As Trump, RFK Jr. and anti-vaxxers push rates down, it's your best defense
By Nancy Lavin, Rhode Island Current
But most patients at Open Door Health in Providence, where Maynard works as senior clinical operations director, showed no hesitancy — even asking for the shot unprompted, despite the controversial guidance from government agencies over who should get it, and whether insurers would cover the cost.
What Maynard was not expecting: telling her patients she couldn’t offer them the vaccine because the health center didn’t have any yet.
While retail pharmacies already carry them, primary care providers and public health clinics are still waiting for their orders through the Rhode Island Department of Health, which buys COVID-19 shots through a bulk contract with the Centers for Disease Control and Prevention. The state health department was unable to place an order until the CDC finalized its vaccine recommendations.
“It feels really icky to have to create this barrier to getting the shot now for people who want it,” Maynard said in an interview on Wednesday.
EDITOR'S NOTE: I got my COVID shot at CVS on September 19 along with my flu shot. I wanted to make sure I got it before Bobby Jr. decided to pull the vaccine off the market. Every COVID shot I've had previously resulted in a 6-10 hour period the next day of feeling sick with flu-like symptoms. Despite those reactions, I reasoned it was better than actually getting COVID and risking death, given my age and medical condition. I am one of the few who has never had COVID and I credit the shots. I was pleasantly surprised this year that I did not experience the next-day reaction. In fact, I felt just fine. Please get your shot for your own protection, that of your family and everyone you come into contact with. - Will Collette
She won’t have to say “no” much longer. The CDC accepted the guidelines of its vaccine panel on Monday, kickstarting the order process for local care providers via the state health department. Maynard ordered 80 doses Tuesday — enough for two weeks of shots for clinic patients.
Vaccines are expected to arrive at primary care centers in Rhode Island by Oct. 14. But the bigger problem – combating public mistrust and misunderstanding about the vaccine — doesn’t have a firm end date.
Public skepticism and fear has accompanied COVID-19 — and its treatment — since 2020. New this year are the words and actions of federal agencies and administrators, casting new doubt on the efficacy of the booster shot, and making it harder to access for people who want it.
“Nothing has changed except the politics,” said Dr. Amy Nunn, chief executive officer at the Rhode Island Public Health Institute, which runs Open Door Health among other programs. “The science is the same. But people are confused because of those mass media campaigns, which really unfortunately instill doubt and have a horribly detrimental impact on the average person.”
‘Abysmally low’ vax rate
Open Door Health may be an anomaly because its LGBTQ+-friendly services cater to younger patients, and potentially, those with more awareness of science-backed recommendations, Nunn said.
Fifteen miles south, at Brown University Health’s East Greenwich primary care office, Sen. Pam Lauria, a nurse practitioner, is fielding vaccine-related concerns from patients who never expressed much skepticism before.
“There’s always been politics around this vaccine, but I have people questioning who have never questioned before,” Lauria, a Barrington Democrat, said in an interview Wednesday. “This is a pretty significant medical breakthrough that got marred by politics. That’s always been the problem.”
Across Rhode Island, about half as many people have gotten the COVID-19 booster so far this year compared with last year, according to public tracking by the state health department.
Just over 21,000 doses of the latest COVID-19 shot have been administered in Rhode Island — equal to 2.0% of the state population — compared with nearly 44,000 at the same time in 2025.
The state vaccine data reflects shots in arms through Sept. 25 — just two weeks into the state-issued guidance around vaccine eligibility and coverage. And, the data only reflects shots distributed by retail pharmacists like Walgreens and CVS, which got their vaccines quicker because they buy directly from manufacturers.
Even so, that’s “abysmally low,” in the words of Nunn.
“The real issue is all the misinformation and disinformation,” Nunn said. “I think people are just confused.”
Indeed, the federal guidance remains on shifting sands. In August, the FDA adopted criteria restricting the updated shots to people 65 and older, or with underlying health conditions, prompting questions for access, and insurance coverage, for other groups. In September, a key CDC advisory panel approved new guidelines granting access for all ages, subject to a “shared decision-making” caveat that first requires recipients to speak with a clinician. It wasn’t until two weeks later — an unusual delay compared with the standard process — that the CDC accepted the recommendation of its immunization panel, giving the green light to ship shots to primary care providers and state-run health clinics nationwide.
Amid the federal tumult, Rhode Island officials took matters into their own hands, issuing a set of state health guidelines on Sept. 12 that guarantee access, and insurance coverage, for the shot to residents age 3 and older. More than two dozen other states have issued similar guidance, some of which have also formed inter-state alliances to help coordinate public health campaigns around immunization. Rhode Island is part of a 10-state collaborative of Northeast states, while a separate three-state group has formed along the West Coast.
Given the recent changes, it’s too early to put much stock in Rhode Island’s COVID-19 vaccine uptake compared with last year, said Joseph Wendelken, a spokesperson for the state health department.
Deadly consequences
However, the seasonal spike on COVID-19 cases has started to hit Rhode Island hospitals and emergency departments. From Aug. 9 to Aug. 16, COVID-19 hospital admissions doubled from 15 to 31 people, according to state health department data. New admissions have remained around 30 people in the intervening weeks. There have been 97 COVID-19 related deaths as of Sept. 20. That’s a fraction of the 1,775 COVID deaths tracked through the same date in 2020, but on par with the deaths in 2025.
Nearly all of the people who died from COVID-19 this year — 90 of 97 — were 65 or older.
That’s the group Dr. Michael Fine worries about most. Fine, a former state health director who now heads a national advocacy group, Primary Care for All Americans, said the low COVID-19 uptake was “not a huge problem” for young, healthy people.
Seniors, and those with autoimmune conditions, on the other hand, will suffer far more without COVID-19 boosters to mitigate more serious side effects of contracting the virus.
A larger percentage of Rhode Island seniors have received the booster than the general population — 5.7% so far this year. But it’s still less than half the 11% vaccination rate among adults 65 and older in 2025.
Like Nunn, Fine blamed the lackluster uptake on confusion and misinformation.
“It’s become a little more difficult to figure out how to get vaccinated,” he said. “No one is quite clear about the insurance coverage. All this stuff adds up, and the result is people get vaccinated less.”
And new state health guidelines don’t cut it, in Fine’s opinion.
“Getting people vaccinated isn’t just, you make a guideline,” Fine said. “You have to start placing ads on buses, and get the primary care community involved. I am not seeing any clear messaging reminding people to get vaccines.”
Lauria tries to leverage her longstanding relationships with patients to encourage them to roll up their sleeves. But waiting for doses to arrive to her office, she can only direct them to a retail pharmacy. And she has no idea whether those who verbally agree follow through.
“Obviously a captive audience is the best way to try to accomplish vaccinations,” Lauria said. “It will be good when our doses arrive.”
Getting the word out
Meanwhile, the state health department has “been doing a lot of communicating” with the public and providers about vaccinations, including COVID-19, with the intent of boosting vaccination rates, Wendelken said.
That includes the Sept. 12 press release announcing state guidelines for vaccine providers and insurers, and a $103,000 advertising campaign in English and Spanish that includes social media, digital networks, and print promotions at senior centers and housing facilities, Wendelken said in an email Wednesday.
In late March, the CDC abruptly canceled more than $30 million in unspent federal funding to Rhode Island for health department programs, including state-run vaccination clinics and tracking of contagious diseases. The funding was later restored, and has not been cut again, Wendelken confirmed.
However, maintaining and improving routine immunization rates for children and adults was identified as a “significant issue” in the state health department’s fiscal 2027 budget request. And federal pandemic aid to Rhode Island, which has supported most of the health department’s COVID-19 work, is winding down.
Federal funding for Rhode Island COVID-19 tracking, supplies and community work has diminished, from $83.4 million in fiscal 2025 to $15.2 million in the current, state fiscal 2026 budget. The health department proposed spending $7.5 million on its COVID-19 unit in fiscal 2027 using federal funding. This does not include state spending on vaccination clinics and public education for other immunizations such as the flu.
But the seasonal flu is just as harmful for vulnerable populations, and the flu shot is just as important, said Nunn. She worried that the distrust and doubt sown by federal leaders over COVID-19 vaccine might bleed over into other standard immunizations, including the flu shot.
“I think people are unfortunately becoming increasingly skeptical of things that are founded in decades of science,” she said.
Flu shots trailing
Fewer flu shots have been given out in Rhode Island so far this year, compared with last year. But the difference is less stark than with the COVID-19 booster — the 53,876 doses administered through Sept. 25 is just over 86% of doses given through the same time 2025, according to state health data.
And a slightly larger chunk of older adults already got their seasonal flu shot: 12.6% this year, compared with 12.2% through the same time last year.
Rhode Island has historically been a national leader in state flu immunization rates — the highest in the country from 2017 through 2022. The 60% of residents who got a flu shot during the 2023-2024 season, the most recent data available, was second only to Massachusetts, according to KFF.
It’s still early in the flu season — even Fine hasn’t gotten his flu shot yet for that reason, he said. But the line between too early and too late is fast approaching.
“My fear is that by the time people realize there really is a disease and a vaccine helps, it will be too late,” he said.
Maynard rolled up her sleeve for a flu shot last week, and plans to get a COVID-19 booster as soon as they arrive at the clinic.
“I have older parents and little kids who are bringing all sorts of germs with them,” Maynard explained. “And, I think working with patients, it’s my duty to protect them.”
More than 180 community and school vaccination clinics are set to begin later this week across the state, offering free access to flu shots and COVID-19 boosters to students, teachers and the general public.
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Rhode Island Current is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Rhode Island Current maintains editorial independence. Contact Editor Janine L. Weisman for questions: info@rhodeislandcurrent.com.
