COVID-19 Resource Center

COVID-19 Vaccine Messaging

► Vaccine Safety   ► Vaccine Boosters   ► Vaccine Benefits  
► Vaccine Availability/Getting the Shot   


► Guidance for Employers: Vaccine Mandate   ► Strategies for Employers
► Messaging for Health Care Workers   ► Messaging for Different Demographics   


► Resources   ► Downloadable Print Resources (CDC)


Updated August 25, 2022
ACOEM continues to follow the latest information related to COVID-19 and will update as necessary.

COVID-19 Vaccine Safety 

  • COVID-19 vaccines are safe and continue to be effective at preventing severe illness, hospitalizations, and deaths.1 The process to develop the vaccines was systematic with each U.S. vaccine undergoing rigorous clinical trials – no steps were skipped or overlooked.
  • For full approval of a new drug or vaccine, the FDA requires extensive data on safety and effectiveness, an inspection of manufacturing facilities, and a comprehensive review of all clinical and “real-world” use.
  • The Food and Drug Administration (FDA) granted full approval to the Pfizer-BioNTech COVID-19 vaccine for individuals aged 16 years and older (08/23/21) (marketed now as Comirnaty).2 The vaccine also continues to be available under emergency use authorization (EUA), for individuals 5 thru 15 years of age and for the administration of booster doses. In children from 5 to 11 years of age, the dose is lower than that used in people aged 12 and above (10 µg compared with 30 µg). As in the older age group, it is given as injections in the muscles of the upper arm, 3 weeks apart. The FDA also granted full approval to the Moderna COVID-19 vaccine for individuals aged 18 years and older (01/31/22). The vaccines also continue to be available under emergency use authorization (EUA) for the administration of booster doses. Additional guidance is also available on COVID-19 vaccines for children ages 6 months and older.3
  • The second dose of an mRNA vaccine may be given at no less than 3 weeks (for Pfizer-BioNTech) or 4 weeks (Moderna). An 8-week interval may be optimal for some people ages 12 years and older, especially for males ages 12 to 39 years.4
  • The FDA has also granted an EUA for the Novavax COVID-19 vaccine for individuals aged 18 years and older (7/13/22). Novavax is a two-dose, protein based vaccine given 3-8 weeks apart.  
  • On December 16, 2021, the Centers for Disease Control and Prevention (CDC) endorsed the updated recommendations made by the Advisory Committee on Immunization Practices (ACIP) to preferentially recommend the use of mRNA vaccines over the Johnson & Johnson/Janssen vaccine. On May 5, 2022, the FDA strictly limited the use of the Johnson & Johnson/Janssen COVID-19 vaccine because of the rare but serious risk of blood clots.5 Given the available supply of mRNA vaccines, these should be used primarily, with the Johnson & Johnson/Janssen vaccine reserved for individuals who are unable to take an mRNA vaccine due to medical contraindications or local supply constraints.

1. Rosenblum HG, Gee J, Liu R, et al. Safety of mRNA vaccines administered during the initial 6 months of the US COVID-19 vaccination programme: an observational study of reports to the Vaccine Adverse Event Reporting System and v-safe. Lancet. March 7, 2022. DOI:https://doi.org/10.1016/S1473-3099(22)00054-8.
2. U.S. Food and Drug Administration. FDA Approves First COVID-19 Vaccine. Available at: https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine.
3. Centers for Disease Control and Prevention (CDC). COVID-19 Vaccines for Children and Teens. June 19, 2022. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html
4. Centers for Disease Control and Prevention (CDC). Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States. March 2, 2022. Available at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html.
5. U.S. Food and Drug Administration. Coronavirus (COVID-19) Update: FDA Limits Use of Janssen COVID-19 Vaccine to Certain Individuals. May 5, 2022. Available at: 
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-limits-use-janssen-covid-19-vaccine-certain-individuals.
Back to top

COVID-19 Vaccine Boosters

  • Everyone is considered up to date with their vaccinations until the time that they are eligible for a booster. CDC currently recommends for individuals who are 5 years and older who received the Pfizer-BioNTech or Moderna two-dose COVID-19 vaccine also receive a booster dose 5 months after completion of their primary vaccine series.5 
  • CDC recommends that adults ages 50 and older receive a second booster with either mRNA vaccine at least 4 months after their first booster, regardless of what type of the first booster they received.6
  • Individuals who are moderately to severely immunocompromised should receive their third dose of vaccine at least 28 days after their second dose, a fourth dose at least 3 months later, and a fifth dose at least 4 months after their fourth dose.7 Eligible individuals may choose which mRNA vaccine they receive as the final two booster doses. The CDC allows for a booster shot that is not the same type as the initial vaccination(s).
  • It is recommended that individuals at risk receive their second booster when they are eligible. Those who receive a second booster will still be eligible for the bivalent vaccine when it becomes available. 
6. Centers for Disease Control and Prevention (CDC). COVID-19 Vaccine Boosters. May 24, 2022. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html.
7. Centers for Disease Control and Prevention (CDC). COVID-19 Vaccines for People who are Moderately or Severely Immunocompromised. May 24, 2022. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html.


Back to top

COVID-19 Vaccine Benefits

  • Receiving a COVID-19 vaccine is a safe way to build protection against the disease. COVID-19 can have serious, life-threatening complications, and there is no way to know how COVID-19 will affect you. COVID-19 vaccinations can help protect you by teaching your body to fight the virus without having to experience sickness or putting yourself at increased risk of severe illness.
  • Currently, all COVID-19 vaccines authorized in the U.S. have proven to be highly effective against COVID-19, preventing severe disease, hospitalization, and death.8 Data show that the mRNA vaccines (Pfizer-BioNTech or Moderna) also provide significant protection against severe disease caused by variants of the virus, including the Delta and Omicron strains.9 There is also recent evidence indicating that the booster dose offers additional protection against the Omicron variant and therefore, it is important to receive a booster dose.10-13 While there is lower vaccine effectiveness against infection and symptomatic disease caused by the Omicron variant, the breakthrough infections in those with up-to-date vaccination are associated with far fewer hospitalizations and deaths.
  • For those who are unvaccinated, receiving the vacine after a COVID-19 infection may help prevent chronic symptoms, or post COVID condition(s).14,15
  • If you remain unvaccinated, you and your family may be at risk of serious lifelong complications from COVID-19 infection. Vaccination can prevent regret and fear that someone you love will die from COVID-19, such as from transmitting it between family members.
  • Individuals with up-to-date vaccination may participate in all activities that they participated in prior to the pandemic but for some of these activities, they may have to resume masking based on employer/institutions policies or state and local ordinances. 
  • Individuals are also encouraged to receive the influenza vaccine as there may be a protective effect of the influenza vaccine against severe SARS-CoV-2 infection.16,17

8. Scobie HM, Johnson AG, Suthar AB, et al. Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021. MMWR Morb Mortal Wkly Rep. 2021;70:1284–1290. DOI: http://dx.doi.org/10.15585/mmwr.mm7037e1external icon.
9. Bernal JL, Andrews N, Gower C, et al. Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. New Engl J Med. 2021;385(7):585-594. Available at: https://www.nejm.org/doi/full/10.1056/nejmoa2108891.
10. Johnson AG, Amin AB, Ali AR, et al. COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021. MMWR Morb Mortal Wkly Rep. 2022;71:132–138. DOI: http://dx.doi.org/10.15585/mmwr.mm7104e2.
11. Thompson MG, Natarajan K, Irving SA, et al. Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance — VISION Network, 10 States, August 2021–January 2022. MMWR Morb Mortal Wkly Rep. 2022;71:139–145. DOI: http://dx.doi.org/10.15585/mmwr.mm7104e3.
12. Tenforde MW, Patel MM, Gaglani M, et al. Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults — United States, August–December 2021. MMWR Morb Mortal Wkly Rep. 2022;71:118–124. DOI: http://dx.doi.org/10.15585/mmwr.mm7104a2.
13. Danza P, Koo TH, Haddix M, et al. SARS-CoV-2 Infection and Hospitalization Among Adults Aged ≥18 Years, by Vaccination Status, Before and During SARS-CoV-2 B.1.1.529 (Omicron) Variant Predominance — Los Angeles County, California, November 7, 2021–January 8, 2022. MMWR Morb Mortal Wkly Rep. 2022;71:177–181. DOI: http://dx.doi.org/10.15585/mmwr.mm7105e1.
14. Kuodi P, Gorelik Y, Zayyad H, et al. Association between vaccination status and reported incidence of post-acute COVID-19 symptoms in Israel: a cross-sectional study of patients tested between March 2020 and November 2021. medRxiv. January 17, 2022. doi: https
://doi.org/10.1101/2022.01.05.22268800.
15. 
Ayoubkhani D, Bermingham C, Pouwels KB, et al. Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study. BMJ2022;377:e069676.
16. 
Taghioff SM, Slavin BR, Holton T, Singh D. Examining the potential benefits of the influenza vaccine against SARS-CoV-2: A retrospective cohort analysis of 74,754 patients. PLoS One. 2021;16(8):e0255541.
17. Tayar E, Abdeen S, Alah MA, et al. Effectiveness of influenza vaccination against SARS-Co-V-2 infection among healthcare workers in Qatar. Preprint at medRxiv: doi: https://doi.org/10.1101/2022.05.09.22274802.

Back to top


COVID-19 Vaccine Availability and Getting the Shot
  • Individuals aged 6 months and older are eligible to receive the vaccine.
  • Vaccine supply is plentiful and is available in doctors’ offices, retail pharmacies, hospitals, and clinics.
  • Prior to receiving the vaccine, you will be screened for any contraindications.
  • There may be minor side effects from the vaccine (fatigue, sore arm, mild fever, headache, body/muscle aches). You should expect to be monitored for 15-30 minutes after the vaccination to watch for rare severe reactions. Though rare, allergic reactions, including anaphylaxis, have been reported. If this occurs, vaccination providers can effectively and immediately treat anaphylaxis. If you have concerns about your medical condition(s) and receiving the vaccine, consult with your doctor.
Back to top

Guidance for Employers Including Those Overseeing Mandatory Vaccination

The CDC updated their guidance on the isolation period for those who are positive for COVID-19 or are a close contact to someone who tested positive. Individuals who test positive for COVID-19 are recommended to end isolation after 5 full days if they are symptom free or if they are fever-free for 24 hours and their symptoms are improving. It is then recommended that they wear a tight-fitting mask for the remainder of the 10-day period. It is important that employees in the workplace wear a mask (or if possible, an N95/KN95 respirator is considerably better) for the full 10 days if they are positive to reduce risk of spread to their coworkers (including not eating together during this period).

CDC is now recommending that individuals exposed to COVID-19 wear a high-quality mask for 10 days and get tested on day 5 instead of quarantining. Employers should consult with OEM physicians familiar with workplace settings as guidance for vulnerable settings (i.e., healthcare) may be more conversative. 

Mandated Vaccination for Healthcare Facilities

On November 5, 2021, the Centers for Medicare & Medicaid Services published the Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule (CMS Rule).18 Under this rule, facilities regulated under the Medicare Conditions of Participation (CoPs) must have a process or plan for:
  • Vaccinating all eligible staff (regardless of clinical responsibility or patient contact),
  • Providing exemptions and accommodations for those who are exempt, and
  • Tracking and documenting staff vaccinations.
ACOEM provides the following guidance to assist employers in implementing the requirements under the CMS Rule or if they decide to voluntarily mandate vaccination for their employees. Employers must meet the requirements in the CMS Rule, but they can also choose to exceed the requirements. For employers who choose to requre vaccination, it is important that they do it equitably and not discriminate against portions of their workforce. It is important to also check with your current local and state recommendations.

EXEMPTIONS
For employers requiring vaccination, it is important to pay attention to religious and medical exemptions. Some guidance is provided below.
 
Religious
Not under the purview of occupational and environmental medicine. These are usually addressed by human resources and legal departments.
 
Medical
Medical exemptions require a medical provider to attest that the employee has one of the contraindications identified by the CDC to the vaccine. Permanent or temporary exemptions may be allowed for employees under the following situations.

Permanent
  • Serious allergic reaction to COVID-19 vaccine.
  • Serious allergic reaction to component(s) of COVID-19 vaccine (may be able to take another vaccine).
  • Serious adverse effect to the first COVID-19 vaccine of a 2-dose vaccination series (e.g., myocarditis).19
 
Temporary
  • Wait until out of isolation from a current COVID-19 infection.20
 
RECORD KEEPING
  • Under the Equal Employment Opportunity Commission (EEOC), an employer is allowed to ask an employee’s vaccination status.
  • Request for a medical exemption should be documented in a form with attestation from a medical provider.
  • Request for medical exemption should be treated as protected health information (PHI), managed, and recorded at the human resource level.
  • Employee’s personal health information should be blinded when a medical exemption is requested.
  • There are various apps available for COVID-19 vaccination tracking of employees.

How will the employer need to interface with the occupational medicine physician to ensure that record keeping is done correctly and within compliance (e.g., HIPAA, OSHA, etc.)?
The employer should ensure they are following proper HIPAA procedures. It is important to confirm the status of the organization to know whether or not they are a HIPAA covered entity. For employers who are not considered a HIPAA compliant entity, then the HIPAA laws do not apply. Defer to state laws as it pertains to workers’ compensation, e.g., if the vaccine is mandated by the employer.

The employer should be educated in advance regarding the acceptable medical conditions that might qualify for an exemption. As stated above, possible medical exemptions include: (1) serious allergic reaction to COVID-19 vaccine, (2) serious allergic reaction to COVID-19 vaccine component(s) (may take another vaccine) (e.g., if you are allergic to PEG, you should not get an mRNA COVID-19 vaccine, if you are allergic to polysorbate, you should not get the Johnson & Johnson/Janssen COVID-19 vaccine), (3) serious adverse effect to the first COVID-19 vaccine of a 2-dose vaccination series (e.g., myocarditis),19 and (4) waiting until out of isolation from a current COVID-19 infection.
 
TESTING
When antigen testing is used before returning to work, an additional layer of protection may be added for employers, individuals, providers, etc. For verification of no longer being infectious, antigen testing should only be used as PCR testing may produce false positves. For individuals who have completed their 5 days of isolation from testing positive for COVID-19, it is recommended that an antigen test be performed before returning to work in situations where there is a higher risk of spreading the virus to others or there are other individuals in the workplace at higher risk of severe disease.

What are the testing recommendations?
Under the CMS Rule, asymptomatic employees granted a medical or religious exemption are not required to test.21,22 However, facilities may voluntarily utilize testing. Testing post-exposure should follow current guidelines or employer's policy.
  
What test is appropriate for periodic testing of an employee?
Choice may be dictated by local test availability and turnaround time. Either PCR or antigen test is acceptable to identify acute infection. For an exposed individual, an antigen test performed 2 to 3 days apart is equivalent in sensitvity to a PCR test in detecting early disease.23,24,25 For asymptomatic individuals who have not been exposed, antigen testing may be adequate and PCR testing is also reasonable. For individuals enrolled in periodic testing, they may be exempt from PCR testing for 90 days after infection.
 
Who can administer COVID-19 tests?
Employers should consult with local public health professionals to determine which type of testing should be used. Medical professionals or an employee under direct observation of a medical professional can administer COVID-19 tests. Self-tests have also been approved by CDC, results should be reported to healthcare provider or local/state health department. If home testing is used, it is recommended to conduct a video observation to track compliance. PCR confirmation is preferred due to the risk of false negatives or testing too early in the infection.
 
Should testing be the responsibility of the employer or employee?
Some companies will require the employees to take responsibility to get the testing while other companies will set up sites for the employees to get tested. Large employers such as hospitals may utilize existing resources and acute care centers. Other employers may utilize resources in the community.

When should you require unvaccinated remote employees to test?
Under the CMS Rule, there is no mandatory testing for any employees who receive a medical or religious exemption. In addition, individuals who provide services 100% remotely and who do not have any direct contact with patients and other staff (i.e., fully remote telehealth or payroll services) are not subject to the vaccination requirements in this rule.

What is the utility of the antibody (Ab) testing for employees?
Antibody (Ab) testing is used in highly specialized situations (e.g., studies and surveillance) and should not be utilized to inform vaccinatoin for employees.26,27 
 
18. CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule FAQs. Available at: https://www.cms.gov/files/document/cms-omnibus-covid-19-health-care-staff-vaccination-requirements-2021.pdf.
19. Centers for Disease Control and Prevention (CDC). Selected Adverse Events Reported after COVID-19 Vaccination. November 30, 2021. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html.
20. Centers for Disease Control and Prevention (CDC). Frequently Asked Questions about COVID-19 Vaccination. February 28, 2022. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html
21. External FAQ: CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule. January 20, 2022. Available at: https://www.cms.gov/files/document/cms-omnibus-covid-19-health-care-staff-vaccination-requirements-2021.pdf.
22. Massetti GM, Jackson BR, Brooks JT, et al. Summary of Guidance for Minimizing the Impact of COVID-19 on Individual Persons, Communities, and Health Care Systems — United States, August 2022. MMWR Morb Mortal Wkly Rep. 2022;71:1057-1064. DOI: http://dx.doi.org/10.15585/mmwr.mm7133e1.
23. Peeling RW, Heymann DL, Teo Y-Y, Garcia PJ. Diagnostics for COVID-19: moving from pandemic response to control. Lancet. 2022;399(10326):P757-768.
24. Smith RL, Gibson LL, Martinez PP, et al. Longitudinal assessment of diagnostic test performance over the course of acute SARS-CoV-2 infection. J Infect Dis. 2021;224(6):976-982.
25. 
Chu VT, Schwartz NG, Donnelly MAP, et al. Comparison of home antigen testing with RT-PCR and viral culture during the course of SARS-CoV-2 infection. JAMA. April 29, 2022. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2791915?utm_campaign=articlePDF&utm_ medium=articlePDFlink&utm_source=articlePDF&utm_content=jamainternmed.2022.1827.
26. U.S. Food and Drug Administration (FDA). Antibody Testing Is Not Currently Recommended to Assess Immunity After COVID-19 Vaccination: FDA Safety Communication. May 19, 2021. Available at: https://www.fda.gov/medical-devices/safety-communications/antibody-testing-not-currently-recommended-assess-immunity-after-covid-19-vaccination-fda-safety.
27. Centers for Disease Control and Prevention (CDC). COVID-19 Testing: What You Need to Know. May 3, 2022. Available at: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html.

Back to top

Strategies for Employers to Promote the Vaccine Message in the Workplace

  • All healthcare professionals are encouraged to take steps to help ensure that their adult patients are fully immunized. For additional guidance, please refer to the Centers for Disease Control and Prevention's Standard for Adult Immunization Practice (SAIP) resource
  • Ensure that the information is personal and targeted to the individual, so it addresses their questions and concerns in a nonjudgmental way.
  • Communicate using simple and clear language when explaining side effects or any potential risks associated with the vaccine.
  • Convene town hall meetings with workers and identify champions within your workplace who are trusted and can deliver the message. Many workers may feel comfortable with the health care provider at their workplace providing them information and sharing their experience.
  • It is important to acknowledge and be truthful about uncertainty to help gain trust.
  • Storytelling about those affected positively by vaccinations is more likely to be effective than statistics.
  • Consider incentivizing employees (e.g., paid time off to get vaccinated) who receive the vaccine to encourage them to contribute to a safe and healthy workplace.
  • Acknowledge COVID-19 fatigue and emotional well-being issues that employees have been experiencing these past two years.
  • Encourage vaccination among employees’ family members including eligible children. If you are providing a vaccination program for your employees, consider inviting family members to participate.
Back to top

Targeted Messages for Health Care Workers 

  • Protect yourself – you are on the front lines and risk being exposed to people with COVID-19 each day on the job. 
  • You can potentially transmit the virus to patients, co-workers, your family, and to others in your community.
  • Protecting yourself also helps protect your patients, coworkers, family, and community including those who may be at higher risk for severe illness from COVID-19.
  • Vaccination allows you to protect vulnerable patients that you care for every day.
  • You matter, and you play an essential role in keeping your community healthy.
  • You are a leader in science and can set an example to others in the community.
  • You can serve as a vaccine champion and positively influence vaccination decisions of peers, patients, friends, and family.
Back to top
Targeted Messages for Different Demographics
Race/ETHNICITY
  • COVID-19 vaccines have been studied in clinical trials with large and diverse groups of people of various ages, races and ethnicities.
  • The vaccine development process is heavily regulated and transparent. For COVID-19, a diverse group of doctors and public health practitioners were assembled to ensure that the vaccine was safe and effective across racial groups.
  • Focus on making decisions that are best for you and your family, following fact-based, trusted information about vaccine safety and efficacy, including links to trusted sources of information (e.g., CDC, WHO, academic institutions).
  • Messaging from personal doctors and other health care providers are typically among the most trusted sources for Black/African Americans; e.g., Black/African Americans may also be more responsive to messaging from faith-based leaders.
  • Messaging from medical experts and community health providers are the most trusted sources for Hispanic/Latinos. Hispanic/Latinos may also be more receptive to messages from their inner circle such as neighbors, their mayor, and people they follow on social media.
WATCH: RWJBH: Fears, Hesitation & Access: What the Black Community Needs to Know About the COVID-19 Vaccine

Age
  • COVID-19 vaccines have been studied in clinical trials with large and diverse groups of people, of various ages, races, and ethnicities.
  • Older adults may be more motivated to reduce their own risk for severe illness or death.
  • Young adults may be less concerned about their own health but more motivated to prevent transmitting the infection to older family members.
  • There is no evidence suggesting that fertility problems are a side effect of any  of the COVID-19 vaccines.26 People who are trying to become pregnant now or who plan to try in the future may receive the COVID-19 vaccine. (See ACOG’s practice advisory and CDC's recommendations on vaccination of pregnant women.)    

26. Aharon D, Lederman M, Ghofranian A, et al. In vitro fertilization and early pregnancy outcomes after coronavirus disease 2019 (COVID-19) vaccination. Obstetrics & Gynecology, January 25, 2022. doi: 10.1097/AOG.0000000000004713.
 
Back to top


Resources