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By Jesus Mesa and Gabe Whisnant
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Four Democratic-led Western states on Wednesday issued their own guidelines for seasonal vaccines, a direct rebuke of federal health policies under Health Secretary Robert F. Kennedy Jr.
The West Coast Health Alliance — made up of California, Oregon, Washington and Hawaii — recommended flu shots for everyone 6 months and older, broad use of COVID-19 vaccines and targeted R.S.V. vaccinations for infants, older adults and those at higher risk.
The recommendations closely track guidance from major medical groups but depart from the Centers for Disease Control and Prevention (CDC), which, under Kennedy, has scaled back COVID vaccine advice for pregnant women and young children. State health officials said their goal is to protect residents and reduce hospital strain this winter.
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Why It Matters
The coordinated move arrives one day before the CDC's Advisory Committee on Immunization Practices (ACIP) is expected to meet and possibly revise national vaccine guidelines.
The committee's credibility has been challenged after Kennedy removed all 17 of its original members and replaced them with appointees, some of whom have publicly expressed skepticism about vaccine safety.
What To Know
The alliance's guidelines are based on recommendations from the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians. They recommend that all children between 6 and 23 months receive the COVID-19 vaccine, along with children 2 to 18 who have risk factors or live with someone at risk.
The guidance also includes pregnant, postpartum or lactating women, as well as adults over 65 or younger adults with underlying conditions. These groups are no longer universally covered under current CDC guidance.
For RSV, the recommendations include infants under 8 months, pregnant women between 32 and 36 weeks of gestation, and adults over 75, along with people aged 50 to 74 with medical risks. Flu shots are advised for all individuals aged six months and older.
This approach diverges from CDC policy, which, under Kennedy, has pulled back on recommendations for COVID-19 vaccines among pregnant women and healthy children. The CDC has yet to update its guidance for the 2025–26 RSV and flu seasons. That uncertainty has already created logistical issues in some states.
In Oregon, for example, pharmacies have required prescriptions for COVID-19 boosters due to the lack of clear federal direction. The Oregon Board of Pharmacy held an emergency meeting on Wednesday to consider allowing pharmacists to administer shots without requiring a doctor's order.
California Public Health Director Dr. Erica Pan said the alliance's effort was a response to confusion at the federal level and was aimed at giving the public access to credible, science-based information. "There is a strong public health, health care and scientific community that will continue to stand together," she said.
Kennedy has said the vaccines remain available to those who want them, but without CDC endorsement, it is unclear whether insurance providers will cover the cost for many people now outside the scope of federal recommendations.
The CDC has not yet responded to requests for comment.
What People Are Saying
Dr. Erica Pan, Director of the California Department of Public Health, said to The New York Times: "There is a strong public health, health care and scientific community that will continue to stand together."
Susan Monarez, former Director of the CDC, said in testimony before the Senate health committee: "I would not rubber-stamp guidance that lacked evidence."
Andrew Nixon, Communications Director at the Department of Health and Human Services, said in a written statement to OPB: "ACIP remains the scientific body guiding immunization recommendations in this country, and HHS will ensure policy is based on rigorous evidence and Gold Standard Science, not the failed politics of the pandemic."
What Happens Next
The ACIP, now composed of members appointed by Kennedy, is scheduled to meet on Thursday and Friday. The panel is expected to review and potentially revise federal guidance for COVID-19, hepatitis B, and measles vaccines.
Update: 9/17/25, 5:37 p.m. ET: This article was updated with new information and remarks.
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