San Francisco health officials told the Health Commission on Oct. 6 that California’s AB 144 and an emerging West Coast Health Alliance aim to reduce confusion about vaccine guidance and expand access, and that the city will step up outreach to providers and multilingual communities.

Deputy Health Officer Dr. Seema Jain and Health Officer Dr. Susan Philip summarized the state changes and described San Francisco’s local response. The West Coast Health Alliance — announced by Gov. Gavin Newsom on Sept. 3, 2025 — includes California, Washington, Oregon and Hawaii and aims to coordinate evidence-based vaccine recommendations and align messaging with professional societies such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.

Dr. Jain said AB 144, signed by the governor on Sept. 17, 2025, directs the California Department of Public Health to use baseline Advisory Committee on Immunization Practices (ACIP) and U.S. Preventive Services Task Force recommendations as of Jan. 1, 2025, and allows CDPH to update recommendations based on evidence. AB 144 requires vaccines covered under the Department of Managed Health Care-regulated plans (including Medi‑Cal managed care) to be covered in accordance with those recommendations; it does not apply to federally regulated plans such as self-insured employer plans, the Veterans Administration or Medicare. CDPH also launched a public-facing site, "Public Health for All," to publish updates.

Dr. Jain summarized other AB 144 provisions: shared decision-making guidance for COVID vaccination, liability protections for vaccinators, and expanded authority allowing pharmacists to immunize patients ages 3 and older without individual prescriptions under specified conditions. She said CDPH will continue to update guidance as evidence and federal agencies (FDA/ACIP/USPSTF) move.

Locally, DPH said it issued a health update to providers the same day, plans social-media outreach in Spanish and Chinese, will host community events beginning Oct. 17 for older adults, and is preparing media outreach. Commissioners asked about several specific items: Commissioner Guggenheim asked whether abrupt changes were expected; Dr. Jain said uncertainty may continue but that AB 144 reduces some swings in coverage. Commissioner Chao asked about RSV timing; Dr. Jain said the state guidance had been corrected to reflect that RSV recommendations for older adults are not necessarily annual for all groups and that pregnant‑person guidance differs. Commissioner Christian asked about outreach to providers, pharmacies and whether cost barriers would be addressed; Dr. Jain said DPH would ramp up provider outreach, coordinate with pharmacies where possible, and that state vaccine registry data (required as of Jan. 3, 2023) allow DPH to track neighborhood-level coverage.

Ending: DPH officials said they will continue provider and community outreach, monitor federal guidance, update the Public Health for All site, and return with data on uptake and community-level gaps.