In a bold move countering recent federal shifts, four Democratic-led Western states—California, Oregon, Washington, and Hawaii—have released their own unified recommendations for seasonal vaccines. This decision marks a significant departure from the policies of Health Secretary Robert F. Kennedy Jr., who has been actively working to reshape national vaccine guidelines.
Operating under the banner of the “West Coast Health Alliance,” health officials across these states advise all residents aged 6 months and older to get their annual flu shot this fall. Their guidance also extends to Covid-19 vaccinations, recommending them for a broad segment of the population, including pregnant individuals and all children between 6 months and 2 years. Furthermore, they suggest RSV vaccines for infants under 8 months, adults over 75, and individuals with specific health vulnerabilities.
These comprehensive recommendations largely align with established clinical advice from prominent national medical bodies, such as the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians.
However, these state-level guidelines notably differ from those issued by the Centers for Disease Control and Prevention (CDC) under Secretary Kennedy. The CDC, for instance, no longer recommends the Covid-19 vaccine for healthy pregnant women and advises that healthy children only receive it after consulting a physician. While the CDC has not made significant changes to flu vaccine recommendations, it has yet to issue guidance on RSV vaccines.
The timing of the Western states’ announcement is particularly impactful. It comes just as the federal Advisory Committee on Immunization Practices is scheduled to convene this week to review and potentially revise recommendations for several vaccines, including those for Covid-19, hepatitis B, and measles. Earlier this summer, Secretary Kennedy controversially dismissed and replaced all members of this federal committee with new appointees, some of whom have publicly expressed skepticism regarding vaccine safety and effectiveness.
Further underscoring the tension, Susan Monarez, the former CDC director recently removed from her post, testified before the Senate health committee on the same day the new state guidelines were revealed. She stated that she was fired by Secretary Kennedy for her refusal to prematurely endorse his vaccine recommendations without a thorough scientific review.
The health officers from these four states, all of whom are medical doctors, emphasized that their guidelines were developed in consultation with leading medical organizations and expert specialists. Their objective, they explained, is to bolster public health and alleviate potential strain on hospitals this winter by curbing community transmission and severe illness across their states.
Dr. Erica Pan, Director of the California Department of Public Health, articulated the states’ commitment, stating, “We want the people who live and work in our states to know that there is a strong public health, health care, and scientific community that will continue to stand together to provide all the necessary data for you to make healthy choices.”
One aspect that remains unclear is whether private insurance providers will be mandated to cover vaccinations for individuals falling outside the scope of federal guidelines. Nevertheless, health experts generally concur that widespread vaccination is a cost-effective strategy, as it often prevents more expensive hospitalizations.
This isn’t the first time Western states have collaborated on health policy. During the height of the Covid-19 pandemic, they formed a similar working group to enhance public trust in vaccines. Northeastern states have also been exploring similar coordinated vaccine recommendation efforts.
It’s worth noting that seasonal vaccination rates are typically lower than those for routine childhood immunizations like the MMR vaccine (which protects against measles, mumps, and rubella). Disturbingly, however, childhood vaccination rates have also been declining, with most kindergartners now residing in states where immunity levels are insufficient to prevent widespread outbreaks within communities.
The current federal administration is anticipated to continue its divergence from leading medical groups on vaccine policy. The very federal committee that Secretary Kennedy reformed is expected to recommend new restrictions on hepatitis B shots for newborns in the coming days, signaling further changes ahead.
For a clear understanding, here are the comprehensive vaccine recommendations from the Western states’ health officials:
Covid-19 Vaccine Recommendations
- Children aged 6-23 months, and those aged 2-18 years with identified risk factors, or who have not been previously vaccinated against Covid-19. All children who are in close contact with individuals presenting risk factors.
- Women who are planning pregnancy, currently pregnant, postpartum, or lactating.
- Adults aged 65 years and older, or adults younger than 65 with identified risk factors. Also, adults who are in close contact with individuals presenting risk factors.
Flu Vaccine Recommendations
- All individuals 6 months of age and older, including women who are planning pregnancy, currently pregnant, postpartum, or lactating.
RSV Vaccine Recommendations
- Children younger than 8 months, and children aged 8-19 months with identified risk factors.
- All pregnant women who are between 32-36 weeks gestational age.
- Adults aged 75 years and older, or adults aged 50-74 with identified risk factors.
Additional reporting was contributed by Apoorva Mandavilli.