Overview

• The FDA cleared 2025–26 Covid-19 vaccines for people 65 and older and for younger people with qualifying conditions, shifting away from prior broad seasonal recommendations.
• CVS now requires prescriptions for Covid shots in 13 states and Washington, D.C., and is not offering them in Massachusetts, Nevada, or New Mexico; Walgreens says prescriptions are needed in many states.
• Pharmacists in numerous states cannot administer vaccines without Advisory Committee on Immunization Practices recommendations, which are not expected before the Sept. 18–19 ACIP meeting that some lawmakers want postponed.
• With ACIP guidance pending, insurers are weighing coverage decisions, and states are exploring workarounds, including Illinois considering direct purchases and a Massachusetts-led effort to coordinate pediatric supply or adopt independent recommendations.
• Access is shifting from pharmacies to clinicians for many under 65, raising hurdles such as office visits and off‑label prescriptions, and limiting pediatric options after Pfizer’s vaccine for children under 5 lost emergency authorization.