A child receives a COVID-19 shot in Annandale, Va., in 2021. Virginia is among the states that have parted ways with new federal guidance restricting access to the vaccine. (Photo by Chip Somodevilla/Getty Images)

At least 17 states have taken steps to ensure broader access to the COVID-19 vaccine since last month, when the federal government significantly restricted eligibility for the shot.

Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Maine, Massachusetts, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Virginia, Washington and Wisconsin have issued orders that aim to make it easier for people to get the COVID-19 vaccine. All but Virginia have Democratic governors.

Together, the moves represent an extraordinary state rebellion against the public health authority of the federal government.

For decades, states have followed the lead of the U.S. Food and Drug Administration and the federal Centers for Disease Control and Prevention on which vaccines Americans should get, and when they should get them. Now, rejecting the antivaccine stance of U.S. Health and Human Services Secretary Robert F. Kennedy, Jr., an increasing number of states say they will rely instead on their own public health experts and professional medical organizations for that advice.

Previously, the FDA recommended that the COVID-19 vaccine booster be available to anyone 6 months or older. But in August, the federal agency said the booster shot should be limited to two specific groups: people who are 65 and older, and anyone who is at least six 6 months old and has an underlying health condition, such as asthma or obesity, that increases the risk of a COVID-19 infection becoming severe.

Under the new guidelines, children under 18 without an underlying condition can only get the shot if a health care provider is consulted first, meaning parents can’t simply take their kids to a vaccination clinic or pharmacy.

“The American people demanded science, safety, and common sense. This framework delivers all three,” Kennedy wrote on the social media platform X on Aug. 27.

In June, Kennedy ousted the entire vaccine advisory committee at the CDC, replacing some of them with vaccine skeptics. The previous month, he announced that the federal government would no longer recommend that pregnant women get the vaccine.

Currently 43 states — all but Arizona, Florida, Georgia, Louisiana, Oregon, Utah and West Virginia, along with the District of Columbia — allow pharmacies to administer FDA-approved shots without a prescription, according to Amy Thibault, a spokesperson for CVS Health.

But the federal government’s new COVID-19 recommendations have sown confusion. Many people are unsure whether their local pharmacy will give them the shot without a prescription — and if so, whether their health insurance will pay for it.

In the 17 states that have acted thus far, governors and state public health officials are trying to clear up that confusion, empower pharmacists to administer the shot and, in some cases, mandate that insurers pay for it.

The latest state to act is Wisconsin. Democratic Gov. Tony Evers signed an executive order Monday directing state health officials to create policies that ease vaccine restrictions, and requiring insurers to keep covering the COVID-19 shot.

“Vaccines save lives, folks. Spreading fear, distrust, and disinformation about safe and effective vaccines isn’t just reckless, it’s dangerous,” Evers said in a news release. “RFK and the Trump administration are inserting partisan politics into health care and the science-based decisions of medical professionals and are putting the health and lives of kids, families, and folks across our state at risk in the process.”

In addition to Wisconsin, Colorado, Massachusetts and Rhode Island have required insurers to cover the shot, and Arizona Democratic Gov. Katie Hobbs’s executive order calls on state insurance regulators to “encourage” insurers to do so.

In many of the states, including Arizona, Colorado, Maine, Massachusetts, New Jersey, New Mexico and Rhode Island, the governor or the chief public health officer issued a standing order clarifying that pharmacies can administer the vaccine without a prescription.

Earlier this month, New York Democratic Gov. Kathy Hochul issued an executive order allowing pharmacies in her state to administer the shot to anyone 3 or older through October 5. The order can be renewed, pending action by the legislature.

And in Connecticut, Delaware and Pennsylvania, state authorities directed pharmacists to follow the vaccine recommendations issued by professional groups such as the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.

North Carolina Democratic Gov. Josh Stein issued an order stating that pharmacies can administer the COVID-19 vaccine without a prescription to all adults over 65 and anyone over 18 with a broad range of underlying health conditions. Virginia’s top public health official issued a similar order.

Earlier this month, the Democratic governors of California, Hawaii, Oregon and Washington announced the formation of the West Coast Health Alliance to coordinate vaccine recommendations for their states. The states pledged to use guidelines based on advice from leading medical organizations.

Meanwhile, Republican-controlled Florida doubled down on Kennedy’s antivaccine stance, announcing plans to become the first state to phase out all vaccine mandates, including ending requirements that kids be vaccinated against dangerous diseases before enrolling in schools.

At a news conference earlier this month, Florida Surgeon General Joseph Ladapo said vaccine mandates are “immoral.”

“Every last one of them is wrong and drips with disdain and slavery,” Ladapo said of such requirements.

In Louisiana, Republican U.S. Sen. Bill Cassidy, who is a physician, suggested last week that state Surgeon General Ralph Abraham should issue a blanket prescription for anyone who wants the COVID-19 shot, the Shreveport Times reported.

Republican Gov. Jeff Landry responded angrily on X.

“The last time I checked you have a prescription pad, why don’t you just leave a prescription for the dangerous Covid shot at your district office and anyone can swing by and get one! I am sure big pharma would love you for that one!” Landry wrote.

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org

Susan Monarez, President Donald Trump’s nominee to be the director of the Centers for Disease Control and Prevention, testifies during her confirmation hearing before the U.S. Senate Committee on Health, Education, Labor, and Pensions on June 25, 2025. (Photo by Kayla Bartkowski/Getty Images)

WASHINGTON — Members of the U.S. Senate Committee on Health, Education, Labor and Pensions pressed President Donald Trump’s nominee to lead the Centers for Disease Control and Prevention about vaccine recommendations Wednesday after the Health and Human Services secretary fired members of a critical vaccine panel this month.

Trump’s pick, former acting CDC Director Susan Monarez, said that she trusted vaccines while defending HHS Secretary Robert F. Kennedy Jr.’s decision this month — widely seen as part of a vaccine-skeptical agenda — to fire all 17 members of the Advisory Committee on Immunization Practices, or ACIP, and recommend eight new members.

“Part of the secretary’s vision in restoring public trust is making sure that the American people can be confident in the way the evidence and science is driving decision-making,” she told senators.

The panel’s seven members — one dropped out this week — will meet Wednesday and Thursday to review data and vote on new vaccine recommendations. The recommendations carry significant weight as insurance providers and federal health programs like Medicaid use them to determine if shots are covered and schools rely on them for immunization mandates.

Cassidy questions

Louisiana Sen. Bill Cassidy, who chairs the committee, said he was concerned about ACIP, especially as a non-CDC staff member is scheduled to give a presentation to the committee about thimerosal, a mercury-based preservative. The panel is expected to vote on approving flu shots that contain the compound.

Lyn Redwood, the former head of Children’s Health Defense, the anti-vaccine group that Kennedy founded, is giving the presentation arguing that thimerosal causes autism. The CDC’s own research shows that thimerosal does not cause autism. 

Cassidy said that while Monarez had no part in this week’s ACIP meeting, or the agenda, he said that “if the ACIP hearing today is being used to sow distrust, I would ask that going forward, that you would make sure that there really was a balanced perspective.”

“Yes, someone can speak as a critic, but there should be someone who is reviewing the overwhelming evidence of the safety of vaccines,” Cassidy, who is a physician, said.

Monarez, who was the agency’s acting director from January to March, said that she trusted vaccines and that immunization was important to save lives.

If Monarez is confirmed by the Senate, she would be the first director of the CDC without a medical degree in nearly 70 years. She has a Ph.D. in microbiology and immunology.

More concerns about vaccine panel

Cassidy was not the only Republican on the panel concerned about the firing of all the members of ACIP.

Alaska Republican Sen. Lisa Murkowski said she was concerned about the backgrounds of the seven new panelists.

“I would hope that one of the things that you would all be looking into is to make sure that these individuals are going to be looking at the science in front of them, (and) leave their political bias at home,” Murkowski said.

Democratic Sens. Patty Murray of Washington state and Angela Alsobrooks of Maryland also pressed Monarez about Kennedy’s actions to fire everyone on the panel.

Murray asked Monarez if the new members of the panel voted to not recommend vaccines, if she would listen to that recommendation.

Monarez sidestepped the question and said the roles at ACIP were difficult to fill and that members needed to pass an ethics process.

“If they have not gone through an ethics approval process they shouldn’t be participating in the meetings,” she said.

Alsobrooks asked Monarez if she believed the 17 members fired from ACIP lacked qualifications.

Monarez did not answer the question, but said Kennedy’s reasoning for “resetting the ACIP to a new cohort was going to be on the path of restoring public trust.”

Grant funding and layoffs

Senators also raised concerns about grants that had been canceled, even though Congress already approved the funds.

Maine GOP Sen. Susan Collins, who is the chairwoman of the Senate Committee on Appropriations, said that her state is suffering from a high level of Lyme disease and as a result a vaccine was in the works at a research institute in Maine.

“This vaccine is very promising and I want to make sure that it is allowed to continue to its conclusion,” Collins said.

Monarez agreed and said if she is confirmed, she will specifically work to make sure funding for that vaccine continues.

“It’s ironic that our dogs can get a vaccine to protect them against tick-borne illnesses like Lyme disease but we humans can’t and I hope we can remedy that,” Collins said.

Sen. Tim Kaine, Democrat of Virginia, pressed Monarez about the elimination of the Office on Smoking and Health at the CDC. He asked if she was involved in laying off all the staff in April, the month after her brief stint as acting director ended.

“I had no participation in (the layoffs) after I left,” she said.

Fluoride in water

Alsobrooks pressed Monarez about Kennedy’s push to have the CDC stop recommending that low levels of fluoride be placed in public drinking water.

Fluoride is added in drinking water to help prevent cavities, tooth decay and other dental health issues.

Alsobrooks asked Monarez, who is her constituent, if the public water supply that contains fluoride in Potomac, Maryland, where Monarez lives, was safe to drink.

“I believe the water in Potomac, Maryland, is safe,” Monarez said.