The recently authorized Covid vaccines promised to protect the public against an expected uptick of respiratory illness this winter. But getting shots into arms is still proving challenging.
At first, there were distribution issues: Pharmacies and clinics had a limited number of doses, resulting in few or canceled appointments. Then there were snags with the new billing codes that providers and insurance companies need to pay for the shots. Those problems were to be expected, said Cynthia Cox, an insurance expert at the nonprofit think tank K.F.F., given that 2023 was the first year Covid shots were rolled out through the commercial market.
The early hiccups with claims and appointments for the Pfizer and Moderna shots have largely been resolved, she said, but other obstacles remain.
Doses for children, in particular, have been slow to reach doctors’ offices. “By the time we got our hands on them, and we knew the payers were going to pay for them, we had already missed opportunities,” said Dr. Tina Scott-Mordhorst, medical director of primary care for Children’s Nebraska in Omaha. Last fall, she said, the health system immunized close to 5,000 children in late September and October. This year, they were able to administer only around 600 pediatric doses in that time.
In New Orleans, when Michael Hoerger first checked the Centers for Disease Control and Prevention’s vaccine finder website, the closest appointment for his 1-year-old twins was six hours away. Several weeks later, he found an appointment in Baton Rouge, La., but that was still too far. “It was really frustrating,” he said.
If parents can’t find appointments with an in-network provider nearby, they may have to pay cash at an out-of-network clinic, fill out claim forms and wait for reimbursement. Children who get Covid shots through the Vaccines for Children program, including those who are eligible for Medicaid, have even fewer options for participating providers.
The end of the Covid-19 public health emergency has also made appointments harder to secure. Under the emergency declaration, pharmacy technicians, retired doctors and other providers could deliver shots, and pediatricians could set up large vaccine clinics inside schools.
“Now we can’t do these big public health drives to get shots in arms,” said Dr. Beau Gilmore, a pediatrician at Mosaic Community Health in Bend, Ore.
Another challenge: The declining interest in getting vaccinated, which has made it tough for doctors and pharmacists to correctly judge the demand when ordering shots.
According to a K.F.F. survey, a smaller share of adults plan to get the new Covid-19 vaccine compared with the flu and R.S.V. vaccines this year. And most parents say they will not get their child the updated shots, even if their child was vaccinated in previous years.
“Covid is just not at the top of people’s minds the way that it was when we were testing regularly,” Dr. Scott-Mordhorst said. But severe cases can still inflict long-term damage, and more than 1,000 people die of Covid each week, according to the Centers for Disease Control and Prevention.
Some adults have also raised concerns about difficulties accessing the updated Novavax vaccine, which clinical trials suggest has fewer immediate side effects than the Pfizer or Moderna shots and may provide longer-lasting immunity against severe disease.
Scott Lee, an entrepreneur who lives in North Bergen, N.J, said that when he tried to find a Novavax shot through the C.D.C.’s vaccine finder, it sometimes showed the shots as available when they actually were not, and some independent pharmacies that may have the shot weren’t listed.
When he tried to book an appointment online at CVS, he had to fill out a lengthy scheduling form — only to realize at the end that he needed to speak with a pharmacist by phone first to get a Novavax shot. “It’s been a bit of a disaster,” Mr. Lee said. CVS has since updated its website to say that the Novavax vaccine is carried at all locations and that appointments are not required.
Mr. Lee turned to crowdsourced resources to search for a dose and eventually got a shot at a CVS store nearby.
But others have not been successful in finding the shots. Many pharmacies that Cindy Sneeringer called near her home in Santa Fe, N.M., said they had only the Moderna vaccine, which she had a bad reaction to in the past.
“I’d rather not drive hours away from where I live to get it,” said Ms. Sneeringer, who has still not gotten her shot.
Experts said that they would like to see more people vaccinated soon, but that “we need to be patient,” Dr. Scott-Mordhorst said. “And we need to be willing to meet families where they’re at so that we can get them protected,” she added. She remains cautiously optimistic that vaccination rates will improve with time.
Many people continue to get flu shots through December, late in the flu season, she noted. Eventually the Covid vaccines may follow a similar pattern. What is important, Dr. Scott-Mordhorst said, is that people get vaccinated before the holidays, when they are more likely to gather indoors or travel to see family.