California, along with Oregon, Washington, and Hawaii, has pushed back against recent federal shifts in vaccine policy by unveiling unified recommendations for immunizations and passing legislation that gives the state greater control over its vaccine guidance.
Why the Change?
State leaders cite growing concerns that federal public health agencies have become politicized. In particular, changes at the Centers for Disease Control and Prevention (CDC) — including replacing its vaccine advisory committee and narrowing eligibility for some vaccines under the guidance of federal authorities — triggered fears that trusted scientific input and public health protections are being undermined.
In response, the four West Coast states formed the West Coast Health Alliance (WCHA). Its goal is to ensure vaccine recommendations are grounded in science, transparency, and safety, rather than political influence.
What Are the New Recommendations?
The alliance has issued joint vaccine guidance for the upcoming respiratory virus season (2025–26) covering:
- COVID-19 vaccines
- Influenza (flu) vaccines
- Respiratory Syncytial Virus (RSV) vaccines
The guidance supports broader eligibility for vaccines than the most recent federal recommendations. It emphasizes protection for vulnerable populations — including infants, the elderly, pregnant people, and those with chronic health conditions — and encourages public access to vaccines for those who “choose protection.”
California’s New Law (AB 144)
Governor Gavin Newsom signed AB 144, a law that codifies California’s ability to set its own vaccine guidance independent of changing federal policy. Key features include:
- Allowing state public health authorities to rely on recommendations from credible, independent medical organizations (e.g., medical societies) rather than being bound by the federal advisory body.
- Requiring state-regulated insurance plans in California to cover vaccines endorsed by the state without cost-sharing, making vaccines more accessible.
- Granting flexibility to protect vaccine access even if federal guidance becomes more restrictive.
Under AB 144, California’s vaccine recommendations take precedence within the state for coverage and public health policy—even if they diverge from new federal guidance.
What It Means for Californians & Beyond
- Greater Access: Individuals—including children, pregnant people, and others who might be excluded under narrower federal criteria—can receive vaccines recommended by the state without as many barriers.
- Insurance Coverage: In most cases, under state-regulated health plans, vaccines approved under state guidance must be covered by insurance, reducing financial barriers.
- Public Trust & Clarity: The unified guidance aims to restore public confidence by offering clear, science-driven recommendations rather than shifting federal rules.
Broader Implications
The move marks a significant moment in U.S. public health policy, illustrating how states can reclaim authority over health guidance when federal agencies undergo rapid changes. It underscores tensions around vaccine policy between states and the federal government, especially when trust in federal institutions appears shaky.
The West Coast Health Alliance’s approach may also influence other states seeking to ensure vaccine access and maintain science-based health policies regardless of federal shifts.
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