Updated COVID-19 vaccines, targeting the XFG strain, are now available in the U.S., but eligibility and insurance coverage remain contentious as federal guidelines shift.
The U.S. Food and Drug Administration (FDA) approved updated COVID-19 vaccines targeting the XFG strain, a recombinant omicron variant accounting for about 40% of cases in the U.S., according to the Centers for Disease Control and Prevention (CDC). These vaccines, including mRNA options from Moderna and Pfizer and a protein-based shot from Sanofi, are expected to arrive at pharmacies, hospitals and clinics across the U.S. in the coming days. However, eligibility criteria and insurance coverage remain unclear, with federal and medical groups offering conflicting guidance.
Vaccine Availability and Target Strain
The FDA approved the updated vaccines on Thursday, with Moderna and Pfizer’s mRNA formulations and Sanofi’s protein-based shot. The XFG strain, a recombinant omicron variant, meaning it formed through the combination of two omicron subvariants, is the primary target, as it accounts for about 40% of cases in the U.S., according to the latest data from the Centers for Disease Control and Prevention (CDC) in July. Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center in Nashville, explained that vaccines must evolve to match circulating variants: The better the match we have with what’s in the vaccine and the circulating strain, the more effective the vaccine will be.
Eligibility for the updated vaccines is limited to specific groups. Moderna’s shot is approved for those 6 months through 64 years old with an underlying condition and for all adults aged 65 and older. Pfizer’s shot is approved for those 5 years through 64 years old with an underlying condition and for all adults over age 65.
Insurance Coverage Uncertainties
Insurance coverage for the updated vaccines remains uncertain. The Affordable Care Act requires insurers to cover vaccines recommended by ACIP, which votes on recommendations for how vaccines should be used after they are approved by the FDA, followed by sign-off from the CDC director. The committee has undergone significant changes since Health and Human Services Secretary Robert F. Kennedy Jr. removed all 17 of its previous members in June 2025 and replaced them with new appointees. Earlier this year, a federal judge stayed Kennedy’s appointments to the panel.
People without health insurance may still be able to receive a COVID-19 vaccine for free. The HHS says uninsured adults may be able to find free COVID-19 vaccines through their state or local health departments. For children, the CDC’s Vaccines for Children program provides vaccines at no cost to eligible children, including those who are uninsured or Medicaid-eligible.
Medical Groups Urge Broader Access
Leading medical organizations are pushing for broader vaccination access despite federal restrictions. Dr. Sandra Fryhofer, of the American Medical Association, stated, There’s been a lot of confusion and chaos regarding vaccine recommendations.
Public health officials also emphasize the importance of combining COVID-19 vaccines with flu and RSV shots. Public health specialists have said that it is safe to receive a COVID-19 vaccine at the same time as a flu shot or an RSV vaccine, for those who are eligible.
The CDC didn’t respond to questions about any new fall guidance. This ambiguity has left many patients and providers navigating a patchwork of federal and medical group guidelines. We have to recognize that these vaccines work best at preventing severe disease,
said Dr. Peter Chin-Hong, an infectious diseases specialist and associate dean for regional campuses at the University of California, San Francisco. They work best at keeping us out of the hospital and intensive care unit.