That puts the burden of ordering shots on hospitals, physician offices and pharmacies. And in some cases, the public will now be on the hook for payment. 

Pfizer and Moderna have decided to charge up to $130 a shot, compared with $30 last year for the booster, which was produced under government contract.

Uninsured or underinsured Americans will have access to free shots as part of the Biden administration’s “Bridge to Access” program, which will keep a limited supply of vaccines and therapeutics on hand to distribute through state and local health departments, as well as pharmacies. But, they may not be available at pharmacies until mid-October at the earliest.

Some experts said they are worried people may fall through the cracks in the system. Just because the vaccine may be available doesn’t mean getting it to people will be easy. The uninsured may not know how to get the vaccine or even that it’s available.

“I think that there’s going to be vaccine available, but it’s not going to be what people saw before because there’s going to be more and more hoops to jump through,” said Bruce Gellin, chief of global public health strategy at the Rockefeller Foundation. 

People who have Medicare or private insurance likely won’t face any out-of-pocket costs, unless they see a provider who is out of network. But some of that may also come down to the recommendations of the CDC’s panel of outside advisers, the Advisory Committee on Immunization Practices (ACIP), which meets Tuesday.

The CARES Act, the 2020 pandemic relief law, requires that employer-sponsored and individual health plans cover a coronavirus vaccine without cost sharing 15 days after it is recommended by ACIP.

Starting Oct. 1, all state Medicaid programs will be required to cover all ACIP-recommended adult vaccines and their administration without cost sharing.

Last year, ACIP recommended only older and at-risk populations get the omicron-specific booster, but then-CDC Director Rochelle Walensky decided instead to recommend everyone get the shots

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