It sure has been a while (hasn’t it?) since I have had to write one of these emails, but I do believe it’s time.
Fresh on the heels of a concerning article in the Arizona Republic (where I was quoted), many patients have significant and important questions, like should I get the vaccine this year? Especially considering conflicting recommendations between professional organizations and the CDC, this is a very important question. https://www.azcentral.com/story/news/local/arizona-health/2025/09/06/updated-covid-shots-arizona-vaccination-how-to-get/85944046007/
The current confusion over the Centers for Disease Control’s (CDC) recommendations for the Covid vaccine, under the direction of Robert F Kennedy Jr (Secretary of HHS), through the Advisory Committee for Immunization Practices (ACIP), have left many people, many pharmacies, many doctors, and many payers confused as to what’s actually recommended and even what should be or shouldn’t be covered.
The ACIP committee members have been completely changed out. There is not one person on that committee that was there last year. And continuity, in terms of what I would call institutional memory, is crucial in science. https://historyofvaccines.org/blog/how-two-key-committees-shape-americas-immunization-policy There are so many scientific studies that are done, read, reviewed, confirmed, and vetted year over year by circulating committee members. https://www.researchgate.net/publication/346242643_The_Public_Can_Trust_the_FDA's_Vaccine_Review_Process And to have a whole new committee really makes it difficult to rely on that committee (which I’ve relied on my whole career) for sticking to the science.
So, I guess each of us doctors need to do what we do best. Review the data. Confirm the science. Review with our other fellow scientists and physicians. Look to our professional organizations. Look to international organizations. Watch the local disease frequency. We train on this. Our undergraduate educations in the sciences gives us the basis in research, report review, statistics, epidemiology, etc. https://pmc.ncbi.nlm.nih.gov/articles/PMC1497128/
The World Health Organization (WHO) continues to recommend vaccinations for all groups, with priority to highest risk groups. This is because in many countries, vaccines are not widely available. https://iris.who.int/bitstream/handle/10665/373987/WHO-2019-nCoV-Vaccines-SAGE-Prioritization-2023.2-eng.pdf?sequence=1 In the US, we happen to be lucky enough that vaccines are greatly available. But now we have new barriers.
ACIP’s last recommendations for Covid19 vaccine actually date to 12/18/2024 https://www.cdc.gov/mmwr/volumes/73/wr/mm7349a2.htm . The 17 brand new members of the organization have not made any recommendations on this vaccine. In the state of Arizona, pharmacies can only provide vaccines recommended by ACIP. It is my feeling that since 12/2024 was the last recommendation by ACIP, that it should allow pharmacies to provide the vaccine. That is not how it is being interpreted.
The CDC’s website reflects that there will be a new policy, and they haven’t even had the expediency to change the website based on ACIP https://www.cdc.gov/covid/hcp/vaccine-considerations/overview.html . This is mostly because what is being put forward is opinion, not consensus. And we in medicine are greatly concerned that these 17 new members will follow political consensus rather than evidence-based and vigorously debated recommendations. Based on this slide deck I found https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/05-Panagiotakopoulos-COVID-508.pdf it is clear they plan to revamp recommendations against what has worked exceedingly well for the past four years. For no good reason.
Multiple studies continue to show that contracting Covid can and does lead to long term symptoms. This is particularly prescient in healthcare workers, those who are exposed to this illness regularly. https://bmjpublichealth.bmj.com/content/3/1/e000269 https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1582872/full .
It is for this reason, and the fact that people do continue to die from Covid illness https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm . On this chart, in 2025, so far 14,660 deaths are attributed to Covid on death certificates. And yet, the press does not report this. The CDC doesn’t highlight it. And social media suppresses it.
So, when asked, should adults get the Covid19 vaccine, my answer is a resounding yes. If the number of people it kills approaches the number of influenza deaths https://www.cdc.gov/flu-burden/php/data-vis/2023-2024.html then we should be protecting people.
We will be offering Novavax (Nuvaxovid) at our office, as well as Pfizer (Comirnaty) for those who choose. Both have equivalent efficacy https://www.yalemedicine.org/news/covid-19-vaccine-comparison and Novavax has been shown to be 100% effective against moderate to severe illness. I also found it to have less side effects and is made more traditionally (protein fragment with adjuvant). We will still offer the mRNA vaccine for those who elect to continue their mRNA generated immunity which is still safe and effective.
We do not have them in stock yet but hope to in the next few weeks. We will only be able to give these vaccines out to current, existing patients, and likely just during a normal office visit. We may not be able to order enough to run vaccine “clinics”.
It is unclear whether insurance companies will cover the vaccine. If you are curious, please call your insurance company, and ask if the following codes are covered under your insurance:
91304 Novavax Vaccine (Nuvaxovid) https://www.fda.gov/vaccines-blood-biologics/vaccines/nuvaxovid
91320 Pfizer Vaccine (Comirnaty) https://www.fda.gov/vaccines-blood-biologics/comirnaty
91322 Moderna Vaccine (Spikevax) https://www.fda.gov/vaccines-blood-biologics/spikevax
90480 Administration Code (for all vaccines)
I don’t know how much the vaccine will be if you pay cash, but likely somewhere between $180 - $200. We can let you know at our office once we have them in hand. Also, because it’s unclear if insurance companies will be covering it, we will ask you to sign a guarantee of payment form that will confirm your agreement to pay for the vaccine if your insurance company doesn’t pay for it, and the amount it would cost.
If we do not or cannot keep the Covid vaccine in stock in a timely fashion, we will be willing to write prescriptions for the vaccine to be received at the pharmacy. However, it is our intention at this time to provide vaccine to everyone who wants one.
So, thank you, all of you, for continuing to read these updates. So many of you have given me positive feedback on them. But, more importantly, it causes you to think, to read, to research, and educate yourselves on your own health and what you can do to make it better and protect yourselves. I hope I provide enough references for you to read and draw your own educated conclusions.
For professional organization recommendations, please visit:
https://www.aafp.org/pubs/fpm/issues/2025/0700/discussing-covid-vaccination.html
For my social media links:
https://www.linkedin.com/in/andrew-carroll-501a9aa2/
https://bsky.app/profile/drcarroll.com (I am very political here, please don’t click unless you’re ready for it).
https://www.instagram.com/drajpcarroll/ (Not political at all, just pictures and real life)
Thank you, Dr. C! Much gratitude and respect from two of your longtime patients!