Upheaval at the country’s top public health agency has left millions of Americans uncertain about access to the updated COVID-19 vaccines at a moment when rising case numbers threaten to disproportionately harm Black Americans.
The U.S. Food and Drug Administration approved the new shots in August. But it narrowed eligibility to people who are 65 and older and younger people who are considered to be at higher risk of contracting a severe COVID-19 infection.
The new guidelines are a departure from previous years when nearly everyone could get the vaccines. The changes come as Florida is on track to become the first state to eliminate vaccine mandates for children. In a Sept. 3 speech, the state surgeon general, Joseph Ladapo, said that “every last” requirement “is wrong and drips with disdain and slavery.”
It’s still not entirely clear who will be able to get the updated shots, whether the shots will be covered by insurance, and which pharmacy chains might carry the vaccines, as the Centers for Disease Control and Prevention faces disorder under the leadership of Health and Human Services Secretary Robert F. Kennedy Jr.
Kennedy, who’s connected to an anti-vaccine advocacy group, is facing calls to resign following his firing of the CDC director, refusal to be briefed by scientists on COVID-19 and other diseases, and efforts to gut the agency charged with promoting public health.
He was on Capitol Hill on Sept. 4 testifying before a Senate committee about the Trump administration’s health care agenda.
U.S. Sen. Ron Wyden, a Democrat from Oregon, said that Kennedy has “elevated conspiracy theories, crackpots, and grifters.” U.S. Sen. Bill Cassidy, a Republican from Louisiana, said that it “surprises him” that Kennedy thinks highly of Operation Warp Speed — an effort initiated by the U.S. government to distribute COVID-19 vaccines — when, as an attorney, Kennedy “attempted to restrict access.”
On Sept. 3, Democratic governors in California, Oregon, and Washington announced their plan for creating a health care alliance that will protect vaccine access by establishing its own immunization guidelines that will adhere to “respected national medical organizations.”
The CDC’s Advisory Committee on Immunization Practices is scheduled to meet for two days beginning on Sept. 18 and is expected to discuss the COVID-19 vaccines, among other agenda items.
In the past, Americans have been able to get the vaccine free of charge after the committee recommended the shots. But this summer, Kennedy forced out every member of the committee and replaced them with people who have criticized vaccines and spread misinformation about immunization, raising concerns from scientists and medical professionals about the future of COVID-19 shots.
The ramifications could be particularly harmful to Black communities that already face inequities when it comes to health care, advocates say.
“Limiting booster eligibility risks further compromising the already fragile health status of many Black Americans,” Oni Blackstock, a physician and founder of Health Justice, a consulting firm that focuses on racial and health equity, previously told Capital B.
Black Americans are at least 1.5 times more likely to contract COVID-19 and four times more likely to be hospitalized, according to early pandemic data. Additionally, the Center for Primary Care at Harvard Medical School found that Black children are more than five times as likely to die from the virus.
“When [systemic barriers to health care access] combine with more restrictive vaccine guidelines,” Blackstock said, “it becomes even harder for Black Americans to get boosters and worsens existing health disparities.”
Here’s what to know about the updated COVID-19 shots.
Which COVID-19 vaccines are available this year?
The FDA has approved Moderna for those who are 6 months and older, Pfizer for those who are 5 years old and older, and Novavax for those who are 12 years old and older.
Am I eligible to get the vaccine?
The updated shots have been approved for people considered to be at higher risk of contracting a severe COVID-19 infection.
Some of the underlying conditions that meet these new vaccine guidelines, according to a February list from CDC, include asthma, diabetes (types 1 and 2), disabilities such as Down syndrome, HIV, mental health conditions, obesity, and the use of immunosuppressive drugs.
However, the list could change. It includes pregnancy as an underlying condition, but in May, Kennedy announced that the shots aren’t recommended for healthy children and pregnant women.
When will COVID-19 vaccines be available?
In an Aug. 27 statement, Moderna announced that, with the green light from the FDA, its updated shots “are expected to be available in the coming days.”
That same day, Pfizer also announced in a press release that its new vaccines would begin shipping “immediately” and “be available in pharmacies, hospitals, and clinics across the U.S. in the coming days.”
Similarly, John C. Jacobs, the president and CEO of Novavax, said in an Aug. 27 statement that the company will begin working to provide the updated shots to “eligible individuals this fall.”
Where can I get the vaccine?
The overwhelming majority of Americans — about 90% — got their COVID-19 shot at local pharmacies such as CVS and Walgreens during last year’s cold and flu season.
But uncertainty looms over this season. That’s partly because the policies governing pharmacy regulations vary by state.
Some states follow the terms that are set by the CDC’s immunization committee, while others have their own laws. Additionally, some states allow pharmacies to provide the vaccines off-label, or outside the FDA’s explicit guidelines.
Because of this regulatory disarray, CVS said that it would offer the vaccines in 34 states, administer them in 13 states and the District of Columbia if people have a prescription, and not administer them at all in Massachusetts, Nevada, and New Mexico.
The states requiring a prescription are Arizona, Colorado, Florida, Georgia, Kentucky, Louisiana, Maine, New York, North Carolina, Pennsylvania, Utah, Virginia, and West Virginia.
According to The New York Times, Walgreens seems to require a prescription in Arizona, Colorado, Georgia, Indiana, Louisiana, Missouri, Montana, New Mexico, New York, Oregon, South Carolina, Utah, Virginia, Washington State, West Virginia, and Wisconsin.
Can I still get a COVID-19 vaccine if I don’t meet the new criteria?
Technically, yes. But health experts worry that the uncertainty of the regulatory environment will only create more barriers to vaccine access.
“Physicians can still provide COVID vaccines off-label, and IDSA [the Infectious Diseases Society of America] strongly urges doctors to continue recommending and administering vaccination to their patients based on the best available science,” Tina Tan, the society’s president, said in an Aug. 27 statement.
“However, pharmacists’ ability to provide off-label vaccines may be severely constrained, underscoring the vital role of physicians and other clinicians in maintaining access,” she added.