New York Gov. Kathy Hochul will sign an executive order that allows pharmacists to administer COVID-19 vaccines “to New Yorkers who request them,” the governor’s office said Thursday evening, a sharp divergence from the Trump administration’s limits on vaccinations.
The announcement occurred as Robert F. Kennedy Jr., the nation’s top health official, faced withering questions from Republican and Democratic senators on Capitol Hill Thursday on reduced access to vaccines, and as other Democratic-run states also made moves to counter federal vaccine policies.
The Food and Drug Administration on Aug. 27 approved updated COVID-19 vaccines but only for Americans 65 and older, and younger adults and children with health conditions that put them at higher risk for severe COVID-19. Previously, the federal government recommended the vaccine for anyone at least 6 months old.
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices plans to meet Sept. 18-19 to determine which groups to recommend for COVID-19 vaccinations. The decision is key in determining who can receive insurance coverage for the vaccine and whether patients will need to obtain a physician’s prescription for the shot or can simply go to their neighborhood pharmacy. Hochul’s executive order will allow New Yorkers to get the updated vaccine from pharmacists, as they have for the nearly five years that previous versions of the vaccine have been available.
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New York Gov. Kathy Hochul will sign an executive order that allows pharmacists to administer COVID-19 vaccines “to New Yorkers who request them,” the governor’s office said Thursday evening.
The move is the latest from a Democratic-run state to counter the Trump administration’s limits on vaccinations. The Food and Drug Administration now recommends vaccines only for people 65 and older and those with certain medical conditions.
Until the order is signed, a prescription from a doctor or other provider is necessary. But there has been confusion about whether a pharmacist could administer a vaccine even with a prescription.
“The governor will sign an executive order allowing pharmacists to prescribe and administer Covid vaccines to New Yorkers who request them,” Hochul spokeswoman Avery Cohen said in an email.
When told about Hochul’s plan, the chairman of the Pharmacists Society of the State of New York, Danny Dang, called it “phenomenal” and praised the governor, who he said “stands up for patients.”
Cohen did not say when the order would be signed, but she said that “in the absence of federal leadership, the Governor is firmly committed to protecting New Yorkers’ access to immunization so they can get the care they need from trusted providers in their own communities. We are reviewing all existing laws and regulations to ensure that right is not impeded by an increasingly politicized CDC.”
Department of Health and Human Services spokesman Andrew Nixon, in a statement to The Associated Press on Wednesday, said the CDC would “ensure policy is based on rigorous evidence and Gold Standard Science, not the failed politics of the pandemic.”
Dr. Christine Doucet, who owns Patchogue Family Medical Care, said Thursday that her office had been receiving calls from patients worried they won’t be able to get the updated COVID-19 vaccine. Most of them were over 65.
“They are freaking out about not being able to get the vaccine at the pharmacy without a prescription,” said Doucet, president of the New York State Academy of Family Physicians and former president of the Suffolk County Medical Society.
“It’s a disaster,” Doucet said of the confusion surrounding administration of the updated COVID-19 vaccine. “Normally a patient would just make an appointment, walk into a pharmacy and get it done. The work now is quadruple of what we would normally do.”
Dang, owner of a Manhattan pharmacy, said his interpretation of current regulations is that a patient first must obtain a prescription from a provider, get the vaccine from a pharmacy and then return to the doctor or other provider for administration of the vaccine.
“The patient has to do three trips,” something none of his customers were willing to do, he said.
The nation’s two largest pharmacy chains, CVS and Walgreens, had said anyone seeking an updated COVID-19 vaccination could get one at a pharmacy with a prescription. State officials on Tuesday acknowledged the confusion and said they were putting together guidance.
Uncertain vaccine costs
Patients also are waiting to know whether insurance will pay for vaccines, Dang said. A typical pharmacy administration cost is about $185, he said.
Hochul’s office did not say whether the state is planning to require insurers to cover COVID-19 shots for anyone who requests them. Jin Yung Bae, a clinical associate professor of public health policy and management at New York University and an expert in public health law, said it can legally do so.
“States can require private insurance companies to mandate benefit coverage that goes beyond federal requirements,” she said in an email.
The Affordable Care Act requires coverage with no co-pays or other costs to people in CDC-recommended groups. But Kennedy fired all advisory committee members and picked their successors, who include vaccine skeptics, and he fired the CDC director. The advisory committee is expected to limit who it recommends receive the vaccine.
Even so, before ACA, some insurers paid for certain vaccines, others did not, and others paid for some of the cost, so “we should not take it as a sure thing that insurers themselves will pull back on their coverage simply because of a changing ACIP recommendation,” said Jason Schwartz, an associate professor of health policy and management at Yale University and an expert on vaccine law.
“Aside from insurers seeing vaccines as a good thing to do,” insurers generally see vaccines as “a really cost-effective tool” to prevent severe illnesses that would be expensive to treat, he said.
States pushing back
In the past, states generally followed ACIP guidelines, but that has changed in recent weeks. California, Washington and Oregon said Wednesday they would make their own recommendations on vaccines after their governors complained of what they called the politicization of the CDC. Massachusetts Thursday said it would require insurance coverage for state-recommended vaccines, and on Wednesday it issued an order allowing pharmacists to administer vaccines to anyone 5 and older. Other Democratic-run states such as Pennsylvania and Colorado also are allowing pharmacists to provide vaccines without prescriptions.
Nixon responded to the moves with a statement that said, “Democrat-run states that pushed unscientific school lockdowns, toddler mask mandates, and draconian vaccine passports during the COVID era completely eroded the American people’s trust in public health agencies.”
Schwartz said for decades, the states and federal government were in sync on vaccine policy. But as the federal government relies less on scientific expertise to establish vaccine policy, and states distrust recommendations coming out of Washington, “that partnership clearly is deteriorated,” he said. “Our vaccination system works best when there’s coordination and clarity regarding what we know, and how best folks can protect themselves and their communities.”