Some States Defy Feds On COVID-19 Vaccine Guidance; Shots Are Hard To Find In Others

If you’re confused about whether you should, or even if you can, get a COVID-19 vaccine, you have plenty of company.

Health Secretary Robert F. Kennedy Jr.’s anti-vaccine policies have thrown the nation’s public health agencies into weeks of tumult. The Trump administration’s latest “Make America Healthy Again” report does little to quiet the noise with its call for more rigorous investigations into vaccine injuries.

Kennedy promised to “recast the entire program” for investigating vaccine injuries as he joined administration officials to unveil the MAHA report on Tuesday. Currently, the Centers for Disease Control and Prevention investigates injuries that are reported by individuals or providers.

“They will be welcomed, and we will learn everything we can about them so we can improve the safety of these products,” Kennedy said of people who report vaccine injuries. He added that doctors are not currently compensated for filing complaints for vaccine injuries.

A bipartisan group of senators has raised alarm over Kennedy's actions at the CDC, which was thrown into chaos last month when Kennedy abruptly fired his hand-picked director and other top leaders walked out on the job, citing disagreements over immunization recommendations. Last week, senators grilled Kennedy over his anti-vaccine agenda and leadership of the public health agencies.

Here are some things to know:

Who’s Eligible For COVID Shots?

The Trump administration’s policy on COVID-19 vaccines narrows their use to people 65 years or older or those with certain underlying medical conditions that put them at risk of a severe COVID illness. Officials haven’t said which conditions apply.

Previous versions of the vaccine were recommended for all people 6 months or older.

The usual process for issuing vaccine guidance has been upended under Kennedy’s tenure, and that could lead to a potential gap in vaccine availability for children who are among the most at risk for severe illness, hospitalization, and complications from the disease.

“I really don’t fully understand it. I’ll be real honest with you, and I’m not sure most physicians who understand the data can make sense of it either, right? There doesn’t seem to be a good reason for restricting the vaccine to only those with underlying health conditions under the age of 65,” Dr. Molly O’Shea, a pediatrician and member of the teaching faculty for the residency program at the Children’s Hospital of Michigan, told the Michigan Advance.

Although the CDC no longer recommends COVID-19 vaccinations for children 6 months to 17 years, the American Academy of Pediatrics recommends that all children 6 to 23 months old receive the vaccine. The guidance also suggests immunizations for kids 2 to 18 years old who are at high risk, or whose parents want to protect them from the illness.

The safest way for the immune system to learn how to respond to the virus is through vaccines, O’Shea told the Michigan Advance. Building immunity through vaccines also eliminates the risk of complications such as Long COVID and others, she said.

States Defy Trump Administration

In rare defiance of the Trump administration, some states are making their own recommendations, including Connecticut, Massachusetts and New Jersey, Patch previously reported.

In New Jersey, Acting Health Commissioner Jeff Brown signed an executive order that eliminates the barriers created at the federal level. It allows all individuals 6 months or older to get the vaccine if they want it or if their parents want it for them.

“New Jersey is committed to defending the principles that safeguard our families and protect the health of our communities. This is about equitable access to the COVID-19 vaccine, which has been proven to prevent serious illness and hospitalization,” Brown said. “Especially as we enter cold and flu season and as students head back to school, New Jerseyans are reminded to stay up to date on all recommended vaccinations.”

• Related: ‘This Is About Equitable Access’: New Jersey Vaccine Defiance

“Making vaccines accessible is grounded in health and safety, which is too important to leave to the whims of a political agenda,” Connecticut Gov. Ned Lamont said in a statement. “Vaccines have been proven for many decades to prevent serious illness, hospitalization, and death, and patients and their doctors should be able to decide what is the best course of treatment for themselves. We will not allow gridlock in Washington to put the people of our state at risk.”

• Related: CT Defies Trump Administration With Its Own Vaccine Guidance

In Massachusetts earlier this month, Gov. Maura Healey said insurance companies will be required to cover the costs of vaccines recommended by the state’s health department, including COVID, influenza and RSV.

Healey said the order will “ensure that Massachusetts residents can afford the vaccines they need and want to keep themselves and others healthy, even if the federal government issues narrower recommendations.”

• Related: MA Requires Insurers To Cover Vaccines

These States Form Own Alliance

California joined with Oregon and Washington to form the West Coast Alliance, a partnership to coordinate health guidelines by aligning immunization plans based on recommendations from respected national medical organizations. Hawaii later joined the alliance.

“The CDC has become a political tool that increasingly peddles ideology instead of science, ideology that will lead to severe health consequences,” Gov. Gavin Newsom of California, Gov. Bob Ferguson of Washington and Gov. Tina Kotek of Oregon said in a joint statement.

In a Sept. 3 briefing with reporters, California State Health Officer Erica Pan said lives are put at risk by “the dismantling of public health and dismissal of experienced and respected health leaders and advisers, along with the lack of using science, data, and evidence to improve our nation’s health.”

The conflicting guidelines — the federal government’s and the West Coast Alliance’s — have left many healthy Californians unsure about whether they’ll be able to get the shot, Patch reported.

California will continue recommending the COVID vaccinations for everyone 6 months or older. Still, some people are being told by their doctors or insurance companies that their vaccination might not be covered.

“The problem is, the pharmacists are confused as well,” UC Berkeley infectious disease expert John Swartzberg told the San Francisco Chronicle. “The doctors are confused as well. People are getting disparate advice from physicians and pharmacists because they’re confused. And the pharmacy companies are confused as to what to do. So they have varying policies.”

Walgreens, one of the largest pharmacies in the state, said this week that many adults under 65 won’t need a prescription to get the shots, nor proof of underlying conditions, as long as they simply attest to one, such as obesity, asthma, diabetes or depression.

• Related: Despite Major Change In CA Vaccine Guidance, Confusion Reigns

Will Insurance Cover Shots?

By law, most private health insurance companies (including those offering Obamacare polices), Medicare and Medicaid are required to fully cover vaccines recommended by the CDC and its Advisory Committee on Immunization Practices, or ACIP.

Healthy people outside the high-risk groups in the federal guidelines can still get their COVID shots, but they may be charged a co-pay for denied coverage altogether by their insurance company.

Without insurance, the COVID shots can cost up to $140 each, according to the CDC’s vaccine price list.

“It could very well get confusing,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Nashville, Tennessee, and an adviser to ACIP, told NBC News. Whether you’re able to get a free shot “may greatly depend on which company with which you have your insurance.”

A spokesperson for AHIP, a health insurance industry trade group, told NBC that every individual insurer will come up with its own policy following the CDC’s final guidance.

It May Be Hard To Find Shots In These States

Pharmacists are still awaiting guidance from the CDC’s Advisory Committee on Immunization Practices on who should be receiving the vaccine. In many cases, pharmacies tie their ability to administer vaccines to ACIP recommendations.

Historically, the committee met earlier in the summer so that shots were available ahead of the winter respiratory illness season, NBC News reported. This year, the committee isn't scheduled to meet until Sept. 17.

Until the committee makes its recommendations, a doctor’s prescription for the updated COVID-19 vaccine will be required in Washington, D.C., and 13 states: Arizona, Colorado, Florida, Georgia, Kentucky, Louisiana, Maine, North Carolina, New York, Pennsylvania, Utah, Virginia and West Virginia.

New York Gov. Kathy Hochul declared a “statewide disaster emergency” to preserve access to COVID vaccines, Hochul’s executive order that allows all pharmacists in the state to administer COVID vaccines until the ACIP sorts it all out, Patch previously reported.

The order will remain in effect for at least 30 days, or until “a long-term legislative solution is developed” to provide uniform access to vaccines, Hochul said.

“By signing this executive order, we are sending a clear message that when Washington Republicans play politics with public health, New Yorkers can still get the care they need, close to home, from trusted providers in their own communities,” Hochul said.

• Related: Hochul Executive Order Allows NY Pharmacies To Administer Vaccines

What Vaccines Are Available?

The U.S. Food and Drug Administration recently approved new versions of the COVID-19 vaccines from Pfizer and BioNTech and from Moderna, the companies announced.

The Novavax COVID-19 vaccine, the only protein-based, non-mRNA version offered in the United States, has also been released to pharmacies. It is intended for people 12 years and older.

The newest versions are designed to target the LP.8.1 sublineage of the SARS-CoV-2 virus, the most recent variant known as “razor blade COVID.”

The vaccine is currently available in pharmacies and doctors’ offices across the country.

• Related: ‘Perfect Storm’ Of Infectious Diseases Brewing

The Associated Press contributed to this report.