This section is an ongoing compilation of tough questions related to COVID-19, with suggested answers. Many of these topics are sensitive and often politicized. The document is designed to provide message guidance and framing for public health officials and others, and it is regularly updated to reflect new developments and emerging issues.

Vaccine Booster Doses

The vaccines work. The COVID-19 vaccines continue to be remarkably effective in reducing risk of severe disease, hospitalization, and death, including against the delta variant. We continue to see highly effective protection against hospitalizations and severe outcomes for people who are fully vaccinated.

Booster doses are now recommended for some groups of people. After the FDA approved Pfizer booster shots for some groups of people, the CDC made recommendations on who should receive booster doses. The CDC recommends Pfizer boosters six months after their second dose for:

  • older adults age 65+
  • adults age 50-64 at high risk of severe COVID-19 due to underlying medical conditions
  • adults age 18-64 for people whose jobs put them at high risk for COVID-19

The CDC also recommends that younger adults age 18-49 with underlying medical conditions that put them at severe COVID-19 assess individual risks and benefits and consider getting a booster. These developments are in addition to CDC’s recommendation that immunocompromised people get an additional dose of the Pfizer or Moderna vaccine.

As the science and the virus evolves, so do our policies and recommendations. Booster doses are common for many vaccines. The scientists and medical experts who developed the COVID-19 vaccines continue to closely watch for signs of waning immunity, how well the vaccines protect against new mutations of the virus, and how that data differs across age groups and risk factors. In addition to the current action on the Pfizer vaccine booster dose, FDA and CDC experts continue to review the latest evidence on whether a booster dose will be appropriate for all people under 65 who received the Pfizer vaccine and for people who received the Moderna and Johnson & Johnson vaccines.

Millions of Americans are now eligible for booster shots, but there’s more guidance coming for others. Scientists and medical experts at the FDA and CDC are reviewing data about booster doses for each COVID-19 vaccine separately, and recommendations may be issued at different times. For example, the latest updates about booster doses for older Americans apply only to those who received the Pfizer vaccine. Pfizer was the first vaccine to be authorized, and therefore its data on its ongoing effectiveness was also available first. Guidance is still forthcoming about boosters for the Johnson & Johnson and Moderna vaccines and the safety of mixing different vaccines.

Updated September 24, 2021

Booster doses are common for many vaccines. Scientists and medical experts have been closely analyzing the data from the U.S. and around the world, data that is beginning to show that, absent a booster shot, protection against COVID-19 infection may decline over time after vaccination. The COVID-19 vaccines continue to be remarkably effective in reducing risk of severe disease, hospitalization, and death, including against the delta variant.

On September 23, based on this data and the recommendation of experts and following FDA authorization of Pfizer boosters for some people, CDC recommended Pfizer booster shots for some groups of people who received this vaccine:

  • Older adults, age 65 and over and those living in long-term care facilities
  • Adults ages 50-64 at high risk of severe COVID-19, due to underlying medical conditions such as cancer, chronic lung disease, diabetes, and heart conditions, among others
  • Adults ages 18-49 at high risk of severe COVID-19 due to underlying medical conditions should consider a booster based on an assessment of their individual benefits and risks and consultation with their medical provider.
  • Adults age 18-64 for people whose jobs put them at high risk for COVID-19, including healthcare workers, teachers, daycare staff, grocery workers, and other essential workers, along with people in shelters and prisons

The single booster should be administered at least six months after the second Pfizer dose of the primary two-dose series.

The CDC did not recommend booster shots for other recipients of the Pfizer vaccine, nor for recipients of the Moderna or Johnson & Johnson vaccines. The Pfizer vaccine was the first COVID-19 vaccine to be authorized in the U.S., so its data about booster doses were the first to be available. Similar analyses and recommendations will be made as the data for the other vaccines become available. 

Prior to the FDA’s decision and CDC’s recommendations on boosters, the U.S. Department of Health and Human Services (HHS) began developing a plan to offer eligible people booster doses pending agency approval and CDC recommendations. HHS, state and local health departments, vaccine distributors, and providers are continuing to coordinate to administer booster doses to eligible people. If you have questions about your booster dose eligibility, or how, where, and when you can get a booster dose, visit your local health department or contact your health provider or pharmacist.

Updated September 24, 2021

On August 13, the FDA amended the emergency use authorization for the Pfizer and Moderna COVID-19 vaccines to allow for the use of an additional dose in some immunocompromised individuals, and the CDC recommends that these individuals get a third dose. Specifically, the CDC recommends an additional dose of the Pfizer or Moderna vaccine for people who are solid organ transplant recipients and some patients being treated for conditions like cancer, advanced HIV infection, or chronic renal disease. A third dose can be administered to these individuals at least 28 days following the two-dose regimen of the same vaccine.

At this time, this recommendation does not apply to recipients of the Johnson & Johnson vaccine who are immunocompromised. 

People with compromised immune systems may have a reduced ability to respond to vaccines, including COVID-19. New data show that a third dose of the mRNA vaccines helps to increase the effectiveness of the vaccine for this group. The need for the third dose for this group is not due to a waning effect of the two-dose regimen; rather, data show the standard two-dose regimen does not produce the same degree of protective effect in immunocompromised individuals as it does in people who are not immunocompromised. Patients who are immunocompromised should consult with their healthcare provider to discuss additional precautions and any questions they have about protecting themselves from COVID-19.

Updated September 24, 2021

The Johnson & Johnson vaccine is not currently authorized for a booster dose, but experts anticipate that these boosters may be needed. J&J has announced it is planning to submit data to the FDA showing the benefits of booster doses for J&J recipients. More information on the J&J vaccine and booster is anticipated in the coming weeks.

Currently, people who received the J&J vaccine, even if they are significantly immunocompromised, are not recommended or authorized to receive a second J&J dose. Furthermore, because there is limited data on the effectiveness and safety of mixing COVID-19 vaccines, the CDC recommends against getting a Pfizer or Moderna vaccine after initially getting the J&J vaccine.

Updated September 24, 2021

The FDA and CDC base their authorizations and recommendations on the latest data, updating their guidance as scientists and medical experts review evidence about COVID-19 immunity and each individual COVID-19 vaccine. The Pfizer vaccine was the first COVID-19 vaccine to be authorized in the U.S., so its data about booster doses were the first to be available. Similar analyses and recommendations will be made as the data for the other COVID-19 vaccines become available.

There is limited data about the safety and effectiveness of mixing COVID-19 vaccines, and data is still under review concerning booster doses for the Johnson & Johnson and Moderna COVID-19 vaccines, so people are advised against seeking “off-label” uses of the vaccines.

The COVID-19 vaccines have received the most intense safety monitoring in U.S. history, and that monitoring has allowed public health officials to make science-based recommendations that keep people safe. If you have questions about your risk of COVID-19, how to protect yourself from COVID-19, or about the vaccines, speak to your health provider.

Updated September 24, 2021

FDA Approval

On August 23, the U.S. Food and Drug Administration (FDA) issued full approval to the Pfizer-BioNTech COVID-19 vaccine, which will now be marketed as Comirnaty. The FDA has been issuing Emergency Use Authorizations (EUA) for COVID-19 vaccines based on the urgent need created by the pandemic and the vaccine’s extensive safety and efficacy data. Topline messages to answer questions about FDA approval include:
  • FDA’s full approval of the first COVID-19 vaccine, which required additional safety and efficacy data beyond what was provided for the EUA, is an important milestone that should reassure anyone who has concerns about getting vaccinated. On top of the rigorous testing and trials that went into Emergency Use Authorization of the Pfizer vaccine, the FDA has now completed additional analysis of the effectiveness and safety data from tens of thousands of clinical trial participants, as well as the analysis of real-world safety data.
  • All of the COVID-19 vaccines authorized or approved in the U.S. are extremely safe and effective, based on extensive clinical trials and the fact that nearly 200 million Americans have received at least one shot.
  • With increasing rates of COVID-19 infection, hospitalization, and deaths across the country, it is more important than ever for all eligible people to get vaccines. All three vaccines work. They reduce the risk of getting COVID-19 and greatly reduce your risk of being hospitalized or dying.
Added August 23, 2021

Comirnaty is the new name for the Pfizer-BioNTech COVID-19 vaccine. Once a drug or other intervention receives FDA approval the manufacturer typically gives it a brand name, and Comirnaty is the brand name that Pfizer has chosen for its COVID-19 vaccine. It is the exact same vaccine as the one that was first authorized for use in December 2020, which we have come to know as the COVID-19 Pfizer vaccine, with the same high degree of safety and effectiveness.

Added August 23, 2021

FDA approval requires a rigorous and structured review process, and it means that a vaccine or drug has cleared every level of review. Compared to emergency use authorization, FDA approval of vaccines requires even more data on safety, manufacturing, and effectiveness over longer periods of time and includes real-world data. The FDA conducts its own analyses of the information included in an application for approval to make sure the vaccine is safe and effective and meets the FDA’s standards for approval.

Added August 23, 2021

On August 23, the FDA issued full approval to the Pfizer COVID-19 vaccine, now known as Comirnaty. The vaccine has been fully approved for use in individuals age 16 and older, with a two-dose regimen spaced at least three weeks apart. The full approval by the FDA means that the Comirnaty vaccine now has the same level of approval as other vaccines routinely in use in the U.S., such as vaccines for hepatitis, measles, chicken pox, and polio.

On top of the rigorous testing and trials that went into Emergency Use Authorization of the Pfizer vaccine, the FDA analyzed additional and follow-up data from the ongoing clinical trial to determine the safety and effectiveness of Comirnaty, including:

  • The analysis of effectiveness data from approximately 20,000 vaccine recipients and 20,000 placebo recipients age 16 and older, which found that overall, the vaccine was 91% effective, with 77 cases of COVID-19 occurring in the vaccine group and 833 COVID-19 cases in the placebo group.
  • The analysis of safety data in approximately 22,000 vaccine recipients and 22,000 placebo recipients age 16 and older. More than half of participants were followed to monitor safety for at least four months after the second dose; approximately 12,000 vaccine recipients have been followed for at least 6 months.
  • Rigorous evaluation of safety surveillance data regarding myocarditis and pericarditis. Data demonstrated an increased risk for vaccine recipients, which was higher in males under 40, particularly males 12-17. Comirnaty prescribing information will include information about this risk, and in addition to these analyses, the FDA is requiring the company to conduct postmarketing studies to further assess the risks of myocarditis and pericarditis in vaccinated individuals. It is important to note that reports of these complications are rare, and most patients who received care responded well to treatment.

The vaccine also continues to be available for adolescents age 12 through 15  and for the administration of a third dose in certain immunocompromised individuals (read more about booster doses here.)

Added August 23, 2021

Emergency use authorization (EUA) allows the FDA to authorize the use of yet to be approved drugs, or unapproved uses of approved drugs, for life-threatening conditions when there are no other adequate, approved, and available options and other conditions are met. In the case of COVID-19, the FDA issued EUAs for the Pfizer, Moderna, and Johnson & Johnson vaccines, and has now issued full approval for the Pfizer COVID-19 vaccine, now known as Comirnaty.

In an emergency when lives are at risk, like a pandemic, it may not be possible to have all the evidence that the FDA would usually have before approving a vaccine or drug. If there’s evidence that strongly suggests that patients have benefited from a treatment, the agency can issue an EUA to make it available. For the COVID-19 vaccines, FDA required two months of safety and efficacy data before the EUA was granted. That included clinical trials with tens of thousands of people and rigorous testing and review, and all the vaccines continue to be closely monitored. Compared to emergency use authorization, FDA approval of vaccines requires even more data on safety, manufacturing, and effectiveness over longer periods of time and includes real-world data.

Added August 23, 2021

Pfizer’s application for FDA approval was for use in individuals age 16 and older. The FDA issued the EUA for the Pfizer COVID-19 vaccine in December 2020, at which time this vaccine was authorized for use in individuals age 16 and older. In May 2021, based on extensive effectiveness and safety data in clinical trials of adolescents, the EUA was expanded to include those 12 through 15 years old. Pfizer plans to request full approval for this age group once it has collected and analyzed six months of safety data from clinical trial participants. The EUA remains in place for individuals age 12 through 15, and the CDC continues to recommend that all adolescents and adults age 12 and older get a COVID-19 vaccine.

Added August 23, 2021

For most people, getting the first available COVID vaccine is the best thing you can do to safeguard your health. If you have additional questions about which vaccine is best for you, check with your doctor.

All of the COVID-19 vaccines have been rigorously tested and reviewed, and are collecting data toward their application for full approval status. Before receiving EUA, all three vaccines underwent clinical trials with tens of thousands of people, and the FDA evaluated comprehensive data on their safety and effectiveness. All three showed excellent safety and effectiveness profiles, and now, hundreds of millions of vaccine doses in the U.S. and billions worldwide have been safely administered.

The Moderna and Johnson & Johnson vaccines will continue to be safely administered through emergency use authorization as the FDA reviews data about their real-world use. The Pfizer COVID-19 vaccine was the first vaccine to receive emergency authorization, which is why it is the first to have enough data to receive full approval. It does not mean anything about the safety and effectiveness of either the Moderna or Johnson & Johnson vaccine. Moderna has also submitted an application for full approval of its COVID-19 vaccine, and the FDA is currently reviewing that data.

August 23, 2021

Mask Guidance

On July 27, the CDC updated its recommendations on mask wearing based on the latest data on the delta variant. In communities with high COVID-19 transmission rates, everyone should wear a mask in indoor settings to help prevent the spread of the virus. Vaccination and mask wearing are the best defense against further spreading of the virus. The CDC is urging local jurisdictions to monitor local vaccination and transmission rates and base their masking regulations on these trends. The following message guidance is based on the new CDC recommendations. When developing messaging, state and local health officials should also consider local scenarios and transmission rates.

Updated July 27, 2021

The CDC bases its recommendations on the latest scientific data, including evidence on the safety and effectiveness of COVID-19 vaccines. In May, before the fast-spreading delta variant became the dominant strain in the U.S., the CDC updated its recommendations for fully vaccinated individuals based on evidence that the COVID-19 vaccines are extremely effective in protecting fully vaccinated people from catching and spreading the virus. The CDC’s updated masking guidance (July 27) advised that vaccinated and unvaccinated people communities with substantial or high transmission rates should wear a mask in indoor, public settings. This new guidance is based on data showing that in rare instances, vaccinated people can catch and spread the virus. In addition, the CDC continues to encourage that everyone be vaccinated.

Topline messages about the July CDC update:

  • The CDC bases its recommendations on the latest scientific data, so it updates  recommendations when there is new information. When the CDC revised its guidance in May, the delta variant represented 1% of all cases. Today that number is more than 80%.
  • The CDC continues to recommend that policies be based on local transmission rates.
  • Data demonstrate that the vaccines are preventing severe illness, hospitalization, and death, and are effective against the delta variant. New data is showing that a small number of vaccinated people can be infected by the delta in a breakthrough infection and may be contagious, but these cases represent a very small amount of transmission occurring around the country.
  • Getting vaccinated prevents severe illness, hospitalization, and death; it also helps reduce the spread of the virus and continues to be the leading public health strategy to end the COVID-19 pandemic.

Updated July 27, 2021

If you are fully vaccinated — which means two weeks have passed since your second dose of the Moderna or Pfizer vaccine or since your one dose of the Johnson & Johnson vaccine — you have a very low risk of contracting COVID-19 or spreading it to others. You can resume many normal activities without wearing a mask, but if you live in an area with substantial and high transmission of COVID-19, the CDC recommends that everyone (including fully vaccinated individuals), wear a mask in public, indoor settings to help prevent the spread of the delta variant and protect others. 

In addition to those local scenarios, there continue to be a few other notable exceptions where fully vaccinated people should wear masks: health care settings, homeless shelters, correctional facilities, public transportation, and airplanes. Additionally, vaccinated people should continue to follow local and state regulations, including individual business (such as retail stores and restaurants) and workplace requirements, which may differ from CDC guidance depending on local scenarios and transmission rates.

While COVID-19 vaccines are highly effective, no vaccine provides 100% immunity. New data  show that a small number of vaccinated people can be infected by the delta variant in a breakthrough infection and may be contagious, but these cases represent a very small amount of transmission occurring around the country. Additionally, fully vaccinated individuals may make the personal decision to continue to wear a mask based on their own risk assessment and preference. Those with certain medical conditions such as immuno-suppression should consult their physicians regarding the continuation of mask-wearing and other protective measures.

Updated July 27, 2021

Everyone should continue to follow local and state rules and regulations, which may or may not have changed since the CDC released new recommendations. In addition, everyone should comply with the practices of businesses that continue to require masks. This is particularly important in indoor settings where vaccinated and unvaccinated people may interact. While many local and state governments, workplaces, and businesses updated their mask policies since the CDC issued its new recommendations, others have not, and others still may wait for additional guidance from the CDC.

Added May 19, 2021

Currently, no COVID-19 vaccine is authorized for children under 12 years old. Children age 12 to 15 can now receive the Pfizer vaccine. Once children age 12 to 15 are fully vaccinated — two weeks after their second Pfizer dose — they can resume summer activities without wearing a mask unless required by local, state or business rules. Children age 2 and older who are unvaccinated or only partially vaccinated should wear masks in public settings, particularly where social distancing is not possible, and when around people who don’t live in their household.

Choosing summer activities with lower risk, in addition to wearing masks, can reduce unvaccinated children’s risk of contracting and spreading COVID-19. These activities include exploring the outdoors, taking a road trip with members of your household, or visiting vaccinated friends or family from another household. No activity is totally risk free: our kids ride bikes, they go skateboarding, etc. Parents should also monitor infections rates in your community and will need to make choices that feel best for their family. Being in crowds and poorly ventilated spaces puts unvaccinated people, including children, at higher risk for COVID-19.

Added May 19, 2021

The CDC does not make laws, but rather, it issues recommendations and guidance to inform policy decisions made at the local and state levels. Throughout the pandemic, many local and state officials have established policies — such as mask requirements and capacity limits — based on local scenarios and transmission rates. Now that the CDC has issued new recommendations on mask-wearing for fully vaccinated people, many cities, counties, states, and other entities have updated their policies, while others continue to review the guidance and their local transmission rates. Everyone should continue to follow the rules and regulations in their area.

Added June 1, 2021

The CDC does not make laws, but rather, it issues recommendations and guidance to inform policy decisions made at the local and state levels. Businesses and workplaces also establish individual policies within the context of their local and state regulations. As some local and state governments have begun easing or lifting mask requirements, businesses and workplaces can still require employees and patrons to wear masks, just like they can issue certain other non-discriminatory requirements such as “no shirt, no shoes, no service” for customers, or a uniform for workers. These decisions might be informed by local scenarios and transmission rates, protections for workers, or other individual risk assessments. Employees should continue to follow the policies of their individual workplaces, and members of the public should continue to abide by the requirements of businesses they choose to patronize.

Added June 1, 2021

On May 13, the CDC updated its public health recommendations for fully vaccinated individuals, including guidance on when people can safely resume normal activities without wearing a mask. However, there are a few important exceptions within the new CDC guidance. Everyone should continue to wear a mask in health care settings, homeless shelters, and correctional facilities, and while traveling on public transportation and planes. While the COVID-19 vaccine is highly effective, and vaccinated people have a very low risk of contracting COVID-19, spreading it to others, or getting severely sick, no vaccine is 100% effective. To protect people at increased risk for contracting COVID-19 or at increased risk of severe illness, and to reduce spread of the virus, everyone should continue to wear masks in these settings. Additionally, everyone should continue to follow local and state regulations, along with individual business and workplace requirements.

Added June 1, 2021

Because COVID-19 spreads from person to person via respiratory droplets, properly wearing a mask helps prevent the spread of the virus to others, including those at a higher risk of severe illness, especially when paired with other prevention tactics such as proper social distancing and frequent hand washing.

Updated May 7, 2021

Surgical and fitted N95 masks are the most effective for the prevention of spread of COVID-19. In the absence of these, homemade masks should have two or more layers of washable, breathable fabric, fit tightly against the face, cover the nose and mouth, and have wire to prevent air from leaking out of the top of the mask. For extra protection, you can layer two fabric masks or a fabric mask over a surgical mask. Masks that have any exhalation vales or vents are not recommended, as these allow for the escape of respiratory droplets.

updated February 24

At the onset of the pandemic, the CDC recommended that those who exhibited COVID-19 symptoms and those who were caring for someone who had COVID-19 wear face masks. Others were dissuaded from wearing surgical masks due to a severe shortage of personal protective equipment (PPE) among health workers treating COVID-19 patients and because, at that time, there wasn’t sufficient evidence of the efficacy of mask-wearing for the general public. As new research demonstrated that the virus could be easily spread by asymptomatic individuals, the CDC updated its recommendations to indicate that everyone should wear face coverings in public settings. Updating guidance based on new scientific evidence is one of the many important roles the CDC plays in protecting public health. The agency will continue to update guidance as more people get vaccinated and we better understand how effective the vaccines are against variants and preventing the spread of COVID-19.

Updated May 7, 2021

Vaccines

Yes. The Moderna and Pfizer-BioNTech vaccines are based on a two-dose regimen, and you are fully vaccinated once two weeks have passed since your second dose. It’s important to get both doses of these vaccines because that’s what was shown to be effective during the clinical trials. Further data have shown that partially vaccinated people have much less protection against the virus. Especially with the fast-spreading and highly contagious delta variant, it’s more critical than ever that you get your second dose as recommended.

Updated August 5, 2021

Not enough is yet known about how long immunity from natural COVID-19 illness might last and protect you from becoming re-infected and spreading the illness to others. For that reason, even if you have already been infected, vaccination is an important step to protect yourself and those around you.

The FDA approves a vaccine for use only if it is proven safe and effective, after clinical trials have been conducted with thousands of people, and when its benefits outweigh any risks. The COVID-19 vaccine builds on years of scientific research and an unprecedented level of scientific investment and cooperation. Every study and every phase of every trial was carefully reviewed and approved by a safety board and the FDA. The process was transparent and rigorous throughout, with continual oversight and expert approval.

The identification of what is approximately a less than 2-in-a-million risk of a blood clotting disorder associated with the Johnson & Johnson vaccine is a sign that the nation’s safety monitoring system for COVID-19 vaccines is working. After any vaccine is successful in clinical trials and authorizes it for use, the FDA continues to monitor it for safety. The pause in the use of the J&J vaccine allowed scientists to evaluate each incident of the clotting disorder. They determined that the level of risk was very low and that the benefits of continued use of the J&J vaccine greatly outweigh any risk associated with it.

The likelihood of a medically significant reaction is extremely low. Temporary side effects like soreness, headaches, or a mild fever are signs that the body is responding and building an immunity to the virus. They typically go away in a day or two.

Updated May 7, 2021

The threat of COVID-19 is real and urgent, and the benefits of getting vaccinated far outweigh any risks. The risk of severe adverse events after any COVID-19 vaccination remains very low, and far lower than the risk of adverse health outcomes associated with contracting COVID-19. More than 600,000 people in the U.S. and millions worldwide have died from COVID, and we’re still learning about “long COVID” — symptoms and adverse health outcomes that continue to impact people long after the initial infection.

It may seem like the vaccines were developed quickly, but it is important to know that they were not rushed. Speedy and greater funding, unparalleled levels of government and industry cooperation, and previous research dating back to 2003 during the SARS epidemic contributed to the development of the COVID-19 vaccines. The vaccine’s clinical trials process was detailed and thorough, no shortcuts were taken. More than 150,000 people participated in U.S. clinical trials of the vaccines, and now, hundreds of millions of vaccine doses have been safely administered.

I understand your concern, but fortunately vaccines don’t generally have long-term side effects, and there is no reason to believe the COVID-19 vaccine will. The scientists, health and medical experts, and researchers who developed the vaccine are closely monitoring for side effects and symptoms reported by anyone who is vaccinated, and watching out for any patterns that are out of the ordinary. Data will continue to be collected for two years after each vaccine is first administered to ensure that they are safe for the long term.

Updated August 9, 2021

You are considered fully vaccinated for COVID-19 two weeks after you have received the second dose in a two-dose series (Pfizer-BioNTech or Moderna) or two weeks after you have received a single-dose vaccine (Johnson & Johnson). While vaccines must be highly effective to be approved for use, no vaccine provides 100% immunity, so fully vaccinated individuals should continue to take precautions in public and when around unvaccinated people.

Added March 12, 2021

Because this is a new virus and these are new vaccines, we don’t yet know how long immunity will last and whether additional doses will be needed, as they are for the flu. The FDA and the scientists and health and medical experts who developed the vaccines are continuing to study the virus and vaccines closely to understand how long immunity lasts and how well the vaccines protect against new mutations of the virus. While vaccines must be highly effective to be approved for use, no vaccine provides 100% immunity. Fully vaccinated individuals should continue to take precautions in public and when around unvaccinated people.

See graphic “I got a COVID-19 vaccine. Now what?

Added March 12, 2021

The risk of a medically significant adverse reaction to the COVID-19 vaccine is extremely low and the CDC and FDA are closely monitoring the safety of all approved vaccines. Mild side effects — like some soreness in the arm, fatigue, headache, or a slight fever — are signs that your body is building up protections and go away in one to two days. Even if you don’t experience any side effects, your immune system is still building your protection against the virus.

Cases of anaphylaxis (an allergic reaction) after a COVID-19 vaccination are extremely rare, occurring in approximately 2 to 5 people per million vaccinated in the United States. The identification of what is approximately a less than 2-in-a-million risk associated with the Johnson & Johnson vaccine is a sign that this safety monitoring system is working. The pause in the use of the J&J vaccine allowed scientists to evaluate each incident of the clotting disorder. They determined that the level of risk was very low and that the benefits of continued use of the J&J vaccine greatly outweigh any risk associated with it.

If you have a question about whether the vaccine is safe for you, you should talk to your physician.

Updated May 7, 2021

The U.S. has a long history of assuring vaccines are safe through the use of specific, detailed, and time-tested protocols. The Food and Drug Administration (FDA) announced on October 6 that before approving a potential COVID-19 vaccine, it will need to see two months of follow-up data after volunteers get their second vaccine doses in a clinical trial. This is a sign that the FDA is taking every precaution to ensure the safety of a COVID-19 vaccine.

Clinical development for vaccines is a three-phase process. During Phase I, small groups of people receive the trial vaccine. In Phase II, the clinical study is expanded and the vaccine is given to people who have characteristics (such as age and physical health) similar to those for whom the new vaccine is intended. In the case of COVID-19 vaccines, Phase II trials in the U.S. should have a demographic makeup similar to that of the country, spanning a wide range of ages, races, ethnicities, and any other factors that would affect risk and efficacy. In Phase III, the vaccine is given to thousands of people and tested for efficacy and safety. During clinical development, a trial vaccine’s effectiveness is determined by comparing outcomes of patients who have received it with outcomes of patients who received the placebo.

In the U.S., the findings from clinical trials are presented to and reviewed by the FDA. The FDA also inspects manufacturing facilities to ensure safety and reviews product labels to ensure clarity. After approving a vaccine, the FDA continues to monitor and oversee its production to ensure that all safety protocols are followed. In addition, many vaccines undergo Phase IV formal, ongoing studies after the vaccine is approved and licensed. The FDA and CDC also collect and analyze information from reports of any side effects that may occur after a vaccine has been licensed.

In summary, before any new vaccine is brought to market, it has been given to thousands of people under stringent monitoring for safety. Sometimes, very rare side effects are recognized only after the vaccine is licensed because they occur so infrequently, but such side effects are very rare and must be weighed against the good the vaccine will do.

Updated January 12, 2021

Everyone is susceptible to infection by the coronavirus. For that reason, a coronavirus vaccine needs to be safe and effective for all people regardless of their age, race, ethnicity, or gender.  Therefore, it’s important to have diversity among participants in clinical trials that measure a potential vaccine’s safety and effectiveness. Safety and effectiveness for all groups of people is particularly important for a COVID-19 vaccine because of the virus’s disproportionate impact on people of color, people with underlying medical conditions, and the elderly. A vaccine that is not sufficiently tested in a diverse clinical trial pool could lead to unexpected effects that didn’t appear in a trial with a more general population.

In May the FDA “strongly encouraged” the inclusion of diverse populations in COVID-19 clinical vaccine trials, including racial and ethnic minorities, the elderly, people with underlying medical conditions, and pregnant women. However, according to Clinical Research Pathways, a nonprofit that focuses on increasing diversity in clinical research, Black people typically represent only about 5 percent of clinical trial pool participants, even though they make up 13 percent of the U.S. population. Hispanics are typically about 1 percent of clinical trial pool participants but make up 18 percent of the population. Overall, Blacks, Hispanics, American Indians, and Alaska Natives make up approximately 32 percent of the U.S. population; optimally, they should be at least 32 percent of the people participating in the COVID-19 clinical trials.

Updated January 12, 2021

Emergency Use Authorization (EUA) allows the Food and Drug Administration (FDA) to authorize use of yet to be approved drugs, or unapproved uses of approved drugs, for life-threatening conditions when there are no other adequate, approved, and available options and other conditions are met. In the case of COVID-19, the FDA has issued Emergency Use Authorizations for the Pfizer-BioNTech, Moderna, and Johnson & Johnson COVID vaccines.

In an emergency, like a pandemic, it may not be possible to have all the evidence that the FDA would usually have before approving a vaccine or drug. If there’s evidence that strongly suggests that patients have benefited from a treatment, the agency can issue an EUA to make it available. For the COVID-19 vaccines, FDA required two months of safety and efficacy data before the EUA was granted.

Before receiving EUA, the COVID vaccines were rigorously tested and reviewed, and they continue to be closely monitored. All three vaccines underwent clinical trials with tens of thousands of people, and the FDA evaluated comprehensive data on their safety and effectiveness. All three showed excellent safety and effectiveness profiles. Before making a decision to grant full approval, the FDA will evaluate even more data covering a longer period of time, including clinical trials and real-world data.

The FDA is currently reviewing Pfizer’s application for full approval of its COVID vaccine, which involves reviewing additional data on the safety and efficacy of the vaccines. Officials say that reviewing the application is among the highest priorities of the agency and a decision could come as early as Fall 2021.

For more information, visit the FDA’s FAQ on Emergency Use Authorization for vaccines.

Updated August 9, 2021

Children and Vaccinations

For additional information and guidance on children and vaccinations, read the American Academy of Pediatrics’ FAQ for parents and register for the Public Health Communications Collaborative next webinar, COVID-19 Vaccination and Children Answering Parents’ Questions.

Added June 14, 2021

Medical and public health experts, including the CDC and the American Academy of Pediatrics, recommend that children and adolescents 12 years of age and older get a COVID-19 vaccine to help protect them from contracting and spreading the virus. Children and adolescents are typically at lower risk than adults of becoming severely ill or hospitalized from COVID-19, but it is still possible. While most children with COVID-19 have mild or no symptoms, they can still spread the disease to others. COVID-19 has caused serious illness, complications, and even death in some children and teens, and those with underlying health conditions may be more likely to become severely ill.

Another important reason for children to get the COVID-19 vaccine is to protect their friends, family, and the broader community. And being vaccinated will allow kids to get back to the things they have missed: in-person school, playing with friends, and participating in sports activities. Vaccinated individuals have a very low risk of contracting COVID-19 or spreading it to others, which adds a layer of protection for unvaccinated individuals around them — such as younger siblings and other children who are not currently eligible. Additionally, as more and more people get vaccinated, the infection rate among the general population will continue to lower, decreasing the chance that the coronavirus will mutate into dangerous variants.

Added June 14, 2021

Yes. The FDA and CDC have carefully reviewed the clinical trials for Pfizer’s COVID vaccine, and it has been proven to be safe and effective for children 12 and older. Moderna has also applied for authorization for its vaccine for 12- to 15-year-olds, and that data is currently under review. Clinical trials are also underway regarding the potential use of these vaccines for children under 12.                                            

In addition, the vaccines are being closely monitored to ensure the safety of the vaccines for all eligible age groups.

Added June 14, 2021

Everyone 12 years and older is eligible now to get a COVID-19 vaccine to protect from contracting and spreading the virus and to help communities return to normal activities. The Pfizer vaccine, which was shown to be highly safe and effective for children during clinical trials, was authorized on May 10, 2021 for early teens, ages 12 to 15. It was previously authorized for everyone 16 and older. The Pfizer vaccine is a two-dose series; children are considered fully vaccinated two weeks after their second dose. Until children are fully vaccinated, they should continue to wear a mask in public indoor settings or when interacting in crowded settings, even outdoors, and when around people who don’t live in their household.

Currently, no COVID-19 vaccine is authorized for children younger than 12. Clinical trials to test the efficacy and safety of the vaccines in younger children are underway, and a vaccine for younger children could become available as early as this fall. Until a vaccine is available for younger children, children age 2 and older should wear masks in public indoor settings or when interacting in crowded settings, even outdoors, and when around people who don’t live in their household.

Added June 14, 2021

Children may experience mild side effects, such as soreness in the arm, fatigue, headache, or a slight fever, and most will pass in one to two days. These are signs that their body is building immunity, but even if they don’t experience any side effects, their immune system is still building protection against the virus. Serious side effects are rare and treatable.

Added June 14, 2021

If your child has a significant health issue – such as those resulting in a compromised immune system — check with their physician to determine if they should be vaccinated.

Added June 14, 2021

Vaccination requirements for public schools vary according to state laws, and that will likely be true for COVID-19 vaccines as well. All 50 states require certain immunizations — including tetanus, measles, polio, and chicken pox vaccinations — and some states have additional requirements. While many states and school districts have not yet announced their COVID-19 vaccination policies for the fall, requirements and/or recommendations will be issued at the state, local, and district levels as officials review guidance and as more children become vaccinated. Regardless of any requirement, all children who are eligible are encouraged to get the vaccine to protect themselves and others from catching and spreading the virus.

Added June 14, 2021

Providing the opportunity for kids to get exercise is as important as ever. In addition to promoting vaccination among eligible children and adolescents, there are important ways that leagues, players, and parents can protect families and communities and slow the spread of COVID-19. Participants should stay home if they’re sick, bring their own equipment to practice, maintain at least three to six feet of space from others, wear a mask if possible, and ensure proper hygiene. Leagues can also focus on lower-risk activities like outdoor skills-building and conditioning rather than running the risk of contact between players. Certain activities are also safer than others — like tennis, soccer drills rather than scrimmages, and passing and catching football drills. If your child is not fully vaccinated or not yet eligible to be vaccinated, the best way to limit your child’s risk from the coronavirus is by ensuring they wear a well-fitting mask, choose sports and activities with lower risk, and maintain social distance.

The risk of activities varies greatly depending on local community spread, so any decision about school sports should be made based upon the virus status locally. What may be considered moderate risk in some areas would be high risk in others. Professional leagues are different from high school and college athletics in many ways, most notably that they can keep their athletes in a bubble and oversee their other activities. By contrast, student athletes do not live in a bubble, which means they face increased risk for themselves, their family members, and their school’s students and staff. While many Americans enjoy watching and playing sports, we need to ensure we aren’t putting the health and safety of students, staff, families, and our community at risk.

Updated August 5, 2021

Schools and in-person learning

In-person learning is critical for the educational and social development of students of all ages. The top priority is to ensure that schools open and operate in a manner that prioritizes the health and safety of students, teachers, school staff, their families, and the community. Preventing the spread of COVID-19, keeping children healthy, and meeting their educational and social needs are not mutually exclusive goals.

The CDC has made recommendations for how schools can safely open, emphasizing that approaches should be informed by local trends. For that reason, safety and prevention protocols and strategies will vary across the country. The CDC continues to recommend that all adolescents and adults age 12 and older get a COVID-19 vaccine, coupled with other mitigation strategies including mask-wearing by unvaccinated people (students and adults), ventilation, cleaning and disinfecting, screening and testing, and other precautions such as distancing, hand-washing, and staying home when sick.

Added July 27, 2021

School policies, including COVID-19 guidance, are made at the state, local, district and school levels. The CDC continues to urge that policies be based on local vaccination and infection rates.

Added July 27, 2021

Data show that the delta variant is roughly twice as contagious as the initial strain of COVID-19 and that it has a much higher viral load. Scientists and public health officials are still learning about how the delta variant affects children, including whether it is more severe for children than other COVID-19 strains. As COVID-19 cases rise across the country, pediatric cases are rising alongside adult cases.

As students return to in-person learning, the goal is to keep students safe and physically in school. Data show that the COVID-19 vaccines are extremely effective in protecting fully vaccinated people from catching and spreading the virus, including the delta variant. But it is critical that people are fully vaccinated to be protected. New data show that a small number of vaccinated people can be infected by the delta variant and may be contagious, but these cases represent a very small amount of transmission occurring around the country. The best way to reduce the spread of the delta variant in schools and communities is for all eligible adolescents and adults to get vaccinated, while following COVID-19 prevention and mitigation strategies informed by local trends.

Added July 27, 2021

The CDC, along with other organizations such as the American Academy for Pediatrics, recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status.

The CDC issues recommendations and guidance to inform policy decisions made at the local and state levels. Decision-makers for public and private schools, on the state, local, district and school levels, establish policies such as mask requirements. Some areas will require that all children, teachers, and staff wear masks at school, while others will only require unvaccinated people to wear masks. Others will not have any school mask requirements.

Even if schools’ policies don’t require masks, many students may decide to wear a mask at school based on their personal risk assessment, preference, or other individual circumstances. It’s important that all students, teachers, families, and staff follow local requirements, while also being supported in any personal decisions about taking additional safety precautions.

If you have further questions about the CDC recommendations on mask-wearing, read our Tough Q&A on mask guidance.

Updated July 29, 2021

There are many ways that schools contribute to the full picture of students’ health and safety, including their social and emotional well-being, access to nutrition and other health services, and opportunities for physical activity. In addition to following local and school requirements and getting vaccinated if eligible, children can protect themselves and others from contracting and spreading COVID-19 by wearing a well-fitting mask if they are not fully vaccinated (and if otherwise required and/or preferred), washing their hands, social distancing when needed, staying home if they are feeling sick, and getting tested if they were exposed to the virus or are symptomatic.

Added July 27, 2021

Pregnancy + fertility

Yes. Based on data on the safety of COVID-19 vaccines during pregnancy, CDC is now recommending COVID-19 vaccination for all people who are pregnant, breastfeeding or trying to get pregnant now or in the future. Data show that pregnant and recently pregnant people are more likely to get severely ill if infected with COVID-19 compared with non-pregnant people, and the highly contagious delta variant makes it even more important for eligible people to get vaccinated.

The CDC’s recommendation, announced on August 11, is based on further evidence about the safety of COVID-19 vaccines and a new analysis of current data from the CDC’s v-safe pregnancy registry. In addition, the American College of Obstetricians and Gynecologists and other leading maternal health and public health organizations are “strongly urging” all pregnant individuals, and anyone planning to become pregnant, be vaccinated against COVID-19.

Added August 12, 2021

No. There is no evidence to show that getting a vaccine increases the risk of miscarriage.

There has been extensive safety monitoring of the COVID-19 vaccines, including analysis of vaccination during pregnancy. Specifically, studies show that the rate of miscarriage in the first 20 weeks of pregnancy in the general population is about 11-16%, and an analysis of safety monitoring data of people who received an mRNA COVID-19 vaccine showed a similar rate of 13%.In other words, being vaccinated with one of the currently available COVID-19 vaccines does not increase miscarriage risk; rather, it protects against the higher risk of serious illness if you are pregnant and become infected with the virus.

Added August 12, 2021

No. There is no evidence that fertility problems are a side effect of any vaccine, including COVID-19 vaccines.

Added August 12, 2021

Antibodies made after a pregnant person received an mRNA COVID-19 vaccine have been found in umbilical cord blood, which means that COVID-19 vaccination during pregnancy might help protect babies against COVID-19. Additionally, recent reports have shown that breastfeeding people who have received mRNA COVID-19 vaccines have antibodies in their breast milk, which could help protect their babies. In both of these cases, more data are needed to determine the level of protection these antibodies may provide to the baby and how long that protection would last.

Added August 12, 2021

Delta and other variants

Yes. Data show that the COVID-19 vaccines are extremely effective in protecting fully vaccinated people from catching and spreading the virus, including the delta variant. But it is critical that you are fully vaccinated to be protected.

New data is showing that a small number of vaccinated people can be infected by delta variant in a breakthrough infection and may be contagious, but these cases represent a very small amount of transmission occurring around the country.

Updated July 27, 2021

The delta variant is a naturally occurring mutation of the SARS CoV-2 virus, the virus that causes COVID-19. Data show that the delta variant is more contagious and spreads more easily than the original COVID-19 virus. The delta variant accounts for a growing proportion of new coronavirus cases across the U.S., and people infected with the delta variant are more likely to need hospitalization than those infected with earlier strains of the virus.

Added July 8, 2021

Johnson & Johnson vaccine

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of Guillain-Barré syndrome. Below are topline messages to guide your talking points, followed by more questions and answers about the Johnson & Johnson vaccine, including information about the rare blood clotting disorder on the vaccine’s warning label, and the safety of other vaccines.

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of a rare neurological syndrome called Guillain-Barré syndrome. The new warning label is based on preliminary data, after about 100 reports of GBS were detected in the Vaccine Adverse Event Reporting System, out of more than 12.8 million administered doses of the Johnson & Johnson vaccine administered.

The CDC continues to advise that everyone 12 years of age and older receive a COVID-19 vaccine. The risk of severe adverse events after any COVID-19 vaccination remains rare, far lower than adverse health outcomes associated with contracting COVID-19.

The CDC and FDA will continue to provide monitoring and treatment information to health care providers and vaccine recipients. Anyone with questions about which vaccine is best for them should speak to their healthcare provider.

Added July 13, 2021

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of Guillain-Barré syndrome (GBS). The FDA and CDC take vaccine safety very seriously, which is why all vaccines are closely monitored. The identification of any possible risks, like the low risks associated with the Johnson & Johnson vaccine, is a sign that the nation’s safety monitoring system for COVID vaccines is working.

  • About 100 reports of Guillain-Barré syndrome have been detected in the Vaccine Adverse Event Reporting System, out of 12.8 million administered doses of the Johnson & Johnson vaccine. GBS is a rare condition, and the risk of contracting it due to the J&J vaccine is very low.
  • The risk of severe adverse events after any COVID-19 vaccination remains very low, and far lower than adverse health outcomes associated with contracting COVID-19.
  • Data do not show any increased risk of GBS for the Pfizer or Moderna vaccines.
  • In the U.S., nearly all COVID-19 hospitalizations and deaths are now occurring in unvaccinated people. The CDC recommends that everyone age 12 years and older receive a COVID-19 vaccine.

Added July 13, 2021

The mRNA vaccines (Pfizer and Moderna’s COVID-19 vaccines) are not associated with increased risk for Guillain-Barré syndrome or for a rare blood clotting disorder that appear on the warning label for the Johnson & Johnson vaccine.

The identification of what is approximately a less than 2-in-a-million risk associated with the Johnson & Johnson vaccine is a sign that the nation’s safety monitoring system for COVID vaccines is working. After any vaccine is successful in clinical trials and approved for use, the FDA continues to monitor it for safety. The 10-day pause of the J&J vaccine in April 2021 allowed scientists to evaluate each incidence of the clotting disorder. They determined that the level of risk was very low and that the benefits of continued use of the J&J vaccine greatly outweighed any risk associated with it.

Updated July 13, 2021

The likelihood of the Guillain-Barré syndrome (GBS) resulting from the Johnson & Johnson vaccine is extremely low. The cases have largely been reported two weeks after vaccination and mostly in males, many age 50 years and older. Additional data that details the risk of incidence is forthcoming, but preliminary data is based on about 100 reports of GBS in the Vaccine Adverse Event Reporting System out of more than 12.8 million Johnson & Johnson doses administered. If you have questions about the J&J vaccine or other vaccines, talk to your healthcare provider.

Added July 13, 2021

In April 2021, the Johnson & Johnson vaccine was paused for 10 days while a CDC panel reviewed data concerning a very rare blood clotting disorder. The decision to lift the pause in April was based on the experts’ determination that the benefits of administering the vaccine greatly outweigh the very small degree of risk associated with its use. The risk of blood clotting is much higher for people who contract COVID than it is for people who receive the J&J vaccine.

Added April 24, 2021

The 10-day pause in April 2021 gave health officials time to review additional data to better understand the degree of risk associated with the Johnson & Johnson vaccine related to a blood clotting disorder. It also gave federal agencies and the medical community time to determine and share information on the most appropriate treatment response. During the pause, nine additional cases of the clotting disorder were identified, bringing the total number of known cases to 15 among the nearly 7 million people who received the vaccine.

The decision to lift the pause was based on the experts’ determination that the benefits of administering the vaccine greatly outweigh the very small degree of risk associated with its use, particularly now that the risk and treatment protocols are better understood. The risk of blood clotting is much higher for people who contract COVID than it is for people who receive the J&J vaccine.

Added April 24, 2021

The likelihood of the blood clotting disorder resulting from the Johnson & Johnson vaccine is extremely rare. The risk varies by age and gender. There have been fewer than 1 case per million for men and for women who are 50 years or older; the risk is estimated to be about 7 cases per million for women ages 18 to 49. If you have questions about the J&J vaccine or other vaccines, talk to your doctor.

Added April 24, 2021

If you received the Johnson & Johnson shot and within two weeks have not developed any of the side effects associated with Guillain-Barré syndrome – muscle weakness, tingling in hands and feet, difficulty catching your breath, or choking on saliva – the risk for an adverse reaction is very low.

The symptoms of the blood clotting disorder – severe headache or abdominal pain, shortness of breath, neurological symptoms, leg swelling – usually develop within three weeks of receiving the vaccine. If you are beyond the three-week mark, the risk of your developing an adverse reaction is very low. If you have questions or concerns, consult your doctor.

Updated July 13, 2021

For most people, getting the first available COVID vaccine is the best thing you can do to safeguard your health. Your odds of contracting a possibly life-threatening case of COVID-19 are much higher than your odds of experiencing serious side effects from the vaccine. For example, the risk of blood clots from COVID illness is 165,000 per million cases, which is much higher than the risk of the rare blood clotting disorder associated with the Johnson & Johnson vaccine. That said, Pfizer and Moderna vaccines are widely available. More than 90% of the fully vaccinated population in the U.S. has received the Pfizer and Moderna vaccine, with only about 8% having been vaccinated with the Johnson & Johnson vaccine.

If you have additional questions about which vaccine is best for you, check with your doctor.

Updated July 13, 2021

Pandemic fatigue

We understand that people are tired, but public health measures are not the enemy — they are the roadmap for a faster and more sustainable recovery. The pandemic has posed so many hardships, from the loss of loved ones, to job loss, to loneliness, to parenting in the context of virtual schooling. We’ve made progress in putting the pandemic behind us, but we risk the health of our communities and our economy if we declare victory too soon, particularly in the light of the high degree of contagiousness of the delta variant..

Many communities have made tremendous progress in protecting ourselves and our loved ones from COVID-19, but vaccination rates are still lagging in many communities. After months of decreasing in many places, COVID cases are increasing across the country, with infection rates highest in places where vaccination rates are low. The delta variant is roughly twice as contagious as the initial strain and is now the dominant strain in the U.S. and worldwide. Because of how contagious this variant is, it’s more important than ever for eligible adults and adolescents to get vaccinated, and for unvaccinated people to continue wearing a mask in public settings.

We’re all looking forward to a time when we can do all the things we love safely, and the way we get there is by getting vaccinated and following local guidelines.

Updated August 5, 2021

Trust in public health officials

For decades, the CDC has put its scientific expertise to work to protect Americans from infectious disease, chronic illness, and preventable injuries. Around the world, the agency is a trusted source for public health and health promotion guidance; the CDC’s career staff remain a respected and credible information source.

The CDC is at its best when its scientists are free to provide public health advice based on the best available data and free of any political or non-scientific considerations.

There’s no avoiding the fact that the COVID-19 pandemic has been extremely challenging for the entire country, including the CDC. There was an early misstep at the CDC with the initial development of a COVID-19 test. However, since then CDC has gathered and shared data on the pandemic’s impact, produced educational materials, distributed billions of dollars in grant funding to local, state, tribal, and territorial agencies, and supported essential services necessary for testing, contact tracing, and protection of the public.

During the initial response, the CDC did not have the central and visible roles in coordinating and messaging during the COVID-19 pandemic that it had during past infectious disease outbreaks, including malaria, HIV, H1N1, Ebola, and Zika. This lack of a central, public-facing role for the CDC impeded the federal response, contributed to mixed messaging on the optimal response to the pandemic, and delayed and sometimes distorted the guidance needed by the American public.

That has changed. The CDC has been empowered to take a central role in developing guidance and messaging and coordinating the national response. Everyone benefits when the CDC is allowed to do its job without interference and with regular, unfettered science-based messaging offered directly to the public and policymakers. Under the new leadership, the thousands of rank-and-file CDC employees scientists and public health experts dedicated only to the protection of the public are leading the day in and day out work necessary to fight the virus.

Going forward, the nation needs to ensure that science guides public health without any interference. When statements are made or policies suggested that are not grounded in science, public health experts need to continue to say so.

Updated May 7 , 2021

Public health officials are trained and experienced in responding to infectious disease outbreaks and life-threatening emergencies. They work closely with scientists and researchers to translate the latest findings into action with the express goal of keeping people as safe and healthy as possible.

Public health officials strive to be guided by science and independent of political or partisan considerations. The most effective way to address COVID-19 is to have state, local, and federal officials working in coordination and operating based on scientific guidance.

As always, the role of public health officials is to follow the science, develop programs and guidelines that protect health, advise elected officials, work with public and private sector partners, and keep the public informed.

updated November 3

Herd immunity

Herd immunity is achieved when a virus stops circulating because a large segment of the population has already been infected or has been vaccinated against the virus. Public health officials estimate that 70 to 85% of the population will need to be vaccinated before herd immunity is achieved. Until then, getting vaccinated and the 3 Ws – wearing a mask indoors (beyond your home), watching your distance, and washing your hands – are the best tools we have to stop the spread of the virus.

Updated May 7, 2021

Hospital shortages

The most serious potential shortage is for hospital intensive care capacity. The only way to prevent such shortages is to control the spread of COVID-19. In the last year, we have seen increased risk for shortages following unprecedented surge in cases, often after holidays or other moments of large gatherings. In those situations, patients may be at risk if the capacity of local hospitals to provide intensive care is exceeded by the number of patients needing that care. That’s why it is vital for us to work together and follow the latest public health guidance to prevent the spread of the virus.

updated February 24

Economy + jobs

Public health measures are not an obstacle to a return to normalcy, they are the roadmap to faster and sustained recovery. Americans are coping with job losses, school closures, social isolation, and fears around health and safety. Many people are frightened, angry, and frustrated. As public health officials, we share this frustration. We want the economy and our schools to open. At the same time, we want to protect our families, friends, and neighbors from the virus, and we know that if we don’t, there will be even worse consequences for the economy and for schools.

Nobody should have to decide between the health of their family and putting food on the table. The goal is both public health safety and economic security; the two are dependent on each other.

Updated May 7, 2021

Testing

Rapid antigen tests are relatively inexpensive and, with proper interpretation, can be used to quickly confirm a suspected case of COVID-19 in a clinical setting. However, these tests are less sensitive than the recommended RT-PCR tests and more likely to return a false negative. Because they are less sensitive, rapid tests perform best when the person is tested in the early stages of infection, when viral load is generally highest. There is limited evidence to confirm the efficacy of rapid antigen tests to detect or exclude COVID-19 in asymptomatic people accurately or determine whether a previously confirmed case is still infectious.

In short, rapid tests are useful for confirming infection in someone with symptoms. They are less reliable in screening of people who are asymptomatic.

Widespread testing is critical to identifying and forecasting outbreaks, conducting effective contact tracing, and preventing the spread of COVID-19. Anyone with signs or symptomsof COVID-19 should get tested, regardless of vaccination status or prior infection.

People who are not fully vaccinated and who have had close contact with an infected individual should get tested for COVID-19 regardless of symptoms. Fully vaccinated people with no COVID-19 symptoms do not need to get tested after close contact. People who have tested positive for COVID-19 in the past three months and recovered do not need to get tested following an exposure as long as they do not develop new symptoms.

Updated May 7, 2021

Treatment

Contact tracing

Vaccination is the most effective public health strategy to reduce the spread of COVID-19, and contact tracing is an important tool to prevent spread while we continue to increase vaccination rates. Contact tracing helps to control the spread of the virus by quickly identifying and informing people who may have been exposed to an infected person. If you contract COVID-19 or are exposed to COVID-19, cooperating with contact tracers will help prevent other people from getting sick.

Changes in official guidance

Safety guidance has changed as more has been learned about the virus and how to prevent its spread. The rate of virus spread in your local community, in addition to your individual health and vaccination status, will largely determine the safest options for you. Your local health department is an important source of COVID-19 information that’s specific to your community.

Updated May 7, 2021

We understand it is frustrating that guidance continues to change. It’s the job of public health officials to tell you what we know, when we know it, and guidance regarding COVID-19 has evolved as our understanding of the virus evolves.

Public health officials and scientists are continuing to learn about how this virus spreads, how it affects different people, and how best to control it. As knowledge evolves and scientists discover new information about COVID-19, public health officials are committed to providing accurate and timely guidance.

updated September 25

Data and reporting

Breakthrough COVID-19 cases are new infections in people who have already been fully vaccinated.

Most states monitor reports of breakthrough infections and report this information to CDC. However, this information is likely not complete because many breakthrough infections are mild or asymptomatic and therefore undiagnosed. States and CDC do investigate and track COVID hospitalizations and deaths in vaccinated people and this information is likely more accurate and a better measure of the risk of severe disease.

Currently, about 99% of new COVID hospitalizations and deaths are unvaccinated people.

Data continue to show that the COVID-19 vaccines are extremely effective in protecting individuals from catching and spreading the virus, but no vaccine provides 100% immunity. For the small percentage of vaccinated people who experience breakthrough cases, they are much more likely to be mild.

Updated August 9, 2021

COVID-19 remains a serious threat to public health, and there is no evidence that the reported number of COVID-19 deaths has been inflated. The CDC has tracked and reported COVID-19 fatalities from the start of the pandemic, with detailed data from the local and state level that originates with each individual death certificate. In fact, experts agree that the number of COVID deaths are probably undercounted because not everyone with COVID will have been tested and diagnosed.

The CDC’s report also gives a detailed account of something we’ve known since the beginning of the pandemic – having pre-existing conditions like diabetes, heart disease, or obesity greatly increases a person’s risk for life-threatening consequences from the infection. We also know that COVID-19 deaths can be caused by related complications, such as pneumonia or respiratory distress. The high rate of chronic illness in the U.S. (6 in 10 adults have a chronic disease) has contributed to the high number of COVID-19 deaths, but it is important to remember that even people with pre-existing conditions may have lived years longer if they had not been infected with COVID-19. For that reason, the cause of these deaths is COVID-19.

Updated August 9, 2021

Equity

Prevention and treatment of infectious and chronic disease for low-income people and communities of color is woefully insufficient in our country, and the COVID-19 pandemic has been no exception to that pattern.

In general, access to affordable health care services for these communities, including testing, has been more challenging than in white communities. Limited economic opportunity and substandard housing have led to higher rates of underlying chronic health conditions, making serious illness and death from COVID more likely among communities of color. In addition, people of color and lower-income Americans have also been disproportionately designated as essential workers during the pandemic, with fewer job protections, placing them at increased risk for exposure. They also tend to live in more densely populated neighborhoods, making social distancing difficult.

These circumstances are the results of our country’s long history of structural racism in housing, jobs, education and healthcare. Addressing this racism is not only critical to protecting communities of color from the impact of COVID, it is critical to address them to allow all people to lead healthy lives.

Seasonal flu

It is more important than ever to protect against influenza, which, like COVID-19, is a respiratory illness. Vaccination for the flu is critical to help reduce the overall impact of respiratory illnesses on the general population and lower the resulting burden on the healthcare system during the pandemic.

State + local response

National, state, local, tribal, and territorial health officials are all working hard to ensure the safety of their communities and the country as a whole. While federal public health experts can coordinate national response strategies, the impact of COVID-19 varies by state, city, county, village, and town. Local and state health officials have the best understanding of how the virus is impacting their immediate community, the level of community spread, community-specific risks, and who the community will trust to provide public health information. They use that understanding to adapt national guidelines for their communities.

U.S. response + infection rate

The COVID-19 pandemic has exposed the impact of chronic underfunding of America’s public health and emergency preparedness systems. More than 56,000 local public health jobs were eliminated between 2008 and 2017 — nearly one-quarter of the workforce. And in 2018, the White House Office of Global Pandemics was eliminated, leaving the country less prepared for pandemics like COVID-19. This chronic under funding has real consequences, as we’ve learned as health departments struggled to respond to the biggest public health crisis in a century with outdated technologies and inadequate staffing levels. Building and maintaining a public health system capable of effectively protecting and promoting health requires a significant increase in funding. This would be a wise investment considering the much higher costs of responding to uncontrolled epidemics.

[sp_faq category="83"]
[sp_faq category="83"]

Medical and public health experts, including the CDC and the American Academy of Pediatrics, recommend that children and adolescents 12 years of age and older get a COVID-19 vaccine to help protect them from contracting and spreading the virus. Children and adolescents are typically at lower risk than adults of becoming severely ill or hospitalized from COVID-19, but it is still possible. While most children with COVID-19 have mild or no symptoms, they can still spread the disease to others. COVID-19 has caused serious illness, complications, and even death in some children and teens, and those with underlying health conditions may be more likely to become severely ill.

Another important reason for children to get the COVID-19 vaccine is to protect their friends, family, and the broader community. And being vaccinated will allow kids to get back to the things they have missed: in-person school, playing with friends, and participating in sports activities. Vaccinated individuals have a very low risk of contracting COVID-19 or spreading it to others, which adds a layer of protection for unvaccinated individuals around them — such as younger siblings and other children who are not currently eligible. Additionally, as more and more people get vaccinated, the infection rate among the general population will continue to lower, decreasing the chance that the coronavirus will mutate into dangerous variants.

Added June 14, 2021

Yes. The FDA and CDC have carefully reviewed the clinical trials for Pfizer’s COVID vaccine, and it has been proven to be safe and effective for children 12 and older. Moderna has also applied for authorization for its vaccine for 12- to 15-year-olds, and that data is currently under review. Clinical trials are also underway regarding the potential use of these vaccines for children under 12.                                            

In addition, the vaccines are being closely monitored to ensure the safety of the vaccines for all eligible age groups.

Added June 14, 2021

Everyone 12 years and older is eligible now to get a COVID-19 vaccine to protect from contracting and spreading the virus and to help communities return to normal activities. The Pfizer vaccine, which was shown to be highly safe and effective for children during clinical trials, was authorized on May 10, 2021 for early teens, ages 12 to 15. It was previously authorized for everyone 16 and older. The Pfizer vaccine is a two-dose series; children are considered fully vaccinated two weeks after their second dose. Until children are fully vaccinated, they should continue to wear a mask in public indoor settings or when interacting in crowded settings, even outdoors, and when around people who don’t live in their household.

Currently, no COVID-19 vaccine is authorized for children younger than 12. Clinical trials to test the efficacy and safety of the vaccines in younger children are underway, and a vaccine for younger children could become available as early as this fall. Until a vaccine is available for younger children, children age 2 and older should wear masks in public indoor settings or when interacting in crowded settings, even outdoors, and when around people who don’t live in their household.

Added June 14, 2021

Children may experience mild side effects, such as soreness in the arm, fatigue, headache, or a slight fever, and most will pass in one to two days. These are signs that their body is building immunity, but even if they don’t experience any side effects, their immune system is still building protection against the virus. Serious side effects are rare and treatable.

Added June 14, 2021

If your child has a significant health issue – such as those resulting in a compromised immune system — check with their physician to determine if they should be vaccinated.

Added June 14, 2021

Vaccination requirements for public schools vary according to state laws, and that will likely be true for COVID-19 vaccines as well. All 50 states require certain immunizations — including tetanus, measles, polio, and chicken pox vaccinations — and some states have additional requirements. While many states and school districts have not yet announced their COVID-19 vaccination policies for the fall, requirements and/or recommendations will be issued at the state, local, and district levels as officials review guidance and as more children become vaccinated. Regardless of any requirement, all children who are eligible are encouraged to get the vaccine to protect themselves and others from catching and spreading the virus.

Added June 14, 2021

Providing the opportunity for kids to get exercise is as important as ever. In addition to promoting vaccination among eligible children and adolescents, there are important ways that leagues, players, and parents can protect families and communities and slow the spread of COVID-19. Participants should stay home if they’re sick, bring their own equipment to practice, maintain at least three to six feet of space from others, wear a mask if possible, and ensure proper hygiene. Leagues can also focus on lower-risk activities like outdoor skills-building and conditioning rather than running the risk of contact between players. Certain activities are also safer than others — like tennis, soccer drills rather than scrimmages, and passing and catching football drills. If your child is not fully vaccinated or not yet eligible to be vaccinated, the best way to limit your child’s risk from the coronavirus is by ensuring they wear a well-fitting mask, choose sports and activities with lower risk, and maintain social distance.

The risk of activities varies greatly depending on local community spread, so any decision about school sports should be made based upon the virus status locally. What may be considered moderate risk in some areas would be high risk in others. Professional leagues are different from high school and college athletics in many ways, most notably that they can keep their athletes in a bubble and oversee their other activities. By contrast, student athletes do not live in a bubble, which means they face increased risk for themselves, their family members, and their school’s students and staff. While many Americans enjoy watching and playing sports, we need to ensure we aren’t putting the health and safety of students, staff, families, and our community at risk.

Updated August 5, 2021