Some Americans are having a hard time getting COVID vaccine appointments for themselves and their kids. Of the 12 million doses shipped to providers, 4 million were administered in September. In many communities it has been especially hard to find vaccines for children due to distribution challenges with cost, storage, delivery systems, and shipping adult vaccines first. This year’s updated vaccine rollout is slower compared to past years, but vaccine supply and availability should increase in the coming weeks.

The way that COVID-19 vaccines are distributed has changed since the start of the pandemic. During the pandemic, the government bought vaccines from drug companies and gave them to vaccination sites for free. Now the vaccine is being distributed through typical healthcare distribution systems like other vaccines. Doctor's offices, hospitals, and pharmacies now pay for the vaccine and are reimbursed by insurance companies.

The complex rollout of this vaccine is especially affecting the availability of children's vaccines, which have different dose sizes and packaging.

Adult vaccines were shipped out first, and officials report that children’s vaccines have now been shipped but may be delayed due to steps in the distribution process.

Some pediatric facilities report cost barriers to buying the vaccine with added complications of reimbursement.

Not all pharmacists are able to give vaccines to children due to some state regulations; this is especially true for children under the age of three. It’s best to call ahead and check if the pharmacy can administer the vaccine.

Confusion around insurance coverage has also been a barrier. Private insurance companies are required to cover this vaccine with no co-pay; however, they can require that people get the vaccinations at an in-network provider. For some, this means going to their doctor's office and not a pharmacy, but everyone can get the updated COVID vaccine for free.

A new Federal Bridge Access Program provides free vaccines to adults who do not have insurance coverage. The CDC website states that they expect the availability of these free vaccines to increase in the coming days.

Both Pfizer and Moderna report having well-stocked quantities of the updated COVID  vaccine on their website, and the delays are in the distribution timing and not in available supply.

This a complicated issue, and we are still learning the extent to which the new vaccination distribution system is affecting vaccine availability.

While the system is expected to improve in coming weeks, the exact timing of increased vaccine availability for children is unclear and will likely vary by location.