The U.S. Department of Health and Human Services has announced new guidelines around who should receive the 2025-26 COVID-19 vaccine.

The new guidelines come as the U.S. Centers for Disease Control and Prevention, which falls under DHHS, has experienced mass layoffs, resignations and changes in vaccine policy.

Health and Human Services Secretary Robert F. Kennedy Jr., who has a long history of making false claims about vaccines, including the COVID-19 vaccine, fired all members of the federal Advisory Committee on Immunization Practices in June and has reportedly replaced them with his advisers aligned with his views.

Earlier this month, Kennedy also fired CDC Director Susan Monarez because she would not automatically approve recommendations from a CDC advisory panel Kennedy appointed, according to a Wall Street Journal opinion piece Monarez wrote.

“I served for 29 days as director of the Centers for Disease Control and Prevention. The Senate confirmed me to ensure that unbiased evidence serves our nation’s health, and for doing that, I lost my job,” Monarez wrote. “America’s children could lose far more.”

In a tense Senate hearing Thursday, Kennedy faced tough questions and criticism from both Democratic and Republican senators about vaccines that sometimes erupted into yelling matches between him and members of the Senate Finance Committee.

Now, many individuals, parents, pharmacies and organizations are scrambling to understand the new CDC guidelines, which further limit who can receive the vaccine and require most people to have a prescription.

A lot remains unclear at this time. There seems to be no information available on the Food and Drug Administration or CDC websites regarding the new recommendations. Kennedy made a public statement Aug. 27 about the changes on the platform X, formerly Twitter.

Many medical groups have issued statements in the last week or so either coming out against the guidelines or calling them concerning and saying the guidelines are dismissive of scientific facts.

Ben Goodman, spokesman for Gov. Janet Mills, said Thursday that the governor is “appalled by the turmoil and politicization of our federal health agencies and their sharp movement away from science-and-evidence-based practices under President (Donald) Trump and Secretary Kennedy.”

The Maine Center for Disease Control and Prevention is assessing the new guidelines, Goodman said, with further guidance expected to come later this month from the advisory committee.

Elected officials in some states have already taken action to ensure that all residents who want the vaccine can access it.

Among those pushing back against the federal guidelines is Massachusetts Gov. Maura Healey, who instructed insurance companies in there to continue to cover vaccines recommended by her state’s health department. Healey issued a standing order to allow pharmacies to continue to give the vaccine to people above the age of 5 without a prescription, and is working to establish a multistate collaboration on the issue.

Here is what we know about how the COVID-19 vaccine will be distributed this fall.

What do the new federal guidelines say?

Under the new CDC guidelines, only people who are 65 or older, or people 6 months or older with at least one underlying health problem, are eligible for the latest version of the vaccine, according to an article published by PBS on Wednesday. This is different from previous guidelines that made the vaccine available to anyone 6 months or older.

The guidelines are more restrictive than many health groups would like to see.

The American Academy of Pediatrics issued a statement Aug. 19 recommending that children between 6-23 months still get the latest version of the COVID-19 vaccine, along with older children in high-risk groups, despite the federal government’s new guidelines.

The American College of Obstetrics and Gynecology issued a statement Aug. 27 refuting the federal government’s updated recommendations on who should get the COVID-19 vaccination. It maintains that all pregnant people should continue to get the updated versions of the vaccine, a recommendation no longer listed on the CDC’s website.

The Maine Department of Health and Human Services COVID-19 Response webpage recommends that anyone over the age of 6 months should stay up to date with the latest COVID-19 vaccine.

When can you get the vaccine?

The approved, updated vaccine is available in Maine currently by prescription for all age groups.

After Sept. 18, when the CDC’s Advisory Committee on Immunization Practices meets, the vaccines will be available in Maine without a prescription to those 65 and older and to those who fall in the high-risk category (having at least one underlying health problem).

People who do not meet the age range outlined in the new federal guidelines, or who are not in the high-risk category outlined in the new federal guidelines, will need a prescription to get the vaccine.

Public health experts fear that this will pose a barrier for people to get the vaccine, and keep health insurance companies from covering the inoculation.

Where can you get the vaccine?

The vaccine will be available at many pharmacies across Maine.

How much will the vaccine cost?

The CDC has not yet listed the cost of the upcoming COVID-19 vaccine but the 2024-25 approved vaccine cost roughly $140 for adults and upward of $140 for children. During Thursday’s Senate hearing, there was some testimony that the updated vaccine could cost about $200.

People should contact their insurance provider to find out if the latest version of the COVID-19 vaccine is covered. Medicaid and Medicare have historically covered the updated COVID-19 vaccinations, but people should reach out to their local Medicaid or Medicare offices regarding coverage of the updated COVID-19 vaccine.

If state officials disagree with the new guidelines, what can they do?

Mills’ office says she is reviewing the options available to Maine as the federal guidelines change.

Maine is part of a coalition of eight northeastern states discussing how to maintain availability of the vaccine.

“The Maine CDC is also discussing these factors with other Northeast states and evaluating the state’s authority under statute,” Goodman, the governor’s spokesman, stated. “The goal of the administration, including the Maine CDC, will be to prevent any medically unnecessary restriction of vaccines, so that Maine people may be able to consult with their health care provider and decide what is in the best interest of their health.”

William Wallace, former chair of the Lewiston Area Public Health Committee, would like to see Mills follow in the footsteps of Healey in Massachusetts and issue a standing order maintaining the former guidelines in Maine.

Removing federal recommendations that everyone should get the vaccine could make people less likely to get it, and insurance companies less likely to cover it, he said.

“One thing that allows for widespread acceptance and compliance with the COVID vaccine in the past was that people didn’t have to pay for it and could go anywhere and get it,” he said.

Perhaps more important, the vaccine was instrumental in preventing further deaths, he said.