to the CDC, “After COVID-19 vaccination, you may have some side effects. This is a normal sign that your body is building protection”. Common vaccine side effects highlighted by the CDC range from pain at the injection site to flu-like symptoms. Learn more from the CDC on dealing with symptoms and when to call the doctor (link opens in new window).
There have been extremely rare incidents of significant allergic reactions reported. The CDC is working with vaccine providers to put safeguards in place for dealing with severe allergic reactions. Learn more about COVID-19 vaccines and severe allergic reaction here (link opens in new window).
Note that the CDC and FDA released a statement on the Johnson & Johnson COVID-19 vaccine stating that, “women younger than 50 years old should be aware of the rare risk of blood clots with low platelets after vaccination, and that other COVID-19 vaccines are available where this risk has not been seen.” If you received a Johnson & Johnson vaccine, here is what you need to know.(link opens in new window)
After receiving the vaccine, consider signing up for V-safe from the CDC. “V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through v-safe, you can quickly tell CDC if you have any side effects after getting the COVID-19 vaccine. Depending on your answers, someone from CDC may call to check on you and get more information. And v-safe will remind you to get your second COVID-19 vaccine dose if you need one.” Learn more about V-safe here (link opens in new window).
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How is it administered? How many doses will I need? Will a booster shot be needed?
The COVID-19 vaccines will be delivered via injection. Some will require two doses to maximize their effectiveness. The Pfizer-BioNTech vaccine requires two shots administered about 21 days apart. The Moderna vaccine requires two shots administered about 28 days apart. It is critical that you schedule and receive the second dose in order to receive the most protection possible.
The Johnson & Johnson vaccine requires just one shot.
The CDC also recommends a booster shot for:
- people aged 65 years and older and residents in long-term care settings, and people aged 50–64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 Vaccine at least 6 months after completing their Pfizer-BioNTech primary series
- people aged 18–49 years with underlying medical conditions, and people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot based on their individual benefits and risks.
People should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.
To learn more, read the details about the CDC’s booster recommendations. (link opens in new window).
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What can I do once I am fully vaccinated?
According to the CDC, “If you’ve been fully vaccinated:
If you’ve been around someone who has COVID-19, you should get tested 3-5 days after your exposure, even if you don’t have symptoms. You should also wear a mask indoors in public for 14 days following exposure or until your test result is negative. You should isolate for 10 days if your test result is positive. The CDC recommends continued observance of travel protocols and, if you have symptoms of COVID-19, testing and staying at home or away from others.
Individuals will still be required to wear a mask on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in U.S. transportation hubs such as airports and stations. In addition, fully vaccinated international travelers arriving in the United States are still required to get tested within 3 days of their flight (or show documentation of recovery from COVID-19 in the past 3 months) and should still get tested 3-5 days after their trip.
Learn more from the CDC about when you’ve been fully vaccinated(link opens in new window).
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What if I am high risk or have a specific medical condition?
If you have concerns due to your health status or a specific medical condition, consult with your doctor about whether the vaccine is appropriate for you and the safest way to get it.
If you have an underlying or chronic medical condition, make sure you are in communication with your doctor during this pandemic. Getting these conditions well-managed—by staying on top of your preventive and regular medical care—will help to manage your health risk during this pandemic. This is one of the best ways to protect yourself while awaiting the availability of the vaccine.
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If someone has already tested positive for COVID-19 antibodies, is a COVID-19 vaccination necessary and why?
Yes. Individuals who have tested positive for COVID-19 antibodies should still get the COVID-19 vaccine to prevent potential re-infection and safeguard against false-positive test results. A false-positive antibody test would lead an individual to believe they have COVID-19 antibodies when they, in fact, do not.
In cases where the antibody test is accurate, vaccination is still important because it is unknown how long the COVID-19 antibodies in a person’s system may offer protection from the virus - and how high the antibody levels would need to be to offer that protection. Additionally, there have been some reports of people getting re-infected with the virus, which indicates that the natural immunity may wear off over time. 2
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How long should someone wait to get vaccinated for COVID-19 if they’ve already had the COVID-19 virus?
Individuals who have previously been infected with COVID-19 should still get the COVID-19 vaccine to prevent potential re-infection. The timing for vaccination should align with CDC-recommendations, which depend upon severity of the infection.
- In COVID-19 cases that are mild and do not require hospitalization, an individual should wait through the CDC-recommended isolation period before getting vaccinated. For most people, this means 10 days after symptom onset and resolution of fever for at least 24 hours, without the use of fever- reducing medications.
- For more severe COVID-19 infections that were treated with monoclonal antibodies or convalescent plasma, the CDC is recommending a 90-day wait, so that your immune system is recovered and ready. 3
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Is it safe to get the COVID-19 vaccine at the same time as the flu or other vaccines?
The CDC has confirmed that “You can get a COVID-19 vaccine and other vaccines at the same visit. You no longer need to wait 14 days between vaccinations. Experience with other vaccines has shown that the way our bodies develop protection, known as an immune response, after getting vaccinated and possible side effects of vaccines are generally the same when given alone or with other vaccines.” Learn more about the timing and administration of other vaccines from the CDC here .
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Will I be able to get the vaccine at no charge to me?
Yes. All Food and Drug Administration (FDA)-authorized COVID-19 vaccines will be covered at no additional cost for CarePlus members during the Public Health Emergency. Coverage applies no matter where you get the vaccine—including at both in-network and out-of-network providers. It also covers instances in which two initial vaccine doses are required, as well as booster shots that are recommended according to CDC guidelines.
- Original Medicare is responsible for coverage of COVID-19 vaccinations. Your vaccine provider will submit vaccine-related charges to Medicare and you will not be responsible for those costs.
Please remember to bring your Medicare card and your CarePlus member ID card when you get your vaccine in case the vaccine provider requests it.
In the unlikely event you require medical treatment due to adverse effects from the COVID-19 vaccine, CarePlus will cover that treatment in accordance with your policy and as with any other covered medical service or treatment.
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What if I was charged for my vaccine and need to be reimbursed?
Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. However, vaccination providers may charge an administration fee for giving someone the shots. If you’ve been vaccinated and you received a bill – either for the vaccine itself or for its administration - you can file for reimbursement directly from CarePlus.
Note that there are separate claim forms for the Pfizer, Moderna and Johnson & Johnson vaccines.
- Complete all information requested on the appropriate Health Benefits Claim Form below:
- Enclose the original itemized bill(s) you paid.
- Mail the completed form with the original itemized bill(s) and proof of payment to:
CarePlus Health Plans, Inc. Attention: Member Services Department
11430 NW 20th Street, Suite 300
Miami, FL 33172
Please note it can take up to 60 days to process the claim, and the reimbursement will be sent as a check to the home address we have on file for you.
DISCLAIMER:
This material is provided for informational use only and should not be construed as medical advice or used in place of consulting a licensed medical professional. If you are in a life-threatening or emergency medical situation, please dial 9-1-1 and seek medical attention immediately.
Sources
- “Possible Side Effects After Getting a COVID-19 Vaccine,” Centers for Disease Control and Prevention, last accessed July 20, 2021, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html (link opens in new window).
- “Frequently Asked Questions about COVID-19 Vaccination,” Centers for Disease Control and Prevention, last accessed July 20, 2021, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html (link opens in new window).
- “Frequently Asked Questions about COVID-19 Vaccination.”
