Western States Release Updated Vaccine Guidelines

The governors of Oregon, Washington, California, and Hawaii announced new immunization guidelines for their states on Wednesday.

These guidelines advocate for broad access to the COVID-19 vaccine for everyone aged six months and older, emphasizing that the vaccine should be available to “all who choose protection.”

This initiative is part of a new organization, the Western States Health Alliance, formed after state leaders expressed concerns about political influences on the U.S. Centers for Disease Control and Prevention (CDC).

Oregon Governor Tina Kotek, California Governor Gavin Newsom, Washington Governor Bob Ferguson, and Hawaii Governor Josh Green issued a joint statement highlighting their commitment to science, safety, and transparency. They emphasized the importance of providing families with clear guidance on vaccination and prioritizing public health over political agendas.

In Oregon, these guidelines could mark a move towards eliminating the requirement for a prescription for the 2025-2026 COVID-19 booster shot.

Recently, the Food and Drug Administration approved updated COVID-19 vaccines from Pfizer and Moderna, which were reformulated in the spring to address currently circulating variants. Initially, this approval was limited to adults aged 65 and older, as well as younger individuals with certain underlying health conditions.

Normally, the FDA’s recommendations follow a public review by the CDC and a key group of experts known as the Advisory Committee on Immunization Practices (ACIP). However, officials at the U.S. Health and Human Services (HHS) have delayed this process for several months.

Guidelines from ACIP regarding the upcoming COVID-19 booster shots are still awaited. This delay means that, in Oregon and many other states, most pharmacies have required a doctor’s prescription for the COVID-19 vaccine. ACIP is expected to meet on Thursday and Friday.

Meanwhile, Oregon’s Board of Pharmacy is holding an emergency meeting on Wednesday to discuss potential changes in vaccine administration protocols for fall respiratory viruses, including COVID-19. This adjustment may allow pharmacists to administer vaccines without a prescription, regardless of ACIP’s decisions.

The recommendations from these four states represent a contrast to federal officials at HHS, who have sought to limit vaccine access primarily to high-risk groups, mirroring practices observed in Europe.

Recently, HHS Secretary Robert F. Kennedy Jr. has faced significant criticism for allegedly sidelining CDC scientists and promoting an anti-vaccine stance. ACIP, traditionally a trusted authority on vaccine safety, has found itself embroiled in controversy following Kennedy’s removal of all previous committee members and key liaisons to major medical organizations this summer.

Some recently appointed members have controversially claimed that MRNA vaccines should be withdrawn and misrepresented the risks of infectious diseases like measles.

Senator Bill Cassidy, the Republican chair of the U.S. Senate Committee on Health, Education, Labor, and Pensions, suggested that recommendations from the current ACIP should be deemed illegitimate due to the CDC’s ongoing turmoil.

The committee heard from Susan Monarez, the recently dismissed CDC director, who was appointed under Trump. Monarez recounted that Kennedy had demanded her prior commitment to approve all ACIP recommendations, irrespective of scientific evidence, and had instructed her to terminate career vaccine policy officials without just cause. After her refusal, she was dismissed by the White House.

Kennedy accused Monarez of fabricating stories regarding her dismissal.

Officials at HHS maintain that the new ACIP members are highly qualified professionals and that Kennedy’s reconstitution of the committee was necessary due to the previous cohort’s hasty endorsement of vaccines.

They criticized the health alliance, arguing that Democratic-led states had eroded public trust through decisions made during the pandemic.

“ACIP remains the scientific body guiding immunization recommendations in this country,” said HHS Communications Director Andrew Nixon. He added that HHS will ensure that policy decisions are based on rigorous evidence rather than pandemic politics.

The guidelines from the West Coast Health Alliance pertain to the 2025-26 COVID-19, influenza, and RSV vaccines. The latter two seem to align with existing CDC guidelines.

These recommendations were crafted by health officials from the four states, drawing on the guidelines of the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians.

According to state health authorities, only 20% of Oregonians received the COVID-19 booster shot last year. Certain demographics, like those aged 65 and older and native Hawaiians and Pacific Islanders—who are at a higher risk for hospitalization due to COVID-19—demonstrated a higher uptake rate.