Eligible Ohio residents are now able to get COVID vaccinations if they desire.
The FDA approved the 2025-2026 COVID-19 vaccine for use in individuals who are 65 years or older, or 6 months to 64 years of age with at least one underlying condition that puts them at high risk for severe outcomes of COVID-19 disease.
"As of today, pharmacies in Ohio are receiving shipments of and giving COVID vaccinations under our protocols (meaning without a prescription) for any qualifying patient," said Sarah Priestle, owner and pharmacist in charge at Hart Pharmacy. "Patients must fill out a vaccination consent form where they are asked to attest that they are eligible for the vaccine. Doctors may also send in a prescription for a patient they would like to receive the vaccine."
On Cincinnati Edition, we discuss vaccinations for the 2025-2026 season.
A transcript of this conversation is below.
This episode was transcribed using a combination of AI speech recognition and human editors and has been lightly edited for clarity. It may contain errors. Please check the corresponding audio before quoting in print.
Guests:
- Carl Fichtenbaum, MD, vice chair for clinical research for internal medicine, University of Cincinnati
- Chris Peltier, MD, pediatrician, Pediatric Associates of Mt. Carmel, Inc.
- Melissa Wervey Arnold, CEO, Ohio chapter of the American Academy of Pediatrics
- Sarah Priestle, RPh PharmD, owner and pharmacist in charge, Hart Pharmacy
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Transcript
Dr Fichtenbaum, can you tell us more about how the CDC guidance on COVID vaccines has changed? Who is the CDC saying should get it?
Fichtenbaum: The Committee on Immunization Practices usually makes recommendations, and those go to the director of the CDC. In the absence of a director, the Department of Health and Human Services director may accept them or reject them. And the latest recommendations and guidance on COVID vaccination is that it is recommended for individuals 65 years of age and older, and those individuals who are adults who have high risk conditions, and after that, it starts to get a bit more murky, and it is what is called shared decision making, so that you can talk with a health care provider, and if you decide with your health care provider that vaccination is something they would recommend for you, then you can get vaccinated.
Would pregnant women fall into that category?
Fichtenbaum: They do fall into the shared decision making category.
Dr Peltier, what's the guidance for children?
Peltier: So you know as Dr Fichtenbaum said there really, you didn't hear him mention children from the CDC. So the AAP, the American Academy of Pediatrics, sort of came out with a policy statement and their own recommendations that infants and children 6 through 23 months of age are at high risk for severe COVID-19, and therefore recommend that all infants and children in that age group get the vaccine. Children 6 months through 18 years of age who have an immunocompromised condition should also get vaccinated. And then the AAP recommends a single dose vaccine for all children and adolescents 2 through 18 years, if they fall into certain high risk groups, such as persons at high risk of severe COVID-19, if they have an underlying illness, residents that are in a long term care facility, if you've never received a COVID vaccine. And then finally, persons with whose household contacts could be at high risk for severe COVID-19.
Dr Peltier, if a pregnant woman gets the vaccine after consultation with her physician, does that mean the fetus would get some protection?
Peltier: Exactly. Because of the way the vaccine — that, you know, with transplacental transfer, that's usually we typically don't start vaccinating some babies for certain diseases until 6 months, because they will have some immunity that's transferred from the mother.
Sarah, we just heard a lot. There are people confused. I mean, if you're younger than 65 Do you need a prescription? If you're in a qualifying category, how easy is it to get the vaccine?
Sarah: Patients are confused. We're getting lots of calls every day. Do I have it? Am I eligible? What do I need to do? And right now, again, we're giving them the recommendations that we're getting from the federal government, and then people who maybe don't fit into those very specific categories, I'm telling them to call their doctor have a conversation. Pharmacists can give vaccines with a prescription in Ohio. So I mean, if they don't fall into a exact category, that's not all hope is lost, they can definitely talk to their doctor and have that conversation.
Melissa, Dr. Peltier just talked to us about the what the American Academy of Pediatrics is recommending for for children and the COVID vaccine. What other kind of advocacy work is the association or the academy doing in this regard?
Melissa: I think, you know, we're getting out there a lot and trying to explain, just like Dr. Peltier just explained. Who is eligible, why you should get it, and really trying to make the case for why we should still be vaccinated against the COVID disease. We have had access problems for a long time in terms of there's just natural barriers that families face, whether it's transportation or scheduling doctor's appointments. And now we've added this confusion layered in, and we've also added in, will my insurance company pay for this? And I think doctors are in the same boat too. They're wondering, if we order this vaccine, if we have it in our practices are people going to use it? So now we've taken up vaccines.
We've already kind of struggled with making sure everyone has access, but now we've confused the issue, and so I think that the American Academy of Pediatrics is working really hard to explain to people why you should still get vaccinated, why you should still vaccinate your children, and then how we can make sure there's still access to vaccines, whether that's through your pediatricians office, whether it is from your local pharmacy or health department, How can we make sure people who want access to these vaccines are given that access. And then also explaining things about community immunity and herd immunization. And, you know, why we care about those things as well. And we'll talk more about that later.
Sarah, you were just talking about how if you're not sick, if you're an adult, you're not 65 or over, if you don't fall into what the CDC is recommending, but not all hope is lost. So does that mean if you go to your local pharmacist and say, hey, I want the COVID shot, do you need to call your doctor right there? Does the pharmacist need to call the doctor? How would that work?
Sarah: So the way it works for pharmacies is that a patient does a consent form, and so they have the option of telling me I have one of these qualifying conditions, and they attest to that qualifying condition. We don't have to call their doctor and go through the whole process of verifying that, we trust our patients to tell us what they need and what conditions they have and if it's a qualifying condition, and they attest to that. We can give those vaccinations. We are happy to facilitate calling a physician or calling a provider, if that's what we need to do.
And do you have the COVID vaccines? How available are they for pharmacies? I know we're hearing, hey, there's no shortage. But do you have them yet?
Sarah: We do not have them. Our expected date is this week from our distributor. I know it's been a problem a couple of places getting them. I do know that some of the bigger chains do have them in stock and have been giving them. I've heard from a couple of my pharmacy friends, but as probably Dr. Fichtenbaum will also talk about the clinics, they have not had them readily available yet, and so there is a little bit of an access issue depending on where your local pharmacy or your local clinic is.
Can you talk about that Dr. Fichtenbaum? I know that some people just get them when they're at the doctor's office, Get a flu shot or a COVID shot.
Fichtenbaum: So distribution of vaccinations throughout the United States undergoes a tiered distribution, and usually the largest providers are the ones who receive vaccines first, and so health care providers and smaller pharmacies tend to be a little lower on the list. And so vaccinations arrive, starting most of the time in August for both influenza and COVID vaccines, and then throughout September and October, the remaining members of interest get their vaccines available. So it's sort of a process, and you just have to check and probably call first to see whether your provider or your pharmacy actually has vaccination in stock. The good news is, as an infectious disease expert, what we really look for is, what's the lasting immunity? How long does it take to become immune and become active, and when do you want to vaccinate? It's a question that my patients ask all the time, and I think that we see peak of the respiratory viruses starting in late October. November they start to rise. And there's a big peak, usually in and around the holiday season in January, with continued activity through February, March. So usually advising people that sometime in September, late September for influenza vaccinations, anytime in late September, October for COVID vaccinations, is a really opportune time to give your body time to prime itself and get the immune soldiers ready to get and to have a defense that lasts through March, when the season starts to wane.
Sarah, I know you said you don't have the vaccine yet at your pharmacy, but I'm wondering, are you expecting a lot of variation in whether a patient's health insurance will pay for the vaccine?
Sarah: We have not seen any problems with that. So just speaking with again, other pharmacists in the retail and community space, they've not had any problems with coverage. You know, all the Medicare plans have covered it, as obviously the federal Medicare plan is covering it, and even private insurance hasn't been a problem.
OK, well, that's good to hear, because I heard on NPR that some of the big insurers were saying, yes, they were going to cover it, but they also talked about what it could cost out-of-pocket. And it's kind of pricey, isn't it?
Fictenbaum: Yes, I mean, if you had to pay out of pocket, the COVID vaccine is around $200. That's my guess at most retail places.
Sarah: I would agree with that. Our average cost last year was around $150 to $250 and we essentially get our costs covered. We maybe make a little bit but that's a pretty big amount for families to have to burden.
Dr. Fichtenbaum, you mentioned that there's a little bit more to be learned about kind of copays, the costs of COVID vaccines. Can you explain that to our listeners?
Fictenbaum: Everybody's insurance differs. And so the really smart thing to do is call your provider and say, if I would like to get this vaccination, will there be any out-of-pocket costs for me? They can run it through the system and find out what your insurance may be covering, and what you may be responsible for paying, and this is true for any immunization, so it's a good idea to just check first, and it may actually differ based upon the provider of the vaccine. So you may want to shop around, because your costs may be absorbed in some ways by certain providers who are willing to maybe take a little bit less each vaccine they give.
Good to know. We got a call from Suzanne who wanted to clarify something. She said, thanks for this informative discussion. So can a person pay out-of-pocket for a COVID vaccine if they want to? Is that something people can do?
Sarah: Certainly. I mean, they would still have to do again, go through the process of signing the consent forms and going through the clinical processes that have to happen. But yes, absolutely.
OK. And Dr. Peltier, you're shaking your head yes.
Peltier: People can pay for it. No question.
Well, let me ask you this, Dr. Fichtenbaum: What percentage of the public needs to be vaccinated to get what we think of as herd immunity for COVID?
Fichtenbaum: Well, to really get herd immunity, and what we mean by that is, that if everyone is protected from an illness, then it makes it hard for it to circulate around as easily and pass from person to person. You know, one of the most important social contracts we have are keeping each other safe. We tend to not run through the red lights. We try not to speed very much. We wear our seat belts. The other social contract is is that it would be really nice if we didn't give each other contagious diseases. So really, you need to get vaccination rates up to somewhere around between 50% to 70% of a community. That means people around you, people you have contact with, to really have significant impact on what we call herd immunity. So what? But we've seen with many studies that have been done before with a number of different immunizations that each percentage that you go — so if you get 20% to 30%, there is an impact on the community and a lowering of the risk of spread, and it starts to go up. But where that inflection point really goes up is when you get past that 70% mark. And for certain diseases, this is very important. Our pediatric colleagues may want to comment. Diseases like measles, we really need things like 95% and upward of coverage because they're so contagious. COVID happens to be very, very contagious, much like measles.
So is there a concern? Because it sounds like, based on the CDC guidance, if they're saying people 65 and older, and then, of course, there's this shared decision-making that you referred to Dr. Fichtenbaum, where people are talking to their doctors. Do you have any concerns about whether we'll get to that herd immunity for COVID?
Fichtenbaum: I think we've seen the numbers over the last few years that the number of people who are being vaccinated for COVID disease is been decreased quite a bit, and so no, we're not going to reach those numbers. Numbers have been, depending on where you live, somewhere between 20% to 30% of individuals, adults who've been getting vaccinated for COVID, and that's been fairly consistent since all the mandates were lifted.
Dr. Peltier, we referenced this earlier, but there are some people, both children and adults, who can't get vaccines for medical reasons, what does it mean for them if fewer people get the COVID vaccine?
Peltier: Great question. Lucy, it essentially means that there is a greater chance that those children or adults who have a weakened immune system for whatever reason, are more likely to contract that disease. And, you know, Dr. Fichtenbaum mentioned measles, and that's one of the reasons that we are really worried about vaccines in general, as we're seeing more and more pockets of measles epidemics that are popping up in the country, and again, those kids that are the most vulnerable, that can't be protected, they're at a great risk.
Dr. Fichtenbaum, you just mentioned kind of the end of the mandates, when, you know, there was much stronger guidance — everybody go out and get those shots if you can. I think the pandemic is largely behind us, at least that's how people feel about it. Why do you think that is? What credit do you give to the vaccine? I mean, a lot of COVID cases are now very mild. What will it mean if people are no longer getting these boosters?
Fichtenbaum: Well, I think a lot of credit has to go to all of the public health policies that were done worldwide. So initially, when we had zero immunity and no immunizations. We separated ourselves from one another, and that saved lives. We knew that from 100 years before with the Spanish influenza, that that is a very good tool to save lives, and then we were lucky enough that our science was able to develop a vaccine that saved lives. By estimates from the World Health Organization, more than two-and-a-half million people's lives were saved by immunization, and we've seen estimates here even higher in the United States alone, of those lives that were saved because of immunization. So a combination of public health practices and immunization really made all the difference in the world for getting a better hold of a pandemic, allowing us to develop what we call hybrid immunity, meaning that some of us, in fact, most everyone has had COVID worldwide, and most people got vaccinated. More than 75% of human beings on the face of this earth got a vaccine, at least one, right? At least one. So that immunity, together, allowed us to survive this because in the early days, the mortality was very high. And then, of course, the virus has evolved, which is a natural thing that viruses do all the time, because they want to survive and they don't want to kill us. They just want to infect us. So we're in a situation now where I think we're very lucky that COVID is a more mild illness, but we still have some really important problems. We have long COVID. That still affects people. We have an inflammatory syndrome that occurs in children that is important. And we still have individuals that are at higher risk, who get hospitalized, and still some people who die with COVID. So it's really, really important that we keep our guard up on infectious diseases.
Yeah. I think I read that COVID is no longer one of the top 10 causes of death in the U.S., but that still, I think it was in excess of 45,000 people a year are dying from COVID in the United States, right?
Fichtenbaum: I mean, what we see consistently with viruses like influenza and COVID and other viruses, RSV and para influenza virus, is is that the most vulnerable individuals in our society, those who have underlying illnesses, immune compromised states, have lung disease, heart disease, these are the individuals at greatest risk, and we do see, unfortunately, some of those people die each year. It's not as common, and it's hard for people to understand that. You go outside, you can see a car accident, you understand that, but you're not in a health care institution, you can't see it, and when people can't see it, it's hard for them to understand and ingrain in themselves that I may have a public responsibility to stop the spread of infectious diseases.
Melissa, what are you expecting from the meeting of the Advisory Committee on Immunization Practices on September 18th and 19th. What are you all keeping an eye on?
Melissa: I think the biggest concerns that we have right now are things like our Vaccines for Children program to make sure that that it remains stable, remains something that our federal government is is willing to put, you know, funds behind. [That's] how children on Medicaid receive the vaccine. So in Ohio, almost 50% of our population, that's where they get it from. Our concern is, if they change recommendations, would they also change what would be eligible for? You know, the various vaccines that will be eligible under the Vaccine for Children program. And you know, if we take any of those off of there, then we're looking at parents having to pay, or caregivers having to pay out-of-pocket for these vaccines for that population. So that's one of the main things we're we're really watching, and for that meeting
Dr. Peltier, we've been talking a lot about the COVID vaccine, but are there concerns about whether people are getting vaccines generally. Are you seeing fewer parents get the vaccinations that are recommended for their children?
Peltier: Yeah, you know, I think we're definitely having more calm conversations. And again, I think it's always good to have a conversation about any medical decision with your health care provider. And you know, I think, at the end of the day, I think both pediatricians and parents want to do what's best for their kids. I think where the issue lies is when people say that they've done their research, which is completely different than, you know, health care providers and medical researchers doing their research, meaning they're, you know, the parents are often getting misinformation, disinformation from from the internet, which, as we know is, is often not very accurate. We definitely have seen, you know, a decrease in certain vaccine uptake. I think I've seen less parents opting for the hepatitis B vaccine early in infancy. And I know, I think that is on the agenda for the ACIP meeting later this week. So we're definitely watching that. And you know, while we're talking about COVID vaccines, and Dr. Fichtenbaum did a really nice job talking about respiratory season, which we are on the cusp of, it is definitely OK to get both your COVID vaccine and your influenza vaccine at the same time.
Sarah, are you getting a lot of questions from patients like people raising concerns about just vaccine research, are they safe? What are you hearing?
Sarah: Yes. I mean there, and that's always been a little bit, but it's been more lately. And our job as pharmacists, right, we're really accessible. People can call us. People can see us at at the counter when they pick up their other medication, is to ask, we're happy, to share all of our knowledge, all of our latest recommendations, and all of the knowledge that we have about vaccination and how it works, and we will try to ease any fear that you have. We will give you the real information, you know, we will make sure that it is researched and well supported.
Fichtenbaum: I think a good way to look at it is this way. You know, I'm a physician, an expert in infectious diseases. I don't think you would bring your car to me to get it fixed. I'm not an auto mechanic. So I think we really need to be careful about who we take advice from, and who do we go to as an expert. And I think the best thing for parents, children and all people to do is really have a conversation with their health care provider and make sure that they're getting all the information from the experts who can then advise them on what is the best thing to do. Because, you know, we have a very different country right now than we did 200 years ago. Because when you think about the lifespan of children and the mortality and infancy and early childhood, it was very different. Just a concrete personal story example, I trained as a pediatrician. I used to take care of kids who got Haemophilus influenza meningitis, we don't see that anymore. Why? We have a vaccine. So why should people get sick or die? And why do we have to go back in time and have things change so dramatically when we have something that we're moving forward to, so we don't need those measles cases again. We just need people to talk to the right experts and have a good conversation.
Got an email from someone who says it's important to emphasize that vaccines appears to reduce risk of long COVID, otherwise, the messaging you're giving about COVID now being mild suggests there's no benefit of vaccination, except for the elderly.
Fichtenbaum: There is still benefit from vaccination and immunization. There's still benefit for serious COVID in certain populations, absolutely. And we do see it for long COVID prevention as well.
I've been talking with University of Cincinnati, vice chair for clinical research for internal medicine, Dr. Carl Fichtenbaum; Pediatric Associates of Mount Carmel pediatrician Dr. Chris Peltier; Hart Pharmacy owner and pharmacist in charge, Sarah Priestle; and American Academy of Pediatrics Ohio chapter, CEO, Melissa Wervey Arnold. Thank you all so much for your time.