The Centers for Disease Control and Prevention (CDC) signed off this week on an advisory committee’s recommendations for updated COVID-19 vaccines for the 2025–2026 season. Under the new guidelines, each person should make their own individual decision about whether to get a COVID-19 vaccine, in consultation with a healthcare provider.
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“Informed consent is back,” CDC deputy secretary Jim O’Neill said in a statement. “CDC’s 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today.”
Read on for more information on what these changes may mean for you, if you’re now unsure of whether or how to get vaccinated and whether insurance will pay.
How Are the New Guidelines Different?
Before this year, the CDC recommended that everyone ages 6 months and older get a COVID vaccine and annual booster shots.
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With its recent decision, the agency no longer recommends vaccination for everyone. Instead, the new guidelines encourage people of all ages to seek medical advice to determine their risk of COVID before considering the shots on a case-by-case basis.
The CDC notes that, for people at high risk of COVID-related complications, the benefits of vaccination may outweigh the risks. The agency previously noted that this high-risk group includes people over 65; individuals with chronic health issues like asthma, heart disease, and obesity; and people with compromised immune systems.
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What Does It Mean to ‘Consult a Clinician’?
The CDC announcement said that shared clinical decision-making means talking to a healthcare provider, “including physicians, nurses, and pharmacists.” It didn’t specify whether you need to have an in-person visit to discuss your vaccination options.
Many people may still be able to walk into a pharmacy and get vaccinated without taking any extra steps — just like they did in the past.
The CDC recommendations don’t require a prescription for COVID shots.
Can Anyone Get a COVID Vaccine if They Want One?
The new CDC recommendations don’t prohibit anyone from seeking out a COVID shot if they want one.
Who Should Get a COVID Vaccine?
Major medical organizations like the American Academy of Family Physicians continue to recommend vaccination for everyone ages 19 older, especially people with risk factors that make them more vulnerable to severe COVID, such as older age (65 and over) and certain medical conditions.
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The American Academy of Pediatrics urges vaccination for children who are at high risk of severe COVID, which they say includes babies ages 6 to 23 months and kids ages 2 to 18 who have medical conditions or other issues that increase their risk.
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The American College of Obstetricians and Gynecologists strongly recommends vaccination at any point during pregnancy to prevent severe COVID that could prove dangerous to the mother or baby.
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Do I Need to Explain Why I Want a COVID Shot?
The new CDC recommendations don’t require people to prove that they spoke to a healthcare provider or that they have an underlying health condition or other risk factor in order to get a COVID vaccine.
How Do I Get a COVID Vaccine?
The drugstore chain Walgreens says that COVID shots are available at locations nationwide without a prescription for individuals ages 3 years and older.
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CVS says that the shots are now available nationwide without a prescription, according to a report in The Mercury News.
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Will Insurance Cover My COVID Shot?
The CDC says that its recommendation for individual-based decision-making allows for insurance coverage through all government entitlement programs, including Medicare, Medicaid, the Children’s Health Insurance Program, and the Vaccines for Children Program, as well as insurance plans regulated by the Affordable Care Act.
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Likewise, most people with employer-provided insurance will still be able to get the shots covered. AHIP, the trade group representing many of the largest health insurance companies in the United States, said in September that its members would cover COVID vaccines at no cost through the end of 2026.
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Without insurance, you can still get the shot, but it may cost between $225 and $250 out of pocket, according to CVS.
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