Vaccine battle shifts to states as federal path narrows
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After being blocked by election-year political considerations and now the courts, vaccine critics' most impactful fights may play out at the state level — at least until the midterm elections are over.
Why it matters: The "Make America Healthy Again" movement and its allies were already targeting state legislatures but those campaigns could take on new significance with much of the federal agenda now frozen.
Driving the news: A federal judge this week temporarily blocked the Trump administration from implementing recommendations made by a vaccine advisory committee handpicked by Health Secretary Robert F. Kennedy Jr.
- It also paused a major overhaul of the childhood vaccine schedule and further recommendations of the advisory panel.
- The decision came as the Trump administration was noticeably shifting away from vaccine rhetoric and policymaking after polling showed it was alienating voters heading into the midterms.
Between the lines: The Department of Health and Human Services said it looks forward to the injunction being overturned. But with so much of its agenda in limbo, statehouses may be vaccine critics' most viable route forward.
- "This likely shifts the medical freedom focus to state-based issues and the midterms," said David Mansdoerfer, a former senior HHS official in the first Trump administration and an adviser to groups critical of vaccine mandates.
State of play: A legislative tracker published by MAHA Action, an organization strongly allied with Kennedy, features more than 50 bills it's watching.
- "Health freedom" bills make up nearly 40% of those being tracked, by far the most common category — though some are bills the MAHA movement opposes, per the tracker.
Where it stands: Idaho passed a bill last year that bans vaccine mandates in the state, as well as requirements for other medical interventions like masks and diagnostic tests. It's been used as a model for legislation introduced in other states in the past year.
- Bills to get rid of vaccine mandates or expand exemptions are being debated in New York, West Virginia, Vermont, Arizona and elsewhere.
- Florida Gov. Ron DeSantis (R) earlier this week urged state legislators to pass a bill that would make changes like expanding school vaccine exemptions and removing the state surgeon general's ability to mandate vaccines during a public health emergency.
- The state's Senate passed a version of the bill, but it's stalled in the statehouse.
States have been key to advancing other Kennedy priorities, like preventing SNAP dollars from going toward highly processed food, in part because it's easier to get legislation passed than in Congress, said Mark Meckler, president of states-rights advocacy group Convention of States.
- He sees similar momentum around vaccine policy.
- "When I go out in the states ... there's a lot of conversation about medical freedom and specifically around vaccines," Meckler said.
- "There tends to be a different culture around [vaccines] in every state, and so we believe it's important to drive that power out from the federal government back to the states," he said.
Yes, but: Vaccine critics have had setbacks at the state level, too.
- Legislators in Idaho this week rejected a bill that would expand on last year's law.
- Major groups in the state opposed the bill, including the Idaho Association of Commerce and Industry, over concerns that it could restrict access to care beyond vaccines.
- New Hampshire's House of Representatives also rejected a bill in February that would have ended all vaccine mandates in the state.
What we're watching: How much progress medical freedom advocates can make this year before most state legislative sessions end in late spring.
- Tony Lyons, MAHA Action president, said in an email to Axios that while the court decision "is a short-term setback, the mission and the direction are clear."
