Vaccine FAQs
IF I’VE HAD COVID, HOW LONG DO I NEED TO WAIT BEFORE I HAVE A VACCINE?
- If you had a mild infection, you should wait 30 days after recovery (i.e. 30 days after the 10 days isolation time).
- If you had a severe infection (requiring Oxygen or hospitalization), you should wait 90 days after recovery to have a vaccine.
- If you had one dose of Pfizer, followed by a Covid infection a few weeks later, the infection serves as a booster dose and there is no rush to have the second vaccine. You could however have it after 90 days.
- ** If you are a contact of someone infected with Covid and should be in quarantine, you shouldn’t go for a vaccine until quarantine is up. (A negative test at this time could be a false negative, and you could still be incubating the virus.) This is dangerous both to other people at the vaccine station and potentially to the person having the vaccine.
IS MY SINGLE DOSE J&J VACCINE EFFECTIVE?
- This week, J&J came out with data showing that the vaccine is effective against Covid infections from the Delta variant (55 to 60% effective) and offers 85% protection against severe disease (100% after day 49). This is better than the data for the beta (original South African) variant, which is important as delta is the predominant strain we are now seeing.
- Remember that 60% effectiveness still means that 4 out of 10 vaccinated people can still become infected with Covid-19 (but should have mild infections).
- The J&J data showed that the vaccine continues to work over time, with strong responses for up to 8 months (hopefully longer, but this is the length of time that data is available for so far).
- J&J demonstrated both a strong neutralising antibody response as well as a persistent robust cellular immune response.
- Sisonke also released a statement on 1st July. They reported that, of the breakthrough infections (positive COVID-19 test more than 28 days after vaccine) : 94% were mild, 4% were moderate and only 2% were severe.
- Breakthrough infections after the Sisonke trial should be reported on https://is.gd/sisonke_bti\
- Sisonke also reinforced that immunity from the vaccine increases over time and retains effectiveness against variants of concern, such as beta and delta.
WHY ARE SO MANY PEOPLE WHO HAVE HAD A PFIZER VACCINE GETTING INFECTED?
- Pfizer is a two dose vaccination regime and we have unfortunately seen many people infected in the first couple of weeks after their first vaccination. This may be because they have contracted COVID in the queues, or because they have let their guards down thinking they are protected, or simply because the delta strain is so prevalent and so contagious.
- The Pfizer vaccine shows only 33% protection from getting infected after one dose, but 80% protection against hospitalisation after one dose, and 94% protection against hospitalisation from the Delta strain after two doses.
- Remember that full immunity from the Pfizer vaccine is only achieved two weeks after the second dose.
HOW LONG SHOULD I WAIT BEFORE GETTING MY SECOND DOSE OF PFIZER?
- New research from the UK showed that a longer than 3 week dose interval produced better and longer lasting immunity.
- Taking this into account, as well as the fact that more people could receive at least one dose in a short time, the South African guideline was changed to extend the dosage interval from 21 to 42 days.
- Some vaccination sites are now using a 35 day interval.
- As long as your return date is after 21 days and up to 42 days, anywhere in between is a safe and effective interval.
IF I HAD A JOHNSON AND JOHNSON VACCINE, CAN I HAVE A PFIZER BOOSTER TO BE MORE PROTECTED?
- Prof Grey and Prof Bekker, the principal investigators from the Sisonke (J&J healthcare worker) trial stated last week that they believed that recommending booster top-ups with another vaccine is premature as the vast majority of breakthrough infections from Sisonke are mild.
- Several doctors have suggested that when available, booster doses of another J&J or with an mRNA vaccine will help to establish better immunity. Trials with mixing different vaccines are ongoing.
- However, when available, this booster dose needs to be prioritised for doctors and nurses working in Covid wards and ICUs who are at highest risk.
- One dose of J&J is good protection against severe illness. *It is much more important at this time for more South Africans to get one vaccination, than for those who have already had the opportunity to have protection from one vaccine to get a booster.
WHAT ABOUT THE NEW SINOVAC VACCINE?
- SAHPRA has now registered the third COVID vaccine for emergency use in South Africa, subject to certain conditions, including the final results of ongoing clinical studies. This vaccine was also recently registered by WHO, and there has been a lot of political pressure to register it in this country.
- Sinovac is an inactivated whole virion, two dose vaccine, administered 4 weeks apart and will be registered for people between 18 and 59 years old.
- We still await robust studies proving efficacy of Sinovac, particularly against the delta variant.
I’M YOUNG & HEALTHY, COVID-19 IS NOT A RISK TO MY AGE GROUP
Stats SA’s Covid data published in December 2020 showed significant infection rates in the age group 35 to 49 years, with almost 2 out of every hundred people in this age bracket in South Africa contracting the disease, and approximately 5% of those infected in this age group needing hospitalisation from Covid. In the 35 to 49 age group, this data showed that 1 in 200 people who contracted COVID died from it. Of the total reported COVID-19 deaths in this same report, 14.2% were from individuals in the age group 35 to 49. I suspect that with the Delta variant, these figures are much higher, but age related data is not yet readily available.
SHOULDN’T I WAIT UNTIL PEOPLE MORE AT RISK THAN ME HAVE BEEN VACCINATED?
While a few months ago, I completely agreed that the first vaccines should be given to frontline healthcare workers and the elderly, who were most at risk, there is now sufficient vaccine stock so that younger age groups can be included. At this stage it is important for as many people as possible to be vaccinated, to get us closer to herd immunity. Older people were given first priority, but it is now important that all resources are used to get the maximum number of people vaccinated in the shortest possible time. There have been empty vaccine centres with the capacity to vaccinate many more people, and not enough people arriving. So you are no longer asked not to jump the queue as you are not taking away a dose from someone more vulnerable than you. Your time is here – grab the opportunity!
HOW DOES HAVING A VACCINE BENEFIT ME?
- It prevents you from getting severe Covid illness, particularly needing hospitalisation and dying.
- It greatly reduces your chances of getting infected and suffering long-term complications (“Long Covid”). A significant proportion of young people who have mild illness suffer for months afterwards from debilitating fatigue, breathing difficulties, loss of smell or taste and “brain fog” (changes in cognitive function, memory and focus).
- It gives you freedom to travel: many countries already require a vaccine passport, with proof of vaccination allowing entry. It is likely that people who remain unvaccinated will be limited in respect of which countries they can visit. This is not dissimilar to countries that require a “yellow fever” vaccine passport to allow entry, or evidence of TB vaccination for people wishing to emigrate from SA (where TB is endemic) to other countries.
- It will give you access to restaurants, gyms and clubs that may not allow entry to unvaccinated people once open (while there is no such policy currently in South Africa, we are seeing restrictions like this in several countries).
- Once a greater number of South Africans are vaccinated and we are no longer in a surge, vaccinated people will not have the strict quarantine requirements of unvaccinated people, should they be a contact of someone who is infected. (Current CDC guidelines state that fully vaccinated people can “refrain from quarantine following a known exposure if asymptomatic”. While this is not yet applicable in our country due to the very small numbers of vaccinated people, it will become a reality once less people are vulnerable to becoming infected).
- Vaccinated people will ultimately have less requirements to wear masks, particularly when engaging with others who have been vaccinated.
HOW DOES ME HAVING A VACCINE BENEFIT OTHERS?
- Being vaccinated makes you less susceptible to getting infected, which in turn makes you less able to transmit the virus to others.
- We await clear data as to whether an uninfected vaccinated person can still transmit infections, but there are promising reports that vaccines also reduce transmission rates.
- Younger people being vaccinated is crucial to us reaching “herd immunity”. This is the point at which enough people in the community (somewhere between 60% and 80%) have either been infected or been vaccinated. When this point is reached, there are so few people left vulnerable to the virus that it cannot continue to be successfully transmitted.
- While many people remain vulnerable and the virus continues to spread unchecked, there is a high risk of it mutating, causing new variants. Like the Delta variant that has driven our third wave, these new variants may be more transmissible and more dangerous. Vaccines still show good efficacy against current strains, but future mutations may bring variants that are vaccine resistant. (**Translation – Have a vaccine as soon as possible, to help drive herd immunity before there are new mutations).
- Getting vaccinated in this age group can help to save the economy – as fewer people are infected, businesses and restaurants will be able to remain open.
- Getting vaccinated protects the elderly in your family – even if your parents who are in their 70s or 80s are vaccinated, if you are not, there is still a risk that you can pass it on to them.
- Getting vaccinated also helps to protect your children who are not yet eligible for vaccines. (While it is rare for children to get severe illness, young children can get a multi inflammatory syndrome, and a significant number of teenagers suffer from complications of Long Covid). Studies show that children in a family are not usually the ones bringing infections into the home – infections usually originate from the adults.
I DON’T WANT TO HAVE A VACCINE THAT MAY AFFECT MY FERTILITY
Although there is a lot of social media misinformation about vaccines causing infertility, the respected BMJ (British Medical Journal) recently published guidance from the Association of Reproductive and Clinical Scientists and the British Fertility Society. This states that “There is absolutely no evidence, and no theoretical reason, that any of the vaccines can affect the fertility of women or men. People of reproductive age should get a covid-19 vaccine, including people who are trying to have a baby or thinking about having a baby in the future.”
I’M PREGNANT OR BREASTFEEDING - I WOULD RATHER DELAY MY VACCINE.
- Although pregnant women are at no greater risk of being infected by SARS-CoV-2, complications from COVID-19 infection are common and severe in pregnancy and in newborn infants.
- The benefits and possible risks of COVID-19 vaccination should be discussed by each pregnant woman with her Gynaecologist and GP so that an individualised decision can be made.
- Although there is not yet sufficient data for the vaccines in pregnant and breastfeeding women, there is a strong immune response conferred to mothers following vaccination as well as the benefits of immune transfer to the baby.
- It should be stressed that there are no known risks associated with other non-live vaccines given routinely to pregnant women.
- As such, Covid vaccination with either Pfizer or J&J is currently recommended for patients past the 14th week of pregnancy, as well as for breastfeeding ladies. However, please discuss this with your healthcare provider.
THERE ARE WORRYING SIDE EFFECTS LIKE MYOCARDITIS AND CLOTTING AND GUILLAIN BARRE SYNDROME IN YOUNG PEOPLE WHO HAVE VACCINES.
- The Pfizer vaccine does carry a very small risk of myocarditis and pericarditis, within a few days of vaccination, particularly following the second dose. Symptoms to watch out for are chest pain, shortness of breath or a pounding / fluttering heart after vaccination. Please consider this in perspective – there have been around 1000 reports of myocarditis in adolescents and young adults (particularly males) from hundreds of millions of doses administered. Also note that COVID-19 infection itself carries a much higher risk of myocarditis than the vaccine. In almost all cases, myocarditis has been treatable and resolved.
- Thrombosis with thrombocytopenia syndrome (TTS) after Johnson & Johnson vaccination is also extremely rare. From more than 12.8 million doses of the J&J Vaccine, there have been only 38 confirmed reports of people who developed TTS. Most reports are in women under the age of 50 years. Again this needs to be looked at in perspective – smoking, the oral contraceptive pill and COVID-19 infection itself all carry much higher risks of clotting than the vaccine.
- There are recent reports of Guillain Barré Syndrome (GBS) in people who have received the J&J Vaccine. GBS is a rare disorder where the body’s immune system damages nerve cells, causing muscle weakness and sometimes paralysis. Most people fully recover from GBS, but some have permanent nerve damage. After 12.8 million J&J COVID-19 Vaccine doses administered, there have been around 100 preliminary reports of GBS identified. These are still being investigated to establish if there is a causal link.
HAVING A VACCINE MIGHT GIVE ME COVID-19 OR CAUSE ME TO TEST POSITIVE FOR COVID-19.
I am often asked this question. Someone is booked for their first or second dose of Pfizer, but they are worried about having it because they need a Covid test (for travelling or a hospital procedure) in a few days time. Being vaccinated CANNOT cause a positive Covid test result. The PCR test measures actual coronavirus particles in the nose or throat. The vaccine is derived from a small non replicating portion of viral protein that cannot be picked up either on a PCR test or on an antigen test. A false positive result caused by a vaccine is not possible.
External Resources
Coronavirus and Vaccines
Download a complete guide.
Business for SA Update
B4SA: Weekly Update 12 June 2021
JJ Vaccine Statement
Department of Health statement on the status of J&J rollout.
Business for SA Update
B4SA: Weekly Update 4 June 2021
Pfizer Vaccine Dosage
Department of Health statement on the Prizer Vaccine.
SA Vaccine Plan
Timeline of planned rollout, updated on 21 May 2021.
Registering on EVDS
Register for your vaccine dose on the Electronic Vaccine Data System.
SA Vaccine Updates
Vaccine News, Updates & Information Portal
SA COVID Toolkits
Guides, printables, videos and more available for download.
Vaccination Sites
View a list of the active vaccination sites.
Daily Case Updates
Keep up to date with the daily cases in South Africa.
SA COVID Portal
SA COVID-19 Online Resource and News Portal
The documents and information on this site were based on information available in March and April 2020. COVID-19 is an evolving pandemic with future regulations and information that may affect the contents on this website.