Infectious disease specialists say updated influenza and COVID-19 vaccines will be available this fall and that insurers have said they will cover them, even though the federal committee that normally issues those recommendations has not acted. The assessment was published by CIDRAP News at the University of Minnesota.
William Schaffner, a professor of infectious diseases at Vanderbilt Health and a spokesperson for the Infectious Diseases Society of America, told CIDRAP News that an updated influenza vaccine and an updated COVID vaccine will both be available, and that the medical insurance industry has said it would cover them. Patients will need to roll up a sleeve, he said, but "you won't have to reach for your wallet."
That is a narrower assurance than it may sound. Availability and coverage are being described by clinicians and insurers rather than guaranteed by federal action, and the statements apply to this season.
The Gap Is in Recommendations, Not in Supply
The Food and Drug Administration weighed in on the composition of this season's flu and COVID vaccines in the spring, which is the step that determines what manufacturers produce. That part of the annual process ran on its normal timeline.
What has not happened is the second step. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices has not issued guidance on either vaccine. MedicalDaily previously reported on the missing federal recommendation for this fall's COVID strain, and that gap has not closed.
Schaffner described the committee as being in limbo. In its place, he said, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians are all recommending routine vaccination. The Infectious Diseases Society of America and the Vaccine Integrity Project at the University of Minnesota published a joint recommendation that adults and children with compromised immune systems receive a COVID vaccine, along with an annual flu shot.
James Campbell, chair of the AAP Committee on Infectious Diseases and head of pediatric infectious diseases at the University of Maryland School of Medicine, said everyone six months and older is recommended to receive a flu vaccine. He put flu vaccine efficacy against death at about 80 percent and said the AAP's COVID recommendations for children are coming soon.
Local Health Departments Are Absorbing the Federal Role
City and county agencies have been holding steady while the federal picture is unsettled, and that has direct consequences for where families can get vaccinated.
Michelle Taylor, commissioner of the Baltimore City Health Department, said during a Big Cities Health Coalition press briefing that local and state public health are standing in the gap, and that they know what to do for respiratory virus season because they do it every year. Health departments across the country continue to recommend flu and COVID vaccination in alignment with medical association guidelines.
Supply appears to be moving normally at the practice level. Sean O'Leary, immunization schedule editor for the AAP's Committee on Infectious Diseases, said at the same briefing that primary care practices are ordering vaccines. Many doctors' offices and hospitals have already secured doses for the season.
Campbell said he does not anticipate that insurers, including federal programs, would decline to cover children's vaccines, noting that a vaccine is inexpensive compared with a hospital stay.
The mRNA Flu Shot Requires Asking by Name
The FDA approved Moderna's mFlusiva, the first mRNA flu shot approval, in early August for people aged 50 to 64. Availability is a separate question from approval.
Schaffner said the company has indicated it will begin delivering the vaccine through pharmacies, and that anyone with a particular interest in receiving it should expect to ask for it. Wide availability may take time.
The evidence base has an age boundary worth understanding. Trials compared the mRNA vaccine against a standard-dose flu shot, and the approval covers people up to 64. Schaffner noted that people 65 and older preferentially receive one of the enhanced vaccines, meaning high-dose, adjuvanted, or recombinant products, and that no comparison against those was performed. Those data, he said, will come later.
Nobody in that age group should delay vaccination waiting for the newer product. Getting vaccinated on schedule matters more than which licensed product is used.
What Households Should Confirm Before the Season
Verify coverage with your own plan rather than assuming it. The commitments described by specialists are statements from the insurance industry rather than a federal requirement tied to a current ACIP recommendation. A plan's preventive services list and Summary of Benefits and Coverage are the documents to check.
Families relying on the Vaccines for Children program should ask a pediatrician or local health department directly how the program is operating this season. Uninsured adults can ask a county health department or federally qualified health center about low-cost or no-cost options.
Both viruses mutate every year, which is the reason for annual updates. Schaffner noted that short-term protection against severe disease is reasonably good but begins to wane after a period of months, particularly for people at highest risk. That is the case for repeating vaccination rather than relying on a prior dose.
What remains unresolved is whether the advisory committee resumes issuing recommendations, and what happens to coverage in future seasons if it does not. Guidance from professional societies has not changed. Anyone weighing a vaccination decision for a child, an older relative, or an immunocompromised family member should work through it with a clinician. The CDC vaccines and immunizations pages remain the reference point for existing schedules.
Key Questions Answered
Will updated flu and COVID vaccines be available this fall? Infectious disease specialists say yes. The FDA set this season's vaccine composition in the spring, manufacturers produced accordingly, and primary care practices are reported to be ordering doses.
Will insurance cover them? Specialists say the insurance industry has stated it will cover the vaccines this season. Those statements are not the same as a federal coverage requirement, so verifying with your own plan before an appointment is worthwhile.
What is missing at the federal level? The CDC's Advisory Committee on Immunization Practices has not issued guidance on either vaccine. Its recommendations normally drive insurance coverage requirements and the Vaccines for Children program.
Who is recommending vaccination in the meantime? The American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians, the Infectious Diseases Society of America, and state and local health departments.
Can I get the new mRNA flu shot? It is approved for people 50 to 64 and is expected at pharmacies, but wide availability may take time and patients will likely need to request it specifically.
Should adults 65 and older wait for it? No. The approval does not cover that age group, and enhanced vaccines are preferentially given to older adults. There is no evidence supporting a delay.
What should uninsured households do? Contact a county health department or federally qualified health center about low-cost or no-cost vaccination, and ask about the Vaccines for Children program for eligible children.
