This was both predictable and inevitable.
The United States now finds itself navigating a fractured public health landscape, a direct consequence of the Trump administration's appointment of Robert F. Kennedy, Jr. (RFK Jr.) as Secretary of Health and Human Services (HHS). Mr. Kennedy is a lawyer with no medical training and a long history of promoting anti-vaccine misinformation. Under RFK Jr's leadership of HHS, he discontinued Emergency Use Authorization for COVID vaccines, and while the FDA has approved new ones with narrower eligibility similar to what were in place before the pandemic, plus he has also dismantled federal immunization guidance by firing the independent panel who make public recommendations. In doing so, that has left local health departments scrambling to respond to a crisis manufactured not by science, but by political ideology. The result is a nation where residents of states with competent public health leadership are likely to remain protected, while those in states governed by underfunded, incompetent, or politically-compromised agencies face renewed vulnerability to largely preventable infectious diseases.
For decades, public school districts across the country have required students to be immunized against a host of transmissible illnesses—polio, measles, hepatitis B, chickenpox, diphtheria, tetanus, and pertussis among them—before attending taxpayer-funded schools. These policies have not only proven effective, but have also enjoyed widespread support from public health officials and the general public. Parents opposed to vaccination have always retained the right to homeschool their children, although those children may still be subject to standardized testing. Alternatively, some families have opted for private religious schools that offer exemptions, though these come at a financial cost many cannot afford.
The principle behind these policies has always been clear: individuals may make personal health choices, but they do not have the right to endanger others in public institutions. If parents wish to avoid immunizing their children, they must seek alternatives outside the public system. Otherwise, they are expected to comply with established public health requirements.
That clarity has now been upended.
In states like Florida, Republican-led efforts to eliminate vaccine mandates for school children threaten to reverse decades of progress. Florida's Surgeon General Joseph Ladapo has championed these changes, despite pushback from qualified medical professionals within the state. If Florida proceeds with its plan to dismantle vaccine requirements, it will not only expose its own children to preventable diseases, but also risk exporting contagions to other states and countries. Parents in Florida are now advised to consult pediatricians rather than relying on state guidance, as the science remains unequivocal: immunizations work, and children in public schools should be protected.
The broader national immunization system—once a model of consistency—has become unsustainable under Kennedy's leadership. His tenure has been marked by the removal of CDC Director Susan Monarez, the replacement of the CDC's independent vaccine advisory committee with known vaccine denialists, and the imposition of more restrictive policies that limit access to COVID booster shots. Even eligible individuals have struggled to obtain vaccines due to new prescription requirements and supply chain disruptions. Senator Bill Cassidy, himself a physician, has accused Kennedy of "effectively denying people vaccines," a charge Secretary Kennedy has been unable to refute with evidence.
The consequences have been swift and severe. Measles, once considered eliminated in the United States since 2000, has reemerged in outbreak clusters among unvaccinated populations. More than 1,400 cases have been confirmed, a grim milestone that underscores the dangers of abandoning science-based policy.
Kennedy's appointment was always controversial. His questionable background includes a decade of work for the anti-vaccine organization Children's Health Defense, and he has also publicly admitted to long-term heroin abuse. His advocacy for disproven COVID treatments like ivermectin and hydroxychloroquine—neither of which has demonstrated efficacy, and both of which pose potential harm—further discredits his leadership. As Pete Buttigieg aptly noted in a recent Substack article (see https://petebuttigieg.substack.com/p/what-rfk-jr-is-taking-away-from-you/ for more), "Robert F. Kennedy, Jr. is not just a quack; he is a quack with power, and he is using that power to undermine public health."
Mother Jones magazine offered a similarly scathing assessment (see https://www.motherjones.com/politics/2025/09/rfk-jr-is-living-in-a-pretend-anti-vax-world/ for detail), while Axios reported on the growing resistance among Democratic-led states (refer to https://www.axios.com/2025/09/05/rfk-vaccine-rule-states-democrats-vaccine-rules/ for more). That resistance has now crystallized into action. NPR offered another article about actions being taken at the state-level found at https://www.npr.org/sections/shots-health-news/2025/09/06/nx-s1-5532121/states-vaccine-guidance-washington-oregon-new-mexico.
Federal Immunization Guidance
In early September 2025, the governors of California, Oregon, Washington (and subsequently joined by the State of Hawaii) announced the formation of what they are calling the "West Coast Health Alliance", a multistate coalition to coordinate public health guidelines separate from the CDC, with a commitment to upholding scientific integrity in public health. Their joint statement (https://governor.wa.gov/news/2025/washington-california-and-oregon-launch-new-west-coast-health-alliance-uphold-scientific-integrity/) condemned the politicization of the CDC and pledged to restore evidence-based policy.
Colorado, often considered a purple state, joined the movement. Governor Jared Polis issued Public Health Order 25-01, directing state agencies to ensure access to updated COVID-19 vaccines (see https://governorsoffice.colorado.gov/governor/news/governor-polis-cdphe-take-swift-action-ensure-easy-access-covid-19-vaccines-coloradans-fall/).
Pennsylvania followed suit. Governor Josh Shapiro empowered pharmacists to follow guidance from trusted medical organizations like ACOG, AAP, AAFP, and the FDA, rather than relying solely on the CDC (https://www.pa.gov/governor/newsroom/2025-press-releases/state-board-of-pharmacy-votes-to-protect-vaccine-access-across-p/).
Massachusetts Governor Maura Healey issued a standing order allowing pharmacists to administer COVID boosters to residents aged five and older, and mandated that insurers cover all state-recommended vaccines without out-of-pocket costs for people in Massachusetts (refer to https://www.mass.gov/news/governor-healey-announces-immediate-steps-to-ensure-vaccine-availability-in-massachusetts-amid-trump-rfk-rollbacks/).
New Mexico's Health Secretary Gina DeBlassie issued a public health order to remove barriers and expand access to COVID vaccines statewide (see https://cv.nmhealth.org/wp-content/uploads/2025/08/PublicHealthOrderCOVID19Vaccine-20250830.pdf).
New York Governor Kathy Hochul signed an Executive Order (EO) allowing pharmacists to administer COVID vaccines to eligible patients, with plans to renew the order until the legislature modifies state laws to reduce reliance on federal guidance (https://www.governor.ny.gov/news/governor-hochul-signs-executive-order-expanding-access-vaccines-amid-uncertainty-washington/). She said she intends to renew the EO every 30 days until the State legislature can reconvene and change state laws to offer credible alternatives to CDC guidance on immunizations, and the legislation is expected to also expand the ability for pharmacists to prescribe the COVID vaccines off-label even for those who are not currently eligible in accordance with the existing FDA label.
Connecticut and Maine have also reaffirmed their commitment to broad vaccine access. Governor Lamont issued a statement (https://portal.ct.gov/governor/news/press-releases/2025/09-2025/governor-lamont-statement-on-access-to-vaccines/), while the Maine CDC emphasized the importance of timely, safe, and effective immunizations (https://www.maine.gov/dhhs/mecdc/diseases-conditions/immunization/).
In sum, a number of blue and purple states are now doing what the federal government under Secretary Robert F. Kennedy, Jr. refuses to do: protect their residents from infectious illness. By asserting their independence and restoring access to life-saving vaccines, they are not just defying a quack—they are defending public health itself.
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