Last month, the Advisory Committee on Immunization Practices, or ACIP, convened to discuss new vaccination policies. The group, which creates recommendations on vaccine policy for the Centers for Disease Control and Prevention, voted to recommend vaccination for adults 65+ and young children, to also have to go through a process called "shared decision making" with their primary care providers. Their recommendations would not prohibit anyone over six months old from getting the shot, but call for patients to talk with a clinician about risks and benefits.

States have always created their own vaccine policies to an extent, but these rules are based on national recommendations given by the CDC. Now, state leaders are going their own way in making vaccine policies, which could mean one’s ability to get the COVID shot would soon depend on where they live.

For example, New York has declared a “statewide disaster emergency” to preserve access to COVID vaccines. New Mexico is also trying to make sure that pharmacies can continue giving out vaccines. Massachusetts is requiring insurers to pay for vaccines recommended by the state and not just those recommended by the CDC. States in the Northeast, from Maine to Maryland, are even considering forming a public health collaboration to continue supporting the administration of vaccines.

For some state leaders, these changes have fueled growing concerns about the credibility of ACIP and what it decides. Many believe the move is part of a larger effort to cast doubt on vaccines and reduce access to them.

Ultimately, however, the ACIP backed away from its most controversial recommendation, which called for states to require those who want a COVID vaccine to get a prescription. But COVID vaccines would still be less available than it has been in the last few years. ACIP's recommendation states that for people 64 and younger, the conversation should emphasize that benefits are greatest for people with the most risk of serious disease and lowest for people without increased risk. They also voted for the CDC to add information about possible risks related to COVID vaccine effectiveness to information sheets about the shots. Many of the risks are speculative or known to be unfounded.

There are also concerns around access problems, especially for people who are underinsured or don't have primary care providers. America's Health Insurance Plans, the industry group for private insurance companies, has stated that COVID-19 vaccines would be covered with no cost-sharing through the end of 2026. However, there's less clarity about how coverage will work for many other public health insurance programs.

While in prior years, the COVID vaccine was available to basically everyone, this is the first time there's any question whether pharmacists need to prescribe the vaccine. Regardless of insurance coverage, many people trying to get vaccinated in different places have reported that they're already being turned away from pharmacies.

No matter what, as the temperatures drop and the holiday season approaches, make sure to stay safe and practice good hand hygiene!