Blue Shield of California
COVID-19 Resource Center for Employers, Plan Sponsors, Brokers and Consultants

B2B General

March 15, 2021 - 2 min read

Understanding who should, and should not, get the COVID-19 vaccine

Considerations for certain groups of people


As COVID-19 vaccines become more widely accessible, guidelines that determine which groups can and cannot receive the vaccine have become a major topic for debate. All employers, especially those facing an eventual return to onsite operations, are encouraged to stay current on vaccine developments and proactively share credible information with their employees.

Though the CDC has deemed COVID-19 vaccines safe and effective for most of the population, there are groups for whom they are not currently recommended:

  • Children under 16:

    The Pfizer vaccine is approved for use in teens 16 and older while the Moderna vaccine is approved for ages 18 and older. Clinical trials are currently underway for children under 16 to determine safety and efficacy, with information expected mid-summer.

  • People who had a severe allergic reaction to the first COVID-19 vaccine dose or are allergic to any vaccine ingredient:

    Anyone who had a severe allergic reaction to the first dose should not get the second dose at this time. All those who have had a severe reaction to any ingredient of a COVID-19 vaccine should also not get the vaccine at this time.

  • People who currently have COVID-19:

    Those battling COVID-19 should not leave isolation to visit a vaccine distribution site. Doing so risks exposure to other community members receiving the vaccine.


The following groups should consult with a physician before deciding to receive the vaccine:

Select groups should consult their physician about their unique health needs before getting a COVID-19 vaccine. According to the CDC, these groups include people who:

  • Have had severe allergic reactions to other vaccines, injections, or certain medications:

    A few cases of severe allergic reaction to the COVID-19 vaccine have been reported. It’s recommended that those who have had severe allergies or carry an epinephrine injector (Epi-Pen, Auvi-Q, etc.) and those who have had a severe allergic reaction to other vaccines or injections, consult with their doctor before being vaccinated against COVID-19.

  • Have had a non-severe reaction to their first COVID-19 vaccine dose:

    Individuals who received their first dose and experienced non-severe allergic reactions, such as hives, swelling, and wheezing, within 4 hours after getting vaccinated, should consult their physician before getting a second dose.

  • Are immunocompromised:
    Individuals with immunosuppression, such as those that have an autoimmune disease, are HIV-positive, or suffer from chronic disease, are encouraged to weigh the risks and benefits of getting vaccinated with their physician before coming to a shared decision regarding COVID-19 inoculation.

  • Are pregnant or breastfeeding:

    Women who are pregnant have a higher risk for complications from COVID-19. Though they can be vaccinated against COVID-19, there are no study results yet available on the safety of COVID-19 vaccines in pregnant women. Health experts believe that the vaccines are unlikely to pose a risk to the woman or the fetus. Those who are pregnant or breastfeeding should discuss their risk of COVID-19 and how they might benefit from the vaccine with their physician; they can also read these FAQs from the California Department of Public Health.

  • Have been treated with monoclonal antibodies within the past 90 days:

    Antibody treatments make the vaccine less effective until they are broken down. It is recommended any individuals treated with antibodies wait 90 days before being vaccinated.

Vaccines, safe and effective for most of the population, are critical to defeating the coronavirus. Californians can register online at myturn.ca.gov to be notified as soon as it’s their turn to get vaccinated. Many counties have established websites sharing county-specific vaccine information, including register for eligibility notification and vaccine locators. Vaccines are provided at no out-of-pocket cost.

Those who should get vaccinated, once eligible, include groups not included in the categories detailed above. In addition, individuals who already have had COVID-19 should get vaccinated as there is not enough information available to confirm whether antibodies developed in response to being infected with COVID-19 are protective. It’s unknown at this time what antibody levels are required to protect against reinfection. Individuals should consult their physician to determine how soon they should be vaccinated after having COVID-19.

Setting guidelines for employee vaccination

While awaiting a return to in-person operations employers should begin developing vaccination policies for employees. Our recent article offers considerations for integrating plans and policies into long-term planning and provides further guidance for employers.

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