In the wake of a sweeping CDC leadership shake-up, deep cuts to mRNA vaccine research funding, and intensifying political debate over public safety, vaccine policy in the US is fracturing under the weight of political and scientific discord. Florida may soon become the first state to eliminate all vaccine requirements for children entering public school — reversing a standard held nationwide since 1980. Meanwhile, nearly a dozen states are charting their own course, issuing independent vaccine recommendations separate from federal guidance. Greater political influence on public health may lead paradoxically to an emphasis on individual choice, even as the range of available options narrows.

Holding The Line: Preventing A Public Health Breakdown

Routine childhood vaccinations saved $540 billion in medical costs and prevented 32 million hospitalizations. Yet policy changes could imperil 30 years of progress. Disruptions to school and work from outbreaks can compound societal and economic costs. US Senator Dr. John Barrasso’s warning underscores the stakes: “If we’re going to ‘make America healthy again,’ we can’t allow public health to be undermined.”

As this fragmentation unfolds and government’s role in safeguarding health is debated, healthcare organizations (HCOs) must work to limit the impact of these changes on population health. Consumers are raising questions about the risks posed by a swelling unvaccinated public. HCOs must guide and support customers on how to navigate any fallout from policy changes. Key stakeholders must act immediately:

  • Providers. Shifts in vaccine policies are reshaping preventive care, increasing clinical risk and operational complexity for providers. Rolled-back mandates, inconsistent guidance, and gaps in funding make outbreaks of contagious diseases more likely. More illnesses contribute to clinician burnout. This will further strain patient trust. Healthcare providers should adjust workflows to ensure access to vaccines and compliance with evolving federal and state regulations. They should also strengthen patient education and prepare for increased operational complexity. Consider reinstating pandemic-era protocols such as digital waiting rooms to accommodate at-risk patients.
  • Health insurers. The rollback of vaccine mandates adds complexity to coverage decisions and risk modeling, forcing insurers to reassess prior projections. Payers must manage growing volatility in their risk pools. Significant premium increases already loom, and health insurers face tough decisions to offset additional risk for their managed populations in 2026. Payers should evaluate how to sustainably cover routine vaccination (where not mandated) and provide members with education and assistance to ensure maximum uptake of preventive measures.
  • Pharmacies. Pharmacies are in limbo. The completely overhauled Advisory Committee on Immunization Practices hasn’t yet issued recommendations, and FDA guidance is limited. This regulatory whiplash complicates staffing, inventory planning, and patient access, especially in states requiring prescriptions or lacking clear protocols. Pharmacists, for example, already get inundated with requests for Tamiflu during peak flu season. Fewer vaccinated people means more requests for already burdened staff. Some pharmacies may opt not to order and administer vaccines at all, which carries bigger impact for the business. Pharmacies must engage customers via digital channels, streamline vaccine scheduling, and promote prevention in new ways.

Dig deeper into the changes and volatility unfolding in the healthcare market. Forrester clients can schedule a guidance session and check out our research on how to thrive through volatility. Not a client? Let’s talk about how we can help.

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