Are You High Risk? How to Prepare for Your COVID Vaccine Appointment
Now that people with underlying conditions are gaining access to the shot, here are some things to know about the process.
Are you still patiently (or not so patiently) waiting for your COVID shot? Most of us fall into this camp. The good news is that some states are beginning to open the rollout process to people with underlying health conditions. Places like New York, Massachusetts, and Texas have recently updated eligibility requirements to include people in high-risk groups under 65 years old. California announced it plans to follow suit on March 15. That means anyone with a health condition that makes them more susceptible to severe illness if they contract the virus can get the vax.
The guidance varies state by state, so check your local health department website to see whether you qualify where you live. If you’re eligible (which might make you cheer for the first time ever about having a chronic condition), it’s time to start figuring out the logistics of your vaccine appointment. Here’s what to expect and how to prepare.
What types of health conditions make someone eligible for the vaccine?
Since every state is different, your best bet is to confirm eligibility with a local vaccine provider. But in general, the Centers for Disease Control and Prevention (CDC) qualifies high-risk people as those with underlying medical conditions that increase the risk of serious complications from COVID-19. Purvi Parikh, M.D., pediatric allergist and immunologist at NYU Langone Health in New York City, lists out some of the major health conditions that experts agree fall into this category:
High blood pressure, hypertension, and other heart conditions
Respiratory illnesses like moderate-to-severe asthma or cystic fibrosis
Any condition or medication that compromises the immune system
“With any chronic illness, you’re at higher risk for getting infections,” Dr. Parikh says. Again, check with your local provider to confirm eligibility in your area.
What can I expect from the appointment process?
Some states are offering drive-by vaccinations to minimize person-to-person contact. Others are asking people to come into a clinic, hospital, pharmacy, or state-run facility to get the vaccine. “You check in, inform people of your medical conditions,” then get the shot, Dr. Parikh says. People with a history of allergic reactions to previous shots, injectables, or other medications who are concerned about having a potential allergic reaction will likely be asked to stay for 15 to 30 minutes afterward as a safety precaution.
Once you get your shot, you’ll receive an official COVID shot record card, which includes the date of vaccination as well as the date window for your second dose—if you're getting the Pfizer or Moderna vaccine because, remember, at this stage both of these FDA-approved vaccines are two-shot deals. If you receive Johnson & Johnson's single-dose vax, which was approved by the FDA for emergency use on February 27, congratulations! You're done.
Some places may require you to book an appointment online before you go in—and if New York’s online registration process is any indication, landing an appointment is a bit like competing in The Hunger Games—the most persistent and technically agile among us tend to win. So be prepared to be tenacious (and to hit the “refresh” button for available dates not once, but many times).
Still not getting anywhere? Some states are providing appointment hotlines, so you may find more success landing your coveted slot if you try calling instead. (Again, be patient—you could be on hold for awhile.)
What should I bring to my vaccine appointment?
When you arrive to your vax appointment, out of an abundance of caution, here’s what you’ll want to bring along with you:
A photo ID
Verification of your current home address (a utility bill should do), as some vaccine locations are open to specific zip codes only, and you may be asked to show proof of residence.
Proof of your medical eligibility, such as a doctor’s note confirming your health condition.
“In New York, they’re telling people to bring a letter saying what medical conditions they have and why they qualify,” Dr. Parikh says. “We’ve been giving letters to all of our patients who need it.” Some health departments have specified that they will not turn people away due to lack of documentation; others may accept your medical records as proof; or you may be asked to sign a legal affidavit instead, attesting that you are, indeed medically eligible.
After that first shot, what behavioral changes can I make (if any)?
Unfortunately, getting the vaccine is not a free pass to start living your life as if COVID didn’t exist. You’re not immune after only one shot—and that's true for all three of the FDA-approved vaccines, even J&J's single-dose vax, because it takes weeks for immunity to build. And even when you have it, there are still important reasons to proceed with caution.
“Behaviorally, you have to act exactly the same: You have to wear your mask, distance, and do frequent hand-washing,” Dr. Parikh says. According to the CDC, for both the Pfizer and Moderna vaccines, it takes two full weeks after the second shot for your body to develop that coveted 95% level of immunity. For the J & J vaccine, full efficacy to prevent moderate-to-severe illness is not achieved for 28 days.
On that note, you may have heard about recent reports saying how the Pfizer shot is 90% effective after 21 days following a single dose—and while this may be true, according to one study, efficacy was measured only in that short period of time. Unlike the double-dose regimen, no studies have yet been done on a single dose to know whether efficacy lasts beyond this limited timeframe—so, if you're getting either Pfizer's or Moderna's vax, be sure to get your second shot to fully protect yourself, especially if you have an underlying health condition.
Plus, it’s still not totally clear how well the vaccines prevent viral transmission—meaning you could potentially spread COVID to other people even after you’re vaccinated because you could have virus in your nasal passages, even if you show or feel no symptoms. “We know these shots will make you less sick and less likely to die from COVID-19, but we don’t know yet if they stop you from spreading it,” Dr. Parikh says. The only data available on this comes from AstraZeneca, which confirmed that its vaccine candidate can reduce transmission by up to 67% after the first dose. But it’s too early to know whether this is the case for all the available shots.
What behavioral changes can I make after the second shot (if any)?
Two weeks after your second shot of either the Pfizer or Moderna vax, you will be considered fully vaccinated against COVID-19. Until the pandemic is truly under control, the CDC recommends that vaccinated people follow the same precautionary guidelines in public settings: wearing masks, maintaining social distance, washing hands often, and avoiding poorly ventilated spaces.
There are a few important and notable caveats. On February 10, the CDC confirmed that fully vaccinated people do not have to quarantine if exposed to COVID-19 if they meet the following criteria:
More than two weeks out from the second shot
Within three months of receiving the second shot (to ensure your immunity is still strong)
Have been asymptomatic since exposure
If any of these things aren’t the case, you’ll still need to quarantine and get tested if needed. There's also new CDC guidance about how to gather with friends and family once you're vaccinated. See more below.
Once I’m fully vaccinated, can I get together with other people who also have received both shots?
One of the things that feels most promising about vaccination is the hope it offers for a return to normal life. On March 8, the CDC released new guidance for fully vaccinated people (that's anyone two weeks out from their second mRNA vaccine or four weeks out from the single-dose J&J vax). Here's what you can do differently once your body has developed vaccine-induced immunity:
You can gather indoors with other fully vaccinated people without wearing masks.
You can gather indoors with unvaccinated people from one other household without wearing masks, unless any of those people have elevated risk for severe COVID-19.
This is thrilling news! (Can you even remember what it was like to socialize without masks?) Still, keep in mind that every choice carries some level of risk. “It is important to understand that none of the vaccines which have the FDA EUA are 100% effective,” says Rashid Chotani, M.D. medical director and senior scientist at IEM in Morrisville, NC. The CDC may have given the green light on maskless gatherings for fully vaccinated people, but Dr. Chotani urges that “caution and prevention are still important" while we're neck-deep in this pandemic. Make sure you're following this guidance as closely as possible and monitoring yourself and your loved ones for symptoms of COVID-19. If you have any suspicion that you might be sick, call off the gathering.
One day, months from now, when we’ve achieved herd immunity as a country, we'll be able to socialize more freely—but for now, you’re still safest in your quarantine bubble or with others who have gotten the shot. Still, vaccination is a huge step forward in our fight against the pandemic. It means there's a future beyond this, and we’re closer now than ever to being able to live like the old times again.
- Vaccine Rollout Recommendations: Centers for Disease Control and Prevention. (2021). “Vaccine Rollout Recommendations.” cdc.gov/coronavirus/2019-ncov/vaccines/recommendations.html
- COVID Vaccine Immunity: Centers for Disease Control and Prevention. (2021). “Myths & Facts.” cdc.gov/coronavirus/2019-ncov/vaccines/facts.html
- AstraZeneca Transmission Protection: AstraZeneca. (2021). “COVID-19 Vaccine AstraZeneca confirms 100% protection against severe disease, hospitalisation and death in the primary analysis of Phase III trials.” astrazeneca.com/media-centre/press-releases/2021/covid-19-vaccine-astrazeneca-confirms-protection-against-severe-disease-hospitalisation-and-death-in-the-primary-analysis-of-phase-iii-trials.html
- CDC Quarantine Updates: Centers for Disease Control and Prevention. (2021). “Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States.” cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
- FDA EUA: Food and Drug Administration. (2021). “FDA Issues Emergency Use Authorization for Third COVID-19 Vaccine.” fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-third-covid-19-vaccine
- J&J Efficacy Data: Johnson & Johnson. (2021). “Johnson & Johnson Announces Single-Shot Janssen COVID-19 Vaccine Candidate Met Primary Endpoints in Interim Analysis of its Phase 3 ENSEMBLE Trial.” jnj.com/johnson-johnson-announces-single-shot-janssen-covid-19-vaccine-candidate-met-primary-endpoints-in-interim-analysis-of-its-phase-3-ensemble-trial
- J&J Distribution Plan: Johnson & Johnson. (2021). “Johnson & Johnson Announces Submission of Application to the U.S. FDA for Emergency Use Authorization of its Investigational Single-Shot Janssen COVID-19 Vaccine Candidate.” jnj.com/johnson-johnson-announces-submission-of-application-to-the-u-s-fda-for-emergency-use-authorization-of-its-investigational-single-shot-janssen-covid-19-vaccine-candidate