As a late-summer COVID-19 spike sweeps across the Bay Area, health experts warn that access to vaccines this fall will be clouded by confusion — and some believe that is intentional.
The Food and Drug Administration is expected to restrict eligibility for the updated 2025–26 vaccines to adults 65 and older and those with underlying health conditions.
Millions of Americans who once received shots at neighborhood pharmacies could soon face new barriers: some may need to prove they qualify, while others will be asked for a prescription.
Healthy adults who simply want extra protection may be shut out altogether.
“The reason why everybody’s confused — I’m confused — is because there’s purposeful confusion,” said Dr. John Swartzberg, a clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley. “This is part of the strategy by HHS — to make things confusing and difficult, where people just don’t have the information that guides them.”
At the federal level, the shift under the second Trump administration has been stark.
Health and Human Services Secretary Robert F. Kennedy Jr. dismantled the long-standing process that guided vaccine recommendations, firing all 17 members of the CDC’s Advisory Committee on Immunization Practices and replacing them with figures skeptical of vaccines.
The committee, which normally meets several times a year to weigh evidence, has not issued timely guidance ahead of the fall virus season. Meanwhile, the FDA’s narrowing of eligibility threatens to cut off routine access for millions of younger, healthy Americans.
The ripple effects are already evident.
Pregnant women and healthy children were dropped from the federal immunization schedule in May, prompting strong opposition from the American Academy of Pediatrics and other medical groups that have since released their own recommendations.
Insurance coverage — which typically follows CDC guidance — could shrink as well, forcing those outside the new eligibility categories to pay copays or full costs out of pocket.
“This usual chain of decisions … has been disrupted. And without clarity and coordination, millions may not be able to have clear access to COVID vaccines, and that could potentially impact hospitalizations and deaths,” Katelyn Jetelina, an epidemiologist and public health communicator, told Politico.
Earlier this month, the Health and Human Services Department said it would pull $500 million in funding for mRNA vaccine research and development.
Experts warn that the consequences could be severe.
“Fewer people are going to get vaccinated because of what’s happening,” Swartzberg said. “Then there’s going to be a lot more serious disease and heath.”
California, with its strong public health infrastructure and high vaccination rates, is better positioned than many states.
But Swartzberg cautioned that local agencies cannot override federal rules, meaning insurance companies could still decline to cover vaccines more broadly.
“It could very well get confusing,” Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, told NBC News.
Whether you’re able to get a free shot may greatly depend on (the) company with which you have your insurance.”
The American Academy of Pediatrics, breaking with the CDC, has recommended COVID-19 vaccines for all children under age 2, citing hospitalization rates comparable to middle-aged adults.
For now, Swartzberg offers simple advice: “If you want to have the added protection that the vaccine’s going to give you, the answer would be yes, get vaccinated now.”