More than 58,000 doses of COVID-19 vaccines had been administered in Maine as of Tuesday morning, with thousands more doses being injected into arms daily. But Maine’s vaccination plan will be a months-long effort, and many people have questions about how it will play out.

Here are answers to some common questions about the vaccination rollout and what to expect in the coming months. Have other questions? Email them to vaccine@pressherald.com.

How common are allergic reactions to the COVID-19 vaccines?

As with any vaccine, recipients of COVID-19 shots can experience pain or swelling at the injection site, fever, tingling or other symptoms soon after vaccination. These are fairly common side effects because vaccines work by triggering an immune system response in order to essentially teach the body to recognize and fight off the real virus down the road.

Severe allergic reactions are rare, however.

Nationwide, there were 3,912 “adverse reactions” to COVID-19 vaccines reported to the U.S. Centers for Disease Control and Prevention as of Dec. 31. About 2.8 million people had received the first dose of vaccine by then, which translates to reactions in 0.1 percent of recipients.

There have undoubtedly been more allergic reactions since the pace of vaccination has increased, but that is the most recent data available on the US CDC’s Vaccine Adverse Event Reporting System.

In Maine, there were 34 adverse reactions reported to the federal database among individuals who received shots between Dec. 17-24, which is the last available date for Maine and many other states. The Maine Center for Disease Control and Prevention relies on the federal CDC’s database to track vaccine reactions.

Among those 34 reactions, the majority involved temporary dizziness, nausea, hives, headaches, body aches or fever – all symptoms of the vaccine triggering an immune response, as expected. In most cases, the symptoms either faded within several hours or dissipated over the course of a day or two.

At least six individuals were taken to emergency rooms for monitoring, and one patient (who was asthmatic) required epinephrine and other allergy-related medications to address breathing problems.

Nationwide, there were 29 case of anaphylaxis – a severe, life-threatening allergic reaction also known as anaphylactic shock – reported in the U.S. as of last week and no deaths tied to the reactions, according to the federal CDC.

“This is still a rare outcome,” Dr. Nancy Messonnier, director of the U.S. CDC’s National Center for Immunization and Respiratory Diseases, said during a news conference last week, according to NBC News. “Right now, the known and potential benefits of the current COVID-19 vaccines outweigh the known and potential risks of getting COVID-19.”

Anyone who receives a COVID-19 vaccine should be monitored by on-site health professionals for at least 15 minutes, or longer, in case of reactions.

Are people with known allergies more likely to have a reaction to the COVID-19 vaccine?

Researchers are still looking into this but preliminary evidence suggests that some allergies could increase the risk of a reaction to COVID-19 vaccines. That said, federal health officials guidance still recommends COVID-19 vaccines for many people who have allergies to things other than vaccines.

“CDC recommends that people with a history of severe allergic reactions not related to vaccines or injectable medications — such as food, pet, venom, environmental, or latex allergies — get vaccinated,” the agency stated in a Dec. 31 update on allergies. “People with a history of allergies to oral medications or a family history of severe allergic reactions may also get vaccinated.”

There is no latex in the vial stoppers used in either vaccine, and the vaccines themselves do not contain eggs or gelatin that could trigger reactions in individuals with those allergies.

However, people allergic to polyethylene glycol (PEG) or polysorbate should not receive a COVID-19 inoculation – unless their allergist determines otherwise – because PEG is used in the vaccine. Additionally, individuals who have had immediate allergic reactions to other vaccines or injectable therapies should consult with an allergist before getting the COVID-19 vaccine because such allergies are “a precaution but not a contraindication to vaccination.”

Again, consult with your doctor about your specific situation.

What if I had an allergic reaction (as opposed to more normal side effects) to the first dose of the COVID-19 vaccine? Should I get the second dose?

No. The federal CDC recommends that anyone who had “an immediate allergic reaction” to the first dose of either the Pfizer or Moderna vaccines should not receive the second dose. However, the agency says medical providers should attempt to determine whether the reactions were “consistent with immediate allergic reactions” rather than other triggers related to anxiety or other “post-vaccination side effects.”

Does the second dose pack a stronger punch than the first and cause more severe side effects?

Yes, clinical trials showed recipients were more likely to report a fever, aches or other side effects after the second dose. But Dr. Nirav Shah, director of the Maine CDC, said that is neither surprising or concerning.

“This is not an adverse reaction and it’s not a concerning reaction,” Shah said on Monday. “It is, indeed, how the vaccine works. The second dose is intended to be that booster shot. … It’s supposed to strengthen and fortify the body’s response.”

Can I get a COVID-19 vaccine at the same time as other vaccines or around the same time?

It depends.

The U.S. CDC advises that, because of the lack of data on interactions with other vaccines, the COVID-19 vaccination series “should routinely be administered alone with a minimum interval of 14 days before or after administration with any other vaccine.”

That is not a hard and fast rule, however. The CDC said the COVID-19 vaccine may be administered in closer proximity to other inoculations if the benefits outweigh the potential unknown risks. Specific examples include tetanus vaccines following a wound, vaccines for measles or hepatitis A during and outbreak, or in some cases of long-term care residents and staff who recently received flu shots.

As always, consult with your doctor about your circumstances.

How many people have been vaccinated in Maine so far?

As of Tuesday, 51,150 people in Maine had received the first dose of vaccine and 6,933 individuals had been fully inoculated with the first and second doses. That equates to 4.15 doses administered for every 100 residents, which was the fifth-highest ratio nationally behind South Dakota, North Dakota, West Virginia and Alaska, according to tracking by Bloomberg.

Where is Maine now in the vaccination rollout?

Maine is still squarely within Phase 1A, which is focused on hospital emergency department and COVID unit staff, first responders, long-term care residents and staff, and other medical professionals at higher risk of contracting COVID-19. Vaccinations are also underway for primary care physicians and specialists not affiliated with hospitals as well as residents of assisted-living facilities.

Timing of the next phase depends heavily on vaccine deliveries from the federal government. Mainers age 75 or older as well as front-line “essential workers” – such as teachers, police officers, grocery store workers, postal clerks and public transit employees – are expected to begin receiving vaccinations in February during Phase 1B.

Those between the ages of 65 and 74, as well as younger individuals with medical conditions that put them at higher risk, are in Phase 1C, which is likely to begin in late winter or early spring. The target audiences of those phases are not set in stone, however, and Gov. Janet Mills indicated Tuesday that she will be making adjustments to vaccine distribution in the coming days and supports prioritizing older residents and those with underlying health conditions.

Widespread vaccination of the rest of Maine’s population is not expected to begin until late spring or early summer.

What about children and teenagers?

The Pfizer vaccine was approved for ages 16 and older, and the Moderna vaccine for those 18 and older. However, research has begun on using the vaccines for those age 12 and older, and is expected to begin this year for younger children. People in these age groups would already be among the last to receive the vaccine, and it’s unclear how long it will take to complete the research on children and have them approved for a vaccine, but expect it to be well into 2021. However, with both Pfizer and Moderna vaccines having 95 percent effectiveness rates and more vaccines potentially being approved in 2021, case rates, if all goes well, will be declining substantially by late spring or summer, public health experts have said.

Why is a healthy, 20-year-old grocery store worker eligible for a vaccine before a 70-year-old, given the risks to older Mainers?

Maine’s vaccination plan is based on guidance from the federal Advisory Committee on Immunization Practices. And public health officials acknowledge they are trying to maximize the effects of limited, early supplies of vaccines. Mainers age 70 or older account for 85 percent of deaths in the state. But 20-something grocery clerk or postal worker has higher likelihood of catching the virus and potentially spreading it to dozens of vulnerable people during their shift while they are infectious but not yet experiencing symptoms.

The goal, according to Shah and federal officials, is to simultaneously reduce the number of COVID-19 deaths among older residents while also reducing the number cases in the community by vaccinating younger but higher-exposure workers. However, several states have deviated from federal guidelines and given elderly residents a higher priority than essential workers. Maine says it is hasn’t made a final decision on this question.

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