When Vaccine is Limited, Who Gets Vaccinated First?

Because the supply of COVID-19 vaccine in the United States is expected to be limited at first, CDC is providing recommendations to federal, state, and local governments about who should be vaccinated first. CDC’s recommendations are based on recommendations from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts. 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 is having on people already facing disparities.

Healthcare personnel and residents of long-term care facilities should be offered the first doses of COVID-19 vaccines (Phase 1A). Iowa is currently in Phase 1A of vaccine distribution.

CDC recommends that initial supplies of COVID-19 vaccine be allocated to healthcare personnel and long-term care facility residents. This is referred to as Phase 1A.

Phase 1A:  Healthcare Personnel 

  • Hospitals
  • Long-term care facilities
  • Outpatient clinics
  • Home health care
  • Pharmacies
  • Dentists
  • Emergency medical services
  • Public health

Phase 1A:  Long-Term Care Facility Residents 

  • Skilled nursing facilities
  • Assisted living facilities
  • Other residential care

Phase 1B: Priority Populations

Phase 1B is expected to start in early February (subject to change based on availability of vaccine)

As the vaccine remains in short supply. This means not everyone in Phase 1B will be able to get vaccine right away. To help balance vaccine supply with the Phase 1B demands, IDPH has implemented a tiered prioritization, outlined below. IDPH remains in close contact with our federal partners to communicate Iowa’s need for additional vaccines.

Persons aged 65 years and over. OR, the following populations vulnerable to high risk of exposure or severity of illness (listed in order of priority):

Tier 1
• First Responders
• PK-12 staff, early childhood education, childcare workers

Tier 2
• Frontline essential workers in food, agriculture, and manufacturing sectors who live or work in non-social distanced settings
• Individuals with disabilities living in home settings and their direct care staff

Tier 3
• Staff and individuals living in congregate settings not covered by previous Phase or Tier
• Government officials, including staff, engaged in business at the State Capitol

Tier 4
• Inspectors responsible for health, life and safety

Tier 5
• Correctional facility staff and individuals incarcerated

As vaccine availability increases, vaccination recommendations will expand to include more groups

The goal is for everyone to be able to easily get a COVID-19 vaccination as soon as large enough quantities of vaccine are available. As vaccine supply increases but remains limited, ACIP will expand the groups recommended for vaccination.