Authors Richard Hughes IV and Lawrence O. Gostin argue that vaccination policy in the US now follows political identity more closely than epidemiology. They strongly recommend uniform, evidence-based national standards from federal agencies such as ACIP. States should follow these recommendations to avoid policy divergence. Previously, the single structure simplified the work of doctors and allowed widespread access to vaccines through school fees, the Vaccines for Children program and insurance under the Affordable Care Act. This system led to the decline of diseases such as measles, mumps, chicken pox and polio. High population vaccination provides herd protection for infants, transplant patients, and people on immunosuppressive therapy. Differences between states threaten residents of neighboring regions sharing schools, workplaces and transportation. These policies conflict with laws such as the National Childhood Vaccine Injury Act of 1986 and the Vaccines for Children Program of 1993.