As of July 1, a new law will allow the state of Maryland to determine what vaccines can be administered to individuals at least seven years of age, while also reducing certain out-of-pocket costs for families. Gov. Wes Moore on Tuesday signed the “Vax Act,” officially decoupling the state’s vaccine policy from shifting federal guidelines.

The law directs Maryland’s health secretary to set recommendations for immunizations, screenings and preventive services, and requires insurance companies to cover vaccines endorsed at the state level.

According to the bill’s fiscal and policy note, implementation will be funded through the Maryland Insurance Administration’s budget, which draws more than $50 million annually from special funds — taxpayer dollars designated for specific uses. That revenue is expected to increase under Moore’s fiscal 2027 budget.

Supporters say the law expands access to care. Under the Vax Act, families who follow state recommendations will not have to pay out of pocket for certain vaccines. Health professionals have also backed the move, noting that it counters recent federal changes that deviate from medical advice issued by leading medical organizations. Still, critics warn the shift could create confusion. Differences between state and federal recommendations, they argue, may make it harder for parents to navigate health care decisions for their children.

The Vax Act was among the first 146 bills that Moore signed into law after the Maryland General Assembly concluded the 2026 legislative session.

“Our vaccine policy in the state of Maryland will be driven by science and not driven by internet conspiracy theories,” Moore said at a signing ceremony. He emphasized that the measure is focused on protecting residents and ensuring access to reliable, evidence-based care.

House Speaker Joseline Peña-Melnyk noted that the Vax Act, like every other bill passed this legislative session, was considered through the lenses of affordability, accountability and opportunity.

Republicans expressed skepticism about both the cost and the structure of the new system. Senate Minority Leader Steve Hershey questioned the financial impact at a time when the state faces budget concerns and warned that moving away from federal standards could undermine clarity.

“For decades, vaccine recommendations have followed a coordinated federal process grounded in broad medical consensus,” Hershey said. “Creating a separate Maryland track is unnecessary and sets a troubling precedent.”

Senate Minority Whip Justin Ready echoed those concerns, adding that federal agencies should continue to play a central role in shaping state health policy. He also criticized the inclusion of outside medical organizations in the decision-making process, saying it elevates advocacy groups alongside federal authorities.

“Putting the American Academy of Pediatrics at the same level of influence as the Federal Health Department and State Department seems wrong to me,” Ready said.

Moore first introduced the Vax Act in January, aiming to expand the authority of the state’s health secretary with input from organizations such as the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.

The law also maintains existing state policies requiring insurance coverage for recommended vaccines and allows pharmacists to administer certain immunizations, including flu and COVID-19 shots, without a prescription to patients as young as 3 years old.

The legislation follows recent changes by the Centers for Disease Control and Prevention, which reduced the number of routine childhood vaccines from 17 to 11 and shifted others to high-risk or case-by-case recommendations. Some medical experts warn that those changes could lead to increased hospitalizations and preventable illnesses among children, adding urgency to Maryland’s decision to chart its own course.

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