A blue state public health alliance

To a much greater extent than the federal Democratic leadership, prominent blue state governors have a clear grasp on what’s happening. And it’s not just about clear-eyed rhetoric, but about creative substantive responses. This is particularly important:

Pritzker’s health department in Illinois is currently exploring the possibility of purchasing Covid-19 vaccines in bulk straight from manufacturers in response to the mess in Washington, a senior Illinois health official confirms to me. Meanwhile, a coalition of mostly-blue states led by Massachusetts Governor Maura Healey is planning to coordinate on the purchase and distribution of pediatric vaccines, should the federal government restrict access to them, according to a source familiar with ongoing discussions. This will likely include big states like New York and Pennsylvania.

One hopes and expects that there will be much more of this going forward. Democratic governors have numerous ways to fill the public health leadership void that Trump is creating, according to public health experts I interviewed.

That void is enormous—and deeply unsettling. The White House fired CDC director Susan Monarez after she came under pressure to support Health and Human Services Secretary Robert F. Kennedy Jr.’s rescinding of various approvals for the Covid-19 vaccines—which was announced this week—and to support vaccine restrictions more broadly as well. Monarez, a Trump appointee and a well-regarded government scientist, refused, seeing this as a betrayal of vaccine science that could threaten countless lives.

Worse, after Monarez was fired (which her lawyers are fighting, though the White House has announced a replacement), a disconcerting spectacle ensued. A parade of top CDC scientists resigned, offering dismaying predictions about the future of vaccines in the United States. Indeed, this is only the beginning. As The Bulwark’s Jonathan Cohn notes, Kennedy has many other tools to do truly immense damage to the vaccine system.

So what can governors do in response to this unnerving state of affairs?

First, says Wendy Parmet, a health policy professor at Northeastern University, governors can scale up clinic systems to make it easier for people to get vaccines, should Trump’s government keep making that harder. This week the Food and Drug Administration narrowed approval for Covid-19 vaccines to people over 65 and those under 65 with a high-risk medical condition who consult with doctors. Experts fear the latter will restrict access even to those adults under 65, who previously could get shots at pharmacies.

Scaled-up state-sponsored clinics could make life easier for that below-65 population by making doctors more accessible to consult and recommend a Covid vaccine, Parmet notes. “States can step up with vaccine clinics overseen by physicians who would administer vaccines even when pharmacies may be unable,” she says.

Alternatively, a more ambitious version of this would entail states buying up large amounts of Covid vaccines from manufacturers and building out distribution systems similar to those employed during the pandemic, says the University of Michigan’s Sam Bagenstos, general counsel to the HHS under President Joe Biden. In this scenario, states could seek to provide the vaccines not just to high-risk adults under 65, but also all other adults who want them.

And it’s probably not only going to be COVID vaccines that are going to require a proactive response from states that still support controlling disease.

Alas, not every blue state governor gets it:

NEW: RFK Jr's purge of CDC leadership isn't shaking Democratic Gov Jared Polis' enthusiastic support of Kennedy to lead America's health policy. Today, Polis praised his collaboration with Kennedy, saying "We hope to work on making America healthier." #copolitics

[image or embed]— Kyle Clark (@kylec.bsky.social) Aug 28, 2025 at 7:07 PM

As with so much “what if we take that one RFK Jr. slogan literally rather than seriously” nonsense, I’m not sure how much of this is a sincere attraction to his pernicious woo-woo bullshit, and how much is the residual cachet of being a failson in America’s most overrated liberalish dynasty. But either way it’s just completely unacceptable to say positive things about the mass murdering children guy in August 2025.