With US Health and Human Services secretary Robert F. Kennedy, Jr. already shaking up federal vaccine policy, some states are stepping in to preserve access to lifesaving shots in anticipation of further changes. If ACIP no longer recommends certain vaccines, individuals could be forced to pay out-of-pocket for livesaving vaccines that have long been provided at no cost. Some state legislators are anticipating more drastic changes to federal vaccine recommendations. Colorado, a predominantly Democratic state, passed legislation during its last legislative session to safeguard access to vaccines even if federal guidelines shift. A Massachusetts bill filed in July by Democratic governor Maura Healey would allow the state’s public health commissioner to determine routine childhood immunizations without exclusively needing to consider ACIP recommendations.