By Marie Rosenthal, MS
California, Oregon and Washington will launch a new West Coast Health Alliance to create vaccine guidelines and develop public health policies that are aligned with respected national medical organizations, rather than follow those of the Advisory Committee on Immunization Practices (ACIP), which they say can no longer be trusted.
In June, Robert F. Kennedy Jr., the secretary of the Department of Health and Human Services, “retired” 17 people from the ACIP and appointed eight people without going through the usual vetting process for ACIP membership, which can take months. Most of the new members have been expressing anti-vaccine sentiments for some time. Both moves were condemned by many organizations, public health leaders and the governors of the three aforementioned states.
“The alliance represents a unified regional response to the Trump Administration’s destruction of the U.S. CDC’s credibility and scientific integrity,” according to a statement issued jointly by California Gov. Gavin Newsom, Oregon Gov. Tina Kotek and Washington Gov. Bob Ferguson.
The alliance will ensure the scientific integrity of its public health policies in the three states by relying on trusted scientists, clinicians and public health experts, they said. “Through this partnership, the three states will start coordinating health guidelines by aligning immunization recommendations informed by respected national medical organizations. This will allow residents to receive consistent, science-based recommendations they can rely on—regardless of shifting federal actions,” they wrote in a statement.
In the coming weeks, the alliance will finalize shared principles to strengthen public confidence in vaccines and public health. While each state will independently pursue strategies shaped by their state and population, these shared principles will form the foundations of the alliance. In addition, the states said they would “respect Tribal sovereignty, recognizing that Tribes maintain their sovereign authority over vaccine services.”
Until recently, the CDC has been central to protecting Americans from disease. But the sidelining of long-trusted advisory bodies has impaired the agency’s capacity to prepare the nation for respiratory virus season and other public health challenges, according to the governors’ statement. Without this leadership, manufacturers lack reliable information to plan vaccine production, health care professionals struggle to provide consistent healthcare, and families face uncertainty about access to vaccines, according to the governors.
“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. The absence of consistent, science-based federal leadership poses a direct threat to our nation’s health security. To protect the health of our communities, the West Coast Health Alliance will continue to ensure that our public health strategies are based on best available science,” the governors said.
Other states are considering forming similar groups to issue vaccine guidance, and several medical associations are also issuing recommendations.
Meanwhile, Florida took a different stance.
In a press conference with Florida Gov. Ron DeSantis, Joseph A. Ladapo, MD, the state surgeon general and health secretary, announced that the state would eliminate all childhood vaccine mandates. “The Florida Department of Health, in partnership with the governor, is going to be working to end all vaccine mandates in Florida law. All of them. All of them. Every last one of them,” he said, adding that “every last one of them is wrong and drips with disdain and slavery.
“Who am I as a government or anyone else, or who am I as a man standing here now to tell you what you should put in your body? Who am I to tell you what your child should put in their body? I don't have that right. Your body is a gift from God. What you put into your body is because of your relationship with your body and your God,” he said.
Dr. Ladapo called vaccine mandates wrong and immoral. He said that one argument in favor of vaccination—that vaccinated children are protecting not only themselves but immunocompromised children that cannot be vaccinated—was not “sincere.” Although he understands the danger unvaccinated children may pose to the immunocompromised “that’s also part of the experience of life. There's no ethical basis for that to be used as a reason to take away your ability to choose what you put in your body and what you as a parent put in your child's body.”
He called mRNA COVID-19 vaccines poison and said public health could not make a better world by “enslaving people in terrible philosophies and taking away people's freedoms.”
Florida’s changes come as the country is recovering from the largest number of measles cases since 1992. More than 1,400 cases have been reported and three people have died in 2025 due to measles, according to the CDC. Most of the hospitalizations were among people who were not immunized or who were under immunized.
Sandra Adamson Fryhofer, MD, a trustee of the American Medical Association said, “The American Medical Association strongly opposes Florida’s plan to end all vaccine mandates, including those required for school attendance. This unprecedented rollback would undermine decades of public health progress and place children and communities at increased risk for diseases such as measles, mumps, polio, and chickenpox resulting in serious illness, disability, and even death. While there is still time, we urge Florida to reconsider this change to help prevent a rise of infectious disease outbreaks that put health and lives at risk.”
For 60 years, the ACIP has gathered professional societies around the table to hear from all the experts before creating vaccine guidelines, reminded William Schaffner, MD, a professor of medicine and preventive medicine in the Division of Infectious Diseases, at Vanderbilt University School of Medicine, in Nashville, Tenn., and the reason they did that was so that the guidelines could be harmonized. The process worked so well that other countries have adopted its model and have similar vaccine advisory groups.
Although well intentioned, having multiple sources for vaccine guidance leaves a lot of questions, and Dr. Schaffner said he is fielding many of them already: Will vaccines be covered by insurance if they are recommended by the state, but not by the ACIP? Will pharmacists be able to provide vaccinations that are recommended by a state or medical organization, but not by the ACIP?
And he said, the answer is, “We don’t know yet.”
Physician and pharmacist liability “is a concern also. If you vaccinate outside of the ACIP guidelines, will there be potential coverage for the patient under the vaccine compensation program? Although there are very unusual or indeed rare serious events [from vaccination], they're real. And that's also a concern [of healthcare professionals],” Dr. Schaffner told Infectious Disease Special Edition.
If every state or region makes its own guidelines, Dr. Schaffner said, they are likely to be very diverse across the country, which could lead to more confusion and lower vaccination rates, even among people who should be vaccinated.
