Health
COVID-19 vaccines: Your biggest questions, answered
The COVID-19 pandemic has resulted in millions of infections and hundreds of thousands of deaths in the U.S., yet we understand the reasons many people haven’t been vaccinated are complicated.
We’ve felt a growing political polarization and misinformation that has discouraged millions from getting vaccinated. But other factors stand in the way, such as concerns about what’s in the vaccines and whether they’re safe and effective.
While the virus is constantly changing and research into the infections among vaccinated people is ongoing, two things are clear: COVID-19 kills and the vaccines prevent hospitalizations and deaths.
What follows are common concerns expressed by those who have not been vaccinated.
If there’s a reason why you’re not vaccinated – or something you’ve heard from a family member, friend or co-worker – that isn’t included here and you would like us to address, we want to hear from you. You can email [email protected].
It is our hope that the responses to these concerns will give you the tools you need to make an informed choice.
‘I don’t need the vaccine.’
I already had COVID-19, so I have natural immunity and don’t need the vaccine.
Because you already had COVID-19, your body may have produced antibodies against the coronavirus spike protein to fight off infection and recover from the disease. While you may have some protection against the virus, it doesn’t mean you’re protected against reinfection and severe illness and death as a result. The virus is changing constantly, and the antibodies you developed might not hold up against different mutations of the virus such as the more contagious Delta variant that now accounts for the vast majority of COVID-19 cases in the U.S. Researchers who’ve found that those previously infected with COVID-19 could continue to develop antibodies for a lifetime still recommend getting vaccinated because the vaccines offer stronger protection than natural immunity alone. For example, a recent study out of Kentucky of people who previously recovered from COVID-19 found that those who weren’t vaccinated were twice as likely to get reinfected. Getting vaccinated is the best way to ensure that you’re protecting yourselves and others from COVID-19.
More:Fact check: Infected with COVID-19 in the past? You still need the vaccine, experts say
If vaccinated people can still get COVID-19, I don’t see why I need to get vaccinated.
Those who are vaccinated can still get COVID-19 and they can still infect others, but the vaccines have proven to offer protection from serious illness and death. Nothing’s perfect, but a combination of vaccination, wearing masks and physical distancing all help lower the probability of infection. The numbers bear that out. Those who are vaccinated are significantly less likely to be hospitalized and die from the disease compared to those who are not vaccinated.
- Unvaccinated people were 29 times more likely to be hospitalized with COVID-19 than vaccinated people, a recent CDC study out of Los Angeles showed.
- Unvaccinated people were 11 times more likely to die of COVID-19, a recent CDC study conducted in states and counties across the U.S. showed.
- By early September, more than 176 million people in the U.S. were fully vaccinated against COVID-19, and only a small share had breakthrough cases that led to hospitalization and death. As of Sept. 7, 11,440 patients with COVID-19 breakthrough infections were hospitalized and 2,675 died, according to reports received by the CDC from 49 U.S. states and territories. The vast majority of hospitalizations and deaths were among people 65 or older.
- A Kaiser Family Foundation analysis published in late July looked at data from 23 states and Washington, D.C. and found that almost all COVID-19 hospitalizations and deaths — more than 90% — were among the unvaccinated or those who hadn’t been fully vaccinated.
If you’re vaccinated and get infected, think of how much easier it will be to live with a mild case of COVID-19 that might keep you home for a few days than to land in the hospital for weeks or die.
I’m young and healthy, so I’m not worried about getting COVID-19.
Most COVID-19 deaths have occurred among older people. If you’re young and healthy, you could get infected and recover. But you might not. COVID-19 is deadly and many young and healthy people have died from COVID-19. Being young and healthy doesn’t mean you’d be spared from a deadly virus. Even if you’re infected and get a mild case of COVID-19, you might develop lasting symptoms such as fatigue, loss of smell or taste and sleep problems, among others. Your asymptomatic or mild case could also lead you to infect others who might not be so lucky. Even populations once thought to be less susceptible to COVID-19 are now vulnerable in the face of the highly contagious Delta variant. The COVID-19 vaccines have not yet been approved for children under 12 years old, and the Delta variant has facilitated a surge in hospitalizations among children. The number of children hospitalized with COVID-19 recently hit a record high. While deaths from COVID-19 are still rare among children, they have been increasing in recent weeks, according to a review of state-level data by the American Academy of Pediatrics and the Children’s Hospital Association.
We’re all going to die someday anyway.
That’s true. But COVID-19 is a highly contagious and deadly virus. If you get infected, it’s not just your life on the line. You could infect family members, friends, colleagues or the person serving your dinner. Ask yourself: how would you feel if you knew that your decision not to get vaccinated meant that you infected someone you love who became ill or died as a result? Dying from COVID-19 is also an awful way to go. Breathing is hard and painful and ventilators and procedures to help COVID-19 patients are invasive and uncomfortable. Separated in ICUs, many who die from COVID-19 die isolated from their loved ones. Think of getting vaccinated as one of many small actions you already take to lower the risk of dying like putting on a seat belt. There’s also a financial cost to severe illness, hospitalization and death. Hospitalization can cost thousands of dollars, leaving you or your loved ones facing a steep bill. If you help financially support your family and die, that could further create hardship for the people in your life.
More:Michigan hospital staffing shortage nears crisis point as COVID-19 patients rise
‘I’m concerned that the vaccine isn’t safe or effective.’
I’m worried the vaccine will make me sick.
Some people who get vaccinated hardly feel anything, while others experience side effects that last a few days such as fatigue, muscle pain, chills, fever and nausea. Being sick for a few days can be disruptive, not to mention physically uncomfortable. You might have to miss work. It might be harder to take care of a child or an older relative. But getting vaccinated offers protection from serious illness and death from COVID-19. Think about how much more disruption ending up in the hospital or dying would cause. A few days of feeling under the weather isn’t so bad in comparison.
Two of the vaccines approved for emergency use haven’t received full FDA approval. I’m worried they’re not safe and effective.
The Pfizer vaccine recently received full FDA approval for people 16 years old and older. Two other vaccines authorized for emergency use — the Johnson & Johnson and Moderna vaccines — haven’t received full FDA approval but are expected to soon. Vaccines approved for emergency use still undergo rigorous testing. When all three vaccines were approved for emergency use that meant that clinical trials showed that the vaccines were effective and safe. Emergency use authorization and full approval by the FDA follow similar processes. The main difference is that full approval takes longer since participants in vaccine studies have to be followed for longer. The mass uptake of vaccination has confirmed what trials on which emergency use authorization were based: the vaccines work and they’re safe. Some cases of heart muscle inflammation have been detected and reported after vaccination and found to be very rare. Millions of Americans have gotten vaccinated since the first doses were administered almost a year ago without widespread problems.
More:Vaccinating Michigan: Tracking the progress of the state’s COVID-19 vaccine rollout
I’m concerned that getting the vaccine could impact my ability to get pregnant or my child’s ability to get pregnant one day.
There isn’t evidence that the COVID-19 vaccines make it harder to become pregnant. Vaccines actually help ensure a healthy pregnancy, which is why doctors recommend getting vaccinated if you’re trying to get pregnant or want to in the future. One study looked at three groups of women: those vaccinated against COVID-19, those previously infected with COVID-19 and those who haven’t been vaccinated or infected. It found no difference in pregnancy outcomes among the three groups.
I’m pregnant and I’m worried that the vaccine isn’t safe for me or the baby.
Following the recommendation of public health officials, many pregnant women have chosen to get vaccinated, while others have chosen not to out of a concern that the vaccine might not be safe. There isn’t any evidence that getting vaccinated isn’t safe for pregnant people while studies have shown that pregnant people are more likely to suffer serious illness from COVID-19 compared to those who aren’t pregnant. Getting vaccinated protects against severe illness and death from COVID-19. Research has found that pregnant people with COVID-19 are more likely to suffer pregnancy complications and preterm birth. Recent studies show that people who have received mRNA COVID-19 vaccines (such as the Pfizer and Modern vaccines) and are breastfeeding have antibodies in their breastmilk that might offer some protection to the baby.
More:Michigan coronavirus cases: Tracking the pandemic
‘I’m not in a rush to get vaccinated.’
The process for approving the vaccine was rushed. I don’t think we know enough about the lasting side effects of the vaccine.
The vaccines were developed quickly but the review of vaccines’ safety was not rushed. The first COVID-19 cases in the U.S. were reported in late January 2020. Less than a year later, the FDA approved the Moderna and Pfizer COVID-19 vaccines for emergency use and the Johnson & Johnson vaccine soon after. The FDA has an emergency use authorization process specifically for public health emergencies like the coronavirus pandemic, so health officials can rapidly approve vaccines to head off hospitalization and death. In order to be approved, the vaccines have to be shown to be safe and effective during clinical trials. Since the vaccines were approved, studies have continued to show that the vaccines are effective in preventing serious illness and death. The CDC has tracked negative reactions to the vaccine, which are very rare. Anaphylaxis after COVID-19 vaccination occurred in about two to 5 people per million vaccinated in the U.S., according to the CDC. The CDC and FDA have identified 45 confirmed reports of people who received the Johnson & Johnson vaccine who later developed Thrombosis with thrombocytopenia syndrome. Other events are after vaccination reported to the CDC are similarly rare and do not necessarily mean that the vaccine caused the health problem. Hundreds of millions of doses of COVID-19 vaccines have been administered without issue. Waiting might feel comforting, but it comes with increased risk of contracting COVID-19 and becoming seriously ill or dying. For months, millions of vaccinated Americans have been able to return to many pre-pandemic routines, knowing that when they do, they’re not putting themselves or their vaccinated friends and family at great risk. The bigger the unvaccinated population, the more opportunities the coronavirus has to infect others, which allows the virus to continue mutating into more contagious and deadly variants. By choosing to get vaccinated, you’d be playing a role to help limit the number of opportunities the virus has to continue changing in ways that could lead to a longer, more deadly pandemic.
I haven’t gotten COVID-19 yet, so I’m not in a rush to get vaccinated.
You are one of millions of Americans who haven’t contracted COVID-19. Others haven’t been so lucky. There have been over 40 million COVID-19 cases in the U.S. and over 650,000 deaths. At hospitals around the country, doctors and nurses have shared stories of patients dying from COVID-19 who expressed regret that they didn’t get vaccinated earlier. It might seem hard to find the time to get vaccinated, but waiting means increasing your chances of contracting COVID-19 and becoming hospitalized or dying. It also means increasing the chances that the pandemic will get worse and last longer. Unvaccinated people — who are more likely to get infected than those who aren’t vaccinated — enable the virus to continue to change and become more contagious and deadly.
‘I have concerns about what’s in the vaccine.’
I heard the vaccine was developed using tissue from aborted fetuses.
None of the vaccines contain fetal cells. Pfizer and Moderna didn’t use cell lines derived from an aborted fetus to develop the vaccine but did use human fetal cells to test the vaccine’s efficacy. The U.S. Conference of Catholic Bishops says that the vaccines’ connection to the abortion “is very remote” and urged anyone concerned about getting vaccinated to see “an act of love” and “moral responsibility for the common good.” Unlike the Pfizer and Moderna vaccines, the Johnson & Johnson vaccine was manufactured using a virus grown on a cell line that was derived from a fetus aborted in 1985. A single cell from the fetus was cloned to create the cell line. The Catholic bishops conference says that if given a choice, Catholics should choose Pfizer or Moderna’s vaccines but that it is morally acceptable to get any of the three vaccines available in the U.S.
I don’t know what’s in the vaccine, so I don’t know whether it’s safe or right for me.
The Pfizer and Moderna vaccines are mRNA vaccines, so they contain genetic material to produce the spike protein on the surface of the coronavirus. The vaccines do not contain the virus and won’t alter your DNA. The vaccines also contain fat, salt and other chemical components. The Johnson & Johnson vaccine contains an adenovirus — commonly used in vaccines — to allow the body to produce the spike protein on the coronavirus. It also contains salt and some other chemical components. None of the COVID-19 vaccines available in the U.S. contain eggs, gluten, preservatives, latex, metals or microchips.
I’m seeing a lot of frightening stories coming from the CDC and FDA’s vaccine safety monitoring program.
The CDC and FDA’s Vaccine Adverse Reporting System monitors health problems that occur after vaccination. Anyone can submit a report to the database, and the CDC notes that the reports shouldn’t be used to conclude that health problems reported to the system were caused by the COVID-19 vaccines. That’s because a problem that comes after an event wasn’t necessarily caused by the event. And the reports may include information that is “incomplete, inaccurate, coincidental or unverifiable,” the CDC notes. The database was set up as an early warning system to ensure vaccine safety experts have reports of health problems from individuals, healthcare providers and vaccine manufacturers to evaluate potential safety concerns with the COVID-19 vaccines. That requires following up on the reports to request patient medical records to determine what happened. The CDC specifically encourages reporting health problems even when the cause is unclear because it allows health officials to take any action necessary to address possible safety concerns. In short, the database is not a log of health problems caused by the vaccine. But the information in the database has been used to spread misinformation about the vaccines, including claims that suggest or falsely assert that health problems reported in the system were caused by the vaccine. One viral claim that a two-year-old died during a Pfizer COVID-19 vaccine trial came from a report in the database that was fabricated, Reuters reported. The report was removed from the database. And the database won’t give you the big picture: hundreds of millions of Americans have received at least one dose of the COVID-19 vaccine without any significant concerns about the safety of the vaccine emerging. A very small share of vaccinated Americans have been hospitalized or died from COVID-19.
Why and how we’re covering this topic
Why we’re doing this story
People have expressed many reasons for not getting vaccinated against COVID-19. Political polarization and misinformation have played their part, but there are other factors at play too. Some fear getting sick from the vaccine or haven’t had COVID-19 yet and don’t feel a sense of urgency to get vaccinated, for instance. We compiled this point-counterpoint piece to speak directly to the reasons why millions have chosen not to get vaccinated and answer questions or concerns people may have.
How we’re doing this story
The studies referenced in this piece were undertaken or cited by the Centers for Disease Control and Prevention or analyze data provided by state and local health authorities around the country. We consulted with Dennis Yi Tenen and Rishi Goyal at Columbia University’s Health Language Lab, which analyzes social media to understand the reasons for hesitancy, and polling by the Kaiser Family Foundation to develop the list of points. Then we worked with additional experts to write from a place of empathy to help people make an informed decision about the vaccine. They include Fred Vultee, an associate professor of journalism at Wayne State University; Karen Kelly-Blake, assistant director and associate professor in the Center for Bioethics and Social Justice and Department of Medicine at Michigan State University’s College of Human Medicine; and Dr. Joshua Liao, an associate professor at University of Washington’s School of Medicine and School of Public Health.
Did we succeed?
If you see yourself in this piece but the counterpoint did not sufficiently answer your concerns, or if your concern was not mentioned at all, please let us know by emailing [email protected]. Likewise, if this piece helped you in any way, we’d like to know. We value this feedback and will use it to improve this article and inform future reporting.
Tell us what you think
The Detroit Free Press is conducting a survey as part of this project on vaccine hesitancy. This survey will take less than 2 minutes to complete. It is anonymous unless you choose otherwise; sharing your email address is optional.
Our sources
CDC, “Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths by Vaccination Status – 13 U.S. Jurisdictions, April 4-July 17, 2021,” 9/10/21
Emerging Infectious Diseases, “Predictors of Nonseroconversion after SARS-CoV-2 Infection,” September 2021.
CDC, “Reduced Risk of Reinfection with SARS-CoV-2 After COVID-19 Vaccination – Kentucky, May-June 2021,” 8/6/21
CDC, “COVID-19 Breakthrough Case Investigations and Reporting,” accessed 9/10/21
Kaiser Family Foundation, “COVID-19 Vaccine Breakthrough Cases: Data from the States,” 7/30/21
CDC, “Provisional Death Counts for Coronavirus Disease 2019 (COVID-19),” accessed 9/10/21
CDC, “Post-COVID Conditions,” 7/12/21
American Academy of Pediatrics, “Children and COVID-19: State-Level Data Report,” 9/7/21
American Academy of Pediatrics and the Children’s Hospital Association, “Children and COVID-19: State Data Report,” 9/2/21
CDC, “Possible Side Effects After Getting a COVID-19 Vaccine,” 8/6/21
American Society for Reproductive Medicine, “SARS-CoV-2 spike protein seropositivity from vaccination or infection does not cause sterility,” 6/1/21
The New England Journal of Medicine, “First Case of 2019 Novel Coronavirus in the United States,” 3/5/21
CDC, “United States COVID-19 Cases, Deaths, and Laboratory Testing (NAATs) by State, Territory, and Jurisdiction,” accessed 9/10/21
U.S. Conference of Catholic Bishops, “Moral Considerations Regarding the New COVID-19 Vaccines,” 12/11/20
U.S. Conference of Catholic Bishops, “U.S. Bishop Chairmen for Doctrine and for Pro-Life Address the Use of the Johnson & Johnson Covid-19 Vaccine,” 3/2/21
CDC, “Vaccine Adverse Event Reporting System (VAERS),” 8/25/21
Reuters, “Fact Check-A two-year-old did not die during Pfizer’s pediatric COVID-19 vaccine trial,” 5/12/21
CDC, “Selected Adverse Events Reported after COVID-19 Vaccination,” 9/7/21
CDC, “COVID-19 Vaccines While Pregnant or Breastfeeding,” 8/11/21
Clara Hendrickson fact-checks Michigan issues and politics as a corps member with Report for America, an initiative of The GroundTruth Project. Make a tax-deductible contribution to support her work at bit.ly/freepRFA. Contact her at [email protected] or 313-296-5743. Follow her on Twitter @clarajanehen.
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