More than two dozen major medical groups are urging payers to continue covering COVID-19 vaccinations for pregnant patients without burdensome utilization management or cost-sharing requirements.
The June 11 letter comes several weeks after HHS Secretary Robert F. Kennedy Jr. said the CDC would no longer recommend routine COVID-19 vaccinations for healthy children and pregnant women. The move drew criticism from healthcare groups who raised concerns about the change being made without a thorough scientific review, and its potential to significantly limit vaccine access.
CDC immunization guidance is highly influential, with insurers broadly basing coverage decisions off the agency’s recommendations.
“It is vital that we ensure that pregnant women continue to have access to this prevention tool so that they can protect themselves and their young infants, a vulnerable group who is not yet eligible for vaccination,” medical groups — including the American Medical Association, the American Nurses Association and the American College of Obstetricians and Gynecologists — wrote in the June 11 letter.
“Payers should be fully reimbursing for the cost of providing immunization counseling and administration services for all evidence-based vaccinations without utilization management practices or cost-sharing requirements for all patients, including pregnant patients. Payers have the authority to go above and beyond the baseline federal recommendations for vaccinations and can provide equitable and free access to this critical tool to increase availability for all patients.”
Two days after Mr. Kennedy’s announcement tightening vaccine recommendations, the CDC updated its childhood immunization schedule, continuing to recommend COVID vaccinations for healthy children 6 months and older based on shared-decision making.
