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COVID-19 vaccines are coming. Here's who will get it first - CNET

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Coronavirus vaccines are just around the corner, but most people probably won't be able to get them until well into 2021.

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Coronavirus vaccines will be here soon, but there won't be enough for everyone at first. There are over 330 million people in the US, but Pfizer, whose vaccine is expected to receive Food and Drug Administration authorization in the coming weeks, says it expects to produce enough to vaccinate about 12.5 million Americans by the end of 2020, or about 3.7% of the US population. 

Other vaccines, like one from Moderna that uses similar technology to Pfizer's, may be authorized in the next few weeks or months as well, which will add to the overall stockpile. Regardless, it will be several months at least before most people in the US who want a vaccine might be able to get one, and it could take years to vaccinate everyone in the world. 

The question then becomes, who will get those first doses of vaccines and how long will you yourself have to wait to get vaccinated? So far, there are no definitive answers. A lot depends on who needs immunization against COVID-19 the most -- older adults, those with underlying conditions, and so on. But another factor will be how the different vaccines themselves actually work. For example, some single-dose vaccines might better serve one group, like rural populations. Other groups -- city-dwellers, say -- might be equally well-protected by vaccines that require subsequent "booster" doses.

We won't know for certain who will be first in line to get a coronavirus vaccine until one or more are approved, but we can look at available information to get an idea. Many of the agencies involved in creating and implementing those guidelines have already begun explaining how they plan to make those decisions when the time comes.

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Even after coronavirus vaccines are authorized, people will have to continue wearing masks and taking other preventative measures for months to come.

Angela Lang/CNET

We dug through reports from agencies such as the US Centers for Disease Control and Prevention to piece together a rough outline of who the experts expect will be the first groups to get COVID-19 vaccinations and why. This article is intended to be a general overview and not a source of medical advice. If you're seeking more information about coronavirus testing, here's how to find a testing site near you.

When will the first COVID-19 vaccines arrive? Will there be more than one?

Short answer: The first vaccine is expected soon and it looks like there will be more than one safe, effective type. Pfizer, which says its vaccine candidate is over 90% effective at preventing coronavirus infections, is expected to be the first COVID-19 vaccine to receive Food and Drug Administration authorization in the coming weeks and to start delivering doses before year's end. 

Moderna isn't far behind and is expected to release efficacy results in the coming days. It could have FDA authorization by December. Vaccines from AstraZeneca and Johnson & Johnson are wrapping up late-stage trials, while a fifth manufacturer, Novavax, is set to begin the final trial for its vaccine sometime later this month. 

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Life probably won't be back to normal until late 2021 or 2022 at the earliest, which could mean regular temperature checks until coronavirus is no longer a threat.

Angela Lang/CNET

The general consensus has been -- and  continues to be -- that the first COVID-19 vaccines will probably be approved in the US soon, but won't reach widespread distribution until closer toward the end of 2021. Until then, supplies are expected to be limited, which is partially why we will need multiple vaccines to treat as many people as possible.

How soon after approval will inoculations start?

"[The government] has plans to distribute vaccines within 24 hours after the ACIP gives its final approval," Paul Mango, a Health and Human Services official, told reporters in October, referring to the CDC's Advisory Committee on Immunization Practices, which is the group that officially sets national guidelines for who should get vaccines once they've been authorized by the FDA.

Who will get the coronavirus vaccine first?

Bill Gruber, Pfizer's senior vice president of vaccine clinical research and development, told Scientific American that Pfizer's vaccine is on track to be distributed to health care workers on the front lines as well as people at high risk of severe disease as soon as the drug is authorized, probably around mid-December.

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Some vaccines will require more than one dose to be effective.

Angela Lang/CNET

Here's who the CDC identified as the top four priority groups to receive the first COVID-19 doses.

Health care workers: Vaccinating roughly 20 million US doctors, nurses, lab technicians and other health care providers helps protect both the country's front-line COVID-19 responders and the patients they care for.

Essential workers: Approximately 87 million US workers provide the basic goods and services we need to survive. Most can't work from home and many jobs require interacting with the public, so guarding against COVID-19 among this population would have a ripple effect across the whole country while also reducing critical service interruptions.

People with underlying medical conditions: Specifically, the 100 million or so people with conditions putting them at high risk for illness or death from COVID-19. Any disease affecting the lungs, but also anything that could compromise a person's immune system, like cancer or HIV. 

Older adults: Risk of severe complications from COVID-19 increases with age. The CDC's ACIP recommends the approximately 53 million US adults age 65 and over be among the first to get vaccinated. 

What if I'm not in one of those groups?

The reality is that you may just have to wait. The top infectious disease expert in the US, Dr. Anthony Fauci, told Good Morning America in November that he expects "the ordinary citizen" should be able to get a vaccine by April, May or June 2021. 

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Normal life probably won't resume for a while, which could mean no sitting in waiting rooms until coronavirus is no longer a threat.

Sarah Tew/CNET

If the vaccine is right around the corner, how soon can I resume normal life?

Infection rates in the US are skyrocketing, with the seven-day rolling average now at almost 140,000 new infections per day and climbing. Europe is entering a second phase of lockdown amid its own spike in new cases. One of the key advisors on president-elect Joe Biden's COVID-19 task force, Dr. Michael Osterholm, has recommended a nationwide lockdown in the US for four to six weeks to help contain the rapidly-spreading virus. (President Donald Trump said Nov. 13 there would be no lockdown under his administration.) Meanwhile the New York City public school system is considering closing down again. 

In other words, we're not out of the woods yet, especially as we get closer to winter, when coronavirus-related deaths are expected to continue surging. Experts agree that people who leave their households will need to continue to wear masks, avoid crowds, maintain social distance and practice regular hand washing until further notice.

Shouldn't priority go to the most vulnerable?

Prior to 2009, older adults and patients with underlying health conditions typically topped lists of those who should get first dibs on a new vaccine because, for them, getting sick could quickly turn into a death sentence. However, that line of reasoning began to shift after a 2009 paper published in the journal Science suggested that health officials dealing with a limited vaccine supply could prevent far more people from getting sick and dying simply by vaccinating those who were most likely to transmit a given disease, rather than those at risk of getting the sickest.

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Unfortunately, coronavirus vaccines aren't as simple as just taking a few pills.

Sarah Tew/CNET

That paper specifically addressed H1N1 -- the "swine flu" -- and generally dealt with seasonal influenzas. In it, researchers identified the biggest demographic of flu-spreaders as children aged 5 through 19. That's why the CDC now advises everyone aged 6 months and older to get a yearly flu vaccine. In the case of COVID-19, experts have identified health care workers on the front lines as the group most likely to catch and therefore spread the disease, which is why they will be among the first to receive vaccinations. 

Whether or not COVID-19 vaccines are effective at stopping the spread of coronavirus will depend a lot on how our bodies build immunity to the disease. Here's what we know so far about whether or not you can get COVID-19 more than once. Testing is also key to slowing coronavirus's spread -- learn about a device that can produce results in under 90 minutes here. And read up on how all of these issues and more weigh in on Biden's plan to fight COVID-19.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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