COVID-19 Vaccine FAQs for Healthcare Professionals

For healthcare professionals new to vaccination, the COVID-19 Vaccination Training Programs and Reference Materials for Healthcare Professionalspdf icon provides a comprehensive list of suggested training and reference materials.

For more immunization resources, see Resources for Health Care Providers and Immunization Education and Training.

No, FDA does not mandate vaccination. However, whether a state, local government, or employer, for example, may require or mandate COVID-19 vaccination is a matter of state or other applicable law.

Yes. CDC requires vaccination providers participating in the COVID-19 Vaccination Program use a specific type of temperature monitoring device (TMD) called a “digital data logger” (DDL). A DDL provides the most accurate storage unit temperature information, including details on how long a unit has been operating outside the recommended temperature range (referred to as a “temperature excursion”). DDLs using a buffered temperature probe provide the most accurate way to measure actual vaccine temperatures. Always use DDLs with a current and valid Certificate of Calibration Testing.

Note that not all DDLs can measure ultra-cold temperatures. For accurate ultra-cold temperature monitoring, it is essential to use an air-probe or a probe designed specifically for ultra-cold temperatures with the DDL.

For the Pfizer-BioNTech COVID-19 vaccine, there are additional considerations for using a TMD with the thermal shipping container. Refer to the Pfizer-BioNTech COVID-19 Vaccine Storage and Handling Summarypdf icon and Pfizer-BioNTech COVID-19 Vaccine webpage for more information.

If the vaccine experienced problems during shipment (e.g., damage or temperature excursion), contact:

• Directly distributed vaccine (i.e., Pfizer): contact Pfizer 800-666-7248 (option 8) or CVGovernment@Pfizer.com
• Centrally distributed vaccine (e.g., Moderna): contact McKesson Specialty Customer Services Phone (833) 343-2703 Monday – Friday, 8 a.m. – 8 p.m. ET

If the vaccine experienced problems after it has been received and placed into storage, contact the vaccine manufacturer for guidance on improper storage and handling.

For temperature excursions (out-of-range temperatures), take immediate action:

• Label the vaccine “Do Not Use” and store at the recommended temperature range until you receive manufacturer guidance.
• Document the date and length of time of the excursion, storage unit temperature, room temperature, and inventory affected.
• Record any other relevant information.
• Contact the manufacturer for guidance on whether to use affected vaccines and whether patients need to be recalled for revaccination.
• Document the event and action taken for record-keeping requirements.

Intramuscular injection is the recommended route for all COVID-19 vaccines.

The recommended site to administer an intramuscular injection to an adult is the deltoid muscle. Refer to the following job aids for identifying administration sites:

• Vaccine Administration: Intramuscular (IM) Injection Adults 19 years of age and olderpdf icon
• Vaccine Administration: Intramuscular (IM) Injection Children 7 through 18 years of agepdf icon
• HCP | Vaccine Administration | Resource Library | CDC (includes demonstration videos for intramuscular injections)

Needle gauge and length recommendations vary based on age, gender, and weight. Use CDC’s Vaccine Administration: Needle Gauge and Lengthpdf icon job aid to help you determine the appropriate gauge and length. A discussion of vaccine administration best practices can be found in the Vaccine Administration chapter of the Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book).

No. You should not aspirate before giving any vaccine, including COVID-19 vaccines. Aspiration can increase pain because of the combined effects of a longer needle-dwelling time in the tissues and shearing action (wiggling) of the needle. A discussion of vaccine administration best practices can be found in the Vaccine Administration chapter of the Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book).

The Pfizer-BioNTech and Moderna COVID-19 vaccines are not interchangeable with each other or with other COVID-19 vaccine products. It is recommended that persons initiating the series with one COVID-19 vaccine complete the series with the same product. However, if two doses of different mRNA COVID-19 vaccine products are inadvertently administered, no additional doses of either product are recommended at this time.

Some steps you can take at the appointment for the first dose:

• Complete COVID-19 vaccination record cards with accurate vaccine information, give them to each vaccine recipient, and encourage recipients to keep the card (this is required).
• Record each recipient’s vaccination in your state’s immunization information system (IIS) within 72 hours.
• Record administration information in the patient’s medical record.
• Make an appointment for the second dose BEFORE the recipient leaves.

Some steps you can take to prepare for the second-dose appointment:

• Provide a reminder (when a dose is due) or recall (when a dose is missed). Reminders might be generated via electronic medical record, IIS, or v-safe. Learn more about v-safe.
• Ask all vaccine recipients to bring their COVID-19 vaccination record cards to their second-dose appointment during the first-dose appointment and when sending appointment reminders.
• Check your state’s IIS for COVID-19 vaccination records. All COVID-19 vaccination providers are required to report data within 72 hours of administering a COVID-19 vaccine.

CDC does not recommend predrawing vaccine. If vaccine must be predrawn:

• Set up a separate administration station for each vaccine type to prevent medication errors.
• Draw up vaccines only after arriving at the clinic site or mass vaccination event.
• Each person administering vaccines should draw up no more than one multidose vial (up to 6 doses for Pfizer-BioNTech COVID-19 vaccine or 10 doses for Moderna COVID-19 vaccine) at one time.
• Monitor patient flow to avoid drawing up unnecessary doses.
• Predraw reconstituted vaccine into a syringe only when ready for administration.
• If a predrawn vaccine is not used within 30 minutes of being reconstituted, follow manufacturer guidance for storage conditions and time limits.

Yes. Persons with a history of Guillain-Barré Syndrome (GBS) may receive COVID-19 vaccine unless they have a contraindication to vaccination. With few exceptions, ACIP’s general best practice guidelines for immunization do not include a history of GBS as a contraindication or precaution to vaccination. Any occurrence of GBS following mRNA COVID-19 vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS)external icon.

Yes. Persons with a history of Bell’s palsy may receive COVID-19 vaccine unless they have a contraindication to vaccination. Cases of Bell’s palsy were reported following vaccination in participants in both the Pfizer-BioNTech and Moderna COVID-19 vaccines clinical trials. However, the FDA does not consider these to be above the frequency expected in the general population and has not concluded that these cases were causally related to vaccination. Post-authorization safety surveillance will be important to further assess any possible causal association. In the absence of such evidence, persons with a history of Bell’s palsy may receive an mRNA COVID-19 vaccine unless they have a contraindication to vaccination. Any occurrence of Bell’s palsy following mRNA COVID-19 vaccination should be reported to VAERS.

Yes. A pregnant person who is part of a group recommended to receive COVID-19 vaccine (e.g., healthcare personnel) may choose to be vaccinated. There are currently few data on the safety of COVID-19 vaccines in pregnant or lactating people. When making a decision, you and your patient should consider the

• level of COVID-19 community transmission
• patient’s personal risk of contracting COVID-19
• risks of COVID-19 to the patient and potential risks to the fetus
• efficacy of the vaccine
• side effects of the vaccine
• lack of data about the vaccine during pregnancy

Yes. A lactating person who is part of a group recommended to receive a COVID-19 vaccine (e.g., healthcare personnel may choose to be vaccinated. There are no data on the safety of COVID-19 vaccines in lactating people or the effects of mRNA COVID-19 vaccines on breastfed infant or milk production/excretion. mRNA vaccines are not thought to be a risk to the breastfeeding infant.

Yes. Vaccination should be offered to eligible persons regardless of whether they have a history of prior symptomatic or asymptomatic SARS-CoV-2 infection. Data from clinical trials indicate that mRNA COVID-19 vaccines can be safely administered in persons with evidence of prior SARS-CoV-2 infection.

Vaccination of persons with known current SARS-CoV-2 infection should be deferred until the person has recovered from acute illness (if the person had symptoms) and until criteria have been met for them to discontinue isolation. This recommendation applies to any vaccine, including the first and second doses of COVID-19 vaccine. Additionally, if a person was infected within the last 90 days, they may defer vaccination until after a 90-day period or if they were treated with monoclonal antibodies or convalescent plasma within the last 90 days vaccination should be deferred.

Yes, but vaccination should be deferred for at least 90 days after they received treatment. Based on the estimated half-life of monoclonal antibodies or convalescent plasma as part of COVID-19 treatment, as well as evidence suggesting that reinfection is uncommon in the 90 days after initial infection, delaying vaccination for 90 days is a precautionary measure until additional information becomes available, to avoid interference of the antibody treatment with vaccine-induced immune responses.

Immunocompromised individuals may receive COVID-19 vaccination if they have no contraindications to vaccination. However, they should be counseled about the

• unknown vaccine safety profile and effectiveness in immunocompromised populations
• potential for reduced immune responses
• need to continue to follow all current guidance to protect themselves against COVID-19

For persons who were vaccinated for COVID-19 while they were undergoing chemotherapy or treatment with other immunosuppressive drugs and who have since regained their immune competence, re-vaccination is not recommended at this time. Recommendations on re-vaccination or additional doses of mRNA COVID-19 vaccines may be updated as additional information is available.

Immunocompromised individuals may receive COVID-19 vaccination if they have no contraindications to vaccination. However, they should be counseled about the

• unknown vaccine safety profile and effectiveness in immunocompromised populations
• the potential for reduced immune responses
• need to continue to follow all current guidance to protect themselves against COVID-19

Either of the currently authorized mRNA COVID-19 vaccines can be used when indicated; the Advisory Committee on Immunization Practices (ACIP) does not state a product preference.

For persons who were vaccinated for COVID-19 while they were undergoing chemotherapy or treatment with other immunosuppressive drugs and who have since regained their immune competence, re-vaccination is not recommended at this time. Recommendations on re-vaccination or additional doses of mRNA COVID-19 vaccines may be updated as additional information is available.

You should schedule doses by the recommended interval for each vaccine:

• second dose of Pfizer-BioNTech COVID-19 vaccine administered 21 days after the first dose
• second dose of Moderna COVID-19 vaccine administered 28 days after the first dose

Second doses administered up to 4 days before the recommended date (4-day grace period) are considered valid. This means that when retrospectively reviewing records:

• second dose of Pfizer-BioNTech COVID-19 vaccine administered 17 or more days after the first dose is considered valid.
• second dose of Moderna COVID-19 vaccine administered 24 of more days after the first dose is considered valid.

However, if a dose is inadvertently administered before the 4-day grace period, it does not need to be repeated. This means that when retrospectively reviewing records:

• second dose of Pfizer-BioNTech COVID-19 vaccine administered 16 or less days after the first dose does not need to be repeated
• second dose of Moderna COVID-19 vaccine administered 23 or less days after the first dose does not need to be repeated.

The 4-day grace period should be used when retrospectively evaluating records and not to schedule appointments. Appointments for a second dose should be scheduled to meet the recommended interval.

No. mRNA COVID-19 vaccines are not interchangeable with each other. The safety and efficacy of a mixed-product series have not been evaluated.

If a patient did not receive the brand of vaccine your practice stocks for their first dose, you may consider referring the patient to another provider. If you are expecting the same product soon, there is no maximum interval between the first and second dose for either vaccine. However, the second dose should be administered as close to the recommended interval as possible.

No. Given the lack of data on the safety and efficacy of mRNA COVID-19 vaccines administered simultaneously with other vaccines, the vaccine series should be administered alone with a minimum interval of 14 days before or after administration with any other vaccines. If mRNA COVID-19 vaccines are inadvertently administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine.

There should be a minimum interval of 14 days before or after administration with any other vaccines. However, if an mRNA COVID-19 vaccine is inadvertently administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine. Additionally, if the only opportunity for vaccination occurs during this 14-day interval and you do not expect the patient to return, you may vaccinate them.

Vaccination providers enrolled in the COVID-19 Vaccination Program are required to:

• Document vaccine administration in their medical record systems within 24 hours of administration.
• Report administration data to the relevant system (i.e., IIS) for the jurisdiction as soon as practicable and no later than 72 hours after administration. See data reporting requirements.
• Report inventory daily using VaccineFinderexternal icon. In some jurisdictions, providers may report vaccine inventory to the jurisdiction’s IIS for the jurisdiction to upload into VaccineFinder. If you have questions about the process for your jurisdiction, please contact your jurisdiction’s immunization program.
• Report the following to VAERSexternal icon:
  • vaccine administration errors
  • serious adverse events
  • multisystem inflammatory syndrome
  • cases of COVID-19 that result in hospitalization or death after the recipient has received COVID-19 vaccine.

There are additional requirements for COVID-19 vaccination providers besides documentation (e.g., providing the EUA Fact Sheet for Recipients and Caregivers). Please refer to your COVID-19 vaccination provider agreement for all provider requirements.

No. VISs are only available for certain licensed vaccines. Under an EUA, there is not a VIS for an authorized vaccine. Instead, providers are legally required to provide the FDA-authorized EUA Fact Sheet for Recipients and Caregivers to individuals receiving vaccine or to their guardians. The Fact Sheet for Recipients and Caregivers includes:

• Basic information on COVID-19, symptoms, and what to discuss with a healthcare provider before vaccination
• Who should and should not receive the vaccine
• Recipients have the choice to receive the vaccine
• Vaccine series information
• Potential and known risks and benefits of the vaccine, including common side effects
• Information on reporting side effects to VAERS
• An explanation of what an EUA is and why it is issued
• Any approved available alternatives for preventing COVID-19
• Additional resources

No. Although you are required to provide the vaccine-specific Fact Sheet for Recipients and Caregivers to vaccine recipients or their caregivers, you are not required to document that you did so. help facilitate such documentation in electronic medical records/immunization information systems for vaccination providers who choose to do so, CDC is leveraging the existing vaccine information sheet (VIS) Code Set infrastructure, barcoding, and URLs to provide the information needed for various systems. This is analogous to the electronic system and workflow documentation of the VIS. The barcode at the bottom of the last page of the EUA Fact Sheet for Recipients and Caregivers may be scanned to capture that the fact sheet was provided to the vaccine recipient or caregiver in electronic medical records/immunization information systems.

Adverse events that occur in a recipient following COVID-19 vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS)external icon. Vaccination providers are required by the FDA to report:

• vaccination administration errors
•  serious adverse events
• cases of multisystem inflammatory syndrome
• cases of COVID-19 that result in hospitalization or death following COVID-19 vaccination under an EUA.

Reporting is encouraged for any other clinically significant adverse event even if it is uncertain whether the vaccine caused the event. Also, vaccine recipients can report adverse events that occur after vaccination. Information on how to submit a report to VAERS is available at https://vaers.hhs.govexternal icon or by calling 1-800-822-7967.

No. COVID-19 vaccines are covered countermeasures under the Countermeasures Injury Compensation Program (CICP)external icon—not the National Vaccine Injury Compensation Program.

The Public Readiness and Emergency Preparedness Act (PREP Act)external icon authorizes the CICP to provide benefits to certain individuals or estates of individuals who sustain a covered serious physical injury as the direct result of the administration or use of the covered countermeasures. The CICP may also provide benefits to certain survivors of individuals who die as a direct result of the administration or use of covered countermeasures identified in a PREP Act declaration. The PREP Act declaration for medical countermeasures against COVID-19 states that the covered countermeasures include:

• any antiviral, any drug, any biologic, any diagnostic, any other device, any respiratory protective device, or any vaccine manufactured, used, designed, developed, modified, licensed, or procured:
  • to diagnose, mitigate, prevent, treat, or cure COVID-19, or the transmission of SARS-CoV-2 or a virus mutating therefrom; or
  • to limit the harm that COVID-19, or the transmission of SARS-CoV-2 or a virus mutating therefrom, might otherwise cause;
• a product manufactured, used, designed, developed, modified, licensed, or procured to diagnose, mitigate, prevent, treat, or cure a serious or life-threatening disease or condition caused by a product described in paragraph (a) above;
• a product or technology intended to enhance the use or effect of a product described in paragraph (a) or (b) above; or
• any device used in the administration of any such product, and all components and constituent materials of any such product.

The CICP is administered by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services. Information about the CICP and filing a claim is available by calling 1-855-266-2427 or visiting http://www.hrsa.gov/cicp/external icon.

At this time, we do not know if COVID-19 vaccination will have any effect on preventing transmission. Some people can be infected with the virus that causes COVID-19 but remain asymptomatic.  It is important to know whether COVID-19 vaccines can help reduce the number of people that have asymptomatic infection as these people can unknowingly spread the virus to others.

CDC will further assess the effectiveness of COVID-19 vaccines after they are approved or authorized for emergency use by FDA and recommended for public use. A special type of cohort study will try to answer the question about whether vaccinated persons can develop asymptomatic infections and spread the virus to others. People who agree to participate will be tested for COVID-19 every week, whether they have symptoms or not. Experts will then compare the proportion of people with infection who were vaccinated to the proportion of people with infection who were not vaccinated.

Learn more about how CDC and other federal partners are ensuring that vaccines work.

The potential for asymptomatic transmission of the virus that causes COVID-19 underscores the importance of applying infection prevention practices, including physical distancing, respiratory and hand hygiene, surface decontamination, and source control, to encounters with all patients while in a healthcare facility. Vaccination providers should refer to the guidance developed to prevent the spread of COVID-19 in healthcare settings, including outpatient and ambulatory care settings.

General practices for the safe delivery of vaccination services is available in the Interim Guidance for Routine and Influenza Immunization Services During the COVID-19 Pandemic.