PROVIDENCE, R.I. (WPRI) — After the Food and Drug Administration recommended restrictions on the new COVID-19 booster shot that deviate from health experts, states are having to decide for themselves if they will require insurance companies to cover the new vaccine for healthy adults.
The FDA guidance released in late August only recommends the new booster for people 65 and older and adults with health conditions, deviating from the American Academy of Pediatrics on vaccine guidance for the first time in 30 years.
BACKGROUND: FDA approves updated COVID-19 shots but limits access for some kids and adults
While Massachusetts Governor Maura Healey announced a flurry of statewide orders requiring insurance companies to cover vaccines, Rhode Island Governor Dan McKee said he’s working with the Department of Health to see if current state regulations will do the same thing.
“We already have a statute that empowers pharmacies to provide shots,” McKee said Friday.
LAST WEEK: McKee meets with RI Health Dept. about vaccine access
But Shamus Durac, a health policy expert for RIPIN, warns that the current state law has its limits.
“Rhode Island state law only applies to about half of Rhode Islanders when it comes to health insurance,” Durac said.
Among the half whose insurance is not governed by state law: Rhode Islanders who work for large out-of-state companies.
So far, only the FDA has put out its guidance. However, Durac said, Rhode Island law and health insurance companies both base their coverage decisions on the Centers for Disease Control and Prevention’s final decision, which is expected to come out next week.
While the current debate concerns the upcoming COVID-19 vaccine, Dr. Eugenio Fernandez at Providence’s Asthenis Pharmacy told 12 News many pharmacies still have the 2024-2025 COVID-19 booster available.
“If someone still needs to get it, they can come in and get that vaccine, assuming they’re over 12 years of age,” he said. “They can still get it until the 2025-2026 [booster] is available.”
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