As COVID-19 continues to circulate, questions remain about how to protect yourself in 2025. Should you get the COVID-19 vaccine? Will the shots be available at your local pharmacy? Will insurance cover it? The answers are complicated.
The confusion stems from shifting federal vaccine recommendations, clashing guidance from medical groups, and the uncertainty of how doctors, pharmacies, insurance companies, and everyday people will navigate it all.
On Aug. 27, the U.S. Food and Drug Administration (FDA) authorized updated COVID-19 shots—but said the vaccines were only approved for people ages 65 and older, as well as adults and children over 6 months who have risk factors for developing severe COVID-19. The FDA announcement follows a decision in May by the U.S. Centers for Disease Control and Prevention (CDC) to stop recommending the COVID-19 shot for pregnant people and healthy children.
It’s a big change. The CDC had previously recommended the shot for everyone older than 6 months, and both the Pfizer and Moderna COVID-19 vaccines had previously been approved by the FDA for that same age group. (Now, only Moderna’s shot is approved for kids under 5, and Pfizer’s is approved for ages 5 and up.)
At least two prominent medical associations have issued their own COVID-19 vaccine guidelines, which contradict the updated federal advice. The American Academy of Pediatrics (AAP) continues to recommend that all children ages 6 months to 23 months get the COVID-19 shot, and the American College of Obstetricians and Gynecologists (ACOG) maintains that all women who are pregnant or breastfeeding get the vaccine.
Here’s what you need to know about getting the COVID-19 vaccine.
What have federal agencies said about the shots?
The FDA has authorized the updated COVID-19 vaccines for seniors and younger people with at least one risk factor for severe illness such as asthma, obesity, or diabetes. The agency also revoked emergency authorizations for the shots in children, which means the COVID-19 vaccine made by Pfizer is no longer approved for kids under the age of 5. The Moderna vaccine is still authorized for children older than 6 months.
But who, exactly, are the updated shots recommended for? While the FDA has the authority to license vaccines for use in certain groups of people, it is the CDC—based on advice from its Advisory Committee on Immunization Practices (ACIP)—that sets the schedule for which vaccines people should get and at what ages they should get them. ACIP’s next meeting is scheduled for Sept. 18 and 19.
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U.S. Health and Human Services Secretary Robert F. Kennedy Jr., a longtime vaccine skeptic, fired all members of ACIP in June and replaced them with people of his own choosing, including several vaccine opponents.
Sen. Bill Cassidy (R-La.), chair of the Senate health committee, said on Aug. 28 that ACIP should indefinitely postpone the September meeting because of serious allegations regarding the “meeting agenda, membership and lack of scientific process being followed” by the committee.
“These decisions directly impact children’s health and the meeting should not occur until significant oversight has been conducted,” said Cassidy, who is a physician. “If the meeting proceeds, any recommendations made should be rejected as lacking legitimacy given the seriousness of the allegations and the current turmoil in CDC leadership.”
On Aug. 27, CDC Director Susan Monarez was ousted from the job, and several senior agency officials resigned. STAT News reported that Monarez had clashed repeatedly with Kennedy over vaccines.
What do doctors recommend?
Many infectious-disease experts agree that the time has come to move away from the recommendation that nearly everyone get the COVID-19 vaccine.
Most people would have been exposed to the virus by now, whether through infection or vaccination, and so have developed some immunity to the disease, says Dr. William Schaffner, professor of infectious diseases at Vanderbilt University. Plus, while the virus strains that are currently circulating are very contagious, they don’t cause as much severe disease as some earlier strains, he says.
But COVID-19 remains a threat to some populations, and people still die and are hospitalized because of the virus. “I absolutely implore everyone who’s in a high-risk group to take advantage of the COVID vaccine this fall,” says Schaffner.
Many doctors and medical associations disagree with the federal government’s definition of who should be considered “high-risk” and say the current FDA and CDC guidelines are too narrow.
In recommendations issued earlier this month, the AAP said children aged 6 months to 23 months are at high risk of severe COVID-19 and should be vaccinated. The hospitalization rate for this age group is similar to that for adults aged 50 to 64, the group said.
Children who are immunocompromised or have underlying conditions should also be vaccinated. Healthy children aged 2 and older should get the shot if they haven’t previously been vaccinated against COVID-19 or if families want to protect others in the household, AAP said.
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“Families may also want protection from Long COVID,” says Sean O’Leary, chair of the AAP Committee on Infectious Diseases. “Vaccination reduces that risk.”
ACOG recommends that everyone who is pregnant, planning to become pregnant, lactating, or in the postpartum period get the COVID-19 shot. “The science has not changed. Pregnant women are at an increased risk of illness if they get a COVID-19 infection,” says Dr. Mark Turrentine, an obstetrics and gynecology professor at Baylor College of Medicine and a co-author of the new ACOG guidelines.
Vaccination during pregnancy can also provide passive immunity to newborns, protecting them from COVID-19 in the first few months of life before they can get the COVID-19 shot themselves, Turrentine says.
Healthy adults who have been vaccinated before can skip the shot unless they want to protect other members of their household or decide after discussions with their doctor that vaccination is the best choice for them, says Dr. Peter Chin-Hong, infectious-disease specialist at the University of California, San Francisco.
In a post on X announcing the FDA decision, Kennedy said the updated COVID-19 shots would be “available for all patients who choose them after consulting with their doctors.” He didn’t clarify whether this would be an official CDC recommendation.
It is still unknown when the updated shots will be made available, though vaccine experts say shots are typically disseminated after ACIP makes its recommendations.
Several pediatricians and family-medicine doctors tell TIME that they are prepared to administer COVID-19 shots “off-label”—a legal and common practice in which medical providers prescribe drugs or vaccines for a different purpose or group than what the FDA approved. They say, however, that there are lingering questions about whether insurance companies will continue to cover the vaccines for people who aren’t in high-risk groups and if pharmacies will allow people who aren’t high-risk to get the shots.
These questions, coupled with the clashing advice from federal agencies and medical groups, will likely fuel a decline in vaccination rates, says Schaffner. “It’s going to lead to a lot of confusion for providers, patients and insurers.”
Will insurance cover the COVID-19 shot?
Almost all health care payers—including private insurers, employer-sponsored health plans, and Medicaid—are required to cover vaccines at no cost if they are recommended by the CDC and ACIP. If they aren’t, then coverage will depend on the payer—who could decide to cover the shots, charge a copay, or not cover the vaccine at all.
Without insurance, the COVID-19 vaccine can cost up to $140.
Medical associations including ACOG, as well as Democrats on House and Senate health committees, have urged insurers to continue covering COVID-19 vaccines for groups that would benefit from them based on the scientific evidence.
Some insurance companies have said that they will continue to cover COVID-19 vaccines for all their members but acknowledged that could change as federal recommendations evolve. People hoping to get a COVID-19 vaccine should call their insurance provider to ask about coverage.
Will I be able to get the COVID-19 vaccine at my local pharmacy?
Nearly 90% of people in the U.S. who got the COVID-19 shot in 2024 received it at a pharmacy, according to CDC data. But access to the shots at pharmacies may soon narrow dramatically.
In at least 18 states and Washington D.C., pharmacists are only allowed to vaccinate people based on official recommendations from the CDC or ACIP, says Brigid Groves, a vice president at the American Pharmacists Association. The remaining states have a patchwork of other regulations, Groves says, but most commonly, pharmacists’ vaccination authority is limited to the groups for whom the FDA has approved the vaccine.
Pharmacists are unlikely to administer vaccines off-label in the way that medical providers can because of liability concerns, said Groves. “You’ll be hard pressed to find a pharmacist who is willing to do that because of the potential ramifications.”
Groves recommends that people who are interested in getting the COVID-19 vaccine call their local pharmacy to find out about its vaccination policies.
The post What to Know About Getting the COVID-19 Vaccine Right Now appeared first on TIME.
