Apr 13, 2021

Frequently Asked Questions About the COVID-19 Vaccine

Like most health care providers, I couldn’t wait to start vaccinating my patients against COVID-19. I was also very curious to see how many would accept the vaccine and what their reaction would be.

We received our first shipments of vials in early January and began vaccinating staff and very high-risk patients. We then offered the vaccine to anyone interested in receiving it, working closely with custody staff and administration to coordinate vaccine clinics. Dedicated staff were trained in vaccine administration, which was scheduled for eight to nine hours, five days a week.

I was pleased to find that, overall, there was a lot of interest in being vaccinated, much more than for any other mass vaccination I have initiated in a correctional setting. In facilities where I have worked, for instance, we generally saw a 20% to 25% acceptance rate for yearly flu shots. As of late January, we had nearly doubled those numbers for the COVID vaccine.

My staff and I have given the vaccine to more than 1,800 people. I have been amazed at how informed some of them are … while others are extremely misinformed.

As you administer vaccines in your facilities, be prepared for a lot of questions. I’ve listed my Top 10 below, along with ideas for how to respond. Knowing the answers to your patient’s questions and answering them confidently will foster trust in both the vaccine and in your medical department.

Did you get the shot?

Not surprisingly, this was the most frequently asked question. Out of the dozens of groups that I have given the vaccine to, someone in every group asked me this. Be sure your answer is yes! I told my patients that not only did I get the vaccine, I received the same vaccine I was giving to them. Hearing me proudly answer yes to this question reassured them. They seemed to relax knowing I was fine after receiving the vaccine, did not experience any major side effects – just some mild soreness – and was now encouraging others to do the same.

When do I get my second shot?

Some of the more informed inmates knew that the available vaccines require two shots and they were very interested in knowing when they would be scheduled to receive their next doses. Know which vaccine you are giving, the appropriate time between doses, and how scheduling second doses will work in your facility. Will the second shots be scheduled in the same manner as the first? Is there a required time frame for getting the second dose? There is a lot of misinformation in the media about this, so make sure you know what the CDC recommends for the vaccine you are administering. What I have done is keep a running spreadsheet of everyone who received the first dose and when, and then used the spreadsheet to schedule the second doses in the appropriate time frame.

What if I am released before my second shot?

The issue is particularly important to people in short-term settings, such as pretrial detention. Discuss the plan for continuation of care with your administration and executive leadership. The answer will vary greatly from state to state and facility to facility. I have several inmates who hope to be released into the community before their second dose. When scheduling your patients, pay attention to this information and inform your classification department and discharge planners. Discuss with your medical director and leadership whether pending releases should be considered when prioritizing your vaccines.

What are the side effects?

Know all of the side effects of the particular vaccine you are giving and speak to the most common: pain at the injection site and feeling run down and achy for 24 to 48 hours. Having had direct experience receiving the vaccine will be helpful here. Let your patients know that while some people experience more severe side effects, that is unusual – and possible with any vaccine.

Will getting the shot make me test positive for COVID-19?

In my facilities, we test regularly for COVID so this was a big concern for my population, and it may be for yours. Assuming you are doing PCR testing to determine if an individual currently has the disease, then the answer is no.

Now that I’ve gotten my shot, can I stop wearing my mask?

The answer is no, but that seemed to surprise many of my patients. I had to do some serious education about the importance of receiving both parts of the vaccine, the fact that they will not have immunity until two weeks after receiving the second dose, that no vaccine is 100% effective, and that there is still a lot to learn and understand before people can confidently (and permanently) remove their masks.

Is this shot going to make me sick?

This is another common concern, as it always is with the flu vaccine. Remind your patients that they are not receiving a live vaccine, and even if they feel a bit under the weather for up to 48 hours post-vaccine, that is a side effect and does not mean that the vaccine gave them COVID or made them sick.

Can I still get COVID even though I got the shot?

While the answer is yes, I don’t think giving that one-word answer is advisable; the next question inevitably will be, “So why bother getting the shot?” When I received this question (several times), I told my patients, “It is technically possible, but being vaccinated is by far the most effective precaution you can take – more effective, even, than the flu shot is against the flu. Not only does the vaccine protect you against getting COVID-19, it protects you from getting seriously ill, being hospitalized, or dying if you do. This is a pandemic. Your chance of being exposed to the virus at some time is almost 100%. The important question is how protected you will be at that time.”

I have (diabetes, hypertension, asthma, HIV, fill in the blank). Can I still get the vaccine?

I tell my patients with preexisting conditions, “Not only can you get the vaccine, you need it more than others!” I know of several facilities in my state that are prioritizing patients with risk factors to receive the vaccine. While there are no contraindications related to specific diagnoses, the CDC recommends delaying the vaccine in some instances, for example, if the patient received plasma treatment within the past 90 days or received another vaccine within the past 14 days. Before administering the vaccine, be aware of any other instances in which it is contraindcated or should be delayed. Be sure to include questions about contraindications in your consent paperwork so you can discuss those issues with your patients.

How do you feel about inmates getting the shot before the general public?

Surprisingly, I got this question several times. I feel that inmates are very deserving of being among the first populations to receive the vaccine due to their increased risk, so I answered truthfully: “I am darned happy to be able to give you this vaccine. I wish there was enough out there to vaccinate everyone right now!”

As I reflect on the last question, I can’t help but wonder where it comes from. Are the patients concerned that I resent them receiving the vaccine? Or is this idea coming from the media or from people they know? Everyone seems to agree that medical professionals, first responders, and nursing home residents should be among the first to be offered the vaccine; those groups are at high risk, so naturally they should have priority. I have never heard anyone from any of those groups question whether they are worthy of receiving the vaccine or wonder what others think about them being prioritized.

Yet despite all the risk factors incarcerated populations face and the good reasons for them to be vaccinated before they return to their communities, the idea of vaccinating them is somehow controversial. For now, I take solace in the fact that my patients are able to receive a lifesaving vaccine.

I sincerely hope we will continue to see the numbers of patients being vaccinated grow as we move through the vaccination phases, supply increases, and the fact that it is a good idea spreads. As I am giving the vaccine, I encourage inmates to share the news. “Tell a friend, tell a cellmate, talk about it in the yard and during meals. Let your peers know that the vaccine is good for everyone.”

Michael Teasdale, RN, CCHP, is regional nurse manager with Rutgers University Correctional Health Care in New Jersey.