It's harder to get a COVID-19 shot right now. But this AZ public health expert says you should

After years of mounting fears of COVID-19 and hopes for a vaccine to prevent it, the Centers for Disease Control and Prevention has reversed course under the leadership of vaccine skeptic Robert F. Kennedy Jr.

The agency has significantly narrowed its recommendations for who should get a COVID-19 booster. He's fired and replaced a panel of health experts who advised the CDC on vaccines, and there are reports that he fired the CDC's former director over her views on vaccines.

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So can you get a booster this fall? Should you?

Here to explain is Will Humble, executive director of the Arizona Public Health Association and former director of the Arizona Department of Health Services.

Full conversation

LAUREN GILGER: Will, with kind of the news that we can all use here, right. Like, who should get a COVID booster this fall?

WILL HUMBLE: Yeah, pretty much anybody who has, well, everyone over 65. Anybody who has frequent contact with people that are vulnerable. So, for example, anybody who's around grandparents or anybody who's around people with special needs. Anybody with chronic medical conditions that put them at higher risk, pregnant women.

So pretty much everybody would benefit. I'm gonna encourage everyone in my family to get the vaccine. So that's — you asked the question who should.

GILGER: That's the next question. Who can now get this COVID booster under this changed and really narrowed guidance?

HUMBLE: So far, the only clear group of people that for sure will be able to get the COVID-19 booster this year are people over 65. That part's clear. I don't think the Advisory Committee for Immunization Practices ... they're going to meet in a couple weeks. They're not going to end that recommendation. So that's the who can.

Depending on what ACIP, that's the acronym for that group, depending on what they decide in a couple of weeks, that'll really drive who else will be able to get the vaccine and what they have to do to get it.

So, for example, they could decide they would recommend the vaccine for people under 65 with a chronic — with some kind of medical condition, but they could couch that with that they need a prescription to prove that. They might not put the prescription part in there.

We just don't know what that committee's going to do. I wish I could give you better answers to these questions, but it's also up in the air until that group meets in a couple of weeks.

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GILGER: Is that a little late in terms of kind of the fall vaccine season here?

HUMBLE: Yeah, it's pretty late. The vaccine manufacturers have already — they're making the vaccine now. Some is ready and in warehouses. But one of the things that's so complicated about all this and doing this this late in the season, as you suggest, is like this doesn't magically happen.

CVS, Walgreens, doctor's offices, they have to order the vaccine. It doesn't just come. They have to order it and pay for it. And they don't know what to order because they don't know what ACIP, that advisory committee, is going to do. They don't know what the CDC director is going to do after that committee makes their decision on COVID. And by the way, they're going to review other vaccines like RSV … and Hepatitis B and stuff in two weeks.

So it's so complicated that people don't know what to order. And then listeners, people out there, they don't know whether they'll be able to get it or not or if they do get it, how they're going to get it. And will their health plan pay for it. All that's up in the air.

GILGER: Will what about the role of pharmacies in this and how they're determining what could happen going forward?

HUMBLE: Well, that's a really super important question, because over the last few years, more and more people —maybe the majority of people — have gotten used to getting their vaccines in pharmacies. And whether or not a pharmacist in Arizona can administer a vaccine requires that vaccine to be recommended by the Advisory Committee for Immunization Practices for that person.

So, right now, as it stands, pharmacists would only be able to administer the vaccine to people over 65. Even if a person under 65's health plan would cover it, even if they had a prescription, they wouldn't be able to do it.

So, one of the things that could happen is after the advisory committee meets, there's a couple of options that the state health department has to broaden access at pharmacies. For example, the chief medical officer at the state health department could issue what's called a standing order. Which would then basically provide people with that prescription without a clinical visit. They could then use that to take it into the pharmacy and then the pharmacist would be authorized to provide that vaccine.

So there are some loopholes that we can exploit in Arizona that's already existing inside of state law if the Advisory Committee for Immunization Practices and the CDC makes some really bad decisions later in the month.

GILGER: What about the public health side of this? What are your concerns?

HUMBLE: Well, that's really the main concern, is that when you limit access to this really important vaccine that prevents hospitalizations, the people that are the most vulnerable are always the people that are gonna suffer the most.

So seniors, people with chronic medical conditions that put them at higher risk, all of them will be more likely to be exposed out in the community because it's, you know, been restricted and there'll be more virus circulating that otherwise would have been. So yeah, it's a public health concern.

GILGER: What about for kids, Will? I know that in maybe European countries and other countries there have been different guidelines on whether or not kids really need a COVID booster. What are your thoughts there?

HUMBLE: Well, if — my kids are all adults now — but if I had little kids, I'd still be encouraging them to get the vaccine. I'd bring them down and make them get the vaccine, actually. And for two reasons.

No. 1, if you have a choice of being infected or not infected, even if you're at low risk, of course I would choose having my kids not to get infected.

No. 2, you know, my parents are in their 90s, and my kids would be around them and older people and I want to — I feel like I have an obligation to do everything I can to prevent my kids from bringing the virus out into the community to infect other people that are at higher risk.

GILGER: We're seeing so much change right now in terms of public health policy on vaccines. Florida just announced they're getting rid of vaccine mandates in schools. 

I wonder what you make of that broader context right now and how it could affect populations like ours here in Arizona — which already kind of struggles with lower than average immunization rates for kids, right?

HUMBLE: Yeah. So Arizona is — we're not the lowest, but we're in the bottom tier of states with respect to childhood immunization rates. I don't expect Gov. [Katie] Hobbs to do anything like what they're doing in Florida, nor Sheila Sjolander, who runs the state health department right now. She would never go along with something like what they're doing in Florida.

But all that could change. You know, these kinds of political decisions that are not based on evidence or science could change. You know, with a new governor. I mean, we'll just have to see.

GILGER: Yeah, three states will just announced on the West Coast that they're bucking the CDC guidance here. They're going to form their own health alliance to give their own vaccine guidance. These are left-leaning states: California, Oregon, Washington. 

I wonder what you make of that. And sort of the fracturing of vaccine guidance and what it might mean for our national public health going forward.

HUMBLE: Yeah, I mean I, you know, those, those West Coast states that are doing that — using their own state authority to do whatever they can is a good thing. But take for example the decisions that are made by the Advisory Committee for Immunization Practices in CDC, that really rolls into what health insurance plans pay for or not, including Medicaid and Indian Health Services.

So, those states can make those decisions, and it may change who can get the vaccine a little bit in those states. But in terms of broad policy it has to be a national — it's a national thing because reimbursement is tied nationally to the Vaccines for Children program and, you know, the Affordable Care Act in terms of what health plans are required to cover.