COVID Vaccine Updates for 2025: what’s new, who can get one, and how to avoid the runaround
Short version:
This fall’s shots were updated to better match today’s variants (JN.1 lineage)
FDA labels now focus on people 65+ and people under 65 with certain health conditions. Pharmacies are mostly following those labels
Pregnancy and kids: Leading medical groups still recommend vaccines in pregnancy and for babies/toddlers 6–23 months even without a diagnosis of an underlying health condition.
Insurance coverage and accessibility of vaccines is in question- you may need a prescription from your doctor to receive a vaccine in a pharmacy.
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:
Pfizer (Comirnaty): approved for 65+, and ages 5–64 with a high-risk condition
Moderna (Spikevax): approved for 65+, and ages 6 months–64 with a high-risk condition.
Novavax (Nuvaxovid): approved for 65+, and ages 12–64 with a high-risk condition.
“High-risk condition” means things like heart or lung disease, diabetes, immune suppression, and more (see CDC list).
What do major medical groups say?
Pregnancy: ACOG recommends COVID-19 vaccination during pregnancy, citing strong safety data and benefits for both parent and baby.
Children: The AAP recommends vaccination for all children 6–23 months, and a risk-based approach for older kids and teens.
Why getting a shot may feel harder this Fall
Pharmacies 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.
Insurance coverage is tied to CDC recommendations. When CDC’s vaccine advisory group doesn’t recommend a shot broadly, plans aren’t always required to cover it at $0—so benefits can vary.
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:
“Do you have the 2025–26 COVID-19 vaccine in stock?”
“Do you require a prescription for my age/health situation?”
“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. PBS
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.) KFF
Cash price: If you’re paying out of pocket, pharmacy prices can exceed $100 (discount coupons may lower this). Ask before you book. GoodRx
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.
