Anti-vaccine movement

How the anti-vaccine movement crept into the GOP mainstream

'Appeals to freedom are like the gateway drug to pseudoscience.'

By ARTHUR ALLEN

The anti-vaccine movement, which swelled with discredited theories that blamed vaccines for autism and other ills, has morphed and grown into a libertarian political rebellion that is drawing in state Republican officials who distrust government medical mandates.

Anti-vaccine sentiments are as old as vaccines themselves — and it’s been nearly 300 years since smallpox immunization began in what is now the United States. Liberal enclaves from Boulder, Colo., to Marin County, Calif., have long been pockets of vaccine skepticism. But the current measles epidemic, with more than 880 cases reported across 25 states of a disease declared eradicated in the U.S. 19 years ago, shows it gaining power within the GOP mainstream.

What’s new about the current anti-vaccine movement is the argument that government has no right to force parents to vaccinate their kids before they enter school. While Trump administration health officials and most Republicans in Congress still back mandatory vaccination, opposition is gaining steam among Republicans in state legislatures.

Among some of these officials, that libertarian demand for medical freedom has displaced the traditional GOP view that it’s a civic responsibility to immunize your kids to prevent the spread of disease. As more politicians take an anti-mandate stand, some end up adopting bogus theories about the supposed harms of vaccination — threatening to roll back one of public health’s great achievements.

In Kentucky, Gov. Matt Bevin said vaccine mandates were un-American. In Oregon, the state party used vaccine mandates to bash Democrats as violating parental rights. And in the California Senate, all 10 Republicans last Wednesday opposed a measure aimed at stopping bogus medical exemptions from vaccination.

President Donald Trump gave measles vaccination a nine-second endorsement on the White House lawn recently. “They gotta get their shots,” he told a press scrum on April 27. In a speech at the World Health Assembly last week, HHS Secretary Alex Azar decried misinformation from “conspiracy groups” that “confuse well-meaning parents.”

Azar and other top health officials, at the CDC and elsewhere, have advocated consistently for vaccination. But Trump himself has shown a disdain for scientific and government expertise, and for years — including during his campaign — he backed a debunked claim that childhood shots cause autism.

The arguments of the skeptics — that vaccine-preventable diseases like measles are God’s will, a natural process, or even a way of strengthening a child’s immune system, that the government and a rapacious pharmaceutical industry are joined in an insidious cover-up of the dangers of vaccines — are varied, and cut across political and geographic spectra, from ultra-liberal bastions of California to the religious conservatism of the South.

The GOP tilt is more pronounced among state lawmakers than among federal ones; many prominent Republicans in Congress including most of the 16 GOP doctors have endorsed vaccines. The most visible and voluble exception is Sen. Rand Paul (R-Ky.), an ophthalmologist who says his own kids were vaccinated but the decision should be left to the parents, not the government.

But in states where legislators have advanced serious efforts to tighten restrictions, such as Maine, Washington, Colorado and Oregon, nearly all of the opponents are Republicans who’ve taken a medical freedom stance.

“The more they dig into it being about freedom, the more susceptible they become to the theories,” said Dave Gorski, a Michigan physician who has tracked the anti-vaccine movement for two decades. “Appeals to freedom are like the gateway drug to pseudoscience.”

At the extremes are legislators like Jonathan Stickland, a pro-National Rifle Association, Christian conservative in the Texas Legislature, who has described vaccines as “sorcery” while personally attacking Baylor University scientist Peter Hotez, who has a daughter with autism and works on vaccines for neglected tropical diseases. “Parental rights mean more to us than your self-enriching 'science,'" Stickland tweeted at Hotez earlier this month.

That same day, the Oregon Republican Party’s official Twitter account posted that Oregon Democrats were “ramming forced injections down every Oregon parent's throat.”

Other Republican state officials have blamed Central American immigrants for disease outbreaks, echoing a talking point of Fox commentator Lou Dobbs. In fact, experts say, children in many of those countries are more thoroughly vaccinated than their U.S. counterparts against diseases like whooping cough and measles.

In Washington state, the House sponsor of a bill to end exemptions from measles vaccination was state Rep. Paul Harris, a moderate Republican whose district was the epicenter of a measles outbreak. But in the state Senate, the entire 20-member GOP delegation — as well as two Democrats — opposed the bill, although they failed to defeat it. In his signing statement, Gov. Jay Inslee, who is seeking the Democratic presidential nomination, said pointedly, “We believe in science. ... And that is why in Washington state, we are against measles.”

In Oregon, where, again, most but not all opposition came from Republicans, Democratic Gov. Kate Brown killed an effort to tighten exemptions as part of a compromise with Republican leaders over a tax bill.

Vaccination was not a partisan issue in the past and even today, in states where vaccination hasn’t become politicized, GOP governments are sometimes as likely as Democratic ones to tighten vaccine requirements. Wyoming, for instance, is deeply conservative, but its state health department in a little-noticed decision last year created an immunization registry, added two vaccines to a list of school-entry requirements, and required home-schooled children to be vaccinated if they want to participate in sports or theater.

In neighboring Colorado, though, opposition to vaccine requirements became an attractive issue for conservatives, a minority in the state Legislature. Colorado has one of the country’s lowest rates of vaccinated kindergartners, but when Democrats tried to pass a modest bill requiring parents to take their vaccination exemption forms to the health department, hundreds came out to testify against it. The witnesses ranged from conservative Christians to parents with children they think were hurt by vaccines, to “natural living” types who don’t want vaccines to muck around with the immune system. But with a few exceptions, it was Republicans who helped stall and kill the bill.

“The antivax messaging has shifted from a focus on questions of safety to things like parental rights and data privacy, and those messages resonate more with conservative lawmakers and play to the GOP political base,” said Stephanie Wasserman, executive director of the Colorado Children's Immunization Coalition.

People who prefer whooping cough

Not all that long ago, the anti-vax movement was dominated by the granola-eating, pharma-distrusting left. Conservative opposition was centered among people who also tended to see water fluoridation as a communist plot. In addition to the political fringes, a few religious sects opposed vaccination for doctrinal reasons — some small churches see them as arrogant interference with God’s plans; adherents of Rudolf Steiner, who propounded what he called anthroposophic medicine, think high fevers are key to a child’s spiritual growth.

The anti-vaccine club includes people like the former dentist Len Horowitz, who suggested that Ebola and HIV were created in CIA-funded laboratories, and the late Harris Coulter of Washington, D.C., whose books linked the pertussis vaccine to everything from blindness to serial murder and attraction to loud rock music.

A good share of the opposition arises in parents who claim to have seen harm from vaccines in their kids. Autism is often diagnosed around the time of the first measles shot, and while research has thoroughly refuted a causal link, it’s hard to shake the convictions — or convincing power — of a parent with a disabled child.

And like any pharmaceutical product, vaccines can, rarely, cause serious adverse events. Scientists at the CDC, FDA and elsewhere get paid to research side effects. Over the years, they have investigated evidence of harm from pertussis and measles shots, and traces of mercury and aluminum in vaccines. They’ve examined theoretical links to autism, allergies and sudden infant death syndrome — all negative. But the anti-vaccine movement waxes and wanes on political currents that have little to do with the evidence. Since Trump began his ascent in 2015, the movement has been growing.

Paranoia, mysticism and cultural pessimism still contribute to anti-vaccine thinking, but freedom from persecution is increasingly the banner raised in social media and public appearances. At a 13-hour committee vaccine bill hearing in the Colorado House last month, there were a lot of parents like Thomas Olmstead, who called the bill “a step toward the complete erosion of our medical freedom.”

Mistrust of government also seems to have underlain the epidemic that struck parts of New York’s ultra-Orthodox Jewish community, a crisis that took scientists by surprise. “I can’t recall in my time at CDC or since where the Orthodox community was involved in anti-vaccine beliefs,” said Walter Orenstein, who led immunization efforts at CDC from 1988 to 2004 — and happens to come from a family of rabbis.

Vaccine resistance has swept into conservative areas of Texas, where parental refusal rates doubled over just a few years. Unsurprisingly, perhaps, rates of refusal increased somewhat in liberal Austin, but the biggest upticks occurred in places like suburban Dallas and Trump-loving West Texas. In Gaines County, midway between Odessa and Lubbock, the percentage of vaccine refuseniks went from 3 percent to 9 percent from 2012 to 2018.

The late feminism opponent Phyllis Schlafly opposed vaccine mandates for years, but she was considered a right-wing gadfly for much of her career. The party has moved toward her. Her son Andrew Schlafly became lead counsel for the Association of American Physicians and Surgeons, a group that’s skeptical of vaccination and for a time counted former Trump HHS Secretary Tom Price as a member.

Kentucky’s Bevin, a conservative, said in March that he had taken his nine kids to a “chickenpox party” to catch the disease. In the pre-vaccine days, doctors recommended this practice because highly contagious chickenpox has fewer complications in the young, so it was actually safer to get it in childhood than later in life. But the chickenpox vaccine, licensed in 1995, changed that. Science had moved on, but not Bevin. “This is America, and the federal government should not be forcing that on people,” he said.

“There’s a populist shift, this ‘The government is telling me I have to do this,’ and then they buy into the conspiracy theories to find motives,” said Angie Anderson, a registered Republican with two small children who testified at one of the Colorado hearings — in favor of the bill tightening vaccine requirements. “It plants seeds of doubt and it’s gaining traction, and it scares me.”

The current measles outbreak can in part be traced back to a 1998 Lancet article by the British gastroenterologist Andrew Wakefield, which linked measles vaccination to autism, setting off a wave of fear. The paper, since disproved and retracted, has become a classic of sorts — frequently employed in college statistics courses to demonstrate bad scientific practice.

Notwithstanding the ridicule, and the fact that Britain stripped him of his medical license in 2010, Wakefield met with Trump during the 2016 campaign, and he’s been interviewed by Tucker Carlson. Robert F. Kennedy Jr., who clings to the long-disproven theory that trace mounts of mercury in certain vaccines caused an autism epidemic, says Trump aides after the election promised to appoint him to a committee to investigate HHS’ vaccine programs.

Del Bigtree, a former TV journalist, teamed with Kennedy and Wakefield to make a tendentious anti-vaccine film. The three men often speak at rallies in state capitols where bills are under consideration, usually in the company of a few Republican state legislators.

The growing clout of the anti-vaccine movement is visible even at the CDC, where hundreds of vaccine opponents show up to speak during public comment periods at thrice-annual meetings of the Advisory Committee on Immunization Practices, the CDC’s key immunization overseer.

“I don’t tune them out, but the concerns they have — safety, appropriateness of vaccine trials — don’t raise a red flag with me,” said committee Chairman José Romero, a University of Arkansas pediatrician. “I wish the public would understand that the safety of these vaccines is looked at many times along the way to their children.”