Here’s who won’t get the COVID-19 vaccine in the first wave

The COVID-19 vaccine is now being dispensed nationwide (find out your coronavirus vaccine priority). For the vast majority of people, the COVID-19 vaccine from Pfizer and BioNTech has been demonstrated to be safe in large-scale clinical trials. As with any new drug, however, there’s also an abundant sense of caution — especially for people who have had adverse reactions to vaccines in the past. 

Experts have advised certain groups of people to take special precautions when receiving the coronavirus vaccine, such as remaining on-site for a period of time after getting the injection, to allow medical professionals to monitor any reactions. One doctor has also identified an even smaller number of people he says should hold off entirely on taking the vaccine; however, other experts disagree.

But what about pregnant or nursing mothers and people with run-of-the-mill allergies to things like pollen or pet hair? Patients with other medical conditions? For these groups and others, the Pfizer vaccine is considered safe to take, according to the US Food and Drug Administration, which authorized it on an emergency basis. Children, however, are a different story altogether (keep reading to find out why). 

Here, we compile available data from the FDA along with information from leading health experts to present a guide on who is advised to take the Pfizer COVID-19 vaccine and who should consult their medical professional before. Consult your physician with any questions about which type of COVID-19 vaccine may be right for you.

When will there be a COVID-19 vaccine for children?

Right now, Pfizer’s coronavirus vaccine is authorized for use in people aged 16 and older. That’s because, in part, of the several dozen COVID-19 vaccines under development, including Pfizer’s, none have yet been tested in children aged 12 and younger. Vaccines are typically tested first in adults before researchers begin tests in children, once the drug has been found to be relatively safe. 

Another factor is that COVID-19 seems to mostly spare children from the worst outcomes. A CDC report from September counted only 121 children among the 190,000 people who had died so far from coronavirus. Other research has found that children catch and spread coronavirus about half as much as adults, though they are still considered vectors in the spread of COVID-19, especially among high-risk populations. For example, a report from the CDC this summer highlighted a Georgia summer camp where coronavirus ran rampant, resulting in over 250 kids and young adults testing positive for it..

Moderna will begin pediatric clinical trials soon with kids aged 12 through 17, the company announced in early December. That’s a good sign. Moderna’s coronavirus vaccine is on the cusp of FDA authorization already, meaning children might have a COVID-19 vaccine option sooner rather than later if it’s shown to be just as safe and effective for minors.

Should people with allergies get the COVID-19 vaccine?

In the UK, on the first day of administering the Pfizer vaccine, doctors observed two patients who experienced  severe allergic reactions to the drug. Now British doctors are being told to  monitor patients for 15 minutes following administration of the vaccine to make sure they don’t have similar reactions. Two health care workers in Alaska had similar reactions, one of whom was hospitalized for two days of observation.

The FDA acknowledges that complications such as these are rare, but possible, and that some people might have an allergic reaction to Pfizer’s COVID-19 vaccine. The  agency’s fact sheet on the vaccine reads, in part, “A severe allergic reaction would usually occur within a few minutes to one hour after getting a dose of the Pfizer-BioNTech COVID-19 Vaccine.” It then lists several signs and symptoms of such an allergic reaction:

• Difficulty breathing
• Swelling of the face and throat
• A fast heartbeat
• A full-body rash 
• Dizziness and weakness

If you have a history of allergies, you can expect to be monitored for 15 to 30 minutes after receiving the vaccine.

The FDA also recommends you should not take the Pfizer vaccine if you’ve ever had a severe reaction to any of these ingredients:

• mRNA
• Lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate) 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide 1,2-Distearoyl-sn-glycero-3- phosphocholine, and cholesterol)
• Potassium chloride
• Monobasic potassium phosphate
• Sodium chloride
• Dibasic sodium phosphate dihydrate
• Sucrose

You might still be able to take the vaccine even if you’ve experienced allergic reactions in the past.

In its most up-to-date guidance, the Centers for Disease Control and Prevention echoes the FDA by indicating that just because you’ve had a severe allergic reaction to having been vaccinated in the past should not automatically stop you from being vaccinated against COVID-19. 

“These persons may still receive vaccination, but they should be counseled about the unknown risks of developing a severe allergic reaction and balance these risks against the benefits of vaccination,” the CDC said on its website. 

Can you take the vaccine if you’re pregnant or nursing?

If you’re pregnant or breastfeeding, the FDA leaves the decision over whether or not to take the COVID-19 vaccine to you and your doctor. Regulators in the UK have so far recommended against it until the vaccine can be tested on pregnant and nursing women (there have been no clinical trials for this group so far). Even though the vaccine has yet to be studied in nursing and pregnant women, many scientists believe the vaccine is generally safe and the  benefits outweigh any potential risks.

How will I be protected against COVID-19 if I can’t take a vaccine?

If you’re a patient with a health condition who is advised against getting a COVID-19 vaccine by your physician, you may have to wait until enough people have been vaccinated in the US to be protected yourself. Even if you yourself don’t take a vaccine, being surrounded by enough vaccinated people — what’s known as “herd immunity” — can provide a measure of protection against the coronavirus. But that takes time.

To usher that process along, the best thing you can do for now is to follow the CDC’s safety guidelines: always wear a mask whenever you’re indoors (except in your own home), always wear a mask in public, avoid large crowds and always maintain at least six feet of distance from people you don’t live with when you do go out. 

It’s going to take time before life returns to normal. To get a sense of how long, take a look at this timeline of when different groups will be able to take the COVID-19 vaccine. There will likely be several coronavirus vaccines rolling out over the next several months, and which one you’ll take will also help determine when you get to take it. Finally, here’s our updated list of places where you can get the vaccine.

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.