Report on United States Vaccine Policy Shifts and Implications for Sustainable Development Goal 3

Recent changes in United States federal vaccine policy present significant challenges to the advancement of Sustainable Development Goal 3 (SDG 3), which aims to ensure good health and well-being for all. Actions initiated by the Department of Health and Human Services (HHS) risk undermining established public health frameworks, prompting legislative responses at the state level to preserve access to essential immunizations. This report outlines the federal policy changes, state-level countermeasures, and the overall impact on achieving key SDG 3 targets.

Federal Policy Developments and Their Threat to SDG 3

The federal government’s new direction on immunization policy directly impacts progress towards SDG 3, particularly Target 3.8, which calls for universal health coverage, including access to safe, effective, and affordable essential medicines and vaccines.

Restructuring of the Advisory Committee on Immunization Practices (ACIP)

The primary mechanism for these policy shifts has been the restructuring of the ACIP, a committee historically responsible for providing science-based vaccine recommendations.

• In June, the HHS Secretary dismissed all 17 sitting members of ACIP.
• Eight new members were appointed, several of whom have publicly expressed criticism of vaccines.
• This overhaul was officially justified as a measure to “reestablish public confidence,” but it raises concerns about the integrity of future science-based recommendations essential for public health and meeting SDG 3.

Changes in Vaccine Recommendations and Coverage

Changes in ACIP recommendations have immediate consequences, as they are often legally tied to insurance coverage mandates in many states. This directly threatens the affordability and accessibility pillars of SDG Target 3.8.

1. COVID-19 Vaccine: In May, it was announced that the Centers for Disease Control and Prevention (CDC) will no longer recommend COVID-19 shots for healthy children and pregnant women.
2. Thimerosal in Influenza Vaccines: The new committee voted to recommend banning the preservative thimerosal from flu vaccines, a move inconsistent with extensive scientific evidence of its safety.

Should ACIP cease to recommend other routine vaccines, individuals could be forced to bear the full cost, creating significant barriers to preventing communicable diseases and undermining SDG Target 3.3 (ending epidemics of communicable diseases).

State-Level Responses to Safeguard Public Health Goals

In response to federal uncertainty, several states are enacting legislation to protect public health infrastructure and uphold the principles of SDG 3 by ensuring continued, equitable access to vaccines.

Legislative Actions to Preserve Vaccine Access

• Colorado: Lawmakers passed a bill requiring the state’s public health department to consider recommendations from a wider range of medical bodies, including the American Academy of Pediatrics, in addition to ACIP. A second bill secures insurance coverage for preventive care based on federal guidelines as they existed in January 2025.
• Maine: The state legislature removed a specific reference to ACIP in state law, empowering its own health department to determine which vaccines are included in its universal vaccination program.
• New York: New legislation has been introduced to mandate health insurance coverage for the COVID-19 vaccine, ensuring financial access is not a barrier.
• Massachusetts: A proposed bill would grant the state’s public health commissioner the authority to determine routine childhood immunizations, decoupling the decision from exclusive reliance on ACIP.

Challenges and Outlook for Universal Vaccine Access

While some states are moving to protect public health, significant challenges remain in ensuring that progress towards SDG 3 is not reversed on a national scale.

Political Division and Insurance Industry Uncertainty

Legislative efforts may face opposition in politically divided states. Lawmakers in Pennsylvania and Michigan are preparing bills modeled on Colorado’s legislation but anticipate political hurdles. Concurrently, major health insurance providers have not confirmed whether they will continue to cover the full cost of vaccines if they are removed from the federal recommended schedule. This uncertainty poses a direct threat to the financial protection and universal access components of SDG Target 3.8.

Role of the Medical and Scientific Community

To counteract the potential erosion of science-based policy, medical and public health organizations are mobilizing to provide independent, evidence-based guidance. The University of Minnesota’s Vaccine Integrity Project and the American Academy of Pediatrics are developing and disseminating scientific data and clinical recommendations to ensure that vaccinations, a critical tool for achieving SDG 3, remain accessible to all populations.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The article’s central theme is public health, specifically focusing on vaccine policy, access to “lifesaving shots,” and the prevention of communicable diseases like Covid-19 and influenza. The potential changes in federal recommendations and the resulting impact on insurance coverage directly threaten the health and well-being of the population, particularly vulnerable groups like children and pregnant women.
2. SDG 10: Reduced Inequalities
   • The article highlights a significant risk of growing inequality. It states that if federal recommendations change, “individuals could be forced to pay out-of-pocket for livesaving vaccines.” This would create a financial barrier, making essential preventive care less accessible for lower-income individuals and families, thereby increasing health disparities based on economic status.
3. SDG 16: Peace, Justice and Strong Institutions
   • The article discusses the functioning and integrity of public health institutions. The firing of all members of the Advisory Committee on Immunization Practices (ACIP) and the appointment of new, critical members raises questions about the institution’s accountability and reliance on scientific evidence. State-level legislative actions are a direct response to this, aiming to create more resilient and “science-based” decision-making structures to ensure public trust and effective governance in health policy.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.3: By 2030, end the epidemics of… communicable diseases.
     
     The article is fundamentally about the tools (vaccines) used to combat communicable diseases such as Covid-19, influenza, and RSV. The policy debate directly impacts the nation’s ability to control the spread of these diseases.
   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
     
     This target is explicitly relevant. The article details state efforts to “safeguard access to vaccines,” protect “insurance coverage for preventive health care,” and ensure vaccines are not subject to “out-of-pocket” costs, which are all core components of universal health coverage.
   • Target 3.b: Support the research and development of vaccines and medicines… provide access to affordable essential medicines and vaccines.
     
     The article discusses the importance of “science-based decisions” and “evidence-based clinical guidance” for vaccines. The conflict described threatens the application of vaccine science and the system that ensures broad access to these essential medicines.

2. SDG 10: Reduced Inequalities

   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome… by promoting appropriate legislation, policies and action.
     
     The legislation being introduced in states like Colorado, New York, and Pennsylvania is a clear example of “promoting appropriate legislation” to prevent inequalities in health outcomes. These bills aim to ensure that access to vaccines is not determined by an individual’s ability to pay, thus promoting equal opportunity for health.

3. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.6: Develop effective, accountable and transparent institutions at all levels.
     
     The article describes a perceived challenge to the effectiveness and scientific accountability of a federal institution (ACIP). The creation of the “Vaccine Integrity Project” and state laws that diversify the sources of scientific advice (beyond just ACIP) are attempts to build more accountable and effective institutional processes for public health at the state level.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For Target 3.8 (Universal Health Coverage)

   • Indicator: Proportion of the population with access to affordable essential medicines and vaccines.
     
     This is a primary theme. The article implies this can be measured by tracking insurance coverage for routine immunizations. The statement that major insurers “have not confirmed whether they will continue to cover the full cost” points directly to this indicator.
   • Indicator: Proportion of the population covered by health insurance.
     
     The bills passed in Colorado and introduced in New York and Pennsylvania are explicitly designed to “protect insurance coverage” and “mandate health insurance coverage” for vaccines, making this a key metric for success.

2. For Target 10.3 (Ensure Equal Opportunity)

   • Indicator: Number of laws and policies that promote equality and non-discrimination.
     
     The article provides concrete examples of this indicator. It names several states (Colorado, Maine, New York, Massachusetts, Pennsylvania, Michigan) that have passed or are introducing bills to protect equitable access to vaccines, which can be counted and tracked.

3. For Target 16.6 (Effective, Accountable Institutions)

   • Indicator: Existence of independent national human rights institutions in compliance with the Paris Principles. (Adapted to public health institutions).
     
     While not a human rights institution, the principle of an independent, science-based advisory body is central. The article implies a measure of institutional integrity by contrasting the new federal ACIP with state-level efforts to rely on multiple scientific bodies like the “American Academy of Pediatrics” to ensure “science-based decisions.” Progress could be measured by the number of states codifying such multi-source, evidence-based review processes.

4. Summary Table of SDGs, Targets, and Indicators

Source: wired.com