A growing number of states have rejected recent changes to the national vaccine schedule as more than 200 health groups across the country urge lawmakers to investigate why the schedule was changed and why credible scientific evidence was ignored.
In early January, the Department of Health and Human Services (HHS) announced that the Centers for Disease Control and Prevention (CDC) now recommends that children receive vaccines against 11 diseases, instead of 17. The new guidelines nixed universal immunizations for hepatitis A, hepatitis B, meningococcal disease, rotavirus, COVID-19 and influenza.
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Typically, an independent group of physicians and public health officials undertakes a lengthy public review process before changing federal vaccine recommendations. While HHS noted that a scientific review was conducted, no further details were provided, and no concrete evidence supporting the update was published.
Marty Makary, commissioner of the Food and Drug Administration, celebrated the CDC announcement as a return to transparency.
“Public health works only when people trust it,” he said. “That trust depends on transparency, rigorous science and respect for families. This decision recommits HHS to all three.”
Physicians and public health officials from across the country immediately criticized the move.
“The decision to change CDC’s childhood immunization schedule is reckless and deeply dangerous,” Massachusetts Public Health Commissioner Robbie Goldstein said in a press release published the same day the CDC announced its new recommendations.
“It abandons decades of rigorous, evidence-based science and replaces clear public health guidance with confusion and doubt,” Goldstein continued.
Since then, at least 18 states have rejected the new guidance, including 14 that voted against President Donald Trump in the 2024 presidential election. Most state public health departments recommend that parents follow the American Academy of Pediatrics schedule, which predates the Trump administration and includes 18 vaccines.
What impact do federal guidelines have?
Federal vaccine recommendations are not legally binding, Dorit Reiss, a professor of law at the University of California San Francisco, previously explained to Straight Arrow News.
Each state has its own procedures and statutes outlining how to utilize federal recommendations in setting local laws and vaccine schedules.
But even state vaccine guidance is not compulsory: States can only dictate which vaccinations children must receive to attend public school.
“We often talk about mandates or compulsory vaccination, but in no case is an individual or a child being vaccinated against their will or against their parents’ will,” said Jason Schwartz, an associate professor in the Department of Health Policy and Management at the Yale School of Public Health.
“When we talk about these required mandates or vaccine mandates in the United States, it’s ultimately a policy in place that makes vaccination a condition of attending school in those states,” he told SAN.
Today, no American, outside of the military, is required by law to receive any vaccine. The federal government has historically, though in rare instances — such as during the COVID-19 pandemic — mandated vaccines.
Growing friction between state and federal governments
Since the second Trump administration began last year, a number of states have moved to form regional health alliances, allowing states to coordinate with one another. California, Oregon, Washington and Hawaii formed the West Coast Health Alliance while nine northeastern states joined the Northeast Public Health Collaborative.
Fifteen states and territories — California, Colorado, Connecticut, Delaware, Guam, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, New York, North Carolina, Oregon, Rhode Island and Washington – also formed the Governor’s Public Health Alliance.
Several states — including California, Illinois and Maryland — have also passed or proposed legislation to empower state health officials to bypass or disregard federal guidance.
A lawsuit over vaccine policy
Last July, six professional health societies — including the American Academy of Pediatrics, American Public Health Association and the Infectious Disease Society of America — and a pregnant woman sued Health and Human Services Secretary Robert F. Kennedy Jr. “for making unilateral, unscientific changes to federal vaccine policy.”
The lawsuit asserts that Kennedy violated federal law by changing COVID-19 vaccine recommendations for children and pregnant women without scientific support, and by firing every member of the CDC’s existing immunization advisory committee.
Kennedy appointed new members to the committee who went on to recommend that children no longer receive the chickenpox vaccine at the same time as the measles, mumps and rubella (MMR) shot. Two months later, the panel altered longstanding recommendations for universal hepatitis B vaccination.
Late last year, the health organizations amended their lawsuit to include concerns that the new advisory committee members lack the expertise required for the role.
The plaintiffs asked a judge to halt Kennedy’s changes to COVID-19 vaccine policy and to nullify decisions made by the newly constituted vaccine advisory committee.
A judge has since rejected the government’s motion to dismiss the lawsuit.
