Mass. will require insurers to cover COVID shots

Massachusetts became the first state in the country Thursday to require insurers to cover the cost of COVID shots and other inoculations recommended by state health officials, in another move to counter the Trump administration’s efforts to undo the long national consensus on vaccines.

The rift was prompted by new federal limitations on who should receive COVID vaccines under Health Secretary Robert F. Kennedy Jr. that have created confusion among consumers, pharmacies, and physicians and made it difficult for even those with demonstrated need to get booster shots.

“In Massachusetts, we will not let Donald Trump or Robert Kennedy get in the way of patients and the care and the treatments and the medication that they want and need," Governor Maura Healey said Thursday. “No one in the great state of Massachusetts is going to be denied because of cost."

In late August, the Food and Drug Administration changed its guidance on COVID shots to limit them to people age 65 and older, or to those with a medical condition that puts them at serious risk if they contract the disease. That could prevent millions of healthy people under age 65 from getting a shot without intervention from a doctor.

But delays in the annual recommendations from another health agency under Kennedy, the Centers for Disease Control and Prevention, mean even those populations are having trouble finding doses.

The insurance mandate in Massachusetts follows the Healey administration’s order Wednesday that essentially authorized COVID booster shots for everyone in Massachusetts age 5 and older. Also, Public Health Commissioner Robbie Goldstein now has the power to determine which vaccines pharmacists can administer in Massachusetts, regardless of the guidance coming out of Washington. Officials said the state-level authority would resolve concerns that led CVS Health to initially not offer COVID shots in Massachusetts and some other states this season because of the limitations recommended by the federal government.

Now, CVS and Walgreens will offer appointments for COVID booster shots on their websites beginning Friday, officials said.

“Vaccines are the greatest public health advance of our time," Goldstein said during a news conference. “To restrict access to vaccines is reckless."

The order on insurance coverage came in a bulletin issued Thursday by the Division of Insurance and Department of Public Health. It directs insurers to abide by the state’s current guidelines that recommend updated vaccine doses for everyone 6 months or older. DPH expects to issue new recommendations for the coming 2025-2026 respiratory season by the end of September, Goldstein said.

With the longtime national consensus on vaccines at risk of unraveling under changes by Kennedy, Massachusetts now expects to coordinate policy with like-minded states, with input from major medical societies and a local advisory council that evaluates the safety and efficacy of vaccines.

While healthy, younger adults who have already been vaccinated or infected derive marginal benefits from COVID boosters, Goldstein has said making them available for everyone is a low risk venture that still offers meaningful protections. A universal booster recommendation ensures enough shots are readily available for those who do need them and provides added protection to those who either routinely interact with vulnerable people or want the assurance of an additional shot.

Massachusetts overall is well vaccinated against COVID, but during the 2024-2025 respiratory virus season, only about 21 percent of residents received COVID vaccines.

In a statement, the trade group representing health insurers, the Massachusetts Association of Health Plans, expressed support for the administration’s move.

Thursday’s directive should resolve growing confusion and worry among Massachusetts residents who want a booster. Brenda Anders Pring, president of the Massachusetts Chapter of the American Academy of Pediatrics, said pediatricians are having trouble knowing how many shots to order, and whether they would even get them.

“There’s confusion about what people can access, what people can give, and what the cost would be potentially to patients," she said. “From an ordering perspective, it’s been really quite a challenge."

Cambridge resident Amy Bernstein, 75, said she’s had difficulty finding a COVID-19 vaccine. Her doctor told her his hospital affiliate, Mass General Brigham, didn’t have doses, and a CVS pharmacy told her they were still waiting for approval from corporate headquarters to administer the vaccine.

“It’s just so messed up," she said. “I’m over 65 so I should be able to get it eventually but I don’t have much confidence."

In a statement Thursday, Mass General Brigham said the most current COVID vaccines will arrive soon.

“Eligible patients will be able to access it through our practices as distribution continues," the hospital system stated.

Amy Thibault, executive director of external affairs for CVS health, said its pharmacies in Massachusetts will soon administer the new COVID vaccine.

Massachusetts is one of the nation’s leaders among states seeking to chart their own paths amid Kennedy’s dramatic reshaping of federal health policy. A longtime vaccine skeptic who has peddled false information about their safety and efficacy, Kennedy last week fired the new head of the CDC and replaced a trusted independent vaccine advisory panel with members who had less expertise but were more aligned with him ideologically. Four other high ranking CDC officials have also quit, warning that Kennedy’s disregard for established science, particularly around vaccines, is endangering lives.

In a hearing before a Senate committee Thursday, Kennedy said the fired CDC director, Susan Monarez, answered “no" when he asked her in a meeting if she was a “trustworthy person" and also said she wouldn’t fire staff he wanted dismissed. Kennedy stood by his position that healthy people do not need the COVID vaccine, saying he doesn’t trust studies attesting to its safety and effectiveness.

Despite overwhelming evidence of the safety and effectiveness of vaccines, the skepticism under Kennedy is spreading. On Wednesday, Florida officials said they intended to do away with all mandatory childhood vaccinations.

But his positions are also prompting a counter-movement. On Thursday, the Healey administration confirmed that Massachusetts is coordinating vaccine and other public health policies with Connecticut, Rhode Island, Pennsylvania, and Delaware.

Vermont, Maine, New Jersey, and New York have also been part of discussions among states about a regional vaccine policy. On Wednesday, California, Oregon, and Washington announced a similar public health alliance.

Regional efforts are essential, officials said, to avoid a patchwork of differing vaccine recommendations coming from each state in the nation.

“We’ve worked with other states, we’re going to invite other states to join our coalition, so that there is more of a consensus," Healey said.

In response, HHS spokesperson Andrew Nixon said, “Democrat-run states that pushed unscientific school lockdowns, toddler mask mandates, and draconian vaccine passports during the COVID era completely eroded the American people’s trust in public health agencies."

HHS is driven by “rigorous evidence and gold standard science," he said.

Jason Laughlin can be reached at [email protected]. Katarina Schmeiszer can be reached at katarina.schmeiszer @globe.com.