Deeper Dive - Group 4 A tested, safe and effective vaccine will be available to all who want it, but supplies will be limited at first. To save lives and slow the spread of COVID-19, independent state and federal public health advisory committees recommend first protecting health care workers caring for patients with COVID-19, people who are at the highest risk of being hospitalized or dying and those at high risk of exposure to COVID-19. Our goal is to vaccinate as many people as possible given the limited supply of vaccines. North Carolina will move to Group 4 on March 17, beginning with people with high-risk medical conditions, people experiencing homelessness, and incarcerated people who have not been vaccinated. North Carolina will move to other essential workers and other people in close group living settings on March 31. Some vaccine providers may not be ready to open to Group 4 on this date if they are still experiencing high demand for vaccines in Groups 1 through 3. Keep practicing the 3 Ws— wear a mask, wait six feet apart, wash your hands—until everyone has a chance to get vaccinated. 4. Adults at High Risk for Exposure and Increased Risk of Severe Illness Group 4 includes anyone 16-64 years old with one or more high-risk medical conditions for severe disease from COVID-19, people living in close group settings and essential workers. (Please note these are different from Group 3 frontline essential workers.) Age 16-64 w/ Higher Risk Medical Conditions and Additional Congregate Settings Essential Workers Not Yet Vaccinated Group 4 – Adults at High Risk for Exposure and Increased Risk of Severe Illness This population includes anyone with conditions that have been identified by the CDC as increasing risk for severe COVID-19 illness. The CDC may update the list of high-risk conditions as scientists learn more about COVID-19. NCDHHS will update the list accordingly: Asthma (moderate to severe) Cancer Cerebrovascular disease or history of stroke Chronic kidney disease Chronic Obstructive Pulmonary Disease (COPD) Cystic fibrosis Diabetes type 1 or 2 A heart condition such as heart failure, coronary artery disease, cardiomyopathy Hypertension or high blood pressure Immunocompromised state (weakened immune system) from: immune deficiencies, HIV, taking chronic steroids or other immune weakening medicines, history of solid organ blood or bone marrow transplant Intellectual and Developmental Disabilities, including Down Syndrome Liver disease, including hepatitis Neurologic conditions,such as dementia and schizophrenia Pulmonary fibrosis Overweight or obesity Pregnancy Sickle cell disease (not including sickle cell trait) or thalassemia Smoking (current or former, defined as having smoked at least 100 cigarettes in their lifetime) PEOPLE LIVING IN A CLOSE GROUP LIVING SETTING This population includes anyone who is living in congregate or close group living settings who is not already vaccinated due to age, medical condition or job function, including: People experiencing homelessness or living in a homeless shelter Correctional facility, such as jail or prison Group 4 - Essential Workers Not Yet Vaccinated Essential workers include: Those working in the essential sectors identified in Group 3 who did not meet the criteria for frontline. Essential sectors identified in Group 3 include critical manufacturing, education, essential goods, food and agriculture, government and community services, health care and public health, public safety and transportation. See Deeper Dive Group 3. Those working in additional essential sectors as defined below. Chemical (including workers in petrochemical plants, agricultural chemicals, pharmaceutical facilities, consumer products) Commercial facilities (including retail workers, hotel workers) Communications and information technology (service repair dispatchers, data center operators) Construction, residential facilities, housing and real estate Defense industrial base (including workers supporting essential services to meet national security commitments) Energy (including electric, petroleum, natural and propane gas workers) Financial services (including workers who maintain systems for processing financial transactions, workers needed to provide consumer access to banking and lending services) Hazardous materials (including nuclear facilities workers, workers managing medical waste) Hygiene products and services (including laundromats, sanitation workers) Public works and infrastructure support services (including plumbers, electricians, exterminators, workers supporting parks) Water and wastewater (including staff at water authorities, wastewater treatment facilities, water sampling and monitoring) The essential sectors and workers, as categorized by Cybersecurity and Infrastructure Security Agency (CISA), align with federal prioritization guidance from the Centers for Disease Control and Preventions’ Advisory Committee on Immunization Practices (ACIP) recommendations. OTHER PEOPLE LIVING IN GROUP LIVING SETTINGS This population includes students living in dormitories or other group living settings (e.g., fraternity or sorority houses), who are not already vaccinated due to age, medical condition or job function.