With all the media attention on emerging vaccines, we want to keep you informed as the development of vaccines evolves and what to expect.

When will vaccines be available?

Key Updates this Week:

  • The FDA approved the emergency use (EUA) of the Pfizer/BioNTech COVID-19 vaccine on 12/11; the CDC provided their full recommendation on 12/12 to administer the vaccine to individuals over age 16
  • Initial doses were shipped on 12/13 and will be available for administration early this week
  • Moderna’s COVID-19 vaccine will be reviewed for EUA on 12/17. The vaccine has the same mechanism and similar efficacy to the Pfizer/ BioNTech vaccine, therefore authorization for Moderna’s vaccine is anticipated next week
  • Pfizer/BioNTech and Moderna have announced very high (>95%) efficacy for their vaccines, both of which require two doses approximately 3-4 weeks apart
  • Estimates are that 20 million people could be vaccinated during December and 30 million per month thereafter

How will vaccines be distributed?

  • The government is overseeing all initial distribution of the vaccine
  • Vaccines are being shipped with GPS Thermal Sensors for temperature and destination tracking
  • Each state has developed its own plan for distribution/allocation

How do we access the vaccines?

  • Initial supplies will be limited
  • Distribution will be phased, with prioritization of health care workers, first responders and long-term care/assisted living facilities
  • Vaccine access for the general population is expected by mid-year 2021
  • Many retail chain pharmacies will have the ability to administer COVID-19 vaccines (like the flu and other vaccines) as supplies become available. Due to restricted initial supplies, cold storage requirements, and medical oversight required for potential allergic reactions/other, we anticipate that it may be months before employers/vendors can facilitate COVID-19 vaccine clinics

How will the cost be covered?

  • The CARES Act requires health insurers and plans to cover any CDC-recommended COVID-19 preventive services, including vaccines, with no cost-sharing

How much will the vaccines cost?

  • The government will fund the cost of vaccine serums for the time being, but self-insured employers and fully insured health plans are required to cover the cost of administration
    • Health plans and PBMs plan to charge employers the approved Medicare fee-for-service rate of $16.94 for the first dose and $28.39 for the second dose ($45.33 total). The administration fee for single-dose COVID-19 vaccines (if/when applicable) is $28.39
  • The vaccine serum (currently being funded by the government) are estimated at $20-$37 per dose
  • Employers will want to consider if they will incur cost for non-enrolled employees and/or families

How many people will take the vaccine?

  • It is difficult to say how many individuals will take the vaccine when it is first available to them; several surveys reveal that many individuals are hesitant to take a COVID-19 vaccine. However, the percentage of Americans that are willing continues to increase
    • Employers should note that willingness to take the vaccine may vary by ethnicity
  • Children have not been significantly included in the initial trials, so vaccines will not be available to them as soon as for adults
  • The clinical trials have also not included pregnant and breastfeeding women and therefore these individuals should discuss the vaccine and their individual situation with their physician to decide

Should we require employees to take the vaccine?

  • Careful consideration is needed, with factors ranging from business sustainability to employee/labor relations
    • Considerations may be different during Emergency Use Authorization
  • Our recommendation is to seek legal counsel for your specific organization/circumstances

What should we tell employees?

  • Hays recommends developing fact sheets applicable to your workforce to provide employees with guidance when available
  • The CDC has developed a strategic framework, Vaccinate with Confidence, to strengthen public trust in vaccines and discourage misinformation. These and similar federal resources can be leveraged to provide employees with credible information
  • Employees should always be encouraged to speak with their PCP or other health care providers for medical advice

Can we relax on precautions now that a vaccine is available?

  • Ongoing vigilance is critical. We are far from being in the clear, even with a vaccine. Employers must continue to strongly promote precautions: social distancing, masks, handwashing, and flu vaccines
  • Herd immunity occurs when most people are immune to a disease and therefore the spread of the disease is effectively mitigated. It is still speculative to estimate when herd immunity will be achieved, but experts do not believe this will happen until late 2021, or even 2022

Please be advised that any and all information, comments, analysis, and/or recommendations set forth above relative to the possible impact of COVID-19 on potential insurance coverage or other policy implications are intended solely for informational purposes and should not be relied upon as legal or medical advice. As an insurance broker, we have no authority to make coverage decisions as that ability rests solely with the issuing carrier. Therefore, all claims should be submitted to the carrier for evaluation. The positions expressed herein are opinions only and are not to be construed as any form of guarantee or warranty. Finally, given the extremely dynamic and rapidly evolving COVID-19 situation, comments above do not take into account any applicable pending or future legislation introduced with the intent to override, alter or amend current policy language.

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