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New White House Plan Aims To Provide Uninsured With Free Covid-19 Vaccines

The Biden administration unveiled Tuesday a $1.1 billion program aimed at providing Covid-19 vaccines and treatments to the uninsured at no cost after the federal supply is exhausted.

The two-part initiative would utilize pharmacies, local health departments and federally supported health centers to provide Covid-19 care, according to a fact sheet distributed by the White House. The funds should support the program through December 2024.

Americans can currently receive Covid-19 vaccines and certain treatments at no charge because the federal government purchased them for distribution to the public. But when that supply is exhausted, the products will shift to the commercial market after Congress refused to provide more funds to purchase additional supplies. Most people with insurance will be able to continue getting vaccinated for free, but that's not the case for those without coverage.

One prong of the new program calls for creating a public-private partnership with local and national pharmacies, which administer the majority of adult Covid-19 vaccinations. The federal government will provide a per-dose payment to the pharmacies to cover the cost of administrating the vaccines and treatments, including the antiviral medications Paxlovid and Lagevrio. Pharmacies can also receive one-time payments for each site that targets areas with low rates of access and vaccination.

To let the uninsured know about the program, the pharmacies will be expected to conduct outreach and work with community groups that focus on underserved populations.

Just how many pharmacies choose to participate, however, remains to be seen. The US Department of Health and Human Services will work to establish contracts with the pharmacies over the next few months with the aim of launching the program in the fall, according to the fact sheet. It expects pharmacies that have participated in the US Centers for Disease Control and Prevention's "COVID-19 Test to Treat" program and other pandemic partnerships to join the effort.

Also, the administration is relying heavily on drug manufacturers' providing vaccines and treatments free of charge to the uninsured. It notes several times in the fact sheet that drug companies have committed to doing so.

HHS also expects that manufacturers will provide the vaccines to participating pharmacies, which will be compensated through the drug companies' patient assistance programs.

Moderna said in February that it would provide the vaccines at no cost to the uninsured through its patient assistance program. Pfizer has also pointed to its patient assistance program, which helps people without insurance get vaccines.

The companies did not immediately respond to CNN's requests for comment about participation in the new initiative.

Asked about whether the vaccine manufacturers have agreed to participate, an HHS spokesperson said the agency "has had very positive conversations" with them.

The second part of the program leverages local health departments and federally supported health centers, which traditionally care for the uninsured. The CDC will purchase vaccines for distribution to the departments and centers, while the Health Resources and Services Administration will support the delivery of vaccines and treatments to its network of health centers.

The federal government said it expects to purchase the supplies at a discount as it does with similar existing immunization programs.

Just how many uninsured Americans will utilize the program is uncertain. Not that many people are getting vaccinated for Covid-19 these days, and the rate is lower among the uninsured, some data has found.

Allowing the uninsured to access the vaccines at no charge is important but so is educating them about the program, said Jen Kates, senior vice president at the Kaiser Family Foundation.

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Biden Administration Will Fund Program To Keep Covid Vaccines Free For The Uninsured

WASHINGTON — The Biden administration plans to spend more than $1 billion on a new program to offer free coronavirus shots to uninsured Americans after the vaccines move to the commercial market later this year, administration officials said on Tuesday.

The program for the uninsured, which will be modeled partly on an existing childhood vaccination program and will cover an estimated 30 million people, will include a first-of-its-kind partnership with pharmacy chains in which the government will pay the administrative costs of giving the doses to patients. Pfizer and Moderna have pledged to offer the shots at no cost to those who lack insurance.

The administration's move partly resolves a critical gap in the nation's coronavirus vaccination strategy ahead of a new booster campaign with reformulated shots that is likely to begin as soon as late summer. Federal officials have said that they no longer plan to purchase doses for all Americans as they have in prior coronavirus vaccination campaigns, allowing the vaccines to be sold commercially and ceding power to manufacturers to set their own prices.

For the new program, the administration is counting on substantial help from the companies making the vaccines. In February, Moderna said it would use a so-called patient assistance program to provide doses free of charge to uninsured Americans. Pfizer plans to offer free vaccines through a similar program, a company spokeswoman said.

The details of those programs are still being worked out. Jennifer Kates, a senior vice president at the Kaiser Family Foundation, said pharmaceutical company assistance programs varied by company and medication, a patchwork system that can be complicated and inaccessible. Companies often require proof of income or proof that a patient is uninsured, Dr. Kates said, and it is unclear how long the drugmakers' programs might last.

"It's a Band-Aid," she said. "The problem is that these are not mandatory or sure bets. These are voluntary efforts by companies."

But Xavier Becerra, President Biden's secretary of health and human services, said it was in the companies' interest to keep the programs going.

"It's their business sense," Mr. Becerra said in an interview. "The last thing they want is to become the object of derision because people are saying: 'What gives? All of a sudden we're having to pay to get this vaccine?'"

The new vaccine initiative comes as the administration is looking beyond the coronavirus public health emergency, which was declared under President Donald J. Trump in 2020 and has been extended under Mr. Biden. The administration plans to allow the emergency to expire on May 11, setting the nation on a course for Covid-19 to be treated as just another respiratory disease, like influenza.

The new initiative will also cover some costs associated with Covid-19 treatments for the uninsured. In addition, the administration is working on a $5 billion program to spur next-generation coronavirus vaccines and treatments.

"Covid is not over," said Dr. Ashish K. Jha, the White House coronavirus response coordinator. "And while we are transitioning out of the public health emergency and all of the flexibilities it provided, we're committed to making sure that we continue to fight Covid. And that means making sure people have access to vaccines, treatments and tests."

The end of the public health emergency will not have any immediate impact on Americans' ability to gain access to coronavirus vaccines. For now, people can still get shots at no cost from the stockpile of doses the federal government has already purchased. On Tuesday, the Food and Drug Administration authorized a second updated booster shot for people 65 and older or those who are immunocompromised.

In June, federal regulators are expected to choose a new formulation for use in another round of booster shots later in the year, around the time people receive their annual flu shot.

As part of the new initiative, called the H.H.S. Bridge Access Program for Covid-19 Vaccines and Treatments, federal officials will also purchase vaccines and distribute them to state and local health departments to be given to the uninsured.

When coronavirus vaccines move to the commercial market, Pfizer and Moderna have said they plan to charge over $100 per dose, or roughly four to five times the price the federal government paid for the companies' shots in the most recent booster campaign. Dr. Jha said White House officials "don't think that kind of price increase is justifiable."

But Mr. Becerra conceded there was little the administration could do. "We don't control the commercial market," he said.

For most Americans, the reformulated shots later this year will not bring any out-of-pocket costs. Most private health plans will cover them, as will Medicare and Medicaid. The costs of doses for uninsured children will be covered by the federal Vaccines for Children program.

The Biden administration has proposed creating a program called Vaccines for Adults, which would mimic the concept used for uninsured children. But administration officials have been unable to persuade lawmakers to establish such an initiative.

Vaccine And Travel In 2023

If you're planning to travel internationally in 2023, your destination country could require specific vaccines for entry. Even if the country doesn't have travel vaccine requirements, the area could have disease risks that make getting vaccinated a good health decision.

Here's what you should know about vaccines and travel in 2023, including which vaccines you might need, how to determine a country's requirements and where to get vaccinated.

Do you need a vaccine to travel?

Vaccination requirements for travel depend on the specific destination and any current outbreaks. Generally, you're much more likely to encounter required travel vaccines if you're traveling to developing countries and rural areas in Africa or Asia than if you're visiting urban destinations in North America or Europe. However, many destinations have disease risks that make it worth considering optional vaccines before taking your trip.

Common types of vaccines travelers may need

Some common travel vaccines include the routine shots you likely already had as a child as well as the COVID-19 vaccine. Others are specific to particular travel regions, including yellow fever, cholera, typhoid and Japanese encephalitis vaccines. Always consult with your doctor to determine your recommended vaccines.

Childhood immunizations

If you're missing some routine childhood vaccines, you may need to get them before you travel. Your destination can have current outbreaks of diseases that are no longer common in the U.S. Some examples include measles, meningococcal meningitis, hepatitis, chickenpox, polio and pertussis. While such vaccines are usually only recommended, international travel requirements for destinations such as Bangladesh and Afghanistan require proof of vaccination status against meningococcal meningitis and polio.

Have your doctor check your medical records for any missing vaccines or boosters. Keep in mind that some childhood immunizations require a series of doses.

COVID-19 vaccination

While countries requiring a COVID-19 vaccine for international travel is now uncommon, Indonesia is one example where you'll be denied entry without proof of vaccination. Indonesia's rules include health screening procedures and a potential COVID-19 test if you have symptoms. While you can enter with just one dose, you must undergo a five-day quarantine at your own expense.

Even if your destination doesn't require COVID-19 vaccination, the U.S. Government still recommends getting vaccinated or boosted before your trip. Along with reducing your health risk, getting vaccinated can prevent inconveniences such as potential tests or quarantines at ports of entry.

Yellow fever vaccination

If your trip itinerary includes South America or Africa, yellow fever is often a risk, and you may need proof of vaccination for travel to many destinations. Other countries can also require proof of vaccination for yellow fever if you've recently visited a country where the condition is common.

While not highly prevalent, yellow fever comes from being bitten by an infected mosquito. A mild case includes symptoms such as a fever, body pain, weakness and stomach troubles. However, severe cases can cause internal bleeding and organ failure.

Travelers who are at least nine months old can get the single-dose yellow fever vaccine for protection. Plan to wait at least 10 days before traveling to a destination that requires proof of vaccination. Also, make sure you use a certified travel clinic that can issue the proof of vaccination required by your destination.

Typhoid vaccination

Caused by touching or ingesting something contaminated with bacteria, typhoid fever is common in areas with sanitation concerns. If you're searching travel booking sites for destinations in Asia, South America, Central America or Africa, these areas may have a higher risk. Other risky areas for typhoid include the Caribbean Islands and Central America.

If you get infected, you'll most likely get a fever with other potential symptoms, including a rash, headache, stomach issues and cough. You can choose between recommended vaccines in pill and shot forms to reduce the risk.

Suitable for travelers age six or older, the pill form requires four doses taken on alternating days. The single-dose shot works for travelers starting at age two. The waiting period before traveling is one week for the pill and two weeks for the shot.

Cholera vaccination

If you plan to travel to one of many African or Asian countries, the Dominican Republic or Haiti, cholera outbreaks can put you at risk. This infection comes from consuming contaminated water or food and is often found in rural areas. If you get infected, you might experience cholera symptoms such as vomiting and diarrhea, which can lead to dehydration.

Previously, travelers between two and 64 years old could get the single-dose Vaxchora vaccine in the U.S. For protection. However, this is no longer an option because the manufacturer has stopped making the vaccine. Other cholera vaccines do not have approval for use in the U.S. Your options include getting an approved vaccine abroad or taking precautions to avoid consuming anything potentially contaminated.

Japanese encephalitis vaccination

Common in rural parts of Asia and Australia, Japanese encephalitis is a virus you can catch from mosquitoes. While the condition is rare and usually just causes mild symptoms or none at all, some people develop brain inflammation and related issues such as fevers and headaches. The disease is also fatal for around 25% of those who catch it.

Usually recommended rather than required, the Japanese encephalitis vaccine is ideal for travelers planning extended stays in areas of concern and general travel during the mosquito season. It requires two doses that you'll get four weeks apart, and you should wait seven days or more before traveling after the final dose. It is available for travelers two months and older.

Where to get vaccinations for traveling

When deciding where to get travel vaccines, keep convenience, cost and availability in mind. Primary care physicians and drugstores provide common travel vaccines, while travel clinics offer specialty vaccines and other helpful services.

Your primary care physician

If you have a primary care physician, you can ask about travel vaccines at your next appointment or schedule a separate visit. The benefit of this route is that your physician already has your medical records and can advise you on what's missing. If the vaccines are routine, insurance may pay for them.

Be sure to check the availability of less common vaccines and the pricing if insurance won't cover them. Depending on how busy the physician's office is, the wait time can be long to get an appointment.

Travel clinics

Particularly if you need the yellow fever vaccine, consider going to a travel clinic that can provide the necessary certification and provide access to hard-to-find travel vaccines. These specialized medical facilities educate travelers on the specific health risks in their target destinations and offer tips on how to avoid and treat diseases abroad. The doctors at travel clinics also specialize in understanding vaccine requirements so that you don't have your trip disturbed by a missing dose.

If you choose a travel clinic, prepare to book ahead since it can take up to a few months for an appointment due to high demand. And be prepared to pay out of pocket, as these clinics usually don't take insurance and will want the fees upfront.

Drugstore chains

Drugstore chains such as CVS and Walgreens are good options for getting a convenient appointment time, often having multiple locations near you. They usually offer a wide range of routine vaccinations for adults and children, but travel vaccine availability varies by chain. For example, one drugstore might only offer typhoid vaccines for travelers, but another could have vaccines for Japanese encephalitis and yellow fever available too.

Make sure to research drugstore chains and their selections before you book an appointment. Like with travel clinics, you'll probably need to pay out of pocket for travel vaccines, but some routine shots may fall under your insurance coverage.

What you should do before traveling

Since vaccine requirements vary by destination, you'll want to start doing your research far in advance of your planned travel date. This makes it easier to book a vaccine appointment at a provider that has the vaccine you need, as well as obtain any necessary proof of vaccination.

Check your destination country's vaccination requirements

U.S. Government websites make it easy for its citizens to determine vaccine requirements for travel to international destinations. They also provide information about current disease outbreaks and list recommended vaccines for your destination area. The Centers for Disease Control and Prevention (CDC) allows you to select your destination from a list to see any applicable travel health notices, which often include outbreak alerts. A list of recommended or required medicines and vaccines will follow.

This list tells you location-specific vaccines for conditions such as yellow fever, as well as routine vaccines for conditions such as measles, the flu and COVID-19. You'll also see details about a vaccine's age requirements, the number of doses needed and any special considerations when traveling in certain regions.

You can also visit the U.S. Department of State website for international travel to learn about health and safety information for a particular destination. The page has a search box where you can enter the target country. The country's page includes a convenient "Quick Facts" box listing any required vaccines, while the "Health" menu shows further details on common diseases for which you should consider vaccination.

Schedule your vaccine appointment well in advance

Once you know which vaccines you need, confirm availability and schedule your appointment as soon as possible. Ideally, you'll do this at least four to six weeks before your trip since it can take time to get an appointment slot. It's useful to plan even further ahead if you'll need a vaccine certificate for travel and need to find a certified travel vaccine clinic.

Keep in mind that the initial appointment may not be the only one. Vaccines involving multiple doses can require you to return several weeks later. This means it's important to check the dose requirements so that you can make your first appointment several months in advance if necessary.

Ensure that your proof of vaccination is accepted

Check the requirements for your destination country to see what type of proof of vaccination it requires. This often includes obtaining an International Certificate of Vaccination or Prophylaxis (ICVP) if you need vaccination against yellow fever, meningococcal disease or polio. For proof of vaccination against COVID-19, the country might accept your vaccine card or a state-issued vaccine record. If in doubt, consider asking a travel clinic.

Where can you travel without a vaccine?

While requirements can always change, many popular destinations in North America and Europe require no travel vaccines. These countries include Canada, Germany, France, Mexico, the Bahamas, Britain, Greece and Italy.

In Asia, you can travel to Japan and South Korea without a vaccine. Several other Asian countries, along with many in South America and Africa, only require vaccination if you've recently traveled from an area where yellow fever is prevalent. New Zealand also doesn't require vaccines.

Even if you're traveling to an area without vaccine requirements, there can still be risks, and you should still research any prevalent diseases in the region. Getting updated on vaccines can offer peace of mind on your trip.

What happens if you fail to get a required vaccination before your trip?

Unless you qualify for an exception, not getting a required vaccination can cause inconveniences, cost you money and put you at risk of getting sick. For example, failing to get a yellow fever vaccine may result in being turned away at the point of entry. This would mean having to pay for a trip back home, likely without getting flight refunds from your airline.

In other cases, you can get tested and quarantined for a certain period at your own expense for the destination to verify that you don't have a disease. Some destinations may let you receive the vaccination upon arrival, but you shouldn't rely on this.

Cross all of your travel chores off of your checklist

Now that you understand vaccine and travel requirements, make sure to complete other important travel chores. These include applying for any required visas, booking flights, locating your passport, considering travel insurance and reading up on any travel advisories. Don't forget to make a packing list, decide on international payment methods and arrange for care for any pets staying behind. It's also helpful to know how to get a refund in the case of flight cancellations.

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