Responding to federal changes, Maryland seeks to clarify 'confusing' COVID-19 vaccine rules

Jeff Barker, The Baltimore Sun on Sep 11, 2025

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BALTIMORE — With the cold and flu season approaching, Maryland health officials issued guidance Wednesday on who may receive COVID-19 vaccines and whether insurance will cover the shots — a shifting landscape a top regulator described as “confusing.”

“I very much appreciate that it’s confusing,” Maryland Insurance Commissioner Marie Grant told The Baltimore Sun. “I want to make sure that people reach out to us if they have any questions.”

The Maryland Department of Health on Wednesday afternoon released a consumer advisory it said was warranted because “federal government uncertainty around vaccine policy has raised questions for many.”

The advisory — which sought to respond to common questions — came as Maryland and other states are developing or refining their own COVID eligibility and insurance protocols because of changes by the Trump administration at the federal level that have been criticized by Democratic lawmakers.

The administration has limited eligibility for COVID shots to adults 65 and older and people with at least one underlying condition that increases their risk of severe illness.

Massachusetts Gov. Maura Healy, a Democrat, recently announced that her state will mandate insurers operating there to cover certain vaccines. Meanwhile, California and other states have formed a West Coast Health Alliance to provide recommendations on immunizations “based on science, not politics.”

The Maryland Health Department advisory said that “right now, Marylanders should have access to a COVID-19 vaccine if they want one.”

But it said “recent actions at the federal level have increased the complexity of the vaccination process and could include access and supply issues for Marylanders looking for a COVID-19 vaccine.”

In changing the COVID policy, Health and Human Services Secretary Robert F. Kennedy Jr., posted in August on X: “The emergency use authorizations for Covid vaccines, once used to justify broad mandates on the general public during the Biden administration, are now rescinded.”

“The American people demanded science, safety, and common sense,” Kennedy added.

But Vinny DeMarco, president of the Maryland Health Care for All coalition, said: “It is critical that vaccines be available for everyone and that everyone be encouraged to take vaccines which public health experts say is necessary for their well-being.”

People who are not officially eligible for the vaccines may still be able to obtain them for themselves or their children with a doctor’s prescription and by paying out of pocket.

Maryland health officials say immunizations are provided by health care professionals, including pharmacists, who are authorized under state law to provide them without a prescription.

Most Americans receive their COVID-19 vaccines at drugstores, according to the Centers for Disease Control and Prevention.

On June 1, a law signed by Gov. Wes Moore took effect, guaranteeing that insurance providers, including Medicaid, would continue to cover the cost of vaccines for COVID and a range of other illnesses.

However, the law is limited because the state cannot regulate self-funded insurance plans. Those plans, also known as “self-insured,” are overseen by an employer — often a large business — that takes on health coverage itself and typically pays a significant share of the costs.

The U.S. Department of Labor’s Employee Benefits Security Administration regulates those plans.

But Grant, the insurance commissioner, said employees shouldn’t assume such plans — even though they aren’t under the state’s purview — don’t cover immunizations.

“I don’t think it’s always immediately clear,” Grant said. She said the insurance administration is working with the state health officials and insurers “to make sure the message is as clear and simple for Marylanders as possible.”

In Baltimore, the vaccines are available throughout the city, including at pharmacies, grocery stores, various Johns Hopkins Hospital sites and other health care providers, and numerous other locations.

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