Jason Mitton wanted one of the new COVID-19 vaccines before leaving on a business trip. But the pharmacists at a drug store near his home in Austin, Texas, refused.
"He's like: 'Do you have a doctor's note?' I said: 'No, I don't.' He said: 'Well, the FDA standards say that you don't qualify. And our policy is that we won't administer it unless you qualify,'" says Mitton.
Mitton, who's 55 and says he has high blood pressure and high cholesterol that's controlled by medication, plans to keep trying to get vaccinated.
"I think it's ridiculous," Mitton says. "I think it should be a person's right to get the vaccine or not. So I'm very angry."
The same goes for Cheryl Huges, 64, who lives outside Cleveland. She was planning to get another shot as soon as the updated versions became available. But, she's not eligible.
"I'm furious," says Hughes. "Who wants to get sick?"
For the first time, COVID vaccines aren't available to anyone ages 6 months and older to obtain simply by walking into a pharmacy and asking to get inoculated.
In a major departure, the Food and Drug Administration only approved the shots for those at greatest risk for getting seriously ill from COVID because they're at least 65 years old or have another health issue that makes them highly vulnerable.
Health and Human Services Secretary Robert F. Kennedy Jr. and other Trump administration health officials argue that most otherwise healthy, younger people have so much immunity that they don't necessarily need annual boosters anymore.
But many Americans who don't meet the new criteria do still want to get vaccinated to avoid getting sick or spreading the virus to vulnerable family members.
And independent medical organizations like the Infectious Disease Society of America argue that everyone should have the option to get vaccinated because there is convincing evidence that the vaccines reduce the risk of serious complications, including hospitalization and death, even for people who are otherwise healthy.
Hughes wants to remain healthy so she can care for her husband, who has dementia. She's his only caretaker.
"If I get sick, my husband might have to go into a care facility. I could lose my job. It would be terrible," Hughes says.
What it takes to get the shot
Secretary Kennedy has repeatedly claimed the new rules won't prevent anyone from getting vaccinated if they want to. But many people have told NPR that they are having trouble.
In principle, you can still get vaccinated if you meet the criteria, get a doctor to prescribe a shot, or if you "self attest" that you're eligible by telling the pharmacist you meet the criteria.
But sometimes people are turned away because supplies of the reformulated shots haven't arrived yet. Sometimes it's because they didn't meet the new criteria. Or they're told they can get a shot if they get a prescription first, only to be inexplicably rejected anyway when they return with a doctor's order.
Some people describe hunting for a shot from pharmacy to pharmacy and doctor's office to doctor's office — even sometimes seeking one out of state.
The companies that make the shots, Moderna, Pfizer and Novavax, didn't say exactly how many doses they were making this year, given the narrower FDA approvals. But Pfizer says it is preparing "similar volumes" as last year, and that it's confident it will meet demand. It also says millions of doses have already shipped.
Claire Hannan, the executive director of the Association of Immunization Managers, says she doesn't expect vaccine supply to be a problem. She says pharmacies are able to order the COVID shots and they've been shipped out.
"I think it's going to be harder to access," she says. "But I think anybody that wants it, you know, will be able to get it. But they're just going to have to work hard to find it."
But some clinics and pharmacies haven't received the supplies they've ordered yet. And some doctors' offices, including pediatricians, and clinics may decide not to stock the shots this year if they don't expect enough demand.
If you're trying to find one, Pfizer and Moderna both have vaccine-finder websites up and running.
Waiting for the CDC's guidance
One major snag is that pharmacists in some states are prohibited from administering the shots until the Centers for Disease Control and Prevention issues specific recommendations for who should get vaccinated.
In past years, those recommendations came in the spring. But Kennedy fired the entire Advisory Committee on Immunization Practices, the independent group that formulates those recommendations, and replaced the members with his own advisers.
Kennedy's new committee is finally scheduled to meet next week about the COVID vaccines and other issues. That could alleviate some of the problems, including hesitancy that some pharmacists and doctors have because of the changing rules and confusion.
But it remains unclear what the advisers will do. They could make it easier, or harder, for people to get a shot. Many of the committee's new members share Kennedy's anti-vaccine views.
Either way, until the committee meeting happens, the shots that are part of the Vaccines for Children Program won't ship, says Hannan, who explained that people haven't been able to order them yet. About half of kids in the U.S. are eligible for free vaccines through the program.
Health insurance coverage could also prove tricky. Although Aetna and United Healthcare told NPR they will cover the COVID shot with no cost sharing for people with fully insured plans — even for people outside the FDA's narrower approval — it's not clear what other insurance companies will do. And even people who have Aetna or United could have other kinds of plans that don't cover the shot, which could set patients back around $200.
Fears for vulnerable family members, kids
In the meantime, many Americans have been scrambling to try to figure out how to still get vaccinated.
"I'm very angry, frustrated," says Allison Cote, 32, of Bristol, Conn.
Cote wants to stay well to protect her father, who has heart failure, other family members who have diabetes, and one relative who recently got a kidney transplant.
She's also concerned about her 16-month-old son. He's not eligible to get vaccinated either this year, even though COVID can be very dangerous for babies. The new shots are only approved for children who have conditions that put them at high risk.
In fact, the CDC this spring dropped recommendations that children and pregnant women routinely get vaccinated. For children, the agency recommends parents talk to their doctors first about vaccinating their children.
"It's just really upsetting," Cote says. "Why do I have to jump through hoops to do this? It's kind of scary."
If she has to, Cote says she may do what some people are doing: just say she's eligible. But she doesn't feel great about that. And she has no idea how to get a shot for her baby boy.
"It's hard to watch this play out and know that there are so many lives at risk — and potentially my son's life is at risk too," Cote says.
Stephan Neidenbach, 45, a public school teacher from Annapolis, Md., is frustrated and angry too. He's worried about getting sick and spreading the virus to his students, his elderly parents or his mother-in-law, who has lung problems.
"I would feel horrible if I did get it and if I passed it off to someone that I cared about. It's terrifying," Neidenbach says.
He's considering fibbing about his eligibility to get a shot too.
Therese McRae, 37, of Sandy, Utah, also wants to get vaccinated. Her main motivation is to protect her 4-year-old daughter, who has Type 1 diabetes, which puts her at risk for serious complications.
"Being a parent of a young child with a complex medical diagnosis is hard enough," McRae says. "Having folks around her not being able to be vaccinated increases her risk. It's just very overwhelming. It's scary."
Karen Lambey, 43, who lives near Richmond, Va., desperately wants a vaccine too. She says she became immunocompromised after developing long COVID. Her pharmacist told her she needed a prescription to get the shot and she hasn't been able to find a doctor to give her one.
"Any sort of flu, COVID, would set me back significantly," Lambey says. "These are all extra hurdles that keep adding up. I feel disappointed because this is something that is important to my health."
And Lambey's parents are immune compromised too. She's afraid of spreading the virus to them. "That could potentially be life-threatening for them," she says. "I couldn't live with that."
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