（1） COVID-19 vaccines are developed and tested rapidly, so the vaccines must be unsafe.

False! Urgent demands for the vaccines accelerated their development, but no shortcuts have been taken in the development processes which have undermined its safety [1]. Technologies nowadays have enabled COVID-19 vaccines to develop at a much faster pace. All ingredients in COVID-19 vaccines have been thoroughly checked and monitored to ensure their safety. [2]

Video description:
Title:　2019新冠肺炎疫苗：安全性和多樣性（2022.05.13）
Source: U.S. Food and Drug Administration
Main content: COVID-19 vaccines have undergone safety testing and extensive testing during their development.

（2） COVID-19 vaccines contain a chip (or using other means) that is implanted in a person's brain to control the person.
This is a rumour! All the ingredients in the vaccines have been thoroughly tested and checked. COVID-19 vaccines cannot be used to track individuals or collect personal information into databases [2].

（3） mRNA COVID-19 vaccines (such as BioNTech) can alter the DNA in our bodies.
This is a rumour! The mRNA in the vaccine does not enter the nuclei of cells and does not alter our DNA. The mRNA vaccines can instruct our cells to make proteins (or a part of the protein) that trigger an immune response. When the virus enters into our body, we are protected from infection [2].

Video description:
Title: 新冠疫苗Fact Check：接種後會改變人體DNA和導致不育嗎（2021.03.10）
Source: BBC News Chinese
Main content: This video will answer the questions of whether the COVID-19 vaccines can implant a chip in humans, alter our DNA, and cause infertility, etc.

（4） Some people died after receiving the BioNTech vaccines. The mortality rate is higher than usual.

This is a rumour! A statement issued by the Global Advisory Committee on Vaccine Safety of the World Health Organization pointed out that the overall mortality rates and causes of death were found to be similar to normal days, after reviewing the death cases reported in Europe and in the WHO global database. In particular, there was no abnormal increase in the mortality rate among frail older adults who had received the BioNTech vaccines. Therefore, the committee considered that the vaccines were beneficial for older adults [2].

（5） The BioNTech vaccine is not safe enough

False! The Global Advisory Committee on Vaccine Safety (GACVS) comprising groups of experts, provides independent and authoritative guidance to the WHO on the safety use of COVID-19 vaccines. The committee is responsible for receiving and evaluating reported incidents that are suspected to have safety concern and with potential international impact.

In October 2021, the COVID-19 Sub-Committee of the GACVS concluded that mRNA COVID-19 vaccines were significantly effective in reducing hospitalisation and deaths caused by COVID-19 in all age groups. This suggested that the BioNTech vaccine is sufficiently safe and effective [3].

（6） The BioNTech vaccine is safer than the Sinovac vaccine.

False! According to the data released by the two pharmaceutical companies, people who received the BioNTech vaccine are more likely to experience side effects than those who received the Sinovac vaccine. However, the efficacy rate of the second dose of BioNTech is 95%, when compared with about 50% in the Sinovac vaccine.

Current data have shown that the BioNTech vaccine remains effective against the virus variants, such as the South African strain, but there is not yet clear data to show the efficacy of the Sinovac vaccine in protecting us against the virus variants.

（7） The pneumococcal conjugate vaccine is not safe enough.

False! The pneumococcal conjugate vaccines (PCV) are shown to be safe. The vaccines are one of the most effective ways to prevent pneumococcal disease [5].

（8） Inactivated influenza vaccines cause influenza.

False! Inactivated influenza vaccines contain killed pathogens. Recombinant influenza vaccines contain haemagglutinin, which are surface antigens of influenza virus’ pathogens. These two kinds of vaccines do not cause influenza. Live-attenuated influenza vaccines contain weakened virus’ pathogens and they are unlikely to cause influenza in immunocompetent individuals [6].

（9） Influenza vaccination may affect the health of breastfeeding mothers and infants.

False! Seasonal influenza vaccines are safe for breastfeeding mothers and infants. Women who get vaccinated during pregnancy or breastfeeding can produce antibodies against influenza that can be passed on to their babies through breast milk to provide protection for the babies [7].

（10） Most people who develop COVID-19 recover, therefore, we do not need to get vaccinated.

False! Coronavirus disease 2019 is a deadly disease that can cause severe illness. Its long-term effects are not yet fully understood. Therefore, vaccines are developed to reduce death and severe complications. Although a very high percentage of the infected persons recover, many others experienced severe diseases and even death. Asymptomatic COVID-19 infections are common and these ‘hidden’ infected persons can transmit the virus to others [1]. Vaccination not only protects you and reduces the rates of mortality of serious complications, but it also protects your family and the people around you from death and serious illness [2].

（11） Older adults are not having a higher need to get vaccinated

False! Older adults are more likely to have complications and die after contracting the novel coronavirus, therefore, they have a higher need to be vaccinated. According to the statistics of the fifth wave of the COVID-19 outbreaks, as of September 2022, more than 9,600 people died of COVID-19 [8]. According to the World Health Organization, the efficacy of the BioNTech against severe disease is 93%; the effective rate is 79% in adults under 60 years old; in those 60 years and above, it is 68% [9]. The Sinovac is 51% effective against severe disease [10].

The mortality rate of older adults aged 60 or above who had not received COVID-19 vaccines is higher than those who had received three doses of COVID-19 vaccines [11], as shown in the table below.

Table 1: Comparison of mortality rates among older adults with different vaccination status

（12） Patients with chronic diseases are not having a higher need to get vaccinated.

False! Patients with chronic diseases are more likely to have complications and die after contracting the novel coronavirus, therefore, they have a higher need to get vaccinated [1]. Taking into account the latest World Health Organization's recommendations, local situation of COVID-19, overseas practice and latest scientific evidence, the Scientific Committee on Vaccine Preventable Diseases and the Scientific Committee on Emerging and Zoonotic Diseases (JSC), joined by the Chief Executive's expert advisory panel (EAP) recommended that people aged 18 years and above with chronic diseases to receive an additional booster dose in 2023, at least six months after the last dose of the vaccine or a COVID-19 infection (whichever is later) [12].

（13） I have had COVID-19 and I do not need to be vaccinated.

False! Vaccination is recommended even if you have had COVID-19. Recovery is defined as 14 days after the date of first positive test (Nucleic Acid Amplification or Rapid antigen tests). The recovered persons should receive the remaining doses according to the interval for the next dose [12]. Studies have found that unvaccinated individuals are more than twice likely to be re-infected when compared with those who have been vaccinated. In addition, vaccination can protect you from the more infectious virus variants, such as the Omicron strain, which may not have been present when you first contracted the COVID-19 virus [13].

（14） Vaccine-induced immunity is useless and natural immunity is much healthier and more effective.

False! Vaccination is one of the best ways to prevent having COVID-19. The risk of infection with virus' pathogens is much higher than the risk of vaccination. It is estimated that vaccines save 2-3 million lives a year [1]. Vaccines work with your body's natural defense system and build protection against viruses to reduce the risk of developing diseases. Vaccination not only protects you, but also protects those people around you [2].

（15） COVID 19 vaccines are effective immediately after administering.

False! After administering the vaccine, it takes some time for the body to develop antibodies to protect you from the novel coronavirus [2].

（16） Administering influenza vaccines can prevent COVID-19.

False! These two vaccines are different. The flu vaccine can prevent co-infection with influenza and COVID-19, which can help avoid more severe illness [1]. The most effective way to prevent COVID-19 is to receive COVID-19 vaccines [2].

（17） We don't need to get vaccinated because herbal tea, probiotics, gingers, garlics or chillies can prevent COVID-19.

False! They may have some antibacterial or anti-inflammatory properties, but they cannot protect you from COVID-19. The most effective way to prevent COVID-19 is to get vaccinated [13].

（18） COVID-19 Vaccines cannot reduce infection rates.

False! In the fifth wave of the pandemic, as of 7 April 2022, the Government announced that the total infection rate of COVID-19 in Hong Kong was 15.8%. The infection rate of those who were unvaccinated was 24.6%. This indicates that vaccination still has some preventive effect. The infection rate was only 3.4% for people who have received three doses of the BioNTech vaccines and 9.1% for people who have received three doses of the Sinovac vaccines. This clearly shows that three doses of the vaccines can prevent COVID-19 infection [14].

（19） I have not yet been vaccinated but I have not had COVID. COVID-19 Vaccination is no use.

False! First, COVID-19 vaccination can reduce the infection rate [14].

Compared with the overall population of Hong Kong, the percentage of reported COVID-19 cases among those who had received three doses of the vaccines was significantly lower. The percentage of critical/severe and death cases in hospitals was even lower, reflecting the effectiveness of three doses of the vaccines in preventing COVID-19 infection, serious illness and death. Data from the University of Hong Kong also showed that three doses of either BioNTech or Sinovac vaccines were highly effective in preventing death and severe illness, with over 90% protection. Those who are eligible for the third dose should receive it as soon as possible [15].

（20） Pneumococcal vaccination does not really work.

False! One of the most effective ways to prevent pneumococcal disease is to get vaccinated [5].

（21） Influenza vaccines do not really work. You can still get a flu even if you were vaccinated.

False. The reasons why some people get a flu or flu-like symptoms after vaccination are as below [7]:

Nonetheless, all persons aged 6 months or above, except those with known contraindications, should receive seasonal influenza vaccine every year as it is one of the most effective ways to reduce the risk of seasonal influenza and its complications, and can also reduce the chances of hospitalization and death due to influenza [7].

（22） The vaccines give us more harm than the novel coronavirus.

False! Same as all medicines, you may have side effects after the vaccination. However, these side effects are usually mild and temporary, such as arm pain or mild fever. More serious side effects are possible but are extremely rare [2]. The most common symptoms of coronavirus disease 2019 include fever and dry cough. Complications such as respiratory distress, which may be accompanied by long-term effects, such as cognitive impairment and headache, are found in severe cases [16].

As shown in the chart below, the mortality rate is higher for unvaccinated patients than for those who have received any of the three doses of the COVID-19 vaccines [11]. Remember, vaccines are effective in preventing disease, and the serious harm caused by disease far outweighs the possible adverse effects of vaccination.

Table 2: Comparison of mortality rates among people with different vaccination status

（23） Vaccines will weaken the immune system.

False! Vaccines use the body's natural defense mechanism to build resistance to specific infections. They can help boost the immune system [2].

（24） Post-vaccination abnormalities are caused by the vaccines.

False! Some symptoms or diseases may occur by coincidence after administering the vaccines but they are not associated with the vaccines. Therefore, not all post-vaccination abnormalities are caused by the vaccines [2].

（25） Side effects of vaccination are many and serious, such as pulmonary nodules, myocarditis, etc.

False!

Pneumococcal vaccines

Pneumococcal vaccine has been proven to be safe. Common adverse reactions include mild pain and swelling at the injection site for a short time after vaccination, but most of these reactions subside spontaneously within two days. Some people may experience mild fatigue, fever, headache, muscle pain or chills. It is very rare to experience severe pain at the injection site or have difficulty in moving the arm being injected [5].

Inactivated influenza vaccines

• Inactivated influenza vaccines generally have no side effects other than pain, redness and swelling at the site of vaccination. Some people may experience fever, muscle aches, and fatigue within 6 to 12 hours after vaccination and these symptoms usually subside within two days. If the fever or discomfort persists, consult your doctor.
• Patients experiencing rare severe allergic reactions such as rash, swelling of the mouth and tongue, or breathing difficulty, must seek immediate medical attention. Some rare but serious adverse events may occur after influenza vaccination, such as Guillain-Barré syndrome (about one to two cases per one million vaccinated persons) and severe allergic reactions (nine cases per 10 million doses).
• There may not necessarily be a causal relationship between influenza vaccination and these adverse events. Studies have shown that the risk of Guillain-Barre Syndrome is much higher after influenza infections (17.20 cases per million infected persons) than after influenza vaccination (1.03 cases per million vaccinated persons).
• The most common side effects after receiving the live attenuated influenza vaccine include mild nasal congestion or runny nose, low-grade fever and sore throat. The safety of live attenuated influenza vaccines in pregnant women has not been confirmed. For children under 5 years old with recurrent wheezing or at any age who have asthma, their risk of wheezing may be increased after receiving the live attenuated influenza vaccine [17].

COVID-19 Vaccines

There are some cases of having rare side effects, but the percentage of having these side effects is less than 0.01%, and those cases can be cured with treatment. Very rare side effects include Bell's palsy, myocarditis or pericarditis, and no case of pulmonary nodules has been reported. Go to module 2 for more information on the side effects of COVID-19 vaccines.