There are very few medical reasons not to have a COVID-19 vaccine. Some reasons include a history of severe allergic reactions, pericarditis, or endocarditis following a prior COVID-19 vaccine.

People considering a COVID-19 vaccine may worry about complications and side effects. Yet for almost all individuals, the known risks of getting COVID-19 far outweigh any potential risks of the COVID-19 vaccine.

For people with chronic health conditions or other medical conditions that weaken their immune system, the risks of COVID-19 are even higher.

The list of medical reasons not to get a vaccine is short, but some other groups may be eligible for a vaccine exemption. No single vaccine exemption applies to everyone in all contexts — instead, exemption eligibility depends on the entity from which a person seeks an exemption.

Read on to learn about the few medical reasons not to get the COVID-19 vaccine.

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All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on COVID-19.

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A small number of people cannot safely get the COVID-19 vaccine, according to the Centers for Disease Control and Prevention (CDC). This includes individuals with a known severe allergic reaction to a previous COVID-19 vaccine or any of its ingredients.

Additionally, people with a history of myocarditis or pericarditis following the vaccine should take precautions when choosing follow-up or booster doses, the CDC says. These individuals should contact a doctor to discuss their options.

Some groups, such as people who have a history of a mild to moderate allergic reaction to the vaccine, may still benefit from the vaccine. It is important for these people to discuss the risks and benefits of the vaccine with a doctor.

Chronic medical conditions, pregnancy, cancer, and other conditions are not a reason to avoid the COVID-19 vaccine, according to the CDC. In fact, for many people with health conditions, the risk of adverse effects from COVID-19 makes it particularly important to get vaccinated.

A medical exemption means that a person is not required to get a COVID-19 vaccine. Because no national or state-level vaccine requirement exists, medical exemptions apply to specific scenarios only.

For example, only a small number of people are eligible for an air travel exemption. Many school systems, on the other hand, do not require the COVID-19 vaccine at all. Others allow a person to assert a religious or personal belief exemption, according to the National Conference of State Legislatures.

The CDC published a list of clinical considerations for why a person might not get the COVID-19 vaccine. They are:

  • Allergy to the COVID-19 vaccine: A person who has had a severe allergic reaction, such as anaphylaxis, to a prior COVID-19 vaccine should not receive that same vaccine again. For a person with a mild or moderate allergic reaction, the benefits still usually outweigh the risks.
  • Allergy to COVID-19 vaccine components: A person who has a known allergy or a history of a severe allergic reaction to any component of a COVID-19 vaccine should not receive any vaccine containing that ingredient.
  • History of allergic reaction to other vaccines: The CDC does not recommend avoiding COVID-19 vaccination for most people who have had an allergic reaction to another vaccine, even when the reaction has been severe.
  • Moderate or severe illness: People who have a current acute illness, such as an infection or the flu, should delay vaccination until their symptoms go away.
  • History of MIS-C or MIS-A: A person with a history of multisystem inflammatory syndrome should still consider vaccination if it has been 90 days or longer since their symptoms went away. A person should talk with a doctor about the timing of the vaccine if that person is still undergoing treatment.
  • Myocarditis or pericarditis: A person with a history of myocarditis or pericarditis after COVID-19 vaccination should typically not get another COVID-19 vaccine.

Some workplaces or schools use this list. Others offer a wider range of exemptions that extend beyond medical reasons. These may include exceptions for religious or personal beliefs.

The following conditions are not medical reasons to avoid getting a COVID-19 vaccine:

  • pregnancy
  • breastfeeding or chestfeeding
  • a history of illness, fever, or other mild reactions after a prior COVID-19 vaccine
  • an autoimmune disease
  • cancer
  • a terminal health condition

A person who has a condition on the CDC list of conditions that make a vaccine unsafe will be exempt from COVID-19 vaccination. But a person might also be eligible for other, broader medical exemptions.

To find out if a person is medically exempt, consider the following:

  1. Determine which specific entity a person seeks an exemption from. For example, a person might not want to get vaccinated for work or school.
  2. Ask for a copy of that entity’s COVID-19 policy.
  3. Check whether the person has a medical condition listed on the exemption list.

Some individuals are exempt from providing proof of the vaccine for air travel, but this is not a medical exemption. This includes:

  • certain non-U.S. citizens, such as those seeking asylum and those with a Visa 92 or 93
  • aircrew members who follow all other industry COVID-19 guidelines, such as masking

People with serious underlying medical conditions have a higher risk of dying from COVID-19. They are also more likely to experience complications that require hospitalization.

The vaccine greatly reduces the risk of dying from COVID-19.

Many of the risks of the vaccine are theoretical and based on anecdotes, not scientific evidence. Conversely, the risks of COVID-19 are significant and well-documented.

According to the CDC, there have been only nine documented deaths linked to the J&J/Janssen COVID-19 vaccine. This is out of more than 612 million doses of the vaccine.

People have reported a total of 16,516 deaths to the Vaccine Adverse Event Recording System (VAERS). However, experts have not validated these deaths as stemming from the COVID-19 vaccine — anyone can report a death for any reason.

Even if this large figure did represent the total number of deaths, the death rate associated with the vaccine would be 0.0027%. While the COVID-19 death rate varies significantly depending on age, location, and other factors, it is generally far higher than the death rate associated with the vaccine.

The following are answers to frequently asked questions about the COVID-19 vaccine.

What if I am pregnant or nursing?

People who are pregnant or have recently been pregnant have a higher risk of complications from COVID-19. The CDC recommends that pregnant people get vaccinated and advises that pregnancy and nursing do not increase the risk of an adverse reaction.

Research from 2022 suggests that the COVID-19 vaccine may help the body produce antibodies that appear in breast milk. These antibodies may help protect the nursing baby.

What if I have an autoimmune condition?

The CDC recommends that, as with the general population, people with autoimmune diseases should receive mRNA vaccines in an age-appropriate dose.

What if I have cancer?

People with cancer have a higher risk of serious COVID-19 complications. Cancer is not a contraindication of the COVID-19 vaccine, meaning it is typically not a reason to avoid the vaccine.

What if I have already had COVID-19?

After a COVID-19 infection, a person may have some temporary immunity. This immunity is not permanent, however, and is not as strong as immunity from a vaccine.

The CDC says that a person may delay their vaccine by up to 3 months following a COVID-19 infection, but that they should still choose vaccination.

It is common to fear something new, like a vaccine, and it is a good idea to be mindful of what one puts in their body. However, COVID-19 itself is much more dangerous than any purported vaccine side effects.

The vaccine provides significant protection that can save a person’s life. People who have anxiety about the vaccine should talk with a healthcare professional they trust and ask about research relevant to them and their health.