New York is proactively expanding access to COVID-19 vaccines as a federal advisory committee prepares to meet and discuss new recommendations. The federal Advisory Committee on Immunization Practices (ACIP) is set to convene on September 15, 2023, to vote on guidelines that could significantly impact vaccine availability and insurance coverage in the state. Historically, these recommendations dictate which vaccines are offered in pharmacies and covered by health plans. However, the release of these guidelines is delayed this year, following the U.S. Food and Drug Administration’s approval of updated vaccine formulations.
In response to this uncertainty, New York Governor Kathy Hochul issued an executive order on September 5, enabling pharmacies to administer the COVID-19 vaccine to anyone aged three and older. The state and city health departments, along with a new regional public health coalition, have indicated that the vaccine is recommended for a broad patient population beyond the limited groups previously stipulated, such as those over 65 or individuals with specific health conditions.
Vaccination Efforts Underway at Pharmacies
Following Governor Hochul’s order, pharmacies in New York City have begun to stock and administer the COVID-19 vaccines. Roger Paganelli, a facilitator for a network of approximately 200 independent pharmacies, noted a surge in eagerness among pharmacy owners to offer the shots. Paganelli, who operates Mt. Carmel Pharmacy in the Bronx, confirmed that they are already administering the vaccines.
Major pharmacy chains like Walgreens and CVS initially required prescriptions for the COVID-19 vaccine but have now clarified that such prescriptions are no longer necessary. Both companies have also updated their online appointment scheduling systems, allowing any eligible patient to receive the vaccine without restrictions related to underlying health conditions.
Doctor’s Offices Adapt to New Guidelines
Access to COVID-19 vaccinations will vary among medical practices. Tribeca Pediatrics, which has multiple locations throughout New York City, had initially limited vaccine access based on ACIP recommendations. However, a recent email to parents indicated that any child could now receive the vaccine, in alignment with guidance from both state authorities and the American Academy of Pediatrics.
In contrast, Essen Health Care, which operates over 35 locations in the Bronx, is expected to adhere more closely to ACIP recommendations. Dr. Binu Kuriakose, medical director at Essen’s urgent care division, mentioned that if the federal guidelines differ significantly from state guidance, they would consult their infectious disease specialists to determine the best course of action.
Insurance coverage for the COVID-19 vaccine is also evolving. Medicaid, governed by state regulations, is mandated to provide broad coverage for the vaccine. Other private insurance plans may still be influenced by the upcoming ACIP guidelines. Nevertheless, Dr. James McDonald, New York’s health commissioner, expressed confidence that most health plans are already covering the vaccine. He advised patients to assume that the COVID-19 vaccine will be covered by their insurance, but to verify with their providers if needed.
Leslie Moran, a spokesperson for the New York Health Plan Association, echoed this sentiment, stating that health plans make coverage decisions based on the latest scientific evidence, which includes ACIP data among other sources.
As New York gears up for this year’s COVID-19 vaccination campaign, the state is taking significant steps to ensure that vaccines are accessible to all eligible residents, irrespective of the federal advisory committee’s delayed recommendations.