A delayed advisory panel meeting alongside changing vaccine guidelines led by Health Secretary Robert F. Kennedy Jr. are creating challenges for individuals trying to obtain the updated Covid vaccinations.

The Advisory Committee on Immunization Practices, part of the Centers for Disease Control and Prevention, needs to give recommendations about who should get a Covid vaccine before pharmacists in certain states can provide the shots.

Traditionally, the committee gathered earlier in the summer so vaccines would be ready ahead of the winter respiratory season. However, this year, the meeting is not scheduled until September 18.

Ethan Slavin, a spokesperson for CVS—one of the largest pharmacy chains in the United States—mentioned in an emailed statement that getting a Covid shot might hinge on your location and whether you possess a prescription.

In 13 states as well as in Washington, D.C., a doctor’s prescription is essential until ACIP provides its guidance, and even with that, eligibility will depend on one’s age. In Massachusetts, Nevada, and New Mexico, CVS won’t be administering the Covid shot until the committee takes action.

“States may change at any time,” noted Slavin. The 13 states affected include Arizona, Colorado, Florida, Georgia, Kentucky, Louisiana, Maine, North Carolina, New York, Pennsylvania, Utah, Virginia, and West Virginia.

Further compounding the confusion are recommendations from Kennedy himself.

In May, Kennedy announced that the CDC would no longer recommend routine Covid shots for children and pregnant women. As of Friday, however, the CDC’s website still recommended the shots for pregnant women, though a note at the top of the page said that the Covid vaccine recommendations have been “recently updated for some populations” and that the page will be updated.

On Wednesday, Kennedy announced that the Food and Drug ministration had narrowed eligibility for this fall’s Covid shot, limiting it to people ages 65 and older or those with underlying health conditions. He didn’t clarify which conditions qualify.

Emily Heumann, 31, went to a Publix pharmacy in central Florida on Tuesday to get her Covid vaccination, armed with a prescription from her doctor.

Heumann, who is 32 weeks pregnant, said she expected the process to be easy. Her doctor had also prescribed the RSV vaccine and recommended she get a flu shot. But she said the pharmacist turned her away, citing “new guidelines” from ACIP.

“He said, ‘I agree the science says they’re good for you, but I cannot give them to you, I have to follow our policy,’” Heumann said.

After pushing back, Heumann said Publix agreed to give her the flu shot, but still refused to provide the RSV and Covid vaccines. By Thursday, she had gotten the RSV shot at a nearby CVS, but staff told her the Covid shot was out of stock until the updated versions arrived.

“I think it’s a really dangerous situation,” Heumann said, “perpetuating this idea that there needs to be some concern around vaccinating pregnant people when all the research shows it benefits us and our baby.”

On Thursday, Heumann got an email from a Publix pharmacy supervisor that read: “I apologize for not being able to provide all of your vaccine requests. In the State of Florida, pharmacists are only permitted to administer vaccines according to the ACIP guidelines only.”

A spokesperson for Publix did not respond to a request for comment.

It’s not clear that the ACIP meeting will make it easier for people to get the Covid vaccine. In June, Kennedy fired all 17 members of the panel and replaced them with his own picks, including several Covid vaccine skeptics. Conflict over the upcoming meeting has led to massive upheaval at the CDC with the director being fired and several top officials resigning in protest.

Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia and a vaccine adviser to the FDA, said pharmacists are often wary of giving vaccines outside ACIP guidelines because they generally have fewer legal protections than doctors and hospitals.

He said he could see how the Publix pharmacist might be confused — which, he added, may be exactly what Kennedy wants.

“Kennedy has said something, but the ACIP has not,” he said.

Andrew Nixon, a spokesperson for the Department of Health and Human Services, said in a statement: “HHS is not limiting access to COVID vaccines.”

“They remain available to those who choose them in consultation with their healthcare provider,” Nixon said.

In a statement, a Walgreens spokesperson said the pharmacy is prepared to offer the Covid shot in states “where we are able to do so” but did not specify which states.

“In accordance with FDA approval and state requirements, we will offer the vaccine to all adults ages 65 years and older as well as to individuals under 65 with at least one underlying condition that puts them at high risk for severe outcomes from COVID-19,” the spokesperson said.

Dorit Reiss, a vaccine policy expert at the University of California Law San Francisco, said in several states, pharmacies tie their ability to give vaccines to ACIP recommendations.

She said the limited access at pharmacies means many patients will simply be told to go elsewhere.

For pregnant women, she noted, that often isn’t an option because most OB-GYN offices don’t stock vaccines.

“The secretary said he will not take away anyone’s vaccines, but he did just that,” Reiss said.