Your Questions, Answered:
Who will be first? | Can I get a vaccine now? | Where can I find a vaccine? |How many shots will I need? | How much is it? | Are there side effects? | Should I speak to my doctor?
December has brought record-day highs of novel coronavirus deaths and cases here in the United States. But the nation's top medical officials have taken steps towards rolling out a much-needed vaccine to stem the outbreak. Earlier this month, officials at the Food and Drug Administration (FDA) authorized pharmaceutical manufacturer Pfizer to roll out its newly created vaccine for emergency use. The shot is being administered to healthcare workers and public officials this month after the FDA said that the "totality of the available data provides clear evidence" that the vaccine "may be effective in preventing COVID-19."
While new information is being released daily about the upcoming distribution of millions of doses of vaccine, one thing is certain — some Americans will receive a shot before others. And the general public probably won't be able to walk into a local clinic, pharmacy, or hospital for a COVID-19 vaccine well into 2021. Many hope that Dr. Anthony Fauci, of the White House Coronavirus Task Force, is right about one of his latest estimates: "By the time we get to April, we would likely have taken care of all the high priority and then the general population… can walk into a CVS or to a Walgreens and get vaccinated," he said during a public interview in late November.
There are likely to be two (or more!) vaccines available to the public when spring rolls around, however. In the same interview, Dr. Fauci told the public that the federal government has contracted with multiple companies to make more than 600 million doses of the vaccine, as it looks like each American will need to receive two shots over the course of multiple weeks. But the New York Times reports that U.S. officials have only purchased 100 million doses from Pfizer, and have purchased other vaccines from companies like Moderna, which is trailing behind Pfizer in the FDA approval process (as well as AstraZeneca and Johnson & Johnson, who are even further behind).
Much remains to be seen about all of the vaccines that may end up available to the American public, but the FDA's approval of the Pfizer product has revealed a few key details. A 53-page FDA report suggests that Pfizer's vaccine offers some protection against severe COVID-19 symptoms after just one shot, and could be upwards of 95% effective when two doses are administered. And other vaccine candidates are showing similar results: You can view the progress of each developing vaccine (and trial results) in an illustrated guide by the New York Times.
But with the government rolling out vaccines to some individuals earlier, you might be wondering when it'll be your turn to get a vaccine — and how you can secure one earlier if you're eligible. Some of this information is covered by officials at the Centers for Disease Control and Prevention (CDC), but most insight is coming from experts who have experience in medical regulations. Below, a pair of leading infectious disease experts with experience in federal and international affairs share how much the vaccine will cost, what the vaccine will be like, and who will be first in line to receive it. Plus, we're sharing a list of retailers who will offer it in your area.
Much of this information may be found within questions answered by CDC officials. As more information about the upcoming COVID-19 vaccine is released, some of the details in this report may have changed since it was last updated. You can find up-to-date information on vaccines by visiting online resources published by the CDC and the World Health Organization, as well as consulting your local public health department.
Federal officials are working with states to put out guidelines on who should receive a vaccine first — and the priority list may differ between regions. Robert Amler, M.D., former CDC officer and U.S. Health and Human Services regional administrator currently serving as vice president for government affairs at New York Medical College, says state officials will largely decide where the vaccine is deployed first. Here's how priority may play out in most states, according to Dr. Amler:
A preliminary report drafted by Johns Hopkins University suggests that the distribution of vaccines could end up being phased in in stages. Phase 1 would include frontline workers and first responders, as well as those at higher risk for severe symptoms. Phase 2 would include critical workers, like teachers and staff at educational institutions, and those at elevated risks, including the homeless, imprisoned, or other older adults not included in Phase 1.
Phase 3 would potentially push out vaccines to children and young adults (more on that later), and Phase 4 would be a general roll out to the public. "Although the framework does not specifically identify racial or ethnic groups, there is recognition of the disproportionate impact of COVID-19 in African-American and Latinx communities due to systemic racism that yields higher rates of underlying diseases, living conditions that contribute to disease risk, and greater employment as essential workers," the report concludes.
Depending on where you fall into the categories above, you may be wondering if you're eligible to get a vaccine before others. The good news is that you won't have to do any extra work to get access to an early vaccine if you are meant to have it, Dr. Amler explains. Since the federal government is working to distribute vaccines to states based on their need, local county and city health boards will end up distributing vaccines to hospitals, clinics, and larger medical practices, which may already have a list of patients who would benefit from an early vaccine. In this case, you'll hear directly from your care provider that a vaccine is being made available to you before others.
But not everyone has a care provider, and the government doesn't know of each and every condition that all Americans have, which is why Dr. Amler says you'll see lots of advertising and educational material about the vaccine soon. "This material can alert people to the fact that they may be eligible to get a vaccine sooner," he explains. Many, many efforts are underway to attempt to convince more Americans to sign up for a vaccine, as anywhere between 40 and 65% surveyed said they have doubts about getting a shot, according to data compiled by the Pew Research Center. Notable leaders and celebrities are already committing to receiving vaccines, some publicly — former Presidents Barack Obama, Bill Clinton, and George W. Bush will publicize their vaccinations, per CNN.
If you don't already have an existing relationship with a healthcare provider, you can try reaching out to your area's local health department in the new year to inquire about receiving a vaccine due to an underlying condition. But it'll likely be easier to seek out a vaccine from a primary care doctor, as their institutions could be quicker in getting you in line for an early vaccine if they determine you qualify for one.
Not sure if you should ask about an early vaccination? The New York Times has put together an illustrated guide to estimating your need for a vaccine compared to others in your local county.
Early reports from the FDA suggest that most vaccines will require two different doses, with what's known as a "booster" shot being administered weeks apart (for Pfizer products, it'll be three weeks). Dr. Amler explains that consumers likely won't have a choice in selecting where their vaccine is coming from in early 2021, but that they'll need to receive two of the same vaccines; "You won't be able to get a Pfizer shot first and then a Moderna shot three weeks later," he says.
It's crucial that both doses are administered in order to offer the most protection. And even if you do successfully receive the entire vaccine, it doesn't mean you can stop practicing social distancing or wearing a mask just yet. Believe it or not, it could be months, or an entire season, before the vaccine stems the spread of COVID-19, says Bojana Berić-Stojšić, M.D., Ph.D., CHES, an ambassador for the United Nations' Society for Public Health Education and director of the master of the public health program at Fairleigh Dickinson University. "It will take some time for the mRNA vaccine to immunize enough people to reach what we know as 'herd immunity,' that would help stop the spread of the virus, locally and globally," Dr. Berić-Stojšić shares.
As of now, though, a rather large question remains unanswered — whether or not we'll need to receive a new coronavirus vaccine annually, periodically, or if one vaccine will be enough for our entire lifespan. "Right now, the length of the immunity protection in the mRNA vaccine is unknown. It could be through our lifetime, but it may be a shorter period of protection, like the flu vaccine," she adds. Like vaccines for pneumonia or tetanus, it's more likely that we will need to be vaccinated again at some point.
Both Dr. Amler and Dr. Berić-Stojšić say that state health departments are finalizing plans for making the vaccine available to the public. Primarily, however, the vaccine will be available at hospitals and pharmacy clinics, and in some cases, even clinics embedded in places like shopping malls and grocery stores.
In an interview with NBC, CEO of CVS Health Larry Merlo said that all of the company's pharmacies will make the COVID-19 vaccine available when they have approval from the federal government. And in some cases, local clinics in your area may directly receive their supply of vaccines from pharmacies like CVS: Merlo said upwards of 31,000 different long-term care facilities have already asked for the pharmacy's help. Similar to getting your flu shot, you'll need to schedule an appointment to receive the vaccine, and clinicians will be reminding you of a next visit. "We'll prompt them as they schedule their first vaccine to also schedule that booster, and much like we do today with refill reminders so that you stay current to your medications, we'll be providing an awful lot of friendly nudges so that you don't miss that first appointment and, equally important, that second appointment."
The Department of Health and Human Services has already announced a partnership with a string of national chains (some pharmacies, others retailers outright) that will carry the vaccine. Here's every pharmacy, clinic, and retailer where you may be able to receive a COVID-19 vaccine, with more information on where you can learn more information or make an appointment:
Per an NBC News analysis, around 99% of Americans live within 50 miles of these places — but another 20% of the population will need to travel at least five miles. If you're a resident of Alaska, Hawaii, California, Arizona, or Montana who doesn't have access to these chains within 50 miles (approximately 700,000 do not), you may seek a vaccine from your direct primary care provider or a hospital or clinic in your area if it's closer.
The short answer: It will be free. "Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost," the CDC shares.
But some vaccine providers may charge a nominal fee for their services, which should be made clear to you before you make an appointment. "Over the decades, if there was free vaccine being sent out to private doctor's offices, or private clinic, or even public clinics, the providers — although the vaccine charge was zero — were allowed to charge a nominal fee," Dr. Amler explains. "It's for the cost of providing the vaccine… putting an alcohol swab on your arm, and so forth."
First things first: If you have concerns about the safety of this brand new vaccine, that is totally normal. "You should ask as many questions as you need to, to being to get [your] arms around the benefit and the risk of the vaccine; the very large benefit, and the small, small risk," Dr. Amler says. "The risk has to be way below the benefit of a vaccine to be recommended. And that's why these final reviews are in place this very month, to make sure that we have the right product going out there."
In approving the vaccine for emergency use, officials at the FDA shared that their review of Pfizer's product didn't reveal any serious risks for the public. In a statement, officials shared that "potential benefits outweigh the known and potential risks" and that "a thorough evaluation of the available safety, effectiveness, and manufacturing quality" was completed before the product earned approval.
Recent headlines drew attention to the possibility of an impact on those with allergies, as officials in the United Kingdom report two healthcare workers — who had previously established allergies and carry adrenaline auto-injectors currently — had allergic reactions to Pfizer's vaccine. According to CNN, these individuals reported symptoms like breathlessness and skin rash, consistent with an "anaphylactoid reaction." Both individuals have since recovered, but the incident is a good reminder that (as with most vaccines) anyone with allergies should discuss a new shot with their doctor first.
In an interview with CNN, current FDA Commissioner Stephen Hahn told the public that vaccine administrators will be instructed to have emergency medication on-site if someone develops an immediate allergic reaction to the vaccine. But healthcare providers will also be aware of any common allergens found within the vaccine they are administering, and should notify their patients ahead of time of any possible complications.
Even if you are itching for a shot, it wouldn't be a bad idea to let your doctor know you're planning to get one ASAP, Dr. Berić-Stojšić says. There may be other health factors that may require a special follow up with care providers beyond allergies, and transparency is best.
There are a couple of groups of people who should not receive the vaccine without speaking to their primary care provider first. Dr. Berić-Stojšić explains the risk to both of these groups: