Local medical experts provide clarity on conflicting covid vaccine guidelines in Pennsylvania
After being told over the summer he needed a prescription to get the latest covid booster, A.R. Ravi of Mars sat in a Downtown Pittsburgh building Friday, hoping the Allegheny County Health Department could help.
“We get it every year,” Ravi, a Mars resident, said of the booster. He expressed frustration at the extra time and energy it took to get the shot.
The CVS Pharmacy that turned him away pointed to new federal vaccine guidelines — rules that Pennsylvania medical experts say have left many patients confused.
“We’ve been seeing some confusion,” said Dr. Michael Fiorina, chief medical officer of Independence Health System. “Some of this stems from recommendations that have been accurate historically but have recently been changed by the (Centers for Disease Control and Prevention) … and also the fact that some information that might be accurate in one state may not be accurate in another state.”
Despite recent medical ambivalence, local vaccine providers say, rather than following the CDC’s vaccine model, almost anyone should qualify for a covid booster under Pennsylvania’s alternative guidelines.
Where is the confusion coming from?
Longtime anti-vaxxer Robert F. Kennedy Jr. runs the Department of Health and Human Services, which oversees the Food and Drug Administration and CDC.
In August, the FDA approved covid vaccines with restrictions that limited access to people with certain underlying health conditions that increase severe disease risk or people 65 or older.
“If you’re 6 months to 64 and you’re healthy … there’s no requirement, no recommendation,” Fiorina said.
Instead, the federal government advises the remaining population to consult a doctor, he said.
Before the change, the boosters were available to anyone 6 months and older regardless of their health.
Historically, pharmacists followed the recommendations of the Advisory Committee on Immunization Practices, which is a committee within the CDC that provides advice and guidance on effective control of vaccine-preventable diseases, said John DeJames, president of the Pennsylvania Pharmacists Association.
In September, Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia, said he began receiving emails from patients who did not fit the required age range and were unsure if they could get a booster without a prescription.
“It’s just been confusing. And I think that’s the point. I think RFK Jr.’s goal is to make this all confusing, and he’s done that,” Offit said, then described Kennedy’s decisions as an “anti-vaccine propagandist science denialist takeover.”
On Oct. 1, Gov. Josh Shapiro signed an executive order that Pennsylvania would follow the medical guidelines of the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists, all of which recommend routine immunizations for all children, pregnant women and adults.
This maneuver did not sit well with some federal officials.
“Democrat-led states that imposed unscientific school closures, toddler mask mandates and vaccine passports during the covid era are the ones who destroyed public trust in public health,” Andrew Nixon, spokesman for the U.S. Department of Health and Human Services, said in a statement to TribLive. “Now the same governors who eroded that trust are trying to reinvent public health under the guise of ‘coordination.’ ”
Who can get the vaccine?
Allegheny County Health Department immunization clinics are following the recommendations from the Pennsylvania Department of Health, said Dr. Barbara Nightingale, deputy director for clinical services at the county health department.
Allegheny Health Network is doing the same, said Dr. Amy Crawford-Faucher, chair of the Primary Care Institute. So are Independence Health System and Children’s Hospital of Philadelphia, Fiorina and Offit said.
Nightingale, Crawford-Faucher, Offit and Fiorina all said it is too early in the respiratory-virus season to known if the number of people seeking covid vaccines will be consistent with previous years.
UPMC did not make anyone available for an interview.
“UPMC clinicians can help individual patients determine their eligibility based on their medical history,” a spokesperson said in a statement.
A CVS spokesperson pointed reporters to a CVS Health statement from Oct. 7 that said, “Vaccines are now available to patients at all CVS Pharmacy and MinuteClinic locations nationwide. Prescriptions from outside prescribers are not required in any states.”
CVS did not respond to Ravi’s contention that he was told over the summer he needed a prescription.
Other large pharmacies in the Pittsburgh area are handling things differently.
A Walgreens spokesperson said in a statement the company is offering vaccines to “eligible” individuals age 3 and older without a prescription.
A Giant Eagle Pharmacy spokesperson said in a statement that “according to CDC guidelines, anyone age 6 months and older is eligible to receive the covid vaccine with guidance from a health care professional, including pharmacists.”
It was unclear Friday what qualified people as eligible to get the covid vaccine from Walgreens and Giant Eagle.
DeJames said there are numerous underlying conditions that could qualify someone for the booster.
“Do you smoke? It’s an underlying condition,” DeJames said. “So when you think about all that, you know, no one’s really being told they can’t get a covid shot.”
Ahmad Fahim Rasooli, 22, of Baldwin said he and his whole family first got the covid vaccine when they moved to the United States from Afghanistan in October 2024.
On Friday, Rasooli, his mother and his siblings each filled out a yellow immunization sheet in Pittsburgh to get their second dose of the covid vaccine from the county health department.
Rasooli said he had heard about the new federal guidelines but he and his family figured they would see what happened once they got to the vaccine clinic.
After the Rasooli family waited about a half-hour, an Allegheny County nurse entered the lobby and called the family’s name to come back for their shots.
Is the covid vaccine covered?
Allegheny County immunization clinics offer free vaccines for people who don’t have insurance, Nightingale said.
“So far, nobody has asked me to pay for it,” Ravi said.
Despite concern surrounding coverage for the vaccine, Offit said, the discourse has settled following Pennsylvania’s alternative guidelines. Insurance companies have continued to pay for the vaccine.
DeJames, who has administered somewhere between 4,000 and 5,000 shots this year, said he has not seen the vaccine go uncovered by insurance once.
“Thus far, we’re not hearing about any problems with insurances,” Nightingale said, echoing DeJames and Offit. “So generally here, we always have been able to give covid vaccines for people with insurance, and insurance covers it. And to our knowledge, that is still the case.”
Megan Trotter is a TribLive staff writer. She can be reached at mtrotter@triblive.com.
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