A guide to the new COVID vaccine recommendations

Axios – Thursday, August 28, 2025
By Herb Scribner, April Rubin

Obtaining a COVID-19 vaccine shot may require some extra lifting this fall.

The big picture: Health Secretary Robert F. Kennedy Jr. announced new limits on who is eligible for COVID vaccines on Wednesday as the FDA issued approvals for updated boosters that may have left some scratching their heads.

• The country’s COVID vaccine policy was already murky since Kennedy and other vaccine critics within and outside the federal health bureaucracy cast doubts on the safety of the mRNA shots.

Reality check: Experts generally see the COVID vaccine as safe and effective, especially for those at risk of serious illness.

• The policy change comes as COVID-19 cases have been surging across the country amid the rise of the “stratus” variant.

The intrigue: Kennedy announced changes that included rescinding the emergency use authorizations for COVID vaccines.

• But there’s still some speculation about whether Kennedy can abruptly end the emergency the way he did, or if he would need a different declaration to do so.

Context: This is all happening amid internal turmoil at the Centers for Disease Control and Prevention, the national public health agency that has seen a wave of high-level departures and has yet to weigh in on the suitability of the updated vaccines.

• Susan Monarez was fired from her post as CDC director Wednesday, just weeks after she was sworn in. Her lawyers immediately disputed an earlier claim that she left her post. The White House later confirmed her termination.
• Demetre Daskalakis, who was director of the National Center for Immunization and Respiratory Diseases, slammed Kennedy in a resignation letter Wednesday, saying that the recent policy changes threatened lives and there had been an “intentional eroding of trust in low-risk vaccines.”

All of the chaos may leave some questions. Here’s a quick guide on the new COVID vaccine recommendations.

COVID vaccine rules: the basics

The FDA rescinded general emergency use authorizations for Pfizer and Moderna mRNA shots, according to Kennedy.

• Boosters for high-risk patients were approved, though.

Yes, but: Pharmacists no longer have the power to dispense vaccines.

• Instead, patients who want the COVID vaccine will need to consult their doctor first rather than book through the pharmacy.

COVID vaccine recommendations for older people

Not much changes for older individuals 65 years old and up.

• The FDA approved a new Pfizer-BioNTech COVID vaccine for adults who are 65 years old and up.
• New shots from Moderna and Novavax are approved for all seniors, too.

High-risk patients vaccine rules

Zoom out: Anyone from 5 to 64 years old is eligible for the updated Pfizer COVID booster, called Comirnaty, if they have at least one underlying health condition that puts them at risk for severe conditions.

• This age group can get the Moderna booster with an underlying condition
• The same goes for those who want the Novavax vaccine, but only for those 12 years and older.

The list of underlying conditions is quite broad, but the current CDC list includes:

• Asthma.
• Heart conditions.
• Depression.
• Physical inactivity.
• Smoking.
• Obesity.
• Read more at the CDC website.

Children and the COVID vaccine

The new FDA policy doesn’t approve the Pfizer vaccine for healthy children under age 5, leaving it open to a doctor’s discretion to prescribe off-label shots.

• Parents can seek prescriptions for the Moderna vaccine, which has approval from the FDA for children 6 months old and up, Kennedy said.
• The Spikevax vaccine, which comes from Moderna, is approved for children with at least one serious health issue.

Insurance and new COVID vaccine rules

It’s mostly unclear how broadly insurers will cover the shots. The CDC is expected to decide soon if patients will need to pay out of pocket for vaccines, which can cost around $140, per the CDC, or may reach $225.

• It is unclear what all pharmacies and insurers will do this fall. Multiple pharmacies and insurers did not immediately respond to Axios’ requests for comment. Some did, though.

CVS will administer COVID vaccines in states where permitted, a spokesperson told Axios in a statement.

• Appointments can be scheduled online through the CVS website and app. Patients can also walk into their pharmacies and clinics, the spokesperson said.

Aetna will “continue to provide coverage for approved vaccines, including COVID-19, in compliance with applicable state and federal cost-sharing requirements,” the insurer said in a statement.

“All members of insured plans voluntarily choosing to vaccinate against COVID-19 may do so with no cost sharing.”

Blue Cross Blue Shield said all plans “provide access to preventive services to promote better health and continued well-being for every American we cover.”

• “We will continue to monitor and follow all federal immunization guidelines,” the insurer said in a statement. “As always, each independent Blue Cross and Blue Shield plan will make their own coverage.”

Kaiser Permanente said in a statement it will make the “COVID vaccine available at no cost to children and adults for protection from severe illness from COVID.”

• Kaiser said it is still reviewing guidelines from the FDA and CDC “to ensure safe and effective administration of the COVID vaccine.”
  “Vaccination continues to be one of the safest and most effective ways to protect against illness and reduce the severity of illness from COVID,” the insurer said in a statement.

Go deeper: What to know about rising COVID-19 cases and the surging “stratus” variant

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