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Late last month, U.S. officials working under Health Secretary Robert F. Kennedy Jr. approved an updated Covid-19 vaccine, but with new eligibility restrictions that many leading health experts disagree with. For many Oregonians who want a booster this fall, that raised a practical question: Can I still get one?
Some two weeks later, straight answers remain elusive, reflecting the entanglement of arcane state and federal regulations that previously few had to seriously examine.
For now, Oregon officials say there are two ways to receive a Covid vaccine: Show up at a pharmacy with a prescription from a medical provider, or get the vaccine directly at that provider’s office.
But only a few days ago, a different reality was in play. After the FDA issued guidelines Aug. 27 restricting access to the new Covid vaccine to those 65 and older or with qualifying health conditions, there was a widespread belief that Oregon might be a state where broad access would be maintained, says Meg Olson of Oregon Families for Vaccines,
That’s not how it’s panned out thus far. In practice, she says, people tend to get a vaccine when it’s convenient and not costly, such as when they can, with minimal fuss, get it concurrently with the flu shot at their local pharmacy and insurance readily pays the bill. Confusion doesn’t help, and the uncertainty is heightened in the state policy patchwork that has emerged as federal health agencies that long led the way descend into chaos.
It’s not just red and blue states that have diverged. Oregon last week announced joining the new West Coast “Health Alliance” to coordinate with its like-minded neighbors on vaccine guidance, but different realities have already emerged on the ground. Where Oregonians must get a prescription to get a new Covid vaccine at a pharmacy, in Washington State, many pharmacies are providing new Covid vaccines to people who simply attest they qualify.
What is going on, Lucas Bezerra of the Oregon governor’s office tells WW, is that “Oregon, and states across the country, are needing to stand up their own state-level vaccine policies because the federal government is no longer providing the clarity that Americans depended on” to access vaccines.
Washington State has a specific law authorizing the order that facilitated access to the Covid vaccine without a prescription at pharmacies there, Bezerra says. He adds that Oregon does not have the same authority, though there may be indirect pathways that allow for a similar action.
Gov. Tina Kotek, he says, “has directed staff to urgently develop ways to mitigate this disruption, with all five agencies working diligently with the governor’s office, to come up with solutions that are the least disruptive, and have the lowest cost, for Oregonians hoping to get the pinch this respiratory virus season. The state is looking at all options with the goal of not adding to federal confusion or new costs.”
For now though, the situation remains obscured in bureaucratic and legal murk. Last week, an Oregon Health Authority spokesperson noted that Oregon allows pharmacists to give vaccines under state rules and protocols. In an email this week, however, he elaborated on the matter: Those state protocols rely on guidance from the U.S. Centers for Disease Control, whose vaccine advisory committee has so far not provided that guidance.
“Eventually, pharmacy protocols will be updated,” wrote the state spokesperson, Jonathan Modie. But, acknowledging how frustrating this was for people, he added, “we can’t say when that will happen or exactly what the guidance will look like.”
Uncertainty extends to industry. On Sept. 1, for example, a spokesperson for CVS, the large national pharmacy chain, told WW that Oregon was among the states where “we currently can offer FDA approved Covid-19 vaccines.” The spokesperson, at the time, distinguished Oregon from states where CVS pharmacies could only give the vaccines to those with an authorized prescription.
“Appointments can be scheduled online via CVS.com, through the CVS Health app, or patients can walk into our pharmacies and clinics,” the spokesperson said at the time. She later in the week added, “all CVS Pharmacy locations nationwide have the vaccine in stock. We are currently offering the updated COVID-19 vaccines in Oregon at all locations.”
Fast forward to early this week, when a WW reporter tried to book a Covid-19 vaccine appointment at a local CVS. The CVS website said, “Vaccine(s) unavailable: Due to state restrictions or inventory we’re unable to schedule your vaccine(s). Update your selection(s) or try a new location.”
Asked about this, the CVS spokesperson said, “After reviewing clarifying guidance issued last week, we’re only offering updated COVID-19 vaccinations to patients who present a prescription from an authorized prescriber. As a result, appointments cannot currently be scheduled online in Oregon. Patients can walk-in to any CVS Pharmacy location, present a prescription and receive the vaccination.”
