Wary of RFK Jr., Colorado started revamping its vaccine policies last spring

As Health Secretary Robert F. Kennedy, Jr.’s dismantling of federal vaccine policy continues to roil the Centers for Disease Control and Prevention, some Democratic-led states have struck out on their own, setting up new systems to help them assess the science and maintain immunization access for their residents.

Four western states — California, Hawaii, Oregon and Washington — are creating a collaborative aimed at preserving access to vaccines. Several northeast states are considering a similar alliance.

New York’s governor declared a “statewide disaster emergency” and issued an order that allows pharmacists to give the COVID vaccine without a prescription. Minnesota made a similar change, and Massachusetts is requiring insurance carriers to pay for vaccines recommended by its health department, not just those recommended by the CDC.

The changes represent a huge shift in public health authority from the federal government to the states. Traditionally, states have looked to the CDC for expertise and guidance on public health issues — not just vaccines but issues such as workplace safety, water fluoridation, vaping and sexually-transmitted diseases.

Now, amid concerns that Health Secretary Robert F. Kennedy is undermining trust in vaccines and public health science, some states are charting new paths, seeking out new sources of scientific consensus and changing how they regulate insurance companies, prescribers and pharmacists.

Colorado has been at the forefront of this wave. On Sept. 3, state officials issued a standing order to let pharmacists provide COVID shots without individual prescriptions.

“I will not allow ridiculous and costly red tape or decisions made far away in Washington to keep Coloradans from accessing vaccines,” said Gov. Jared Polis.

Seeking non-federal sources of scientific consensus

But Colorado’s leadership had already been clearing the way for more autonomy on vaccine policy for months.

In April, the state legislature changed a law, allowing the state to consider scientific sources other than the federal government, when setting school vaccine requirements.

“You could see the writing on the wall that it was just becoming overly politicized rather than relying on actual science with this new HHS director,” said state Sen. Kyle Mullica, referring to Kennedy’s role leading the Department of Health and Human Services (HHS).

Mullica, who co-sponsored the new law, is a Democrat and works as an emergency department nurse in Denver.

Colorado is believed to be the first state to make this move. In addition to looking to the CDC for vaccine guidance, the state health board can now also consult with leading medical groups, like the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.

“We decided to protect Colorado,” Mullica said, so it “wouldn’t be as vulnerable to political upheaval that we’re seeing right now.”

Colorado Dems also try to shore up insurance coverage

The Democrat-led legislature passed the bill in a party-line vote. Gov. Polis signed it into law, despite previously praising RFK Jr.’s appointment last fall.

“Colorado I think is really leading the way on this,” said Dr. David Higgins, a pediatrician at the University of Colorado who was part of a stakeholder group that helped craft the bill.

Higgins pointed to a companion bill, passed in May, that he said makes Colorado’s push even stronger. It deals with insurance coverage for preventive health care services, and aims to help make sure state-regulated insurance plans cover the cost of some vaccines, regardless of future moves by the CDC.

“Effectively, it’s meant to help ensure the Colorados will still have access to vaccines,” he said.

The Colorado chapter of Children’s Health Defense, the anti-vaccine advocacy group that Kennedy led before taking over HHS, did not respond to a request for comment.

Another co-sponsor of the bill, Democratic state Rep. Lindsay Gilchrist, said there’s so much false information circulating about vaccines, including for COVID-19, that it’s important to hear from a range of trusted medical experts.

Colorado had previously looked to the CDC for scientific guidance on vaccines, particularly for children entering school. Like other states, it had tracked the recommendations of a CDC panel known as Advisory Committee on Immunization Practices (ACIP).

Earlier this year, Kennedy fired all 17 members and replaced them with eight members who critics warn are vaccine skeptics, and don’t have the qualifications to provide critical guidance for Americans.

“I think where the confusion will lie is the difference in the recommendations between the ACIP, who we traditionally defer to, and then everyone else,” said Dr. Ned Calonge, Colorado’s chief medical officer.

He expects that the national professional physician groups that Colorado is now empowered to consult will likely be aligned in their overall guidance, and will “look at the last evidence-based recommendations that were provided by the ACIP” before Kennedy replaced its members.

In May, Kennedy announced the federal government had removed COVID-19 vaccines from the list of shots recommended for healthy pregnant women and children.

But Colorado is still recommending a COVID-19 vaccine during pregnancy, Colange said.

“There’s been no new evidence of issues of safety in that population,” Calonge said. “So, we’re telling providers that our recommendation is to continue to follow the recommendation as it was in place in January of 2025.”

In a statement on its website, the American College of Obstetricians and Gynecologists (ACOG) strongly recommended pregnant individuals be vaccinated against COVID-19. “ACOG continues to recommend that all pregnant and lactating individuals receive an updated COVID-19 vaccine or ‘booster,'” it said.

Likewise, the American Academy of Pediatrics recommended in August all young children ages six-to-23 months get vaccinated against COVID, as well as older children in certain risk groups. Colorado’s current pediatric recommendation aligns closely with this.

For now, Colorado is following the same immunization recommendations it used last year, following the ACIP schedule published last November under the Biden administration.

The next ACIP meeting is set for Sept. 18, and could result in additional changes to vaccine recommendations.

Doctors and vaccine scientists have expressed alarm at the splintering national consensus on vaccines.

“There’s now going to be much more confusion and distrust of vaccines among the public,” said Dr. Allison Kempe, a professor of pediatrics at the University of Colorado, Anschutz, who served on ACIP from 2013 to 2018.

Still, she said she’s glad Colorado is actively forging ahead with its own recommendations.

This story comes from NPR’s health reporting partnership with Colorado Public Radio and KFF Health News.