Getting a COVID-19 Booster Shot This Fall

Are you confused about whether to get the latest COVID-19 vaccine this fall? You’re not alone. Recent changes in federal vaccination guidelines have left many people wondering if the shots will be available to them and whether they’ll still be covered by their health plan.

Let’s clear up any confusion: We support the decision to vaccinate for you and for all our members ages 6 months or older get an updated COVID-19 vaccination this fall. Blue Cross VT will cover the COVID-19 vaccine for any member, at no cost to them.

Reasons to Get a Booster

COVID-19 remains a considerable health threat in the U.S., with the number of infections growing or likely growing in 34 states, including Vermont, according to the Centers for Disease Control and Prevention (CDC). COVID-19 cases surged this summer, especially in the West and South. Another wave is expected this winter, when respiratory viruses typically spread quickly.

To avoid getting sick, you should get a COVID-19 booster shot this fall at a pharmacy, clinic, or your healthcare provider’s office. Updated vaccines from several pharmaceutical companies will be available.

“While risk levels vary by individual, emerging data suggest that updated COVID-19 vaccines can reduce the risk of severe illness, missed work or school, and long COVID — even for healthy adults under 65,” says Tom Weigel, MD, Blue Cross VT’s chief medical officer. “For many, staying up to date on vaccination remains a reasonable step heading into respiratory virus season.”

The reasons why you should get a COVID-19 booster include:

• Immunity from previous COVID-19 vaccinations or infections tends to decrease over time. Getting a booster this fall will help your body be ready to fight the virus during the winter.
• New variants of the COVID-19 virus continue to appear. COVID-19 boosters have been updated to give you protection from the strains that are currently circulating.
• If you have a higher risk of COVID-19 infection, such as an underlying health condition, a weakened immune system, or being age 65 or older, getting a booster this fall will provide additional protection.
• If you are in close contact with someone who is at higher risk, such as a person with a chronic health condition like diabetes or lung disease, getting a booster can help reduce the chances of transmitting the virus to them.  

Shifting Federal Policies

Federal policies on who should be immunized against COVID-19 have recently changed in several ways:

• The Food and Drug Administration has only approved the latest COVID-19 vaccines for people ages 65 and older, as well as individuals under 65 who have an underlying health condition that puts them at risk. The CDC lists these conditions that include: asthma, mood disorders, physical inactivity, pregnancy, or obesity. Previously, annual vaccination was recommended for anyone 6 months or older.
• The CDC no longer recommends COVID-19 vaccination for healthy children and healthy pregnant women (although pregnant women are a higher risk group). The CDC’s website now says that “parents of children ages 6 months to 17 years should discuss the benefits of vaccination with a healthcare provider.”
• The CDC’s Advisory Committee on Immunization Practices, at its Sept. 19 meeting, voted to no longer recommend that most adults get the COVID-19 vaccine. Instead, the panel said individuals should decide for themselves whether to get the vaccine.

Several medical groups have announced their opposition to the federal policy changes and issued their own recommendations, including:

• The American Academy of Pediatrics recommends the COVID-19 vaccine for all children ages 6 months through 23 months. Beyond age 2, annual vaccination is recommended for children and teens with health conditions that put them at greater risk. Any parent who wants their child vaccinated should have access to the vaccine, the group says.
• The American College of Obstetricians and Gynecologists continues to recommend that all pregnant and lactating individuals receive an updated COVID-19 vaccine. Vaccination may occur in any trimester.
• The American Academy of Family Physicians still recommends that all adults 18 years and older should receive a COVID-19 vaccine.

State of Vermont Recommendations

The Vermont Department of Health (VDH) recommends the COVID-19 vaccine for anyone (ages 6 months and up) who wants it. VDH encourages individuals at higher risk to get the vaccine, including those age 65 and older or who have underlying health conditions. Children ages 6 months to 23 months old, and people who are pregnant or breastfeeding, should also get the COVID-19 shot, VDH says.

To make it easier for Vermonters to get vaccinated, VDH has issued a standing order that permits Vermont pharmacists to immunize anyone ages 5 years and older for COVID-19. Pharmacies do not need a prescription from another healthcare provider to administer the COVID-19 vaccine.

“These recommendations should make it clear to Vermonters and providers that COVID-19 vaccines are available to all who want and need them,” said Julie Arel, Vermont’s interim health commissioner.

Are COVID-19 Shots Still Covered?

Among people who plan to get a COVID-19 vaccine this fall, 62% are concerned that their health insurance won’t cover it, a recent KFF poll found.

Blue Cross VT members don’t have to worry. All our members can get COVID-19 vaccinations at zero cost. This includes members under age 65 who don’t have a health condition that increases their risk of infection.

“We will cover the COVID-19 vaccine for members younger than 65 without risk factors,” says Dr. Weigel. There is no prior authorization requirement or other restrictions for the vaccine, he adds.

Along with getting the updated COVID-19 shot this fall, we recommend that members get their annual flu shot. You can safely get the flu shot and the COVID-19 vaccine at the same time, and in the same arm, if you wish.

Adults over age 60 should also consider getting vaccinated against respiratory syncytial virus (RSV), which spreads in the fall and winter, typically peaking in December and January. RSV infection can be dangerous for older adults, as it may lead to complications such as bronchiolitis (inflammation of small airways in the lungs) and pneumonia.

Parents should consider getting their infants vaccinated against RSV, which is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age. For more information, check out our blog article on vaccines to consider getting in fall.

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Underlying condition and higher risk for severe COVID-19: