Health and Human Services Secretary Robert F. Kennedy Jr.'s moves to upend decades of vaccine policy could hit patients hardest in their wallets, as shifting guidance over shots could make insurance coverage confusing and scattershot.

For decades, the Centers for Disease Control and Prevention’s (CDC) independent advisory panel recommended which shots Americans should get and when.

The Affordable Care Act requires all insurance companies to cover, for free, all vaccines the panel recommends. Those recommendations also help states decide which shots should be mandated for schoolchildren.

Kennedy’s most recent move to purge the entire advisory panel and replace them with his own handpicked members, including several vocal vaccine critics, is throwing that process into doubt.

“If we have a system that has been dismantled — one that allowed for open, evidence-based decisionmaking and that supported transparent and clear dialogue about vaccines — and then we replace it with a process that's driven largely by one person's beliefs, that creates a system that cannot be trusted,” Helen Chu, a newly ousted member of the panel and professor of infectious disease at the University of Washington School of Medicine, said during a press conference.

Vaccine prices vary, but without insurance, coronavirus vaccines can cost nearly $150, the MMR shot ranges from $95 to nearly $280, and the HPV vaccine can exceed $300,

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