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.

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.

The three states will coordinate to release a shared, consistent immunization recommendation schedule in the coming weeks, 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.

The governors called the partnership a unified response to what they called the Trump administration’s “destruction” of the CDC to make it a “political tool.”

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.

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.

Pennsylvania

Also 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 American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP) and the 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.

New York

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.

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

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.

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.

New Jersey

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 passed several measures 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 released 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.

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.

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.

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 Sept. 12, directing the Illinois Department of Public Health (IDPH) and other state agencies to develop consistent vaccine guidance.

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.

This article originally appeared on USA TODAY: Which states have taken action on COVID-19 vaccine access after FDA, CDC turmoil?

Reporting by Mary Walrath-Holdridge, USA TODAY / USA TODAY

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