Rewriting the Schedule: Washington, the States and Congress

Which vaccines American children are told to get, which they must get for school, and which insurance must pay for are now being changed at three levels at once. Here is who is doing what, where the courts stand, and why members of Congress have joined in — on both sides.

1. Washington: the schedule and the courts

Health Secretary Robert F. Kennedy Jr. removed all 17 ACIP members in June 2025 and appointed his own. Over the next seven months the reshaped committee and the CDC narrowed COVID-19 recommendations, ended the universal hepatitis B birth dose, and on 5 January 2026 cut the routine childhood schedule, from 17 recommended vaccines to 11 by the plaintiffs’ count. The full timeline is on our RFK Jr. running file.

Coverage, for now. The insurers’ trade group, AHIP, said its members would keep covering the previously recommended vaccines at no cost at least through 2026. Several states point insurers to recommendations as they stood on 31 December 2025. Families are still told to check with their own plan.

2. The states: pulling in opposite directions

With federal guidance in dispute, states have split. By 10 March 2026, KFF counted 29 states and the District of Columbia rejecting at least some of the new federal guidance, mostly by following the American Academy of Pediatrics schedule instead. Every state with a Democratic governor is among them. Many Republican-led states have kept to the federal schedule, and a few have gone further, loosening school requirements.

States protecting access

• Regional alliances. The Northeast Public Health Collaborative (Connecticut, Delaware, Maine, Maryland, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island, Vermont and New York City) announced on 12 January 2026 that it would follow the AAP schedule. The West Coast Health Alliance (California, Hawaii, Oregon and Washington) has done the same. Fourteen Democratic governors share public-health information through the Governors Public Health Alliance.
• Pharmacists and insurers. By September 2025, 26 states let pharmacists give COVID-19 vaccines without a prescription, and 13 required state-regulated insurers to cover them at no cost.
• Untying state law from ACIP. Colorado now lets officials use recommendations from bodies such as the AAP when setting school requirements. Massachusetts and Hawaii have proposed ending non-medical exemptions; neither has passed.

States loosening requirements

3. Congress: where the rules are actually written

Congress wrote the three laws at the centre of this fight: the 1986 National Childhood Vaccine Injury Act, which created the compensation program and shields manufacturers from most lawsuits; the Vaccines for Children program; and the Affordable Care Act’s coverage rule. Anything the Health Secretary does can be locked in, undone or overtaken by Congress — which is why both sides are now there.

None of these bills has passed either chamber.

Why members of Congress join in

1. Because that is where the levers are. Coverage, the Vaccines for Children program and liability are all in federal law. A Health Secretary can reshape ACIP; only Congress can make a change permanent, or reverse one. Supporters of the new direction want the liability shield gone; defenders want ACIP and free coverage written into statute so no future Secretary can undo them.
2. Hearings are a platform. Sen. Ron Johnson’s Permanent Subcommittee on Investigations held a hearing on 9 September 2025 titled “How the Corruption of Science has Impacted Public Perception and Policies Regarding Vaccines.” Witnesses included Aaron Siri, the lawyer who represents the Informed Consent Action Network, and Robert Malone, then an ACIP member; one witness, Stanford infectious-disease specialist Jake Scott, defended the evidence. A Senate hearing gives claims a congressional record that can be cited for years. In September 2026 Johnson received Children’s Health Defense’s “Defender Award” at its Washington conference (see our running file).
3. The political cost of resisting. Sen. Bill Cassidy, a physician and chair of the Senate health committee, voted to confirm Kennedy after receiving commitments about vaccines, then criticized him publicly as the vaccine changes came. On 16 May 2026 Cassidy lost his Louisiana Republican primary, taking about a quarter of the vote, after President Trump endorsed his opponent. His vote to convict Trump in 2021 was a major factor, but his public break with Kennedy also drew fire from voters aligned with the Make America Healthy Again movement. Cassidy leaves the Senate in January.
4. COVID grievance became a broader agenda. Opposition to COVID-19 mandates built a constituency, donors and organizations — Children’s Health Defense, the Informed Consent Action Network, the Health Freedom Defense Fund — that now campaign on the whole childhood schedule. Their language of “medical freedom” and “accountability” appeals to libertarian members of Congress, including some with no previous record on vaccine policy.
5. And on the other side, constituents and doctors. Democrats, and some Republicans, hear from pediatricians, insurers, hospitals and parents. The American Academy of Pediatrics went to court; more than 200 organizations endorsed its schedule. In the minority, Democrats’ tools are bills that will not pass this Congress, oversight letters and the courts.

4. The worst offenders

These are the people and organizations doing the most to roll back childhood vaccination in the United States, judged by what they have actually done in office, in court or in law. Their supporters describe the same actions as defending “medical freedom” or “accountability”; the record is set out so readers can judge for themselves.

5. Landmark legal results

American courts have upheld vaccination requirements for more than a century. Today’s fights are mostly about exemptions and about who controls federal advice, not about whether states may require vaccines at all.

6. What the public and health professionals can do

7. Why Canadians should watch

Canada’s schedule is set by the National Advisory Committee on Immunization and the provinces, not by Washington, and no province has adopted the January 2026 U.S. schedule. But three things cross the border:

• Citations. Canadian anti-vaccine groups such as Action4Canada and Vaccine Choice Canada can now cite cdc.gov and U.S. Senate hearings for claims they once had to source to activists. See our page on Action4Canada and Vaccine Choice Canada.
• Model bills. Idaho’s “medical freedom” act is being distributed as a template. Watch for the same wording in provincial private members’ bills and petitions.
• Measles. Outbreaks do not stop at the border. Canada lost its elimination status in November 2025, and six Ontario babies were born with measles in 2024–25. See What These Diseases Do.