Vaccine Policy in Flux as Federal Changes and State Actions Diverge

Federal vaccine policy is entering a period of uncertainty, as a judge’s intervention and a major restructuring of a key advisory panel open the door to revisiting routine childhood immunization recommendations.

In March, a federal judge temporarily blocked an effort by federal health officials to scale back recommendations for several routine childhood vaccines, including those for flu, rotavirus, hepatitis A, hepatitis B and some forms of meningitis and RSV.

On April 9, the Trump administration updated the charter of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP), expanding membership qualifications to allow for the inclusion of anti-vaccine activists.

With new appointees and revised guidelines, the panel is expected to revisit existing recommendations and could significantly influence national vaccine policy.

Health Secretary Robert F. Kennedy Jr. has focused on overhauling ACIP. Dismissing all 17 members of the committee in 2025, Kennedy replaced them with his hand-selected members, including critics of vaccines.

Federal officials say these changes are intended to diversify viewpoints in the decision-making process. Critics, however, argue it could elevate perspectives that fall outside of mainstream scientific consensus.

Medical organizations have challenged the overhaul, and public health experts warn the outcome could affect vaccine confidence and disease prevention efforts nationwide.

As lawmakers debate potential changes, the gap between strong public support for vaccines and shifting policy proposals is likely to remain a central issue across the country.

Poll Finds Strong Support for Vaccines in Ohio

Ohioans overwhelmingly support vaccines and view them as essential for protecting public health, even as lawmakers consider legislation that could significantly alter childhood immunization requirements.

Across the state, investing in early childhood health is widely seen as one of the most effective ways to improve long-term health outcomes, with preventive care, including vaccinations, playing a critical role.

This view is reinforced by a recent poll by the Ohio Chapter of the American Academy of Pediatrics (OAAP), which indicates residents of the state show strong support for vaccines and their role in public health.

The OAAP poll revealed:

• 85% of respondents believe there are risks to public health without vaccine requirements
• 88% of Ohioans say vaccines are effective at protecting children.
• 86% said routine vaccines are safe.
• 89% indicated they were very confident or fairly confident that their pediatrician/family physicians provide them with the information they need to make informed decisions about vaccines.
• 75% of respondents believe that parents should be required to have their children vaccinated against preventable diseases.
• 43% of respondents felt confident or very confident in the safety of the COVID-19 vaccine.

These findings come as policymakers weigh potential changes that could reshape how vaccines are required and administered in schools and childcare settings in Ohio.

Ohio House Bill 561 Proposes Changes

Lawmakers in the Ohio House of Representatives are considering House Bill 561, introduced by Representatives Melanie Miller (R - Ashland) and Monica Robb Blasdel (R-New Waterford). The legislation would significantly reshape childhood vaccine requirements in the state.

Bill sponsors say the bill is designed to clarify and protect parents’ rights in making medical decisions for their children. One of its central provisions would remove the requirement that children attending daycare and preschool children receive the hepatitis B vaccine. Lawmakers in support of the bill argue the change would put state policy in alignment with evolving federal guidance and ultimately reduce mandates on families.

The bill also reinforces existing exemption pathways, including medical, religious and conscientious objections, and requires schools to honor them consistently. Meanwhile, healthcare providers and public health experts continue to warn that lower rates of vaccination children could increase the risk of outbreaks of preventable diseases.

Those concerns are especially pronounced in childcare settings, where many parents return to work shortly after childbirth and often place infants in care before they are fully immunized. In settings with lower vaccination rates, the risk of transmission of vaccine-preventable diseases increases.

Another key provision would change how schools respond to disease outbreaks. If passed, schools would be required to allow unvaccinated students to continue attending during outbreaks if certain health guidelines are followed. Temporary exclusion has been a long-standing public health practice that protects the broader school population, prevents further spread and keeps outbreaks small and manageable.

The bill further clarifies when a school may deny admission based on vaccination status, with the goal to standardize policies across school districts.

HB 561 has drawn attention from both supporters and critics, reflecting ongoing debate over how to balance individual choice with public health protections.

Ohio’s kindergarten students have seen a decline in vaccinations in recent years. During the 2019-2020 school year, 89% of Ohio’s incoming kindergartners met all vaccine requirements. That number dropped to 85.4% in 2025-2026. In that same period, the percent of non-medical exemptions for vaccines increased from 2.6% to 5.3%.

View more data by visiting the Annual Ohio Kindergarten Immunization Level Assessment website. 

Shifting National Landscape for Vaccine Policy

Amidst the national debates, broader international discussions on immunization strategy took place in Washington, D.C. earlier this month at The World Vaccine Congress.

Bringing together public health leaders, researchers and policymakers, the discussions included a focus on vaccine innovation, emerging diseases, regulatory shifts and pandemic preparedness. The conference highlighted growing separation in how states and federal agencies are approaching vaccine guidance, especially as recommendations and advisory structures continue to evolve.

The debate around vaccine requirements and rates has also been a focus for regional stakeholders, including WellLink affiliate The Healthcare Council in the Mid-Atlantic region, as providers and public health leaders navigate how shifting federal recommendations may affect local implementation.

In January, 23 states, including Maryland and Virginia, along with Washington, D.C. rejected changes to the CDC vaccination schedule and reduction in the number of routine childhood vaccines from 17 to 11. They announced plans to follow vaccine guidance from the American Academy of Pediatrics, which continues to recommend immunization policy approved by the CDC prior to the Trump administration.

On April 14, Maryland Governor Wes Moore signed the “Vax Act”(HB 637/SB 385), a law that ends the state’s reliance on federal CDC vaccine recommendations. The act allows the secretary of health to issue recommendations for certain immunizations, screenings and preventative services based on certain evidence-based scientific and clinical guidance, beginning July 1.

In Washington, D.C., public health officials report relatively strong school immunization rates following stricter enforcement measures. According to D.C. Health data, measles, mumps and rubella (MMR) vaccination rates among kindergarteners increased from only 79% in the 2020-2021 school year to approximately 93% in 2024-2025, aligning with national averages.

Virginia continues to maintain existing school-entry vaccine requirements, with state health officials emphasizing that routine childhood immunizations remain a key component of preventing outbreaks and protecting school-age children, even as national guidance evolves.

Together, these regional developments underscore a widening policy landscape across Washington, D.C., Maryland, and Virginia, where states are increasingly charting different courses on vaccine guidance and enforcement.