After months of trials, the first coronavirus vaccines have been approved. Gov. Tim Walz in December laid out the initial steps in Minnesota's vaccination plan, and the first phase of vaccinations is underway. Here are answers to questions you may have about vaccines and the state's strategy to vaccinate millions of Minnesotans.

Which vaccines have been approved?

While more than 50 vaccine candidates have progressed to clinical trials with humans, two have been approved for emergency use by the U.S Food and Drug Administration. A vaccine developed by Pfizer and BioNTech was approved by the FDA on Dec. 11, and a second vaccine produced by Moderna was authorized Dec. 18. A third vaccine developed by the University of Oxford and AstraZeneca could be ready for review in early 2021.

How do the vaccines work?

The Pfizer/BioNTech and Moderna vaccines use messenger RNA to instruct cells to create a harmless piece of the virus that causes COVID-19. This piece of "spike protein" is a key feature of the virus (you've likely seen COVID-19 depicted as a spiky ball). The body recognizes this spike protein as foreign and triggers an immune response to fend off future infection.

AstraZeneca's is a viral vector vaccine, using the adenovirus — a strain of the common cold found in chimpanzees — to deliver a piece of that spike protein into cells. This prompts an immune response to inoculate the recipient against infection.

When could vaccines become widely available?

The FDA approved the Pfizer vaccine Dec. 11 and the Moderna vaccine on Dec. 18. States were required to place orders for the initial round of vaccine doses by Dec. 4.

The first doses of the Pfizer vaccine arrived in Minnesota at the Minneapolis VA Medical Center on Dec. 14. Vaccines are being shipped to 25 "hub" medical facilities around the state. From there, they are being distributed to smaller clinics, or "spokes," that will make doses available to providers. The federal government decides how many doses each state will receive weekly. Minnesota Health Commissioner Jan Malcolm cautioned that it could be six months before vaccines become widely available.

When will I be able to get vaccinated?

In Minnesota, first priority has been given to front-line health care workers in COVID-19 hospital units, emergency departments and nursing homes along with paramedics, COVID-19 testing personnel and some public health workers. Residents in nursing homes are also in the highest priority group. MDH announced Jan. 18 that it would expand vaccinations on a very limited basis to Minnesotans 65 and older, educators and child care workers at nine test sites around the state — Anoka, Brooklyn Center, Fergus Falls, Marshall, Mountain Iron, North Mankato, Rochester, St. Cloud, and Thief River Falls.

The plan to administer vaccines in Minnesota has been divided into several phases:

  • Phase 1a: Frontline health care workers and residents of long-term care facilities. This phase is currently underway and includes an estimated 500,000 people.
  • Phase 1b: Frontline essential workers and adults 75 years and older. Vaccinations for this group could start in late January or early February, health officials say. This phase will include a little more than a million people, according to health officials.
  • Phase 1c: Adults between the ages of 65 and 74, people aged 16 to 64 with high-risk medical conditions, and other essential workers. Health officials have not yet estimated the number of people in this phase.
  • Phase 2: When larger numbers of doses are available, any remaining Phase 1 recipients will be vaccinated, plus adults in communities that have been hit particularly hard by COVID-19.
  • Phase 3: As the vaccine becomes widely available, anyone who wishes to be vaccinated will be able to do so.

How will I know when it's my turn to be vaccinated?

In Phase 1a of the vaccine rollout, front-line health care workers and nursing home residents will be contacted by their employer or their residential facility when a vaccine is available to them, according to the Minnesota Department of Health.

Though the state has not yet moved to Phase 1b of the vaccination rollout, on Jan. 21, vaccinations will be available on a limited basis to Minnesotans age 65 and older, educators and child care workers, by appointment only at nine pilot sites around the state. Because demand outpaces federal supply, not everyone who is eligible will be able to receive a vaccine right away. Eligible people can make an appointment on the state website starting at noon on Jan. 19. If you are currently eligible to receive the vaccine but all of the appointments are booked, you will be given the opportunity to join a waitlist.

For all other vaccine recipients in Phase 1b, Phase 1c, Phase 2 or Phase 3, there is currently no need to get on a waitlist or make an appointment to get a vaccine; state health officials will offer updates as more vaccine doses become available.

How are the vaccines administered?

All three vaccines will require two doses, delivered via injection. The Pfizer vaccine requires a booster shot three weeks after the first dose, while the Moderna vaccine's booster shot is administered four weeks later. It's unclear what dosage schedule AstraZeneca will submit to regulators.

Will I get to choose which vaccine I get?

It is unlikely you will be able to choose, because the vaccines are so similar and so few doses are available.

What are some of the differences between the vaccines?

Both the Pfizer and Moderna vaccines must be frozen for transportation and storage. Pfizer's vaccine is the most demanding, needing a storage temperature of -70 degrees Fahrenheit, which requires specialized freezers. Moderna has said its vaccine can be kept stable at around -20 degrees Fahrenheit for up to six months, closer to the temperature of a standard freezer.

AstraZeneca's vaccine only needs to be refrigerated at between 2 and 8 degrees Fahrenheit, making its distribution less complicated and less expensive. AstraZeneca's vaccine is also significantly cheaper to manufacture, at roughly $3-$4 per dose.

How safe are the vaccines?

The first phase in any clinical trial is dedicated to making sure a drug is safe. Vaccines cannot be approved without passing this crucial step. According to the CDC, a clinical trial is paused whenever an "unexpected health event" is detected so that researchers can investigate any potential safety concerns. Minnesota health officials have said that they have confidence in the clinical trials conducted and the regulatory approval process so far.

The experimental vaccines have been tested in tens of thousands of volunteers so far, and serious side effects have not been reported. Health officials will be monitoring for side effects as more people get vaccinated, as well as for any potential longer-term issues.

Dr. Anthony Fauci, the nation's top infectious disease expert, has noted that people might feel achy or feverish right after the shot, or some soreness in the arm. Other temporary side effects reported by study participants included fatigue, headache and chills.

Associated Press
VideoVideo (00:46): As COVID-19 vaccinations roll out to more and more people, health authorities are keeping close watch for any unexpected side effects.

How effective are the vaccines?

Pfizer and Moderna have both reported that their vaccines reached 95% efficacy in clinical trials, far exceeding scientists' expectations. According to Fauci, the goal was to reach 75% efficacy with any COVID-19 vaccine, and the FDA said it would approve a vaccine with just 50% efficacy.

AstraZeneca has reported 62% efficacy with its vaccine, though that rate appears to jump to 90% when administered with a stair-step dosage. Participants were given a half-dose for the first round of immunization followed by a full dose, and researchers noted the vaccine was more effective.

Are the vaccines effective immediately?

The Pfizer vaccine provides strong protection against COVID-19 within 10 days after the first dose, according to documents published by the FDA. Minnesota state epidemiologist Kris Ehresmann cautioned that it could take up to six weeks after the first dose for vaccines to provide full protection against COVID-19.

How long will the vaccines protect against infection?

We don't know yet. It's possible that these vaccines could provide long-lasting protection against the virus, or the protection could fade over time and require additional booster shots. The FDA said the Pfizer vaccine seems to provide protection for at least two months after the second and final dose.

Will I still need to wear a mask after vaccination?

Because it could take weeks for vaccines to provide full protection, state health officials stressed that it will be important that people continue to wear masks, maintain social distancing and quarantine after exposure to slow the spread of the virus.

Can children be vaccinated?

The initial rounds of vaccines will only be available to adults, according to state officials. Children may be eligible later.

Are the vaccines safe for pregnant or nursing women?

We don't know yet. The first clinical trials did not study the safety of vaccines for women who are pregnant or breastfeeding. Vaccine manufacturers "have likely started expanding to pregnant people and some children as they get more data from the first part of their studies,"according to the Minnesota Department of Health.A research division at HealthPartners has received $2 million from the federal government to monitor the safety of new COVID-19 vaccines for pregnant women and their babies.

If I've already had COVID-19, should I get vaccinated?

Because re-infection is possible and may bring additional health risks, the U.S. Centers for Disease Control and Prevention (CDC) saysvaccinations may be advised for those who have already been infected and recovered from COVID-19.

How much will it cost to get the vaccine?

Under Operation Warp Speed, the U.S. government contributed billions of dollars for the development of vaccines, and ordered hundreds of millions of doses. Federal health officials have pledged that vaccinations will be made available free of charge to all Americans. The Minnesota Department of Health has confirmed that vaccines will be provided to people at no cost.

Will vaccinations be mandatory?

Health officials encourage people to get vaccinated and expect vaccinations to be available to everyone who wants one, but it will not be required by law. However, some employers may require their employees to be vaccinated.

The Associated Press contributed to this report. This post has been updated.