The state health department has issued a “standing recommendation" intended to allow anyone 6 months and older to get this year’s COVID-19 shot, despite recent FDA restrictions limiting the vaccine to those at “higher risk.”
But anyone who hasn’t yet received this year’s immunization is, in fact, at higher risk of getting seriously ill from COVID, compared to those who have been vaccinated, health officials said Friday.
This gives the public “the ability to say, 'Yes, I have a high-risk condition,' because the Michigan Department of Health and Human Services has determined after reviewing the data, that if I haven't received my vaccine, I am at higher risk for the severe complications from COVID,” said Dr. Natasha Bagdasarian, the state’s chief medical executive.
The standing recommendation should also give broad cover to pharmacists who’ve been asking for clarity, she said. Because the FDA hasn’t defined “higher risk,” most major pharmacies have been relying on the CDC’s list of risk factors to determine who qualifies. That list includes those over the age of 65 and a broad range of medical conditions, including mental health issues and physical inactivity.
“Because of the political climate in this country right now, people who administer vaccines were nervous about how strictly they had to adhere to this not-comprehensive list that has been put out by the CDC,” Bagdasarian said.
“The data is clear: there are studies from last year that showed 33% higher risk of hospitalization if you didn't receive that year's vaccination, 68% higher risk of emergency department visit or urgent care visit if you didn't receive the shot,” Bagdasarian said. “And so this gives people a little bit to fall back on, on why they determined that someone was high-risk.”
Confusion over who can get the shot as CDC panel meets
Several states have already issued orders aimed at circumventing the recent restrictions announced by U.S. health secretary Robert F. Kennedy Jr., who last month authorized this year’s COVID shots only for “those at higher risk.” (Kennedy also ended the Emergency Use Authorizations that effectively allowed anyone over the age of 6 months to get the COVID vaccines without a prescription.)
The FDA didn’t define “higher risk,” but pharmacies like CVS have been referring the public to the CDC’s list of risk factors. But that list specifically states it is not intended to be exhaustive, Bagdasarian said.
“When we spoke to some of the big pharmacy chains, what we heard is that they prefer to follow the FDA label, and they actually didn't feel that a standing order, a standing prescription, or even an individual prescription would be helpful,” she said.
“Now, some pharmacy chains said that would be helpful … [but] they all felt that some sort of guidance from the state would be helpful on what exactly allows them to categorize someone as higher-risk for the severe outcomes of Covid. And this is not game-playing. This is solely based on the scientific data.”
The “standing recommendation” comes days after Michigan Governor Gretchen Whitmer, a Democrat, issued an “executive directive” instructing state health and insurance officials to “ensure COVID-19 vaccines remain widely available in Michigan.”
“I think it is helpful for some clarity and direction, for especially pharmacists or any vaccine providers who want to do the right thing and need some guidance and sort of authority to tell them it's okay,” said Dr. Pamela Rockwell, a clinical professor at the University of Michigan Medical School who chairs the Michigan Advisory Committee on Immunizations.
“I think it's, at this time, the most optimal direction they can go in, given our own current political environment, save any legislative action that comes from the state,” Rockwell said.
The guidance came during the CDC’s Advisory Council on Immunization Practices (ACIP) meetings on Thursday and Friday, which were often heated and at times contradictory and confusing.
Kennedy’s newly hand-picked panel voted against requiring a prescription for the COVID vaccine, but did say people should make the decision in consultation with a healthcare provider. The powerful panel issues recommendations that, if adopted by the CDC, determine whether or not insurers and federal vaccine programs have to cover the shots.
While some private insurers have indicated they plan to continue covering the shots at least through the end of the year, it’s not clear yet what the implications of this week’s votes will be.
