We need an Alt-CDC, funded by a coalition of states. Hire everyone from the CDC that the Trumpies have fired. And when the next pandemic hits, the states that refused to support the Alt-CDC can pay for the vaccines that they will desperately want once they confront the reality of disease.
Wrinkles: CDC recs inform the ACIP recs, which dictate CMS coverage, with HHS having final say. Other insurance companies typically follow CMS guidelines. Lack of coverage = decreased utilization = decreased/eliminated production. Clinics lose $ on vaccines, so can't make up the difference for pts.