With the first COVID-19 vaccination receiving emergency-use authorization and beginning to ship across the United States, questions are arising as to who will pay for the vaccine and how much it will cost. Additionally, employers are wondering whether they can or should mandate the vaccine for their employees. There is still a lot of information emerging, but this bulletin contains what we know as of December 15, 2020.
The federal government has purchased hundreds of millions of doses of the COVID-19 vaccine and plans to administer them using protocols developed under the CDC COVID-19 vaccination program plan. Under this plan, the vaccine itself will be paid for by the federal government, while the administration costs will be paid by the recipient’s health plan without cost-sharing to plan members through 2021.
At this time, the Pfizer-BioNTech vaccine is only approved for emergency use for ages 16 to 85 in the U.S., although the company has begun testing on children and adolescents. Moderna, the only other pharmaceutical company that has applied for emergency use in the U.S., has only tested its vaccine on ages 18 and above. Children and adolescents will not be vaccinated until test results demonstrate the vaccine is safe for those age groups, which is expected to occur by fall 2021.
The chart below shows the status of the three front runner vaccines for the U.S. at this time and their current expectations for volume, cost and availability:
- Vaccine Coverage, Pricing, and Reimbursement in the U.S. | KFF
- CMS Payment Allowances and Effective Dates for COVID-19 Vaccines and their Administration during the Public Health Emergency
- COVID-19-Vaccination-Program-Interim_Playbook.pdf (cdc.gov)
- COVID-19 vaccine: Hidden costs, where and when you'll get it, how many doses you need - CNET
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