Your Questions On The COVID-19 Vaccine
Are you living with Scleroderma and/ or Raynaud’s and are concerned about or have questions in relation to the Covid-19 vaccine. Please check out our FAQs to get the advice you may need.
The recent rollout of the Pfizer, Astra Zeneca and Moderna COVID-19 vaccines is a huge step forward in the fight against coronavirus. The current government advice is that vaccination using approved vaccines is the best way to protect the most vulnerable and save lives.
This FAQ was put together using a vaccine toolkit put together by DHSC and other publicly available government guidance and is designed to try and answer any questions that you may have relating to these vaccines.
- How many vaccines are approved/in use?
- How do these vaccines work - are they safe?
- Who should be vaccinated?
- Vaccination for children and young people
- Third doses
- Booster vaccines
- Book a COVID-19 vaccination
- Fraud awareness
- Will I be able to choose which vaccine I receive?
- Who should no receive the vaccine?
- How will I receive the vaccine?
- What side effects could occur?
- Receiving your second dose
- Oxford-AstraZeneca for the under 30s
- Can you still infect others once you have been vaccinated?
- How much protection does the vaccine provide?
- I am taking immunosuppressants for my condition, are the vaccines safe and effective?
- Are the vaccines tested on people with autoimmune conditions like scleroderma?
- Should I receive either vaccine as a patient with scleroderma?
- Should I receive either vaccine if I suffer with Raynaud's?
1.How many vaccines are approved/ in use?
At the time of this update, 4 vaccines are authorised for emergency use in the UK. These are the Pfizer BioNTech (Pfizer for short) vaccine, the Astra-Zeneca ‘Oxford’ (Astra-Zeneca for short) vaccine the Moderna vaccine, and the Janssen vaccine. There are many other vaccines in advanced clinical trials and this guidance will be updated as more achieve authorisation.
The Pfizer vaccine, Astra Zeneca and Moderna vaccines are currently in use across the UK. The Janssen single dose vaccine is in the process of being rolled out across all four nations of the UK, with the first deliveries expected to arrive later this year.
2. How do these vaccines work – are they safe?
Vaccines are safe and are the most effective way of protecting us and others from infectious disease. None of the vaccines approved for use in the UK contain ‘active’ COVID-19 virus so there is no risk of catching COVID-19 from vaccination.
They are safe for use in people who may be immunocompromised or immunosuppressed since they cannot cause ‘COVID-19’. The approved vaccines drive an immune response against a part of the COVID-19 virus, the ‘spike protein’, this is used by the virus to enter certain cells in the body and cause illness. The protective immune response generated through vaccination protects us from infection and subsequent illness.
The Pfizer and Moderna vaccines are mRNA vaccines which use bits of the COVID-19 virus’ genetic code to generate an immune response.
The Astra-Zeneca and Janssen vaccines are made using a harmless, unrelated virus as a vector to deliver the bit of the COVID-19 virus’ genetic code needed to generate the immune response. This virus has been modified so it cannot grow and cause illness in humans.
The vaccine is one of the surest ways of preventing severe illness and complications from contracting COVID-19. The benefits that vaccination will offer you is far greater than limited risk of side effects.
You can learn more about how the COVID-19 vaccines were developed so quickly in this helpful short video from the National Institute for Health Research (NIHR).
3. Who should be vaccinated?
Vaccination has been deployed in line with guidance from The Joint Committee on Vaccination and Immunisation (JCVI) with the prioritisation list outlined below.
The full prioritisation list can be found here and is as follows (in order of priority):
- Group 1 - Residents in a care home for older adults and their carers
- Group 2 - All those 80 years of age and over and frontline health and social care workers
- Group 3 - All those 75 years of age and over
- Group 4 - All those 70 years of age and over and clinically extremely vulnerable individuals
- Group 5 - All those 65 years of age and over.
- Group 6 - All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality and unpaid carers (family and friends).
- Group 7 -All those 60 years of age and over
- Group 8 - All those 55 years of age and over
- Group 9 - All those 50 years of age and over
People aged over 16 are now able to receive a COVID-19 vaccination and can book through the NHS booking service.
Phase 2 of the COVID-19 vaccination programme
JCVI final statement of phase 2 of the COVID-19 vaccination programme advises that the offer of vaccination during phase 2 will continue to prioritise people by age and not their occupation to avoid slowing down the rollout. The significant milestone marks the beginning of phase two of the vaccination programme and people aged over 18 in England can now book appointments through the NHS booking service. In line with the JCVI advice, eligible people will be invited to receive their vaccines in order of age over the coming weeks and months. The new guidance should be accompanied by continued efforts to extend coverage among those prioritised in phase 1 but who remain unvaccinated, and to complete delivery of second doses to all those given first doses in phase 1.
4. Vaccinations for children and young people
The COVID-19 vaccination program has now been extended to include children and young people under the age of 18 who are now able to receive the Pfizer-BioNTech vaccine.. Currently this is limited to children at increased risk of serious COVID-19 disease, which includes:
- Children aged 12-15 with severe neurodisabilities
- Children aged 12-15 with Down’s syndrome
- Children aged 12-15 who are immunosuppressed
- Children aged 12-15 with multiple or severe learning disabilities.
- Children aged 12-15 with haematological malignancy
- Children aged 12-15 with sickle cell disease
- Children aged 12-15 with type 1 diabetes
- Children aged 12-15 with congenital heart disease
- Children aged 12-15 with poorly controlled asthma and less common conditions where respiratory infections can result in severe illness
It is also recommended by the JCVI that children and young people aged 12-17 who live with an immunosuppressed person should be offered the vaccine. Children aged 16-17 with underlying health conditions which put them at higher risk should have already been offered vaccination.
Children outside of these groups are not currently being offered vaccination as there is a very low risk associated with covid for those young people.
5. Third vaccine doses
The JCVI are advising that people with severely weakened immune systems should have a third vaccine dose as part of their primary COVID-19 vaccination schedule. This third dose should be offered to people over 12 who are severely immunosuppressed. This vaccine will be either Pfizer or Moderna where possible, irrespective of previous vaccines given.
Based on the JCVI recommendations, nearly all rheumatology patients (aside from those solely on hydroxychloroquine or sulfasalazine), should receive a third dose. This is for all patients on immunosuppression (e.g. Mycophenolate, Methotrexate, Azathioprine, Cyclophosphamide, Rituximab, Tocilizumab) and/or with interstitial lung disease (ILD) or pulmonary arterial hypertension (PAH).
The guidance is specific with respect to certain drugs and the timings of when the patient has had their previous injections. As such, clinicians need to know the following information in order to make an informed decision:
- What medication the patient is on
- When the patient had their vaccine and what medication they were on at that time
The JCVI is still considering the potential benefits of booster vaccines for those who have completed primary vaccination but now may have waning vaccine effectiveness. It should be noted that a third vaccine dose is NOT the same as a booster injection, and that these are two separate programs.
6. Booster Vaccines
The booster program is the rollout of a booster vaccine dose to those most vulnerable to COVID-19, in order to maintain their protection throughout the winter months.
This dose will be given to the same priority groups (1-9) that were vaccinated during phase 1 of the vaccine rollout. This includes adults aged 16 and over who are immunosuppressed, those over the age of 50, and people aged 16-49 with an underlying health condition.
The booster vaccine will be offered no earlier than 6 months following the second dose. Preference is for the booster vaccine to be either Pfizer or Moderna.
7. Book a coronavirus (COVID-19) vaccination
In England, if you fall into the eligible groups you can access the online national booking system to make an appointment or call 119 free of change between 7am and 11pm.
In Scotland, if you are in the top 5 priority groups, you should already have been invited for the vaccine. If you haven't, contact your GP or visit the NHS Inform website. You can book your appointment online, if you are eligible for the vaccine.
In Wales, some NHS local health boards are asking people in the top priority groups to get in touch if they have not been invited for the vaccine yet. Find your local NHS health board.
In Northern Ireland, if you’ve got a shielding letter or if you’re 60 or older, you can book your appointment online.
Partners and unpaid carers who provide care and support
If you’re the main carer for someone, you’re in group 6 on the list alongside people aged 16 to 64 who have underlying health conditions.
The 4 Nations governments have slightly different ways to identify unpaid carers who are eligible for the vaccine.
In England, you can you can access the online national booking system to make an appointment or call 119 free of charge between 7am and 11pm if:
- You have been receiving Carer's Allowance or have an underlying entitlement
- You are receiving support following a carer’s assessment
- Your GP record already records that you are eligible as a carer.
If none of these apply, but you’re the main carer for someone, contact your GP. They might be able to update your record.
When you go for your vaccination, you might be asked to prove your identity, but you won’t be asked to prove you’re an unpaid carer, or that you receive Carer’s Allowance.
Every effort will be made to ensure that you can be vaccinated at the same time as someone you care for if you are accompanying them to their appointment. If you wish to receive your vaccination at the same time, you must make this known to the GP surgery in advance to confirm an appointment. Note that the vaccination sites are not able to support walk-in appointments.
In Scotland, from Monday 26th April unpaid carers (aged 16-64) will be invited to get their coronavirus vaccine by phone or letter. It is possible to register for the vaccine online with the NHS or by calling 0800 030 8013. You can use this service if you’re aged 16 to 64 and provide regular face-to-face care for a family member or friend.
In Wales, if you’re the main unpaid carer, you can self-identify to receive the COVID-19 vaccine. You can do this by filling in an online form for your local NHS health board – or the health board where your GP is based, if that’s different. Once you have completed the form, you’ll be invited for the vaccine.
The Welsh Government have set three factors to make an unpaid carer eligible to receive the COVID-19 vaccine at priority group / cohort 6 of the COVID-19 vaccine rollout. The full eligibility guidance is explained on the Welsh government website.
If you’re already registered as an unpaid carer with your GP, the practice will get in touch with you to invite you for the vaccination.
In Northern Ireland, a self-referral scheme has been in place for carers – but now, you may need to contact your local trust to check if you can register. The nidirect website has information and contact details for carers to access the vaccine.
For all other groups
If you do not fall into these categories, you should continue to await invitation for vaccination. Do not attend a site where vaccinations are being offered without an appointment.
Find out more about why you have to wait for your COVID-19 vaccine on the Gov UK website. Read more about guidance in your area and how the vaccine will be rolled out in England, Scotland, Northern Ireland and Wales.
8. Fraud awareness
According to the prioritisation guidance, you will be contacted by the NHS, your employer, a GP surgery, or pharmacy local to you, to receive your vaccine.
The vaccine is free of charge and at no point will you be asked to pay or provide your bank account or card details.
Advice from Action Fraud:
- The NHS will never ask you for your bank account or card details.
- The NHS will never ask you for your PIN or banking password.
- The NHS will never arrive unannounced at your home to administer the vaccine.
- The NHS will never ask you to prove your identity by sending copies of personal documents such as your passport, driving license, bills or pay slips.
9. Will I be able to choose which vaccine I receive?
Current consensus is that individuals will not be able to pick which vaccine they would prefer to receive and that individuals will be given vaccines according to both availability and guidance from JCVI. The JCVI have advertised a preference for adults aged 30-39 without underlying health conditions to receive an alternative to the Oxford / AstraZeneca vaccine - where available, and only if this does not cause substantial delays in being vaccinated.
All licensed vaccines have been shown to be safe and effective in protecting against COVID-19. There is currently no available data which supports the use of one vaccine over another in people with certain conditions.
As you might have seen in the news, trials are underway to look at the effects of mixing and matching vaccines, but this is not yet a part of routine clinical practice.
10. Who should not receive the vaccines?
As is routine for all vaccinations you should inform the doctor, nurse, or pharmacist whether you have any pre-existing health conditions so you can receive the best advice and treatment at your vaccination appointment.
There are some groups for which vaccination is currently not recommended. These include:
- Those who are pregnant/ breast feeding
The Joint Committee on Vaccination and Immunisation (JCVI) has recently amended their guidance to advise that pregnant women should be offered the COVID-19 vaccine at the same time as the rest of the population, based on their age and clinical risk group.
Individuals who are pregnant, or who they they might be should speak to their GP about their vaccine appointment, so that it can be arranged at a site which offers the Pfizer/BioTech or the Moderna vaccine, as they are preferable for pregnant women.
The latest COVID-19 vaccine guidance for pregnant and breastfeeding women can be found here. We recommend discussing further with your healthcare professional.
2. Those with a history of severe allergy
People who suffer from severe allergies (anaphylaxis) in general or who may be allergic to one or more of the Pfizer vaccines ingredients (see section 6) have been advised not receive the Pfizer vaccination. These people generally have a history of anaphylaxis and always carry epi-pens for this reason.
Prior to receiving either vaccine you are advised to inform the medical professional if you have any known allergies or past serious reactions to vaccination.
Anaphylactic reactions occur quickly after vaccination, the chances of this happening are extremely low if you do not have history of these. All those receiving the vaccine are monitored immediately after receiving vaccination, should a reaction like this occur you will receive immediate care. If you do suffer any type of allergic reaction following the first dose you will be told not receive a second dose.
3. Ongoing severe infection
A mild cold or infection is not a reason to delay vaccination but if you have a severe infection with a temperature of 38˚C or higher you should not receive the vaccination and should reschedule your appointment. Likewise, if you have any symptoms of COVID-19 you should not present for vaccination.
4. Elective surgery
It is recommended that you should not receive vaccination within 7 days of either undergoing or having undergone elective surgery. This is to ensure any symptoms or side effects resulting from surgery are not attributed to vaccination or vice versa.
5. A history of major thrombosis with thrombocytopaenia
Those having blood clots with thrombocytopaenia (low platelets) including those who have experienced this in response to the Astra Zeneca vaccine or as a result of Heparin therapy. Having had blood clots in the absence of these factors is not enough to contraindicate vaccination.
Those with a history of clots in the blood vessels of the brain, acquired or genetic thrombophilia or anti-phospholipid syndrome are advised to notify their doctor.
11. How will I receive the vaccine?
Both vaccines are given as an injection into your upper arm requiring two doses. You will receive some short-term protection after the first dose, but two doses are required to achieve longer term protection.
There is a 3 to 12 week interval between doses of the Pfizer Vaccine.
There is a 4 to 12 week interval between doses of the Astra Zeneca vaccine.
Unless there is a medical reason not to, you must complete your course and receive your second dose of vaccine to get the best possible protection from COVID-19.
Click here to read What to expect after your COVID-19 vaccination.
12. What side effects could occur?
Vaccines like other medicines can cause side-effects. The side-effects reported from both vaccines are in line with those experienced from other vaccines and include tenderness in the injected arm, tiredness, headache, general aches, and pains/ flu-like symptoms for a day or two.
A history of allergic reactions can alter the chances of developing side effects soon after immunisation. If you do have any known allergies, please advise the person giving the vaccine prior to injection.
The MHRA is committed to monitoring the safety of all drugs and vaccines introduced to combat coronavirus. The MHRA Yellow Card reporting scheme allows members of the public to report any suspected side effects of any COVID-19 vaccine in current use or any other COVID related treatments.
If you would like to read about the experiences of Scleroderma and Raynaud’s patients being administered the COVID-19 vaccines, please take a look at our online community forum.
13. Receiving your second dose
Following an announcement on the 17th May, in response to new variants in the UK, the government have announced that the most vulnerable will be offered their second dose of COVID-19 vaccine earlier. Appointments for a second dose will be brought forwards from 12 to 8 weeks for the remaining people in the top nine priority groups who are yet to receive their second dose.
The NHS will let those who should bring their second appointment know when they are able to do so, therefore there is no need to contact the NHS.
14. Oxford-AstraZeneca for the under 30s
On 7 April, the government vaccine advisers (the JCVI) announced new advice for people aged 18-30 who don’t have an underlying condition. This group is less at risk from COVID-19 complications.
If you are in this age category and are going for your first jab, you should be offered an alternative to the Oxford-AstraZeneca vaccine, where possible. The advice for younger people is changing after an investigation into cases of very rare blood clots occurring in roughly 4 in every 1 million people who receive the jab. The MHRA have listed these clots as a ‘suspected very rare side effect’ and have stated that more research is required to prove or disprove this theory and gain a greater understanding of how these clots develop.
On the 7th May, this advice was expanded to include adults aged between 30 and 39.
If you have had your first dose of the Oxford-AstraZeneca vaccine, you should have your second Oxford-AstraZeneca jab according to the JCVI even if you’re under 30 and have no underlying conditions.
If you experience any of these symptoms within 28 days of receiving your Astra Zeneca vaccination you should seek urgent medical advice:
- New onset of severe headache, which is getting worse and does not respond to simple painkillers
- An unusual headache which seems worse when lying down or bending over, or may be accompanied by blurred vision, nausea and vomiting, difficulty with speech, weakness, drowsiness or seizures
- New unexplained pinprick bruising or bleeding
- Shortness of breath, chest pain, leg swelling or persistent abdominal pain
The recommendation that under-40s in the UK should be offered an alternative to the Oxford-AstraZeneca jab. There is a suggestion from a small cohort of under 30s that there is a slightly higher risk of blood clots with low platelet counts. This risk is more finely balanced with the benefits of receiving the vaccine in this age category. For those aged 40 or more, the benefits of the vaccine significantly outweigh any potential risks. This does not mean that the Joint Committee on Vaccination and Immunisation advise against using AstraZeneca in under 40s, only that, where possible, an alternative vaccine would be preferable. Any vaccine is always better than no vaccine. This is reassuring to see that safety monitoring continues under the close scrutiny of regulators and public health authorities as the vaccine is rolled out around the world.
15. Can you still infect others once you have been vaccinated?
We have robust clinical data showing that the vaccines are effective at preventing illness from COVID-19, less is known about whether those who have been vaccinated can carry the virus and transmit it to others. For this reason you are advised to follow the most up-to-date rules on social distancing and respect public health messages such as hands-face-space.
15. How much protection does the vaccine provide?
No vaccine is ever 100% effective. All vaccines approved for use in the UK have met the effectiveness criteria set by the MHRA to show that they can protect against serious illness from COVID-19.
The latest advice for those who are clinically extremely vulnerable is being updated frequently in light of the easing of social distancing restrictions.
Can I catch COVID-19 from the vaccines?
- You cannot catch COVID-19 from the vaccines. But it is possible to have caught COVID-19 and not realise you have the symptoms until after your vaccination appointment.
- If you have any of the symptoms of Covid, stay at home and arrange to have a test.
- If you need more information on symptoms visit: www.nhs.uk/conditions/coronavirus-COVID-19/symptoms/
17. I am taking immunosuppressants for my condition, are the vaccines safe and effective?
Immunosuppressant drugs dampen the immune response and are prescribed to help manage autoimmune conditions like scleroderma. The approved vaccines are safe to use in those undergoing treatment with immunosuppressant medications. But those taking these types of treatments may generate a lower level of protection in response to COVID 19 vaccination compared with the general population. It is still very important that you get vaccinated as it will offer you a certain amount of protection against catching COVID-19. It is important that you receive two doses of the vaccine to maximise the protection that vaccination offers you.
If you are due to start a scheduled immunosuppressive therapy (e.g., biologics such as rituximab) you may be advised by your Doctor to delay treatment so that you may receive one or both vaccine doses before commencing your treatment cycle. This should allow your immune system to make a better response to vaccine. Alternatively, your Doctor might suggest an alternative treatment which may improve the protection offered by the vaccine.
If you are currently taking oral corticosteroids or ‘steroids’ such as prednisolone to manage your condition it is safe to receive the vaccine. The current advice is that vaccination should not be delayed for those who are taking, have received or are due to receive steroids in any form.
If you are on a waiting list to receive a high dose steroid injection such as methylprednisolone or triamcinolone then you and your Doctor may discuss whether you should delay having your injection by two weeks in order to get the best possible response from the vaccine.
You should not stop your immunosuppressants or any other medications that you may be taking to manage your condition on our own. Any decision to defer immunosuppressive therapy or to delay possible benefit from vaccination until after therapy should be made in partnership with your medical professional considering fully the risks from both COVID19 and your underlying condition(s).
18. Are the vaccines tested on people with autoimmune conditions like scleroderma?
Given the rarity of scleroderma it is unlikely that any of the vaccine trial volunteers are people living with this condition.
Some of the vaccine developers have not excluded people with autoimmune conditions from participating in their trials unless they have a weakened immune system because of the ‘immunosuppressive’ medicines they are receiving as treatments. This is likely to be because these individuals would have lower antibody responses used as a readout to measure the effectiveness of a vaccine.
Whilst there is research underway looking at the effectiveness of vaccination in those who are immunosuppressed through medication or immunocompromised through their medical conditions. There is currently no data suggesting that the vaccine performance would be different in people with autoimmunity and the Government advise that those with autoimmunity and who are taking immunosuppressants to present for vaccination.
19. Should I receive either vaccine as a patient with scleroderma?
Vaccination is currently the surest way to reduce your chances of becoming seriously unwell if you contract the coronavirus. COVID-19 can be an extremely serious illness in certain groups of the population not limited to the elderly, and/ or those who are clinically extremely vulnerable with serious underlying health conditions.
If you have been invited to receive the vaccine and have not done so due to reservations due to your health conditions, we advise that you discuss these with your medical practitioner.
19. Should I receive either vaccine if I suffer with Raynaud’s?
COVID-19 can be serious in some individuals, for most individual’s vaccination is currently, the surest way to protect against serious illness from COVID-19.
If you are 50 or older and/ or have other health issues as well as Raynaud’s, you should have been invited to receive your vaccination in line with the priority groups mentioned above. If you fall into these categories and have not received a vaccine invite, please follow the booking instructions outlined in the sections above.
If you are younger, and are in relatively good health i.e., you do not have any health issues in relation to your Raynaud’s which would make you clinically vulnerable you will follow the same guidance as per the general population and will be invited for vaccination in line with your age group. Furthermore, by the time you are invited for immunisation there may be additional vaccines authorised by the MHRA for emergency use in the UK. We recommend you follow our posts on our website as we will be updating our guidance as more information becomes available.
I have remaining questions
If you continue to have unanswered questions, please contact either our helpline on 0800 311 2756 or email us firstname.lastname@example.org where we will endeavour to respond to your question.