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Article

Coronavirus vaccine - information for the public

Published Updated

The main goal of the coronavirus vaccine is to protect the lives and health of those most at risk for COVID-19 disease.

Folkehelseinstituttet
Folkehelseinstituttet

The main goal of the coronavirus vaccine is to protect the lives and health of those most at risk for COVID-19 disease.


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.

The purpose of vaccination against COVID-19 is to prevent disease or to alleviate the course of the disease without the risk of serious side effects. 

The Norwegian Institute of Public Health recommends five goals (ranked by priority) for coronavirus vaccination:

  1. Reduce risk of death
  2. Reduce risk of severe disease course
  3. Maintain essential services and critical infrastructure
  4. Protect employment and the economy
  5. Re-open society

Implementation

The municipalities are responsible for offering coronavirus vaccination to people in recommended groups who are staying in the municipality. The municipalities will decide how they will carry out vaccination locally and which partners they will use. GPs are central in identifying people in the risk groups who will be offered a vaccine. In many places, they may also contribute to local vaccination.

Check the website of your municipality about who is being offered the vaccine, how vaccination is carried out locally and when it will take place: 

Doctor in another municipality

The municipality is responsible for offering a coronavirus vaccine to those in the priority groups. The municipality's responsibility includes people who live in the municipality, or who are staying there for a certain period of time due to studies, work, etc. Doctors can help to identify people who are entitled to a vaccine since they have an overview of their patients’ conditions.

However, many people have their regular doctor in another municipality than where they live. In order for the home municipality to be able to offer vaccines to people with a doctor outside their own municipality, they must first gain an overview of who this applies to. The municipalities and the patients' doctors can work together to choose different solutions to ensure that those who are entitled to a vaccine are offered one. In some municipalities, doctors notify about their patients who live in other municipalities, so the patient is offered a vaccine in their home municipality. Others choose to solve it by the doctor offering the vaccine directly to their patients, regardless of where they live or stay.

Administered doses of coronavirus vaccine

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.

Who will get coronavirus vaccine?

A fair geographical distribution of vaccine doses across the country has been chosen. The coronavirus vaccine is mainly distributed according to how many people there are in the relevant risk groups in each municipality, with a dynamic order of priority. The order can be adjusted according to the infection situation and decisions by the Government.

Due to limited availability, there will be an initial prioritisation. The Government determines this priority on the advice of the Norwegian Institute of Public Health. We recommend that the elderly, risk groups and healthcare professionals are prioritised.

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.

Informed choice 

We will inform about what we know about the effect, and any side effects, from the approved vaccines so that everyone can make an informed choice.

All vaccination in Norway is voluntary. 

How do RNA vaccines work? 

Two of the approved coronavirus vaccines Comirnaty and COVID-19 Vaccine Moderna are known as RNA vaccines. 

The vaccines contains the recipe (messenger RNA) for the spikes on the coronavirus. The body makes 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 quickly broken down by the body and has no effect on genetic material.

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.

This method of making vaccines has not been used for infectious diseases in humans before, but the technology is known and is used in cancer treatment.

Ingredients in RNA vaccines

The vaccines contain the recipe (messenger RNA) for the characteristic spikes of the coronavirus. The RNA pieces are encased in small fat bubbles. RNA from the vaccine 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.

No antibiotics are 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:

How do viral vector vaccines work?

A viral vector vaccine, COVID-19 Vaccine AstraZeneca, is approved and in use in Norway.

The vaccine uses a harmless virus (cold virus) that helps transport the recipe for the typical spikes of the coronavirus into the body. This allows the body to make copies of these spikes for the immune system to practise on. This is how the body learns to recognise and defend itself against real coronavirus if you later become infected.

The transport virus cannot multiply in the body and is quickly broken down. The vaccine can not cause coronavirus disease or another infectious disease. The coronavirus vaccine has a preventive effect. It cannot cure coronavirus disease.

This way of making vaccines is already used in Ebola vaccines.

Ingredients in COVID-19 Vaccine AstraZeneca

The vaccine contains pieces of the genetic material from the coronavirus (DNA) with the recipe for the typical spikes of the coronavirus. These are inserted into harmless cold viruses (viral vectors) that help it to be transported into the body. This transport virus cannot multiply in the body. The vaccine is therefore not considered to be live, and can be given to people with impaired immune systems. The transport virus is quickly broken down.

In addition, the vaccine contains several substances that help to provide the correct pH and keep the vaccine stable during production, storage and transport. The correct pH is important to reduce the pain of injection. One of the substances used is called polysorbate 80. It is added to make an even solution and to stabilise the vaccine. It is one of the most widely used protein stabilisers in medicines and is included in several vaccines. It is also widely used in both food and cosmetics. The other substances in the vaccine are amino acids, alcohol, water, salts and sugar.

The vaccine does not contain adjuvants, which are substances added to some vaccines to boost the immune system's response. The vaccine does not contain products from pigs. The vaccine does not contain mercury or antibiotics.

More information about virus vector vaccine:

Choice of vaccine

Coronavirus vaccines have been purchased from several different manufacturers and are based on slightly different technologies. The vaccine doses are prioritised and distributed strictly according to criteria determined at a national level. When it's your turn, you will be offered the type of coronavirus vaccine that is available. Until everyone who is to be offered a vaccine has been offered one, it will not be possible for the individual to choose between different types of coronaravirus vaccine. It may be possible at a later date when we have a sufficient vaccine for everyone who wants it.

Over time, it is possible that people who have already been vaccinated may need a booster dose. If this is the case, another type of vaccine could be used for subsequent booster doses.

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.

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.

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 weeks 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.

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 a few weeks.  

The two doses of the RNA vaccines Comirnaty and COVID-19 Vaccine Moderna are given with an interval of 21 and 28 days, respectively. The two doses of the viral vector vaccine, COVID-19 Vaccine AstraZeneca are given with an interval of 9-12 weeks. 

We will know more about the requirements for the other vaccines following their approval in Europe by the European Medicines Agency and the EU. 

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 vaccines:

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.

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.

After vaccination - 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

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

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. For the eldest, there are few data.

  • The viral vector vaccine from AstraZeneca protects against disease caused by the new coronavirus. Two weeks after the second dose, an average of 60% of those vaccinated in the studies had received protection against coronavirus disease. However, the protection seemed to be higher if the interval between the two doses was 9 weeks or more. For those over 65, data are lacking.

  • The figures above apply to protection against coronavirus disease in general. For all three vaccines, the studies indicate that the vaccines also provide protection against severe coronavirus disease that requires hospital treatment.

  • 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. Therefore, it is important to continue to follow the current infection control advice.

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.

Effect on society

Since the coronavirus vaccines have been shown to protect against coronavirus disease, we also expect an effect against severe disease and death among those who are vaccinated. Vaccination will also reduce transmission, but we do not yet know to what extent.

As the proportion of vaccinated people increases, we can begin to reduce some of the most intrusive infection control measures, as long as the infection situation otherwise allows. We will first look at easing the measures that shield the risk groups because when these groups are vaccinated, their risk is significantly lower.

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

Side effects

All vaccines have side effects, most are mild and temporary. 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 the 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.

It can be difficult to conclude whether an event is due to a vaccine or coincidence based on one or a few single events. This is especially true if there are deaths shortly after vaccination in the group of nursing home residents and the eldest. On average, 400 people die per week in Norwegian nursing homes and similar institutions, so some deaths will occur completely randomly in the period after vaccination when many in this group are vaccinated.

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.

Vaccination after having COVID-19

It is not yet clear how well protected someone who has had COVID-19 is from becoming sick again. The same applies to how long immunity lasts.

Therefore, it is recommended that people who have had COVID-19 and who are in the priority groups should also be vaccinated - as long as they feel well and do not have lasting effects from the disease at the time of vaccination.

The vaccine should be given no earlier than 3-4 weeks after being symptom-free.

Vaccination of pregnant and breastfeeding women

Pregnancy

There is little experience with coronavirus vaccine in pregnant women, and healthy pregnant women are currently not recommended to be vaccinated. However, 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 you can, in consultation with your doctor, consider whether you should take the vaccine when you are offered it. 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.

Currently, only women belonging to priority groups will be offered the vaccine. 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.

Quarantine duty after vaccination

Vaccination does not give exemption from quarantine duty.  

Vaccination cards and vaccination 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.

Vaccination 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.

If this becomes relevant, the Government will consider whether it will be introduced in Norway. In that case, we will return with information on how the certificates are to be issued and any rights they give.

History

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

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