COVID-19 vaccine prioritization should prioritize those with advanced cardiovascular (CVD) disease over well-managed CVD disease, according to an American College of Cardiology (ACC) health policy statement published in the Journal of the American College of Cardiology (JACC). All CVD patients face a higher risk of COVID-19 complications and should receive the vaccine quickly, but recommendations in this paper serve to guide clinicians in prioritizing their most vulnerable patients within the larger CVD group, while considering disparities in COVID-19 outcomes among different racial/ethnic groups and socioeconomic levels.