Thirteen states representing more than 100 million Americans have formed regional health coalitions to bypass federal vaccine guidance in an unprecedented state-level rejection of the Centers for Disease Control and Prevention under Health and Human Services Secretary Robert F. Kennedy Jr.
The rebellion began in late August when eight northeastern states quietly met in Providence, Rhode Island, to coordinate their own public health recommendations. Two weeks later, four West Coast states launched a more public alliance, with officials explicitly criticizing the “destruction” of the CDC’s scientific credibility.
Together, the coalitions span from Maine to Hawaii and include some of the nation’s most populous states: California, New York, Pennsylvania, and Massachusetts. Delaware joined the northeast group last week, bringing the total to 13 states openly seeking alternatives to federal health guidance.
“President Trump’s mass firing of CDC doctors and scientists — and his blatant politicization of the agency — is a direct assault on the health and safety of the American people,” governors from California, Oregon, and Washington said in announcing their West Coast Health Alliance on Wednesday.
This is the most significant challenge to the federal health authority in modern times, as states traditionally rely on CDC recommendations for vaccine policy, insurance coverage decisions, and public health guidance.
Read: CDC ‘Being Ripped Apart,’ Trump Says in First Response
Kennedy has fundamentally altered the CDC since taking office, firing the agency’s director, Susan Monarez, after she resisted new vaccine directives. Four top officials resigned in solidarity.
In June, Kennedy replaced all 17 members of the CDC’s Advisory Committee on Immunization Practices with seven appointees, many with histories of vaccine skepticism.
The changes have created confusion across the healthcare system. Earlier this year, Kennedy announced COVID-19 vaccines would no longer be recommended for healthy children and pregnant women, contradicting decades of medical consensus.
“When federal agencies abandon evidence-based recommendations in favor of ideology, we cannot continue down that same path,” said Washington Governor Bob Ferguson.
The northeastern coalition, which includes Massachusetts, New York, and Pennsylvania, has operated more quietly than its West Coast counterpart. Vermont’s interim health commissioner, Julie Arel, described the group as still defining its mission but preparing to act collectively when federal guidance fails.
Both coalitions plan to rely on guidance from medical organizations like the American Academy of Pediatrics rather than the CDC. The groups are exploring bulk vaccine purchasing and coordinated messaging campaigns.
The federal government pushed back against the state efforts, with HHS saying “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.”
Nine former CDC directors broke ranks this week to publicly condemn Kennedy’s management and urge Congress to exercise oversight of HHS. The former agency leaders’ rebuke exposes deep fractures within the public health establishment.
New Hampshire is the only New England state declining to join the northeastern coalition, with Governor Kelly Ayotte saying the state will continue relying on health experts for guidance.
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