According to the Centers for Disease Control and Prevention (CDC), people six months and older, with rare exception, should get the updated annual flu vaccine, ideally by the end of October. The CDC also recommends that everyone ages six months and older should get the updated 2024–2025 COVID-19 vaccine, unless otherwise noted, to help restore and enhance protection against the currently circulating virus variants.
It’s especially important to protect certain populations. This includes those at increased risk of complications from severe flu or COVID-19 illness, such as adults 65 and older, people with certain immunocompromising or chronic medical conditions, infants, children younger than two and pregnant women.
“Preventive vaccinations are the best way to protect yourself and your family from seasonal illnesses,” said Dr. Sree Chaguturu, executive vice president and chief medical officer at CVS Health. “Access to preventive vaccinations is critical to keeping communities healthy.”
According to Dr. Chaguturu, it’s helpful to understand the science behind vaccines so people feel informed and safe getting vaccinated.
Myth #1: You should wait until flu season peaks to get vaccinated.
According to the CDC, the timing of flu season is difficult to predict and can vary in different parts of the country and from season to season. It’s important to get vaccinated before flu season peaks or outbreaks occur in your area since it takes about two weeks for your body to build up protection after getting vaccinated.
Myth #2: You can’t receive other vaccinations with the flu shot.
The CDC says patients can get a COVID-19 vaccine at the same time as the flu vaccine and other eligible vaccines. At CVS Pharmacy, patients can schedule multiple vaccinations in one appointment.
Myth #3: You don’t need updated vaccinations for the flu.
Getting the flu shot every year is essential because the body’s protection from the vaccine declines over time. Also, flu viruses vary yearly, so receiving the latest vaccine formulation provides optimal protection.
Flu shot appointments (for up to four people in one appointment) can be scheduled at CVS Pharmacy or MinuteClinic by visiting CVS.com or the CVS Pharmacy app.
Now is the time to protect yourself from the flu and COVID-19
According to the Centers for Disease Control and Prevention (CDC), people six months and older, with rare exception, should get the updated annual flu vaccine, ideally by the end of October. The CDC also recommends that everyone ages six months and older should get the updated 2024–2025 COVID-19 vaccine, unless otherwise noted, to help restore and enhance protection against the currently circulating virus variants.
It’s especially important to protect certain populations. This includes those at increased risk of complications from severe flu or COVID-19 illness, such as adults 65 and older, people with certain immunocompromising or chronic medical conditions, infants, children younger than two and pregnant women.
“Preventive vaccinations are the best way to protect yourself and your family from seasonal illnesses,” said Dr. Sree Chaguturu, executive vice president and chief medical officer at CVS Health. “Access to preventive vaccinations is critical to keeping communities healthy.”
According to Dr. Chaguturu, it’s helpful to understand the science behind vaccines so people feel informed and safe getting vaccinated.
Myth #1: You should wait until flu season peaks to get vaccinated.
According to the CDC, the timing of flu season is difficult to predict and can vary in different parts of the country and from season to season. It’s important to get vaccinated before flu season peaks or outbreaks occur in your area since it takes about two weeks for your body to build up protection after getting vaccinated.
Myth #2: You can’t receive other vaccinations with the flu shot.
The CDC says patients can get a COVID-19 vaccine at the same time as the flu vaccine and other eligible vaccines. At CVS Pharmacy, patients can schedule multiple vaccinations in one appointment.
Myth #3: You don’t need updated vaccinations for the flu.
Getting the flu shot every year is essential because the body’s protection from the vaccine declines over time. Also, flu viruses vary yearly, so receiving the latest vaccine formulation provides optimal protection.
Flu shot appointments (for up to four people in one appointment) can be scheduled at CVS Pharmacy or MinuteClinic by visiting CVS.com or the CVS Pharmacy app.
Plan ahead to stay healthy, avoid the flu during the holiday season
by Matt SheehanOSF Healthcare
OSF Infectious Disease Specialist
Navigating flu season during the holidays
“We're in a unique part of the year. We had Thanksgiving and we're going into the Christmas and New Year holiday. We have schools on breaks and people traveling,” says Doug Kasper, MD, infectious disease specialist with OSF HealthCare. “We notice nationwide that when there's viral activity on the coasts, it will eventually find its way into every part of the area, which includes Central Illinois.” Health organizations such as the U.S. Centers for Disease Control & Prevention (CDC), the American Academy of Pediatrics (AAP) and the Illinois Department of Public Health (IDPH) are also urging families to stay alert to flu symptoms and take steps to protect themselves.Flu vaccine helps preserve normal routines
For many families, staying healthy during the holidays means protecting not only themselves but also older adults, infants and immunocompromised relatives. “People will start to travel and be around older and younger family members as families congregate. We want people to protect themselves but also be able to enjoy those activities without getting sick,” Dr. Kasper says. “It's also a time where kids are bringing home infections from school. So, we want our kids to be in school and participate in activities. Anything we can offer them to help keep them in their normal routine is beneficial, which includes flu vaccines for our children.” Flu vaccination remains the best way to reduce severe illness and disruption, which is especially important for school-aged children whose attendance affects the whole household.When you're sick, staying at home matters
While vaccination reduces risk, the flu can still spread quickly – especially in places where people gather. That’s why knowing when to stay home remains essential. “If you are sick, you need to stay home. Especially in our school populations, it's hard when a child is sick. Maybe they're borderline and you don't know how sick they are, it's hard to remain home,” Dr. Kasper says. “We see a lot of infections that start at the level where we congregate. Whether that's at school or a medical facility, it will find its way into our homes. So, the way to try and address that is that if you're sick, particularly if you have a fever, is to stay home. At least be without a fever for 24 hours before resuming normal activity.” Public health agencies echo this guidance, advising families to keep children home from school when they have a fever, vomiting, severe cough or other flu-like symptoms. Flu symptoms can come on suddenly and vary from person to person. Common flu symptoms include:- Fever
- Muscle or body aches
- Extreme exhaustion or fatigue
- Headache
- Cough
- Runny or stuffy nose
- Sneezing
- ometimes a sore throat
- Vomiting or diarrhea
More Healthcare Stories
Health experts say it is okay to get your flu and COVID shots at the same time
OSF Healthcare
Since 2010, the Centers for Disease Control and Prevention (CDC) has recommended annual flu vaccines for everyone six months and older, with few exceptions. New this year is an added recommendation for a higher dose for those 65 and older. The CDC has also recommended the use of updated COVID-19 boosters from Pfizer-BioNTech for people ages 12 years and older and from Moderna for people ages 18 years and older. If you have not yet received your COVID-19 booster shot, or if you still have yet to receive an initial dose, it’s not too late. "I urge everybody who is eligible to get a COVID booster to do so, and the reasons why are multifactorial. Number one is because your immunity wanes and you need to protect yourself. Number two is that the virus has changed slightly and the newest booster is most effective at protecting against those changes, " says Dr. Bill Walsh, an OSF HealthCare chief medical officer. Dr. Walsh adds that it is important to get the seasonal flu shot as well as a COVID shot because they protect against different viruses. "Please understand that the recommendation is for both the flu shot and the COVID shot. There is no cross reactivity even though the symptoms might be similar between COVID-19 and influenza. The influenza shot will not help against COVID, and the COVID vaccination will not protect you against influenza, " Dr. Walsh explains. The timing of when to get your flu shot and COVID booster can be confusing. The CDC says if you haven’t yet gotten your initial recommended dose of the COVID-19 vaccine, to get one as soon as you can. Health experts typically recommend getting your seasonal flu vaccine by the end of October for best protection during the peak of flu season, and say it is safe to get both vaccines during the same visit. "There are many times when you get more than one vaccine. Most of the time when you get a tetanus shot, it also includes pertussis. Many of the vaccinations pediatricians give to children have more than one vaccine in each shot. So, it is standard and normal for more than one vaccine to occur at a time, " Dr. Walsh says. Dr. Walsh adds getting both shots done at once alleviates having to make multiple trips to your doctor’s office or local pharmacy. But this route may not be for everyone. As with all vaccinations, there are mild side effects that both vaccines can cause, such as joint or muscle pain, fatigue, and chills. If you have experienced side effects from vaccines in the past and it took a couple days for them to subside, you may opt to get the vaccines at separate times. "You know yourself best. If you are certain that you will get them both despite not getting them at one appointment, then that is completely fine, too. You may want to space them out because sometimes you have side effects. There have been a lot of questions about whether to get them both in one arm or in different arms so you have different injection sites. That really boils down to personal preference, " advises Dr. Walsh. The important thing is making sure you do get both of these vaccinations to protect both yourself and your loved ones. Because the holiday season is approaching, you may have holiday gatherings on your calendar over the next few months. If you get your flu shot in October but choose to wait to get your COVID-19 booster at a later date, Dr. Walsh recommends getting it at least two weeks before any large gatherings in order to ensure the best protection against the virus. To schedule your seasonal flu vaccine and COVID-19 booster, make an appointment with your primary care provider or local pharmacy. Talk to your primary care provider if you have any questions about either vaccine.
How to discuss getting vaccinated with family and friends
Family Features - During the fall and winter months, respiratory infections such as flu, COVID-19 and RSV can surge. People who are vaccinated lower their risk of getting seriously ill and needing medical care if they get infected. About 70% of adults in the United States said they probably or definitely will get a flu shot, and more than 50% said they probably or definitely will get an updated COVID-19 vaccine. While many people are ready to get this season's vaccines, others might still have questions.
"It is normal for people to have questions about vaccines," said Peter Marks, MD, PhD, director of the U.S. Food and Drug Administration's Center for Biologics Evaluation and Research, which oversees and reviews vaccine clinical trials. "It's important for everyone to know that all vaccines go through extensive testing before they are approved and that following approval, they are carefully monitored to identify any safety concerns so that they can be addressed quickly. Hundreds of thousands of volunteers have taken part in respiratory vaccine trials. The results tell us that these vaccines are safe and effective in preventing severe disease caused by flu, COVID-19 and RSV." Here are some ways to talk about the importance of this season's vaccines with a family member or friend who is unsure about getting vaccinated.
Diabetes is a silent killer because people tend to ignore symptoms
OSF Healthcare
According to the American Diabetes Association (ADA), when someone who has diabetes gets sick with things like colds or the flu, the illness and stress cause their body to release hormones that raise blood sugar (blood glucose) levels, making it harder to keep their blood sugar in their target range. The ADA adds that while having diabetes in and of itself does not necessarily make someone more likely to get a cold or the flu, it does raise the chances of getting seriously sick. Some people may not even know they have diabetes until a severe illness occurs.
“If you have poorly controlled or undiagnosed diabetes and develop symptoms of something like the flu, you will have increased risk factors of severe illness. I would encourage those people to get quickly examined at an urgent care or their primary physician,” says Mohammed Khan, M.D., an OSF HealthCare family medicine physician.
The National Institutes of Health (NIH) says that nearly a third of people with diabetes do not know they have it, and someone can go years before getting a diagnosis. The reason diabetes can fly under the radar is because the symptoms can be minor, especially early on.
“When patients have certain symptoms like more frequent urine and going to the restroom more often, losing weight, having lack of energy, having dry mouth, feeling thirsty and drinking more often, having recurrent infections like skin and urine infections – those are the things that indicate a screening for diabetes,” explains Dr. Khan.
He adds, “People who have diabetes sometimes ignore the symptoms and think they are not affected which is why it is a silent killer. The body is getting destroyed from the inside and many do not notice it unless you go to regular health exams or are screened for it. Diabetes is also one of the most common causes for chronic kidney disease. For a lot of people who develop problems like kidney failure or needing dialysis, the root cause for that most of the time is diabetes.”
Dr. Khan advises people who do have diabetes to keep it under control as best as possible, as well-controlled diabetes helps manage seasonal illnesses when they do occur. However, serious illness can still occur.
“With diabetes, your immune system goes down which is a risk factor. If you have diabetes, you want to make sure you are fully vaccinated and get the flu shot and are up to date on COVID vaccinations. If they are at a higher risk factor due to age and are in the age group to receive the pneumonia vaccination, we encourage get that as well, Dr. Khan advises.
The Centers for Disease Control and Prevention (CDC) recommends a pneumonia shot for anyone age two or older who, because of chronic health problems (such as diabetes) or age, has a greater chance of getting pneumonia, and urges all eligible individuals who are six months and older to get their annual flu shot.
If you have diabetes, have a kit on hand with the following items in it: A glucose meter, extra batteries, supplies for your insulin pump or continuous glucose monitor, ketone test strips, a week’s worth of glucose-lowering medication (but don’t store these longer than 30 days before use), glucose tabs or gels, and flu or cold medications that won’t disrupt your diabetes management.
If you do end up with a seasonal illness, keep track of your symptoms and let your primary doctor know if they get worse. If your symptoms become severe or unmanageable, go to the nearest urgent care or emergency department.
If you have not been diagnosed with diabetes but are exhibiting any possible signs and symptoms, make an appointment with your doctor.
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Back-to-school illnesses, kids need their immunizations
by Matt SheehanOSF Healthcare
- Fever
- Chills
- Fatigue (tiredness)
- Cough
- Runny or stuffy nose
- Decrease in appetite
- Sore throat
- Vomiting
- New loss of taste or smell
- Headache, muscle or body aches
- Diarrhea
- Weakness
Have you been boosted? Here's why the CDC recommends it
Kaiser Health News
Everyone over the age of 6 months should get the latest covid-19 booster, a federal expert panel recommended Tuesday after hearing an estimate that universal vaccination could prevent 100,000 more hospitalizations each year than if only the elderly were vaccinated.
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted 13-1 for the motion after months of debate about whether to limit its recommendation to high-risk groups. A day earlier, the FDA approved the new booster, stating it was safe and effective at protecting against the covid variants currently circulating in the U.S.
After the last booster was released, in 2022, only 17% of the U.S. population got it — compared with the roughly half of the nation who got the first booster after it became available in fall 2021. Broader uptake was hurt by pandemic weariness and evidence the shots don’t always prevent covid infections. But those who did get the shot were far less likely to get very sick or die, according to data presented at Tuesday’s meeting.
The virus sometimes causes severe illness even in those without underlying conditions, causing more deaths in children than other vaccine-preventable diseases, as chickenpox did before vaccines against those pathogens were universally recommended.
The number of hospitalized patients with covid has ticked up modestly in recent weeks, CDC data shows, and infectious disease experts anticipate a surge in the late fall and winter.
The shots are made by Moderna and by Pfizer and its German partner, BioNTech, which have decided to charge up to $130 a shot. They have launched national marketing campaigns to encourage vaccination. The advisory committee deferred a decision on a third booster, produced by Novavax, because the FDA hasn’t yet approved it. Here’s what to know:
Who should get the covid booster?
The CDC advises that everyone over 6 months old should, for the broader benefit of all. Those at highest risk of serious disease include babies and toddlers, the elderly, pregnant women, and people with chronic health conditions including obesity. The risks are lower — though not zero — for everyone else. The vaccines, we’ve learned, tend to prevent infection in most people for only a few months. But they do a good job of preventing hospitalization and death, and by at least diminishing infections they may slow spread of the disease to the vulnerable, whose immune systems may be too weak to generate a good response to the vaccine.
Pablo Sánchez, a pediatrics professor at The Ohio State University who was the lone dissenter on the CDC panel, said he was worried the boosters hadn’t been tested enough, especially in kids. The vaccine strain in the new boosters was approved only in June, so nearly all the tests were done in mice or monkeys. However, nearly identical vaccines have been given safely to billions of people worldwide.
When should you get it?
The vaccine makers say they’ll begin rolling out the vaccine this week. If you’re in a high-risk group and haven’t been vaccinated or been sick with covid in the past two months, you could get it right away, says John Moore, an immunology expert at Weill Cornell Medical College. If you plan to travel this holiday season, as he does, Moore said, it would make sense to push your shot to late October or early November, to maximize the period in which protection induced by the vaccine is still high.
Who will pay for it?
When the ACIP recommends a vaccine for children, the government is legally obligated to guarantee kids free coverage, and the same holds for commercial insurance coverage of adult vaccines. For the 25 to 30 million uninsured adults, the federal government created the Bridge Access Program. It will pay for rural and community health centers, as well as Walgreens, CVS, and some independent pharmacies, to provide covid shots for free. Manufacturers have agreed to donate some of the doses, CDC officials said.
Will this new booster work against the current variants of covid?
It should. More than 90% of currently circulating strains are closely related to the variant selected for the booster earlier this year, and studies showed the vaccines produced ample antibodies against most of them. The shots also appeared to produce a good immune response against a divergent strain that initially worried people, called BA.2.86. That strain represents fewer than 1% of cases currently. Moore calls it a “nothingburger.”
Why are some doctors not gung-ho about the booster?
Experience with the covid vaccines has shown that their protection against hospitalization and death lasts longer than their protection against illness, which wanes relatively quickly, and this has created widespread skepticism. Most people in the U.S. have been ill with covid and most have been vaccinated at least once, which together are generally enough to prevent grave illness, if not infection — in most people. Many doctors think the focus should be on vaccinating those truly at risk.
With new covid boosters, plus flu and RSV vaccines, how many shots should I expect to get this fall?
People tend to get sick in the late fall because they’re inside more and may be traveling and gathering in large family groups. This fall, for the first time, there’s a vaccine — for older adults — against respiratory syncytial virus. Kathryn Edwards, a 75-year-old Vanderbilt University pediatrician, plans to get all three shots but “probably won’t get them all together,” she said. Covid “can have a punch” and some of the RSV vaccines and the flu shot that’s recommended for people 65 and older also can cause sore arms and, sometimes, fever or other symptoms. A hint emerged from data earlier this year that people who got flu and covid shots together might be at slightly higher risk of stroke. That linkage seems to have faded after further study, but it still might be safer not to get them together.
Pfizer and Moderna are both testing combination vaccines, with the first flu-covid shot to be available as early as next year.
Has this booster version been used elsewhere in the world?
Nope, although Pfizer’s shot has been approved in the European Union, Japan, and South Korea, and Moderna has won approval in Japan and Canada. Rollouts will start in the U.S. and other countries this week.
Unlike in earlier periods of the pandemic, mandates for the booster are unlikely. But “it’s important for people to have access to the vaccine if they want it,” said panel member Beth Bell, a professor of public health at the University of Washington.
“Having said that, it’s clear the risk is not equal, and the messaging needs to clarify that a lot of older people and people with underlying conditions are dying, and they really need to get a booster,” she said.
ACIP member Sarah Long, a pediatrician at Children’s Hospital of Philadelphia, voted for a universal recommendation but said she worried it was not enough. “I think we’ll recommend it and nobody will get it,” she said. “The people who need it most won’t get it.”
Illinois steps up amid federal vaccine guidance uncertainty
by Ben SzalinskiCapitol News Illinois
SPRINGFIELD - The Illinois Department of Public Health has recommended all adults get a COVID-19 shot this fall despite federal guidelines that narrowed the group of people recommended for the shot. IDPH released a standing order on Tuesdays that recommends the COVID-19 vaccine for all children between six and 23 months; children ages 2 through 17 that have an underlying risk or live in a home with another person who is at high risk for severe complications from COVID-19; any child whose parents want them to get a vaccine; people who are pregnant, planning to be pregnant or postpartum; and all adults.
The recommendation bucks new and murky guidelines from the Centers for Disease Control and Prevention that recommend vaccines only for people ages 65 and older. A recent CDC advisory panel vote allowed people younger than 65 to receive the vaccine after being informed of the risks and benefits of the shot, backing away from requiring people to get a prescription in order to receive the vaccine. Illinois’ latest recommendations follow the state’s Immunization Advisory Committee Monday vote on the issue. “IDPH’s recommendations, made in consultation with our Immunization Advisory Committee, will ensure that residents can protect themselves and their family members this upcoming respiratory season,” IDPH Director Dr. Sameer Vohra said in a statement. “In addition, the accompanying standing order will allow residents access to COVID-19 vaccine in local pharmacies and other health care settings.” Gov. JB Pritzker also issued an executive order earlier this month requiring IDPH to issue its own guidelines for vaccines this fall amid uncertainty over what the federal government would recommend. “At a time when the federal government is abdicating its responsibility to provide clear, science-informed guidance, Illinois is stepping up,” Pritzker said in a statement. “Illinois will continue to empower providers and families across our state with the information and access they need to guard against illness and disease.”
IDPH’s standing order allows health care providers and pharmacies in Illinois to give COVID-19 shots within the department’s guidelines. It also requires federal insurance plans, insurance plans under the Affordable Care Act and state-regulated insurance plans to cover the vaccines. Insurance companies that are members of America’s Health Insurance Plans, which are most major insurance companies, plan to continue covering the shots, according to the Associated Press.
Other vaccines
The Trump administration has also been unclear about how it will approach future recommendations on other vaccines. A CDC advisory panel last week recommended against administering the combination of measles, mumps, rubella and chickenpox vaccines, MMRV, to children under 4 years old. IDPH is recommending children and adults follow the CDC’s prior guidelines that recommend the MMRV. IDPH is also recommending everyone receive flu shots this fall. RSV vaccines are also recommended for adults aged 74 years old and older, adults at high risk for severe illness who are over 50, people who are between 32 and 36 weeks of pregnancy and children between eight and 19 months who are at a high risk of severe illness.Updated COVID-19 vaccine approved by FDA coming soon
by Matt SheehanOSF Healthcare
- Unvaccinated individuals 6 months through 4 years of age are eligible to receive three doses of the updated, authorized Pfizer-BioNTech COVID-19 vaccine or two doses of the updated, authorized Moderna COVID-19 vaccine.
- Individuals 6 months through 4 years of age who have previously been vaccinated against COVID-19 are eligible to receive one or two doses of the updated, authorized Moderna or Pfizer-BioNTech COVID-19 vaccines (timing and number of doses to administer depends on the previous COVID-19 vaccine received).
- Individuals 5 years through 11 years of age regardless of previous vaccination are eligible to receive a single dose of the updated, authorized Moderna or Pfizer-BioNTech COVID-19 vaccines; if previously vaccinated, the dose is administered at least two months after the last dose of any COVID-19 vaccine.
- Individuals 12 years of age and older are eligible to receive a single dose of the updated, approved Comirnaty (manufactured by Pfizer BioNTech) or the updated, approved Spikevax (manufactured by Moderna); if previously vaccinated, the dose is administered at least two months since the last dose of any COVID-19 vaccine.
- Additional doses are authorized for certain immunocompromised individuals ages 6 months through 11 years of age as described in the Moderna COVID-19 vaccine and Pfizer-BioNTech COVID-19 vaccine fact sheets.
She had a change of heart on the Covid vaccine
Then her son attended church camp, and, unknowingly, brought the virus home. Bramlett woke up one morning with a throbbing headache, 103-degree fever and fatigue. She also discovered she had lost her sense of smell and taste, telltale symptoms of the coronavirus. Eleven days later, she couldn’t get out of bed. Her head was hurting so badly that her husband took her to the hospital where they checked her for a brain bleed.
"I was terrified because I had never had head pain like this before," said Bramlett. She was diagnosed with inflammation of her brain vessels and myocarditis, a heart condition that made her heart feel like she was constantly running on a treadmill. Her body swelled as her kidney functions failed. Her recovery ultimately took 72 days.
"It was really, really scary and I don’t wish that on anybody," Bramlett says of the experience.
While Bramlett was ill, she asked her doctor if she could get vaccinated, but her medical team advised that she had to wait until she was feeling better. The moment she was cleared, Bramlett went right to the drug store for her vaccine.
"The hardest part was that people were dying all around me the entire time I was sick—healthy people, young people," Bramlett reflects. “I just felt so stupid. Here’s this vaccine available and I just assumed that it wouldn’t happen to me."
In fact, COVID-19 remains a serious threat across the U.S. as we head into the pandemic’s second winter. The Delta variant, which now makes up virtually all cases in the country, spreads more easily than the common cold and has led to a dramatic increase in hospitalizations nationwide. This rise in serious cases and deaths was most pronounced in the Southern U.S., where vaccination rates are lower.
What The CDC Says
According to the Centers For Disease Control and Prevention, people who have not yet been vaccinated are 29 times more likely to be hospitalized and 11 times more likely to die from COVID-19 complications, compared to those who have already received their vaccine.
Other CDC data reveals people ages 18 to 49 are the largest demographic hospitalized for COVID-19 as of September 25. Studies also show that even for individuals who have a mild case of COVID-19 and avoid hospitalization, they remain at risk of post-COVID symptoms, often called long COVID, that may last for weeks, months or longer. Symptoms of long COVID appear to affect as many as one in three people infected with the virus.
Bramlett now shares her experience with her friends and family to encourage them to consider being vaccinated. She urges everyone to talk to their doctor and learn about how they can keep themselves healthy and safe, so they can be present for their own children and families. To those still hesitant, Stephanie Bramlett says: "I understand. I understand that people are scared. I respect whatever decision you make or how you feel about the COVID-19 vaccine, but I would encourage people to do what they have to do to find the truth and do what you need to do to keep yourself healthy and safe."
Learn More
COVID-19 vaccines are safe, effective, widely available and free to everyone in the U.S. age twelve and older. Additionally, the FDA has formally approved Pfizer’s COVID-19 vaccine in the U.S. for those sixteen and older.
If you have questions about the COVID-19 vaccines, talk to a doctor or pharmacist, and visit www.GetVaccineAnswers.org for the latest information.
Prepare for a healthy pregnancy
Time is running out for free Covid vaccines, tests, and many treatment for Americans
Kaiser Health News
Take vaccines. Until now, the federal government has been purchasing covid-19 shots. It recently bought 105 million doses of the Pfizer-BioNTech bivalent booster for about $30.48 a dose, and 66 million doses of Moderna's version for $26.36 a dose. (These are among the companies that developed the first covid vaccines sold in the United States.)
People will be able to get these vaccines at low or no cost as long as the government-purchased supplies last. But even before the end date for the public emergency was set, Congress opted not to provide more money to increase the government's dwindling stockpile. As a result, Pfizer and Moderna were already planning their moves into the commercial market. Both have indicated they will raise prices, somewhere in the range of $110 to $130 per dose, though insurers and government health programs could negotiate lower rates.
"We see a double-digit billion[-dollar] market opportunity," investors were told at a JPMorgan conference in San Francisco recently by Ryan Richardson, chief strategy officer for BioNTech. The company expects a gross price — the full price before any discounts — of $110 a dose, which, Richardson said, "is more than justified from a health economics perspective."
That could translate to tens of billions of dollars in revenue for the manufacturers, even if uptake of the vaccines is slow. And consumers would foot the bill, either directly or indirectly.
If half of adults — about the same percentage as those who opt for an annual flu shot — get covid boosters at the new, higher prices, a recent KFF report estimated, insurers, employers, and other payors would shell out $12.4 billion to $14.8 billion. That's up to nearly twice as much as what it would have cost for every adult in the U.S. to get a bivalent booster at the average price paid by the federal government.
As for covid treatments, an August blog post by the Department of Health and Human Services' Administration for Strategic Preparedness and Response noted that government-purchased supplies of the drug Paxlovid are expected to last through midyear before the private sector takes over. The government's bulk purchase price from manufacturer Pfizer was $530 for a course of treatment, and it isn't yet known what the companies will charge once government supplies run out.
How Much of That Pinch Will Consumers Feel?
One thing is certain: How much, if any, of the boosted costs are passed on to consumers will depend on their health coverage.
Medicare beneficiaries, those enrolled in Medicaid — the state-federal health insurance program for people with low incomes — and people with Affordable Care Act coverage will continue to get covid vaccines without cost sharing, even when the public health emergency ends and the government-purchased vaccines run out. Many people with job-based insurance will also likely not face copayments for vaccines, unless they go out of network for their vaccinations. People with limited-benefit or short-term insurance policies might have to pay for all or part of their vaccinations. And people who don't have insurance will need to either pay the full cost out-of-pocket or seek no- or low-cost vaccinations from community clinics or other providers. If they cannot find a free or low-cost option, some uninsured patients may be forced to skip vaccinations or testing.
Coming up with what could be $100 or more for vaccination will be especially hard "if you are uninsured or underinsured; that's where these price hikes could drive additional disparities," said Sean Robbins, executive vice president of external affairs for the Blue Cross Blue Shield Association. Those increases, he said, will also affect people with insurance, as the costs "flow through to premiums."
Meanwhile, public policy experts say many private insurers will continue to cover Paxlovid, although patients may face a copayment, at least until they meet their deductible, just as they do for other medications. Medicaid will continue to cover it without cost to patients until at least 2024. But Medicare coverage will be limited until the treatment goes through the regular FDA process, which takes longer than the emergency use authorization it has been marketed under.
Another complication: The rolls of the uninsured are likely to climb over the next year, as states are poised to reinstate the process of regularly determining Medicaid eligibility, which was halted during the pandemic. Starting in April, states will begin reassessing whether Medicaid enrollees meet income and other qualifying factors.
An estimated 5 million to 14 million people nationwide might lose coverage.
"This is our No. 1 concern" right now, said John Baackes, CEO of L.A. Care, the nation's largest publicly operated health plan with 2.7 million members.
"They may not realize they've lost coverage until they go to fill a prescription" or seek other medical care, including vaccinations, he said.
What About Covid Test Kits?
Rules remain in place for insurers, including Medicare and Affordable Care Act plans, to cover the cost of up to eight in-home test kits a month for each person on the plan, until the public health emergency ends.
For consumers — including those without insurance — a government website is still offering up to four test kits per household, until they run out. The Biden administration shifted funding to purchase additional kits and made them available in late December.
Starting in May, though, beneficiaries in original Medicare and many people with private, job-based insurance will have to start paying out-of-pocket for the rapid antigen test kits. Some Medicare Advantage plans, which are an alternative to original Medicare, might opt to continue covering them without a copayment. Policies will vary, so check with your insurer. And Medicaid enrollees can continue to get the test kits without cost for a little over a year.
State rules also can vary, and continued coverage without cost sharing for covid tests, treatments, and vaccines after the health emergency ends might be available with some health plans.
Overall, the future of covid tests, vaccines, and treatments will reflect the complicated mix of coverage consumers already navigate for most other types of care.
"From a consumer perspective, vaccines will still be free, but for treatments and test kits, a lot of people will face cost sharing," said Jen Kates, a senior vice president at KFF. "We're taking what was universal access and now saying we're going back to how it is in the regular U.S. health system."
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