West Coast states are teaming up to issue their own vaccine guidelines in the face of rapid changes at the Centers for Disease Control and Prevention and the Food and Drug Administration. The federal turmoil has some people wondering what this means for their seasonal shots.
Dr. Helen Chu is an infectious disease specialist at the University of Washington. She clarifies what you need to know about vaccines, illnesses and insurance coverage this year.
FILE - A COVID vaccine, left, is readied as a flu vaccine sits nearby at the L.A. Care and Blue Shield of California Promise Health Plans' Community Resource Center where they were offering members and the public free flu and COVID-19 vaccines, Oct. 28, 2022, in Lynwood, Calif.
Mark J. Terrill / AP
Note: The following transcript is from KUOW’s podcast Seattle Now. It was transcribed digitally and validated for accuracy, readability and formatting by The Northwest News Network’s Adia White. The Northwest News Network is a collaboration of public radio stations in Oregon and Washington.
Patricia Murphy: I’m Patricia Murphy. This is Seattle Now.
Things have changed a lot at the Department of Health and Human Services since Robert F. Kennedy Jr. took over as secretary. To say things are in flux, would be putting it mildly. As the nation enters respiratory virus season, the CDC has a completely new vaccine panel and no director. The FDA has yet to approve the newest COVID vaccine for most people.
All this has resulted in confusion and skepticism. In response, Washington, Oregon and California announced a new West Coast Health Alliance on Wednesday. It’s supposed to ensure that science, not politics, drives public health information, according to Washington Secretary of Health, Dennis Worsham.
The states plan to lean on doctors and medical associations for guidance. Dr. Helen Chu is here now to break down what you need to know going into respiratory illness season. Thanks for coming in Dr. Chu, really good to see you.
Dr. Helen Chu: Thanks for having me. It’s nice to be here.
Murphy: So there have been a lot of changes to the FDA and CDC in the last year. How different is the landscape for people getting vaccines this fall compared with last?
Dr. Chu: I think it’s quite different. There’s been so many changes at the FDA and CDC, as you said, over the course of just the last several months. And mostly what that impacts are the COVID vaccines.
For flu and RSV, those are largely the same. You will be able to get your flu shot, you’ll be able to get your RSV vaccines.
But for COVID, that has really changed significantly, and it’s an ever-evolving state. I don’t really know exactly where things are headed, but as of right now, it’s a pretty complicated process to get a COVID vaccine.
Murphy: Alright, let’s break that down a little bit more in a minute. Dr. Chu, since the beginning of the school year usually means lots of respiratory illnesses, what are the viruses and vaccines people should be on the lookout for?
Dr. Chu: So usually, starting in the fall, we say you should get your annual flu vaccine, you should get your RSV vaccine if you’re eligible.
Murphy: OK, and like you said, it should not be a problem for anyone who needs these vaccines to get these vaccines?
Dr. Chu: That’s correct. The flu and RSV vaccines have been licensed by the FDA, and they have been recommended by the CDC, and those have been signed off, and those should be available.
Murphy: OK, I can walk into a QFC or a Safeway pharmacy. No problem.
Dr. Chu: That’s correct.
Murphy: OK, great. Who should be getting the RSV vaccine?
Dr. Chu: So, RSV vaccines should be given to people who are at higher risk for severe disease, and usually what that means is older adults or younger adults who have a high risk condition like chronic heart disease or chronic lung disease.
Babies are also extremely high risk for RSV hospitalization, especially in their first year of life, and so what we do is we give a vaccine to the mother during pregnancy, or we give a monoclonal antibody to the baby at birth, or as the baby is entering their first season.
The new thing about RSV monoclonal antibodies is we now have two choices. There used to be one last year, which was called nirsevimab, and then just last week, we recommended another one called clesrovimab. And they essentially work the same way, but it just gives hospitals more options, just in case there are shortages.
Murphy: OK, so RSV, flu vaccines, pretty standard this year, pretty straightforward. Now you mentioned COVID is a little more complicated. Who can get the COVID vaccine right now?
Health and Human Services Secretary Robert F. Kennedy Jr., appears before the Senate Finance Committee on Capitol Hill in Washington, Thursday, Sept. 4, 2025.
J. Scott Applewhite / AP
Dr. Chu: That’s very complicated to answer.
So what has happened in the course of the last several weeks to months is that there has been separating of science from policy at the national level. RFK Jr. has declared that COVID vaccines are not needed for pregnant persons or for young children, but we know that those individuals are actually very high risk for severe COVID disease. What that means in terms of availability is that it’s going to be harder for those groups to get a COVID vaccine.
For adults who are age 65 and up, COVID vaccines are licensed and recommended, just as they have been in prior seasons, and adults who have high risk conditions should be able to get them as well. But for pregnant women and for babies, it’s very unclear how difficult it’s going to be to get a COVID vaccine.
The vaccine that we usually give to young children is not going to be as available as it has been because it lost its FDA licensure for very young children. So that means if you’re an older child, older than age five, you’re probably going to be able to get your COVID vaccine after you talk to your pediatrician, probably at your pediatrician’s office.
But for children who are highest risk, the six month to two year olds, there’s very limited choices of what vaccines might be available. The FDA has revoked authorization for vaccines in young children under the age of five years if they don’t have a high risk condition.
Murphy: I can’t imagine parents right now trying to figure this out, Dr. Chu. Let’s talk about insurance. Are these vaccines still going to be covered by most insurance?
Dr. Chu: It’s hard to say. The way that health insurance works in the United States for vaccine coverage is that first the vaccine is to be licensed by the FDA, and then it needs to be recommended for use by the CDC.
In the case of the COVID-19 vaccine, it’s not clear that for young children and for pregnant women, that recommendation from CDC exists, and so the health insurance companies are not necessarily required to cover vaccines for these groups.
We know as scientists that these individuals, these young children and pregnant women, are at very high risk, and so the hope is that the insurance companies will continue to cover vaccines for this group. But it’s very unclear right now.
Murphy: What have you heard?
Dr. Chu: I’ve heard that it’s not been possible for pregnant women to get COVID vaccines.
Murphy: Wow. OK. How expensive are vaccines? I know there was a $35 copay years ago, but I have no idea what I might pay if I’m uninsured.
Dr. Chu: Vaccines are very expensive. For COVID vaccines, they range in the hundreds of dollars per dose, especially these newer vaccines. For flu vaccines, for RSV vaccines, those are also quite expensive. The RSV vaccines are also quite new, so they’re also several hundred dollars per dose. So these are very expensive products, and if you have to make the choice to pay for it yourself, that’s a difficult choice.
Murphy: Is it possible that there could be some clarity soon about some of these guidelines?
Dr. Chu: I hope so. I think that we are heading into the season where everyone is going to need their shot, so I’m really hopeful that we will have some mechanism to understand what is happening.
The national policy seems like it’s headed in a certain direction, which is divergent from what’s happening at the professional societies, potentially at the state level. So it’s just very confusing, because you don’t know whose advice to follow, and ultimately, it also just depends on what does health insurance cover, and whether or not these vaccines are even going to be available.
Murphy: There was so much mis- and disinformation around vaccines for years, Dr. Chu. This is probably only going to add to that and reignite the confusion around vaccines. For listeners who may be wary of trusting the CDC right now, where can they turn to for advice?
Dr. Chu: The CDC website is going to be difficult to trust right now, probably the best thing to do is to talk to your doctor, talk to your pediatrician, your family doctor, your internist, and ask them their advice.
A lot of the states are coming up with their own recommendations, and then we also turn to professional societies like the American Academy of Pediatrics. They’re still making very strong, science-based decisions.
Murphy: How are you thinking about this? As a clinician, as a parent, this is an extremely distressing time for a lot of people who don’t know what they’re going to do.
Dr. Chu: I’m pretty worried. I’m worried not so much for myself. I’m worried for people who have young children. I’m worried for the people who have kids between the ages of six months and two years.
Because you really don’t want your first exposure to COVID to be the infection and not the vaccine. And we have vaccines that are safe and that are effective, and I’m not sure how those babies are going to get protected this season.
Murphy: How will you advise your patients moving forward, over the next few months, what are you watching for?
Dr. Chu: I think it’s an ever-evolving state. I think what we want to be really thinking about is, if you’re able to get your COVID vaccine, you should get your COVID vaccine. If you think that you live with someone who’s high-risk, or you work in a high-risk setting like health care, you should get your COVID vaccine. Because the vaccines work to protect those around you.
In terms of how to get your COVID vaccine, I think it’s going to have to be through your doctor’s office, unless you meet one of these conditions, and that’s very different from previous years.
You used to just be able to go to a pharmacy and get your COVID vaccine. I’m not exactly sure what’s going to happen in terms of how we’re going to be able to figure out whether somebody meets the criteria to get a COVID vaccine at a pharmacy. So that’s something I’ll be watching.
Are pharmacies still going to be offering it? What do you have to do to be able to get your vaccine at a pharmacy? Are you going to need a prescription, or are you simply going to be able to check a box that says, I qualify for a COVID vaccine?
Murphy: You know, at the beginning of the pandemic, way back in 2020 you flagged some of the earliest COVID cases, and it was such a scary time. There were so many things we didn’t know about COVID.
We know so much more about COVID and and what it means to get COVID now. How do you compare those early days to the ones we’re in now?
Dr. Chu: I think for most people, COVID is a mild illness, and I think that really you can see that in the data. Most people now have a combination of infection and vaccine-induced immunity, and so they’re well-protected. But there are these very high-risk people, so pregnant women and young children and older adults, and those people need to be protected still.
The other thing that I continue to worry about is long COVID, because vaccines are protective against long COVID.
There’s been a lot of studies now that have shown that if you have a vaccine within the last six months, you’re more likely to be protected against long COVID.
And so for the general population, if you don’t want long term disability, it’s a good idea to keep your antibody levels up and protect yourself from getting severe COVID infection.
Murphy: Alright, before I let you go, the new COVID variant, what are the symptoms? What should people do to avoid getting it, besides the obvious things like masking and washing your hands?
Dr. Chu: I mean, I think you should get your booster. And the COVID variants that are circulating right now are very similar to the ones that have been circulating for the last several years, for the last three to four years.
And so really, the symptoms are indistinguishable. You would have to test to know which COVID you have, or you would have to test to know whether or not you have COVID or the flu or something else.
So yeah, I think the same as usual. Stay home when you’re sick and stay up to date on your vaccines.
Murphy: All right, UW infectious disease specialist Dr. Helen Chu, thanks so much for coming in. We’re so fortunate to have you.
Dr. Chu: Thanks for having me.
Patricia Murphy and Brooklyn Jamerson-Flowers are journalists at KUOW. This story comes to you from the Northwest News Network, a collaboration between public media organizations in Oregon and Washington.
It is part of OPB’s broader effort to ensure that everyone in our region has access to quality journalism that informs, entertains and enriches their lives. To learn more, visit our journalism partnerships page.
