CDC COVID-19 Vaccine Bridge Access Program Ends 4 Months Earlier than Planned

The August authorization of the updated 2024-2025 mRNA COVID-19 vaccines brought an end to the CDC’s Bridge Access Program, the federally funded initiative launched in September 2023 that provided free COVID-19 vaccines to uninsured adults and to those whose insurance did not cover all vaccine-related costs. The average cost of a shot for those without the cushion of even partial insurance coverage can be as much as $200 at a local CVS or Walgreens, according to the Wall Street Journal.¹

The end of the program was planned originally for December of this year, but it happened with little notice, months ahead of that. The Bridge Access Program ceased on August 22 as a result of a funding shortfall, specifically $6.1 billion in coronavirus emergency spending authority that was rescinded by Congress to avoid a government shutdown.¹ In another blow to public health efforts against virus transmission, Congress also refused to fund the current administration’s proposal for an adult program modeled on the Vaccines for Children program that would provide COVID-19 shots, in addition to routine vaccinations, for free. According to the CDC,² of the approximately 34 million doses of the 2023-2024 COVID-19 vaccine administered to adults last year, 1.5 million were funded through the Bridge Access Program, provided for free through retail pharmacies, community health centers and public health departments.²

Caught short

Executives with the nonprofit advocacy group the National Association for Community Health Centers said while they knew the program was a temporary measure, the early halt came as a surprise, according to USA Today.³ In a statement cited by the news outlet, association director of public health integration Sarah Price said, “Health centers will either stock these vaccines or refer to resources within their community – with an aim to addressing access barriers and closing the loop.”

Referral to other community resources may be the only option these organizations have, based on a comment from CDC spokesperson David Daigle, in an email quoted by The Hill:

“After August, there may be a small amount of free vaccine available through health department immunization programs, but supply would be very limited. We don’t yet know if the manufacturers will have patient assistance programs.”⁴

The loss of access to protection from SARS-CoV-2 for a large and already vulnerable population (~25 million people lack health insurance in the US) compounds growing concern among health experts about the upcoming respiratory virus season. Since COVID-19 vaccines became available in mid-September 2023, less than one-quarter (22.5%) of US adults have remained up to date on receiving them.

“Lower-income uninsured individuals — which by and large are the majority of people who are uninsured — are at the greatest risk for deciding to forego getting vaccinated because of the costs they are likely to face,” Jennifer Tolbert, deputy director of the Program on Medicaid and the Uninsured and director of State Health Reform at the health policy research group KFF, told NPR’s Marketplace Morning Report.⁵ According to KFF, approximately 11% of the nonelderly adult population is uninsured. Moreover, a majority of these individuals live in states, such as Texas and Florida, which have not expanded Medicaid coverage.⁶

Medicare, Medicaid, and private insurers are required to pay for COVID-19 shots.

For anyone without insurance or with inadequate health coverage, George Benjamin, MD, executive director of the American Public Health Association, strongly recommends checking with a state or local health department to learn about provisions in place for those in need.

Some of these agencies, "understanding this is a problem, are working with their governor’s office or mayor’s office to find funding to provide access to vaccine. In most cases, if the vaccine is available and if they have [it], they’ll be able to provide it for you at either no cost or reduced cost,” Benjamin said in an interview with CNN. “And there are some pharmacy assistance programs that should be available for Pfizer and Moderna.”⁷

References

1. Nirappil F. Coronavirus vaccines, once free, are now pricey for uninsured people. Wall Street Journal. September 3, 2024. https://www.washingtonpost.com/health/2024/09/03/covid-vaccine-bridge-access-program-expires-cdc/

2. Weekly COVID-19 vaccination dashboard. COVIDVaxView. Centers for Disease Control and Prevention. Updated June 21, 2024. Accessed September 9, 2024. https://www.cdc.gov/vaccines/imz-managers/coverage/covidvaxview/interactive/vaccination-dashboard.html

3. Cuevas E. Free COVID-19 vaccines could be a ting of the past. Experts weigh in. USA Today. May 22, 2024. https://www.usatoday.com/story/news/health/2024/05/22/cdc-covid-bridge-access-program-ending/73733643007/

4. Weixel N. CDC to end free COVID vaccine program for uninsured early. The Hill. May 17, 2024. https://thehill.com/policy/healthcare/4670459-cdc-ending-free-covid-vaccines-uninsured/

5. Trovall E. CDC ends free COVID-19 vaccine program for uninsured adults Marketplace. August 26, 2024. https://www.marketplace.org/2024/08/26/cdc-ends-free-covid-19-vaccine-program-for-uninsured-adults/

6. Tolbert J, Drake P, Singh R, The uninsured population and health coverage. In Altman, Drew (Editor), Health Policy 101, (KFF, May 28, 2024) https://www.kff.org/health-policy-101-the-uninsured-population-and-health-coverage/ Accessed September 9, 2024.

7. Howard J. For people without insurance, updated Covid-19 shots are no longer free of charge at pharmacies. CNN. September 5, 2024. https://www.cnn.com/2024/09/05/health/covid-vaccine-cost-pharmacies/index.htm