Most pharmacies in the US can't give your infant or toddler a COVID shot. Here's why.

States have different rules for when pharmacists can give vaccines to kids, and emergency exceptions don’t cover everyone. Experts recommend parents call ahead for appointments.

Millions of Americans have heavily relied on pharmacies to easily access COVID-19 vaccines and boosters throughout the pandemic.

More than 254 million doses of COVID-19 vaccine have been administered and reported by retail pharmacies across the country through June 8, according to the Centers for Disease Control and Prevention.

But parents seeking to vaccinate their toddlers and babies following last week’s authorization of COVID-19 vaccines for children under 5 may be in for a surprise. Most U.S. states don't allow pharmacists or their technicians to administer vaccines to kids under a certain age, according to a 2021 map created by the National Alliance of State Pharmacy Associations.  

“It’s been a process for the past 30 years to get pharmacists immunization administration authority,” said Allie Jo Shipman, director of state policy at the pharmacy association. “It depends on the state, and a lot of it is political.”

Many states in the Northeast don’t allow pharmacists to give vaccines to children at all, restricting the minimum age to 18. Other states have age restrictions ranging from 6 to 14.

These age restrictions were modified in June 2021 by the federal Public Readiness and Emergency Preparedness Act, which temporarily allows pharmacists to order and administer vaccines to children over 3 during a public health emergency. 

But that still means a sizable chunk of children who are eligible to get a COVID-19 shot won’t be able to get one at their local pharmacy, including some of the largest chains in the country.

Walgreens confirmed in a statement to USA TODAY that its pharmacy personnel are authorized to provide the COVID-19 vaccine to children over 3, in accordance with the PREP Act.

CVS pharmacists offer vaccinations to children 5 and over in select locations, according to company spokesperson Matthew Blanchette. Parents of younger tots are directed to the MinuteClinic website, where board-certified family nurse practitioners, physician associates and nurses are authorized to vaccinate children under 5. 

Although COVID-19 vaccines are authorized for infants 6 months and older, the youngest the MinuteClinic will vaccinate is 18 months. 

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"We recommend reaching out to your child’s pediatrician for children ages six to 17 months for vaccination options," Blanchette said in a statement sent to USA TODAY Wednesday. 

While some states don't have any restrictions regarding pediatric vaccines, Shipman said many pharmacists decline to vaccinate little kids. 

"Even though pharmacists are trained to do it, they don't feel comfortable because they haven’t had a lot of practice or haven't immunized in that age range since they were trained," she said. 

She advises parents to call ahead before scheduling a COVID-19 vaccine appointment to make sure their pharmacist is willing to administer the shot. 

Vaccinating babies and toddlers requires "a greater level of skill and experience" than adults, said Dr. Robert Amler, a pediatrician and the dean of New York Medical College's School of Health Sciences and Practice.

The overall target is smaller, he said, which means medical professionals need to use a shorter needle. Instead of the shoulder, shots are given in the leg, steering clear of certain muscles "to avoid serious injury." 

"Calming and handling an anxious baby and parent also require an advanced skill set that is developed with experience," Amler said. "Medical personnel who regularly care for patients in this age group are aware of these issues." 

While it might be ideal to provide vaccines at one-on-one pediatrician appointments, some families, especially in poorer communities, don't have a "medical home," said pediatrician Dr. Sara Bode, medical director of Nationwide Children's Hospital's school-based health and mobile clinics program in Columbus, Ohio.

She said a key to vaccinating younger children of color and others in marginalized communities will be leveraging relationships with trusted neighborhood centers, such as day cares or preschools, where the hospital already sends mobile medical units for other health services.

"We already have several of our early childhood education centers that serve kids that might be either economically disadvantaged or might be centers that have a higher percentage of kids of racial and ethnic minorities," Bode said. "We have to think about having clinics that are at locations that are easily accessible."

Contributing: Nada Hassanein, USA TODAY. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT. 

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.