Revisiting common COVID-19 vaccine questions

illustration of female in red shirt holding a symbol of SARS-CoV-2 in one hand and a vaccine vile in the other hand

Before the COVID-19 pandemic, many people didn’t need to know how our immune systems work. Or exactly how vaccines partner with this system to keep us safe.

Many continue to face decisions about COVID-19 vaccination. So let’s revisit some common questions we continue to see today.

Dr. Andrea Willis, chief medical officer for BlueCross BlueShield of Tennessee, has a background in pediatrics as well as public health. And she helped us understand the most recent information about these vaccines.

Are COVID-19 vaccines actually working?

Dr. Willis: COVID-19 vaccines are working. But it can be difficult to fully understand how if you’re less familiar with how vaccines work.

Here are 6 things to keep in mind:

  1. The goal of any vaccine is to prevent serious illness that could lead to hospitalization or death. That’s how we define whether it “works” or not.
  2. There is no vaccine that’s 100% effective at preventing infection or illness. That’s never been a promise with any vaccine.
  3. The strong efficacy numbers reported during initial clinical trials illustrate the ideal scenario, meaning that’s what could happen if everyone was vaccinated.
  4. In the real world, if everyone isn’t vaccinated, the virus will linger in the environment. This means it can infect the unvaccinated and even vaccinated people. Vaccinated people tend to have milder illness though.
  5. Continued spread of the disease due to low vaccination rates also allows more dangerous variants to develop. We saw this with the Delta variant. The Omicron variant has now been identified and has more mutations than any of the variants seen so far. We’re still finding out how transmissible the Omicron variant is and the severity of illness it causes.
  6. We’re fortunate that COVID-19 vaccines have been successful in protecting vaccinated people from the Delta variant. We saw very few vaccinated patients in hospitals during the height of this variant’s surge. Research is going on to determine how the current vaccines will protect against the Omicron variant.

What about long-term side effects?

Dr. Willis: There hasn’t been a vaccine in history that has had side effects appear later than 8 weeks after vaccination. But why is that? The very nature of how vaccines work and how our immune system uses them suggests our immune systems process vaccines quickly. That’s why we don’t see vaccine side effects pop-up years after vaccination like we might with something we put into our bodies regularly. Think of it this way: If immunity we get from COVID-19 vaccination can wane over time, how would new side effects surface years from now?

But, “long COVID” continues to affect many people after they recover from COVID-19, even if it’s a mild case. Memory loss, fatigue, loss of smell or taste, blood clotting issues, organ damage and other symptoms are causing problems for people well-after recovery.

What should we look at instead?

Dr. Willis: When it comes to vaccines, the experts are most concerned with effects seen from large-scale vaccination. More than 442 million vaccine doses have been administered in the U.S. as of Nov. 15, 2021, and adverse events still remain rare. The CDC has provided updates on these rare events in the interest of transparency and public awareness. This information is collected from multiple agencies and organizations monitoring vaccines. It also includes information submitted to the Vaccine Adverse Event Reporting System (VAERS) by healthcare providers.

What’s the safest option?

Dr. Willis: There’s no option that eliminates all risks. Except in people with rare medical issues, choosing not to get vaccinated is far riskier than choosing to get vaccinated. We’re seeing real-world evidence that people are not having severe complications from these vaccines. But we are seeing many people experience serious long-term side effects from getting sick with COVID-19. And more than 773,000 people in the U.S. have died from the disease.

Is natural immunity better than vaccination?

Dr. Willis: When it comes to natural immunity, people have varying degrees of COVID-19 infection. Some may have a very mild case, others more severe, and the responses are different depending on that. And, natural immunity does wane over time, making those individuals susceptible to reinfection.

With COVID-19 vaccination, we know immunity can wane over time, too. That’s why everyone 18 and older can get a booster. But the vaccine stimulates more parts of the immune system to mount a response. It’s impossible to predict how your body will react to COVID-19. So it’s safer to help your body be prepared to fight infection than risk having severe symptoms from getting sick or dealing with “long COVID” effects.

What’s the most recent data saying?

Dr. Willis: The most recent study on this topic was conducted in 187 hospitals across nine states. The conclusions of the study so far indicate that natural immunity is not as strong as the immunity that comes from getting vaccinated.

How do vaccines change when they become fully approved?

Dr. Willis: The COVID-19 vaccines were still approved by the FDA, even though they were initially released under Emergency Use Authorization (EUA). The review process was the same as any other vaccine. Because of the pandemic, the data could be submitted after a shorter period of participant follow-up than usual, even though those studies would continue and data would still be reported on.

The vaccines used today under EUA will be no different than those that are being used the day after the vaccines get full Biologics License Application (BLA) approval. The vaccines have already been given safely to millions of people. And manufacturers have been monitoring vaccine recipients for months. Delaying vaccination until the vaccines get “full approval” is taking an unnecessary risk.

How do we know who to trust?

Dr. Willis: You’ll find no shortage of answers online – and intentional misinformation used to try to scare you. Consensus among the medical community at large is that COVID-19 vaccines are safe, effective, and saving lives. The CDC makes its recommendations based on data and information from studies done by multiple respected medical organizations and sources.

Speak to a provider who knows your medical history if you have questions or concerns about vaccines. Avoid looking for answers from places or people who may not have the education, expertise or reliable, vetted data available to help you make the safest decision.

Need more advice?

Speak to a provider who knows you or your child’s medical history if you have questions or concerns about vaccines based on you or your child’s health status. Your friends and family may have good intentions, but they may not know your body like you and your doctor, so it’s important to speak to a provider who knows you well.

If you do decide to go online to learn more about vaccines, do seek reputable sources like the CDCFDA or World Health Organization (WHO). BlueCross BlueShield of Tennessee members can also visit to get the latest on our support for COVID-19.

More COVID-19 vaccine information from BlueCross medical experts

Ali Whittier, CHES®

Ali joined the BlueCross BlueShield of Tennessee corporate communications team in 2014 and is a Certified Health Education Specialist (CHES®) through the National Commission for Health Education Credentialing (NCHEC). A native of Iowa, she has more than a decade of experience in health promotion and community engagement, as well as health care communications. When she’s not at BlueCross, she and her husband Spencer are racing their bikes, spending time outdoors or cooking healthy food and treats in their kitchen.

More Posts - LinkedIn

Get more information about specific health terms, topics and conditions to better manage your health on BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.