(Reuters) -Moderna ( MRNA ) lowered the top end of its 2025 revenue forecast by $200 million on Thursday, citing weaker-than-expected sales of its COVID-19 vaccine in the U.S. as Americans struggled to access the shots.

The company said it now expects revenue of $1.6 billion to $2 billion for the year, down from its previous forecast of $1.5 billion to $2.2 billion.

Moderna ( MRNA ) reported third-quarter revenue of $1 billion, a 45% drop from a year ago, but ahead of analysts' estimates of $886.54 million, according to LSEG data.

Moderna ( MRNA ) reported a quarterly loss of 51 cents per share, far smaller than analysts' expectations of a $2.11 loss. The Cambridge, Massachusetts-based vaccine maker posted a profit of 3 cents a share in the year-ago quarter.

Moderna ( MRNA ) announced its results as Americans faced confusion and roadblocks at pharmacies, driven by new U.S. guidelines that scaled back broad support for COVID-19 shots, contributing to the lowest vaccination rates since they were introduced.

In August, the U.S. Food and Drug Administration limited updated COVID shots to seniors and high-risk groups. In September, a revamped group of vaccine advisers to the Centers for Disease Control and Prevention recommended that they be given only after shared decision-making with a doctor, adding a roadblock to easy access.

Pfizer ( PFE ) and Gilead Sciences ( GILD ) have warned of slumping demand for COVID-19 shots and treatments. Earlier this week, Pfizer ( PFE ) cited falling Comirnaty vaccine sales due to lower infection rates and reduced U.S. vaccination guidance.

Moderna ( MRNA ) Chief Financial Officer James Mock said in an interview that the timing of the CDC recommendation, which came later than expected, played a role in declining U.S. sales.

Mock said the revenue forecast cut was offset by a projected $100 million bump on the lower end of its projected range for sales outside the U.S.

Moderna's ( MRNA ) COVID-19 shot brought in $971 million in the third quarter, beating Wall Street expectations of $783 million. At its pandemic peak in 2022, the vaccine generated $18.4 billion in sales.

Moderna ( MRNA ) has been banking on revenue from newer vaccines using mRNA technology, including mRESVIA for RSV and an experimental COVID/flu combination shot, to make up for declining COVID revenue.

But the company reported $2 million in third-quarter sales of the respiratory syncytial virus vaccine, well below the $20.9 million analysts expected, as it struggled to compete with Pfizer's ( PFE ) Abrysvo and GSK's Arexvy.

Moderna ( MRNA ) said it was awaiting further guidance from the FDA on refiling for its combo shot, after withdrawing its application in May to wait for efficacy data from a late-stage trial of its influenza vaccine.

Last month, the company said it would stop developing an experimental vaccine to prevent cytomegalovirus, a virus that can cause birth defects, after it failed to meet the main goal of a late-stage trial.

Moderna ( MRNA ) on Thursday also trimmed its adjusted operating expenses outlook for 2025 by $700 million to a range of $5.2 billion to $5.4 billion.