New England public health initiative policy debut marks official break with federal government

The Boston Globe – Wednesday, September 10, 2025
By Jason Laughlin

The first product of an ambitious effort to coordinate public health policy among Northeastern states has quietly made its debut.

It may not sound like much: Massachusetts and Connecticut released similar guidelines for health care workers exposed to respiratory viruses, including COVID.

But the move marked an official break with the federal government that had been brewing since soon after Donald Trump was elected president last year.

The intention, officials said, is to pool the expertise and resources of the states to maintain vaccination policy, emergency management, disease tracking, and state lab services at a time of deep funding cuts and turmoil at federal health agencies.

The policy, applicable only to a small percentage of the public and introduced without any press, is representative of a cautious, low-profile approach to regionalizing public health guidance across at least eight states.

“A collaborative that has no name, a collaborative that is very cautious,” said Dr. Robbie Goldstein, Massachusetts’ public health commissioner and a leader in the regionalization effort. “Nevertheless, we are a collaborative that has worked together on real, concrete issues.”

Public health leaders from every New England state but New Hampshire, as well as Pennsylvania, New Jersey, and New York, have since the beginning of the year explored sharing resources and coordinating policies to compensate for diminished federal expertise and support. Massachusetts state officials have also said Delaware is involved.

So far, only Massachusetts, Connecticut, and Vermont have confirmed that formal coordination is now underway, though Connecticut officials downplayed the uniqueness of the new recommendations, saying states routinely discuss best practices. Vermont expects to release its own, similar guidance for health care workers soon, a spokesperson for Vermont’s Department of Health said Tuesday, confirming for the first time Vermont’s active involvement in the coordinated, regional public health effort.

The collaboration is a sign of the splintering of the country’s public health system in response to the divisive policies of Health and Human Services Secretary Robert F. Kennedy Jr. He has a long history as an anti-vaccine activist, and he has dragged the Centers for Disease Control and Prevention away from decades of vaccine-supportive positions toward his ideological priorities.

Kennedy has said children and pregnant women don’t need COVID vaccines, contradicting evidence that shows healthy young children and pregnant women are at heightened risk from COVID infections. He also disbanded an influential CDC advisory panel on vaccines and replaced it with a smaller group of hand-picked individuals, several of whom are either skeptical of or lack experience with vaccines. That panel, which dictates which vaccines are covered by insurance, has yet to issue any guidance on COVID immunizations, which has caused delays in the availability of the shots and mass confusion among the public.

A spokesperson for HHS denied that Kennedy was seeking to restrict access to vaccines.

“HHS is returning focus to the doctor-patient relationship,” the spokesperson said in an emailed statement. “The Department encourages individuals to talk with their healthcare provider about any personal medical decision, including vaccines.”

When the reconstituted committee does meet next week, it is expected to release COVID booster recommendations and discuss policies related to the common childhood vaccines for hepatitis B, measles, mumps, rubella, chickenpox, and RSV. Many are concerned the panel will move to restrict access to vaccines beyond COVID.

A report on children’s health that Kennedy issued Tuesday includes an effort to “investigate vaccine injuries,” despite an existing reporting system and low documented incidences of real harmful side effects of vaccines, which are heavily studied and tested.

The new regional policy, released in August by Connecticut and by Massachusetts on Sept. 1, advises health care workers how long they should stay out of work during a respiratory viral infection. The states recommend no less than three days away from work, and a longer absence as long as the person is still experiencing fever or other symptoms.

Typically, states rely on the CDC’s Healthcare Infection Control Practices Advisory Committee for guidance in shaping such recommendations, but HHS disbanded that committee in May, saying it was “unnecessary.”

The states looked back to that CDC committee’s guidance from 2024 to craft the new recommendations, Connecticut officials said in an August memo.

Goldstein’s comments came during his participation as a speaker at the Health Coverage Fellowship, a health journalist training program hosted by the Center for Health Communication at the Harvard T.H. Chan School of Public Health, in Boston on Monday night. Goldstein said participation in the Northeast regional coalition could expand substantially, and he has communicated with public health officials in a range of states, including those participating in the West Coast Health Alliance, a similar regional public health collaborative including California, Hawaii, Oregon, and Washington. He has also been “actively communicating” with public health officials in New Hampshire, Goldstein said.

The more states’ vaccination policies align, the better for the country, Goldstein said.

“The worst thing that could happen is that we have 50 different recommendations for COVID vaccine,” he said.

Last week, Florida officials announced a plan to do away with childhood vaccination mandates.

Under discussion now, Goldstein said, is which medical societies the states will look to for guidance in building a collective vaccination policy. He expects the states will soon release coordinated recommendations.

Massachusetts has been ahead of other states in breaking with federal health policies. Last week, Governor Maura Healey announced a shift in state regulations that dictate insurance coverage and pharmacists’ practices to make it easier to obtain COVID booster shots, even without a CDC recommendation for healthy, younger adults.

“She feels strongly that this is an area where the state wants to lead,” Goldstein said.

There is concern that could cause a backlash from a Trump administration that may relish a fight with Massachusetts’ liberal governor as part of a larger move to reduce access to vaccines, said Dr. Debra Houry, the CDC’s former chief medical officer and one of the top officials who resigned at the end of August to protest Kennedy’s decision making and firing of former CDC director Susan Monarez. Houry was also a speaker at the fellowship.

Goldstein emphasized the state was not requiring vaccinations but was giving people permission to get vaccines the vast majority of the public wants.

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