What You Need to Know about the New COVID-19 Booster
On September 12, the U.S. Centers for Disease Control and Prevention (CDC) Committee on Immunization Practices recommended a new COVID-19 booster to protect individuals against variants currently circulating across the nation. The updated mRNA vaccines, manufactured by ModernaTX Inc. and Pfizer Inc., include a monovalent (single) component that corresponds to the latest Omicron variant.
A day prior, the U.S. Food and Drug Administration approved the following recommendations for use of the new vaccine to prevent hospitalizations and deaths resulting from COVID-19.
Individuals 5 years of age and older regardless of previous vaccination are eligible to receive a single dose of an updated mRNA COVID-19 vaccine at least 2 months since the last dose of any COVID-19 vaccine.
Individuals 6 months through 4 years of age who have previously been vaccinated against COVID-19 are eligible to receive one or two doses of an updated mRNA COVID-19 vaccine (timing and number of doses to administer depends on the previous COVID-19 vaccine received).
Unvaccinated individuals 6 months through 4 years of age are eligible to receive three doses of the updated authorized Pfizer-BioNTech COVID-19 Vaccine or two doses of the updated authorized Moderna COVID-19 Vaccine.
According to KFF Health News, the CDC advises that everyone over 6 months old should be vaccinated for the broader benefit of all. Those at highest risk of serious disease include babies and toddlers, the elderly, pregnant women, and people with chronic health conditions including obesity.
The vaccines are expected to provide good protection against COVID-19, but may need to be updated annually as is done for the seasonal influenza vaccine. While the boosters may prevent infection in most people for only a few months, they can also slow spread of the disease to the vulnerable, whose immune systems may be too weak to generate a good response to the vaccine.
This marks the first time that COVID-19 vaccines have been commercialized, which means they have transitioned to the commercial market for their manufacturing, procurement and pricing. Previously, the federal government purchased all COVID-19 vaccines and provided them free of charge to anyone, regardless of insurance coverage or ability to pay.
The commercial price being charged by Pfizer and Moderna is $115 to $128 per dose, respectively, about three-to-four times higher than the price paid for by the federal government. In addition to the cost of the vaccine, there may be a cost associated with administering the vaccine and/or the cost of a provider visit.
Who is now paying for the vaccines? When the CDC recommends a vaccine for children, the government is legally obligated to guarantee them free coverage. The same holds true for commercial insurance coverage of adult vaccines. Due to provisions of the Affordable Care Act, COVID-19 vaccines will continue to be free of charge to virtually everyone with private and public insurance coverage.
However, for 25 to 30 million uninsured adults, the federal government created the Bridge Access Program. It will pay for rural and community health centers – as well as Walgreens, CVS and some independent pharmacies – to provide COVID shots for free. Manufacturers also have agreed to donate some of the doses. Unlike earlier in the pandemic, mandates for the booster are highly unlikely.
For more information on insurance coverage rules by insurance type and for people who are uninsured, please click here.
Pacific Federal is a Zenith American company and subsidiary of Harbour Benefit Holdings, Inc.
