Why Some Underlying Conditions Qualify For The COVID Vaccine & Others Don’t

You live with something that makes you at higher risk for severe COVID. Shouldn’t you get to drive your way up the vaccine line? Before you go through the myriad ups and downs of trying to book a COVID vaccine appointment, make sure you know what underlying conditions qualify you for the COVID vaccine in your state.

In early March, President Biden announced that all Americans are supposed to be eligible for vaccinations by May 1. As of March 17, Alaska and Mississippi have said that all residents over 16 can get vaccinated without waiting longer for specific tiers to open up. Unless you’re in those two states, though, you’ve got to go state by state to figure out where you fit into the eligibility line before May.

What Criteria Are Used To Qualify People For The COVID Vaccine?

To qualify to get the vaccine, your state has to consider you in an at-risk category — that might be based on age, employment type, underlying health conditions, or a combination of these factors. “The criteria set for early vaccination were designed to protect individuals who are at the highest risk of dying from COVID-19 (e.g., people over 75 years old) and those at highest risk of exposure (e.g., health care workers and first responders),” says Dr. Michael Richardson, M.D., a family medicine doctor with One Medical.

Following that first wave of vaccination eligibility, it’s up to specific states to determine who goes next. “Every state developed their own guidelines on who to prioritize for the limited supply of the vaccine, so differences are to be expected,” Richardson tells Bustle. Before you go through the stressful hassle of signing up for your COVID vaccine, make sure your underlying conditions qualify you as eligible in your state first.

What Underlying Conditions Does The CDC Recommend For Vaccine Eligibility?

According to the Centers for Disease Control and Prevention (CDC), “People aged 16 years and older who have underlying medical conditions that increase the risk of serious, life-threatening complications from COVID-19, should be among those offered COVID-19 vaccine first.” The underlying conditions that the CDC lists are:

• Cancer
• Chronic kidney disease
• COPD (chronic obstructive pulmonary disease)
• Down Syndrome
• Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• Immunocompromised state (weakened immune system) from solid organ transplant
• Obesity (body mass index [BMI] of 30 kg/m² or higher but < 40 kg/m²)
• Severe Obesity (BMI ≥ 40 kg/m²)
• Pregnancy
• Sickle cell disease
• Smoking
• Type 2 diabetes mellitus

The CDC also recommends that states consider the increased risk of getting very sick from COVID for folks with the following conditions:

• Asthma (moderate-to-severe)
• Cerebrovascular disease (affects blood vessels and blood supply to the brain)
• Cystic fibrosis
• Hypertension or high blood pressure
• Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
• Neurologic conditions, such as dementia
• Liver disease
• Overweight (BMI > 25 kg/m², but < 30 kg/m²)
• Pulmonary fibrosis (having damaged or scarred lung tissues)
• Thalassemia (a type of blood disorder)
• Type 1 diabetes mellitus

However, states are not required to distribute the vaccine in order that these conditions are listed — so if you’re looking to find out when you can get vaccinated, you’ll want to check your state’s vaccine eligibility guidelines.

What Underlying Conditions Qualify You For The Vaccine In Different States?

“Individuals with certain underlying health conditions (comorbidities), such as cancer and diabetes, are at significantly higher risk of dying from COVID-19 than the general public, so many states have priorities for these individuals in their early vaccination efforts,” Richardson says.

In practice, that means that there are uneven standards from state to state — so just because you’re qualified in the state you grew up in doesn’t mean you’re definitely qualified in the state you live in now. (And yes, certain states require you to prove your current residency to receive your vaccine.) In other words, if your cousin has hypertension and lives in New York City, they can get vaccinated — but they’re not eligible yet in California.

Different states are rolling out different standards due to differing viewpoints on resource availability and priorities. Depending on the state, people may be receiving vaccines based on employment status before many who are vulnerable to the virus because of health or living conditions. In Washington state, for example, people who are homeless, living in correctional facilities, or in group homes for people with disabilities won’t be eligible for the vaccine until at least late April, while people who work in correctional facilities are eligible around mid-March.

In another example, Massachusetts is currently vaccinating people who smoke, but not folks who are immunocompromised due to HIV. Other states — like New York — have already included conditions like cystic fibrosis in their list of vaccine-eligible folks, whereas people with cystic fibrosis in states like Michigan, Washington, and Pennsylvania are not eligible yet.

Even within states, standards are rapidly changing. For example, while unhoused and incarcerated individuals were originally included in the first tier for vaccines in California, these folks were bumped from that spot when the state faced complaints that the rollout was too slow.

What Underlying Conditions Qualify You For The Vaccine In Your State?

Having a condition identified by the CDC as definitely or possibly high-risk doesn’t automatically qualify you where you live.

“The criteria for vaccine eligibility vary from state to state and may not match the criteria outlined by the CDC, so it's important to visit your state vaccination website for guidance,” Richardson explains.

You can check your state’s current eligibility guidelines for the COVID vaccine by selecting your state or territory in the CDC’s dropdown menu here, in the blue box labeled “How Do I Get A Vaccine?” By checking your state’s standards, you’ll be one step closer to answering the question of the year — and getting yourself your shot.

Experts:

Dr. Michael Richardson, M.D., family medicine doctor with One Medical