COVID-19 Vaccine Guide: State-Level Updates

• Updated versions of the mRNA vaccines (Pfizer, Moderna) and Novavax for the 2024–2025 season are available.
• Everyone aged 6 months and older is recommended to get the updated vaccine once it is available.

• The Alaska Department of Health has adopted the updated COVID‐19 vaccines for the 2025–2026 season, per FDA approval. Must Read Alaska
• The state is urging providers to immediately remove any older 2024-2025 COVID vaccine formulations from storage. Must Read Alaska
• For children ages 6 months to 11 years: older versions of vaccine formulations (from 2024-2025) are no longer authorized; only the newly licensed 2025-2026 versions should be administered.

• everyone aged 6 months and older is encouraged to receive the new updated COVID-19 vaccine for the current respiratory virus season. AZ Dept. of Health Services News
• The state says that if someone recently got a COVID vaccine, there should be a two-month wait before getting the newly updated vaccine.

• everyone aged 5 years and older should receive one dose of the updated Pfizer-BioNTech or Moderna COVID-19 vaccine to protect against serious illness. Arkansas Department of Health
• Children aged 6 months to 4 years need multiple doses to be considered up to date, including at least one dose of the updated vaccine. Arkansas Department of Health
• People who are moderately or severely immunocompromised may have additional doses per provider guidance. Arkansas Department of Health

• everyone aged 6 months and older receive at least one dose of the updated COVID-19 vaccine. CDPH+2CDPH+2
• The state allows remaining unexpired 2024-25 vaccine supply to continue being used until the 2025-26 version is widely available.

• trained health care workers (pharmacists, nurses, etc.) to administer updated COVID-19 vaccines under a protocol without needing separate prescriptions. CDPHE+2Colorado Governor's Office+2
• The updated COVID-19 vaccines are those targeting more recent variants. Most people only need one dose of the updated vaccine. CDPHE

• Everyone aged 6 months and older can get the updated vaccine. Delaware's Coronavirus Official Website+2My Healthy Community+2
• People 65+ who had prior vaccine doses consult about additional doses (beyond the initial updated shot) per provider discretion. Delaware's Coronavirus Official Website+1
• Vaccine availability: through pharmacies, medical providers, hospitals, clinics, FQHCs, state‐coordinated and community events. Delaware's Coronavirus Official Website+1

Florida’s policy is best categorized as restricts relative to CDC/ACIP:

• It is not aligned with the broader CDC/ACIP recommendation that updated COVID-19 vaccines be offered to all individuals aged 6 months and older (or those who are eligible). Instead Florida’s guidance actively discourages/limits vaccine use for some populations.

• Everyone aged 6 months and older. Hawaii Department of Health

• High-risk groups are particularly encouraged to receive either 2024-2025 vaccine or updated formulations as available. These high-risk groups include immunocompromised persons and older adults 65+. Hawaii Department of Health+1

• Vaccines are available at multiple locations: pharmacies, health centers, clinics, DOH-participating providers. Free vaccination options are available via programs like Vaccines for Children for eligible children, and via Bridge Access Program for uninsured or underinsured adults. Hawaii Department of Health+1

• Pregnant and breastfeeding individuals are advised that the vaccine is safe and benefits outweigh potential risks; DOH follows CDC recommendations regarding pregnancy. Hawaii Department of Health

• For example, some newer formulations may only have authorization for those 65+ or with underlying conditions, but the IL guidance still encourages broad eligibility. Patch+1
• The Illinois Department of Public Health (IDPH) recommends that everyone aged 6 months and older be up to date with COVID-19 vaccination. Illinois Extension+2Patch+2
• Illinois offers immunization record access via a state portal (“Vax Verify”) for residents, which helps clinicians and patients track vaccination history.

Iowa’s policy aligns with CDC/ACIP guidance.

• KDHE issued a “Non-Routine VFC Vaccine Update” (August 8, 2025) that includes guidance for COVID-19 vaccine ordering: the 2024-25 season doses (Pfizer, Moderna) are being phased out; final ordering deadlines were listed (Pfizer through Aug 7, Moderna through Aug 22). GovDelivery+1

• The state is awaiting further guidance from CDC about the 2025-26 COVID-19 vaccine availability for providers in the VFC (Vaccines for Children) and VFA (Vaccines for Adults) programs

Kansas is currently classified as: Aligned with CDC/ACIP guidance (with practical constraints)

• Kentucky’s new guidance explicitly allows pharmacists to offer the 2025-2026 formula COVID vaccine before the ACIP formally issues its updated recommendation. WUKY+1

• Eligibility under that guidance is currently limited to people 65 years and older, and those with medical conditions that increase risk of severe COVID-19 illness.

Kentucky’s policy is best classified as expanding access beyond federal limits in certain respects, though still constrained:

• Expanded: Kentucky has moved to allow pharmacists to administer the updated vaccines under protocol before ACIP’s formal recommendation—this is an expansion beyond the rigid requirement in many states to wait for ACIP.

• Restricted: But eligibility remains limited by the FDA’s narrower authorization (≥65, underlying medical risk). So Kentucky is not fully open to all ages or persons, as might have been in previous seasons.

Because the updated COVID-19 vaccines for the 2025-26 season were not yet ACIP-recommended at some points, pharmacies have been holding off or requiring prescriptions

Louisiana’s policy is best classified as restricts (relative to CDC/ACIP) due to the following:

• The requirement for prescriptions at pharmacies for many patients, which adds a barrier not present in many states.

The Maine Immunization Program (June 2025) issued an update: for children aged 6 months through 17 years, the Child & Adolescent Immunization Schedule now uses shared clinical decision-making for COVID-19 vaccination. For adults (18+), no major changes in eligibility or access under current guidance. GovDelivery

On August 27, 2025, the FDA approved the 2025-2026 season vaccine formulations (Moderna, Pfizer, Sanofi/Novavax). Maine’s bulletin (Sept 3, 2025) says providers should prefer using 2025-2026 licensed vaccines, stop using 2024-25 versions once possible, return unused stock, and remove prior season vaccines from storage/inventory. However, the new formulations are not yet available for ordering via Maine’s Immunization Program or the VFC program.

Maine’s policy is best characterized as Aligned with CDC/ACIP:

• It closely follows ACIP recommendations (vaccination for ≥ 6 months, pregnancy inclusion, etc.).

• Maine is not overtly expanding access beyond federal or ACIP limits (no standing order to override restrictions, etc.).

• It is not broadly restricting either; however, the shared clinical decision-making requirement for children introduces some nuance, which aligns with revised ACIP guidance.

Maryland law allows pharmacists to administer COVID-19 vaccines (and flu vaccines) without a prescription to anyone aged 3 years and older. Maryland Governor's Office+1 As of June 1, 2025, the Maryland governor signed legislation that requires insurance providers (both private and Medicaid) to cover all vaccines recommended by ACIP as of December 31, 2024; this includes COVID-19. Maryland Governor's Office+1

• State officials are making efforts to maintain vaccine access amid uncertainty at the federal level: ensuring insurance coverage, working with pharmacy/insurer/health department partners, and emphasizing that vaccine eligibility for COVID-19 remains at 6 months and older

Maryland’s approach is Expands access beyond federal limits, to the extent that:

• it authorizes vaccine administration without prescriptions for ages 3+ (pharmacies),

• ensures that insurance covers vaccines recommended by ACIP as of Dec 2024,

• Maryland is taking steps to preserve broader access, countering potential narrowing of vaccine eligibility at the federal level.

• maintains eligibility messaging for ages 6 months and older, even though federal authorizations may be more restrictive.

• Massachusetts has issued a standing order (similar to many other states recently) that allows pharmacies to administer COVID-19 vaccines to residents age 5 and older without requiring a prescription. WBUR+2Mass.gov+2
• Massachusetts DPH vaccine info states that every resident aged 5 years and older should receive an updated COVID-19 vaccine to protect against serious illness. There are dose-specific recommendations:
  • For ages 6 months-4 years: 1-3 updated doses depending on prior vaccine history.
  • Ages 5-11: 1 updated dose
  • Ages 12+ : 1 updated dose (or 1-2 Novavax doses) depending on immune status.
  • Moderately or severely immunocompromised may have additional doses.

• MDHHS also emphasizes that COVID-19 vaccination is safe during pregnancy, aligning with AAP and ACOG, citing data that maternal vaccination reduces risk of hospitalization for infants in their first 3 months by more than 50%.

• The same MDH guidance urges everyone aged 6 months and older to get the updated vaccine. Children 6-months through 4 years may need multiple doses (depending on prior vaccine history). Older adults (65+) are recommended to get two doses, at least 2 months apart. Immunocompromised people may receive extra doses. MN Dept. of Health+2GovDelivery+2

• Minnesota governor issued an executive order (early September 2025) directing the state epidemiologist to issue a standing order or protocol for COVID-19 vaccines, which will give pharmacists and other providers more flexibility in vaccine administration.

Guidance is aligned with CDC/ACIP recommendations at the time. (September 12, 2025)

Aligned with CDC/ACIP guidance.

Because federal authorization is limited to 65+ / high-risk, access for younger healthy adults is constrained unless states/providers expand access via off-label use or state permissions. Missouri has not issued an executive order expanding access beyond those federal limits.

Missouri’s current policy is partially aligned with CDC/ACIP, but in practice more restrictive than past seasons, because federal authorization is narrower.

• It does not appear that Missouri is expanding access beyond the FDA limits.

• Thus, Missouri currently restricts access relative to earlier broad access norms, especially for people under 65 without high-risk conditions.

Montana’s policy is best classified as: Aligned with CDC/ACIP

Aligned with CDC/ACIP guidance as of September 12, 2025.

• The Nevada Board of Pharmacy recently issued guidance that allows CVS to begin carrying the updated COVID vaccine statewide. This Is Reno+1
• There is still confusion and delays in availability: many major pharmacies (including CVS, Walgreens) in Nevada are not yet offering the updated vaccine, particularly for those younger than 65 or without high-risk conditions.

Aligned with CDC/ACIP (with constraints), leaning toward restrictive in practice as of September 12, 2025.

Aligned with CDC/ACIP, but with practical constraints due to federal authorization limits.

• NH’s recommendations match ACIP in encouraging vaccination for ages 6 months and older, plus booster doses where applicable.