Frequently asked questions

SAFETY OF COVID-19 VACCINES

UNICEF, WHO
© UNICEF/UN070241/Hatcher-Moore
UNICEF/UN070241/Hatcher-Moore
25 March 2021

I) SAFETY OF COVID-19 VACCINES

1. Are COVID-19 vaccines safe?

The same steps are used for COVID-19 vaccine development as are used for other vaccines. Vaccines go through various phases of development and testing – there are usually three phases to clinical trials. All phases assess safety. The last phase, phase III, is usually conducted in a large number of people, often tens of thousands.

Cambodia has a national regulatory authority in place under the Ministry of Health. The Ministry of Health issues emergency use authorizations for vaccines after reviewing their safety and efficacy profile and the data available from other regulatory authorities, or after a vaccine has received WHO emergency use listing (EUL).

Once they are in use, vaccines are continuously monitored to make sure they are fully safe for the people who receive them.

 

2. Do the vaccines protect you from COVID?

Yes, the available vaccines have all demonstrated efficacy in reducing COVID disease.  None of the vaccines protect 100% so other measures - including handwashing, mask wearing and physical distancing  - must be maintained.

 

3. Can I get sick with COVID-19 from the vaccine?

None of the COVID-19 vaccines currently in use or likely to be used soon contain the live virus that causes COVID-19. This means that a COVID-19 vaccine cannot make you sick with COVID-19. In some rare cases you may still get COVID-19 even after vaccination, which is why you must continue to take precautions until advised otherwise.

As with all medicines, side effects can occur after getting a vaccine. However, these are usually very minor, such as a sore arm or a mild fever, and typically go away within a few days. More serious side effects are possible, but extremely rare.

 

4. Is it safe to get a COVID-19 vaccine if I have an underlying medical condition?

COVID-19 vaccination is especially important for people with pre-existing illnesses which put them at higher risk of getting sick from COVID-19.

However, if you have a pre-existing illness, you should consult with a health care provider to discuss whether COVID-19 vaccination is appropriate for you.

On rare occasions, allergic reactions to vaccination can occur. Severe life-threatening allergic reactions are observed in a frequency of about 1 out of 1 million doses.

 If you have had allergic reactions to any vaccines, drugs, medical products, or foods in the past, discuss these with a healthcare provider before being vaccinated.

 

5. Can I return to life as normal after I've been vaccinated?

As long as COVID-19 is still a global pandemic, you should continue to take preventive measures, such as covering your mouth and nose with a mask, washing your hands regularly and staying at least 1.5 metres away from others. It is also important to avoid crowded areas with poor ventilation. These steps will help reduce any chance of spreading the virus to other people.

COVID-19 has changed many things, including what “normal” life looks like. For as long as the pandemic lasts, we must adapt to a “new normal”—including after vaccination.

 

6. What happens if I do not want to get the vaccine?

No one will be forced to take the vaccine. It is voluntary. However, vaccines will be an important tool - in combination with other measures - to protect ourselves, our family and our communities from COVID-19 and save lives. Finally, it is much safer to be vaccinated than to contract the disease.

 

7. What kind of vaccine will I get

The type of vaccine available for you will depend on the supply of vaccines and other factors but all vaccines that will be offered will meet rigorous safety standards. Based on the information available to us, most vaccines require two doses. It is advised that you receive the same vaccine product for both doses.

 

8. What do I do if I get the vaccine and I do not feel well?

Like any vaccines, COVID-19 vaccines can cause mild reactions including redness, swelling or pain around the injection site. Other common side effects include fever, headache and aching limbs during the first few days after receiving the vaccine. More serious side effects from vaccines are possible but rare. If you have a concern at any time, contact a healthcare provider.

It is important that before you get the vaccine, you let health personnel know of any health conditions or allergies you may have.

Each person who is vaccinated will be asked to stay at the health facility for 30 minutes afterwards to monitor any side effects. The majority of severe reactions from any vaccine usually take place within this time, although they are very rare. Health personnel are trained to manage the situation in these rare cases.

Vaccines go through robust clinical trials and are only approved for use in the wider population after their safety and efficacy has been rigorously tested, and the benefits are shown to far outweigh any risks.

Serious vaccine reactions are rare. The Government has monitoring systems in place for any unexpected medical event after someone has received a vaccine which may or may not have been caused by the vaccine.

 

9. I saw in the news that people may still get infected after getting vaccinated or even die, so why should I risk it?

Once vaccinated, it takes a certain period of time for the body to produce antibodies to fight the virus and protect the individual from getting sick. The vaccines may not immediately confer protection and thus there is still a possibility that an infected individual will get the disease after vaccination.

This is one of the reasons why people should continue to practice preventive measures—masking, handwashing, physical distancing, etc—even after receiving the vaccines.

 

10. I have heard that some countries stopped using the AstraZeneca vaccine because of its adverse effects. Should I be worried if I get that vaccine?

As a precautionary measure, some countries in the European Union suspended use of a specific batch of AstraZeneca vaccine distributed in the EU, based on reports of rare blood coagulation disorders in persons who had received vaccine from that particular batch. However, the European Medicines Agency’s Pharmacovigilance Risk Assessment Committee has concluded that the vaccine’s benefits continue to outweigh its risks, and the vaccine can continue to be administered while investigation of cases of thromboembolic events is ongoing.

Vaccination against COVID-19 will not reduce deaths from other causes. Deaths from other causes will continue to occur, including after vaccination, but were not caused by the vaccination.  

As of 23 March, over 430 million doses of COVID-19 vaccines have been administered, based on data reported to WHO by national governments. No deaths have been found to have been caused by COVID-19 vaccines to date. 

 

11. Should people who may have a history of allergic reactions get the vaccine?

A history of severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine is a contraindication. This means that these people should not routinely receive the vaccination. In persons who report a history of anaphylaxis, a risk assessment should be conducted to determine type and severity of the reported previous reaction and the reliability of the information. These persons may still receive vaccination, but should be counselled about the unknown risks of developing a severe allergic reaction and balance these risks against the benefits of vaccination. Such persons should be observed for 30 minutes after vaccination.

 

12. I am already very sick, shouldn’t I skip vaccination because it might kill me?

Please talk to a health care provider if you are concerned. They will be able to advise whether you should get vaccinated or not.

 

13. What can I do now to help protect myself from getting COVID-19 as I wait for my vaccination?

You should continue covering your mouth and nose with a mask, washing your hands regularly, staying at least 1.5 metres away from others and avoiding crowded areas with poor ventilation where possible. These steps will help reduce your chance of being exposed to the virus or spreading it to others.

Even once you have been vaccinated, you should follow these measures because it is not yet known if the vaccines will stop you from spreading COVID-19 to others.

II) HOW VACCINES WORK

1. How do vaccines work?

Vaccines teach the body’s immune system to safely recognize and block viruses. They have a long and successful history, having first been used 225 years ago. Since then, humans have successfully developed vaccines for a number of life-threatening diseases, including meningitis, tetanus, measles and polio--and now COVID-19.

Vaccines are a critical new tool in the battle against COVID-19.

 

2. What are the different types of vaccines?

Several different types of vaccines for COVID-19 have been developed, or are in development, including:

  • inactivated or weakened virus vaccines, which use a form of the virus that has been inactivated or weakened so it doesn’t cause disease, but still generates an immune response
  • protein-based vaccines, which use harmless fragments of proteins or protein shells that mimic the COVID-19 virus to safely generate an immune response;
  • viral vector vaccines, which use a virus that has been genetically engineered so that it can’t cause disease but produces coronavirus proteins to safely generate an immune response; and
  • RNA and DNA vaccines, a cutting-edge approach that uses genetically engineered RNA or DNA to generate a protein that itself safely prompts an immune response.

Different types of vaccines have different vaccine characteristics, including the strength of the immune response, number of doses required, safety profiles, cold chain requirements, and manufacturing time.

 

3. How many doses of vaccines have to be taken and at what time interval?

Based on current information, most vaccines require two doses, with the second dose administered a few weeks or a few months after the dose (each has different guidelines). It is very important to have the second dose or the vaccine will not be as effective. Follow the advice of your healthcare provider. 

You should get the second shot even if you have side effects after the first dose, unless a vaccination provider or your doctor tells you not to get a second dose.

It is currently advised that you receive the same vaccine product for both doses

 

4. If I have already had COVID-19 and recovered, do I still need to get a COVID-19 vaccine?

Yes. The COVID-19 vaccination should be offered to you regardless of whether you have already had a COVID-19 infection previously. The protection from a vaccination appears to provide more effective protection.

However, those who are currently infected with COVID-19 should postpone vaccination until after their illness has run its course and after they have met their health authorities’ criteria to discontinue isolation.

 

5. If I get a COVID-19 vaccine, will it cause a false positive for COVID-19 diagnostic testing (i.e. PCR or antigen tests)?

Being vaccinated for COVID-19 will not cause a positive PCR or antigen laboratory test result since these specific tests check for active disease and not whether an individual is immune or not.

However, it should be noted that the antibody test (or “serology test”) may be positive in someone who has been vaccinated, since that is a specific test that measures COVID-19 immunity in an individual.

Currently in Cambodia, only PCR are often used to test for COVID-19, and antigen and antibody tests are not routinely used.

 

6. After I am vaccinated, how long will vaccine immunity last?

Immunity begins a few weeks after receiving the first dose of the vaccine and persists for several months but the full duration is not yet known. That is why it is important to continue preventive practices, such as wearing a mask, washing your hands regularly and physical distancing. Taking these steps to protect ourselves and others will still be important for some time to come. It is also important to remember that this immunity refers to protection from more severe COVID-19 disease. We don’t yet know how good the vaccines are at stopping someone becoming infected with the virus that causes COVID-19

 

7. Why is a vaccine needed if we have other public health measures like social distancing and wearing masks to prevent COVID-19 from spreading?

While safe and effective vaccines are an important tool to protect people against COVID-19, no single measure, not even vaccines, can protect us completely. Using numerous measures together provides the best protection for you, your family and your community.

III) WHO WILL GET VACCINATED?

1. Who can get the vaccines and why?

The Government has prioritised certain people for vaccination because either their work exposes them to COVID-19 or their health puts them at greater risk of severe sickness if they contract it. Those priority groups currently include healthcare workers, armed forces, police, Government staff, people over 60, adults with underlying health conditions and certain foreigners.

 

2. How can they get it?

You can now register yourself online at www.cambodia-vaccine.gov.kh and then wait to receive your appointment. You can also register through your village chief by showing your ID and then waiting for your appointment. If you register online, you do not need to also register with your village chief.

 

3. How long after registration can I get the vaccine?

Most people receive a vaccine dose within 3 days of registration, though this may vary according to location and availability of vaccines. Please be patient and wait for your turn.

 

4. Is the vaccine only for people who are high risk?

In view of limited vaccine supply, high-risk groups should be vaccinated first. WHO has advised that this should include health care workers, in order to sustain vital health service functions. Other high-risk groups include the elderly, those with pre-existing illnesses which put them at higher risk of getting sick from COVID-19, and those with high risk to exposure.

If you are not sure whether you are at high risk or part of a priority group, seek advice from a healthcare provider.

 

5. What can I do now to help protect myself from getting COVID-19 as I wait for my vaccination?

You should continue covering your mouth and nose with a mask (particularly when having close contact with others, or going into into crowded enclosed spaces), washing your hands frequently with soap or an alcohol hand sanitizer, staying at least 1.5 metres away from others and avoiding crowded areas with poor ventilation where possible. These steps will help reduce your chance of being exposed to the virus or spreading it to others.

 

6. Will pregnant women receive vaccinations, or should they?

Given the current lack of data on safety and efficacy regarding COVID-19 vaccines for pregnant women, they are not prioritised or recommended for COVID-19 vaccination at this point in time. Studies are ongoing.

 

7. Will breastfeeding mothers receive vaccination?

Yes, WHO recommends that if a breastfeeding woman is a health worker or part of another priority group for COVID-19 vaccines, the vaccination should be offered.

Breastfeeding offers substantial health benefits to women and their breastfed children. WHO does not recommend discontinuing breastfeeding after vaccination.

 

8. Why are children under 16 years old not being vaccinated sooner?

We do not yet have data on vaccine use in children under 16 years of age, so it is not yet clear if these vaccines are safe and effective for them. Guidance will be updated as evidence becomes available concerning COVID-19 vaccine effectiveness and safety in children under 16 years of age.

Some vaccines are recommended for use in adults aged 18 years and older. If you or a family member are 16 or 17 years old, check with a healthcare provider before being vaccinated.

 

9. I am young and healthy/ there aren’t many infections in Cambodia, so why should I rush to get a COVID-19 vaccine?

Vaccination is important for everyone. Given the limited supply of vaccines, people will be vaccinated in phases, beginning with priority groups including healthcare workers, and frontline officials and workers.

If you are not part of a priority group, you can wait to be vaccinated. The Ministry of Health will advise when you should be vaccinated.

Vaccines have proven to be effective and to save lives. By vaccinating these priority groups in a first phase, we will protect the health system and reduce severe disease and societal disruption. The Government’s National Deployment and Vaccination Plan for COVID-19 Vaccines (NDVP) sets out a plan to vaccinate other vulnerable groups, such as the elderly and people with pre-existing illnesses which put them at higher risk of getting sick from COVID-19, by the end of 2021.

While Cambodia has had few cases of COVID-19 to date, it has been dramatically affected by the socio-economic impact of the pandemic. Not only will vaccines help save lives and stabilize health systems, but they can help to drive an economic recovery by restoring Cambodian society – making it possible for schools and businesses to remain open, for people to travel and be with their families, for low-wage workers to resume their work, and much more.

No country, including Cambodia, will be safe from the pandemic until all countries are safe. COVID-19 cannot be beaten one country at a time. Risk remains so long as COVID-19 cases continue to rise globally, especially in neighbouring or nearby countries. Vaccines will be an important tool, in combination with other measures, to protect against COVID-19 and save lives.

 

10. I personally am unsure whether to get vaccinated (because I am not travelling/ not at risk/ am covered by insurance if I fall sick so should I get a vaccination or not?

You are encouraged to get vaccinated if you are one of the priority or vulnerable groups identified. If you are not among these groups, you should be patient and wait to get the vaccine, as the supply of vaccines is limited and will be prioritised to those who need it the most.

If you are not sure whether you are part of a priority group, consult a healthcare provider.

 

11. I am old and don’t see many people, should I get a vaccine?

You are encouraged to get vaccinated if you are one of the priority or vulnerable groups identified, even if you don’t see many people. People over 60 are a priority group.

If you are not among these groups, you should wait to get the vaccine, as the supply of vaccines is limited and will be prioritised to those who need it the most.

 

12. Can people over 60 who live in the provinces come for vaccination at Phnom Penh?

No. People older than 60 years old are a priority group and will be vaccinated in their home provinces. 

 

13. Can older people who have ID issued in the province but currently live in Phnom Penh with their children get vaccinated in Phnom Penh?

Yes, they should receive their vaccination in Phnom Penh, but they need to receive an invitation letter from local authorities (village chief or commune council or district governor) before arriving at the vaccination site. 

 

14. What documents should people have for pre-registration?

Cambodian ID card or passport. If they do not have an ID card or passport, they can present their birth certificate.

 

15. What documents do people need to bring when going to a vaccination site?

A Cambodian ID card or passport.

 

16. Can foreigners doing business in Phnom Penh be vaccinated if they are older than 60?

Foreigners are eligible to be vaccinated, including those older than 60. Foreigners or the company employing them should follow the instruction of the Ministry of Foreign Affairs and International Cooperation.

IV) SELECTING AND ROLLING OUT COVID-19 VACCINES

1. Why are there so many different vaccines?

The world needs enormous quantities of vaccines in order to meet the unprecedented global demand caused by a truly global pandemic. This need can best be met by multiple manufacturers providing different vaccines.

The approval process for all new COVID-19 vaccines has followed the usual high standards for regulation of vaccines. The studies taking place prior to vaccine roll out are as rigorous as for any other vaccine.

[See question 15 for detail on the types of vaccines.]

 

2. What is Cambodia’s plan to vaccinate the population?

The Ministry of Health has developed a National Deployment and Vaccination Plan for COVID-19 Vaccines (NDVP) for COVID-19 and begun planning for all the elements of rolling out a new vaccine, including regulations, logistics, safety monitoring, priority groups for vaccinations, and communication and community engagement.

As there will not immediately be enough vaccine doses for the entire population - as in every other country in the world - the Government is planning a phased approach to vaccination. Priority groups will be the first to receive vaccines.

 

3. How do I know when/ where to go to get vaccines in Cambodia?

Currently, COVID-19 vaccines are available and provided in hospitals – including designated national hospitals in Phnom Penh and all Provincial and District referral hospitals across the country – and some heatlh centres. Vaccination will be provided at more health centres in the future. Only frontline armed forces will receive vaccination through military healthcare facilities.

 

Currently, village chiefs and other appointed community leaders identify eligible people and arrange appointments and registration at the nearest vaccination location. A web-based, mobile-friendly registration system is under development.

 

4. How long after registration can I get the vaccine?

Most people receive a vaccine dose within three days of registration, though this may vary according to location and availability of vaccines. Please be patient and wait for your turn.

 

5. What steps are taken to protect people from COVID-19 when they come for vaccination?

The safety of both health care workers and target populations for COVID-19 vaccines is very important. Vaccinations will be administered following strict safety protocols.

At the vaccination site, all vaccination team members will be provided with masks, sanitisers and gloves to protect themselves and the people being vaccinated.

Before entering the vaccination site, everyone will have their temperature taken, be checked to ensure proper use of face mask and be given hand sanitiser. The vaccination teams will ensure that people coming to be vaccinated remain at least 1.5 metres apart.

 

6. How/why did Cambodia’s government decide to choose which vaccine?

In view of the threat that COVID-19 continues to pose to Cambodians, the Royal Government of Cambodia considers it an urgent priority to secure vaccines to protect the Cambodian people. Like other countries, the Royal Government of Cambodia makes the decisions on which vaccines to secure based on vaccine efficacy, safety, quality, availability and cost.

To date, the Cambodian Government has announced it will secure vaccines through various means: from the COVAX Facility, a platform that is co-led by Gavi, CEPI and WHO, in partnership with UNICEF; from donations; and through bilateral procurement agreements. Given the limited global supply of vaccines, the Government has pursued all of these means in order to procure vaccines that have met regulatory standards as quickly as possible.

The first doses of COVID-19 vaccines arrived in Cambodia on 7 February. This vaccine was manufactured by Sinopharm and donated by the Chinese Government at the request of the Royal Government of Cambodia. This was followed by the AstraZeneca SII vaccines provided by COVAX and Sinovac vaccines.

In view of the vaccine profile and given the experience of other countries, the Government has granted both vaccines Emergency Use Authorization and begun administering doses to priority groups. The Government has put appropriate safety and medical protocols in place to ensure it is administered safely.

To date, numerous other countries, including Bahrain, China, Egypt, Iraq, Jordan, Pakistan, Peru, Serbia and the United Arab Emirates have also granted Emergency Use Authorization to this vaccine.

 

7. How does the clearance process work?

The same steps are used for COVID vaccine development as are used for other vaccines. Vaccines go through various phases of development and testing – there are usually three phases to clinical trials.

All phases assess safety. The last phase, phase III, is usually conducted in a large number of people, often tens of thousands.

Cambodia has a national regulatory authority in place under the Ministry of Health. The Ministry of Health will issue emergency use authorizations for a vaccine after reviewing its safety and efficacy profile and the data available from other regulatory authorities, or after a vaccine has received WHO EUL.

Once they are in use, vaccines are continuously monitored to make sure they are fully safe for the people who receive them.

 

8. Is the United Nations involved with the vaccines plans in Cambodia?

WHO and UNICEF are longstanding UN partners of the Cambodian government and its routine immunisation programme. WHO and UNICEF are also key UN partners supporting country preparation and roll-out of the COVID-19 vaccines. They are providing technical advice and support across key areas including strategy development, planning, supply chain, capacity building, communications, safety and surveillance, monitoring. Final decisions rest with the Government.

UN agencies are not directly involved in the procurement of vaccines obtained through bilateral cooperation or agreements. However, UNICEF will support the procurement of vaccines through the global COVAX mechanism, as UNICEF has been designated a lead agency role globally. The COVAX mechanism will provide participating countries with vaccines that have obtained WHO EUL approval.

 

9. How does government decide which vaccine is the best one?

Every government in the world is facing the challenge of how to vaccinate as many of its people as possible as quickly as possible. Each government has the right to decide on the best approach to vaccination, always with the priority of keeping people safe, including the most vulnerable to disease, and in consideration of socio-economic recovery. Like other countries, the Royal Government of Cambodia makes the decisions on which vaccines to secure based on vaccine efficacy, safety, quality, availability and cost.

The same steps are used for COVID-19 vaccine development, no matter where the vaccine has been developed and manufactured. Every vaccine needs to go through extensive and rigorous testing before it can be introduced in a country. All vaccines go through various phases of development and testing. There are usually three phases to clinical trials, all of which assess safety. The last phase, phase III, is usually conducted in a large number of people, often tens of thousands.

In view of the threat that COVID-19 continues to pose to Cambodians, the Royal Government of Cambodia considers it an urgent priority to secure vaccines to protect the Cambodian people. Like other countries, the RGC makes decisions on which vaccines to secure based on vaccine efficacy, safety, quality, availability and cost.

Given the limited global supply of vaccines, the Government has pursued securing vaccines through various means—the COVAX Facility, donations, and bilateral procurement—in order to procure vaccines that have met regulatory standards as quickly as possible.

Once they are in use, vaccines are continuously monitored to make sure they are fully safe for the people who receive them.

 

10. How much do vaccines from these countries cost?

Vaccines vary in cost. Some vaccines are being donated for free to Cambodia, and others, such as those provided through COVAX, are being subsidised.

 

11. How can I support the vaccination roll-out?

If you are not in a priority group to receive the vaccine, be patient and wait to get the vaccine, as the supply of vaccines is limited and will be prioritised to those who need it the most.

If you belong to a priority group, you are strongly encouraged to get vaccinated. COVID-19 vaccines are safe and efficacious.

Continue taking steps to protect yourself and others, such as hand washing, mask wearing and physical distancing, even if you do receive the vaccine.

Help vulnerable people you know, such as the elderly, to register for the vaccine and get to the vaccination site when it is their turn to be vaccinated.

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