{"id":1085,"date":"2025-09-24T09:00:00","date_gmt":"2025-09-24T09:00:00","guid":{"rendered":"http:\/\/www.dangeladvertising.com\/?p=1085"},"modified":"2025-09-26T15:05:15","modified_gmt":"2025-09-26T15:05:15","slug":"amid-confusion-over-us-vaccine-recommendations-states-try-to-restore-trust","status":"publish","type":"post","link":"http:\/\/www.dangeladvertising.com\/index.php\/2025\/09\/24\/amid-confusion-over-us-vaccine-recommendations-states-try-to-restore-trust\/","title":{"rendered":"Amid Confusion Over US Vaccine Recommendations, States Try To \u2018Restore Trust\u2019"},"content":{"rendered":"

When the CDC\u2019s Advisory Committee on Immunization Practices<\/a> met last week, confusion filled the room.<\/p>\n

Members admitted they didn\u2019t know what they were voting on, first rejecting a combined measles-mumps-rubella-chickenpox vaccine for young toddlers, then voting to keep it funded minutes later. The next day, they reversed themselves on the funding.<\/p>\n

Now Jim O\u2019Neill, the deputy health and human services secretary and the Centers for Disease Control and Prevention\u2019s acting director (a lawyer, not a doctor), must sign off. The panel\u2019s recommendations matter, because insurers and federal programs rely on them, but they are not binding. States can follow the recommendations, or not.<\/p>\n

In the West, California, Oregon, Washington, and Hawaii have joined forces<\/a> in the West Coast Health Alliance<\/a>. Their first move was to issue joint recommendations on covid, flu, and RSV vaccines, going further than ACIP.<\/p>\n

\u201cPublic health should never be a patchwork of politics,\u201d said Sejal Hathi, Oregon\u2019s state health director.<\/p>\n

California\u2019s health director, Erica Pan, described the goal as \u201cdemonstrating unity around science and values\u201d while reducing public confusion.<\/p>\n

The bloc is also exploring coordinated lab testing, data sharing, and even group purchasing. \u201cOur intent is to restore trust in science and safeguard people\u2019s freedom to protect themselves and their families without endless barriers,\u201d Hathi said.<\/p>\n

In the Northeast, New York and its neighbors created the Northeast Public Health Collaborative<\/a>. Democratic Gov. Kathy Hochul<\/a> called it a rebuke to Washington, D.C.\u2019s retreat from science.<\/p>\n

\u201cEvery resident will have access to the COVID vaccine, no exceptions,\u201d she said in a statement<\/a>.<\/p>\n

The group has already gone beyond vaccines. After the CDC disbanded its infection-control advisory body, the Northeast states created their own return-to-work rules. Work groups now span vaccines, labs, emergency preparedness, and surveillance.<\/p>\n

\u201cInfectious diseases don\u2019t respect borders,\u201d said Connecticut\u2019s health commissioner, Manisha Juthani. \u201cWe had to move in the same direction to protect our residents.\u201d<\/p>\n

The two blocs are in regular contact. \u201cWe communicate every day,\u201d Hathi said.<\/p>\n

\u201cWe can\u2019t just sit by while federal agencies are hollowed out,\u201d said acting New York City health commissioner Michelle Morse. \u201cPublic health is local, and we have to act like it.\u201d<\/p>\n

State leaders describe their coalitions as filling a vacuum left by Washington, D.C.<\/p>\n

\u201cYou would think emerging from a pandemic, we would be embracing public health, but the federal government was heading in the opposite direction,\u201d said James McDonald, New York state health commissioner.<\/p>\n

Massachusetts commissioner Robbie Goldstein added: \u201cThe federal government has historically been the entity that held us all together. In January of this year, that tradition seemed to be going away.\u201d<\/p>\n

Boston University law professor Matt Motta summarized the dilemma: \u201cStates are taking matters into their own hands, sometimes to expand access to vaccines, sometimes to roll it back. That\u2019s technically how the system works, but it risks inefficiency and confusion.\u201d<\/p>\n

Public health law has long tilted toward the states.<\/p>\n

\u201cIf there was a public health issue, we\u2019d say it\u2019s for the states,\u201d said Wendy Parmet of the Northeastern University School of Law.<\/p>\n

States have mandated vaccines since the 1800s. Federal agencies can approve vaccines and fund programs, but they cannot force mandates except in very specific circumstances (e.g., federal employees).<\/p>\n

UC Law-San Francisco\u2019s Dorit Reiss agreed with Parmet: \u201cPublic health authority resides primarily with the states. Recommendations are recommendations.\u201d<\/p>\n

ACIP\u2019s votes matter for coverage rules and insurance mandates, but states are free to diverge.<\/p>\n

That divergence is already widening. Florida, led by Surgeon General Joseph Ladapo, is moving to eliminate<\/a> childhood vaccine requirements altogether \u2014 a first-in-the-nation step. Georgetown Law\u2019s Larry Gostin warned this could reopen century-old battles dating to Jacobson v. Massachusetts<\/em> (1905), when the Supreme Court upheld state vaccine mandates for public safety.<\/p>\n

Health leaders warn that competing systems risk causing confusion and costing lives. \u201cFederal silence creates a vacuum, and states either step up together or splinter apart,\u201d Hathi said.<\/p>\n

Pan added that \u201cwithout federal credibility, we\u2019re left improvising.\u201d<\/p>\n

McDonald cautioned that partisan divides could grow sharper.<\/p>\n

And Morse said that \u201cblue and red states could each go their own way, leaving the public even more divided.\u201d<\/p>\n

Gostin put it bluntly: \u201cThat risks confusion, inefficiency, and ultimately lives.\u201d<\/p>\n

This state-by-state tug-of-war is not new. In the 1800s, local boards of health fought cholera with sewers and sanitation when federal authority was absent. In the 1950s, states organized mass polio clinics, with uneven uptake until federal funding smoothed disparities.<\/p>\n

During the covid pandemic, Trump White House response coordinator Deborah Birx saw firsthand the limits of federal power. She visited 44 states, urging governors to adopt masks, closures, and vaccines.<\/p>\n

\u201cI was trying to get them to tailor responses to their populations, not just follow generic federal guidance,\u201d she later recalled.<\/p>\n

Supreme Court Justice Louis Brandeis once said that states are \u201claboratories of democracy,\u201d where leaders could test out new ideas without putting the whole country at risk. But diseases don\u2019t follow state lines. A virus that starts in Tallahassee could spread to Times Square by the next morning.<\/p>\n

Today, states have become laboratories of public health. Each state is experimenting \u2014 some expanding protections, others cutting them back. And those choices could, for better or worse, affect us all.<\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

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