Ohio public health leaders concerned about COVID-19 vaccine recommendations, expected this week

By Lauren Cohen

Statehouse Reporting Project

After the updated COVID-19 vaccine was approved Aug. 27, many Americans were left confused as to who is eligible to receive it. The Centers for Disease Control and Prevention has yet to issue a final recommendation for who should get the vaccine due to disarray within the Advisory Committee on Immunization Practices (ACIP).

The committee’s next meeting is today and Friday, during which they are expected to make an official recommendation to the CDC for who should get the vaccine and when.

Currently, FDA approval for the vaccine applies to people 65 and older and those who are at high risk of severe infection. The current vaccine is the same as last year’s.

Many doctors are concerned that the committee will make a narrow recommendation for who should receive the COVID-19 vaccine. The committee was disbanded and reconstituted this past June by the U.S. Department of Health and Human Services. HHS Secretary Robert F. Kennedy Jr. said it was an effort to restore public trust.

“The people who currently staff the ACIP have previously been on record as being less than enthusiastic either specifically about the COVID vaccine or vaccines in general,” said Amy Edwards, president-elect of the Infectious Diseases Society of Ohio and pediatric infectious diseases doctor.

Many experts have expressed concern about the effect the new committee will have on public health.

Edwards said even though the meeting will occur during a time of confusion about eligibility for the COVID-19 vaccine, she doesn’t believe much of it will be cleared up.

“The system is no longer built for … doing what’s best for the public. That’s not what this is about at all anymore,” she said. 

Edwards hopes the committee will push back against the FDA’s limited approval, but she believes they will either toe the FDA line or further restrict vaccine access.

Carl Fichtenbaum, president of the Infectious Diseases Society of Ohio and an infectious diseases doctor, said he anticipates the committee will continue the recommendation for people who are 65 and over and those who are at high risk of severe infection.

He does not believe they will recommend routine vaccination for most children without significant chronic illness or for pregnant women.

He hopes the meeting is transparent, open and that decisions are based on data and public health implications.

“This particular health problem has been very politicized and has been used as a discussion point that somehow is dividing our society, and that’s very unfortunate, because I think the health of a society really is not something that we want to argue about from a political perspective,” Fichtenbaum said. “Having these arguments is really setting back our public health.”

Consequences of a limited recommendation

Fichtenbaum said providers and pharmacists may refuse to administer the vaccine to people for whom it is not explicitly recommended, which is within their rights to do.

Even if people can get the vaccine off-label, it is unclear whether insurance would cover it, as most companies use CDC recommendations to determine how they will cover vaccines.

“What’ll happen is, once again, like many other problems in our society, those people with means who can afford it will get vaccinated and those people who live on the margins — who don’t have the wherewithal — will be the ones who don’t,” Fichtenbaum said.

According to CVS’s website, without insurance, the COVID-19 vaccine could cost $224.99 or $249.99, based on product type and eligibility.

During a three-month survey the CDC conducted in 2024, 71.5% of updated COVID-19 vaccinations were administered in pharmacies. 

CVS, Walgreens and other pharmacy chains have also recently shifted their policies to require a prescription to get an updated COVID-19 shot in some states.

In a statement, CVS said it’s waiting for guidance from the ACIP — which could come this week.

“Once ACIP acts on the updated COVID-19 vaccines or states take additional action to authorize pharmacy dispensing prior to ACIP recommendations, we’ll be able to offer the FDA-approved COVID-19 vaccines — without a prescription — in the remaining states,” it read.

The CDC is also responsible for buying vaccinations for the Vaccines for Children Program, which is how some children and pediatric offices — especially those that serve lower-income families — get their vaccines.

If these offices and public health departments do not receive COVID-19 vaccines under the program, people with limited financial means may not be able to get vaccinated.

The issue of availability may also arise. Edwards said last winter, many pediatric offices did not carry the vaccine because they lost money on it due to its storage needs and the low number of children who received it. 

In general, COVID-19 has settled into a summer and winter surge pattern. If there ends up being a limited recommendation for who can get the vaccine, Edwards said it could lead to a larger winter surge.

“We don’t know what kind of winter we’re facing, and we’re facing that winter with even more uncertainty around the vaccine, which is just not a great way to do things,” she said.

Alternative recommendations

In place of an official recommendation, organizations like the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have released their own. Edwards said the Infectious Diseases Society of America is working closely with these associations to base its own recommendation on science, public health and what is best for everybody.

Health officials in California, Oregon and Washington have formed a new West Coast Health Alliance to provide “evidence-based, unified recommendations to their residents regarding who should receive immunizations and to help ensure the public has access and credible information for confidence in vaccine safety and efficacy,” according to a Sept. 3 statement from California Gov. Gavin Newsom.

Fichtenbaum worries that the politics of different states could lead to further politicization of health care. He said he believes it would be reasonable for medical societies to come together with joint guidelines based on science.

“None of us lives alone by ourselves; we live together in a collective society,” he said. “People should not make arbitrary decisions to not take a vaccine based upon beliefs that may not be grounded in science and public health, and then to risk the health of other people because of their choice.”

Lauren Cohen is a reporter for Kent State NewsLab. This story was co-published with the Statehouse Reporting Project, a nationwide collaborative based at the University of Missouri.