Five years after COVID-19 hit the United States, officials can largely anticipate how the virus will operate and, with available vaccines, antivirals and at-home tests, the natural seasonal rise in cases is more manageable than at the peak of the pandemic.
But public health advocates and researchers worry that recent “mixed messaging” from the federal level on who should get the new batch of COVID-19 vaccines may disrupt that progress.
“Mixed messaging results in people being confused. It will increase vaccine hesitancy and will undermine our nation’s ability to adequately protect ourselves from COVID,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “We’re seeing some confusion. I think part of the confusion is not knowing what the precise recommendations are.”
The U.S. Food and Drug Administration on Wednesday approved an updated COVID-19 vaccination for seniors and those with health issues that suppress their immune system – a change from previous vaccine guidance that recommended the shot for everyone older than 6 months.
FDA Commissioner Marty Makary said in a follow-up social media post that the latest FDA approval is not “limiting availability” of the vaccine to anyone, and those who want it could still get it.
That said, it will likely be harder to get a COVID-19 shot if it’s not widely recommended, as insurance carriers may not cover the cost of the vaccine. Those who want the shot may need to go through additional administrative hurdles to get it.
“There’s a great deal of confusion and a lack of clarity about the vaccinations,” Benjamin said. “Their (FDA) communication has been so confusing that people aren’t sure quite how to get it … I don’t personally think they are following the science in their recommendations.”
Andrew Pekosz, professor at the Johns Hopkins Bloomberg School of Public Health who researches COVID-19 and other respiratory illnesses, says the new recommendations are not based on any changes in the COVID-19 virus.
“What’s changed is the political will to utilize vaccines. We have a secretary of Health and Human Services who has clearly not supported vaccines in the past,” Pekosz said of Secretary Robert F. Kennedy Jr., a noted vaccine skeptic.
“What you’re seeing with the government recommendations now are exactly that kind of attitude,” Pekosz said.
Top medical societies, such as the American Academy of Pediatrics, are pushing back on federal COVID recommendations. On Aug. 19, the AAP recommended that “all young children ages 6-23 months get vaccinated against COVID-19, along with older children in certain risk groups.”
“Whenever people are confused about an issue or they don’t think they understand it, the default is to not do something,” Pekosz said. “And in this case … people will not be getting the vaccine simply because they are not sure if they should or shouldn’t because of the mixed messaging.”
He noted that COVID-19 cases in Maryland are starting to rise, but other places are seeing faster increases. The Centers for Disease Control and Prevention reported last week that COVID-19 infections were “growing or likely growing” in 31 states. That included Maryland, where the CDC reported that the number of people in emergency rooms who were diagnosed with COVID-19 remained low, but that the numbers were likely growing.
Pekosz says that while COVID-19 in 2025 is milder than it was in the early pandemic days, it is “still a severe disease,” and worries that lower vaccination rates will provide less protection for those more susceptible to severe disease – older people, children and those with weaker immune systems.
In Maryland, there had been 1,521,314 reported cases of COVID-19 through last week, according to the most recent data from the Maryland Department of Health. There were at least 18,507 deaths in the same period, the department said.
What’s changed is the political will to utilize vaccines. We have a secretary of Health and Human Services who has clearly not supported vaccines in the past. What you’re seeing with the government recommendations now are exactly that kind of attitude.
– Andrew Pekosz, professor at the Johns Hopkins Bloomberg School of Public Health, who studies respiratory illnesses
Just last week, there were 1,317 active COVID-19 cases in Maryland. But weekly cases have been on a steady rise since mid-summer, when there were just 390 reported COVID-19 cases during the first week of July.
That said, fatalities attributed to COVID-19 are low. There were only three COVID-related deaths last week, according to the state health department. Since July 1, there have been 27 deaths attributed to the virus.
Pekosz said that even though the new guidelines specifically say “high risk” populations should have access to vaccines, limiting its availability to others could still end up lowering protection for the high-risk groups.
“More cases in healthy individuals will spill over into the high-risk groups,” Pekosz says. “More-vulnerable populations do not respond as well to the COVID vaccine. So while the vaccine works, it doesn’t work as well. When you vaccinate the whole population you start to generate these layers of protections.”
Pekosz expects that fewer people will get the vaccine this year due to the confusion.
He and other public health advocates await further guidance on the COVID-19 vaccine this year. Meanwhile, Pekosz recommends that Marylanders prepare for the seasonal rise in cases by picking up some at-home COVID tests. But he still says the COVID vaccine is effective and safe.
“The vaccine is efficacious, I would much rather get the vaccine than get COVID. And that is now being taken off the table for a large number of people,” he said.
