Who gets the COVID vaccine first? CDC priority and everything else we know

Huge developments in the effort to create a COVID-19 vaccine mean the first group of people is on track to receive vaccinations against the coronavirus before the end of the year. On Wednesday, the UK approved Pfizer’s vaccination for use, and the US is expected to follow suit. Moderna has also sought emergency FDA approval for its first doses of a similar type of vaccine.

The question is, who will get those first doses of vaccines and how long will you yourself have to wait to get vaccinated? Despite government efforts to beef up the supply of vaccine doses, simple math shows the size of the challenge. There are over 330 million people in the US, but Pfizer says it expects to send the US 25 million doses, or enough to vaccinate about 12.5 million Americans, by the end of 2020 (two per person because you’ll need a booster shot). That’s roughly the populations of New York City and Los Angeles combined.

Moderna says it will be able to make about 15 million vaccine doses at first, which can treat 7.5 million people (again, a series of two shots per person). The unfortunate reality is that most people in the US will have to wait several months at least before they might have access to a coronavirus vaccine. Worse still, it could be a matter of years before everyone in the world can get vaccinated against COVID-19.

The answers as to who gets a priority immunization are becoming a little less hazy, but they’re far from definitive. Here’s what we know of the coronavirus vaccine rollout so far, as well as where you might fall in the priority list. And here’s how much you might expect to pay for your COVID-19 vaccine.

This article was updated recently with new information, and is intended to be a general overview and not a source of medical advice.

First priority group? Frontline health care workers, nursing home residents and employees

Frontline health care workers who are particularly at risk of being exposed to coronavirus — like roughly 20 million US doctors, nurses, lab technicians, EMT and hospital staff — have long been at the top of the US priority list. Now that’s nearly official. 

An independent advisory panel that reports to the Centers for Disease Control and Prevention officially recommended on Dec. 1 that medical and emergency workers who are at the highest extended daily risk of acquiring COVID-19 should be first in line for a vaccine.

The panel also recommended that employees and residents of long-term care facilities — more or less, nursing homes — should also be part of the first batch of inoculations. 

The director of the CDC, Dr. Robert Redfield, could decide as soon as this week whether to adopt the Advisory Committee on Immunization Practices’ decision as the agency’s formal guidance. Ultimately, the decision on who gets first dibs on a COVID-19 vaccine belongs to state governors in consultation with their own public health experts, but states typically follow CDC guidelines, the New York Times reported.

Next in line: Essential workers, people with medical conditions, older adults

When the CDC advisory panel, ACIP, met last month in preparation for this week’s vote, it identified a handful of other groups that committee members believed should get priority access to coronavirus vaccines while supplies remain limited.

Essential workers: Approximately 87 million US workers provide the basic goods and services we need to survive. Most can’t work from home and many jobs require interacting with the public, so guarding against COVID-19 among this population would have a ripple effect across the whole country while also reducing critical service interruptions.

People with underlying medical conditions: Specifically, the 100 million or so people with conditions putting them at high risk for illness or death from COVID-19. Any disease affecting the lungs, but also anything that could compromise a person’s immune system, like cancer or HIV, would be included. 

Older adults: It’s widely accepted that risk of severe complications from COVID-19 increases with age. The ACIP recommends the approximately 53 million US adults age 65 and over be among the first to get vaccinated. 

What if I’m not in any of those groups?

The reality is that you should expect to wait. The top US infectious disease expert, Dr. Anthony Fauci, told Good Morning America in November that he expects “the ordinary citizen” should be able to get a vaccine by April, May or June 2021. 

In the interim, you’re still expected to adhere to pandemic safety practices like universal masking, avoiding crowds, maintaining social distancing and washing our hands even more than usual. That includes everyone; vaccinated and nonvaccinated alike (keep reading for more on what to expect).

When will the first COVID-19 vaccines be given? Will there be more than one?

Short answer: The first vaccine is expected soon and it looks like there will be more than one safe, effective type. Pfizer, which says its vaccine candidate is 95% effective at preventing coronavirus infections, is expected to produce the first COVID-19 vaccine to receive Food and Drug Administration authorization in the coming weeks. The company has already started shipping doses across the US.

Moderna isn’t far behind with its reportedly 94% effective vaccine. Moderna is expected to receive FDA authorization sometime in December as well. Other vaccines from AstraZeneca and Johnson & Johnson are wrapping up late-stage trials, as well, while a fifth manufacturer, Novavax, is set to begin the final trial for its vaccine sometime this year.

The general consensus has been — and continues to be — that although the first COVID-19 vaccines will probably be approved in the US in a matter of days and weeks, they won’t reach widespread distribution until sometime in 2021. Until then, supplies are expected to be limited, which is partially why we will need multiple vaccines so that as many people can be treated as possible.

How soon after approval will vaccinations start?

“[The government] has plans to distribute vaccines within 24 hours after the ACIP gives its final approval,” Paul Mango, a US Department of Health and Human Services official, told reporters in October, referring to the CDC’s Advisory Committee on Immunization Practices, which is the group that officially sets national guidelines for who should get vaccines once they’ve been authorized by the FDA.

If vaccines are right around the corner, how soon can we resume normal life?

Infection rates in the US are skyrocketing, with the seven-day rolling average now over 150,000 new infections per day. Much of Europe has been locked down since early November. One of the key advisors on President-elect Joe Biden’s COVID-19 task force, Dr. Michael Osterholm, has recommended a nationwide lockdown in the US for four to six weeks to help contain the rapidly spreading virus, although President Donald Trump said in November there would be no lockdown under his administration. 

In other words, we’re not out of the woods yet, especially as we get closer to winter, when coronavirus-related deaths are expected to continue surging. Experts agree that people who leave their households will need to continue to wear masks, avoid crowds, maintain social distancing and practice regular hand-washing until further notice.

Shouldn’t the most vulnerable get the first priority?

Prior to 2009, older adults and patients with underlying health conditions typically topped lists of those who should get first dibs on a new vaccine because, for them, getting sick was more likely to be fatal. However, that line of reasoning began to shift after a 2009 paper published in the journal Science suggested that health officials dealing with a limited vaccine supply could prevent far more people from getting sick and dying by vaccinating those who were most likely to transmit a given disease, rather than those at risk of getting the sickest.

That paper specifically addressed H1N1 — aka the swine flu — and generally dealt with seasonal influenza. In it, researchers identified the biggest demographic of flu spreaders as children aged 5 through 19. That’s why the CDC now advises everyone aged 6 months and older to get a yearly flu vaccine. In the case of COVID-19, experts have identified health care workers on the front lines as the group most likely to catch and therefore spread the disease, which is why they will be among the first to receive vaccinations. 

Whether or not COVID-19 vaccines are effective at stopping the spread of the coronavirus will depend a lot on how our bodies build immunity to the disease. Here’s what we know so far about whether you can get COVID-19 more than once. Testing is also key to slowing the coronavirus’ spread — learn about a device that can produce COVID-19 test results in under 90 minutes. And read up on how all of these issues and more affect Biden’s plan to fight COVID-19.

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The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.