Millions of dollars have been drawn from state and local vaccination programs without explanation, After reviewing funding contracts by the US Department of Health and Human Services.
The affected programs may have to cut staff and services due to shortages, and they are worried that vaccination rates will also decline if they lose their ability to support low-income and uninsured people.
Vaccination programs across the nation are already struggling to deal with the rise in vaccine-preventable diseases. These include pertussis, which has made more than 10,000 Americans sick this year and killed five children, as well as pertussis, and the smoldering appearance of measles, which kills three people in the United States and threatens to end the state’s exclusion status.
“That’s the baffling part,” said one policy expert who spoke to CNN on the condition that it wasn’t named for fear of government retaliation. “Why does everyone cause this confusion in the midst of the worst measles outbreak of 30 years?”
Most of the money the state spent on vaccinations comes from the federal government.
Grants allocated by Congress under section 317 of the Public Health Services Act allow states, regions and several large cities to collect vaccination data and provide shots to children and adults who are not receiving services. The funding will also help monitor vaccine safety and combat misinformation. The funding was released in a five-year grant overseen by the U.S. Centers for Disease Control and Prevention, with the latest award being by the state on July 1st.
However, this year, HHS conducted a lengthy review of the awards, and in some cases delayed their arrival.
HHS Communications Director Andrew Nixon said the review was part of the agency’s cost-cutting efforts.
“The advocacy initiative is a departmental-wide effort to ensure that taxpayer dollars are being used effectively, transparently and in harmony with this administration,” Nixon said in a statement to CNN. “As part of this oversight, grant recipients may be asked to provide additional information, which is essential to prevent waste, fraud and abuse. HHS is committed to ensuring all grantees work to resolve any notable issues as quickly as possible, while maintaining the highest standards of accountability.”
Public health advocates say the latest funding cuts appear to be part of a larger pattern of effort by HHS Director Robert F. Kennedy Jr. to disrupt and dismantle America’s vaccination infrastructure.
“Millions of children missed out on daily vaccinations during the pandemic.” Dr. Caitlyn Rivers, director of the Johns Hopkins Bloomberg School of Public Health’s Center for Response and Outbreak Innovation.
Vaccine hesitancy is also on the rise, driven by a massive flood of misinformation, some of which are now coming from official channels.
As a result, vaccination rates have declined, and some communities are no longer protected by herd immunity. This is the vaccination threshold required to prevent the spread of certain infectious diseases easily.
If the state’s vaccination program is not properly resourced, “we will continue to be even more behind and set the stage for what we see as the outbreak of measles and whooping cough,” Rivers said.
Public health programs often become victims of their success, she said.
“If there is a massive public health emergency… there is a huge investment in public health because we can see very clearly that resources and inadequate infrastructure are the outcome.
“And I think now, five years after Covid, we’re seeing a lot of the investment we’ve made during the pandemic pull back, very clearly in the neglect cycle,” she added.
This year, it received approximately 40 awards below funding targets out of 66 jurisdictions awarded federal vaccination funds. More than a dozen states and cities have won awards this year, compared to 2019, just before the Covid-19 pandemic began, and just before the Covid-19 pandemic began, according to an analysis of CNN federal data.
Massachusetts, New York, Indiana, California and Arizona were among the fewest awards this year than in 2019 when the COVID-19 pandemic began.
“That’s really incredible for us,” said a public health advocate who asked not to name because he was afraid of political retaliation for opposition to the cut. “How can we get out of a pandemic that half of the state is not ready?”
Other states have found their awards far lower than they were said to be expected.
In January 2025, the CDC sent out notifications of funding opportunities (essentially invitations) to states, territories and certain metropolitan cities. It has a fundraising goal. This is the amount you can expect if the grant proposal is accepted.
For example, Washington was told it could expect around $9.5 million, so the Department of Health had planned that amount for 2026. But when the state was notified of the ruling on July 1, it was $18.8 million, a 18% cut.
Massachusetts was said to be able to expect $7.7 million next year, but it has already been cut by 20% from its 2025 budget. When the award arrived it was a target of $1 million, $6.7 million. In other words, we expect the division to operate with about 30% less funding than next year.
Colorado is almost $500,000 less than expected, down about 5% from the budget amount, according to federal government data.
California, Illinois, Michigan and New York have also received lower than expected funding awards, according to a CNN analysis of federal data.
Sometimes funding delays and errors caused confusion. At least one state, Idaho, has abandoned vaccination program staff without notifying them after notifying them as expected. When the award came a day later, they were returned to work, but the health care providers who had tentatively reached out to submit regular data updates had no one to help them and had no idea when the services would be restored.
The cuts didn’t just affect the state’s health department. The city of New Haven, Connecticut, had to fire the vaccination position supported by Saba Westland, which it received from the state grant. When the grant did not arrive in time, the state instructed the city not to owe any further costs, and when federal money passed it was 20% less than expected.
Chicago is also preparing to fire vaccination workers, according to multiple sources about the city’s plans that they asked not to name because they feared retaliation by the Trump administration.
However, not all awardees saw the cuts. Approximately 20 jurisdictions, including Alabama, Idaho, Wyoming and Montana, have won significant funding for this year’s awards target.
State officials who spoke to CNN for the story say they have not explained why this cycle has decreased or increased.
The cuts come in addition to billions of losses in undistributed symbiotic relief funds that were being used by the state to support staff vaccination programs. In late March, the HHS directed the CDC to roll back the approximately $11.4 billion Covid-era funding granted to state and local health departments. Another $1 billion was recovered from the Department of Substance Abuse and Mental Health Services.
A survey conducted by the Association of Vaccination Managers found that Covid Money Clawback alone led to the elimination of 579 staff in the state’s vaccination program.
Some jurisdictions after new grants have been cut They said they probably need to fire more workers, but were trying to assess the changes they thought were needed. Some programs said they hope that state funding will help fill the gap.
In the past, it was said that the amount of funding in a jurisdiction is expected to be determined by a relatively simple formula that was primarily dependent on the population of the region.
But this year, federal officials have rolled out a more complicated formula that takes into account population levels, how many states are rural, and how many healthcare providers will participate in the children’s program compared to the overall children’s program.
The vaccination program was said to be able to expect approximately $418 million in funding. Their awards totaled around $398 million.
However, the changes to the funding ceremony do not appear to take into account reductions. The formula was applied to the target amount distributed in January.
Instead, award changes were made after the HHS review.
Hawaii, for example, has been granted permission from the state government to pay wages until the award is made about two weeks later and borrow up to $100,000 to cover operating expenses.
Public health advocates denounced the fundraising decision.
“The 317 exemption funds combined with other losses starve state and local public health budgets, and are reckless, not myopic,” said Dr. Brian Castrucci, president and CEO of Debeaumont Foundation, a nonprofit advocate for the public health workforce.
“We’re looking at the deliberate demolition of public health safety nets in real time,” Castrucci said.
