ST. LOUIS — Conflicting information from federal agencies about who should get an updated COVID-19 vaccine has led to confusion among those seeking — and administering — the dose, providers say.

The confusion stems from what is typically a seamless process of approving vaccines and how the Food and Drug Administration and the CDC, which establish guidelines for state agencies and pharmacies to follow, distributes them to the public.

Unsure how to proceed, pharmacies differ in how they are doling out the vaccine, updated to match the latest circulating strains of the COVID-19 virus, said Lisa Cox, spokeswoman for the Missouri Department of Health and Senior Services.

Some pharmacies are awaiting official sign-off on guidelines by the U.S. Centers for Disease Control and Prevention before

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