Sept. 10, 2025 – Everyone's talking about COVID-19 vaccines – and how difficult getting one may be if you're a healthy adult under 65.
Recent shifts in federal guidance may affect what insurance is willing to cover for those who don't meet the new rules for the shot, which without insurance can cost up to $140, according to the CDC's vaccine price list. Access is another consideration: The healthy under-65 crowd may now need a prescription to get the shot – requiring a visit to a doctor's office rather than a pharmacy.
Hurdles aside, many doctors still recommend COVID shots for healthy young adults. COVID experts suggest asking yourself these questions when making up your mind.
1. Are you sure you're not eligible?
The FDA approved the updated COVID vaccines for adults who are 65 or older and people with medical conditions that put them at risk of severe illness. That list of qualifying conditions and risk factors is long and includes depression, anxiety, and even being just slightly overweight (body mass index of 25 or greater; calculate yours here). You're also eligible if you don't meet physical activity guidelines, said Marc Sala, MD, co-director of the Northwestern Medicine Comprehensive COVID-19 Center in Chicago – that is, you get less than 150 minutes per week of aerobic activity, or do fewer than two muscle-strengthening activities (like lifting weights) per week.
2. How concerned are you about developing COVID?
COVID boosters improve the immune system's response to SARS-CoV-2, the virus that causes COVID, by increasing antibodies – so they reduce your risk of severe symptoms, Sala said. Healthy young adults have always had a low risk of severe COVID symptoms like fever, fatigue, body aches, and a sore throat, he said. Getting a shot lowers your already low risk, so you know you're doing all you can to protect your health.
If you've had COVID before with mild or no symptoms, you could perhaps skip the vaccination, Sala said. And there are other things to consider, such as the risk posed to others when you have COVID.
“For healthy adults, I would suggest talking with a health care professional about the benefits and risks,” said Robert H. Hopkins Jr., MD, medical director of the National Foundation for Infectious Diseases.
3. How concerned are you about getting long COVID?
A persistent risk for healthy younger adults who get COVID is having prolonged symptoms, or long COVID – even if you've had COVID before and recovered well. As many as 20% of people who've had COVID report symptoms lasting three months or more, and one analysis of 2022 data showed that boosters reduced the odds of long COVID by 25%. Other studies show the risk reduction can exceed 40% in some groups, such as people over 60. "If you're talking about all post-viral outcomes that last over three months, COVID vaccines definitely have great impact," Sala said.
But no evidence yet shows that vaccination protects against a particular subtype of long COVID marked mainly by fatigue – a form that tends to affect younger adults more than older adults, Sala said. If you're concerned about the risk of longstanding fatigue from COVID, you may want to consider a layered prevention approach. Wearing a mask when you travel or using an air filter in your workspace can provide extra protection, Hopkins said.
4. What if you were to get very sick?
Instead of asking whether a COVID shot will reduce your risk of getting COVID or being hospitalized or dying, healthy younger adults should consider the risk of severe symptoms – feeling really sick but being able to manage symptoms at home, said Sala. You may have less serious but still meaningful risks to consider, like missing out on holiday plans or calling in sick to to work. "[If] you're in a necessary occupation and you can't afford to be out," Hopkins said, that's a major factor to consider.
5. How much time do you spend around others?
If you often go to concerts, travel, or spend time in places with large groups, you likely have an increased risk of getting COVID. You also may choose to get vaccinated to protect people in your life who are at risk of severe disease, like a co-worker on chemotherapy or older grandparents. Some people get vaccinated because they have young children in their home, Sala said.
6. Are you north of 50?
Differing from the FDA, Hopkins's organization recommends that 50- to 64-year-olds get vaccinated because they have the next highest rate of COVID hospitalization, after very young children and people ages 65-plus.
Even FDA chief Martin Makary, MD, MPH, acknowledged in The New England Journal of Medicine that it's worth further looking into whether 50- to 64-year-olds may particularly benefit from COVID vaccines.
7. Did you have side effects the last time you got a COVID vaccine?
COVID vaccines can cause a fever, fatigue, pain, headaches, and chills – side effects that usually last a day. If they were really unpleasant or even caused you to miss a day of work, those are signs that you may particularly benefit from a booster this year. Sala tells people, "Think about how much worse it would be if you got the actual virus."
8. After you get sick, do you often have a lingering cough?
"Some people get a respiratory virus maybe four times a year, and they have a protracted cough every single time, even though they're not necessarily an unhealthy adult," said Sala, who is a pulmonologist. A COVID booster may help prevent a lingering cough from COVID, he said.
9. How much do you value doing your part?
The more people who are vaccinated, the more likely everyone around you is to benefit from herd immunity, when a large portion of the population becomes immune to an infectious disease – making it harder to spread from person to person and protecting those at higher risk. That benefit can serve the entire nation – but also your extended family, friend circle, or community. (These are all just smaller herds, after all.) Steve Furr, MD, a family doctor in a small Alabama town, encourages all his healthy patients to get vaccinated, and for some, the motivating factor is to keep an elderly parent or grandparent safe. "We're trying to create this umbrella around our people, and the problem is that the fewer people that get vaccinated, the less likely we are to get any kind of herd immunity," he said.
10. Are you just an extra cautious kind of person?
That's a perfectly fine reason to get a COVID vaccine. "The biggest concern is that if you don't get it, you always say 'what if?' – particularly if a family member dies or gets hospitalized with severe disease," said Furr, who is board chair of the American Academy of Family Physicians. "It's just really a strange disease. Some people can get it and have very mild symptoms, and somebody who's incredibly healthy and is a marathon runner, it can just really devastate them. So you don't know who is going to be that person that doesn't react well to getting COVID."
