Three states take steps to ensure COVID vaccine access

Amid confusion in some states over whether pharmacies can provide COVID shots to residents before they are recommended by a federal vaccine advisory group, several states are taking steps to ensure access.

Among them is Pennsylvania, where the State Board of Pharmacy yesterday voted to allow pharmacists in the state to follow the vaccine recommendations of other “trusted authorities,” including the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians, and the Food and Drug Administration (FDA).

The vote came after Governor Josh Shapiro called on the board to ensure access to the updated vaccines, which received more restricted approvals from the FDA in late August. Although the FDA approved updated COVID shots for all people ages 65 and older, those below age 65 need to have at least one underlying condition identified by the Centers for Disease Control and Prevention (CDC) that puts them at increased risk of severe illness.

Confusion after CVS decision

The confusion began after pharmacy chains such as CVS began receiving the updated vaccines from Pfizer, Moderna, and Novavax last week. Pennsylvania is one of 16 states that require all vaccines administered by pharmacists to be approved by the CDC’s Advisory Committee on Immunization Practices (ACIP), which will not vote on those recommendations until its next meeting on September 18. CVS officials said the vaccines would not be available in those states.

CVS subsequently said residents of Pennsylvania and 12 other states could obtain the updated COVID vaccines with a doctor’s prescription. But critics say that requirement makes it more difficult to get the shots, and there have been reports that even those for whom the vaccines have been approved are being turned away. The vote by Pennsylvania’s pharmacy board means residents will no longer need a prescription.

“The Trump Administration’s outrageous decision to limit access to the COVID vaccine is an affront to Pennsylvanians’ personal freedoms,” Shapiro said in a news release. “I called on the State Board of Pharmacy to hold a special meeting to bring clarity to the people of Pennsylvania.”

“Following today’s regulatory action by the Pennsylvania Board of Pharmacy, CVS Pharmacy will ensure COVID-19 vaccinations are available as soon as possible at our locations throughout Pennsylvania,” said Sid Tenneti, MBA, of CVS Health.

Unclear what ACIP will recommend

Other states taking action include Colorado, where Governor Jared Polis yesterday directed the Colorado Department of Public Health and the Environment to issue a standing order allowing pharmacists in the state to provide COVID-19 vaccines without an individual prescription. The order goes into effect tomorrow.

“Colorado is committed to empowering individuals to make choices to protect their own health and safety, and I will not allow ridiculous and costly red tape or decisions made far away in Washington to keep Coloradans from accessing vaccines,” Polis said in a news release.

In Massachusetts, the Department of Public Health (DPH) yesterday also issued a standing order allowing all Massachusetts pharmacies to dispense and administer COVID-19 vaccines to all eligible people. Last week, the New Mexico Department of Health said it would work with the state’s Board of Pharmacy to remove potential barriers to access.

It’s unclear what the newly reconstituted ACIP, which now includes members who have been highly critical of COVID-19 vaccines, will recommend at its upcoming meeting. But AAP and ACOG have recently issued less restrictive recommendations for updated COVID-19 vaccines. Those recommendations addressed COVID shots for pregnant women and healthy children. In June, Health and Human Services Secretary Robert F. Kennedy Jr. said the CDC would no longer recommend COVID vaccines for those populations.

Another issue that could provide a barrier to COVID vaccine access is insurance. According to KFF, almost all payers are required to cover ACIP-recommended vaccines at no cost. If ACIP does not recommend the COVID vaccines for certain groups, that could mean some people have to pay out of pocket. 

In response to those concerns, Massachusetts Governor Maura Healey today issued an order requiring insurance carriers in the state to cover vaccines recommended by DPH.

Healey also said the state is leading an effort to create a collaboration with other states in New England and the northeast that will focus on developing evidence-based recommendations on vaccines.

“The actions we are announcing today will make sure people can continue to get the vaccines they need and want in Massachusetts,” Healey said in a news release. 

Editor’s note:  This story was updated at 3:10 pm.