Why some patients have had their vax appointments canceled and their coverage denied.
The CDC has urged everyone six months and older to get the updated Covid booster, but getting the jab might be a little trickier this time around. Supply delays and confusion over insurance coverage has stymied the release of the new vaccine. Here’s what to know about the booster and its rocky rollout.
The new Covid booster’s rough release
In the two weeks since the Centers for Disease Control approved the newest formulation of the Covid booster, millions of the shots have been shipped across the country. But some people have had their vaccination appointments abruptly canceled, either because of delayed deliveries or because insurers haven’t updated their billing systems to cover the vaccines, while others say they were denied coverage and charged up to $200 for the shot.
What gives? Well, it’s the first time the federal government hasn’t bought and distributed the shots itself, relying instead on the commercial market to get the new formulation to Americans. They still seem to be working out the kinks of the new process, Xavier Becerra, the U.S. health and human services secretary, suggested last week.
“We’ve heard these stories, and we’ve contacted the insurers,” he told the New York Times. “We’ve contacted the pharmacists, and we’re working with them to make sure everyone understands how this works.”
Is the Covid booster covered by insurance?
Anyone with Medicaid, Medicare, or private insurance should have the shot covered without a co-payment. But in order to get the booster at no cost, you’ll have to make sure to find a provider that’s in your insurance network; you can’t just wander into any old pharmacy anymore like you could early on in the pandemic.
Those who don’t have insurance can get the shot for free at pharmacies included in HHS’s Bridge Access Program.
If your coverage does happen to get denied, an HHS representative told the New York Times to “call your insurance for details about in-network coverage to receive the updated Covid-19 vaccine.”
When should you get the Covid booster?
The Centers for Disease Control recommends that Americans get the updated booster ahead of the flu season. The vaccine was designed to target the XBB.1.5 subvariant, which was the dominant strain earlier this year. However, experts also believe it should provide some protection against EG.5, a new variant that’s begun to take hold in the U.S.
This is the first year that a vaccine for Covid, flu, and RSV — the three viruses responsible for the most hospitalizations — are available. The CDC recommends getting a dose of each, but you may want to space the shots out. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, told CBS he’s planning to get the Covid booster right away and the flu shot in early October.
He says leaving a gap of about two weeks could “minimize the chance of interactions, and minimize confusing side effects from one with another.” Although getting all your seasonal inoculations in one go is safe too, Dr. Marks said.
What are the side effects of the new Covid booster?
Experts say the side effects are similar to previous versions of the vaccine. You might experience chills, fever, nausea, headaches, or pain and swelling at the injection site, per the CDC. And some researchers think the reactions may be more mild this time around for folks who have already been vaxxed and boosted.
