If you are looking to get an updated COVID-19 vaccine in Virginia, navigating it this fall may prove more difficult than most patients are accustomed to.
A local woman found this out the hard way when she was unable to get a vaccine appointment online with her CVS pharmacy this week. She stopped by the pharmacy but was still denied the shot despite being over the age of 65.
Recent federal guidance has caused chaos and confusion among patients, doctors and pharmacists, leading many national pharmacy chains to put a pause on the vaccine until they know who is going to pay for it and if a valid prescription will be required to administer it. For example, CVS and Walgreens pharmacies have discontinued offering COVID shots in Virginia without a prescription, regardless of age or eligibility, according to multiple online sources.
The Food and Drug Administration, or FDA, recently revoked the emergency-use authorization for COVID-19 vaccines that allowed patients to walk in and receive the shot without a doctor’s prescription.
Virginia requires recommendations from both the Centers for Disease Control and Prevention, or CDC, and Advisory Committee on Immunization Practices, or ACIP, in order for pharmacists to distribute vaccines. Thirty four states allow pharmacies to distribute vaccines over the counter with only FDA approval.
A lot hinges on the decision of the ACIP as commercial health insurers, Medicare and Medicaid are required to cover vaccines if they are recommended by ACIP. If not, there may be an out-of-pocket costs for patients looking to get the vaccine or booster. No decision will likely be made by the ACIP until a scheduled meeting in two weeks.
In Virginia, nine deaths were attributed to COVID-19 in the month of August. In the week ending Aug. 30, there were 1,349 emergency room patients diagnosed with COVID-19, according to a Virginia Department of Health online dashboard.
Any delay is receiving the COVID-19 vaccine could be risky, according to the American Academy of Pediatrics.
“As we enter respiratory virus season, any barrier to COVID-19 vaccination creates a dangerous vulnerability for children and their families,” said AAP President Susan J. Kressly, M.D., FAAP.
Americans overwhelming look to pharmacies to receive seasonal vaccines for COVID-19 and the flu, according to the CDC.
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Dr. Robert Hopkins, medical director for the National Foundation of Infectious Diseases, said he recommends patients reach out to their physician through a patient portal or phone call to help navigate the situation. Local pharmacists may also be able to let patients know “what the situation is in their community.”
Primary care doctors in the region have expressed concern that requiring a prescription for every patient wanting a COVID-19 vaccine could lead to an administrative nightmare; small practices are afraid they may be overwhelmed with requests and unable to meet the demand.
Department of Health releases guidance to pharmacists
The Virginia Department of Health put out vaccine guidance today to pharmacists in the state.
According to the VDH, pharmacists may administer vaccines in two ways:
- Under the direct authorization of a medical provider
- Following the Virginia Board of Pharmacy’s statewide pharmacy protocols
The protocols permit pharmacists to administer vaccines in accordance with the CDC immunization schedule. The CDC schedule does not include the 2025-26 formula, which should better match the strains expected to circulate this season.
The ACIP is scheduled to meet Sept. 18-19. The VDH said it expects ACIP will vote on the updated vaccine at this meeting.
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Crystal Graham
