OPINION: COVID vaccines for the 2025-26 season are available

Right now, there are so many questions about COVID-19 vaccines: Who should get them, will insurance cover the cost, where can a person get vaccinated? With all the confusion, some may wonder if they are safe.

We hope this op-ed will help to answer these questions and reassure people that New Mexico’s Department of Health is working hard to make vaccines accessible to those who want to get vaccinated. The NMDOH on Sept. 5 announced the state Board of Pharmacy’s new protocols now in place to provide the COVID-19 vaccine using state guidelines. The quick response supports New Mexicans who seek the vaccine, since federal guidelines have not yet been set. Respiratory season is around the corner, and COVID-19 still poses a risk to everyone, especially to our most vulnerable populations — those older than 65, those younger than 2 and those with underlying conditions.

Recently, there have been some big changes at the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP). This group helps make vaccine recommendations for the U.S. For COVID-19 vaccines, the Health and Human Services secretary changed the recommendations without the input of ACIP, and these changes are in opposition to the recommendations by respected medical groups such as the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetrics and Gynecology. It’s confusing to know what to do. When in doubt, talk to your health care provider for guidance.

New Mexico, along with many other states, wants to make good, sound, science-based decisions, and has listed new guidelines to help providers and the public navigate getting a COVID-19 vaccine.

Who should get vaccinated?

Most experts agree:

• Anyone age 65 and older.
• Anyone 6 months old to 64 years old, with a medical condition that puts them at risk for severe outcomes from COVID-19. (This includes many conditions.)

American Academy of Pediatrics adds:

• Children 6-24 months of age.
• Children whose parents or guardian want them to be protected from COVID-19.

American College of Obstetricians and Gynecologists advises:

• Pregnant patients should receive an updated COVID-19 vaccine at any point during pregnancy, when planning to become pregnant, in the postpartum period or when lactating.

Is the vaccine safe?

Most experts agree vaccination is the best possible way to keep safe from COVID-19. Three mRNA vaccines are licensed for 2025-26 and one adjuvanted vaccine. Age indications vary for each vaccine, but all are approved for 65 and older and for those age 12-64 who have underlying conditions.

Will insurance cover the cost?

Yes, no and maybe. For those 65 and older and those with underlying conditions, the vaccine should be covered by private insurance, Medicaid and Medicare. At this moment, a prescription from a health care provider may be required that documents an underlying condition for insurance to cover the vaccine in the 6 months to 64-year age group. If a person under age 65 does not have an underlying condition, they may be able to get vaccinated off-label but will need to be prepared to pay for the vaccine — which could cost up to $300 out of pocket.

Where can people get the COVID vaccine?

Call ahead to your local pharmacy to check on vaccine availability, or contact your health care provider to check if they will have the 2025-26 vaccine this year. Our state government is working tirelessly in response to support New Mexicans in staying safe from COVID-19. For questions about the COVID-19 vaccinations, call the NMDOH Helpline at 1-833-SWNURSE (1-833-796-8773).