Vaccines — What You Need to Know

Why should you get vaccinated and boosted?

Vaccines (including boosters) are one of the most effective public health tools available to prevent disease and help end the pandemic. Getting vaccinated prevents severe illness, hospitalizations, and death. Vaccination can also reduce the spread of disease, which helps protect those who get vaccinated and the people around them. It’s important to learn more about why vaccinations are so important and how they work. In America, COVID-19 cases have begun rising again across our country and world due to the highly contagious Omicron strain and its subvariants, BA.2, and XBB1.5., and more, which now constitute more than 75% of cases in the United States. For detailed information on the prevalence of currently circulating variants, visit the CDC COVID Data Tracker: https://covid.cdc.gov/covid-data-tracker/#variant-proportions.

Immunization is critical to halting the further spread of the COVID-19. As the pandemic evolves and new viral variants emerge, it is important to maintain a high level of vaccine-mediated immunity in our communities to stop the spread of the disease. Boosters are the key to keeping us safe in the long-term.

Some people may be concerned about getting COVID-19 vaccines. Accurate vaccine information is essential and can help stop common myths and rumors as well as the infodemic of misinformation circulating about them.  While COVID-19 vaccines were developed more rapidly than previous immunizations for other diseases, strict guidelines are used to ensure their safety and effectiveness by the U.S. Food and Drug Administration (FDA).

Find a summary of the benefits of COVID-19 vaccination here.

Here are some key things you and your family need to know about COVID-19 vaccines.

Find a summary of the benefits of COVID-19 vaccination based on what we currently know here.

Here are some key things you and your family need to know about COVID-19 vaccines.

How do COVID-19 vaccines work?

Vaccines have been rapidly developed to prevent COVID-19. A vaccine is a substance that stimulates a person’s immune system to build resistance to a specific disease, protecting the person from that illness. Vaccines reduce the risk of getting a disease by working with your body’s natural defenses to build immune protection. When you get a vaccine, your immune system responds — it recognizes the invading germ, such as a virus like SARS-CoV-2; produces antibodies (special proteins that stop the spread of the virus) to fight the disease; and remembers the disease in order to fight it in the future.

As new viral variants emerge, your body must be prepared to respond to them, and boosters are key in preparing your immune system to do so. Booster vaccines reintroduce your immune system to the virus (but does not cause an infection), and some changes in viral structure that have occurred, so that you are protected against new variants as well as old ones. The most recently available bivalent booster protects against the original viral strain of COVID-19 as well as the one of the newer omicron variants that is currently circulating.

Learn the basics about the immune system and the different types of COVID-19 vaccines here.

Learn more about how COVID-19 vaccines work

Different Types of COVID-19 Vaccines

Understanding mRNA COVID-19 Vaccines

Report Vaccine Side Effects

Coronavirus Variants

Learn more about how COVID-19 vaccines work

Different Types of COVID-19 Vaccines

Understanding mRNA COVID-19 Vaccines

Report Vaccine Side Effects

Coronavirus Variants

What progress is being made in developing additional COVID-19 vaccines?

Novavax has developed a two-dose, protein-based coronavirus vaccine. In January, 2021, Novavax announced results from a Phase 3 clinical trial conducted in the United Kingdom that their vaccine had an efficacy rate of 89%. In June 2021, the company also announced a 90% effectiveness rate from a 30,000 person clinical trial conducted in the United States and Mexico. The Novavax vaccine can be shipped at normal refrigeration temperatures and will stay stable for up to three months in a refrigerator, making it much easier to distribute than many other available vaccines. Novavax is expected to submit a request to the U.S. Food and Drug Administration for an Emergency Use Authorization (EUA) of its COVID-19 vaccine sometime in 2022. The vaccine manufacturer had to delay its U.S. submission multiple times due to development and manufacturing setbacks.

Other countries have approved additional vaccines for use in their populations and more are expected to be reviewed in the coming months. Some scientists are working on developing intranasal vaccines that potentially could provide more durable protection than mRNA vaccines. Intranasal vaccines can elicit antibodies and T cells that circulate throughout the body, but are most efficient at inducing the production of antibodies that can bind to viruses before they invade mucosal surfaces of the nose, eyes and mouth, where people are most vulnerable to respiratory viruses such as SARS-CoV-2. This could also help block transmission of the virus to other people. The use of intranasal vaccines would also be a less invasive method of administering immunizations potentially increasing compliance. Some suggest they would also be less expensive to manufacture, transport and administer as well. Basic and clinical studies are underway to test several different formulations of intranasal vaccines for their safety, effectiveness and durability in preventing COVID-19 infection and transmission.

Other research is underway at Walter Reed Medical Center and other institutions to create a single vaccine against all COVID & SARS variants. Walter Reed’s SpFN immunization uses a soccer ball-shaped protein with 24 faces for its vaccine, which allows scientists to attach the spikes of multiple coronavirus strains on different faces of the protein. Phase I clinical trials are underway. This approach is looking towards the future rather than focusing solely on the original variants of COVID. The platform and approach of this scientific team hopes to design a vaccine that can help protect against the evolving mutations of these viruses.

Which COVID-19 vaccines are currently available in the United States?

Currently, the Moderna and Pfizer vaccines have been approved by the FDA to prevent COVID-19 in the United States. The bivalent booster vaccines from Moderna and Pfizer are available under Emergency Use Authorization.  The J&J COVID-19,Novavax and Janssen/Johnson and Johnson vaccines are available under Emergency Use Authorization (EUA).  More than 12 billion vaccine doses have been administered in America, but vaccination rates have plateaued. Approximately 20% of people in the United States are still unvaccinated.

Visit the CDC Vaccine Administration Tracker to learn more about progress in getting people immunized in America to prevent COVID-19.

Depending on where you live and the facility where you get vaccinated, you may receive any one of these options

• ​​​​Pfizer-BioNTech COVID-19 vaccines (monovalent and bivalent)
• Moderna’s COVID-19 vaccine​​ (monovalent and bivalent)
• Novavax  COVID-19 Vaccine
• Johnson & Johnson’s COVID-19 vaccine
• Janssen COVID-19 Vaccine

The first two vaccines listed above are from a new generation of immunizations that use mRNA technology to fight the novel coronavirus and were found to be at least 94% effective initially in preventing hospitalizations and deaths from COVID-19. mRNA vaccines teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. This immune response produces antibodies and helps protect us from getting infected if the real virus enters our system.

The primary vaccination series consists of two shots administered3-8 weeks apart. A booster is needed at least 2 months after the second dose. These guidelines apply to both children and adults aged 6 months and older. For immunocompromised individuals and individuals older than 50, the first booster should be administered at least four weeks after the primary vaccination series is completed A second booster dose for immunocompromised individuals  and people older than 50 can be administered at least two months after the first booster.

Adults and children older than 5 who receive the Pfizer or Moderna primary vaccination series may choose to receive either the Pfizer or Moderna booster series. For children younger than 5, the CDC recommends keeping the primary vaccination series and the booster series consistent (matching vaccines).

The FDA provided an emergency use authorization for the Novavax vaccine in July 2022. While other vaccines trick the body’s cells into creating parts of the virus that can trigger the immune system, the Novavax vaccine takes a different approach. It contains the spike protein of the SARS-CoV-2 itself, but formulated as a nanoparticle, which cannot cause disease.

The primary vaccination series for Novavax consists of two doses taken 3-8 weeks apart. A bivalent Moderna or Pfizer booster is recommended at least two months after the end of the primary Novavax vaccine series. Novavax is not authorized for children younger than age 12. The same guidelines apply for immunocompromised individuals.

The FDA provided an EUA for use of the Janssen vaccine in people 18 years and older for whom other FDA authorized or approved COVID-19 vaccines are not accessible o clinically appropriate, and individuals 18 years and older who elect to receive the Janssen vaccine because they would otherwise not receive a COVID-19 vaccine. The Johnson & Johnson vaccine was 72% effective in preventing COVID-19 in the United States. It is nowrecommended that people who received the J and J vaccine receive a booster dose of one of the mRNA COVID-19 vaccines at least two months after receiving the J & J vaccine. For immunocompromised individuals, a booster of the Pfizer or Moderna vaccine is recommended at least 4 weeks after the first does, followed by a  bivalent mRNA booster two months later.

The CDC now recommends that in most situations, the Pfizer-BioNTech, Moderna, or NovavaxCOVID-19 vaccines are preferred over the Janssen vaccine for primary vaccinations due to the risk of adverse events  with these products. Bivalent mRNA boosters are recommended for all individuals

The Janssen/J&J COVID-19 vaccine may still be considered in some situations, including for persons who:

• Had a severe adverse reaction after an mRNA vaccine  or who have a severe allergy to an ingredient of Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines.
• Would otherwise remain unvaccinated for COVID-19 due to limited access to Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines.
• Prefers getting the J&J COVID-19, Janssen vaccines despite being informed of the safety concerns.

The FDA has provided an emergency use authorization for the single-shot vaccine made by Johnson & Johnson, which has been found to be safe and effective and completely prevented hospitalizations and deaths in a large clinical trial. The Johnson & Johnson vaccine was 72% effective in preventing COVID-19 in the United States.  It is recommended that people who received the J and J vaccine receive a booster dose of one of the mRNA COVID-19 vaccines at least two months after receiving the J & J vaccine. A second booster of a mRNA booster is also recommended for immunocompromised people and individuals over the age of 50 at least four months after receiving the first booster dose.

However, the CDC now recommends that in most situations, the Pfizer-BioNTech or Moderna COVID-19 mRNA vaccines are preferred over the Johnson & Johnson (J&J) COVID-19 vaccine for primary and booster vaccinations due to the risk of serious adverse events with the Johnson and Johnson vaccine as well as the longer durability of the mRNA vaccines.

The J&J COVID-19 vaccine may still be considered in some situations, including for persons who:

• Had a severe reaction after an mRNA vaccine dose or who have a severe allergy to an ingredient of Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines).
• Would otherwise remain unvaccinated for COVID-19 due to limited access to Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines).
• Prefers getting the J&J COVID-19 vaccine despite being informed of the safety concerns.

How effective are vaccines against the COVID-19 Delta, Omicron, and other variants?

Current data suggest that COVID-19 vaccines that have been approved or provided an emergency use authorization in the United States offer significant protection against most variants currently spreading in America,  includingthe dominant, highly contagious Omicron variants The most recent circulating Omicron lineage, XBB1.5,is highly transmissible and people who have had COVID or been vaccinated are still getting infected. Importantly, the vaccines are helping prevent serious illness, hospitalization, and death from COVID-19. However, it is essential that individuals receive two doses of these mRNA vaccines, as well as all recommended booster doses for maximal protection against these variant strains.  A Danish study published in early 2022 found that the Omicron variant is better at circumventing vaccinated peoples’ immunity than the Delta variant which might explain why Omicron has spread so rapidly. The researchers investigated nearly 12,000 Danish households and found that Omicron was 2.7 to 3.7 times more infectious than the Delta variant among vaccinated people. https://www.reuters.com/business/healthcare-pharmaceuticals/omicron-evades-immunity-better-than-delta-danish-study-finds-2022-01-03/ (). The study has yet to be peer-reviewed. Studies suggest the Omicron BA.2 subvariant is 3-5 times more transmissible than the original strain.

According to the CDC, the Pfizer, Moderna,  Johnson & Johnson and Novavax vaccines, offer significant protection against the Delta and Omicron variants. The majority of cases in the United States linked to the Delta and Omicron variants are occurring in unvaccinated people, though recent studies suggest that a significant number of breakthrough infections are occurring in vaccinated individuals as a result of the highly contagious omicron variant and its highly transmissible subvariants BA.2 and XBB.1.5.

Studies are underway to determine the ongoing effectiveness of currently available vaccines against emerging variants of the virus that causes COVID-19 and how frequently boosters will be needed. A study conducted in the United Kingdom found that the Pfizer-BioNTech vaccine was only 36% effective against the Delta variant after one dose, but 88% effective after two doses. Data from Israel suggests reduced efficacy of the Pfizer vaccine. After two immunizations, the vaccine was 39% effective at reducing the risk of infection, 40% effective at reducing the risk of symptomatic disease, but importantly was still 91% effective at preventing severe illness, hospitalization and death during a period when the Delta variant was the dominant strain in Israel. A study in Canada found that two doses of the Pfizer-BioNTech vaccine were 87% effective in protecting against symptomatic infection. The data suggests that mRNA vaccines like Pfizer and Moderna offer a high degree of protection against COVID-19 infection especially preventing severe illness, hospitalization, and death.

We’re still learning about how effective COVID-19 vaccines are against the Omicron variants. Initial results show that while the existing mRNA vaccines offer some protection against Omicron and its subvariants, there appears to be a significant decline in neutralizing antibodies against this variant in people who have received two shots of an mRNA vaccine. However, studies conducted both in the lab and in the real world show that people who get a booster shot, or third dose of vaccine, may be better protected. Though these data are preliminary, they suggest that getting booster shots will help protect people already vaccinated from breakthrough or possible severe infections with Omicron during the coming months. The CDC has recommended that a second booster (or 4^th dose) be administered 4 months after the first booster, if a bivalent booster was not received previously.  A third bivalent booster (or 5^th dose) for people who are immunocompromised and for individuals over the age of 50, if a bivalent booster was not received previously.

Studies of Johnson & Johnson’s single shot COVID-19 vaccine had initially suggested it provided durable protection.  Research conducted in South Africa found the Johnson & Johnson’s coronavirus vaccine helps prevent severe disease among those infected with the Delta variant, with the evidence showing that the single-dose shot was 71% effective against hospitalization and as much as 96% effective against death.

However, other research found that the Johnson & Johnson vaccine was not as effective as the mRNA vaccines. Subsequently, the CDC has updated its recommendations for COVID-19 vaccines in the United States with a preference for people to receive mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna).  Read CDC’s media statement about their recommendation.

As COVID-19 infections continue spreading, it is important to keep practicing the 3 W’s: wear a mask if you are unvaccinated and in some settings if you are vaccinated; wash your hands; and watch your distance if unvaccinated.

We’re still learning about how effective COVID-19 vaccines are against the Omicron variants. Initial results show that while the existing mRNA vaccines offer some protection against Omicron and its subvariant BA.2, there appears to be a significant decline in neutralizing antibodies against this variant in people who have received two shots of an mRNA vaccine. However, studies conducted both in the lab and in the real world show that people who get a booster shot, or third dose of vaccine, may be better protected. Though these data are preliminary, they suggest that getting  booster shots will help protect people already vaccinated from breakthrough or possible severe infections with Omicron during the coming months. The CDC has recommended a second booster (or 4^th dose) be administered 4 months after the first booster for people who are immunocompromised and for individuals over the age of 50.

Studies of Johnson & Johnson’s single shot COVID-19 vaccine had initially suggested it provided durable protection.  Research conducted in South Africa found the Johnson & Johnson’s coronavirus vaccine helps prevent severe disease among those infected with the Delta variant, with the evidence showing that the single-dose shot was 71% effective against hospitalization and as much as 96% effective against death.

However, other research found that the Johnson & Johnson vaccine was not as effective as the mRNA vaccines. Subsequently, the CDC has updated its recommendations for COVID-19 vaccines in the United States with a preference for people to receive  mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna).  Read CDC’s media statement about their recommendation.

As COVID-19 infections continue to spread, it is important to keep practicing the 3 W’s (wear a mask if you are unvaccinated and in some settings if you are vaccinated; wash your hands; and watch your distance if unvaccinated) to prevent the spread of the virus

How do COVID-19 mRNA vaccines work?

mRNA vaccines use mRNA created in a laboratory to teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what helps protect us from getting infected if the real virus enters our bodies. . COVID-19 mRNA vaccines are administered to the upper arm muscle. Once the instructions (mRNA) are inside our immune cells, the cells use them to make the protein piece which can be displayed on the cell surface. After the protein piece is made, our cells break down the mRNA and remove it. Our immune systems recognize that this protein doesn’t belong there and triggers our immune defenses to produce antibodies and activate other immune cells to fight off what it thinks is an infection. This is what your body might do to fight off a real infection if you got sick with COVID-19. At the end of the process, our bodies have learned how to protect against future infection. The benefit of mRNA vaccines, like all vaccines, is those vaccinated gain this protection without ever having to experience the serious complications of getting sick with COVID-19.

mRNA vaccines do not use the live virus that causes COVID-19 and cannot give someone COVID-19. They do not affect or interact with our DNA in anyway. mRNA never enters the cell’s nucleus where DNA (genetic material) resides. The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.

Learn more about how mRNA vaccines work here.

Additional Information about COVID-19 Vaccines

• • Coronavirus Vaccine Tracker
  • Understanding How COVID-19 Vaccines Work
  • Understanding mRNA COVID-19 Vaccines
  • Ensuring the Safety of Vaccines in the United States

Ensuring the Effectiveness of Vaccines in the United States

mRNA vaccines do not use the live virus that causes COVID-19 and cannot give someone COVID-19. They do not affect or interact with our DNA in anyway. mRNA never enters the cell’s nucleus where DNA (genetic material) resides. The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.

Learn more about how mRNA vaccines work here.

Additional Information about COVID-19 Vaccines

• • Coronavirus Vaccine Tracker
  • Understanding How COVID-19 Vaccines Work
  • Understanding mRNA COVID-19 Vaccines
  • Ensuring the Safety of Vaccines in the United States
  • Ensuring the Effectiveness of Vaccines in the United States

What are the side effects of COVID-19 vaccines?

After receiving a COVID-19 vaccination, you may experience some side effects, which are normal signals that your body is building protection to help prevent you from getting sick with COVID-19.  These side effects may affect your ability to engage in daily activities, but they should go away in a few days. That said, some people have no side effects, and allergic reactions are rare.

The most common side effects include pain, redness, and swelling in the arm where you receive the shot as well as fatigue, headache, muscle pain, chills, fever, and nausea. These symptoms should resolve within a day or two. Serious side effects that could cause a long-term health problem are extremely unlikely following any vaccination, including COVID-19 immunizations. Vaccine monitoring has shown that if serious side effects are to occur, then generally happen immediately or within six weeks of receiving a vaccine dose.

There have been rare reports of myocarditis (heart inflammation) in adolescents and adults that have occurred more frequently in men. Additionally, there have also been rare reports of Guillain-Barré syndrome developing after receiving Johnson & Johnson’s COVID-19 vaccine, leading the FDA to add a warning to the vaccine’s fact sheet. These cases have largely been reported about 2 weeks after vaccination and mostly in men who are older than 50 years of age.

If you have persistent discomfort from vaccine side effects, talk to your doctor about taking an over-the-counter medicine, such as ibuprofen or acetaminophen. Pain medication should only be taken after receiving the vaccine, not before, unless it is part of a usual medication regimen. To reduce pain where you got the shot, apply a clean, cool, wet washcloth over the area and use or exercise your arm.

Sides Effects Following Second Vaccines and Booster Doses

With the currently available mRNA COVID-19 vaccines, you will need 2 shots and boosters to gain maximum protection. Make sure to get the entire vaccination series even if you have side effects after the first shot, unless a vaccination provider or your doctor tells you not to get a second immunization. Recent research has shown that immunity decreases after 5 months, so boosters are then needed to prevent getting infected with COVID-19.

Side effects after the second vaccine dose and booster shots may be more intense than the ones experienced after the first shot. These side effects are normal signs that the body is building protection and should go away within a few days. Reactions reported after getting  booster shots were similar to those after the two-dose or single-dose primary series. Fever, headache, fatigue and pain at the injection site were the most commonly reported side effects, and overall, most side effects were mild to moderate. However, as with the two-dose or single-dose primary series, serious side effects after boosters are rare, but may occur.

Contact your doctor or healthcare provider for further consultation if: 

• The redness or tenderness where you got the shot increases after 24 hours.
• Your side effects are worrying you or do not seem to be going away after a few days.

If you get a COVID-19 vaccine and think you might be having a severe allergic reaction after leaving the vaccination site, seek immediate medical care by calling 911. Learn more about COVID-19 vaccines and rare severe allergic reactions here. 

Learn more about Side Effects

• What to Expect after Getting a COVID-19 Vaccine (CDC)
• FDA Report on COVID-19 Vaccine Side Effects
• Pfizer-BioNTech COVID-19 Vaccine Overview and Safety
• Moderna COVID-19 Vaccine Overview and Safety
• Johnson & Johnson’s COVID-19 Vaccine Overview and Safety

Contact your doctor or healthcare provider for further consultation if:

• The redness or tenderness where you got the shot increases after 24 hours.
• Your side effects are worrying you or do not seem to be going away after a few days.

If you get a COVID-19 vaccine and think you might be having a severe allergic reaction after leaving the vaccination site, seek immediate medical care by calling 911. Learn more about COVID-19 vaccines and rare severe allergic reactions here.

Learn more about Side Effects

• What to Expect after Getting a COVID-19 Vaccine (CDC)
• US. FDA Report on COVID-19 Vaccine Side Effects
• Pfizer-BioNTech COVID-19 Vaccine Overview and Safety
• Moderna COVID-19 Vaccine Overview and Safety
• Johnson & Johnson’s COVID-19 Vaccine Overview and Safety

How many shots of the COVID-19 vaccine will be needed?

The number of doses needed to complete the primary vaccination series depends on which vaccine you receive, your age and whether you are immunocompromised. To get the most protection and be considered fully vaccinated you need:

• Two monovalent Pfizer-BioNTech vaccine  doses  should be given 3- -8 weeks apart followed by a bivalent booster at least two months after the last dose (four weeks if immunocompromised). A second booster is recommended two months later for immunocompromised individuals. People over the age of 50 are also eligible for a second booster at least 4 months after receiving an initial booster dose.

• Two monovalentModerna vaccine doses  should be given 3 -8 weeks apart followed by a bivalent booster at least two months after the last dose (four weeks if immunocompromised). A second booster is recommended two months later for immunocompromised individuals. People over the age of 50 are also eligible for a second booster at least 4 months after receiving an initial booster dose.

• Johnson & Johnson’s COVID-19 vaccine requires only one dose  for the primary series and and a bivalent mRNA vaccine booster at least 2 months later. Immunocompromised individuals should their first mRNA booster at least 4 weeks after their initial J&J dose, followed by a second bivalent booster at least 2 months later. People over the age of 50 can receive a bivalent booster at least 4 months later.
• Novavax COVID-19 vaccine  requires two doses 3-8 weeks apart followed by an mRNA vaccine booster at least two months later.

Booster shots are necessary after the primary vaccination series; the new bivalent booster provides broader protection against new variants that are currently circulatihng. Now, anyone ages 6 months and older can get a first booster shot 2 months after they have completed their COVID-19 primary vaccine. The CDC recommends the Pfizer or Moderna bivalent boosters regardless of the type of primary vaccine series that was administered.(https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html). Children under 5 should not mix and match their primary and booster vaccine type.

Most individuals require at least one bivalent mRNA booster following completion of the primary vaccination series, regardless of which primary vaccination was administered. Immunocompromised individuals and people over the age of 50 are eligible for a second booster at least four months after their last booster. Visit (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html) for the latest recommendations.

Now, anyone ages 12 years and older can get a first booster shot 5 months after they have completed their COVID-19 vaccine series or 2 months after receiving the Johnson and Johnson vaccine. The CDC’s recommendations now allow for this type of mix and match dosing for booster shots (Pfizer-BioNTech, Moderna, or J&J) for people, ages 18 years and older.

Since there is declining immunity with currently available vaccines, the CDC now recommends that some immunocompromised people and individuals over the age of 50 receive a second booster shot. This second booster dose can be given to eligible people four or five months after a first booster dose of any authorized or EUA approved COVID-19 vaccine.

How do you report vaccine side effects?

V-Safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through V-safe, you can quickly report any side effects that you experience after receiving the COVID-19 vaccine. Once you receive a COVID-19 vaccine, you can enroll in V-safe using your smartphone. Participation is voluntary and you can opt out at any time. During the first week after you get your vaccine, v-safe will send you a text message each day to ask how you are doing. Depending on your answers someone from the CDC may call to check in on you. Your personal health information recorded in v-safe is protected so that it stays confidential and private.

Additionally, side effects can also be reported to Vaccine Adverse Event Reporting System (VAERS). This national system collects reports of adverse events that happen after vaccination from healthcare professionals, vaccine manufacturers, and the public.

Additional Information

• Getting Started with V-safe
• V-safe Health Checker Web Resources
• V-safe Print Resources

Additionally, side effects can also be reported to Vaccine Adverse Event Reporting System (VAERS). This national system collects reports of adverse events that happen after vaccination from healthcare professionals, vaccine manufacturers, and the public.

Additional Information

• Getting Started with V-safe
• V-safe Health Checker Web Resources
• V-safe Print Resources

If I am unvaccinated, what can I do now to help protect myself from acquiring COVID-19?

Until you get vaccinated, in order to protect yourself and others, follow these recommendations:

• Wear a high-quality mask over your nose and mouth when around other people, preferably a N95 respirator
• Stay at least 6 feet away from others
• Avoid crowds
• Avoid poorly ventilated spaces
• Wash your hands often

Get more information about these and other steps you can take to protect yourself and others from COVID-19

If I am fully vaccinated against COVID-19, will I need a booster shot?

Yes, booster shots are necessary to be up to date on your COVID-19 vaccinations. Immunizations are the very best tool that are available to prevent COVID-19. New CDC studies show that while all the COVID-19 vaccines authorized for use in the United States remain highly effective against preventing hospitalizations and deaths, the protection they provide against infection with the virus has weakened over the past several months, especially among certain populations including those aged 50years and older. That is why boosters are now recommended for everyone 6 months and older. Visit (3. Which COVID-19 vaccines are currently available in the United States, and how many vaccinations do I need?) to learn more about which booster is right for you.

Evidence is still accruing regarding the duration of protection following vaccination. While breakthrough infections are rising among people who are fully vaccinated, the illness tends to be milder.  One model predicted that an initial vaccine effectiveness of 90% would likely decline to approximately 70% around 250 days post-vaccination. This model does not account for other factors that could contribute to susceptibility to the virus such as non-serologic components of the immune response or the impact of new circulating variants. Recent studies have demonstrated waning of both antibody titers and vaccine effectiveness against infection over time, especially among older populations and immune compromised individuals. Other evidence shows that among healthcare and other frontline workers, vaccine effectiveness against COVID-19 infections is decreasing  likely due to the combination of reduced immune protection as time passes after getting vaccinated, as well as the greater infectiousness of the Omicron variant and its subvariants BA.2 and XBB.1.5.The decline in vaccine effectiveness against infection may result from waning vaccine immunity, most people no longer taking precautions like wearing masks or the rise of the highly contagious Omicron variants, or a combination of all three. That’s why people who are eligible should get their booster shots now.

Booster R: ecommendations and Availability

People age 5 and older: Everyone ages 5 and older can get an updated bivalent Pfizer or Moderna booster shot if it’s been at least 2 months since the last dose.

You may choose which mRNA COVID-19 bivalent vaccine you receive as a booster shot. Some people may prefer the vaccine type which they originally received, and others may prefer to get a different booster. The CDC recommendations now allow for this type of mixing and matching of immunizations for booster shots.

For children 6 months- 4 years of age: One updated bivalent booster is recommended for children 6 months – 4 years who completed the Moderna primary series and if has been at least 2 months since their last dose. There is no booster recommendation for children ages 6 months- 4 years who got the Pfizer COVID-19 primary series.

Mixing and Matching Vaccines – The CDC has released guidance about who might benefit from choosing one mRNA booster shot over another. The reason for this mixing of vaccines recommendation includes data from a recent study showing that the antibody levels of those who had received a Johnson & Johnson vaccine followed by a Moderna booster rose 76-fold within 15 days, whereas the antibody levels of those who received a Johnson & Johnson booster rose only fourfold during the same period. A Pfizer booster raised antibody levels 35-fold in Johnson & Johnson recipients.

To learn more about vaccine boosters, see below:

Pfizer-BioNTech Vaccine

COVID-19 Vaccine booster shots are currently available for all Pfizer-BioNTech vaccine recipients over the age of 5 who completed their initial two dose series at least 2 months ago. Anyone over the age of 18 who received another vaccine type, can choose to get a Pfizer booster.  For those people who are immunocompromised, a 2^nd booster vaccine is recommended 2 months after receiving the 1^st booster and a 3^rd booster vaccine may be recommended 4 months following the 2^nd booster, if a bivalent booster was not yet received. A second and third booster dose is also recommended for individuals 50 years of age and older at least 4 months after receipt of a first booster dose of any approved or EUA authorized COVID-19 vaccine.

Moderna Vaccine

A first COVID-19 vaccine booster shot is currently available for all Moderna vaccine recipients who completed their initial series at least 2 months ago.

A second booster dose of the Moderna COVID-19 vaccine may now be administered at least 4 months after the first booster dose of any authorized or approved COVID-19 vaccine to individuals 18 years of age and older who are immunocompromised or who are over the age of 50 at least 2 months after receipt of a first mRNA booster.  A third bivalent booster dose is recommended 4 months following the 2^nd booster in these population groups.

Johnson and Johnson Vaccine 

COVID-19 vaccine booster shots are currently available for adults,  18 years and older, who initially received a Johnson and Johnson vaccine at least two months ago. These individuals should get their boosters with either  a Moderna or Pfizer mRNA vaccine. The CDC has updated its recommendations for COVID-19 vaccines in the United States with a preference for people to receive an mRNA COVID-19 vaccine (Pfizer-BioNTech and Moderna). Read CDC’s media statement  about this recommendation.

NOVAVAX

A first COVID-19 vaccine booster shot is currently available for all Novavax vaccine recipients who completed their initial series at least 2 months ago. An mRNA booster is recommended for all individuals unless they are unwilling to receive an mRNA booster, in which case a monovalent Novavax booster is available. Immunocompromised individuals and those over age 50 are eligible for a 2^nd booster at least 2 months after the prior dose, and a third at least 4 months after that.

Additional Booster Shots

Immunocompromised people are eligible for additional boosters to protect them against COVID-19, according to  recommendations from the Centers for Disease Control and Prevention (CDC). Israel was the first to deliver a fourth vaccine dose for the most vulnerable people to coronavirus infection including those over the age of 60 and immunocompromised individuals. A second and third booster dose of an mRNA COVID-19 vaccine is recommended for people who have a weakened immune system and individuals age 50 or older. This second booster dose can be given to those eligible four months after a first booster dose of any EUA authorized or approved COVID-19 vaccine and the third bivalent booster dose administered 4 months after that. The CDC recommends that mRNA vaccines be  given as boosters.

To learn more about vaccine boosters, see below:

Pfizer-BioNTech Vaccine

COVID-19 Vaccine booster shots are currently available for all Pfizer-BioNTech vaccine recipients over the age of 12 who completed their initial two dose series at least 5 months ago. Anyone over the age of 18 who received another vaccine type, can choose to get a Pfizer booster.  For those people who are immunocompromised, a 2^nd booster vaccine is recommended 4 months after receiving the 1^st booster. A second booster dose is also recommended for individuals 50 years of age and older at least 4 months after receipt of a first booster dose of any approved or EUA authorized COVID-19 vaccine.

Moderna Vaccine

A first COVID-19 vaccine booster shot is currently available for Moderna vaccine recipients over the age of 18 who completed their initial series at least 5 months ago. All adults, 18 years and older, can choose to get their booster shot with the Moderna vaccine.

A second booster dose of the Moderna COVID-19 vaccine may now be administered at least 4 months after the first booster dose of any authorized or approved COVID-19 vaccine to individuals 18 years of age and older who are immunocompromised or who are over the age of 50 at least 4 months after receipt of a first booster dose of any EUA authorized or approved COVID-19 vaccine. 

Johnson and Johnson Vaccine 

COVID-19 vaccine booster shots are currently available for adults, 18 years and older, who initially received a Johnson and Johnson vaccine at least two months ago. These individuals should get their boosters with either an a Moderna or Pfizer mRNA vaccine. The CDC has updated its recommendations for COVID-19 vaccines in the United States with a preference for people to receive an mRNA COVID-19 vaccine (Pfizer-BioNTech and Moderna). Read CDC’s media statement  about this recommendation.

Additional Booster Shots

Immunocompromised people are eligible for a fourth shot to protect them against COVID-19, according to recent recommendations from the Centers for Disease Control and Prevention (CDC). Israel was the first to deliver a fourth vaccine dose for the most vulnerable people to coronavirus infection including those over the age of 60 and immunocompromised individuals. A second booster dose of an mRNA COVID-19 vaccine is recommended for people who have a weakened immune system and individuals age 50 or older. This second booster dose can be given to those eligible four months after a first booster dose of any EUA authorized or approved COVID-19 vaccine.

Who is eligible for vaccination in the United States?

COVID-19 vaccines are available for everyone, 6 months and older. Mass vaccination is a critical tool for ending the pandemic. It is estimated that 80-90% of people should be vaccinated to achieve herd immunity. Children, younger than 12 eligible only for the COVID-19 Pfizer and Moderna vaccines in the United States.

Bivalent mRNA booster vaccines are recommended for all individuals 6 months and older. These must be administered at least 2 months after the end of the primary vaccination series.

For more information on which vaccines, you are eligible for, visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.

Everyone, ages 12 years and older, can get a booster shot 5 months after they have completed their mRNA COVID-19 vaccine series or 2 months after receiving the Johnson and Johnson vaccine. Teens, ages 12 years old and up, are eligible to receive the Pfizer-BioNTech COVID-19 booster dose, while adults, ages 18 years and older, have the option to either get the same COVID-19 vaccine as their primary series, or to get a different COVID-19 vaccine. A second booster dose of an mRNA COVID-19 vaccine is recommended for certain people who have a weakened immune system and people age 50 or older. This second booster dose can be given to those eligible four months after a first booster dose of any authorized or approved COVID-19 vaccine.

If I have already had COVID-19 and recovered, do I still need to get vaccinated?

You can get COVID again! Even if you have recovered from COVID-19, you should get immunized, especially as cases of  highly transmissible viral variants are  increasing in communities across our country. Getting the vaccine is the best way to protect yourself and others around you. Experts do not yet know how long you are protected from getting sick again after recovering from COVID-19 but there are reports of people having had multiple infections. COVID-19 illness provides some protection from future illness with COVID-19, sometimes referred to as “natural immunity.” The level of protection people acquires from having COVID-19 may vary depending on how mild or severe their illness was, the time since their infection, and their age. It is recommended to wait 10 days after symptom onset to get vaccinated to increase your protection against future infections.

All COVID-19 vaccines currently available in the United States are effective at preventing COVID-19. They reduce the risk of serious illness, hospitalization, and death. Getting a COVID-19 vaccine gives most people a high level of protection against COVID-19 even in people who have already been sick with COVID-19.

Emerging evidence shows that getting a COVID-19 vaccine after you recover from COVID-19 infection provides added protection to your immune system. One study showed that, for people who already had COVID-19, those who do not get vaccinated after their recovery are more than 2 times as likely to get COVID-19 again than those who get fully vaccinated after their recovery.

People who were treated for COVID-19 with convalescent plasma or people who have a history of multisystem inflammatory syndrome in adults or children (MIS-A or MIS-C) may need to wait a while after recovering before they can get vaccinated.

Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.

Emerging evidence shows that getting a COVID-19 vaccine after you recover from COVID-19 infection provides added protection to your immune system. One study showed that, for people who already had COVID-19, those who do not get vaccinated after their recovery are more than 2 times as likely to get COVID-19 again than those who get fully vaccinated after their recovery.

People who were treated for COVID-19 with monoclonal antibodies or convalescent plasma or people who have a history of multisystem inflammatory syndrome in adults or children (MIS-A or MIS-C) may need to wait a while after recovering before they can get vaccinated. For those who received monoclonal antibodies, the recommendation is to wait 90 days before getting vaccinated. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.

Will I be required to get vaccinated for work or school?

Vaccines are recommended for all individuals, and some workplaces and schools require vaccination. The federal government does not mandate (require) vaccination for all individuals in the United States. However, there are several vaccine mandates for people who work in the government. For example, federal government employees and on-site contractors were to be fully vaccinated by November 22, 2021 per an Executive order issued in September 2021. While all active service members of the military were required to receive vaccinations, this mandate was rescinded on January 10, 2023, and are no longer required..

In November, 2021 the US Department of Labor’s Occupational Safety and Health Administration (OSHA) announced a requirement for employers with 100 or more employees to ensure each of their workers is fully vaccinated or tests negative for COVID-19 on at least a weekly basis. This was rescinded on January 26, 2022. The Centers for Medicare & Medicaid Services (CMS) requires that health care workers at facilities participating in Medicare and Medicaid are fully vaccinated. Be sure to check with your employer to see if they have any rules that apply to you.

Many colleges and universities have opted to require vaccinations as well as boosters for the safety of students, staff, and faculty. Any K-12 school vaccination requirements are determined at the state level. Check with your child’s school about their vaccine requirements for attendance.

Many colleges and universities have opted to require vaccinations as well as boosters for the safety of students, staff, and faculty. Any K-12 school vaccination requirements are determined at the state level. Check with your child’s school about their vaccine requirements for attendance.

Do I need to wear a mask and still social distance if I have been vaccinated?

It is advisable that vaccinated and boosted individuals wear high quality masks indoors in public settings in communities where the virus is spreading. The rapid spread and increased transmissibility of Omicronvariants has underscored the importance of masking even after vaccination. Wearing a mask is recommended on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and while indoors at U.S. transportation hubs such as airports and train stations. If possible, wear a N95 or a certified KN95 mask, for maximum protection.  People are considered fully vaccinated:

• 2 weeks after their second dose in a 2-dose series, such as the Pfizer, Moderna, or Novavax vaccines
• 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

People are considered up- to- date on their vaccinations when they have received all recommended booster doses.

Some vaccinated and boosted people may choose to wear a mask out of extra precaution, for example if they have a weakened immune system or if, because of their age or an underlying medical condition, if they are at an increased risk for severe disease, or if a member of their household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated.

Some vaccinated and boosted people may choose to wear a mask out of extra precaution, for example if they have a weakened immune system or if, because of their age or an underlying medical condition, if they are at an increased risk for severe disease, or if a member of their household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated.

Can I get a COVID-19 vaccine at the same time as another vaccine?

Yes, COVID-19 vaccines can be administered with other vaccines at the same time.  Given that the annual flu vaccine is also available, it may be convenient for patients to receive both a COVID-19 vaccine and a flu vaccine at the same appointment. It is unknown whether reactogenicity of COVID-19 vaccine is increased with coadministration, including with other vaccines known to be more reactogenic, such as adjuvanted vaccines or live vaccines. When deciding whether to co-administer other vaccine(s) with a COVID-19 vaccine, providers should consider whether the patient is behind or at risk of becoming behind on recommended vaccines, their risk of vaccine-preventable disease (e.g., during an outbreak or occupational exposures), and the reactogenicity profile of the vaccines.

Can I take a pain reliever before getting a COVID-19 vaccine?

Many experts believe that taking anti-inflammatory pain relievers such as Tylenol or ibuprofen before getting a coronavirus vaccine to prevent symptoms could blunt the body’s immune response. It’s recommended that people only take these medications following vaccination if they experience symptoms such as fever, chills, or severe body aches.

If a COVID-19 vaccine is inadvertently given within 14 days of another vaccine, you do not need to restart the COVID-19 vaccine series; you should still complete the series on schedule. When more data are available on the safety and effectiveness of COVID-19 vaccines administered simultaneously with other vaccines, this recommendation might then be updated.

If a COVID-19 vaccine is inadvertently given within 14 days of another vaccine, you do not need to restart the COVID-19 vaccine series; you should still complete the series on schedule. When more data are available on the safety and effectiveness of COVID-19 vaccines administered simultaneously with other vaccines, this recommendation might then be updated.

Do COVID-19 vaccines interfere with common prescription drugs?

Medical experts believe that the vast majority of prescription drugs will work just as well after you get a COVID-19 vaccine, nor will they  diminish the effectiveness of the shot you’re getting to ward off the coronavirus. You should consult your doctor if you have specific concerns, but most maintenance medications do not affect your immune system which is the primary target of COVID-19 vaccines.

However, there are a few exceptions to this principle that should be taken into consideration. If you happen to be taking prescription drugs that do affect your immune system, the vaccine might not be as effective as it would be if you weren’t. For example, if you are taking immunosuppressant drugs for an autoimmune disease or following an organ transplantation, these drugs could decrease the efficacy of the COVID-19 vaccine. Certain cancer chemotherapies could have a similar effect.

If you are taking a blood thinner, the Food and Drug Administration (FDA) recommends informing your vaccine provider when you go in for your COVID-19 shot. Blood thinners prevent clotting, so even a small injury such as a needle piercing the skin can cause more bleeding or bruising than usual. Neither the FDA nor the Centers for Disease Control and Prevention (CDC) say that being on a blood thinner is a contraindication to receiving a coronavirus vaccination.

If you are taking a blood thinner, the Food and Drug Administration (FDA) recommends informing your vaccine provider when you go in for your COVID-19 shot. Blood thinners prevent clotting, so even a small injury such as a needle piercing the skin can cause more bleeding or bruising than usual. Neither the FDA nor the Centers for Disease Control and Prevention (CDC) say you shouldn’t receive a coronavirus vaccination just because you are on a blood thinner.

After I get vaccinated for COVID-19, do I still need to quarantine after being exposed to someone who has been infected with the coronavirus?

Those people who have been fully vaccinated against the coronavirus, meaning they have received two doses of either the Pfizer/BioNTech, Moderna or Novavax vaccines or one dose of Johnson & Johnson and at least 14 days have passed, should be tested to check for infection at least 5 days after they last had close contact with someone with COVID-19. This guidance applies to people who have received booster shots as well.  Vaccinated people are no longer required to quarantine following an exposure to someone with COVID-19 but should wear a mask for 10 days after the exposure, according to the CDC. People who have been vaccinated should still watch for symptoms for 14 days after they have been exposed to a person who is infected and should quarantine if they show symptoms. Recent research has found that people who have been fully vaccinated and boosted can get infected with COVID-19 and transmit the virus to other people.

Can I get vaccinated when I am pregnant or breastfeeding?

COVID-19 vaccination is recommended for people who are pregnant. In addition, everyone who is ages 12 or older, including those who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future, should get  booster shots. Getting a COVID-19 vaccine can protect you from severe illness from COVID-19, and a healthy mom is important for a healthy baby. If you are pregnant, you might want to have a conversation with your healthcare provider about COVID-19 vaccination. While such a conversation might be helpful, it is not required before vaccination. You can receive a COVID-19 vaccine, including booster shots, without any additional documentation from your healthcare provider. Recent research has revealed that women who get infected with COVID while pregnant are at greater risk for severe disease from COVID-19. (https://gh.bmj.com/content/8/1/e009495).

CDC recommendations align with those from professional medical organizations serving people who are pregnant, including the American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine. along with many other professional medical organizations. If you became pregnant after receiving your first shot of a COVID-19 vaccine that requires two doses (i.e., Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine), you should get your second shot and boosters to get as much protection as possible. If you experience fever following vaccination, you should consider taking acetaminophen because fever—for any reason—has been associated with adverse pregnancy outcomes.

Although the overall risk of severe illness is low, pregnant people are at an increased risk for severe illness  and death from COVID-19 when compared with non-pregnant people. Severe illness includes illness that requires hospitalization, intensive care, need for a ventilator or special equipment to breathe, or illness that results in death. Additionally, pregnant people with COVID-19 are at increased risk of preterm birth and might be at increased risk of other adverse pregnancy outcomes compared with pregnant women without COVID-19. Infants who were exposed to COVID-19 while their mothers’ were pregnant experience more adverse outcomes.

Additional Information Resources

COVID-19 and Pregnant or Recently Pregnant People

COVID-19 Vaccines While Pregnant or Breastfeeding

Although the overall risk of severe illness is low, pregnant and recently pregnant people are at an increased risk for severe illness from COVID-19 when compared with non-pregnant people. Severe illness includes illness that requires hospitalization, intensive care, need for a ventilator or special equipment to breathe, or illness that results in death. Additionally, pregnant people with COVID-19 are at increased risk of preterm birth and might be at increased risk of other adverse pregnancy outcomes compared with pregnant women without COVID-19.

Additional Information Resources

COVID-19 and Pregnant or Recently Pregnant People

COVID-19 Vaccines While Pregnant or Breastfeeding

Are COVID-19 vaccines safe?

The U.S. Food and Drug Administration (FDA) has approved or provided emergency use authorization (EUA) for COVID-19 vaccines that have been shown to be effective and that meet rigorous safety criteria from manufacturers data from large clinical trials. The known and potential benefits of a COVID-19 vaccine must outweigh the known and potential risks of the vaccine. Learn more about how federal agencies are ensuring the safety of COVID-19 vaccines in the United States.

If you’d like to learn more, view a video describing the FDA emergency use authorization process.

Will a vaccine affect my fertility?

No. There is no evidence to suggest that COVID-19 vaccines will negatively impact fertility in men and women nor do they reduce the chance of becoming pregnant and completing a healthy pregnancy. There is currently no evidence that any vaccines, including COVID-19 vaccines, cause female or male fertility problems. The CDC does not recommend routine pregnancy testing before COVID-19 vaccination. If you are trying to become pregnant, you do not need to avoid getting pregnant after receiving a COVID-19 vaccine. As with other vaccines, scientists are studying COVID-19 vaccines carefully for side effects now and will report findings as they become available.

Is it safe for me to get a vaccine if I have an underlying medical condition?

Vaccination is an important consideration for adults of any age with certain underlying medical conditions because they are at increased risk for severe illness from COVID-19. Most people with underlying medical conditions can receive the FDA-authorized COVID-19 vaccines provided they have not had an immediate or severe allergic reaction to a COVID-19 vaccine or to any of the ingredients in the vaccine. Learn more about vaccination considerations for persons with underlying medical conditions here.     If you have questions about getting a COVID-19 vaccine, talk with your healthcare provider for advice. Inform your vaccination provider about all your allergies and health conditions. 

Is there risk of a severe allergic reaction if I receive the vaccine?

Serious adverse effects from vaccination can happen, but they are rare. There have been reports that several people have experienced severe allergic reactions—also known as anaphylaxis—after getting a COVID-19 vaccine. As an example, an allergic reaction is considered severe when a person needs to be treated with epinephrine or if they must go to the hospital. Learn more about COVID-19 vaccines and allergies. Given how many people have received the vaccine, these allergic reactions are very rare.

Which is longer, immunity after getting COVID-19 or protection from a COVID-19 vaccination?

Experts are working to learn more about both natural immunity and vaccine-induced immunity. We don’t know how long protection lasts for those who are vaccinated. What we do know is that COVID-19 has caused very serious illness and death for millions of people. If you get COVID-19, you also risk transmitting it to loved ones, friends, and colleagues who may get very sick. Some people who have had COVID-19 can be reinfected with the virus.  We do know that vaccines are very effective in preventing COVID-19. CDC will keep the public informed as new evidence becomes available.

What percentage of the population needs to get vaccinated to achieve herd immunity to COVID-19?

Experts do not know what percentage of people would need to get vaccinated to achieve herd immunity to COVID-19 but estimates range between 80-90%, The spread of the highly transmissible Omicron variants have some experts believing we’ll need to have higher than an 80% vaccination rate. Herd immunity is a term used to describe when enough people have protection—either from previous infection or from vaccination—that it is unlikely a virus or bacteria can spread and cause disease. As a result, everyone within the community is protected even if some people don’t have immunity to the disease. The percentage of people who need to have protection in order to achieve herd immunity varies by disease. For COVID-19, it’s very important that most people in the population get vaccinated.

What are the ingredients in COVID-19 mRNA vaccines?

Two mRNA COVID-19 vaccines are currently available in the United States. based. They do not contain eggs, preservatives, latex, or gelatin. All COVID-19 vaccines are free from metals such as iron, nickel, cobalt, lithium, and rare earth alloys. They are also free from manufactured products such as microelectronics, electrodes, carbon nanotubes, or nanowire semiconductors. For a full list of ingredients, review each vaccine’s Fact Sheet for recipients and caregivers:

• • Ingredients Included in COVID-19 Vaccines
  • Pfizer-BioNTech COVID-19 Vaccine Overview and Safety
  • Moderna COVID-19 Vaccine Overview and Safety
  • Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety
  • Novavax COVID-19 Overview and Safety (https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/novavax-covid-19-vaccine-adjuvanted)

Who pays for COVID-19 vaccines?

Vaccine doses purchased with U.S. taxpayer dollars are being given to the American people at no cost. However, vaccination providers can charge an administration fee for immunizing people. Vaccine providers can get this fee reimbursed by the patient’s public or private insurance company or, for uninsured patients, by the Health Resources and Services Administration’s Provider Relief Fund. No one can be denied a vaccine if they are unable to pay this vaccine administration fee.

What can I safely do if am unvaccinated?

Unvaccinated individuals should continue to wear high quality masks, stay 6 feet from others, and wash their hands frequently. Consult the CDC’s guides to “Choosing Safer Activities” and “Daily Activities and Going Out” for more information about specific activities. The most important thing you can do right now is to get vaccinated and boosted.

What can I safely do if I am vaccinated?

When you are up to date on your vaccinations, you can participate in activities that you did prior to the pandemic. However, to reduce the risk of being infected, you should continue to wear a high-quality mask indoors in public if you are in an area where the virus is spreading. Some individuals might even choose to wear a mask regardless of the level of transmission if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if a member of your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated. View the CDC’s guidelines to assess the risk level of various activities.

People who are immunocompromised should be counseled about the potential for reduced immune responses to COVID-19 vaccines and to follow current prevention measures (including wearing a high quality mask, if possible, staying 6 feet apart from others they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) regardless of their vaccination status to protect themselves against COVID-19 until advised otherwise by their healthcare provider.

Can I get vaccinated if I am HIV positive?

Vaccination is recommended! The U.S. vaccine safety system makes sure all vaccines are as safe as possible. COVID-19 vaccines have gone through the same safety tests and meet the same standards as other vaccines. People with HIV were included in clinical trials, though safety data specific to this group are not yet available.

We are still learning about COVID-19 and how it affects people with HIV.  A recent study found that people with HIV appear to have a slightly increased risk of dying from COVID-19. A low CD4 count increases the risk of serious illness. People with HIV who have underlying health conditions such as obesity, poorly controlled diabetes, chronic kidney disease and high blood pressure appear to be at higher risk as well. People living with HIV should follow the CDC guidance for individuals with underlying medical conditions. If you have HIV, you may choose to get vaccinated if you have not had a severe or immediate allergic reaction to any of the vaccine ingredients. If you have a weakened immune system, you should also be aware of the potential for a reduced immune response to the vaccine. If you decide to get vaccinated, continue to take everyday preventive actions to protect yourself against COVID-19. Learn more about COVID-19 and HIV here.

Find additional guidance about COVID-19 for HIV positive people here.

Are booster shots available and recommended?

The case for a booster shot:

Vaccines are the very best tool for preventing COVID-19. Recent research has found that booster shots are now indicated for certain population groups. New C.D.C. studies show that while all the COVID-19 vaccines authorized for use in the United States remain highly effective against preventing hospitalizations and deaths, the protection they provide against infection with the virus has weakened over the past several months. The findings suggest a rise in breakthrough infections and a small increase in hospitalizations among the vaccinated as the highly transmissible Omicron variants spread across our country. Emerging evidence also shows that among healthcare and other frontline workers, vaccine effectiveness against COVID-19 infections has decreased over time. The new CDC studies indicate overall that vaccines have an effectiveness of approximately 55 percent against all infections, 80 percent against symptomatic infection, and 90 percent or higher against hospitalization. The decline in effectiveness against infection may result from waning vaccine immunity, a lapse in precautions like wearing masks or the rise of the highly contagious Omicron variants, or a combination of all three.

The new Pfizer and Moderna bivalent booster shot provide increased protection against new viral variants circulating since they encode both the original SARS-CoV-2 spike protein and the Omicron spike protein. Getting your bivalent booster will not only enhance your immunity to the original COVID-19 variants, but also some of the emerging variants of the virus. That’s why people should get their booster shots now.

Booster Recommendations and Availability

The CDC recommends either the Pfizer or Moderna bivalent booster for people older than 6 months, regardless of primary vaccination series (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html). The booster should be administered at least 2 months after the conclusion of the primary vaccination series or last booster.

If you have received a monovalent booster but not a bivalent booster, a bivalent booster is recommended at least 2 months after your last dose for everyone 5 years and older. This is also recommended for all individuals 6 months and older who received the Moderna primary series. An updated booster is not recommended for children 6 months-4 years who received the Pfizer primary series.

Mixing & Matching Vaccines

The CDC has approved that adults and children >5 years of age who are eligible for boosters can get a different COVID-19 vaccine than the one they initially received. Children younger than 5 should not get a different COVID-19 vaccine than the one they initially received. The CDC has released guidance about who might benefit from choosing one booster over another.

The reason for this mixing of vaccines recommendation includes data from a recent study showing that the antibody levels of those who had received a Johnson & Johnson vaccine followed by a Moderna booster rose 76-fold within 15 days, whereas the antibody levels of those who received a Johnson & Johnson booster rose only fourfold during the same period. A Pfizer booster raised antibody levels 35-fold in Johnson & Johnson recipients.https://www.nejm.org/doi/10.1056/NEJMoa2116414

Additional Considerations for all Vaccine Recipients

Additional population groups may be recommended to receive booster shots as more data become available. The COVID-19 vaccines approved and authorized for use in the United States continue to be effective at reducing risk of severe disease, hospitalization, and death. Experts are looking at all the available data to understand how well the vaccines are working for different population groups and how long their effectiveness endures. This includes examining how new variants impact the currently available vaccines’ effectiveness.

Moderna Vaccine

On Thursday, October 14, 2021, the CDC Advisory Committee voted in support of booster shots for the Moderna COVID-19 vaccine in people aged 65 and older, any adults at high risk of severe illness because of underlying conditions, job exposure or because they are in institutional settings, and who have gone at least six months since their second dose.  The booster recommendation is for a half-dose, at least six months after the second full dose of the vaccine was administered, following the same eligibility requirements for recipients of Pfizer-BioNTech’s vaccine.

Johnson and Johnson Vaccine

The CDC now recommends recipients of the Johnson & Johnson vaccine who are ages 18 and older receive a booster shot at least 2 months after receiving their first shot. The agency has also approved that booster shots can be with mRNA vaccines (Moderna or Pfizer) or with the original Johnson and Johnson vaccine. The CDC discourages Johnson & Johnson booster shot for anyone who developed blood clots after receiving a first shot.

Mixing & Matching Vaccines

The CDC has approved that Americans who are eligible for a booster can get a different COVID-19 vaccine than the one they initially received. The CDC has released guidance about who might benefit from choosing one booster over another.

The reason for this mixing of vaccines recommendation includes preliminary data from a recent study showing that the antibody levels of those who had received a Johnson & Johnson vaccine followed by a Moderna booster rose 76-fold within 15 days, whereas the antibody levels of those who received a Johnson & Johnson booster rose only fourfold during the same period. A Pfizer booster raised antibody levels 35-fold in Johnson & Johnson recipients.

Additional Considerations for all Vaccine Recipients

Additional population groups may be recommended to receive a booster shot as more data become available. The COVID-19 vaccines approved and authorized in the United States continue to be effective at reducing risk of severe disease, hospitalization, and death. Experts are looking at all of the available data to understand how well the vaccines are working for different population groups and how long their effectiveness endures. This includes examining how new variants, like Delta plus, impact the currently available vaccines’ effectiveness.

How long does COVID-19 vaccination protection last?

We don’t know yet how long COVID-19 vaccine protection lasts. Recent studies show that vaccine protection against the virus decreases over time. This reduction in protection has led CDC to recommend that everyone ages 6 months and older get  booster shots after completing their primary vaccination series. It is recommended that everyone who has not received the bivalent booster get boosted at least 2 months after their last dose.

Learn more about COVID-19 vaccine booster shots.

Why should I get my child vaccinated against COVID-19?

Vaccination, including boosters, is now recommended for children, ages 6 months and older. Vaccinating infants and children can help protect them from getting COVID-19, spreading the virus to others, and getting sick if they do get infected. While COVID-19 tends to be milder in children than adults, it can make children very sick, requiring hospitalization, and some children have even died. Children with underlying medical conditions are more at risk for severe illness compared to children without underlying medical conditions. With the very contagious omicron variant and its subvariants BA.2 and XBB.1.5. circulating in communities, hospitalizations of children are increasing.

Getting your child vaccinated helps to protect them and your family, including siblings who are not eligible for vaccination and family members who may be at risk of getting very sick if infected.

COVID-19 vaccines are being administered under the most intensive safety monitoring in U.S. history. Scientists have conducted clinical trials with thousands of children, and the results show that COVID-19 vaccines are safe and effective.

Your child cannot get COVID-19 from any COVID-19 vaccine, and there is no evidence that COVID-19 vaccines cause fertility problems.

Your child may have some side effects, which are similar to those seen with other routine vaccines and are a normal sign that their body is building protection. These side effects may affect their ability to engage in daily activities, but they should go away in a few days. Some people have no side effects and severe allergic reactions are very rare.

Additional Information

• COVID-19 Vaccines for Children and Teens
• Booster Shots for Teens over the age of 12
• Pfizer-BioNTech
• Possible Side Effects
• Families and Children

Your child cannot get COVID-19 from any COVID-19 vaccine, and there is no evidence that COVID-19 vaccines cause fertility problems.

Your child may have some side effects, which are similar to those seen with other routine vaccines and are a normal sign that their body is building protection. These side effects may affect their ability to engage in  daily activities, but they should go away in a few days. Some people have no side effects and severe allergic reactions are very rare.

Additional Information

• COVID-19 Vaccines for Children and Teens
• Booster Shots for Teens over the age of 12
• Pfizer-BioNTech
• Possible Side Effects
• Families and Children

How can I get a new vaccine card?

If you need a new vaccination card, contact the vaccination provider site where you received your vaccine. Your provider should give you a new card with up-to-date information about the vaccinations you have received.

If the location where you received your COVID-19 vaccine is no longer operating, contact your state or local health department’s immunization information system (IIS) for assistance.

CDC does not maintain vaccination records or determine how vaccination records are used, and CDC does not provide the CDC-labeled, white COVID-19 vaccination record card to people. These cards are distributed to vaccination providers by state and local health departments. Please contact your state or local health department if you have additional questions about vaccination cards or vaccination records.

Take a picture of your vaccine cards and keep readily available to use as needed. There are apps that also allow you to upload this information. 

Additional Information

• Getting Your CDC COVID-19 Vaccination Record Card

COVID-19 Vaccine Inequities

Significant racial and ethnic disparities have been reported during the COVID-19 pandemic. At the beginning of the pandemic, Blacks and Hispanics had a two-fold higher rate of dying from COVID-19 compared to their white counterparts. Life expectancy decreased about three years for both Black and Latino Americans during the COVID-19 pandemic as well. Vaccinations are urgently needed in communities of color to prevent the further spread of COVID-19 in the United States.

Visit this website to review the latest data on COVID-19 Vaccinations by Race/Ethnicity

COVID-19 Vaccinations by Race/Ethnicity, Sex, and Age –CDC

This resource page provides graphic representation of  the percent of people vaccinated within each demographic group.. Visit the website here.

 COVID-19 Vaccinations by Race/Ethnicity – Kaiser Family Foundation

This resource page provides the latest data on COVID-19 Vaccinations by Race/Ethnicity. Visit the website here.

Barriers to Vaccinations

Many people of color and from low-income communities face challenges that interfere with their ability to get vaccinated. Below are three of the most common barriers to accessing COVID-19 vaccines with some helpful resources to address these obstacles.

Transportation Challenges

Lack of affordable transportation prevents people from reaching a vaccination site. Millions of older adults and people with low-incomes do not have cars, drive, or live near public transportation Several rideshare companies are mobilizing partners and community members to help provide transportation to and from vaccine appointments.

Demanding Work Schedules

The demands of work schedules pose additional challenges to getting vaccinated. Research has shown that unvaccinated Hispanic and Black adults report more concerns compared to their White counterparts that they may miss work due to getting the vaccine or because of its possible side effects.

Visit this resource to learn about  employer actions that can facilitate equity in obtaining COVID-19 vaccinations.

Immigration Status Concerns 

With nearly 22 million non-citizen immigrants living in the United States, many are working essential jobs and face a variety of barriers to getting vaccinated. To achieve a high vaccination rate across all communities and eliminate the disproportionate impact of COVID-19 on immigrant communities, it is important to address these concerns as a barrier to getting vaccinated.

Visit this website to learn about vaccine eligibility. The CDC does not require that a person be a US citizen to get the COVID-19 vaccine.

Immigration Status Concerns 

With nearly 22 million non-citizen immigrants living in the United States, many are working essential jobs and face a variety of barriers to getting vaccinated. To achievea high vaccination rate across all communities and eliminating the disproportionate impact of COVID-19 on immigrant communities, it is important to address the concerns of citizenship that exist as a barrier to getting vaccinated.

Visit this website to learn about vaccine eligibility. The CDC does not require that a person be a US citizen to get the COVID-19 vaccine.

Promoting Vaccine Equity

To ensure that COVID-19 vaccines are widely distributed and administered, it is important to involve community-and faith-based organizations, national and community influencers, employers, healthcare providers, public health agencies, policy makers and others in promoting equitable access to healthcare. These influencers can also serve as important role models for healthy behaviors like getting vaccinated to prevent COVID-19.

Additional Health Equity Resources

Health Equity Hub – U.S. Centers for Disease Control and Prevention (CDC)

The CDC’s resource center describes the longstanding systemic health and social inequities that have put racial and ethnic minorities at increased risk for COVID-19. Resources on this site includes data on racial and ethnic health disparities during the pandemic and health equity updates. Additionally, it provides information on advancing vaccine equity for racial and ethnic minority groups. Visit the website here.

COVID-19 Vaccine Community Toolkit – CDC

This toolkit assembled by the CDC is designed to provide accurate and clear COVID-19 vaccine information for communities around the country. It includes communication resources (e.g. posters, fact sheets, and infographics) for health departments and local organizations to use in their communities. The toolkit also includes sample social media posts and strategies for communicating about COVID-19 vaccines to diverse population groups. Visit the website here.

Guide for Community Partners – CDC

The CDC has created this guide for community organizations that are seeking to boost COVID-19 vaccine confidence and access in racial and ethnic minority communities. Visit the website here.

Shots at the Stop Initiative – The University of Maryland School of Public Health

Shots at the Shop is a program to engage 1,000 Black-owned barbershops and hair salons nationwide to act as health advocates. Participants assist their clients in making informed COVID-related decisions, dispel misinformation and host COVID-19 vaccination clinics in their shops. Visit the website here.

Guide for Community Partners – CDC

The CDC has created this guide for community organizations that are seeking to boost COVID-19 vaccine confidence and access in racial and ethnic minority communities. Visit the website here.

Shots at the Stop Initiative – The University of Maryland School of Public Health

Shots at the Shop is a program to engage 1,000 Black-owned barbershops and hair salons nationwide to act as health advocates. Participants assist their clients in making informed COVID-related decisions, dispel misinformation and host COVID-19 vaccination clinics in their shops. Visit the website here.

Achieving Global Vaccine Equity

While the United States has a sufficient supply of vaccinations to immunize people in America, there are currently significant global disparities in vaccine access. Below are several international initiatives that are working to secure and distribute vaccines around the world:

ACT-Accelerator – World Health Organization (WHO)

The Access to COVID-19 Tools (ACT) Accelerator is a global collaboration to accelerate the development, production and equitable access to COVID-19 tests, treatments, and vaccines. It brings together governments, scientists, businesses, civil society, philanthropists, and global health organizations to speed up an end to the COVID-19 pandemic. Visit the website here.

COVAX – World Health Organization (WHO) working in partnership with other organizations

COVAX is one of three pillars of the Access to COVID-19 Tools (ACT) Accelerator, which was launched in April in response to the COVID=19 pandemic. Bringing together governments, global health organizations, manufacturers, scientists, private sector, civil society and philanthropy, with the aim of providing innovative and equitable access to COVID-19 diagnostics, treatments and vaccines. The COVAX pillar is focused on the latter component. Its mission is to ensure that people around the world will get access to COVID-19 vaccines once they are available, regardless of their wealth. COVAX has the world’s largest and most diverse portfolio of COVID-19 vaccines, and as such represents hope of bringing the acute phase of this pandemic to an end globally. It is co-led by WHO, CEPI, and GAVI, in partnership with UNICEF.  Visit the website here. 

The Vaccine Alliance – (Gavi)

GAVI is co-leading COVAX, the vaccine pillar of the Access to COVID-19 Tools (ACT) Accelerator. It is coordinating the development and implementation of the COVAX Facility, the global procurement mechanism for COVAX. Visit the website here.  

The Coalition for Epidemic Preparedness Innovation – (CEPI)

CEPI is a global partnership between public, private, philanthropic, and civil society organizations that develops vaccines to stop future pandemics. Its mission is to accelerate the development of vaccines against emerging infectious diseases and to ensure equitable access to them. Visit the website here.

The Vaccine Alliance – (Gavi)

GAVI is co-leading COVAX, the vaccine pillar of the Access to COVID-19 Tools (ACT) Accelerator. It is coordinating the development and implementation of the COVAX Facility, the global procurement mechanism for COVAX. Visit the website here.  

The Coalition for Epidemic Preparedness Innovation – (CEPI)

CEPI is a global partnership between public, private, philanthropic, and civil society organizations that develops vaccines to stop future pandemics. Its mission is to accelerate the development of vaccines against emerging infectious diseases and to ensure equitable access to them. Visit the website here.

Resources to Understand the Drivers of Vaccine Hesitancy

It is important to understand the underlying factors that drive mistrust of COVID-19 vaccines. While additional information might help those who are hesitant feel more confident in their decision to get immunized, addressing the systemic factors that lead to their skepticism, fears, and hesitancy are integral to identifying population-level patterns. The resources below can help individuals and communities better understand the structural factors and trends behind why certain populations are reluctant to get immunized.

Surgeon General’s Advisory on Building a Healthy Information Environment – U.S. Department of Health and Human Services

During the COVID-19 pandemic, there has been a parallel infodemic of misinformation that has undermined the messaging we need to beat the virus. This Surgeon General’s Call to Action provides recommendations on what individuals, institutions, and other communities can do to take action against harmful health misinformation. View the report here.

Building Vaccine Confidence Through Community Engagement – American Psychological Association

This resource highlights attitudes and behaviors associated with vaccines. It offers strategies to build vaccination acceptance and confidence that will be important to the COVID-19 vaccination effort. Visit the website here.

How to Build Trust in Vaccines: Understanding the Drivers of Vaccine Confidence – World Economic Forum

This report explores online communication about vaccines during the COVID-19 pandemic and offers insights into how positive and negative messages spread. Visit the website here.

COVID-19 Vaccine Monitor – Kaiser Family Foundation

The COVID-19 Vaccine Monitor tracks public attitudes and experiences with COVID-19 vaccinations. It provides data and reports on intentions about vaccination, concerns or barriers, messaging and information, and experiences with immunization across target population groups. Visit the website here. 

Vaccine Confidence Project – London School of Hygiene and Tropic Medicine

The Vaccine Confidence Project tracks polarization, mistrust, and disinformation surrounding immunization and provides strategies for designing vaccination programs tailored to diverse communities.. Visit the website here.

How to Build Trust in Vaccines: Understanding the Drivers of Vaccine Confidence – World Economic Forum

This report explores online communication about vaccines during the COVID-19 pandemic and offers insights into how positive, and negative messages spread. Visit the website here.

COVID-19 Vaccine Monitor – Kaiser Family Foundation

The COVID-19 Vaccine Monitor tracks public attitudes and experiences with COVID-19 vaccinations. It provides data and reports on intentions about vaccination, concerns or barriers, messaging and information, and experiences with immunization across target population groups. Visit the website here.

Vaccine Confidence Project – London School of Hygiene and Tropic Medicine

The Vaccine Confidence Project tracks polarization, mistrust, and disinformation surrounding immunization and lays forth strategies to design vaccination programs fit for the communities they service. Visit the website here.

Resources to Help Boost Vaccine Confidence

Vaccine confidence comes from resolving questions and concerns unique to the individual through the messengers and channels that the individual trusts. There is no one way to inspire vaccine confidence. People might understandably have questions about COVID-19 vaccines and boosters. Giving people the space to ask these questions and providing them with resources to find credible information from people they trust can help decrease concerns about the vaccine and increase confidence about getting immunized.

How to Talk about COVID-19 Vaccines –CDC

 This resource page provides guidance on how to have productive conversations about COVID-19 vaccines with friends and family. It has recommendations for communicating about vaccine concerns and ways to share information. Visit the website here.

Building Confidence in COVID-19 Vaccines –CDC

This resource page provides guidance on ways to build vaccine confidence; emphasizes why it is so important during the COVID-19 pandemic; and offers resources for individuals trying to build it in their community. Visit the website here.

COVID-19 Vaccine Education – Ad Council

As a part of the It’s Up to You campaign, the Ad Council has created severaltoolkits and sample print, video, and social media messages for individuals to adapt for use in their communities to inspire vaccine confidence and address common misperceptions about the COVID-19 vaccines. Visit the website here. 

Beat the Virus Social Media Posts  – Beat the Virus

The Beat the Virus social media tiles provide public health messaging on COVID-19 to share on Facebook, Twitter, and Instagram, all in a package that’s easy to use. Visit the website here.

COVID-19 Vaccine Education – Ad Council

As a part of the It’s Up to You campaign, the Ad Council has created various toolkits and sample print, video, and social media messages for individuals to adapt for use in their communities to inspire vaccine confidence and address common misperceptions about the COVID-19 vaccines. Visit the website here.

Beat the Virus Social Media Posts  – Beat the Virus

The Beat the Virus social media tiles provide public health messaging on COVID-19 to share on Facebook, Twitter, and Instagram, all in a package that’s easy to use. Visit the website here.

Resources to Boost Vaccine Confidence in Communities of Color

When discussing vaccine hesitancy, it is critical to acknowledge the historical trauma and experiences of systemic racism that have contributed to a lack of trust in health care systems among communities of color. To address these concerns, more health care professionals of color need to be leading efforts to distribute vaccines, administer doses, and deliver trusted messages. The following resources explore the historical inequities contributing to vaccine hesitancy today and provide strategies to overcome these concerns:

Vaccinations by Race/Ethnicity Reports – Kaiser Family Foundation

The Kaiser Family Foundation provides analysis and data visualization of COVID-19 vaccinations by race and ethnicity. The data provide insights into who is and who is not getting immunized in the United States. Visit the website here.

Questions and Answers about COVID-19 Vaccines – Emory Healthcare 

Emory Healthcare has created videos that answer the most common questions being asked about the COVID-19 vaccines with messages delivered by physicians of color.  Visit the website here.

Community Equity Stories – Johns Hopkins University 

This collection of articles and videos spotlights community engagement efforts and partnerships to boost vaccination in communities of color and advance health equity. Visit the website here.

Beyond Tuskegee — Vaccine Distrust and Everyday Racism – New England Journal of Medicine

This article outlines the historical traumas experienced in African American communities that underly current concerns and mistrust about COVID-19 vaccines and provides recommendations to address these concerns. Visit the website here.

Lecture Series on Improving Health Equity During the COVID Era – American Academy of Child and Adolescent Psychiatry

This lecture series explores the complex social issues surrounding health disparities that have been exacerbated by the pandemic. It provides an in-depth look into the challenges facing schools, systems of care, and child and adolescent psychiatry training programs. Additionally, it offers suggestions on how to better utilize these systems to promote health equity.

Beyond Tuskegee — Vaccine Distrust and Everyday Racism – New England Journal of Medicine

This article outlines the historical traumas experienced in African American communities that underly current concerns and mistrust about COVID-19 vaccines and provides recommendations to address these concerns. Visit the website here.

Lecture Series on Improving Health Equity During the COVID Era – American Academy of Child and Adolescent Psychiatry

This lecture series explores the complex social issues surrounding health disparities that have been exacerbated by the pandemic. It provides an in-depth look into the challenges facing schools, systems of care, and child and adolescent psychiatry training programs. Additionally, it offers suggestions on how to better utilize these systems to promote health equity