California releasess its own vaccine recommendations as RFK shifts federal policy
By Ana B. Ibarra and Kristen Hwang, CalMatters
This story was originally published by CalMatters. Sign up for their newsletters
Photo: Amaya Palestino, 6, receives a COVID-19 vaccine at one of St. John’s Well Child and Family Center mobile health clinics in Los Angeles on March 16, 2022. Photo by Alisha Jucevic for CalMatters
September 23, 2025 (Sacramento) - In anticipation of restrictive federal immunization rules, state health officials issued their own vaccination guidelines on Wednesday, recommending that all Californians 6 months and older who want protection from the COVID-19 virus get this season’s updated vaccine.
Gov. Gavin Newsom and state health officials released the recommendations as part of the state’s newly formed health alliance with Oregon, Washington and Hawaii. Leading medical organizations, including the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, informed the recommendations, according to the state’s announcement. Simultaneously, Newsom signed Assembly Bill 144, which among several things, requires insurance plans to cover the vaccines the state endorses.
“We are here to protect our communities,” Dr. Erica Pan, director of the California Department of Public Health, told CalMatters. “Many of us have dedicated our lives to doing that. We feel really strongly and want to show our unity” as medical, scientific and public health experts.
Pharmacies across the country started dispensing the vaccine in recent weeks, but anecdotes and news reports reveal a patchwork of access, with some people having no difficulty getting the shot, while others still unable to get it.
Last month, the U.S. Food and Drug Administration approved the use of an updated COVID-19 vaccine, but only for seniors and for people ages 5 to 64 who have an underlying condition that puts them at high risk for complications from a COVID-19 infection. This is more restrictive than in previous years, when the federal drug agency approved the vaccine for nearly everyone. Leading medical groups and some states immediately pushed back on the agency’s decision.
California’s guidance comes just two days ahead of a key meeting where a federal vaccine panel will review the updated COVID-19 vaccine. Public health experts anticipate this panel will restrict access to the vaccine.
That’s because U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. who is known for anti-vaccine activism, in June dismissed all 17 members of this panel known as the Advisory Committee on Immunization Practices at the U.S. Centers for Disease Control. He replaced them with 12 new members, some of whom are documented vaccine skeptics.
Typically, after the FDA approves a vaccine for use, this federal committee makes recommendations on who should be immunized. In the past, insurers have based their vaccine coverage on the guidelines issued by this group.
Pan said California’s actions are necessary because the committee’s credibility has been “compromised”. Now with the state’s separate guidance, the CDC group’s recommendations will carry no weight for Californians.
“Whatever comes out of [this committee], our new law is independent of that,” Pan said.
Easier access under state rules
The new law accompanying the state’s independent guidance ensures that most Californians will be able to get a COVID-19 vaccine, including young children, pregnant people and those without underlying medical conditions, said Dorit Reiss, a professor at UC Law San Francisco and an expert on vaccine law. That’s in part because it allows pharmacists to independently prescribe and administer the shot so long as the state health department recommends it.
Many people rely on pharmacies for seasonal vaccines like the flu shot and COVID-19 booster, Reiss said. Now if somebody who does not meet the more narrow federal guidelines goes to a CVS or Walgreens they won’t need a separate doctor’s prescription.
The law also grants the state health department broad authority over other vaccine policies. Many of the state’s immunization laws, including school vaccine schedules, insurance requirements and prescriber authorization, had also been tied to recommendations made by the CDC advisory committee. The state health department’s recommendations now take precedence.
Under these new policies, the department will be able to respond to future threats to vaccine availability and access, Pan said.
“We do anticipate there may be other issues that we would like to be unified on again,” she added.
It also comes amid reports that Kennedy intends to change the childhood vaccine schedule.
Pan said California and the other states in the alliance will base immunization recommendations on the work done by “trusted medical groups” that have independently assessed vaccine safety for years.
Insurers to cover state-endorsed vaccines
Most Californians have insurance through state-regulated health plans, which now must cover the updated COVID-19 shot without copays. The new law also requires Medi-Cal, the state run insurance program for low-income residents and people with disabilities, to cover the COVID-19 shot and other vaccines recommended by the state health department.
Mary Ellen Grant, a spokesperson for the California Association of Health Plans, said the state’s policy changes “will greatly reduce the amount of confusion” among patients and ensure they have access to vaccinations.
About 5.4 million Californians have insurance that is subject to federal regulations rather than state ones. Generally, these are people who work for large, multi-state or multinational companies. Nationally, insurers have been hesitant to make statements about vaccine coverage ahead of the CDC’s vaccine advisory committee, leaving coverage for people with federally regulated plans uncertain.
Still, Reiss said, she expects insurers to continue covering vaccines regardless of future changes made by the CDC’s advisory committee. It’s much cheaper for insurers to pay for vaccines than it is for them to pay for treatment of the diseases they prevent.
The state’s partnership with Hawaii, Oregon and Washington also creates market pressure on insurers to continue vaccine coverage, Reiss said.
“They might just say, ‘This is a big chunk of the population. We might as well have the same policy for all the country,’” she added.
Vaccines continue to be key protection
The rollout of this year’s vaccine is coinciding with a moderate surge in COVID-19 infections. Data from the California Department of Public Health show that cases have been ticking up since July. As of Sept. 6, 11.72% of samples sent in for testing were positive, slightly higher than this time last year.
Public health officials say the best way to stay healthy this fall and winter is to get vaccinated.
In addition to the COVID-19 vaccine, California’s immunization guidance also recommends that everyone 6 months and older get a flu shot. The vaccine to protect against Respiratory Syncytial Virus, or RSV, is recommended for all babies younger than 8 months and for babies between 8 months and 19 months if they carry risk factors. The RSV vaccine is also recommended for pregnant women at 32 weeks to 36 weeks of gestation and for all seniors 75 and older, as well as for those ages 50 to 74 with comorbidities.
“If we want to make America healthy, rather than treating disease, we want to prevent disease, and well, vaccination is one of the best creations to prevent disease,” said. Dr. Jeffrey Silvers, an infectious disease specialist at Sutter Health. “It’s right up there with clean water in terms of preventing disease.”