Maryland’s health secretary this week sought to reassure state residents that protection from COVID-19 should be widely available, despite the federal government’s shifting guidance over the vaccine’s latest rollout.

During a clinic tour on Wednesday, Dr. Meena Seshamani said she expects to get her COVID shot on Friday. That would come right after the health secretary received her flu shot on Wednesday at the Montgomery County clinic.

“We are doing everything we can to ensure vaccine access,” Seshamani said, adding that the state wants to help people through “a confusing time.”

The health department’s moves come after a federal advisory panel declined to make specific recommendations for COVID vaccines during a meeting last Friday, telling people instead to engage in “shared decision making” with medical providers.

The increasing divisions between the approach by the Trump administration and some states, including Maryland, over COVID shots has concerned public health officials, who are worried about how many people may seek inoculations.

They fear evolving, and even conflicting, information from federal officials could dampen uptake, and not only of the COVID vaccine. They also worry about other vaccines, including for measles, mumps, rubella, and chickenpox, which were also limited by the federal advisory panel last week.

State officials said they plan to continue offering their own “science-backed” recommendations that align with those from leading medical, pediatric and gynecological organizations. The state also is collaborating with several other states to provide guidance and ensure access.

The moves by Maryland, which are outside of federal guidance, are a remarkable turn. Public health officials and all layers of government traditionally work in tandem to insure consistency.

But Seshamani‘s approach is a direct response to new guidance from a federal advisory panel to the U.S. Centers for Disease Control and Prevention that didn’t recommend the vaccine to group specifically.

The panel’s guidance also contradicted recommendations given by another federal agency, the Food and Drug Administration. The FDA had authorized the vaccine only for those over age 65 and those with certain health conditions.

The CDC advisory panel guidance said people should ask their medical provider about whether they should get a shot.

In Maryland, pharmacists are already allowed to give COVID and flu shots to anyone age 3 and older without a prescription. But given the conflicting information from the federal government in recent weeks, Seshamani issued a blanket prescription for all state residents in case a pharmacist insisted on one.

CVS and Walgreens confirmed this week that once the CDC officially signs off on its advisory panel guidance, the giant pharmacy chains will give the vaccine to those who want it and without a prescription.

And those shots should remain affordable. Many insurers, including CareFirst BlueCross BlueShield, have already said they will cover the doses obtained at in-network pharmacies or doctor’s offices.

Some experts, however, still have worries over the conflicts inside the federal government. That could mean that use of the vaccine would be considered “off-label,” and not offered by pharmacies to everyone, according to Deanna Tran, associate professor at the University of Maryland School of Pharmacy.

If they do make that determination, they may not administer it to anyone under age 5, Tran added.

Dr. Wilbur Chen, a former federal vaccine advisory panel member, said he still worries about the integrity of the federal government’s vaccine panel because they are no longer made up of “subject matter experts.” And during the meetings last week, Chen said some members didn’t demonstrate that “they even understood the basic tenets” of what was discussed or “the consequences of their decisions.”

“It’s why we have such alarm with what’s happening,” said Chen, a vaccine expert in University of Maryland School of Medicine’s Center for Vaccine Development and Global Health.

Public health experts such as Chen point to criticism made by Health Secretary Robert F. Kennedy Jr. of the vaccines, including for those for measles, mumps and rubella — known as the MMR vaccine. Experts maintain the vaccines have been proven safe and effective in studies. Most of the more than 1,400 people infected during a recent national measles outbreak, for example, were not vaccinated.

Concerned about federal changes, Maryland lawmakers passed a law that went into effect in June requiring private insurers and Medicaid to cover vaccines that were recommended by the end of last year. That law, however, doesn’t apply to people who get their coverage through self-insured employers, which is the majority in Maryland.

Such laws will offer some protections in state such as Maryland, said Kathleen Hoke, a professor in Maryland’s Francis King Cary School of Law.

Still, she said, “The shenanigans under the [advisory panel] really do impact coverage.”