After several weeks of rising COVID-19 cases in San Diego County, numbers are starting to dwindle according to data published Thursday by the County. The recent surge has prompted people to get vaccinated. But some San Diegans trying to get a COVID-19 vaccine now are running into obstacles.
Cancelled appointments, insurance issues, even Medicare patients have had difficulty accessing shots in recent weeks, physicians and other health practitioners have said.
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices is scheduled to meet next week. The group, known as ACIP, helps set vaccine recommendations nationwide but has yet to vote on those guidelines this year. The delay is part of the problem for Jacinda Abdul-Mutakabbir’s patients.
“They are unable to get vaccines through our clinic because San Diego County needs an ACIP recommendation to be able to provide those vaccines to patients,” said Abdul-Mutakabbir, an associate professor of clinical pharmacy at UC San Diego who also runs vaccine clinics in underserved areas.
San Diego County Health and Human Services hasn’t received doses of the new vaccine, according to spokesperson Fernanda Lopez, but they are monitoring updates through the state.
Abdul-Mutakabbir said clinic staff now have to pre-check insurance to avoid surprise bills.
“Some plans do have stipulations where they require that ACIP recommendation for us to provide that vaccine and for people to be able to receive it free of charge,” she said. “With us having, you know, a lot of seniors, that's really the question of, can I get this vaccine and not have to pay for it?”
Medicare officials said it covers the vaccine at no cost. But pharmacies and clinics are still updating billing systems, causing gaps in coverage.
For now, people under 65 without high-risk conditions can’t get the new shot under current guidelines from the U.S. Food and Drug Administration, unless their doctor steps in.
“I am a patient's advocate. We want to do the best for our patient. And sometimes that means what's called prior authorization,” said Dr. Davey Smith an infectious disease specialist at UC San Diego.
He said doctors can sometimes write a prescription and work with insurance to get the shot covered.
In California, CVS Pharmacy said patients can get the new vaccine with a prescription. The out-of-pocket cost is nearly $225. But until ACIP issues guidance, broader access is on hold.
Hospitals are waiting too. Sharp Health and Kaiser said they’ll move forward once CDC guidance is finalized. Scripps expects the new vaccines this week but said it won’t give shots until the rules are clear.
In the meantime, experts recommend asking your doctor for a prescription, confirming coverage, or getting other seasonal shots like flu and RSV.
Abdul-Mutakabbir also recommends basic precautions.
“I would say continue to mask…keep that social distancing. Make sure that you're washing your hands,” she said.
Experts hope that once ACIP’s recommendations are issued, access to the new boosters will open more widely across San Diego.
