Nine States Unite in Northeast to Challenge CDC’s New Vaccine Use Recommendations

In response to recent changes made to vaccine use recommendations issued by the Advisory Committee on Immunization Practices (ACIP) of the U.S. Centers for Disease Control and Prevention (CDC), nine northeastern states and New York City have formally established the Northeast Public Health Collaborative, a regional partnership they say is intended to improve coordination of disease control efforts among their public health departments. The states include Connecticut, Maine, Massachusetts, New Jersey, New York State, Pennsylvania, Rhode Island, Maryland, Delaware, as well as New York City.^{1 2}

The alliance builds on an informal initiative that began earlier in 2025 and now formalizes joint disease control efforts across the state public health departments in the region.

Representatives of the new multi-state public health collaborative held a first in-person meeting in Rhode Island in August 2025. Since then, the collaborative has created working groups to examine coordination in several areas, including public health data collection, emergency preparedness and response, epidemiology, laboratory services, infectious disease management, vaccine guidance, and vaccine purchasing.³

The Northeast Public Health Collaborative closely mirrors the West Coast Health Alliance, a partnership launched by California and two other western states. Both efforts reflect a shift by some states toward regional decision-making in areas traditionally initiated and overseen by federal health agencies.⁴

Raising Concerns Over Fragmented Vaccine Policies

 On Sept. 17, 2025, breaking from vaccine use guidance provided by the CDC and U.S. Food and Drug Administration (FDA), the West Coast Health Alliance released its first set of public health policy recommendations focusing on promoting widespread use of COVID-19 shots by children and adults. The group recommended the COVID shots for healthy children between six months and two years old, as well as for pregnant women. For children ages two to 18 years, the alliance advised evaluating each child’s individual risk level for COVID before vaccination.⁵

California Governor Gavin Newsom also signed a new law allowing the state to use independent medical groups, like the California Department of Public Health (CDPH), instead of relying solely on the CDC’s vaccine committee when establishing insurance coverage rules for vaccines.⁶

Reactions from the public health community remain mixed. Debra Houry, MD, MPH, the former Chief Medical Officer at the CDC who resigned last month in protest of Secretary of Health and Human Services Robert F. Kennedy, Jr. and President Trump’s  overhaul of the agency, expressed concern about the state-by-state shift. She said, “I get why people are doing it. But it’s going to cause some confusion and haves and have-nots.”⁷

Dr. Megan Ranney, dean of the Yale School of Public Health, also voiced concern. She said she worries about “a balkanization of public health”, which is fragmentation of a unified national health system into separate, state-led approaches, which can lead to inconsistent policies and confusion for both providers and the patients.⁸

U.S. Department of Health and Human Services (DHHS) spokesperson Andrew Nixon criticized states dominated by the Democratic Party for creating alliances and collaboratives that create their own public health policy and vaccine use recommendations. He said, “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. HHS will ensure policy is based on rigorous evidence and Gold Standard Science, not the failed politics of the pandemic.”⁹

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