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GIRONA, SPAIN - DECEMBER 27: A health care professional shows one of the first doses of the Pfizer-BioNTech Covid-19 vaccine in Spain to the media, at Gent Gran Creu de Palau nursing home on December 27, 2020 in Girona, Spain. Spain will begin to administer the coronavirus vaccine developed by Pfizer and BioNTech on December 27. With 1.84 million cases recorded since the start of the pandemic, Spain has reported almost 50,000 covid-19 deaths. (Photo by David Ramos/Getty Images)

In light of the current Pfizer/Biotech and Modera COVID vaccine rollouts, and reports of rare allergic reactions by some recipients, the CDC has issued guidance entitled, Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States.

To summarize, the following guidance has been given by the CDC and may change once more data becomes available:

Who can receive the COVID vaccine?

The Moderna vaccine can be administered to anyone who is over 18. The Pfizer/Biotech can be administered to those over 16 years of age.

Can children receive the COVID vaccine?

At this time, those younger than 16 are not “authorized” to receive the Pfizer/Biotech vaccine. Children of any age are not “authorized” to receive the Moderna vaccine at this time.

How far apart must the shots be given?

The Pfizer/Biotech vaccine is given in 2 doses 21 days apart.

The Modera vaccine is given in 2 doses as well but 28 days apart.

A 4 day “grace period” is given for the second shot for both vaccines but the CDC states:

The second dose should be administered as close to the recommended interval as possible. However, there is no maximum interval between the first and second dose for either vaccine.

Can you mix and match vaccines?

It is currently NOT advised to have doses from different mRNA vaccines but to stick with the brand that was administered as a first dose. However, guidance may change.

Can you get the flu shot at the same time as the COVID vaccine?

Since data is limited, it is not currently advised to have both shots given at the same time.

How soon after having COVID can you get the COVID vaccine?

Once symptoms have improved and isolation ended, the CDC states: Vaccination of persons with known current SARS-CoV-2 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. This recommendation applies to persons who develop SARS-CoV-2 infection before receiving any vaccine doses as well as those who develop SARS-CoV-2 infection after the first dose but before receipt of the second dose.

When should you defer getting the COVID Vaccine if you were treated for COVID?

According to the CDC if one received antibody therapy to fight their COVID infection, a 90 day waiting period is recommended to avoid interference of the antibody treatment with vaccine-induced immune responses.

What if you had a severe allergic reaction to another vaccine, can you still receive the COVID vaccine?

According to the CDC: These persons may still receive mRNA COVID-19 vaccination, but they should be counseled about the unknown risks of developing a severe allergic reaction and balance these risks against the benefits of vaccination.

When should you avoid the COVID vaccine?

If a person has had a “severe allergic reaction (anaphylaxis)” to any component of the vaccine. The CDC states: Severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine is a contraindication to vaccination for both the Pfizer-BioNTech and Moderna COVID-19 vaccines. 

What if I was exposed to COVID…when can I get the vaccine?

To avoid exposing those administering the vaccine, it is recommended that those in non-healthcare settings wait until they are out of quarantine to receive it: Thus, persons in the community or outpatient setting who have had a known COVID-19 exposure should not seek vaccination until their quarantine period has ended to avoid potentially exposing healthcare personnel and other persons to SARS-CoV-2 during the vaccination visit.

How long should I wait to leave after receiving the COVID vaccine?

Although an allergic reaction (if one would occur) could happen immediately or delayed, the CDC recommends:

  • Persons with a history of anaphylaxis (due to any cause): 30 minutes
  • All other persons: 15 minutes

Can immunocompromised individuals such as those with HIV or cancer receive the COVID vaccine?

Although data is limited, the CDC states: Immunocompromised individuals may still receive COVID-19 vaccination if they have no contraindications to vaccination.

Can those with autoimmune disorders receive the COVID vaccine?

Although data is limited, the CDC states: Persons with autoimmune conditions who have no contraindications to vaccination may receive an mRNA COVID-19 vaccine.

Can those with a history of Guillain-Barré syndrome (GBS) receive the COVID vaccine?

Although no GBS cases have been reported, the CDC states: Persons with a history of GBS may receive an mRNA COVID-19 vaccine unless they have a contraindication to vaccination.

Can those with a history of Bell’s Palsy receive the COVID vaccine?

Although rare cases of Bell’s Palsy have been reported in both vaccines, the CDC states: Persons with a history of Bell’s palsy may receive an mRNA COVID-19 vaccine unless they have a contraindication to vaccination

Can pregnant women receive the COVID vaccine?

Although studies are currently being planned, the CDC states: Based on current knowledge, experts believe those mRNA vaccines are unlikely to pose a risk to the pregnant person or the fetus.

Can breastfeeding women receive the COVID vaccine?

Although data is limited, the CDC states: mRNA vaccines are not thought to be a risk to the breastfeeding infant.

The above guidance may change and updates can be found here.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is a Board Certified Family Physician

@DRDALIAH