A once-straightforward seasonal vaccine process has become puzzling this year because of changes in new federal guidance. Understanding what has changed with this year’s COVID vaccine recommendations requires a brief review of the usual way vaccines are adopted each year in the US. Two federal agencies are involved. The Food and Drug Administration (FDA)oversees review of the safety and efficacy of candidate vaccines and is authorized to determine whether or not to approve vaccines for use. The Centers for Disease Control and Prevention (CDC)is responsible for providing recommendations on how to use approved vaccines. This includes issuing annual U.S. adult and childhood immunization recommendations (referred to as “immunization schedules.”)
What’s changed – and why?
Since 1964 The Advisory Committee on Immunization Practices (ACIP), an expert panel of clinical, scientific and public health scientists with expertise in immunizations, has been making recommendations to the Department of Health and Human Services through the CDC. Every year the Committee meets three or more times and after considerable research and scientific review, votes in the spring on immunization recommendations, which advises the federal government how various vaccines should be used to minimize disease. That process changed this year when on July 9 the Secretary of Health and Human Services J.F. Kennedy Jr. fired all 17 members of ACIP, and the next day announced without explanation the sudden and abrupt cancellation of the spring ACIP meeting.
More surprises
In an even more surprising move, on August 27, Kennedy fired Senate-confirmed CDC Director Susan Monarez. In response, several high-ranking CDC officials also exited, citing the need to “protect the public over serving a political agenda.”
More drama followed when Mr. Kennedy announced in a video statement posted on social media that while the 2025-26 COVID vaccine had been approved by the FDA, it came with restrictions, removing healthy children and adults and pregnant women without risk factors for eligibility. The Advisory Committee had not been consulted on this and the next day the Secretary announced he had chosen new members for the Advisory Committee, some with known anti-vaccine views. The Secretary of HHS personally directing changes to recommended immunization schedules was unprecedented, as was the mass dismissal of ACIP, recognized as “the global model for providing expert advice on vaccines too the government” (as quoted in the New England Journal of Medicine by Dr. Jason Schwartz Professor, Department of Health Policy and Management- Yale School of Public Health.
Friction in Health and Human Services causing Delays, Questions
These events delayed the usual process for COVID vaccine recommendations. The fact that ACIP recommendations must be accepted by the CDC director further complicates the situation. Although APIC usually meets in the spring and votes on vaccine recommendations, due to all the changes and confusion at the CDC, the necessary meeting was delayed. This put the usual fall rollout of seasonal vaccines behind schedule.
When the Committee finally met on September 18, there were more surprises. By this time the FDA had approved COVID vaccination for seniors aged 65 or older due to increased risk for complications of COVID. It was anticipated the APIC would recognize the FDA approval for seniors but would make some limits on vaccines for all those under 65. However instead of making any specific recommendations or recognizing risk, the Advisory Committee simply voted to end universal recommendations for COVID shots, advising that COVID vaccination should be based on “individual decision making” and encouraging consultation with a healthcare professional.
The APIC left stand, at least for this year, the FDA’s previous approval for COVID vaccine to:
– those 65 and over due to increased risk of COVID complications
– and those aged 6 months to 64 who have a health condition that increases risk of COVID complications.
For all others there were no recommendation and the official vote on COVID vaccination did not mention any specific recommendations. Instead, Americans were advised that they should engage in “shared decision making” with their doctors, nurses and pharmacists. In a seemingly contradictory statement, APIC added that all Americans “could get the vaccine and don’t need a prescription.”
For readers who are over 65 and want the COVID vaccine, the process is much simpler than for others, since age makes one eligible and Medicare will cover costs. Even easier is taking advantage of the OSCO-Sun City arrangement bringing vaccines onsite. The first immunization clinic was October 6, the next one is on October 23 with a few available slots. Call the general Sun City/Huntley number to register.
Three local pharmacies (CVS-Lake in the Hills) OSCO Huntley, both locations) and Walgreens (Huntley-both locations) have the 2025-26 vaccines and are offering free vaccination for those over 65 or those who state they have at least one of the health conditions making them at higher risk for COVID complications.) If you are under 65 and do not have any health conditions which makes you more at risk for severe COVID complications, you may receive the vaccine, as verified with all three local pharmacies; however, vaccine charges will be submitted to your insurance carrier and may or not be covered. Private-pay is an option, but costs (as verified by local pharmacies) range from $200-$250.
All three pharmacies provide online registration and walk-up appointments. However, if you choose the walk-in option, check the schedules, to avoid closures during lunch and dinner breaks.
Kane County Health Department also provides a more comprehensive online list of pharmacies giving COVID vaccines: KANE COUNTY COVID-19 VACCINE PROVIDERS
Bottom line, at least for this year: Seniors eligible for free COVID vaccines this year, but barriers and confusion for others
Sorting out who is eligible for Covid vaccines and who pays is predicted to cause great confusion for those under 65, prompting AARP to state “Narrowed vaccine approvals and delayed recommendations are fueling confusion over the fall rollout and sparking questions about who can get the shot, where to find it and who will pay for it.” These questions and others (including the basic question: “Do I even need the COVID 25-26 vaccine?”) will be addressed in next month’s Health News Report.
