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Deaconess nurse Craig Meier gets one of the first doses of the Pfizer-BioNTech vaccine delivered to the Tri-State.2020...and now 2021 will go down in history- its full impact is still being written. Here is WNIN, IPBS and Side Effects complete coverage.

How Will Indiana Distribute COVID-19 Vaccines? Here's What You Need To Know

Indiana opened registration beyond first responders and health care workers on Jan. 8, allowing Hoosiers 80 and older to schedule appointments for vaccines. Gov. Eric Holcomb announced the state will expand eligibility to all Hoosiers 16 and older on March 31.

Who can get the vaccine right now? 

Hoosiers 40 and older. The state has expanded eligibility four times in March by age group – it has also opened state sites to teachers, staff and child care workers, and extended the list of underlying health conditions.

Those who qualify may schedule vaccination appointments at OurShot.in.gov or by calling 211. About 70 public libraries, AARP and Indiana’s Area Agencies on Aging may also be able to help with registration.

The prioritized comorbidities are: 

  • active dialysis patients, 
  • Down syndrome
  • post-solid organ transplant recipients
  • sickle cell disease patients
  • people in treatment for cancers now or in the last three months, or with active primary lung cancer or active hematologic cancers, like lymphoma, leukemia or multiple myeloma.
  • Cystic fibrosis
  • Muscular dystrophy
  • People born with severe heart defects, requiring specialized medical care.
  • People with severe type 1 diabetes, who have been hospitalized in the past year.
  • Phenylketonuria (PKU), Tay-Sachs, and other rare, inherited metabolic disorders.
  • Epilepsy with continuing seizures, hydrocephaly, microcephaly and other severe neurologic disorders
  • People with severe asthma who have been hospitalized for this in the past year
  • Alpha and beta thalassemia
  • Spina bifida
  • Cerebral palsy
  • People who require supplemental oxygen and/or tracheostomy
  • Pulmonary fibrosis, Alpha-1 Antitrypsin
  • Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, combined primary immunodeficiency disorder, HIV, daily use of corticosteroids, use of other immune weakening medicines, receiving tumor necrosis factor-alpha blocker or rituximab
  • Pregnancy

Those comorbidities were prioritized based on Indiana’s population and the recommendations from the Centers for Disease Control and Prevention.

State officials said, depending on the vaccine supply, the state will continue opening eligibility in five-year increments by age group. For Hoosiers with comorbidities, state officials have asked them to reach out to their primary care providers – there will be a separate registration link provided to that group.

Vaccination appointments were opened to first responders, law enforcement and similar groups in January. Long-term care facility residents and health care workers were prioritized as the state received its first doses.

Who’s next?

Everyone else! Governor Holcomb announced the state would expand vaccine eligibility to all Hoosiers 16 and older on March 31. 

The state’s rollout up to now focused on reducing hospitalizations and deaths by focusing on those most at risk: older Hoosiers and, eventually, those with comorbidities.

But after gradually moving down in age by five-year increments for weeks, the state is opening eligibility to everyone 16 and older. Holcomb said federal partners promised a large increase in vaccine doses sent to the state the last week of March.

What if I’m immunocompromised or taking medications that affect my immune system?

The FDA guidance says you should talk to your primary care physician and make that decision with them. 

They’ll likely give you the OK, but be sure to bring up these concerns with your doctor to make an informed decision. If your doctor says it’s OK, FDA guidance says to give your vaccine provider a heads up.

Who is included in the group of educators?

Basically anyone who works in a pre-K through 12 school or child care facility. 

That means pre-K through 12 teachers, Head Start and Early Head Start programs, licensed child care providers, center-based and family care providers, classroom aides, bus drivers, janitors, counselors, administrative staff, cafeteria workers and substitute teachers can all register to get vaccinated. 

However – you will need to bring proof of your employment (like a work ID or something along those lines) to your appointment, along with proof that you live in Indiana (like a driver’s license or utility bill). 

Some counties previously wait-listed education staff, allowing them to receive vaccinations earlier than state recommendations. But health officials announced Feb. 24 the state would be cracking down on eligibility requirements for waitlists. 

What about other essential workers? Will they be prioritized?

Health officials have made no indication that they will be. They argue prioritizing based on age and underlying health conditions means they’re preventing serious illness or death from COVID-19.

If I qualify to receive the vaccine, how do I sign up? 

There are two main ways to do so: go to OurShot.in.gov or call 211. About 70 public libraries, AARP and Indiana’s Area Agencies on Aging may also be able to help with registration.

If you’re registering online, at the top of the page, there is a muted red bar that reads “Click here to find a vaccination site and register.” 

That will redirect you to a map, which lists vaccination sites by county. Select the one closest to you (or your loved one). And then select “Click here to register.” 

Select what group best describes you, and then register for your vaccine.

Can I sign up through Kroger, Meijer or Walmart?

Yes. Walmart will use the state’s registration system at OurShot.in.gov. 

But Kroger and Meijer will be using their own sign up system. Hoosiers who are eligible for vaccine appointments may schedule them through the stores’ websites – clinic.meijer.com or kroger.com/rx/guest/get-vaccinated

On Meijer’s website, you’ll fill out a brief questionnaire and then provide your zip code to select a store pharmacy providing vaccines. 

On Kroger’s website, you’ll provide a zip code to see your nearest stores. If the COVID-19 vaccine is available at that store’s pharmacy, it should be at the top of the list. But there isn’t a way to filter out stores that don’t have COVID-19 vaccines.

Do I still have to wear a mask once I have the vaccine? When will we get to go back to normal?

Yes, you still have to wear a mask. But for folks who are getting vaccinated, life can be more normal soon.

The CDC released its first public health recommendations March 8 for people who are fully vaccinated – which is up to two weeks after receiving the last required dose for Pfizer-BioNTech, Moderna and Johnson & Johnson. 

Fully vaccinated people can:

  • Visit with other fully vaccinated people indoors without wearing masks or physical distancing
  • Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
  • Refrain from quarantine and testing following a known exposure if asymptomatic

But there’s a big caveat to the CDC’s recommendations. Mask-wearing and social distancing still need to happen in public. According to NPR’s Shots, studies of the new vaccines only measured whether vaccinated people developed symptoms, not whether they got infected. It's possible that they got mild infections — not enough to make them ill, but enough to pass the virus on to others. So, for the safety of others, you still need to wear a mask.

The CDC also says fully vaccinated people should still wear masks and socially distance from unvaccinated people at higher risk for severe illness from the virus. It also recommends: 

  • Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from multiple households
  • Avoid medium- and large-sized in-person gatherings
  • Get tested if experiencing COVID-19 symptoms

How long does the vaccine take to be effective? How effective are the vaccines?

According to the CDC, a week or two.

After the first dose, the Pfizer-BioNTech vaccine only measured 50 percent efficacy against COVID-19. But both available vaccines measured more than 94 percent efficacy against COVID-19 after the second dose in clinical trials. 

For the Johnson & Johnson vaccine, you only need one shot, but the measured efficacy is a little lower than the mRNA vaccines at 66.1 percent. 

Join the conversation and sign up for the Indiana Two-Way. Text "Indiana" to 73224. Your comments and questions in response to our weekly text help us find the answers you need on COVID-19 and other statewide issues.

It is important to remember: flu vaccines with about 40 to 60 percent efficacy are still pretty good.

Are the new strains of COVID-19 resistant to vaccines?

Not so far. 

Indiana officials announced on Jan. 11 the United Kingdom variant of COVID-19 was confirmed in the state. There are several newly identified strains including ones in California, South Africa and Brazil. 

The vaccines still protect against the new strains, and vaccine manufacturers may make adjustments or add additional doses of vaccines to protect against future strains. 

How does Indiana’s vaccine distribution compare to neighboring states?

States receive vaccines from the federal government based on population. Both Ohio and Michigan have distributed initial vaccines to more than 800,000 of their residents.

Indiana’s population is about 6.7 million Hoosiers. Ohio has 11.7 million, Michigan has just shy of 10 million people, and Kentucky has about 4.5 million. 

The state remains on par with its Midwest neighbors. The state remains nearly on par with its Midwest neighbors. As of March 16, 19.2 percent of Hoosiers have received at least one COVID-19 vaccine dose compared to 21 percent in Kentucky, 20.8 percent in Ohio, and 19.9 percent in Michigan.

Health officials said on March 17, despite being the 17th most populous state, Indiana ranked seventh for least number of allocated vaccine doses. They are working with the Biden administration to increase vaccine supplies in the next few weeks.

How many people need to get vaccinated to achieve herd immunity?

Brian Dixon, director of public health informatics at the Regenstrief Institute, said in order to achieve herd immunity in the state, 70 percent, or roughly 4.8 million Hoosiers need to be vaccinated.

He said we’re not likely to reach that number until late summer – and that’s assuming everything goes to plan and everyone gets the vaccine when it’s their turn. 

If I’ve already had COVID-19, do I still need a vaccine?

Prevailing science says yes for a few reasons: while not common, there have been some reports of reinfection after recovering from COVID-19. In fact, reinfection appears to be more likely with the new strains. The available evidence, according to the CDC, suggests most people who recover from COVID-19 would have a degree of immunity for at least three months following initial diagnosis, some early research suggests that lasts for eight months or longer.

The CDC also says there isn’t enough information about the length of natural immunity – what you’d get from having the virus – and has not made a recommendation yet about whether you’d benefit from getting a vaccine if you’d previously had the virus. 

About 5-10 percent of participants in both the Moderna and Pfizer-BioNTech trials included participants who had the virus previously.

Indiana University is conducting a study to shed light on COVID-19 immunity, after a person has been infected or after being vaccinated.

What’s in the vaccines? How is Johnson & Johnson’s different?

The FDA lists 10 ingredients in the Pfizer-BioNTech vaccine – mRNA, lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 2[(polyethylene glycol)-2000]-N, N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3-phosphocholine, and cholesterol), potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose.

Basically, that’s three types of fats, cholesterol, sugar, and four types of salt (including sodium chloride, which is table salt). 

The Moderna vaccine’s ingredients are listed as: lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose.

That’s four different fats, salt, sugar, tromethamine, tromethamine hydrochloride, and acetic acid. 

Both the Pfizer-BioNTech and Moderna vaccines use mRNA to deliver a cheat code to your body’s immune system, without giving an inactive or a live but weakened version of the virus. 

The Johnson & Johnson vaccine is a vector-based vaccine: it contains a totally different virus than COVID-19, but it has parts of COVID-19 inserted into it, so your body can learn to respond to it. This vaccine uses adenovirus type 26, which can cause cold symptoms and pink eye. The strain in the virus is manipulated so it cannot replicate in your body to cause illness. 

The Johnson & Johnson vaccine’s ingredients are listed as: recombinant, replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein; citric acid monohydrate; trisodium citrate dihydrate; ethanol; 2-hydroxypropyl-β-cyclodextrin (HBCD); polysorbate-80; and sodium chloride.

That’s the disarmed virus, acid, two types of salt, ethanol, sugar, and polysorbate-80 – which is a pretty common emulsifier in foods to hold ingredients together.

I have had allergic reactions in the past to vaccinations – can I still get the COVID-19 vaccine?

If you’ve had allergic reactions to vaccines in the past, you should talk to your primary care provider about the vaccine. People who have had severe allergic reactions may need to be monitored after receiving the vaccine. Polyethylene glycol – which is in both Moderna and Pfizer-BioNTech vaccines – has been pointed to as what has triggered some anaphylaxis. 

The most common allergic reaction – especially in flu shots – are in people with egg allergies. The most common flu vaccines are developed with egg-based technology, but the FDA and CDC said common food allergies and medicines shouldn’t prevent most people from receiving the vaccine.

My doctor has suggested I get a particular version of the COVID-19 vaccine. Can I choose which one I receive?

Yes and no. The ingredients and side effects are very, very similar for both the Moderna and Pfizer-BioNTech vaccines. 

If your primary care provider has recommended you receive one over the other, your best option is to call the vaccine provider to see which vaccine they have. Indiana is distributing both vaccines, and it depends on a number of factors which is available in any given county. But there isn’t a whole lot of choice in the version of vaccine.

Will I have to pay for the vaccine?

No. 

Vaccine providers will be able to bill insurance for a fee to administer the vaccine, but will not be able to charge you. They can seek reimbursement for uninsured patients from the Health Resources and Services Administration’s Provider Relief Fund.

Can I get or spread COVID-19 from the vaccine?

No. 

There are several different types of vaccines. Rotavirus and MMR vaccines use a live but weakened version of the virus to teach your body to develop long-term immunity to a disease. Flu and rabies shots use an inactive version of the virus, but that’s why you don’t develop long-term immunity from those viruses. 

The COVID-19 vaccine doses developed by Pfizer-BioNTech and Moderna use a new type of vaccine, an mRNA vaccine. This type of vaccine has been in development for about three decades, but is only now being used for COVID-19. According to the CDC, mRNA vaccines teach your cells how to make a protein – or even just a piece of a protein – that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects you from getting infected if the real virus enters our bodies.

The Pfizer-BioNTech and Moderna vaccines require two doses to be effective – more similar to many childhood vaccinations than getting a flu shot.

However, studies of the new vaccines only measured whether vaccinated people developed symptoms, not whether they were infected. There’s still a lot of ongoing research into whether someone who has been vaccinated can be infected with the virus and spread it to someone who is not vaccinated.

Why do we have to get a second dose of the vaccine?

If you want the full protection of the vaccine, you’ll have to get the second dose. In an FDA analysis of the Pfizer-BioNTech vaccine, after only one dose, a little more than 50 percent of participants were still protected from the virus. But that jumped up to 95 percent after the second dose. 

That applies to the Moderna and Astra-Zeneca vaccines as well. 

What are the side effects of the vaccine?

WITF, a station in Pennsylvania, asked that question of Johns Hopkins Bloomberg School of Public Health’s Dr. William Moss.

He said at this point, we only know the short-term side effects – which appear in about 5 to15 percent of participants.

Those include inflammation, soreness at the injection site, a low-grade fever, headaches, muscle aches and fatigue. These can last from 12 to 36 hours after vaccination. 

The CDC includes some tips on how to best alleviate some of those side effects – including placing a cool, wet washcloth over the injection site and taking an over-the-counter medicine.

This story was originally published on Dec. 14, and has been updated Dec. 18, Jan. 12, Feb. 2, Feb. 10, March 2, March 8, March 21 and most recently, March 23.

Contact Lauren at lchapman@wfyi.org or follow her on Twitter at @laurenechapman_.

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