Few Minnesota kids get COVID shots, but federal switch could make access harder for families

New federal guidance that does not recommend COVID-19 vaccines for healthy children and pregnant women is expected to have little practical impact in Minnesota, where the state estimates that only 1 in 10 children and teens are up-to-date with their shots.

Doctors said they are more worried about the longer-term impact of the abrupt policy switch, including whether it creates insurance barriers for people who want COVID vaccines or sows doubt among parents about vaccines in general.

“That’s a really unfortunate possibility” if parents end up thinking healthy children maybe don’t need vaccines, said Dr. Gigi Chawla, chief of general pediatrics for Children’s Minnesota.

Many doctors were open to a risk-based vaccine strategy, following the lead of European countries that have adjusted their COVID vaccine recommendations to focus on the ages and demographic groups most at risk for severe infections. Two leaders of the U.S. Food and Drug Administration had hinted in an editorial last week in the New England Journal of Medicine that the Trump administration would pivot to this approach as well.

But Health and Human Services Secretary Robert F. Kennedy Jr. ignored the usual scientific process Tuesday when he announced in a social media post that the federal government was immediately removing COVID vaccines for healthy children and pregnant women from a federal recommended immunization schedule.

The federal Advisory Committee on Immunization Practices (ACIP) would usually offer input from outside experts before such a switch, for example, but its next meeting isn’t until mid-June.

The unorthodox announcement left Minnesota doctors and health authorities confused about whether it governed current COVID vaccines, or only the next generation of boosters. FDA leaders just last week had ordered that the next boosters be matched to the JN.1 family of coronavirus variants that are the most common cause of COVID illnesses now.

The Minnesota Department of Health issued a written response Wednesday backing COVID vaccines as a “critical tool in preventing severe illness and death, particularly for people at higher risk of severe disease, including young children and pregnant people.”

State health leaders are “monitoring this process closely as it differs from the standard federal procedure for updating vaccine recommendations and are mindful of how it may impact insurance coverage and vaccine access in Minnesota.”

Vaccinations for COVID have plummeted since 2023, when the federal government ended its emergency response to the pandemic. Only 52% of Minnesota’s seniors are up to date with COVID vaccinations, according to the state’s latest update, even though age is a risk factor for severe COVID illness or death.

Seniors have made up 230 of the 249 COVID-related deaths reported in Minnesota since Jan. 5. COVID risks are relatively low in Minnesota now, based on sampling of wastewater for coronavirus levels.

State data show less than 11% of Minnesotans aged 19 and younger are vaccinated for COVID, while federal surveys suggest that nearly a quarter of Minnesota children 5 to 17 have received the latest booster shot. Either way, only a fraction of kids in the state are getting the vaccines.

Children’s pediatrics chief Chawla said she is accustomed to parents declining COVID vaccines, even after she warns that children 4 and younger are at elevated risk for severe COVID, and that older children are at risk for long COVID fatigue and lingering symptoms after infection.

“We’re not in the business of getting our way,” she said. “We’re in the business to make sure that parents have their questions answered and can make decisions for their kids. We’re there to advise. We’re there to recommend. But we’re not knocking them over the heads to get any kind of vaccine, honestly.”

Studies during the pandemic urged COVID vaccines for pregnant women because they are at heightened vulnerability to infections and the vaccines can offer protection to their infants after birth.

Doctors are concerned Kennedy might use this similar process to subvert other vaccine recommendations. The HHS commissioner, appointed by President Donald Trump, has a long history of vaccine skepticism. Parents also could use the announcement as pretense to decline other shots.

Worries about COVID vaccines already have prompted fewer Minnesotans to seek vaccinations for their children against measles and other infectious diseases. The state once had one of the nation’s highest measles vaccine rates, but now it has one of the lowest. Only 86.5% of kindergartners were vaccinated at the start of the 2024-25 school year.

Usually, a new federal vaccine recommendation comes with a formal recission of the old one, Chawla said. That didn’t appear to happen this week, leaving doctors uncertain whether Kennedy’s recommendation only takes effect with the next boosters.

Next month’s ACIP meeting could add clarity. Licensed practitioners need to know whether they are complying with federal guidance on vaccine recommendations, Chawla said, otherwise they face “risk ... on many levels” if they continue to provide them to patients.

Insurers also weren’t immediately sure whether they should still cover COVID vaccines for healthy children and pregnant women. Typically, health plans pay the entire cost of recommended vaccines, because it costs much less to prevent disease than to treat severe illness.

Minnetonka-based Medica in a statement Wednesday said it has “not made a decision yet” on whether its health plans will change how they cover COVID vaccines.

A spokesperson for Bloomington-based HealthPartners said, “We’re still working to understand the recommendations,” and didn’t know how they would change the care provided by its doctors or coverage provided by its health plans.

Blue Cross and Blue Shield of Minnesota said in a statement, “We continue to cover COVID-19 vaccines and boosters for eligible members who choose to receive them” but will review updated recommendations.