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Vitals

Axios Vitals

Washington D.C.

Axios D.C.

New federal limits around COVID-19 vaccine eligibility are stirring confusion about whether people will be able to get shots this fall.

Why it matters: Philadelphians who want the vaccine will need a doctor's approval — often tied to underlying health conditions — and many could end up paying out of pocket. 

Driving the news: Health and Human Services Secretary Robert F. Kennedy Jr. announced a series of moves last week that will limit who is eligible for COVID vaccines as the stratus variant spreads across the country.

Meanwhile, the changes have brought new uncertainty about accessing the shots at pharmacies — including CVS and Walgreens.

Zoom in: The FDA rescinded general emergency use authorizations for Pfizer and Moderna mRNA shots, according to Kennedy.

Boosters for high-risk patients were approved, though.

And patients who want COVID shots will need to consult with their doctor rather than booking directly with a pharmacy.

Data: Department of Health and Human Services; Note: Novavax is only available for people ages 12 and older; Chart: Axios Visuals

Who is eligible: Adults 65 and older are eligible for an updated Pfizer-BioNTech COVID vaccine, as well as new shots from Moderna and Novavax.

Anyone between 5 and 64 is eligible if they have at least one underlying health condition — including asthma, cancer, kidney disease, heart conditions, HIV, certain mental health conditions, physical inactivity and smoking.

For children: The new FDA policy doesn't approve the Pfizer vaccine for healthy children under age 5, leaving it open to a doctor's discretion to prescribe off-label shots.

Yes, but: For kids 6 months old and up with underlying health conditions, the FDA has given approval for the Moderna vaccine.

Reality check: Many health experts argue that shots are still important for the general public, which remains at risk for severe outcomes as well as long COVID.

Zoom out: Individuals who aren't part of the recommended groups may not be covered by insurance and forced to pay for the shot, which can cost around $140.

That could especially strain the more than 665,000 Philadelphians on Medicaid — that's around 42% of the city's population, per state data.

What else: A CVS spokesperson tells Axios that COVID-19 vaccines are available at its pharmacies in Pennsylvania, but patients must present an authorized prescription for the shot.

Yes, but: Patients don't need a prescription for a COVID shot at MinuteClinics found inside select CVS stores, which will offer the vaccines as soon as they are available.

Worth noting: Following Kennedy's announcement last week, CVS changed its COVID shot accessibility to offer the vaccines in 34 states, only with prescriber authorization in 13 others (including Pennsylvania), and completely barring access in three. 

By the numbers: Across Pennsylvania and the nation, COVID rates are low but increasing, per the latest CDC data.

COVID hospital admissions in Philly have hovered at 10 or below since May, with only one reported during the first week of August, according to the city's most recent data. 

What we're watching: The CDC is expected to weigh in soon with its recommendations, which can impact whether insurers will pay for vaccines or whether patients will need to pay out of pocket for them.

Jim Kyle, a spokesperson for the city's Department of Public Health, tells Axios the city has not received any guidance from the CDC on changes for Medicaid coverage related to COVID shots.

Getting a COVID vaccine in Philly could be more complicated this fall

Illustration of a syringe casting a shadow shaped like a question mark.

New federal <a class="gtmContentClick" data-vars-link-text="limits" data-vars-click-url="https://www.axios.com/2025/08/28/cdc-covid-vaccine-rules-recommendations-high-risk-fda" data-vars-content-id="92964740-9450-4239-ac4a-f8c50296f78a" data-vars-headline="Getting a COVID vaccine in Philly could be more complicated this fall" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2025/08/28/cdc-covid-vaccine-rules-recommendations-high-risk-fda" target="_self">limits</a> around <a class="gtmContentClick" data-vars-link-text="COVID-19 vaccine" data-vars-click-url="https://www.axios.com/2025/08/27/covid-19-vaccine-policy-cases-rise" data-vars-content-id="92964740-9450-4239-ac4a-f8c50296f78a" data-vars-headline="Getting a COVID vaccine in Philly could be more complicated this fall" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2025/08/27/covid-19-vaccine-policy-cases-rise" target="_self">COVID-19 vaccine</a> eligibility are stirring confusion about whether people will be able to get shots this fall.Why it matters: Philadelphians who want the vaccine will need a doctor&#x27;s approval — often tied to underlying health conditions — and many could end up paying out of pocket.

Health

News

Data: American Cancer Society; Note: Death rate is computed as the average of the male and female rates; Map: Erin Davis/Axios Visuals

Cancer deaths have fallen in every congressional district in the U.S., typically between 20% and 45% among males and a 10% and 40% among females, over the past quarter century, according to a study published in the journal Cancer.

Methodology: Researchers used county-level cancer death counts and population data from the National Center for Health Statistics dating back to 1996, Axios' Tina Reed reports.

Zoom in: In Philadelphia, cancer remains the second leading cause of death after heart disease, per the city's latest health report.

Pennsylvania's cancer deaths declined between 17%-49% across its congressional districts over the same period.

By the numbers: Lung cancer saw the biggest drops among men, declining between 21%–72% since 1996. 

Female breast cancer deaths dropped between 14% and 58% depending on the district. 

Yes, but: The study found "substantial" disparities. For instance, the fall in cancer deaths was steepest among Black men, but overall cancer mortality is substantially higher among the Black population.

Map: Fewer cancer deaths in Pennsylvania

Fewer people dying of breast, lung and other types of cancer.

<a class="gtmContentClick" data-vars-link-text="Cancer deaths" data-vars-click-url="https://www.axios.com/2023/05/09/cancer-congressional-district-mapped" data-vars-content-id="9ff96c3d-8e59-4385-abf8-877373a09190" data-vars-headline="Map: Fewer cancer deaths in Pennsylvania" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2023/05/09/cancer-congressional-district-mapped" target="_self">Cancer deaths</a> have fallen in every congressional district in the U.S., typically between 20% and 45% among males and a 10% and 40% among females, over the past quarter century, according to a study published in the journal Cancer.<ul><li>But health disparities remain.</li></ul>

More Pennsylvania parents are opting out of vaccinating their children for religious or personal reasons.

Why it matters: As a new school year gets underway, lingering vaccine hesitancy from the pandemic is evident in pediatricians' offices as more parents reject the shots for measles, chickenpox and whooping cough, among others.

While official data lags by several months, public health experts told Axios that anecdotal reports suggest child vaccination rates continue to fall, leaving the population more vulnerable to outbreaks.

The big picture: U.S. parents still overwhelmingly support childhood vaccinations. But kindergarten exemptions rose to a median of 3.3% nationally during the 2022-2023 school year, up from 2.7% the year before.

A Gallup Poll last month found that 69% of respondents view childhood vaccines as "extremely" or "very" important, down from 94% in 2001.

Gallup attributed the drop to people who lean Republican, noting the percentage of that cohort saying childhood vaccinations are "extremely important" stood at 26% this year, compared to 62% in 2001.

Zoom in: 3.8% of Pennsylvania kindergartners had vaccine exemptions in the 2022–23 school year, per the Centers for Disease Control and Prevention.

That's up from 3.3% statewide in the 2021–22 school year.

In Philadelphia, the 2022–23 rate ticked up slightly to 1.7% from 1.5% in the 2021–22 school year, per state data.

Between the lines: UPenn's Annenberg Public Policy Center says false beliefs about vaccines remain prevalent.

The CDC says there's no evidence linking the MMR vaccine to autism. But a quarter of U.S. adults believe that statement is "somewhat or very inaccurate," according to a recent survey of over 1,500 people conducted by the center.

Some people believe COVID-19 vaccine misinformation, such as that the shots caused thousands of deaths and alter our DNA, per the center.

What they're saying: Kathleen Hall Jamieson, the center's director, tells Axios pro-vaccination public messaging isn't as prominent post-pandemic, allowing those who amplify anti-vax beliefs to fill the void.

"They have more of a playing field," she says. "They haven't stood down. The balance of information matters."

Zoom out: The ease of opting out of vaccinations varies by state and can have a direct bearing on uptake, Megan Ranney, dean of the Yale School of Public Health, told Axios.

Yes, but: It's not just hesitancy — "a perfect storm" of factors like physician shortages and pharmacy closures are putting a drag on vaccination rates, says FarmboxRx CEO Ashley Tyrner.

How it works: Pennsylvania grants exemptions if a doctor determines the vaccine isn't safe for a student or if the student is opposed because of religious or personal beliefs.

What's next: New COVID-19 vaccine boosters are being rolled out to local pharmacies.

More Pennsylvania parents opt out of vaccines for kids

Lingering vaccine hesitancy from the pandemic is evident in pediatricians' offices.

Vaccines

Choropleth map of U.S. states showing the estimated share of kindergartners with vaccine exemptions in the 2022-2023 school year. States on the West Coast (apart from California) have a higher exemption rate than the rest of the country. In Idaho, 12.1% of kindergartners requested exemptions, compar

More Pennsylvania parents are opting out of vaccinating their children for religious or personal reasons.Why it matters: As a new school year gets underway, lingering <a class="gtmContentClick" data-vars-link-text="vaccine hesitancy" data-vars-click-url="https://www.axios.com/2024/08/27/vaccine-hesitancy-back-to-school-shots" data-vars-content-id="aa2014f8-a8da-487c-994c-efd09a845daa" data-vars-headline="More Pennsylvania parents opt out of vaccines for kids" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2024/08/27/vaccine-hesitancy-back-to-school-shots" target="_self">vaccine hesitancy</a> from the pandemic is evident in pediatricians&#x27; offices as more parents reject the shots for measles, chickenpox and whooping cough, among others.

Education

The nation's worst flu season in 15 years is driving "very high" influenza activity across Pennsylvania.

Why it matters: The virus is causing more severe complications and hitting young children especially hard.

The big picture: There have been at least 29 million cases across the country, the most since the 2009-2010 flu season, according to the latest Centers for Disease Control and Prevention data.

It's left hundreds of thousands of Americans hospitalized while straining physicians' offices and emergency departments.

Flu hospitalizations and deaths have surpassed COVID-19 for the first time since the pandemic, said Carol McLay, president of the Association for Professionals in Infection Control and Epidemiology.  

Data: CDC; Chart: Erin Davis/Axios Visuals

Zoom in: February is typically peak flu season, the Pennsylvania Department of Health says. 

State data from the most recent week shows more than double the number of reported cases compared with the same time last year. 

There have been more than 153,000 cases statewide as of Feb. 15, including 348 deaths. The previous two seasons, there were more than 500 and 430 flu deaths, respectively.

The percentage of flu-related deaths has outpaced COVID-19 deaths since Jan. 25, per state data. The weekly rate of flu-related ER visits is currently higher than coronavirus and RSV combined. 

Philadelphia is seeing higher flu infection rates than peaks in November-December 2022, health spokesperson James Kyle tells Axios. 

Philadelphia's flu rate is about 1,031 cases per 100,000 people, similar to collar counties such as Bucks (1,052) and Montgomery (956). 

Philly has reported more than 16,000 cases this season.

What they're saying: Philadelphian Kaitlyn Covert tells Axios that she started taking the flu more seriously after the death of her 4-year-old cousin and her own hospitalization last fall. 

The 19-year-old, now a freshman at the University of Florida, was on the brink of sepsis after contracting both flu strains. It left her with a condition known as post-viral depression.

"You may think the flu is not a big deal, but it needs to be taken seriously," Covert tells Axios.

Zoom out: Experts are concerned about the severity being seen in kids this year, including reports of some pediatric cases with serious neurological complications associated with the flu. 

Across the U.S., 68 children have died of the flu.

Pediatric flu deaths hit a record 200 last year, and this season is shaping up to be worse, said Matthew Cook, president and CEO of Children's Hospital Association.

Between the lines: This flu season may have been made more severe because rates of seasonal flu vaccination have been falling in recent years for some groups, including children.

Compounding the problem is the fact that this year's flu vaccine has been a bit less effective (35%) than in a typical year (45%).

People have also had much less exposure to flu in recent years amid the COVID-19 pandemic.

"We think because people were social distancing and using masks for so long during COVID that we have reduced immunity to it," McLay said. 

What we're watching: Public health officials say they are increasingly flying blind since they can't interact with or get flu data from global sharing platforms FluNet and FluID since the Trump administration announced the U.S. exit from the World Health Organization.

The bottom line: There's a lot of respiratory virus still going around this season. If you haven't gotten the vaccine yet, it'd still be prudent to get one, experts urge. 

Pennsylvania facing "very high" flu activity: What to know

The nation is experiencing its worst flu season since 2009.

Illustration of a store window sign that reads Sorry We're SICK

The nation&#x27;s <a class="gtmContentClick" data-vars-link-text="worst flu season" data-vars-click-url="https://www.axios.com/2025/02/18/us-facing-worst-flu-season-since-2009-experts-say" data-vars-content-id="b9b16be3-fd88-4a80-9501-dade6f155ff0" data-vars-headline="Pennsylvania facing &quot;very high&quot; flu activity: What to know" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2025/02/18/us-facing-worst-flu-season-since-2009-experts-say" target="_self">worst flu season</a> in 15 years is driving <a class="gtmContentClick" data-vars-link-text="&quot;very high&quot; influenza activity" data-vars-click-url="https://app.powerbigov.us/view?r=eyJrIjoiMDBhNjI4NjItNGJlYS00MjdlLWFjZTAtMTFlODUwNzJhYTU5IiwidCI6IjQxOGUyODQxLTAxMjgtNGRkNS05YjZjLTQ3ZmM1YTlhMWJkZSJ9" data-vars-content-id="b9b16be3-fd88-4a80-9501-dade6f155ff0" data-vars-headline="Pennsylvania facing &quot;very high&quot; flu activity: What to know" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://app.powerbigov.us/view?r=eyJrIjoiMDBhNjI4NjItNGJlYS00MjdlLWFjZTAtMTFlODUwNzJhYTU5IiwidCI6IjQxOGUyODQxLTAxMjgtNGRkNS05YjZjLTQ3ZmM1YTlhMWJkZSJ9" target="_blank">&quot;very high&quot; influenza activity</a> across Pennsylvania.Why it matters: The virus is causing more severe complications and hitting young children especially hard.

Tina Reed

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