ARI SHAPIRO, HOST:
The end of summer is normally the time of year when doctors and pharmacists start to suggest vaccinations for viruses like flu and COVID based on federal recommendations. But this year's very different. With Robert F. Kennedy Jr. leading the Department of Health and Human Services, the process and guidance have changed significantly, over the objections of many doctors and epidemiologists. Now some state public health officials are considering how they might collaborate to issue their own public health guidance. Dr. Robbie Goldstein is the commissioner of the Massachusetts Department of Public Health, and he's one of the leaders of that effort. Welcome to ALL THINGS CONSIDERED.
ROBBIE GOLDSTEIN: Thanks for having me.
SHAPIRO: What do you make of the changes to the CDC's vaccine recommendations this year?
GOLDSTEIN: Yeah, I think so far, what we've seen out of CDC is minor changes that they have been making throughout the summer, but they're adding up to pretty significant changes to our vaccine policy here in America. I think in particular what we've seen is a direct attack on some of the types of vaccines that we use in this country, including mRNA vaccines, and specific diseases that we know are important to protect against, but yet are being called into question by the current federal administration. In particular, I want to call out COVID-19.
SHAPIRO: And so that's one of the reasons that you pulled together this group of public health leaders from across eight states in the Northeast to start a conversation about possible collaboration. Explain how that would work. How would this region issue public health guidance when the CDC has public health guidance that might conflict with it?
GOLDSTEIN: I want to first say that states have always traditionally put out their own guidance for their own states, to make sure that the information that we're sharing resonates with our communities and the people that live in our states. So we're not necessarily doing anything different this year. What we are doing is we're coming together proactively, and we're making a commitment to do this process transparently and together. And we think by doing so, we'll help build trust in the recommendations that we put out, and we'll also make sure that we're protecting as many people as possible across the Northeast.
SHAPIRO: That question of trust seems really foundational here. Do you run the risk of muddying the waters if, for example, the CDC says, healthy people over the age of 18 don't all need to get a new COVID shot, and yet Massachusetts and seven other states say, healthy people over the age of 18 do need to get a COVID shot, to take a hypothetical?
GOLDSTEIN: Well, I think trust is really built through conversation and through transparency. And so if we in the Northeast come together and share our data publicly, I do think we can build trust, even if our recommendations are different than what we see out of the federal government. I also hope that what we're doing here in the Northeast might be an example that we could set for others across the country, and certainly for the federal government, about how they can use data and how they can present those data transparently in their decision-making process.
SHAPIRO: Does this ultimately lead to a future where you have one set of health policies for red states and another for blue states, no matter who's in charge at the federal level? - 'cause you could imagine a scenario where a Democratic HHS secretary endorses a vaccine that public health appointees in Texas or Florida might oppose.
GOLDSTEIN: Well, I certainly hope that doesn't happen, and that is not our intention with the Northeast collaborative. I'll note for folks that in the Northeast we have Democrats and Republicans, including Democratic and Republican governors and state legislators. We're coming together not based on partisan politics, but we're coming together rather because of science and evidence.
SHAPIRO: I know you said this is not political, but for so many decades Democrats have said, the federal government is acting in your best interests, while Republicans have said, listen to us at the state level. It really does seem like the tables have turned - that you're now saying, people shouldn't necessarily trust the federal government's guidance. Trust us, the state appointees, instead.
GOLDSTEIN: It may feel that way, but so much has changed in the past nine months that this feels like a necessity. It feels as if we have to shift in this way. The reason that historically Democrats may have pointed to the federal government and to the guidance is that we could believe in that guidance. We knew that that guidance, those recommendations, were based in fact. That's just not the case now. We oftentimes see decisions being made by a tweet or a post on Truth Social, decisions in public health being made by a video posted to YouTube. That's not the system that we've existed in before, and so it requires us to change our tactics.
SHAPIRO: What's at stake? What are the risks here?
GOLDSTEIN: I think, you know, if we don't rely on the evidence, if we don't use data to drive our decisions, we will see people get sick. We'll see the health of our communities fail. We'll see our hospitals fill with people who have vaccine-preventable diseases. And I don't think we have to look too far into the future to see that. If we take a look just this past year at what happened in West Texas with a measles outbreak spreading to many other states in the region and other countries, that's what happens when we don't use evidence and data to drive the recommendation. In the case of measles, we know that the measles vaccine is safe and effective, but that message didn't come clearly from the federal government.
SHAPIRO: Dr. Robbie Goldstein is commissioner of the Massachusetts Department of Public Health. Thank you very much.
GOLDSTEIN: Thanks so much for having me. Transcript provided by NPR, Copyright NPR.
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