When the CDC's Advisory Committee on Immunization Practices , or ACIP, met last week, confusion filled the room.

Members admitted they didn't know what they were voting on, first rejecting a combined measles-mumps-rubella-chickenpox vaccine for young toddlers, then voting to keep it funded minutes later. The next day, they reversed themselves on the funding.

Now Jim O'Neill, the HHS deputy secretary and CDC's acting director — a lawyer, not a doctor — must sign off. The panel's recommendations matter because insurers and federal programs rely on them, but they are not binding. States can follow the recommendations, or not.

Regional blocs step in

On the West Coast , California, Oregon, Washington and Hawaii have joined forces in the West Coast Health Alliance . Their first mov

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