Seniors in Westchester, Nassau and Fairfield County, Connecticut, were first in line for COVID-19 vaccinations, resulting in a rapid decline in infections, related hospitalizations and deaths among this age group in the past few months. It is cause for much needed optimism even if it's too early to declare victory against the COVID-19 virus.

After speaking with our clients, their families and our STEPS Home Care aides, we realized that while so many of you may have already received your COVID-19 vaccinations, there are still so many unanswered questions moving forward.

1. Will I test positive IF I take a COVID-19 test after I get the vaccine?

No. Neither the recently authorized and recommended vaccines nor the other COVID-19 vaccines currently in clinical trials in the United States can cause you to test positive on COVID-19 viral tests.

2. How long will protection from my COVID-19 vaccination last? 

Because the vaccines are so new, the scientists do not know how long their protection will last so we will likely need booster shots at some point to update our protection and fight against new COVID-19 variants. It is possible that COVID-19 vaccinations will become an annual part of our medical routines,  just like the flu shot. We will have to wait and see.

3. Can I still catch COVID-19 and transmit it to someone else after getting the vaccine?

Yes.  However, medical experts know that getting a COVID-19 vaccination will protect you from very serious illness and possible death resulting from a COVID-19 infection. Your vaccination can also protect the people around you, as the risk of your spreading the virus is very low if you do become mildly ill or have an asymptomatic case. One study conducted by the Israeli Health Ministry and Pfizer Inc. found that the vaccine reduced infection, including asymptomatic cases, by 89.4% and in symptomatic cases by 93.7%.

“That’s something that the recipients will have to understand when they get the vaccine,” says William Schaffner, M.D., an infectious disease specialist and professor of preventive medicine at the Vanderbilt University School of Medicine. The vaccine provides protection, but it is not a 100% guarantee of immunity.  Just because you roll up your sleeve and get the vaccine doesn’t mean you can throw away your mask and disregard other prevention efforts such as social distancing and handwashing. Those will be crucial for quite some time” in order to get control over the virus,” Schaffner says.

4. What happens if I contract the COVID-19 virus between the first dose and second dose of the vacccine?

Because the first vaccine shot takes a few weeks to start making adequate antibodies in your bloodstream to fight off COVID-19, it is possible to catch COVID-19 while you’re waiting for your second dose. In most cases, it was not known whether patients already had the virus when they were given the first vaccine, or whether they were exposed after vaccination. Those who did get the virus between shots experienced a much more mild illness because their bodies did have some antibodies made and were ready to fight the virus off.

Clinical trials of the vaccines from Moderna and Pfizer-BioNTech showed they reach only about 50 percent efficacy in the first few weeks after the first shot. If you develop COVID-19 after the first dose, you should still plan on getting the second dose on schedule, but check with your doctor first. And remember, even after two doses, no vaccine offers 100 percent protection

5. Do I need the vaccine if I already have had a COVID-19 infection?

Yes.  Although people who have contracted the virus are believed to have at least some natural immunity, it is too soon to know how long it lasts: Some research shows immunity lasting up to three months and maybe longer. On a positive note, studies are now showing that people who had COVID-19 and developed long-term side effects, “longhaulers,” are feeling better and having symptom relief after getting the vaccine. 

According to the CDC, if you were treated for COVID-19 symptoms with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Check with your doctor if you do not remember what treatments you received or if you have questions about getting a COVID-19 vaccine.

6. If I have a reaction to the vaccine, how will I know if I have symptoms of COVID-19 or it is the vaccine?

COVID-19 vaccine side-effects seem to last one to three days - fatigue, headache, chills, fever, redness and swelling in your arm and muscle pain may appear. These symptoms typically resolve one to three days after they begin. If your symptoms do not improve within a few days, you should contact your primary care physician to rule out a COVID-19 infection or any other medical issue. Vaccine researchers say there is no need to worry if you do find out you were infected with COVID-19 at the time of vaccination….you might not feel well, but that’s due to the infection, not the vaccine.

7. Will the vaccines we have now still be effective in fighting against the new COVID-19 strains?

Viruses naturally change over time through the process of mutation. When this happens, new variants can develop. COVID-19 is no exception. As the pandemic has progressed, new coronavirus variants have been detected around the world. Some that you may have heard of in the news are:

• B.1.1.7 (the variant first seen in the United Kingdom)
• B.1.351 (the variant first seen in South Africa)
• P.1 (the variant first seen in Brazil)

Although the current mutated strains of COVID-19 are concerning, the NYBC found that the Pfizer, Johnson & Johnson, and Moderna vaccines create enough antibodies to fight the virus variants, according to the article “Vaccine efficacy probable against COVID-19 variants” by Dr. Christopher D. Hillyer and Dr. Larry Luchsinger.

This is currently an area of ongoing, intense research.  Even if the current vaccines are less effective against some variants, they still provide some level of protection from becoming sick with COVID-19. Additionally, when more people have some immunity, the transmission of the virus can be slowed. in the future to improve its effectiveness against emerging new variants.

8. Help!  I am Homebound in Westchester. How Do I find Someone to Vaccinate Me in my Home?.

About one out of every eight Westchester County residents has been fully vaccinated against COVID-19 as of last week and nearly one-quarter are at least partially inoculated.

"Westchester is expected to receive a shipment of additional Johnson & Johnson vaccines on Mar. 29.  Those are considered best for seniors, including the homebound, because they require just one dose and would prevent the less mobile population from having to venture out for a second shot," according to Westchester County Government.

The county is working with Empress Ambulance Service to distribute the Johnson & Johnson vaccine to homebound seniors who are at least 65 years old, said Latimer.

Following New York City's lead, the city of Yonkers has also started administering the COVID vaccine to residents who are older than 60 and homebound.

Yonkers has vaccinated nearly 1,000 homebound residents so far, with plans to reach more people soon. The city's program is part of a statewide push to vaccinate homebound individuals who otherwise have been unable to receive a COVID vaccine.

If you have any questions about your loved ones and the COVID-19 vaccine, please call your primary care physician or Barbara Moran, RN, STEPS Director of Patient Care 914.618.4200.