COVID-19 Vaccine Access Guide

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Updated 4-13-2021

This page will be updated as new information becomes available.

Driving COVID-19 Vaccine Access for Our Community

Evidence shows that adults with T1D have similar risks with COVID-19 as people with T2D and therefore JDRF is advocating for them to receive the same priority access to vaccines as they become available as people with T2D.

What Has JDRF Done to Advocate for Vaccine Prioritization for the Type 1 Diabetes (T1D) Community:

JDRF provided formal comments to the U.S. Centers for Disease Control and Prevention (CDC) calling for a review of the latest data, met with officials there, and joined with other diabetes organizations in submitting a joint letter to the CDC. We have continued to communicate directly with the agency to advocate for those with T1D and T2D to be categorized as high priority for receiving the COVID-19 vaccine. A copy of each letter can be found here and here. 

In the Fall, we provided input to the National Academies of Science, Engineering, and Medicine, which were seeking input on a proposed framework for vaccine distribution. 

JDRF has also been sharing this important data with the news media including being featured in STAT News, a health and medicine focused news website, and contributing to the piece featured in The Hill, a media source for policy and political coverage.

On March 29, the CDC announced that it has updated their COVID-19 prioritization guidance to include T1D as a high risk condition, thus paving the way for states who follow CDC guidance to include those with T1D in their priority groups. We urge these states to immediately adopt the CDC’s revised guidelines to save lives and reduce the risk of complications for those living with T1D.

How YOU Can Take Action:

While many communities are relying on CDC guidelines, others are revising them. The vaccine prioritization landscape is fluid, so we urge you to stay current on what’s happening in your state, by visiting your respective state department of health website.

At the time of publication, the following states currently list those with T1D as eligible alongside T2D and other high risk diseases: Alabama, Alaska, Colorado, Idaho, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, and Wisconsin. As we understand it, the following states list ‘diabetes’ generally in their prioritized groups for vaccination, but we have not yet seen policies that clearly include those with T1D so there’s uncertainty at the moment: Arkansas, Delaware, District of Columbia, Georgia, Illinois, Mississippi, Oklahoma, and Wyoming

You may wish to reference the following steps as you consider advocating for yourself and the T1D community for COVID-19 vaccine prioritization.

  1. Look Up Vaccine Plans in Your State. The vaccine plans are rapidly evolving, so start by checking the current T1D status in your state through:
  2. Identify Key Vaccine Policy Influencers in Your Community. This could include news organizations, public health agency leaders, elected officials, hospital CEOs, and physicians.
  3. Study Our Resources to Gather Key Facts and Prepare Your Message on why people with T1D should be prioritized for vaccines alongside T2D.
    • Reference the information and messaging from our “Frequently Asked Questions” below
    • Use this spreadsheet on prevalence of T1D by state
  4. Connect with Key Vaccine Policy Influencers to Share Your Message by taking steps such as:
    • Engage on Social Media. Regularly comment on the social media accounts of key influencers and post from your own platforms. Tag key influencers, use the hashtag #Prioritize T1D, and encourage your friends and family to do the same.
    • Submit Letters to the Editor to local newspapers. Many have ways to do so on their websites.
    • Speak at Community Meetings. Many communities are having virtual meetings to share information about the COVID response. Speak up during the public comment period on this issue.
    • Submit Comment Letters. Some agencies are offering an opportunity to provide written comments about vaccine policies specifically, or the COVID plans more broadly. You can also send letters directly to your governor and state department of health.

 

Frequently Asked Questions (FAQs)

What is JDRF’s position on the new vaccines?

JDRF celebrates the authorization of the Pfizer-BioNTech, Moderna, and Janssen (J&J) COVID-19 vaccines by the U.S. Food and Drug Administration, which we hope will be the first three of many available in the weeks to come to address this deadly pandemic. We appreciate the many research scientists, clinical trial participants, industry partners, and government officials who are making this progress possible.  

COVID-19 has taken a significant toll on the diabetes community. Recent studies shows that adults who get COVID and have diabetes, whether type 1 or type 2, have three to four times higher risk of severe illness and hospitalization. Based on this evidence, JDRF calls upon healthcare decision makers to make people with type 1 or type 2 diabetes, as well as their caregivers, a high priority for receiving COVID-19 vaccines. 

How do I get a vaccine?

The distribution of vaccines is being organized on a state-by-state basis following guidelines established by the Centers for Disease Control and Prevention (CDC). The initial number of doses will remain limited until additional doses are manufactured. Please refer to your state department of health to learn more. Also, reference ‘VaccineFinder’ a website that helps you find clinics, pharmacies, and other locations that offer COVID-19 vaccines in the United States. The website is operated by Boston Children’s Hospital and supported by the Centers for Disease Control and Prevention and the United States Digital Service.

How much does the vaccine cost?

All COVID-19 vaccines purchased by the Federal government are free to the patient regardless of health insurance coverage. All providers must vaccinate individuals regardless of their insurance status, type of coverage, and are prohibited from balance billing or otherwise charging recipients for the vaccine.

Are the vaccines safe for people with T1D?

All data show the vaccines are safe and effective for people with T1D and both vaccines were tested in people with diabetes. 9.4% of Moderna trial participants had diabetes and 8.4% of Pfizer-BioNTech participants had diabetes. There were no adverse effects reported in these populations. We do not have any information on the number of people with T1D in these trials, nor about T1D-specific adverse events reported yet in scientific literature, but there is no evidence at the moment to indicate that these vaccines are unsafe for people with T1D.

When people with T1D have a sickness, e.g. fever, flu, etc., it’s important to follow the guidelines that your practitioner provides. It is possible that a vaccination, like the COVID-19 vaccine or otherwise, can lead to illnesses with similar symptoms. If you become ill following a COVID-19 vaccination, please consult your doctor and follow sickness-related guidelines.

 

I received the Johnson & Johnson (J&J) vaccine. What does the FDA announcement mean for me?

The recent statement from the FDA and CDC recommending a pause in the use of the J&J vaccine is a result of a review of 6 cases of a rare and severe type of blood clot, a cerebral venous sinus thrombosis, after receiving the vaccine. The CDC and FDA state that people who have received the Johnson & Johnson shot and developed severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider.

What about children with T1D?

The Pfizer vaccine is authorized for use in people 16 years of age and older, and the Moderna and Janssen (J&J) vaccines in people 18 years and older. The vaccines are now being tested in clinical trials enrolling people age 12 and older. We will continue to monitor progress and enhance our efforts as there is more evidence and as vaccines are authorized for use in broader populations, such as younger individuals.

Does it matter which vaccine I get?

It does not matter which one you get. Brand availability varies from market to market, and JDRF does not recommend getting one over another. The most important thing is getting vaccinated as soon as possible.

Who will set priorities for vaccine distribution?

The CDC is establishing national guidelines for prioritizing vaccine distribution; however, states will make decisions on how and in what order the vaccine will be distributed. As of March 29, those with T1D are now considered a high risk group that the CDC advises should be prioritized for COVID-19 vaccines, but the decision-making process will vary in each state, with some public health officials and health systems seeking community input. Review your respective state department of health website, or this resource from Kaiser Family Foundation which provides the sources for each state’s prioritization criteria.

What is the rationale for people with T1D being prioritized?

JDRF has been closely monitoring the data on how COVID-19 affects people with T1D. The most recent data show that adults with diabetes—type 1 and type 2—are more likely to have serious complications from COVID-19. There are other risk factors, which include glycemic and vascular health, ethnicity, and socio-economic status.

The bottom line is people with T1D need higher priority access to the vaccines as they become available, and JDRF has been working hard to make that happen. JDRF also strongly encourages decision makers to recognize the disparate impact COVID-19 has had on people of color in the United States and to prioritize health equity in its vaccine distribution plans. 

Who do I talk to about getting a vaccine?

Each state is responsible for distributing the vaccine through the networks of hospitals, doctors, and pharmacies within their jurisdiction. We encourage you to visit your state’s department of health website and get in touch with your doctor to learn more about your state’s process.

Did JDRF provide input for national vaccine distribution prioritization?

JDRF provided a letter about COVID-19 risks to the T1D community to the CDC, both to CDC staff directly and through formal comments to the Advisory Committee on Immunization Practices, including data published in December. A copy of each letter can be found here and here. JDRF also held several meetings with CDC staff to share the latest data regarding the elevated risk of COVID-19 to the T1D community. 

In the Fall, we also provided input to the National Academies of Science, Engineering, and Medicine, which were seeking input on a proposed framework for vaccine distribution. The CDC is now using this framework.

JDRF, along with other diabetes organizations, sent a letter to the CDC about the urgent need to prioritize people with T1D. 

JDRF has also been sharing this important data with the news media including being featured in STAT News, a health and medicine focused news website, and contributing to the piece featured in The Hill, a media source for policy and political coverage.

On March 29, the CDC announced that it has updated their COVID-19 prioritization guidance to include T1D as a high risk condition, thus paving the way for states who follow CDC guidance to include those with T1D in their priority groups. We urge these states to immediately adopt the CDC’s revised guidelines to save lives and reduce the risk of complications for those living with T1D.

How can I advocate for people with T1D to receive the vaccine earlier?

There are several steps you can consider taking to advocate for vaccine access for people with T1D, whether for individuals seeking the vaccine or on behalf of the community. Options will vary by locality, depending on health systems and policy decision-making processes. You may wish to reference the following steps as you consider advocating for yourself and the T1D community for COVID-19 vaccine prioritization:

  • Identify where T1D is prioritized in your state, and which key vaccine influencers are relevant in your area. Reference your state department of health (see list), or this resource from Kaiser Family Foundation which may also be a helpful starting point. For you and your family, these influencers could be your doctor, your hospital, or your local health agency. For the T1D community, you may wish to contact your respective state department of health and your governor.
  • Develop your message and feel free to utilize information from this page. Reference our prevalence of T1D by state spreadsheet and our messaging below for your consideration.
  • Consider ways to make your voice heard, such as engaging on social media tagging key influencers, speaking at public meetings, submitting comment letters, a letter to the editor of your local newspaper, or a letter directly to your governor and state department of health.

What if those with T1D are still not prioritized for COVID-19 vaccines in my state even though the CDC has revised their guidelines to include T1D? What message can I deliver to decision makers in my local community?

  • We applaud the healthcare workers, research scientists and so many others who have helped our community during this pandemic and are now bringing us life-saving vaccines.
  • We strongly support the initial prioritization of healthcare personnel and residents and staff of long-term care facilities, and other high risk disease groups, and also urge decision makers to prioritize health equity in their vaccine distribution plans, given the disparate impact COVID-19 has had on people of color in the United States.
  • We want to draw attention to the latest research, which shows COVID-19 has taken a significant toll on the diabetes community.
  • A study published in December 2020 shows that adults who get COVID-19 and have diabetes, whether type 1 or type 2, have three to four times higher risk of severe illness and hospitalization, compared to people without diabetes.
  • This study is consistent with earlier data, and unequivocally demonstrates that adults with diabetes are at a significantly heightened risk of severe illness and mortality due to COVID-19.
  • Based on this evidence, state vaccine distribution plans should make people with T1D or T2D – as well as their caregivers – a high priority for receiving COVID-19 vaccines.

What Do We Know about T1D and COVID?

  • Based on current scientific literature, there is no evidence that people with T1D are at higher risk for contracting T1D.
  • Although children with T1D can catch the virus, they usually have mild symptoms. However, the virus could make it harder to manage blood glucose levels and therefore create a risk for diabetic ketoacidosis.
  • Two new studies show that adults with T1D are at an increased risk of severe COVID-19 illness. Details on each of these studies are below. These add to an October 2020 UK population-based registry publication showing that people with type 1 diabetes have more than 3-fold level of increased risk of mortality when hospitalized due to COVID-19.
  • A December 2020 U.S.-based study shows that adults who get COVID-19 and have diabetes, whether T1D or T2D, have three to four times higher risk of severe illness and hospitalization.
    • Specifically, the study found “after adjustment for age, race, and other risk factors, the odds of a COVID-19–related hospitalization and greater illness severity for patients with type 1 diabetes are three- to four-fold higher than patients without diabetes. This increased risk is approximately the same for patients with type 2 diabetes.”
    • Per this study, “hypertension, race, recent diabetic ketoacidosis, health insurance status, and less diabetes technology use were significantly associated with illness severity.”
    • Those at greatest risk are people with consistently elevated blood-sugar levels and those with a second comorbidity (such as obesity or heart, kidney, or lung disease).
    • This study “COVID-19 Severity Is Tripled in the Diabetes Community: A Prospective Analysis of the Pandemic’s Impact in Type 1 and Type 2 Diabetes,” by Justin M. Gregory et.al. was published in December 2020 in the peer-reviewed journal Diabetes Care. It was conducted by a clinical research team at the Vanderbilt University School of Medicine and the University of California San Diego Medical Department. The study analyzed data from nearly 6,500 patients with COVID-19 in a regional health network, comparing factors and outcomes in patients with T1D, T2D, or no diabetes.
  • A December 2020 study published out of Scotland shows that the risk of serious outcomes among adults with T1D and T2D were significantly higher than compared to a baseline of the general population.
    • Specifically, the study found that the risk of severe COVID-19 for adults with diabetes compared to the general population when adjusted for age and sex was 2-4 times higher for T1D and 1-4 times higher for T2D.
    • The report indicates that greater elevation in T1D “is probably accounted for by longer duration of diabetes because in the older age bands, cumulative incidence was higher in type 1 than type 2 diabetes…”.
    • The study found that the “risk of fatal or critical care unit-treated COVID-19 in diabetes rose steeply with age and was higher in males…”.
    • The authors state, “The risk of fatal or critical care unit-treated COVID-19, and therefore the need for special protective measures, varies widely among those with diabetes but can be predicted reasonably well using previous clinical history.”
    • This study, “Risk of and risk factors for COVID-19 disease in people with diabetes: a cohort study of the total population of Scotland” by Stuart J McGurnaghan et al. was published in December 2020 in the peer-reviewed journal Lancet Diabetes and Endocrinology. It was a cohort study conducted by Health Protection Scotland in conjunction with several universities using the total population of Scotland.
  • Given the higher risks of severe illness and hospitalization from COVID-19 found in these studies, JDRF calls for people T1D and T2D to have prioritized access to the COVID-19 vaccine.

What do we know about COVID variants, the intersections of T1D, and vaccine efficacy?

Currently, there isn’t published research that has studied the SARS-CoV-2 variant and its impact on T1D. The current vaccines approved by the FDA and their efficacy against this new variant in T1D or other populations are still being studied, but we are committed to providing you with updates as soon as we learn more.

* The committee defined frontline essential workers as first responders, teachers and other education workers, food and agriculture workers, correctional facility staff, postal workers, public transit workers, and people who work in manufacturing and in grocery stores.

For more information about Coronavirus, visit https://www.jdrf.org/coronavirus/.