What to know about COVID in CT, the vaccine and insurance coverage for fall 2025

Sep. 2—Public health officials are once again bracing for a rise in respiratory illnesses as the school year begins and colder weather approaches.

Here's what you need to know about this season's COVID-19 trends and vaccine recommendations.

How many people in Connecticut have COVID-19?

Parts of the country are seeing a recent increase in COVID-19 cases. Even so, it's not to the degree that has been seen before, including in Connecticut, said Dr. Scott Roberts, an infectious disease specialist at Yale New Haven Hospital.

In Connecticut, COVID-19 cases have fluctuated similarly to previous years, but overall remain low, with recent spikes falling well below earlier highs, according to data from the state Department of Public Health. There were a little more than 400 reported cases last week. Data does, however, remain difficult to track as many people do not report their cases.

Roberts noted that this past summer, the Yale New Haven Health System recorded its lowest COVID-19 hospitalization numbers since the start of the pandemic. At the same time, he said the trend leaves nowhere to go but up, warning of a possible spike in the coming weeks.

The virus is constantly evolving and mutating into milder versions of itself, Roberts said, and "we're always gonna have new variants."

The most prevalent strains of it, at the moment, include Nimbus and the Stratus variants, which are both on upswings based on CDC and wastewater data. Roberts said that both are descendants of the omicron mutation, with people reporting milder symptoms compared to the first COVID strain.

"I can tell you, with almost 100% certainty, we were going to have an increase at some point. We are increasing right now, but we're still well below the levels that we've seen with other surges," Roberts said, noting that this prediction is no different from last year's.

An increase in cases is expected in the coming weeks as schools resume, added Dr. Ulysses Wu, chief epidemiologist and system director of infectious diseases at Hartford HealthCare. He said that the arrival of the respiratory illness season in the fall and winter could further drive the numbers upward, highlighting the importance of preventative measures.

Wu said that only certain age groups should be getting the vaccine this far ahead of the respiratory season, but emphasized that vaccines remain important, as does ensuring universal access to them.

"From my standpoint, vaccination remains something that is very important to public health, and the more people that we get vaccinated — and they are safe vaccines — the more people that we can protect to a certain extent," he said.

Wu adds that washing your hands, wearing a mask in crowded places and not going out while sick are also habits that can help minimize exposure to the virus and potential illness.

What is the latest COVID vaccine guidance?

Earlier this week, the Food and Drug Administration approved the updated COVID-19 vaccines, but they had some notable changes from the historical recommendations.

Adults aged 65 and older are still advised to receive the vaccine. Still, for younger adults and children, it is now recommended only for those with one or more high-risk health conditions, such as asthma, cancer, obesity, depression, and others.

The FDA also announced it was revoking the emergency use authorization for Pfizer's vaccine in children under five. Moderna's Spikevax is now the only vaccine recommended for children as young as six months, but it's only for those with an underlying high-risk condition.

It's not the first time the federal government has made waves in the public health sphere this year.

Health and Human Services Secretary Robert F. Kennedy, a long-time vaccine critic, announced in May that COVID-19 vaccines would no longer be recommended for healthy children and pregnant women, a move that surprised many in the medical world. He also replaced the entire panel of medical experts who set the CDC's vaccine recommendations for the year with like-minded researchers.

At the same time, the medical research field is also still recovering from the loss of hundreds of millions of dollars in vaccine development grants.

What do experts think?

Following a risk-based approach to vaccines makes sense in theory, Roberts said, especially since many people have developed some form of immunity to the virus over the years. However, he thinks the agency's approach has been "a little bit haphazard," adding that he's not aware of new data showing an adverse impact on pregnant women or children.

"I deal with this every day. I have an administrative role in vaccine advisement for the Yale Health System. I'm an infectious disease physician. I have public health colleagues, I follow this stuff, and I don't know what's right one week or the other," Roberts said. " It's hard to keep straight for me, so I can't imagine how hard it is to keep straight for someone who isn't as immersed in this world and really doesn't know what recommendations to follow."

A long-term question that all these changes bring up for Roberts is whether the CDC will continue to be the best resource for health information.

Several national medical groups have issued their series of recommendations in response to the turbulence at the federal level. The American College of Obstetricians and Gynecologists has said pregnant women should continue to get the shots, following Kennedy's May announcement.

More recently, the American Academy of Pediatrics has recommended annual vaccinations for children aged six months and two years, which the Associated Press reports is the first time in 30 years that the organization has deviated from the recommendations of federal health agencies.

Wu said it's important for medical experts to take a stand, but this could also mark the beginning of a shift in which vaccine recommendations are made at the state level rather than the federal level.

He added that discussions around COVID-19 need to be more balanced — recognizing the risks without venturing into denial or panic.

"By that, I mean making sure that you're vaccinated. If you are sick, try not to get other people sick... if appropriate, washing your hands," he said. "These are all important things that we certainly need to consider going into this respiratory season."

Are COVID vaccines covered by insurance?

Medicare will continue to cover the vaccine for people aged 65 and older as a result of the new FDA regulations. However, the coverage of everyone else is still unclear.

Most health insurance plans cover vaccines recommended by the CDC and its advisory committee, but they have greater discretion when it comes to vaccines that are not on the list. Some may continue to do so, looking to more experts than just the CDC when deciding what vaccines to cover. Others may require a co-pay or may choose not to cover it at all.

Aetna, for example, said in a statement that it will continue to cover COVID-19 vaccines in accordance with state and federal cost-sharing rules, allowing members who choose to get vaccinated to do so without incurring out-of-pocket costs. For self-funded employer plans that Aetna administers, however, coverage decisions are made by the employers themselves.

A COVID-19 vaccine can cost up to $140 without insurance, according to the CDC.

"Pharmacies may not stock it, and we may all be indirectly hit by this," said Roberts, noting that it'll also worsen disparities in care. "I imagine that we may see vaccine supply broadly decrease with a lot of these changes, and that's going to impact everyone."

Roberts said he's curious to see where the CDC vaccine panel goes once they meet in a few weeks, but imagines that more narrow recommendations will follow.

In the meantime, he encourages anyone who thinks they might be at risk of a severe infection to discuss their vaccine eligibility with their health care provider.

Reporting from the Associated Press was used in this story.

Correction: This story's headline has been corrected to reflect the COVID guidance is for 2025.

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