Vaccine Policy Shake-Up: Insurers Rethink Coverage Amidst Kennedy's Overhaul

Health insurers are evaluating new expert sources to decide which vaccines to cover as anti-vaccine activist and current U.S. Health Secretary Robert F. Kennedy Jr. modifies government inoculation guidelines, industry insiders report. Kennedy recently dismissed the 17-member CDC vaccine panel, citing conflicts of interest without providing evidence. He replaced them with eight appointees, some against certain vaccines. Two CDC staffers resigned over his decisions. The updated panel convenes soon, with insurers stating they will continue covering CDC-recommended vaccines unless those guidelines change, at which point they may consult medical associations.

Consultant Elif Alyanak from Avalere emphasizes potential shifts in insurance coverage due to the Affordable Care Act's stipulations aligned with ACIP's vaccine schedule. Without ACIP's endorsement, uniform coverage may fade, leading to patient and provider confusion. Kaiser Permanente will continue offering COVID shots for pregnant women and children, against CDC's updated stance. The American College of Obstetrics and Gynecology and the American Pharmacists Association warn that removing this recommendation could compromise patient safety.

Public health figures, including Michael Osterholm, are forming alternative advisory bodies like the Vaccine Integrity Project. Insurers are considering inputs from these groups to maintain immunization plans, prioritizing member health despite financial implications. Former CDC adviser Dr. Fiona Havers casts doubt on insurers' abilities to independently determine vaccine access. Dropping vaccines like the HPV shot could reduce immediate costs but risk future outbreaks and losses.

(With inputs from agencies.)