HARRISBURG — Pennsylvania’s governor has considerable power over policies that affect children’s well-being, from vaccination schedules to childcare subsidies to high-level efforts at preventing harm or death.
Democratic Gov. Josh Shapiro has fought the Trump administration’s overhaul of vaccine recommendations by directing state-level authorities to adopt alternatives and challenging the changes in court. He has overseen an expansion of childcare tax credits and called for the legislature to increase funding for county teams that investigate the deaths of children.
Republican state Treasurer Stacy Garrity says she would promote vaccination among commonwealth families, but has said little else publicly about key issues affecting children. Her campaign responded to Spotlight PA’s request for clarity on some topics, but not others, like childcare.
Ahead of the Nov. 3 election, here’s a look at where the two major party candidates stand. For information about education, you can read Spotlight PA’s separate guide here.
Disease control
Addressing the ongoing measles outbreak in Pennsylvania and across the country is a priority for policymakers. The commonwealth has the most cases in the nation; within the state, Lancaster is the worst-hit county.
The rising number of cases and a high-profile dispute between Shapiro and federal Health Secretary Robert F. Kennedy thrust the issue into this year’s gubernatorial race.
This summer, Shapiro held a news conference announcing two deaths his administration said were related to measles — the first such deaths, the administration said, in 35 years.
“When the information we see coming from the federal government in some cases isn't driven by facts and by science, it makes it even more confusing for parents. And that has a serious impact,” Shapiro said at the news conference, promoting MMR vaccines. “All we want to do as parents is what's right for our kids.”
The Trump administration publicly questioned whether the deaths had actually been caused by measles — Kennedy wrote that they may have been “fabricated by one of the Governor's hopeful staffers.”
(Both deaths were of infants. Lancaster County’s coroner said he concluded one infant’s death was caused by measles, while he disagreed with other medical professionals that the other was.)
These clashes over how to tabulate measles deaths have continued as the epidemic has worsened: As of Oct. 27, the Pennsylvania Department of Health reported 1,286 total cases this year, concentrated in the center of the commonwealth, and five measles-associated deaths. The CDC has confirmed only three measles-related deaths nationwide and has not said which states they were in.
Kennedy and Trump have argued Shapiro should be working more closely with the federal government to mitigate the outbreak by requesting aid from the CDC. They have also said he rushed to announce the deaths for political gain.
The Shapiro administration says it has the resources and staff to address the measles outbreak, and it has seen a rise in the number of vaccinations given since it began.
In September, the administration asked the CDC for additional aid, but added a condition that the agency recognize the deaths it identified as measles-related. It’s unclear if the CDC agreed to those terms, but it announced this month it would send more support to Pennsylvania.
Garrity has heavily criticized Shapiro for his response to the measles deaths, claiming he used them “to score cheap political points.” In an emailed statement, she told Spotlight PA that she would have taken a different approach.
“I would have deployed health officials to the area of the outbreak to get to the bottom of the crisis, and then employed a strategy to address, contain, and end the outbreak before it expanded,” she said. “I would have partnered with the localities as well as the federal government to ensure the Commonwealth had every resource and tool at our disposal.”
She said her only public comments would have been to tell Pennsylvanians what her administration was doing to control the outbreak.
Vaccines
The measles outbreak isn’t the only time Shapiro has clashed with Kennedy and the Trump administration over health policy.
Last year, following a Kennedy-backed overhaul of the CDC’s Advisory Committee on Immunization Practices (ACIP), the Trump administration began working to change federal vaccine recommendations and access. This included reducing the number of recommended childhood vaccines. (Health experts raised concerns about the shift, arguing it could confuse parents on when to vaccinate their kids and lead to fewer immunizations nationwide. The American Academy of Pediatrics called it “dangerous and unnecessary.”)
Shapiro publicly called on Pennsylvania’s Board of Pharmacy to resolve the situation, and the board voted to rely on suggestions from other “competent authorities” — beyond the Kennedy-controlled ACIP.
Pennsylvania officials chose to adhere to the vaccine schedule recommended by the American Academy of Pediatrics.
Shapiro also signed an executive order in 2025 broadly aimed at maintaining vaccine access amid shifting federal recommendations.
The order sought to backstop a federal program that guarantees vaccines to children, saying if federal officials reduce the vaccines available through the program, the state will work to keep them free. It also directs the state Insurance Department to require insurers to cover any vaccines endorsed by “leading medical organizations,” not just the CDC.
Separately, Shapiro signed on to a multistate lawsuit to challenge the federal changes.
“The Trump Administration and RFK Jr. are once again ignoring decades of science and evidence, pushing slop research that isn't based in reality and actively imposing new policies that will lead to more children getting sick from preventable diseases,” Shapiro said in a statement announcing the lawsuit.
Shapiro’s office did not respond to a question about whether the governor would support changes to state vaccination law, which allows exemptions for children in public schools and subsidized childcare programs for medical, religious, or philosophical convictions.
Garrity’s campaign told Spotlight PA in an email she respects “the religious beliefs of all Pennsylvania residents,” but she “would encourage families to vaccinate their children.”
Garrity attended a student nutrition rally with Kennedy in the state Capitol earlier this year, but has tried to put some space between herself and the secretary. Asked at the gubernatorial candidates’ only debate if she supports “what he stands for,” Garrity said she only appeared with Kennedy “in support of, basically, healthy eating for our kids.” She reiterated that she is fully vaccinated and believes in vaccines.
Childcare access
Childcare is getting more expensive, and staffing shortages, rising operating costs, and the loss of pandemic-era funding are all contributing to a crunch for families. Advocates argue this is bad for the economy because it forces parents to miss work, harming them, their employers, and ultimately state finances.
Garrity’s campaign did not respond to questions about whether her administration would seek to make childcare more affordable. Spotlight PA could not locate any information about Garrity’s position on her campaign website or in news articles.
Shapiro and state lawmakers have agreed to a number of proposals targeting the industry since he entered office.
He has acted multiple times to expand Pennsylvania’s Child and Dependent Care Enhancement Tax Credit. Modeled on the federal Child Tax Credit, the Pennsylvania version was created in 2022 under the previous Democratic administration. It returns a portion of childcare-related expenses that filers claim on their federal tax returns.
In 2023, Shapiro’s first year in office, he signed a law expanding the credit from up to 30% of the federal credit to 100%. That increased the maximum per-family credit from $630 to $2,100.
In 2025, Shapiro and the General Assembly also created a tax credit for employers who contribute to their workers’ childcare costs — employers can claim up to 30% of their eligible contributions, with a cap of $500 per employee.
That same year, state lawmakers allocated $25 million to fund roughly $450-per-person bonuses for people employed at licensed Child Care Works providers. Pitched as an effort to stabilize the childcare industry and recruit workers, this year’s budget expanded the effort by an additional $5 million.
Funding for the Pre-K Counts program, which provides free pre-kindergarten for income-eligible families with kids three and older, has also grown under Shapiro’s tenure.
Shortcomings in prevention
Counties across the commonwealth are failing to keep up with a state mandate that they review the circumstances of every death of a person under the age of 21, then use the data to come up with prevention strategies. Spotlight PA found earlier this year that just half of all cases have been reviewed by county panels since 2020.
That’s just one of the prevention programs Pennsylvania has. Advocates have also criticized the effectiveness and transparency of county-level investigations under Act 33, which requires them in situations where a child younger than 18 dies or nearly dies due to suspected abuse or neglect.
Neither candidate responded to a question about what changes to Act 33, if any, they’d pursue.
To address the shortcomings of the Child Death Review program, Shapiro pitched lawmakers on $2.5 million to aid state-level coordination of the review effort. They approved less than $250,000 as part of this year’s state budget.
Shapiro’s office expressed disappointment about the lower funding, with spokesperson Rosie Laposky calling the budget a “result of compromise and reflects the reality of working with a divided government.”
Garrity did not respond to a question asking how she would address the program.
BEFORE YOU GO… If you learned something from this article, pay it forward and contribute to Spotlight PA at spotlightpa.org/donate. This story was funded in part thanks to the support of the Lancaster County Local Journalism Fund. Learn more about how we are supported here.