Answers to Your Questions About the New Covid Vaccines in the U.S.

Vaccines are rolling out to health workers now and will reach the arms of the rest of us by spring. Here’s what you need to know.

The Pfizer-BioNTech Covid vaccines are prepared to be shipped at a Pfizer plant on Dec. 13, 2020 in Portage, Michigan.
The Pfizer-BioNTech Covid vaccines are prepared to be shipped at a Pfizer plant on Dec. 13, 2020 in Portage, Michigan.Credit…Pool photo by Morry Gash

Published Dec. 14, 2020Updated Jan. 14, 2021

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Keep reading for answers to these questions and more.

Who is eligible for the Covid vaccine?
I qualify now. How do I sign up?
How long will it take to work?
Will it hurt? What are the side effects?
I had Covid-19 already. Do I need the vaccine?
Will it work on older people?
Why not take my chances with Covid-19 rather than get a vaccine?
What about women who are pregnant or breastfeeding?
When will vaccines be available for children?
What if I forget to take the second dose on time?
What will life be like after vaccination?
How do these new genetic vaccines work?

Who is eligible for the Covid vaccine?
ImageA nurse in Martinez, Calif. receives the vaccine on Tuesday.
A nurse in Martinez, Calif. receives the vaccine on Tuesday.Credit…Sarahbeth Maney for The New York Times

Currently more than 150 million people — almost half the population — are eligible to be vaccinated. The nation’s 21 million health care workers and three million residents of long-term care facilities were the first to qualify. In mid-January, federal officials urged all states to open up eligibility to everyone 65 and older and to adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19. States will decide which medical conditions might qualify someone to be vaccinated before the general population, although the federal Centers for Disease Control and Prevention has published a list of particularly high-risk conditions, including cancer, diabetes and obesity.

The C.D.C. recommendations aren’t binding, and ultimately states will decide vaccination priorities. Some states have prioritized people whose jobs put them at substantially higher risk of exposure to the virus, such as teachers, emergency responders and grocery store employees. To find out about eligibility in your state, check your state health department website.

Adults in the general population are at the back of the line. If federal and state health officials can clear up bottlenecks in vaccine distribution, everyone 16 and older will become eligible as early as this spring. The vaccine hasn’t been approved in children, so it may be several months, or possibly a year, before a vaccine is available for anyone under the age of 16. Read more here. —Abby Goodnough
How much vaccine does the U.S. have access to?

There aren’t enough doses for everyone, so initially the vaccine will be rationed for those who need it most. It will take time to produce and distribute the vaccine, and then schedule two vaccinations per person, three to four weeks apart.

So far, Pfizer and Moderna, the only two companies whose vaccines have been approved for emergency use here, together have pledged to provide 400 million doses through July. Both vaccines require two doses, so that will be enough for 200 million people, out of roughly 260 million who are eligible at this point to be vaccinated. Children younger than 16 are not yet eligible for Pfizer’s vaccine, and those younger than 18 cannot yet take Moderna’s. Johnson & Johnson, which has a single-dose vaccine candidate in late-stage clinical trials, has a contract with the federal government to provide 12 million doses by the end of February, and a total of 100 million doses by the end of June. But the company has fallen behind on its production schedule. How many doses will your state get? Look up your state’s vaccine distribution plans here. —Abby Goodnough
How will the first doses of the vaccine get to health workers?

Hospitals and medical groups are contacting health workers to schedule vaccine appointments. FedEx and UPS will transport the vaccine throughout most of the country, and each delivery will be followed by shipments of extra dry ice a day later.

Pfizer designed special containers, with trackers and enough dry ice to keep the doses sufficiently cold for up to 10 days. Every truck carrying the containers will have a device that tracks its location, temperature, light exposure and motion. Pfizer will ship the special coolers, each containing at least 1,000 doses, directly to locations determined by each state’s governor. At first, almost all of those sites will probably be hospitals that have confirmed they can store shipments at minus 94 degrees Fahrenheit, as the Pfizer vaccine requires, or use them quickly. —Abby Goodnough
How will the vaccine get to nursing homes?

The pharmacy chains CVS and Walgreens have contracts with the federal government to send teams of pharmacists and support staff into thousands of long-term care facilities in the coming weeks to vaccinate all willing residents and staff members.

More than 40,000 facilities have chosen to work with CVS. Nearly 35,000 picked Walgreens. Each U.S. state has already picked either the Pfizer or the Moderna vaccine for all of its long-term care facilities that will be working with the pharmacies. —Rebecca Robbins, Abby Goodnough
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I qualify now. How do I sign up?
Image
When the vaccine is more widely available, shots will be handed out similarly to flu shots — through clinics and pharmacies.
When the vaccine is more widely available, shots will be handed out similarly to flu shots — through clinics and pharmacies.Credit…Brian Kaiser for The New York Times

This depends very much on what state or even what county you live in. Some local public health departments have set up portals where people can make appointments; others are holding mass vaccination events and inoculating people on a first-come, first-served basis. Generally, doctor’s offices and pharmacies have asked that patients and customers not call them seeking vaccine appointments just yet, and instead wait to be contacted. Most pharmacies are not yet offering the vaccine, but CVS, Walgreens and a number of other chain pharmacies, including some in grocery and big-box stores, will soon start doing so through a partnership with the federal government. —Abby Goodnough
Is the vaccine free?

You should not have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you don’t have insurance, you should still be given the vaccine at no charge. Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a co-payment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients, including those who are uninsured. Even so, health experts do worry that patients might stumble into loopholes that leave them vulnerable to surprise bills. This could happen to those who are charged a doctor visit fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules. If you get your vaccine from a doctor’s office or urgent care clinic, talk to them about potential hidden charges. To be sure you won’t get a surprise bill, the best bet is to get your vaccine at a pharmacy once the shots become available. Read more here. —Sarah Kliff
Is there a risk my state will run out of vaccine before I get my second dose?

The Trump administration decided in January to release all available doses of the vaccine instead of holding about half in reserve for second doses. The transition team for President-elect Joe Biden has also said that the incoming administration would release almost all doses from the government’s reserves. It’s not clear yet how the new policy will affect the availability of second doses, but health officials have said that the requirement for a reserve would end once the government became more confident in the vaccine supply chain. Read more here. —Sheryl Gay Stolberg and Abby Goodnough
Can I choose which vaccine I get?

This depends on a number of factors, including the supply in your area at the time you’re vaccinated and whether certain vaccines are found to be more effective in certain populations, such as older adults. The Pfizer and Moderna vaccines are the only two vaccines currently approved. —Abby Goodnough
How long will it take to work?

You won’t get the full protection from the Pfizer-BioNTech vaccine until about a week after the second dose, based on clinical trial data. The researchers found that the vaccine’s protection started to emerge about ten days after the first dose, but it only reached 52 percent efficacy, according to a report in the New England Journal of Medicine. A week after the second dose, the efficacy rose to 95 percent. Read more here. —Carl Zimmer, Noah Weiland
Will it hurt? What are the side effects?

The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems other than allergic reactions. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain.

While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity. —Abby Goodnough, Carl Zimmer
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How do I know it’s safe?

Each company’s application to the F.D.A. includes two months of follow-up safety data from Phase 3 of clinical trials conducted by universities and other independent bodies. In that phase, tens of thousands of volunteers got a vaccine and waited to see if they became infected, compared with others who received a placebo. By September, Pfizer’s trial had 44,000 participants; no serious safety concerns have been reported. — Abby Goodnough
If I have allergies, should I be concerned?

People with severe allergies who have experienced anaphylaxis in the past should talk to their doctors about how to safely get the vaccine and what precautions to take. Health officials are recommending that people with allergies should still get their shots and wait the standard 15 minutes post-injection before leaving the vaccination site. Anyone who previously had an anaphylactic reaction to a substance, including another vaccine or injectable drug, should be monitored for an extra 15 minutes.Although severe reactions to vaccines are rare, federal agencies are investigating at least six cases involving people who suffered anaphylaxis after receiving the Pfizer-BioNTech vaccine, during the first few weeks of its distribution in the U.S. Two health care workers in Britain had anaphylaxis after receiving the vaccine on the first day it became available there. And a Boston physician reported a severe allergic reaction shortly after receiving the Moderna vaccine. In all cases the patients were treated and have recovered. (Anaphylaxis can be life-threatening, with impaired breathing and drops in blood pressure that usually occur within minutes or even seconds after exposure to a food, medicine or substance like latex.) With more than 1.1 million injections already delivered to arms across the country, severe allergic reactions remain a rarity, and should not prompt concern in most people, said Dr. Merin Kuruvilla, an allergist and immunologist at Emory University. “This should not deter people who are not obviously at increased risk,” she said. Read more here. — Katherine J. Wu, Denise Grady
What will happen if serious side effects crop up after the vaccine is rolled out?

Once a vaccine starts to reach large numbers of people, it’s possible (and not uncommon) for a small number of severe “adverse events” to occur. Many existing vaccines, including the flu shot, also can cause rare complications, including Guillain–Barré syndrome, seizures and sudden unexplained death. While this sounds frightening, the risk is minuscule when considered over the millions of people who are safely vaccinated each year, and some of these complications can be triggered by the virus itself. Health officials will investigate each event to see if it’s simply coincidence — or if it could have been caused by the vaccine. While everyone should be prepared to hear about these reports, they should not be a cause for worry or prompt you to delay getting the vaccine. Your risk of severe complications from Covid-19 is far higher than your risk of complications from the vaccine. Read more here. —Donald G. McNeil Jr.
I had Covid-19 already. Do I need the vaccine?

It’s safe, and probably even beneficial, for anyone who has had Covid to get the vaccine at some point, experts said. Although people who have contracted the virus do have immunity, it is too soon to know how long it lasts. So for now, it makes sense for them to get the shot. The question is when. Some members of the C.D.C. advisory committee have suggested people who have had Covid in the past 90 days should be toward the back of the line.Read more here. —Abby Goodnough, Apoorva Mandavilli
Will it work on older people?
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Frank Bruno, 95, participated in a trial for the Moderna vaccine.
Frank Bruno, 95, participated in a trial for the Moderna vaccine.Credit…Cassidy Araiza for The New York Times

All the evidence we have so far suggests that the answer is yes. The clinical trials for the two leading vaccines have shown that they work about the same in older people as younger people. As the vaccines get distributed, the vaccine makers and the C.D.C. will continue to monitor the effectiveness of the vaccine in people 65 and older who, because of age-related changes in their immune systems, often don’t respond as well to vaccination as younger people do. But just as certain flu vaccines have been developed to evoke a stronger immune response in older people, it’s possible that one of the new vaccines could emerge as a better option for this age group. It’s just far too soon to know. Read more here. —Carl Zimmer
Why not take my chances with Covid-19 rather than get a vaccine?

Covid-19 is by far the more dangerous option, even if you are young and at low risk. Although people who are older, obese or have other health problems are at highest risk for complications from Covid-19, younger people can become severely ill, too. In a study of more than 3,000 people ages 18 to 34 who were hospitalized for Covid, 20 percent required intensive care and 3 percent died.

And as many as one in three people who recover from Covid have chronic complaints, including exhaustion, a racing heart and worse for months afterward. Covid vaccines, in contrast, carry little known risk. Read more here. —Apoorva Mandavilli
The New York Times