California and West Coast States Release Recommendations on Respiratory Vaccination
The recommendations are provided through the West Coast Health Alliance and pull from guidance from the American Academy of Pediatrics and other organizations.
Governor Gavin Newsom of California, Governor Tina Kotek of Oregon, Governor Bob Ferguson of Washington, and Governor Josh Green of Hawaii coordinated respiratory season vaccination recommendations through the West Coast Health Alliance (WCHA), which was launched by Newsom, Kotek, and Ferguson in early September 2025. The recommendations include the 2025-2026 COVID-19, influenza, and respiratory syncytial virus (RSV) vaccines.1,2
The recommendations are provided through the West Coast Health Alliance and pull from guidance from the American Academy of Pediatrics and other organizations. | Image Credit: fotodrobik - stock.adobe.com
WCHA will help California, Oregon, and Washington to coordinate health guidelines and align immunization recommendations through the guidance of national medical organizations instead of the CDC’s Advisory Committee of Immunization Practices (ACIP). In the statement from California, officials state, “We will continue to provide clear, evidence-based guidance to people living in our states, look to scientific experts in trusted medical professional organizations for recommendations, and work with public health leaders across the country to ensure all Americans are protected.”2
The recommendations came from the guidance of the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians. For COVID-19, the WCHA recommends the vaccine for all children 6 through 23 months, children 2 through 18 years who have risk factors or have never been vaccinated for COVID-19, all children who are in close contact with patients with risk factors, and children and parents/guardians who wish them to have protection. The Alliance also recommends vaccination for patients who are planning to be pregnant, pregnant, postpartum, or lactating, as well as patients 65 years and older, those younger than 64 years with risk factors, those who are in close contact with others who have risk factors, and patients who choose to get vaccinated.3
For influenza, they recommend all patients 6 months and older, patients who are planning pregnancy, pregnant, postpartum, or lactating, and all other patients. For RSV, it is recommended that all patients younger than 8 months receive the vaccine, all patients 8 to 19 months with risk factors, patients who are 32 to 36 weeks gestational age, all patients 75 years and older, and patients aged 50 to 74 years with risk factors.3
This decision comes after the AAP released its annual respiratory immunization schedule, which included guidance for all 3 infectious diseases for pediatric patients. The guidance has been provided for pediatricians since 1930, but this is the first time there has been a major divergence from ACIP guidance. In the AAP’s guidelines recommend that all children younger than 2 receive a single dose of the COVID-19 vaccine and patients 2 through 18 years have to meet certain requirements for vaccination, such as being at high risk for severe disease, residents of long-term care facilities, and those who have not been vaccinated against COVID-19.4
Although there has been no official statement of vote on the COVID-19 recommendations from ACIP or the CDC, 4 vaccines have been approved with varying requirements for vaccinations. Ages can start as young as 6 months, with other recommendations starting as young as 12 years.4
READ MORE: Immunizations Resource Center
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REFERENCES
1. Following Trump’s politicization of CDC, West Coast states issue unified vaccine recommendations — California breaks from future federal guidance with new law. News release. State of California. September 17, 2025. Accessed September 18, 2025. https://www.gov.ca.gov/2025/09/17/following-trumps-politicization-of-cdc-west-coast-states-issue-unified-vaccine-recommendations-california-breaks-from-future-federal-guidance-with-new-law/
2. California, Oregon, and Washington to launch new West Coast Health Alliance to uphold scientific integrity in public health as Trump destroys CDC’s credibility. News release. State of California. September 3, 2025. Accessed September 18, 2025. https://www.gov.ca.gov/2025/09/03/california-oregon-and-washington-to-launch-new-west-coast-health-alliance-to-uphold-scientific-integrity-in-public-health-as-trump-destroys-cdcs-credibility/
3. California Department of Public Health. Public health for all. Updated September 18, 2025. Accessed September 18, 2025. https://www.cdph.ca.gov/Pages/public-health-for-all/publichealthforall.aspx
4. Gallagher A. HHS and American Academy of Pediatrics differ on COVID-19 vaccine recommendation. Drug Topics. September 10, 2025. Accessed September 18, 2025. https://www.drugtopics.com/view/hhs-and-american-academy-of-pediatrics-differ-on-covid-19-vaccine-recommendation
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