Maryland Enacts Law to Issue Its Own Vaccine Guidance, Bypassing Federal CDC Recommendations

Maryland Governor Wes Moore signed the Vax Act into law, directing the state’s health secretary to independently develop official recommendations for immunizations, health screenings, and preventive services — effectively decoupling the state from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP). The move represents one of the most significant state-level responses to concerns over federal health policy under Health and Human Services Secretary Robert F. Kennedy Jr., whose longstanding skepticism of vaccines has alarmed public health officials nationwide.

For more than four decades, virtually every state in the nation has relied on the CDC’s ACIP to set the standard for vaccine schedules. ACIP, a panel of medical and public health experts, reviews clinical trial data, epidemiological studies, and post-market surveillance before recommending which vaccines should be administered and on what timeline. These recommendations have historically formed the backbone of school immunization requirements, insurance coverage mandates under the Affordable Care Act, and the Vaccines for Children Program, which provides free immunizations to roughly half of all American children. Maryland’s decision to create a parallel state-level recommendation process is therefore not merely symbolic — it has practical consequences for which vaccines are covered by insurers, which are required for school entry, and how public health campaigns are structured within the state.

The catalyst for the Vax Act is the appointment and confirmation of Robert F. Kennedy Jr. as Secretary of Health and Human Services. Kennedy, who founded the advocacy organization Children’s Health Defense, has spent years promoting claims that vaccines are linked to autism and other disorders — assertions that have been extensively studied and rejected by the overwhelming scientific consensus. Since taking office, Kennedy has signaled potential changes to how federal health agencies approach immunization policy, including restructuring advisory panels and questioning the scope of the childhood vaccine schedule. These signals have prompted alarm among pediatricians, immunologists, and state health officials who fear that any weakening of federal guidance could lead to declining vaccination rates and the resurgence of diseases like measles, whooping cough, and polio. Indeed, measles outbreaks have already surged in parts of the United States in 2025, with CDC data showing a sharp increase in cases compared to recent years — a trend many epidemiologists attribute in part to growing vaccine hesitancy fueled by misinformation.

The Vax Act raises important questions about the future of federalism in public health. Historically, the CDC’s unified recommendations ensured a degree of national consistency, which simplified vaccine manufacturing, distribution logistics, and medical training. If a significant number of states begin issuing their own guidance, the resulting patchwork could create confusion for families who move between states, complicate insurance coverage determinations, and place additional administrative burdens on state health departments that may lack the research infrastructure of federal agencies. Supporters of the Maryland law counter that the state’s health secretary will draw upon the same body of scientific evidence used by ACIP and can consult with independent experts, ensuring that recommendations remain evidence-based even if the federal process becomes politicized. They argue the law is a necessary safeguard — a firewall against potential erosion of public health standards at the national level.

Looking ahead, the Vax Act is expected to take effect in the coming months, with the Maryland Department of Health tasked with establishing the framework for issuing its own recommendations. Other blue-leaning states are closely watching Maryland’s approach as a potential model. Meanwhile, the broader national debate over vaccine policy is likely to intensify as the Trump administration continues to reshape federal health agencies. Public health advocates warn that the stakes are extraordinarily high: vaccination programs are responsible for the near-elimination of diseases that once killed or disabled tens of thousands of Americans annually, and any significant decline in coverage could have devastating consequences, particularly for vulnerable populations including infants, the elderly, and immunocompromised individuals.