Governor Moore VS. Federal Vaccine Policy: How Maryland Plans To Set Its Own Health Rules

ANNAPOLIS, Md. — Gov. Wes Moore is taking a bold step to move Maryland’s vaccine policy away from recent federal changes, introducing what his administration calls the Vax Act of 2026 just days before the Maryland General Assembly convenes. The proposed bill is a response to recent changes in national vaccine guidance issued by the Centers for Disease Control and Prevention, and it signals a potential clash over public health authority between state and federal government.

The move suggests that Maryland could set its own immunization recommendations rather than automatically follow federal guidance. The bill, as introduced, would grant the Maryland secretary of health explicit authority to issue state vaccine recommendations, screening protocols, and preventive health guidelines based on science and clinical expertise, drawing on respected medical associations such as the American Academy of Pediatrics and the American Academy of Family Physicians. Under the proposal, this state guidance would determine which vaccines insurers must cover and what shots pharmacists can administer, independent of changing federal rules.

The proposal comes after the CDC updated the childhood vaccine schedule to reflect fewer routine vaccinations, narrowing the list of universally recommended shots and leaving decisions about others to clinical judgment or individual risk categories. In public statements, Moore said Maryland’s approach will keep vaccine guidance “driven by proven science, not political headwinds,” and emphasized that access to vaccinations remains essential to protecting communities from preventable disease outbreaks.

Maryland has already taken steps to protect vaccine access independent of federal action, including a 2025 law requiring insurers to cover vaccines recommended as of the end of 2024 and expanding pharmacists’ authority to administer flu and COVID-19 shots. Maryland’s approach is part of a broader trend among Democratic-led states responding to federal vaccine policy changes. Several states, including Maryland, have joined the Northeast Public Health Collaborative, a coalition created to share expertise and support evidence-based guidelines outside of CDC direction.

Within the Maryland General Assembly, the issue is expected to be a point of debate early in the session. Lawmakers must decide whether to codify the governor’s proposal and, if so, how far state authority should extend in areas traditionally shaped by federal agencies. The outcome of this legislative discussion could influence similar efforts in other states if they also seek to establish independent vaccine schedules and public health priorities. For now, the Vax Act sets the stage for a broader conversation about the balance of power in health policy, scientific authority, and the role of state government in those areas.