Updated September 22, 2025 at 8:18 AM AKDT
This is a major update to a story that was first published earlier in September. It reflects what readers need to know after an important vaccine advisory panel met on Thursday and Friday.
Getting a COVID shot has been tricky lately. Some people asking for one in the pharmacy or their doctor's office have been turned away.
If that happened to you, it's worth trying again this week. It's been a rapidly changing landscape over the past several months and weeks.
The real-world impacts of all the changes are still not entirely clear but here's what to know, and where more information is still expected.
Q: What's been going on?
In late August, the Food and Drug Administration narrowed its approval for the shots to only certain groups: those 65 and older, and people at high risk for developing severe illness from the virus.
Then last week, advisers to the Centers for Disease Control and Prevention weighed in on the shots. That group's guidance — if made official by the acting CDC director — tells pharmacists, doctors and insurers about who can get the vaccine and get it paid for.
The CDC advisers said adults 65 and older, and younger people can all get the shot if they want it, but added a new hoop to jump through: Patients have to consult with a clinician about the risks and benefits, a process called shared clinical decision-making. This is a break from past recommendations. The vaccine advisers previously recommended COVID vaccines broadly to anyone 6 months and older, and without many restrictions.
Q. What's shared clinical decision-making?
This is a process for deciding on a treatment in which your health care provider talks through your options, the benefits and risks, and helps you choose what makes sense for you personally based on your health history and other factors.
Q. How is this recommendation different from CDC guidance on COVID shots in the past and for most other vaccines?
In the past, the COVID vaccine "was encouraged as a routine recommendation," says Jen Kates, director of global health and HIV policy at KFF, a nonpartisan health policy org. Friday's vote by the CDC advisers essentially says "this is no longer routinely recommended" for everyone, but instead it's a vaccine where you decide with your doctor or other health care provider if it's a good idea for you personally.
The CDC lists four other vaccines that are recommended under this framework.
Q. Can I get a shot at a pharmacy or do I need to talk to my doctor first?
You should be able to go straight to the pharmacy, says Brigid Groves, vice president of professional affairs at the American Pharmacists Association. She told NPR that pharmacists are permitted to conduct shared clinical decision-making and have done so for other vaccines. It is "well within their training, expertise, and experience to have these clinician-patient discussions on risks and benefits," she says.
Even before the CDC advisers issued their guidance, some states had already modified rules and regulations to make sure that pharmacists could offer the shots. But Groves anticipates that once the CDC director greenlights the guidance, patients in all states should be able to get a vaccine from a pharmacist, with no additional prescription needed.
Still, in states where officials are skeptical about COVID vaccines, the shots may remain difficult to get in pharmacies.
Q. Will insurance or government programs cover it?
The Department of Health and Human services issued a statement saying the new recommendations should be broadly covered, including by Medicaid, Medicare, individual plans bought through the federal Health Insurance Marketplace and the Vaccines for Children Program which pays for vaccines for many low-income kids.
Vaccines recommended under shared decision-making and listed on the CDC's immunization schedule are required by law to be covered by private insurers without co-pays.
However, there may be challenges with insurance coverage, because the shared decision-making recommendation is not as strong as other more routine recommendations, Dr. Kelly Moore, president and CEO of Immunize.org, a vaccine education and advocacy group said in a statement.
She said Medicare and commercial insurance should cover it but there could be issues with Medicaid. "We have seen states with inconsistent coverage of other vaccines with this type of permissive recommendation," she said.
For those who have to pay out of pocket, the shots cost between about $150 and $200.
The industry group that represents the largest health insurers, AHIP, has said that it will continue to cover COVID shots and other vaccines without copays through the end of 2026.
Q. If I'm under 65 do I have to prove I am high-risk to get a shot?
In theory, you shouldn't have to, as the vaccine committee doesn't list that as a factor. But Moore said that "with this type of individual decision-making recommendation, we often see confusion on the part of both health care providers and patients."
The confusion could stem from the difference between the details of the FDA's approval, which specify that people 64 and younger are only approved if they have at least one high-risk condition, whereas the CDC recommendation doesn't say that.
It appears that the CDC's advisory group "intends to allow anyone to have the vaccine if they choose to get it after a conversation with their pharmacist or healthcare provider," said Moore.
Still some pharmacists could be confused. How this plays out in remains to be seen.
If you think you may be high-risk, this might be worth mentioning to your pharmacist or provider. Not sure? The CDC lists risk factors for the public here and for health care providers here. They include common ones like asthma, obesity, diabetes, cancer and heart conditions as well as many others. Even physical inactivity is on the list, so some people have cited having desk jobs as a reason for getting the shot.
Q. What about my kids? Can they get a shot?
Yes, the FDA approved the COVID vaccine for children, though only for children with risk factors for serious complications. Under the CDC's guidance, even healthy kids over 6 months old should be able to get it after a consultation with a pharmacist or doctor.
To note: For the first time, only one vaccine, Moderna's, has been approved for children between 6 months old and 5 years old. The Pfizer-BioNTech vaccine is approved for children 5 and older. Novavax's vaccine has been approved for children as young as age 12.
No vaccine has been approved for the youngest babies, under 6 months, which is why booster shots for their moms are so important, doctors say. Babies under 6 months are among those most vulnerable to getting seriously ill from COVID.
Q. Some pharmacies don't seem to have them – where can I find the shots?
This year's vaccines started to become available as of mid-September at many pharmacies, doctor's offices, clinics and hospitals, but some locations may not have received their orders yet. The vaccine manufacturers say they are producing plenty of vaccine, so supply shouldn't be an issue even with the narrower FDA approvals.
But some doctors that stocked the vaccine in the past may pass this time if they don't think there will be enough demand. That means you may need to go to a pharmacy to get a shot.
Pharmacy chains like CVS and Walgreens have websites where people can find a vaccine and schedule appointments. Pfizer and Moderna both opened vaccine-finder websites.
Q. What if I'm pregnant?
Pregnancy is named as a risk factor for severe COVID-19 illness by the American College of Obstetricians and Gynecologists, and that group recommends booster shots at any time before, during or after pregnancy, including during breastfeeding.
The shot inoculates moms from severe disease and passes antibodies to babies in the womb, protecting newborns in the first months of life. But Health Secretary Robert F. Kennedy Jr. confused matters in May when he announced on social media that it was no longer recommended.
ACOG still recommends the shot during pregnancy, and policy experts think it will still be available via shared-clinical decision making.
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