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CDPH Immunization Recommendations

Flu, RSV, COVID-19
MMRV
Hepatitis B ​
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Resources
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Vaccines for Al​​l

The California Department of Public Health (CDPH) is committed to improving the health and wellness of all Californians including by ensuring continued access to life-saving immunizations. 

CDPH stands by science and is committed to ensuring Californians have access to safe, effective vaccines. 

Recent changes in national vaccine guidelines have caused confusion on who should get vaccines and when. CDPH bases recommendations for vaccines​ on guidelines from trusted medical professional organizations.  

The trusted medical groups include the following: ​

California has joined the West Coast Health Alliance (WCHA) to increase consistency of recommendations across states and increase public confidence.   

CDPH and the WCHA will continue to review new information and will update recommendations as needed. 

These recommendations are the official recommendations of CDPH, as required under Assembly Bill 144 (2025, California Health and Safety Code section 120164). 

Insurance Coverage 

Some important aspects of Assembly Bill 144 (2025) include, but are not limited to: 

  • Health insurance plans regulated in California are required to cover immunizations recommended by CDPH. 
  • Persons providing immunizations in California as recommended by CDPH have liability protections. 
  • California pharmacists may administer immunizations recommended by CDPH to patients three years and older. No prescription is needed. 

​This means vaccines will continue to be covered by health plans (PDF) (including Medi-Cal managed care plans (PDF)) and insurance companies, in most instances. It may not apply to Medicare Advantage plans or to specialized health care service plans. Visit the Public Health for All Vaccines Questions & Answers page to learn more about access.     

If you have questions about coverage, check with your health plan or health insurer. To schedule your vaccine appointment, check with:   

  • Your health care provider   
  • Local pharmacy   
  • myturn.ca.gov    ​

Routine Immunization Schedule  

Children and adolescents through age 18 years: CDPH recommends immunization of children and adolescents in accordance with the American Academy of Pediatrics immunization schedule (PDF) (version September 17, 2025).  

Adults age 19 years and older: CDPH recommends immunization of adults in accordance with the American Academy of Family Physicians immunization schedule (PDF) (version August 28, 2025). 

Visit the CDPH Immunization Recommendations Under Assembly Bill 144 page for recommendations pertaining to all statutes in California law that reference California Health and Safety Code section 120164​.

Respiratory Virus Vaccine Recommendations  

Vaccines are safe, work well and are the best way to protect against respiratory viruses. In collaboration with California’s partners in the WCHA, CDPH has released vaccine recommendations for the 2025–26 respiratory virus season. [*]​​    ​​      

Download the printable PDF.​​​

Age/Condition COVID-19 Influenza (Flu) RSV
Children
  • All 6–23 months
  • All 2–18 years with risk factors or never vaccinated against COVID-19
  • All who are in close contact with others with risk factors [1]
  • All who choose protection [1]
  • All 6 months and older
  • All younger than 8 months [2]
  • All 8–19 months with risk factors
Pregnancy
  • All who are planning pregnancy, pregnant, postpartum, or lactating
  • All who are planning pregnancy, pregnant, postpartum, or lactating
  • 32–36 weeks gestational age [3]
Adults
  • All 65 years and older
  • All younger than 65 years with risk factors
  • All who are in close contact with others with risk factors
  • All who choose protection
  • All
  • All 75 years and older [3]
  • All 50–74 years with risk factors​ [3]​
    ​

    ​
    ​

Specific COVID-19 Considerations 

Some health conditions can make it more likely for someone to get very sick from COVID-19. CDPH strongly recommends the COVID-19 vaccine for people with these conditions.  

Our COVID-19 Risk Factors List (PDF) provides examples but isn’t meant to be a complete list.  

Our COVID-19 Vaccine Timing Chart reviews timing for the routine schedule and for patients with immune compromise. ​Young children, older adults, and immunocompromised people may need multiple doses for full protection.

High Risk Factors

Getting vaccines helps:  

  • Prevent serious illness  
  • Slow the spread of viruses in the community  
  • Reduce stress on hospitals and clinics  

The CDPH recommendations are based on data and focus on protecting people who are most at risk, including:   

  • Older adults, especially those 65 and older  
  • People with certain chronic or medical conditions such as heart disease or cancer  
  • People with weakened immune systems  
  • People who are pregnant or were recently pregnant  
  • People with disabilities  
  • People who are in a skilled nursing facility and other long term care facilities  
  • Young children ​

Other Vaccine Considerations​

The CDPH Mpox Vaccination website has current CDPH recommendations on the use of mpox vaccine for California. These recommendations are designed to protect those at increased risk of infection based on disease data in California.​

The Federal Advisory Committee on Immunization Practices (ACIP) met in September 2025. The actions at that meeting do not change CDPH recommendations. CDPH recommendations below align with American Academy of Pediatrics. ​

Measles, Mumps, Rubella, and Varicella vaccine (MMRV) 

  • Recommend that parents, for their children younger than 4 years of age, be able to choose either: 
    • The combined Measles, Mumps, Rubella, and Varicella vaccine (MMRV) (one injection) or  
    • Separate MMR and Varicella vaccines (two injections)   
  • There is a very small increased risk of febrile seizures when the combination MMRV vaccine is given as the first dose compared to separate MMR and Varicella vaccines (0.08% after MMRV vs 0.04% after MMR and varicella). This increase is not present for later doses of MMRV. This risk has been considered in U.S. vaccine recommendations for many years. Even so some parents prefer the MMRV vaccine to reduce the number of injections for their children. For comparison, febrile seizures happen in 2-5% of all children for many different reasons. Febrile seizures do not have long term effects on a child’s health.    ​

 Hepatitis B​ vaccine 

  • Recommend all children receive hepatitis B vaccine as early as possible, including a dose of hepatitis B vaccine at birth. 
    • When given to children starting at birth, hepatitis B vaccine is highly effective in preventing hepatitis B infection, which often leads to liver scarring or cancer. 
    • Starting the vaccine series at birth provides the best protection from this serious disease. Without immunization, infants who are infected in the first year of life have a 90% chance of developing chronic hepatitis B, and one in four of those with chronic hepatitis B will die from liver disease.​​​ 
  • Widespread use of hepatitis B vaccine has almost eliminated new infections from our state, and has been tested extensively for safety and efficacy. ​   
  • Hepatitis B virus is highly infe​ctious. Children may be infected by unknown sources in their everyday lives. Vaccination is the best way to prevent infection.  ​
  • Screening in pregnancy is important but not 100% effective. A birth dose of hepatitis B vaccine provides some protection if a parental infection was missed.​​

Resources ​

References

[*]​ California Health & Safety Code (HSC) 120164 requires CDPH to publish its current immunization recommendations, and any updates, modifications, or supplements. ​

[1] COVID-19 vaccine is available for persons 6 months and older.

[2] Protect infants with either prenatal RSV vaccine or infant dose of nirsevimab or clesrovimab.​

[3] RSV vaccination during pregnancy or for adults is currently recommended once rather than annually.

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