When U.S. Health Secretary Robert F. Kennedy Jr. testified before the Senate Finance Committee on Sept. 4, several senators criticized him for restricting the COVID-19 vaccine after promising in November he wouldn’t “take away anybody’s vaccines.”
“Did you hold up a big sign saying that you were lying when you said that?” Sen. Elizabeth Warren, D-Mass., asked Kennedy.
On Aug. 27, the U.S. Food and Drug Administration updated its COVID-19 vaccine guidancelimiting the groups of people approved to get the updated shot to anyone age 65 and older and any person 6 months and older who has at least one underlying health condition that increases their risk of severe COVID-19 infection.
Kennedy pushed back, “Anybody can get the booster,” he said, later adding that “it’s not recommended for healthy people.”
Warren said, “If you don’t recommend, then the consequence of that in many states is that you can’t walk into a pharmacy and get one. It means insurance companies don’t have to cover the $200 or so cost.”
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Warren and Kennedy continued to speak over each other debating the vaccine’s availability.
“It depends on the states,” Kennedy said. “But they can still get it. Everybody can get it. Everybody can get it, senator.”
Asked for evidence, the Health and Human Services Department pointed us to an Aug. 27 X post from Kennedy that said, “These vaccines are available for all patients who choose them after consulting with their doctors.”
Kennedy’s blanket statement to senators is misleading and premature.
Under current guidance, healthy people under 65 years old might need a doctor’s prescription to get the shot. If they successfully get a prescription, they may need to pay out of pocket.
Further, whether the vaccine is available at pharmacies and covered by insurance is largely dependent on a vaccine panel that has so far issued no recommendations.
What was the status quo for years — that the majority of Americans, regardless of age, could easily make an appointment at their local pharmacy for the vaccine at little to no out-of-pocket cost — is no longer guaranteed in the 2025-26 season.
FDA limited COVID-19 vaccine approval, CDC has yet to issue guidance
The FDA’s approval is not the only step in the process of making vaccines available to the public.
The Advisory Committee on Immunization Practices, a panel of independent experts that guides vaccine policy, has not voted on or issued current guidance. Typically, the Centers for Disease Control and Prevention recommends vaccines based on the panel’s guidance.
And that guidance affects insurance coverage and vaccine access. Federal law requires that most health insurance plans fully cover vaccines recommended by the CDC. Some states also require these recommendations before they allow vaccines to be offered over-the-counter at pharmacies.
On June 9, Kennedy fired all 17 members of the CDC’s immunization advisory committee and replaced some with new members, many of whom have expressed antivaccine views. CDC Director Susan Monarez was fired Aug. 27 over what Monarez described as a dispute about vaccine policy.
According to the CDC’s website, the advisory panel is scheduled to meet Sept. 18 to 19.
Whether people in FDA-approved groups can get the vaccine over the counter depends on the state
People in the FDA-approved groups should be able to schedule vaccinations as soon as authorized health care providers receive it, likely in the next few weeks.
Even if you are in these approved groups, where you can get the COVID-19 vaccine varies by state. By law, pharmacies in certain states won’t be able to offer the vaccine or will only administer it with a doctor’s prescription until the CDC’s vaccine advisory panel issues its recommendations.
That means even though the FDA has issued its approval for some groups, in 18 states and Washington D.C., “pharmacists cannot administer it because it isn’t on the CDC immunization schedule yet,” Brigid Groves, American Pharmacists Association vice president of professional affairs, previously told PolitiFact.
As of Sept. 4, the scheduling apps for Walgreens and CVS notified patients in some locations that they could not schedule a COVID-19 vaccine appointment because of state restrictions, inventory or the need for a prescription.
People not in FDA-approved categories may require off-label prescriptions
People who are not in the FDA’s approved group are not banned from getting the COVID-19 vaccine, per se. But accessing the vaccine will likely require navigating some barriers.
Doctors can legally prescribe a COVID-19 vaccine for people who fall outside the FDA categories.
That’s true for adults and children — and the practice of prescribing medications and vaccines for “off-label” use is fairly common in pediatrics, Dr. William Schaffner, Vanderbilt University Medical Center professor of infectious diseases, previously told PolitiFact.
That requires making and paying for a doctor’s appointment, and finding a doctor willing to prescribe it off-label.
Depending on ACIP’s guidance, pharmacists might be able to vaccinate people not in an FDA-approved group through a process called “shared clinical decision making.”
That means, for example, “If you were 52 years old and otherwise healthy, but you nonetheless wanted to get the vaccine, you could discuss that with your doctor — shared clinical decision making — and you could receive the vaccine,” Schaffner said.
Pharmacists are considered clinicians who can conduct that shared decision making, Groves said.
But again, without CDC recommendations, “We don’t know if that provision is still there,” Schaffner said.
Vaccine insurance coverage is dependent on CDC guidance that is not yet available
Insurance coverage for the vaccine is still up in the air, too, and will largely depend on what the CDC recommends.
Insurance coverage is more probable for people in an FDA-approved category. But, if the CDC recommendations include giving vaccines to healthy people through the shared clinical decision making process, insurance companies will generally honor that, Schaffner said.
COVID-19 vaccines cost about $142, according to the CDC’s price lists. It’s unclear whether that would be the out-of-pocket cost for patients receiving a COVID-19 vaccine not covered by insurance.
Our ruling
Kennedy said “everybody can get” the COVID-19 vaccine.
The FDA limited the groups of people who are eligible for the COVID-19 vaccine, which has already diminished the shot’s drugstore availability in some states. People who are not in those groups aren’t banned from getting the shot, but are likely to face additional barriers. For example, people may need a doctor to prescribe the vaccine “off-label,” making the process more challenging and potentially more costly.
Kennedy’s blanket statement also is premature.
A CDC vaccine panel has not issued recommendations for the vaccine. The group’s guidance might affect insurance coverage and over-the-counter access.
The statement contains an element of truth — the vaccine has not been banned and some people are approved to get it. But it ignores critical facts about the barriers others could face accessing and paying for it. We rate it Mostly False.
PolitiFact Staff Writer Madison Czopek contributed to this report.
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