Ideally, the United States wouldn’t have a patchwork public health system, with different vaccine recommendations depending on where Americans live. But with Health Secretary Robert F. Kennedy Jr. taking a sledgehammer to the federal system, once-trusted public health departments reeling under politically imposed chaos and Republican-led states moving in radical and dangerous directions, the national system that has existed for decades without controversy has been rendered unsustainable.

And so, reality-based officials are having to get creative.

NBC News reported, for example, on three West Coast states forging a new public health alliance to provide “credible information” about vaccine safety to the public.

The governors of California, Oregon and Washington announced Wednesday that they were working to provide unified recommendations to ‘ensure residents remain protected by science, not politics.’ The action comes after months of upheaval at the Centers for Disease Control and Prevention, including the firing of the agency’s director last week.

The Democratic governors — Washington’s Bob Ferguson, Oregon’s Tina Kotek and California’s Gavin Newsom — warned that the public would likely face “severe” consequences if the CDC becomes “a political tool that increasingly peddles ideology instead of science.”

Their joint statement added, “President [Donald] Trump’s mass firing of CDC doctors and scientists — and his blatant politicization of the agency — is a direct assault on the health and safety of the American people.”

What’s more, they’re not alone. The New Republic’s Greg Sargent reported last week:

[Democratic Gov. JB] Pritzker’s health department in Illinois is currently exploring the possibility of purchasing Covid-19 vaccines in bulk straight from manufacturers in response to the mess in Washington, a senior Illinois health official confirms to me. Meanwhile, a coalition of mostly blue states led by Massachusetts Governor Maura Healey is planning to coordinate on the purchase and distribution of pediatric vaccines, should the federal government restrict access to them, according to a source familiar with ongoing discussions.

Indeed, The Boston Globe reported this week that Healey “essentially wrote a prescription for Covid shots for every person in the state over the age of 5, a move that would blunt potential federal restrictions on Covid boosters.”

That news coincided with news out of Pennsylvania, where the Democratic-led state government announced that pharmacists throughout the state can offer new Covid vaccines without concern for unnecessary restrictions imposed by the Trump administration.

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The Philadelphia public media station WHYY reported, “The state will recognize vaccine recommendations from major medical organizations like the American Academy of Pediatrics in addition to other professional medical groups in the absence of federal guidance from the Centers for Disease Control and Prevention.”

This came on the heels of similar developments in New Mexico, where the Democratic-led state government announced last week that it was ordering pharmacies to “remove potential barriers and ensure access to COVID-19 vaccines.”

While these efforts are likely to save lives, they are only a partial solution: Dangerous contagions and communicable diseases don’t care about arbitrary state boundaries.

But given the circumstances, it’s nevertheless encouraging to see Democrats and other officials in blue states scramble to do the right thing — unlike Trump appointees at the federal level.

Dr. Michael Osterholm, a University of Minnesota vaccine expert who heads a project to help states and professional societies make science-based vaccine recommendations, told the Globe this week, “This is one of the most dangerous times that public health has faced in the last 50 years.”