COVID-19 may no longer dominate daily headlines, but the virus is still moving through communities across the United States as fall approaches. According to the Centers for Disease Control and Prevention, national and regional COVID-19 activity was increasing as of August 28, 2026, even though overall respiratory illness activity remained very low. That makes the latest conversation around COVID vaccine coverage especially timely as updated shots begin reaching pharmacies and health care providers.
The virus also continues to cause serious illness and death. In a February 2026 report, the CDC estimated that COVID-19 was associated with between 10.4 million and 16.7 million illnesses, 290,000 to 450,000 hospitalizations and 34,000 to 53,000 deaths during the 2024 to 2025 respiratory virus season. The agency recorded 34,981 COVID-associated deaths through its vital statistics system during that period, with nearly nine in 10 occurring among adults 65 and older.
The overall toll remains significant. In March 2025, ABC News reported CDC data showing that more than 1.22 million Americans had died from COVID-19 since the pandemic began. Current CDC mortality surveillance continues tracking COVID deaths through death certificates, although the agency cautions that the newest numbers are provisional because reporting can lag by several weeks.
For fall 2026, the Food and Drug Administration selected a vaccine formula designed around the JN.1 lineage XFG variant. The FDA approved updated versions of Moderna’s Spikevax and mNEXSPIKE, Pfizer and BioNTech’s Comirnaty, and Sanofi’s Nuvaxovid in late August.
According to the FDA, all of the updated vaccines are approved for adults 65 and older. Younger age eligibility depends on the product and whether a person has an underlying condition associated with a higher risk of severe COVID-19. Spikevax is approved for high-risk patients beginning at 6 months old, Comirnaty beginning at age 5, and mNEXSPIKE and Nuvaxovid beginning at age 12.
That is where COVID vaccine coverage can become complicated.
ABC News reported that AHIP, the trade group representing U.S. health insurers, said its member plans expect to cover updated COVID-19 vaccines during the 2026 to 2027 season. ABC also reported that AHIP previously committed to covering vaccines recommended by the CDC’s Advisory Committee on Immunization Practices without cost sharing through the end of 2027.
However, there is a discrepancy in publicly available information about exactly how long that commitment lasts. An August 2026 analysis from KFF says AHIP members committed to covering vaccines recommended as of September 1, 2025, including updated COVID and flu vaccines, without cost sharing through the end of 2026. Because the two sources describe different end dates, people should confirm coverage directly with their insurance company before getting vaccinated.
Federal law still provides an important layer of protection. According to KFF, most private health plans and Medicaid programs are required under the Affordable Care Act to cover vaccines recommended by ACIP without patient cost sharing. The situation is more complicated because vaccine policy has changed and states have begun creating their own coverage safeguards.
As of August 3, 2026, KFF found that 36 states used current ACIP recommendations to determine which vaccines private insurers must cover, while 15 states did not. Some states instead rely on earlier vaccine recommendations, medical organizations, state health departments, or state advisory groups. That means COVID vaccine coverage could differ depending on where someone lives and what insurance plan they carry.
People with Medicare have another route. According to Medicare.gov, Medicare Part B covers FDA-approved or authorized COVID-19 vaccines, and beneficiaries generally pay nothing for the vaccine when the provider accepts Medicare assignment.
People without insurance may still have options. The U.S. Department of Health and Human Services says state and local health departments and federally funded health centers may provide access to free or lower-cost vaccines. The CDC also operates the Vaccines for Children program, which provides vaccines at no cost to eligible children younger than 19, including children who are uninsured or Medicaid eligible.
At the same time, medical organizations are issuing their own recommendations. The American Academy of Family Physicians recommends COVID-19 vaccination for all adults 19 and older, with particular emphasis on adults 65 and older, people at higher risk of severe infection, and people who have never received a COVID vaccine.
The CDC says age remains the strongest risk factor for severe COVID outcomes. Conditions associated with higher risk include asthma, cancer, chronic kidney or lung disease, diabetes, certain heart conditions, obesity, pregnancy, immune system disorders and several other medical conditions.
Public health specialists are also reminding Americans that COVID is only one respiratory threat expected to circulate as temperatures cool. Flu and RSV prevention remain part of the seasonal conversation as well.
“Recommending and delivering all three seasonal vaccines early this fall remains our single most effective defense against preventable hospitalizations, critical illness, and death,” Dr. Ronald Nahas, president of the Infectious Diseases Society of America, said during a briefing, according to ABC News.
The larger takeaway is that COVID-19 never stopped circulating simply because emergency declarations ended and public attention moved elsewhere. Updated vaccines are arriving, COVID vaccine coverage is expected to remain available for many insured Americans, and free or lower-cost options may exist for people without insurance. But with federal recommendations, state rules, and individual insurance policies no longer moving in perfect lockstep, checking coverage before making an appointment may be just as important as deciding when to get the shot.
