SEATTLE (AP) — Four Democratic-led Western states announced joint recommendations Wednesday about who should be vaccinated for seasonal respiratory viruses, including the flu and COVID-19, saying the Trump administration has jeopardized public health by politicizing the U.S. Centers for Disease Control and Prevention.

California, Oregon, Washington and Hawaii early this month formed the West Coast Health Alliance in an effort to combat what they describe as the “weaponization” of federal health agencies to advance antivaccine policies, despite decades of scientific research showing that vaccines are safe and effective.

Their recommendations follow those of major medical organizations and came a day before a panel of CDC advisers were due to begin meeting to review recommendations for some vaccines, including COVID.

U.S. Health Secretary Robert F. Kennedy Jr., a leading antivaccine activist before becoming the nation’s top health official, fired the entire 17-member panel earlier this year and replaced it with a group that includes several anti-vaccine voices. Former CDC chief Susan Monarez told senators on Wednesday she was fired after 29 days on the job after refusing Kennedy’s demands that she sign off on changes to the childhood vaccination schedule without data to back up the changes.

“Public health leaders warn these moves dismantle independent, science-based oversight and inject politics into decisions that protect Americans’ health — undermining the CDC’s credibility at a moment when trust and clarity are most needed,” the West Coast Health Alliance said Wednesday.

In a written statement Wednesday, U.S. Department of Health and Human Services spokesman Andrew Nixon criticized the effort.

The recommendations from the West Coast Health Alliance include that all residents older than 6 months get a flu vaccine and that all babies receive protection from RSV. Among those who should receive the COVID vaccine are children 6 months to 23 months old; all adults over 65, and everyone younger than 65 who has risk factors or is in contact with people with risk factors; anyone pregnant or planning a pregnancy; and “all who choose protection.”

Kennedy’s moves have prompted debate and action in the states. Florida has taking steps to become the first state to get rid of school vaccine mandates, with some states looking to follow its lead. Others are promising to protect vaccines for children and adults.

Pennsylvania’s pharmacy board voted this month to protect the availability of COVID-19 vaccines for those most in need and to make it accessible across the state, at the urging of Gov. Josh Shapiro. Colorado Gov. Jared Polis and Washington Gov. Bob Ferguson have directed health officials to make sure residents are able to be vaccinated against the virus.