With the end of a key federal program, it’ll be harder for uninsured Wisconsin residents to get a free COVID-19 vaccine.
The Bridge Access Program, a federal program that provided free vaccinations for those uninsured and underinsured, ended in late August.
Dr. Ben Weston is Milwaukee County’s Chief Health Policy Advisor and an Associate Professor of Emergency Medicine at the Medical College of Wisconsin.
He says the updated COVID-19 vaccine could cost people without health insurance upwards of $200. But with the help of some local health departments, there will be a limited supply of free COVID-19 vaccines.
Lake Effect’s Xcaret Nuñez spoke with Dr. Weston to learn more about the latest COVID-19 vaccine rollout.
This interview has been edited for length and clarity.
Late last month, the Food and Drug Administration approved new COVID shots, which comes at a time when most of the U.S., including Wisconsin, is still caught up in a summer wave of COVID-19. How are these new COVID vaccines different from previous ones?
So there are a few differences. I think the most important difference is that they're updated, and that means that they target the most recent, the newest variant or strain. It's an alphabet soup of variants. But for those who want detail, it's the KP.2 variant, and so that's what's going around. It still is Omicron, which everybody has probably heard of, but it's the latest [variant]. So when you get the newest vaccine, you have the most up to date protection. The other thing that's newer about this is just a simplified dosing schedule. So for most adults, you only need one dose of this vaccine to stay protected. Now, for certain folks who are older or are immunocompromised, they may want to get a second dose partway through the year. But long story short, this is an updated vaccine to maintain your immunity as much as possible against COVID.
Around the same time that these new COVID vaccines were approved, the Centers for Disease Control and Prevention sunsetted the Bridge Access Program. Can you explain what this program was designed to do and why it ended right?
So the Bridge Access Program was a federal program. It ensured that uninsured individuals could still get vaccinated. But unfortunately, now that the landscape of COVID has changed, that's no longer the case. So that makes, to be frank, for a more complex landscape of how to go about getting your vaccine, depending on whether you have insurance or you don't have insurance. So for folks who have insurance, whether it's private insurance, Medicare, Medicaid, they should be covered. Probably the easiest thing is to go to your pharmacy, and your pharmacy, you can ask them, but typically we'll cover anyone with any of those insurances to get the vaccine.
Where it becomes trickier is for folks who don't have any insurance. For those individuals, it's more challenging. They have to search a little bit more. I think the easiest thing to do is contact your local health department, whether that's a municipal health department or a county health department, call them up, tell them you don't have insurance and that you're looking to get the COVID vaccine. I'll tell you, in Milwaukee, for example, the Milwaukee health department is offering the COVID vaccine for free to individuals without insurance who are residents of Milwaukee. So that's one example of the health department using the funding that they have to overcome this lack of the bridge access program, but to be sure, it is a more complex landscape than it was a year ago.
So it sounds like this will be a huge hit to people who are uninsured and underinsured. In Milwaukee County alone, nearly 10% of residents are uninsured. With the timing of this program ending, how is the Department of Health managing this obstacle?
So one clarifying point — the county, of course, doesn't have a health department. We have municipal health departments. So the health department I was talking about is the City of Milwaukee Health Department offering the vaccine free or low cost for folks who don't have insurance. Other health departments in Milwaukee County are as well. But that gap can be challenging to fill, and it comes at a difficult time when we have increased vaccine hesitancy among members of the community, and the last thing we want to do is put up more barriers to getting that vaccine. We really really want to take down [barriers] just like we have throughout the pandemic, and put COVID aside, it's for any vaccine. We want to take down barriers as much as possible for vaccines, for healthcare access, and this is an added barrier that people have to overcome. Hopefully, it's a small barrier — hopefully with health departments engaged and pharmacies engaged, it's not too hard to overcome and to find the vaccine for free, but it is an extra step.
For someone who is uninsured or underinsured, if they were to get the newest COVID vaccine, it could cost them upwards of $200 Do you know what makes this vaccine so expensive, or what makes up the cost of this vaccine?
It's not inexpensive. $200 is a significant amount for most folks, and that price reflects all sorts of costs. It involves the cost of research to get the vaccine developed, the cost of manufacturing that vaccine, distributing and administering the vaccine. So there's a lot of different things that are bundled up in that cost, but for the end user, for the person who's looking to get vaccinated, they don't really care how that cost came about. It's too high. So hopefully, whether it's through their insurance coverage or their local health department, they can bring that cost down to $0 and get a vaccine to protect themselves, protect their family, and make sure they can stay healthy through the winter.
Even as we're coming out of a summer surge of COVID cases, do you expect cases to go up again in the winter?
So it's really hard to predict, but certainly what we've seen with COVID is that during the summer and during the winter we tend to see spikes. It's not, I don't think, quite as defined as seasonality quite yet, but we do have several years of data, and each winter we have seen an increase in COVID. Right now, we're seeing signs of a decline. And of course, we want to look at all of this in perspective. This increase is nothing near what we've seen before with COVID. Nonetheless, we have folks getting hospitalized, especially when you look at the population over 65. We are seeing a decline [in COVID-19 cases] right now, but I would say looking at the past few years, it's very likely that come winter, we'll see an increase again. To restate it, I don't think it'll be an increase like we've seen years ago, where we're seeing massive levels of hospitalizations and deaths, but I do think it's likely that we'll see an uptick in the amount of COVID.
Who should be getting vaccinated once these booster shots roll out?
So the simple answer is, everyone. Everyone six months and older should get this vaccine. It's the safest way to effectively obtain immunity from COVID. There's no doubt about that. But then we can drill down a little bit. And if we really want to target our resources, which we have to it, it really is older age groups, specifically 65 and older. So to put that into context, back when we had the surge from Omicron back in January of 2022, that was when we had skyrocketing hospitalizations. We were worried about hospital capacity. At that time, older age groups were hospitalized at a rate about twice as high as the next oldest age group, the middle-aged group. But now we're seeing the older age groups hospitalized at five times a higher rate. We just didn't see that sort of of dichotomy from COVID in the past. So that tells us that while the pandemic has largely normalized for a lot of the population, it hasn't done so as much for that 65 plus [age group], and so that's where we really need to focus our efforts. So whether it's your friends, your family, your neighbors, if you know folks over 65 [years old] those are the folks to encourage to get vaccinated. Offer them a ride. Talk about your experiences. Those are the people to really try to get vaccinated. We just didn't see a high enough uptake. Last year's updated vaccine in the fall was only received by about 29% of folks over 65 [years old] in the U.S. So we just didn't hit the numbers we needed to last year, and hopefully we can target it and do as well, if not better, this year.
When's the best time to get vaccinated?
Yeah, so let's do a short answer and a long answer. The short answer is, whenever you can get it. If you fit it in between work, if you happen to be at the grocery store when they're offering it, whatever it is, get the vaccine when you can get it.
Now, if you have the time, and you have the flexibility to kind of target when you get it, you can get more nuanced here. For example, if you've recently been infected with COVID, you certainly want to wait to get the vaccine. You want to give it a couple of months for that immunity that you got from the infection to sort of wear off a little bit so you can get that boost from the updated vaccine. Likewise, if, for some reason, this would be unusual, but if, for some reason, you decided to get the previous vaccine in the last couple of months, you'd also want to wait to get your updated vaccine. Give it two, three months.
Now, the other reason why people may want to wait is if you want to be a little bit strategic and gamble a little bit on when the winter surge is likely to come. So with most of the winter surges, we've seen it around January or so, and we're just coming out of our current increase. So one could argue, you wait till later in October, you get your COVID vaccine at that point, and then you let your immunity last a little bit longer. Who knows? Maybe the spike will be December this year? Maybe it'll be November. Maybe it won't come at all. It's hard to say. But that's another reason why folks may want to wait.
Now, some reasons not to wait are, if you are in a high risk group, if you're over 65 [years old], if you're immunocompromised, those would be some reasons why you'd probably want to go get the vaccine right away, to maintain your protection, because… certainly, if you're in one of those higher risk groups, you could get real sick.
