The U.S. Food and Drug Administration approved updated COVID-19 vaccines last week — but many healthy Texans may face new hurdles in getting the shots this fall.
The FDA approved updated formulations from the drugmakers Pfizer, Moderna and Novavax for people over the age of 65 and those who have an underlying condition that puts them at risk for severe illness. This policy marks a departure from previous years, when the vaccines have been approved for most Americans, regardless of age and health status.
According to the Centers for Disease Control and Prevention, there are a wide range of risk factors that could count as underlying conditions, from diabetes to asthma to pregnancy. “Physical inactivity” is also on the list.
“The list of conditions that qualify people under the age of 64 are pretty broad, and I'm pretty sure most people would fit into a category,” said Rannon Ching, the pharmacist-in-charge at Tarrytown Pharmacy.
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. also indicated in a social media post that people interested in a shot would generally be able to get one if they consult with a doctor.
Protocol may vary between doctors and medical practices. In some cases, doctors may be willing to prescribe the vaccine to patients outside of the FDA’s guidance, which is known as prescribing “off-label.” A doctor may also be able to assess risk level for conditions not explicitly listed by the CDC as risk factors for severe disease.
“People should go and speak to their providers so that they can do that shared decision-making and understand whether they're eligible,” said Dr. Desmar Walkes, the health authority for Austin-Travis County.
Dr. Manish Naik, chief medical officer for Austin Regional Clinic, said in a statement that ARC would recommend vaccines for pregnant patients and for children between 6 months and 23 months old regardless of risk factors. That aligns with guidance from the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.
"For all other patients, ARC recommends discussing the risks and benefits of COVID vaccination with your healthcare provider," Naik said. "If patients elect to be vaccinated, the vaccine will be available to them."
As in previous years, many pharmacies will also administer the vaccines. In certain states, pharmacists may have to hold off until the CDC makes its own recommendations, which are expected to come out of an agency meeting scheduled for Sept. 18-19. However, Texas law gives pharmacists latitude to prescribe FDA-approved vaccines for people over the age of 14 as long as there is a consulting physician working with the pharmacy, even absent a CDC recommendation.
In Texas, many pharmacies are simply asking patients to self-attest whether they have an underlying condition before booking an appointment for a COVID vaccine. At CVS, this process looks like checking a “yes” or “no” box. At Tarrytown Pharmacy, it looks like choosing a condition from a list.
Ching said he hopes to be a resource for clients who might be confused about their eligibility under the new FDA guidance — and encouraged folks not to get bogged down in confusion over the changes. He has already administered the updated Moderna vaccine after receiving a shipment this week.
“Do your homework; talk to your pharmacist,” he said. “They're knowledgeable.”
One unknown that remains is whether insurance companies will continue to cover the cost of COVID vaccines for patients. If the CDC chooses not to recommend the vaccines, insurance companies could choose to change their coverage policies. However, Reuters and other news outlets have reported that key insurance company representatives say they plan to continue broad coverage of the shots.
Support for KUT's reporting on health news comes from St. David’s Foundation. Sponsors do not influence KUT's editorial decisions.
