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Article

Coronavirus vaccine - information for the public

Published Updated

The purpose of vaccination against COVID-19 is to prevent disease or to give a milder disease course without being exposed to serious side effects. We will inform about the effect and potential side effects so that everyone can make an informed choice. The goal is that everyone who is recommended vaccination chooses to take the vaccine.

Folkehelseinstituttet
Folkehelseinstituttet

The purpose of vaccination against COVID-19 is to prevent disease or to give a milder disease course without being exposed to serious side effects. We will inform about the effect and potential side effects so that everyone can make an informed choice. The goal is that everyone who is recommended vaccination chooses to take the vaccine.


Why do we vaccinate?

Having undergone an infectious disease will often provide some protection (immunity) against reinfection, but some diseases can cause such a strong inflammatory reaction in the body that, for some people, it can become dangerous. Some people become severely ill and may die, or have serious medical complications.

A vaccine gives the body something to practise on that resembles the disease virus, but that cannot cause the disease. The immune system is stimulated so the body can recognise and fight the virus. The vaccine quickly disappears from the body but has taught the body to defend itself if it is later exposed to infection. We can easily and effectively protect ourselves against some of the dangerous infectious diseases, without having to be exposed to the risk of having the disease.

Implementation

Vaccination in your municipality

Each municipality is responsible for offering coronavirus vaccination to people in recommended groups who are living there. Check the website of your municipality to see how vaccination is carried out locally and when you will be offered the vaccine.

Find the link to your municipality here:

 

Coronavirus vaccines and vaccination are free, you do not need to pay when you are vaccinated.

Who will get the coronavirus vaccine?

See the separate article about the order of priority for vaccination. There you can also read about risk groups.

Vaccine is free

The government has decided that the vaccine and vaccination in the Coronavirus Immunisation Programme is free for everyone in recommended groups who are living in Norway, including foreign nationals.

The offer does not apply to Norwegian citizens living abroad.

All vaccination in Norway is voluntary. 

How do RNA vaccines work? 

Two of the approved coronavirus vaccines Comirnaty (BioNTech/Pfizer) and COVID-19 Vaccine Moderna are known as RNA vaccines. 

The vaccines contains the recipe (messenger RNA) for the characteristic spikes on the coronavirus encased in small fat bubbles. The body uses this recipe to make harmless copies of these spikes for the immune system to practise on. In this way, the immune system learns to recognise the coronavirus spikes and can defend the body if it becomes infected with the virus.

The messenger RNA is rapidly broken down by the body and has no effect on genetic material.

In addition, the vaccines contain substances to keep them stable during production, storage and transport, as well as to provide the right pH, which is important for reducing pain during injection. These substances are water, salts and sugar.

The vaccines do not contain live virus and do not cause COVID-19 disease. The coronavirus vaccines act to prevent disease. They cannot cure an ongoing illness.

Antibiotics are not used in the production process, so the vaccines do not contain antibiotics or antibiotic residues.

The vaccines do not contain adjuvants, which are substances that are added to some vaccines to increase the immune system's response. The vaccines do not contain products derived from pigs. The vaccines do not contain mercury.

More information about RNA vaccines:

AstraZeneca vaccine removed from coronavirus immunisation programme

The coronavirus vaccine Vaxzevria from AstraZeneca is a viral vector vaccine. It was used in Norway until 11 March 2021. It was removed from the Norwegian coronavirus immunisation programme because of rare but serious vaccine side effects in the form of low platelets, blood clots and bleeding.

Vaccination with Vaxzevria from AstraZeneca was suspended in Norway on 11 March 2021 following reports of rare, severe cases of low platelets, blood clots and haemorrhages after vaccination. The European Medicines Agency (EMA) has concluded that there is an association between these cases and the AstraZeneca vaccine. Blood clots, low platelet counts and haemorrhages are now described as a very serious and rare side effect in the product information. The EMA considers that the vaccine still has a positive benefit-risk ratio, but that the authorities in each country must assess the benefit-risk against the situation in their country.

Following a review and evaluation of available data and the situation in Norway, the Norwegian Institute of Public Health published a recommendation on 15 April that the AstraZeneca vaccine should be removed from the national immunisation programme. The Government decided on 10 May that the AstraZeneca vaccine will not be used in Norway and will be removed from the coronavirus immunisation programme.  

The Norwegian Institute of Public Health provided information on further vaccination of those who received the first dose of the AstraZeneca vaccine. 

Janssen-vaccine not used in coronavirus immunisation programme

The coronavirus vaccine from Janssen-Cilag is a so-called viral vector vaccine. It was conditionally approved by the medicines authorities on 11 March 2021, but has not been used in the coronavirus immunisation programme in Norway. Following a recommendation from the Norwegian Institute of Public Health, the Government has decided that the Janssen vaccine will not be used in the coronavirus immunisation programme based on the current situation in Norway, due to the risk of rare but serious vaccine side effects in the form of low platelets, blood clots and bleeding.

The Government has decided that anyone who wishes to take the vaccine can be assessed by a doctor in order to get the Janssen vaccine. For most people, the risk of serious side effects from the Janssen vaccine will outweigh the benefits in the current situation. This also applies to most people who are travelling abroad. The Janssen vaccine is only available from a doctor after a thorough risk-benefit assessment.

This arrangement is not part of the coronavirus immunisation programme and is not recommended by the Norwegian Institute of Public Health. The Norwegian Institute of Public Health recommends that people should follow the coronavirus immunisation programme. According to the plan, all adults over the age of 18 will be offered the first dose of mRNA vaccine (from BioNTech / Pfizer or Moderna) during the summer, see vaccination calendar.

More about the serious side effects after the Janssen vaccine

The European Medicines Agency (EMA) has concluded that there is a probable link between the Janssen vaccine and serious cases of blood clots, low platelet counts and bleeding. These are now referred to as a very serious but rare side effect in the product information. The EMA still considers the vaccine to have a positive benefit-risk ratio, but the authorities of each country must assess the benefit-risk based on their infection situation. Based on the current situation in Norway, the Norwegian Institute of Public Health considers that the risk of the rare but serious side effects may outweigh the benefits for those groups who have not yet been vaccinated through the coronavirus immunisation programme.

About vaccination

You will be contacted by your municipality or doctor when it is your turn for vaccination. Check your local municipality's website for details. 

Do not turn up for vaccination if, on the day:

  • you have cold symptoms, fever over 38 °C or other symptoms of an infectious disease 
  • you are in quarantine* or are awaiting a coronavirus test result
  • you have received another vaccine within the last 7 days 
  • it has been less than 3 months since you ended your isolation period after coronavirus disease (SARS-CoV-2)
  • you are pregnant and do not belong to a risk group for severe COVID-19 disease course.

Inform the vaccination centre as soon as possible. Your vaccination will be postponed.

* For people who are in entry quarantine, vaccination can be carried out in certain circumstances, provided a negative rapid antigen test result is available on the same day. This can, for example, apply to professional drivers, train personnel or border commuters in quarantine in their leisure time.

Before the vaccine is given

Before you receive the vaccine, you will be asked if you are feeling well and if you have had any reactions to other vaccines you have had. Remember to say if you are pregnant, have any allergies, use medicines or have other health problems.

It is common to delay vaccination with acute illness and a fever above 38 °C

How is the vaccine given?

The vaccine is injected into the upper arm.

A second dose will be given after an interval of several weeks.  

The two doses of the mRNA vaccines Comirnaty (BioNTech / Pfizer) and COVID-19 Vaccine Moderna (Moderna) are given 6 weeks apart if you are over 65 years of age or under 65 years of age and have an underlying disease. If you are under 65 years of age and have no underlying disease, the doses are set at 9-week intervals.

Delays in taking the second dose

It is important that you try to take the second dose at the scheduled time for optimal protection. If something unforeseen occurs, inform the vaccination site as soon as possible to arrange a new appointment.

More information about the coronavirus vaccines in use in Norway:

After vaccination 

After you have had the vaccine, you will be asked to wait for 20 minutes in case you experience any reactions.

Everyone who administers vaccines has had training and necessary medication will be available to treat possible allergic reactions.

Side effects and symptoms after vaccination

The vaccines can cause side effects in many of those vaccinated, but they are mostly mild / moderate and short-lived.

Stay at home or be tested for symptoms?

The vaccine can give side effects up to three days after vaccination, so how should you deal with potential symptoms after vaccination?

Symptom 

Measure 

Symptoms that are typical vaccination side effects:  

Fever, headache, fatigue, muscle or joint pain

Stay at home until you are fever-free and have a better general condition

If symptoms persist for more than 48 hours, consider a coronavirus test

Symptoms that are not typical vaccination side effects:

Cough, sore throat, runny nose, wheezing, lost taste / smell

Stay home and arrange a coronavirus test

If you experience unexpected, severe or prolonged symptoms that you think may be due to the vaccine, contact your doctor or another healthcare worker for assessment and advice. Healthcare workers have a duty to report any serious or unexpected reactions that they suspect are due to a vaccine. You can also send in a notification yourself via helsenorge.no.

When vaccines are developed, the goal is always for vaccines to give the best possible effect with the fewest possible side effects. Even if the new vaccines are tested thoroughly, rare side effects cannot be ruled out. Some side effects are only discovered when vaccines are in wider use, and have been given to many more people and to more varied groups than in the studies.

When vaccines are approved, we will know a lot about common and less common side effects in adults, but probably less about side effects in children, the elderly and pregnant women. We will know little about the long-term side effects of vaccination.

More information about the coronavirus vaccines:

After the vaccines are in use, the Norwegian Medicines Agency, together with the Norwegian Institute of Public Health, will monitor closely whether any unexpected side effects arise. There is also extensive international collaboration with the other countries that use the same vaccines. In addition, the vaccine manufacturers are required to conduct new systematic safety studies.

What happens to the notifications about side effects?

The Norwegian Institute of Public Health (NIPH), in collaboration with the Regional Medicine Information and Pharmacovigilance Centres (RELIS), processes reports of suspected side effects from healthcare personnel. The notifications are entered in the ADR Registry at the Norwegian Medicines Agency. The Norwegian Medicines Agency publishes regular reports with an overview of reports of suspected adverse reactions after vaccination in Norway.

Notifications from healthcare professionals are thoroughly assessed to find out if the incident may be due to the vaccine, or if it happened at the same time as vaccination. It is important to be aware that events that coincide in time are not necessarily due to vaccination. In some cases, it can be difficult to conclude whether an event is due to a vaccine or coincidence based on one or a few single events. 

Protection and immunity after vaccination

  • The two RNA vaccines from BioNTech/Pfizer and Moderna protect against disease caused by the new coronavirus. The protection is similar for the vaccines. About 95 per cent of those vaccinated in the vaccine studies had protection against COVID-19 one-two weeks after the second dose. 

  • The studies indicate that the vaccines also provide protection against a severe course of coronavirus disease that requires hospital treatment. This means that in those cases where people get a coronavirus infection despite vaccination, the vaccine can contribute to a milder course.

  • We do not yet know how long the protection will last. If the protection decreases over time, booster doses may be necessary.

  • Since the vaccines prevent disease, they will also prevent transmission, but we do not yet know to what extent.

  • The risk that vaccinated people get COVID-19 diseases is small, but can happen. Therefore, it is important to continue to follow the current infection control advice and to be tested if symptoms arise, even if vaccinated.

Mutated virus variants

It appears that the vaccines will protect against the various mutated virus variants, but that the effect may be lower in some cases. There are now slightly different estimates for the different vaccines, and they are uncertain.

Although some data suggest a lower vaccine effect against mild disease for some of the virus variants, it is important to remember that the vaccine may still have a good effect against severe disease.

If a virus variant comes where the current vaccines do not work, then we can vaccinate again to improve the degree of protection.

Coronavirus vaccine with another vaccine

It is not recommended to take another vaccine on the same day as the coronavirus vaccine. There should be at least one week between taking the coronavirus vaccine and other vaccines. If it is necessary to take several vaccines at once, you should consult a doctor.

Coronavirus vaccine and testing

You will not be tested for coronavirus before vaccination to find out if you have previously had a coronavirus infection. You will be recommended a vaccine if you belong to the recommended groups.

For more information about vaccination of people who have had COVID-19, please see:

It is not planned that those who are vaccinated through the coronavirus immunisation programme in Norway will be tested after vaccination to test the effect of the vaccine.

Since the vaccines do not give 100% protection, people can become infected with coronavirus even if they have been vaccinated. It is therefore important that vaccinated people should also be tested if they develop symptoms of COVID-19 disease.

Coronavirus vaccination does not affect the result of a coronavirus test, both PCR test and rapid antigen test. If a vaccinated person has to be tested against the coronavirus, the results of the test can be considered to be reliable.

Vaccination after having COVID-19

People with valid documentation of having COVID-19 from Norway

It is not yet clear how long the immunity from having had COVID-19 lasts.

Therefore, it is recommended that people who have had COVID-19 and who are in the priority groups should also be vaccinated. However, people who have had COVID-19 only need one dose of vaccine. It is recommended that the vaccine be given 3 months after recovery from COVID-19.

If you have had COVID-19 and are called in for vaccination, inform the vaccination centre so they can take this into account for their planning.

People without valid documentation of having COVID-19 from Norway

If you had COVID-19 while you were abroad, or suspect that you have had it either in Norway or abroad, you can take an antibody serology test performed at a microbiological laboratory (i.e. not a rapid antigen test) in Norway. This will then be registered in the MSIS Laboratory database and therefore shown on Helsenorge. The antibody test must be taken no later than the day before vaccination to give a valid COVID-19 certificate based on the combination of infection and one dose of vaccine. This applies regardless of how long it has been since the suspected infection, as long as at least 3 weeks have passed. Together with documentation of having received one vaccine dose, this is sufficient for you to be considered fully vaccinated.

As there is no requirement for a maximum interval between the disease and the vaccine (for one vaccine dose to be sufficient), a PCR / equivalent test or rapid antigen test is not required (these differ from the antibody tests in that they document the timepoint of disease - by detecting antigens, they document the presence of viral material at the time of testing). For the COVID-19 certificate, data on antibody tests will be obtained from MSIS and linked to SYSVAK.

This is reflected in the vaccination guidelines about vaccination after undergoing COVID-19: The Norwegian Institute of Public Health therefore considers that one vaccine dose is enough for those who have previously undergone COVID-19 (approved PCR test / other NAT, antigen test or antibody test *). This applies regardless of how long ago they had COVID-19. The Norwegian Institute of Public Health recommends that this dose is given 3 months after recovery, as this provides the best protection.

However, antibody test results will not give a valid COVID-19 certificate based on  having the disease alone, because there is a requirement that the disease must be a maximum of 6 months back in time. Since PCR or antigen rapid tests are the only tests that can document disease at a specific time, only these tests are approved for certificate based on having had the disease.

Vaccination of pregnant and breastfeeding women

Pregnancy

There is still little experience with coronavirus vaccine in pregnant women but available data do not indicate that vaccination is harmful to the pregnant woman or the foetus.

If you are pregnant and at risk of severe COVID-19 due to another condition, it is important that you, in consultation with your doctor, consider whether you should take the vaccine when you are offered it. Pregnant women without underlying conditions, in areas with high transmission and who cannot limit their contact with others, can be vaccinated in consultation with their doctor.  The risk of a severe disease serious course should then be weighed against a possible, unknown risk from vaccination for the mother and the child.

The NIPH does not recommend postponing pregnancy until you have been vaccinated because it will take time for all young women to be vaccinated.

Breastfeeding

The effect of the vaccine on breastfeeding women has not been studied but it is unlikely that vaccination of the mother involves any risk to a breastfed child. Women who breastfeed can be vaccinated and do not need to stop breastfeeding after vaccination.

Vaccination of children

The vaccines that have been approved have not been tested on children and adolescents. Children also have a lower disease burden than the rest of the population. Vaccination will initially not be recommended for children and adolescents under 18 years of age.

Vaccination of people who are sick, on medication or have allergies

It is common to postpone vaccination in cases of acute illness and with a fever above 38 °C.

Previous allergic reaction to vaccines

In case of a previous severe or life-threatening allergic reaction to the first dose of the vaccine, or to the ingredients of the vaccine, it is not advisable to give the second dose.

In a person who has experienced a non-severe allergic reaction to the first dose of vaccine, it may be appropriate to give the second dose. This applies if the doctor considers that the risk of COVID-19 disease outweighs the risk of an allergic reaction when vaccinated. In such cases, vaccination should be carried out with increased preparedness and with an observation time of 1 hour.

Previous allergic reaction to food, medicine, etc.

People with a previous severe or life-threatening allergic reaction to other vaccines, food or medicine can be vaccinated with the coronavirus vaccine. Extra precautions will be taken, including an extended observation period after vaccination.

Impaired immune system

RNA vaccines do not contain live viruses and do not cause COVID-19. People with impaired immune systems can therefore take the vaccines.

Although the vaccines generally provide protection of about 95 per cent, protection may be lower among people with an impaired immune system, as has been seen for other vaccines.

Frail people with short life expectancy

For the vast majority of elderly people living with frailty, any side effects of the vaccine will be outweighed by a reduced risk of a severe COVID-19 disease course.

However, for people with severe frailty and those with a very short life expectancy, even relatively mild vaccine side effects can have serious consequences. Any benefits of taking the vaccine may be small. For these patients, their doctor should make a careful overall assessment and, in consultation with the patient and their relatives, decide whether the patient should be advised to take the vaccine.

Increased bleeding tendency

If you are taking blood-thinning medication, you can be vaccinated as you normally would. There is little risk of significant bleeding when the vaccine is injected into the arm. When you are offered a vaccine, tell the vaccination site that you are using this type of medication, so they are prepared to help you if there are signs of bleeding at the injection site. In that case, it will help to apply pressure to the area.

Examples of common medications prescribed in this group are Marevan, Eliquis, Pradaxa, Xarelto, Lixiana, Albyl-E, Aspirin, Acetylsalicylic acid, Plavix, Clopidogrel, Persantin, Brilique, Heparin, Fragmin and Klexane. If you have an increased tendency to bleed due to an underlying disease, you should contact a doctor for individual assessment.

If you have haemophilia and are being treated with a coagulation factor, you should contact the vaccination site to schedule vaccination so that the vaccine can be given as soon as possible after the last dose.

Beta blockers

Healthcare professionals should be aware that you are taking this type of medication so that they can give you the best possible help if you have an allergic reaction. You do not have an increased risk of allergic reactions, but may need more of the medication used to treat allergies.

What can vaccinated people do?

Now that the proportion of vaccinated people is increasing, we can gradually ease some of the most intrusive infection control measures, as long as the infection situation allows for this. Read more about what has been eased so far for people who have been vaccinated or have undergone COVID-19:

We have increasingly certain knowledge that the vaccine protects the vast majority well against becoming ill from COVID-19 and against infecting others. Vaccinated people should continue to follow the infection control advice that applies at all times and arrange to be tested if they get symptoms that may be consistent with COVID-19. The few who get COVID-19 despite being vaccinated or having undergone the disease will most often have a mild disease course or no symptoms.

We will probably have to live with the basic infection control advice about keeping more distance, staying home when we are sick, and being tested for symptoms, a little longer. However, the long-term goal is for vaccination to help bring society back to normal, with the freedom this entails. 

Post-registration of coronavirus vaccines

How are EMA-approved coronavirus vaccines given outside Norway post-registered?

In the ongoing corona pandemic, we initially focused on making sure that vaccinations given in Norway were registered in SYSVAK, according to the SYSVAK registry regulations § 1-3 on maintaining an overview of vaccination coverage in the population.

If you were given an EMA-approved vaccine in another country, a COVID-19 certificate issued in the EU / EEA should primarily be used for border crossing, contact tracing and quarantine.

If you intend to stay in Norway for a longer period or have moved back, COVID-19 vaccinations approved in the EU can be post-registered in SYSVAK provided there is credible written documentation.

Who can you contact to post-register coronavirus vaccine(s) in SYSVAK?

  • General practitioner (doctor)
  • Municipal health service (see Implementation above)
  • Private health service 

What documentation do you need?

  • COVID-19 certificate issued in the EU / EEA
  • Written documentation of vaccination

How do you do this?

  • Request a consultation with a healthcare professional in one the above services (video or physical consultation).
  • Residents must log in to Helsenorge to check the COVID-19 certificate (the time taken to update the information on Helsenorge varies due to different medical record systems, but usually within 24 hours).

The Norwegian Institute of Public Health cannot post-register vaccines on behalf of private individuals.

Statistics

The number of registered doses in the Norwegian Immunisation Registry SYSVAK, is published on this page (currently only in Norwegian). The statistics show the number of people vaccinated against COVID-19 in SYSVAK. There may be some delay in registrations.

Vaccination cards and COVID-19 certificates

Vaccination card

A vaccination card is a documentation of which vaccines you have been given (in Norway) and are registered for you. You can log in to the vaccine service at helsenorge.no and download your electronic vaccination card. Coronavirus vaccination will also be visible on the card.

If you do not use helsenorge.no, the person who vaccinates you can give you a simplified vaccination card for coronavirus vaccination. You can make a note for the appointment for dose number 2.

Both types of vaccination cards are available in Norwegian and English.

COVID-19 certificate

Both the EU authorities and the World Health Organization (WHO) are considering the possibility of introducing a global vaccination certificate/"passport" for those who have been vaccinated against coronavirus (as for yellow fever vaccination). The idea is that this could give certain rights, for example, to fly, cross borders and participate in events.

The Norwegian Institute of Public Health, in collaboration with the Norwegian Directorate of Health, the Directorate for e-Health, the Norwegian Health Network SF and other relevant actors, has been commissioned by the Ministry of Health and Care Services (HOD) to map the requirements and possible solutions for establishing an international vaccine passport.

History

17.06.2021: Specified that antibody testing must be taken no later than the day before vaccination for a valid COVID-19 certificate based on the combination of confirmed COVID-19 and one dose of vaccine.

16.06.2021: New section: Post-registration of coronavirus vaccines

09.06.2021: Updated text about AstraZeneca and Janssen vaccines

08.06.2021: New section: People without valid documentation of having COVID-19 from Norway

07.06.2021: Changed interval between vaccines from 12 to 9 weeks, following Government announcement

21.05.2021: Some restructuring of text, cut down on text,

19.05.2021: Updated text about vaccine from AstraZeneca

11.05.2021: About vaccination: added sentence about people in entry quarantine and vaccination What can vaccinated people do - updated text and link to article.

30.04.2021: Updated with information on 12-week interval for the mRNA vaccine for people under 65 years without underlying disease

29.04.2021: New paragraph about what vaccinated people can do. Updated paragraph about pregnancy.

22.04.2021: Paragraphs about viral vector vaccines updated

19.04.2021: Small adjustments throughout article, as per Norwegian version

31.03.2021: updated text with interval of 6 weeks for Moderna and Pfizer vaccines

15.03.2021: New section about AstraZeneca vaccine being put on hold.

10.03.2021 Updated section on vaccination after having COVID-19 and section on protection from viral vector vaccines.

18.02.2021: New paragraphs: "Why do we vaccinate?" "How the viral vector vaccines work / ingredients" "Coronavirus vaccination and testing" "Mutated virus variants." Updated section "Protection and immunity after vaccination" "vaccination cards and certificates"

15.02.2021: Updated section about "Choice of Vaccine"

12.02.2021: New sections added: "Doctor in another municipality", "What happens to the notifications about side effects?", "Effect on society", "After vaccination - stay at home or be tested for symptoms?", "Beta-blockers".

09.02.2021: Added link to information brochure about COVID-19 Vaccine AstraZeneca

08.02.2021: Added link to "If you experience symptoms after vaccination"

04.02.2021: Added information about AstraZeneca coming soon. Changed link for self-reporting to helsenorge

01.02.2021: Added information about ingredients, increased bleeding tendency, testing before vaccination and choice of vaccine.

22.01.2021: Added link to "Who will get the vaccine?"

18.01.2021: General updates according to Norwegian version.

12.01.2021: Updated text about pregnancy and breastfeeding. Added link to Moderna vaccine.

05.01.2021 Updated text, removed some text that is found in the "Who will get the vaccine?"article.

02.01.2021 Added text to section about Effect regarding uncertainty until more people are vaccinated.

15.12.2020 Added text about vaccination cards and vaccination certificates.

04.12.2020 Updated text