COVID-19 vaccines are now available to everyone ages 6 months and older in the United States, so there’s no longer a strict rollout where some groups wait in line behind others. But certain groups are still prioritized more strongly than the general population, meaning they’re recommended to get vaccinated first each season and to receive additional doses that others don’t qualify for. Adults 65 and older and people with weakened immune systems sit at the top of that priority list.
How Priority Worked During the Initial Rollout
When COVID-19 vaccines first became available in late 2020, supply was extremely limited. States followed a tiered system: healthcare workers and long-term care residents went first, followed by older adults and essential workers, then the general public in phases based on age and medical conditions. That scarcity-driven system no longer applies. Vaccines are widely available at pharmacies, clinics, and doctor’s offices without appointment restrictions or eligibility screening.
Who Gets the Strongest Recommendation Now
The CDC updates its COVID-19 vaccine guidance each year, similar to the flu shot. For the current seasonal vaccine, three groups receive the strongest push to get vaccarded early:
- Adults 65 and older are recommended to receive two doses of the updated seasonal vaccine, spaced six months apart. This reflects the reality that older immune systems produce a weaker and shorter-lived response to a single dose.
- People with moderate or severe immunocompromise (ages 6 months and up) are also recommended at least two doses, six months apart. After consulting with a healthcare provider, they may receive three or more total doses of the seasonal vaccine, with a minimum of two months between each.
- Long-term care residents and staff fall under the same age-based recommendations but are specifically called out by the CDC because nursing homes and assisted living facilities carry higher transmission risk. Residents 65 and older should get two doses; those under 65 should get at least one.
For everyone else between 6 months and 64 years old, the CDC frames vaccination as an individual decision. The agency notes that the benefit is greatest for people with underlying conditions that raise the risk of severe illness, and lowest for otherwise healthy individuals without risk factors.
What Counts as Immunocompromised
The CDC uses a broad definition. You qualify if you have a weakened immune system because of a medical condition or because you take medications or receive treatments that suppress immune function. Common examples include organ transplant recipients on anti-rejection drugs, people undergoing chemotherapy, those on high-dose corticosteroids, and individuals with advanced or untreated HIV. The key distinction is moderate to severe immunocompromise, not mild. If you’re unsure where you fall, your prescribing doctor can typically tell you based on your current treatment regimen.
Children and Teens
Children as young as 6 months are eligible for COVID-19 vaccination, though the specific products available vary by age. Children 6 months through 4 years have one vaccine option, while older kids and teens have access to additional products. As with adults under 65, vaccination for children is framed as an individual decision, with the strongest case for those who have underlying health conditions. There is no preferential recommendation for one vaccine brand over another when multiple age-appropriate options exist.
Timing of Each Season’s Vaccine
COVID-19 vaccines now follow an annual update cycle. Manufacturers reformulate the vaccine to target circulating variants, and the updated version typically becomes available in late summer or early fall. The 2025-2026 vaccine follows this pattern. People in priority groups, particularly those 65 and older and the immunocompromised, benefit most from getting vaccinated early in the season rather than waiting, since their protection tends to wane faster and respiratory virus activity climbs through winter.
Global Vaccine Access
Internationally, the COVAX initiative coordinated vaccine distribution to lower-income countries through the end of 2023, when the program formally closed. At its peak, COVAX focused on 34 countries that had vaccinated fewer than 10% of their populations by January 2022. With COVAX concluded, global COVID-19 vaccination now depends on individual countries’ purchasing agreements with manufacturers and their domestic health priorities. Access remains uneven, with many low-income nations still well below the vaccination rates seen in wealthier countries.