Seven US states and the nation’s largest city announced this week that they have formed the Northeast Public Health Collaborative, in an effort to strengthen the region’s health guidance as the national health landscape fractures.
As national health agencies revisit their recommendations, including high-profile restrictions on the updated Covid shots and the measles, mumps, rubella and varicella (MMRV) vaccine, the pressure is increasingly falling on states to navigate recommendations and new federal rules.
“I definitely see a future where there is considerable state-level variability on vaccine policy, much like we have seen in the abortion space,” said Katelyn Jetelina, an epidemiologist and former senior adviser for the US Centers for Disease Control and Prevention (CDC).
There were already some access issues with vaccines, especially for people who have been marginalized. “But in general, it didn’t matter where you lived,” said Jen Kates, senior vice-president at the health non-profit KFF. “Now it does.”
And while Covid shots were the first to be restricted, policies could also change on other shots – as with the MMRV restrictions proposed on Thursday.
“The area where it could really have a dramatic impact, is what might change with the kids’ [routine vaccination schedule],” Kates said.
The new alliance – among Connecticut, Maine, Massachusetts, New Jersey, New York state and New York City, Pennsylvania and Rhode Island – has been collaborating for months, including a meeting in August to discuss emergency preparedness, vaccine purchasing, lab capacity and more.
The West Coast Health Alliance, a similar organization led by the governors of Oregon, Washington, California and Hawaii, issued their first winter vaccine recommendation on Wednesday, encouraging residents to stay up to date on vaccines against Covid, flu and RSV.
In the past, the federal government funded much of the public health work done at state, local, territorial and tribal levels, and has worked as a “norm setter” by offering the best available evidence and public health