Nurse Kayla Mitchell, left, of Maine Medical Center’s COVID ICU unit in Portland, Maine, becomes the first person in the state to receive the Pfizer-BioNTech COVID-19 vaccine, Tuesday, Dec. 15, 2020. Credit: Derek Davis / Portland Press Herald via AP

The coronavirus vaccination rollout is proving complicated as Maine works to overcome federal hurdles and inoculate the broader population.

We asked readers what questions you have about the process, and most of you wanted to know when you would be able to get your own shot and how it would happen. Many of those questions circled around your employment or health care conditions.

Here you can find answers on how the vaccines work, whether you should keep wearing a mask after being vaccinated, how you will know it is your turn and what you should do if you live in another state. This story will be periodically updated with new questions, events and guidelines. 

What types of vaccines are available? 

There are three vaccines currently approved for emergency use by the U.S. Food and Drug Administration. 

The Pfizer vaccine and the Moderna vaccine — were approved in December, and are similar in that they both require two doses administered three to four weeks apart through a shot. A third vaccine from Johnson & Johnson is a single-shot alternative, and that was approved for emergency use on Feb. 28.

The Pfizer and Moderna options need to be stored at super-cold temperatures to remain viable, with the former needing a special freezer to be kept at minus 40 degrees below Fahrenheit. The Moderna candidate needs only to be kept at minus 4 degrees and can be stored in a refrigerator for 30 days, compared with five days for the Pfizer vaccine. Maine officials have used those requirements to determine who is able to distribute the vaccines. 

Both of those offerings have roughly similar efficacy rates, with the Moderna option being 94.1 percent effective in preventing infection once completed and the Pfizer vaccine at 95 percent. 

The Johnson & Johnson vaccine can be stored in a normal refrigerator for three months. It is less effective than the Pfizer and Moderna vaccine but has been found to provide good protection against the more severe cases of disease. The U.S. Food and Drug Administration recommended pausing the use of the vaccine on April 13 after six women among the millions to get the vaccine developed rare blood clots. Maine is following that guidance while a federal advisory committee investigates the nature of the blood clots.

All three have the potential for adverse reactions, but the majority have been minor, including injection site discomfort, muscle pain and fatigue.

Have any of the new virus strains been detected in Maine, and are vaccines effective against them?

A variant of the virus first detected in the United Kingdom was confirmed to have been found in Maine on Feb. 10, according to Maine CDC officials. The strain, as with other new versions of the virus, is believed to be 20 to 70 percent more contagious than the previous versions circulating in the country. There are at least two other new strains circulating in the U.S. — one from South Africa and one from Brazil. Those have not been detected in the state yet.

The Moderna and the Pfizer vaccines have been found to work against the U.K. strain, but may be less effective against the original version of the virus and less effective against the South African strain. Neither of those findings have been peer-reviewed, however, and both companies have said they are working on boosters to protect against variants. The Johnson & Johnson vaccine was found to be similarly effective against variants as it is against the original virus.

How do the vaccines work?

The two approved vaccines in use right now are both mRNA vaccines, meaning they use genetic material present in all cells that sends instructions to cells on how to make a piece of a protein unique to the coronavirus. The body responds by producing antibodies that fight off what it believes is an infection, producing the immune response.

The Johnson & Johnson vaccine uses a virus vector method. Instructions for creating an immune response to the coronavirus are delivered by the injection of a harmless virus.

Once I’m vaccinated, can I hang out with people without a mask?

The U.S. CDC determined on March 9 people who have been fully vaccinated for two weeks can gather indoors with other fully vaccinated people and unvaccinated people who are not at an elevated risk of COVID-19 without masks safely. It also says a vaccinated person who has been around a COVID-19-positive person does not need to quarantine or get tested unless they have symptoms. It carves out an exception for those in congregate settings.

It could be some time before social distancing recommendations relax, however. One of the biggest outstanding questions about the vaccines is whether they keep you from getting the virus outright or if they only prevent symptoms of the virus, meaning you could still harbor the virus and pass it onto others. Maine still requires masking and social distancing in public.

What are the side effects of the vaccine?

Side effects like redness or pain around the injection site, fatigue, a low-grade fever or chills and nausea are common in the hours or days after getting vaccinated for the coronavirus or other ailments. More serious side effects have been isolated and rare. The U.S. CDC recommends anyone who has been sick with COVID-19 wait until they have met the criteria to stop isolating before getting vaccinated. The Johnson & Johnson vaccine appears to carry less risk of these common side effects, which is why it is being considered for drive-thru clinics.

I got my first Pfizer or Moderna dose but needed to cancel my second appointment. How quickly should I reschedule?

The first dose of the Pfizer vaccine needs to be given within 21 days of the first shot, compared to 28 days for the Moderna vaccine. The U.S. CDC has said in special circumstances that the second dose of a vaccine can be given within four to six weeks after the first dose. But the best way to get the vaccines’ efficacy rates of 94 to 95 percent has been to get the second dose within the prescribed timeframe.

I’m not sure where I fall in the vaccination plan.

Currently, adults over the age of 60 and certain health care workers and workers crucial to the the COVID-19 response are eligible to be vaccinated. The state is also allowing K-12 school staff and child care workers to get vaccinated regardless of their age.

Those over age 50 will be eligible in April, and the Mills’ administration announced March 12 that any adults under that age will be eligible after May 1, following a directive from President Joe Biden. Hospitals are permitted to prioritize those with health conditions putting them at greater risk of severe COVID-19 symptoms within the age bands.

Where can I get vaccinated?

Health care providers are the biggest providers of vaccines to the general public, but places including Hannaford, Walgreens, Walmart and CVS pharmacies are also offering doses with an appointment. The state keeps a list of places where you can sign up to be vaccinated.

What health conditions qualify me as “high-risk”?

The federal CDC has identified several conditions that increase the risk of complications from the coronavirus. The list — which is not exhaustive — includes cancer, chronic kidney disease, chronic obstructive pulmonary disease, heart conditions such as heart failure, compromised immune systems from organ transplants, obesity, pregnancy, smoking, sickle cell disease and Type 2 diabetes.

The Maine CDC has removed priority for this group when it switched to its age-based system. There are several other conditions which could complicate risk. You should talk to a primary health care provider if you are unsure if you have a condition that could increase your risk.

I’m a legal resident of another state or I get my health care in another state. Where should I get vaccinated?

Maine Department of Health and Human Services Commissioner Jeanne Lambrew said in January that people should get vaccinated in the state where they are legal residents, because vaccine allocations are based on population. She said residents who get their care in another state should look for a place in Maine to get vaccinated.

Where can I travel and who is allowed to come to Maine right now?

A March 5 policy change now allows Mainers to visit any New England state — and visitors from those states to visit Maine — without having to quarantine regardless of whether they are vaccinated. Any other state requires quarantining for 10 days. Anyone who has been fully vaccinated for two weeks can skip those requirements.

After May 1, the state will shift its policy to allow anyone to travel to the state except those from states that appear on a new exclusionary list that has yet to be developed. That means it will list the states from which people are not allowed to visit, and green-light all others.

BDN writer Michael Shepherd contributed to this report.

Still have questions about the COVID-19 vaccines? Ask us here and we’ll do our best to answer them.

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