A key federal vaccine advisory committee met to discuss and vote on its COVID-19 vaccine recommendations Friday, with potential implications for insurance coverage and access in New York.

The committee voted to recommend that all patients should be required to consult with a clinician to discuss the risks and benefits of COVID vaccination before getting the shot. The group narrowly voted against a proposal to require prescriptions. The recommendations now go to Jim O’Neill, the acting director of the U.S. Centers for Disease Control and Prevention, for approval.

The recommendations from the federal Advisory Committee on Immunization Practices have traditionally determined which vaccines pharmacies in New York can offer, which patients they can vaccinate and which vaccines health plans will cover.

But the recommendations on COVID-19 vaccines are coming late this year, about three weeks after the U.S. Food and Drug Administration approved the latest versions of the shots. They're also coming from a newly overhauled committee that Health and Human Services Secretary Robert F. Kennedy Jr. has stacked with vaccine skeptics.

As a result, the state stepped in to try to ensure widespread access to the COVID-19 shots without waiting for the committee’s recommendations.

Gov. Kathy Hochul issued an executive order on Sept. 5 giving pharmacies the ability to vaccinate anyone over 3 years old. The city and state health departments and a new regional public health coalition have also offered guidance to health care providers, indicating the shots are recommended for a broad patient population, not only the limited groups — those over 65 or with certain health conditions — approved by the FDA.

The state Department of Financial Services sent a circular to health plans on Sept. 10, urging no-cost COVID-19 vaccine coverage.

While some health care providers and insurers may still consider the federal advisory committee’s recommendations, this season’s COVID-19 vaccination effort in New York started without them.

Here’s where things stand now.

Are pharmacies offering COVID-19 shots?

After Hochul issued her executive order, pharmacies that had previously been reluctant to offer the COVID-19 vaccines because of a lack of federal guidance were anxious to get them in stock, said Roger Paganelli, who facilitates a network of about 200 independent pharmacies in New York City and surrounding areas.

Paganelli is the owner and supervising pharmacist at Mt. Carmel Pharmacy in the Bronx, which he said is already administering the vaccines.

When the FDA first approved the latest COVID-19 shots, Walgreens and CVS said they would offer them in New York, but only for patients who got a prescription. Now, they say a prescription is no longer needed.

Both pharmacy chains still have pop-ups that appear when patients try to schedule a COVID-19 vaccine appointment online, asking if they’re eligible for the shots. A Walgreens spokesperson clarified that anyone who indicates they are eligible will get the shot, regardless of underlying health conditions.

Are doctors offering COVID-19 shots?

Policies on who will be able to get a shot will likely vary somewhat from practice to practice.

Tribeca Pediatrics, which has offices across the city, initially told parents interested in getting their children vaccinated against COVID-19 that access would be limited to only certain patients and would depend on the recommendations from the Advisory Committee on Immunization Practices.

But on Sept. 11, the practice sent out an email to parents, which was reviewed by Gothamist, that said any child could get the shot. Tribeca said it was following guidance from New York and New Jersey as well as the American Academy of Pediatrics, and would have a supply of shots available starting in late October.

Essen Health Care, which has more than 35 locations across the Bronx, will still likely be relying on recommendations from the Advisory Committee on Immunization Practices, said Dr. Binu Kuriakose, the medical director of Essen’s urgent care division.

If that guidance is completely different from state guidance, Kuriakose said, “We would have to consider that with our own infectious disease specialists.” He said the result could end up being a mix of the two.

Are insurance companies covering COVID-19 shots?

Medicaid, which is regulated by the state, is required to offer broad coverage for the shots. Other insurance companies and employers could still be influenced by federal recommendations.

Still, Dr. James McDonald, the state health commissioner, said he is already observing that coverage is the norm.

“Patients should operate now under the assumption that [the COVID-19 vaccine] is covered by your health insurance because it more than likely is,” McDonald said.

He noted patients could check with their health plans ahead of time to be sure.

Leslie Moran, a spokesperson for the New York Health Plan Association, also said plans are broadly covering COVID-19 vaccines.

“Health plans make coverage decisions informed by science and the latest medical evidence that evaluates multiple sources of data, including but not limited to ACIP,” Moran said.

This article was updated with information from Friday's meeting of the federal Advisory Committee on Immunization Practices.