Updated COVID-19 vaccines have arrived in Illinois. Who can get them?

Updated COVID-19 vaccines have arrived in Illinois — along with confusion about who can get them and how.

In previous years, anyone 6 months and older could get the shots, and they were covered by insurance. Now, some individuals can still get the shots with ease, while others may face roadblocks.

Further complicating matters, guidance about the shots may change again in coming weeks, even though the vaccines are already here.

“It’s confusing for patients. It’s confusing for physicians,” said Dr. Michael Hanak, a family medicine physician at Rush University System for Health, who said he’s been getting inquiries from patients.

The Tribune spoke with doctors, pharmacies and health insurers to explain how people in Illinois can get the vaccines.

Q: Where can people get updated COVID-19 vaccines in Illinois?

A: Pharmacy chains, including Walgreens, CVS Health and Jewel-Osco, are now allowing people in Illinois to get the shots. Walgreens and Osco are currently allowing people ages 12 and older to make appointments to get the shots, while CVS is allowing appointments for people ages 7 and older in Illinois.

A number of Illinois health care systems and doctors’ offices also plan to offer the updated vaccines in their offices in coming months, but have not yet received their shipments.

Q: Who can get the updated COVID-19 vaccines?

A: At this point, Walgreens, CVS and Jewel-Osco are administering the updated vaccines to people ages 65 and older and people younger than 65 who have certain underlying conditions. Qualifying conditions include illnesses such as diabetes, chronic kidney disease and cancer.

But they also include a number of less obvious risk factors such as being overweight, being physically inactive and mood disorders such as depression. Walgreens and CVS also list pregnancy as a condition that would qualify people to receive a vaccine at their pharmacies.

Q: How do I prove I have a condition that qualifies me for the vaccine?

A: You don’t have to prove it. Walgreens and CVS are asking patients to check a box online indicating that they’re eligible for the vaccine, when they make their appointments. Neither pharmacy is requiring further proof, said spokespeople for CVS and Walgreens.

Q: Do I need a prescription to get a COVID-19 vaccine in Illinois?

A: No, if you are 65 or older or if you’re younger than 65 but have one of the qualifying conditions you don’t need a prescription to get the COVID-19 vaccine in Illinois.

Illinois, unlike some other states, does not require vaccines be recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices before pharmacists can administer them, said Garth Reynolds, executive director of the Illinois Pharmacists Association.

“In Illinois, pharmacists are trusted to use their professional and clinical judgment just as physicians and other health care providers do when determining which FDA-approved vaccines can be administered,” Reynolds said in an email.

There is, however, one big exception. People who are younger than 65 and don’t have a qualifying condition would need a prescription from a doctor to get a COVID-19 vaccine at CVS in Illinois, said CVS spokesperson Amy Thibault.

When asked whether Walgreens will give the shots to people younger than 65 without underlying conditions if they have a prescription from a doctor, a Walgreens spokesperson said in a statement: “The regulatory environment around COVID-19 vaccination remains dynamic. During this time, we are leveraging our pharmacy professionals across the country to help patients understand their options and stay informed.”

Q: Are Illinois doctors writing prescriptions for COVID-19 vaccines for healthy people who are younger than 65?

A: It is possible for doctors to write prescriptions for medications and vaccines for uses outside those approved by the FDA. Such prescriptions are considered “off-label.”

“We do this all the time where we’ll recommend a treatment or medication, and it’s technically off-label,” said Dr. Laura Zimmermann, a primary care physician and division chief of general internal medicine at Rush. It’s done, “when we engage with a patient and apprise the situation, and it is our deep belief this will benefit the patient.”

An example might include a person younger than 65 and healthy but lives with or is close to someone who is at high risk of developing severe COVID-19, she said.

Zimmermann, however, said it’s likely that most of her patients will not need prescriptions because they’ll be able to check one of the boxes indicating they have a qualifying, underlying condition.

She and Hanak said they have not yet had any patients ask them to write prescriptions for COVID-19 shots.

Some physicians, however, might hesitate to write prescriptions for COVID-19 vaccines off-label.

“The regulatory environment is very important to consider in this process and prescribing off-label is not something that’s done infrequently, but there are regulatory implications of that,” said Dr. Larry Kociolek, an infectious diseases physician and vice president of System Preparedness Prevention and Response at Lurie Children’s Hospital.

Lurie is awaiting guidance from the state on the updated shots before finalizing its plan of how to administer them to its pediatric patients, Kociolek said.

Q: Could guidance about COVID-19 vaccines change in Illinois in coming weeks?

A: Yes. Amid controversy over vaccine discussions at the federal level, a number of states, including several on the West Coast, have indicated that they plan to issue their own guidance this year. That’s a change from past years when states typically followed the CDC’s Advisory Committee on Immunization Practices’ recommendations.

That CDC committee is scheduled to discuss COVID-19 vaccines at a meeting Sept. 18 and Sept. 19.

Illinois’ own Immunization Advisory Committee will consider the federal committee’s recommendations but also many other sources, such as guidance from medical societies and other states, before making recommendations to the state health department, wrote Dr. Sameer Vohra, director of the Illinois Department of Public Health, in a letter last month.

The state health department plans to issue its own vaccine guidance by the end of September.

A health department spokesperson previously told the Tribune that if state recommendations differ from federal ones, providers may follow state recommendations.

Some major medical groups have made recommendations that differ from FDA guidelines for the updated vaccines. The Itasca-based American Academy of Pediatrics has recommended updated COVID-19 vaccines be given to all children ages 6 months to 23 months old, to older children who meet certain criteria, and that the vaccines be made available to all children whose parents want them to have it.

The American Academy of Family Physicians is also recommending vaccination for all adults.

States including Illinois may look to those groups’ recommendations as they form their own.

Q: Will health insurance plans cover the updated COVID-19 vaccines?

A: At this point, Illinois’ largest health insurer, Blue Cross and Blue Shield of Illinois, has not made any changes to its vaccine coverage, said spokesman John Simley in a statement.

Blue Cross is “currently reviewing the updated COVID-19 guidance from (the U.S. Department of Health and Human Services),” he said.

Under federal law, health insurers must cover vaccines recommended by the Advisory Committee on Immunization and adopted by the CDC director, according to KFF, a nonprofit organization focused on health policy. But it’s unclear what that committee might recommend when it meets next week.

At a national level, health insurance industry group AHIP is working with its member insurance companies to review the FDA approvals and will be monitoring recommendations from the federal committee and the CDC, said spokesperson Tina Stow in a statement.

“Individual health plans and plan sponsors will be prepared to make coverage decisions informed by science, the latest medical evidence and data,” Stow said. “This process will be evidence-based, evaluate multiple sources of data, including but not limited to (the Advisory Committee on Immunization Practices), and will be informed by customer needs.”

Without insurance, COVID-19 vaccines can cost as much as $130 or $140 a dose, according to the CDC.

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