In Brief:
- CDC guidelines for COVID-19 vaccines could create new restrictions to access.
- Connecticut is one of 19 states where cases are on the rise. It’s a state public health priority to make vaccination available to those who want it.
- Three separate state agencies have released guidance meant to ensure continued access to vaccines.
The Food and Drug Administration approved updated COVID-19 vaccines for the fall vaccination season but with new limitations on who can receive them. This has created confusion about access to vaccines, who can administer shots and whether they will be covered by insurance.
Manisha Juthani, Connecticut’s public health commissioner, wants vaccinations to be available to all who want them. The state has developed a three-pronged approach to make this possible.
Other blue states are looking to set their own standards for vaccinations, given changes at the federal level. Connecticut is seeking to clarify that existing practices should pretty much be maintained.
The Department of Public Health published its own interim vaccination guidance based on recommendations from the American Academy of Family Physicians and other medical experts. This opens the door for anyone to receive a vaccination who wants one.
Connecticut’s Department of Consumer Protection issued guidance for pharmacists, clarifying that state law and existing instructions for vaccinations from the federal Centers for Disease Control and Prevention (CDC) allow them to give shots. Separately, a state Insurance Department bulletin informed insurers and health-care centers that Public Health Department guidance and state law support coverage.
Federal Action
The Food and Drug Administration recommends vaccination against COVID-19 for adults 65 or older, as well as adults with medical conditions that put them at risk for severe illness if they become infected. Healthy children under 18 can be vaccinated on advice from a physician.
Theoretically, anyone with a doctor’s order for a vaccination could receive one. But there are complications. Most people receive their shots from a pharmacist, and pharmacists only administer vaccinations according to CDC guidelines. Insurers apply the same rule to covering costs.
This week's meeting of the Advisory Committee on Immunization Practices (ACIP) could bring changes to access and administration recommendations. The Trump administration dismissed the existing committee, which can have up to 19 voting members. Twelve new members have been named so far.
It’s hard to predict what will come from this meeting. Members are appointed by Health and Human Services Secretary Robert F. Kennedy Jr. and presumably share his vaccine-skeptical views. ACIP recommendations are usually approved by the CDC director, Juthani says, but the firing of Susan Monarez as the CDC director, plus resignations from every leading CDC scientific director with infectious disease expertise, mean this could fall to an acting director with no medical or scientific training.
Some who want shots are already being turned away at pharmacies, Juthani says, but similar confusion was common as the first COVID-19 vaccinations were rolled out. Complicated and changing guidance contributed to this.
The framework Connecticut created to address federal policy changes might allow it to navigate uncertainties yet to come. Juthani's department will continue to work with providers to clarify who should be vaccinated. The consumer protection agency will clarify for pharmacists that they can and should continue administering shots.
For now, private insurers seem to be signaling a willingness to cover vaccinations.
The fortunate thing, Juthani says, is that sorting out vaccination delivery is taking place as a preventive measure, not in the midst of a deadly pandemic.
“We are not mandating that anybody get a vaccine,” Juthani says. “But for anyone who wants one, we want them to get it easily, without a lot of hurdles.”
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