What happened? The six women developed blood clots six to 13 days after their shot. All were between ages 18 and 48. One died, and three remained in the hospital. None of the cases was in Oregon.

Why are officials recommending a pause? Senior officials with the Food and Drug Administration and the Centers for Disease Control and Prevention recommended the pause to:

• Investigate the blood clot cases.
• Raise awareness of this complication so patients seek medical care and so providers use the right testing and treatments.

How long will the pause last? A CDC advisory committee decided April 14 to take more time to study the issue. The Advisory Committee on Immunization Practices said it wouldn't vote on a recommendation before meeting again in seven to 10 days (late April).

• Health officials advise calling your doctor if you have new and severe symptoms among the following within three weeks after a Johnson & Johnson vaccine:
  • Severe headache
  • Backache
  • New neurologic (brain/nervous system) symptoms
  • Severe abdominal pain
  • Shortness of breath
  • Leg pain
  • New or easy bruising
• Anyone who had health issues after getting a vaccine from OHSU can call our hotline at 833-647-8222.
• You are still encouraged to get a COVID-19 vaccine as soon as you can. The health risks of getting sick with COVID-19 are much greater than the risks of potential side effects from a vaccine.

Use this Oregon Health Authority tool to check your eligibility, sign up for alerts and to be contacted when appointments are available.

The CDC's VaccineFinder tool helps you find vaccines in your area. Just enter your ZIP code.

You can also find the tool and more information on the Oregon Health Authority's "How to find a COVID-19 Vaccine in Oregon" page.

The Oregon COVID-19 Vaccine Spotter tool will help you look for appointments at Oregon pharmacies. (Go to VaccineSpotter.org to use the tool for other states.)

You can also check on the pharmacy sites themselves. Appointments are required, and availability depends on vaccine supplies.

• Albertsons
• Bi-Mart
• Costco
• CVS
• Fred Meyer
• Health Mart
• QFC
• Rite-Aid
• Safeway
• Walgreens
• Walmart

For people enrolled in the Oregon Health Plan:

• Ride to Care (Health Share of Oregon members): 503-416-3955 or 855-321-4899
• MTM (Trillium members): 877-583-1552
• Tri-County MedLink (Oregon Health Plan Fee for Service members): 800-889-8726

For some others:

• Ride Connection (weekdays, older adults and people with disabilities in Multnomah, Washington and Clackamas counties): 503-226-0700
• TriMet LIFT (people unable to use regular buses and trains because of disability; enroll before scheduling): 503-962-8000
• One Call (Providence Medicare members): 866-733-8994

• Text ORCOVID to 898211 for updates (English and Spanish only)
• Email ORCOVID@211info.org
• Call 211 or 866-698-6155, 6 a.m. to 7 p.m. every day
• TTY: Call 711 or 866-698-6155
• Help for people with disabilities or who speak a language other than English: Call 971-673-2411 or email COVID19.LanguageAccess@dhsoha.state.or.us

• COVID-19 Vaccine in Oregon
• COVID-19 Vaccine Information by County
• Scam advisory: Providers and public health officials will never ask for money or for your bank account, credit card or Social Security number. Any offer to sell or ship vaccine doses is also a scam.

• Every Oregonian age 16 and older will be eligible for a vaccine starting April 19.
• A vaccine will help protect you and your family from getting COVID-19.
• The Food and Drug Administration has given emergency-use authorization to three vaccines: by Pfizer-BioNTech, by Moderna and by Johnson & Johnson.
• The Pfizer vaccine is approved for ages 16 and older. The Moderna and Johnson & Johnson vaccines are approved for ages 18 and older. The FDA needs more data to know if the vaccines are safe for younger people.
• The Pfizer and Moderna vaccines require two doses — Pfizer's three to four weeks apart and Moderna's four weeks apart. Johnson & Johnson's vaccine is one dose.
• If you miss the recommended time frame for your second dose, schedule it as soon as you can. You do not have to start over with another first dose. Learn more in the FAQ below titled "I missed the recommended time frame for my second dose. Should I still get it?"
• Experts have placed a high priority on making sure the vaccines are safe and effective. All three vaccines approved so far were found to be highly effective in clinical trials.
• Cost shouldn’t be an issue. The federal government is buying doses to provide free of charge.
• It’s important to continue safety practices: Wear a mask, maintain physical distance, and wash your hands often.

All three vaccines spur the body to make antibodies that specifically fight the coronavirus. Antibodies are made by white blood cells and are part of the immune system — the body’s system to fight infection.

Pfizer and Moderna:

These vaccines send a snippet of genetic material from the coronavirus — instructions called messenger RNA or mRNA — into  cells. The instructions tell the cells to make a harmless spike protein like the one on the coronavirus.

The body’s immune system recognizes that this protein doesn’t belong here. It activates white blood cells to form the infection-fighting antibodies. The immune system also remembers the spike protein, so it's ready to fight the real coronavirus should it become present in the body.

Once the proteins are made, the body destroys the mRNA.

Johnson & Johnson: 

This is a viral vector vaccine. Specifically, it’s a type called an adenovirus vector vaccine or an adenovector vaccine.

Like the mRNA vaccines, the vaccine uses a snippet of genetic material from the coronavirus to tell cells to make spike proteins. The spike proteins activate the immune system.

In this case, though, instructions are in DNA delivered in a virus called an adenovirus. Normally, this virus causes the common cold. It is NOT the coronavirus.

The adenovirus is genetically altered. The virus cannot make copies of itself, and it cannot cause illness. The virus is just a carrier (vector). The DNA cannot change your DNA.

After vaccination with any of these vaccines:

• If you contract the coronavirus, your immune system is better able to attack it, making you less likely to develop COVID-19.
• Based on knowledge of other illnesses, health experts expect that if you do develop COVID-19, you will be less likely to become seriously ill.
• Your immune system knows how to fight the coronavirus without having come in contact with it.

Learn more:

• Understanding mRNA Vaccines, CDC
• Understanding Viral Vector COVID-19 Vaccines, CDC
• Understanding how COVID-19 Vaccines Work, CDC
• How Nine Covid-19 Vaccines work, The New York Times

To start your protection as soon as possible, you should be vaccinated as soon as possible. This means getting any of the vaccines that are available to you.

You can look on this page, in the information with each vaccination site, to see the vaccine(s) available at each site. You can also filter by vaccine in the CDC VaccineFinder tool. 

The Pfizer, Moderna and Johnson & Johnson vaccines have all been found to be highly effective. In addition, any new vaccine must be found to offer good protection against COVID-19 to win FDA authorization. The FDA also continues monitoring vaccines to see how they perform.

See an update on the Johnson & Johnson vaccine near the top of this page.

• To start your protection as soon as possible, you should get vaccinated as soon as possible. That means getting any of the three vaccines (Pfizer, Moderna or Johnson & Johnson) that are available to you.
• The Johnson & Johnson vaccine is highly effective at preventing serious illness and death.
• OHSU is using all three vaccines (use of the Johnson & Johnson vaccine is currently paused). All three are safe, effective and free of charge. They are all essential to meeting our goal of vaccinating as many Oregonians as quickly as possible.
• The three vaccines can’t be directly compared because they were studied at different times, in different geographic areas, with different infection rates, and with different circulating variants.
• The Johnson & Johnson vaccine is one dose. That makes it convenient for anyone who would find it hard to attend two appointments.
• The Johnson & Johnson vaccine does not need ultra-cold storage, making it an option for more areas.

See an update on the Johnson & Johnson vaccine near the top of this page.

All three vaccines are highly effective, health experts say. The three vaccines did report different efficacy rates, though, and you may have concerns about that.

Let’s take a look:

• Johnson & Johnson reported an efficacy rate of 66%. Pfizer and Moderna reported rates of about 95%. The efficacy rate is the reduction in any severity of illness, during clinical trials, among those who got the vaccine compared with those who didn’t.
• But health experts say the vaccines can’t be compared apples-to-apples. The vaccines were tested in different ways and at different times. Johnson & Johnson’s was tested later, for example, after more-contagious variants had emerged.
• On the most important measures — preventing hospitalization and death — Johnson & Johnson had a 100% efficacy rate. That means no one who received the vaccine in clinical trials died or needed hospital care because of COVID-19. The Johnson & Johnson vaccine also had an 85% efficacy rate for preventing severe illness.

Overall, health experts advise getting whichever vaccine is available to you first. Speed is especially important as variants emerge and spread.

Learn more: 

• Why comparing COVID-19 vaccine efficacy numbers can be misleading

Yes. If you got a first dose of the Pfizer or Moderna vaccine, it’s important to get your second shot, or booster. This makes sure that your vaccination is as effective as possible. Schedule your second dose as soon as you can. (The Johnson & Johnson vaccine is just one dose.)

It’s also important to know:

• There is no maximum time between doses.
• OHSU has no limit on how long after a first shot people can schedule a second.
• OHSU recommends second doses:
  • 19-35 days after your first Pfizer dose (Pfizer recommends three weeks, or 21 days).
  • 25-35 days after your first Moderna dose (Moderna recommends four weeks, or 28 days).
• The CDC updated its guidelines to recommend second doses — when a delay is unavoidable — up to six weeks (42 days) after the first dose.
• Even if you miss all these windows, you don’t have to start over by repeating a first dose. Just get your second dose.
• There is little data on how well mRNA vaccines (like the Pfizer and Moderna vaccines) work when the second dose is more than six weeks after the first. That means it’s not known whether waiting longer makes the vaccine more effective, less effective or causes no change.

Learn more:

• Is it Safe to Delay a Second COVID Vaccine Dose? Scientific American

Yes. There are several reasons:

• If you have a two-dose vaccine, your vaccination won’t be complete until after you’ve had the second dose. The second dose is after three or four weeks for the Pfizer vaccine, four weeks for Moderna.
• It can take two weeks for your body to develop immunity after your vaccination. You could come in contact with the coronavirus in the meantime.
• The vaccines appear to do a good job of preventing COVID-19. But experts don't yet know if being vaccinated will prevent you from carrying and spreading the virus to others, with or without symptoms.
• Health experts say that stopping the pandemic will require every tool available. Masks, frequent hand-washing and physical distancing (staying at least 6 feet from others) will still play important roles.

It's not entirely clear yet, but vaccine makers are making progress.

So far, vaccines are available in the U.S. only for people who are at least 16. Vaccines are first tested in adults to make sure they are safe and effective. Then they are tested in older children before clinical trials start with younger children.

Both Moderna and Pfizer have trials underway to test vaccines in two groups of children: ages 12 and older, and ages 6 months to age 12 years.

Pfizer announced March 30 that early results show its vaccine is highly effective in children ages 12 to 15. CEO Albert Bourla said the company plans to seek FDA emergency-use authorization soon in hopes of offering shots before the fall start of school.

Both Moderna and Pfizer also announced in March that they've begun testing their vaccines in younger children and babies as young as 6 months. Moderna CEO Stephane Bancel said in January that the company expects results in 2022.

Meanwhile, vaccinations of adults will help protect children, too. As more people are vaccinated, the coronavirus will become less able to spread. Children are also at much lower risk of serious illness from the coronavirus.

Medical gloves are in short supply worldwide. Oregon would need millions of additional pairs if gloves were used for all vaccinations.

In addition, under Occupational Safety and Health Administration (OSHA) regulations, providers are not required to wear them for COVID-19 vaccinations. Except in special cases, providers can clean their hands between each recipient instead.

The Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices agree that hand hygiene can replace glove use.

Learn more: 

The Reason Why Nurses Don’t Wear Gloves When Giving COVID-19 Vaccine Explained

Yes. It's possible to get COVID-19 again, which can result in serious illness.

In addition, experts don’t know how long people can expect to be immune after having COVID-19. The CDC said early evidence suggests it’s not very long.

Scientists don’t know yet. Dr. Anthony Fauci, the nation's top infectious-disease expert, estimates the U.S. will reach population immunity (also called herd immunity) when 75-80% of the population has been vaccinated. This is the point at which enough people have immunity to keep the coronavirus from easily spreading.

Health and government experts are confident the vaccines are as safe as possible.

The FDA’s emergency-use authorization makes a vaccine or other treatment available quickly in a crisis. It is not full FDA approval. Vaccines are also being developed in months instead of years.

To get emergency authorization, though, vaccines have gone through three phases of clinical trials (tests on people) involving tens of thousands of participants. Clinical trials must follow rigorous rules for safety and oversight.

The FDA, CDC and other government agencies have many systems to monitor the vaccines for any safety issues that didn’t turn up in the trials. They can act quickly if a problem is spotted. Tools include v-safe, which lets people use a smartphone to report any side effects to the CDC.

Dr. Anthony Fauci, the nation’s top infectious-disease expert, is among health officials who say speed did not sacrifice safety. “The speed was the reflection of extraordinary advances in the science of vaccine platform technology,” Dr. Fauci told ABC.

Learn more:

• Ensuring the Safety of COVID-19 Vaccines in the United States, CDC
• Vaccine Development 101, FDA

No. The Pfizer, Moderna and Johnson & Johnson vaccines — and others in the pipeline — do not contain live virus. That makes it impossible to get COVID-19 from a vaccine.

Although mRNA vaccines have not been widely used against an infectious disease before, they have been used in cancer treatments. Researchers have also been working with mRNA vaccines for decades in studies of the flu, Zika and other illnesses.

The mRNA vaccines for COVID-19 have been developed with the same rigorous standards applied to all vaccines.

No. DNA is in the nucleus of cells, protected by the nuclear membrane. The mRNA does not enter the nucleus, and it does not affect or interact with DNA. In addition, mRNA from a vaccine cannot be made into DNA that could change a person's DNA.  

Viral vector vaccines have been studied since the 1970s. Two Ebola vaccines are viral vector vaccines. The vaccines have also been used in clinical trials against viruses that include the Zika virus, HIV and flu viruses. 

In addition, all COVID-19 vaccines approved for use in the U.S. were developed with the same rigorous standards applied to all vaccines.

No. Unlike with mRNA vaccines, the genetic material (DNA) does enter the cell’s nucleus. But the cell only reads the instructions. The DNA cannot interact, alter or combine with your DNA.

See an update on the Johnson & Johnson vaccine near the top of this page.

You can expect mainly mild to moderate side effects such as:

• Fatigue
• Fever
• Chills
• Muscle aches and pains

In clinical trials, side effects tended to be higher after the second dose, and less for those older than 65.

Side effects can be managed with:

• Rest
• Drinking fluids
• Fever-reducing medication, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)

Call your health care provider if you have side effects that bother you or that don't go away.

Learn more:

What to Expect after Getting a COVID-19 Vaccine, CDC

Call 911 or go to the nearest hospital if you have a severe allergic reaction such as:

• Swelling of the throat and mouth
• Trouble breathing
• Lightheadedness
• Confusion
• Blue skin or lips
• Fainting

Call your health care provider if you have side effects that bother you or that don’t go away.

Learn more:

COVID-19 Vaccines and Allergic Reactions, CDC

Health officials are tracking side effects as part of widespread efforts to monitor vaccine safety. You can report side effects to:

• The FDA/CDC Vaccine Adverse Event Reporting System (VAERS): Visit the VAERS website or call 1-800-822-7967.
• V-safe: Learn how to use the CDC’s new v-safe smartphone tool.

For some people, getting a COVID-19 vaccine is followed by swelling in lymph nodes under the arm where they got the shot.

The swelling is a normal sign that your body is building protection against COVID-19. It could cause a false result on a mammogram, though. If you are due for a mammogram, we recommend that you:

• Get your mammogram before your vaccine.
• Or wait at least four weeks after your Johnson & Johnson vaccine, or after your second dose of the Pfizer or Moderna vaccine.

Yes, you may choose to be vaccinated. Though it’s not required, you may want to talk with your pregnancy provider about:

• Your risk of being exposed to the coronavirus.
• The higher risk of serious illness for people who get COVID-19 while pregnant.
• The higher risk of premature birth or other pregnancy complications for people who get COVID-19 while pregnant.
• Whether you have any other medical condition that could put you at higher risk of serious illness from COVID-19.
• Information about vaccines in people who aren’t pregnant.
• The lack of information about COVID-19 vaccines in people who are pregnant.

Learn more:

Vaccination Considerations for People who are Pregnant or Breastfeeding, CDC

OHSU experts recommend that you talk with your health care provider. The CDC says people who are both breastfeeding and in a high-priority group recommended for vaccination, such as health care workers, may choose to be vaccinated.

There is no data on the safety of COVID-19 vaccines in people who are breastfeeding, in breast milk or in breastfeeding infants. Breastfeeding people were not part of clinical trials. The CDC says, though, that mRNA vaccines are not thought to be a risk to breastfeeding infants.

The American College of Obstetricians and Gynecologists recommends that vaccination be offered to people who are breastfeeding under the same guidelines as for people who aren’t.

Learn more:

Vaccination Considerations for People who are Pregnant or Breastfeeding, CDC