How the U.S. Vaccine Rollout Looks Right Now
Nearly three months into the U.S. COVID-19 vaccine rollout, only 26.9% of Americans have received both doses of the two-shot Pfizer-BioNTech and Moderna drugs or a single injection of the temporarily paused one-dose Johnson & Johnson version. Since the first vaccine was given to the first patient on Dec. 14, the U.S. has delivered 282.2 million doses of the cutting-edge inoculations, of which 218.9 million (77.6%) have been administered.
Given that the vaccination program represents the greatest hope to end a pandemic that has claimed 2 million lives worldwide, including more than 500,000 Americans, many are hoping that the pace of the rollout will accelerate as supply increases. The interactive maps and charts below are updated daily to track the progress of both the shipment of shots in the U.S. and the success in getting them into patients’ arms.
While this dashboard initially tracked first and second doses separately, with the introduction of J&J's one-shot vaccine, we now report "completed" treatments—representing either two shots of the Pfizer and Moderna vaccines or a single shot of the J&J vaccine, as well as "initial" treatments, representing those who have received just one dose of the two-dose vaccines.
While a few smaller states say they have administered virtually all of the first doses they have received from the federal government, there remains a nationwide gap between the reported number of surplus doses and ground-level reports of mass shortages. While the Department of Health and Human Services releases weekly figures on vaccine allocations and shipments to every state, territory, and a handful of federal programs, these maps use Centers for Disease Control and Prevention figures to show how many of those doses have arrived on site each day.
Answers to Key Questions About the COVID-19 Vaccine Rollout, and the Science Behind the Shots
To help answer common vaccine questions, we consulted Dr. Stanley Perlman, a professor at the University of Iowa’s Carver College of Medicine and a member of the U.S. Food and Drug Administration’s (FDA) vaccine advisory committee, and Angela Shen, a visiting scientist with the Vaccine Education Center at Children’s Hospital of Philadelphia.
Click on any of the questions below to see the answers.
When can I get a vaccine?
President Joe Biden has directed all states to open vaccine access to anyone 16 or older by April 19, 2021—even earlier than his prior deadline of May 1.
Many states have already done so, stripping away eligibility requirements that prioritized groups like the elderly, long-term care residents and frontline workers and welcoming all adults to get vaccinated.
(For more information on kids and vaccination, click here.)
I’m in a high-risk group. How do I make sure I get vaccinated early?
At this point, you probably don't have to worry about meeting strict eligibility criteria. Many states have already opened up vaccine access to all adults, and those that haven't have been directed to do so by April 19. As long as you're older than 16, you'll be able to get a vaccine soon.
Where will COVID-19 vaccines be available?
COVID-19 vaccines are now available in a variety of locations, including at pharmacies, hospitals, clinics, and mass vaccination sites in venues including professional sports arenas. However, you will likely need to arrange an appointment before you arrive. To find an appointment in your area, you can search VaccineFinder.org, which collects data directly from government agencies.
At the moment, most vaccination sites are using only Moderna and Pfizer-BioNTech's shots, after federal officials recommended a pause on Johnson & Johnson's shot while they investigate reports of extremely rare but serious blood clots among a handful of women who received it.
How much will it cost to get vaccinated?
Nothing for the vaccine itself. The federal Operation Warp Speed program funded vaccine development with the intent that they be offered free to all Americans, regardless of insurance status.
The caveat: The facility where you get the vaccine may choose to charge something like an administrative fee.
Can I choose which vaccine I get?
Probably not. Some vaccine providers do, however, list appointments for different shots separately, allowing people to choose if multiple shots are in stock. Right now, options are likely limited to the shots made by Pfizer-BioNTech and Moderna, as Johnson & Johnson's shot remains on a recommended pause after reports of extremely rare but serious blood clots in a handful of women who received it.
The shots made by Pfizer-BioNTech and Moderna both appear to be almost 95% effective at preventing disease after two doses. Johnson & Johnson's shot appears to be 66% effective at preventing symptomatic disease overall—but is 85% effective at preventing severe disease, and it has the added benefit of only requiring one shot.
Health officials have urged people to get whichever vaccine is first available, rather than picking and choosing among brands.
Can pregnant people get the vaccine?
Yes—but initial COVID-19 vaccine trials enrolled non-pregnant adults, so “there are no data on the safety and efficacy of COVID-19 vaccines [among people who are pregnant or breastfeeding] to inform vaccine recommendations,” the U.S. CDC says. Pfizer and BioNTech are testing their vaccine on 4,000 pregnant people around the world, but that trial may not finish for more than a year. Anecdotally, health officials in February reported that 20,000 pregnant people in the U.S. had so far been vaccinated, without any red flags.
As of now, it’s essentially up to each individual to decide what to do. Some may decide it’s worth it to get vaccinated, given that studies have shown pregnant people are at risk of severe disease or pregnancy complications if they get sick with COVID-19. “Women who are pregnant and/or lactating should not be excluded from what are identified as high priority populations for the COVID-19 vaccine allocation strategy,” the chair of the American College of Obstetricians and Gynecologists said in an October statement.
Many public health groups have taken that stance. The World Health Organization says there is no “specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.”
Can kids get the vaccine?
When the U.S. Food and Drug Administration granted emergency-use authorization to Pfizer-BioNTech’s vaccine, it did so only for people ages 16 and older; Johnson & Johnson and Moderna's shots were authorized only in people 18 and older. That means, at least for now, that younger children cannot get a COVID-19 vaccine in the U.S.
Initial clinical trials studied COVID-19 vaccine candidates only in adults. Pfizer-BioNTech, Moderna and Johnson & Johnson are all testing their shots in children of various ages, in order to prove that they are safe and provoke an immune response in younger people. In March, Pfizer-BioNTech announced that their shot appears to be 100% effective at preventing adolescents ages 12 to 15 from developing symptomatic disease.
Older kids may be able to get vaccinated at some point in 2021, but it's not clear when. “Once [data are] collected and analyzed, you could imagine a staggered rollout that would go to older children first, down to age 12, and then down to a lower age group,” Shen says.
Until then, parents will have to help their kids—who have fortunately been mostly spared the worst of COVID-19’s effects—take non-vaccine precautions, such as masking and social distancing.
Will I be protected if I only get one dose?
It depends which vaccine you receive.
If you are vaccinated with the Pfizer-BioNTech or Moderna shots, you will not be fully protected with one dose. Both are designed to be given in two separate doses, a few weeks apart. When you receive the first dose of a two-dose vaccine, it kick-starts your body’s immune system; the second significantly strengthens your immune response. Recent research from the CDC says a single dose provides about 80% protection against infection, but "it's a bit of a tenuous 80%," according to National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci. In other words, it's not clear how long that protection lasts. To get the vaccine's full benefits, you need both doses.
Johnson & Johnson's shot, however, is meant to be given in a single dose. Studies show that it is 85% effective at preventing severe disease.
Can I get a first dose of one vaccine, and a second dose of another?
No. The CDC says the currently authorized COVID-19 vaccines are "not interchangeable with each other or with other COVID-19 vaccine products."
The FDA’s vaccine advisory committee has discussed the possibility of eventually mixing doses, according to Perlman, since most of the vaccines target the same protein within the body, even though they do so using different technologies. So far, however, each vaccine has only been studied independently, so experts are calling for everyone to get two doses of the same shot.
In the U.K., experts have said it may be necessary to mix and match doses on "extremely rare occasions," but maintain that ideally both doses should come from the same manufacturer.
How will I keep track of which vaccine I got and when?
When you get your first dose, you should get a card on which your health care provider will mark the date and brand of the shot. The card will also say when you’re due for your second dose.
If you lose your card, don’t panic. CNN reports that many states will also keep searchable records of patients’ immunization statuses. Some providers may also use voluntary text message reminder programs to prompt patients to come in for their second dose.
Once I get vaccinated, can I go back to normal life?
Not totally, but you’ll get closer.
In March, the U.S. Centers for Disease Control and Prevention released guidance for fully vaccinated individuals (those who are at least two weeks out from their second Pfizer-BioNTech or Moderna dose, or the single-dose Johnson & Johnson vaccine). People who meet those standards can safely gather in a private home with a small group of other fully vaccinated people, the CDC says, and can also visit with a household of unvaccinated people, as long as none of them have risk factors for severe disease. In April, the CDC also said fully vaccinated individuals can travel at low risk to themselves, though the agency did not fully recommend a return to non-essential travel given rising case counts.
Those guidelines are based on increasingly promising science that suggests COVID-19 shots slow transmission of the virus, as well as symptomatic illnesses. One recent study found that both two-dose vaccines were 90% effective at stopping not just COVID-19 disease, but also infections. Research is ongoing, but those findings suggest vaccinated people are much less likely to spread the virus than non-vaccinated people.
With that said, even fully vaccinated people should continue wearing masks in public and avoiding crowds, the CDC says, since most of the American public is not yet fully protected against the virus and new variants continue to spread.
If my loved one has been vaccinated already, is it safe for me to go visit?
Maybe, under guidance from the U.S. Centers for Disease Control and Prevention, which says that fully vaccinated people—those who are at least two weeks out from their second Pfizer-BioNTech or Moderna dose, or the single-dose Johnson & Johnson shot—can visit with unvaccinated people from a single household. The caveat: If you have any risk factors for severe disease, like an underlying health condition, you may want to wait to visit until you're vaccinated. You may also want to skip it if the visit will involve interstate travel, which the CDC still does not recommend for unvaccinated people.
Encouraging new evidence suggests the two-dose COVID-19 vaccines are about 90% effective at blocking infections, as well as symptomatic disease. So if your loved one is vaccinated, they seem unlikely to pass on the virus to you. The visit still carries a small amount of risk if you're unvaccinated, but it's pretty safe.
Once both you and your loved one have received both vaccine doses, you can feel even more confident about spending time together indoors and without masks.
How do we know these vaccines were developed safely?
Just like any vaccine, those authorized for emergency use against COVID-19 have gone through a rigorous review process by the U.S. Food and Drug Administration, which receives input from its expert vaccine advisory committee. If anything, Shen says, the FDA has given COVID-19 vaccine developers more stringent guidelines than usual. “They have told industry, ‘We need at least 30,000 individuals in a Phase 3 trial,’ and they usually don’t give a number,” she explains.
The FDA has also asked each manufacturer to track study participants for two months after they get fully vaccinated, to help ensure the vaccines do not come with serious side effects. The agency also said up front that it will not approve any vaccine less than 50% effective at preventing COVID-19, Shen says. (Pfizer, Moderna and AstraZeneca have so far reported that their vaccines are significantly more effective than that.)
The speed of vaccine development shouldn’t be cause for concern. It’s true that COVID-19 vaccines were developed much faster than typical shots, but that’s in part because pharmaceutical companies had massive amounts of government funding and manufacturing support—and because many other research efforts have been put on hold to facilitate vaccine development.
Can I get the shot if I have allergies?
During the first month of vaccination in the U.S., there were only 4.5 severe allergic reactions per million doses administered, according to CDC data.
The risk is quite low, but the CDC recommends that anyone with a known allergy to polyethylene glycol, a component of both the Pfizer-BioNTech and Moderna vaccines, or polysorbate, a substance which may cause a similar reaction, avoid vaccination unless they’ve been cleared by an allergist-immunologist. Johnson & Johnson's vaccine does not contain polyethylene glycol.
People who have experienced allergic reactions after getting other vaccines should consult their doctors prior to vaccination, and alert providers at the vaccination site so they can be monitored for about 30 minutes after getting the shot.
People with other types of allergies—such as to foods, animals or oral medications—can get the shot.
What are the vaccines’ side effects?
Each COVID-19 vaccine was developed a bit differently, so they’ll each come with a unique set of potential side effects. Across brands, common reactions include pain or swelling at the injection site, fatigue, headaches or muscle aches and low-grade fever. For most people, these effects are fairly mild and clear after about a day.
Some people have also reported less-common side effects, including skin rashes and arm swelling more than a week after vaccination.
If I already had COVID-19, do I need a vaccine?
“If you can get a vaccine, you should,” Shen says. While natural antibodies likely provide some level of immunity against the virus, it’s not yet clear how well they work or how long they last. A vaccine is a surer bet for protection.
A study published in March underscores that conclusion. Researchers in Denmark found that COVID-19 survivors had, on average, about 80% protection against reinfection—but getting the disease again was possible. Elderly adults appeared to be at highest risk of reinfection. For people older than 65, a prior infection only provided 47% protection against a future one, the researchers found. A separate study published in April, which looked at U.S. Marines recruits ages 18-20, also found that 10% of those who had COVID-19 later tested positive for it again.
There is some evidence to suggest COVID-19 survivors mount a strong immune response after a single vaccine dose, but there's no official guidance to that effect at the moment—so you should plan on getting a full course of vaccinations even if you've had the virus.
Will I need a COVID-19 vaccine every year?
It’s too soon to tell, but it's looking increasingly likely.
A recent study from Pfizer-BioNTech found that its vaccine offered protection for six months, but it's not yet clear if the shots will last even longer than that. Pfizer's CEO recently said people will "likely" need a third dose within a year of their second one, after which the shots could be given annually.
Following up with people who have gotten the vaccines will help determine how often they need to be re-upped.
Can my employer require me to get a COVID-19 vaccine?
They probably can, but many probably won’t, says Stacy Hawkins, an employment law expert at Rutgers Law School. As of January, employers polled by consulting firm West Monroe were split almost 50-50 on that question.
There is legal precedent for private employers requiring certain vaccinations—many health care facilities, for example, require staff members to get annual flu shots. That’s legal, as long as the employer offers accommodations for people with disabilities or religious objections, Hawkins says.
That said, Hawkins thinks most employers will encourage or incentivize COVID-19 vaccination, rather than flat-out requiring it as a condition for returning to or continuing in-person work. For one thing, COVID-19 vaccines have been granted emergency-use authorization, as opposed to full FDA approval. Typically, people have more legal leeway to refuse a product authorized under emergency use.
Hawkins adds that a mandatory vaccine policy can get businesses into tricky liability scenarios. Take a retail business. Employees who must report for in-person work, such as cashiers and stockroom employees, would face more immediate consequences from refusing a mandatory vaccine policy than would upper managerial staffers who could presumably work from home. It gets even stickier if one group of employees is predominantly of color, while the other is predominantly white, she says.
“Under federal workplace anti-discrimination law, even policies that are neutral on their face, like a mandatory vaccine policy, but that have a racially discriminatory impact, may give rise to employer liability,” Hawkins explains.
Do I need a COVID-19 shot and a flu shot?
Yes. Different viruses cause the seasonal flu and COVID-19. And since it is possible to get both viruses in one season, doctors recommend you get both shots.