Want a COVID vaccine? Here's how much it could cost you out of pocket

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Want a COVID vaccine? Here's how much it could cost you out of pocket Trump administration COVID-19 vaccine policy changes mean anyone who is healthy and under 65 will likely have to pay out of pocket, including pregnant women.
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RFK Jr. says COVID-19 vaccine no longer recommended for some
The COVID-19 vaccine is no longer recommended for healthy children and pregnant women, HHS Secretary Robert F. Kennedy Jr. says.
Health Secretary Robert F. Kennedy Jr. unilaterally changed COVID-19 vaccine recommendations, limiting recommended vaccination to those over 65 and individuals with pre-existing health conditions.
The changes bypass the usual expert panel review process and may limit insurance coverage for those outside the recommended groups.
Medical experts express concern over the lack of transparency and supporting data for the changes, particularly the removal of recommendations for pregnant women and children.
The decision raises questions about vaccine access and contradicts Kennedy's prior statements on respecting individual medical choices.
Several medical organizations urge insurers to continue covering the vaccine for all, emphasizing the importance of individual choice and protection against severe outcomes.
Most Americans have decided that they're done getting vaccinated against COVID-19, but there are still reasons to consider it, and it remains an essential protection for some.
That's why many doctors and medical organizations are concerned about changes to the vaccine recommendations made single-handedly by Health Secretary Robert F. Kennedy Jr.
Under the changes Kennedy announced in a social media post on May 27 and others announced a week prior by two of his appointees, the only people who will be recommended for COVID-19 vaccines are those over 65 and people with existing health problems.
These changes, which bypassed the normal protocol, will likely make it harder for others who want the COVID-19 vaccine to get it, including healthcare workers and healthy people under 65 with a vulnerable family member or those who want to reduce their short-term risk of infection.
Kennedy specifically changed the recommendations so pregnant women and healthy children aren't included, though it's not clear if that's just for booster shots or whether it would also include a baby's first COVID-19 vaccine.
Insurance coverage typically follows federal recommendations, so anyone who is healthy and under 65 is likely to have to pay out of pocket to get the shot ‒ which runs about $200 ‒ if they can get it.
Recent statement: RFK Jr.: 'I don't think people should be taking medical advice from me'
Limiting access in this way, several medical experts said, contradicts Kennedy's previous statements about how he'd handle vaccines. It also runs counter to the general practice of medicine, which supports people making medical decisions in collaboration with their doctor, they said.
"I think we can treat people respectfully and show them the information and let them make their own decisions," said Dr. Jesse Goodman, a professor of medicine and infectious diseases at Georgetown University.
He and others said they're especially concerned that these policy changes are happening without supporting data or the typical scientific review by two panels of experts.
"We haven't been presented with one shred of information to show that this step is needed at this time," Goodman said. "If it is, fine, but present that publicly, use the advisory committees and let's have a transparent process."
Who still needs a vaccine?
The federal government has stopped tracking COVID-19 infections, hospitalizations and deaths, but local data shows they are still happening in every age group, with two-thirds of hospitalizations in those 65 and up.
Meanwhile, safety data on the vaccines continues to show that serious side effects are extremely rare, leading most specialists and expert organizations to conclude that it's still worthwhile to get the vaccine.
While the vaccine is most important for people in vulnerable groups, such as those over 65 and people with health conditions, a booster remains useful for everyone, even children, several experts and disease organizations told USA TODAY.
"What is clear is that pregnant women, infants and young children are at higher risk of hospitalization from COVID, and the safety of the COVID vaccine has been widely demonstrated," Dr. Sean O'Leary, chair of the American Academy of Pediatrics' Committee on Infectious Diseases, said in a statement.
Should children get the COVID-19 vaccine?
Healthy kids will no longer be recommended for COVID-19 vaccines, according to Kennedy's policy announcement.
Fewer than 5% of children received the COVID-19 vaccine between the fall of 2023 and the fall of 2024, data shows. Yet COVID-19 continues to lead to about as many hospitalizations in children as the flu, at about 100 hospitalizations for every 100,000 kids under 4.
On balance, the vaccine still provides a benefit, said Dr. Melissa Stockwell, division chief of child and adolescent health at Columbia University. "The point of a booster is to give protection against whatever the current circulating variant is and shorter-term protection against infection, but what we're really looking for is protection against severe outcomes," said Stockwell.
The COVID-19 vaccine has repeatedly been found to be safe in children, though every vaccine carries some risk. Most notably with the COVID-19 vaccines, adolescent boys and young men were at somewhat higher risk for a rare heart problem known as myocarditis. But that risk has dropped dramatically since the early days of vaccination when the initial two doses were given relatively close together, Stockwell said.
What remains unclear ‒ and of much higher concern to most pediatricians and infectious disease experts ‒ is whether Kennedy's new policy covers all shots or just boosters. Children between 6 months and 2 years are at high risk for severe COVID-19 because they've not been exposed to it before, just as everyone was at higher risk when the virus was new.
And vaccination, including boosters, reduces the risk for long COVID, in which symptoms can linger for months or even years after a COVID-19 infection. Stockwell, who said she would get boosters for her own children, cited research showing that vaccines reduce the risk of long COVID in children by 60%.
A new study in JAMA Pediatrics shows that children younger than 2 who had been infected with COVID were more likely to experience trouble sleeping, fussiness, poor appetite, a stuffy nose and cough, while preschoolers, aged 3 to 5, who had been infected were more likely to have low energy, daytime tiredness and a dry cough than children who avoided infection.
The study found that roughly 1 in 7 previously infected children meet the criteria for long COVID.
"For parents who want their children to be vaccinated, we want them to have that opportunity," Stockwell said.
Is it risky to skip COVID-19 vaccine during pregnancy?
The new policy removes the recommendation for the COVID-19 vaccination during pregnancy. This concerns a number of obstetricians, infectious disease specialists and pediatricians.
Pregnant women are at high risk for severe disease and studies show that the likelihood of miscarriage, stillbirth and pregnancy complications like preeclampsia, blood clots, heart and kidney damage and hypertension are much higher among women who develop COVID-19 during pregnancy.
Newborns are also at very high risk of severe outcomes from COVID-19. Any respiratory infection is more dangerous in newborns than in others, because their airways are so small. Plus, they have never been exposed to COVID-19 before. Vaccinating during pregnancy protects newborns until they are old enough to get their own shot, Stockwell said.
The COVID-19 vaccine has also been shown to be extremely safe during pregnancy and far safer than a COVID-19 infection.
The Society for Maternal-Fetal Medicine, which has expertise in high-risk pregnancy, issued a statement saying the society "strongly reaffirms its recommendation that pregnant patients receive the COVID-19 vaccine."
The COVID-19 vaccine, the society said, "is safe to be given at any point during pregnancy. Maternal immunization is also associated with improved infant outcomes and decreased complications, including maternal and infant hospitalizations. "
What's the process for changing vaccine recommendations?
Changes to the vaccine schedule are typically made after federal officials solicit recommendations from two panels of experts in infectious disease, pediatrics and other relevant specialties. The heads of the Centers for Disease Control and Prevention and the Food and Drug Administration then review the decisions of their respective panels and issue a joint recommendation.
Kennedy's unilateral decision breaks with this practice. It will likely make many families wonder whether the vaccine is safe.
"It can be confusing to families, particularly when there's conflicting information about vaccination," Stockwell said.
The American Academy of Pediatrics (AAP) also raised concerns about Kennedy's disregard for the normal procedure of changing vaccine recommendations. In his brief comments on social media on May 27, he didn't mention consulting any doctors or panels.
"This decision bypasses a long-established, evidence-based process used to ensure vaccine safety and ignores the expertise of independent medical experts, including members of CDC committees who are examining the evidence regarding the vaccine to make recommendations for the fall," Dr. Sean O'Leary, chair of the AAP Committee on Infectious Diseases, said in a statement.
"By removing the recommendation, the decision could strip families of choice. Those who want to vaccinate may no longer be able to, as the implications for insurance coverage remain unclear," he said.
In the wake of Kennedy's statement, the Infectious Disease Society of America (IDSA) urged insurers to continue to cover the COVID-19 vaccine for everyone, including the groups Kennedy said the government would no longer recommend get the shot.
"IDSA strongly urges insurers to maintain coverage for COVID-19 vaccines so that all Americans can make the best decisions to protect themselves and their families against severe illness, hospitalization and death," society president Dr. Tina Tan said in a statement. "IDSA also urges Congress to conduct meaningful and necessary oversight to ensure appropriate decision-making processes at the Department of Health and Human Services, which will impact people of all ages."
Contributed: Adrianna Rodriguez