With fall approaching, Sacramento residents are saying goodbye to an unusually chilly summer filled with festivals, sporting events and lots of socializing, all of which has factored into the recent increase in COVID-19 infections.
But for the first time since COVID-19 vaccines came on the market, the U.S. Food and Drug Administration on Aug. 27 changed eligibility criteria on who can get the shot.
In response, California, Oregon, Washington and Hawaii are seeking to create their own implementation guidelines through the West Coast Health Alliance formed on Sept. 3.
The California Department of Public Health is still recommending that anyone who is six months of age or older and wants the shot should be able to get the shot. But whether or not national insurers will cover it is also a question.
Sacramento Public Health Manager Rachael Allen confirmed that this change has been confusing. As of this week, she said county health officials are in a wait and see mode.
“ We look forward to some future announcements from the West Coast Health Alliance that would hopefully give Californians and Sacramento County residents more confidence in their ability to be vaccinated,” she said.
CapRadio sought the opinion of experts, hospitals and pharmacies to get a better idea of where things stand right now and what that means for people who want to get vaccinated.
Who is officially eligible for the new COVID-19 Vaccine?
The FDA approved new vaccines designed to fight Covid strain LP.8.1– nicknamed Stratus– for those over the age of 65 or between the ages of 5 and 64 that have one or more underlying conditions that would make them more vulnerable to previous infection.
According to the Centers for Disease Control, these include illnesses like cancer, chronic kidney disease, chronic lung disease, diabetes and HIV. The CDC also recommends vaccines for those who are considered overweight, have attention deficit disorder or those who smoke.
UC Berkeley Infectious Disease Expert John Swartzburg told CapRadio this is a shift from the way the COVID vaccine has been distributed in previous years, where the federal government has recommended anyone 6 months or older be eligible for vaccination.
“ The first time since the vaccine's been available, we're restricting who can get it,” he said.
Why is this change happening?
The Trump administration has made some drastic changes to the CDC. Those changes will continue to impact who gets the vaccine and how fast.
Swartzburg explained that, historically, the CDC has remained nonpartisan. He said their recommendations to the American people have been based on the Advisory Committee on Immunization Practices (ACIP).
This has not been the case in 2025. At the beginning of the summer, Health and Human Services Secretary Robert F. Kennedy Jr. completely overhauled the advisory body to the CDC by removing its previous members and appointing known vaccine skeptics.
Leadership shake ups have also caused a stir within federal agencies. At the end of August, the Trump administration removed CDC Director Susan Monarez. All the while, four senior staff resigned, according to reporting by AP News.
Swartzberg said these events have led to a slower vaccine roll out, and new guidelines.
“ Normally we know from the CDC and the ACIP, not only that the COVID vaccine is recommended, but who should get it and when they should get it,” he said. “We know this by June and a ACIP has not yet even met.”
What if you don’t fall into that group and want to get vaccinated?
Those outside the FDA eligibility requirements in California may be able to get the vaccine depending on who their primary care provider is and their insurance.
Spokesperson for Kaiser Permanente Jordan Scott said the medical institution is staying consistent with California recommendations and allowing those six months or older to get the shot when it arrives at facilities September 15.
“Kaiser Permanente’s administration of the COVID-19 vaccine is based on the latest scientific evidence and clinical guidance from our physician experts and many other sources, including leading medical societies,” he said.
Major pharmacies, in particular CVS and Walgreens, said they are administering the new COVID-19 vaccine now in compliance with FDA rules, but are allowing people to self-attest to having a preexisting condition — no proof needed.
UC San Francisco Law Professor and Vaccine expert Dorit Riesse said that this is a bit of a loophole.
“It's a way around that. It's a way for CVS to give the vaccine to anyone who says yes,” she said. “The reason they're doing it is because of California law, not because of the FDA.”
Will that change?
Most likely.
In the case of California, state leadership has teamed up with Oregon, Washington, and Hawaii to give their own independent recommendations on any vaccine approved by the FDA through the West Coast Health Alliance.
The goal of the alliance is for the states to administer their own health and vaccine policy as a way to give residents “consistent, science-based recommendations they can rely on — regardless of shifting federal actions.”
Swartzburg clarified that states have the power to administer vaccines as they see fit, but historically they have taken cues from the Center for Disease Control.
He said that the alliance highlights a mistrust in the federal government’s decisions around disease management.
“ The message is that Californians, Oregonians, and Washingtonians along with Hawaiians cannot trust the CDC and that's just a tragic thing to say,” he said.
What about health insurance? Will the COVID-19 vaccine be covered?
It’s complicated.
According to UC San Francisco Law Professor and vaccine expert Dorit Reiss, insurers will most likely cover costs surrounding the COVID-19 vaccine, and the West Coast Health Alliance will play an important role in this.
She explained that the alliance shows national health insurers there is a united front.
“ Insurers are a lot more likely to play along, even if they're national. Insurers might say, ‘we really don't want to lose all these three states for good reasons’,” Riess said. “The Alliance gives more political power against insurers.”
Reiss noted that for insurers, covering the cost of treating a serious COVID-19 infection is more expensive than providing vaccinations.
That being said, those on government provided health plans such as Medicaid may run into issues. Federal health plans are often bound by FDA guidelines, and so people who aren’t eligible by that criteria may have a difficult time getting it.
“Unless California steps in and covers through its own medical, people on Medicaid might find themself out of luck if ACIP next week makes a different recommendation.”
Riess said the average cost for an out-of-pocket COVID-19 vaccination is $150.
When will we have more clarity?
The next few weeks will be telling for vaccine accessibility across the country and state.
The ACIP is meeting next week on September 18 and 19. The panel will then take their recommendations to the CDC, which will issue its recommendation for the country.
The West Coast Health Alliance said it will “finalize shared principles to strengthen public confidence in vaccines and in public health” in the coming weeks.
California is also looking at future legislation with bill SB 144 that would give it more control in telling pharmacies how to administer vaccines.
As the American people wait for more clarity, Riess emphasized that each person’s situation will differ depending on where they live and who insures them, so it is important to go to a trusted physician or medical institution for guidance.
“It really is going to vary by person,” she said.
