As the Trump administration shakes up recommendations for childhood vaccines, a growing number of states are moving quickly to ensure vaccines remain free and health care workers are protected from lawsuits.
“States are stepping in to protect their communities proactively,” said Dr. David Higgins, a practicing pediatrician in Aurora, Colorado, and vice president of the Colorado chapter of the American Academy of Pediatrics.
Colorado is one of at least six states –– along with Alaska, California, Illinois, Maryland and Vermont –– that have introduced vaccine-related bills in recent months, in an unprecedented break from the Centers for Disease Control and Prevention, which overhauled the childhood vaccine schedule in early January.
Colorado’s Senate Bill 32 stands out as the most extensive of the proposals.
It would expand malpractice liability protections for health care providers –– including doctors, nurses, pharmacists, clinics, hospitals and insurance companies –– related to childhood vaccines recommended by the American Academy of Pediatrics, the leading pediatricians group, as well as the CDC’s vaccine advisory committee.
This protection is important because lawsuits can be used by anti-vaccine groups as a tactic to dissuade health workers, state programs or clinics from giving childhood vaccines, lawmakers say.
“We are not going above and beyond; we are just trying to preserve the environment that health care in the U.S. has been functioning in,” said Democratic Colorado state Sen. Kyle Mullica, an emergency department nurse who introduced the legislation. “This does not protect someone if they go out of the norms and do something wrong. It just tries to prevent the weaponization of lawsuits related to vaccines.”
So far, 28 states have broken from the CDC’s new childhood vaccine recommendations to various degrees, according to KFF, a nonpartisan health care research group. The shifts away from federal guidelines range from legislation that would make sure vaccines remain free, and protect health care workers from lawsuits, to relying on guidance from the AAP.
The CDC’s change in guidance dropped recommendations that all babies should be protected against hepatitis A, hepatitis B, RSV, dengue and two types of bacterial meningitis. Almost immediately, the AAP and at least 12 other major medical groups, including the American College of Obstetricians and Gynecologists and the American Medical Association, reiterated their recommendations for childhood vaccination against 18 diseases.
Until now, most states have defaulted to federal guidance and liability protections for vaccines. Some states also have contracts that allow them to purchase vaccines from the CDC for the cheapest price available.
“States that are not taking proactive steps to clarify these issues are going to see disruption in the vaccine delivery system in their state, whether that’s for legal reasons, liability reasons or simply confusion,” Higgins warned.
Under Kennedy’s guidance, the CDC’s vaccine advisory committee has taken steps to undermine support for childhood vaccination. Kennedy, an anti-vaccine activist, has repeatedly and incorrectly linked vaccines to autism and abruptly fired all 17 members of the CDC’s vaccine advisory committee, replacing them with several vaccine critics. Shortly after, the committee pared back the number of vaccines recommended for all children.
While Kennedy focuses public attention on the “Eat Real Food” campaign to discourage ultra-processed foods and promote the revised dietary guidelines, it’s fallen to Mehmet Oz, administrator for the Centers for Medicare and Medicaid Services, to voice support for vaccines. On CNN in early February, as the largest outbreak of measles in decades escalated in South Carolina, Oz urged people to “take the vaccine, please.”
Vaccines required for school
States determine vaccine requirements for schoolchildren. They allow families to opt out of immunizations for medical reasons and many allow religious vaccine exemptions for kids attending public school. Dorit Reiss, a professor at the University of California College of the Law, San Francisco, said states have previously deviated from the CDC’s vaccine schedule, but “this is the first time that states have wholesale broken away from federal guidance.”
Higgins worries that without clear, science-backed guidance from the federal health agencies, “vaccine policy becomes fractured.”
For example, Colorado’s new bill would ensure liability protection for vaccine providers, as well as allow pharmacists to prescribe and administer vaccines, and it would require insurance companies in the state to cover the HPV vaccine. It would also make state immunization program funding available to providers, to cover any vaccine-related cost that is not subsidized by the federal government’s immunization program funding.
The bill would also allow health officials to follow vaccine guidance from the AAP, the American Academy of Family Physicians, the ACOG and the American College of Physicians, in addition to the CDC. The proposed law was approved by the Senate in early February.
It “aims to preserve access to science-backed vaccines to people in Colorado who want them,” Higgins said.
The bill is now in the Colorado House. If passed, the law would take effect in August.
