CVS and Walgreens are changing where and how they offer COVID-19 vaccines this season as they work to comply with state laws and current U.S. Centers for Disease Control and Prevention (CDC) guidelines.

Both pharmacy chains say vaccine access will now vary by state. CVS announced that it can only offer COVID-19 shots in the following states:

Alaska, Alabama, Arkansas, California, Connecticut, Delaware, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Maryland, Michigan, Minnesota, Missouri, Mississippi, Montana, Nebraska, North Dakota, New Hampshire, New Jersey, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Washington, Wisconsin and Wyoming.

In 16 other states, patients may need a prescription from an authorized provider depending on their age and health status. In some states—including Massachusetts, Nevada and New Mexico—CVS says it cannot administer COVID-19 vaccines at all, even with a prescription, due to local regulations, CBS News reported.

Walgreens also confirmed it will follow state rules, saying it is “prepared to offer the vaccine in states where we are able to do so.”

The changes follow recent decisions from the U.S. Food and Drug Administration (FDA).

The FDA has authorized updated vaccines from Pfizer, Moderna and Novavax for all seniors and for younger adults and children who have certain health conditions.

However, options for children under age 5 are now limited. The FDA ended emergency authorization for Pfizer’s shot in this age group, leaving Moderna as the only vaccine available for children 6 months to 4 years old with at least one qualifying medical condition.

Adding to the confusion, new guidance from the American Academy of Pediatrics (AAP) differs from the CDC’s recommendations for the first time in 30 years.

The AAP strongly recommends COVID-19 vaccines for children 6 months to 2 years old. The CDC does not recommend COVID shots for all healthy children. It says parents should talk with their child’s doctor and then decide whether to get vaccinated.

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