Once again, profound changes are washing over the U.S. health landscape. As many of you know, in late August, the Food and Drug Administration (FDA) announced the rescission of emergency use authorizations for COVID-19 vaccines. Reactions to this decision have been decidedly mixed. Perhaps most significantly, such an idea has been endorsed by the current U.S. health secretary and longtime vaccine skeptic, Robert F. Kennedy Jr. He lauded the FDA’s new framework as an important step in permanently terminating all remaining Biden-era vaccine mandates. Simultaneously, he did a good job keeping vaccines accessible for people who still wanted them.
Under the new guidelines, COVID-19 vaccinations will be primarily recommended for adults 65 and older. Joining the ranks of eligibility are those with one or more underlying health conditions that put them at greater risk for severe COVID-19. This represents a radical departure from past rules. Those rules had allowed vaccination for every American age six months and older. As health officials continue to find their way through this dynamic environment, issues of accessibility and public safety are coming into question.
New Vaccine Availability Guidelines
Robert F. Kennedy Jr. just made a critical disclosure that could change everything. The FDA has approved the use of the Moderna vaccine for those six months and older, the Pfizer vaccine for all five years and older, and Novavax for anyone 12 years and older. These approvals have been made during increased scrutiny over the efficacy and safety of COVID-19 vaccination.
In fact, the American Academy of Pediatrics (AAP) came out four-square against the new vaccine policy. They are supported in their opposition by a dozen national medical associations. Their open letter is a warning signal of the dangerous consequences of having widespread limited access to vaccinations. This problem especially endangers sensitive populations including pregnant women and children. Pregnancy is known to be a risk factor for severe disease from COVID-19 and there have been urgent calls to expand access to vaccines.
Dr. Richard Ricciardi remarked on the challenges faced by pregnant women, stating, “Pregnancy’s a risk factor for a lot of reasons. Your lungs are compressed, your immune system changes dramatically, and you don’t fight off infections as well as you would when you’re not pregnant.”
Challenges in Vaccine Accessibility
The recent changes have led to a confusing tangle of rules regarding vaccine administration, especially at major pharmacy chains like CVS and Walgreens. According to CDC data, during the 2024-2025 cold and flu season, nearly 90% of individuals who received a COVID-19 shot did so at a pharmacy. Yet CVS and Walgreens have set very high barriers to access for their vaccine deployment. These limitations are an immediate outcome of the recently released guidelines.
CVS will continue to provide vaccines in all 34 states. In 13 of these states and the District of Columbia, they will need a prescription in order to excuse administration. CVS will stop providing COVID vaccines entirely in Massachusetts, Nevada and New Mexico. These restrictions have created unnecessary chaos and confusion for patients trying to get vaccinated.
Allison Hill emphasized the urgency of vaccine access: “We know that patients, when they come into the pharmacy and you talk to them about a vaccine, they really need to get that vaccine then and there. If you have to wait on a prescription, you lose the patient.”
Mixed Reactions from Health Officials
Despite the good intentions behind these new guidelines, health officials worry about the overall implications. Dr. Adam Ratner articulated apprehension regarding upcoming recommendations from the Advisory Committee on Immunization Practices (ACIP), stating, “There’s a lot of concern about this ACIP and our ability to get science-based recommendations from them.”
Moreover, Dr. Ratner noted that vaccine hesitancy could exacerbate public health issues: “The more people who choose not to vaccinate their kids and not to vaccinate themselves, the more it will spread.” He further expressed frustration over the unclear paths to accessing vaccines: “I wish I had a good answer to how people are going to access vaccines in the coming weeks and months.”
As public health agencies continue to implement these unexpected changes, experts note the importance of clear communication on vaccine eligibility. Dr. Ricciardi remarked on the ambiguity surrounding qualifications for vaccination: “So who qualifies for a vaccine is still a little nebulous.”