If you test positive for COVID-19 and have one or more health conditions that increase your risk of becoming very sick, treatment may be available. Contact a health professional right away after a positive test to determine if you may be eligible, even if your symptoms are mild right now. Don’t delay: Treatment must be started within the first few days to be effective.

What You Need to Know

• A person with any of the medical conditions listed below is more likely to get very sick with COVID-19.
• Staying up to date with COVID-19 vaccines (getting primary series and booster) and following preventive measures for COVID-19 are important. This is especially important if you are older or have severe health conditions or more than one health condition, including those on the list below.
• Approved and authorized COVID-19 vaccines (primary series and booster) are safe and effective.
• Some immunocompromised people, or people with weakened immune systems, may be eligible for a COVID-19 additional primary shot.
• The list below does not include all possible conditions that put you at higher risk of severe illness from COVID-19. If you have a condition not included on this list, talk to your healthcare professional about how best to manage your condition and protect yourself from COVID-19.

Overview

Based on current evidence, a person with any of the conditions listed below is more likely to get very sick with COVID-19. This means that a person with one or more of these conditions and who gets very sick with COVID-19 more likely to:

• Be hospitalized
• Need intensive care
• Require a ventilator to help them breathe
• Die

In addition:

• Older adults are more likely to get very sick from COVID-19. More than 81% of COVID-19 deaths occur in people over age 65. The number of deaths among people over age 65 is 97 times higher than the number of deaths among people ages 18-29 years.
• A person’s risk of severe illness from COVID-19 increases as the number of underlying medical conditions they have increases.
• Some people are at increased risk of getting very sick or dying from COVID-19 because of where they live or work, or because they can’t get health care. This includes many people from racial and ethnic minority groups and people with disabilities.
  • Studies have shown people from racial and ethnic minority groups are also dying from COVID-19 at younger ages. People in racial and ethnic minority groups are often younger when they develop chronic medical conditions and may be more likely to have more than one medical condition.
  • People with disabilities are more likely than those without disabilities to have chronic health conditions, live in shared group settings, and face more barriers in accessing health care. Studies have shown that some people with certain disabilities are more likely to get COVID-19 and have worse outcomes.

Staying up to date with COVID-19 vaccines (getting primary series and booster) and following preventive measures for COVID-19 are important. This is especially important if you are older or have severe health conditions or more than one health condition, including those on this list. Learn more about how CDC develops COVID-19 vaccination recommendations. If you have a medical condition, learn more about Actions You Can Take.

Medical Conditions

• The conditions on this list are in alphabetical order. They are not in order of risk.
• CDC completed a review for each medical condition on this list. This was done to ensure that these conditions met criteria for inclusion on this list. CDC conducts ongoing reviews of additional underlying conditions. If other medical conditions have enough evidence, they might be added to this list.
• Because we are learning more about COVID-19 every day, this list does not include all medical conditions that place a person at higher risk of severe illness from COVID-19. Rare medical conditions, including many conditions that mostly affect children, may not be included on the list below. We will update the list as we learn more.
• A person with a condition that is not listed may still be at greater risk of getting very sick from COVID-19 than other people who do not have the condition. It is important that you talk with your healthcare professional about your risk.

Cancer

Having cancer can make you more likely to get very sick from COVID-19. Treatments for many types of cancer can weaken your body’s ability to fight off disease. At this time, based on available studies, having a history of cancer may increase your risk.

Get more information:

• Cancer
• COVID-19: What People with Cancer Should Know – National Cancer Institute

Chronic Kidney Disease

Having chronic kidney disease of any stage can make you more likely to get very sick from COVID-19.

Get more information:

• Chronic Kidney Disease
• National Kidney Foundation: Kidney Disease and COVID-19

Chronic Liver Disease

Having chronic liver disease can make you more likely to get very sick from COVID-19. Chronic liver disease can include alcohol-related liver disease, non-alcoholic fatty liver disease, autoimmune hepatitis, and cirrhosis (or scarring of the liver).

Get more information:

• Liver Disease
• American Liver Foundation: Your Liver and COVID-19

Chronic Lung Diseases

Having a chronic lung disease can make you more likely to get very sick from COVID-19. Chronic lung diseases can include:

• Asthma, if it’s moderate to severe
• Bronchiectasis (thickening of the lungs’ airways)
• Bronchopulmonary dysplasia (chronic lung disease affecting newborns)
• Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis
• Having damaged or scarred lung tissue known as interstitial lung disease (including idiopathic pulmonary fibrosis)
• Pulmonary embolism (blood clot in the lungs)
• Pulmonary hypertension (high blood pressure in the lungs)

Get more information:

• COPD
• Asthma
• People with Moderate to Severe Asthma
• American Lung Association: Controlling Lung Diseases Amid COVID-19

Cystic Fibrosis

Having cystic fibrosis, with or without lung or other solid organ transplant (like kidney, liver, intestines, heart, and pancreas) can make you more likely to get very sick from COVID-19.

Get more information:

• Cystic Fibrosis
• CF and COVID-19 | Cystic Fibrosis Foundation

Dementia or Other Neurological Conditions

Having neurological conditions, such as dementia, can make you more likely to get very sick from COVID-19.

Get more information:

• Dementia
• Alzheimer’s Association: COVID-19, Alzheimer’s and Dementia

Diabetes (Type 1 or 2)

Having either type 1 or type 2 diabetes can make you more likely to get very sick from COVID-19.

Get more information:

• Diabetes
• American Diabetes Association: How COVID-19 Impacts People with Diabetes

Disabilities

People with some types of disabilities may be more likely to get very sick from COVID-19 because of underlying medical conditions, living in congregate settings, or systemic health and social inequities, including:

• People with any type of disability that makes it more difficult to do certain activities or interact with the world around them, including people who need help with self-care or daily activities.
• People with attention-deficit/hyperactivity disorder (ADHD)
• People with cerebral palsy
• People with birth defects
• People with intellectual and developmental disabilities
• People with learning disabilities
• People with spinal cord injuries
• People with Down syndrome

Get more information:

• People with Disabilities | COVID-19

Heart Conditions

Having heart conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension) can make you more likely to get very sick from COVID-19.

Get more information:

• Heart Disease
• American Heart Association: COVID-19
• NHLBI Information and Resources on COVID-19

HIV Infection

Having HIV (Human Immunodeficiency Virus) can make you more likely to get very sick from COVID-19.

Get more information:

• HIV Infection
• Interim Guidance for COVID-19 and Persons with HIV

Immunocompromised State (Weakened Immune System)

Some people are immunocompromised or have a weakened immune system. For example, people on chemotherapy or who have had solid organ transplant, like a kidney transplant or heart transplant. Being immunocompromised can make you more likely to get very sick from COVID-19. Many conditions and treatments can cause a person to be immunocompromised or have a weakened immune system. For example, some people inherit problems with their immune system. Once example is called Primary immunodeficiency. Other people have to use certain types of medicines for a long time, like corticosteroids, that weaken their immune system. Such long-term uses can lead to secondary or acquired immunodeficiency.

People who are immunocompromised or are taking medicines that weaken their immune system may not be protected even if they are up to date on their vaccines. They should continue to take all precautions recommended for people who are not vaccinated, including wearing a well-fitting mask, until advised otherwise by their healthcare professionals.

After completing the primary series, some moderately or severely immunocompromised people should get an additional primary shot.

Everyone 12 years and older, including immunocompromised people, should get a booster shot. If you are eligible for an additional primary shot, you should get this dose first before you get a booster shot.

Get more information:

• Types of Primary Immune Deficiency Diseases
• Jeffrey Modell Foundation
• Immune Deficiency Foundation
• Primary Immunodeficiency (PI)

Mental Health Conditions

Having mood disorders, including depression, and schizophrenia spectrum disorders can make you more likely to get very sick from COVID-19.

Get more information:

• National Institute of Mental Health (NIMH) Shareable Resources on Coping with COVID-19
• National Institute of Mental Health (NIMH) Depression
• Mood Disorders

Overweight and Obesity

Overweight, obesity, or severe obesity, can make you more likely to get very sick from COVID-19. The risk of severe COVID-19 illness increases sharply with higher BMI.

Get more information:

• Overweight & Obesity | CDC
• Obesity, Race/Ethnicity, and COVID-19
• Obesity Action Coalition: COVID-19 and Obesity

Physical Inactivity

People who do little or no physical activity, or exercise, are more likely to get very sick from COVID-19 than those who are physically active. Being physically active (or exercising regularly) is important to being healthy. Get more information on physical activity and health, physical activity recommendations, how to become more active, and how to create activity-friendly communities:

• Physical Activity
• Physical Activity Guidelines for Americans, 2^nd Edition
• Move Your Way
• Active People, Healthy Nation: Strategies to Increase Physical Activity
• National Center on Health, Physical Activity and Disability – Building Healthy Inclusive Communities

Pregnancy

Pregnant and recently pregnant people (for at least 42 days following end of pregnancy) are most likely to get very sick from COVID-19 compared with non-pregnant people.

Get more information:

• Pregnant and Recently Pregnant People
• Toolkit for Pregnant People and New Parents
• Investigating the Impact of COVID-19 during Pregnancy

Sickle Cell Disease or Thalassemia

Having hemoglobin blood disorders like sick cell disease (SCD) or thalassemia can make you more likely to get very sick from COVID-19.

Get more information:

• Sickle Cell Disease
• Thalassemia

Smoking, Current or Former

Being a current or former cigarette smoker can make you more likely to get very sick from COVID-19. If you currently smoke, quit. If you used to smoke, don’t start again. If you’ve never smoked, don’t smart.

Get more information:

• Smoking & Tobacco Use
• Tips from Former Smokers
• Health Benefits of Quitting Smoking

Solid Organ or Blood Stem Cell Transplant

Having a solid organ or blood stem cell transplant, which includes marrow transplants, can make you more likely to get very sick from COVID-19.

Get more information:

• Transplant Safety
• COVID-19 Resources for Transplant Community

Stroke or Cerebrovascular Disease

Having cerebrovascular disease, which affects blood flow to the brain, can make you more likely to get very sick from COVID-19.

Get more information:

• Stroke
• COVID-19 Stroke Podcast Series for Patients and Caregivers

Substance Use Disorders

Having a substance use disorder (such as alcohol, opioid, or cocaine use disorder) can make you more likely to get very sick from COVID-19.

Get more information:

• How to Recognize a Substance Use Disorder
• Drug Overdose

Tuberculosis

Having tuberculosis can make you more likely to get very sick from COVID-19.

Get more information:

• Basic TB Facts
• Public Health Emergencies

Actions You Can Take

It is important to protect yourself and others by taking preventive measures against COVID-19:

• Stay up to date with your COVID-19 vaccines
• Wear a well-fitting mask
• Avoid crowds and poorly ventilated spaces
• Test to prevent the spread to others
• Wash your hands often
• Cover coughs and sneezes
• Monitor your health daily

Seek Care When Needed

• Call your healthcare professionals if you have any concerns about your medical conditions or if you get sick and think that you may have COVID-19. Discuss steps you can take to manage your health and risks. If you need emergency help, call 911 right away.
• Do not delay getting care for your medical condition because of COVID-19. Emergency departments, urgent care, clinics, and your healthcare professionals have infection prevention plans to help protect you from getting COVID-19 if you need care.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Summary of Changes

• Guidance streamlined
• Added links to guidance on testing for determining length of work restriction for healthcare personnel with SARS-CoV-2 infection or exposure to SARS-CoV-2 and for mitigating staff shortages in healthcare settings
• Time period for confirmatory testing was clarified

This document is intended to assist long-term care facility (LTCF) providers and state and local public health departments with interpretation of and response to results of antigen tests used to diagnose new SARS-CoV-2 infections in the following circumstances:

• Testing of symptomatic residents and healthcare personnel (HCP),
• Testing of asymptomatic residents and HCP in facilities as part of a SARS-CoV-2 outbreak response or following close contact with someone with SARS-CoV-2 infection, and
• Testing of asymptomatic HCP as part of expanded screening testing in facilities without a SARS-CoV-2 outbreak.

Information on the role of testing in determining the length of work restriction  for HCP with SARS-CoV-2 infection or exposure to SARS-CoV-2 is available here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html.

Information on the role of testing in mitigating staff shortages is available here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html

Testing Symptomatic Residents or HCP

• Recommended infection prevention and control precautions for residents and HCP with suspected or confirmed SARS-CoV-2 infection are described in:
  • Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes
  • Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 | CDC

• If an antigen test is positive, confirmatory testing is generally not necessary.  The symptomatic individual should be classified as having SARS-CoV-2 infection.
  • Residents should be placed on Transmission-Based Precautions and HCP should be excluded from work until they meet criteria to discontinue isolation.
  • If the resident or healthcare worker is the first positive case of SARS-CoV-2 within the facility (i.e., an index case), an outbreak response might be indicated.

• If an antigen test is negative, confirmatory testing¹ with a nucleic acid amplification test (NAAT) should be performed as soon as possible (within 1 to 2 days of the antigen test).  Residents should be kept on Transmission-Based Precautions and HCP should remain excluded from work until NAAT results return.
  • If the confirmatory NAAT is negative:
    • If not in an outbreak facility and no known close contact with someone with SARS-CoV-2 infection, residents and HCP may be treated as not SARS-CoV-2 infected or exposed; further management will depend on the suspected etiology of their symptoms.
    • If in an outbreak facility or there has been close contact with someone with SARS-CoV-2 infection, residents and HCP should be managed as described in current guidance for long-term care infection control and HCP return to work.

• If the confirmatory NAAT is positive:
  • Residents and HCP should be considered to have SARS-CoV-2 infection. Residents should remain on Transmission-Based Precautions  and HCP should be excluded from work until they meet criteria to discontinue isolation.
  • If the resident or healthcare worker is the first positive case of SARS-CoV-2 within the facility (i.e., an index case), an outbreak response might be indicated.

• Facilities should test for both influenza and SARS-CoV-2 if influenza and SARS-CoV-2 are circulating in the community.

Some antigen platforms have higher sensitivity when testing people soon after symptom onset (e.g., within 5 days). Clinical discretion may be used when determining if people who test negative should be retested with NAAT. Confirmatory testing may not be necessary if the individual has a low likelihood of SARS-CoV-2 infection. Factors that might indicate a lower likelihood of infection include: low to moderate levels of community transmission, no known or suspected close contact with someone with SARS-CoV-2 infection, and/or the person is up to date with COVID-19 vaccination.

Asymptomatic residents or HCP in LTCF tested as part of an outbreak response or following close contact with someone with SARS-CoV-2 infection

• If an antigen test is positive, confirmatory NAAT should generally be performed².
  • Residents should be placed on Transmission-based Precautions in a single room or, if single rooms are not available, remain in their current room pending results of confirmatory testing. They should not be transferred to a COVID-19 unit or placed in another shared room with new roommates. HCP should be excluded from work.
  • If confirmatory NAAT is positive, residents and HCP should be considered to have SARS-CoV-2 infection.  Residents should remain on Transmission-Based Precautions  and HCP should be excluded from work until they meet criteria to discontinue isolation.

• If an antigen test is negative OR if the antigen test is positive but the confirmatory NAAT (performed within 1 to 2 days of the antigen test) is negative:
  • Residents and HCP may be treated as not SARS-CoV-2 infected; however, because of their potential exposure (in an outbreak facility or have had close contact) residents and HCP should be managed as described in current guidance for long-term care infection control and HCP return to work.

• Note: In general, asymptomatic people who have recovered from SARS-CoV-2 infection in the past 3 months should not be tested for SARS-CoV-2.

In situations where the pre-test probability is higher (e.g., facility with a large outbreak, a person who is a close contact of someone with SARS-CoV-2 infection and is not up to date with all recommended COVID-19 vaccine doses), the antigen positive test might not require confirmation and the individual should be treated as infected with SARS-CoV-2.

Asymptomatic HCP as part of expanded screening testing in LTCF without an outbreak 

• If an antigen test is positive, perform confirmatory NAAT as soon as possible (within 1 to 2 days of the antigen test). Asymptomatic HCP who are antigen test positive should be excluded from work but initiation of an outbreak response, including facility-wide testing, can be delayed until confirmatory test results are available.
  • If the confirmatory NAAT is positive, then the healthcare worker should be considered infected and guidance for HCP return to work and infection control response in long-care should be followed.
  • If the confirmatory NAAT is negative, the antigen test should be considered a false positive and the HCP may return to work.

• If an antigen test is negative, allow HCP to continue to work following all routine recommended infection control practices.

Note: In general, asymptomatic HCP who have recovered from SARS-CoV-2 infection in the past 3 months should not be tested for SARS-CoV-2.

For more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-antigen-testing.html.

Wash hands with soap and water for at least 20 seconds. Use the cleanest water possible, for example, from an improved source. *If soap and water are not available use an alcohol-based hand rub that contains at least 60% alcohol.

Handwashing Solution

Make a Handwashing Solution

Remember, only use chlorine-based handwashing solutions when soap and water or alcohol-based hand rub are not available.

Making Handwashing Solution from 5% Liquid Bleach

Use the MILD chlorine water to wash hands. Make new mild chlorine water every day.

1. Mix 14 tablespoons (1 Cup plus ¾ Cup) of 5% bleach into 20 liters (5 gallons plus 4½ Cups) of clear water. Stir well.
   Label plastic bucket for handwashing only / MILD 05%. Do not drink or use for cooking.
2. Make sure the bucket is covered. Use the MILD chlorine water to wash hands.

Making Handwashing Solution from HTH Chlorine Powder

Use the MILD chlorine water to wash hands. Make new mild chlorine water every day.

1. Mix 1 tablespoon of HTH chlorine powder into 20 liters (5 gallons plus 4½ Cups) of water every day. Stir well. Label plastic bucket for handwashing only /MILD 05%. Do not drink or use for cooking.
2. Stir well and wait 30 minutes.
3. Use the MILD chlorine water to wash hands.

To learn more, please visit: https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/handwashing.html

What You Need to Know

• Testing is critically important to help reduce the spread of COVID-19.
• COVID-19 self-tests can be taken at home or anywhere, are easy to use, and produce rapid results.
• Self-tests (also referred to as at-home tests or over-the-counter (OTC) tests) are one of many risk-reduction measures, along with vaccination, masking, and physical distancing, that protect you and others by reducing the chances of spreading  COVID-19.
• Free self-tests can be ordered at COVIDtests.gov.
• You can use COVID-19 self-tests regardless of vaccination status or whether or not you have symptoms.
• Consider using a COVID-19 self-test before joining indoor gatherings with others who are not in your household. This is especially important before gathering with individuals at risk of severe disease, older individuals, those who are immunocompromised, or unvaccinated people, including children who cannot get vaccinated yet.
• To obtain accurate results, follow all of the manufacturer’s instructions for performing the self-test.
• If you test positive, you should isolate and wear a well-fitting mask if you must be around others, inform your healthcare provider, and inform any close contacts. If you are a healthcare provider, follow CDC guidance for healthcare providers.
• A negative self-test result means that the test did not detect the virus that causes but it does not rule out a COVID-19 infection. A single negative self-test result may not reliable, especially if you have symptoms associated with COVID-19.
• If your result is negative, repeating the self-test within a few days, with at least 24 hours between tests, will increase the confidence that you are not infected with the virus causing COVID-19.

What is a Self-Test?

Self-tests for COVID-19 are those that can be performed on yourself at home or anywhere. Sometimes a self-test is also called a “home test,” an “at-home test,” or an “over-the-counter (OTC) test.” Self-testing offers fast results. Self-tests are one of several options for testing for the virus that causes COVID-19 and may be more convenient than laboratory-based tests and point-of-care tests.

Visit FDA’s website for a list of authorized tests. Some self-tests may have age limitations for self-collection or collection by an adult for a child.

As of January 2022, self-tests are used to detect current infection. No self-tests are available to detect antibodies to the virus, which would suggest previous infection.

When to Consider Self-Testing

Self-tests may be used if you have COVID-19 symptoms or have been in close contact or potentially in close contact with an individual with COVID-19.

Even if you don’t have symptoms and have not been in close contact with an individual with COVID-19, using a self-test before gathering indoors with others can give you information about the risk of spreading COVID-19. This is especially important before gathering with individuals at risk of severe disease, older individuals,  those who are immunocompromised, or unvaccinated people, including children who cannot get vaccinated yet.

Specifically, the best timing when using a self-test is:

• If you have COVID-19 symptoms, use a self-test immediately
• If you were a close contact of someone with COVID-19, self-test after at least 5 days, plus a second test in 1 or 2 days if your first test is negative (See Serial Testing, below)
• If you are testing before a gathering, test immediately before the gathering (or as close in time to the event as possible)

How to Get a Self-Test

Self-tests can be purchased online or in pharmacies and retail stores. Private health insurance will reimburse the cost of purchasing self-tests.

Self-tests can be purchased online or in pharmacies and retail stores. They are also available at no cost through some local health departments, Federally Qualified Health Centers (FQHC), or by ordering at COVIDtests.gov

For a list of authorized self-tests, see FDA EUA Testsexternal icon. Some tests may have age limitations for self-collection or collection by an adult for a child. If you are unable to obtain a self-test, but have symptoms of COVID-19 or have been exposed, stay away from others as much as possible and follow CDC recommendations for What to Do If You Are Sick. You may also consider visiting a community testing site. Call your local health department for additional testing options.

How to Use a Self-Test

Read the complete manufacturer’s instructions for use before using the test. Talk to a healthcare provider if you have questions about the test or your results.

Prepare to Collect a Specimen

• Wash your hands with soap and water for at least 20 seconds.
• Open the box and follow the instructions included with the COVID-19 self-test to collect your own nasal specimen.
• If you do not collect the specimens as directed, your test results may be incorrect.

Collect a Specimen and Perform the Self-Test

Follow the manufacturer’s instructions exactly and perform the steps in the order that they are listed. The manufacturer may also provide other resources, such as quick reference guides or instructional videos, to help you perform the test correctly.

Most COVID-19 self-tests require the collection of a nasal specimen (see the Additional Print Resources section below).

Once collected, use the specimen as described in the instructions to complete the self-test.

If Your Test Result is Positive

You should isolate according to CDC recommendations  and wear a well-fitting mask if you must be around other people. Report your positive result to your healthcare provider. It is particularly important to seek medical care and possible treatment if you have an underlying medical condition that increases your risks from COVID-19. If your illness becomes severe, seek medical attention. If you have an emergency warning sign (including trouble breathing), seek emergency medical care immediately. To avoid spreading the virus to others, follow CDC recommendations.

Tell your close contacts that they may have been exposed to the virus that causes COVID-19. A person with COVID-19 can begin spreading the virus starting 48 hours (or 2 days) before they have any symptoms or test positive. By informing your close contacts that they may have been exposed, you are helping to protect everyone.

If you think your positive test result may be incorrect, contact a healthcare provider to determine whether additional testing is necessary.

If Your Test Result is Negative

A negative test result means that the virus that causes COVID-19 was not detected in your specimen, and you may have a lower risk of transmitting the disease to others. If you took the test while you had symptoms and followed all instructions carefully, a negative result means your current illness may not be COVID-19, though it does not rule out COVID-19 infection.

It is also possible for a test to give a negative result in some people who have COVID-19. This is called a false negative. You could also test negative if the specimen was collected too early in your infection. In this case, you could test positive later during your illness. You should consider serial testing (see below).

Even if you receive a negative result, you should continue to practice preventative measures, such as being up to date on your COVID-19 vaccination, wearing a mask indoors, and physical distancing to reduce the risk of spreading COVID-19.

If Your Result Shows Invalid or Error

Sometimes invalid results or an error can occur on the self-test device. Invalid results or an error can occur for many reasons. Your specimen may not have been collected correctly, or the test may have malfunctioned.

Invalid test results are rare but can occur. If the self-test shows an invalid result or a test error, the test did not work properly. If this happens, a new test is needed to get an accurate result. Refer to the manufacturer’s instructions in the package insert and contact the manufacturer for assistance, consider taking another self-test, or contact a healthcare provider for additional help.

Serial Testing (Repeat Testing)

Serial testing is when a person tests multiple times for COVID-19, or on a routine basis, such as every few days. Some self-tests are designed to be used in a series. By testing more frequently, you may be able to detect COVID-19 more quickly and could reduce the spread of infection. Some self-tests include instructions for performing serial testing, including the number of days between tests, and may include more than one test in the package.

If your self-test is negative, you should follow the manufacturer’s instructions for serial testing, if applicable. Manufacturer’s instructions are included in the test box and are also available on the FDA website. The instructions may recommend you test again within 2 or 3 days. Contact a healthcare provider if you have any questions about your test results or serial testing. You may also use the COVID-19 Viral Testing Tool to help you determine the next steps after testing.

If you think your negative test result may be incorrect, contact a healthcare provider to determine whether additional testing is necessary.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/testing/self-testing.html

COVID-19 vaccines are effective at protecting you from getting sick even if you have had COVID-19. Vaccination is an important tool to help us get back to normal. This information will help you prepare for your COVID-19 vaccination.

Learn more about the different types of COVID-19 vaccines and how they work.

• Pfizer-BioNTech COVID-19 vaccine for everyone ages 5 years and older
• Moderna COVID-19 vaccine for adults aged 18 years and older
• Johnson & Johnson’s Janssen COVID-19 vaccine for adults ages 18 years and older

Learn more about the benefits of getting a COVID-19 vaccination.

Plan and Prepare for Your COVID-19 Vaccination

• Find out how to get a COVID-19 vaccine
• Get vaccinated even if you have already had COVID-19
• If you are getting a COVID-19 vaccine that requires two doses, be sure to schedule an appointment for your second shot
• Get a COVID-19 vaccine and any other recommended vaccines, including a flu vaccine, at the same visit
• Learn more about routine medical procedures and screenings and COVID-19 vaccination

Who should Get a COVID-19 Vaccine?

• COVID-19 vaccination is recommended for everyone ages 5 years and older
• Moderately or severely immunocompromised people who are ages 5 years and older and received a Pfizer-BioNTech primary vaccine series or ages 18 years and older received a Moderna primary vaccine series should receive an additional primary dose of the same vaccine at least 28 days after their second one
• Everyone ages 12 years and older who is fully vaccinated against COVID-19 should get a booster shot. Learn more about booster shots

Get Vaccinated Even If You Had COVID-19 and Think You Have Natural Immunity

You should get a COVID-19 vaccine even if you already had COVID-19.

Getting sick with COVID-19 offers some protection from future illness with COVID-19, sometimes called “natural immunity”. The level of protection people get from having COVID-19 may vary depending on how mild or severe their illness was, the time since their infection, and their age; and no currently available test can reliably determine if you are protected after a COVID-19 infection.

All COVID-19 vaccines currently available in the United States are effective at preventing COVID-19. Getting a COVID-19 vaccine gives most people a high level of protection against COVID-19, even in people who have already been sick with COVID-19.

Emerging evidence shows that getting a COVID-19 vaccine after you recover from COVID-19 infection provides added protection to your immune system. One study showed that, for people who already had COVID-19, those who do not get vaccinated after their recovery are more than 2 times as likely to get COVID-19 again than those who get fully vaccinated after their recovery.

People Who Should Wait to Get Vaccination

If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma while sick with COVID-19, you should wait 90 days before getting a COVID-19 vaccine. If you received monoclonal antibodies or convalescent plasma after you were exposed to someone with COVID-19 to prevent you from getting sick, you should wait 30 days before getting a COVID-19 vaccine. Talk to your healthcare professional if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.

If you or your child have a history of multisystem inflammatory syndrome in adults or children, consider delaying vaccination until you have recovered from being sick and for 90 days after the date of diagnosis of MIS-A or MIS-C. Learn more about the clinical considerations for people with a history of MIS-A or MIS-C.

Considerations for Taking Medication before Getting Vaccinated

For most people, it is not recommended to avoid, discontinue, or delay medications that you are routinely taking for prevention or treatment of other medical conditions around the time of COVID-19 vaccination.

If you are taking medications that suppress the immune system, you should talk to your healthcare provider about what is currently known and not known about the effectiveness of getting a COVID-19 vaccine. Ask about the best timing for receiving a vaccine. Learn about COVID-19 vaccines for moderately to severely immunocompromised people.

Most people who take medication can get a COVID-19 vaccine. Taking one of the following medications is not, on its own, a reason to avoid getting your COVID-19 vaccination:

• Over-the-counter medications (non-prescription)
• Non-steroidal anti-inflammatory drugs (NSAIDs) (naproxen, ibproufen, aspirin, etc.)
• Acetaminophen (Tylenol, etc.)
• Biologics or biologic response modifiers that treat autoimmune diseases
• Chemotherapy or other cancer treatment medications
• Antiviral medication
• Antibiotics
• Statins
• Blood pressure medications/antihypertensives (amlodipine, lisinopril, etc.)
• Diuretics
• Thyroid medications
• Antidepressants
• Metformin
• Diabetic medications
• Insulin
• Steroids (prednisone, etc.)

This is not a complete list. It is meant to provide some examples of common medications. Taking any of these medications will not make COVID-19 vaccination harmful or dangerous.

If you have questions about medications that you are taking, talk to your healthcare professional or vaccination providers.

For more information, please visit

visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/prepare-for-vaccination.html.

COVID-19 Vaccines

COVID-19 vaccines available in the United States are effective at protecting people from getting seriously ill, getting hospitalized, and even dying. As with vaccines for other diseases, people who are up to date are optimally protected. CDC recommends that everyone 5 years and older get their primary series of COVID-19 vaccines, and receive a booster dose when eligible.

When Are You Up to Date?

You are up to date with your COVID-19 vaccines when you have followed the current recommendations listed below. The recommendations will be different depending on your age, your health status, and when you first got vaccinated.

Many people who are immunocompromised may need an additional dose as part of their primary vaccine series.

Note that booster shots are not recommended for everyone at this time.

Pfizer-BioNTech	Moderna	Johnson & Johnson’s Janssen
Primary Series 2 doses Given 3 weeks (21 days) apart	Primary Series 2 doses Given 4 weeks (28 days) apart	Primary Series 1 dose
Fully Vaccinated 2 weeks after final dose in primary series	Fully Vaccinated 2 weeks after final dose in primary series	Fully Vaccinated 2 weeks after 1st dose
Booster Dose Everyone ages 12+ should get a booster dose at least 5 months after the last dose in their primary series – Teens 12-17 should only get a Pfizer-BioNTech COVID-19 Vaccine booster – Everyone 18+ should get a booster dose of either Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines)	Booster Dose Everyone ages 18+ should get a booster dose of either Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) at least 5 months after the last dose in their primary series	Booster Dose Everyone ages 18+ should get a booster dose of Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) at least 2 months after the first dose of J&J/Janssen COVID-19 Vaccine. You may get J&J/Janssen in some situations.
When Boosted A person is considered “boosted” and up to date right after getting their booster dose.	When Boosted A person is considered “boosted” and up to date right after getting their booster dose.	When Boosted A person is considered “boosted” and up to date right after getting their booster dose.

If you have a severe allergic reaction after a previous dose or if you have a known (diagnosed) allergy to a COVID-19 vaccine ingredient, you should not get that vaccine. If you have been instructed not to get one type of COVID-19 vaccine, you may still be able to get another type.

CDC has updated its recommendations for COVID-19 vaccines with a preference for mRNA (Pfizer-BioNTech or Moderna) vaccines. Learn more about the updated guidance of the use of the Janssen (Johnson & Johnson) COVID-19 vaccine.

The primary series of these vaccinations include a third dose for people ages 18 years and older with moderate to severe immunocompromise. This third dose occurs 28 days after the second dose in the primary series.

You should get your second shot as close to the recommended 3-week or 4-week interval as possible. You should not get the second dose early.

To learn more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.

Contact tracing is key to slowing the spread of COVID-19 and helps protect you, your family, and your community.

Contact Tracing Slows The Spread Of COVID-19

Contact tracing helps protect you, your family, and your community by:

• Helping people diagnosed with COVID-19 get referrals for services and resources they may need to safely isolate.
• Notifying people who have come into close contact with someone diagnosed with COVID-19 and helping them determine what steps to take, depending on their vaccination status and history of prior infection with SARS-CoV-2 (the virus that causes COVID-19). Follow-up may include testing, quarantine, and wearing a well-fitted mask.
• Discussions with public health workers are confidential. This means that your personal and medical information will be kept private and only shared with those who may need to know, like your healthcare provider.

If You Come Into Close Contact With Someone With COVID-19

• A public health worker, other professional, or the person you came into close contact with may tell you that you are a close contact and have been exposed to COVID-19.
• Follow recommendations for quarantine, testing, and wearing a well-fitted mask. Quarantine recommendations vary based on up-to-date COVID-19 vaccination status or history of prior COVID-19 infection in the past 90 days.
• Monitor your symptoms. If you have an emergency warning sign (including trouble breathing), seek emergency medical care immediately.
• If you develop symptoms, get tested immediately and isolate from others. If your test result is positive, follow recommendations to isolate.
• If you need help, health department staff can provide information about the best time to get a vaccine and resources for COVID-19 testing in your area.

If You Are Waiting For A COVID-19 Test Result Or Diagnosed With COVID-19

	If you are waiting for COVID-19 test results	If you are diagnosed with COVID-19 or have symptoms
Stay away from others	Quarantine: – Stay away from others while waiting for your COVID-19 test result, especially people who are more likely to get sick from COVID-19, if possible. – If you have come into close contact with someone with COVID-19, follow recommendations to quarantine and wear a well-fitted mask. Quarantine recommendations vary based on up-to-date vaccination status or history of prior COVID-19 infection in the past 90 days.	Isolate: – Stay at home away from others (isolate), except to get medical care. – Monitor your symptoms. If you have an emergency warning sign (including trouble breathing), seek emergency medical care immediately. Stay in a separate room, away from other household members, if possible. – Use a separate bathroom, if possible. – Avoid contact with other household members and pets. – Don’t share personal household items, like cups, towels, and utensils. – Follow recommendations for isolation.
Think about your close contacts	While you wait for your COVID-19 test result, think about anyone you have come into close contact with starting 2 days before your symptoms began (or two days before you test if you do not have symptoms). This information can help with contact tracing efforts and help slow the spread of COVID-19 in your community. Use this resource to help you think of people you may have been around while you may have had COVID-19.	Tell your close contacts that you have COVID-19 right away so they can follow recommendations to quarantine, get tested, and wear a well-fitted mask, depending on their vaccination and booster status or history of prior infection. – An infected person can spread COVID-19 starting 2 days before the person has any symptoms or tests positive. People who have COVID-19 don’t always have obvious symptoms. – A person is still considered a close contact even if they were wearing a mask while they were less than six feet from someone with COVID-19 for a cumulative total of 15 minutes or more over a 24-hour period. – You can call, text, or email your contacts. By letting your close contacts know they may have been exposed to COVID-19, you are helping to protect everyone. – If you would like to stay anonymous, there is also an online tool that allows you to tell your contacts by sending out emails or text notifications anonymously.

Answer The Call

If a public health worker from the health department calls you, answer the call to help slow the spread of COVID-19 in your community.

• Discussions with public health workers are confidential. This means that your personal and medical information will be kept private and only shared with those who may need to know, like your healthcare provider.
• Your name will not be shared with those you came in contact with, even if they ask. The public health worker will only notify people you were in close contact with that they might have been exposed to COVID-19.
• Public health workers may be able to connect you with other supportive services that can help you isolate or quarantine.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/contact-tracing.html.

This quick reference highlights key COVID-19 Clinical Care information for healthcare providers and provides selected links to full guidance and research for easier CDC web navigation.

Caring for Patients

• Signs and symptoms of COVID-19 can include fever, chills, cough, shortness of breath, fatigue, muscle aches, headache, loss of taste or smell, sore throat, nasal congestion or rhinorrhea, vomiting or diarrhea, and skin rashes.
• Some patients with COVID-19 may progress or dyspnea and severe disease about one week after symptom onset.
• Clinicians who wish to consider the use of therapeutics or other available investigational therapies should review the COVID-19 National Institutes of Health (NIH) Treatment Guidelines.

Ending Isolation

• For most people with a current laboratory-confirmed SARS-CoV-2 infection, isolation and precautions can be discontinued 10 days after symptom onset and after resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms.
• For adults who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive viral test.
• Some severely immunocompromised persons with COVID-19 may remain infectious beyond 20 days after their symptoms began and require additional SARS-CoV-2 testing and consultation with infection disease specialists to determine the appropriate duration of isolation and precautions.

Reinfection

• Confirmation of SARS-CoV-2 reinfection requires confirmation of initial infection and virus detection at two distinct time periods with genetic sequencing data that support reinfection.
• A toolkit and criteria have been developed to support state and local health departments investigations of suspended cases of SARS-CoV-2 reinfection.

People at Increased Risk of Severe Illness

• People of any with underlying medical conditions on CDC’s evidence-based list can be more likely to get severely ill from COVID-19.
• Older adults are at highest risk for severe illness from COVID-19.
• The risk of severe COVID-19 increases as the number of underlying medical conditions increases in a person.
• Long-standing systemic health and social inequalities have put various groups of people at increased risk of getting sick and dying from COVID-19.
• CDC highlights key findings from a large cross-sectional that examined risk factors and comorbidities associated with severe outcomes of COVID-19.

Multisystem Inflammatory Syndrome (MIS)

• Multisystem inflammatory syndrome is a rare but serious complication associated with COVID-19 in which multiple organ systems become inflamed.
• MIS can affect children and adolescents (MIS-C) and adults (MIS-A).
• The MIS-C healthcare provider page provides information on clinical presentation, case definition of MIS-C, case report form (CRF), and more resources about MIS-C.
• CDC has developed a MIS-A case definition for healthcare providers.

Post-COVID Conditions

• Post-COVID conditions describe a range of new, returning, or ongoing health issues that persist four or more weeks after being infected with the virus that causes COVID-19, sometimes after initial symptom recovery.
• New or ongoing symptoms can occur in people who have varying degrees of illness during acute infection, including patients who had mild or asymptomatic infections.
• Medical and research communities are still learning about post-acute symptoms and clinical findings.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care-quick-reference.html.

The Centers for Disease Control and Prevention (CDC) has identified the potential for a rapid increase in infections of the new variant of SARS-CoV-2, the Omicron variant, in the United States. Plausible scenarios include steep epidemic trajectories that would require expedient public health action to prevent severe impacts on the health of individuals and the healthcare system. The CDC Center for Forecasting and Outbreak Analysis developed this finding as a synthesis of scenario models conducted by U.S. government, academic, and international partners. The models assess the range of plausible scenarios for the epidemic trajectory based on what is currently known about the Omicron variant. Recent case data of the Omicron variant from South Africa, Botswana, the United Kingdom, and elsewhere are consistent with the faster scenarios that were modeled.

Findings

Infections with the recently identified Omicron variant of SARS-CoV-2, the virus that causes COVID-19, are exponentially increasing in multiple countries. Increases in infections are most likely due to a combination of two factors: increased transmissibility and the ability of the variant to evade immunity conferred by past infection or vaccination (i.e., immune evasion). Though the precise contribution of each of the two factors remains unknown, a substantial degree of immune evasion is likely as has been demonstrated in early vitro studies.

CDC has collaborated with partners to model scenarios of the epidemic trajectory in the U.S. that simultaneously consider transmissibility and immune evasion. Results from scenario analysis indicate that current increases in Omicron cases are likely to lead to a national surge in the coming weeks with peak daily numbers of new infections that could exceed previous peaks; these scenarios may be realized as soon as January. In scenarios with lower immune evasion, a surge is still likely, but the peak could be lower and begin as late as April 2022. Projected large surges in cases indicate surges of hospital demand even if the severity is reduced, because of the large number of anticipated cases occurring in a short period of time.

Background

Since its identification in November 2021, the Omicron variant has been reported in South Africa, Botswana, and numerous countries where it is driving rapid epidemic growth. In the U.S., the variant has been found in the majority U.S. states. The Omicron variant is increasing in the percent of circulating SARS-CoV-2 viruses in the United States. S-gene Target Failure (STGF) is a market for identifying Omicron cases. Preliminary analysis of SGTF data from testing completed through a national chain of pharmacies also observes regional increases in this proxy measure of the Omicron variant. Modeling of both genomic surveillance and SGTF data predict that Omicron will become the most common variant nationally by December 25, 2021, with some regions exceeding this threshold earlier. Furthermore, multiple large clusters of Omicron variant cases have demonstrated the rapid spread of the virus. Upcoming holiday gatherings may further accelerate these trends.

The rapid growth rate in Omicron infections is believed to result from a combination of increased transmissibility and the ability to evade immunity conferred by past infection or vaccination (i.e., immune evasion). Data from laboratory experiments and epidemiologic investigations suggest a greater role for immune evasion than increased transmissibility; immunity conferred by prior infection or vaccination is likely to be reduced compared with Delta, but not completely overcome. Data also shows that vaccinated people who either receive a booster dose or who were also previously infected are likely to have stronger protection against Omicron.

The clinical severity profile of Omicron infection will strongly influence its impact on future U.S. hospitalizations and deaths. At present, early data suggest Omicron infection might be less severe than infection with prior variants; however, reliable data on clinical severity remains limited. Even if the proportion of infections associated with severe outcomes is lower than with previous variants, given the likely increase in number of infections, the absolute numbers of people with severe outcomes could be substantial. In addition, demand for ambulatory care, supportive care for treatment of mild cases, and infection control requirements, quarantining/isolation of exposed/infected workforce could also stress the healthcare system. These stresses likely will be in addition to the ongoing Delta variant infections and rising burden of illness caused by other respiratory pathogens, such as influenza, which have begun circulating at greater frequencies.

Analytic Approach

The modeled scenarios of the epidemic trajectory in the U.S. consider varying degrees of transmissibility and immune evasion: high transmissibility and low transmissibility together with high immune evasion and low immune evasion. Modeled scenarios with faster relative growth rates (of Omicron as compared to Delta) indicate that a large surge of infections could begin in the U.S. in early January 2022 and that the peak daily number of new infections could exceed previous peaks. With low immune evasion, the surge could be lower and occur as late as April 2022. Multiple modeling groups in the United States, as well as those from other countries’ public health agencies, have identified similar trends.

Recent case data of the Omicron variant from the United Kingdom and elsewhere are consistent with the faster growth scenarios which increase the plausibility of faster growth scenarios.

Scenario*	Inherent transmissibility relative to Delta	Immune escape relative to all prior strains
Faster growth (Higher transmission**. Mid escape)	1.5x	43%
Slower growth (Higher transmission. Low escape)	1.5x	10%
Faster growth (Unchanged transmission. High escape)	1.0x	85%
Slower growth (Lower transmission. Mid escape)	0.8x	50%

*Parameters were chosen to span a range of apparent growth rate advantages for Omicron over Delta of ~2-3.5x in an environment where 75% of the population has immunity to infection due to vaccination or prior infection. **Relative to Delta

For more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/science/forecasting/mathematical-modeling-outbreak.html.

What You Need to Know

• Delay travel until you are fully vaccinated.
• Check your destination’s COVID-19 situation before traveling. State, local, and territorial governments may have travel restrictions in place.
• Wearing a mask over your nose and mouth is required in indoor areas of public transportation (including airplanes) and indoors in U.S. transportation hubs (including airports).
• Do not travel if you have been exposed to COVID-19, you are sick, or if you test positive for COVID-19.
• If you are not fully vaccinated and must travel, get tested both before and after your trip.

Before You Travel

Make sure to plan ahead:

• Check the current COVID-19 situation at your destination.
• Make sure you understand and follow all state, local, and territorial travel restrictions, including mask wearing, proof of vaccination, testing, or quarantine requirements.
  • For up-to-date information and travel guidance, check the state or territorial and local health department’s website where you are, along your route, and where you are going.
• If traveling by air, check if your airline requires any testing, vaccination, or other documents.
• Prepare to be flexible during your trip as restrictions and policies may change during your travel.

Do NOT Travel If…

• You have been exposed to COVID-19 unless you are fully vaccinated or revered from COVID-19 in the past 90 days.
• You are sick.
• You tested positive for COVID-19 and haven’t ended isolation (even if you are fully vaccinated).
• You are waiting for results of a COVID-19 test. If you test comes back positive while you are at your destination, you will need to isolate and postpone your return until it’s safe for you to end isolation. Your travel companions may need to self-quaranti

During Travel

Masks: Wearing a mask over your nose and mouth is required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and while indoors at U.S. transportation hubs such as airports and train stations. Travelers are not required to wear a mask in outdoor areas of a conveyance (like an open deck area of a ferry or the uncovered top deck of a bus).

Protect Yourself and Others: Follow all state and local health recommendations and requirements at your destination, including wearing a mask and staying 6 feet (2 meters) apart from others. Travelers 2 years of age or older should wear masks in indoor public places if they are not fully vaccinated, if they are fully vaccinated and in an area with substantial or high COVID-19 transmission, or if they are fully vaccinated and with weakened immune systems.

• If you are not fully vaccinated and aged 2 years or older, you should wear a mask in indoor public places.
• In general, you do not need to wear a mask in outdoor settings.
  • In areas with high numbers of COVID-19 cases, consider wearing a mask in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated.
• Wash your hands often or use hand sanitizer (with at least 60% alcohol).

After Travel

• ALL Travelers
  • Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
  • Follow all state and local recommendations or requirements after travel.
• If you are NOT Fully Vaccinated
  • Self-quarantine and get tested after travel:
    • Get tested with a viral test 3-5 days after returning from travel.
      • Check for COVID-19 testing locations near you.
    • Stay home and self-quarantine for a full 7 days after travel, even if you test negative at 3-5 days.
    • If you don’t get tested, stay home and self-quarantine for 10 days after travel.

If Your Test is Positive

Isolate yourself to protect others from getting infected. Learn what to do and when it is safe to be around others.

If you Recently Recovered from COVID-19

You do NOT need to get tested or self-quarantine if you recovered from COVID-19 in the past 90 days. You should still follow all other travel recommendations. If you develop COVID-19 symptoms after travel, isolate and consult with a healthcare provider for testing recommendations.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html.