Covid Vaccine Availability in the US: A Complex Web of Eligibility and Access

Strategic Insights -

In a shift from previous guidelines, the Food and Drug Administration (FDA) has rescinded emergency use authorizations for Covid-19 vaccines for adults under 65, unless they have at least one underlying condition that puts them at higher risk for severe Covid. The new restrictions come as a new Covid variant, XFG or "Stratus," is spreading in the US. Experts warn that the limitations may lead to larger and more severe outbreaks.

Key Takeaways:

  • The FDA has approved updated versions of Covid-19 vaccines, but only for adults 65 and older and those with at least one underlying condition that puts them at higher risk for severe Covid.
  • The Centers for Disease Control and Prevention (CDC) advisory committee on immunization practices (ACIP) will meet in September to discuss Covid vaccine policy, but its recommendations are uncertain due to the presence of vaccine skeptics on the panel.
  • Adults under 65 qualify for a Covid vaccine if they have at least one underlying condition that puts them at high risk for severe outcomes from Covid-19, but what qualifies as an underlying condition is unclear.
  • The CDC's new list of qualifying conditions is expected to differ from the previous list, with some concerns that pregnancy will no longer be considered a risk factor.
  • Children will not be eligible for Covid vaccines under the new guidelines, causing confusion among parents and healthcare providers.
  • Adults who do not qualify under the new guidelines may be able to get off-label prescriptions, but doctors may be hesitant to prescribe them.
  • Pharmacists are uncertain about how to administer vaccines under the new guidelines, with pharmacy regulations varying from state to state.
  • Some states have their own statutes, while others follow ACIP recommendations, leading to confusion and limiting access to vaccines.

Statistics:

  • Nearly 90% of people who received a Covid shot during the 2024-2025 cold and flu season received it in a pharmacy (According to CDC data).
  • Two of the country's biggest pharmacy chains, CVS and Walgreens, have severely limited how and where they are providing vaccines.
  • 34 states allow CVS to offer vaccines without prescriptions, 13 states and the District of Columbia require prescriptions, and Massachusetts, Nevada, and New Mexico have stopped offering vaccines altogether.

Sources:

  • Food and Drug Administration (FDA) statement on rescinding emergency use authorizations for Covid-19 vaccines
  • Statement from US Secretary of Health, Robert F Kennedy Jr. on Twitter/X
  • Interview with Dr. Marty Makary, FDA commissioner, on Twitter/X
  • Statement from Dr. Jake Scott, clinical associate professor of infectious diseases at Stanford Medicine
  • Statement from Dr. Adam Ratner, member of the American Academy of Pediatrics (AAP) committee on infectious disease
  • Interview with Dr. Richard Ricciardi, practicing nurse practitioner and associate dean for clinical practice and community engagement at the George Washington University School of Nursing
  • Open letter from the American Academy of Pediatrics (AAP) and dozens of other major medical associations opposing the new policy on Covid vaccines for healthy pregnant women and children.