Vaccine policy is rapidly fracturing along party lines under Health Secretary Robert F. Kennedy Jr., setting the United States on a path for a patchwork of policies and a likely dip in vaccination rates.

Some blue states, fearing the federal government’s antagonistic stance towards vaccines and eager to draw a political contrast with the Trump administration, are stepping up to create their own policies. Red states are going in the opposite direction, loosening or even ending vaccine requirements.

Experts said differing state policies could lead to confusion among doctors and patients, and varying levels of insurance coverage.

“It's going to be, not quite the Wild Wild West, but pretty close for the next few years,” said Georges Benjamin, executive director of the American Public Health Association.

Already, pharmacies in a handful of states no longer administer COVID-19 shots, or require a prescription, due to confusion over recent federal changes.

Last week, states on both sides began taking matters into their own hands.

A coalition of West Coast, Democratic-led states formed a new public health alliance to provide “science-driven” advice on vaccines, in defiance of Kennedy. Washington, Oregon, Hawaii and California said they will provide "evidence-based unified recommendations to their residents” based on the guidance of national medical organizations.

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