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After slow fall COVID shot rollout, Oregon moves to bolster public health officials’ authority

Oregon has been “behind the eight ball” when it comes to ensuring vaccine access, bill sponsor says

The stories during fall’s annual vaccine season kept piling up: Patients driving to Washington. Doctors concerned about a lack of liability protections. Pharmacists navigating a legal gray area they had never seen before.

Oregonians went to great lengths to access their annual COVID-19 vaccine last year in the wake of U.S. Secretary of Health and Human Services Robert F. Kennedy Jr.’s political overhaul of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. The committee dragged its feet on issuing guidance around the updated COVID shot, leaving providers to defer to the Food & Drug Administration’s recommendation for the vaccine to people aged 65 or older or those at risk of severe illness due to an underlying condition.

Concerns about the federal government’s scientific integrity prompted the September creation of a pro-vaccine coalition led by the governors of Oregon, Hawaii, California and Washington. The West Coast Health Alliance has since rebuked the advisory panel’s recommendations, issuing its own guidance to encourage anyone who wants the COVID-19 vaccine to get it, as well as supporting access to childhood vaccines such as the Hepatitis B shot for newborns regardless of a mother’s infection status.

But not all states have moved at the same pace. On Sept. 4, Washington issued a standing order to ensure doctors and pharmacists could provide the COVID vaccine for individuals ages 6 months or older. The Oregon Health Authority lacked the authority to issue a similar order. Nearly two weeks after Washington’s decision, Gov. Tina Kotek tapped five state agencies for a similar proclamation, while creating liability protections for doctors and mandating insurers cover the shot.

Now Oregon Democrats are charging ahead with legislation to give the state that power. Senate Bill 1598, which cleared the Senate in a party-line vote Thursday, would empower Oregon’s public health officer to issue standing orders for vaccines in alignment with “evidence-based guidance” and recommendations from professional medical organizations. The bill would require health insurers to cover those recommended vaccines.

“That whole ruling by the federal government in the fall created a lot of confusion that I think pharmacists were worried about doing anything at that point,” Sen. Lisa Reynolds, a Democrat from Portland and a pediatrician, told the Capital Chronicle. “The standing order, which does not compel or mandate or force any vaccines or treatments on anyone, just gives the state an authority that most states have had, and we’ve just been behind the eight ball.”

Immunization access has already proven to be a politically thorny issue in the Oregon Legislature. In 2019, hundreds of parents made their way to Salem in at times vitriolic opposition to a bill that would have eliminated religious and philosophical exemptions to vaccine mandates. A record number of Oregon kindergartners, about one in 10, received nonmedical vaccine exemptions for their state due to requests from their parents, according to state data from the 2024-25 school year. Fewer babies are also receiving their Hepatitis B vaccinations, according to data released Tuesday by the Oregon Health Authority.

This year, some conservative activists have falsely claimed on social media that Reynolds’ bill creates new vaccine mandates. But Reynolds said she continues to stress that a standing order is a “permission slip,” not a requirement for vaccination. The legislation clarifies that a standing order does not mandate a person to receive or administer treatment.

Reynolds said she was supportive of being more specific in the bill and having requirements to refer to guidance from the American Academy of Pediatrics, for instance. But she said that “we tend to not try to name specific things in statute.”

Health authority, Republicans weigh in

The proposed legislation would empower Oregon’s public health officer, appointed by the director of the Oregon Health Authority, to respond to a “significant health concern.” They would be directed to solicit input from local public health officials for the areas where their vaccine standing order would apply unless delaying action is “likely to endanger the public health.”

In a Feb. 10 written testimony, two of the state’s top insurance regulators and public health officials clarified the bill’s impact on vaccine access. They noted that the legislation does not prevent a patient from suing a provider unless the provider can show they acted in good faith under the state’s guidelines.

“Any evidence-based immunizations recommended by the public health officer would be in addition to the federally required immunizations,” wrote Oregon Health Officer Dean Sidelinger and Oregon Insurance Commissioner TK Keen. “This bill does not enable the public health officer to make coverage changes to any preventive services other than immunizations.”

The nation’s leading private insurance company trade group already announced in September that it would continue to cover COVID and flu vaccines without any cost-sharing measures until the end of 2026. But one area of insurance that the state cannot regulate due to longstanding federal insurance law is self-insured or self-funded plans.

These require the employer to cover the cost of medical claims, rather than just paying premiums to an insurance company. More than 30% of private businesses in Oregon offer at least one insurance plan through this method, according to federal data from 2024. State officials wrote that they expect self-funded plans covering state employees to comply with the law.

Republicans, meanwhile, have roundly opposed the vaccine legislation. Sen. Cedric Hayden, a Republican from Fall Creek who also works as a dentist, told the Capital Chronicle that he was concerned about giving authority to what he called a “politically-appointed” position.

When asked about Oregon responding slower than other states, he said there was “debate in that discussion” and that he saw the legislation as part of a reaction to the Trump administration.

“All I try to do is get parameters around that, and that’s what my caucus wants — parameters around a position that isn’t politically appointed,” he said. “Give it to the medical board. Give it to something else that isn’t necessarily a direct appointee of the government.”

The governor appoints each member of the Oregon Medical Board, and the Oregon Senate confirms or rejects those selections.

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