A New Model for Public Health: Why States Are Forming Vaccine Alliances

By Vanessa Muller, PharmD

As a pharmacist in Washington State, I see every day how access to vaccines protects our communities. The ability for patients to walk into a pharmacy and receive recommended vaccines without delay isn’t a coincidence, it reflects deliberate state policies designed to make prevention straightforward and equitable.

In September 2025, Washington joined California, Oregon, and later Hawaii to form the West Coast Health Alliance (WCHA) a regional partnership dedicated to maintaining consistent, evidence-based immunization guidance across member states (West Coast Health Alliance, 2025).The alliance emerged during national transitions in vaccine oversight, ensuring residents in the member states could continue following clear, science-driven recommendations. The WCHA coordinates policy alignment across state departments of health and medical organizations such as the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG), and American Academy of Family Physicians (AAFP). The alliance was established following significant federal restructuring of vaccine advisory bodies in 2025, which created uncertainty about the continuity of national immunization recommendations. By aligning regionally, member states sough to ensure residents remained protected by science-based standards even as federal policy evolved.For Washington, that collaboration strengthens programs already in place. The Department of Health’s standing order, issued September 4, 2025, authorizes pharmacists to administer COVID-19 vaccines to anyone six months and older no separate prescription required (Washington DOH, 2025). This state policy builds directly on WCHA guidance and ensures local access remains uninterrupted.

By jointly reviewing medical evidence and issuing shared recommendations, WCHA helps participating states maintain consistent vaccine schedules, reducing confusion among providers and the public. While not a purchasing union, the alliance allows coordinated distribution strategies and data sharing, supporting efficient vaccine rollout when new products become available. Aligned legal frameworks and clear standing orders help pharmacists and other immunizers work confidently under standardized authority.The alliance’s cross-state communication helps synchronize surveillance and outbreak responses.

Washington’s Strengths and Challenges

Strengths

• Standing-Order Access: Residents can receive COVID-19 vaccines at most pharmacies without prescriptions.

• Comprehensive Vaccine Programs: The Childhood Vaccine Program and Adult Vaccine Program remove major cost barriers.

• Alignment with WCHA: Washington’s immunization guidance matches regional recommendations for COVID-19, influenza, and RSV.

Challenges

• Staffing and Wait Times: “Walk-in” availability can vary; pharmacies often experience long lines during peak fall vaccination periods.

• Pediatric Supply Gaps: Many retail pharmacies do not stock small-dose pediatric COVID-19 vaccines due to storage limits and variable demand.

• Persistent Vaccine Hesitancy: Even strong programs require continued community education and outreach.

Side-by-Side Comparison: Washington vs. Idaho Vaccine Policy (2025)

Policy Area	Washington	Idaho	Reference
Pharmacy Standing Order for COVID-19 Vaccine	Yes – statewide standing order for residents ≥ 6 months	No – prescription or provider authorization required	WA DOH (2025); ID DHW (2024)
State-Funded Adult Vaccine Program	Yes – COVID-19, flu, RSV	No – limited adult vaccine support	WA DOH; ID DHW
School Immunization Requirements	CDC-aligned; medical and religious exemptions only	Broader exemptions including philosophical	CDC School Data (2024)
Public Access to Pediatric Vaccines at Pharmacies	Increased access understanding order	Variable, limited availability	WA DOH; ID DHW

This comparison highlights how Washington’s alignment with WCHA policies translates to broader and more consistent vaccine access compared to neighboring states.

The West Coast Health Alliance continues to define its governance framework, expand data-sharing systems, and explore interoperable digital immunization records. Nevada is being encouraged by public-health leaders to join in the future (WCHA, 2025).As these cooperative systems grow, residents across the western states may benefit from unified communication campaigns, streamlined access, and faster responses to emerging health threats.

Each time a patient walks into a Washington pharmacy and leaves protected from illness, it reflects more than individual convenience, it’s part of a coordinated regional effort to safeguard public health. By collaborating through the WCHA, Washington reinforces its long tradition of science-based, community-centered care. The alliance offers a model for how states can maintain consistency, trust, and access even when national guidance changes.

In practical terms, that means Washington residents can continue to depend on clear, evidence-driven vaccination policies that protect individuals, families, and communities alike. Proof that regional cooperation strengthens public health resilience.

Sources

• Washington State Department of Health. Standing Order for COVID-19 Vaccination (2025). https://doh.wa.gov/sites/default/files/2025-09/COVID19VaccineStandingOrder.pdf

• West Coast Health Alliance. Regional Vaccine Guidance Framework (2025). https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/VACCINESIMMUNIZATION/GETTINGIMMUNIZED/Documents/2025-26-Respiratory-Virus-Vaccine-Recommendations-2-pager.pdf

• State of Idaho. House Bill 481 (2024) – Vaccine Mandate Prohibition. https://legislature.idaho.gov/sessioninfo/2024/legislation/H0481/

• Idaho State Board of Pharmacy. Pharmacist Immunization Authority Guidance (2024). https://bop.idaho.gov/

• Centers for Disease Control and Prevention. School Immunization Assessment Data (2024).

• Northeast Public Health Collaborative. Formation and Guidance Announcement (2025). https://www.reuters.com/business/healthcare-pharmaceuticals/northeast-us-states-form-health-alliance-response-federal-vaccine-limits-2025-09-18

Assessed and Endorsed by the MedReport Medical Review Board