A COVID-19 Vaccine: What You Need to Know

October 27, 2020

A COVID-19 Vaccine: What You Need to Know

Since mid-March of this year, it is not an exaggeration to say that life has been turned upside down by something that is as old as time itself and microscopic in size.  The newly discovered coronavirus (SARS-Cov-2 or HCoV-19) was first identified in the Wuhan, Hubei province in China, in December 2019, following cases of patients who developed pneumonia of unknown origin.

Is Coronavirus New?

Coronaviruses themselves are not new and have been known to cause infection in the nose, sinuses and upper throat.  Many infections that we refer to as the “common cold” are in fact caused by types of coronaviruses and are not dangerous for most people.  However, SARS-Cov-2 has proven to be particularly troublesome causing severe illness and death.

Concerns about the Coronavirus

There are several factors which serve to make this new coronavirus exceptionally concerning.  First of all, since it is new, scientists and experts don’t have a complete understanding of it.  Also it has proven to be very easily spread by person to person contact, and, finally, its ability to cause sickness is relatively unpredictable.  In the eight plus months since the virus has been identified there have been some patterns develop that serve to predict risk.  Those who seem to be at a higher risk for becoming ill are:

  • Elderly (> 60 years old), with those over 85 being at most risk
  • Presence of underlying medical conditions including cancer, chronic kidney disease, COPD, solid organ transplant patients, obesity, serious heart conditions, type 2 diabetes mellitus, sickle cell disease.

Social distancing, the use of face coverings, increased testing and quarantining have helped to mitigate some spread of the virus, but cases, illness and deaths continue to be problematic.

The Need for a Vaccine

History has proven that the best way to combat viruses, especially those with the potential to spread rapidly and cause significant illness, is to develop a vaccine.  Simply put, vaccines use various methods to mimic the virus that they protect against, which allows the body’s natural immune system to develop defenses specific to that virus.  The good news is that in the United States, there are multiple entities working tirelessly on a vaccine for COVID-19 following the president’s Operation Warp Speed initiative.  The government has thus far invested more than $10 billion to support this program.  Several different vaccine production technologies have been proposed and studied in effort to hone in on the most effective and safest option.

COVID-19 Vaccine Status

The United States government’s Operation Warp Speed initiative has certainly served to accelerate the development of vaccines for Covid-19 (also known as SARS-CoV-2).  There are more than 50 vaccine products currently in development worldwide with two distinct vaccines that are on track for FDA EUA (Emergency Use Authorization) within the next weeks.  Products from Moderna and Pfizer are leading the way with the product from Pfizer / BioNTech receiving approval in the United Kingdom on December 2nd, 2020.  The US FDA has scheduled a meeting of its Vaccines and Related Biological Products Advisory Committee for December 10th and December 17th to discuss the safety and effectiveness data provided by Pfizer and Moderna respectively for their Covid-19 vaccine products; with approval expected shortly thereafter.  Data from both products shows effectiveness in excess of 90% against infection and almost zero against severe disease.

Some evidence suggests that individuals who have contracted Covid-19 may be susceptible to re-infection; meaning that the natural immunity developed from infection may not last. At this time it is not known whether a Covid-19 vaccine would be recommended for those who have previously developed an infection or have tested positive in the past.

What Will Distribution Look Like?

At this point, there is still some conjecture among government officials about the groups of individuals who will be prioritized to receive the vaccine.  It is clear however that front line healthcare workers and elderly persons (> 65years; especially those who are in long term care facilities and with multiple chronic conditions) will be among the first to receive the vaccine.  This is likely to occur with the first month or two following approval and release of the vaccines.  There are an estimated 21 million people working in health care and somewhere in the neighborhood of 3 million people in long term care facilities in the US.

Based on the known information at this time, estimates for when the vaccine may be available for the following phased groups are as follows.

  • Phase 1  (January and February 2021) – Includes front line health care workers including those caring for patients in hospitals, nursing homes or providing home health care; first responders (EMT’s, firefighters, police).  These individuals are at high risk for exposure and serve a critical role in insuring that the health care system remains functional.  This group represents approximately 5% of the population.
  • Phase 1b (March, April and May 2021) – Includes individuals of all ages with chronic conditions (e.g. cancer, serious heart disease or heart conditions) which place them at a higher risk for illness or death from COVID-19.  Also, included are adults aged 65 and older who are living in communal facilities (e.g. nursing homes, retirement communities).  This group constitutes about 10% of the population.
  • Phase 2 (Summer 2021) – Includes elementary and high school teachers and staff, childcare workers, and certain critical workers in high risk settings such as food supply and public transportation.  Additionally, included are those who are homeless, residing in group homes, prison inmates, and workers in these settings.  This group is about 30% of the population.
  • Phase 3 (Summer and Fall 2021) – Includes young adults, children and workers in colleges, universities, banks, hotels, factories and other facilities that are key to functional societal continuance.  Immunization in children will depend on the established safety and effectiveness in these age groups.  This group represents about 45% of the general population.
  • Phase 4 (Fall 2021) – this phase covers any U.S. resident who did not receive the vaccine in previous phases.

For more questions around COVID-19, visit our resource area for Coronavirus.

Updated: Dec. 2020

  1. Marlin Binnebose

    I’m pushing 78 and I’m good health. Looks like I won’t get shot til phase 4. Bankers etc will get vaccinated before me!? Wow

  2. CHI Health

    The population percentage statistics are directly from the National Academy of Medicine Allocation Approach. These percentages are high level estimates based on known population data and include overlap between phases. For example; Phase 1 includes adults with two or more chronic conditions. It is estimated that around 30% of adults in the United States fall into this category. Phase 2 encompasses adults with a single chronic condition. This is estimated to be around 60% of the population of which one half would have two or more. Additionally, as we age it becomes more likely that we develop and manage a chronic health condition. Projections indicate that the final phase of Covid-19 vaccine allocation (those who have not received the vaccine in a previous phase0 would be around 10% of the population. For the relatively few individuals who fall in the category of 65 or older without a chronic condition they would be considered a healthy adult and would be eligible to receive vaccine as part of Phase 4. -Bob Grenier, PharmD

  3. June

    This is an Informative article. I searched for my vaccine phase and surprisingly found myself in Phase 4. I guess I thought the elderly seniors would be some of the first vaccinated since they have been touted as one of the most vulnerable and compromised groups. If you are a senior and do not live in a communal setting and do not have serious health issues, it appears you fall in phase 4, after all others. Thank you to all those who put their health at risk to care, teach or assist others.

  4. Michael Carlin

    Two groups of people are not listed in the Phase list: - 65 and older who DON'T live in communal living facilities? - 65 and older with underlying medical conditions that are not included in the list of chronic conditions?

  5. Gerald Demuth

    I find it interesting that in your writeup you indicate: "Those who seem to be at a higher risk for becoming ill are: Elderly (> 60 years old), with those over 85 being at most risk" yet those individuals are pushed to Phase 4 unless they have and underlying health issue or living in a communal facility. Do I read that right? Do the homeless, young adults, children, bank workers all receive the vaccine before those that you indicate are at a higher risk?

  6. Barbara Braden

    What happens to those of us who are over age 65 with no chronic conditions and living independently rather than in communal settings?

  7. Connie S Eggen

    I have seen things about forced vaccinations....I will not be coerced into a vaccine that is not proven and can have negative side affects.

  8. Nancy Wilson

    Where have you assigned those people over 65 without other health conditions and living independently?

  9. Chuck Real

    Am I to understand there is no plan for distribution to age 70+ except in the case of chronic health conditions, or living in a communal facility. That seems to put at risk the older population living at home without a pre-existing condition. Doesn't that somewhat ignore the statistics on the elderly being more susceptible to the virus?

  10. Michael Thomas

    I did not see in phase groups for age 65 and living at home unless that is in phase 4

  11. Myrle J Saunders Jr

    Great reading, really explains the facts about the COVID-19, what’s being done, and the facts on who will get the vaccine and when. Thank you

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