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Which states have taken action on COVID-19 vaccine access after FDA, CDC turmoil?

Mary Walrath-Holdridge, USA TODAY
Updated
10 min read

Several states have issued their own guidance about COVID-19 vaccines since the FDA released its 2025-2026 formula approvals on Aug. 27, significantly restricting who can access the vaccines for the first time since their release.

Under the updated approvals,  only those over 65 and people with existing health problems are recommended to get the COVID-19 vaccine, according to federal guidelines. The controversial announcement came a few months after Health and Human Services Secretary  Robert F. Kennedy Jr. said the COVID-19 vaccine  would no longer be included in the Centers for Disease Control and Prevention (CDC) recommended immunization schedule for healthy children and pregnant women, a move that drew criticism from national medical organizations.

In this photo illustration, Ruth Jones, Immunization Nurse, holds a Pfizer-BioNTech COVID-19 vaccine (brand name: Comirnaty) at Borinquen Health Care Center on May 29, 2025 in Miami, Florida.
In this photo illustration, Ruth Jones, Immunization Nurse, holds a Pfizer-BioNTech COVID-19 vaccine (brand name: Comirnaty) at Borinquen Health Care Center on May 29, 2025 in Miami, Florida.

What to know right now: RFK Jr., the CDC and confusing vaccine recommendations.

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While HHS said that the tighter eligibility criteria would not impede access to vaccines, confusion quickly followed. The uncertainty was compounded by the lack of a recommendation from the Advisory Committee on Immunization Practices (ACIP), which provides guidance on vaccine use to the CDC.

While the vast majority of people receive their seasonal vaccines at pharmacies, licensed pharmacists in some states cannot administer vaccines without an ACIP recommendation. Some insurance providers are likewise not obligated to or choose not to cover vaccines not included in the CDC immunization schedule.

To bridge the gap, a handful of states have expanded and protected vaccine access, issuing blanket prescriptions, executive orders and insurance coverage requirements.

Here are the states that have taken action on COVID-19 vaccine access so far.

California, Oregon & Washington

California, along with Oregon and Washington, announced the formation of the West Coast Health Alliance  on Sept. 3 to “provide evidence-based unified recommendations” on who should receive immunizations and to ensure the public gets credible information on vaccine safety and efficacy.

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The three states coordinated to release a shared, consistent immunization recommendation schedule on Sept. 17, informed by “respected national medical organizations ,” according to  a joint announcement from California Gov. Gavin Newsom, Oregon Gov. Tina Kotek and Washington Gov. Bob Ferguson.

"Immunization is safe, effective, and the best protection available against respiratory viruses such as COVID-19, influenza, and RSV," said the Alliance's Sept. 17 statement. Its recommendations include COVID-19 vaccines for everyone over the age of 6 months, including anyone who is planning pregnancy, pregnant, postpartum or lactating.

The trio previously teamed up at the height of the COVID-19 pandemic in 2020, forming the  “Western States Pact”  to review federal vaccine recommendations and coordinate pandemic restrictions. Two more states, Colorado and Nevada, later joined the pact.

Colorado

On Sept. 3, the Colorado Department of Public Health and Environment (CDPHE) issued a public health order that essentially functions as a prescription, allowing pharmacists to provide COVID-19 vaccines to those 6 months or older without individual prescriptions beginning Sept. 5.

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The order also directs CDPHE to collaborate with other state agencies and offices to identify and remove barriers to vaccination, ensure state health insurance plans and Medicaid cover COVID-19 vaccines and review and revise rules to ensure pharmacies can provide COVID-19 vaccines.

New York

Several Northeastern states, including New York State and NYC, announced on Sept. 18 that they were forming their own coalition similar to the West Coast Health Alliance, called the Northeast Public Health Collaborative. Other participating states include Connecticut, Maine, Massachusetts, New Jersey, Pennsylvania and Rhode Island. The coalition's purpose is to promote collaboration between public health agencies and leaders to "improve coordination, enhance capacity, strengthen regional readiness, and promote and protect evidence-based public health."

The Collaborative issued its own COVID-19 vaccination guidance on Sept. 18, consistent with recommendations put out by the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). It recommends and allows vaccination for everyone over the age of 6 months.

Previously, New York State Governor Kathy Hochul issued an executive order Sept. 5 declaring a Statewide Disaster Emergency “due to federal actions related to vaccine access.” Executive Order 52 allows pharmacists to prescribe and administer COVID-19 vaccines to anyone 3 years or older through Oct. 5. It also allows physicians and nurse practitioners to prescribe the administration of a COVID-19 vaccine by a pharmacist.

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CVS was the first pharmacy to confirm it would be taking action to follow this order, as previously reported by USA TODAY.

Pennsylvania

On Sept. 3, Pennsylvania’s State Board of Pharmacy voted to allow pharmacists to administer COVID-19 vaccines based not on ACIP recommendations, but on recommendations of “other trusted authorities,” including the ACOG, AAP, AAFP and U.S. Food & Drug Administration (FDA).

Before this ruling, pharmacists could only administer vaccines recommended by ACIP. In a statement issued by the commonwealth, CVS also confirmed that it would again offer these vaccinations at its pharmacies throughout the state.

It is also a member of the Northeast Public Health Collaborative and adheres to the coalition's recommendations issued on Sept. 18.

U.S. Secretary of Health and Human Services Robert F. Kennedy Jr . stands silently as Agriculture Secretary Brooke Rollins speaks during an event to "Celebrate the Implementation of the Dietary Guidelines for Americans" at the Health and Human Services Headquarters on Feb.11, 2026 in Washington, DC. HHS Secretary RFK Jr. celebrated the updated guidelines and the Make America Healthy Again movement with Agriculture Secretary Brooke Rollins, former boxing heavyweight champion Mike Tyson, U.S. Chief Design Officer Joe Gebbia, American Medical Association President Bobby Mukkamala, Chef Andrew Gruel, Defense Department Undersecretary Mike Obadal, and Bureau of Prisons Director William Marshall.

New Mexico

On Sept. 11, the New Mexico Department of Health issued a  standing order expanding access to COVID-19 vaccines, allowing healthcare providers and pharmacists to vaccinate anyone 6 months and older without requiring individual prescriptions. It also confirmed via the New Mexico Health Care Authority that Medicaid would fully cover the vaccine.

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The order, which again acts like one blanket prescription, allows pharmacists and other healthcare professionals to look at FDA approval for vaccines and not ACIP recommendations.

Minnesota

Minnesota Gov. Tim Walz issued an executive order Sept. 8 directing the Minnesota Department of Health to collaborate with other state agencies to “identify, review and remove barriers to vaccine access.” Executive Order 25-09 also directed the state epidemiologist to issue a standing order or protocol for protecting access to the COVID-19 vaccine no later than Sept. 24, 2025.

Pharmacists in Minnesota can already administer FDA-approved COVID-19 vaccines to patients 3 and up without a separate prescription, sans input from ACIP.

CVS, one of the largest providers of seasonal vaccinations in the U.S., has resumed allowing pharmacists to administer the COVID-19 vaccines in some states in which there was a pause due to changing guidelines.
CVS, one of the largest providers of seasonal vaccinations in the U.S., has resumed allowing pharmacists to administer the COVID-19 vaccines in some states in which there was a pause due to changing guidelines.

New Jersey

New Jersey is part of the Northeast Public Health Collaborative and adheres to the coalition's recommendations issued on Sept. 18.

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On Sept. 9, the New Jersey Department of Health issued an Executive Directive and Standing Order , with the former allowing anyone 6 months of age and older to receive a COVID-19 vaccine and the latter authorizing pharmacists to order and administer COVID-19 immunizations without an individual prescription to people aged 3 years and older. Children younger than 3 are authorized to receive the vaccine from their healthcare provider.

The executive order was based on recommendations from the AAP, ACOG, AAFP and the Vaccine Integrity Project at the University of Minnesota, according to a press statement.

Connecticut

Connecticut is also part of the Northeast Public Health Collaborative and adheres to the coalition's recommendations issued on Sept. 18. The state passed several measures on Sept. 10 in a joint effort between the Connecticut Department of Public Health (DPH), the Connecticut Department of Consumer Protection (DCP) and the Connecticut Insurance Department (CID).

DPH release d interim guidance recommending the COVID-19 vaccine based on standards put forth by the AAP, ACOG and AAFP. The DCP, meanwhile, encouraged pharmacists to continue ordering and administering the vaccine as they are already allowed to. It specifies that prescribers and pharmacists may order, prescribe and administer the COVID-19 vaccine to individuals who fall outside the eligibility criteria authorized by the FDA for “off-label” use.

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CID also issued a statement affirming that the COVID-19 vaccine must be covered by state insurance policies in line with recommendations of the professional agencies listed above and “regardless of ACIP’s position.”

Virginia

On Sept. 10, Virginia State Health Commissioner Dr. Karen Shelton signed a new  statewide  standing order allowing pharmacists to administer the vaccine to anyone 65 years of age and older and anyone between the ages of 18 and 64 years of age with at least one underlying medical condition without a prescription.

Pharmacists in the state may administer vaccines either under the direct authorization of a medical provider or by following the Virginia Board of Pharmacy’s statewide pharmacy protocols, which are usually made in accordance with ACIP recommendations. The standing order allows pharmacists to administer the vaccine per FDA guidelines without ACIP input.

The FDA approved three updated COVID-19 formulas for 2025-2026, with new restrictions.
The FDA approved three updated COVID-19 formulas for 2025-2026, with new restrictions.

Arizona

Arizona Gov. Katie Hobbs signed an executive order Sept. 11 directing the Arizona Department of Health Services, the Arizona Board of Pharmacy and the Arizona Department of Insurance and Financial Institutions to ensure statewide access to the COVID-19 vaccine.

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It allows the health department to issue a standing order that serves as a prescription for pharmacists and health care providers to administer COVID vaccines in accordance with guidance from nationally recognized professional organizations (AAP, ACOG and AAFP). It also directs the Department of Insurance to coordinate with plan providers to cover the vaccine.

Nevada

On Sept. 5, the Nevada State Board of Pharmacy issued new guidance allowing pharmacists to administer the COVID-19 vaccine and other immunizations approved by the FDA. Previously, pharmacists in Nevada could only administer vaccinations recommended by ACIP.

Nevada had been one of the states in which CVS and other pharmacy chains paused offering COVID-19 vaccines. In a statement to the Nevada Current , part of the USA TODAY Network, CVS said, “Following today’s regulatory action by the Nevada Board of Pharmacy, CVS Pharmacy will ensure COVID-19 vaccinations are available as soon as possible at our pharmacies throughout the state.”

Illinois

Illinois Governor JB Pritzker signed an executive order establishing the Statewide Vaccine Access Initiative on Sept. 12, directing the Illinois Department of Public Health (IDPH) and other state agencies to develop consistent vaccine guidance.

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It directs IDPH Director Dr. Sameer Vohra to issue a standing order to enable more providers to give the vaccine after consulting with the state’s Immunization Advisory Committee, which will meet Sept. 22 to establish recommendations.

The order also instructs IDPH to publish its own, accessible vaccine guidance to the public, support school vaccination efforts and work with local health departments, community health centers, disability organizations and rural providers to encourage vaccination on a larger scale statewide.

Massachusetts

Massachusetts, also a member of the Northeast Public Health Collaborative, released its own vaccine recommendations on Sept. 17 in alignment with AAP, ACOG and AAFP, recommending everyone over the age of 6 months to be vaccinated against COVID-19 if they have not been previously.

Gov. Maura Healey likewise issued an executive order on Sept. 3, ordering health insurance companies to cover all state and federally recommended vaccines fully. Even before that, on Aug. 29, the state’s Board of Registration in Pharmacy issued a standing order allowing pharmacists to order and administer COVID-19 vaccines to anyone aged 5 or older, regardless of CDC recommendations.

"We won’t let Donald Trump and Robert Kennedy get between patients and their doctors,” Healey said in a statement.

Michigan

Michigan Gov. Gretchen Whitmer  signed an executive directive on Wednesday, Sept. 17, i nstructing state agencies to identify and remove barriers that could hinder vaccine access. It also ordered the Michigan Department of Health and Human Services, Department of Insurance and Financial Services and Department of Licensing and Regulatory Affairs to allow pharmacists to prescribe and administer the COVID-19 vaccine and ensure the vaccines are covered by insurance.

Rhode Island

Rhode Island is also part of the Northeast Public Health Collaborative and adheres to the coalition's recommendations issued on Sept. 18.

On Sept. 12, the Rhode Island Department of Health (RIDOH) issued a  standing order allowing pharmacists to administer the COVID-19 vaccine to anyone aged 3 or older, independent of the FDA restrictions.

RIDOH and the Office of the Health Insurance Commissioner (OHIC) also issued guidance to insurers, telling them to cover COVID-19 vaccines according to recommendations by AAP, ACOG and AAFP.

Wisconsin

On Sept. 15, Gov. Tony Evers issued an executive order instructing state officials overseeing health and insurance policies to work together to "ensure vaccine access for Wisconsinites to the fullest extent of the law and available funding" and ordering the state's chief medical officers to issue their own orders and guidance on COVID-19 vaccines.

On Sept. 16, state health officials  issued a standing medical order , authorizing pharmacists in Wisconsin to provide the COVID-19 vaccine without a prescription to anyone 6 months and older.

This story has been updated to add new information.

This article originally appeared on USA TODAY: See which states and issued their own COVID-19 vaccine guidance

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