Nine major medical organizations in Nevada are asking Gov. Joe Lombardo to join a recently formed group of states seeking to establish their own criteria for who should receive vaccines, amid shifting federal guidance.

The letter was sent Tuesday morning to the Republican governor and was signed by major medical groups, including the Nevada State Medical Association, which represents thousands of physicians and physicians-in-training, as well as other professional groups representing gynecologists, family physicians, pediatricians, physician assistants, nurses and doctors.

It highlighted shifting federal policy and leadership around vaccine-preventable disease control that has created an “uncertain landscape for public health.” It called on Lombardo to join the West Coast Health Alliance, launched earlier this month by officials in Washington, Oregon, California and Hawaii as part of a “shared commitment to safeguard public health.”

“By joining this alliance, Nevada can ensure its public health decisions remain grounded in science, thereby protecting our communities and economy from the threat of preventable disease outbreaks,” the letter stated.

It also pointed out longstanding challenges with childhood and adult vaccination rates that could further strain the state’s health care system should vaccine-preventable diseases make a resurgence. The letter noted that Nevada’s tourism-dependent economy could suffer if there are uncontrolled outbreaks of preventable diseases.

Lombardo’s office did not immediately respond to emailed questions sent by The Nevada Independent on Tuesday about whether he will join the alliance or how he responds to the letter.

The governor’s office has not responded to prior questions about joining the alliance, but state officials have previously said that the state’s health authority is working to ensure coverage for the COVID-19 vaccine for all populations. Nevada, however, has no authority to mandate private insurers cover COVID-19 vaccines outside of recent FDA label restrictions.

California Democratic Gov. Gavin Newsom’s office said in a press release that the alliance addresses federal actions that have undermined the independence of the Centers for Disease Control and Prevention and aims to “ensure residents remain protected by science, not politics.”

Research shows Nevada ranks 44th lowest in the nation for its vaccination rate, with adult Nevadans being vaccinated at a significantly lower rate than the national average. Child immunization rates have also declined since the rollout of the COVID-19 vaccines, which Nevada health officials have warned in the past stems in part from a lack of “vaccine confidence.”

At an IndyTalks event last year, Lombardo said vaccines should be a “personal choice.”

Lombardo responded to questions about mandating childhood vaccines by saying parents should play a role in the decision and support for or against vaccines shouldn’t lead people to be “marginalized.”

The World Health Organization reported in 2024 that vaccines saved at least 154 million lives globally in the past 50 years, with the majority of those being infants and children.

Public health experts widely consider vaccine mandates to be an essential part of preventing disease outbreaks and increasing vaccination rates, which protect the broader community.