Vaccine Policy: The State Role in a Time of Public Health Disruption

Policy Points Over the past year, the nation's highest-ranking public health officials have pursued a concerted strategy of degrading access to childhood vaccines and undermining public confidence in vaccine safety and efficacy. As primary regulators of medical care, states have the power to maintain strong public health protections. A strong childhood vaccination policy has three components: maintaining a robust routine childhood vaccination schedule; focusing on broad vaccine access; and restoring public confidence in the safety and efficacy of childhood immunization. CONTEXT: Beginning in 2025, longstanding opponents of vaccines have held the highest positions of federal public health policy powers. METHODS: Using these powers, high ranking officials have sought to disrupt vaccine coverage and delivery and sow public mistrust in vaccine safety and efficacy. FINDINGS: The results of their efforts have been confusion and declining levels of childhood immunization. As of summer 2026, a federal court has enjoined efforts to degrade the childhood vaccine schedule and the public health expertise of the Advisory Committee on Immunization Practices, whose recommendations lie at the heart of US vaccine policy. CONCLUSION: As the nation's most important regulators of public health practice, states play a critical role in countering these efforts and protecting vaccine accessibility and acceptance.