Maryland Gov. Wes Moore proposed legislation Thursday that would expand the state’s health secretary’s authority to set vaccine and preventive care recommendations, a move his administration says intends to protect access to immunizations after major changes to federal childhood vaccine guidance.
The proposal, known as the Vax Act of 2026, follows a recent decision by the Centers for Disease Control and Prevention to cut the number of routine vaccines recommended for children from 17 to 11. Several other vaccines were shifted to recommendations for high-risk groups or left to patient-doctor decision-making.
The Department of Health and Human Services said in a Monday news release that the move came after a review of vaccine schedules in “20 peer-developed nations” that was ordered after President Donald Trump directed health agencies to reassess whether the nation’s approach relied on the best available evidence. HHS Secretary Robert F. Kennedy Jr. said the move would “strengthen transparency and informed consent.”
Still, medical professionals criticized the decision, warning it lacked a transparent public review process and could lead to more hospitalizations and preventable deaths among children.
Maryland officials said the federal shifts highlight the need for the state to set its own guidance.
“The legislation is in response to the endless changes at the federal level around vaccine policy,” Maryland Department of Health Secretary Dr. Meena Seshamani said on a Wednesday press call. “Now more than ever, with the swirl and uncertainty at the federal level, evidence-based data will continue to be our North Star.”
Under the Vax Act, the health secretary would be authorized to issue official state recommendations for vaccines, screenings and preventive services based on “scientific guidance,” Moore’s office said. Federal recommendations would still be considered, but no longer automatically determine state policy.
The bill would require the secretary to instead rely on guidance from independent medical organizations, including the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.
Seshamani said vaccines remain “one of the most powerful public health tools” to keep families and communities healthy and that the bill is intended to ensure “broad access” for Marylanders of all ages.
The legislation would also maintain existing state policies requiring insurance coverage for recommended vaccines and allowing pharmacists to administer certain vaccines, such as flu and COVID-19 shots, without a prescription to patients as young as 3 years old.
Deputy Health Secretary Dr. Meg Sullivan said the bill focuses on insurance coverage and pharmacist authority, not school vaccine mandates. Seshamani added that the proposal builds on a law passed last year that tied insurance coverage to vaccines recommended by a federal advisory committee as of the end of 2024.
“What this legislation would do is enable there to be a more dynamic determination of what are the recommended vaccines that insurance providers have to cover,” Seshamani said.
In response to questions about cost and funding, state health officials told The Baltimore Sun the proposal would “carry no fiscal impact.”
This legislation builds on the Moore administration’s previous efforts to expand vaccine access, his office said, including joining the bipartisan Northeast Public Health Collaborative and GovAct Public Health Alliance, issuing standing orders that allow residents six months and older to receive COVID-19 vaccines and newborns to receive the hepatitis B vaccine, and launching a new adult vaccine program.
“This act further safeguards vaccine access,” Seshamani said, adding that Marylanders “deserve recommendations grounded in rigorous science” and to know that “we have their backs.”
The bill is an administration proposal – meaning no sole lawmaker is sponsoring it – and will be introduced during the 2026 legislative session, which starts on Jan. 14. Final language, including the scope and duration of the secretary’s authority, will be developed in partnership with the General Assembly, Seshamani said.
After filing, the bill will be assigned to a committee for hearings and a vote, then debated and voted on by the full chamber before moving to the other chamber for the same process. If it passes both chambers, the Vax Act will move to be signed by the governor before becoming law.Sullivan, a practicing pediatrician, said conflicting guidance at the federal and state levels risks confusing Marylanders.
“We know that parents out there are confused,” she said. “At the Maryland Department of Health, we are really committed to trying to provide clear recommendations for parents at the state level, but in collaboration with neighboring states, with other health officials … and make sure that parents have all of the information they need and have all of their questions answered.”
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