More than 500 million doses of the COVID-19 vaccine have been administered in the U.S. and the numbers are climbing by the day.

Doctors and other experts agree: It’s the best way to protect yourself, your family and your community from getting sick, or spreading it to children who are not yet eligible for the vaccine. Others whose immunity systems are compromised are also at risk.

Here are answers to common COVID-19 vaccine questions from Novant Health doctors.

We keep hearing about “breakthrough” cases in which vaccinated people get COVID. Does that mean the vaccines don’t work as well as promised?

No vaccine is 100% effective. But the COVID vaccine protects the vast majority of recipients from severe illness from COVID-19. While numbers vary by the day, more than 90% of hospitalized patients are unvaccinated. Nearly all deaths due to COVID occur among the unvaccinated.

Dr. Charles Bregier
Dr. Charles Bregier

Much has been made of the fact that those who got breakthrough cases can infect others. That’s true. “But if you get vaccinated, you are much less likely to become infected and infect others,” said Dr. Charles Bregier, Novant Health medical director of corporate health.

So yes, there will be breakthrough cases, but getting the vaccine will greatly reduce your chance of becoming infected by someone who has a breakthrough infection. The biggest danger from breakthrough infections is to the unvaccinated.

One more key point: If you get vaccinated and have a breakthrough case, your chances of becoming seriously ill are greatly reduced compared to those who are not vaccinated.

We keep hearing rumors about the vaccines posing dangers to women’s fertility. What’s the truth? And what about the future fertility of children?

Dr. Pam Oliver
Dr. Pam Oliver

There are no links to fertility problems and the vaccine, said Dr. Pamela Oliver, an ob-gyn with Novant Health WomanCare in Winston-Salem, Novant Health executive vice president and president of Novant Health Physician Network. “There's nothing even theoretical about this, or any, vaccine, causing infertility,” she said. “Anything you hear or read to the contrary is absolutely unfounded.”

The mRNA technology shows cells how to make a protein – think of it as a blueprint – that triggers an immune response. And then it disappears. “There is no plausible mechanism by which an mRNA vaccine could affect future fertility of children,” said Dr. Catherine Ohmstede, a pediatrician and Novant Health leader.

‘I already had COVID. That means I have natural immunity. I don’t need the vaccine.’

Dr. David Priest
Dr. David Priest

The struggle with “natural immunity” is that everyone is different, said Dr. David Priest, Novant Health senior vice president and chief safety, quality and epidemiology officer.

“How old you are, what other health problems you have, what medications you take, and frankly, how big a dose of COVID you got when you were infected. Some people will get infected and have very mild symptoms, and they tend to have milder immune responses and their protection probably doesn't last very long,” Priest added. “And there's a study on the CDC website right now that looks into this, which found that those individuals were much more likely to get COVID a second time. What we know about vaccination is that it gives you a more even and predictable immune response.

"And so, we take the same approach as the CDC, that if you've had COVID, we encourage you to get vaccinated. It's very hard for an individual person to determine whether their COVID gave them enough protection to avoid getting infected again, and how long that protection lasts. So, we do encourage individuals who've had COVID to go ahead and get vaccinated."

Historically, vaccines have taken years to develop. How do we know this is safe?

Yes, the vaccines are new, but the mRNA technology is not new. It’s been in development for over a decade. The COVID vaccine was tested on 70,000 people before it was made available to the public. Government and independent scientists — all free from political influence — carefully researched and reviewed all the science and findings behind development of the vaccines before declaring them safe. More than 5 billion doses have been administered worldwide.

On Aug. 23, the Food and Drug Administration granted final approval for the Pfizer COVID-19 vaccine for people 16 and older. A June poll from the Kaiser Family Foundation found that a third of unvaccinated people said they would be more likely to get vaccinated once it received full FDA approval. That approval is now in place.

Why is Novant Health requiring all team members to get vaccinated for COVID-19?

To keep patients safe.

“Patients come to us at the lowest and most vulnerable times in their lives,” Priest said. “They are sick, they are dying, they are afraid, and they are looking to us for our expertise and protection. Vaccines are the only way we have at this time to end this pandemic and the only way to ensure that we do not give a deadly virus to those who trust us.

“As an organization, we will not waver in our commitment to preventing harm to patients, and we are taking the steps necessary to protect our communities.”

Novant Health is not alone in this decision. In North Carolina, Atrium Health, Cone Health, UNC Medical Center, Duke University Health System, Wake Forest Baptist Medical Center are among health care systems requiring team members to get vaccinated.

'The vast majority of people infected with COVID have survived. I’m willing to take the chance.'

Dr. Megan Donnelly
Dr. Megan Donnelly

The odds of getting COVID without complications aren't as strong as some might think. Within six months of contracting COVID, 1 in 3 survivors is diagnosed with a brain, mood or psychiatric disorder, according to a study in Lancet Psychiatry. “I would say the actual numbers are much higher for COVID survivors experiencing neurological effects post-COVID,” said Dr. Megan Donnelly, a women’s neurologist at Novant Health Neurology and Headache – SouthPark.

“Among other issues we’re encountering in patients are acute delirium or encephalopathy – which essentially means brain fog, confusion or general inability to focus,” Donnelly said. Other post-COVID fallout includes fatigue and heart palpitations, ringing in the ears, longer-term loss of sense of smell and depression.

'It’s my choice. If I get sick, I’m hurting no one but myself.'

It’s your choice, to be sure. But Ohmstede, the pediatrician, reminds us: Babies and children under 12 are not eligible for the vaccine yet. When we choose not to get vaccinated, we also choose to increase our odds of becoming sick and spreading the disease to others who are not able to protect themselves.