Public health chief calls Healey’s vaccine plan “proactive”

By Chris Lisinski

As lawmakers weigh Gov. Maura Healey’s legislation seeking more spending controls in the face of federal funding uncertainty, they’ll also face a decision on whether to grant the Democrat’s administration new authority over pediatric vaccine policy.

The bill Healey filed (H 4251) alongside her annual budget signature would empower the state public health commissioner to determine “routine childhood immunizations” for all Bay Staters younger than 19 years old, cutting out a federal vaccine advisory panel whose recommendations have long played an integral role.

Department of Public Health Commissioner Robbie Goldstein said his team is worried the Trump administration and U.S. Health and Human Services Secretary Robert F. Kennedy Jr., who has long voiced skepticism about some vaccines, might soon pursue changes that would imperil immunization efforts in Massachusetts.

At DPH, Goldstein said, “we can all agree that an open, honest discussion of the science is what will get us to the right recommendation.”

“That is not what we are seeing at the federal level,” he said in an interview. “We are seeing closed-door discussions, presentations of junk science that is not peer-reviewed and has not gone through appropriate processes. You’re seeing people coming in with political agendas driving the discussion. That is a disservice to the children and the families in Massachusetts who rely on public health [officials] to make the appropriate recommendations.”

All Bay Staters ages 18 and younger are automatically eligible to receive vaccinations, and the system is governed by the Massachusetts Vaccine Purchasing Advisory Committee. Under current law, that panel is required to take into account the recommendations of the U.S. Centers for Disease Control’s Advisory Committee on Immunization Practices, or ACIP, when deciding which vaccines should be available to children.

Goldstein, a former infectious disease physician who ran for Congress as a Democrat in 2020 and served as a senior policy advisor at the CDC during the Biden administration, said there’s a “direct link between what ACIP votes on and what recommendations ACIP makes and what the Massachusetts advisory committee is supposed to evaluate.”

Medical experts and elected officials in many blue states have been concerned by recent changes at the federal level.

Kennedy fired all 17 members of the panel in June, writing in a Wall Street Journal op-ed that “a clean sweep is necessary to reestablish public confidence in vaccine science.” The smaller group of replacements he picked signaled plans to examine the vaccine schedule for children.

“ACIP’s new members will prioritize public health and evidence-based medicine. The Committee will no longer function as a rubber stamp for industry profit-taking agendas,” Kennedy said in a statement. “The entire world once looked to American health regulators for guidance, inspiration, scientific impartiality, and unimpeachable integrity. Public trust has eroded. Only through radical transparency and gold standard science, will we earn it back.”

Some of the new members of the federal panel have, according to NPR, “gained a following for, at times, promoting misleading and inaccurate information on COVID-19 vaccines.”

The terminations were a turning point for state regulators, according to Goldstein.

“I had hoped that we would never need to get to this point, and we identified this as a potential problem. We identified potential solutions to it. But I was really hopeful that ACIP would continue to have its independence,” Goldstein said. “What we saw with the abrupt firing of all of the members and then the appointment of eight people, most of whom have no background to support their appointment, really pushed us to a place where we felt it was really necessary to remove the reference to ACIP that exists in statute.”

The measure is one component of a $130 million supplemental budget Healey filed, which also seeks to create a reserve account the administration could use to plug any funding gaps and give the governor greater authority to trim spending partway through the year in so-called 9C cuts.

Carlene Pavlos, executive director of the Massachusetts Public Health Alliance, called the governor’s proposal to empower DPH “a very sound step.”

“The commissioner of public health, the governor and the Legislature all have responsibilities to protect and promote the health and safety of people in Massachusetts. The [U.S.] secretary of health and human services, in making the changes he has to ACIP, is posing a genuine threat to the health and safety of Massachusetts residents,” Pavlos said. “This is a necessary step to ensure that evidence-based policy is in Massachusetts statute.”

Current recommendations from the federal panel support pediatric vaccines for MMR, COVID, influenza, polio, tetanus and more.

“Right now, if we froze the ACIP recommendations for children in place, we wouldn’t have to make this change,” Goldstein said. “That said, what we heard in the most recent ACIP meeting was that the committee will be addressing the pediatric schedule in upcoming meetings, perhaps as early as August although potentially not until October.”

“We do want to be proactive and remain prepared so that if there were a politically based decision, or a non-scientific-based decision made to remove a vaccine or delay a vaccine, here in Massachusetts, we would have the ability to make a recommendation that is consistent with the science,” he added.

Massachusetts children must receive a suite of shots, including for polio, hepatitis B and MMR (measles, mumps and rubella), to attend K-12 schools unless they receive exemptions. Goldstein said the state generally displays “overwhelming support” for pediatric vaccinations based on immunization rates.

About 4% of kindergarten students did not meet school requirements for full vaccination in the 2024-2025 school year, with some variation by county, according to DPH data. Less than 1% of kindergarteners had at least one exemption and no vaccinations on file.

A DPH official said the commissioner, if empowered by the legislation, would consult with subject matter experts, professional organizations and other agencies when making any decisions about childhood vaccination schedules.

The state could also choose to continue to follow recommendations of ACIP or other groups such as the American Medical Association, even after the measure eliminates the explicit connection to the federal panel.

Pavlos said that despite her concerns about the current federal approach, she and her counterparts “have confidence that the state Department of Public Health is committed to evidence-based public health practice.”

“It’s necessary for the state to take action and return confidence about the recommendations that are being made by public health officials,” she said. “The department has a history of focusing on trustworthy experts and apolitical science, and we are expecting that if this passes, they will continue to do so.”

The MPHA is also challenging Kennedy’s approach to the COVID-19 vaccine in particular.

The organization joined the American Academy of Pediatrics, the American College of Physicians, the American Public Health Association, and the Society for Maternal-Fetal Medicine in a lawsuit filed Monday. Their complaint alleges that Kennedy and his deputies disregarded federal procedural rules when they announced that the CDC’s recommended immunization schedule no longer included the COVID-19 vaccine for “healthy children and healthy pregnant women.”

Pavlos said the shift in policy “puts the lives of pregnant people and children at risk,” and could undermine confidence in vaccines more broadly.