What Gov. Katie Hobbs’ executive order means for COVID-19 vaccine access in Arizona

Arizona Gov. Katie Hobbs recently signed an executive order designed to expand access to COVID-19 vaccines.

Given all the headlines about the federal policy changes related to the vaccine — and vaccines in general — it might be good to have someonet o clarify the status of COVID-19 vaccine access here in Arizona.

The Show spoke with Dr. Sarah Coles, a physician who sits on the board of directors of the Arizona Medical Association, and asked her to explain the context for the governor’s order.

Full conversation

DR. SARAH COLES: So, Governor Hobbs' recent executive order does two critical things, both of which are designed to try to improve access and ensure that all Arizonans can get the COVID-19 vaccine if they choose. So first, it asks the Department of Insurance and Financial Institutions to encourage their insurers and insurance companies to provide access and pay for the COVID-19 vaccine.

The second big thing that it did was ask the Arizona Department of Health to issue a standing order for everybody to be able to get COVID-19 vaccines in a pharmacy without requiring a physician's prescription. So a standing order is like a blanket prescription for anybody who wants it to be able to walk into a pharmacy and get that vaccine. And that order has been issued by the Arizona Department of Health.

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SAM DINGMAN: OK, so safe to say that as of this moment, anybody who wants to get a COVID vaccine can go into a pharmacy and get one.

COLES: So the pharmacies are currently implementing this order right now, but in the next few days, yes, that should be the case.

DINGMAN: OK, I think probably some people listening to this, myself included, might have lost track of where things stood exactly prior to the executive order. What does this executive order change, and what was it issued in response to?

COLES: That's a great question. It has been very confusing and you are not alone in feeling confused about why this needs to happen. So, Gov. Hobbs issued this executive order in response to two big things that happened. So the FDA decided to change the COVID-19 vaccine eligibility recently in which they limited access to the vaccine for people 65 years and older, and to those who have conditions that put them at highest risk.

The CDC's Advisory Committee on Immunization Practices, or ACIP, met last week and issued an entirely different recommendation from the FDA which — was narrower than their previous recommendations that they've made in the past. So the ACIP said that they now recommend vaccines for individuals with shared decision making, meaning they recommend a discussion with your primary care doctor to talk about risks and benefits.

All of these actions, both by the FDA and the ACIP potentially limit access to that vaccine. So Gpov. Hobbs issued this order to try to override that and ensure that everybody can get the vaccine if they want it.

DINGMAN: So if I'm hearing you right, basically what Gov. Hobbs has done here is create a separate infrastructure within our state for people to have open access to the vaccine so that they don't have to worry about these new restrictions and guidance that have been implemented at the federal level.

COLES: Correct. So this will override both the ACIP and the FDA, allow them to get the vaccines without those restrictions, and be able to do it without having to have the burden or the hassle of having to go through your primary care doctor's office to get that vaccine. So you don't need a prescription, you don't need to make an appointment, arrange transportation, get out of work or provide caregiving for someone else. Everybody can go to a pharmacy and get the vaccine that they need.

DINGMAN: And is coverage of payment for the vaccine contingent on someone's insurance situation?

COLES: The good news is everybody should be able to get the vaccine covered now without out-of-pocket costs. So the Department of Health and Human Services has confirmed under the new ACIP recommendation that the COVID-19 vaccine will be covered by government insurances like Medicaid, Medicare, the Children's Health Insurance Program, commercial insurances through the marketplace and the Vaccines for Children Program. The trade organization that represents commercial insurers has also confirmed that they will be providing the access to the vaccine without out-of-pocket cost.

DINGMAN: Can I ask you, Doctor Coles, as a family physician, are you recommending to your patients to get the COVID vaccine?

COLES: Absolutely. I am strongly recommending that everybody ages 6 months and up get the COVID-19 vaccine just as I have in past years. Vaccines remain our best tool to prevent infection and serious illness like hospitalization and even death from COVID-19. This vaccine is very safe and very effective, and I myself have gotten the vaccine and encourage other people to do so.

DINGMAN: Is there any evidence that you're aware of that suggests the vaccine can have dangerous side effects or any sort of adverse health impacts?

COLES: Every vaccine can have potential side effects. That is absolutely true. The most common side effects of the COVID-19 vaccine, similar to other vaccines, are what we call reactogenic effects. That means side effects you feel as your immune system turns on and builds antibodies to help you fight infection.

So most of the symptoms we feel after getting a vaccine are our immune systems doing their job. So you can get things like fevers, sore, achy arms, or muscles, feeling a little bit more rundown, or just kind of generally blah for a day or two after getting the vaccine. But these are expected, mild and typically go away on their own without doing anything at all.

There are some potential risks to the COVID-19 vaccine, particularly for younger men, including a risk of myocarditis, which is inflammation of the heart. This is very rare, and very often resolves without any intervention, and has not resulted in any serious or long-term health consequences. And it's important to note that that kind of a risk that myocarditis is much more likely to happen if you get COVID-19 infection rather than the vaccination.

DINGMAN: There might be, I think, some people listening to this who got one or two or maybe even three rounds of the vaccine back in 2020, 2021, 2022, but maybe have not re-upped since then. For those folks, would it be your recommendation to go ahead and, and go to a pharmacy and get a fresh shot?

COLES: Absolutely. I would encourage everybody to go get this year's updated COVID-19 vaccine. And the reason that we recommended is that the COVID virus is tricky. It changes a little bit every year and mutates pretty rapidly compared to other viruses. So, a vaccine that you got last year or an infection that you got in the last season is not as protective as the current vaccine.

DINGMAN: Got it. And I was talking about this with somebody recently who said like, "Oh, yes, yes, I've been meaning to go to the pharmacy, but I can't find my vaccine card." You know, those, those little white cards that people were being issued when the first round of COVID vaccines came out. Do you need that card in order to get a shot?

COLES: Nope, you don't need to bring your old vaccine cards to get your shot this year.

DINGMAN: And then last question for you, Dr. Coles, where do things stand in terms of danger with the latest strain of COVID? I think, again, there's probably some people listening to this who maybe haven't thought very much about COVID for a year or two. What are the dangers of the current strain of COVID that people should be aware of?

COLES: It continues to cause millions of illnesses a year, hundreds of thousands of hospitalizations, and still tens of thousands of deaths every year. It is still more dangerous than the flu, for example, or the common cold. It is most dangerous for people who have chronic medical conditions like heart or lung conditions or diabetes, or older folks, people over the age of 65, but it is dangerous for potentially anyone.

COVID infections can cause long-term illness that's called long COVID, and that can happen to anyone, even people who have very mild illness, and long COVID can cause really debilitating symptoms like brain fog, fatigue, trouble breathing. So COVID vaccine remains our best way to prevent this kind of serious illness and long-term consequence.