Colorado officials on Wednesday issued public health orders aimed at making it easier for Coloradans to receive a COVID vaccine booster this fall.
The orders essentially create a standing prescription allowing for any Coloradan ages 6 months or older to receive a COVID shot if they or their parents choose. That is significant because pharmacy heavyweights CVS and Walgreens, amid confusion over federal vaccine policy, have thus far refused to administer COVID shots this year to anyone in Colorado without a doctor’s prescription.
In addition, the state Board of Pharmacy will meet Friday to discuss rule changes that could further ensure access to COVID vaccines.
“Colorado is committed to empowering individuals to make choices to protect their own health and safety,” Gov. Jared Polis said in a statement, “and I will not allow ridiculous and costly red tape or decisions made far away in Washington to keep Coloradans from accessing vaccines.”
The prescription order goes into effect on Friday.
Confusion on federal policy
Typically, pharmacies can administer seasonal vaccines without a doctor’s note, and they are a vital part of the vaccination system. Retail pharmacies administered 92% of COVID vaccine doses last year nationwide.
But the decisions by Walgreens, CVS and other large chains to restrict vaccination in Colorado came this year amid a shakeup in federal vaccine policy.
First, the Food and Drug Administration authorized COVID shots from makers Moderna, Pfizer and Novavax, but restricted their use in people under 65 to only those with medical conditions placing them at higher risk of severe illness.
Dr. David Higgins, a Colorado pediatrician and researcher who is also the vice president of the Colorado chapter of the American Academy of Pediatrics, said the FDA’s decisions to narrow the authorizations are perplexing.
“From my perspective, it’s not clear what the rationale and the justification was for the narrowing,” he said. “There’s no new evidence suggesting new safety risks or changes to effectiveness that would seem to justify narrowing the approval.”
Meanwhile, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices has yet to meet to decide on recommendations for this year’s COVID vaccines, and there are calls for that committee’s September meeting to be postponed, amid a massive shift in the committee’s makeup. Health and Human Services Secretary Robert F. Kennedy Jr. previously fired all members of the advisory committee — including a Colorado doctor — and replaced them with a smaller, handpicked contingent that includes some members who have been critical of vaccines.
This means that there is currently no CDC guidance on the annual vaccines, leading to nationwide confusion over who can actually get a vaccine this year and under what conditions.
Answering questions Saturday on the social media site Reddit, Polis criticized the FDA decision, as well as Kennedy and President Donald Trump. He said he had been working to resolve the issue with pharmacies Friday and promised a solution “in the next few days.”
“I am so disappointed that RFK and the Trump administration did this, as it will cost lives in other states that don’t make it easier,” Polis wrote. “The step of going through a physician for a safe, effective vaccine is absurd.”
Why Colorado was singled out
Walgreens’ and CVS’ prescription-only policy isn’t uniform nationwide. In some states, the pharmacies are administering the vaccines as usual. But the companies have said state laws and regulations in a few states prohibit them from administering vaccines without ACIP approval.
In Colorado, the regulation at issue appears to be State Board of Pharmacy rule 3 CCR 719-1. The rule authorizes certain pharmacists, pharmacy interns and pharmacy technicians to administer vaccines only so long as “the vaccines are administered in accordance with CDC guidelines.”
Without CDC guidelines to go by, that caused the companies to require a prescription.
Polis wrote on Reddit that the companies’ decisions caught the state by surprise.
“We didn’t know until the announcement that Colorado would be a state that didn’t allow it automatically,” he wrote.
Colorado lawmakers this year moved to RFK Jr.-proof school immunization requirements, by removing the previous reliance on ACIP recommendations to decide which vaccinations kids need to attend school. But COVID is not a vaccine required for school, and the pharmacy rule shows how rooting out the state’s deference to federal vaccine policies would require a lot more work.
What the new orders do
In addition to the prescription policy — known as a standing order — the new public health order directs CDPHE to “issue guidance to providers, pharmacists, and the public regarding the safety and efficacy of COVID-19 vaccines.”
It also instructs CDPHE to work with other state agencies to remove barriers to COVID vaccines. This includes working with the state Medicaid agency and the state Division of Insurance to make sure the vaccines are covered by state-regulated health insurance plans and that Medicaid members continue to have access, as well.
“Since Oct. 1, 2024, more than 4,500 Coloradans have been hospitalized due to COVID-19,” Jill Hunsaker Ryan, CDPHE’s executive director, said in a statement. “This order ensures that Colorado takes every step possible to prevent hospitalizations, protect frontline health care workers, and preserve critical health care resources. Equitable vaccine access is a cornerstone of protecting the public’s health.”
COVID infections have been increasing in Colorado as back-to-school season ramps up. As of late August — the most recent period for which data is available — there were 74 people in the hospital in Colorado with COVID. Utilities along the Front Range have reported increasing detection of COVID in the wastewater, as well.
Last year, COVID was listed as a cause in 374 deaths in Colorado, nearly four times more deaths than influenza.
The standing prescription order lays out guidelines for administering COVID vaccines to people of various age groups — including specifying the needle length and the location on the body where the shot should be given.The guidelines are similar to what they have been in previous years save for one change. Children under the age of 5 are allowed to receive only the vaccine made by Moderna.
That’s in keeping with the FDA’s authorization, which did not approve the Pfizer vaccine for use in kids under 5. The vaccine had previously been given to young children, but as part of its approval this year, the FDA canceled the emergency authorization allowing for that.