How many doses of a COVID-19 vaccine will be needed? Will a second booster dose be needed?

The protection someone gains from having an infection (called natural immunity) varies depending on the disease, and it varies from person to person. Since this virus is new, we don’t know how long natural immunity might last. Some early evidence—based on some people— seems to suggest that natural immunity may not last very long. Regarding vaccination, we won’t know how long immunity lasts until we have a vaccine and more data on how well it works. Both natural immunity and vaccine-induced immunity are important aspects of COVID-19 that experts are trying to learn more about, and the CDC will keep the public informed as new evidence becomes available.

Prince George’s County recently launched its “Proud to be Protected” campaign to encourage all Prince Georgians to get the COVID-19 vaccine when it becomes widely available. We recognize the hesitancy and concerns that our residents have regarding this vaccine, so our goal is to ensure every Prince Georgian has the information needed to fully understand how the vaccine will protect them from COVID-19.

The U.S. vaccine safety system ensures that all vaccines are as safe as possible. Safety is a top priority while federal partners work to make a COVID-19 vaccine(s) available. Vaccines undergo a series of rigorous clinical trials using thousands of study participants to generate data and other information for the Food and Drug Administration (FDA) to determine their safety and effectiveness to approve or authorize for emergency use. Following approval or authorization, many vaccine safety monitoring systems watch for adverse events or possible side effects. Visit the CDC’s website for more information about ensuring the safety of COVID-19 vaccines in the U.S.—including information about specific vaccine monitoring systems.

Generally, it takes a week or two for immunity to develop following vaccination, but the specific timeline for any coronavirus vaccine will depend to some extent on which type of vaccine is licensed. For example, a live, weakened vaccine requires time to reproduce in the body, whereas an inactivated vaccine is given at a dose that will generate immunity. On the other hand, because the live, weakened vaccine reproduces to generate immunity, it might provide a more robust immune response than an inactivated vaccine.

MDH will focus this plan on three major phases of vaccine availability and distribution.

Phase 1 will begin when there is limited vaccine availability and will focus on target priority groups to receive vaccination. These groups will include those at highest risk of exposure to or developing complications from COVID-19, including:

• Healthcare workers, residents and staff of long-term care facilities, first responders
• People at significantly higher risk of severe COVID-19 illness

Phase 2 will include people in critical infrastructure roles, including essential non-healthcare and transportation workers, and people at moderately higher risk of severe COVID-19 illness.

Phase 3 will be a wide-scale distribution of the vaccine associated with broad availability to the general population of the state.

The move to advanced phases will be based on the availability of COVID vaccine, achievement of targeted metrics for vaccination of higher priority groups or notification by CDC and state authorities that the general public phase can begin.

Yes. While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to us to help stop this pandemic, like covering your mouth and nose with a mask, washing hands often and staying at least 6 feet away from others. Together, COVID-19 vaccination and following the CDC’s recommendations for how to protect yourself and others will offer the best protection from getting and spreading COVID-19. Experts need to understand more about the protection that COVID-19 vaccines provide before deciding to change recommendations on steps everyone should take to slow the spread of the virus that causes COVID-19. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision.

We do not know how long antibodies last after infection or whether they will protect against reinfection. So, while vaccine trials are being completed, it will be important for scientists to continue learning about COVID-19, particularly whether people who got sick with COVID-19 can be re-infected. The current vaccine trials will include immunizing people who have never been infected with COVID-19 as well as those who have been previously infected. We will soon know whether vaccination of those who have been previously infected affords more complete or longer lasting protection than those who were previously infected but haven’t been vaccinated.

COVID-19 infections can be a minor hindrance or lead to severe disease or even death. There are many reasons to get vaccinated.

• Based on what we know about vaccines for other diseases, experts believe that getting a COVID-19 vaccine may help keep you from getting seriously ill even if you do get COVID-19.
• Getting vaccinated yourself may also protect people around you, particularly people at increased risk for severe illness from COVID-19.
• Getting COVID-19 may offer some natural protection, known as immunity. But experts don’t know how long this protection lasts, and the risk of severe illness and death from COVID-19 far outweighs any benefits of natural immunity. COVID-19 vaccination will help protect you by creating an antibody response without having to experience sickness.
• Wearing masks and social distancing help reduce your chance of being exposed to the virus or spreading it to others, but these measures are not enough. Vaccines will work with your immune system so it will be ready to fight the virus if you are exposed.

You should cover your mouth and nose with a mask when around others, avoid close contact with people who are sick, stay 6 feet away from others, avoid crowds and wash your hands often. Get more information about these and other steps you can take to protect yourself and others from COVID-19. Marylanders are encouraged to visit covidlink.maryland.gov to learn more.

A COVID-vaccine is one way to prevent serious illness due to COVID-19. Vaccination causes your body to create antibodies without getting sick with the COVID-19 disease. The Advisory Committee on Immunization Practices (ACIP) and other experts will provide recommendations on priority groups and when groups should be vaccinated. Guidance on determining and providing the vaccine to priority groups will be based on the principles included in the Center for Disease Control’s (CDC) Interim Updated Planning Guidance on Allocating and Targeting Pandemic Influenza Vaccine During an Influenza Pandemic.

Viruses constantly change through mutation, and new variants of a virus are expected to occur over time. Multiple variants of the virus that causes COVID-19 have been documented in the United States and globally during this pandemic. Information about the characteristics of these variants is rapidly emerging. At this time, there is no evidence that these variants can evade the recently developed vaccines or cause more severe illness or increased risk of death.

For more information, see the CDC Emerging SARS-CoV-2 Variants.

In certain types of emergencies, the FDA can issue an EUA to provide more timely access to critical medical products that may help during the emergency when there are no adequate, approved, and available alternative options. The EUA process is different from full FDA approval, clearance or licensing because the EUA standard requires significantly less data than otherwise would be required for approval, clearance or licensing by the FDA. This enables the FDA to authorize the emergency use of medical products that meet the criteria for issuance within weeks rather than months to years. It must be determined that the vaccines are safe and effective in diminishing the severity of COVID-19 symptoms to gain an FDA emergency use authorization or full licensing.

Maryland is working with partners at the federal, state, local and community level to work through the logistics of delivering, storing and administering the COVID-19 vaccine once it is
available. Maryland is also making sure that people have the information they need to be confident in deciding to get vaccinated. Key priorities include:

• Developing and regularly sharing clear and accurate information with people to make sure they understand the risks and benefits of getting vaccinated and can make informed decisions.
• Helping healthcare providers answer their patients’ questions about the vaccine.
• Engaging communities and individuals in an equitable and inclusive way to ensure that people have opportunities to ask questions and get clear, accurate information about the COVID-19 vaccine.

Easy access to COVID-19 vaccines is equally critical. Maryland is working with public health professionals, healthcare providers, and other partners to make sure people can easily get a COVID-19 vaccine and that cost is not a barrier.

Operation Warp Speed is a partnership among components of the U.S. Department of Health and Human Services and the U.S. Department of Defense to help develop, make and distribute millions of vaccine doses for COVID-19 as quickly as possible while ensuring that the vaccines are safe and effective. Operation Warp Speed has been working since the pandemic started to develop COVID-19 vaccine candidates.

Experts do not know what percentage of people would need to get vaccinated to achieve herd immunity to COVID-19. Herd immunity is a term used to describe when enough people have protection—either from previous infection or vaccination—that it is unlikely a virus or bacteria can spread and cause disease. As a result, everyone within the community is protected even if some
people don’t have any protection themselves. The percentage of people who need to have protection in order to achieve herd immunity varies by disease.

Prince George’s County entered Phase 1B on January 18, 2021 and enters Phase 1C for pre-registration on January 25, 2021. Individuals in prior phases are still eligible to sign up to receive vaccines as we move to additional phases. Vaccines are currently being administered at the Health Department’s Cheverly Health Center and the Wayne K. Curry Sports and Learning Complex. At this time, these locations require an appointment in order to receive a vaccine. Additional vaccination sites are scheduled to be operational soon.

Individuals who live or work in the County that wish to receive a vaccine should complete the County Health Department’s pre-registration form. Those who are eligible for a vaccine will receive a link with instructions on how to schedule an appointment, as appointments become available. Current appointments are limited due to a limited supply of vaccines in the County and State. At this time, it may take several weeks or longer to receive an appointment, especially for individuals in Phase 1C.

Vaccination distribution is an ongoing process. It will take several weeks to months to get through each phase. We will continue to keep you updated on our progress in each phase and when we are ready to move into the next phase. Below is a tentative timeline for our vaccination distribution plan, which is subject to change based on a number of factors.

• Phase 1A: January 2021
• Phase 1B: Began January 18, 2021 (majority of appointments will start going out in early to mid-February)
• Phase 1C: Pre-registration begins January 25, 2021 (majority of appointments will start going out in early to mid-March)
• Phase 2: April – May
• Phase 3: May – June

All individuals who live or work in Prince George’s County are required to fill out the County Health Department’s pre-registration form if they wish to schedule a vaccine appointment. When you are eligible to receive a vaccine based on the County’s phased distribution plan AND as vaccine appointments become available based on supply, the Health Department will follow up via email with a link and instructions on how to schedule your appointment. Based on the current supply of vaccines, it may take several weeks or longer for the Health Department to follow up with available appointments.

Efforts to reduce the spread of COVID-19, such as stay-at-home and shelter-in-place orders, have led to decreased use of routine preventive medical services, including immunization services. Ensuring that you continue or start getting routine vaccinations during the COVID-19 pandemic is essential for protecting yourself and others from vaccine-preventable diseases and outbreaks, including flu. Routine vaccination prevents illnesses that lead to unnecessary medical visits and hospitalizations, which further strain the healthcare system.

For the upcoming flu season, flu vaccination will be very important to reduce flu because it can help reduce the overall impact of respiratory illnesses on the population and lessen the resulting burden on the healthcare system during the COVID-19 pandemic. A flu vaccine may also provide several individual health benefits, including keeping you from getting sick with flu, reducing the severity of your illness if you do get the flu and reducing your risk of a flu-associated hospitalization. For more information about seasonal influenza in Maryland, visit https://phpa.health.maryland.gov/influenza/Pages/home.aspx.

Stopping a pandemic requires using all the tools available. Vaccines work with your immune system so your body will be ready to fight the virus if you are exposed. Other steps, like covering your mouth and nose with a mask and staying at least 6 feet away from others, help reduce your chance of being exposed to the virus or spreading it to others. Together, COVID-19 vaccination and following CDC’s recommendations to protect yourself and others will offer the best protection from COVID-19.

When a vaccine is authorized, we will only have information about the length of immunity for as long as people were vaccinated during the trials. For example, if the first people in the study were vaccinated in July 2020 and the vaccine is licensed in December 2020, we will only have information about the immune response up to 5 months after vaccination. The vaccine manufacturer will continue to monitor vaccine recipients for several months or more, so that over time, we will continue to get a better picture of the durability of immunity. With this information, we will be better able to understand whether vaccines against COVID-19 will require annual dosing like influenza.

Getting a flu vaccine will not protect against COVID-19. However, flu vaccination has many other important benefits. Flu vaccines have been shown to reduce the risk of flu illness, hospitalization and death. Getting a flu vaccine this fall will be more important than ever, not only to reduce your risk from flu but also to help conserve potentially scarce health care resources.

According to the CDC, vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. However, vaccination providers will be able to charge an administration fee for giving the shot to someone. Vaccine providers can get this fee reimbursed by the patient’s public or private insurance company or, for uninsured patients, by the Health Resources and Services Administration’s Provider Relief Fund.

When the FDA first authorizes or approves the use of one or more COVID-19 vaccines in the United States, there will be a limited supply, and not everyone will be able to be vaccinated right away. It is understandable how concerning this would be for people, especially for those who are at increased risk for serious illness from this virus and for their loved ones. That is why, early in the response, the federal government began investing in select vaccine manufacturers to help them increase their ability to quickly make and distribute a large amount of COVID-19 vaccine. This will allow the United States to start with as much vaccine as possible and continually increase the supply in the weeks and months to follow. The goal is for everyone to be able to easily get a
COVID-19 vaccine as soon as large quantities are available. Several thousand vaccination providers will be available, including doctors’ offices, retail pharmacies, hospitals, and federally qualified health centers.