healthcare provider

Seniors in some parts of the country say they are being denied COVID-19 vaccinations amid an ongoing spike in cases, leading to rising frustration over new Trump administration policies that are making it harder to get the shots.

Matthew D’Amico, 67, of New York City, said a Walgreens declined to administer COVID-19 vaccines to him and his 75-year-old wife on Friday because they didn’t have a prescription. They’re trying to get vaccinated ahead of a trip.

“I can’t believe we can’t get” the vaccine, D’Amico said in an interview. “I’ve been inoculated a number of times and never had to get a prescription. And it’s just very frustrating that this is where we are.”

He’s not alone in his exasperation. Under the leadership of the vaccine skeptic Health and Human Services Secretary Robert F. Kennedy Jr., federal agencies have effectively made it more difficult to get vaccinated against COVID-19 this year. The Food and Drug Administration has only “approved” COVID-19 vaccines for those age 65 and up, as well as younger people with underlying health conditions.

That means across the country, people younger than 65 interested in getting the COVID-19 vaccine must now either consult with a healthcare provider or “attest” to a pharmacy that they have an underlying health condition. It’s a potential hurdle that can make getting the vaccine more difficult and, some health experts worry, prompt even more Americans to eschew getting vaccinated.

As D’Amico can attest, though, being part of a group for whom the COVID vaccine is “approved” doesn’t necessarily guarantee easy access.

“For me to go to my primary [healthcare provider] now and get a prescription, it’s just kind of ridiculous,” D’Amico said.

At least some people younger than 65 are encountering pharmacy staff asking probing questions about their medical conditions.

That happened Friday at a CVS in Orange County, according to 34-year-old Alex Benson, who takes medication that can suppress his immune system.

Besides just protecting himself, he wanted to get vaccinated as he has family members who are at high risk should they get COVID — his mother is immunocompromised, and his mother-in-law had open-heart surgery on Thursday night.

Benson said an employee asked why he thought he was eligible for the vaccine.

“They asked me for either a prescription or they wanted to know … why I felt I needed the vaccination,” Benson said. At one point, a staffer offered to call his doctor to get an authorization for the vaccine.

Benson said he was alarmed by the questions, and started to “feel kind of some desperation to plead my case to the pharmacist.” Another CVS staffer later came over and said further answers weren’t necessary and simply attesting he was eligible was good enough. He eventually got the vaccine.

Still, he felt the experience was dismaying.

“I think easy access should be the policy,” Benson said. “I tend not to get too political, but it seems just rather juxtaposed to me that an anti-regulation administration is using regulation in this way. They’re supposed to be removing barriers to healthcare.”

The vaccine chaos comes as COVID-19 is either increasing or starting to hit its late summer peak. According to data released Friday, there are now 14 states with “very high” levels of coronavirus detected in their wastewater — California, Texas, Florida, North Carolina, Indiana, South Carolina, Alabama, Louisiana, Connecticut, Utah, Nevada, Idaho, Hawaii and Alaska, as well as the District of Columbia.

Dr. Elizabeth Hudson, the regional physician chief of infectious diseases for Kaiser Permanente Southern California, said data continue to show an increase in coronavirus cases.

“Over this past week, we’ve seen an increase in the number of outpatient COVID cases, and even a smattering of inpatient cases,” Hudson said. “It appears that we may be nearing the top of the wave, but it may be another two weeks or so until we truly know if we’re there.”

The rate at which coronavirus lab tests are confirming infection also continues to rise statewide and in the Los Angeles area. For the week ending Aug. 30, California’s COVID test positivity rate was 12.83%, up from 7.05% for the week ending Aug. 2. In L.A. County, the positive test rate was 14.83%, up from 9.33%.

Other data, however, suggest some areas may have reached their summer COVID peak.

In Orange County, the COVID positive test rate was 13.1%. That’s below the prior week’s rate of 18%, but still higher than the rate for the week that ended Aug. 2, which was 10.8%.

In San Francisco, the test positivity rate has been hovering around 9% for the last week of reliable data available. It’s up from 7% a month earlier.

In addition, wastewater data in L.A. County show coronavirus levels declined slightly from the prior week.

“It’s too early to know if this decrease in wastewater viral concentrations is the first sign that COVID-19 activity is peaking or is regular variation typical of this data source,” the L.A. County Department of Public Health said.

COVID hospital admissions in California are increasing — with the latest rate of 3.93 admissions per 100,000 residents, up from 2.38.

But they remain relatively low statewide and in L.A. County. The number of L.A. County residents seeking care for COVID-related illness, or who have been hospitalized, “is quite a bit lower than during summer surges in 2023 and 2024,” the public health department said.

A relatively mild summer wave, however, could mean that the annual fall-and-winter COVID wave might be stronger. In July, the state Department of Public Health said that scientists anticipate California would see either a stronger summer COVID wave or a more significant winter wave.

The current confusion over federal COVID vaccine policy has been exacerbated by the chaos at the U.S. Centers for Disease Control and Prevention, where Kennedy earlier this year fired everyone on the influential Advisory Committee on Immunization Practices, and orchestrated the firing of CDC Director Susan Monarez just 29 days after she was confirmed to the post by the Senate.

Some of Kennedy’s handpicked replacements on the ACIP have criticized vaccines and spread misinformation, according to the Associated Press. And the new interim CDC director — Jim O’Neill, a Kennedy deputy — is a critic of health regulations and has no training in medicine or healthcare, the AP reported.

The CDC hasn’t issued its own recommendations on who should get vaccinated, and that inaction has resulted in residents of a number of states needing to get prescriptions from a healthcare provider for at least the next couple of weeks. In some cases, that’s true even for seniors, as D’Amico found out.

As of Friday, CVS said people need a prescription to get a COVID-19 vaccine, sometimes depending on their age, in Arizona, Florida, Georgia, Louisiana, Maine, North Carolina, New Mexico, New York, Pennsylvania, Utah, Virginia and West Virginia, as well as the District of Columbia.

CVS couldn’t even offer the COVID-19 at its pharmacies in Nevada as of Friday; they were only available at the company’s MinuteClinic sites, according to spokesperson Amy Thibault.

CVS said it expects to offer COVID-19 vaccines without prescriptions at its pharmacies in New Mexico, Nevada, New York and Pennsylvania “soon,” due to recent regulatory changes in each state.

“Right now, all patients in all states need to attest to being eligible for the vaccine in order to schedule an appointment online,” Thibault said. If an adult says they have no underlying health conditions, but do have a prescription from a healthcare provider for “off-label” use of the vaccine, they can get the shot, Thibault confirmed.

On Thursday, Hawaii joined California, Washington and Oregon in launching the West Coast Health Alliance: an interstate compact meant to provide science-based immunization guidance as an alternative to the CDC.

“Together, these states will provide evidence-based immunization guidance rooted in safety, efficacy, and transparency — ensuring residents receive credible information free from political interference,” according to a statement from Gov. Gavin Newsom’s office.

The statement suggested that the Trump administration was essentially “dismantling” the CDC.

“The absence of consistent, science-based federal leadership poses a direct threat to our nation’s health security,” the statement said. “To protect the health of our communities, the West Coast Health Alliance will continue to ensure that our public health strategies are based on best available science.”

It was not immediately clear, however, whether the formation of the West Coast Health Alliance would make it easier for people to get COVID-19 vaccines at the nation’s largest pharmacy retailers, where many people get their shots.

Mainstream medical groups, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, are also offering their own recommendations to advise individuals and families on what vaccines they should get.

California and a coalition of other liberal-led states sued the Trump administration Friday over efforts to end gender-affirming care for transgender, intersex and nonbinary children and young adults nationwide — calling them an unconstitutional attack on LGBTQ+ patients, healthcare providers and states’ rights.

The lawsuit was brought by California Atty. Gen. Rob Bonta and officials from 15 other states and the District of Columbia. It challenges a Jan. 28 executive order by President Trump that denounced gender-affirming care as “mutilation” and called on U.S. Justice Department officials to effectively enforce a ban, including by launching investigations into healthcare providers.

The lawsuit notes the Justice Department last month sent more than 20 subpoenas to doctors and clinics that have provided such care nationwide, with justice officials suggesting they may face criminal prosecution.

Bonta’s office, in a statement, said such efforts “have no legal basis and are intended to discourage providers from offering lifesaving healthcare that is lawful under state law.” The lawsuit asks a federal court in Massachusetts to vacate Trump’s order in its entirety for exceeding federal authority and undermining state laws that guarantee equal access to healthcare.

The White House did not immediately respond to a request for comment Friday.

Trump made reining in transgender rights a key promise of his presidential campaign. Upon taking office, he moved swiftly to do so through executive orders, funding cuts and litigation. And in many ways, it has worked — particularly when it comes gender-affirming care for minors.

Clinics across the country that had provided such care have closed their doors in response to the threats and funding cuts. That includes the renowned Center for Transyouth Health and Development at Children’s Hospital Los Angeles, one of the largest and oldest pediatric gender clinics in the U.S.

The clinic told thousands of its patients and their families that it was shuttering last month. Other clinics have similarly closed nationwide, radically reducing the availability of such care in the U.S.

Republicans and other Trump supporters have cheered the closures as a major win, and they praised the president for protecting impressionable and confused children from so-called woke medical professionals pushing what they allege to be dangerous and irreversible treatments.

Bonta said in the Friday statement that Trump and his administration’s “relentless attacks” on such care were “cruel and irresponsible” and endangered “already vulnerable adolescents whose health and well-being are at risk.”

“These actions have created a chilling effect in which providers are pressured to scale back on their care for fear of prosecution, leaving countless individuals without the critical care they need and are entitled to under law,” Bonta said.

Mainstream U.S. medical associations have supported gender-affirming care for minors experiencing gender dysphoria for years. They and LGBTQ+ rights organizations have accused Trump and his supporters of mischaracterizing that care, which includes therapy, counseling and support for social transitioning, and can include puberty blockers, hormone treatment and, in rarer circumstances, mastectomies.

Queer advocates, many patients and their families say such care is life-saving, alleviating intense distress — and suicidal thoughts — in transgender and other gender-nonconforming youth. They and many mainstream medical experts acknowledge that gender-affirming care for young people is still a developing field, but say it is also based on decades of solid research by medical professionals who are far better equipped than politicians to help families make difficult medical decisions.

However, as the number of children who identify as transgender or nonbinary has rapidly increased in recent years, that argument has failed to take hold in many parts of the country. Conservatives and Republican leaders have grown increasingly alarmed by such care, pointing to young people who changed their minds about transitioning and now regret the care they received.

“Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding,” Trump’s executive order stated.

Trump and others have escalated tensions further by spreading misinformation about kids being whisked away from school to have their gentials mutilated without their parents’ knowledge — which is not happening.

The battle has played out in the courts, in part as a state’s rights issue. In June, the Supreme Court ruled that conservative states may ban puberty blockers and hormone treatments for transgender teens, with the court’s conservative majority finding that states are generally free to set their own standards of medical care.

The Trump administration, however, has not taken the same view. Instead, it has aggressively tried to eradicate gender-affirming care nationwide, regardless of state laws — like those in California — that protect it.

Trump’s Jan. 28 executive order, titled “Protecting Children from Chemical and Surgical Mutilation,” claimed that “medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions.”

It defined children as anyone under the age of 19, and said that moving forward, the U.S. wouldn’t “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another,” but would “rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”

The states’ lawsuit focuses on one particular section of that order, which directed Atty. Gen. Pam Bondi to convene state attorneys general and other law enforcement officials nationwide to begin investigating gender-affirming care providers and other groups that “may be misleading the public about long-term side effects of chemical and surgical mutilation.”

The section suggested those investigations could be based on laws against “female genital mutilation,” or even around a 1938 law known as the Food, Drug, and Cosmetic Act, which authorizes the Food and Drug Administration to regulate food, drugs, medical devices and cosmetics.

On July 9, Bondi announced the Justice Department’s subpoenas to healthcare providers, saying doctors and hospitals “that mutilated children in the service of a warped ideology will be held accountable.”

On July 25, The Times reported that Bill Essayli, the Trump administration’s controversial pick for U.S. attorney in L.A., had floated the idea of criminally charging doctors and hospitals for providing gender-affirming care, according to two federal law enforcement sources who spoke on the condition of anonymity for fear of reprisal.

The targeting of gender-affirming care is part of a wider effort by the administration to eliminate transgender rights more broadly, in part on the premise that transgender people do not exist. On his first day in office, Trump issued another executive order declaring there are only two sexes and denouncing what he called the “gender ideology” of the left.

His administration has sought to limit the options transgender people have to get passports that reflect their identities, and the Justice Department has sued California over its policies allowing transgender girls to compete against other girls in youth sports. Many transgender Americans are looking for ways to flee the country.

Still, many in the LGBTQ+ community fear the attacks are only going to get worse. Among those who are most scared are the parents and families of transgender kids — including those who believe their health records may have been collected under the Justice Department’s subpoenas.

One mother of a Children’s Hospital patient told The Times last month that she is terrified the Justice Department is “going to come after parents and use the female genital mutilation law … to prosecute parents and separate me from my child.”

Bonta is leading the lawsuit along with the attorneys general of Connecticut, Illinois, Massachusetts and New York. Joining them are Pennsylvania Gov. Josh Shapiro and the attorneys general of Delaware, the District of Columbia, Hawaii, Maine, Maryland, Michigan, Nevada, New Jersey, New Mexico, Rhode Island and Wisconsin.