U.S. Health and Human Services Secretary Robert F. Kennedy, Jr’s policy decisions and actions continue to undermine public health and cause harm. In particular, his approach to vaccine policy has repeatedly disregarded established scientific guidance and practice.

Amid this landscape of misguided leadership, New Jersey can, and must, act to protect its citizens. Our state’s public health leaders can provide science-backed guidance and policy decisions to enable our residents to obtain the vaccinations they need to protect their health. Here’s why.

Last May, Kennedy changed the recommendations for COVID vaccinations without consulting the Advisory Committee on Immunization Practices (ACIP) or the Centers for Disease Control and Prevention’s subject-matter experts and without providing evidence for the changes. For example, the CDC is no longer recommending that healthy pregnant women be vaccinated. Then last June, Kennedy replaced existing ACIP members with a newly appointed group, whose members have either limited vaccine policy experience or known anti-vaccine views.

Under Kennedy’s leadership, the Food and Drug Administration recently revised its authorization of COVID-19 vaccines, restricting eligibility to individuals 65 and older or those under 65 with risk factors for severe disease. The agency is also considering limits on the co-administration of respiratory vaccines, including COVID-19 and influenza — an approach that would almost certainly reduce vaccine uptake and lead to more preventable illness. Next week, ACIP will meet to issue recommendations on COVID-19 vaccination and is expected to align with the FDA’s dangerous restrictions on a vaccine that saves lives and reduces serious illness. Together, these changes will significantly restrict access for millions of Americans and undermine the public health benefits of widespread vaccination.

States are responding to these developments by charting their own paths.

Last week, California, Oregon and Washington State announced their intention to form an alliance to formulate and issue vaccine recommendations separate from the CDC. Hawaii plans to join this alliance as well, and Washington state has already issued a standing order allowing all licensed health care providers to vaccinate any Washington resident  over the age of six months.

Pennsylvania’s Board of Pharmacy recently voted to allow pharmacists to follow the recommendations of professional organizations such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, groups that want to continue following the ACIP recommendations that were in place before the changes by the CDC and FDA.

New York’s governor, Kathy Hochul, signed a short-term executive order expanding who can prescribe and administer COVID-19 vaccines, while the legislature considers a long-term solution.

Massachusetts and New Mexico have also taken steps to expand access to the COVID-19 vaccines in response to the changes in federal policy.

New Jersey continues to follow the recommendations and regulations for COVID-19 vaccines based on revised ACIP/CDC guidance. This puts New Jersey pharmacists (who give over 90% of COVID-19 vaccines) in a tough spot. Many are hesitant to schedule shots because of the federal policy changes. Currently, they have no option but to follow those misguided recommendations.

New Jersey recognizes the need to counter the federal recommendations and recently met with eight other northeastern states to consider jointly making their own recommendations to ensure broad access to all vaccines.

Meanwhile, in Florida, state leaders are going in the opposite direction. Gov. DeSantis and his surgeon general intend to remove all vaccine mandates, including vaccine mandates for school attendance. This is a policy guaranteed to lead to vaccine-preventable disease outbreaks that will not be limited just to those who live in the state. Meanwhile, other states may follow Florida’s dangerous lead.

What we are seeing is the balkanization of vaccine recommendations, fueling public confusion. We need state vaccination policies that are based on trusted, research-based findings.

Earlier this year, the Center for Infectious Disease Research and Policy, an independent, academic-based organization, established the Vaccine Integrity Project, which is “dedicated to safeguarding vaccine use in the U.S. so that it remains grounded in the best available science, free from external influence, and focused on optimizing protection of individuals, families, and communities against vaccine-preventable diseases.”

The center is leading a collaborative effort to review all the available research on COVID-19 and other respiratory vaccines and provide guidance to established medical professional associations and clinicians to assist them in advising and caring for patients.

We previously advocated that New Jersey be proactive in addressing the changes at the CDC in formulating vaccine recommendations, changes similar to what the Pennsylvania Board of Pharmacy has done. Now we are up against a deadline. The respiratory infection season is approaching, and COVID-19 incidence is rising nationally.

The New Jersey Department of Health recently filed amendments to state vaccine regulations, which would ultimately allow it to reference recommendations from other professional organizations such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. Unfortunately, given the lengthy process to amend regulations in New Jersey, these changes will not occur in time for this respiratory season.

New Jersey vaccine providers and the public need to know that there will not be barriers to getting the COVID-19 vaccine.

The state must act quickly to ensure the newly approved reformulated vaccines are available to all who seek them. Given the public health risks, action can be taken through executive order while the proposed regulations go through the review and approval process. The executive order would grant authority to all authorized health practitioners to give COVID-19 shots to those six months and older without a prescription.

Alternatively, or simultaneously, a physician in New Jersey’s Department of Health could issue a standing order to that effect, as was done in Colorado, Massachusetts and Washington state.

An executive order could also require continued insurance coverage for the vaccines and their administration, and promote public messaging based on the research and evidence of the safety and effectiveness of these vaccines.

The changes we are advocating would help people working in nursing homes who care for vulnerable patients, as well as other caregivers, pregnant patients, and all those seeking to protect their own health. New Jersey’s government must act now. Lives depend on it.