As new variants of COVID-19 emerge, COVID-19 vaccines are updated to remain effective. This year’s formulations were approved by the Food and Drug Administration (FDA) with narrower eligibility, and an advisory committee of the Centers for Disease Control and Prevention (CDC) issued new recommendations for who should receive them.
However, while the federal guidance is different from last year, the advice from medical professionals hasn’t changed, says Bernard Camins, MD, MSc, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai. “It’s a good idea for everyone to get the COVID-19 vaccine, because data shows it prevents severe disease and still saves lives.”
In New York State, and many other states across the nation, the state government and public health agencies have taken steps to ensure anyone who wishes to receive a COVID-19 vaccine will be able to do so.
If you’re thinking of getting a COVID-19 shot, Dr. Camins explains what you should know about them.
Bernard Camins, MD, MSc, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai
What are the new COVID vaccines and their label restrictions?
Vaccines are available from the manufacturers Pfizer-BioNTech, Moderna, and Novavax. These have been tested in clinical trials to be safe and effective, as with previous versions, says Dr. Camins.
Here are the details of each approved vaccine.
- Pfizer-BioNTech’s Comirnaty: It is available to adults 65 years and older, and to people ages 5 through 64 with at least one underlying condition that puts them at high risk for severe outcomes with COVID-19.
- Moderna’s Spikevax and mNEXSPIKE: Spikevax is approved for those 65 years and older, and for people six months through 64 years old with at least one underlying condition that puts them at high risk for severe outcomes. The new mNEXSPIKE vaccine is approved for those 65 years and older, and for people ages 12 through 64 with at least one underlying condition that puts them at high risk.
- Novavax’s Nuvaxovid: It is approved for those 65 years and older, and to people ages 12 through 64 years old with at least one underlying condition that puts them at high risk.
What qualifies as an underlying condition?
As of February 2025, the list includes things like cancer; chronic diseases of the lung, kidney, and liver; heart conditions; immunocompromised conditions; obesity; pregnancy, and others. The full list can be found here.
Does this mean I can’t get the new vaccines if I’m under 65 and don’t have an underlying condition?
Not quite, says Dr. Camins. The new FDA labels for the vaccines do mean that if you are under 65 years old, and don’t have an underlying condition that puts you at risk of severe COVID-19, getting the vaccines would be considered an “off-label” use, he notes.
This mostly has implications on getting your vaccine at a pharmacy, because some states have restrictions on pharmacists being able to prescribe vaccines off-label, and some restrict pharmacists from giving off-label vaccines even when prescribed by a doctor. Your physician and primary care provider, however, would still be able to prescribe and provide off-label vaccinations in clinics, Dr. Camins points out.
In response, New York and several states enacted actions through executive and agency orders to ensure people would still be able receive COVID-19 vaccines in pharmacies. The new federal guidance does imply that people will be able to access COVID-19 vaccines at pharmacies, regardless of label language.
What are the new recommendations for COVID-19 vaccines?
The CDC’s Advisory Committee on Immunization Practices (ACIP) voted to leave COVID-19 vaccination to an individual’s choice, rather than recommend vaccination for various populations. This deviates from the previous ACIP guidance of recommending that adults 18 and older get the vaccine, and people 6 months to 17 years old decide through discussions with a health care provider.
Several medical associations, however, have given their own guidance on COVID-19 vaccination for various demographics. These include:
- Infectious Diseases Society of America: All people six months of age and older should receive the updated vaccine. It’s even more important for people who are 65 years and older, or have high risk for developing severe COVID-19.
- American College of Obstetricians and Gynecologists: Recommends that patients receive an updated COVID-19 vaccine or “booster” at any point during pregnancy, when planning to become pregnant, in the postpartum period, or when lactating.
- American Academy of Pediatrics: Recommends COVID-19 vaccination for all infants, children, and adolescents six months of age and older who do not have contraindications to receiving the vaccine.
“Medical professionals are all saying the same thing: if you’re able to receive the vaccine, you should be getting it,” says Dr. Camins. “While no vaccine is a 100 percent guarantee in preventing you from contracting COVID-19, if you do get it, data has shown that the vaccines reduce the disease severity—including avoiding the need to visit an urgent care center or emergency room—prevent hospitalization, and improve recovery, even if you’re in the high-risk category.”
Will insurance still cover COVID-19 vaccines?
COVID-19 vaccines were provided at no cost sharing previously, as it had been an ACIP-recommended immunization.
With the new ACIP recommendations, people on public insurance, such as Medicaid, or on an insurance plan that relies on ACIP recommendations to dictate coverage, should continue to receive COVID-19 shots without cost sharing, as brought up in the ACIP meeting.
“However, this is uncharted territory,” says Dr. Camins. “Do check in with your insurance provider to see if your copay would remain the same as before.”
On September 16, AHIP, a trade group representing many large health insurance companies, said in a statement that its members would offer COVID-19 vaccines with no cost sharing through the end of 2026, using the pre-September ACIP recommendations. And New York’s Department of Financial Services has issued a memo to insurance companies to remind them about relevant state laws regulating member coverage. Broadly, the letter highlights:
- If ACIP has recommended an immunization, insurers must cover at no cost.
- If a policy provides COVID-19 coverage, it must maintain coverage throughout the contract year, even if ACIP recommendations change in the interim.
- For those under 19 years old, New York State requires COVID-19 vaccines to be covered at no charge, regardless of ACIP recommendations.
What’s the current COVID-19 situation like?
“As we go into the fall months, the number of cases will go up, as expected,” says Dr. Camins.
“COVID-19 is here to stay, and SARS-CoV-2 continues to evolve,” says Dr. Camins, “but as long we remain protected and have good antiviral treatments available, the situation is under control and of low concern.”