Time may be running out for people under 65 to get vaccinated against Covid.
Health experts are warning that the Food and Drug Administration as soon as Friday may restrict eligibility for the upcoming 2025–26 formula to high-risk populations. That means younger patients who are not immunocompromised will be unable to get the shot, experts warn.
“If you’re under 65 and not high risk, the window to get a Covid-19 vaccine is right now — before the FDA label changes,” epidemiologists Katelyn Jetelina and Hannah Totte wrote Monday in their Substack newsletter. “Once it happens, access will be limited immediately (if it isn’t already).”
Their warning was followed by predictions from other medical professionals that widespread access to various Covid vaccines will be cut off.
“Many people have conditions that would qualify them as higher risk for Covid and therefore eligible for the updated vaccine, BUT they may change this list and make it much more restricted when they change the FDA label,” Dr. Lucky Tran, a biochemist, posted on X.
Details about whom the FDA will consider “high risk” haven’t been released. Representatives of the agency did not respond to requests for comment.
Over the last three weeks, Covid rates have surged across much of the United States, with the highest concentrations detected in the West. Wastewater levels for Covid are peaking in Alaska, California, Hawaii, Texas, Nevada, and Utah, according to the Centers for Disease Control and Prevention.
San Francisco is caught in the surge. The risk of Covid is “high” throughout the city, according to data from wastewater treatment plants. Influenza and RSV rates are low.
“We’re in an unfortunate limbo, created by an administration that’s uncommitted to vaccines,” said Matt Willis, the former Marin County public health officer, alluding to Health and Human Services Secretary Robert F. Kennedy Jr., who has a history of casting doubt on immunizations. “So, I’m worried the federal foot-dragging will get us the vaccine late and that it will be too narrow in who can get it.”
Amid the uncertainty, San Francisco health officials have adopted a cautious position. The Public Health Department urged residents to stay up to date on Covid vaccinations, noting that anyone who has not yet received the 2024–25 vaccine should do so immediately. The agency recommends two doses for those 65 and older or immunocompromised. Officials also advise people to consider wearing well-fitted masks in crowded indoor spaces and to stay home if sick.
“We continue to monitor federal vaccine guidance for the upcoming 2025–26 respiratory virus season,” the department said in a statement.
Kennedy has narrowed access to Covid shots. In May, he updated guidelines that removed pregnant women and healthy children from the vaccine schedule.
Once updated guidelines are rolled out, pharmacies will dispose of any unused doses of the 2024–25 Covid vaccine, according to UCSF immunology expert Dr. Peter Chin-Hong.
Even people who remain eligible for the vaccine may be less likely to get it because of confusion over who qualifies, Chin-Hong said.
On Aug. 19, the American Academy of Pediatrics recommended Covid shots for all children ages 6 to 23 months, a stronger stance than the CDC’s recommendation, which leaves the choice to parents and providers.
Deaths and hospitalizations from Covid among children are likely to rise under the new vaccine rules, according to Chin-Hong. CDC data show children under 2 accounted for 57% of pediatric Covid hospitalizations in 2024.
“What happens is no one gets it, because patients are confused,” Chin-Hong said of the vaccine. “It’s the people who are vulnerable who get caught up in the confusion.”