Michigan is one of 34 states seeing a summer rise in COVID-19 infections, according to the CDC, as questions swirl about who will be eligible for updated fall vaccines, how insurance will handle coverage, and when doses will be widely available.
The coming wave arrives amid uncertainty over the availability and eligibility rules for updated vaccines this autumn, and as debates continue over who should be prioritized for boosters. A central driver of the confusion is a widening split between major medical groups and Robert F. Kennedy Jr., the head of the Department of Health and Human Services, who has reshaped vaccine guidance and the process by which vaccines are reviewed in the United States.
Vaccination plans for the fall remain unsettled. Pharmacy leaders in Michigan say the rollout timetable and coverage details have yet to be clarified, with questions about which populations will be eligible and whether insurance will cover everyone who wants a booster. “Everything is kind of up in the air … with what’s going to be available and what’s not,” said Farah Jalloul-Rizk, chief pharmacy officer with the Michigan Pharmacists Association.
Kennedy Jr. has been at the center of several leadership changes that have unsettled confidence in vaccine recommendations. In May, he announced that updated vaccines would not be recommended for healthy children or pregnant women due to a perceived lack of clinical data supporting a repeat booster strategy. He also dismissed all 17 members of the Advisory Committee on Immunization Practices (ACIP) and installed eight new members, including some who have expressed vaccine skepticism, triggering lawsuits from multiple medical groups.
ACIP’s reshuffling and the subsequent pushback from medical organizations have fed into concerns about how vaccine guidance will be shaped for fall. The groups say they have been barred from contributing to data reviews and recommendations, a move that they argue undermines the credibility of the vaccination program.
Despite the policy shifts, several major Michigan insurers say they will continue to cover COVID-19 vaccines for their members. Blue Cross Blue Shield of Michigan affirmed that there are no changes to vaccine coverage. Health Alliance Plan of Michigan and Priority Health also stated that their plans cover COVID-19 vaccination consistent with CDC and state guidance, while noting that plans will continue to review evolving recommendations from the CDC’s ACIP, the U.S. Preventive Services Task Force, the Michigan Department of Health and Human Services, and other medical groups.
What sparked the current controversy over boosters? Kennedy Jr.’s May announcement that vaccines for healthy children and pregnant women should not be routinely recommended was followed by a broader shake-up of vaccine governance, including the removal of ACIP members and a push to appoint new voices to the committee. Some medical groups protested, arguing that the science supports vaccination during pregnancy and for children to protect mothers, infants, and the broader public.
As the dispute escalated, Pfizer raised concerns that the FDA might revoke the emergency use authorization for Comirnaty in healthy children under five, complicating the fall vaccination landscape. With only Moderna’s Spikevax authorized for certain pediatric groups and varying rules for young children, manufacturers are racing to align with regulators on new formulations.
At the same time, a range of expert bodies is weighing new guidance. The American Academy of Pediatrics (AAP) released its own guidelines in August, recommending vaccination for most children 6 months and older and outlining risk-based considerations for older children and teens. The CDC’s current guidance, as of mid-August, continues to reserve routine vaccination for older adults and people with underlying conditions, while inviting shared clinical decision-making for others.
Michigan’s health leadership has aligned with broader pediatric and obstetric guidance, supporting vaccination during pregnancy and for anyone 6 months and older to protect against severe illness. Dr. Natasha Bagdasarian, the state’s chief medical executive, noted the high risk of hospitalization among infants under six months and urged residents to discuss vaccination with their providers.
Looking ahead, the debate also touches broader issues about preventive care: Kennedy Jr. has floated replacing all 16 members of the U.S. Preventive Services Task Force, a move AMA officials warned could undermine evidence-based preventive care. In June, ACIP recommended removing thimerosal from all flu vaccines, a decision Kennedy Jr. endorsed, though Jalloul-Rizk observed that thimerosal had already been largely phased out in U.S. vaccine supply, especially in single-dose vials.
For the fall season, vaccine manufacturers are ramping up production in hopes of regulatory approval. Moderna’s Spikevax is authorized for those 65 and older and for younger people with certain health risks; Pfizer-BioNTech’s Comirnaty faces uncertainty if its EUA for some pediatric groups will be revoked; Novavax’s Nuvaxovid is positioned as an alternative for certain age groups with underlying conditions. Grenier of Sanofi emphasized efforts to make Nuvaxovid available nationwide once approved, with expected broad coverage by insurers when used through in-network providers.
ACIP’s next steps are anticipated in September or October, as federal advisory bodies weigh updated formulations and eligibility. In the meantime, Michigan pharmacists are following CDC guidance that supports vaccination through shared clinical decision-making for healthy individuals under 65 who request a dose, while authorities work through the policy questions about payer coverage and universal access.
What this means for residents
– If you’re considering a fall booster, check with your insurer about coverage for updated vaccines and discuss eligibility with your healthcare provider.
– Expect potential variability in what vaccines are available by provider and pharmacy, depending on regulatory decisions and state alignment with federal guidance.
– Pregnant individuals and caregivers of young children should stay informed about evolving recommendations, as expert groups emphasize the protective benefit of vaccination during pregnancy and for infants and children.
– Monitor updates from official health authorities and your local health department for guidance on when vaccines will be available at pharmacies and clinics near you.
Summary
A summer surge in COVID-19 cases is prompting renewed attention to vaccination, but shifting leadership, mixed recommendations among major medical groups, and ongoing debates over who should be eligible for updated boosters are clouding the rollout for fall. Michigan health leaders and insurers are signaling continued support for vaccination, with clinicians urging residents to consult with providers to determine the best course of action amid the evolving guidance and regulatory landscape.
Additional comments
– The situation highlights the need for clear, consistent communication from federal and state health authorities to reduce confusion among patients and providers.
– Public health messaging that emphasizes the safety and benefits of vaccination, especially for pregnant people and young children, could help protect vulnerable populations as new formulations are reviewed.
Potential positive angle
– Despite policy upheaval, insurers in Michigan are maintaining vaccine coverage, and state health officials are aligning with pediatric and obstetric guidance to promote vaccination where appropriate, signaling a path toward broader protection if regulatory decisions permit timely access to updated vaccines.