Link to Green Book Chapter on COVID Vaccine The following FAQs relate to the Pfizer/BioNTech and the Oxford AstraZeneca COVID-19 vaccine. The following FAQs will be frequently updated as new information becomes available. Any printed version of these FAQs will become outdated. Please note that some numbering on the document below may appear to skip a number. This is due to the FAQs being a work in progress. As answers become available, the document will be updated. 1. Pregnancy and Breastfeeding Question Answer The vaccines are not routinely recommended in pregnancy. Both the Pfizer/BioNTech or Oxford AstraZeneca vaccine can be considered for use in pregnancy 1.1 Can I have the when the potential benefits of vaccination Pfizer/BioNTech or Oxford outweigh the risks of the vaccine. Pregnant AstraZeneca vaccine if I am women should discuss this with their healthcare pregnant? provider. If you are eligible for and have been offered a COVID-19 vaccine, the decision whether to have the vaccination in pregnancy is your choice. If you are considering the COVID-19 vaccine, please read this information sheet from RCOG. If you find out you are pregnant after the first dose, routine advice is to complete the 1.2 What if I have started the pregnancy before finishing the recommended vaccine course and then I schedule. You should be offered vaccine as soon become pregnant? as possible after your pregnancy. You can discuss further with your healthcare provider. There is no need to avoid pregnancy after 1.3 Do I need to avoid receiving the vaccine. You should ideally pregnancy after receiving complete both doses before becoming the vaccine? If so, for how pregnant. long? This is the most updated advice from MHRA and the JCVI from 30 December. The available data for both vaccines does not indicate any safety concern or harm in 1.4 I am trying to become pregnancy. pregnant and received the Pfizer/BioNTech or Oxford AstraZeneca vaccination not If this was your first dose, you should complete knowing that I was pregnant. the pregnancy before finishing the recommended schedule. Please inform your midwife you have received the vaccine whilst pregnant. If you are offered the vaccine you should have 1.5 I am trying to become the vaccine before becoming pregnant. It is not routinely advised to come forward to be pregnant. Should I have the vaccinated if you are pregnant. vaccine? You may have either vaccine whilst breastfeeding. There is no known risk associated with giving non-live vaccines 1.6 Can I have the vaccine if I am whilst breastfeeding. However breastfeeding? Safety data have not yet been accrued. This is based on the most recent advice from 30 December 2020. 2. Current/Past COVID-19 infection and the vaccine Question Answer If you are seriously debilitated, still under 2.1 I have prolonged COVID investigation or if your condition has recently symptoms/Long COVID, should I deteriorated you should consider deferring your get the vaccine? vaccine. Otherwise yes, you may have it. No. If you have been identified as a close contact or have been told to self-isolate then you should 2.2 I am self-isolating, should I not be attending for vaccination and should get the vaccine? defer your appointment until after this period. Yes. There is no evidence of any safety concerns from vaccinating individuals with a past 2.3 I have had COVID-19 in the history of COVID-19 infection or with detectable past (greater than 4 weeks ago) antibodies. should I get the vaccine? There are clinical trials being undertaken to determine if past infection protects against further infection. Vaccination should be deferred until at least four weeks after the onset of your symptoms. If you 2.4 I have had a confirmed are asymptomatic, then this is four weeks from COVID diagnosis within the past your first PCR positive specimen. four weeks. You don't need another primary dose of the vaccine if you have been diagnosed with COVID- 2.5 I have been diagnosed with 19 following your first vaccine dose. You should wait at least 4 weeks from your symptom onset COVID-19 after my first dose of (or, if you're asymptomatic, 4 weeks since your vaccine. Do I need the first dose positive result) before receiving your second again? dose. The vaccines generally take 14 days to become fully effective. No, the vaccine can't cause 'false positive' COVID-19 PCR tests. It is not a live vaccine and 2.6 I have had a COVID-19 cannot cause you to develop COVID-19. If vaccine and now my COVID-19 your vaccine was within 14 days of your positive swab is positive but I am test, it is most likely that you were already asymptomatic. Has the vaccine incubating COVID-19 infection at the time of caused this? vaccination. The vaccine cannot stop you from developing COVID-19 if this is the case. If you have a minor illness without fever or systemic upset this is not a contraindication to vaccination. If you have symptoms consistent with COVID-19 (see NHS inform website) then you should isolate and arrange testing and not attend for 2.7 I am not feeling well. Should vaccination. I get my COVID vaccine? If you have a more severe illness then immunisation should be postponed until after recovery. This is to avoid wrongly attributing any symptoms to the vaccine. 3. Contraindications to vaccination Question Answer Any person with a history of anaphylaxis (serious allergy) to a previous dose of the 3.1 I have had anaphylaxis to vaccine, or to a component of the vaccine, vaccines, medicines or food. should not receive it. Should I receive the COVID- 19 vaccine? The Pfizer vaccine contains polyethylene glycol (PEG) which is from a group of known allergens commonly found in medicines, and also in household goods and cosmetics. Known allergy to PEG is extremely rare but would contraindicate receipt of the Pfizer vaccine. People with known PEG allergy or immediate onset anaphylaxis to multiple classes of drugs or an unexplained anaphylaxis should not have the Pfizer vaccine. The AZ vaccine may be an alternative. People with a history of anaphylaxis to food, an identified drug or vaccine or an insect sting can receive any Covid-19 vaccine (as long as they are not allergic to any component of the vaccine). This advice is based on close surveillance by MHRA of the initial rollout of the Pfizer vaccine. When you attend for your vaccine your vaccinator will ensure it is safe for you to receive the vaccine. People who cannot be vaccinated with either the 3.2 Who should not receive the Pfizer or AstraZeneca vaccine are those with an vaccine? anaphylactic reaction to a previous dose of the COVID-19 vaccine, or one of its ingredients. If you are pregnant or breastfeeding, discuss the risks and benefits of vaccination with your healthcare provider prior to vaccination. The Pfizer-BioNTech vaccine can be used 3.3 What is the age range in those aged 16 and above. Trials are underway of people who can get the in children under 16. The AstraZeneca vaccine COVID vaccine? Can children get can be used in those aged 18 and above. There is the COVID vaccine? no upper age limit. Unlike some other vaccines, eggs are not used in the preparation of either the Pfizer- 3.4 I am allergic to eggs, can I BioNTech or AstraZeneca vaccine. You can still still have the COVID vaccine? have either COVID-19 vaccine with a history of egg allergy. 3.5 I have asthma/ hayfever, can I still have either COVID- 19 vaccine? Yes. 3.6 I am on steroids can I still receive either COVID- Yes. 19 vaccine? 3.7 I have recently received chemotherapy/radiotherapy. Yes. Can I still receive either COVID- 19 vaccine? 3.8 I am on medication for anxiety/depression. Can I Yes. There are no known interactions receive either COVID- of either vaccine with any drugs. 19 vaccine? If you usually receive vaccines intramuscularly, then it is likely you will be able to have the COVID-19 vaccine by the same route. If you take medication to prevent or minimise bleeding, e.g. for haemophilia, your vaccination should be scheduled for a time shortly after you've had that medication. 3.9 I have a bleeding disorder. Can I get the vaccine? If you are stable on anticoagulation medicine e.g. apixaban, or warfarin with a stable INR, you can have the vaccination, followed by firm pressure at the site without rubbing for at least 2 minutes. There will be a risk of haematoma and bruising at the site. As this is a venom allergy and not an allergy to a 3.10 I have an allergy to bee COVID-19 vaccine or one of its ingredients, yes stings (or other venom allergy). you can receive the vaccine. Can I receive the Pfizer- BioNTech or This is advice from the British Society for Allergy AstraZeneca vaccine? and Clinical Immunology. 4. I have taken part in the Oxford AstraZeneca COVID-19 vaccine trial Question Answer If you are participating in a clinical trial of COVID- 4.1 I have been in a COVID-19 19 vaccines then provision will be made for you vaccine trial - which vaccine to be unblinded to assess whether further should I get? vaccination is required. The trial team will contact you before your vaccination date with instructions on how to access this information. 5.Infection Control Question Answer No.