Quick Take
A new state law gives the California Department of Public Health the ultimate decision-making power for issuing vaccine recommendations. California-based insurers are required to cover vaccines that the public health department recommends — and the guidelines are much wider than the federal ones.
As federal vaccination recommendations continue to change in ways many do not fully understand, California is taking matters into its own hands. The state’s goal: increase access to immunizations and provide some level of clarity that has evaded even the top local public health officials.
“If you’re confused, you’re not the only one,” county deputy health officer Dr. Karissa LeClair-Cortez told Lookout.
Last week, the California Senate passed Assembly Bill 144, which updated state law to expand access to vaccines. Gov. Gavin Newsom signed the bill into law last Wednesday. The bill ensures that immunization recommendations from the California Department of Public Health (CDPH) are the applicable guidelines for state residents. The state will no longer rely as it has long done on federal committees like the national Advisory Committee on Immunization Practices and the U.S. Preventive Services Task Force.
“There are concerns with the upheaval of those organizations and that they might not be following the best evidence-based practices,” said LeClair-Cortez. “On the state level, [legislators] wanted to consider other professional societies’ evidence-based recommendations and ultimately give the decision-making power to CDPH.”
Those other professional societies include, but are not limited to, organizations such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, whose COVID vaccination recommendations California had already supported.
The West Coast Health Alliance made up of California, Oregon, Washington and Hawaii issued its recommendations for the 2025-26 COVID, flu and respiratory syncytial virus (RSV) the same day that California updated its state law. CDPH is using those same recommendations. The alliance formed on Sept. 3 in an effort to “safeguard public health” by providing evidence-based vaccination guidance separated from political agendas.
What is the state’s recommendation for COVID shots?
It’s about the time of year where many begin to schedule their COVID boosters, with the reformulated vaccine now available through health care providers and pharmacies.
Robert F. Kennedy Jr., secretary of the Department of Health and Human Services and an outspoken vaccine skeptic, initially approved the shot only for people ages 65 and up, along with younger people with certain health conditions. Those who did not qualify would have needed a doctor’s approval or attest to a pharmacy that they have an underlying health condition. Health care professionals were concerned that the stricter guidelines might further discourage people from getting the updated COVID shot, even if they were eligible for it.
However, pharmacies in California will now follow the state’s recommendations for COVID vaccines. The state recommends that shot for children who:
- are between 6 months and 23 months,
- are between 2 years and 18 years old with risk factors, or who were never vaccinated against COVID,
- are in close contact with others with risk factors,
- choose to be vaccinated.
The state recommends the shot for adults who:
- are 65 and older,
- are under 65 with risk factors,
- are in close contact with others with risk factors,
- choose to be vaccinated.
The state also recommends the shot to women who are planning pregnancy, are pregnant, postpartum or lactating.
LeClair-Cortez added that the COVID vaccine is required to be covered by insurance under the updated law, and added that pharmacies in the state will be following the new state recommendations over the federal guidelines issued earlier this month.
Both major and independent pharmacies, including CVS and Santa Cruz’s Horsnyder Pharmacy, confirmed to Lookout that they would be following the state recommendations for vaccinations rather than the federal ones: “We will administer one to whoever wants one,” said Horsnyder pharmacist Karem Ayyad.
Frank’s Pharmacy in Aptos does not offer the COVID vaccine, nor does its other locations, said pharmacy technician Cheryl Felice. However, she added that the pharmacies would be following state recommendations for the shots that they offer including flu and RSV.
LeClair-Cortez also said that the updated state law provides liability protections through 2030 to establishments that are administering vaccines.
“That was certainly a concern if you’re providing something that’s technically now considered off-label from the Food and Drug Administration,” she said. “So for those administering the vaccines, whether that’s a pharmacist or a clinician, if there’s an adverse effect or they get sued related to something for the vaccine, the state will actually cover the cost.”
CDPH has issued guidelines for only COVID, RSV and flu. The flu shot is recommended for children 6 months and older and all adults, including pregnant women. RSV is recommended to children younger than 8 months and between 8 and 19 months with risk factors, pregnant women between 32 and 36 weeks gestational age, and adults 75 and older or between ages 50 and 74 with risk factors.
LeClair-Cortez said that recommendations for other immunizations are in discussion, and are likely to be announced in the near future.
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