California Law Sets State’s Own Vaccine Schedules, Deepening Rift With CDC

Gov. Gavin Newsom signed a law on Wednesday asserting California’s ability to set its own immunization schedules amid a widening rift with the Trump administration’s public health officials — and confusion about who exactly can get the new COVID-19 vaccine. 

AB 144 empowers the California Department of Public Health to adopt its vaccine recommendations from major professional medical societies rather than rely solely on the Centers for Disease Control and Prevention and its Advisory Committee on Immunization Practices. The legislation also requires California insurance companies to pay for any authorized vaccines at no cost to patients.

The law came the same day that California joined Oregon, Washington and Hawaii — its partners in the newly formed West Coast Health Alliance — in announcing coordinated recommendations for winter vaccinations against COVID-19, influenza and RSV.

President Donald Trump and Health Secretary Robert F. Kennedy Jr., meanwhile, have fired or replaced top CDC officials, stripped away vaccine recommendations for pregnant women and children, replaced every member on the federal immunization advisory committee and slashed funding for mRNA research.

Ousted CDC chief Susan Monarez, who was recently fired after less than a month on the job, warned senators on Wednesday morning that Kennedy and his newly stocked team of advisers with a history of anti-vaccine statements are taking the country’s public health system to “a very dark place.”

Typically, the CDC sets vaccine recommendations based on the available data, which insurers use to set reimbursement guidelines concerning which vaccines they’ll pay for. The push by California and other Western states comes in anticipation of the Trump administration’s new federal vaccine recommendations, which are expected to land later this week when the CDC advisory panel meets.

California’s new vaccine schedule preempts the CDC’s guidance, recommending COVID vaccines to all children 6 to 23 months old; any children under 18 with risk factors or who haven’t been immunized before; and anybody who is pregnant, planning pregnancy, postpartum or lactating. It also opens up immunization to any adult who chooses. The guidelines were developed based on recommendations from the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians.

“I’ve talked to so many people who are married to somebody who’s at high risk. But they can’t get vaccinated because they’re in good health. And that’s just absurd,” said Dr. John Swartzberg, an infectious disease specialist at UC Berkeley’s School of Public Health. “And so I think California has really fixed that loophole there.”

Health insurers regulated by California are required to cover the state’s winter vaccine recommendations and have up to 15 days to comply with the new guidelines, a spokesperson for Newsom’s office told KQED.

In a statement, the California Association of Health Plans said its members are on board, noting that the new law “will greatly reduce the amount of confusion for our enrollees and ensure they receive life-saving vaccinations.”

In its own letter, Blue Shield of California applauded California’s move and said it “will continue to partner with the California Department of Public Health to cover science-backed immunization recommendations that protect public health.”

Catherine Flores, executive director of the California Immunization Coalition, said she’s never seen providers, experts and advocates coalesce so fully nor so quickly in her 26 years working in public health.

“On one hand, it’s terrible that we’re having to spend the time, energy and resources to create new systems to be able to protect our communities,” Flores said. “On the other hand, I’m really proud.”

Stanford infectious disease physician and researcher Dr. Abraar Karan praised California’s efforts to sharpen its independence, alongside other Western states.

“My feeling is that the next few years are going to be a lot of state-led public health initiatives that are not in line with what’s going on federally,” Karan said. “And I think that’s fine, because we are disagreeing with what the federal government is doing, and whatever experts they’re relying on have different opinions than leading academics and medical institutions.”

KQED’s Lesley McClurg and Brian Krans contributed to this report.