September 9, 2025 - New proposed federal restrictions on who can get COVID-19 vaccinations has caused confusion and worry across the country. Some states, including California, have decided to break away from federal guidelines and create their own rules for who can receive COVID-19 vaccinations.
Meanwhile, the state of Florida is moving to end all vaccine mandates for schoolchildren.
A contentious appearance by HHS Secretary Robert F. Kennedy, Jr., at a Senate Finance Committee hearing this week has sowed even more confusion. We asked UC Berkeley infectious disease expert John E. Swartzberg for insight into what’s going on, and who will be able to receive COVID-19 vaccines this fall.
UC Berkeley Public Health: Can you explain what the new rules are on who is able to receive an updated COVID-19 vaccination this fall? Who is able to get the vaccine, who is not?
John Swartzberg: It’s impossible to explain with assurance the new rules as HHS has created confusion and chaos in communicating policy. And the Advisory Committee on Immunization Practices (ACIP) will not be meeting until September 18–19. I suspect they will add further confusion along with disinformation. [HHS Secretary Kennedy recently fired all members of this panel, replacing some of them with vaccine skeptics.)
All of this said, it is likely that people 65 and over and those younger with health conditions that put them at risk for a bad outcome from COVID will be eligible for getting the vaccine.
Stay tuned as things are changing rapidly. It’s likely that California along with other states will defy the FDA’s restrictions on the COVID vaccine and allow the vaccine to be given to a much wider swath of people. Last week, New Mexico’s health department issued an order to remove potential barriers and ensure access to COVID vaccines for all residents at pharmacies across the state.
What about those who want a vaccine? Can they just ask their doctor for one? What about pharmacies, like CVS, that normally offer vaccines?
If the vaccine is not approved, it is unclear what pharmacists can and will do. Doctors can administer an approved vaccine “off label.” Doctors could give patients a written prescription for the vaccine, but it may not be honored by pharmacies.
Stay tuned for changes in this as well. States, including California may be changing the laws to allow pharmacists to give the vaccine even though it has not been recommended by the ACIP and the Centers for Disease Control and Prevention (CDC). New York’s governor just issued an executive order Friday, September 5, allowing pharmacists to prescribe and administer COVID vaccines for the next 30 days.
Massachusetts just imposed rules that will require health insurance companies to pay for vaccines recommended by the state’s health department.
Are COVID-19 vaccines updated each season, like the flu vaccine is? Can you explain that process and why updated vaccines are needed?
COVID vaccines have been updated annually to keep up with how the virus has evolved. This is how we have handled the influenza vaccine for decades. There is no reason it should be any different for the COVID vaccine.
How will these guidelines affect the creation of new vaccines as SARS-CoV-2, the virus that causes COVID-19, changes over time? Will there be less interest on the part of drug manufacturers to work on this?
Confusion about the vaccine will lead to more people opting out of getting it. Making it difficult for people to get vaccinated will do the same.
There is also an effort by HHS to impede vaccine development (e.g., the $500 million cut for supporting mRNA research) and make it more difficult for vaccine manufacturers to produce vaccines. Unless there is a change in leadership of HHS and its agencies, Americans are going to have less choice in vaccines and a progressively difficult time getting vaccinated.
What about other vaccines? Are any other guidelines changing?
The COVID vaccine is only the beginning. I expect to see HHS limiting the availability of other vaccines.
The leadership at HHS is ideologically opposed to vaccination. Our world is upside down—we’re now basing decisions about the public’s health on ideology and not science.
How can Americans keep up to date with current COVID-19 vaccine guidelines?
They can use resources like the American Academy of Pediatrics, the American College of Physicians, the American College of Obstetricians and Gynecologists, and the Infectious Diseases Society of America. Soon the new consortium of California, Oregon, and Washington will become a good source. So will the Vaccine Integrity Project.
Source: UC Berkeley Public Health
