There’s quite a bit of confusion surrounding who is eligible for updated COVID-19 vaccines.
It follows Health Secretary Robert F. Kennedy Jr.’s shifting comments on vaccines and the announcement that people who are under 65 and considered healthy need a prescription to receive the shot. There had also been upheaval in the leadership at the Centers for Disease Control and Prevention — pushing some states to take matters into their own hands.
The U.S. Food and Drug Administration has approved the vaccines for people 65 and older, and for people who have an existing underlying health condition. In the past, anyone over six months old could get a COVID vaccine.
So, Utahns who want the vaccine will need a prescription if they don’t fall into those categories. Local health officials are hopeful, however, that the need for a prescription won’t last long.
The federal Advisory Committee on Immunization Practices has a major influence on who is eligible to receive vaccines. The CDC sets its vaccine schedules based on the recommendations of the panel.
But those schedules haven’t been set yet, which is leading to further confusion for those wanting to get an updated vaccine.
In June, Kennedy removed all members of the advisory committee and replaced them with eight of his own picks, including some vaccine critics. This newly selected committee will meet Sept. 18 and 19 to determine who is eligible to receive updated vaccines.
The Salt Lake County Public Health Department is awaiting the federal guidance to determine next steps, according to Communications Director Nicholas Rupp.
Depending on what happens, the county can set its own medical rules, Rupp said. If the medical director deems it necessary, she can write a standing order, which tells nurses and pharmacists what they can administer and to whom.
“Our medical director can do that, but she has not made any determinations on what she's going to do for COVID vaccines yet, because she's waiting to see what ACIP does,” Rupp said.
It’s unusual to go against the committee’s recommendations, Rupp said.
“But if ACIP’s decision is something that she, in her medical opinion, doesn't agree with, she might change that to be something specific for Salt Lake County,” he said.
Local pharmacies are waiting for new guidelines, too.
Tony Rhodes, a staff pharmacist and vaccine coordinator at University Pharmacy in Salt Lake City, said they get around two dozen questions per day on whether or not they can administer vaccines.
“Now that people are starting to get word that supplies are available, but pharmacies are waiting on guideline updates, I only expect those numbers to increase until we finally get a good, solid resolution,” he said.
In previous years, the pharmacy has only needed a photo ID, insurance and a phone number to administer COVID-19 vaccines to anyone who wants one.
That’s because of the pharmacy’s collaborative practice agreement, which gives a pharmacist prescription authority on behalf of a local doctor.
“That contract allows us, here at University Pharmacy, to put that contracted doctor's name as the prescribing authority on the vaccine,” Rhodes said. “Without it, vaccines are still a prescription-only item, but the way that people are able to walk in without a prescription is by us having that contract, which is a form of a prescription.”
Until they get updated guidelines, patients who want a vaccine need a prescription.
But this situation isn’t permanent, Rhodes said.
“That is simply how Utah has arranged this contract, that I do expect guidelines to be published like normal and a lot of the vaccination processes to go through very similar to previous years.”
There are other options for patients to get a vaccine if they don’t have a primary care doctor, Rhodes said. People can go to a walk-in care clinic or emergency room to see if there are prescribers who will help. At University Pharmacy, they can recommend doctors.
Rhodes has already had to deny someone a vaccine, since he didn’t have a prescription. He said a couple came in trying to get shots since the wife has multiple sclerosis and is immunocompromised, one of the qualifying underlying conditions for someone under 65. But because the husband did not have a prescription, he wasn’t able to get vaccinated.
“In that context, we could not administer it to the husband, but if he gets a prescription, he can get it,” Rhodes said.
Chain pharmacies, like CVS Health and Walgreens, are offering vaccines in Utah to individuals with a prescription or who are over the age of 65 or who have an underlying health condition. But even with a prescription, it could still cost more to get vaccinated if insurance refuses to cover it. For the private sector, a COVID-19 vaccine currently costs around $140 per shot.
If the Advisory Committee on Immunization Practices doesn’t change the current guidelines, there’s a chance University Pharmacy could follow what Salt Lake County Public Health decides, because of wording in the state’s vaccine guidance document that gives pharmacists the choice to follow local health directives.
“If Salt Lake County were to say we don't need additional health conditions for under age 65, then yes, we would be covered under that recommendation,” Rhodes said.
