States Are Moving to Protect Access to Vaccines

With US Health and Human Services secretary Robert F. Kennedy, Jr. already shaking up federal vaccine policy, some states are stepping in to preserve access to lifesaving shots in anticipation of further changes.

The federal government has historically had a major influence on vaccine policy through the Advisory Committee on Immunization Practices (ACIP), formed in 1964 to develop science-based recommendations on how vaccines should be used. The recommendations are almost always adopted by the Centers for Disease Control and Prevention, and in many states, these recommendations are tied to insurance coverage. If ACIP no longer recommends certain vaccines, individuals could be forced to pay out-of-pocket for livesaving vaccines that have long been provided at no cost.

A longtime anti-vaccine activist, Kennedy announced in May that the CDC will no longer recommend Covid-19 shots for healthy children and pregnant women. In June, he fired all 17 sitting members of ACIP and installed eight new members, several of whom are critical of vaccines. “A clean sweep is necessary to reestablish public confidence in vaccine science,” Kennedy said in an agency statement.

During the new committee’s first meeting at the end of June, members voted to recommend banning the preservative thimerosal from flu vaccines. The move was largely symbolic since thimerosal has not been in any routine childhood vaccines in the US since 2001. It was removed due to growing public backlash, despite the fact that it has been shown to be safe. Now, thimerosal is only used in some multi-dose vials of the influenza vaccine, which represent a small percentage of all flu vaccines given in the US. HHS adopted ACIP’s recommendation in July.

Some state legislators are anticipating more drastic changes to federal vaccine recommendations. “Where there’s a challenge here is in states where there are legal requirements to follow ACIP recommendations,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. His center founded the Vaccine Integrity Project in April in response to Kennedy’s vaccine agenda.

Colorado, a predominantly Democratic state, passed legislation during its last legislative session to safeguard access to vaccines even if federal guidelines shift. The bill directs the Colorado Department of Public Health and Environment to consider vaccine recommendations from the American Academy of Pediatrics and other medical organizations in addition to ACIP. Previously, the department only considered recommendations from ACIP.

“We really wanted to make sure that we were making science-based decisions in Colorado,” says Representative Lindsay Gilchrist, a Democrat who cosponsored the bill.

Another recently passed Colorado bill protects insurance coverage for preventive health care more broadly in the event of federal policy changes. It gives state insurance agencies the authority to reinstate guidelines on preventive care from federal agencies, including from ACIP, that existed in January 2025.

Maine recently eliminated a reference to ACIP in a law to empower its state health department to determine what shots should be available through a universal vaccination program. In New York, state senator Andrew Gounardes introduced new legislation in June that would mandate health insurance coverage for the Covid-19 vaccine. A Massachusetts bill filed in July by Democratic governor Maura Healey would allow the state’s public health commissioner to determine routine childhood immunizations without exclusively needing to consider ACIP recommendations.

Democratic-leaning states may have an easier time adopting these measures, but in battleground and conservative states, such efforts may run into more opposition from Republicans.

Pennsylvania state representative Arvind Venkat, a Democrat, says he plans to introduce a bill to protect vaccine access after the legislature’s summer recess. “The idea behind this legislation is to make sure that we continue to have insurance coverage, both in private insurance and through Medicaid, for vaccines that were approved and are shown to be safe and effective by the Food and Drug Administration,” he says. Venkat is an emergency physician and the first medical doctor to serve in the Pennsylvania General Assembly in nearly 60 years.

Michigan state representative Jason Morgan, also a Democrat, is drafting a bill based on the Colorado legislation and is preparing to meet with key medical and public health organizations in Michigan to get feedback. He plans to introduce the bill in the next month or so. “I know we have some colleagues on the other side of the aisle who understand that vaccines save people’s lives,” he says. “My hope would be to earn some support from some of those folks.”

In the wake of Kennedy’s new guidance on Covid-19 vaccines, some state health departments have said they continue to recommend vaccination for children and pregnant women. “The recent changes in CDC guidance were not made based on new data, evidence, or scientific or medical studies, nor was the guidance issued following normal processes,” reads a statement issued in June by the Wisconsin Department of Health Services.

It’s not yet known what insurers in states that do not adopt these measures will do. Major insurers have not confirmed whether they will continue to cover the full cost of routine vaccinations if federal guidelines change. “Health plans continue to follow federal requirements related to coverage of ACIP-recommended vaccines and will continue to support broad access to critical preventive services, including immunizations,” said Tina Stow, a spokesperson for AHIP, the trade association that represents US insurance companies, in an emailed statement to WIRED.

Meanwhile, the American Academy of Pediatrics and other medical societies are convening to develop evidence-based clinical guidance on flu, Covid-19, and respiratory syncytial virus, or, RSV, for the fall. The University of Minnesota’s Vaccine Integrity Project is reviewing scientific data on vaccines and sharing it with medical societies to help inform their recommendations.

“A vaccine is nothing until it turns into a vaccination,” Osterholm says, “and vaccinations only occur if people have access to the vaccine.”