The COVID-19 pandemic has had worldwide impact on our daily lives, creating a new “normal” for most of us. In December 2020, the Food and Drug Administration (FDA) issued emergency use authorizations (EUAs) for two vaccinations, starting us down the path back to our pre-COVID “normal.” And on February 1, we hit a major milestone with more Americans receiving at least one dose of a vaccine (26.5M) than have tested positive for the virus (2.63M).[1]
As the vaccination rollout continues, you and your members may have questions. Following are some helpful answers.
About the Vaccines
Available Now: As of February 3, two vaccines—one from Pfizer-BioNTech and one from Moderna—have received EUA from the FDA. EUA is a way to facilitate the availability and use of medical treatments—including vaccines—during public health emergencies, such as the COVID-19 pandemic. Both vaccines are messenger RNA, or mRNA vaccines, a new vaccination approach and the first of their kind licensed in the United States. mRNA is a genetic vaccine that uses one or more of the coronavirus’ own genes to provoke an immune response. Both require two doses three to four weeks apart, offer over 94% efficacy and need to be stored at extremely cold temperatures.
In Development: Two vaccination candidates, AstraZeneca and a single-dose option from Janssen/Johnson & Johnson, will be seeking EUA from the FDA in the coming weeks.* Both of these candidates are adenovirus vaccines that may offer easier storage than the mRNA vaccines.
Safety: While some fear the safety of vaccines that were developed so quickly, all of the proper development and testing steps were followed, just at an expedited pace. Additionally, researchers were able to speed up the development process in part because they were able to use previously collected data from the SARs outbreak in the early 2000s.
Length of Immunity: Information is not yet available on the length of immunity provided by these vaccines and it is, therefore, not yet known if COVID-19 vaccinations will be required annually, like the flu shot.
* The FDA's Vaccines and Related Biological Products Advisory Committee will meet on February 26 to discuss EUA for the Janssen/Johnson & Johnson vaccine candidate.
Who Can Get the Vaccines
The Centers for Disease Control and Prevention (CDC) has recommended a phased roll out program that started with healthcare personnel and seniors living in long-term care facilities being prioritized for the vaccination, followed by frontline workers and people 75 years of age and older, then those aged 65 to 74, people with underlying health conditions and other essential workers. Each state or jurisdiction is determining prioritization, distribution and scheduling for their area. Additionally, the Pfizer-BioNTech vaccine is only for those 16 years of age and older, and the Moderna vaccine is only for those aged 18 and older.
Vaccine Availability
An agreement must be signed with the U.S. government in order to administer the vaccine. Numerous pharmacies, retail clinics, providers and other sites of care have signed such agreements and are administering doses per their areas’ distribution schedule. To get more information on who can get the vaccine and where in your area, it is best to check the department of health’s website for your state.
Rite Aid signed such an agreement and is providing vaccinations in the states and jurisdictions where it has been approved and scheduled. They are also working on a pre-registration process that will enable customers to receive timely information about vaccine scheduling. More information can be found at riteaid.com/covid-19, including a compilation of information on the prioritization and distribution schedules in the states where they are located, which can be found by clicking here.
Vaccination Costs
There will be no cost to individuals receiving the vaccine, regardless of their insurance coverage or site of administration. The cost of the vaccination will be covered with funding from the Coronavirus Aid, Relief and Economic Security Act (CARES Act). For Medicare beneficiaries, the vaccine will be administered under Medicare Part B and excluded from Part D coverage. Payers will need to cover any administration fees for the vaccine. Medicare payment for the vaccine and its administration will be made through the original fee-for-service Medicare program. Elixir has worked with all of our network pharmacies, providing information on how to become vaccinators and how to submit claims.
More Information
The vaccination rollout is dynamic and continually changing. Elixir is providing updated information on our website for both members and plan sponsors. In the meantime, it is important to continue rigorous COVID-19 testing. Rite Aid is offering free drive-thru testing at their locations for people age four and older, regardless of if they have symptoms, and will have results in two to three days. For more information on testing, click here.
[1] Cortez, M.F., Court, E. (2021). U.S. Hits Pandemic Milestone With More Vaccinated Than Cases. https://www.bloomberg.com/news/articles/2021-02-01/u-s-hits-milestone-in-pandemic-with-more-vaccinated-than-cases.
