Ensuring safety

 Millions of people have safely received COVID-19 vaccines. All of the approved COVID-19 vaccines have been carefully tested and continue to be monitored. Like all vaccines, COVID-19 vaccines go through a rigorous, multi-stage testing process, including large clinical trials that involve tens of thousands of people. These trials are specifically designed to identify any safety concerns An external panel of experts convened by WHO analyses the results from clinical trials and recommends whether and how the vaccines should be used. Officials in individual countries decide whether to approve the vaccines for national use and develop policies for how to use the vaccines based on WHO recommendations. data:image/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw== After a COVID-19 vaccine is introduced, WHO supports work with vaccine manufacturers, health officials in each country and other partners to monitor for any safety concerns on an ongoing basis.

New vaccine technology

Some COVID-19 vaccines have been developed with an approach that uses messenger RNA (mRNA). The mRNA vaccine technology has been studied for over a decade, including in the development of vaccines for Zika, rabies and influenza. These mRNA vaccines have been rigorously assessed for safety, and clinical trials have shown that they provide a long-lasting immune response. mRNA vaccines are not live virus vaccines and do not interfere with human DNA. For more information on mRNA vaccines, see WHO’s explainer on the different types of COVID-19 vaccines.

Safety of COVID-19 vaccines for different groups

COVID-19 vaccines have been tested in large, randomized controlled trials that include people of a broad age range, both sexes, different ethnicities, and those with known medical conditions. The vaccines have shown a high level of efficacy across all populations. Vaccines have been found to be safe and effective in people with various underlying medical conditions that are associated with increased risk of severe disease. These include high blood pressure; diabetes; asthma; pulmonary, liver or kidney disease; and chronic infections that are stable and controlled. Those who should consult with a doctor before vaccination include people with a compromised immune system, older people with severe frailty, people with a history of severe allergic reaction to vaccines, people living with HIV, and those who are pregnant or breastfeeding.

Pregnancy

While pregnancy brings a higher risk of severe COVID-19, at present, very little data is available to assess vaccine safety in pregnancy. However, people at high risk of exposure to the COVID-19 virus (such as health workers), or who have a history of underlying medical conditions that increase their risk of severe disease, may be vaccinated during pregnancy after consultation with their health care provider. There is no evidence that suggests vaccination would cause harm during pregnancy.

Breastfeeding

The vaccine can be offered to those who are breastfeeding if they are part of a group recommended for vaccination (health workers, for example).

Safety of COVID-19 vaccines for children

COVID-19 vaccine trials for children are currently under way, and when results become available, WHO will provide updated guidance for vaccination in children. Vaccine trials targeting adults were prioritized because COVID-19 has proven to be a more serious and dangerous disease among older populations. 

 Following proven health measures is still the best way to keep everyone, including children, safe from COVID-19. This includes keeping hands clean, practising sneezing and coughing into bent elbows, opening windows, wearing a mask if age-appropriate, and continuing physical distancing.   

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Getting vaccinated is safer than getting infected

Vaccines train our immune system to recognize the targeted virus and create antibodies to fight off the disease without getting the disease itself. After vaccination, the body is ready to fight the virus if it is later exposed to it, thereby preventing illness. Most people who are infected with SARS-CoV-2, the virus that causes COVID-19, develop an immune response within the first few weeks, but we are still learning how strong and lasting that immune response is, and how it varies between different people. People who have already been infected with SARS-CoV-2 should still get vaccinated unless told otherwise by their health care provider. Even if you’ve had a previous infection, the vaccine acts as a booster that strengthens the immune response. There have also been some instances of people infected with SARS-CoV-2 a second time, which makes getting vaccinated even more important. 

What to expect during vaccination

Medical professionals can best advise individuals on whether or not, and when, they should receive a vaccine. A health worker will administer the vaccine, and the person receiving it will be asked to wait for 15–30 minutes before leaving the vaccination site. This is so that health workers can observe individuals for any unexpected reactions following vaccination. Like any vaccine, COVID-19 vaccines can cause mild-to-moderate side effects, such as a low-grade fever or pain or redness at the injection site. These should go away on their own within a few days. See WHO’s Safety of COVID-19 Vaccines explainer and Vaccines Safety Q&A to learn more about common side effects and find out who should consult with a doctor before vaccination. 

Vaccine doses

For some COVID-19 vaccines, two doses are required. It’s important to get the second dose if the vaccine requires two doses. For vaccines that require two doses, the first dose presents antigens – proteins that stimulate the production of antibodies – to the immune system for the first time. Scientists call this priming the immune response. The second dose acts as a booster, ensuring the immune system develops a memory response to fight off the virus if it encounters it again. Because of the urgent need for a COVID-19 vaccine, initial clinical trials of vaccine candidates were performed with the shortest possible duration between doses. Therefore an interval of 21–28 days (3–4 weeks) between doses is recommended by WHO. Depending on the vaccine, the interval may be extended for up to 42 days – or even up to 12 weeks for some vaccines – on the basis of current evidence. There are many COVID-19 vaccines being developed and produced by different manufacturers around the world. WHO recommends that a vaccine from the same manufacturer be used for both doses if you require two doses. This recommendation may be updated as further information becomes available.

Safety against infection and transmission after vaccination

Available clinical trials have shown COVID-19 vaccines to be safe and highly effective at preventing severe disease. Given how new COVID-19 is, researchers are still looking into how long a vaccinated person is likely to be protected from infection, and whether vaccinated people can still transmit the virus to others. As the vaccine rollout expands, WHO will continue to monitor the data alongside regulatory authorities. 

 Safe and effective vaccines are making a significant contribution to preventing severe disease and death from COVID-19. As vaccines are rolling out and immunity is building, it is important to continue to follow all of the recommended measures that reduce the spread of SARS-CoV-2. This includes physically distancing yourself from others; wearing a mask, especially in crowded and poorly ventilated settings; cleaning your hands frequently; covering any cough or sneeze in your bent elbow; and opening windows when indoors.

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