COVID Vaccine Updates for 2025: what’s new, who can get one, and how to avoid the runaround

Short version:

What changed this year?

  • New formula: FDA advised manufacturers to use a JN.1-lineage (preferably LP.8.1) strain for 2025–26. That’s what you’ll see on packaging and clinic websites.

  • Who’s on the label:

“High-risk condition” means things like heart or lung disease, diabetes, immune suppression, and more (see CDC list).

What do major medical groups say?

Why getting a shot may feel harder this Fall

  1. Confusion about labeling and guidelines. Pharmacies generally follow the FDA label. Many stores are vaccinating 65+ and younger people who are high-risk. If you’re under 65 without a listed condition, they may ask for a prescription or say they can’t do it. So far in Texas prescriptions are not required, but you may be asked to attest to having a high-risk condition if you don’t have a prescription.

  2. Uninsured adults: CDC’s Bridge Access program ended in August 2024, so free adult doses now depend on local/state programs and community clinics.

How to get your shot with less hassle

Step 1 — Decide where to go.

  • 65+ or high-risk at any age: Most pharmacies and clinics can vaccinate you now.

  • Pregnant or getting a child vaccinated: Start with your OB/GYN or pediatrician to see if you can receive the vaccine in their office.

Step 2 — Call or check online first. Ask three quick questions:

  1. “Do you have the 2025–26 COVID-19 vaccine in stock?”

  2. “Do you require a prescription for my age/health situation?”

  3. “What proof of a high-risk condition do you need (medication list, problem list, diagnosis code, etc)?”

Step 3 — If a prescription/order is needed:

  • Message your primary care physician, OBGYN, or pediatrician and request an order for the 2025–26 COVID-19 vaccine based on your risk factor(s).

Step 4 — Bring the right info:

  • A medication list and a note (or portal printout) of any high-risk conditions. That’s often enough for on-label vaccination under 65.

Cost & coverage tips

  • Medicare (65+): Shots are covered. Bring your Medicare card.

  • Private insurance / Medicaid: Coverage can vary this year. Call the number on your card and ask: “Is the 2025–26 COVID-19 vaccine covered at $0 for me?” (Historically, plans must cover ACIP-recommended vaccines without cost-sharing.)

  • Cash price: If you’re paying out of pocket, pharmacy prices can exceed $100 (discount coupons may lower this). Ask before you book.

  • Uninsured: Check your local health department or community health center for free or low-cost clinics; some states have new programs replacing CDC’s ended Bridge Access. Harris County Public Health has available vaccines for our patients locally.

Which brand should I choose?

All three brands (Pfizer, Moderna, Novavax) use the 2025–26 formula. The main difference is which ages are on-label under 65. If you’re 65+, any brand is on-label. If you’re under 65, your clinician or pharmacist can match you to an option that fits your age and health conditions.

Final thoughts

  • COVID-19 can still cause severe illness, especially in older adults and people with certain conditions. Vaccination lowers that risk.

  • If you hit a roadblock at a pharmacy, it doesn’t mean you would not benefit from a vaccine. Reach out to your physician to discuss if vaccination is right for you, and obtain a prescription if needed.

At Vida Family Medicine- we are committed to helping our patients access the care they need to stay well. If you are a current patient and have questions about vaccinations or need assistance from your physician to access a vaccine- please reach out to your physician directly so we can help! If you are not a current patient and need assistance- we are currently accepting new patients! Please contact us to learn more and schedule your first appointment.

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