What vaccines do I need? How much do they cost?

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Every cold and flu season, you probably find yourself thinking about vaccinations for your kids: flu, Covid, the works. Maybe you’re at a routine checkup and you’re wondering if you should ask your doctor for the shots; maybe the pediatric clinic is running a vaccine clinic and you’re considering stopping by with the whole family. Either way, it has become a routine part of every autumn.

But this year, it’s different.

Any parent who reads the news or logs onto social media has probably heard that the US government has changed its vaccine guidance. They may also have learned that some of the leading doctor organizations in the country are opposed to those changes, as are a growing number of states.

I am lucky to have three healthy children under age 7, but I have still found myself wondering particularly about the value of Covid-19 shots for them the past few years. Like many parents, I have a lot of questions: Is the government going to change what vaccines we can get? Are Covid and flu shots going to be accessible anymore? Will they be covered by health insurance? How do I even know anymore which vaccines are safe for my child?

It used to be simple: The federal government, professional medical societies, your personal physician would all tell you the same thing about which vaccines you should get. And then your health insurance company — following that guidance — would usually cover the cost. But perhaps not anymore.

Robert F. Kennedy Jr., the US health secretary, is making a lot of changes to the government’s vaccine policy.

He has unilaterally declared that healthy children and healthy pregnant women should not receive a dose of the Covid vaccines — a move that has spurred uproar among staff at the Centers for Disease Control and Prevention and led to an exodus of its leaders, including director Susan Monarez. There have been reports that the Trump administration may pull the Covid vaccines from the market entirely. He has ordered a review of all of the vaccines that children receive when they’re growing up, and Kennedy has put vaccine skeptics in important positions in the administration.

Now, the medical establishment has started pushing back forcefully. In the past few weeks, the American Academy of Pediatrics and the American College of Obstetrics and Gynecologists have said that children and pregnant women should receive the Covid vaccine.

There is a group of infectious disease experts at the University of Minnesota who are working on alternative vaccine recommendations, in consultation with a range of medical organizations. Groups of states on the West Coast and across New England are teaming up with their neighbors to potentially issue their own vaccine recommendations. Massachusetts will require health insurers to cover state-endorsed vaccines, and more states may follow suit.

Here are some essential things to know about where vaccine access stands right now: The Trump administration has granted more limited approval for the latest update of the Covid shots. Healthy adults under 65 and children are not technically covered by the new Food and Drug Administration approval, and it’s not clear how widely available the vaccines will be at pharmacies and doctors offices in the fall. And the CDC will release its own recommendations for the Covid vaccines later in September, which could match the FDA approval — but could not. We’re in uncharted territory.

So far, other vaccines have not yet been affected, but we have already seen Kennedy make changes to the vaccine guidance outside of the normal process. The government could still make changes to who is recommended to get flu shots and RSV shots, and, in the long term, they could change the recommendations around measles shots, hepatitis shots, and all of the other vaccines that make up the childhood immunization schedule.

And in this new normal, where the government and medical establishment are at odds, whenever Kennedy walks back a recommendation for a specific vaccine, professional medical organizations may recommend the exact opposite. So, what are parents, trying to do the best for their children, supposed to do?

First, know which sources can help you find your bearings. Even though many experts in the public health establishment are pushing back on the federal government right now, it’s still worth understanding what the CDC recommends. You can find this on the CDC’s website. After that, you want to get the bigger picture: Understand what the relevant professional medical societies recommend. Some of the big ones are: the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Infectious Diseases Society of America.

But you’re not on your own in the labyrinth of the internet, either.

Your family physician, primary care doctor, and pharmacist will also be able to walk you through the best available information. They may also be able to tell you about any recent changes to the federal policy and what’s being communicated to the public about why they were made.

If both the CDC and the doctors’ groups agree on their vaccine guidance — as they might for, for example, the flu shot — then you can feel good about which shots to get, and you can be confident that your health insurance will cover it. Federal law mandates that most insurers cover the vaccines that are recommended by the federal government.

But what if the CDC and the doctor groups disagree, as they seem to on the value of Covid shots at the moment? This is a situation where it is valuable to have a doctor you can trust.

Unfortunately, finding a primary care doctor is more difficult than it should be in the United States. But something most families can do is pose these questions even to a nurse at a pharmacy or health care worker at a vaccine clinic, for your own knowledge and peace of mind:

What are the benefits of receiving the vaccine? What are the potential risks? How common are serious side effects?

And, in their opinion, Do the benefits outweigh the risks or vice versa? Is one vaccine preferable over the other? The Pfizer vaccine, for example, is approved for children ages 6 and older, while the Moderna shot is approved for kids 6 months and older.

The next major question we’re all going to have to face is: If I want to get a vaccine for myself or my child, will it cost me any money? This largely depends on your health insurance, if you have it.

As of today, none of the major health insurers have made significant changes to their vaccine coverage policies. But that could change.

Your doctor likely deals with insurance coverage in these situations all the time. Use them as an ally when trying to figure out if you can get your health insurance to cover a vaccine in a scenario where it is not federally required. They should also know about any state-level mandates that could require a health plan to cover you or your child’s shots.

Doctors may even be able to help you file a claim with your health insurer, and they might be aware of other public and private programs that are available to help cover the cost of vaccines. The new FDA approvals do allow for kids with underlying health conditions to receive the vaccine in consultation with a doctor, which could ensure insurance coverage. Adults may also want to ask if any of their preexisting medical conditions allow them to qualify under the new criteria. In general, the list of qualifying conditions is quite long, but it includes things like asthma, diabetes, heart disease, mental health conditions, and immunodeficiencies.

Making health care decisions might not be as easy as it used to be. But your best allies are your health care provider — and yourself. Learn as much information as you can, try to find a doctor you trust, and you can be more confident in your health care decisions for yourself and your family.