Mass. shouldn't rely on RFK Jr.'s appointees for vaccine advice
Massachusetts has historically used the federal recommendations to determine what shots to include in the state's Vaccine Purchase Trust Fund, which bulk buys all routine childhood vaccines and distributes them to providers. The state is reimbursed by private insurance and by a federal program that pays for vaccines for children who are uninsured or on Medicaid. This system ensures every child receives free vaccines, regardless of insurance.
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But relying on Washington's judgment now seems unwise.
In June, Health and Human Services Secretary Robert F. Kennedy Jr., a longtime vaccine skeptic, abruptly fired ACIP's members and appointed a new slate, many of whom lack expertise in vaccines and
Kennedy also bypassed the typical scientific review process when he recently eliminated a recommendation that healthy pregnant women and children get the COVID-19 vaccine. Medical organizations, led by the American Academy of Pediatrics,
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That lawsuit is ongoing, but states don't have to wait to protect their residents.
This month, in a
Massachusetts Public Health Commissioner Robbie Goldstein told the editorial board that under Healey's proposal, state experts would assess the various recommendations that are out there — for example, the American Academy of Pediatrics's childhood vaccine schedule — and adopt those recommendations they believe to be science- and evidence-based.
The main practical impact would be in requiring the Vaccine Purchase Trust Fund to rely on state, not federal, guidance. For example, if ACIP stops recommending giving the hepatitis B vaccine at birth (a recommendation that's
Looking ahead, state officials could choose to rely on state, rather than federal, recommendations in determining what vaccines are required for school attendance. State recommendations could affect what vaccines insurers cover.
Increasingly, a lack of trust in federal health officials is becoming a bipartisan problem. Having guidance from state health officials could also increase public confidence in vaccine recommendations among residents skeptical of federal authorities.
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'Public confidence in the recommendations of public health officials, whether about vaccines or other health behaviors, is only as good as the public's sense of those recommendations being trustworthy, being expert, and being apolitical,' said Carlene Pavlos, executive director of the Massachusetts Public Health Alliance.
State recommendations would also give physicians an authoritative source they could use in their practice and in speaking to patients.
'In the absence of timely ACIP guidance, we need a credible, transparent alternative that pediatricians and institutions can trust,' said Everett Lamm, co-chair of the Massachusetts Chapter of the American Academy of Pediatrics Immunization Initiative. Lamm said pediatricians today are overwhelmed and are seeking guidance on vaccine-related issues that have become politicized.
In an ideal world, vaccine recommendations would continue being made by an independent, unbiased US government committee of experts, allowing for uniformity across states and insurers. A regulatory patchwork can create problems, and there's no guarantee that an individual state's regulatory bodies won't become as politicized as the current federal administration. But even with those risks, if the federal government's vaccine-related apparatus can no longer be trusted, giving more authority to the state makes sense.
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