SALT LAKE CITY (KTVX) — It has been eight months since the first doses of the COVID-19 vaccine were administered to healthcare workers nationwide. Since then, the vaccine has become available to anyone over the age of 12.

If you have not gotten your COVID-19 vaccine you may be wondering — who does not need a shot?

Dr. Tamara Sheffield, Medical Director for Community Health and Prevention at Intermountain Healthcare, spoke with NewsNation affiliate KTVX about the few instances in which a person would not qualify for, or should delay getting the vaccine.

Who should not get the COVID-19 vaccine?

“So it’s very rare for an individual to not be qualified to get the vaccine,” Sheffield explains. “The key reason not to be vaccinated, or what is called a contraindication, is if you’ve had an allergic reaction to that specific COVID vaccine.”

Sheffield says if you have an allergic reaction after receiving the first dose of the Pfizer or Moderna vaccine, you can still receive the Johnson & Johnson vaccine. 

“It’s the one time you can mix the series, if there’s been an allergy with one as long as you’re in a supervised medical setting,” Sheffield explains.

Outside of an allergy, Sheffield says there are some other conditions under which you may delay getting the COVID-19 vaccine. If you are currently infected with COVID-19, health officials encourage waiting to get your shot rather than possibly infecting others.

Additionally, if you have been on therapies like a monoclonal antibody to treat a COVID-19 infection, Sheffield says you will need to wait 90 days to prevent the treatment from interfering with the vaccine. 

If you are currently on cancer therapy, Sheffield explains you may want to wait to get the shot. Instead, she recommends speaking with your doctor about the timing of when to get the vaccine.

What about pregnant women? 

When COVID-19 vaccines first became available to the general public, pregnant women were advised to speak with their physician before getting the shot. This was because “we hadn’t had enough experience,” Sheffield explains. 

“Now we’ve had extraordinary amounts of experience with many millions of pregnant women getting the vaccine,” Sheffield says. “And we’ve seen that for the baby, there is no increase in terms of any of the poor outcomes that we’d be worried about.”

Sheffield continues, describing having COVID-19 illness while pregnant as “a really dangerous situation.”

“We want to make sure that we protect them from that,” Sheffield explains. “In fact, the American College of Obstetrics and Gynecology has said the benefits of the vaccine outweigh any of the potential side effects or risks.”

While side effects with the vaccines are common, health officials have concerns about one in pregnant women — a fever. 

“We don’t want a person who’s pregnant to have a fever,” Sheffield tells KTVX. If you are pregnant and experience a fever after getting the COVID-19, she recommends treating the fever by bringing it down. “You should be safe with that.”

What if you are taking a medication?

If your medications are impacting your immune system, like a monoclonal antibody, you should talk to your doctor about when to get the vaccine, Sheffield explains.

“It’s really rare that someone would have something that would prevent them from getting the vaccine,” Sheffield says. “All they need to do is consult with their physician about what’s the right time.”

When should I talk to my doctor about the side effects from the vaccine?

Sheffield says there are “very rare cases of a few things that we have seen that have been more common in vaccinated individuals than we would expect in the general population.”

She explains that individuals who have had myocarditis pericarditis — an inflammatory response that occurs in some of the muscles in the heart — in the past are OK to get the COVID-19 vaccine as long as they do not still have symptoms. Those symptoms include chest pain and shortness of breath.

If you have had myocarditis after your first dose, Sheffield says you should not get the second dose of the Pfizer or Moderna vaccine.

“That’s one of the situations and it’s treatable,” Sheffield explains. 

With the Johnson & Johnson vaccine, Sheffield says there have been cases of Guillain-Barre syndrome. It is a rare syndrome in which your immune system attacks your nerves. 

“We’ve seen those in a couple of other vaccines as well,” Sheffield said. “In there, we’re talking about a few cases per million of individuals who will get a progressive numbness and tingling, starting usually in the feet and hands and it moves up into the body, and it can cause some paralysis.”

“It’s an immune response,” she adds. This is usually temporary, according to Sheffield, and works its way out again over time. 

If you have had Guillain-Barre syndrome in the past, Sheffield says it is recommended you get the Pfizer or Moderna vaccine. 

If the vaccine hasn’t received full FDA approval, is it safe for me to get it?

All three vaccines have received Emergency Authorization approval from the FDA. Pfizer and Moderna have begun the process to receive full approval. 

Sheffield explains one of the biggest differences between emergency authorization and approval is time. 

“With an authorization, you need to have at least two months out of data to look at. And you have to have no other recourse for a person,” Sheffield says. “And then you also have to have the ongoing examination of it for approval. You just have to have six months of data.”

At this point, Sheffield says the appropriate steps have been completed and we may soon see full approval. 

“The data was overwhelmingly good to start with, even with the authorization, and the benefits clearly outweighed any risks. And that is why [the FDA] went ahead and gave the authorization when they did.”

What about the reports of blood clots?

Sheffield explains there was an increase of cases of blood clots in patients who received the Johnson & Johnson vaccine that tend to be younger women between 20 and 30 years old.

Locally, Sheffield says they have not seen any cases that are different from those seen nationally. 

“It’s a very rare occurrence. But because we’ve given so many vaccines, we do see an occasional case pop up,” Sheffield says. “The key piece on this, again, is they’re treatable. You just have to be able to recognize the symptoms, and then make sure you get in for care and the anticoagulants that you need.”

Have there been deaths related to the COVID-19 vaccine?

“The first thing is there are not reported deaths due to that vaccine,” Sheffield explains. “So the question is, are we seeing people dying from COVID who’ve been vaccinated? And yes, that is true.”

Sheffield continues, saying this is expected.

“We didn’t see cases of death in those trial participants when it was first approved, but we knew that there are individuals who … would still develop COVID. When you have a 90% protection rate, that means that compared to those who weren’t vaccinated, you have a tenfold reduced risk, but there’s still a risk that you’ll develop a condition. But the risk for hospitalizations and deaths are vastly smaller once you’ve been vaccinated, but it doesn’t mean it’s down to zero.”

When someone who has been vaccinated tests positive for the virus, officials refer to it as a “breakthrough” case. According to Sheffield, there is one age group seeing breakthrough cases more than others. 

“Sixty to 75% of those breakthrough cases are in people over age 65,” she explains. “It is individuals who, again, their immune system may not work as well, it may be older, and they have comorbidities, they have other diseases that make them more likely to feel the symptoms and have to be hospitalized.”

Sheffield says every death or hospitalization of a vaccinated individual is recorded, regardless of the cause of death. For example, if you have been vaccinated and die in a car accident, it will be recorded. She adds most of the deaths being reported “are not necessarily related to COVID disease.”

“Predominantly, those who are seeing the hospitalizations and death are individuals who have not been vaccinated. Those are the people that we’re trying to protect,” Sheffield says. “This delta variant is extraordinarily transmissible, meaning there are people who are vaccinated who can still colonize, can still get a virus that they could pass to somebody else.”

Because there are still so many unvaccinated people, Sheffield explains it is important to mask up when in public. And if you can get vaccinated, you should.

“If you’re gonna be sending your kids off to school, get those kids over 12 vaccinated. So they’re not spreading disease between themselves as well,” she adds. 

Sheffield echoes the sentiments of so many other healthcare officials, calling on the public to help keep hospitalization numbers down.