ARCHIVED WEBPAGE: This web page is available for historical purposes. CDC is no longer updating this web page and it may not reflect CDC's current COVID-19 guidance. For the latest information, visit CDC's COVID-19 home page.

Important update: Healthcare facilities
CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more
Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the guidance for fully vaccinated people. CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place.
The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here.
Travel requirements to enter the United States are changing, starting November 8, 2021. More information is available here.

How CDC Is Making COVID-19 Vaccine Recommendations

How CDC Is Making COVID-19 Vaccine Recommendations

When the U.S. Food and Drug Administration (FDA) authorizes or approves a COVID-19 vaccine, the Advisory Committee on Immunization Practices (ACIP) quickly holds a public meeting to review all available data about that vaccine (sign up to receive email updates whenever ACIP’s Meeting Information is updated). ACIP is an independent panel of medical and public health experts. Before making recommendations, ACIP reviews all available clinical trial information, including descriptions of:

  • Who received the vaccine (age, race, ethnicity, underlying medical conditions)
  • How different groups responded to the vaccine
  • What side effects people had
  • How common infection is within the population
  • Health outcomes related to infection

Based on these data, ACIP then votes on whether to recommend the vaccine and on which populations should receive the vaccine.

Ethical Principles

ACIP identified four ethical principles to guide their decision-making process when supply was limited:

  • Maximize benefits and minimize harms — Respect and care for people using the best available data to promote public health and minimize death and severe illness.
  • Mitigate health inequities — Reduce health disparities in the burden of COVID-19 disease and death, and make sure everyone has the opportunity to be as healthy as possible.
  • Promote justice — Treat affected groups, populations, and communities fairly. Remove unfair, unjust, and avoidable barriers to COVID-19 vaccination.
  • Promote transparency — Make a decision that is clear, understandable, and open for review. Allow and seek public participation in the creation and review of the decision processes.

​​Learn more about ACIP’s ethical principles for allocating initial supplies of COVID-19 vaccine.​

Vaccine Rollout Recommendations

When the U.S. supply of COVID-19 vaccine was limited, CDC provided recommendations to federal, state, and local governments about who should be vaccinated first. CDC’s recommendations were based on those from ACIP.

The recommendations were made with these goals in mind:

  • Decrease death and serious disease as much as possible
  • Preserve functioning of society
  • Reduce the extra burden COVID-19 had on people already facing disparities

While CDC made recommendations for who should be offered COVID-19 vaccine first, each state had its own plan for who would be vaccinated first and how they could receive vaccines.

On November 2, 2021, vaccine eligibility expanded to everyone in the United States ages 5 and older.

Other Frameworks

Input from the public and the following professional groups informed ACIP’s discussions on who should receive COVID-19 vaccines when supply was limited: