Fall is usually the time to get your annual vaccinations, including the COVID-19 booster. But this year, under the Trump administration, Pennsylvanians are navigating conflicting sets of COVID-19 vaccine guidelines, new restrictions, and barriers to access. Recently, Pa. Gov. Josh Shapiro received national attention for his actions to safeguard vaccine access and curb confusion statewide.
So what does the local landscape currently look like? Pittsburgh City Paper spoke with the Allegheny County Health Department, reviewed the ongoing federal saga, and checked federal and state recommendations to get a clearer picture of the situation heading into peak respiratory virus season.
What’s causing the confusion?
Under Pennsylvania state law, pharmacists can administer vaccines based on recommendations from the federal Advisory Committee on Immunization Practices (ACIP). This committee of independent experts advises the CDC, providing guidance for all licensed vaccines and their “appropriate use,” according to its website. ACIP’s recommendations become official policy once adopted by the CDC.
In June, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. — known for his decades of anti-vaccine advocacy and circulating medical misinformation — removed all 17 sitting members of ACIP, stating the move was necessary to “restore public trust” in vaccine science. ACIP’s COVID-19 vaccine recommendations had not yet been issued, leaving Pennsylvania pharmacies unable to give the updated shots.
Compounding the confusion, in August, the FDA approved COVID-19 vaccines with new imposed restrictions, limiting access to to people 65 or older or with certain underlying health conditions that increase severe disease risk. Initially, this led major pharmacy chains in Pennsylvania to require a prescription for the COVID-19 vaccine.
Enter Shapiro, who, in early September, intervened to bypass federal vaccine restrictions.
“Health care decisions should be up to individuals — not the federal government and certainly not RFK Jr.,” Shapiro stated in a Sept. 3 press release.
At Shapiro’s urging, the Pennsylvania State Board of Pharmacy approved new “competent authorities” for establishing statewide vaccine guidelines, naming medical associations including the American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and American Academy of Family Physicians.
Pennsylvania then joined the newly-formed Northeast Public Health Collaborative, a group of health agencies from seven states setting their own vaccine and health guidelines. A similar coalition, the West Coast Health Alliance, was established in September by the governors of California, Oregon, Washington, and Hawaii.
Following nationwide controversy and uncertainty, on Oct. 6, the newly installed ACIP voted to shift away from broad federal COVID-19 vaccine guidelines and toward individual-based decision-making.
“Informed consent is back,” stated Acting CDC Director and Deputy Secretary of HHS Jim O’Neill in an Oct. 6 press release. The CDC is expected to recommend that people seeking the shot consult with a healthcare provider, and those administering vaccines may require “proof of a discussion,” though not necessarily a prescription, under new federal guidelines (still pending at press time).
In the meantime, Gov. Shapiro signed an Oct. 1 executive order ensuring Pennsylvania residents “have regular, easy access to safe and effective vaccines” based on national medical associations’ recommendations, and apart from federal guidelines.
Who should get the updated vaccine?
According to Dr. Barbara Nightingale, Deputy Director for Clinical Services with the Allegheny County Health Department (ACHD), the county follows “evidence-based guidance” from the Pennsylvania Department of Health (DOH) and other medical organizations named in Shapiro’s recent executive order.
ACHD recommends the COVID-19 vaccine for all children aged 6 months to 2 years, and for all adults 19 and older. In contrast to broader recommendations from past years, children between the ages of 2 to 18 are only encouraged to get the shot under certain conditions.
“For children between the ages of 2 to 18, we recommend vaccination for those at higher risk of severe illness and fully support families who choose to vaccinate their children,” Dr. Nightingale tells City Paper.
Under DOH guidelines, COVID-19 vaccination is also recommended for pregnant people. Getting vaccinated against COVID-19 during pregnancy was also recommended in ACIP’s recent guidelines, reversing an earlier recommendation made by Robert F. Kennedy and surprising some experts.
Does insurance cover a COVID-19 shot?
As it stands, the Affordable Care Act mandates that most private insurers cover vaccines recommended by ACIP, and it’s expected most Americans with health insurance should be able to receive the vaccine at no cost. Medicaid also currently provides ACIP-recommended vaccines at no cost.
A Sept. 26 DOH fact sheet states that the Pennsylvania Insurance Department “expects all insurers that issue health policies in Pennsylvania providing coverage of health care services to continue to cover the COVID-19 vaccine.” DOH recommends contacting your health insurance provider to verify coverage.
Pennsylvania’s Medicaid (Medical Assistance) program, both HealthChoices managed care and fee-for-service programs, cover the vaccine.
Where can I get the COVID-19 vaccine?
The Allegheny County Health Department has COVID-19 vaccines available for all residents at the Immunization Clinic on First Avenue in Downtown Pittsburgh. Major area pharmacy chains including CVS and Giant Eagle — which, this season, is also absorbing hundreds of former Rite Aid customers — also have the shot available.
Though CVS began administering the COVID-19 vaccine again under Pennsylvania’s new guidance, patients must still self-attest they are eligible for the 2025/26 COVID-19 vaccine under FDA guidelines.
Should we expect a surge this winter?
According to Dr. Nightingale, county trends in COVID infections “mirror those seen nationally” and typically the county experiences “an increase in reported infections and associated hospital visits during the winter months.”
Last month, 599 COVID-19 infections were reported, compared to 219 in July and 387 in August, though there have been fewer emergency room visits compared with earlier in September. Nightingale says we should expect an increase, especially with the upcoming holiday season. ACHD shares local respiratory virus illness numbers weekly on its online dashboard.
What about the future?
At the moment, Pennsylvanians have more vaccine access than residents of some other states, especially as state governments form independent health organizations and break away from what’s been described as the “politicization” of the CDC.
Locally, leaders have praised Gov. Shapiro’s efforts, including Pa. Rep. Dan Frankel (D-Allegheny), who “applauded” the launch of the Northeast Public Health Collaborative.
“Unfortunately, our federal decision-makers have chosen to undermine trust in vaccines, doctors, and science itself,” Frankel stated in a Sept. 18 release. “That makes this multistate effort even more urgent, because lives are at stake.”
This article appears in Oct. 15-21, 2025.
