CDC delays free COVID shots for low-income and uninsured children

The CDC approved updated COVID-19 vaccines for the 2026-27 season on August 27, and manufacturers began shipping doses to medical offices by September 7. Doctors and pharmacies have been able to buy these shots for children with private insurance since then. But the CDC has not opened the ordering process for the Vaccines for Children program, which supplies free immunizations to children who are uninsured, underinsured, eligible for Medicaid, or American Indian or Alaska Native.

About 52 percent of US children qualify for the program, according to figures cited from the CDC. Public health officials in California, Georgia, New York, Pennsylvania, and South Carolina confirmed to CIDRAP News that COVID vaccines are still not available through their states' Vaccines for Children programs. States also cannot order COVID vaccines through a related federal effort, the Section 317 program, which funds vaccination for underinsured adults.

At least 11 states and one US territory go further, buying all children's vaccines — regardless of a family's income or insurance status — through the same contracts used for the Vaccines for Children program. Those places, including Alaska, Connecticut, Hawaii, Maine, Massachusetts, New Hampshire, New Mexico, Rhode Island, Vermont, Washington, and Wyoming, plus American Samoa, are also waiting on the CDC before any child in the state can get a dose that way.

Michelle Fiscus, chief medical officer of the Association of Immunization Managers, said the delay creates what she called a two-tiered system: children whose families can pay out of pocket or have private insurance can get vaccinated now, while lower-income and uninsured children wait. A pediatric COVID vaccine costs $149.99 out of pocket without insurance coverage, according to CVS. Fiscus noted that some delay between commercial and Vaccines for Children availability is typical each year, but said the current "environment we're currently living in" has raised anxiety about when access will resume.

The gap puts pediatricians in an uncomfortable position. Doctors who have privately purchased doses can vaccinate insured children while telling families in the Vaccines for Children program that shots "aren't in yet," which Fiscus said "feels terrible ethically and morally." Alternatively, a provider can choose not to vaccinate any child, even ones with commercially available doses, to avoid treating patients unequally. New York's health department has told providers they may use privately purchased doses to vaccinate children in the Vaccines for Children program now, replacing those doses with free stock once it arrives — an option not confirmed to exist in other states.

Last year, Vaccines for Children shots for COVID were not available until October 6, 40 days after approval, according to Fiscus. Officials in California say the CDC has told them approval is "anticipated soon," but no date has been given this year either.

Normally, a CDC advisory panel called the Advisory Committee on Immunization Practices votes on whether to recommend a seasonal vaccine and whether it should be covered through the Vaccines for Children program; that vote is required before the vaccine can be distributed through the program. That process has not happened this year. Health Secretary Robert F. Kennedy Jr. fired all 17 members of the committee in June and replaced them with his own appointees, several of whom are critical of vaccines, and last year the administration ended the broad recommendation that healthy children and pregnant women get COVID vaccines.

A federal judge in Massachusetts found that Kennedy likely violated federal law in how he selected the new committee members, and in a related ruling in March blocked his broader overhaul of the childhood vaccine schedule, which had cut the number of recommended childhood vaccinations from 18 diseases to 11. The committee has not met since, and a scheduled meeting was postponed as a result of the ruling. "There is no ACIP recommendation" for this year's COVID shots, said Claire Hannan of the Association of Immunization Managers. "We are in uncharted waters here."

HHS has said only that the CDC "is finalizing decisions regarding COVID-19 vaccine procurement through the Vaccines for Children and Section 317 programs," and that more information will come "soon." A department spokesperson added that HHS and CDC have "a responsibility to ensure responsible stewardship of taxpayer resources and that vaccines procured through federally funded programs are appropriate for the populations those programs serve" — language that, according to Ars Technica, suggests officials are questioning whether children should be vaccinated at all. HHS did not answer questions about why the decision has been delayed.

The delay comes as COVID-19 activity has been increasing. During the first week of September, COVID accounted for a higher share of emergency department visits than at any point since February, and for more hospitalizations than at any point since March, according to data compiled by PopHIVE and cited by CNN. The CDC separately notes that hospitalization rates remain highest among adults over 65 and babies under 1 year old.

HHS has pushed back on the idea that a September deadline matters, arguing that "COVID-19 does not follow the same predictable seasonal pattern as influenza," circulating year-round with regional variation, and that "an arbitrary September date should not be treated as a public-health deadline for COVID-19 vaccine procurement." The American Academy of Pediatrics disagrees with the current posture: its president, Andrew Racine, said the administration "promised that changes to the federal vaccine process would not interfere with families' ability to access recommended vaccines, yet that is exactly what is occurring." The Academy recommends COVID vaccines for all infants ages 6 to 23 months, for children and teens with elevated risk factors, and more broadly for children ages 2 to 18 whose parents want them.

Independent reviews by the American Medical Association and the University of Minnesota's Vaccine Integrity Project reached similar recommendations for infants and high-risk children this fall, according to CNN. Kennedy has said in public statements that the administration's changes "preserved access and coverage" and that the court's order, not the administration, has left the advisory committee unable to function; he has also said, "We have not taken vaccines away from anyone." HHS has said it will appeal the ruling blocking the committee's restructuring, and the AAP's attorney has suggested the underlying legal dispute could eventually reach the Supreme Court.