Experts-U.S. health insurers likely to cover vaccines without new ACIP panel recommendations

[TallGuyJohninBKK]

June 17, 2025

 

"Although vaccines may have a tougher time winning the endorsement of the CDC's Advisory Committee on Immunization Practices after HHS Secretary Robert F. Kennedy Jr. recently replaced all of its members, that should not have any implications for coverage of shots by health insurers.

 

...For economic reasons, health insurers are likely to still cover vaccines even if they aren't recommended by the newly reconstructed panel, according to two health policy experts.  "The economics are there," said Sherri Berger, the CEO of SB Strategies who spent nearly 30 years at the CDC. "It's a lot less expensive to cover a vaccine than a hospitalization."

 

"Most people are pro-vaccine," added Luciana Borio, a venture partner at ARCH Venture Partners who has also served as a member of President Biden's transition COVID-19 Advisory Board and Director for Medical and Biodefense Preparedness at the National Security Council. "I think insurance companies will pay for vaccines because people want vaccines."

 

While ACIP's recommendation of a vaccine has typically been a requirement for payor coverage, Berger said that it is likely other health organizations will need to come out with their own guidelines. She also cited an update from the University of Minnesota Center for Infectious Disease Research and Policy's Vaccine Integrity Project that on Tuesday came up with recommendations in an interim report.

 

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