CVS says it won't provide the shots to residents in Massachusetts, Nevada and New Mexico.
In 13 states, including New York, depending on the patient's age, you will need a doctor's approval and a prescription to get the vaccine.
The U.S. Food and Drug Administration this week narrowed approval of the new, updated COVID-19 vaccines only to people who are over 65, or younger people with underlying conditions that put them at higher risk for severe disease.
That decision has raised questions about access for the millions of Americans who don't fall in those categories - and potentially even for some who do.
According to pharmacists, insurance groups and trade organizations, it will be more difficult for younger, otherwise healthy people to get a COVID-19 vaccine ahead of the winter respiratory virus season, as it will involve a trip to the doctor instead of walking into a pharmacy, and insurance coverage is, for now, unclear.
For at least the next few weeks, as the policy shifts are absorbed, the confusion may also impact access for older, higher-risk people.
This comes as Trump administration officials maintain that "100% of adults in this country can still get the vaccine if they choose," as FDA Commissioner Marty Makary wrote on X. "We are not limiting availability to anyone," he said.
"The FDA's decision does not affect the availability of COVID vaccines for Americans who want them," White House press secretary Karoline Leavitt said Thursday during a press conference. "We believe in individual choice. That's a promise both the president and HHS Secretary Robert F. Kennedy Jr. have made. And it's a promise they have now delivered on."
Experts interviewed by ABC News said this may be technically accurate, as a doctor can still determine that a non-eligible person needs the vaccine "off label."
But in practice, the confusion around the new policy and fear from doctors of going against the federal guidelines could make it significantly more challenging for people to get that prescription.
It also creates another hurdle to getting the vaccine, if someone needs to add in the step of going to their doctor rather than a pharmacy. The vast majority of Americans have gotten their COVID-19 vaccines from pharmacies, not the doctor's office.
There are 19 states where pharmacists are permitted to only give vaccines to people who qualify under FDA and CDC guidelines, according to Brigid Groves, vice president of professional affairs at the American Pharmacists Association.
Those states are: Colorado, Connecticut, Georgia, Iowa, Kentucky, Maine, Maryland, Massachusetts, Montana, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, South Carolina, Virginia, Washington D.C., and West Virginia.
60-year-old Jacklyn gets her COVID-19 vaccine at her local pharmacy in East New York every year and says she plans to get it again this year.
"It was in my best interest to get it. I have MS..that's why I got it," she said.
But now if she goes to CVS, it could be tougher to get the shot.
"Recently we've been getting more messages for patients with Covid," Dr. Caren Behar, Medical Director of the Joan Tisch Center for Women's Health said.
Dr. Behar says her patients are worried ahead of peak respiratory virus season.
"People are concerned about access, will enough be produced, is it going to be available? For me, it won't change how i recommend the covid vaccine. But it's going to change some people practices bc people abide by the recommendation of CDC guidelines," Dr. Behar said.
In states like New Jersey and Connecticut, the American Pharmacists Association says pharmacists aren't allowed to give shots to people who do not meet the federal health guidelines.
That means people will need to go to their doctor to get the vaccine.
Jacklyn in East New York says she doesn't mind the added step if it means more protection this upcoming season.
BACK IN EAST NEW YORK...JACKLYN SAYS SHE DOESNT MIND THE ADDED STEP...IF IT MEANS MORE PROTECTION THIS UPCOMING SEASON.
"I'm down for that, as long as I stay safe, I'm down for it," she said.
ABC News contributed to this article.
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