COVID-19 FAQ for members #


What does Governor Inslee’s emergency proclamation mean for health care personnel who work in Washington? #

Governor Inslee’s emergency procla­ma­tion means that health care personnel who work in Washington need to be fully vacci­nated by October 18, 2021, with limited exemp­tions for medical or sincerely held religious beliefs, or they will be prohib­ited from working.

Fully vacci­nated” (under Section 6 defin­i­tions of the procla­ma­tion) means that nurses will need to have received their second Moderna or Pfizer COVID-19 vaccine or will have received the Johnson & Johnson vaccine on or by October 4, 2021, in order to be consid­ered fully vacci­nated by October 18, 2021, as a condi­tion of further employ­ment. In other words, nurses will have to have a second Moderna or Pfizer vaccine, or a Johnson & Johnson vaccine, on or by October 4 or risk being prohib­ited from working.



Is it legal to mandate a vaccine that does not have full FDA approval? #

Yes. First, the FDA granted full approval to the Pfizer-BioNTech vaccine on August 23, 2021. Beyond that, the Governor’s procla­ma­tion carries the full force of law and is granted as part of the emergency powers afforded in the Washington State Consti­tu­tion. In addition, the Depart­ment of Justice has ruled that mandating vaccines subject to an Emergency Use Autho­riza­tion is legal. In case law, there is prece­dent for employer-mandated vaccine mandates, most recently in the Texas lawsuit filed against Houston Methodist. This lawsuit, brought by termi­nated employees, was dismissed by a federal court.



What if a health care worker refuses to get vaccinated and does not have an exemption in place, can my employer prohibit me from working? #

Yes, under Gov. Inslee’s emergency procla­ma­tion, employers are prohib­ited from permit­ting health care workers who are not fully vacci­nated by October 18, 2021, to continue to work. 



Are there any exemptions to the state vaccine mandate? #

Yes, limited exemp­tions remain: a medical exemp­tion and a sincerely held religious belief exemp­tion. There are no personal or philo­soph­ical exemp­tions permitted.



What happens if I have a valid medical or religious exemption, will I be prohibited from working? #

If you have a valid medical or religious exemp­tion, the health care worker should be allowed to continue to work with a reason­able accommodation.



If an employee refuses to get vaccinated and is not allowed to work by the employer, is the employee entitled to unemployment benefits? #

When an employee’s separa­tion is the result of failure to comply with an employer’s require­ment to become vacci­nated, the Employ­ment Security Depart­ment will examine a number of factors. These factors may include when the employer adopted the require­ment, whether the employee is other­wise eligible for benefits, the specific terms of the vaccine policy including allow­able exemp­tions, and the reason why the employee did not comply with the vaccine requirement. 

For example, if the employee does not qualify for an exemp­tion and does not comply with the vaccine require­ment, a claim would likely be denied. However, some individ­uals may still qualify based on their own unique circum­stances. ESD will evaluate each case on its own merit.



Is there an option for frequent testing in lieu of vaccination? #

No. The procla­ma­tion does not allow for testing instead of vacci­na­tion. Affected workers must either be fully vacci­nated or receive a religious or medical exemption. 



I am planning to be vaccinated outside of the United Stated with the AstraZeneca/​or another vaccine. Is this acceptable according to the Washington state proclamation? #

Fully vacci­nated is defined under section 6e of the procla­ma­tion (8/9/2021), stating that the vaccine must be under EUA, licensed or other­wise approved by the FDA. As such, vacci­na­tions that are accepted are Moderna, Pfizer, and Johnson & Johnson.



What is the evidence regarding the safety of the COVID-19 vaccine? #

COVID-19 vaccines are safe and effec­tive. Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history. The CDC recom­mends that eligible individ­uals get a COVID-19 vaccine as soon as possible. Steps taken to make sure COVID-19 vaccines are safe:

  • Careful testing — All vaccines go through clinical trials to test safety and effec­tive­ness. For the COVID-19 vaccine, the FDA set high safety standards for vaccine devel­opers to meet.
  • The FDA granted full approval to the Pfizer-BioNTech vaccine on August 23, 2021.
  • Autho­riza­tion for Emergency Use — If a vaccine or medicine is needed to address an emergency situa­tion such as the coron­avirus pandemic, once it is shown to be safe and effec­tive, the FDA can grant it an emergency use autho­riza­tion, or EUA. An EUA allows a vaccine, treat­ment, or medica­tion to be used before the formal FDA approval.
  • Contin­uous monitoring for problems and side effects — Once a vaccine gets an EUA and is being given to people, the FDA and the U.S. Centers for Disease Control and Preven­tion (CDC) continue to watch carefully to make sure no problems arise. Data on the vaccine’s safety record accumu­lates over time when more and more people who receive it report on their experi­ence and any side effects they experi­ence. One impor­tant way to report any adverse events after vacci­na­tion is through the Vaccine Adverse Events Reporting System (VAERS).
  • You can learn more from the CDC about the safety steps for the COVID-19 vaccine.



How effective are COVID-19 vaccines? #

All autho­rized vaccines are very good at preventing severe infec­tion, hospi­tal­iza­tion, and death from COVID-19. The testing methods for the vaccines are not all alike, which makes it diffi­cult to compare them. Johns Hopkins Medicine considers them to be equally effective.



Is the COVID-19 vaccine experimental? #

The FDA granted full approval to the Pfizer-BioNTech vaccine on August 23, 2021. The J&J and Moderna vaccines are FDA approved under an emergency use autho­riza­tion. They are past the exper­i­mental phase. While data is still being collected on adverse vaccine events, this is very common with all vaccines and medica­tions that require FDA approval. This specific process is called post-marketing surveil­lance, other­wise known as a Stage 4 trial. 



How was the COVID-19 vaccine developed so quickly? #

In the past, vaccines have taken many years to develop. However, the relatively quick devel­op­ment of this vaccine does not mean safety measures were skipped. There are several reasons why the COVID-19 vaccines were devel­oped faster than other vaccines:

  • The technolo­gies used to develop the COVID-19 vaccines have been years in devel­op­ment to prepare for outbreaks of infec­tious viruses. The manufac­turing processes were ready very early in the pandemic.
  • Countries shared genetic infor­ma­tion about the SARS-CoV‑2 coron­avirus when it was avail­able, which gave vaccine devel­opers an early start at finding a vaccine.
  • The testing processes for the vaccines didn’t skip any steps, but the vaccine devel­opers conducted some stages of the process simul­ta­ne­ously to gather as much data as quickly as possible.
  • Govern­ments gave money to vaccine devel­opers in advance, so the compa­nies had resources they needed.
  • Some types of COVID-19 vaccines were created using messenger RNA (mRNA), a new technology that allows a faster approach than the tradi­tional way vaccines are made.
  • Social media enabled compa­nies to reach out to and enroll study volun­teers, and plenty of people wanted to help, so there were enough research partic­i­pants to test the COVID-19 vaccines.
  • Because the SARS-CoV‑2 coron­avirus is so conta­gious and widespread, many volun­teers who got the vaccine were exposed to the virus, and with so many exposures, the trials took a shorter time to see if the vaccine worked.
  • Compa­nies began manufac­turing vaccines ahead of their autho­riza­tion or approval so some supplies would be ready if autho­riza­tion occurred.



What does the evidence say about the COVID-19 vaccine and pregnancy, lactation, and future consideration of becoming pregnant? #

The Centers for Disease Control and Preven­tion (CDC) issued this state­ment: COVID-19 vacci­na­tion is recom­mended for all people aged 12 years and older, including people who are pregnant, breast­feeding, trying to get pregnant now, or might become pregnant in the future. Pregnant and recently pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people. Getting a COVID-19 vaccine can protect you from severe illness from COVID-19.”

In addition to the CDC, the American College of Obste­tri­cians and Gynecol­o­gists and the Society for Maternal-Fetal Medicine recom­mend COVID-19 vacci­na­tion for pregnant, lactating, those (eligible) that are consid­ering becoming pregnant or who may consider future pregnancy. Pregnancy testing is not required prior to receiving Food and Drug Admin­is­tra­tion EUA-approved COVID-19 vaccine. Claims linking COVID-19 vaccines to infer­tility are unfounded and have no scien­tific evidence supporting them. COVID-19 vaccines may be admin­is­tered simul­ta­ne­ously with other vaccines, including within 14 days of receipt of another vaccine and vaccines routinely admin­is­tered during pregnancy, such as influenza and Tdap.

Addition­ally, people who are pregnant and received their doses of the Pfizer-BioNTech COVID-19 vaccine more than 6 months ago may be eligible for a booster vaccine. Individ­uals are encour­aged to talk with their health­care provider to deter­mine if a booster vaccine is appropriate.



Do mRNA vaccines alter DNA? #

No. Vaccines of any type do not alter DNA. Coron­aviruses and mRNA have been studied for decades. Coron­aviruses cause SARS, MERS, and the common cold, and cause severe illness in endan­gered big cats. This early, prelim­i­nary research allowed scien­tists to build upon existing studies when creating the COVID-19 vaccine. Research into mRNA has been ongoing for decades. Both the Pfizer and Moderna vaccines utilize mRNA. The Johnson & Johnson vaccine uses viral vector technology, the same technology used by other FDA-approved vaccines.



If an employee takes the COVID-19 vaccination and has side effects, is the employer required to pay the worker for sick time without tapping into the health care worker’s sick time/​accrual hours? #

The Procla­ma­tion does not require this. Any provi­sion like this would have to be negoti­ated and agreed to by the employer.



Once vaccinated, is it possible to transmit COVID-19 to others? #

Infec­tions happen in only a small propor­tion of people who are fully vacci­nated, even with the Delta variant. However, prelim­i­nary evidence suggests that fully vacci­nated people who do become infected with the Delta variant can spread the virus to others. To reduce their risk of becoming infected with the Delta variant and poten­tially spreading it to others CDC recom­mends that fully vacci­nated people:

  • Wear a mask in public indoor settings if they are in an area of substan­tial or high trans­mis­sion.
    Fully vacci­nated people might choose to mask regard­less of the level of trans­mis­sion, partic­u­larly if they or someone in their house­hold is immuno­com­pro­mised or at increased risk for severe disease, or if someone in their house­hold is unvac­ci­nated. People who are at increased risk for severe disease include older adults and those who have certain medical condi­tions, such as diabetes, overweight or obesity, and heart conditions.
  • Get tested if experi­encing COVID-19 symptoms.
  • If you came into close contact with someone with COVID-19 get tested 3 – 5 days after the date of your exposure and wear a mask in public indoor settings for 14 days after exposure or until a negative test result.
  • Isolate if they have tested positive for COVID-19 in the prior 10 days or are experi­encing COVID-19 symptoms.
  • Follow any applic­able federal, state, local, tribal, or terri­to­rial laws, rules, and regulations.



If I have had COVID-19, is it necessary to take the vaccine? #

Yes. If you’ve been infected with COVID-19, you have some protec­tion. But that immunity has limits. The biggest limit is that it doesn’t last as long as we would like it to. Studies have shown that people who have been infected can benefit signif­i­cantly from vacci­na­tion. It gives them a strong, lasting immunity boost. After receiving the first dose of the Pfizer or Moderna vaccine, vaccine recip­i­ents have immunity levels compa­rable to those of uninfected people who have received their second dose. 

The CDC states: The COVID-19 vaccine is neces­sary for those who contracted the COVID-19 infec­tion. New CDC Study: Vacci­na­tion Offers Higher Protec­tion than Previous COVID-19 Infec­tion. This study of COVID-19 infec­tions in Kentucky among people who were previ­ously infected with SAR-CoV‑2 shows that unvac­ci­nated individ­uals are more than twice as likely to be reinfected with COVID-19 than those who were fully vacci­nated after initially contracting the virus. These data further indicate that COVID-19 vaccines offer better protec­tion than natural immunity alone and that vaccines, even after prior infec­tion, help prevent reinfections.

If you have had COVID-19 before, still get vacci­nated,” said CDC Director Dr. Rochelle Walensky. This study shows you are twice as likely to get infected again if you are unvac­ci­nated. Getting the vaccine is the best way to protect yourself and others around you, especially as the more conta­gious Delta variant spreads around the country.”



Who should receive a third vaccine dose? #

Currently, the CDC recom­mends a third dose for moderate to severely immuno­com­pro­mised persons who have received either the Pfizer or Moderna vaccines. There is not enough data at this time to deter­mine if a second dose of the Johnson and Johnson vaccine would produce an improved antibody response in immuno­com­pro­mised persons. Someone who quali­fies for a third dose should receive the same brand of vaccine as their first two doses. Condi­tions causing moderate to severe immune compro­mise include but are not limited to high doses of corti­cos­teroids, recent cancer treat­ment for tumors or cancers of the blood, organ or stem cell trans­plant within the last two years or are taking medicine to suppress the immune system, advanced or untreated HIV infec­tion, and moderate or severe primary immun­od­e­fi­ciency. People should consult their health­care provider to see if they qualify for a third vaccine dose based on their medical condition. 



Who is eligible for a booster vaccine? #

On October 29th, the CDC formally recom­mended booster COVID-19 vaccines for those in certain popula­tions who had previ­ously received 2 doses of the Pfizer or Moderna vaccine, or 1 dose of the Johnson&Johnson vaccine. Addition­ally, the CDC approved receiving booster doses from a different manufac­turer than the original series — known as mixing-and-matching’.

Persons who received a primary mRNA vaccine series and are 65 years or older, 50 – 64 years with under­lying medical condi­tions, or 18 years and older who live in long-term care settings should receive a booster shot at least 6 months after completing the primary series. 

Persons who received a primary mRNA vaccine series and are 18 – 49 years old with under­lying medical condi­tions, or 18 years and older who live or work in high-risk settings may receive a booster shot at least 6 months after completing the primary series.

Persons who received the Johnson & Johnson/​Janssen COVID-19 vaccine and are 18 years and older should receive a booster shot at least 2 months after receiving their primary vaccine dose.

The above includes those who received an additional third dose, such as those with moderate to severe immuno­com­pro­mise. This means that those persons could be eligible for a fourth vaccine. 

Persons who received the Johnson and Johnson/​Janssen COVID-19 vaccine and are 18 years or older should receive a booster shot at least 2 months after receiving their primary dose.

High risk settings” include health­care workers, educa­tion staff, correc­tions workers, and others. 

Under­lying medical condi­tions” includes persons with cancer; chronic liver, kidney, or lung diseases, pregnancy, dementia or other neuro­log­ical condi­tions; mental health condi­tions such as depres­sion, schiz­o­phrenia, and other mood disor­ders; smoking related condi­tions; stroke or other neuro­log­ical condi­tions; diabetes, substance misuse disor­ders; and other respi­ra­tory and cardio­vas­cular conditions. 



Are COVID-19 vaccines available for children? #

The CDC recom­mends everyone 5 and older get a COVID-19 vaccine. The Pfizer/​BioNTech vaccine is currently approved for children ages 5 and up. The approved pediatric vaccine dose is one-third the adult dose, with two doses give three weeks apart. 

It is currently recom­mended that children NOT receive pain relievers such as Tylenol or Advil prior to vacci­na­tion to prevent side effects, as these can negatively impact the efficacy of the vaccine. It is also recom­mended that children be monitored for 15 minutes post vaccine admin­is­tra­tion for any immediate side effects, similar to the process for adult vaccination.

Pediatric doses can be found by contacting your child’s pedia­tri­cian, local health depart­ment, or the WA state vaccine finder.



Is Hydroxychloroquine an alternative to taking the COVID 19 vaccine? #

The World Health Organi­za­tion does not recom­mend hydrox­y­chloro­quine to prevent COVID-19. This recom­men­da­tion is based on six trials with more than 6000 partic­i­pants who did not have COVID-19 and received hydrox­y­chloro­quine. Using hydrox­y­chloro­quine for preven­tion had little or no effect on preventing illness, hospi­tal­iza­tion, or death from COVID-19. Taking hydrox­y­chloro­quine to prevent COVID-19 may increase the risk of diarrhea, nausea, abdom­inal pain, drowsi­ness, and headache. More infor­ma­tion can be found here.

However, hydrox­y­chloro­quine and chloro­quine are safe for use in patients with autoim­mune diseases or malaria (not COVID-19).



Can Ivermectin be used for prevention or treatment of COVID-19? #

Ivermectin is an anti-parasitic drug used to treat certain abdom­inal and topical parasite infes­ta­tions in humans. It is also approved for the preven­tion and treat­ment of heart­worm and other parasites in large animals, such as horses. Ivermectin is not FDA-approved for the preven­tion or treat­ment of COVID-19 in humans. Initial studies are underway to assess the efficacy of Ivermectin as a treat­ment for COVID-19. It is impor­tant to note that Ivermectin prepa­ra­tions for animals differ than those for humans, and humans should not ingest any medica­tions that are manufac­tured for animals. 



What supplements/​vitamins prevent or reduce the risk of contracting COVID-19? #

No supplements/​vitamins have been shown to reduce the risk of contracting or treating COVID-19. 

At present, there is no known agent that can be admin­is­tered before exposure to SARS-CoV‑2 (COVID-19) to prevent infec­tion. Clinical trials are inves­ti­gating supple­ments such as zinc, vitamin C, and vitamin D. 



What happens if a health care worker tests positive for COVID-19? #

Specific CDC guide­lines are avail­able with nuanced instruc­tions depending on inves­ti­ga­tions findings/​circumstances related to the individual case.



If someone has been vaccinated, should they still be tested for COVID if they have symptoms? #

Yes. While the COVID vaccine (like other vaccines) does not guarantee 100% immunity, it does signif­i­cantly decrease the likeli­hood that a fully vacci­nated person will be hospi­tal­ized or die from COVID-19. While vaccine break­through cases are rare, persons with COVID-like symptoms should be tested and should follow public health guidelines. 



What should someone do if they feel they have been injured by a vaccine? #

Injuries from vaccines (including the COVID-19 vaccines) are rare. If individ­uals feel they have been injured by a COVID-19 vaccine, they should first contact their health­care provider. Vaccine injuries are reported through the Vaccine Adverse Event Reporting System.



Where can I learn more about the COVID-19 vaccines from the Food and Drug Administration (FDA)? #

The FDA website provides evidence for each COVID-19 vaccine and the reasoning behind the FDA’s emergency use autho­riza­tions. Each vaccine has a fact sheet with a list of frequently asked questions.



What other resources are available to nurses to learn more about COVID-19 vaccines? #

The American Nurses Associ­a­tion (ANA) has several resources for nurses regarding COVID-19, vaccines, treat­ments, and other infor­ma­tion. Nurses do not need to be a member of ANA to access these resources.