COVID-19 – Vaccines

• COVID-19 vaccine registration 
• About the vaccine 
• Frequently Asked Questions
• Separating Myths from Facts
• How do I get more information?

What is a vaccine?

A vaccine is used to train your immune system to be able to deal with an infection and fight it off in the future.  

The COVID vaccines are a vital part of stopping the spread of COVID-19.

Is there a vaccine for COVID?

Yes, there are a number of vaccines against COVID-19 that have been registered and approved for use by regulatory bodies, both globally and in South Africa. Many more are in development/awaiting approval. Once they have demonstrated safety and efficacy in trials, the data are carefully assessed by regulatory bodies, like the South African Health Products Regulatory Authority before being approved for use.

The World Health Organization (WHO) collaborates with global partners to try to ensure equal access to COVID-19 vaccines for the billions of people who will need it. 

Which COVID vaccine is South Africa using?

Currently, the Johnson and Johnson vaccine, called the Janssen COVID-19 Vaccine™ (single dose), and the Pfizer vaccine, called Comirnaty™ (two doses, 42 days apart) are being used in South Africa. Both these vaccines protect against COVID caused by the 501Y.V2 variant that has been circulating in South Africa since November 2020. Both vaccines have been tested for safety and safety is continuously being monitored.

As more vaccines are approved, and when stock becomes available, other vaccines are expected to be added.

Are these vaccines effective against the delta COVID-19 variant?

There is evidence that the vaccines being used in South Africa are effective against the delta variant. The regulators and advisory committees are analysing all data that comes through and will update, as more data comes in.

What happened with the J&J vaccine?

Millions of doses of this vaccine were ordered for South Africa, with the first delivery expected in the second quarter of 2021. Unfortunately, a manufacturing issue was found at the factory in the USA that was producing the vaccine, meaning that millions of doses had to be destroyed, including some in South Africa. Plans are being finalised to procure further doses so as not to delay the vaccination progamme.

How was the vaccine made so quickly?

The COVID vaccine was made faster than any other vaccine in medical history. Experience with SARS and MERS outbreaks (both caused by coronaviruses), faster manufacturing, funding for multiple trials and regulators moving more quickly than before made the process much faster.
The genetic material of the virus that causes COVID was made available to all scientists around the world in January 2020 so that work on a new vaccine started very early.

What is contained in the vaccine?

All COVID vaccines contain instructions for the spike protein on the coronavirus. The Johnson and Johnson vaccine contains an adenovirus which has been modified so that it cannot cause disease or multiply in humans. The Pfizer/BioNTech vaccine contains a messenger RNA (mRNA) fragment. The vaccines naturally disintegrate within days after they have instructed your immune system to respond to the spike protein on the coronavirus. In addition, the vaccines contain the following non-active ingredients:

Johnson and Johnson vaccine:

• Sodium chloride
• Citric acid monohydrate buffer
• Polysorbate 80
• 2 hydroxypropyl-β-cyclodextrin (HBCD)
• Ethanol (absolute)
• Sodium hydroxide
• Water for injection

Pfizer/BioNTech vaccine:

• ALC-0315 = (4-hydroxybutyl) azanediyl) bis
  (hexane-6,1-diyl) bis(2-hexyldecanoate)
• ALC-0159 = 2-[(polyethylene glycol)-2000]-N,Nditetradecylacetamide
• 1,2-Distearoyl-sn-glycero-3-phosphocholine
• cholesterol
• potassium chloride
• potassium dihydrogen phosphate
• sodium chloride
• disodium hydrogen phosphate dihydrate
• sucrose
• water for injections

Neither vaccine contains animal products or eggs. They are suitable for vegans and are halaal. The rubber stoppers of the vaccine vials do not contain latex.

How will the vaccine be given?

You will get an injection in your upper arm. The Johnson and Johnson vaccine is a single dose, and the Pfizer/BioNTech vaccine is given as two doses, 42 days (6 weeks) apart.

When will I be protected?

Protection starts around two weeks after the first injection but is best one month after the single Johnson and Johnson vaccine.

With the Pfizer/BioNTech vaccine, there is some protection two weeks after the first dose, but the best protection is achieved two weeks after the second dose.

Take note of the vaccine you receive so that you know to return for a second dose if you have received the Pfizer/ BioNTech vaccine. You will receive an SMS telling you when to go.

Are COVID vaccines safe?

All COVID vaccines being used have been extensively tested to ensure safety. Close monitoring is being carefully rolled out alongside vaccines globally, and all serious side-effects are reviewed by independent scientists from multiple medicine safety agencies.

The National Department of Health and the South African Health Products Regulatory Authority (SAHPRA) are monitoring the safety of the vaccines as they are rolled out across the country.

What are the common side effects of the vaccines?

Common side effects are pain and redness in the upper arm where you are injected, headache, feeling tired, muscle and joint aches and fever/chills. This is normal and these side effects usually start around 6 hours after the vaccine. Side-effects occur more commonly in younger people and people who have had COVID before. You can use paracetamol or an anti-inflammatory if you need to.

How long do the side effects last?

The vaccine side effects should resolve within about 2 to 3 days of taking a COVID-19 vaccine. At most, the mild side effects can last up to a week.

Contact your doctor if the redness or tenderness where you got the injection gets worse after 24 hours or if your side effects are worrying you or do not seem to be going away after a few days.

What are the rare side effects of the vaccines?

These are extremely uncommon and usually affect around 1 to 4 people for every million vaccinations given.

Some people experience a severe allergy to the vaccine, sometimes as anaphylaxis. This usually occurs within the first 15 minutes of vaccination and can be managed using medications available at the vaccination sites. This is why you will be asked to stay at the vaccination site for 15 minutes after you are vaccinated. Precautions can be taken in people with a severe history of allergy, so please discuss this with your usual doctor and/or vaccination site staff before getting the vaccine.

In the United States, an extremely rare side effect of the Johnson and Johnson vaccine has been reported, called Vaccine Induced Thrombosis and Thrombotic Thrombocytopaenia. The side effect involved clots in unusual veins in the body (brain, abdomen) together with low levels of platelets, a component of the bloodstream that normally helps your blood clot and prevents bleeding.

The symptoms of this condition may include severe headache that won’t go away, blurred vision, abdominal pain, vomiting leg swelling, or small blood spots around the site of injection around 5 to 20 days post vaccination. The headache should not be confused with the usual headache that follows vaccination in the first 1-3 days.

If you develop any of these symptoms, seek healthcare urgently, and tell the doctor you have been recently vaccinated. Specialists in these rare side effects are on hand to help support your doctor to manage you in the best way possible. Serious side effects like these can be frightening even if extremely rare.

It is important to remember that the risk of COVID-19 far outweighs the risk of these side-effects and safety agencies around the world have recommended the Johnson and Johnson and Pfizer vaccines for use.

Do I still need to take the flu vaccine if I have had the COVID-19 vaccine?

Yes, the flu vaccine protects against infection from influenza viruses, while COVID-19 vaccines protect against the SARS-CoV-2 virus. It is important to take the flu vaccine to protect oneself from influenza, thereby reducing the burden on the health system.

How long should I wait between having the flu vaccine and the COVID vaccine?

The flu vaccine and COVID-19 vaccine should be given at least 14 days apart. There is no particular requirement regarding the order of receiving the influenza and COVID-19 vaccine. If both vaccines are available at the same time and an individual is eligible for both, it is recommended to prioritise the COVID-19 vaccine. 

Once I’m vaccinated, can I still get COVID?

Yes, individuals may still be at risk of contracting COVID-19, although the disease will likely be milder in comparison to those who are unvaccinated. More evidence is required to confirm whether COVID-19 vaccines provide protection against asymptomatic or mild disease.

Once I’m vaccinated, can I stop wearing a mask?

No, the evidence shows that COVID-19 vaccines protect from severe disease, hospitalisation and death but it is not yet known whether the vaccine stops transmission, and no vaccine is 100% effective.

Continue wearing your mask, practising social distancing, opening windows and doors and sanitising/washing your hands and frequently touched objects regularly.

If I feel sick after vaccination, should I consider having a COVID test?

Several common vaccine side effects are similar to COVID symptoms. If you experience a mild fever, aching muscles, headache or fatigue, this is likely due to your body’s reaction to the vaccine.

If you develop a cough, sore throat, a change in your sense of taste or smell, or you have a fever over 38°C that lasts several days, you might have COVID and should isolate yourself and have a test. The vaccine does not interfere with the usual COVID tests used for diagnosis such as the polymerase chain reaction (PCR) and rapid antigen tests.

Do I need the vaccine if I’ve already had COVID?

Yes, you should still be vaccinated if you’ve already had COVID or if you’ve had a positive antibody test. So far, we know that the natural immunity from having COVID may not last or provide as good protection as that following vaccination. The vaccination will boost any response your immune system put in place after a previous coronavirus infection.

You should wait until 30 days after recovering from COVID before getting the vaccine. If you were hospitalised with COVID, please consult your doctor about when it would be safe for you to get the vaccine.

Can I get the vaccine if I have symptoms of COVID or if I am in quarantine?

If you currently are in quarantine because of exposure to someone with COVID, you should wait until you have completed your quarantine period before getting vaccinated.

If you have had COVID you should wait until 30 days after recovering from COVID. If you have COVID symptoms on the day or your vaccination, you will be referred for a test and the vaccination will be rescheduled. Please do not go to a vaccination site if you are symptomatic as you risk spreading it to others.

Is it safe to get a vaccine if I have an underlying medical condition?

If you are an adult with an underlying medical condition or illness, you have a greater risk of severe illness from COVID. Because of this, you should consider getting vaccinated as soon as vaccines become available to people in your age group. If you are unsure, consult your doctor before going for your vaccination.

There are some special considerations for people living with certain conditions, but no underlying medical condition is a reason for not being considered for vaccination:

• Allergy: if you have suffered a severe allergy or anaphylaxis to a vaccination, medication or food in the past you need to talk to your usual doctor before receiving the vaccine. The risk of severe allergic reactions to any of the COVID vaccines is very low, can easily be managed, and far outweighs the risk of getting COVID in most cases.
• Longterm COVID-19: vaccination will add extra protection to the natural immunity that you may already have. Only if you are seriously debilitated, still under active investigation, or have become worse recently, should you consider delaying vaccination. This is to avoid confusing a reaction to the vaccine with any change in your condition.
• Bleeding disorders: as with any injection, there is a small risk of bleeding at the injection site. Speak to your healthcare worker about your condition so that s/he can take precautions such as applying prolonged pressure after the injection.
• Anticoagulant medications (like warfarin): a history of blood clotting is not a contraindication to vaccination. As with any injection, there is a small risk of bleeding at the injection site. As long as you are up to date with your scheduled international normalised ratio (INR) testing and your latest INR was below the upper threshold of your therapeutic range, you can receive the vaccination safely. The rare clotting condition described following the Johnson and Johnson vaccine is brought about through different pathways to usual clotting problems. People with usual clotting problems are at increased risk of developing clots during an infection with COVID-19 and are urged to take up vaccination. If you have any concerns speak to your usual healthcare provider or vaccination site staff.
• Immunosuppressive disorders (like HIV, cancer or being on immunosuppressant therapy): people with immunosuppressive disorders, including HIV, irrespective of CD4 count, can be vaccinated.

Can I have the vaccine if I am pregnant or breastfeeding?

Yes. Pregnant and breastfeeding women are receiving COVID-19 vaccinations throughout the world. Information regarding the safety of COVID-19 vaccines is incomplete but becoming increasingly available and shows no concerns. You can have the vaccine at any stage of your pregnancy. COVID-19 can be serious during pregnancy especially in older women, or those with pre-existing hypertension, diabetes or obesity.

I tested my antibodies after my vaccination and the test came back showing I had none. Does this mean my vaccine did not work?

There is no reason to be alarmed. Commercially available antibody tests are not designed to test vaccine-specific antibody responses and test for the n-protein (nucleocapsid), and not the spike protein. For this reason, we advise against antibody testing after vaccination. A negative antibody test does not mean you are not protected. You do not need to re-vaccinated.

In South Africa, do I still need to quarantine if I am exposed to a case of COVID-19 after I have been vaccinated?

Yes. A vaccinated person should still quarantine (self-isolate) for 10 days following exposure to a case of COVID-19. Although the evidence suggests that people who are vaccinated are less likely to get infection after exposure, at this time point there are too few people who are vaccinated for a change in quarantine guidelines.

In South Africa, too few people have received the COVID-19 vaccine, yet, and circulating virus levels are currently too high in order to relax public health measures.

I tested my antibodies after my vaccination and the test came back showing I had none. Does this mean my vaccine did not work?
There is no reason to be alarmed. Commercially available antibody tests are not designed to test vaccine-specific antibody responses and test for the n-protein (nucleocapsid), and not the spike protein. For this reason, we advise against antibody testing after vaccination. A negative antibody test does not mean you are not protected. You do not need to re-vaccinated.

Will the vaccine change my DNA?
No, the vaccine will not work on your DNA. Evidence shows that some vaccines are made using RNA technology, but the technology used affects how the vaccine is made, not what it does to your body.

Is there a microchip in the vaccine?
No, there is no proof that microchips or trackers are in any of the vaccines. Getting vaccinated does not mean that you will be tracked or that any of your personal information will be stolen.

I’m not sure if I should get vaccinated. Do I really need to?
Uncertainty and doubts about the vaccine will impact all of us. If too few of us choose to get vaccinated, more people get sick. If more of us get vaccinated, fewer people get sick. 

Will I get COVID from the vaccine?

No, the vaccine does not cause COVID-19.

COVID-19 Public Hotline: 0800 029 999
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e-mail: [email protected]