By Ivey DeJesus, pennlive.com
You are not alone if the ever-changing news on the COVID-19 vaccine has given you whiplash.
Changing guidelines and policy reversals issued over the past few months by the U.S. Department of Health and Human Services, the Centers for Disease Control and Health Secretary Robert F. Kennedy, Jr., have created confusion about eligibility and access for the public.
The state Department of Health on Thursday clarified some of the lingering questions, as Pennsylvania took action to expand access to the COVID-19 vaccine. A state regulatory panel this week voted to allow pharmacies to follow the guidance of several medical organizations.
That means that pharmacies in the Commonwealth do not solely have to adhere to the guidance from the Trump administration, which has limited access to the COVID-19 vaccine to adults 65 or older; and adults and children 6 months or older who have at least one high-risk health condition.
Pennsylvania is among 16 states that restrict pharmacists to administering only vaccines that are approved by the federal Advisory Committee on Immunization Practices, which has not yet recommended COVID shots.
The policy change by the State Board of Pharmacy, which is effective immediately, allows an individual with a prescription regardless of their age or status with high-risk medical conditions to get the COVID vaccine.
In an email to PennLive, a spokesperson for the Department of State said: “The State Board of Pharmacy’s actions to expand access to COVID vaccines take effect immediately. However, while pharmacies work through the practical implementation of the board’s expanded approvals, Pennsylvania patients interested in getting a COVID vaccine should contact their pharmacy before scheduling an appointment to ensure availability.”
For now, availability may vary.
CVS Pharmacy, for instance, issued an immediate advisory, saying it will ensure COVID-19 vaccinations are available as soon as possible at its 500 locations throughout Pennsylvania.
“As soon as we begin offering vaccinations, appointments will be made available via CVS.com and the CVS Health app,” said CVS spokeswoman Amy Thibault. “Patients will also be able to walk into our pharmacies and clinics.”
Will insurance providers cover the cost of the vaccine?
That remains the sticking point – at least the point not fully clear.
Medicare will cover the vaccines for people who fall under the special criteria outlined by the FDA.
For everyone else covered by commercial insurance: check with your individual insurance provider. Some companies, like Kaiser Permanente, have already indicated they will provide coverage. Many other companies are still formulating their policy.
Capital Blue Cross said this year’s COVID vaccine, along with other vaccines, may be included in an eligible member’s Capital Blue Cross health plan as a covered preventive benefit.
“We advise our members to check their plan and reach out to us if they have questions about coverage, eligibility for a particular vaccine, potential co-pays, or if any pre-authorization is required,” said Jeff Wirick, a spokesman for Capital Blue Cross.
“If our members have questions or concerns about whether they should get the vaccine or its availability, we recommend they talk to their regular healthcare provider.”
Wirick notes that historically, vaccines have proven effective in preventing or minimizing the spread of viruses like COVID-19 and the flu.
People who get vaccines typically are at lower risk of serious illness and hospitalization. Capital Blue Cross has data showing seniors who received their flu shots during last year’s flu season were nearly 20% less likely to visit the emergency room for viral respiratory infections than those who were not vaccinated.
According to the National Center for Health Statistics, COVID-19 ranked the 10th highest leading cause of death in 2024.
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