‘It’s a mess right now’: RFK’s sweeping changes place new vaccines in limbo
Özet haber: Health secretary’s effort to alter makeup of ACIP panel means no new recommendations coming – even as new vaccines are approved
Health secretary’s effort to alter makeup of ACIP panel means no new recommendations coming – even as new vaccines are approved
US vaccine recommendations are in limbo, access to vaccines is suffering, and some of the uncertainty may continue for years following major blows to vaccination by the Trump administration, experts say.
Robert F Kennedy Jr, the secretary of the US Department of Health and Human Services (HHS), has made sweeping changes to vaccination policy, cutting childhood immunization recommendations by a third and replacing experts on the Advisory Committee on Immunization Practices (ACIP) with his own handpicked allies.
A judge’s order halted these changes because they were not done correctly, but Kennedy has not nominated any new ACIP members – which means there are no new vaccination recommendations coming from the committee, even as new vaccines are approved.
Ron Kroening, 63, has asthma and bad allergies this time of year, so his doctor recommended the new Moderna mRNA flu vaccine, approved by the US Food and Drug Administration (FDA) in August for ages 50 and up. Trials suggest it provides even stronger protection than traditional flu shots.
It took time to locate the one pharmacy in his area that stocked the shot – and then Kroening was shocked to be charged a $40 co-pay.
“I figured that was an error because I’ve never had to pay for a flu shot in my life,” he said. But his insurance company told him it’s because there’s no recommendation from the ACIP, Kroening said: “The reason the mRNA isn’t covered is because it’s not listed as an ACIP vaccine.”
If the ACIP doesn’t recommend the new shot by the end of the year – a scenario experts say is likely – insurers won’t be required to cover it until January 2029 at the earliest.
“This is really a barrier. And any barrier to immunizations is going to keep people from getting them,” said Kroening, a retired public health employee who worked on immunizations at the state level in Oklahoma. “A $40 co-pay is going to turn people off,” he added, noting that his pharmacist also didn’t inform him that there were other flu shot options.
Insurers usually have at least a year after FDA approval to add coverage of a new vaccine to their plans, so a co-pay like Kroening’s isn’t unusual in the first year or so. But the difference now is it’s not clear when the vaccine will be fully covered.
Typically, when a vaccine is approved for a new group of people – either because it’s new to the market or because the approval expanded to include more people – insurers have a year from the recommendation to implement it by the next plan year, which usually starts in January. That means if a vaccine is recommended by ACIP in December 2026, insurers are required to cover it by January 2028. If it’s recommended a month later, in January 2027, then the coverage requirement is pushed to January 2029.
“The legal requirement doesn’t go into effect very quickly. The process takes time,” said Lindsay Wiley, professor of law and faculty director of the Health Law and Policy Program at UCLA Law.
