When COVID-19 vaccines entered the commercial market last fall, the federal government launched a program to make vaccines available to people with limited coverage or without insurance. That program — which provided millions of free vaccines to low-income people — is now being discontinued, U.S. health officials said.
The Bridge Access program is expected to end in August, months earlier than local health departments and health centers expected, as congressional pandemic funding expires. Biden administration officials are seeking permanent funding so that routine vaccinations can remain free for adults, through a program similar to the long-running Vaccines for Children program, a Centers official said by email for Disease Control and Prevention.
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Leaders of health centers and departments said that without the Bridge Access Program, they worry about how they will obtain funding for vaccines in anticipation of the winter respiratory virus season, when hospitalizations and deaths tend to increase. increase. Many low-income Americans may not be able to afford vaccines against the novel coronavirus and its countless variants. Updated vaccines will be formulated to target these strains, but pandemic-era funding will be gone.
“Money is not unlimited, but COVID is still with us,” said Frederica Williams, CEO of Whittier Street Health Center, a federally qualified health center that primarily serves low-income communities of color from Boston. The program leveraged Bridge Access funds to administer vaccines.
About a fifth of the center’s patients are uninsured, including many new migrants from Haiti and Central and South America, Williams said. That doesn’t include others — like rideshare drivers or restaurant staff — who may have some health insurance but don’t have insurance coverage for vaccines.
Last fall, CDC Director Dr. Mandy Cohen visited the Whittier Street Health Center to promote the updated COVID-19 vaccine. The sudden stop in funding surprised Williams. As of this week, she said, the health center has not received notice that the Bridge Access program will end.
Leaders of the National Association of Community Health Centers, a nonprofit advocacy group, said they knew the program was temporary but were surprised to learn it was ending in August . As looming respiratory illnesses such as influenza, RSV and COVID-19 increase during the colder months of this year, health centers will continue to vaccinate people daily, said Sarah Price, director of the integration of public health of the association, in a press release. “Health centers will store these vaccines or refer to resources within their community – with the aim of overcoming barriers to access and closing the loop,” she said.
Since its launch on September 13, 2023, Bridge Access has provided more than 1.4 million free COVID-19 vaccines through retail pharmacies, community health centers and public health departments across the states -United States, David Daigle, a spokesperson for the Centers for Disease Control and Prevention, said in an email. The CDC did not respond to inquiries about whether the agency had informed health centers and departments that the Bridge program would end in August.
“After August, there may be a small amount of free vaccine available through health ministries’ vaccination programs, but supply would be very limited,” said Daigle, in an email first shared on social media by a CBS News reporter. “We don’t yet know if manufacturers will have patient assistance programs.”
Vaccine makers Novavax and Pfizer said by email that they plan to evaluate their accessibility options for U.S. consumers following this change and help ensure vaccines are accessible to uninsured and under-insured patients. -insured. Moderna did not respond to a request for comment.
When a federal panel broadly recommended the updated vaccine in September, many people faced obstacles trying to pay for the shots. Major American pharmacies charged more than $100 per dose. In that time, the Bridge Access Program became a beacon, cited by many on social media, offering shots to people struggling to afford them.
The loss of the program led health officials to worry about a surge in cases.
“This creates a barrier that could lead to much larger resurgences of COVID,” said Dr. Walter Orenstein, associate director of the Emory University Vaccine Center. Orenstein previously worked as director of the U.S. National Immunization Program when the Vaccines for Children program launched in the 1990s and foresees problems if vaccines are not made more accessible.
“I hope I’m wrong. But I think it’s better to remove barriers to access when we have such safe and effective vaccines than to prevent people from wanting those vaccines.”
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The United States has reached a record level of uninsured people, the Department of Health and Human Services announced in August. However, around 7.7% of the population, or around 25 million people, still do not have health insurance. Among adults 18 and older, 11% are uninsured. Experts say many people without insurance are people of color and immigrants. Uninsured people also tend to be younger, lower-income, and live in Southern states that have not expanded access to Medicaid. This demographic includes millions of undocumented people who are not eligible for federal health coverage.
Additionally, millions of adults have weak health coverage through their employers, and many earn too much to qualify for Medicaid. People in this category would likely have had difficulty getting a COVID-19 vaccine without Bridge Access funding.
Vaccine funding ends as Medicaid is canceled in the United States. Nearly 22 million people who received Medicaid during the pandemic were disenrolled as of May 10, according to KFF, a nonpartisan health policy organization.
An exception is North Carolina, where the state legislature expanded Medicaid to adults in late 2023. The state has seen a smaller decline in Medicaid enrollment than elsewhere in the country. The state covered the cost of preventive vaccines, according to Raynard Washington, director of the public health department in Mecklenburg County, which includes Charlotte.
About 13 percent of the county’s adult population is uninsured, Washington said. These patients are disproportionately Latino and foreign-born. Many of the county’s underinsured people, who also received the vaccines, work jobs without benefits or make too much money to qualify for Medicaid.
Washington, who chairs the Big Cities Health Coalition, a consortium of senior US health officials, believes Congress should work to improve public health systems rather than roll back initiatives put in place since the pandemic. He said it is important to invest in vaccines to protect ourselves and
He said it’s important to invest in vaccines to protect yourself and others at risk of serious illness.
“In the case of COVID, of course we know that some people are still very vulnerable to severe illness,” Washington said. “So these vaccines save some people’s lives in many ways.”
The Washington coalition supports the Biden administration’s adult vaccine proposal, which did not pass.
It is not time to give up on COVID-19 prevention, he said.
“We need to invest both in times of crisis and when we are not in crisis,” he said.
The next round of COVID-19 vaccines – intended to target dominant strains – has not yet been launched. When it does, Washington expects local and state jurisdictions to cover the cost with other resources.
At the Whittier Street center in Boston, Williams said she recently received a call from two patients who tested positive for COVID-19.
The Haitian man and Williams woman had met at a local church program and asked about antiviral medications available through the state public health department. They were not insured. She told them the program they were asking about was ending in March, but that the Whittier center would cover their treatment regardless of their insurance.
The need for care remains, even though the pandemic has eased, she said.
“We just have to find a way, as we always have, to make sure that we continue to stay true to our mission,” she said.