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In the Age of Donald Trump, Vaccine Policy is Becoming Politicized, with Potentially Deadly Consequences

Traditionally state vaccination policy and school vaccine mandates have been as close to a nonpartisan issue as we have in this country. There has usually been broad bipartisan support for such mandates and the idea that children should be vaccinated in order to attend school. It’s a consensus that has served the country well for many decades now. What I fear is that this consensus is breaking down, and—even worse—school vaccine policies are becoming a partisan issue.

Back in December, I took note of the vaccine situation in Texas. First, I pointed out how a new article by Peter Hotez, MD, a pediatrician at Baylor University, had sounded the alarm that the number of schoolchildren with nonmedical exemptions to the Texas school vaccine mandate had skyrocketed by 19-fold over the last 13 or 14 years. As if that weren’t alarming enough, I discussed the resident antivaccine groups in Texas, who had become quite active. I thought that that was probably all I would write about Texas for a while. Silly me. Texas is fast turning into a series of its own, much as I did several posts a few years ago on how the outbreaks would happen in California because of its rising number of nonmedical vaccine exemptions. Then California passed SB 277, which eliminated nonmedical exemptions, and suddenly Texas is the new California.

Don’t believe me? Take a look at an article that was waiting for me in my in box yesterday morning. It’s from The Washington Post and entitled Trump energizes the anti-vaccine movement in Texas. As I like to say, our new President is the gift that keeps on giving when it comes to blogging material, but, really, I could do without all the excitement. Be that as it may, it looks as though antivaxers in Texas are really, really happy that Trump is President:

The group of 40 people gathered at a popular burger and fish taco restaurant in San Antonio listened eagerly to the latest news about the anti-vaccine fight taking place in the Texas legislature.

Some mothers in the group had stopped immunizing their young children because of doubts about vaccine safety. Heads nodded as the woman giving the statehouse update warned that vaccine advocates wanted to “chip away” at parents’ right to choose. But she also had encouraging news.

“We have 30 champions in that statehouse,” boasted Jackie Schlegel, executive director of Texans for Vaccine Choice. “Last session, we had two.”

Now they also have one in the White House.

President Trump’s embrace of discredited theories linking vaccines to autism has energized the anti-vaccine movement. Once fringe, the movement is becoming more popular, raising doubts about basic childhood health care among politically and geographically diverse groups.

I’ve written about Donald Trump’s embrace of antivaccine pseudoscience before. He has a long, sordid history of spewing antivaccine nonsense, both in interviews and on Twitter dating back to 2007. Then, of course, he met with disgraced British antivaccine “scientist” and antivaccine hero Andrew Wakefield during the height of the presidential campaign and, more recently, met with our very own American antivaccine activist, Robert F. Kennedy, Jr., purportedly to discuss setting up a “vaccine safety commission.” At least, that’s what RFK, Jr. claimed, although the Trump Administration was quick to say that nothing had been decided and they had really met about—cough, cough, vaccines—autism. Autism or vaccines, though, it was bad enough that Trump would met with a crank as incredibly cranky as RFK Jr. about vaccines or autism. In any case, you can tell that antivaxers are excited. They sense that one of their own—or at least someone with such a lack of scientific acumen and critical thinking skilled coupled with a conspiratorial mindset that he actually believes vaccines cause autism.

We’ve encountered Texans for Vaccine Choice before. As I pointed out at the time, many states have groups like this, but, like Texas, Texans for Vaccine Choice is big, at least bigger and more active than most groups like it. They’re also trying to mobilize antivaxers to act to persuade the legislature to do what they want:

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In San Antonio, 80 miles southwest of the state capital, Texans for Vaccine Choice convened a happy hour to encourage attendees to get more involved politically. The event was among dozens of outreach events the group has hosted across the state. The relatively new group has boosted its profile, aided by a savvy social-media strategy, and now leads a contentious fight over vaccines that is gearing up in the current legislative session.

If you wander over to the Texans for Vaccine Choice website, you’ll se that it’s pretty slick and that it also is full of the standard antivaccine talking points and misinformation. For instance, it proudly proclaims that this is about “freedom,” saying that “we promote the preservation of personal liberties and informed consent by opposing measures to limit vaccine choice rights or discriminate against those who exercise such rights. Of course, whenever an antivaxer says “freedom,” what he really means is the “freedom” to expose his child and community to potentially deadly infectious diseases and the “freedom” to use whatever quackery on his child that he so desires. Similarly, when an antivaxer says, “informed consent,” I like to go all Princess Bride on him, saying something like: “Informed. You keep using that word. I do not think it means what you think it means.” The reason, of course, is that the “informing” that antivaxers do and want is to vastly exaggerate the risks of vaccines, even attributing risks to them that are not supported by science, and to downplay the benefits of vaccines.

The worst thing is that, in Texas, the pro-vaccine advocates appear to be losing the battle:

Peter Hotez, director of the Texas Children’s Hospital Center for Vaccine Development, predicts that 2017 could be the year the anti-vaccination movement gains ascendancy in the United States. Texas could lead the way, he said, because some public schools are dangerously close to the threshold at which measles outbreaks can be expected. A third of students at some private schools are unvaccinated.

“We’re losing the battle,” Hotez said.

Although the anti-vaccine movement has been strong in other states, including California, Oregon, Washington and Colorado, experts say the effort in Texas is among the most organized and politically active.

“It’s a great example of an issue that has a targeted, small minority but an intense minority who are willing to mobilize and engage in direct action,” said Mark Jones, a political science professor at Rice University in Houston.

The reason is passion. Consider the story of Jinny Suh, who runs Immunize Texas, a group working to counter the antivaccine message of groups like Texans for Vaccine Choice. She’s fighting a brave battle, but is hopelessly outgunned by Texans for Vaccine Choice:

But immunization advocates like Suh say it’s hard to counter the passion of her opponents. Most people consider vaccinations to be such a basic part of life, like clean drinking water, that it’s hard to motivate them to take time to show up at lawmakers’ offices.

“We’re completely outgunned,” said Suh, adding there are only about a dozen members whom she can call on to show up for events. Immunize Texas is part of the Immunization Project.

Suh often writes emails and posts to the group’s Facebook account from her cellphone while caring for her two sons. She juggles her immunization advocacy, a mostly volunteer gig, with other businesses she runs from home.

And this has always been the problem. Most people really do consider vaccines just a part of life that are in general good for you. They think childhood vaccines are uncontroversial, and, scientifically, they are. As this WP article so nicely summarizes, the evidence that vaccination is not correlated with autism or any of the other disorders, diseases, and bad outcomes that antivaxers attribute to vaccines. It also nicely summarizes how the antivax movement is not, as the common misconception goes, a bunch of hippy dippy, granola-crunching left wingers. After all, this is Texas:

Vaccines aren’t a standard conservative or liberal issue. In many parts of the country, pockets of unimmunized children tend to be in white, upper-middle-class neighborhoods, including in Austin, said Anna Dragsbaek, who heads the Immunization Partnership, a Houston-based immunization advocacy group.

One particularly strong strain of anti-vaccine rhetoric in Texas is libertarian and anti-government. Texans for Vaccine Choice receives help and expertise from “friendly” lawmakers and groups such as Empower Texans, said Jonathan Stickland, a tea party Republican representative from Tarrant County and a key supporter. Political experts consider Empower Texans the state’s most sophisticated and influential conservative organization.

“Our message resonates with people,” said Schlegel, 37, in a brief interview after a day of meetings at the Capitol. “Texans value parental rights,” she said. “We have a message of liberty. We have a message of choice.”

As I’ve said more times than I can remember, antivaccine pseudoscience is an irrationality that appeals to both the right and the left, but for different reasons. On the left, it’s often due to a belief that “natural” is somehow better coupled with distrust of big business, especially big pharma, while on the right it’s “freedom” and anti-government rhetoric. Think of it this way. Political operatives know that people tend to be more passionate when they are against something rather than for something. It’s easier to get them to donate and do stuff to oppose a policy rather than to promote a policy. That was how the Tea Party got started, and we’re seeing what might be the start of a similar passion on the left in response to Donald Trump. So the antivaccine movement in Texas has slick, glossy literature, complete with red, white, and blue emblems to go along with the lies that vaccines aren’t tested adequately for safety and are full of “questionable ingredients” (a.k.a. “toxins”), while Suh doesn’t even have business cards.

They also have a message that resonates in a state like Texas. This might be the most telling passage in the article:

When the group recently sought volunteers on Facebook for “engagement days” at the state Capitol this month and in March, one woman said she wanted to help but was concerned she didn’t know enough about vaccines. Don’t worry, she was told. “Very little talk about vaccines and a LOT of talk about parental rights and CHOICE.”

Just the way Rand Paul said it when he said, “The state doesn’t own the children. Parents own the children, and it is an issue of freedom.” The antivaccine movement is full of this attitude, namely that parental “rights” trump any rights children might have as autonomous beings. The right of the child and any public health considerations are subsumed to parental “freedom to choose” and “parental rights,” with children viewed, in essence, as their parents’ property or an extension of the parents, to do with as they will, never mind what’s actually best for the child.

Here’s what worries me. Traditionally state vaccination policy and school vaccine mandates have been as close to a nonpartisan issue as we have in this country. There has usually been broad bipartisan support for such mandates and the idea that children should be vaccinated in order to attend school. It’s a consensus that has served the country well for many decades now. What I fear is that this consensus is breaking down, and—even worse—school vaccine policies are becoming a partisan issue, every bit as bitter and divided as many others.

I’m not the only one who’s had such fears, too. For instance, Saad Omer and Sarah Despres over at Politico expressed a fear that vaccine policy become as politicized as climate science, noting:

Increased politicization of the vaccination issue would be deadly, because it could spawn new anti-vaccination converts and further insulate the debate from scientific research, potentially lowering immunization rates and increasing the risk of disease. The likelihood of infectious disease outbreaks increases substantially when there is a “critical mass” of unprotected individuals in a community. For most diseases against which we vaccinate, this critical mass is achieved when at least 10 percent-20 percent of the population is un-vaccinated. Therefore, even a 70 percent-30 percent split in public opinion in favor of vaccines could result in an unacceptably low immunization rate. This type of divide will inevitably lead to reduced immunization rates and disease outbreaks. Thousands of people could die. So as the country becomes increasingly divided, we must ensure that vaccine remains on the fringes of both parties.

There’s a bit of false equivalence in the article, such as neglecting to note that powerful mainstream conservative forces in Texas and elsewhere are behind groups like Texans for Vaccine Choice, while there is no equivalent support on the “other side” to match. In essence, Empower Texans is using antivaccine conspiracy theorists like those running Texans for Vaccine Choice as cannon fodder in a larger battle to decrease government regulation and promote far right wing causes. Indeed, that’s why I’m so concerned. What I’ve sensed watching the antivaccine movement since Donald Trump jumped into the race for president is a rightward shift in its preferred politics. Basically, antivaxers love Donald Trump because the sense in him (correctly, I believe) a kindred conspiracy theorist. No, actually, I noticed it before that, with the antivaccine dog whistles about “freedom” and “parental choice” dominating the rhetoric over SB 277. That’s not to say that left wingers don’t have antivaccine dog whistles of their own (I’m talking to you, Jill Stein), but by far the loudest antivaccine dog whistles seem to be coming from the right these day. Yes, I do think a lot of it is due to Donald Trump, but it predates Trump as well. For example, Texans for Vaccine Choice sprang into being in 2015, when in the wake of the Disneyland measles outbreak, the state legislature considered bill like California SB 277.

Sadly, now that we’ve gone down this road, I don’t see a clear path to preventing the further politicization of school vaccine mandates and state vaccine policy. I fear that it might require much bigger outbreaks than we’ve seen thus far before we as a nation come to our senses about vaccines, at least.