Questions about eligibility and insurance coverage lack clear answers, but the Washington Department of Health still recommends COVID boosters for everyone.

PORTLAND, Ore. — Local health care authorities, providers and patients have all been left with unanswered questions following the U.S. Food and Drug Administration’s announcement of a new and stricter set of recommendations to accompany the latest formulation of the COVID-19 vaccine.

In a post on X on Wednesday, U.S. Health and Human Services Secretary Robert F. Kennedy Jr wrote that “the emergency use authorizations for Covid vaccines, once used to justify broad mandates on the general public during the Biden administration, are now rescinded.”

His post was accompanied by an announcement that although the FDA will approve the 2025-26 versions of the vaccine, it will only officially recommend them for people who are above the age of 65 or who have at least one health condition that puts them at higher risk such as asthma, diabetes, heart disease or cancer.

Previous versions of the vaccines have been recommended for everyone, regardless of health status — the only restrictions were the minimum ages at which patients could receive the shots, which were different for each vaccine manufacturer.

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In the X post, Kennedy said that the vaccines are available for patients who choose them after consulting with their doctors — but local pharmacists and health agencies sounded less certain about that claim.

Daniel Lee, a pharmacist at Fairley’s Pharmacy in Portland, explained how he believes that process will work at the pharmacy going forward.

“Basically, we will have to ask them, ‘Are you at risk of complications from COVID?'” he said. “So, if you are, then we will probably need some documentation in order to get you vaccinated. Most likely, insurance will probably require that as well.”

If someone wants to get the vaccine but doesn’t qualify, Lee said he expects things will get more complicated.

“If the insurance does not cover it because the patient is not eligible for it, then I would have to say… I do have to make sure the patient is eligible to get the vaccine,” he said. “I cannot just override that, so in that case, it will be really hard for patients to get the vaccine if they are not eligible for it, even if they are willing to pay out of pocket for it.”

The new FDA guidance also revokes emergency-use authorization for the Pfizer vaccine for children under the age of 5, meaning they can no longer receive it even if they have a health condition. The Moderna vaccine’s authorization for children under 5 remains in place, but that authorization was already limited to children with at least one health condition.

Oregon Families for Vaccines Director Meg Olson said she believes the FDA’s changes are unnecessarily burdensome.

“They haven’t really clarified what would put you in that (high-risk) category, so it’s just going to cause more confusion until parents don’t know what to do,” she said.

The Washington State Department of Health said it is “carefully reviewing the implications of this FDA development,” but added that it will continue to recommend that everyone 6 months and older stay up to date with the latest COVID vaccine.

“Our goal remains the same: to ensure that vaccine policy, including COVID-19 vaccine recommendations, will be guided by the best available science to support the health and safety of everyone in our state,” the department said in a statement to KGW.

Clark County Public Health offered similar comments and said that it’s not yet clear what the new guidance will mean as far as insurance coverage.

“We don’t yet know if or how the FDA’s changes to eligibility may impact vaccine cost,” the agency said in a statement. “Washington Apple Health (Medicaid) continues to cover the COVID-19 vaccine for members, including children and pregnant individuals, in line with DOH recommendations. We’ve also learned from DOH that while the state Office of the Insurance Commissioner cannot require all health plans to cover COVID-19 vaccines for everyone, many health plans are still expected to provide coverage.”

KGW reached out to the Oregon Health Authority for comment but has not yet received a reply.

The new FDA guidance comes amid massive turmoil at the U.S. Centers for Disease Control and Prevention after the Trump administration declared Wednesday night that it had fired CDC director Susan Monarez, which triggered resignations from other top leaders at the agency — one of whom told the Associated Press that Monarez had clashed with Kennedy about health recommendations including vaccines.

Kennedy was known for his anti-vaccine rhetoric before being appointed HHS secretary, and he’s already made headlines multiple times this year for controversial decisions, including cancelling funding for mRNA vaccine development projects and removing all members of the CDC’s vaccine advisory committee, naming replacements that drew alarm from the American Academy of Pediatrics (AAP) and other medical groups.

The AAP has also publicly clashed with Kennedy over the new FDA guidelines for the COVID vaccines and released its own recommendation that all children receive the shot between the ages of 6 months and 2 years, calling Kennedy’s decision “deeply troubling.” It’s the first time in 30 years that the academy’s guidance has conflicted with the government’s recommendations, according to the Associated Press.