How the U.S. Vaccine Rollout Looks Right Now
Since Dec. 14, 2020, when an intensive care nurse in New York became the first American to receive an injection of a COVID-19 vaccine, the U.S. has delivered 109.9 million doses of two cutting-edge inoculations, from Pfizer-BioNTech and Moderna, that represent the greatest hope for closure to a pandemic that has claimed 2 million lives worldwide, including more than 500,000 Americans—by far the largest toll of any nation. Of those doses—which include both the first and second rounds of either vaccine, both of which require two shots several weeks apart—states and jurisdictions have administered 82.6 million: 54.0 million first doses, accounting for 16.3% of the total population, and 27.8 million second doses, or 8.4% of the total population. The interactive maps below indicate how many first and second doses each state has received from the federal government and how many have been administered.
While a few smaller states report having administered virtually all of the first doses they have received from the federal government, nationwide 75.1% of the vaccines–which have to be kept at extremely cold temperatures to remain viable–are confirmed to have been delivered to a patient’s arm. The precise percentage may vary slightly because of the several different sources of data on the rollout's progress. While the Department of Health and Human Services releases weekly figures on the number of Pfizer and Moderna drugs allocated and shipped to each state and territory, including how many of each are assigned for the initial and follow-up treatments, these maps use CDC figures on how many of those doses have arrived on site each day.
Figures for the number of doses administered comes from both federal data compiled daily by the Centers for Disease Control and Prevention and reports from individual states collected by the Johns Hopkins University Vaccine Tracker.
(reported and developed by TIME director of data journalism Chris Wilson)
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.
(compiled and written by TIME health reporter Jamie Ducharme)
When can I get a vaccine?
Estimates vary. Federal health authorities have said vaccines should be available to anyone who wants one by April 2021. But in December 2020, U.S. Surgeon General nominee Dr. Vivek Murthy said people should be prepared to wait until summer or even fall of 2021, depending on how smoothly rollout goes.
People who fit into several high-risk groups, however, will be eligible for vaccines much earlier, if they aren't already.
Each state gets to determine its own vaccine distribution, though the U.S. Centers for Disease Control and Prevention (CDC) has published recommendations to guide the process.
Frontline health care workers and residents of long-term care facilities are currently eligible for vaccination across the country. Many states have also begun vaccinating subsequent priority groups: elderly adults, essential workers and/or people with preexisting health conditions. In many areas, however, demand for vaccines is so high that even people who are technically eligible for shots have not been able to make appointments.
After those groups get access to vaccines, they will be rolled out to remaining American adults and teenagers. (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?
The answer to this question largely depends on where you live, since each state is handling distribution differently.
The CDC's vaccine advisory group initially recommended that health care workers and people living in long-term care facilities get the first doses. On Jan. 12, the Trump Administration issued new guidelines, recommending that all states expand access to adults 65 and older, as well as people with underlying medical conditions. But ultimately, each state gets to decide its own vaccine schedule—hence why 65-year-olds are currently eligible for shots in some states, but not others.
Perlman says the FDA’s vaccine advisory committee first discussed plans for getting the vaccine out to health care workers and nursing home residents, both of which are fairly fixed populations that are easy to locate. For people in later waves—like essential workers and people with underlying medical conditions—it might take “some self-advocacy,” Perlman admits.
“What I can imagine is people coming to a clinic, being told there are enough doses for people who have diabetes and are older, they’ll prove they have those things, and then they’ll get vaccinated,” Perlman says by way of example.
Some health systems are proactively identifying patients with conditions that put them at high risk of severe COVID-19—such as type 2 diabetes and heart disease—and messaging them about setting up appointments. In other areas, people must show proof of being a first responder or other essential worker. And in some places, anyone older than 65 is eligible for a shot.
In short, there’s no single answer to this question. Your best bet may be looking for information from your state health department or local hospital.
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.
When the U.S. vaccination program began, limited supplies and the fragility of the vaccines available at the time curtailed where the shots were available. Initially, Pfizer-BioNTech’s vaccine was the only option, and it needed to be kept at ultra-cold temperatures (-80°C to -60°C), which meant that the doses required specialty refrigeration, which many health care facilities could not offer. However, the U.S. Food and Drug Administration has since said that the Pfizer-BioNTech vaccine can be kept at regular freezer temperatures (-25°C to -15°C) for up to two weeks, which allows the vaccines to be distributed at a wider variety of places.
In addition, now that shots from Moderna and Johnson & Johnson are also available, vaccines can be distributed in more places. Moderna’s shot can also be stored at regular freezer temperatures, and Johnson & Johnson’s shot is the most flexible of all: it can be kept at normal refrigerator temperatures (2°C to 8°C). Unlike Moderna and Pfizer-BioNTech’s vaccines, it also requires only one shot, which makes a strong option for locations where it’s difficult for patients to return for a second shot, such as homeless shelters.
Changes to the way vaccines are produced and distributed have also helped increase overall distribution. For instance, additional syringes are now being distributed along with the Pfizer-BioNTech shots in order to extract more vaccines from its vials. The Biden Administration has also led an effort to expand the number of places where vaccines can be given out, including sending vaccines to pharmacies.
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—especially not at first.
Vaccine distribution plans vary from state to state. Depending on the proposals put together by your state’s health department, there may only be one type of vaccine available in your area, especially in the early phases of distribution when doses are limited.
We’ll learn more about how the different vaccines compare in the coming months. But in clinical trials, the shots made by Pfizer-BioNTech and Moderna (the only two authorized by the FDA so far) both appear to be almost 95% effective at preventing disease after two doses. AstraZeneca’s shot, which is not yet authorized in the U.S., looks to be about 70% effective on average.
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 have reported that 20,000 pregnant people in the U.S. have 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.
While many U.S. public health groups have taken that stance, others have been more cautious. The World Health Organization, for example, says Moderna's COVID-19 vaccine is "currently not recommended" for pregnant people—but that's given the lack of data, not documented safety concerns.
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 and Moderna have started enrolling children as young as 12 for their studies. And Oxford University is now testing its vaccine, which was developed in coordination with AstraZeneca and has not yet been approved in the U.S., in kids as young as six. Johnson & Johnson is also testing its vaccine in children 12 and older.
Shen says it will likely take manufacturers a while to amass enough data for health officials to recommend a vaccine for younger kids. “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, but it’s not clear when that would happen.
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 out of Israel suggests the Pfizer-BioNTech vaccine is around 85% effective at preventing disease after a single dose, but to reap the full benefits, you need both.
However, a new single-shot vaccine produced by Johnson & Johnson has been authorized in the U.S.—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 right away. It’s crucial to understand that these vaccines prevent you from getting sick with COVID-19, but they don’t necessarily prevent you from getting infected.
There have been some promising signs that COVID-19 vaccines may prevent infections, as well as symptoms of the disease. Preliminary data from Moderna’s trial, for example, suggest there were about two-thirds fewer positive test results among people who got a single dose of its shot versus the placebo. And in Israel, researchers found preliminary evidence that people who’d been vaccinated with one dose of the Pfizer-BioNTech vaccine tested positive for COVID-19 about 33% less frequently than unvaccinated people.
More research is required to conclude anything, which means it’s possible that, even if you’re vaccinated and never experience symptoms, you could potentially still carry and spread the virus. Plus, no vaccine is 100% effective.
Especially in the early days of rollout, when many people haven’t yet been vaccinated, it will be important to keep wearing masks and practicing social distancing to avoid putting unprotected people at risk of serious disease, Shen says.
That won’t last forever, but it will take a while for coverage to be widespread enough to drop other precautions. Shen says it’s impossible to predict exactly when you can put your masks in storage. It depends how quickly people get vaccinated, which will be dictated by both the logistics of distribution and the public’s willingness to get their shots.
If my loved one has been vaccinated already, is it safe for me to go visit?
Your grandparents (and probably some other relatives) will likely get vaccinated before you do. Once a loved one has received both vaccine doses, you can feel more confident that a visit won’t get them sick—but you should still wear a mask and practice social distancing, especially if you have not yet been vaccinated.
The COVID-19 vaccines available now have only been confirmed to protect against illness, not to block infection entirely. There is encouraging evidence that the shots also reduce the chances of getting asymptomatically infected, but research in that area is ongoing. That means there’s a chance that if you went to visit grandma while unknowingly carrying the virus, she could potentially still pick it up and transmit it to others, even if she herself didn’t get sick. She could also potentially infect you if she had previously been exposed. Plus, no vaccine is 100% effective, even though the currently available COVID-19 shots come awfully close.
Once both you and your loved one have received both vaccine doses, you can feel more confident about spending time together indoors and without masks. Until then, however, it’s best to play it safe.
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 of the COVID-19 vaccine candidates was developed a bit differently, so they’ll each come with a unique set of potential side effects.
If I already had COVID-19, do I need a vaccine?
Initially, there was some speculation about whether people who have had COVID-19—and thus have likely developed antibodies, proteins produced by the body to fight infection—would be barred from getting the shot, since they presumably already have some level of protection against the virus.
One paper posted online in December (which was not yet peer-reviewed) suggested it could be beneficial for COVID-19 survivors to wait to get vaccinated until those who have not had the virus get their shots, so that everyone has some amount of protection. The CDC’s vaccine advisory committee also suggested that if vaccine supplies run low among health care workers, those who have had COVID-19 within the past 90 days could wait to get vaccinated to free up doses for those without antibodies.
But as of now, there is no official policy preventing COVID-19 survivors from getting vaccinated, and experts have pretty clear guidance for those individuals: “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.
Will I need a COVID-19 vaccine every year?
It’s too soon to tell. Following up with people who have gotten the vaccines will help answer that question over time. They may end up being annual shots, like the flu vaccine; long-lasting shots that require occasional boosters, like the tetanus vaccine; or, possibly, lifetime-long immunizations.
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.