When Can You Get the COVID-19 Vaccine?

As much of the world's population waits to be immunized, U.S. agencies have expanded eligibility to every American age 12 and up.

by Sarah Ellis Health Writer

Spring is finally here, and so are the long-awaited COVID-19 vaccines. Three of them, in fact, have been approved for emergency use. And while supply is beginning to exceed demand in some states due to lingering vaccine hesitancy (after a Hunger Games-like start to the rollout), more than 264 million doses of the vax have been administered across the U.S. And, as of May 12, all Americans ages 12 and over are officially eligible to receive their shot.

About the three vaccines: Back in December, the FDA granted emergency-use approval to both Pfizer’s and Moderna's candidates, giving them the official green light for distribution in the U.S. Both vaccines deploy a new scientific approach, the use of messenger RNA, or mRNA.

The third vaccine by Johnson & Johnson was approved on February 27, 2021. This vaccine uses a different type of technology from Pfizer's and Moderna's shots; it’s an adenovirus viral vector vaccine, delivered in a single dose (meaning your appointment process is one-and-done. Yay!). After a brief "pause" of the J&J vax in April, ordered by the CDC and FDA to review six reported U.S. cases of a rare type of blood-clotting following receipt of the vaccine, the agencies gave the go-ahead to make the vaccine available again, just with the warning that women 50 and under may be at higher risk for this rare complication.

So, there's finally some light at the end of a pretty dark tunnel. And as of mid-May, we have yet another reason to celebrate: Pfizer's vaccine has received official clearance from the FDA and CDC for use in children ages 12 to 15. Adolescent vaccinations are already beginning across the country, putting us one step closer to gettings all U.S. kids safely back into schools this fall.

And, with the Biden administration procuring 300 million doses from Pfizer, 300 million from Moderna, and 200 from Johnson & Johnson, there are vaccines for every eligible person who wants one in this country.

Even so, “it's going to take a while to digest everything that has happened, but we will never think about pathogens and viruses the same way,” says Thomas Hope, Ph.D., professor of cell and developmental biology at Northwestern University Feinberg School of Medicine in Chicago.

Based on allocation recommendations from the CDC’s Advisory Committee on Immunization Practices and the National Academies of Sciences, Engineering, & Medicine, this is how the U.S. rollout has gone so far:

See where you fall on the priority list:

  • Front-line Healthcare Workers

    In the early days of vaccination, healthcare workers became the first group to get access. Considering their constant proximity to infected people, it makes a lot of sense. “We know that multiple exposures equate to a higher risk, thus healthcare workers are at the highest risk for contracting the virus,” says Rashid Chotani, M.D., medical director and senior scientist at Innovative Emergency Management (IEM) in Morrisville, NC. “We want all the healthcare workers safe and healthy so they can take care of the sick.”

  • Elderly Adults Living in Long-term Care Facilities

    That brings us to the second group at highest priority—those living in nursing homes or other long-term care facilities. “That captures a population that has a lot of comorbidities, is elderly, and checks all the boxes for those at highest risk for severe consequences,” Hope says.

  • Elderly Adults Living at Home

Elderly adults (aged 65+, although some states, including New York, phased in adults aged 75+ first) living independently were next in line.

  • Essential Workers

    Plenty of people, from USPS workers to K-12 teachers, are putting themselves at risk every day to keep our society functioning. Those people became eligible early on in many states, although the specifics of who went first really depended on where you live. Some states gave priority to “older individuals and individuals with comorbidities” who work outside the home.

  • Those With Pre-Existing Health Conditions

People of any age who have pre-existing medical conditions that put them at high risk for COVID complications came next.

  • Adults (16 and Over) at Average Risk

    On April 19, the Biden administration announced that all Americans 16 and over were eligible to get the COVID vaccine. (It should be noted: the Moderna and J&J vaccines are available only those who are 18 and up.) The hope is that all U.S. adults can get vaccinated by the summer of 2021. “In order to develop herd immunity, 70% of the population must either get vaccine-induced or natural immunity,” Dr. Chotani says. “It will not make any difference which vaccine is available—the objective is to have 70% herd immunity to significantly decrease the spread of the disease.”

  • Kids Ages 12 to 15

On May 12, the CDC officially endorsed the safety and effectiveness of the Pfizer vaccine in adolescents ages 12 to 15. This came two days after the FDA issued an emergency use authorization for this population. In a clinical trial of 2,260 patients, Pfizer found that its vaccine had 100% efficacy in preventing symptomatic disease for this age group, with similar side effects to people 16 and older. Vaccinations of this group are now underway.

For now, there are still several groups of people who aren’t eligible to receive the COVID-19 vaccine. We won’t know where they fall in the rollout (or if they’ll get vaccinated at all) for another month or two.

Those who can't or shouldn't get the vaccine yet include:

  • Children Under 12

    Children are generally considered to be at lower risk of COVID complications than adults, barring any serious comorbidities, so they are not the first priority to get the shot. But they’ll still need to be vaccinated for their safety and to prevent them spreading the virus to family members or teachers. (School-age kids, especially younger school-aged children, have been shown to transmit COVID to adults, even when they have few or no noticeable symptoms.) It is standard procedure not to test vaccines in children until the shots have been shown to be safe and effective in thousands of adults first. As such, Pfizer didn’t initially enroll children in the vaccine trials; they only started testing the vax on children 12 and older in October 2020 after the FDA gave them the OK to do so. Pfizer's vaccine is now being offered to children ages 12 to 15, and Moderna and J&J are testing their vaccines in this population. (For now, Moderna and J&J's vaccines are only approved for adults 18 and older.) Unfortunately, most experts don’t expect the vaccines to be available for kids under 12 before the start of the 2021-22 school year.

  • People With Severe Allergies to Ingredients in the Vaccine

    The CDC recommends that those who have had an anaphylactic (a.k.a. a severe, potentially life-threatening allergic) reaction to their first dose of the COVID vaccine should not proceed with a second dose. Those with known allergies to any ingredients in one of the three vaccines should not be vaccinated at all, at least until more is known. To be clear, anaphylaxis is an extreme and, as of now, highly unusual reaction to the vax, involving a drop in blood pressure, weak pulse, and difficulty breathing. This does not refer to people getting COVID-like side effects after being vaccinated. Getting a fever, headache, and/or chills that last one to three days it means your immune system is working how it’s supposed to by building immunity that will protect you from serious COVID infection (although for how long remains a big question). “The point of the vaccine is to mimic the consequences of infection without the worst of the symptoms and other problems,” Hope says.

The Pfizer vaccine ingredients include:

  • mRNA, aka “messenger RNA,” which are molecules that give instructions to the body about how to build proteins to trigger a protective immune response

  • Lipids to help encase and protect the mRNA molecules

  • Potassium chloride

  • Monobasic potassium

  • Phosphate

  • Sodium chloride

  • Dibasic sodium phosphate dihydrate

  • Sucrose

The Moderna vaccine ingredients include:

  • mRNA, aka “messenger RNA,” which are molecules that give instructions to the body about how to build proteins to trigger a protective immune response

  • Lipids to help encase and protect the mRNA molecules

  • Tromethamine

  • Tromethamine hydrochloride

  • Acetic acid

  • Sodium acetate trihydrate

  • Sucrose

It’s important to stress how rare it is to have an allergic reaction to a vaccine like this. Here in the U.S., there have been 21 confirmed cases of anaphylaxis after receipt of Pfizer's COVID vaccine, 17 of which happened in people with a documented history of severe allergic reactions. As of late January 2021, there have been 10 confirmed cases of anaphylaxsis to the Moderna vaccine. Remember, thousands of people enrolled in clinical trials for all three approved vaccines were fine. Talk to your doctor if you’re concerned.

As for the Johnson & Johnson and AstraZeneca vaccines, these vaccines do NOT use mRNA tehnology. Instead, they inject a harmless, specific virus designed to help the body recognize the spike protein for COVID-19, using a technology that has been used before in previous vaccines. Neither of these vaccines contain polyethylene glycol (PEG), which some experts suspect may be triggering allergic responses in some people.

The J&J vaccine ingredients include:

  • adenovirus vector encoding an inactivated variant of the SARS-CoV-2 spike protein

  • Polysorbate-80

  • 2-hydroxypropyl-β-cyclodextrin

  • Citric acid monohydrate

  • Trisodium citrate dihydrate

  • Sodium chloride

  • Ethanol

Finally, there are the groups of people that experts still have questions about, but who may choose to receive the vaccine on an individual basis.

Those who should speak to their doctor before considering vaccination include:

  • Pregnant Women

    CDC guidance says that pregnant women may opt to receive the COVID vaccine if they wish, but they may want to talk to their doctors first. This group was excluded from the original clinical trials, so the data on COVID vaccines and pregnancy is still limited. But what we know so far looks promising: On March 29, a new study in the American Journal of Obstetrics and Gynecology found that the Pfizer and Moderna vaccines are safe and effective in pregnant women. The FDA has asked that Pfizer-BioNTech and Moderna release data on pregnant women as soon as it becomes available, and Pfizer-BioNTech is currently conducting a trial of its vaccine in healthy pregnant women 18 and older. For now, it’s up to each woman and her doctor to decide whether to get the vaccine.

  • Immunocompromised People

    This is another population that hasn’t been included in clinical trials—which is unfortunate, because immunocompromised people are among the highest-risk groups for serious COVID complications. Researchers hope to know more about the safety of the vaccine for this group within a few months. Because they weren’t included in the first round of studies, we don’t have much data yet on how well the vax will work, or if increased risks are involved. However, the theory is that because mRNA vaccines do not contain live or weakened virus, they should be safer than some traditional vaccines. But again, it’s not proven yet. So where does that leave you? With a need to have a conversation with your MD. Touch base with your doctor to get his or her advice on the potential risks and benefits for you, depending on your potential exposure to COVID. (In its vaccine fact sheet, Pfizer suggests talking to your doctor if you have an autoimmune disease and/or are on immunosuppressant medications.)

As for access, Brandon Brown, Ph.D., associate professor at the Center for Healthy Communities at the University of California Riverside School of Medicine, hopes the COVID vaccine will be available at no cost to the recipient. So far, that has been the case. “Health insurance should not be a factor in deciding who gets vaccine,” Brown says. COVID vaccines purchased by the U.S. government will be free, but once those run out, the manufacturer could theoretically charge consumers for vaccines they sell privately.

Brown also notes the importance of making it available to people in jails and prisons. “We must not forget about people who are incarcerated,” he says, “as they are at very high risk for COVID-19 due to their placement in close quarters and lack of resources.” Ultimately, the most important thing will be to prioritize the groups who need a vaccine most due to their likelihood of infection.

So, how long until everyone in the U.S. is vaccinated?

That’s the million-dollar question, and we still don’t have a clear answer. Dr. Chotani estimates that by winter of 2021, life will return to something closer to normal—provided the manufacturing and rollout process goes smoothly. Hope’s guess is a little sooner—maybe even by later this summer.

Still, we’re taking the wins where we can get them these days. And having developed several effective and officially approved COVID-19 vaccines in a year (with more potentially on the way) is a magnificent feat of science. We can’t wait until each one of us gets our turn.

Get the Full Story on COVID-19
Go!
Sarah Ellis
Meet Our Writer
Sarah Ellis

Sarah Ellis is a wellness and culture writer who covers everything from contraceptive access to chronic health conditions to fitness trends. She is originally from Nashville, Tennessee and currently resides in NYC. She has written for Elite Daily, Greatist, mindbodygreen and others. When she’s not writing, Sarah loves distance running, vegan food, and getting the most out of her library card.