On August 10, just as California kids were starting the new school year, President Donald Trump signed an executive order calling for changes to the Centers for Disease Control and Prevention’s childhood immunization schedule, including the removal of some vaccines required to attend school.
The order was the president’s latest move to influence the CDC’s historically science-based vaccination guidelines.
Yet, deep into the Trump administration’s campaign to disrupt longstanding norms of vaccine access and information, childhood vaccine uptake in the state, and its Central Valley, has remained high.
At the start of the 2025-26 school year, 95% of California kindergartners had received the 10 state-mandated vaccines needed to attend school, according to the most recent data available from the state health department.
To understand how the childhood vaccination rate has stayed so high during the second Trump term, The Intersection spoke with doctors, pharmacists, medical experts and families in the Valley.
“Are we following CDC guidelines?” said Dr. Elaine Soriano, senior regional medical director at Golden Valley Health Centers in Modesto. “No, we’re not.”
Instead, she said, Golden Valley’s doctors are continuing to follow the vaccine recommendations issued by the American Academy of Pediatrics and the California Department of Public Health.
“It’s evidence-based science,” she said. “[Vaccines] are highly effective, so why settle for less?”
Golden Valley is a federally qualified health center, a nonprofit medical provider that receives federal funding and treats patients regardless of their ability to pay. The group is one of the largest FQHCs in the San Joaquin Valley, with about 380 providers at 48 locations across San Joaquin, Stanislaus and Merced counties.
Along with rural and community health centers, FQHCs are lifelines for underserved communities in the Valley.
“I have a desire to serve this population with really great, high-quality care,” said Soriano, who was raised in the Philippines by a pastor father and social-worker mother. … “I treat my patients like they are my family.”
Across the Valley, doctors like Soriano are contending with multiple barriers they say threaten their ability to achieve high vaccination rates and endanger public health.
As the second Trump administration has halted the development of some vaccines, fired experts on the CDC’s vaccine advisory panel and promoted unfounded or debunked vaccine rhetoric in the media, doctors have relied more than ever on the relationships they’ve built with their patients to keep them coming in for vaccinations.
Part of that means giving patients access to health care providers who speak their language and come from similar ethnic or socioeconomic backgrounds. For example, 69% of Valley youth are Hispanic/Latinx, as are a majority of patients seeking care at the Valley’s FQHC’s. According to the California Health Care Almanac, doctors working in California’s FQHCs are more ethnically and linguistically diverse than the overall population of physicians licensed in the state.
“Our population has a culture that trusts their providers,” Soriano said. “They really rely on their primary care provider’s recommendation, not looking at what’s in the news.”
President Trump’s August executive order directed the CDC to reduce the number of childhood vaccines from 18 to 11, and asserted that vaccines have a causal link to autism, which has been disproven by multiple peer-reviewed studies. The order also called for splitting the measles-mumps-rubella vaccine into individual shots, which are not currently manufactured in separate doses.
Additionally, the order allows parents more say in choosing which vaccines to give their children and obligates states to offer religious and personal-belief exemptions, contrary to California law.
Although the order has no legal standing, as states set their own vaccine laws, some doctors say it contributes to a growing mistrust of vaccines.
The U.S. Department of Health and Human Services did not respond to a request for comment.
The possibility that Trump would try to limit vaccine access became apparent almost two years ago when he picked the country’s most well-known vaccine skeptic, Robert F. Kennedy Jr., to serve as U.S. Secretary of Health and Human services. If the goal was to undermine conventional thinking about vaccinations, the tactic may have worked.
In a September 2025 survey by the Kaiser Family Foundation and The Washington Post, at least one-third of U.S. parents reported confusion about the safety and effectiveness of childhood vaccines because of what they heard on the news and social media. Only 14% of those surveyed said they trusted federal health agencies, and about half of respondents said that they didn’t know who to trust for vaccine information.
In the same survey, more than one-third of parents reported that they get vaccine information from social media but don’t necessarily trust it.
“I think that’s part of the game plan in an effort to sow confusion,” said Dr. Eric Ball, pediatrician and Chairperson of the American Academy of Pediatrics in California. “It’s hard to be a parent right now. They’re getting inundated with a lot of information, and a lot of it is not trustworthy or accurate.”
Relationships lead to vaccinations
About 140 miles southeast of Modesto, in Tulare, doctors at Altura Clinics for Health, a smaller and more rural FQHC than Golden Valley, are wrestling with the same issues.
“It’s frustrating to see how a big institution like the CDC, that we all respect, became so political,” said Dr. Jorge Rivera, pediatrician and Chief Medical Officer at Altura Clinics.
Rivera said the CDC’s personnel shake-up and non-evidence-based recommendations have motivated his team to keep politics and disinformation from interfering with caring for kids.
“Before it was a lack of education,” Rivera said. “Now it’s mis-education.”
Altura doctors use whichever opportunities they can to share health information directly with their patients. For example, they host baby showers for pregnant mothers under their care and use the occasions to educate families about vaccines.
“From what I see on TV, they [CDC] are not requiring all the vaccines to be mandatory,” said Stephanie Ramirez, a patient at Altura. “I don’t agree with that.”
Ramirez drives her six-month-old son, Liam, almost 20 miles each way for his checkups at Altura. He was born six weeks premature and had difficulty breathing, so he had to be cared for in the hospital for almost three weeks before he could go home. Since then, he’s been healthy, and Ramirez says she wants to keep him that way.
She said she searches the internet for verifiable sources of vaccine information, such as the American Academy of Pediatrics, but ultimately counts on Liam’s pediatrician for vaccine advice.
“I worry about Liam because he is still so little,” she said. ”That’s why I want to make sure he’s vaccinated.”
Some barriers to vaccination are Valley-centric
Although the Valley overall appears to be maintaining high rates of childhood vaccination, multiple factors specific to the region present ongoing barriers to preventative health care, including vaccines.
For example, patients and health care providers are now bracing for looming federal funding cuts to Medi-Cal – California’s version of Medicaid – which are scheduled to kick in after the midterm elections in November. The cuts are expected to cause more than 1 million Californians to lose their health insurance, according to the California Budget Center.
California has already seen a 12% decrease in Medi-Cal enrollment over the past year in part due to budget cuts and stricter eligibility requirements stated in H.R. 1, nicknamed “The One Big Beautiful Bill.”
H.R.1 ferrets away more than $910 billion from Medicaid over the next 10 years, and about $30 billion from Medi-Cal annually.
“This (issue) is even more important for the Central Valley,” Ball said. “In California, that area has the highest Medi-Cal enrollment.”
The eight counties of the San Joaquin Valley – Kern, Kings, Tulare, Fresno, Madera, Merced, Stanislaus and San Joaquin – are home to more than 1 million children and teens younger than 18. About 45% of them live below or within 200% of the federal poverty level.
Nearly three-fourths of youth in Kern, Madera and Tulare Counties, and at least 45% of kids in the other Valley counties, were insured by Medi-Cal and eligible for the publicly funded Vaccines for Children program for their vaccinations in September .
California has nearly 4,000 VFC providers, including about 500 across the San Joaquin Valley. That’s about one for every 1,000 Valley kids on Medi-Cal.
“The Vaccines for Children program is hugely important in California and nationwide,” Ball said. “Over 50% of kids in California receive their vaccines through the program.”
Another barrier to vaccine access and information in the Valley has been a persistent scarcity of doctors and medical facilities across the region. According to a 2020 report from the American Medical Association, nearly 92% of the Central Valley is considered a Health Professional Shortage Area. That’s compared to 28% in California generally. Examples of shortage areas include rural and low-income communities, migrant farmworker communities and areas with people who are unhoused.
Geographic areas with limited or no access to vaccines, inadequate health care infrastructure or that require patients to travel long distances to get care are what public health researchers call vaccine deserts. The term arose during the COVID-19 pandemic, when COVID vaccines were hard to find in some areas.
“We think of it as analogous to food deserts,” said Dr. Rob Schechter, Chief of the Immunization Branch of the California Department of Public Health. “Large regions, areas with limited access to routine immunizations and often other primary care services as well.”
Although there is no official designation for vaccine deserts, in some rural parts of Kern and Tulare, as well as other countries in the Valley, residents have to travel 24 to 60 miles to see a doctor, according to a report by the Coordinating Council on Access and Mobility. In those areas, lack of transportation, travel expenses and inability to take time off of work can be barriers to families trying to get vaccinated.
Vaccine deserts are particularly an issue in Kern County, which has the largest land area of all the San Joaquin Valley counties and has about half of the number of primary care doctors needed to serve the population. At 89%, Kern was the only Valley county to have a kindergarten vaccination rate below 93% at the beginning of the 2024-25 school year, the most recent county-level data available.
To achieve community immunity against measles, for example, at least 93-95% of a population must be vaccinated. So far this year, Kern County is the only county in the Valley to report new cases of measles amid a recent national surge in the infection.
In California, the 2025-26 kindergarten immunization rate for the 10 vaccines needed to attend school – including measles – was about 95%, according to a data summary submitted by the California Department of Public Health to the CDC. In an email to The Intersection, the state public health agency said it had not posted vaccination rates for 2025-26 on its website yet because school-level and county-level analyses were ongoing.
Pharmacies try to fill the gap
Delano is a farming town of about 52,000 in Kern County, and was, until recently, a vaccine desert. That started to change in 2023 when the Komoto Pharmacy joined a pilot vaccine initiative with Vaccines for Children.
Komoto Pharmacy is housed in a concrete building with a metallic blue roof along Highway 99, adjacent to open fields and a small cafe. Inside it’s stocked wall-to-wall-to-ceiling with medical equipment and medications, plus two tiny cubbies for giving vaccinations. The cubbies are decorated with images of the pharmacy’s mascot, Vaxx, a smiling, pale blue cartoon Komodo Dragon.
In an email to The Intersection, owner and Doctor of Pharmacy Brian Komoto said local school leaders had reached out to him for help. Parents, especially farmworkers, were struggling to get their kids vaccinated for school because there weren’t clinics nearby or because clinic hours conflicted with their work schedules.
“I was really excited to become a Vaccines for Children provider,” said Consuelo Robles, a pharmacy technician who coordinates the program. “Dr. Komoto and upper management see what the community needs, and this was a really big issue.”
Now, the pharmacy participates in a summertime Back-to-School Vaccination Day for the Delano Union School District, and other districts in the area.
On community-event days, Robles and pharmacy manager Alma Robles (not related) pack up paperwork, needles and the vaccines, which have to be transported in specialized refrigerators.
“In small communities like ours, we have to go out of the way to find solutions,” Robles said. “Otherwise, it’s the kids that suffer.”
The immunization rates for Delano Union district schools were 95–99% at the start of the 2025-26 school year, among the highest in the state.
In addition to their local efforts, health care professionals in the Valley working to keep vaccine rates high have received significant assists from the state.
For example, to expand access to immunizations, the California Department of Public Health initiated the pharmacy pilot that allowed Komoto to start vaccinating more kids. Three of the nine pharmacies in the pilot are in the San Joaquin Valley — one each in Patterson in Stanislaus County, Kerman in Fresno County and Delano in Kern County.
Further back, in the wake of a measles outbreak that started at Disneyland in southern California in 2014, the state legislature passed a vaccine-mandate law requiring all children to have age-appropriate vaccinations to attend in-person public school, private school or daycare. Since implementation of the law in 2017, at least 93% of kindergarteners statewide have received the 10 state-mandated vaccines.
In September 2025, California lawmakers again zeroed in on vaccines in response to non-evidence-based changes to the CDC’s vaccination recommendations, such as dropping the universal recommendation for Hepatitis B vaccine at birth. The legislators enacted a law that authorized the California Department of Public Health to set the state’s vaccine policies and required health plans to cover the costs of vaccination for their members.
The same month, California, along with Oregon, Washington and Hawaii, launched the West Coast Health Alliance, as a show of unity in opposition to federal changes.
“I’m really happy that here in California, like many other states, we’ve decided to go our own way and use evidence-based, scientifically based guidelines,” said Ball.
ChrisAnna Mink is a pediatrician and independent journalist covering children’s health. Her reporting on access to vaccinations is part of her fellowship with the Association of Health Care Journalists, supported by The Commonwealth Fund.
tanka dhakal produced data visualizations for this story. dhakal is an independent journalist from Nepal covering climate change, science and marginalized communities.
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