In the most restricted parts of the COVID-19 vaccine distribution guidelines from the Centers for Disease Control and Prevention (CDC), the highest priority populations would have included health care and frontline workers, people living in assisted living facilities and those older than 75. ValuePenguin analyzed demographic numbers for high-risk populations and found that just 18.2% of the population would have been eligible to receive the COVID-19 vaccination in the first phase of the rollout under these guidelines.
Under the federal government's new recommendations, which would open vaccination eligibility to seniors and people with certain high-risk, chronic conditions, the inoculated population of the U.S. would grow significantly. Seniors without preexisting conditions alone would raise the vaccinated share of the country by 31 million people.
- Without implementing the government's new guidelines for vaccinations, Maine, Pennsylvania, New York, Vermont and Rhode Island would have the largest shares of their populations at the front of the line.
- A maximum of 113 million people would qualify for early vaccination under guidelines that open eligibility to those with certain high-risk diseases.
- West Virginia has the highest possible share of people with high-risk ailments of any state in the country, while California has the highest number of people with these characteristics.
- In only 13 states were uninsured and underinsured people not identified by state policymakers as people who would have to be included in vaccine prioritization planning and outreach.
Different plans from state and federal governments and the CDC complicate who can receive the vaccines and determine the number of people ahead of you
The CDC's recommendations for the allotment of COVID-19 vaccines prioritize residents of nursing homes and health care workers. This amounts to 18.1 million Americans across the country. After these groups, the agency placed essential frontline workers from a variety of backgrounds and those 75 or older next in line for the vaccine — there are 59.7 million people in these groups across the country, though some of the seniors may also have been included in the earlier group of people living in nursing homes. Together, the number of people who qualified for the earliest vaccinations under these guidelines equaled 18.2% of the population.
Across all states, an average of 1.1 million people fall under these two categories. By raw populations totals, California, Texas and Florida — also the largest states in the country — would have the longest lines according to the CDC's prioritization for vaccinations. In Florida, the number of people eligible for the COVID-19 vaccine would equate to one-fifth of the state's population.
Indeed, in some states, health care and frontline workers and older residents make up larger shares of the population compared to larger states. For instance, an average of 21.4% of the people living in Maine, Pennsylvania, New York, Vermont and Rhode Island would be eligible to be vaccinated in the first wave of inoculations, according to the CDC.
However, when New York's lawmakers announced that the state would adopt the federal government's recommendations, the state ultimately expanded early eligibility. This is because the Trump administration said states should expand eligibility to Americans who are 65 or older, and to those with chronic health conditions who are more likely to experience complications from COVID-19.
In New York, this means that 30.8% of the state's population could get vaccinated against the virus. In other terms, by adopting the government's distribution recommendation, New York enables 1.9 million more people to get the shot than before. Likewise in California, Florida and Texas, vaccinations would be open to an average of 2.7 million more people under guidelines that make those 65 and older eligible.
Across the country, an average of 619,129 more people could be vaccinated in states that adjust their guidelines to mirror more closely those recommendations from the federal government — even before factoring in any of the people who have high-risk characteristics, such as cancer patients or survivors, those with high blood pressure or chronic heart disease and those with diabetes, among others.
A maximum of 113.2 million people stand to be vaccinated once individuals with high-risk status are eligible
According to the CDC, people with cancer, chronic kidney disease, chronic obstructive pulmonary disease (COPD), heart disease and Type 2 diabetes are at greater risk of being more severely affected by COVID-19. Americans with these conditions fall into the third stage of the CDC's recommended vaccination plan with those aged 65 to 74.
Under the federal government's recommendations, these individuals fall into the first grouping of vaccine-eligible Americans.
ValuePenguin calculated that there would be a maximum of 113.2 million Americans — or 35% of the country's population — who could move up in the vaccine line due to having at least one of these chronic conditions. However, in reality, the number is likely far lower. Many with these chronic conditions would already have been vaccinated earlier — because they lived in a long-term care facility, were older than 74 years old or had an "essential" job.
Across all states, West Virginia has the highest possible percentage of high-risk individuals relative to its population. In the state, up to 54% of residents would qualify for early vaccination. Following West Virginia, Kentucky, Arkansas, Alabama and Tennessee have the highest possible shares of high-risk populations.
In terms of raw numbers, however, the largest states again lead the way: California, Texas, Florida, New York and Ohio have an average of 7.9 million residents who could possibly qualify for the COVID-19 vaccination program because of the presence of a high-risk condition.
States define their critical populations differently, but a subset includes special attention to uninsured and underinsured people
Although the federal government and CDC can advise the states on how to distribute their vaccinations, it's ultimately each state's responsibility to oversee vaccine distribution. This means that states don't necessarily have to implement the plans suggested by others.
Critical populations, or those at greater risk of serious consequences from COVID-19, differ slightly according to each state. For this reason, a number of states specifically identify groups of uninsured and underinsured residents as critical populations. In these 31 states, the distribution of vaccines may prioritize these financially at-risk groups of people.
The following table shows the states where people without health insurance coverage are considered critical populations, or where state governments plan to reach out specifically to these underserved communities of people.
Uninsured listed as a critical population?
|Nevada||State commits to outreach to uninsured/underinsured||7%|
Table sorted by percentage of population uninsured.
Do you need health insurance to get a COVID-19 vaccine?
While researchers have found that about six in 100 people may avoid getting vaccinated because of financial constraints or a lack of insurance, you don't actually need health insurance to get a COVID-19 vaccine. By federal law, health care providers and health insurance companies can't issue fees for receiving the vaccination.
This is welcome news for the millions of uninsured Americans. According to data from the U.S. Census Bureau, there are more than 3 million fewer people without health insurance now than there were in May. However, there are 14 states where there are now more people living without health insurance:
- New Mexico
- West Virginia
In nine of these states, uninsured populations are listed as critical populations in the COVID-19 vaccination distribution plans — Arkansas, Louisiana, Maryland, Oklahoma and Colorado don't specify uninsured people in their breakdowns of their critical populations.
ValuePenguin combined several databases to get the data for this piece. From the Census Bureau, we pulled numbers on uninsured people by state, age and total population. From the Bureau of Labor Statistics, we obtained information on the number of health care and frontline workers. While frontline workers who qualify for early vaccination vary by state, our numbers reflect populations of workers in these industries:
- Grocery, convenience and drug store
- Public transit
- Trucking and warehouse
- Postal service
- Cleaning services
- Child care and social services
- First responders and protective services
From the Kaiser Family Foundation, we pulled figures on the number of people in long-term care facilities that are Medicare- and Medicaid-certified. These groups of people correspond to the CDC's general recommendations for the allocation of the COVID-19 vaccine, though specific procedures differ by state.