Jill Schwartz has been searching Chicago for Covid shots for her three young children, ages 1, 3 and 5. She tried their pediatrician’s office. A pediatric clinic. Walgreens. No luck.
In Womelsdorf, Pa., Rebecca Seidel has been trying to find a vaccine for her 7-year-old son. The pharmacist at a nearby CVS said that the store had no pediatric doses and that two other CVS locations didn’t either. So Ms. Seidel contacted the family’s pediatrician — who directed her to CVS.
Leigh Bullion of Portland, Maine, also struggled to find shots for her 5- and 7-year-old sons. Her pediatrician did not have vaccines for children under 12. Neither did a supermarket-pharmacy chain. And the closest Walgreens offering pediatric doses was about 20 miles away.
“It’s just like a nightmare,” Ms. Bullion said.
The decisions of public-health agencies under President Trump and his health secretary, Robert F. Kennedy Jr., have created new obstacles for many people seeking Covid vaccines. But it has been particularly difficult to secure shots for children, including infants and toddlers under the age of 2, who are at higher risk of severe illness from Covid even if they are healthy.
In August, the Food and Drug Administration limited approval of the latest Covid shots, authorizing them only for adults 65 and older and younger people with certain health conditions. A few weeks later, a vaccine advisory panel for the Centers for Disease Control and Prevention released its own guidance, saying that anyone 6 months and up could get the vaccine in consultation with a medical provider.
Children under 12 need a different version of the Covid vaccines. Many pediatricians, as well as pharmacies that carry adult formulations, aren’t stocking pediatric doses. Some cite low demand, but others cite uncertainty about the federal guidelines and logistical problems, including one in particular: The F.D.A. limited its approval of Pfizer’s vaccine to ages 5 and up, which left the Moderna vaccine as the only option for younger children.
Representatives for Moderna and Pfizer said their companies had enough doses to meet demand. But some providers have told parents that they didn’t place orders because of the regulatory confusion.
Some were waiting for the interim C.D.C. leader’s formal approval of the vaccine panel’s recommendations, which was announced Monday, about two weeks after the panel had voted. Others stocked Pfizer’s pediatric doses in past years and are scrambling to determine the feasibility of a new contract with Moderna.
Two parents who spoke with The New York Times said their pediatricians had cited the need to switch to Moderna as one reason they didn’t have Covid vaccines for children under 5. Dr. Sean O’Leary, the chair of the American Academy of Pediatrics’ committee on infectious diseases, said he had heard the same from providers.
The A.A.P. recommends Covid vaccination for children under 2 regardless of their overall health status. It also recommends the shot for older children who have high-risk conditions, those in close contact with high-risk people and those who haven’t received a Covid vaccine before. The group says the shot should be available to any child whose parents want it.
For pediatricians, the ambiguity of the C.D.C. panel’s recommendations is another concern: It called for doctors to change how they obtain informed consent and to “discuss the risks and benefits” of vaccines with patients, but didn’t specify how.
Some providers are grappling with the fact that, because the F.D.A. limited its approval to people who are 65 and older or who have a high-risk condition, many of the Covid vaccinations they would administer would be off label. This refers to giving a drug or vaccine to a group, or for a purpose, that the F.D.A. hasn’t approved it for, and C.D.C. recommendations don’t change that status.
Doctors have the legal authority to prescribe off label, but some are uneasy about it. In an email shared by one parent on the condition that the practice not be named, a pediatrician’s office in Virginia wrote that off-label use “raises important considerations, including the need to consult our malpractice insurance and other regulatory provisions.” (The office, which confirmed the authenticity of the email, ultimately decided to offer the shots.)
Dr. Thomas Nguyen, a pediatrician in Canton, Ohio, said he and his colleagues had needed to discuss whether they could vaccinate in the period after the F.D.A. issued its limited approval but before the C.D.C. weighed in. They ultimately placed “a small order” with Moderna on Sept. 11, he said, and shots were delivered Sept. 17. But it took another week to decide how best to document the risk-benefit conversations that the C.D.C. panel had called for.
It is very unusual for doctors to have to navigate a disagreement between the recommendations of the C.D.C. and the A.A.P., Dr. Nguyen said, adding, “We always felt some protection by acting based on expert guidance.”
The Trump administration’s actions have compounded existing challenges to pediatric Covid vaccine access. One is cost: If providers don’t think there will be enough demand, they are often loath to risk losing money by ordering shots that they might not be able to administer. Then there’s the anti-vaccine sentiment that Mr. Kennedy has helped stoke among some parents.
“The confusion that’s coming out of the federal government is just magnifying all of those problems,” Dr. O’Leary said.
Andrew Nixon, a representative for the Department of Health and Human Services, wrote in a statement that the F.D.A. had authorized pediatric vaccines and that federal insurance programs would cover them, but he did not address questions about their availability.
Pharmacies say they are doing their best within legal limits. Regardless of F.D.A. and C.D.C. decisions, some states have higher minimum ages than others for pharmacists to vaccinate, with variation depending on the vaccine. In New York, for example, pharmacists can currently give Covid shots to children 3 and older, which makes access exceedingly difficult for the high-risk under-2 group if their pediatricians don’t stock the vaccine.
Amy Thibault, a representative for CVS, said select CVS pharmacies nationwide had Covid vaccines available for children 5 and up. She added that all MinuteClinics — medical facilities inside some CVS stores that have more regulatory freedom than pharmacies — were vaccinating children 18 months and older. Only about 10 percent of CVS locations have a MinuteClinic.
Walgreens and Walmart did not respond to inquiries about pediatric vaccine availability, and a Costco representative said only that parents should “continue to visit our website and check the scheduler for availability.”
But many parents are trawling websites, calling and showing up to every provider they can think of, often to no avail. Some have succeeded in finding shots only after weeks of persistence.
Ms. Bullion, the Portland mother, managed to find a CVS with appointments for pediatric doses available for mid-October. After a month of trying, Ms. Seidel still hasn’t found a Covid shot for her son. Neither has Ms. Schwartz for her three children.
In Santa Fe, N.M., Caitlin Smith and her partner got their own shots on Sept. 7, but their children were turned away. Over three weeks, she contacted various pharmacies citywide before finding one offering pediatric doses on Sept. 28.
The pharmacist told her he had received only 10 of them.
“It feels like the system for pediatric Covid vaccines is designed on the assumption that parents are vaccine-hesitant,” Ms. Smith said. “It’s extraordinarily frustrating for parents who are not hesitant and want to protect our kids.”