States Diverge on COVID Vaccine Access as Federal Guidance Lags
A UNC-Chapel Hill study of all 50 states found 31 strengthened COVID-19 vaccine infrastructure/access, 13 weakened it, and five did both during April–December 2025, amid missing federal guidance. States used standing orders, insurance directives, executive actions, and legislation to shape access; many expanded pharmacist vaccination authority and issued their own recommendations, with 28 states no longer relying solely on CDC guidance as of January 2026. The paper warns continued state-level policy divergence could determine how vaccines are accessed until a stable national framework is established.