Three Democratic-controlled West Coast states announced plans on Wednesday to form a “health alliance” that would review scientific data and make vaccine recommendations for their residents, saying that the federal agency responsible for issuing such guidance for the country had become “a political tool that increasingly peddles ideology instead of science.”
The move, which comes at a time of unparalleled turmoil at the agency, the Centers for Disease Control and Prevention, is an effort by California, Oregon and Washington to take scientific stewardship into their own hands after Health Secretary Robert F. Kennedy Jr., a vaccine skeptic, has taken control of the C.D.C.’s vaccine decisions. Other states, including several in the Northeast, are considering joining in a similar effort.
Hours after the Western states’ announcement, Florida announced it was going in a starkly different direction: The surgeon general said the state would end all vaccine mandates, including for children to attend schools, claiming in a news conference that each mandate “drips with disdain and slavery.” Florida’s governor, Ron DeSantis, a Republican, endorsed the plan, though it was not immediately clear whether it would require legislative input.
The differing state moves underscored the increasingly disjointed nature of vaccine policy across the country. States have always set their own vaccine policy and mandates for schoolchildren, but those rules were based upon national recommendations put forth by the C.D.C. Now that all 17 experts on the agency’s advisory panel have been dismissed by Mr. Kennedy — several of them replaced by vaccine skeptics — the opaque federal landscape has led to a hodgepodge of state moves.
Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia who was recently blocked from participating in a vaccine advisory committee for the Food and Drug Administration, said that unless all states aligned their guidelines with respected medical organizations like the American Academy of Pediatrics and the American College of Obstetrics and Gynecology, the cacophony of advice could ultimately obscure scientific truth.
“If you can’t trust the Advisory Committee for Immunization Practices, and with Robert F. Kennedy Jr as the head of H.H.S., you can’t trust the C.D.C. — as we always have up to this point — what do you do?” he asked.
“What happens if one state says one thing and another says something else? I just think it will only add to the confusion. Science is losing its place as a source of truth, and that is a dangerous time. We’re seeing the results of that.”
A spokesman for the Department of Health and Human Services responded to news of the alliance by saying that the immunization advisory committee “remains the scientific body guiding immunization recommendations in this country.” He said that Democratic-run states “completely eroded the American people’s trust in public health agencies” during the pandemic, and that “H.H.S. will ensure policy is based on rigorous evidence and Gold Standard Science, not the failed politics of the pandemic.”
The new alliance of Western states is intended to provide residents with scientific data about vaccine safety and efficacy, and to issue guidance on vaccines for respiratory illnesses like Covid and the flu, as well as an array of childhood immunizations. The announcement did not specify which medical groups would be consulted in formulating the guidance, but both the American Academy of Pediatrics and the American College of Obstetrics and Gynecology have publicly broken with the new federal health guidelines.
But the announcement did not address an array of brewing questions. Among them: whether health insurance plans would cover the cost of vaccines that were recommended by states but not by the federal government; whether primary care doctors and pharmacies could face repercussions for providing them; and whether states may continue to require certain vaccinations if they are no longer recommended by the C.D.C.
Western states formed a similar working group during the peak of the Covid pandemic to boost public confidence in vaccines. States in the Northeast, including Massachusetts, Maine, Vermont, Connecticut, Rhode Island, New York, New Jersey and Pennsylvania, recently gathered to discuss coordinating their own vaccine recommendations.
In June, the governors of California, Oregon and Washington jointly condemned Mr. Kennedy’s decision to dismiss all 17 vaccine experts on the federal Advisory Committee on Immunization Practices. The secretary went on to appoint vaccine skeptics to several of the posts and to end $500 million in federal funding for mRNA vaccines, a category that includes several of the most widely used and effective Covid shots.
Federal vaccine policies have been changing rapidly since Mr. Kennedy was appointed. Last week, the Food and Drug Administration limited its approval of updated versions of Covid shots to people who are 65 or older or who have a medical condition that puts them at higher risk of severe illness. No one else would be eligible for the new shots under the F.D.A. approval, even if they lived with someone at high risk.
Emily Baumgaertner Nunn is a national health reporter for The Times, focusing on public health issues that primarily affect vulnerable communities.
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