Demand is high for coronavirus vaccinations this fall that offer protection against the circulating Omicron variant. However, there were some distribution problems.
Rogelio V. Solis/AP
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Rogelio V. Solis/AP
Demand is high for coronavirus vaccinations this fall that offer protection against the circulating Omicron variant. However, there were some distribution problems.
Rogelio V. Solis/AP
When federal health officials recommended the next round of coronavirus booster shots for people 6 months and older, the doses were supposed to be readily available at pharmacies. But after two weeks, consumers are reporting problems. Some stores may not have doses available yet or insurance coverage may not be easy for some people.
“This rollout faces several obstacles,” said Jennifer Kates, senior vice president and director of the Global Health and HIV Policy Program at the Kaiser Family Foundation (KFF). “On the one hand, this was partly expected, but it seems to be a little more confusing than expected.
Cates himself was trying to get vaccinated at a pharmacy this week, but his appointment was canceled. She went inside anyway.
“A very kind pharmacist said, ‘Well, we don’t have enough supply. We don’t have enough, and they’re still making us make appointments,'” Kates says.
There is a lot of demand for shots.Approximately half of U.S. adults plan to receive a coronavirus vaccine this fall Survey on Wednesday Two-thirds of those from KFF are seniors. This is much higher than last year’s bivalent booster intake – Approximately 17% of Americans Got them.
And while vaccine manufacturers say there are enough doses available, the problem appears to be distribution, Cates said. Unlike last year, when the federal government purchased vaccines and provided them free to consumers, this year pharmacies were required to purchase vaccines from suppliers.
“This is the first time a vaccine has been commercialized. The procurement, supply and payment for the vaccine is mostly done in the private sector. So this is like the health system as we know it.” Cates says.
Issues also include insurance coverage. Since the government no longer provides vaccinations for free, most people must use their health insurance to pay for the vaccination. (The federal government is making the vaccine free only to the uninsured through a temporary program. A program called Bridge Access.)
People who are insured, whether they have private insurance through their job or government-provided insurance such as Medicare. It should be free with no out-of-pocket costs or fees.
But KFF’s Kates said it appears insurers have either missed the memo or been “slow in preparing their systems to make the process easier for consumers.” For example, her colleague tried to get vaccinated at a pharmacy that was out of her plan’s network, but her insurance company refused to cover it. “This actually violates federal law and regulations,” she says.
Kates said if a plan doesn’t have a pharmacy in its network that has the vaccine, the insurance company is supposed to cover it even if it’s out of network.
The situation is also a headache for pharmacies, says John Beckner. John Beckner is the senior director of strategic initiatives for the National Association of Community Pharmacists, which represents many independent pharmacies in rural and urban underserved areas.
Beckner said some pharmacies are facing problems with insurance companies not reimbursing vaccines. This is likely because many health plans have not updated their systems to reflect new rules regarding vaccines now that the public health emergency is over and the federal government no longer pays for vaccines.
Insurance plans only had to reimburse pharmacies for administering the vaccine, not the vaccine product itself. “I don’t think health plans have done a good job of updating their systems to prepare for the vaccine rollout,” he says.
Beckner said pharmacies often distribute vaccines to consumers even though these issues have not yet been resolved. “The pharmacy will be held back on that money until this problem is corrected.”
american health insurance planIn a statement to NPR, an industry group for health insurance plans said insurers are covering the coronavirus vaccine and working with pharmacies, governments and others to ensure consumers don’t have to cover any costs.
Pien Huang contributed to this report.
