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Blue Shield is closely monitoring the dynamic federal and state policies regarding vaccines and have released updated guidance.

For fully-insured groups and members: The passage of Assembly Bill 144 (AB 144) establishes California's baseline for vaccine coverage by referencing the immunization schedule recommendations from key U.S. health agencies as they stood on January 1, 2025. Blue Shield will cover vaccinations as required by California law. How members who reside outside of the state receive vaccinations will depend upon state laws governing vaccine access and coverage.

For self-funded groups and members: On September 19, 2025, the Advisory Committee on Immunization Practices (ACIP) issued the recommendations below:

•    2025-26 COVID Booster (Adults): The ACIP recommends patients consult providers prior to receiving the vaccine. In many states, pharmacists can provide this clinical consultation. The vaccine itself remains recommended and subject to coverage without cost-sharing by self-funded groups.

•    This change does not materially affect self-funded groups’ current coverage obligations.

•    Pediatric Measles, Mumps, Rubella and Varicella (MMRV): For children under age four, ACIP now advises separate MMR and varicella shots instead of the combined MMRV vaccine. Most children already receive the shots separately, and the separate shots continue to be required for coverage without cost-sharing.

Blue Shield will work with self-funded groups to align benefits with evolving state and federal policies.

Blue Shield is committed to ensuring ongoing coverage and access to preventive, evidence-based care, including immunizations. They continue to partner with the California Department of Public Health to cover science-backed immunization recommendations that protect public health.

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