After years of updates on COVID-19 vaccines and boosters, it can be confusing to know who should get a shot and when. While a lot of that confusion has to do with the new COVID strains that have emerged, recent changes to federal vaccination guidelines by U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. have made it more complicated.
On October 6, 2025, the Centers for Disease Control and Prevention officially updated both its adult and child immunizations schedules, dropping universal recommendations for the COVID vaccine. Instead of recommending the vaccine for everyone ages 6 months and older, the CDC says patients must consult their health care provider — such as their physician, nurse or pharmacist — to discuss the risks and benefits of vaccination.
This new guidance comes five months after Kennedy announced on May 27 that COVID-19 vaccines have been removed from the list of routine immunizations recommended for healthy pregnant women and children.
Many health experts are concerned about the changing vaccination guidelines, including what it means for public health and how it’ll affect people’s access to life-saving vaccines.
“Recent changes to COVID-19 vaccine guidance are worrisome,” says Dr. Naima Joseph, assistant professor of medicine at Boston University and vice chair of the Society for Maternal-Fetal Medicine’s committee on infectious disease and emerging threats.
Here’s what you need to know about the latest vaccine recommendations and how they may apply to you or your loved ones.
[READ: How Adults Can Get Free or Low-Cost Vaccines]
COVID Vaccine Changes: What You Need to Know
The CDC now recommends “individual-based decision-making” to COVID vaccination, dropping the universal recommendation for annual COVID vaccines for people ages 6 months and older. This means people may have to go the extra step to talk to their physician, pharmacist or other health care provider about the risks and benefits of the COVID shot before getting vaccinated.
While the CDC states that people will not need a prescription to receive the COVID vaccine, there remains a lot of confusion. Generally, you simply need to speak with a health care provider — such as a pharmacist, nurse practitioner or physician assistant at your local pharmacy — when you go to get your shot. However, how this guidance is being interpreted varies depending on where in the country you are and what provider you see.
Who is eligible for the COVID vaccine?
Most pharmacies can still administer COVID vaccines to eligible individuals as long as you fill out a self-attestation form to confirm that you meet at least one of the following requirements:
— Are age 65 or older
— Are age 6 months or older with at least one eligible underlying health condition
Eligible health conditions that can increase your risk of severe illness from COVID include:
— Cancer
— Cerebrovascular disease
— Chronic lung disease, including asthma and chronic obstructive pulmonary disease (COPD)
— Cystic fibrosis
— Dementia or other neurological conditions
— Type 1 diabetes or Type 2 diabetes
— Disabilities
— Heart conditions, such as heart disease, coronary artery disease and high blood pressure
— Hemoglobin blood disorders
— HIV infection (human immunodeficiency virus)
— Immunocompromised condition or weakened immune system
— Mental health conditions, such as anxiety, depression and schizophrenia
— Solid organ or blood stem cell transplant
COVID vaccine schedule
Previously, health experts recommended an updated COVID vaccine or booster for most adults annually. The CDC’s vaccine recommendations varied depending on your age, health status and previous vaccination history, as follows. Many health experts and organizations — including the American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians and American College of Obstetrics and Gynecologists — continue to recommend this vaccine schedule.
Adults (ages 19 to 64)
— Unvaccinated: one dose of an mRNA vaccine or two doses of Novavax several weeks apart
— Previously vaccinated (before 2024-2025 season): one updated mRNA dose at least 8 weeks after last dose
— Prior Novavax recipients: one additional Novavax dose or one mRNA dose, depending on timing
— Prior Janssen recipients: one mRNA dose to update protection
Older adults (ages 65 and up)
Because our immune systems naturally weaken with age, it’s important for older adults to get vaccinated to protect against COVID and other viruses.
Recommendations for older adults are similar to younger adults, plus a second dose 6 months later to maintain protection.
— Unvaccinated: one dose of an mRNA vaccine or two doses of Novavax, plus an additional dose after 6 months
— Previously vaccinated: Same as younger adults, with an extra dose at the 6-month mark
[SEE: Recommended Vaccines for Pregnant Women]
Pregnant and breastfeeding people
Although COVID-19 vaccines have been removed from the HHS’s list of routine immunizations for healthy pregnant women, the American College of Obstetricians and Gynecologists continues to strongly recommend the COVID vaccine. Pregnant and breastfeeding people can safely receive either vaccine type at any time during pregnancy or while breastfeeding.
It’s a good idea to speak with your health care provider to discuss the best approach based on your individual circumstances.
Children (ages 6 months to 17 years)
The COVID vaccines were originally recommended for all children ages 6 months to 17 years.
However, under the new guidance, the CDC states parents should talk with their child’s pediatrician about the risks and benefits of vaccination first.
[Read: Best Immune Support]
Why COVID Vaccines Are Still Essential
Even though the CDC is leaving it to individuals to talk to their health care providers about getting the COVID vaccine, most health experts and organizations — including the American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians and American College of Obstetrics and Gynecologists — say it’s important to stay up to date with your vaccines.
Furthermore, state health officials from several regions across the country have formed their own alliances in response to the federal governments changing guidance. For example, California, Oregon and Washington established the West Coast Health Alliance and seven northeastern states — including New York, Pennsylvania and New Jersey — created the Northeast Public Health Collaborative.
Like all viruses, the virus that causes COVID continues to change — mutating into new variants that evade our immune systems.
COVID vaccines help your body build stronger, more reliable immunity to protect against the virus — even as new variants continue to emerge. Vaccines remain safe and are carefully monitored for side effects.
Benefits of COVID vaccination
There are several benefits to getting the COVID vaccine, including:
— Lower risk of severe illness. The COVID vaccine helps shorten the length and severity of illness if you do get infected. It reduced the risk of severe illness by about 70% in adults within two months of vaccination, with protection around 50% after 10 months.
— Reduced hospitalizations. Vaccinated adults had a 50% lower risk of needing hospitalization within two months of getting the vaccine. After 10 months, the risk was reduced to around 30%.
— Fewer emergency visits. The COVID vaccine lowered the risk of needing urgent care or emergency care among vaccinated adults by 50% within the first two months.
— Reduced risk of long COVID. Vaccinated people who later get COVID were less likely to develop long COVID than unvaccinated people or those who hadn’t received their latest boosters.
Who’s at risk?
COVID vaccines are especially important for people at higher risk of serious illness. That includes:
— Unvaccinated individuals
— Adults 65 and older (who make up most COVID-related deaths)
— People living in long-term care facilities, such as nursing homes
— People with certain health conditions, such as kidney disease, diabetes, heart conditions or obesity
— People with weakened immune systems
In people with weaker immune systems, vaccines can lower the risk of hospitalization by 36% in the first two months, though protection fades over time, which is why some may need another dose after six months.
[Read: How Aging Affects Your Immunity]
Growing Public Health Concerns
Many health experts have voiced serious concerns over the CDC’s recent decision to remove its universal recommendation for the COVID vaccine.
The agency’s shifting guidance on who should get the shot has created confusion and could lead to new barriers that make it harder for some people to access the vaccine. While CVS and Walgreens have stated that patients will not need a prescription to receive the vaccine in any state, an appointment with a health care provider may still be required for certain age groups. For example, at CVS, patients ages 18 months to 4 years need to make an appointment with the pharmacy’s MinuteClinic to speak with a family nurse practitioner or physician assistant in order to receive the COVID vaccine.
If people receive pushback from pharmacists, experts say it’s important for patients to speak up and advocate for themselves if they want the vaccine.
“I would suggest patients detail how COVID or other viruses can or have affected them in the past in relation to their medical conditions or the needs of those they care for,” Valdez says. “I’d also remind patients to engage their primary care providers who can serve as their ally by giving them the vaccine in their own clinic.”
For now, public insurers — including Medicare, Medicaid, Children’s Health Insurance Program and the Vaccines for Children Program — say they will continue to cover the vaccine; and major private insurance providers have stated they will cover the cost through 2026.
After that, insurers may choose not to cover the COVID vaccine, which could cost up to $136.75, according to the CDC’s current price list.
“I’m afraid their (the CDC’s) stance may decrease uptake for the vaccines, which in turn could pose a risk to both individuals’ and public health,” says Isabel Valdez, a physician assistant and associate professor of medicine at Baylor College of Medicine. “I’m saddened to think insurance companies will lessen coverage or reimbursement for vaccinations and, by extension, decrease access.”
[Read: COVID, Flu and RSV: Why Older Adults Need to Get Vaccinated]
Overview of COVID Vaccines Types and Boosters
COVID vaccines help your immune system develop active immunity to recognize and fight the virus. Regardless of which vaccine you receive, it typically takes about two weeks after vaccination to build full protection.
Bottom Line
COVID-19 vaccine recommendations continue to evolve as the virus changes and policies shift. Vaccines remain important for protecting adults, especially those who are at higher risk for severe illness.
If you’re unsure whether you or your child should receive a COVID vaccine or booster, speak with your health care provider. They can help you navigate the latest guidance and make the best decision for your personal situation.
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COVID Vaccines and Boosters: What?s Changing in 2026 originally appeared on usnews.com
Update 10/16/25: This story was previously published at an earlier date and has been updated with new information.
