I’m USA TODAY editor-in-chief Nicole Carroll, and this is The Backstory, insights into our biggest stories of the week. If you’d like to get The Backstory in your inbox every week, sign up here.

States soon will start rolling out the COVID-19 vaccine. And you have questions. More than 2,000 of you have written to us in the past two weeks. Among what you’ve asked the most: Will Americans be required to get vaccinated?

“For some, the short answer is yes,” wrote reporter Grace Hauck. But a mandate is not likely to come from the government. “Instead, employers and states may condition return or access to workplaces, schools and colleges upon getting the vaccine and mandate it once the FDA issues full approval, potentially months later.”

President-elect Joe Biden told reporters Friday that he would not mandate vaccines.

“But I would do everything in my power – just like I don’t think masks have to be made mandatory nationwide – I’ll do everything in my power as president of the United States to encourage people to do the right thing,” Biden said.

Arthur Caplan, a professor of bioethics at the New York University Grossman School of Medicine, told Hauck: “It’s much more likely that a private organization or company will require you to be vaccinated to get certain access to places.”

Two vaccines are expected to ship soon. Authorization for the vaccine from Pfizer and German startup BioNTech is imminent; the Moderna vaccine goes for authorization next week.

Other top questions, Hauck said: “Is the vaccine safe? Are there side effects? Will insurance cover it? Does the booster shot have to be from the same manufacturer? Will we get it every year like the flu shot? Many readers also ask questions about whether the vaccine will be safe for people with specific health conditions – anything from heart conditions to soy allergies.”

A vial of the COVID-19 candidate vaccine developed by BioNTech and Pfizer is displayed at the headquarters in Puurs, Belgium.

Our health reporters have spent this week researching your questions. Here are just some of the answers:

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Yes, it is safe. The approval process for vaccines is stringent and heavily reviewed. The FDA on Tuesday released a 53-page report summarizing data from Pfizer/BioNTech’s COVID-19 candidate vaccine trial. “The data supports earlier findings that the vaccine is safe and will prevent 95% of people from becoming sick with COVID-19,” wrote patient safety reporter Karen Weintraub.

What are potential side effects? All three vaccine makers have reported mild to moderate reactions, including pain at injection site, fatigue and sore muscles and joints. Doctors say this is normal.

The vaccine itself will be free, but health care providers can charge a fee for administering it, which can be paid for by insurance or a government relief fund.

The vaccines require two doses, and they must be from the same manufacturer, as the composition and timing of vaccines differ.

It is not known if you can still get sick or spread the virus to others after you’ve been vaccinated. However, the vaccines are at least 95% effective. It’s not known yet how long the vaccination lasts.

The vaccines weren’t tested on children, so school-age kids won’t be getting vaccinated at first. But college students are eligible, and colleges are debating whether they will, or when they will, be required.

Vaccines weren’t tested on pregnant women, either. So the effectiveness and impact aren’t yet known. “Experts are still debating when vaccines should in general be tested on those who are pregnant,” Hauck reported. “Historically, major vaccines have not been tested during pregnancy because of concerns that both the pregnant person and fetus would be at risk for complications.”

If you’ve already had COVID-19, experts still suggest you get vaccinated, as it’s not known if or when you could get reinfected.

Experts will watch closely for any adverse reactions as the vaccine rolls out. Those vaccinated can download smartphone apps that will prompt them to report how they’re feeling. Those first in line also may get follow-up texts, emails and phone calls. All information will be reported to the CDC. Health systems, as well, will be combing medical records for any problematic patterns.

Healthcare workers and long-term care residents are first up for the vaccine. Other details will be determined by where you live. How do we know? We researched the vaccine roll-out plans for all 50 states. Here’s what we found.

The White House has promised to get the vaccine to all 50 states, the District of Columbia and five U.S. territories within 24 hours of FDA authorization.

Some states are handling logistics with their own staffs; others have requested National Guard help. Some publish maps of where the vaccine is being stored, and others keep it a secret.

“Who will get the vaccine first is pretty set, generally frontline healthcare workers and people in long-term care facilities,” health writer Elizabeth Weise reported. “But because there won’t be enough vaccine to go around at the beginning, states are divvying up within those groups differently.”

For example, in Kentucky, two-thirds of the supply will go to residents and workers in long-term care centers; the rest goes to workers in hospital COVID-19 units. Hospital chaplains go first in Indiana. Tennessee prioritizes health care workers 65 and older.

And there is continuing confusion over exactly how many doses each state will get, and when they will arrive.

“It really shows how decentralized the U.S. public health system is,” Weise said. “Now we’ll see if that works well, because they know local conditions better than the feds, or if the wheels come off.”

So there is much we know. Much we are learning. And then there are the misinformation campaigns. Already.

Margaret Keenan, 90, the first patient in the United Kingdom to receive the Pfizer/BioNtech covid-19 vaccine, speaks with Healthcare assistant Lorraine Hill as she prepares to leave University Hospital Coventry & Warwickshire, the day after receiving the first of two doses of the vaccine, on December 9, 2020 in Coventry, United Kingdom. The UK is the first country in the world to start vaccinating people with the Pfizer/BioNTech jab.A 90-year-old grandmother from the United Kingdom, Margaret Keenan, became the first person to get Pfizer’s COVID-19 vaccine this week. Immediately, social media posts swirled that she was dead, didn’t exist or was part of a microchip conspiracy.

Staff writers Jessica Guynn and Aleszu Bajak investigated one false claim that said Keenan was actually a crisis actor and found that within 24 hours, it had been seen by more than 475,000 people.

This week, Guynn reported, Facebook took down at least nine pages that were funneling millions of followers to unfounded claims about the coronavirus, the flu vaccine and other health issues.

She talked to Gabby Brauner, 25, who is in a dual program studying to be a medical doctor and to get a master’s in public health at Stony Brook University.

“I’ve unfortunately been seeing a lot of vaccine misinformation. It’s really easy to fall prey to, especially with social media,” she said. “An account can seem legitimate but actually be anti-vaxx posting lies, and it is hard to know.”

Brauner has become an unofficial misinformation first responder, taking it upon herself to reassure those who are worried about the COVID-19 vaccine being safe. Two people recently asked her if the vaccine leads to infertility in women. (It doesn’t.)

“I try to provide information in a gentle way, and I always tell them I’m open to talking about it more,” she said. “I think it’s important to meet people where they are. We have to show that we understand where they’re coming from and not judge them for believing these things.”

I think that’s good advice for all of us. Meet people where they are. Listen to the questions (ask them here). Research the answers. Provide facts. Share truth.

So far, more than 2,000 of you have written to us, trusting us to do just that.

Backstory: Why do people deny the seriousness of COVID-19? I asked them. Here’s what they said.

Backstory: Anthony Fauci has had it with people who think COVID-19 is no worse than the flu

Nicole Carroll is the editor-in-chief of USA TODAY. Reach her at [email protected] or follow her on Twitter here. Thank you for supporting our journalism. You can subscribe to our print edition, ad-free experience or electronic newspaper replica here.

This article originally appeared on USA TODAY: COVID vaccine: Answering your most-asked questions is crucial



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