COVID-19 can affect anyone, and the disease can cause symptoms ranging from mild to very severe. We know that certain things can make people more likely to get very sick with COVID-19. We also know that certain settings and activities can make you more likely to get infected with the virus that causes COVID-19.

Understanding Your Risk Helps You Make Decisions

Understanding the risk of COVID-19 for yourself and those around you can help you make informed decisions to keep you safe and healthy. If you have risk factors, have a COVID-19 plan in place in case you get sick, and discuss that plan with your healthcare provider and those close to you. Learn what extra precautions you can take to protect yourself and others in settings that make you more likely to be exposed to COVID-19.

Know your risk

Older adults who get COVID are at greater risk for:

• Severe illness
• Hospitalization
• Death

But people of any age with these underlying medical conditions are also at increased risk:

• Cancer
• Chronic kidney disease
• Chronic liver diseases, including cirrhosis, non-alcoholic fatty liver disease, alcoholic liver disease, and autoimmune hepatitis
• Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension
• Diabetes (type 1 or type 2)
• Down syndrome
• Heart conditions, such as heart failure, coronary artery disease, cardiomyopathies or hypertension
• HIV infection
• Immunocompromised state (weakened immune system) from solid organ transplant or the use of corticosteroids or other immunosuppressive medications
• Mental health disorders, including mood disorders (such as depression) and schizophrenia spectrum disorders
• Neurologic conditions, including dementia
• Overweight and obesity
• Pregnancy and recent pregnancy
• Sickle cell disease or thalassemia
• Smoking, current or former
• Stroke or cerebrovascular disease
• Substance use disorders
• Tuberculosis

General questions to ask your doctor

Take this list of questions with you on your next visit to your doctor’s office to create an informed care plan for your specific health condition:

• Does my condition put me at higher risk of getting very sick from COVID? Why or why not?
• Are the COVID vaccines safe for people with my health condition?
• Should I stop taking any of my medications before getting a dose of a COVID vaccine?
• Does your office offer COVID vaccines? If not, do you have a suggestion about where I can get a COVID vaccine?
• What symptoms of COVID should I watch for?
• What should I do if I have symptoms of COVID?
• Does your office provide COVID testing? If not, do you have a suggestion about where I can get a COVID test?
• If I get sick from COVID, will it affect my underlying condition?
• Is there treatment to help keep me from getting very sick from COVID?
• Should I continue taking my medications if I get COVID?
• If I get tested and I’m negative for COVID, but I still don’t feel well, what should I do?
• Is telehealth available so I can get care virtually or be seen by a doctor over the Internet?
• How many doses of a COVID vaccine do I need and how often?

Questions to ask your doctor if you have upcoming medical exams, tests, or surgeries

• Will having this procedure put me at a higher risk of getting COVID? Why or why not?
• Is it important for me to have this procedure now, or is it safe to wait?
• Do I need to get a COVID test before I can get my procedure?
• Should I get a COVID vaccine dose before or after my procedure is done?
• Do you allow family or caregivers to accompany me? Can people visit me?
• Is there a chance the hospital or facility will cancel my procedure or surgery? What are my options if it’s canceled? Can I have the procedure or surgery somewhere else?

Vaccination, past infection, or timely access to testing and treatment can help protect you from getting very sick if you get COVID-19. However, some people are more likely than others to get very sick if they get COVID-19. This includes people who are older, are immunocompromised, have certain disabilities, or have underlying health conditions. Understanding your COVID-19 risk and the risks that might affect others can help you make decisions to protect yourself and others.

Factors That Raise Your Risk of Getting Very Sick from COVID-19

Age

Older adults (especially those ages 50 years and older, with risk increasing with older age) are more likely than younger people to get very sick if they get COVID-19. This means they are more likely to need hospitalization, intensive care, or a ventilator to help them breathe, or they could die. Most COVID-19 deaths occur in people older than 65.

Immunocompromised or a Weakened Immune System 

Having a weakened immune system, also known as being immunocompromised, can make you more likely to get very sick if you get COVID-19. People who are immunocompromised, or who are taking medicines that weaken their immune system, may not be protected as well as others, even if they are up to date on their vaccines. For this reason, it is important to have a COVID-19 plan to protect yourself from infection and prepare for what to do if you get sick.

Underlying Health Conditions

Certain underlying health conditions you have (for example, obesity or chronic obstructive pulmonary disorder) may affect your risk of becoming very sick if you get COVID-19.

Often, the more health conditions you have, the higher your risk. Certain conditions increase your risk more than others. For example, severe heart disease increases your risk more than high blood pressure.

Factors That Can Help Protect You from Getting Very Sick from COVID-19

Vaccination

COVID-19 vaccines are safe and effective. Staying up to date with your COVID-19 vaccines is the best way to protect yourself and others around you from getting very sick, being hospitalized, or dying from COVID-19.

People who are up to date with their COVID-19 vaccines are far less likely to be hospitalized or die from COVID-19 than people the same age who have not been vaccinated or who are not up to date on their COVID-19 vaccines. However, even though vaccines reduce their risk, some people, particularly older adults with multiple underlying health conditions or people who are immunocompromised, can still get very sick from COVID-19.

Timely Treatment

If you are at increased risk for getting very sick from COVID-19, free medications are available that can reduce your chances of severe illness and death. Treatment needs to be started within a few days of infection to be effective. It can also help to have a plan for what to do if you feel sick or are diagnosed with COVID-19, especially if you have barriers to testing or treatment, such as transportation challenges or lack of insurance.

Previous Infection

Having a previous infection with the virus that causes COVID-19 offers some protection from future illness. However, people who have had previous infections can still be reinfected and get severe COVID-19, especially if their previous infection was months ago or with a different variant (e.g., Delta variant). There are also risks to being repeatedly infected, including the potential of longer term symptoms or development of post-COVID conditions.

Studies show that people with previous infections who are vaccinated are less likely to be hospitalized than those with previous infections who are not vaccinated. This means that people who have had previous infection should still get vaccinated to increase their protection against COVID-19. Getting a COVID-19 vaccination is a safer way to build protection than getting sick with COVID-19.

COVID-19 spreads when an infected person breathes out droplets and very small particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouth. In some circumstances, they may contaminate surfaces they touch.

About Variants

Many viruses are constantly changing, including the virus that causes COVID-19. These changes occur over time and can lead to the emergence of variants that may have new characteristics, including different ways of spreading.

Anyone infected with COVID-19 can spread it, even if they do NOT have symptoms.

COVID-19 and Animals

COVID-19 can spread from people to animals in some situations. Pet cats and dogs can sometimes become infected by people with COVID-19. Learn what you should do if you have pets.

Food and Water

Food

There is no evidence to suggest that handling food or consuming food can spread COVID-19. Follow food safety guidelines when handling and cleaning fresh produce. Do not wash produce with soap, bleach, sanitizer, alcohol, disinfectant, or any other chemical.

Drinking Water

There is also no current evidence that people can get COVID-19 by drinking water. The virus that causes COVID-19 has not been detected in drinking water. Conventional water treatment methods that use filtration and disinfection, such as those in most municipal drinking water systems, should remove or kill the virus that causes COVID-19.​

Natural Bodies of Water (Lakes, Oceans, Rivers)

There are no scientific reports of the virus that causes COVID-19 spreading to people through the water in lakes, oceans, rivers, or other natural bodies of water.

Wastewater

Genetic material from the virus that causes COVID-19 has been found in untreated wastewater (also referred to as “sewage”). There is no information to date that anyone has become sick with COVID-19 because of direct exposure to treated or untreated wastewater. Wastewater treatment plants use chemical and other disinfection processes to remove and degrade many viruses and bacteria. The virus that causes COVID-19 is inactivated by the disinfection methods used in wastewater treatment.

Learning about how COVID-19 spreads and the factors that can increase or decrease that risk can help you make informed choices.

The questions below are written in past tense to help you assess the likelihood that you were infected when you were around a person with COVID-19. If multiple factors below indicate higher transmission risk, you should follow the steps for what to do if you are exposed.

You can also ask yourself the same questions, but about future interactions with others, to help you decide what prevention actions to take. If multiple factors below indicate higher transmission risk, you should consider adding more prevention actions.

Factors that lower or increase risk of transmission

Length of time: How long were you with the infected person?

Longer exposure time increases the risk of transmission (for example, contact longer than 15 minutes is more likely to result in transmission than two minutes of contact).

Cough or heavy breathing: Was the infected person coughing, singing, shouting, or breathing heavily?

Activities like coughing, singing, shouting, or breathing heavily due to exertion increase the risk of transmission.

Symptoms: Did the infected person have symptoms at the time?

Being around people who are symptomatic increases the risk of transmission.

Masks: Were you or the infected person or both wearing a respirator (for example, N95) or high-quality mask?

If one person was wearing a mask, the risk of transmission is decreased, and if both people were wearing masks, the risk is substantially decreased. Risk is also lower if the mask or respirator is a type that offers greater protection.

Ventilation and filtration: How well-ventilated was the space?

More outdoor air can decrease the risk of transmission. Being outside would be lower exposure risk than being indoors, even with good ventilation and filtration; both of those options would be lower risk than being indoors with poor ventilation or filtration.

Distance: How close was the infected person to you?

Being closer to someone who is infected with COVID-19 increases the risk of transmission. Crowded settings can raise your likelihood of being close to someone with COVID-19.

COVID-19

What is COVID?

COVID is an infectious disease.

There’s no way to know how COVID will affect you. Most people have a mild case, but it can cause serious illness and death.

Some people develop Long COVID, where they have symptoms that last for weeks or months.

COVID can even cause some people to develop new health conditions, such as:

• Diabetes
• Heart conditions
• Blood clots
• Neurological conditions that affect the brain and nervous system

Why is vaccination so important?

Getting and staying up to date with your COVID vaccine can reduce the risk that you’ll:

• Get seriously ill, need hospital care, or die from COVID.
• Develop Long COVID.
• Spread the disease to others, putting their health and lives at risk.

Who is more likely to get Long COVID?

Anyone who gets sick with COVID can develop Long COVID. Researchers are working to better understand why some people do and some people don’t develop Long COVID.

So far, studies have found that the following people may be more likely than others to get Long COVID:

• People who get severely ill from COVID, especially those who need hospital care
• People who have underlying health conditions
• People who aren’t vaccinated against COVID
• People who experience multisystem inflammatory syndrome (MIS) during or after COVID illness
• People who have COVID more than once

What are the symptoms of Long COVID?

People who have Long COVID can experience a variety of symptoms, some of which may be hard to explain. Commonly reported symptoms include:

• Tiredness or fatigue that interferes with daily life
• Symptoms that get worse after physical or mental effort (also known as “post-exertional malaise”)
• Fever
• Difficulty breathing or shortness of breath
• Cough
• Chest pain
• Fast-beating or pounding heart (also known as heart palpitations)
• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Headache
• Sleep problems
• Dizziness when you stand up (lightheadedness)
• Pins-and-needles feelings
• Change in smell or taste
• Hair loss
• Depression or anxiety
• Diarrhea
• Stomach pain
• Joint or muscle pain
• Rash
• Changes in menstrual cycles

Getting vaccinated

Who should get a COVID vaccine?

Everyone 6 months or older in the United States should get and stay up to date with their COVID vaccine.

It’s especially important for the following people to get and stay up to date with their COVID vaccine because they’re at increased risk for severe illness from COVID:

• People 50 and older
• People who live in long-term care settings
• People with certain medical conditions
• Pregnant and recently pregnant people

Where can I find COVID vaccines?

You can find vaccines near you at vaccines.gov.

How are COVID vaccines given?

The available COVID-19 vaccines are given as a shot in the upper part of your arm. Infants and toddlers may receive vaccines in their thighs.

The process is quick and practically painless, because the needle is very thin and the dose is small.

How many vaccine doses do I need for the best protection? And when do I get them?

The number of doses you need to stay up to date with your COVID vaccine and when to get them depend on two things:

• Your age
• Whether you have certain health conditions

Talk to your vaccine or health care provider about when you need to get a COVID vaccine dose.

Vaccine safety

Are COVID vaccines safe?

Yes. The COVID vaccines available in the United States meet the FDA’s and CDC’s very high safety standards.

Hundreds of millions of people in the United States have safely received COVID vaccines under the most intense safety monitoring in U.S. history.

Serious side effects and allergic reactions are very rare, occurring in only a small number of people.

There is no evidence that COVID vaccines will cause long-term health problems, such as infertility or cancer.

COVID is a greater threat to you than any risk from vaccine side effects.

COVID can leave you with heart and lung damage and other conditions that require long-term treatment.

If you’re allergic to any ingredients in the vaccines, your vaccine or health care provider can help you decide if it’s safe for you to get a COVID vaccine.

Are COVID vaccines safe for children?

COVID vaccines were rigorously tested in thousands of children before authorization by the FDA. They were shown to be safe and effective during the clinical trials. And real-world evidence from vaccinating millions of children confirms their safety.

Children had the same kinds of temporary side effects from vaccines as adults. Side effects during the clinical trials were usually mild and went away on their own in a few days.

What safeguards are in place to make sure COVID vaccines are safe?

Before the FDA makes vaccines available to the public:

• Scientists must test the vaccines in medical studies, called clinical trials, with thousands of participants. These studies compare what happens to people who get the vaccine with people who don’t get the vaccine.
• More than 100,000 volunteers from diverse populations took part in clinical trials for the available COVID vaccines.
• FDA scientists review the data from the medical studies and inspect the places where the vaccines are made before they authorize or approve the vaccines for public use.
• Even after vaccines are available to the public:
• FDA and CDC scientists closely monitor how the vaccines are made and given, to identify any safety issues.
• FDA and CDC scientists closely review any reports of side effects or reactions and share these facts with the public.

How can COVID vaccines be safe? They were developed so fast.

COVID may be a new disease, but vaccines aren’t new.

Scientists were able to quickly develop safe, effective COVID vaccines by applying many years of vaccine experience and advances in technology.

Also, the National Institutes of Health had been working on a coronavirus vaccine before the pandemic and was able to use that experience in developing a COVID vaccine.

Importantly, no one cut any corners or skipped any steps that affect vaccine safety in the development, testing, authorization, and approval of COVID vaccines.

Will the shot make me sick?

You can’t get COVID from the vaccines because they don’t contain the virus that causes the disease.

Your arm might feel sore after you get your shot. You might also experience flu-like symptoms, such as fever, headaches, body aches, and tiredness.

These are normal signs that your immune system is responding to the vaccine. Although these side effects may be unpleasant, you’re not actually sick. And they last a few days at most.

What are the more serious side effects of COVID vaccines?

Serious side effects from any vaccine, including the COVID vaccines, are very rare.

It’s also highly unlikely that the vaccines will cause any long-term health problems, such as cancer.

A very small proportion of vaccinated people have experienced the following in the hours and days after vaccination with one or more of the vaccines:

• Anaphylaxis—an allergic reaction that, if it happens, is likely to occur within minutes of vaccination. Vaccination sites are prepared to handle any rare cases of anaphylaxis that occur.
• Myocarditis and pericarditis—two kinds of heart inflammation that, if they happen, are likely to occur within several days of vaccination.
• Guillain-Barré syndrome—a rare autoimmune disorder that, if it happens, is likely to occur within the first couple of weeks after vaccination.
• Thrombosis with thrombocytopenia syndrome—an extremely rare blood-clotting condition that, if it happens, is likely to occur within the first couple of weeks after vaccination. Importantly, the type of vaccine associated with this rare condition is no longer available in the United States.

If any of these unlikely reactions happen, health care providers know how to treat them.

The fact that we know of these extremely rare cases shows that the FDA's and CDC’s vaccine safety monitoring systems work and catch even the rarest reactions.

Are COVID vaccines safe for people who are pregnant, want to become pregnant, or are breastfeeding?

Yes. Getting a COVID vaccine can protect you against severe illness from COVID and help keep your baby safe.

COVID can be a dangerous disease during pregnancy and increases the risk of preterm birth. It might increase risks for other adverse pregnancy outcomes.

Vaccination against COVID does not lead to complications during pregnancy.

There’s also no evidence that any vaccines, including COVID vaccines, cause fertility problems in women or men.

And there’s no reason to put off getting vaccinated if you’re on your period.

CDC recommends COVID vaccination as soon as possible for all people who are pregnant, trying to become pregnant, wanting to become pregnant someday, or breastfeeding.

How do COVID vaccines work?

The COVID vaccines available in the United States introduce your immune system to the spike protein found on the surface of the coronavirus.

Your immune system sees the spike protein as an invading germ and reacts by creating cells that will be ready to identify and attack the coronavirus if you’re exposed to it.

The vaccines don’t contain the coronavirus, so you can’t get COVID from them.

Once your immune system is introduced to the spike protein, your body breaks down the vaccine ingredients and gets rid of them.

At no point do the vaccines change or interact with your DNA.

Vaccine effectiveness

How effective are COVID vaccines?

All available COVID vaccines are effective at preventing severe illness, hospitalization, and death due to COVID.

For the best protection, you need to stay up to date with your COVID vaccine.

Why should I get and stay up to date with my COVID vaccine if I can still get infected with COVID?

COVID vaccines work best to prevent severe illness, hospitalization, and death due to COVID.

If you’re up to date with your COVID vaccine and the virus enters your body (infects you), your immune system will quickly recognize the virus and will work to keep it from doing real harm.

Will COVID vaccines prevent me from infecting others?

If you stay up to date with your COVID vaccine, you’re less likely to get and spread COVID.

If you’re exposed to someone with COVID or if you get COVID, there are things you can do to prevent spreading COVID. These include:

• Keeping your distance from other people
• Wearing a high-quality mask if you must be around others at home or in public

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Anyone can have mild to severe symptoms. Possible symptoms include:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

This list does not include all possible symptoms. Symptoms may change with new COVID-19 variants and can vary depending on vaccination status. Older adults and people who have underlying medical conditions like heart or lung disease or diabetes are at higher risk for getting very sick from COVID-19.

When to Seek Emergency Medical Attention

Look for emergency warning signs* for COVID 19:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

If someone is showing any of these signs, call 911 or call ahead to your local emergency facility. Notify the operator that you are seeking care for someone who has or may have COVID-19.

*This list is not all possible symptoms. Please call your medical provider for any other symptoms that are severe or concerning to you.

Difference Between Flu and COVID-19

Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2, and flu is caused by infection with influenza viruses. You cannot tell the difference between flu and COVID-19 by symptoms alone because some of the symptoms are the same. Some PCR tests can differentiate between flu and COVID-19 at the same time. If one of these tests is not available, many testing locations provide flu and COVID-19 tests separately. Talk to a healthcare provider about getting tested for both flu and COVID-19 if you have symptoms.