New York pharmacies and doctors’ offices are starting to get requests for the latest, federally approved COVID shots, but getting a shot could be complicated by shifting federal guidance on the vaccines.
CVS and Walgreens have confirmed they will administer the new COVID shots in New York, but said patients will now need a prescription from a doctor, something that was never required in the past. Spokespeople for the pharmacy chains said their policies vary based on each state’s vaccine regulations.
Meanwhile, many local providers are still figuring out what their policies around administering the shots will look like this year — and how widely available they’ll be.
The U.S. Food and Drug Administration last week approved multiple COVID vaccines with updated formulas that aim to target evolving strains of the virus. The shots have been approved for people over 65 as well as younger people with underlying health conditions that put them at higher risk for severe symptoms.
Despite these narrow approvals, the U.S. Department of Health and Human Services has insisted that there are no concrete restrictions on access. “The COVID vaccine remains available for anyone who chooses it in consultation with their healthcare provider,” Emily Hilliard, a spokesperson for the agency, said Tuesday.
But in New York, changes in how federal immunization guidelines are being rolled out are already causing access issues. Pharmacies in New York require a non-patient-specific prescription, or “standing order,” for each vaccine they offer, giving them broad permission to administer the shots to those who qualify. In New York City, the standing order can come from the city health department or certain medical providers.
Standing orders for vaccines are generally based on guidance from the federal Advisory Committee on Immunization Practices. But that committee, which was completely overhauled in June by HHS Secretary Robert F. Kennedy Jr., has yet to issue its official guidance on COVID shots this year. The committee has a meeting scheduled for Sept. 18 and will discuss COVID vaccines then, according to Hilliard.
Until then, Roger Paganelli, the supervising pharmacist and owner of Mount Carmel Pharmacy in the Bronx, said he won’t be offering COVID vaccines.
“We need that guidance to be able to get those shots in those arms,” Paganelli said. He added that standing orders are “extremely specific,” detailing which patient populations can receive each vaccine.
Paganelli also facilitates a network of health care providers called CPESN NY that can issue its own standing orders for pharmacies. He said that the group is awaiting ACIP guidance as well.
It’s unusual not to have ACIP guidance on the shots by this time of year, Paganelli added. He said he sees the new prescription policies at CVS and Walgreens as an alternative to a standing order, but said he won’t be taking that route.
The confusion around access to COVID shots comes as CDC data shows an uptick in cases and hospitalizations nationally. In New York state, the amount of COVID detected in the wastewater is currently very low, according to the CDC. But New York continues to experience periodic surges of the virus and thousands of New Yorkers are living with long COVID — long-term symptoms that linger for months or years after an acute infection.
The city and state health departments did not respond to questions about whether they plan to issue standing orders without ACIP guidance, or whether they will continue to hew as closely to ACIP recommendations as they have in the past once they come out.
In a statement on X, the city health department said it plans to continue to follow the science.
“No new data has been presented in recent months that raises any concerns about the safety of the COVID-19 vaccines,” the health department said. “We are assessing the situation together with NYS, other colleagues and experts from around the country. We will issue updated guidance regarding COVID-19 vaccination in the upcoming weeks.”
Danielle DeSouza, a spokesperson for the state health department, said the agency is still reviewing the latest federal guidance.
Doctors are also still sifting through the changing federal regulations on COVID shots, which are now out of line with recommendations from prominent medical groups such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. Some parents in the city say they are adamant about immunizing their kids against COVID but are struggling to get clear answers from their pediatricians about whether they’ll be able to get the shots this year.
Brooklynite Emily Hoffman said the question of whether the shots will be available has been a hot topic in parent group chats. She is seeking a COVID shot for her 3-year-old.
“ She is in preschool, so she has a lot of exposure to COVID and other illnesses, which not only puts her at risk of getting sick but puts my husband and I at risk of getting sick as well,” Hoffman said.
Hoffman shared a screenshot of an online chat she had with the pediatric group Tribeca Pediatrics, which has locations across the city. Hoffman asked if the COVID vaccine would be available to all children whose parents want them to get it and was told, “We are awaiting final recommendations from ACIP.”
Gothamist reviewed messages from Tribeca Pediatrics to another Brooklyn parent saying the shots will only be available to patients who are immunocompromised.
Tribeca Pediatrics did not respond to a request for comment.
Even doctors who want to offer the shots to a broader swath of patients face the question of whether those shots will be covered by insurance.
“We’re all kind of in a state of limbo right now,” said Dr. Jessica Sessions, a pediatrician and medical director at the Ryan Chelsea-Clinton Community Health Center in Manhattan.
Dr. Philippa Gordon, a recently retired pediatrician, said doctors are unlikely to order a large supply of the shots if they’re not sure they will get reimbursed for administering them.
“Nobody wants to be in the position of saying to patients, ‘you can have it, but you have to pay for it,’” she said.
Leslie Moran, a spokesperson for the New York Health Plan Association, said insurers are also still figuring out what their coverage will look like. Some plans have indicated they are maintaining the status quo on their coverage policies, while others are still reviewing the situation as it develops, Moran said.
According to the CDC, about 15% of New York kids were up-to-date on their COVID shots as of April, similar to the previous year.
But the American Academy of Pediatrics issued updated guidance last month categorizing children between six months and two years old as “high risk” for severe COVID and recommending they stay up-to-date on their shots. The group also recommended COVID shots for older children who are at higher risk or live with people who are, and for any child whose parent wants them to get vaccinated
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