ATLANTA — Health Secretary Robert F. Kennedy Jr.’s new vaccine advisers added confusion Friday to this fall’s COVID-19 vaccinations — declining to recommend them for anyone and leaving the choice up to those who want a shot.

Until now, the vaccinations had been recommended as a routine step in the fall for nearly all Americans who wanted them — just like a yearly flu vaccine. The Food and Drug Administration already had placed new restrictions on this year’s shots from Pfizer, Moderna and Novavax, reserving them for people over 65 or younger ones who are deemed at higher risk from the virus.

In a series of votes Friday, advisers to the Centers for Disease Control and Prevention took the unprecedented step of not recommending them even for high-risk populations like seniors — instead deciding that people could make individual decisions.

The panel also urged the CDC to adopt stronger language around claims of vaccine risks, despite pushback from outside medical groups who said the shots had a proven safety record from the billions of doses administered worldwide. The divided panel narrowly avoided urging states to require a prescription for the shot.

In response to the federal advisory panel meeting Friday, Maryland health officials issued a blanket prescription for the COVID-19 vaccine so residents would not have to ask their providers for a script.

The state also made recommendations about who should get the COVID-19 and flu vaccines based on guidance from major pediatric, gynecological and medical associations.

“The Maryland Department of Health is focused on using evidence-based science to make decisions that best serve the people of our state. Research continues to show that vaccines are an effective way to keep our communities healthy,” Maryland Health Secretary Meena Seshamani, said in a statement. “We encourage everyone to talk with a health care provider who can help assess your personal health care needs and determine if a vaccine is right for you.”

The move is on top of other state moves on vaccines, including joining a coalition of states that will make vaccine recommendations and ensure access. The state also passed a law earlier this year to require insurers cover COVID-19 and other previously recommended vaccines.

In Maryland, any pharmacist already could give a COVID-19 vaccine to anyone age 3 and up without a prescription. The move Friday was an extra step officials hoped would spur pharmacies to give shots to those who want them.

Some pharmacies had been turning away people who did not meet previous federal recommendations for a COVID-19 shot. And even with the standing orders, Maryland can allow pharmacies to give the shots but can’t require them.

Dr. Sean O’Leary of the American Academy of Pediatrics said the panel’s daylong debate involved clear efforts to “sow distrust” about vaccines and would have “real-time impacts on American children.”

But he expressed relief that people could instead follow guidelines from his and other medical groups that still recommend the vaccines be available like in prior years.

“It was a very, very strange meeting,” O’Leary said.

Several states have announced policies to try to assure that access, worried about Friday’s decision. And a group representing most health insurers, America’s Health Insurance Plans, said earlier this week that its members will continuing covering the shots through 2026.

The COVID-19 vaccines are not perfect, but CDC data shows they provide the strongest protection against severe infection and death, even if people still become infected. Likewise, people can get COVID-19 repeatedly as the virus continues to evolve.

Like flu vaccines, COVID-19 shots now are being updated yearly, but only about 44% of seniors and 13% of children were up-to-date on the coronavirus vaccinations last year, the CDC said.

Among many unproven questions about risks that the panel raised Friday was one rare side effect that people already are warned about: a kind of heart inflammation called myocarditis, mostly in young men, that was discovered in the early days of vaccination in 2021. A scientist studying whether people with certain genes are uniquely susceptible to that risk told the panel the Trump administration had canceled his grant before the research could be finished.

The panel took up COVID-19 vaccinations as the virus remains a public health threat. CDC data released in June shows the virus resulted in 32,000 to 51,000 U.S. deaths and more than 250,000 hospitalizations last fall and winter. Most at risk for hospitalization are seniors and young children — especially those who were unvaccinated.

The panel opened the second day of its meeting with continued confusion over a question it left hanging Thursday: whether to end a longstanding CDC recommendation that all newborns be vaccinated at birth against a liver virus, hepatitis B.

The panel had been considering whether to recommend delaying that initial vaccination — something doctors and parents already can choose to do. But amid criticism from independent pediatric and infectious disease specialists who say the vaccine is safe and has helped infant infections drop sharply, the advisers decided Friday to postpone that decision.

On Thursday, the panel recommended a new restriction on another childhood vaccine.

They recommended that for children under 4, their first dose of protection against MMR — measles, mumps and rubella — and chickenpox should be in separate shots, not a combination version known as MMRV. Since 2009, the CDC has said it prefers separate shots for initial doses of those vaccines and 85% of toddlers already do.

On Friday, the committee also recommended that the government’s Vaccines for Children program — which covers vaccine costs for about half of U.S. kids — align its guidance with that narrower MMRV usage.

Banner reporter Meredith Cohn and Associated Press writer Laura Ungar contributed to this report.

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