Trust in public health officials

There have been reports suggesting the CDC’s reputation has been diminished as a result of its role in the COVID-19 response. Is the CDC’s leadership still credible?

For decades, the CDC has put its scientific expertise to work to protect Americans from infectious disease, chronic illness, and preventable injuries. Around the world, the agency is a trusted source for public health and health promotion guidance; the CDC’s career staff remain a respected and credible information source.

The CDC is at its best when its scientists are free to provide public health advice based on the best available data and free of any political or non-scientific considerations.

There’s no avoiding the fact that the COVID-19 pandemic has been extremely challenging for the entire country, including the CDC. There was an early misstep at the CDC with the initial development of a COVID-19 test. However, since then CDC has gathered and shared data on the pandemic’s impact, produced educational materials, distributed billions of dollars in grant funding to local, state, tribal, and territorial agencies, and supported essential services necessary for testing, contact tracing, and protection of the public.

During the initial response, the CDC did not have the central and visible roles in coordinating and messaging during the COVID-19 pandemic that it had during past infectious disease outbreaks, including malaria, HIV, H1N1, Ebola, and Zika. This lack of a central, public-facing role for the CDC impeded the federal response, contributed to mixed messaging on the optimal response to the pandemic, and delayed and sometimes distorted the guidance needed by the American public.

That has changed. The CDC has been empowered to take a central role in developing guidance and messaging and coordinating the national response. Everyone benefits when the CDC is allowed to do its job without interference and with regular, unfettered science-based messaging offered directly to the public and policymakers. Under the new leadership, the thousands of rank-and-file CDC employees scientists and public health experts dedicated only to the protection of the public are leading the day in and day out work necessary to fight the virus.

Going forward, the nation needs to ensure that science guides public health without any interference. When statements are made or policies suggested that are not grounded in science, public health experts need to continue to say so.

Updated May 7 , 2021

Why should people trust public health officials?

Public health officials are trained and experienced in responding to infectious disease outbreaks and life-threatening emergencies. They work closely with scientists and researchers to translate the latest findings into action with the express goal of keeping people as safe and healthy as possible.

Public health officials strive to be guided by science and independent of political or partisan considerations. The most effective way to address COVID-19 is to have state, local, and federal officials working in coordination and operating based on scientific guidance.

What is a public health official’s most important role during a health emergency?

As always, the role of public health officials is to follow the science, develop programs and guidelines that protect health, advise elected officials, work with public and private sector partners, and keep the public informed.

updated November 3

How do I know the COVID-19 vaccines are safe?

The COVID-19 vaccines have received the most intense safety monitoring in U.S. history, which has allowed public health officials to make science-based recommendations that keep people safe.

All COVID-19 vaccines have been rigorously tested and reviewed. The vaccine’s clinical trials three-phase process was detailed and thorough, and no shortcuts were taken. More than 150,000 people participated in U.S. clinical trials of the vaccines, and now, hundreds of millions of vaccine doses in the U.S. have been safely administered. Data from trial will continue to be collected for two years after each vaccine is first administered to ensure that they are safe for the long term. As with all vaccines, there will be ongoing monitoring for adverse events among people who are vaccinated into the future.

Updated October 12, 2021

How was the vaccine developed so quickly?

It may seem like the vaccines were developed quickly, but the process included rigorous safety reviews required for all new vaccines. The urgency of the pandemic created greater access to research funding, reduced bureaucratic obstacles, and encouraged unparalleled levels of government and industry cooperation. With these supports in place, scientists built upon previous work on coronavirus vaccines and on mRNA vaccine technology to develop these new vaccines quickly and effectively.

Updated October 12, 2021

What does it mean to be fully vaccinated?

In general, you are considered fully vaccinated for COVID-19 two weeks after you have received the second dose in a two-dose series (Pfizer-BioNTech or Moderna) or two weeks after you have received a single-dose vaccine (Johnson & Johnson).

As the science and the virus evolve, so does our understanding of what it means to be fully vaccinated.  Scientists and medical experts continue to closely watch for signs of waning vaccine immunity over time, how well the vaccines protect against new variants of the virus, and how that data differs across the population.

While additional or booster doses are recommended for some people, the CDC definition of what it means to be “fully vaccinated” has not changed at this time. More messaging guidance about booster doses can be found here.

Updated October 12, 2021

I already had COVID-19—why do I still need the vaccine?

Not enough is yet known about how long immunity from natural COVID-19 illness might last, and evidence is emerging that vaccination provides protection even in people who have had COVID-19.

One study, for example, showed that unvaccinated people who have had COVID-19 are still twice as likely as vaccinated people to get COVID-19 again. For that reason, even if you have already had COVID-19, vaccination is an important step to protect yourself and those around you.

Updated October 12, 2021

Am I permanently immune after getting vaccinated? What about breakthrough infections?

While COVID-19 vaccines are highly effective, no vaccine provides 100% immunity. Because this is a new virus, scientists and medical experts continue to monitor how long immunity lasts, whether some groups may need additional doses, and how well the vaccines protect against new variants of the virus.

Data continue to show that the COVID-19 vaccines are extremely effective in protecting fully vaccinated people from catching and spreading the virus, including the delta variant. A small percentage of vaccinated people experience breakthrough cases, but they are much more likely to have milder symptoms than unvaccinated people with COVID-19.

Unvaccinated people continue to account for the vast majority of severe cases, hospitalizations, and deaths from COVID-19. CDC data show that in August 2021, the risk of dying from COVID-19 in the U.S. was more than 11 times greater for unvaccinated people compared to fully vaccinated people.

The risk of severe illness from COVID-19 is increased for some groups — including older adults, people with underlying medical conditions, immunocompromised people, and pregnant or recently pregnant people. If you have questions about your risk of COVID-19, how to protect yourself from COVID-19, or about the vaccines, speak to your health provider.

Updated October 20, 2021

What is the risk of having an adverse reaction to the vaccine?

The threat of COVID-19 is real and urgent, and getting vaccinated is the best way to protect yourself. Side effects to the COVID-19 vaccines are typically mild and subside in one to two days — like soreness in the arm, fatigue, headaches, or a slight fever.

The risk of having a serious adverse reaction to the COVID-19 vaccine is very low — far lower than the risk of contracting COVID-19. The CDC and FDA are closely monitoring vaccine outcomes to ensure safety.

If you have a question about the vaccines, talk with your healthcare provider.

Updated October 12, 2021

What is emergency use authorization, and why aren’t all of the COVID-19 vaccines FDA-approved?

Emergency use authorization (EUA) allows the FDA to authorize the use of yet-to-be-approved drugs, or unapproved uses of approved drugs, often in emergency situations when there are no other prevention or treatment options. The FDA issued EUAs for the Pfizer, Moderna, and Johnson & Johnson vaccines, and has now issued full approval for the Pfizer COVID-19 vaccine.

In an emergency when lives are at risk, like a pandemic, it may not be possible to gather all the evidence that the FDA would usually require before approving a vaccine or drug. If evidence strongly suggests patients have benefited from a treatment, the FDA can issue an EUA to make it available to the public. For the COVID-19 vaccines, the FDA required two months of safety and efficacy data before the EUA was granted, including clinical trials with tens of thousands of people and rigorous testing and review. Compared to EUA, full FDA approval of vaccines requires even more data on safety, manufacturing, and effectiveness over longer periods of time. All the vaccines continue to be closely monitored.

The Pfizer COVID-19 vaccine was the first vaccine to have the necessary data to receive EUA, and it was the first to have enough data to receive full approval (read more about FDA approval here). Moderna has also submitted an application for full approval of its COVID-19 vaccine, and the FDA is currently reviewing those data. For the time being, the Moderna and Johnson & Johnson vaccines will continue to be safely administered through emergency use authorization.

Updated October 12, 2021

Children and Vaccinations

Topline messages on children and COVID-19 vaccination

The CDC recommends that children and adolescents age 5 and older get a COVID-19 vaccine. The Pfizer COVID-19 vaccine is authorized for children and adolescents age 5 and up, as a 2-dose series taken 3 weeks apart. The dose for children age 5-11 is one-third of the dosage of the vaccine for older adolescents and adults.

Vaccination is the best way to protect children age 5 and older from COVID-19. COVID-19 has become one of the top 10 causes of pediatric death, and tens of thousands of children and teens have been hospitalized with COVID-19. While children and adolescents are typically at lower risk than adults of becoming severely ill or hospitalized from COVID-19, it is still possible.

The vaccine is safe and effective. Before being authorized for children, scientists and medical experts completed their review of safety and effectiveness data from clinical trials of thousands of children. The Pfizer COVID-19 vaccine was rigorously tested and reviewed, and more than 11 million adolescents ages 12-17 have already safely received the COVID-19 vaccine.

Updated November 3, 2021

Why should children get the COVID-19 vaccine?

Medical and public health experts, including the CDC and the American Academy of Pediatrics, recommend that children and adolescents age 5 and older get a COVID-19 vaccine to help protect them from contracting and spreading the virus.

The vaccine is the best way to protect children from becoming severely ill or having long-lasting health impacts due to COVID-19. COVID-19 has become one of the top 10 causes of pediatric death, and tens of thousands of children and teens have been hospitalized with COVID-19. While children and adolescents are typically at lower risk than adults of becoming severely ill or hospitalized from COVID-19, it is still possible.

Another important reason for children to get the COVID-19 vaccine is to protect their friends, family, and the broader community from the spread of the virus. As vaccination rates increase, the lower the chances that the coronavirus will mutate into dangerous variants.

Updated November 3, 2021

Is the COVID-19 vaccine safe for children?

Yes. Keeping children safe and healthy is top of mind for parents, and scientists have worked to ensure the vaccine is safe for children ages 5-17. Before being authorized for children, scientists and medical experts completed their review of safety and effectiveness data from clinical trials of thousands of children. The Pfizer COVID-19 vaccine was rigorously tested and reviewed, and more than 11 million adolescents ages 12-17 have already received the COVID-19 vaccine. As of November 2, the Pfizer vaccine is also authorized for children ages 5-11.

Data from trials will continue to be collected for two years after each vaccine is first administered to ensure that they are safe for the long term. As with all vaccines, there will be ongoing monitoring among people who are vaccinated.

Updated November 3, 2021

Will children experience any side effects from the vaccine? I’ve heard about myocarditis.

Side effects to the COVID-19 vaccines are typically mild and subside in one to two days — like soreness in the arm, fatigue, headaches, or a slight fever.

The risk of a child having a serious adverse reaction to the COVID-19 vaccine is very low. One rare complication that has been linked to the COVID-19 vaccine is myocarditis (inflammation of the heart), and data demonstrate a higher risk for such inflammation among younger males. However, reports of these complications are rare. The risk of developing myocarditis after a COVID-19 infection is much higher than the risk of developing myocarditis after the vaccine.

If you have questions about how to protect your children from COVID-19, about the vaccines, or about myocarditis, speak to your health care provider or pediatrician.

Updated November 3, 2021

Schools and in-person learning

Is in-person learning safe? What are the best ways to keep my child safe at school?

In-person learning is critical for the educational and social development of students of all ages. Ensuring that schools open and operate in a manner that prioritizes the health and safety of students, teachers, school staff, their families, and the community is a national priority.

In addition to following local and school requirements and getting vaccinated if eligible, children can protect themselves and others from contracting and spreading COVID-19 by wearing a well-fitting mask, washing their hands, social distancing, staying home if they are feeling sick, and getting tested if they were exposed to the virus or are symptomatic.

Updated October 12, 2021

Should children, teachers, and staff wear masks?

The CDC recommends that all students, teachers, and staff at K-12 schools wear masks to protect children and the community against the spread of COVID-19. Along with COVID-19 vaccination, mask-wearing can play an important role in ending the pandemic. Especially in schools where children under 12 can’t yet get vaccinated, masks are a critical line of defense against the spread of COVID-19.

Data show that wearing masks in schools is effective in preventing COVID-19 outbreaks and keeping children safe. A CDC study found that schools without mask requirements were 3.5 times more likely to have COVID-19 outbreaks than schools that started the fall 2021 school year with mask requirements. In another analysis of 520 U.S. counties, the CDC found that in places where schools did not have mask requirements, pediatric COVID-19 cases rose at a  higher rate than in counties where schools do require masks.

Updated October 12, 2021

Why does school reopening and in-person learning guidance vary across districts, counties, and states?

School policies, including COVID-19 guidance, are made at the state, local, district, and school levels. The CDC continues to recommend universal masking in K-12 schools, vaccination, distancing, ventilation, and other prevention strategies, and that additional measures be based on local vaccination and infection rates.

Updated October 12, 2021

Pregnancy + fertility

Should I get the COVID-19 vaccine if I am pregnant or breastfeeding?

Yes. Based on data on the safety of COVID-19 vaccines during pregnancy, CDC is now recommending COVID-19 vaccination for all people who are pregnant, breastfeeding or trying to get pregnant now or in the future. Data show that pregnant and recently pregnant people are more likely to get severely ill if infected with COVID-19 compared with non-pregnant people, and the highly contagious delta variant makes it even more important for eligible people to get vaccinated.

The CDC’s recommendation, announced on August 11, is based on further evidence about the safety of COVID-19 vaccines and a new analysis of current data from the CDC’s v-safe pregnancy registry. In addition, the American College of Obstetricians and Gynecologists and other leading maternal health and public health organizations are “strongly urging” all pregnant individuals, and anyone planning to become pregnant, be vaccinated against COVID-19.

Added August 12, 2021

Does the COVID-19 vaccine increase risk of miscarriage?

No. There is no evidence to show that getting a vaccine increases the risk of miscarriage.

There has been extensive safety monitoring of the COVID-19 vaccines, including analysis of vaccination during pregnancy. Specifically, studies show that the rate of miscarriage in the first 20 weeks of pregnancy in the general population is about 11-16%, and an analysis of safety monitoring data of people who received an mRNA COVID-19 vaccine showed a similar rate of 13%.In other words, being vaccinated with one of the currently available COVID-19 vaccines does not increase miscarriage risk; rather, it protects against the higher risk of serious illness if you are pregnant and become infected with the virus.

Added August 12, 2021

Does the COVID-19 vaccine cause infertility or fertility issues?

No. There is no evidence that fertility problems are a side effect of any vaccine, including COVID-19 vaccines.

Added August 12, 2021

Will getting a COVID-19 vaccine during pregnancy or while breastfeeding protect my baby from COVID-19?

Antibodies made after a pregnant person received an mRNA COVID-19 vaccine have been found in umbilical cord blood, which means that COVID-19 vaccination during pregnancy might help protect babies against COVID-19. Additionally, recent reports have shown that breastfeeding people who have received mRNA COVID-19 vaccines have antibodies in their breast milk, which could help protect their babies. In both of these cases, more data are needed to determine the level of protection these antibodies may provide to the baby and how long that protection would last.

Added August 12, 2021

Delta and other variants

Are the COVID-19 vaccines effective against the delta variant?

Yes. Data show that the COVID-19 vaccines are extremely effective in protecting fully vaccinated people from catching and spreading the virus, including the delta variant. But it is critical that you are fully vaccinated to be protected.

New data is showing that a small number of vaccinated people can be infected by delta variant in a breakthrough infection and may be contagious, but these cases represent a very small amount of transmission occurring around the country.

Updated July 27, 2021

What is the delta variant, and why is it concerning?

The delta variant is a naturally occurring mutation of the SARS CoV-2 virus, the virus that causes COVID-19. Data show that the delta variant is more contagious and spreads more easily than the original COVID-19 virus. The delta variant accounts for a growing proportion of new coronavirus cases across the U.S., and people infected with the delta variant are more likely to need hospitalization than those infected with earlier strains of the virus.

Added July 8, 2021

Johnson & Johnson vaccine

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of Guillain-Barré syndrome. Below are topline messages to guide your talking points, followed by more questions and answers about the Johnson & Johnson vaccine, including information about the rare blood clotting disorder on the vaccine’s warning label, and the safety of other vaccines.

What is the current status of the Johnson & Johnson COVID-19 vaccine?

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of a rare neurological syndrome called Guillain-Barré syndrome. The new warning label is based on preliminary data, after about 100 reports of GBS were detected in the Vaccine Adverse Event Reporting System, out of more than 12.8 million administered doses of the Johnson & Johnson vaccine administered.

The CDC continues to advise that everyone 12 years of age and older receive a COVID-19 vaccine. The risk of severe adverse events after any COVID-19 vaccination remains rare, far lower than adverse health outcomes associated with contracting COVID-19.

The CDC and FDA will continue to provide monitoring and treatment information to health care providers and vaccine recipients. Anyone with questions about which vaccine is best for them should speak to their healthcare provider.

Added July 13, 2021

The Johnson & Johnson Vaccine, Guillain-Barré syndrome, and topline messages

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of Guillain-Barré syndrome (GBS). The FDA and CDC take vaccine safety very seriously, which is why all vaccines are closely monitored. The identification of any possible risks, like the low risks associated with the Johnson & Johnson vaccine, is a sign that the nation’s safety monitoring system for COVID vaccines is working.

  • About 100 reports of Guillain-Barré syndrome have been detected in the Vaccine Adverse Event Reporting System, out of 12.8 million administered doses of the Johnson & Johnson vaccine. GBS is a rare condition, and the risk of contracting it due to the J&J vaccine is very low.
  • The risk of severe adverse events after any COVID-19 vaccination remains very low, and far lower than adverse health outcomes associated with contracting COVID-19.
  • Data do not show any increased risk of GBS for the Pfizer or Moderna vaccines.
  • In the U.S., nearly all COVID-19 hospitalizations and deaths are now occurring in unvaccinated people. The CDC recommends that everyone age 12 years and older receive a COVID-19 vaccine.

Added July 13, 2021

Should I be concerned about the safety of other vaccines?

The mRNA vaccines (Pfizer and Moderna’s COVID-19 vaccines) are not associated with increased risk for Guillain-Barré syndrome or for a rare blood clotting disorder that appear on the warning label for the Johnson & Johnson vaccine.

The identification of what is approximately a less than 2-in-a-million risk associated with the Johnson & Johnson vaccine is a sign that the nation’s safety monitoring system for COVID vaccines is working. After any vaccine is successful in clinical trials and approved for use, the FDA continues to monitor it for safety. The 10-day pause of the J&J vaccine in April 2021 allowed scientists to evaluate each incidence of the clotting disorder. They determined that the level of risk was very low and that the benefits of continued use of the J&J vaccine greatly outweighed any risk associated with it.

Updated July 13, 2021

Who is at risk for the Guillain-Barré syndrome associated with the Johnson & Johnson vaccine?

The likelihood of the Guillain-Barré syndrome (GBS) resulting from the Johnson & Johnson vaccine is extremely low. The cases have largely been reported two weeks after vaccination and mostly in males, many age 50 years and older. Additional data that details the risk of incidence is forthcoming, but preliminary data is based on about 100 reports of GBS in the Vaccine Adverse Event Reporting System out of more than 12.8 million Johnson & Johnson doses administered. If you have questions about the J&J vaccine or other vaccines, talk to your healthcare provider.

Added July 13, 2021

Why was the Johnson & Johnson vaccine paused?

In April 2021, the Johnson & Johnson vaccine was paused for 10 days while a CDC panel reviewed data concerning a very rare blood clotting disorder. The decision to lift the pause in April was based on the experts’ determination that the benefits of administering the vaccine greatly outweigh the very small degree of risk associated with its use. The risk of blood clotting is much higher for people who contract COVID than it is for people who receive the J&J vaccine.

Added April 24, 2021

What was learned during the April 2021 pause of the Johnson & Johnson vaccine?

The 10-day pause in April 2021 gave health officials time to review additional data to better understand the degree of risk associated with the Johnson & Johnson vaccine related to a blood clotting disorder. It also gave federal agencies and the medical community time to determine and share information on the most appropriate treatment response. During the pause, nine additional cases of the clotting disorder were identified, bringing the total number of known cases to 15 among the nearly 7 million people who received the vaccine.

The decision to lift the pause was based on the experts’ determination that the benefits of administering the vaccine greatly outweigh the very small degree of risk associated with its use, particularly now that the risk and treatment protocols are better understood. The risk of blood clotting is much higher for people who contract COVID than it is for people who receive the J&J vaccine.

Added April 24, 2021

Who is at risk for the blood clotting disorder associated with the Johnson & Johnson vaccine?

The likelihood of the blood clotting disorder resulting from the Johnson & Johnson vaccine is extremely rare. The risk varies by age and gender. There have been fewer than 1 case per million for men and for women who are 50 years or older; the risk is estimated to be about 7 cases per million for women ages 18 to 49. If you have questions about the J&J vaccine or other vaccines, talk to your doctor.

Added April 24, 2021

If I got the Johnson & Johnson shot, am I at risk of Guillain-Barré syndrome or a blood clotting disorder?

If you received the Johnson & Johnson shot and within two weeks have not developed any of the side effects associated with Guillain-Barré syndrome – muscle weakness, tingling in hands and feet, difficulty catching your breath, or choking on saliva – the risk for an adverse reaction is very low.

The symptoms of the blood clotting disorder – severe headache or abdominal pain, shortness of breath, neurological symptoms, leg swelling – usually develop within three weeks of receiving the vaccine. If you are beyond the three-week mark, the risk of your developing an adverse reaction is very low. If you have questions or concerns, consult your doctor.

Updated July 13, 2021

If I’m offered the Johnson & Johnson vaccine, should I wait until I can get either Pfizer or Moderna?

For most people, getting the first available COVID vaccine is the best thing you can do to safeguard your health. Your odds of contracting a possibly life-threatening case of COVID-19 are much higher than your odds of experiencing serious side effects from the vaccine. For example, the risk of blood clots from COVID illness is 165,000 per million cases, which is much higher than the risk of the rare blood clotting disorder associated with the Johnson & Johnson vaccine. That said, Pfizer and Moderna vaccines are widely available. More than 90% of the fully vaccinated population in the U.S. has received the Pfizer and Moderna vaccine, with only about 8% having been vaccinated with the Johnson & Johnson vaccine.

If you have additional questions about which vaccine is best for you, check with your doctor.

Updated July 13, 2021