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COVID-19 Vaccine: Side Effects in the Elderly

By Devon NespicaJanuary 22, 2021
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When it comes to side effects of the COVID-19 vaccines in the elderly, the news is good: Preliminary clinical data for the Pfizer-BioNTech vaccine showed the majority of side effects were mild or moderate, and less common in adults over 55. Additionally, safety studies for both the Pfizer-BioNTech and Moderna vaccines included thousands of adults older than 65, and the Centers for Disease Control and Prevention (CDC) reports no serious safety concerns were noted. That’s why many scientific experts agree that the benefits of the vaccine far outweigh the risks.

Here, we’ve answered some of the most common questions about COVID-19 vaccine side effects in the elderly.

Vaccine side effects: What’s normal and what’s not?

According to the CDC, the side effects of the COVID-19 vaccines are similar to those of other vaccines, like the flu shot. Most are mild to moderate and occur within the first three days of vaccination. Pain or soreness at the injection site is the most common side effect. Other normal potential side effects include fatigue, headache, muscle aches, chills, joint pain, and fever.

Serious complications are rare

Serious side effects of the COVID-19 vaccines are rare. In fact, the Food and Drug Administration (FDA) states that the rate of serious complications for the Pfizer-BioNTech and Moderna vaccines is .05% and 1%, respectively.

However, some people have reported severe allergic reactions — or anaphylaxis — after receiving the COVID-19 vaccine. Anaphylaxis is an abnormal response by your immune system that causes your body to go into shock.

Symptoms of anaphylaxis may include:

  • Generalized hives, itching, or swelling of the face, lips, and/or throat
  • Cardiovascular distress, including fast heartbeat, low blood pressure, dizziness, fainting
  • Respiratory issues like coughing, wheezing, or shortness of breath
  • Gastrointestinal problems like vomiting, diarrhea, or nausea

Make sure you and your loved one’s care team are aware of any adverse reactions to previous vaccines. Older adults who have experienced serious allergic reactions to medical treatments in the past may not be able to receive the COVID-19 vaccine.

How do you treat COVID-19 vaccine side effects?

Most COVID-19 side effects can be treated safely at home without any sort of special care. Over-the-counter pain medication like ibuprofen or acetaminophen can be used to reduce pain or discomfort at the injection site. Drinking plenty of fluids and dressing lightly can reduce discomfort from fever, says the CDC.

Are side effects more common after the first or second dose?

Studies suggest it’s more common to experience side effects following the second COVID-19 vaccine shot. The second dose of the vaccine is administered three to four weeks after the first dose. In clinical trials, both older and younger participants reported reactions that were more frequent or intense, with fatigue, headache and new or worsened muscle pain being the most common. However, the side effects from the second injection were mild to moderate in severity, and less frequent for those older than 55.

Why do some doctors say side effects from the COVID-19 vaccine are a good thing?

Experiencing mild to moderate side effects after vaccination means your immune system is functioning like it should – and that is a good thing. Your body is learning to develop a response to SARs-CoV-2 (the scientific name for COVID-19) and building immunity against the disease. That way, when you’re exposed to the actual virus, your body will recognize and fight it.

How are COVID-19 vaccine side effects in the elderly being monitored?

All people who receive the vaccine, regardless of age, will be monitored for at least 15 minutes to ensure they don’t have an allergic reaction. Those with a history of severe allergic reactions should be watched for 30 minutes after vaccination, according to the CDC.

Other safeguards are in place, too. The CDC and FDA are closely monitoring the safety of the COVID-19 vaccine in the elderly. For senior living communities, the CDC is working with Walgreens, CVS, and other health care partners to report, track, and monitor any serious complications of the vaccine.

Caregivers of elderly loved ones are also encouraged to report any adverse events immediately to their doctor or through V-safe – a smartphone-based app that provides health check-ins after receiving your COVID-19 vaccine.

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When to call the doctor

If your loved one develops a fever after receiving the COVID-19 vaccine, monitor it to ensure it’s indeed a response to the vaccine and nothing more serious. If side effects like fever, redness, or pain don’t improve within a few days, or if you’re worried, it’s time to call a doctor, says the CDC.


Centers for Disease Control and Prevention. “COVID-19 vaccines and allergic reactions.” 

Centers for Disease Control and Prevention. “Importance of COVID-19 vaccination for residents of long-term care facilities.” 

Centers for Disease Control and Prevention. “Interim clinical considerations for use of mRNA COVID-19 vaccines currently authorized in the United States.” 

Centers for Disease Control and Prevention. “Interim considerations: preparing for the potential management of anaphylaxis after COVID-19 vaccination.” 

Centers for Disease Control and Prevention. “Local reactions, systemic reactions, adverse events, and serious adverse events: Pfizer-BioNTech COVID-19 vaccine.” 

Centers for Disease Control and Prevention. “What to expect after getting a COVID-19 vaccine.” 

Food and Drug Administration. “Vaccines and related biological products advisory committee meeting.” 

Devon Nespica

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