Introduction to COVID-19 Vaccines
The question of whether to get a COVID-19 vaccine has become increasingly complicated for many individuals. The answer may depend on various factors such as age, insurance coverage, health, and finding a healthcare professional who will administer the shot. The once-straightforward seasonal vaccine process has become muddled this year due to new federal guidance on who can receive the shots, raising questions about whether pharmacists will provide the shots and if insurers will cover them.
What Has Changed?
The U.S. Food and Drug Administration has approved new shots from Pfizer, Moderna, and Novavax, but the approvals came with some new caveats. The shots were approved for people who are 65 and older and those who are younger and have a health condition that makes them vulnerable to severe COVID-19. This includes people with asthma, cancer, heart or lung problems, obesity, depression, a history of smoking, or physical inactivity. According to Dr. Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital in Boston, "A high proportion of people would qualify for these vaccines even if they’re not over 65."
Where Can I Get a Shot?
Most Americans visit drugstores to get their COVID-19 vaccines, according to the CDC. However, it’s not clear yet how easy that will be this fall, depending on where you live. Nineteen states have laws or regulations that only let pharmacists administer vaccines recommended by the Advisory Committee on Immunization Practices (ACIP), according to the American Pharmacists Association. In those states, pharmacies may not be able to dole out shots even for people who fit the FDA’s narrowed range until the committee makes its recommendation. Additionally, some pharmacists may be reluctant to give shots to customers who fall outside the FDA’s approval range, said Brigid Groves, a pharmacist and vice president with the American Pharmacists Association.
Will COVID-19 Vaccines Be Covered by Insurance?
For people age 65 and older, the FDA’s decision means Medicare will cover the shots. For everyone else, the answer is still evolving. It’s essential to check with your insurer or the employer who provides coverage. Employers and insurers have been covering the full bill for the shots because they have been recommended by ACIP. Some may continue to do so, such as Walmart, which will cover the shots for employees, and the health system Kaiser Permanente, which provides coverage for more than 12 million people and says it will keep covering them too.
Why Might the Shots Still Be Covered?
The vaccines can save money for an insurer or employer by preventing expensive medical care like hospital stays. They can also keep workers from getting sick and spreading the virus to colleagues. Companies are concerned about healthcare affordability, especially for their lower-paid workers, said Beth Umland, director of health and benefits research for the benefits consultant Mercer. The shots can cost $150 or more without insurance. Insurers say they look at more than just the CDC committee’s recommendation when deciding coverage, and some also consider the opinions of doctor groups like the American Medical Association, which strongly encourages vaccinations.
Sorting Conflicting Opinions
In May, Health Secretary Robert F. Kennedy Jr. announced COVID-19 vaccines would no longer be recommended for healthy children and pregnant women. Since then, the American College of Obstetricians and Gynecologists has said pregnant women should continue to get the shots, counter to what Kennedy announced. The American Academy of Pediatrics is continuing to recommend them for all children ages 6 months to 2 years, another contradiction to Kennedy’s decision. Conflicting advice like this has stirred a lot of questions from patients about what guidance they should follow, Groves said. "There’s just a lot of confusion out there," she said. "People are thinking, ‘Why should I get it?’"
Do We Still Need a Vaccine?
People who want shots typically seek them in the fall to prepare for a possible winter surge in cases. The vaccinations are strongly recommended for older people and those with a health condition, said Sax, the Brigham and Women’s physician. Doctors and researchers say most people have some immunity from either previous COVID-19 infections or vaccines. But an annual shot is still a good idea. The built-up immunity means your body will respond faster to an infection or vaccination than it did in the pandemic’s early days, said Andrew Pekosz, a virus expert at Johns Hopkins University. "That’s one of the reasons why COVID hospitalizations have gone down: That population immunity is high," he said. "But population immunity isn’t perfect, and it does wane over time."
Conclusion
In conclusion, getting a COVID-19 vaccine has become more complicated due to new federal guidance and conflicting opinions. It’s essential to consider factors such as age, insurance coverage, and health when deciding whether to get a shot. While some pharmacists may be reluctant to administer shots, and insurers may not cover them, the vaccines can still be beneficial in preventing expensive medical care and keeping workers from getting sick. Ultimately, it’s crucial to consult with a healthcare professional and stay informed about the latest guidance and recommendations.
FAQs
Q: Who is eligible for the COVID-19 vaccine?
A: The vaccine is approved for people who are 65 and older and those who are younger and have a health condition that makes them vulnerable to severe COVID-19.
Q: Will Medicare cover the COVID-19 vaccine?
A: Yes, Medicare will cover the vaccine for people age 65 and older.
Q: Can I get the COVID-19 vaccine at a pharmacy?
A: It depends on the state and the pharmacy’s policies. Some states have laws or regulations that only let pharmacists administer vaccines recommended by ACIP.
Q: Is the COVID-19 vaccine still necessary?
A: Yes, the vaccine is still recommended for older people and those with a health condition, as it can help prevent expensive medical care and keep workers from getting sick.
Q: How much does the COVID-19 vaccine cost without insurance?
A: The vaccine can cost $150 or more without insurance.
Q: What should I do if I’m unsure about getting the COVID-19 vaccine?
A: Consult with a healthcare professional and stay informed about the latest guidance and recommendations.
