EvergreenHealth Monroe COVID-19 Vaccine Clinic

EvergreenHealth Monroe partnered with Snohomish County Health District to serve as a community COVID-19 vaccination site for the Moderna vaccine. This partnership began February 3 and will conclude April 28 when we will administer our last grouping of second doses. 

If you are seeking a vaccination appointment, we invite you to visit here for information on appointments at the King County Vaccination Partnership-Redmond, a collaboration of EvergreenHealth, Overlake Medical Center, and Microsoft. For locations specific to Snohomish County, those seeking vaccination may click here for more information.

3 Reasons We Must Continue COVID-19 Protective Measures

The vaccine doesn’t guarantee complete immunity.

Moderna, along with the Pfizer vaccine, has been found to provide up to 95% immunity against COVID-19. That means that there is still a small chance that you could get infected. You need to continue to protect yourself and wearing a mask can limit your exposure to the virus. This should further lower your chances of becoming ill.

You might infect others with COVID-19.

It’s unclear whether or not people who receive the COVID-19 vaccine have the ability to spread the virus to others. Researchers are now studying whether the vaccines prevent asymptomatic transmission of the virus. If you’ve been vaccinated, it may be possible for enough of the virus to be present in your nose or mouth for you to unknowingly spread it to those around you, even if you don’t experience symptoms.

Until researchers confirm that this doesn’t happen, wearing a mask helps you protect the people in your community who haven’t received the vaccine yet.

“Herd immunity” will take time to achieve.

For herd immunity to help stop the spread of COVID-19, enough people have to become immune (through vaccination) to the virus that causes it. It’s unknown at the moment what percentage of the

population would need to get vaccinated to limit the spread of the virus this way.

Some experts believe that herd immunity may be achieved if 60 or 70 percent of the population is vaccinated. Others suggest that an even higher percentage (as much as 90 percent) of people would need to be vaccinated for herd immunity to have an effect.

Currently, only a small percentage of King County residents have received at least one dose of the COVID-19 vaccine, so we have a long way to go before our communities will reach herd immunity.

Until we achieve herd immunity, it’s important that we all continue to take steps to protect one another:

  • wear a mask over your nose and mouth when you’re around people from outside your household
  • stay at least 6 feet away from people who aren’t from your household
  • limit the time you spend in indoor spaces, especially poorly ventilated ones
  • avoid crowds and close contact with people from outside your household
  • wash your hands often with soap and water, or use hand sanitizer.

COVID-19 Vaccine Resource Library

We have built this COVID-19 Vaccine Resource Library as a single source of information, from many sources, with the goal of what to expect in the coming months and year.

COVID-19 Vaccine Information from Snohomish County

This information is available in several languages, including:

Amharic | Arabic | Chinese | Japanese | Khmer | Korean | Marshallese | Punjabi | Russian | Tagalog | Ukrainian | Vietnamese

COVID-19 Vaccine Information from King County

This information is available in several languages, including:

Amharic | Arabic | Chinese,Simplified | Chinese,Traditional | French | Khmer | Korean | Marshallese | Oromo | Russian | Samoan | Somali | Spanish | Tigrinya | Tongan | Ukrainian | Vietnamese

COVID-19 Vaccine Information from CDC

From the Department of Health:


EvergreenHealth's Medical Director of Infectious Disease, Dr. Francis Riedo, offers information about the vaccine(s) and clinical trials:

COVID-19 Vaccine Q&A


What is the final Advisory Committee on Immunization Practices (ACIP) recommendation for who should receive the vaccine?

The Advisory Committee on Immunization Practices (ACIP) recommends the intervention. The Pfizer-BioNTech COVID-19 vaccine is recommended for persons 16 years of age and older in the U.S. population under the FDA’s Emergency Use Authorization. It is likely that Moderna will be approved for persons 18 years of age and older; but that has not yet been finalized by the ACIP.

Should pregnant or breastfeeding women receive the vaccine?

We recommend pregnant women consult with their healthcare provider and/or OB to determine if the COVID-19 vaccination is right for them.

Currently, there are limited data available on the safety of COVID-19 vaccines for people who are pregnant. Animal developmental and reproductive toxicity (DART) studies are ongoing and studies in people who are pregnant are planned. CDC and the FDA have safety monitoring systems in place to capture information about vaccination during pregnancy and will closely monitor reports.

CDC and the ACIP have provided information to assist pregnant people with their decision to receive the COVID-19 vaccine. At this time, ACIP recommends that healthcare personnel be offered vaccination in the initial phase of the COVID-19 vaccination program. 

Will those who have been ill with COVID-19 still receive the vaccine? Do they not already have antibodies?

The CDC is stating that the Pfizer-BioNTech COVID-19 vaccine is safe and likely efficacious in people with evidence of prior COVID-19 infection, and it should be offered regardless of history of prior symptomatic or asymptomatic COVID-19 infection. This is based on the fact that it is not entirely clear how protective immunity from natural infection is nor for how long. Based on the CDC’s recommendations we are planning to offer vaccines to those who have had prior COVID-19 illness. Note: it is recommended that individuals with active COVID-19 have vaccination deferred until they have recovered from the acute illness and have met criteria to discontinue isolation.

Will this vaccine have any age restrictions?

Currently the vaccines are for 16 and above (for Pfizer) and 18 and above (for Moderna); they are looking at the 12-15 age group. We are not aware of any studies for those under age 12 and indirect assessments of efficacy may be employed in this age group. The Advisory Committee on Immunization Practices (ACIP) will have recommendations for Pfizer and Moderna vaccines shortly after the FDA (Food & Drug Administration) review is completed.

When will the vaccine be available to everyone?

As part of the vaccine distribution planning effort, the federal government and Washington State are considering many factors such as prioritization of high-risk groups, vaccine supply and distribution, logistics, safety, and clinical guidance.

On January 7, 2021, Washington DOH released new allocation prioritization guidance for the phased/tiered release of the vaccine in Washington state. You may find full details of this allocation guidance here. In short:

  • Phase 1a: 
    • Tier 1:
      • High-risk workers in healthcare settings
      • High-risk first responders
      • Residents and staff of nursing homes, assisted living facilities, and other community-based congregant living settings
    • Tier 2: 
      • All other workers at risk in healthcare settings
  • Phase 1b:
    • Tier 1:
      • All people 65 years and older
      • People 50 years and older in multigenerational households
    • Tier 2:
      • High-risk critical workers 50 years and older who work in certain congregate settings (e.g., grocery, education, childcare, corrections facilities, public transit)
    • Tier 3:
      • People 16 years and older with 2 or more co-morbidities or underlying conditions
    • Tier 4:
      • High risk critical workers under age 50 in certain congregate settings
      • People, staff, and volunteers in congregate living settings

Future phases (Phases 2, 3 and 4) are still tentative and will be based on clinical trial data, federal guidance, vaccine supply projections, and ongoing community input.

Please continue to check back here on EvergreenHealth Monroe's COVID-19 Information Hub for additional details on when the vaccine will be available to you.


What are the typical side effects?
We’ve had tetanus shots, flu shots, shingles vaccination (for some of us) – the side effects for this vaccine are similar. You may get a sore arm. You might get a headache or muscle aches. Perhaps even a low-grade fever or some fatigue. Vaccines generate an immune response – this is part of your body’s innate immune response. Much of the current data are from phase 1 and phase 2 of the trials (small samples of people) – we will learn more when the phase 3 data are released (40,000+ people) and will update you accordingly.

According to the company’s press releases, no serious safety concerns have been reported in either the Pfizer or the Moderna trial. The side-effects profile of the Pfizer vaccine includes pain at the injection site, as well as fatigue, chills, and fever. The side effects noted in Moderna’s news release include pain at the injection site, muscle aches and headaches.

Unfortunately, these side effects can mimic COVID-19 symptoms. We just need to be very mindful that if these symptoms come on at the same time as our vaccine – it is highly likely to be the vaccine and not COVID-19.
They are transient, are an expected side effect and can be seen as a sign that your immune system is working.

Is reactogenicity typically more likely for certain patient demographics?
Reactogenicity – or side effects – from the vaccine are likely to affect younger populations. The younger you are, the more robust your body’s immune response will be. While annoying, side effects are not a bad thing – they are your body’s way of letting you know the vaccine is doing what it is supposed to do.

What is Phase 1 testing for a vaccine?
Phase 1 consists of a small number of individuals who are asked to volunteer – around 30-40 individuals. It is purely a safety trial. The sole purpose of phase 1 is to find out if we administer a vaccine, are there immediate and serious side effects.

What is Phase 2 testing for a vaccine?
Phase 2 continues to monitor safety but is also directed at immunogenicity – this is actually the measurement of antibody production in the participant. Phase 2 trials are also often dose ranging trials to determine the optimal dose both in terms of antibody production but also to minimize side effects. You want to make sure that if you give a vaccine, it will generate an antibody response in that individual.

What is Phase 3 testing for a vaccine?
Once you have decided on the appropriate dose, have confirmed safety, and have determined the vaccine actually generates a response, you want to test it for efficacy. Both the Pfizer and the Moderna vaccines went into phase 3 testing on July 27. The goal in any Phase 3 trial is to enroll a large number of individuals. In this vaccine Phase 3 testing, half are given the vaccine candidate and half are given a placebo (saline injection). Analyzing the number of individuals who contract the infection in the placebo group and in the vaccinated group helps determine how effective the vaccine is in actually preventing infection.

Wasn’t this timeline rushed?
The target was met rapidly – but not “rushed” in a way that would cut corners. The rapidity happened for many reasons. In vaccine studies, Phase 1 and Phase 2 are made up of very small numbers of people. Because Phase 1 was showing such success, Phase 2 did overlap with Phase 1 – so that sped up the timeline a bit. When a vaccine enters Phase 3 trials, MANY people are studied (for example, Pfizer enrolled over 40,000 people in Phase 3). In Phase 3, you need to get to a point where a certain prespecified number of individuals become infected. With many diseases, Phase 3 can take years! Think about meningitis, for example. Meningitis is simply not very common anymore. If a new vaccine for meningitis came today it could take millions of people and years to demonstrate efficacy. COVID-19, on the other hand, is extremely prevalent. This allowed the study to reach the prespecified number of infections very quickly. The timeline was compressed because of the large prevalence of COVID-19 across the country.

What is Messenger RNA or mRNA?
The use of messenger RNA (mRNA) is a novel technology that has turned out to be highly effective at generating an antibody response. Vaccines work by training the body to recognize and respond to the proteins or sugars produced by disease-causing organisms, such as a virus or bacteria. Traditional vaccines are made up of inactivated (killed) bacteria or viruses that cause infections. More recently vaccines are made of proteins or polysaccharide (sugar) molecules that coat the virus. These are introduced into the body to provoke the immune system into mounting a response. mRNA vaccines, in contrast, use the body’s cellular machinery to produce the viral proteins which then lead to an antibody response. They work by using mRNA, or messenger RNA, which is the molecule that essentially puts DNA instructions into action. Inside a cell, mRNA is used as a template to build a protein. To produce an mRNA vaccine, scientists produce a synthetic version of the mRNA that a virus uses to build its infectious proteins. This mRNA is delivered into the human body, whose cells read it as instructions to build that viral protein, and therefore create some of the virus’s molecules themselves. These proteins are solitary, so they do not assemble to form a virus. The immune system then detects these viral proteins and starts to produce a defensive response to them. Once the job of the mRNA is complete it disappears and does not become part of your cellular structure or DNA.


How effective are these vaccines?
The Pfizer vaccine has an efficacy rate of 95%. The Moderna vaccine has an efficacy rate of 94.5%.

Do you have to get two doses? What if you only get one dose?
Those receiving the vaccine must receive two doses to be fully immunized and protected. Everyone must get the second dose. Additionally, if two brands of vaccine become available (for example, Pfizer and Moderna), you must get your first and second dose from the same brand. The first dose primes the immune response – it’s the second dose that pushes the level of antibodies into a protective level. Having a single dose will not provide protective antibody concentrations. You need both doses of the vaccine.

What is the duration between 1st and 2nd vaccine doses?
For the Moderna vaccine, it is as close to 28 days as possible - per the CDC, ideally 24 to 42 days.

How soon after the second dose will the vaccine be considered effective?
It appears that at 7-14 days post second dose, there is an adequate level of protection against COVID-19.

Do we know how long the vaccine is effective?
It is unknown at this time.