In a significant move, four Western states led by Democratic governors—California, Oregon, Washington, and Hawaii—collectively announced their own guidelines for three common seasonal vaccines on Wednesday. This unified decision directly challenges recent attempts by Health Secretary Robert F. Kennedy Jr. to overhaul federal vaccine policies.
Operating under the banner of the West Coast Health Alliance, these states’ health officials are advocating for a widespread flu vaccination campaign this fall, urging all residents aged 6 months and older to get their shot. Their recommendations also extend to Covid-19 vaccinations for large segments of the population, specifically pregnant women and all children between 6 months and 2 years old. Furthermore, they advise R.S.V. vaccines for infants under 8 months, adults over 75, and individuals with specific underlying health conditions.
These comprehensive guidelines largely align with the established clinical recommendations from various national medical organizations, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians, as well as previous federal government stances.
However, these state-level advisories mark a departure from the current Centers for Disease Control and Prevention (CDC) guidelines under Health Secretary Kennedy’s leadership. The CDC, for instance, no longer recommends the Covid vaccine for healthy pregnant women and suggests it only for healthy children after a doctor’s consultation. While federal action on flu vaccine recommendations remains unchanged, the CDC has yet to issue guidance on R.S.V. vaccines.
This week, the federal Advisory Committee on Immunization Practices (ACIP) is scheduled to convene, potentially to revise its recommendations for several vaccines, including those for Covid-19, hepatitis B, and measles. Notably, this summer, Mr. Kennedy controversially dismissed and replaced all existing committee members, appointing individuals with a documented history of skepticism regarding vaccine safety and effectiveness.
The Western states’ announcement coincided with a Senate health committee testimony from Susan Monarez, the former director of the CDC. Monarez revealed she was dismissed by Mr. Kennedy for her refusal to endorse his vaccine recommendations without prior scientific review and substantiation.
The health officers from these four states, all medical doctors, emphasized that their guidelines were developed in close consultation with leading medical organizations and expert specialists. They also highlighted an additional goal: to alleviate potential strain on hospitals this winter by actively reducing community transmission and the incidence of severe illnesses across their states.
Dr. Erica Pan, Director of the California Department of Public Health, issued a statement reinforcing this commitment. She expressed her desire for residents to understand that a robust public health, healthcare, and scientific community remains united, ready to provide essential data to empower individuals in making informed health decisions.
One unresolved question from the states’ announcement concerns insurance coverage: it remains unclear whether these new guidelines mandate coverage for individuals not included in federal recommendations. However, health experts broadly agree that covering vaccines is a cost-effective strategy, as it significantly reduces the likelihood of far more expensive hospitalizations.
This isn’t the first time Western states have collaborated on health policy; during the height of the Covid pandemic, they established a similar working group to foster public confidence in vaccines. Echoing this proactive approach, Northeastern states have also held discussions about coordinating their own vaccine recommendations.
While seasonal vaccination rates generally lag behind those for routine childhood immunizations like the MMR vaccine (which protects against measles, mumps, and rubella), even these crucial childhood vaccination rates have been declining. Alarmingly, the majority of kindergartners now reside in states with vaccination levels insufficient to achieve widespread community immunity.
The Trump administration’s divergence from leading medical organizations on vaccine policy appears poised to continue. The very federal committee that Mr. Kennedy reconstituted is anticipated to recommend new restrictions on hepatitis B shots for newborns in the near future.
For a complete overview, here are the detailed vaccine recommendations issued by health officials in these Western states:
Covid-19 vaccine
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Children who are 6-23 months; are 2-18 years who have risk factors; or were never vaccinated against Covid-19. All children who are in close contact with people who have risk factors.
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Women who are planning pregnancy or are pregnant, postpartum or lactating.
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Adults who are 65 years and older; adults younger than 65 who have risk factors; adults who are in close contact with people who have risk factors.
Flu vaccine
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Everyone 6 months and older, including women who are planning pregnancy or are pregnant, postpartum or lactating.
R.S.V. vaccine
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Children who are younger than 8 months; children 8-19 months who have risk factors.
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All pregnant women who are 32-36 weeks gestational age.
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Adults who are 75 years and older; adults who are 50-74 with risk factors.