On August 29, 2025, Cambridge Health Alliance (CHA) made a striking announcement: it will not be following the latest federal government restrictions on COVID-19 vaccines. Instead, the Massachusetts-based health system is charting its own course, leaning on recommendations from leading medical societies and the state health department. For many residents and healthcare providers, this move adds another twist to an already tangled web of COVID-19 vaccine guidance, eligibility, and access across the United States.
The federal government’s new stance, introduced by the Food and Drug Administration (FDA) just days earlier, marked a significant shift from previous policy. While COVID-19 vaccines had been available to anyone 6 months and older regardless of health status, the FDA’s August 27, 2025, approval of the latest Moderna, Pfizer, and Novavax shots came with new restrictions. Now, only those 65 and older or individuals with health conditions that put them at higher risk for severe illness are eligible. Healthy children and adults under 65 are generally excluded, unless they consult with a physician and have an underlying risk factor.
According to NPR, this change has revived questions that harken back to the early pandemic days, when eligibility and access to vaccines were in constant flux. The FDA’s decision also ended emergency authorization for the Pfizer vaccine for children under five, leaving Moderna as the sole option for kids aged 6 months to 4 years with at least one high-risk condition, as reported by USA Today.
Health Secretary Robert F. Kennedy, Jr., who was appointed by the Trump administration and is known for his vaccine skepticism, defended the new approach. “The new vaccines are available for all patients who choose them after consulting with their doctors,” Kennedy said on social media. Yet many health experts have voiced concern that the new guidance will make it significantly harder for otherwise healthy individuals to receive a COVID shot. Virologist Andy Pekosz told NPR, “The FDA guidance will limit accessibility of the vaccine to individuals because it puts additional hurdles in place for otherwise healthy individuals to get the vaccine. This makes things much more complicated and when things get complicated, we see vaccine uptake go down.”
Insurance coverage has also become a major point of uncertainty. Dr. Evan Nadler explained to NPR that a CDC advisory panel, scheduled to meet in September, will vote on whether to recommend the vaccine more broadly. The composition of the panel itself has become a flashpoint: Kennedy dismissed all previous members and installed new ones earlier this year. The panel’s decision will likely determine if insurers pay for vaccinations outside the FDA’s limited recommended groups. For now, some patients may face out-of-pocket costs exceeding $140 if their insurance does not cover the shot.
In the midst of these federal changes, CHA is taking a different path. As spokesperson David Cecere told Cambridge Day, the Alliance will adhere to the recommendations of the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the Massachusetts Department of Public Health (MDPH). These organizations have been among the most vocal critics of the new federal vaccination policies. The AAP, for example, broke with U.S. government advice for the first time in 30 years, issuing guidance on August 19, 2025, that “strongly recommends” COVID-19 shots for children ages 6 months to 2 years.
Similarly, ACOG reiterated in August that all pregnant, recently pregnant, and nursing individuals should be vaccinated, despite the CDC’s decision in May to drop its recommendation for pregnant people. The CDC, however, still lists pregnancy as a high-risk condition for severe COVID-19, which technically could allow pregnant adults under 65 to get vaccinated under the new rules.
Massachusetts state rules require pharmacists to follow CDC recommendations, further complicating vaccine access. As a result, major pharmacy chains are in a holding pattern. CVS, for instance, is not offering COVID-19 vaccines in Massachusetts, Nevada, or New Mexico until the CDC issues its own guidance—a process expected to take about a month. “Based on the current regulatory environment,” CVS explained, “we cannot vaccinate those even with a prescription in Massachusetts, Nevada, and New Mexico due to state laws and regulations.” CVS is offering COVID-19 vaccinations without prescription in 34 states and with prescription in 16 others, but this list may change as state and federal guidance evolves.
Walgreens echoed a similar stance, stating it is “prepared to offer the vaccine in states where we are able to do so.” In Cambridge, the locally run Inman Pharmacy has ordered COVID vaccines for children but cannot ship them until CDC approval is granted, leaving many families in limbo. “I assure you, that we are ready to immunize as soon as the vaccine arrives. I know many of you are eager to be vaccinated,” reads a message on the pharmacy’s website.
For now, CHA is providing COVID shots to children aged 6 months to 18 years in its clinics and is waiting for shipments of adult vaccines that were just approved. Cecere said, “When the adult doses arrive, CHA will administer them in our care centers and pharmacies.” The Alliance’s approach is more inclusive than the federal stance, offering shots to children and adults under 65 when indicated by medical society or state health guidance.
The patchwork of recommendations has left both providers and patients confused. According to MLive, Michigan residents are also finding it more difficult to get a COVID-19 vaccine this fall, as federal regulations now limit eligibility to those 65 and older or younger people with health conditions—a sharp break from earlier policy.
Adding to the uncertainty is the question of insurance and funding. The Vaccines for Children Program, which supports free vaccination clinics in places like Cambridge, must follow federal guidance, putting its future role in question. Generally, health insurers pay for vaccines recommended by the CDC, but with the CDC’s stance in flux and the advisory panel yet to weigh in, coverage for many remains unclear.
Cambridge Public Health spokesperson Dawn Baxter summed up the state’s position: “We are heartened to see that Massachusetts and other states are exploring the option of shaping vaccine recommendations with guidance from professional medical societies.” She added that the department is waiting for official guidance and approval to determine the exact COVID vaccination plan for the coming year.
This evolving landscape has created a patchwork of access, eligibility, and advice. For now, CHA and some state health departments are pushing back against federal limits, siding with professional organizations that stress the importance of broad vaccine coverage. Meanwhile, millions of Americans are left waiting—some with hope, others with frustration—wondering when and how they will be able to get their next COVID-19 shot.
As the CDC prepares to issue its own recommendations and insurance companies weigh their options, the coming weeks will be critical in determining who can access vaccines this fall. For now, the only certainty is uncertainty itself, as the nation’s COVID-19 vaccine guidance continues to shift beneath everyone’s feet.
