In a significant move, four Western states, all led by Democratic governors, have released their own comprehensive recommendations for three common seasonal vaccines. This action serves as a direct challenge to recent efforts by Health Secretary Robert F. Kennedy Jr. to alter federal vaccine policy.
The “West Coast Health Alliance,” comprising health officials from California, Oregon, Washington, and Hawaii, advises that all residents aged 6 months and older should receive the flu vaccine this fall. They also suggest broad Covid-19 vaccination for various groups, including pregnant women and all children between 6 months and 2 years old. Furthermore, RSV vaccines are recommended for infants under 8 months, adults over 75, and individuals with specific risk factors.
These detailed guidelines largely align with established clinical recommendations from prominent national medical organizations, such as the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians.
However, the new state guidelines notably diverge from those issued by the Centers for Disease Control and Prevention (CDC) under Mr. Kennedy’s leadership. The CDC no longer recommends the Covid vaccine for healthy pregnant women and suggests it only for healthy children after consultation with a doctor. The CDC has not significantly changed its flu vaccine recommendations and has yet to issue guidance on RSV vaccines.
The announcement comes just ahead of a federal Advisory Committee on Immunization Practices meeting, where potential changes to recommendations for Covid, hepatitis B, and measles vaccines are on the agenda. This summer, Mr. Kennedy controversially dismissed and replaced all committee members with individuals known for their skepticism regarding vaccine safety and effectiveness.
Adding to the controversy, Susan Monarez, the former director of the CDC, testified before the Senate health committee on the same day the Western states announced their guidelines. She claimed her firing by Mr. Kennedy was a direct result of her refusal to endorse his vaccine recommendations without supporting scientific evidence.
The health officers from the four states, all medical doctors, emphasized that their guidelines were developed after consulting leading medical organizations and expert specialists. They also stated that these new recommendations aim to alleviate potential stress on hospitals during the upcoming winter season by reducing community transmission and the incidence of severe illnesses.
Dr. Erica Pan, director of the California Department of Public Health, stated that the initiative aims to assure residents that a strong public health, healthcare, and scientific community stands ready to provide accurate data, empowering them to make informed health decisions.
A key unanswered question, however, is whether insurance providers will be mandated to cover vaccinations for individuals falling outside federal guidelines. Health experts generally concur that widespread vaccination is a cost-effective measure, as it can prevent much more expensive hospitalizations.
During the peak of the Covid-19 pandemic, these same Western states collaboratively formed a similar working group to bolster public confidence in vaccines. Additionally, Northeastern states have reportedly held discussions about coordinating their own vaccine recommendations.
While seasonal vaccination rates are typically lower than those for routine childhood immunizations like the MMR vaccine, coverage for the latter has also been declining. Currently, a majority of kindergartners reside in states where childhood vaccination rates are below the levels necessary to achieve widespread community immunity.
The trend of the Trump administration deviating from established medical consensus on vaccine policy is anticipated to persist. The federal committee, reformed by Mr. Kennedy, is expected to soon recommend new restrictions on hepatitis B shots for newborns.
For clarity, here are the detailed vaccine recommendations issued by health officials in these Western states:
Covid-19 Vaccine Guidance
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Children aged 6-23 months; children aged 2-18 years with existing risk factors; or any child not previously vaccinated against Covid-19. This also includes all children who are in close contact with individuals at higher risk.
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Women who are planning to become pregnant, are currently pregnant, have recently given birth, or are lactating.
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Adults aged 65 years and older; adults under 65 with identified risk factors; and adults who are in close contact with individuals at higher risk.
Flu Vaccine Guidance
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All individuals aged 6 months and older, encompassing women who are planning pregnancy, are pregnant, postpartum, or lactating.
RSV Vaccine Guidance
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Infants under 8 months of age; children aged 8-19 months with specific risk factors.
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All pregnant women between 32 and 36 weeks of gestational age.
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Adults aged 75 years and older; adults aged 50-74 with identified risk factors.
Apoorva Mandavilli contributed reporting.