ACIP Recommends Making COVID Shots an Individual Decision. Insurers May Still Cover Them

The Advisory Committee on Immunization Practices (ACIP) voted unanimously to abandon broadly recommending COVID-19 vaccination and shift the COVID-19 vaccination to an individual decision guided by shared decision-making with ahealthcare professional.

The panel, which was handpicked by HHS Secretary Robert F. Kennedy Jr., narrowly voted down a proposal that would have recommended that a prescription be required for the vaccine.

ACIP is a group of outside experts whose role is advisory. The acting director of the Centers for Disease Control and Prevention, Jim O’Neill, must sign off on the recommendations for them to become official CDC policy, although that is likely a formality. O’Neill also was picked by Kennedy.

It will take months, though, before the practical consequences of the changed COVID-19 recommendations fully take shape. Insurers have tended to tailor their coverage policies to CDC recommendations. But on Tuesday, AHIP, the largest trade association for the health insurance industry, issued a statement saying insurers will continue to cover all ACIP-recommended immunizations that were recommended as of Sept. 1, 2025. The Wall Street Journal reported today that an HHS spokesman said that federal health plans and Affordable Care Act plans still must cover the COVID-19 shots. The news release posted on the HHS website this evening doesn’t mention coverage requirements. Instead, it says that the individual choice framework “allows for immunization coverage through all payment mechanisms, including entitlement programs such as the Vaccines for Children Program, Children’s Health Insurance Program, Medicaid, and Medicare, as well as insurance plans through the federal Health Insurance Marketplace.”

Pharmacists may be the healthcare professionals most affected by the recommendation. Shared decision-making isn’t limited to physicians and nurses, and the recommendation may mean a larger role for pharmacists, who currently deliver most of the COVID-19 shots.

Meanwhile, states are forming coalitions that are issuing their own sets of vaccinations. California, Washington, Oregon and Hawaii have joined forces to create the West Coast Health Alliance and New Jersey, New York, Pennsylvania, Massachusetts, Connecticut, Maine, Rhode Island Maryland, Delaware and New York City are members of the Northeast Public Health Initiative.