PORTLAND, Ore. – Health care providers, families, and state agencies in the Pacific Northwest are grappling with uncertainty after the U.S. Food and Drug Administration (FDA) issued a new set of recommendations that dramatically narrows who should receive the latest formulation of the COVID-19 vaccine.
The guidance, announced this week alongside comments from U.S. Health and Human Services Secretary Robert F. Kennedy Jr., marks a sharp departure from prior policy and has left local pharmacies and public health leaders questioning how to proceed.
What the New FDA Guidelines Say
In a post on X, Kennedy said that the emergency use authorizations (EUAs) that once allowed broad access to COVID-19 vaccines are now rescinded. Instead, the FDA will approve the 2025–26 vaccines but only recommend them for people aged 65 and older or those with at least one underlying health condition such as asthma, diabetes, heart disease, or cancer.
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This marks a major shift. For the past several years, vaccines were recommended for nearly everyone above a certain age threshold, regardless of health status. Now, millions who previously qualified may no longer be covered under the new criteria.
Kennedy added that vaccines remain available to patients who wish to receive them after consulting with their doctors. But that promise appears murky at best.
Pharmacies Expect Insurance Hurdles
At the local level, pharmacists are unsure how to balance patient demand with regulatory changes. Daniel Lee, a pharmacist at Fairley’s Pharmacy in Portland, said he anticipates a more restrictive process.
“Basically, we will have to ask them, ‘Are you at risk of complications from COVID?’” Lee explained. “If you are, then we will probably need documentation in order to get you vaccinated. Most likely, insurance will require that as well.”
For patients who want the shot but do not meet the new criteria, Lee expects significant barriers. “If insurance does not cover it … I cannot just override that. It will be really hard for patients to get the vaccine even if they are willing to pay out of pocket,” he said.
Impact on Children
The FDA’s update also tightens restrictions for young children. Emergency authorization for Pfizer’s vaccine for children under age 5 has been revoked entirely, meaning even high-risk children cannot receive it. Moderna’s vaccine remains available for children under 5, but only for those with documented health conditions.
For parents, the abrupt change is deeply unsettling. Meg Olson, director of Oregon Families for Vaccines, criticized the FDA for failing to clarify what qualifies as a “high-risk” condition.
“They haven’t really clarified what would put you in that category,” Olson said. “It’s just going to cause more confusion until parents don’t know what to do.”
Oregon and Washington Response
Regional agencies are reviewing the implications of the new guidance. The Washington State Department of Health (DOH) said it is carefully evaluating the FDA’s decision but for now will continue recommending vaccines for everyone six months and older.
“Our goal remains the same: to ensure that vaccine policy will be guided by the best available science,” the DOH said in a statement to KGW.
Clark County Public Health echoed that position, noting uncertainty about insurance coverage. “We don’t yet know if or how the FDA’s changes to eligibility may impact vaccine cost,” the agency said. The department also emphasized that Washington Apple Health (Medicaid) continues to cover vaccines for children, pregnant individuals, and other populations in line with DOH guidance.
In Oregon, the Oregon Health Authority (OHA) has not yet issued a formal response.
National Fallout: CDC in Crisis
The FDA announcement comes amid wider turmoil in federal public health leadership. On Wednesday, the Trump administration fired CDC Director Susan Monarez, reportedly after clashes with Kennedy over vaccine guidance. Her dismissal triggered resignations from several senior officials.
Kennedy, once known for his outspoken anti-vaccine stance, has already made multiple controversial moves since becoming HHS secretary. These include canceling funding for mRNA vaccine research and removing all members of the CDC’s vaccine advisory committee, replacing them with appointees criticized by major medical groups.
The American Academy of Pediatrics (AAP) strongly condemned the new recommendations, calling them “deeply troubling.” Breaking with government policy for the first time in 30 years, the AAP advised that all children ages six months to two years receive the COVID-19 vaccine.
Uncertainty for Providers and Patients
For now, local providers are left in limbo, trying to interpret guidance that conflicts with state recommendations and medical group standards. The confusion raises practical questions about who will actually be able to get the vaccine this fall, whether insurance companies will cover it, and how pharmacies can ensure they are complying with both federal and state rules.
Health advocates warn that the uncertainty could deepen vaccine hesitancy. “It’s already hard enough to convince families to keep up with shots,” Olson said. “Now you’ve got mixed messages from federal agencies, states, and pediatric groups. Parents are left wondering who to trust.”
The Road Ahead
As Oregon and Washington await clearer federal instructions, health departments stress that their primary goal remains protecting vulnerable residents. But with conflicting policies and leadership upheaval at the CDC, providers on the ground face an immediate challenge: explaining to patients who once qualified for COVID vaccines why they may now be turned away.
For now, both states are urging residents to consult with health care providers while state and federal authorities sort out next steps. What is certain is that, once again, COVID-19 vaccine policy has landed at the intersection of science, politics, and public trust — leaving providers, patients, and families caught in the middle.
