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.

The situation is fluid as the plan updates and the amount of available vaccines fluctuate. This story will be periodically updated with new questions and guidance.

What are the two types of vaccines currently available? 

There are currently two vaccines approved by the U.S. Food and Drug Administration in December for emergency use: the Pfizer vaccine and the Moderna vaccine. They are similar in that they both require two doses administered three weeks apart through a shot. 

But they differ critically on how cold they need to be to remain viable: while the Pfizer vaccine needs to be kept at minus 40 degrees below Fahrenheit, the Moderna candidate needs only to be kept at minus four degrees — and it can be stored in a refrigerator for 30 days compared to five days for the Pfizer vaccine. Those differences affect who gets what vaccine, because typically only hospitals, the Maine CDC and some universities have the super-cold freezers that can support the Pfizer vaccine.

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

Vaccines provided through the federal government are free.

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. Neither has been discovered in Maine.

Both vaccines have been found to work against the U.K. strain, but are less effective against the original version of the virus and even 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 booster shots to protect against the variants.

READ MORE ON MAINE COVID VACCINATIONS

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.

I’ve been vaccinated. When can I see people again?

One of the biggest outstanding questions about the vaccines is whether they keep you from getting sick outright or if they only prevent the symptoms of the virus, meaning you could still be infected once vaccinated and pass it on to others.

The federal CDC notes it is also possible you could get infected in the few weeks after being vaccinated as your body builds immunity to the virus. It is likely public health measures meant to curb the virus’ spread, such as mask-wearing and social distancing, will continue even as the vaccine becomes more widely available.

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.

I had to cancel my vaccine appointment. How quickly do I need to 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.

The Maine CDC, following federal guidelines, now has four phases for vaccination in the state.  The first phase is divided further into three parts. The plan underwent a major change the week of Jan. 11 after the federal CDC released new guidelines.  Phase 1A, which began in December, is reserved for health care workers, residents in long-term care facilities, first responders, corrections officers and those who work in the COVID-19 testing field.

Phase 1B is people over the age of 65 and frontline workers. This group is expected to begin getting vaccinated on Jan. 18, with people over the age of 70 going first, followed by people aged 65-69. You should consult your doctor on vaccinations because the state needs to ensure doses line up with appointments.

Anyone with comorbidities and underlying conditions, regardless of age, are also included in Phase 1B, along with frontline workers. Phase 1C includes other workers not covered in the first wave. Phase 2 is when the vaccine will start to become available to the general public, according to the Maine CDC. It covers everyone above age 16 not included in Phase 1.

The state has a tentative timeline that would see all “acute care” personnel — emergency and intensive care staff, COVID units, emergency management and home health — vaccinated in December and January. After that is supposed to be non-patient-facing individuals, such as information technology, management and medical records.

Phase 1A is currently ongoing and expected to be completed by February. Phase 1B will begin in mid-January and continue through April, according to Maine CDC timelines. Phase 1C is expected to begin in May and run through June. Phase 2 will start in June.

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.

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. This group is part of the first phase of vaccinations, but will have to talk to their care providers about when and how they will get vaccinated, Long said.

When will I know when it’s my turn to get vaccinated, and where will it happen?

It depends on what phase you fall into. Right now, the Maine CDC is estimating the general public may not get the vaccine until summer 2021.

The agency will publicize when the phase you belong to is expected to begin; your employer or medical provider may also be able to give you guidance on when you are eligible. Starting Jan. 18, providers will be able to schedule vaccines for people 70 and older; the Maine CDC has said it will publish information on its website on providers willing to vaccinate this group.

Long-term care facilities will be primarily used as sites for the first phase of vaccinations. But some with few residents or staff have also been identified by the state as candidates for “strike teams” of Maine public health nurses and emergency management services staff to provide vaccination services. 

Pharmacies are also part of the Phase 1 rollout for nursing homes, but will also become sites to vaccinate the general public once it is available. CVS and Walgreens are heading the nursing home vaccinations, but other chains, like Hannaford, will likely play big roles in the second phase of vaccinations. A company spokesperson for the supermarket chain said all 57 locations that have pharmacies will be offering the vaccine.

Your employer may play a role as well. The Maine Immunization Program will look at employers that provided influenza clinics for employees in the past and is working with the Department of Labor to obtain lists of the largest employers. If you are in Phase 2, you might be able to get a vaccine at work.

The state is also recruiting federally qualified health centers, rural health centers and physicians’ offices to provide vaccines starting in Phase 2. Mobile vaccine providers who typically inoculate school children against the common flu will also be used for those populations during the general public phase. Other locations — like colleges, homeless shelters and correctional facilities — may offer vaccination services depending on the high-risk populations they serve.

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 on Jan. 19 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.

Have any vaccines been compromised in Maine?

Over 4,000 Moderna vaccines meant for 35 sites in the state had to be replaced after their temperature was compromised during the shipping process, officials announced Jan. 19. The issue is believed to have occurred during the packing or shipping stage of transport, but the CDC determined the vaccines can still be used.

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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