Vaccination

Why should I get vaccinated?

The vaccine stimulates your body to create antibodies. These substances help your body fight the virus. What if you come into contact with the virus afterwards? The antibodies will protect you.

The vaccine not only protects you but also the people around you. Coronavirus is dangerous for people older than 65 or persons that have certain conditions. If as many people as possible in Belgium are vaccinated, the spread of the virus will be inhibited. This, in turn, will protect the people who cannot have the vaccination. This is known as herd immunity.

Vaccination against coronavirus is voluntary and free to all.

You must continue to comply with the coronavirus rules after vaccination, until sufficient people have been vaccinated. So, maintain a 1.5 metre distance, wear a face mask and wash your hands frequently.

Is the vaccine safe?

There was already a great deal of expertise about the creation of vaccines. Scientists, pharmaceutical specialists, businesses and governments across the world worked together on the coronavirus vaccine. A great deal of time and money has been freed up in order to tackle this urgent problem. As a result, the vaccines have been developed very quickly.
All vaccines, however, are checked extremely carefully by the government. More information here.

When will I get my vaccine?

Month	Who
January	residents and personnel in residential care centres + healthcare staff (doctors, nurses, etc.) in hospitals
February	personnel from first line care (GPs, pharmacists, etc.) + collective care institutions (disability care, etc.) and other hospital staff
March	everyone aged 65 and above
April	people with a higher risk due to specific healthcare issues (see further)
June	everyone from the age of 12

These timings could change.

Practical: how does the vaccine process work?

You will receive an invitation by post, text message and/or email.
You must register online or by phone.
Is the time of your appointment not suitable? Then you can choose another time.
each region can take its own measures for the practical implementation of vaccinations. Therefore, also check the website of the region where you live.

For Flanders: www.laatjevaccineren.be
for Brussels: www.vaccination-info.be; www.coronavirus.brussels.be
for Wallonia: covid.aviq.be/fr; www.vaccination-info.be; www.Jemevaccine.be
for the German-speaking community: www.ostbelgienlive.be

During your appointment:

You will be given an injection in your upper arm.
A few weeks after the first injection, you will be given your second injection. At the moment, each vaccine requires two doses, except for the vaccine from Johnson & Johnson.
After vaccination, it takes between 10 and 14 days before your body begins to make antibodies. Only then do you have the best possible protection against the virus.

Overview of vaccinations and deliveries

How many vaccines have already been administered, how many have been delivered? You can find an overview in the Belvax.

This information will be continuously updated.

Frequently asked questions (FAQs)

Why should I be vaccinated?

In order to ensure the best possible effectiveness of the vaccine among the population, and to create herd immunity, at least 70% of Belgians must be vaccinated. Herd immunity means that a sufficiently large group of individuals have built up immunity to the virus, which then hinders or stops its transmission entirely. This will stop the virus from spreading through the population and will prevent a serious epidemic with the corresponding lockdown measures. It will also protect people who cannot be vaccinated (e.g. pregnant women, cancer patients undergoing acute treatment or those with a serious allergy history to vaccines (a type of anaphylactic shock)).
If too few people are vaccinated, the virus will continue to spread, variants arise, and herd immunity will not be achieved. As a result, too many people will be at risk of infection. This will lead to an epidemic and the corresponding lockdown measures.
The quicker the vaccination level rises, the quicker the measures can be relaxed. An infected but vaccinated person will then infect fewer people.
This does not mean, however, that we will be able to go back to normal as soon as vaccinations start. The relaxation will take place gradually as not everyone can be vaccinated at the same time. People will receive their vaccines in different phases, which will be set by the government. So, as long as there are still a lot of infected people, there is a serious risk of new waves and the measures must stay in place and be enforced.
We are trying to realise herd immunity step-by-step using the vaccine. Even then, you should be aware that there is an ongoing risk of local flare-ups.
Becoming infected with COVID-19 can also be risky for young, healthy people. We have seen that even healthy people can become seriously ill as a result of the virus and may suffer long-term symptoms, such as lung damage.

Who can get vaccinated?

Anyone domiciled in Belgium and aged 12 or older can be vaccinated in Belgium.
Anyone who carries out an economic activity in Belgium, but lives abroad (see next questions)
Belgians residing abroad (see next questions).
For certain groups that are difficult to reach, one will work through the aid organizations involved (eg the homeless). These persons also have a national register number if they are Belgian, and a domicile address of their NGO. You will receive a personal invitation when it is your turn.

What about the vaccination of Belgians abroad?

If you are Belgian, but you live or work abroad, you will in principle be vaccinated in the country of residence. But you can also choose to be vaccinated in Belgium, especially if you live in a country that does not work with the same corona vaccines as in Belgium.

Same vaccines. Belgians living in countries that use the same vaccine types as Belgium are advised to get vaccinated locally. For this, it is best to contact the Belgian embassy or the Consulate General in the country of residence. If you cannot be vaccinated in the country of residence or if practical concerns prevent you, you can still choose to be vaccinated in Belgium.
Other vaccines. In about [150 countries or territories] (https://diplomatie.belgium.be/sites/default/files/downloads/landenlijst.pdf) different vaccines are used than in Belgium. Belgians who live there and are registered at the local embassy or consulate-general can register for vaccination in Belgium. The vaccination is planned from June. Their partner of another nationality and adult children can also be vaccinated in Belgium.

I am not Belgian, but I do reside in Belgium. Can I be vaccinated in Belgium?

Non-Belgians who stay in Belgium for more than 3 months can be vaccinated in Belgium can ask a BIS number from a GP or another physician. The patient must be able to present a valid identity document for this. A BIS number is a unique identification number for social security for persons who are not registered in the National Register, but who nevertheless have a relationship with the Belgian authorities. This concerns, for example:

foreign trainees or employees who have been active in Belgian health care for more than 3 months.
non-Belgians who have been registered in Belgium as a student or employee for more than 3 months.
non-Belgians staying in Belgium for more than 3 months (not as an employee or student).

If the patient does not have a valid identity document or does not live in Belgium, but is only staying in the country for a short time, the physician can create a unique number for this person, the so-called TER number/COVID ID, which is only valid for an identification in the context of the Covid crisis. This TER number/COVID ID must be communicated to the patient. The doctors can use this system for undocumented travelers, and this only in the context of the COVID health crisis.

What is a vaccine and how does it work?

Vaccines work by stimulating a person’s immune system (the body’s natural resistance), and getting them ready to recognise a certain germ and defend against this germ or infectious disease. If you get infected with a virus, e.g. COVID-19, at a later date, your immune system recognises it and, because it is already prepared to attack it, protects you against this virus. Currently, different vaccines are being tested that are made in different ways. They result in the body building up resistance to the virus in different ways.

What are the different types of vaccines?

Scientists have developed various types of vaccine to combat COVID-19. All these vaccines target our immune systems safely in order to ‘train’ it to fight coronavirus. The body is thus prepared for a genuine coronavirus infection.

Different types of potential COVID-19 vaccines are under development:

Inactivated or weakened virus vaccines, which use a form of the virus that is inactivated or weakened so that it does not cause the illness but does generate an immune response.
Protein-based vaccines, which use harmless fragments of protein or protein casings which mimic the COVID-19 virus in order to generate an immune response.
Viral vector vaccines, which use a virus that is genetically modified so it cannot cause illness, but does produce coronavirus proteins to safely generate an immune response.
RNA and DNA-vaccines, an advanced approach which uses genetically modified RNA or DNA to generate a protein which then safely generates an immune response.

Which vaccines are available for COVID-19 at the moment in Belgium?

Currently, 4 vaccines have been approved by the European Commission to prevent COVID-19 infections:

The COVID-19 vaccine from Pfizer-BioNTech, which was approved by the European Commission on 21 December 2020, and is administered In Belgium.
The COVID-19 vaccine from Moderna, which was approved by the European Commission on 6 January 2021, and is administered In Belgium.
The COVID-19 vaccine from AstraZeneca, which was approved by the European Commission on 29 January 2021, nd is administered In Belgium.
The COVID-19 vaccine from Johnson & Johnson, which was approved by the European Commission on 11 March 2021, and is administered In Belgium.

There are various other candidate vaccines in development, for which intermediate results have been published. Worldwide, efforts are being made to develop COVID-19 vaccines, approve them as a matter of priority and make them available.

What are the different types of vaccines?

Different types of potential COVID-19 vaccines are under development:

Inactivated or weakened virus vaccines, which use a form of the virus that is inactivated or weakened so that it does not cause the illness but does generate an immune response.
Protein-based vaccines, which use harmless fragments of protein or protein casings which mimic the COVID-19 virus in order to generate an immune response.
Viral vector vaccines, which use a virus that is genetically modified so it cannot cause illness, but does produce coronavirus proteins to safely generate an immune response.
RNA and DNA-vaccines, an advanced approach which uses genetically modified RNA or DNA to generate a protein which then safely generates an immune response.

Is the vaccination against COVID-19 mandatory?

No. As with most vaccines in our country, vaccination against COVID-19 is voluntary.
The vaccination is offered free of charge in Belgium.

How many doses of the vaccine do I need?

Most vaccines that have already been approved (Pfizer, Moderna, AstraZeneca/Oxford), or are currently on the table for approval by the European Medicines Agency (Curevac), involve 2 doses, administered a few weeks apart (3 weeks for Moderna, 3 to 6 weeks for the Pfizer vaccine, and 8 to12 weeks for AstraZeneca). In this way, the vaccines provide optimal protection. Only 1 dose of the Johnson & Johnson vaccine, which is also approved, needs to be administered.

Your second vaccination will be with the same vaccine as the first dose. The vaccination centers will have enough vaccines of the correct type to give each person a second dose of the same vaccine type. All vaccines are registered in Vaccinnet with name and lot number, so that you get the correct second dose. You will also receive a vaccination card after your first vaccination, stating which vaccine you were vaccinated with and when you will receive the second dose.

Do I need a vaccine if I've already had COVID-19?

As the protection after contracting COVID-19 lasts for a few months, and cases of reinfections have now been established, vaccines will also be offered to people who have had COVID-19. It is expected that protection after vaccination will last for longer than protection after catching the virus, but that is still being investigated at the moment. In any case, the vaccines offer wider protection against certain variants than an infection does.

How are the effectiveness and the side effects from the vaccine monitored?

Once the vaccine has been approved by the European Medicines Agency, and enters the European market, a leaflet will be developed for the public at large (found in the pack with the vaccine). There is also a so-called scientific leaflet that is provided to doctors and similar. This has now been completed for the Pfizer COVID-19 vaccine. The Belgian Federal Agency for Medicines and Health Products (FMAHP) will publish the leaflets on its website (www.faff-afmps.be) once they are available in our three languages and a few additional languages.

Where can we see how many people have already been vaccinated?

On the Belvax you get an overview of the number of vaccinated and the deliveries already made in our country: https://observablehq.com/@tf-vaccination/belvax

The Sciensano website also provides a daily update of the number of vaccinated people in our country: https://datastudio.google.com/embed/u/0/reporting/c14a5cfc-cab7-4812-848c-0369173148ab/page/hOMwB

Specifically for Flanders, you can visit the Vaccination Counter: https://www.laatjevaccineren.be/vaccinatieteller

Do I need to be tested before I am given the vaccine?

No, you do not need to be tested for the virus (PCR) or antibodies before the vaccination. Even if you are infected without knowing it, the vaccine can be safely administered. Antibodies will also not be measured after the vaccination. After all, as it stands we do not know how many antibodies we need to be protected.

When is it better to delay your vacccination?

If you have symptoms of an illness, with or without a fever (>38.5°C), you can be vaccinated once you have recovered (for illness as a result of COVID-19, see below).
If you have a COVID-19 infection or have tested positive for COVID-19, you can be vaccinated from the 14th day after you have recovered, or from the 14th day after a positive PCR test if you have had an asymptomatic infection.
If you are in quarantine, vaccination will be postponed until the quarantine period is over.
If you have had a severe case of COVID-19 and have been treated with a high dosage of systematic corticosteroids, it is advisable to postpone the vaccination until at least 4 weeks after you have stopped this treatment, because corticosteroids suppress the immune response. ¨* If you have had a severe case of COVID-19 and have been treated with monoclonal anti-COVID-19 antibodies or plasma with anti-COVID-19 antibodies (passive immunity), you must wait for 2 to 3 months after your treatment, due to the potentially insufficient immune response because of circulating antibodies.
A planned medical intervention under general anaesthetic is grounds for postponing a vaccination. A minimum interval of 48 hours is advised between a general anaesthetic and vaccination. No such interval applies after a local anaesthetic.

Can I choose what vaccine I get?

No. We are dealing with an unprecedented situation: in a relatively short period of time, millions of people must be vaccinated against the coronavirus, which has been holding the world under its spell for over a year now. It is now a race against time, the faster we vaccinate, the fewer people will be infected with the COVID-19 virus. More than 25,000 people died from this virus in Belgium alone.

In addition, the number of vaccines is still limited, which is why people cannot choose their vaccine. The Belgian government must decide, in a scientifically substantiated manner, which vaccines are best administered to which groups of people. The aim is to protect as many people as possible in a safe way against the virus, which in the meantime is also mutating and becoming more contagious. All vaccines used in Belgium are approved by the European Medicines Agency on the basis of quality, safety and efficacy.

How long does a vaccine protect you against COVID-19?

During an infection, the virus attacks part of our immune system, which partly compromises antibody formation. Therefore the situation after virus infection and the situation after a vaccination are not the same. We know that the protection after infection lasts a few months, and we expect the protection after vaccination will be longer. Follow-up studies on some people who have been vaccinated should soon give us more clarity on this. At the moment we also do not know if repeat vaccinations or booster shots will be required.

Can I give up my place to someone else?

No, the vaccine is strictly personal. Your identity will be checked and every effort will be made to prevent any identity change. In addition, the vaccine is registered in the vaccination registry in your name and will thus be added to your personal file. You can see this online via Myhealthviewer.be/mijngezondheid and also print a certificate if you have to prove somewhere that you have been vaccinated. There you will also find the fate of the vaccine. You need this if you want to report possible side effects of the vaccine to the Federal Agency for Medicines and Health Products., via https://www.famhp.be/en/reporting_a_side_effect_as_a_patient

Wat is the mission of the Task Force Vaccination?

In order to ensure that the roll-out of the vaccination program runs smoothly, a Taskforce ‘operationalization of the COVID-19 vaccination strategy’ was set up under the auspices of the Government Commissariat for Corona. This Taskforce is responsible for the development of the vaccination strategy. In addition, it must determine, assign and support all necessary actions. Her job is coordinating. This Task Force consists of scientists, representatives of federal and state government services, crisis managers and, where necessary, representatives of professional organizations and technical working groups. In addition, a core team of about 10 people is involved in day-to-day operations. The 4 federal states are responsible for the practical organization of the vaccination. This is done in close consultation with the Taskforce.

Is it currently useful to use a blood test to check whether your body has produced enough antibodies after vaccination?

Antibody tests or serological tests currently do not say enough about the possible protection your body has built up after a corona vaccination. There are several pitfalls:

At the moment we do not know from which concentration of antibodies you are protected. The test can tell whether you have antibodies and how many you have, but no one can tell you whether there are enough.
Not all antibodies produced are equally effective. To eliminate the virus, you need neutralizing or disease-preventing antibodies. Not all commonly available antibody tests can distinguish such antibodies from others.
Antibodies can also disappear from the blood over time, but that does not mean that you have lost all protection. Immunity is not only achieved by antibodies, but also by immune cells. These are not detected with the serological tests. In addition, there may also be memory immunity.

Conclusion: The immunity that someone builds up after an infection or after vaccination is too complex to be able to make a good estimate using one test at the moment. These tests only show part of the story.

Who is eligible for an additional vaccine?

The available data suggest that persons with diminished immunity, caused by a particular disease or by treatment, may be less well protected after basic vaccination with one or two doses. Recent scientific data show that administering an extra dose of an mRNA vaccine (currently Pfizer or Moderna) may improve the immune response in these immunocompromised patients. In Belgium, it has been decided to invite these particularly vulnerable patients for an extra vaccine dose in order to optimise their protection against COVID-19.

This concerns approximately 350,000 patients with:

congenital immune disorders
chronic kidney dialysis
inflammatory diseases treated with immunosuppressants
blood cancers or other malignancies, which are/or have been in active treatment in the past 3 years
pre-transplant, stem cell transplant and organ transplant patients
HIV patients whose CD4 cell count is less than 200 per mm³ of blood

Attention! This group is not the same as the people who were called up in the spring as a risk person or person with underlying suffering. The group with reduced immunity is much smaller than the group that was called up in the spring.

You can find more information here: https://d34j62pglfm3rr.cloudfront.net/downloads/tekst-extraprik-september_EN.pdf

I think I'm eligible for an extra vaccination, but did not receive an invitation (yet)?

Vulnerable persons who are eligible for an extra vaccination are invited on the basis of the data from their sickness fund, the Cancer Registry and/or general practitioner. That selection is done automatically.

You can check for yourself whether you belong to this group via www.myhealthviewer.be or www.mijngezondheid.belgie.be/www.masante.be. If applicable, you will see a new activation in September at the top, that is the extra vaccine. Your previous vaccinations are listed below.

Are you not on the list and do you think you are at risk ? There may be several reasons why you have not yet received an invitation:

Your initial vaccination schedule (1st and 2nd shot) has not yet been completed. In that case, contact your vaccination center to finalize the vaccination schedule.
Your 2nd shot was administered less than 28 days ago. Wait for your invitation until 4 weeks after the last dose.
Your immunity problem is recent, is not being treated medically, is only followed up by a specialist… Then contact your general practitioner twho can add you to the list.

Is it a problem that the extra vaccination with Pfizer or Moderna is different from my previous vaccination?

No, this is not a problem.

Regardless of the type of vaccine given with the first and second shot, a vaccine from Pfizer or Moderna (mRNA vaccine) will be administered for an additional dose. Scientific research shows that an extra dose of mRNA can improve the immune response in patients with reduced immunity.

Is the additional vaccination for people with immune problems mandatory?

No, this is not mandatory.

Recent scientific data show that administering an additional vaccine dose to immunocompromised individuals can improve the immune response. An extra shot for these people is therefore strongly recommended to optimize their protection against COVID-19.

Does the extra vaccination for persons with immune problems affect the vaccination certificate (CST)?

No.

Persons who received an extra vaccine will receive a notification of this on their vaccination certificate (CST), but the mention of the basic vaccination (1st and 2nd shot) remains valid as proof of full vaccination. A refusal of the extra shot also has no influence on the certificate.

Is the corona vaccine safe?

How have the COVID-19 vaccines been developed?

COVID-19 vaccines have been developed in accordance with the same legal requirements around pharmaceutical quality, safety and efficacy as all other medications.

   In the first phase, the developer subjects the vaccine to **strict tests**, which check the quality of the vaccine, namely its purity, ingredients and production process.

   Secondly, a **scientific evaluation** is carried out by regulatory bodies: the European Medicines Agency (EMA) and other regulators in EU/EEA countries.

   Next, the effect of the vaccine is tested by the developer through **lab research and animal testing**.

   If it works as desired, the vaccine is **tested on human volunteers**. This happens in 3 clinical test phases, each one with greater numbers of participants than the previous phase. This testing programme must be approved by a Committee for Medical Ethics and must be implemented in accordance with the procedures and protocols established by the regulators.

   At the end of the testing programme, the developer presents the results to the **European Medicines Agency (EMA)**. The EMA only gives approval if it has been provided with sound scientific evidence showing that the benefits of a vaccine are greater than its risks.

What is different for COVID-19 vaccines is that the development and approval process has been prioritised at all levels because of the urgent public health situation, and therefore it has happened more quickly. For example, difference phases in the development have been allowed to overlap: phase 3 studies have been started in parallel with phase 2 studies. That does not mean that the vaccines are less safe. They have also been tested on a large target group. The EMA has a special expert taskforce, and has prioritised the evaluation procedures for COVID-19 vaccines. As a result, the applications from companies are evaluated quickly, but the scientific recommendations remain well founded.

Video: how vaccines are approved in Europe: https://www.youtube.com/watch?v=eDE4Fo1PFxE&list=PL7X6T30850OjZbJzHD00NA9hnk8X7i406

Video: How the European Medicines Agency (EMA) evaluates medicines for human usehttps://www.ema.europa.eu/en/about-us/what-we-do/authorisation-medicines/how-ema-evaluates-medicines

How safe are vaccines that have been developed so quickly?

The speed of development of the COVID-19 vaccines has been primarily determined by the extent to which all activities have been prioritised: from the initial development and the recommendations of ethical committees or regulatory authorities, to the implementation of vaccine studies in the research centres in various counties. As COVID-19 vaccine studies have continually been given priority, years have been saved, without jeopardising the quality of these studies or the safety of the vaccines. All regulatory decisions on the approval of vaccines are based on extensive tests, which give sufficiently robust data to guarantee quality, effectiveness and patient safety. This is no different for COVID-19 vaccines. The scientific experts who evaluate vaccines always look very closely at the advantages and potential risks, especially because vaccines are given to healthy people. Every batch of vaccines is continually checked to ensure that they remain safe and effective.

Read more about the development and testing of coronavirus vaccines: https://www.laatjevaccineren.be/ontwikkelen-en-testen-van-coronavaccins

How could a safe, workable and quality vaccine be developed quicker than usual?

With respect to COVID-19, the development and possible approval of a vaccine has been given priority on all levels due to the public health emergency; the process has therefore been much quicker than normal.

Production: The producer was allowed to overlap the various development phases for the vaccines; i.e. phase 3 studies could start at the same time as phase 2 studies. This does not mean that the vaccines are less safe though as each phase has been completed correctly. Like all medicines, COVID-19 vaccines are tested in a laboratory and in pre-clinical and clinical trials (phases 1, 2 and 3). At every step of the way, the same strict requirements have been applied as for other medicines. They have also been tested on a broad target group.
Approval: The European Medicines Agency (EMA) has engaged a taskforce of specialists to give priority to the COVID-19 evaluation procedures. Requests from companies are thus rapidly evaluated and robust, scientific advice can be assured.
Worldwide: As a result of the COVID-19 pandemic, the development of COVID-19 vaccines have been prioritised across the globe.
Extensive experience and expertise: the development of vaccines against COVID-19 will also be accelerated by the expertise accumulated over the past few years in relation to the development of vaccines for other SARS/coronaviruses. Some companies and research institutes have been able to build on existing constructions to make their vaccine.
More resources: additionally, more resources have been mobilised and pooled from the outset, whereas in a normal development these are spread over a longer period of time (both in the pharmaceutical companies and in the competent authorities).

The process of development and approval of COVID-19 vaccines is, therefore, more efficient. No important steps have been skipped in the evaluation and these vaccines must meet the same requirements as all other vaccines. Only when there is sufficient evidence that a vaccine is safe, effective and of a good quality, will a positive opinion for its market authorisation be issued.

It has been developed so quickly, is there any certainty about long-term side effects?

A vaccine is only approved if its quality, effectiveness and safety have been satisfactorily proven. That is why clinical studies are so important. In the last phase (phase 3), the vaccine is tested on large groups of people, often tens of thousands. For the coronavirus vaccines the numbers have been even greater: between 20,000 and 60,000 people, of whom half have received the candidate vaccine and half a placebo. Such studies allow us to see if there are any side effects, and if so what they are. Most side effects can be seen within 6 weeks after vaccination, so they are picked up during clinical trials. Therefore the chance of serious side effects from a vaccine that has been approved is small. However, we can never rule it out altogether. This is true not only for COVID-19 vaccines, but all vaccines and medicines. That is why we keep an eye on vaccines after they have been approved. A special monitoring system has been set up to monitor the safety of COVID-19 vaccines, which will allow us to intervene quickly where necessary.

What are the side effects of the vaccines?

Just like other vaccinations, we observe local and general side effects. These increase slightly after the administration of the second dose but disappear within 48 hours. The side effects comprise pain, redness and muscle stiffness in the injection site, and for some people a mild fever, fatigue, headache and nausea. The side effects respond well to paracetamol.

What about serious side effects?

Once a vaccine has been approved, the Federal Agency for Medicines and Health Products (FAMHP) continues to monitor this vaccine and studies on it. This is just the same as for other medicines or vaccines, because every medicine or vaccine has side effects — normally mild, or only short term. If someone experiences side effects following their vaccination that are not stated in the patient information leaflet (package insert), this can be reported to the Federal Agency for Medicines and Health Products (FAMHP). Experts from the FAMHP evaluate the side effects, and their findings are shared across the world. By bringing data together on a large scale, potential indicators will be discovered more quickly. If an uncommon side effect is experienced with a medicine or vaccine, or if there is an issue with its quality, the FAMHP will evaluate this and take action where necessary, e.g. by modifying the patient information leaflet or warning care providers. In the most serious cases, the medicine or vaccine will be withdrawn from the market.

Is the AstraZeneca vaccine safe?

The European Medicines Agency (EMA) and its Safety Committee (PRAC) drew attention to a limited number of reports of very rare side effects (combination of serious thromboses with reduced platelet counts) up to 14 days after the administration of the AstraZeneca vaccine, mainly in younger people, in Germany, France and the UK, among others. There is no indication that the rare side effects occur more in certain patients at risk.

The EMA undertook a thorough review of these reported cases in Europe. The conclusion on April 23, 2021 was that the AstraZeneca vaccine remained a safe and effective vaccine. The vaccine protects against serious illness from COVID-19, a risk that is many times greater than the risks of serious side effects from vaccination.

The EMA asked that people remain alert for the symptoms of the rare side effects for 2 weeks after being vaccinated with the AstraZeneca vaccine, and that they seek medical attention if they occur. After all, a quick response is important for a good recovery and can prevent complications.

Symptoms:

Shortness of breath
Chestpain
Persistent abdominal pain
Swelling of a leg
Severe or worsening headache or blurred vision after vaccination
Small red spots, not just at the injection site

The EMA will also continue to investigate this further. Our Interministerial Conference (IMC) Public Health follows the recommendation of the EMA and continues the vaccination campaign with the AstraZeneca vaccine. It decided on 4/26/21 to only administer the vaccine to people older than 40 years, because in this age group the benefits of vaccination far outweigh the possible risks of very rare side effects.

The medical specialists of the Belgian Society on Thrombosis and Heamostasis developed [info about thrombocytopenia with thromboses after COVID vaccination or for people with underlying conditions] (https://bsth.be/covid19-resources). These specialists also continue to strongly recommend vaccination, especially for people who have already had classic thrombosis. After all, an infection with COVID-19 increases the risk of these classic thromboses, which have nothing to do with the rare thromboses after vaccination.

Opinion EMA [Decision Interministerial Conference on Public Health of 26-4-21](https://www.health.belgium.be/nl/news/imc-public health-4)

Do some vaccines change your DNA?

No. mRNA vaccines are administered intramuscularly and the mRNA is taken up by a number of human cells. However, the mRNA does not enter the cell’s nucleus and so does not come into contact with human DNA. The mRNA is a code that is read to produce a protein, the S protein. The human cell can decipher the code and therefore does not require the intervention of its DNA. After deciphering, the human cell will produce the S protein, so that our immune system is able to produce antibodies that specifically act against the S protein. The mRNA disappears from our bodies after a few hours.

Will the vaccine protect me if the virus mutates?

Viruses are constantly mutating, which means that part of the genetic material in the virus changes. This happens at different speeds for different viruses. Mutations do not necessarily influence how well a vaccine works against a virus. For example, for the variant that is currently increasing in the UK at a dramatic rate, and that has now also spread to many other countries, initial data on the Pfizer, Moderna and AstraZeneca vaccines shows that the vaccine-induced antibodies can neutralise this variant. For the South African variant, these 3 vaccines score less in terms of effectiveness. This is currently subject to further investigation. Some vaccines remain effective many years after they have been developed and provide long-term protection, such as the measles and rubella vaccines. On the other hand, virus strains for illnesses such as flu change so often and to such an extent that the vaccine’s composition must be updated every year so that it continues to be effective. The scientific community and supervisory bodies will monitor to see if the coronavirus changes over time and if the vaccines can provide protection from infection with the new variants.

I am pregnant or trying to get pregnant. Should I get vaccinated?

Contrary to previous recommendations, and based on the most recent scientific data and recommendations, the Superior Health Council states that all pregnant women should ideally be vaccinated as a priority (phase 1b of the campaign). This is because, especially in the 3rd trimester, they are at an increased risk of severe COVID-19 and preterm delivery. The available COVID-19 mRNA vaccines (Pfizer and Moderna) can be safely given to them.

If the pregnant woman suffers from conditions such as elevated BMI before pregnancy, high blood pressure, diabetes, etc., that is an additional argument for recommending vaccination. This is also the case with an increased risk of contamination, such as with healthcare providers.

There is no increased reporting rate of adverse events in pregnant women after vaccination. In case of fever up to 24-48 hours after vaccination, the SHC recommends paracetamol according to the recommended dose (https://www.bcfi.be/nl/chapters/9?frag=6437). If the fever persists or if other symptoms appear, the patient should consult her doctor.

If you are pregnant and want to be vaccinated as a priority, it is best to contact your doctor. He/she can add you to the priority list (not your gynaecologist or midwife). Once this is done, you will automatically receive an invitation from your vaccination center where you will be vaccinated with a Pfizer or Moderna vaccine.

Can I have the vaccine if I am breastfeeding?

If you are breast-feeding, you may be vaccinated against COVID-19. You should not interrupt breast-feeding. Although there are no scientific studies on the safety of these vaccines for the nursing baby, these vaccines are believed to be safe. After all, they do not contain a live virus and the vaccine components are broken down very quickly in the woman’s body. Attention: you will not be vaccinated as a priority because you are breast-feeding.

How much time must I leave between the COVID-19 vaccine and other vaccines?

Here we apply the general rule for vaccination with inactive vaccines: the COVID-19 vaccine can be administered 2 weeks before or 2 weeks after another inactive vaccine, such as the flu vaccine, the pneumococcal vaccine, the whooping cough vaccine and the human papillomavirus (HPV) vaccine. If the 14-day interval is mistakenly not respected, i.e. the interval is shorter, the vaccines that have been administered are still considered valid and no new vaccinates need to be given.

A 4-week interval should be respected between live vaccines, such as the measles vaccine, and the COVID-19 vaccine.

This means that any side effects can be ascribed to the correct vaccine.

Do you need to get vaccinated if you have developed COVID-19 and/or if you are HIV-positive?

It cannot be confirmed today that someone who has already come into contact with COVID-19 also remains immune to the disease.
Unfortunately, there are reports of re-infections and it is not yet known whether and for how long you will be immune if you have been ill.
Vaccination is not an obligation but it does ensure that you protect yourself and others. Vaccines train the immune system in case the disease really strikes (again). This way, the body and immune system are prepared in case the virus strikes again.
Moreover, it is virtually impossible ahead of the vaccine rollout whether someone has COVID-19 antibodies in their blood.
- The phase 3 clinical trials include broad target groups, including HIV-seropositive people. Analyses of the different groups will be presented and analysed in detail by the regulators.
Also in the Pfizer and Moderna phase 3 trials, COVID-19 positive participants were included with a similar side effect profile as the COVID-19 negative participants.

I am chronically ill, how do I know whether I am eligible for vaccination?

In Phase 3 clinical trials, the results of several patients with chronic diseases (diabetes, pulmonary disease, etc.) were analysed. The analysis of these groups will allow us to provide more specific responses later on. That is why an individual analysis of the benefits and risks must always be made for each patient. (zou ik weglaten) Just under 50% of participants in Pfizer’s COVID19 Phase 3 vaccination trial had a co-morbidity. The side-effects and efficacy (with the exception of people with cancer) in this group were very similar to those of the participants without co-morbidity. However, not all chronic diseases are represented in clinical trials.

Can I have the vaccine if I am breastfeeding?

If you are breastfeeding, you can be given the mRNA COVID-19 vaccine. You do not have to stop breastfeeding. Although there are no scientific studies on the safety of these vaccines for the nursing baby, it is assumed that these vaccines are safe as there is no live virus involved and because the vaccine components are broken down very quickly in the woman’s body. Read the recommendation of the Superior Health Council for vaccinating pregnant women, women wishing to conceive and breastfeeding mothers against SARS-CoV-2 using an mRNA vaccine https://www.health.belgium.be/en/report-9622-vaccination-against-covid-19-pregnant-women

Can I donate blood if I've been infected with the virus or if I have been vaccinated?

For more information, see the website of the Belgian Red Cross https://www.donneurdesang.be/en/covid19

Allergy in itself is not a reason not to get vaccinated.

Have you ever had an immediate or severe allergic reaction after a previous vaccine or needed urgent medical attention after taking a medicine? Your doctor will assess your allergies. He can then consult the guidelines here: https://www.info-coronavirus.be/nl/vaccinatie-professionelen/#zorgverlen (in Dutch) or https://www.info-coronavirus.be/fr/vaccination/#professio (in French). If necessary, your doctor will refer you for evaluation to an allergist or for vaccination in a hospital.

Do you have systemic mastocytosis or hereditary angioedema (2 rare, hereditary disorders)? Be sure to discuss this with your doctor.Contact your doctor. He will take the necessary actions for your vaccination.

The vaccines themselves contain no preservatives. The cap of the vaccine vial is not made of latex. People with a latex allergy can therefore safely receive the vaccine.

Who will get the vaccine and when?

Will there be enough vaccines for everyone?

The vaccines will be produced continuously and quantity available will increase as they are delivered.
Pending their large-scale production, several steps should be planned to best protect the most vulnerable groups and gradually increase individual immunity. (see question hereunder ‘who is included in the priority groups?')

Will there be enough vaccines for everyone?

Vaccines will be produced continuously and the available quantities will increase as deliveries take place. Over time, there will be enough vaccines for everyone.
While waiting for production in large quantities, various steps must be planned in so that the most vulnerable groups can be protected and individual immunity is gradually increased.

Will the vaccine be immediately available to everyone?

No. Vaccines will be produced continuously and the available quantities will increase as deliveries take place. While waiting for production in large quantities, various steps must be planned in so that the most vulnerable groups can be protected and individual immunity is gradually increased. (Read more under question 4 ‘Which are the priority groups?")
At the moment, it is hard to say precisely when vaccines will be provided. That is why the gradual provision of the vaccine to priority groups is vital.

Can everyone be vaccinated at the same time?

No. Vaccines will be produced continuously and the available quantities will increase as deliveries take place. While waiting for production in large quantities, various steps must be planned in so that the most vulnerable groups can be protected and individual immunity is gradually increased. (Read more under question ‘Which are the priority groups?")

In what order is the vaccination done? Who is included in the priority groups?

In order to expand the immunity of the population and protect the most vulnerable people against the virus, the vaccination must take place over three phases, depending on the number of available doses.

GROUP 1a

In the first instance, the most vulnerable and exposed people will receive the vaccine.

Residents and employees in residential care centres and collective care institutions: since the outbreak of the pandemic, COVID-19 has hit the elderly particularly hard, principally those in residential care centres. They will be vaccinated first, then the corresponding staff (including volunteers), followed by collective care institutions.
Medical personnel from first-line care and hospitals: they are in close contact with COVID-19 patients every day. To protect them, they will be prioritised for vaccination.
The other staff in hospitals and healthcare centres will be vaccinated, including organisations which work in prevention activities, such as vaccination centres and cancer screening centres, Child and Family and ONE.

GROUP 1b : vulnerable people without acute medical issues, but at high risk

In this phase, priority was given to people outside hospitals, who are at the highest risk. It concerns the following groups:

People over the age of 65 : people older than 65 will be a priority in this phase. We have started with the oldest people and then go down through the age groups.
Patients aged 18 to 64 with: • chronic kidney disease present for at least 3 months • chronic liver disease present for at least 6 months • haematological cancers (eg leukemia) • down syndrome • transplant patients (including those on the waiting list) • impaired immune system i.e. suffer from an immunodeficiency or take immunosuppressants • active HIV/AIDS • Some rare diseases belonging to the official lists of rare diseases

Patients aged 45 to 64 with: • Chronic severe respiratory disease • chronic cardiovascular disease • obesity (obesity) with BMI ≥ 30 • diabetes type I and II • chronic nervous system disorders • dementia • cancer (tumours) no more than 5 years ago • elevated blood pressure at least 14O mmHG systolic or at least 90 mmHg diastolic

Pregnant women: to be vaccinated as a priority, they must contact their regular GP. Only their GP can add them. Pregnant women who do not yet have a GP should consult one.
Critical functions: In this phase people who fulfill an essential function will be vaccinated. This concerns a limited group of public order services with high-risk contacts (i.e. the intervention units of the police).
penitentiary officers
(para)olympic athletes and the Red Devils who participated in the European Championship
People aged 12 to 18 with the following risk factors (since June 2021, see below for procedure): *chronic kidney disease for at least 3 months *chronic liver disease for at least 6 months *haematological cancers (eg leukemia) *down syndrome *transplant patients (including those on the waiting list) *impaired immune system i.e. suffering from immunodeficiency or use of immunosuppressants *active HIV/AIDS *Some rare disorders (see Orphanet list: https://www.orpha.net/consor/cgi-bin/Disease_Search_List.php?lng=EN).

GROUP 2 - broader population from 12 years old

In this phase, it is likely that the vaccine will be stored and administered like other vaccines (e.g. flu).

Can children receive a COVID-19 vaccine? Is parental consent required?

They can, from the age of 12.

Do you live in Flanders? see https://www.laatjevaccineren.be/node/277#d9a322bf-308c-45f3-bd14-835f942ea45b , ‘Moet ik als minderjarige toestemming aan mijn ouders vragen ?’ Do you live in Wallonie? see https://covid.aviq.be/fr/faq-vaccination#21 ‘la vaccination des 12-15 ans’

I have a chronic sickness, how do I know if I can be vaccinated?

In Phase 3 of the clinical studies, the results from various patients with chronic diseases (diabetes, lung disease and so on) were analysed. Just under 50% of the participants in the Pfizer COVID-19 phase 3 vaccination study had a co-morbidity. The side effects and effectiveness (with the exception of people with cancer) were very similar to participants without co-morbidity. Not all chronic diseases, however, were represented in the clinical studies.
In order to know which people with chronic diseases will be prioritised for vaccination, the Belgian Health Council will issue a recommendation which will then be published.

Do you need to be vaccinated if you have developed COVID-19 and/or you are HIV-positive?

At the moment, there is no certainty as to whether someone who has already had COVID-19 has immunity against the disease.
There are unfortunately some reports of reinfection and it is currently impossible to say how long you remain immune once you have had the virus.
Vaccination is not mandatory but it means you are protecting yourself and others. Vaccines train the immune system, in case it has to face the actual virus again. This prepares the body and the immune system for a (repeat) viral infection.
It is also impossible to check everyone to see if they have antibodies against COVID-19 in their blood as part of the vaccine roll-out.
Phase 3 of the clinical studies encompass many target groups, including HIV-positive people. Analyses of the various groups in detail will be presented and analysed by the regulatory bodies. The phase 3 trials of Pfizer and Moderna also included COVID-19 positive participants with a similar side-effect profile as the COVID-19 negative participants.

I am a informal caregiver, trainee or PAB-Assistant. When will I be vaccinated?

If you work as an informal caregiver, trainee or PAB-assistant in a care facility, you can be vaccinated when it is the turn of care providers from your facility. If you work as a private, informal caregiver or PAB-assistant, you will be vaccinated along with the rest of the broader public.

My family member resides in a care home and is unable to provide informed consent. May I provide my consent?

Just like other vaccinations, consent for a person who is unable to provide their own informed consent will be requested from one of the following people:

the holder of the medical power of attorney
the scientific representative (if the holder of the medical power of attorney is unavailable)
the treating physician (if the above are unavailable)
the coordinating and advising doctor (none of the above are available).

The decision by the resident or the representative will be noted in the resident’s care file with the date and the way in which the consent was obtained. If the verbal consent of a competent person cannot be noted in the care file with any certainty (e.g. there is disagreement within the family), you are advised to document the consent in writing.

What is the procedure to follow for the vaccination of the 12-15 year old?

see: https://d34j62pglfm3rr.cloudfront.net/downloads/procedure+vaccinatie+12-15+j+E.pdf

I am pregnant. What do I have to do to get priority to be vaccinated?

Contact your GP. He/she can add you to the priority list (not your gynaecologist or midwife). Once this is done, you will automatically receive an invitation from your vaccination center where you will be vaccinated with a Pfizer or Moderna vaccine. Pregnant women who have already received a first dose of the Astra Zeneca vaccine can safely receive their second dose of this vaccine, on schedule.

If you are pregnant, you are at a higher risk of severe COVID-19 and premature birth if you are infected. The Superior Health Council therefore advised to vaccinate pregnant women against Covid-19 as a priority (https://www.health.belgium.be/sites/default/files/uploads/fields/fpshealth_theme_file/20210422_hgr-9622_vaccinatie_zwangere_borstvoeding_vrouw_vweb_1.pdf ) . This vaccination offers protection for both the woman herself and the unborn child against the serious consequences of an infection.

Can children get the vaccine? Is the authorization of the parents needed?

In Belgium, children from 12 to 18 years old are invired for vaccination with the Pfizer-vaccine.

Does the child live in Flanders? see https://www.laatjevaccineren.be/node/277#d9a322bf-308c-45f3-bd14-835f942ea45b, ‘As a minor, do I have to ask my parents’ permission?' Does the child live in Brussels? see https://coronavirus.brussels/wp-content/uploads/2021/07/Invitation-Doctena_NL.pdf Does the child live in Wallonia? see https://covid.aviq.be/fr/faq-vaccination#21 ‘la vaccination des 12-15 ans’ "

For information in English, see: https://d34j62pglfm3rr.cloudfront.net/downloads/brief+vaccinatie+12-15+j+E.pdf

Vaccines in practice

How do I know when I will be vaccinated?

When it is your turn, you will receive a personal vaccine invitation. Via text message, letter or email. You will have the option to confirm, refuse or move your appointment. The invitation will also say where your vaccination will take place. And if you can’t access this location, for very good reasons, mobile teams may be able to vaccinate you at home.

Can I be vaccinated by my GP?

At the moment, there are various possible scenarios. For phase 1a, a centralised system will be used for the vaccination of residents and staff in residential care centres (WZC), hospital personnel and 1st line healthcare workers (doctors, physiotherapists, district nurses, pharmacists, etc.) This is also the case for phase 1b, with the vaccination of the over-65s and people between 45 and 65 with co-morbidities, if they are sufficiently mobile. In phases 1b and 2, it is possible that there will be a combination of a centralised and decentralised system, with GPs becoming increasingly involved.
The most important reasons for a centralised system are the specific storage requirements for the vaccine, such as (extremely) low temperatures and the supply of certain vaccines in multi-dose packs. This means that, in a relatively short time span, hundreds of vaccines must be administered to groups, taking account of the coronavirus measures.
In line with several of our neighbouring countries, including Germany, the Netherlands and France, we will roll-out the vaccination strategy in an efficient and controlled manner. This process will use existing structures such as hospitals and vaccination centres as much as possible. In this context, a distinction will be made between phase 1a with centralised vaccination administration to high priority target groups, and phase 1b with the expansion to target groups and the broader availability of vaccines.
Only in phase 2 can we talk of broad vaccination for low-risk groups too. The start of each phase will be determined by the availability and characteristics of the vaccine, and the resulting consequences with respect to distribution.

In Brussels it is now also possible to get vaccinated by your GP. If you want to be vaccinated by your GP, it is best to contact him/her to make sure that he/she carries out this medical procedure. GPs can choose whether or not to vaccinate. This is an additional workload for them that should not be underestimated.

How will the vaccines be distributed?

The ‘operation COVID-19 vaccination strategy’ taskforce has developed a vaccination strategy in consultation with local authorities. This strategy can be consulted via the following link: https://d34j62pglfm3rr.cloudfront.net/downloads/Note_TF_Strategy_Vaccination_NL_0312_post_press.pdf

Will a vaccination centre be set up in my neighbourhood?

This will be discussed with the federated entities. In Flanders, the ELZ (first line zones) will also be called to action. This will only be the case in phase 1b, when we are able to offer vaccines on a broader scale. When we will begin with phase 1b is hard to say while we have uncertainties about supply. It is not yet possible to say when phase 2 will start.

Where will the vaccines be stored?

The vaccines will be stored securely in a central location The precise locations are not being divulged for security reasons. Given the fact that the first vaccines must be stored at an extremely low temperature, the right cooling installations will have to be provided.

I am less mobile. How or where can I get vaccinated?

If you cannot or are not allowed to go to the vaccination center, home vaccination is an option.

The general practitioners make a selection of patients/clients who are eligible for home vaccination. This selection is made on the basis of predetermined medical criteria, e.g. bed-ridden, severe physical or mental disability,…. (see the guidelines for mobile vaccination of the Vaccination Task Force (in Dutch): https://d34j62pglfm3rr.cloudfront.net/downloads/ 210526_SOP_Mobile_vaccination_V2.0_NL.pdf) You do not have to take any action yourself for this.

Have you nevertheless received an invitation to come to a vaccination center and do you think you meet one of the above criteria? Then you can call your vaccination center, whose contact details can be found in your personal invitation. The vaccination center will then give you more information on how to request a home vaccination. A medical evaluation by your doctor is always necessary.

If you live in Brussels, there are other options for mobile vaccination without an appointment. Please see: https://coronavirus.brussels/en/home-2/

Can I volunteer at a vaccination center?

Do you want to help as a volunteer in a vaccination center? Students and retired people are also more than welcome! Register on the various platforms where people are looking for volunteers or temporary workers:

For Flanders • www.helpdehelpers.be: specifically for people with a (para)medical background, both volunteer and temporary worker • www.rodekruis.be/crisisvoluntaryers: volunteer at the red cross • www.vdab.be/helpindezorg: vacancies for healthcare, especially non-medical profiles

For Brussels: https://www.iriscare.brussels/nl/professionals/covid-19-coronavirus-2/volunteers-vaccination-covid-19

For Wallonia: https://solidaire.aviq.be

For the German-speaking community: karin.cormann@dgov.be

Many vaccination centers also have local channels and websites to recruit volunteers. The vaccination centers themselves of course choose which volunteers to call on.

After vaccination

Will I have to be vaccinated every year against COVID-19? Is a third shot needed?

At the moment, there is no definitive answer to this question. At present this is being studied.

Can I still get COVID-19 after vaccination?

Just like other vaccines, the COVID-19 vaccine does not offer 100% protection, even after 2 doses.
Because we cannot check whether someone is infected at the time of the vaccination, it is possible that the infection with COVID-19 is detected shortly after the first vaccination. This is due to the fact that the person being vaccinated was already infected at the time of vaccination, but showed no symptoms. Furthermore, just like other vaccinations, there is a 14 day interval before the immune system is stimulated by the first vaccine. If anyone is exposed to the virus shortly after the first vaccination, this could lead to an infection.
The vaccination prevents you from becoming ill from an infection. At the moment, we do not know whether the vaccination prevents you from transferring the virus to others.

As long as insufficient people have been vaccinated, it is therefore vital that you comply with the protective measures even after you have been vaccinated (social distancing, wearing a face mask, washing hands, airing rooms, etc.).

Am I protected immediately after vaccination?

After vaccination, it takes between 10 and 14 days before your body begins to make antibodies. If you are exposed to the virus in this period, your immune system is not yet sufficiently stimulated by the vaccine and you could still become infected. Two weeks after the first vaccination, the effectiveness rises to around 90% and this then increases to around 95% after the second dose. In the interim, it is extremely important that you respect the protection measures (social distancing, wearing a face mask, washing hands, airing rooms, etc.)
Even those people who are fully vaccinated must continue to comply with the measures. It will take a while before enough people are vaccinated and herd immunity is realised.
Just like other vaccines, the COVID-19 vaccine does not offer 100% protection, even after 2 doses.
Because we cannot currently check whether the person being vaccinated is carrying the virus, it could be that he/she was infected at the moment of vaccination and then tests positive for COVID-19 and becomes sick. That is due to the fact that the virus was still in the incubation period at the moment of vaccination.

Can I infect other people with COVID-19 if I have been vaccinated?

The results of studies suggest that the COVID-19 vaccines protect against infection (confirmed by a PCR test) and against illness and complications. Whether or not you are less likely to transfer the virus to others when you have been vaccinated is still under investigation. On the basis of animal testing in monkeys, we can assume that the vaccination affects the number of days that a person is contagious. Additionally, an awareness of symptoms such as sneezing and coughing will also impact on transmission.

Can I get back to normal once I've been vaccinated?

Once we have achieved a high enough vaccination level among the risk groups and reduced the pressure on the healthcare system, changes will be implemented with respect to the safety measures. At the moment, you must continue to follow coronavirus measures for your own safety and the safety of others. Particularly if you do not belong to a high-risk group but do come into contact with high-risk persons.

Helping as a volunteer

Would you like to help as a volunteer/caregiver in a vaccination centre? Students and pensioners are also more than welcome!

Flanders: register via https://www.helpdehelpers.be/
Brussels: send an email to vacci-hyg@ccc.brussels
German-speaking Community: send an email to karin.cormann@dgov.be
French Community: https://solidaire.aviq.be/

For more information about the vaccination, see:

For Flanders: www.laatjevaccineren.be
for Brussels: www.vaccination-info.be; www.coronavirus.brussels.be
for Wallonia: covid.aviq.be/fr; www.vaccination-info.be; www.Jemevaccine.be
for the German-speaking community: www.ostbelgienlive.be
vaccination-info.eu/en: https://vaccination-info.eu/en