The vaccine situation in the United States has become confusing and chaotic. With evolving policies and recommendations, it can be hard to keep up.
Members of the Centers for Disease Control and Prevention’s vaccine guidelines committee convened last week and voted to limit access to updated Covid vaccines and combination shots for measles, mumps, rubella and chickenpox, pursuing an agenda pushed by Health Secretary Robert F. Kennedy Jr. The full consequences of the changes are not yet clear, but if adopted by the acting director of the C.D.C., they have the potential to affect both patient decisions and insurance coverage.
President Trump and Mr. Kennedy have also repeatedly suggested that vaccines may be linked to the rise of autism diagnoses, a claim that has been discredited by decades of scientific studies.
We know you have questions about vaccines. After we asked what readers wanted to know, we received hundreds of queries about efficacy, safety, cost and access.
Here are some of the most common ones we received, answered by New York Times health and science reporters.
Are updated Covid shots available? Who can get them?
The short answer: Largely, yes. On paper, anyone 6 months and older should be able to get the updated shots, which target more recent variants of the virus, after consulting a medical provider, a broad term that can include doctors, nurses and more. In practice, though, some people may face challenges.
The longer answer: Previous versions of the Covid shots were approved without caveats for all Americans 6 months and older. This year, though, the Food and Drug Administration approved the shots only for people 65 and older or those with an underlying medical condition that puts them at high risk.
But weeks later, the C.D.C. vaccine panel weighed in, a separate step from F.D.A. approval. The panel, called the Advisory Committee on Immunization Practices, recommended that anyone 6 months and older could get the shots through “shared clinical decision-making” with a medical provider. It’s likely, though not guaranteed, that a pharmacist could serve that role.
CVS and Walgreens, the nation’s two largest pharmacy chains, said they would provide Covid shots without prescriptions if the new recommendations were formally adopted by the head of the C.D.C., which they had not been as of Wednesday morning.
For children and pregnant women, access is more complicated. Many pharmacies and pediatricians’ offices aren’t stocking pediatric doses of the new Covid shots. And even though the C.D.C. recognizes pregnancy as a high-risk condition, it has stopped recommending vaccination during pregnancy.
Covid shots are “not prohibited for use in the United States,” said Jason Schwartz, an associate professor of health policy at the Yale School of Public Health. “That doesn’t suggest, in a meaningful sense, that individuals can easily access a vaccine.”
Are updated flu shots available?
Flu shots are widely available, and the C.D.C. recommends them for everyone 6 months and older. There have been no changes in eligibility.
The shots target three strains of flu that the F.D.A. determined to be most likely to circulate this season. The accuracy of that assessment varies from year to year, but even in years when the vaccine is less effective, it can still reduce the severity of symptoms if you do get sick.
Experts say the ideal window to get the flu shot is late September through October.
What has changed about access to the M.M.R.V. vaccine?
Parents have two options for protecting their children against measles, mumps, rubella and chickenpox.
Option No. 1: Children get two shots — one for chickenpox, and another that covers measles, mumps and rubella, called the M.M.R.
Option No. 2: Children get one combined shot that covers chickenpox, measles, mumps and rubella, called the M.M.R.V. The combination shot slightly increases the risk of fever-induced seizures in young children, which can alarm parents but do not cause lasting harm. Parents may choose this option to reduce the number of injections or clinic visits.
Last week, the C.D.C. panel rescinded the recommendation for the combination shot for children younger than 4. The panel also voted that the Vaccines for Children program, which provides free vaccines to roughly half of all American children, would no longer cover the combination shot in children under 4.
This change, however, is unlikely to affect most children. The C.D.C. had already recommended that children get the M.M.R. vaccine for the first of their two doses, unless a parent preferred the combined shot. (Thursday’s panel decision did not affect the availability or coverage of the M.M.R. shot.) The combination shot accounted for just 15 percent of first doses given in 2023, according to data presented at the meeting by C.D.C. scientists.
Children generally receive a second dose of the M.M.R. or M.M.R.V. shot between 4 and 6 years of age. As the C.D.C. recommendation is only for children under 4, this dose is unaffected by the panel’s decision.
Why do newborns get the hepatitis B vaccine?
Hepatitis B can lead to lasting liver damage. The C.D.C. vaccine advisory panel has recommended the hepatitis B vaccine for all infants since 1991, as hepatitis B can be transmitted during birth if the mother has the virus. Rates of the disease have dropped sharply since.
The virus is more transmissible than H.I.V., and many people do not know they have it. While hepatitis B can spread through sex or shared needles, people can also encounter the virus via household objects, such as if traces of blood or other body fluids end up on towels or razors.
President Trump has raised doubts about whether newborns should receive the hepatitis B vaccine, saying he thinks children should wait until age 12.
While most pregnant women are screened for hepatitis B, there are gaps in testing. Babies who are infected in the first year of life have about a 90 percent chance of developing a chronic infection.
Will my insurance keep paying for vaccines?
It probably will.
Under the Affordable Care Act, almost all insurers must fully cover vaccines recommended by the C.D.C. panel. Insurers are not required to cover shots that aren’t recommended, but they can choose to — and many have indicated that they plan to disregard recent changes by the panel.
AHIP, a national trade organization for many health insurers, said this month that through at least the end of 2026, its members would cover all vaccines that the C.D.C. recommended as of Sept. 1. If that decision stays firm, both the M.M.R.V. and Covid vaccines will still be covered by a long list of private insurers and Medicare Advantage plans.
United Healthcare, which is not a member of AHIP, told The Times that it, similarly, would continue to cover all shots that were recommended at the start of this year.
And Medicaid, Medicare and the Vaccines for Children program will still cover Covid shots, according to the Department of Health and Human Services.
The details of individual plans can differ even within one insurance company, though. So it’s best to check with your insurer to confirm your coverage.
If I have to pay out of pocket, how much do vaccines cost?
Most insurers must fully cover any vaccine the C.D.C. panel recommends. But if you don’t have insurance — or if your insurance stops covering a vaccine in response to the panel’s recommendations — out-of-pocket costs vary greatly depending on which vaccine you’re getting and where you get it.
The C.D.C. maintains a list of private-sector prices for various vaccines. But this list reflects only how much the provider who administers your vaccine pays; what the provider charges you is likely to be more. For example, the private-sector cost for Moderna’s and Pfizer’s adult Covid vaccines is listed as around $140, but you can easily pay more than $200 at a pharmacy if you have to pay out of pocket.
Parents may still be able to get their children the combination M.M.R.V. shot, which insurers are no longer required to cover for children under 4, but they might need to pay for it. The private-sector cost is around $290.
Will I be able to get vaccines at a pharmacy, doctor’s office or health clinic?
Flu shots and most routine childhood vaccinations — the M.M.R., Tdap and polio shots, for example — remain widely available.
Covid vaccines have been less accessible for many people, though that may change if the acting director of the C.D.C. approves the vaccine panel’s recommendations.
Routine pediatric vaccines are usually administered at pediatricians’ offices, not pharmacies, and that is unlikely to change.
How are vaccines and their ingredients tested for safety?
While all vaccines can have at least some mild side effects, new shots are rigorously evaluated to ensure their benefits outweigh their risks.
Testing for vaccines often begins in lab animals, like mice or primates. If the vaccine appears to be safe and promising, it advances to its first clinical trial. This safety trial often includes less than 100 people. After that, researchers monitor side effects in a larger trial, which includes more participants of different ages and backgrounds. Finally, the vaccine is tested in thousands — sometimes as many as tens of thousands — of participants, which lets the researchers detect rare side effects.
In these trials, some participants are given the vaccines and others are given a placebo, such as a saline mixture, so scientists can tease out whether the effects result from the drug itself or some other factor, such as the expectation of treatment.
In cases where there is a “proven intervention” with an established record of safety — a vaccine already in use, for example — it would not be ethical for scientists to test the new product against a placebo, which would withhold a lifesaving intervention from some participants, experts say.
Instead, researchers compare the newer product to the older vaccine to ascertain if the new shot is at least as effective. Many vaccines in use now have been tested rigorously in this way for safety and effectiveness.
Testing for vaccines can take up to a decade, after which the F.D.A. reviews the data and decides whether to approve the shot.
The C.D.C. and F.D.A. continue to collect data about any side effects of a vaccine even after its approval. The agencies may update recommendations or add warning labels if they find a link between a serious side effect and a vaccine.
Is it safe for my child to follow the childhood vaccine schedule? How about to receive multiple vaccines at once?
Significant side effects from the current roster of vaccines for children are extremely rare, and there is no hint that getting multiple shots at once is dangerous. Every vaccine or drug has some side effects, but a vast majority of symptoms are mild and transient.
The “Make America Healthy Again” strategy report released this month charges the government with “ensuring America has the best childhood vaccine schedule,” and calls for more research into vaccine injuries. Mr. Kennedy has repeatedly questioned the safety of individual vaccines, as well as the wisdom of administering multiple shots at once.
Children receive many more vaccines now than they did decades ago. But the shots used now are cleaner and more efficient, and they contain far fewer stimulants to the immune system — by orders of magnitude — than they used to.
What’s more, children harbor trillions of bacteria, more than the number of their own cells, and encounter pathogens everywhere — from caregivers and playmates; in kitchens, bathrooms and playgrounds; on toys, towels and sponges. The number of antigens — the parts of a pathogen that elicit an immune reaction — in vaccines is vanishingly small compared with their daily exposure.
Do vaccines cause autism?
The Trump administration has gone on the offensive against various vaccine ingredients and the traditional childhood vaccine schedule. On Monday, officials from the Department of Health and Human Services announced new research into the “root causes” of autism, committing millions of federal dollars to study factors including vaccines.
Dozens of studies over the last three decades have failed to find a connection between vaccines and autism. The notion that vaccines cause autism gained traction in the late 1990s, when a British researcher named Andrew Wakefield published a study of 12 children purporting to reveal a link between autism and the vaccine for measles, mumps and rubella.
But the study was fraudulent and Mr. Wakefield had conflicts of interest. His article was eventually retracted and Mr. Wakefield lost his medical license.
Many larger studies related to vaccines and autism have since been carried out, including one that examined the entire child population of Denmark. There, investigators followed 657,461 babies born between 1999 and 2010, of whom 6,517 eventually received a diagnosis of autism. There was no greater proportional incidence of the diagnosis between vaccinated and unvaccinated children.
Regardless of the types of vaccines, the ingredients in them or the timing of the childhood vaccine schedule, those researchers and others who have investigated the topic still have not found any meaningful link between vaccines and autism.
How common are serious reactions to vaccines? Are certain groups more susceptible to them?
Significant side effects to vaccines are extremely rare. Most shots may produce fatigue, fever and pain at the injection site, but do not carry serious side effects. On the rare occasions that health officials have found more serious side effects, they have withdrawn the shots. For example, in 1999, the C.D.C. withdrew its recommendation for a rotavirus vaccine that was associated with a serious type of intestinal blockage in children, and the manufacturer voluntarily ceased production.
A fraction of a percent of young people — especially young men between 12 and 24 — who receive their first two doses of Moderna’s and Pfizer’s Covid shots may experience myocarditis, or heart inflammation. The side effect is even more rare in adults of other ages and has not been observed in younger children. In all age groups, myocarditis is more common after contracting Covid than after getting a Covid vaccine, according to an analysis of nearly two dozen studies.
(Myocarditis was also observed after smallpox vaccines, including a version that has been used to prevent the related mpox.)
Myocarditis is treatable, and most people who experience it recover fully. If you have chest pain, heart palpitations or shortness of breath in the week or so after a vaccine, seek medical care.
Flu shots are also very safe. Guillain-Barré syndrome — in which the immune system attacks nerves — occurs in one or two recipients in a million, according to the C.D.C. and the World Health Organization, and flu infections are much more likely than vaccines to cause it.
It is possible, though not common, to have an allergic reaction to any vaccine. If you’ve ever been asked to wait a little while after a vaccination before going home, it’s so that, in the unlikely event of anaphylaxis, the provider can quickly treat you.
Maggie Astor covers the intersection of health and politics for The Times.
Dani Blum is a health reporter for The Times.
Teddy Rosenbluth is a Times reporter covering health news, with a special focus on medical misinformation.
Apoorva Mandavilli reports on science and global health for The Times, with a focus on infectious diseases and pandemics and the public health agencies that try to manage them.
Reed Abelson covers the business of health care, focusing on how financial incentives are affecting the delivery of care, from the costs to consumers to the profits to providers.
Emily Baumgaertner Nunn is a national health reporter for The Times, focusing on public health issues that primarily affect vulnerable communities.
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