• COVID-19 Vaccine

    Updated June 15, 2021

    The Latest: Myocarditis and Pericarditis after mRNA COVID-19 Vaccination

    Since April 2021, there have been increased reports to the Vaccine Adverse Event Reporting System (VAERS) of cases of inflammation of the heart—called myocarditis and pericarditis—following receipt of the mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna). Reported events have been rare and most cases have been mild, and observed in adolescents and young adults within a few days after vaccination. There is no established link that the vaccines caused myocarditis or pericarditis in these individuals. Most cases resolved with minor treatment and rest. Read more. 

    COVID-19 vaccines are still recommended for eligible individuals aged 12 years and older. Individuals should seek medical care if any of the following symptoms occur after vaccination: chest pain, shortness of breath, and any feelings of fast-beating, fluttering, or pounding heart. Family physicians are strongly encouraged to report potential cases of myocarditis and pericarditis to the VAERS system.

    AAFP will monitor the situation and update members as information becomes available. 

    CDC’s ACIP Votes to Recommend Pfizer/BioNTech COVID-19 Vaccine for Adolescents Aged 12-15; AAFP Approves Recommendation

    The committee voted unanimously to recommend the vaccine for individuals aged 12 – 15 in the U.S. population under the Emergency Use Authorization (EUA). The ACIP recommendation follows the announcement from the FDA amending its EUA to include individuals aged 12 to 15 based on recent safety and efficacy data, which showed 100% effectiveness in the vaccine group (0 cases) compared to the placebo group (16 cases). The EUA Fact Sheets reflect the changes.

    The AAFP has approved the recommendation following an expedited review of the evidence. The new recommendation means that family physicians and other health care professionals who have access to the Pfizer-BioNTech vaccine may begin administering it to patients in that age group immediately as the dose for this age group is the same as for individuals aged 16 and older.

    Clinical Considerations

    The CDC has updated its clinical considerations to include updates on eligible ages, co-administration of COVID-19 vaccines with other recommended immunizations, and information for vaccination of children and adolescents.

    Updated COVID-19 Vaccine FAQs

    Thinking about what your patients will ask after the announcement? You can use our COVID-19 Vaccine FAQs to answer their most common questions about the vaccines. We'll continue updating as new information is released. 

    About the COVID-19 Vaccines

    To date, no COVID-19 vaccine candidates have been approved (licensed) by the FDA. The FDA issued emergency use authorizations for three vaccines. EUAs were given for mRNA vaccines from Pfizer/BioNTech and Moderna in December 2020. The third EUA was issued on February 27, 2021 for the Janssen (Johnson & Johnson) COVID-19 vaccine, which uses a non-replicating adenovirus vector. Read more. 

    All three of the authorized COVID-19 vaccines have been recommended by the CDC’s Advisory Committee on Immunization Practices, which was reviewed and approved by the AAFP. All three vaccines are effective at preventing COVID-19 disease, hospitalizations and death. 

     

    Variants and Impact on COVID-19 Vaccines: What We Know

    Virus mutations are common, so it's not surprising that SARS-CoV-2 variants have been detected. The CDC is monitoring these variants and tracking their spread across the U.S., as well as the effect on infection and disease. Researchers are also rapidly checking vaccine effectiveness against the different variants. 

    It is important to note that all the variants appear to have increased efficiency in spreading from person to person so the use of mitigation measures like masks, ventilation, hand washing, physical distancing, and quarantine are paramount.

    A Variant Classification scheme that defines three classes of SARS-CoV-2 variants has been developed and information for the different variants is provided at the links below:


    The B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), B.1.427 (Epsilon), B.1.429 (Epsilon), and B.1.617.2 (Delta) variants circulating in the United States are classified as variants of concern. Use the CDC's map to see where the different variants are found in the U.S.

    Vaccine Availability

    The CDC and other federal agencies are working to distribute vaccine doses to states and jurisdictions. At this time, limited vaccine quantities are available, so vaccine appointments may be difficult to find as more states open slots to all eligible individuals. 

    CDC has provided a vaccine finder to assist in finding locations with available vaccine at . Additionally, many jurisdictions have provided phone numbers to aid individuals without access to internet. 

    • A list of state-by-state distribution plans and federal vaccine sites, and a map from the National Academy of State Health Policy, are available on the COVID-19 Vaccine Distribution page. 
    • The CDC's COVID-19 Data Tracker is also tracking the number of vaccines distributed and administered by state.  

    Interested in how we're advocating on vaccine distribution issues? The AAFP is working to ensure that family physicians are prioritized in federal and state vaccine strategies. Learn more about these efforts on our Vaccines and Immunizations Advocacy Hub. 

    Quarantine Criteria for Vaccinated Persons

    Additionally, the CDC has issued updated guidance on quarantining after an exposure for vaccinated individuals. Note that while mRNA COVID-19 vaccines have demonstrated high efficacy at preventing severe and symptomatic COVID-19, there is currently limited information on how much the vaccines might reduce transmission and how long protection lasts. In addition, the efficacy of the vaccines against emerging SARS-CoV-2 variants is not known. 

    At this time, vaccinated persons should continue to wear a mask, practice physical distancing, practice hand hygiene and other public health measures. However, vaccinated persons with an exposure to someone with suspected or confirmed COVID-19 are not required to quarantine if they meet all of the following criteria: 

    1. Are fully vaccinated (i.e., ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine)
    2. Are within 3 months following receipt of the last dose in the series
    3. Have remained asymptomatic since the current COVID-19 exposure

    Persons who do not meet all three should continue to follow current quarantine guidance after exposure to someone with suspected or confirmed COVID-19. 

    FDA Approval Process

    The FDA released guidance for manufacturers to request approval for EUA of a COVID-19 vaccine. The standards for EUA for the vaccine will be stricter than those for other products and vaccine candidates must meet prespecified efficacy and safety data with at least two months of follow up. Additionally, under an EUA, the FDA will continue to collect safety and efficacy data as the vaccine is made available to the public. All data will be reviewed by experts in vaccinology and the CDC’s Advisory Committee in Immunization Practices. 

    Find a list of other vaccine candidates and phase of development in a World Health Organization report.

    AAFP member, Jennifer Middleton, MD, MPH, also wrote a blog on what's ahead with additional vaccines in "Here come the COVID vaccines". 

    Coding and Payment

    The American Medical Association published the first set of COVID-19 vaccine and administration codes. Their unique structure allows for tracking and accommodating multiple COVID-19 vaccines.  

    CDC's COVID-19 Vaccine Resources

    Check out information on the CDC's COVID-19 site, including:


    Expect updates to this site, plus CDC’s Vaccination and Immunization site, as more information is available. It's critical that jurisdictions and federal entities receiving vaccine have information to implement an effective COVID-19 vaccination program.

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