Although a coronavirus vaccine has yet to be approved for the masses, experts are looking to the future, and talking details. One of the big questions to come out of May 12's Senate hearing, which was conducted virtually, was how much an approved vaccine would cost. Senator Bernie Sanders of Vermont asked health officials if they could guarantee that COVID-19 vaccines, once available, would be free and accessible for all.
“If and when the vaccine comes, it won’t do somebody any good if they don’t get it, and if they have to pay a sum of money for it… that will not be helpful,” the former presidential candidate said. “Do you think poor people and working people should be last in line for the vaccine?”
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Sanders didn't get a definitive answer from health officials. “I share your concern that this needs to be made available to every American,” said Stephen Hahn, MD, commissioner of the Food and Drug Administration. Though he noted that the payment of vaccines isn't a responsibility of the FDA, he added that he’d take the senator's request back to the White House coronavirus task force.
The Affordable Care Act requires health insurers to cover the full cost of all federally recommended vaccines. That's the case for the flu shot, and one would assume that it would be for the coronavirus vaccine as well. Currently, however, uninsured people can end up paying a fee of around $40 at the pharmacy to receive a flu shot. Sanders wants to know if this would be true for COVID-19.
During the hearing, Brett Giroir, MD, assistant secretary for health at The U.S. Department of Health and Human Services (HHS), also told Sanders that HHS doesn’t control vaccine prices, but said that he’d advocate for vaccines to be free to all.
“My office is one of the offices committed to serving the underserved, and we need to be absolutely certain that if a vaccine... is available, that it reaches all segments of society regardless of their ability to pay, or any other social determinants of health that there may be,” Dr. Giroir said.
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Making the vaccine free for all would certainly be a big step toward enabling everyone in the U.S. to receive to the potentially life-saving shot. But it's only a start. Many other factors will affect how accessible even a $0 vaccine is for all Americans.
Certain groups will have greater difficulty getting vaccinated regardless of price, Dennis Andrulis, PhD, associate professor of public health at The University of Texas Health Science Center at Houston, tells Refinery29. That includes anyone who lives in rural areas, far from major hospitals or doctors they trust, for instance. Essential workers — grocers, delivery people, home health aides, and more — who may not be able to take the time off work to visit a healthcare facility. Parents without easy access to child care.
If officials are truly committed to creating an accessible vaccine, they must begin identifying groups like these, who face roadblocks when it comes to getting the shot, and "taking action to mitigate these challenges," Andrulis says.
Ensuring that everyone can get a coronavirus vaccine will also require a big push toward creating effective communication from the government. “[We need] messages that reach vulnerable populations," about how well the vaccine works, about its side effects, about its cost, Andrulis says. "Overcoming language barriers will be essential, as will as mitigating fear among immigrants — both documented but especially undocumented,” he adds. Officials will also need messages that dispel "miscommunication, conspiracies, anti-vaccination distortions."
If that seems like a big task, it is. And while it's somewhat unlikely an effective vaccine will be ready for mass market development by the end of this year, Andrulis says it will also take time for government officials to develop the kind of programs and messages necessary to make the shot truly accessible — and that's assuming they start now.
So while Sanders's work to ensure vaccines are free is important, it’s just one step down a long road to truly equal access.