Dozens of medical and public health organizations have signed a letter urging insurers to continue covering COVID-19 vaccination in pregnant patients.
The letter from the American College of Obstetricians and Gynecologists is in response to the recent move by the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) to no longer recommend COVID-19 shots for healthy pregnant women.
"Our organizations call upon payers and insurers to continue making the COVID-19 vaccine available to pregnant people without undue utilization management or cost-sharing requirements," the letter states. "As organizations dedicated to public health and evidence-based health care for pregnant patients, we are particularly passionate about ensuring equitable and free access to these critical vaccines."
HHS Secretary Robert Fr. Kennedy Jr. announced the COVID vaccine recommendation for healthy children and pregnant women was being dropped in a brief video on the social media site X on May 27. While HHS said pregnant women are still free to consult their doctor about vaccination, removal of the recommendation from the CDC's adult immunization schedule has raised concerns that insurers won't cover COVID shots.
"When these vaccines aren't supported in this way, often insurers and other payers decide not to cover these medications, which creates additional barriers," John Lynch, MD, MPH, associate director of the Harborview Medical Center in Seattle, explained at a media briefing held last week by the Infectious Diseases Society of America (one of the groups that have signed the ACOG letter).
Groups cite benefits of vaccination during pregnancy
ACOG is still recommending the use of updated COVID-19 vaccines in pregnant and lactating individuals. In letter, the group said COVID vaccination in healthy pregnant women is supported by research showing pregnant women who have COVID-19 are more likely to be admitted to intensive care or die from the illness, that infants born following a COVID-19 infection during pregnancy are at increased risk of low birth weight and stillbirth, and that COVID vaccination during pregnancy is safe and protective for both women and their infants after birth.
"The science around the benefits of COVID-19 vaccination in pregnancy has not changed; therefore, we maintain our position and strong recommendation that all pregnant patients should continue to receive the COVID-19 vaccine," ACOG said. "As such, payers should be fully reimbursing for the cost of providing immunization counseling and administration services for all evidence-based vaccinations without utilization management practices or cost-sharing requirements for all patients, including pregnant patients."
The letter adds that payers have the authority to go above and beyond baseline federal recommendations for vaccination.
In a COVID Recommendation FAQ sent to Congress, HHS supported the decision by citing studies that it claimed showed higher rates of fetal loss in pregnant women who'd received a COVID vaccine during pregnancy and statistically significant increases in preterm birth. But in a Viewpoint published earlier this week, CIDRAP's Vaccine Integrity Project noted the studies cited in the document do not make those claims.
