Four Western U.S. states — California, Washington, Oregon, and Hawaii — have announced a joint effort to release unified vaccine recommendations for the upcoming respiratory illness season, marking a dramatic break from relying solely on the U.S. Centers for Disease Control and Prevention (CDC).

The West Coast Health Alliance

Earlier this month, the Democratic-led states formed the West Coast Health Alliance (WCHA), citing a loss of confidence in the CDC’s credibility and independence. California Governor Gavin Newsom said the move was designed to restore trust in public health by leaning on independent medical groups rather than federal agencies he accused of political interference.

“The alliance represents a unified regional response to the Trump Administration’s destruction of the U.S. CDC’s credibility and scientific integrity,” Newsom stated in a press release.

New California Law Changes Vaccine Guidance Framework

Alongside the regional guidelines, Newsom signed a new California law on Wednesday that shifts the state’s immunization guidance away from the CDC. Instead, recommendations will now be based on prominent medical organizations, including the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG).

This means that California will no longer automatically align with the CDC on vaccine schedules but will instead reference these professional bodies when advising residents.

Recommendations Issued

The new joint recommendations issued by the WCHA cover COVID-19, flu, and RSV vaccines, urging eligible residents to get protected ahead of the winter season.

Washington Governor Bob Ferguson underscored the alliance’s emphasis on science, saying:

“Science matters. We will ensure our policies are based on rigorous science. We stand united with our partner states and medical experts to put public health and safety before politics. I will continue to do everything in my power to protect Washingtonians.”

CDC Meeting Looms

The timing of the announcement came just one day before the CDC’s Advisory Committee on Immunization Practices (ACIP) convened for a two-day session. Under the leadership of HHS Secretary Robert F. Kennedy Jr., the panel is set to vote on parts of the childhood immunization schedule as well as updated recommendations for COVID-19 vaccines.

At present, the FDA has only authorized the newest COVID-19 vaccines for individuals at high risk of severe illness, including adults over 65. Others may still obtain the vaccine with a prescription after consultation with their doctor.

Insurance Coverage and Access

Despite the uncertainty, the Association of Health Insurance Plans (AHIP) has pledged to cover the cost of any vaccine currently included in guidelines until ACIP finalizes its recommendations. Existing federal guidance continues to advise that all individuals over 6 months old consider annual flu shots and updated COVID-19 vaccinations through at least 2026.

Pharmacies in many states, including those in the alliance, remain authorized to administer vaccines to anyone who requests them, regardless of age or risk profile.

Federal Pushback

The U.S. Department of Health and Human Services (HHS) criticized the West Coast Health Alliance, calling it a partisan maneuver. In a statement earlier this month, an HHS spokesperson said:

“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.”

A Divided Landscape

The decision by the four Western states highlights the growing fragmentation of vaccine policy in the U.S. While federal agencies remain the primary authority for national recommendations, states are increasingly carving out their own approaches in response to both scientific debates and political tensions that emerged during the COVID-19 pandemic.

As flu season approaches and COVID-19 continues to circulate, the coming months will test whether regional alliances like the WCHA can strengthen public confidence in vaccines — or further deepen divides over who Americans trust to guide their health.