Patient advocate: Don’t throw away your shot

In the Broadway blockbuster “Hamilton,” Alexander sings, “I’m not throwin’ away my shot.” Neither should we.

Americans’ trust in the Centers for Disease Control and Prevention (CDC) has been tested in the past. In 2020, early guidance on COVID-19 was all over the place and test kits were faulty. People perceived that the CDC was subject to political, rather than medical, influence.

Trust is easy to lose and hard to regain. While some applaud the current CDC leadership for cutting back on vaccine recommendations and gutting its panel of vaccine experts in 2025, the medical community is expressing alarm that we may see a resurgence of diseases thought defeated, like measles.

So this is the atmosphere as we head into fall vaccine season. Understandably, confusion reigns. Should I get that vaccine? Will I have to pay for it if the CDC doesn’t require it? Should I get it from a doctor or a pharmacy?

All good questions!

I remain firmly in the camp that vaccines not only save lives, but also protect us from serious illnesses, from everyday flu to shingles to cancer. Studies have found that vaccines increase life expectancy by reducing deaths from infectious diseases and improving overall health.

Let’s look at our fall vaccines

COVID-19

While COVID-19 has dropped out of the top 10 deadliest diseases, it was still a contributing factor in about 47,000 deaths in the U.S. in 2024. The CDC says older people and those with underlying conditions need the vaccine. Medical experts say it’s important for more people to be vaccinated in order to not spread disease to others.

While the CDC dropped its recommendation that pregnant women get vaccinated, doctors say vaccination protects both mothers and babies, who cannot be vaccinated.

What you should do: A majority of Americans falls into one of the permitted categories (age, chronic health conditions, etc.). But go by what your doctor tells you, and don’t delay. Supplies may be limited.

Where can you go? Following a recent executive order by Gov. J.B. Pritzker, Illinois residents can get the 2025 COVID-19 vaccine at pharmacies without a prescription. Pharmacies like Walgreens and CVS have the 2025-26 vaccine; the Illinois Department of Public Health (dph.illinois.gov) has a dashboard where vaccines are available.

Will you have to pay? Not if you have Medicare or a Medicare Advantage plan. Most private insurers are also covering the vaccines, but check with them to see if there’s a copay. Medicaid is also covering vaccines. Uninsured? The state Department of Public Health offers immunizations, though availability may be more limited than in recent years.

Where can you go? Currently in Massachusetts, everyone 6 months and older is eligible for the updated 2025-2026 COVID-19 vaccine. Nearly all Massachusetts residents can still get a COVID-19 vaccine for no or little cost.

Massachusetts residents may get their COVID-19 vaccine at their doctors’ office, health center or pharmacy, or through their local health department. Pediatricians’ offices and community health centers are the best option for accessing COVID-19 vaccines for children, especially those between 6 months and 5 years of age.

Will you have to pay? Not if you have Medicare or a Medicare Advantage plan. Additionally, Gov. Maura Healey signed an executive order requiring insurance companies that operate in the state to cover the cost of vaccines. Medicaid is also covering vaccines.

Influenza

Unlike the COVID-19 vaccine, guidelines for the flu vaccine haven’t changed. The CDC recommends that everyone 6 months and older should get vaccinated against the flu — even if they are healthy — with rare exceptions. That’s because influenza is a highly contagious disease and can lead to serious complications, including pneumonia and hospitalization, even in otherwise healthy people.

What you should do: Get the shot from your doctor, a pharmacy or a public health department. The best timing is October so the antibodies have time to develop.

Will you have to pay? Unlikely. Medicare, Medicaid and private insurance programs cover the cost. Again, check with your insurer to make sure there isn’t a copay.

RSV

RSV (respiratory syncytial virus) is dangerous for older adults (75 and older), ages 50-74 with underlying conditions and for babies. It’s a big reason babies are hospitalized each fall.

The nice thing about this vaccine is that it’s a one-and-done.

What you should do: If you haven’t had it already, get it at your doctor’s office or a pharmacy.

Will you have to pay? Probably not. The vaccines are covered by Medicare, Medicaid and most commercial insurers.

One of the things I find with vaccines is that people forget what they had, or when they had them. This is where the electronic patient portal your health care provider uses comes in handy because it will keep track of your immunizations and tell you when it’s time to ask whether it’s time to get (yet) another one.

Whatever you do, don’t throw away your shot!

• Teri (Dreher) Frykenberg, a registered nurse, board-certified patient advocate, is the founder of www.NurseAdvocateEntrepreneur.com, which trains medical professionals to become successful private patient advocates. She is the author of “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” available on Amazon. Frykenberg offers a free phone consultation to readers. Contact her at Teri@NurseAdvocateEntrepreneur.com.