The Centers for Disease Control and Prevention (CDC) updated its Covid vaccine guidelines on Monday, recommending that individuals aged 65 and older consider getting the Covid shot, but only after consulting with their doctors or pharmacists.
This latest guidance, signed off by acting CDC Director Jim O’Neill, follows recommendations from an advisory panel last week, bringing clarity after months of uncertainty surrounding this season’s Covid vaccine. The update comes after a period of turbulence within the agency, particularly following actions earlier this year by Health Secretary Robert F. Kennedy Jr. In May, Kennedy, who has long been a vocal anti-vaccine advocate, made headlines by dismissing all 17 members of the influential vaccine advisory panel and replacing them with individuals who have been critical of Covid vaccines.
Kennedy, who has repeatedly made misleading claims about vaccine safety — including calling the Covid vaccine the “deadliest vaccine ever made” — had already moved to restrict vaccine access. In a controversial decision, he bypassed the usual regulatory procedures and announced that the CDC would no longer recommend Covid vaccinations for healthy children and pregnant women.
The CDC’s updated Covid vaccine guidance, issued Monday, does not prevent those under 65 from getting the vaccine — they are still eligible, but only after consulting with a doctor or pharmacist.
This so-called “shared clinical decision-making” process introduces a new layer of complexity, according to Dr. Yvonne Maldonado, a professor of global health and infectious diseases at Stanford University. She explained that this approach “puts up one more little barrier” to vaccination, with healthcare providers advising individuals on the risks and benefits of the shot before it’s administered.
The CDC clarified that the vaccine is most beneficial for those under 65 who are at increased risk for severe Covid due to underlying conditions. For those without such risk factors, the benefit of vaccination is lower.
However, access to the Covid vaccine may vary depending on where you live.
Historically, states have largely followed the CDC’s guidance, particularly the recommendations from the Advisory Committee on Immunization Practices (ACIP), which is seen as one of the top authorities on vaccination policy. Ahead of the CDC’s official recommendation, 26 states — mostly with Democratic governors — had already set their own, broader Covid vaccine guidelines, aiming to maximize access.
As a result, the country now faces a confusing patchwork of Covid vaccine policies.
“We now have had a breakdown in consensus between the federal government and the states as to how to manage Covid immunization,” said Dr. Ofer Levy, director of the Precision Vaccines Program at Boston Children’s Hospital. “We are facing an unprecedentedly complicated landscape.”
For instance, states like Illinois, Maryland, and Washington, D.C., recommend universal Covid vaccination for everyone ages 6 months and older. Meanwhile, other states like California, Michigan, and Minnesota suggest the shot for everyone 3 years and older.
“Viruses don’t respect state borders,” Levy noted. “From the perspective of protecting the public against infectious diseases, the last thing you would want as a strategy is to protect different states differently. It’s confusing, it’s inconsistent, and it leaves certain people vulnerable.”
Additionally, some doctors’ offices may not have the incentive to stock the Covid vaccine, especially since the CDC’s recommendation focuses primarily on older adults. Last season, only 23% of adults and 13% of children got the Covid vaccine, according to CDC data.
“There are many ways in which people who want the vaccine might not be able to get it because of all these barriers,” said Dr. Maldonado, who is also a pediatrician.
In response, major pharmacy chains like CVS and Walgreens are stepping up. CVS Health announced it would be ready to administer Covid vaccines for individuals aged 5 and older as soon as the CDC signed off. Walgreens, meanwhile, plans to offer Covid shots starting at age 3, without the need for prescriptions.
Do You Need a Covid Shot?
While the summer surge in Covid cases appears to have peaked in most areas, winter waves have occurred every year since the pandemic began in 2020, according to CDC data. Like the flu shot, the Covid vaccine doesn’t guarantee that you won’t get infected, but it significantly reduces the risk of severe illness, hospitalization, or death.
The updated Pfizer and Moderna vaccines target the LP.8.1 variant, which dominated earlier this year but has since been replaced by newer strains. Novavax’s updated vaccine, in contrast, targets an older strain called JN.1.
As of September 27, LP.8.1 only accounted for 3% of all new Covid cases, while the XFG strain now makes up at least 85%. All of these variants are descendants of the omicron strain, which emerged in late 2021. Research presented by Moderna and Pfizer at an FDA advisory committee meeting in May showed that the updated vaccines produced a stronger immune response to the circulating strains compared to last year’s versions.
It typically takes a few weeks after vaccination for immunity to build.
Is the Covid Shot Free?
For most people with insurance, the Covid vaccine should be free this year. AHIP, a health insurance industry trade group, confirmed that private insurers will continue covering all CDC-recommended vaccines, including Covid shots, for those aged 6 months and older.
Medicare, Medicaid, and other government health programs will also continue to cover the shots at no cost to recipients, according to a spokesperson from the Department of Health and Human Services.
