On the West Coast, officials in California, Oregon, and Washington sought to shore up vaccine access for residents and announced the formation of a “health alliance” that would set public health policies independent of the federal government.
The moves are the latest in a nationwide upheaval over vaccines, related policies, and access. They follow the federal government’s suspended authorization last week for COVID shots for healthy adults under the age of 65.
“This is one of the most dangerous times that public health has faced in the last 50 years,” said Dr. Michael Osterholm, a University of Minnesota vaccine expert heading a project to help states and professional societies make science-based vaccine recommendations.
Collectively, the disparate decisions show states increasingly charting their own path for immunization policies as Robert F. Kennedy Jr. has overhauled federal health agencies.
Kennedy, a longtime antivaccine activist, has shifted federal policy to mirror his vaccine skepticism and at times, ignore science. Massachusetts is among the states that aren’t going along willingly.
“No matter what happens with [Kennedy] and the federal government, we are going to make sure vaccines remain available in Massachusetts,” Healey said in a statement Wednesday. “We are working to ensure that all pharmacies make the vaccine available as soon as possible.”
Massachusetts is in the midst of coordinating a regional public health collaborative with every New England state — save for New Hampshire — as well as Pennsylvania and New Jersey.
Many public health and medical experts this week mourned the end of national vaccination leadership that just five years ago launched the creation of highly effective vaccines that helped end the COVID pandemic. Trump himself previously hailed the vaccines as extraordinary.
“They say it’s somewhat of a miracle, and I think that’s true,” Trump said in December 2020.
His comments marked a rare point of agreement between the president and vaccine experts, who say mRNA vaccine technology enables the development of inoculations to new viruses at speeds that would have been impossible a few years ago.
But still-controversial, pandemic-era vaccine mandates make COVID booster shots an easy target today. Several experts allege Kennedy is leveraging resentment and distrust of COVID shots to upend vaccination policies that for decades have been essential pieces of children’s health care.
“Are you going to believe in science and the whole process of research and discovery, or are you going to believe in the alternative, which is magic, smoke, and mirrors?” said Osterholm.
Among Kennedy’s controversial actions are his decision to fire all 17 members of the Advisory Committee for Immunization Practices, an independent board that advises the CDC on vaccine policy. Some of the replacements share his anti-vaccine or vaccine skeptical ideology.
Last spring he also announced the government would no longer recommend that children and pregnant women receive COVID shots despite evidence that young children are vulnerable to serious illness from COVID and that newborns can inherit meaningful protection from mothers who get COVID shots while carrying babies. And last week, Kennedy fired the CDC’s director for refusing to let go of top officials or rubber stamp decisions from his hand-picked vaccine advisory committee.
Three high-level CDC officials later resigned in protest, warning that Kennedy appeared poised to move beyond COVID vaccines to restrict access to immunizations more widely. On Wednesday, more than 1,000 current and former CDC staffers urged Kennedy to resign over his vaccination policies.
The federal Department of Health and Human Services did not respond to multiple requests for comment, but Andrew Nixon, an HHS spokesperson, told the Associated Press in response to the Western states’ health alliance, that “Democrat-run states that pushed unscientific school lockdowns, toddler mask mandates, and draconian vaccine passports during the COVID era completely eroded the American people’s trust in public health agencies.”
The FDA in August approved COVID booster doses only for people 65 and older or those with medical conditions that put them at risk of severe COVID infections. This was the first time since their introduction that boosters were not approved for universal administration.
The newly reconstituted CDC advisory panel is scheduled to meet on Sept. 18, and is expected to concur with the FDA, denying most healthy Americans easy access to the doses.
In itself, the decision doesn’t fly in the face of science, health experts say. COVID booster shots do little to fully prevent people from contracting the virus, and for someone who has already been vaccinated or has had COVID, the doses provide only incremental, temporary, and probably unnecessary additional protection against severe illness, hospitalization, or death. Most other high-income countries don’t recommend the doses for healthy people under the age of 65.
But health experts argued there are good reasons to maintain widespread access to COVID boosters. Enough people are on the margins of high risk groups that making shots widely available will save lives, said Dr. Robbie Goldstein, the Massachusetts public health commissioner and the official who signed the standing order.
The FDA’s restrictions also add barriers to getting the shots even for those who need them.
Last week, CVS announced it wouldn’t carry the doses at its pharmacies in Massachusetts in anticipation of the CDC committee’s recommendations — a decision that Healey’s order seeks to counteract.
“My top worry is the people who are still at high risk of severe illness, who are going to have a hard time getting the boosters they want,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health.
Nuzzo was among those who described the restrictions on COVID boosters as a sign of a larger assault on vaccinations in America. COVID vaccines are unpopular with a segment of American society due to pandemic-era vaccination mandates, which she said she felt were a mistake.
“I think what they’re doing right now is capitalizing on existing resentment to attack vaccines in general,” she said. “RFK is trying to use the only point in which he may have a small bit of leverage as away to attack the entire public health infrastructure.”
Nuzzo said that despite mixed feelings about COVID vaccines, the public overwhelmingly embraces routine childhood vaccinations for illnesses such as polio, measles, and pertussis.
“It’s the vast majority of adults,” who support widespread vaccination, she said. “Has it slipped a little bit? Yes. Is it the crisis of confidence that they are telling you about? No.”
Healey’s Wednesday order, along with steps the Board of Registration in Pharmacy is expected to take Thursday morning, may resolve CVS’s concerns.
The Massachusetts order authorizes pharmacists to administer four different types of booster shots to anyone over the age of 5. (Children younger than 5 typically receive vaccines at their pediatrician’s offices.) By issuing the order, Healey ensures pharmacies will have liability coverage if they administer the vaccine without the CDC advisory committee’s recommendation, said Brigid Groves, vice president for professional affairs with the American Pharmacists Association, a trade organization.
The governor’s order, and states’ efforts to create regional public health collectives, create a patchwork of vaccine policies across the nation. Experts say this can make interstate travel more dangerous, and robs the country of the coordination and expertise the CDC provided.
“Do I think it’s an ideal situation? Hardly,” Osterholm, the Minnesota vaccine expert, said. “This is about making sure vaccines survive in today’s governmental world.”
Jason Laughlin can be reached at jason.laughlin@globe.com. Follow him @jasmlaughlin. Jonathan Saltzman can be reached at jonathan.saltzman@globe.com.
