• Arkansas: Last week, U.S. District Court Judge Brian Miller issued a preliminary injunction against an Arkansas law that would prohibit companies that own pharmacy benefit managers (PBMs) from operating retail and mail-order pharmacies in the state. The law, which was signed in April and expected to go into effect in January 2026, was the first of its kind in the country. Several major companies and healthcare organizations, including CVS Health, Express Scripts, and the Pharmaceutical Care Management Association, pushed back against the law, arguing that it is unconstitutional and discriminates against out-of-state entities. According to STAT, an earlier version of the law would have required Walmart, which is based in Arkansas, to close its pharmacies since it administers its own pharmacy benefits for employees, but legislators amended the policy to exempt the company. In his ruling, Miller agreed with the companies, saying that the law "appears to overtly discriminate against plaintiffs as out-of-state companies and the state has failed to show that it has no other means to advance its interests." Arkansas attorney general Tim Griffin (R) issued a statement detailing plans to appeal the ruling, but Michael Gordon, who heads legal research at Washington Analysis, said that "the most likely action is for the parties to continue to litigate the case in the district court to final judgment." (Silverman, STAT+ [subscription required], 7/29)
• Georgia: According to new CDC data, U.S. childhood vaccination rates have continued to decline, and vaccine exemptions are now on the rise. Before the pandemic, the childhood vaccination rates for several diseases, including polio, whooping cough, and measles, mumps, and rubella, were around 95%, but they have since fallen to just over 92%. Although these declines may seem small, they have contributed to a significant rise in infectious diseases. In 2024, there were more than 32,000 cases of whooping cough, the highest number in a decade. There have also been several outbreaks of measles this year, with cases reaching their highest number since the virus was declared eliminated in 2000. At the same time, exemptions for vaccines have continued to rise. Although medical exemptions for vaccines have remained steady for years at around 0.2%, the percentage of nonmedical exemptions has increased, reaching 3.6% in the last school year. According to CDC, vaccine exemptions increased in 36 states and Washington, D.C., with 17 states reporting exemptions of over 5%. (Mandavilli, et al., New York Times, 7/31; Stobbe, Associated Press, 7/31)
• Massachusetts: Last week, Moderna announced plans to lay off around 10% of its workforce, or over 500 employees, as it continues efforts to reduce operating costs amid challenges in the vaccine industry. According to STAT, Moderna has already cut costs in several areas, including research and manufacturing, in attempts to cut operating expenses by $1.5 billion by 2027. "Every effort was made to avoid affecting jobs," but layoffs were necessary so the company could align its "cost structure to the realities of our business," Moderna CEO Stéphane Bancel wrote in a note to employees. "I know this is a difficult moment for the company. We all feel a range of emotions whenever we have to say goodbye to colleagues." By the end of the year, Moderna expects to have fewer than 5,000 employees worldwide, down from 5,800 workers at the end of 2024. (Feuerstein, STAT+ [subscription required], 7/31)

Writing for The Atlantic, Sarah Zhang analyzes how past and present vaccination campaigns in the United States have attempted to boost child vaccination rates — and why vaccine uptake among children has never been "immediately universal."