The vocal backlash to COVID-19 vaccines and mandates around them is sparking concerns that the “anti-vaxx” movement is finding a way to broadcast its message far and wide and chip away at school vaccinations for other diseases.
Cyber-trackers say the anti-vaccine movement greatly expanded its reach on social media during the pandemic, and lawmakers in some states have floated bills that could water down long-standing immunization requirements or prevent colleges and institutions from adding any new vaccine requirements.
Much of the debate around COVID-19 shots focuses on how far the government should go in mandating them instead of the safety of the vaccine. Yet immunization advocates are worried that a confluence of interests among political activists is creating the perfect storm for the anti-vaxx community, which demonstrated an ability to latch onto pro-freedom movements —notably in 2015 in Texas — and reach a broader audience.
A rally against vaccine mandates last weekend in Washington drew thousands to the National Mall, including anti-vaccine activist Robert Kennedy Jr.
“People who oppose vaccines are a small group but they have found other groups who don’t like the government telling them what to do. Unfortunately [the anti-vaccine activists] have seen opportunities to glom onto other groups to amplify their voice,” said Rekha Lakshmanan, director of advocacy and policy at The Immunization Partnership. “The worry we have is this spilling over into kind of those routine school requirements that we’ve had for decades and that we know are effective. They’ve been around for a long long time, it’s a cornerstone in public health. One of the things the anti-vaccine community is trying to achieve is completely undoing things like school requirements.”
Attitudes around vaccine requirements for things like measles, mumps and rubella appear to be shifting alongside the COVID-19 mandate wars, and some politicians have shown a willingness to broaden exemptions from school rules.
YouGov, which tracks attitudes around vaccination, found only 46% of Republicans believed in October that parents should be required to have their children vaccinated against infectious diseases compared to 59% in August 2020. The share among independents dropped from 61% to 56% although support for vaccine requirements increased, 79% to 85%, among Democrats.
Texans for Vaccine Choice, which advocates for broad exemptions to vaccine rules, said it has received increased interest during the pandemic.
The group advocated for a Texas bill, SB1669, which would eliminate all vaccine requirements, including in schools, but the group said COVID-19 mandates remain its top target.
“Texans for Vaccine Choice has seen tremendous growth as Democrats have attempted to forcefully vaccinate every American citizen and many Republicans are also hesitant to end all vaccine mandates. Our organization has gained thousands of members every month as more and more Texans wake up to the reality of forced vaccines in Texas,” said board President Christine Welborn. “The most clear and present threat for our members is the ineffective COVID vaccine and the mandates surrounding it. All vaccine mandates, both public and private, must be banned.”
The bill was left pending in committee.
In Kentucky, lawmakers are considering legislation that would prohibit colleges from imposing new vaccine mandates.
Tennessee in mid-2021 fired a top vaccine official amid a spat over her push to get minors vaccinated for COVID-19. The state briefly halted outreach for adolescents for all vaccines in July, only to resume efforts weeks later. Health officials said they were simply making sure vaccine messages were directed at parents, not children, but the pause caused a national uproar.
A pending bill in Georgia would prohibit proof of vaccination for access to public places, leading some to fear it would rope in school requirements.
Ms. Lakshmanan said it is common to see lawmakers go hard out of the gate because of the uproar over COVID-19, only to see them pull back when they realize that other diseases could be involved.
“You see them realize, ‘Oh my gosh, that’s not what the intention is,’ but once something is proposed it starts to steamroll,” she said. “Even if it’s COVID now, in the future, it creates a pathway to expose all those other childhood vaccinations [to challenges].”
Roughly 64% of the U.S. population is vaccinated for COVID-19, though only those ages 5 and up are eligible. About one in five Americans have not come forward for any shots despite being eligible and near-constant pleas from federal and state officials to receive a primary series and a booster shot five months later.
There is a spectrum of vaccine hesitancy, with some people only concerned about the COVID-19 shots because they are so new or they hear about people who still get infected after vaccination.
On the other side of the spectrum is those who are ardently anti-vaccine, a movement that stretches back at least to the late 1800s, when people said a smallpox vaccine derived from less severe cowpox might cause them to take on farm-animal attributes.
Some people are attracted to the anti-vaccine movement because they, rightly or wrongly, fear their child had an adverse reaction from a shot, while others have used it in an attempt to explain autism.
The modern anti-vaccine movement was fueled in part by a 1998 study by Andrew Wakefield that linked vaccination and autism. The study was later shown to be critically flawed.
Efforts to rein in non-medical exemptions to childhood vaccination requirements in California and Texas after well-publicized measles outbreaks in 2015 sparked a major backlash as anti-vaccine activists joined forces with pro-liberty groups with parallel worries about the reach of government.
Questions about the safety of vaccines versus pushback against mandates are distinct from each other, even if they are often muddled together. For that reason, it is hard to measures how many new people are being drawn to anti-vaxx sentiments beyond opposition to the mandates.
Even so, there are signs the anti-vaxx movement “has reached new adherents,” according to Renee DiResta, a researcher at Stanford University who tracks the issue.
“Longstanding anti-vaccine activists such as RFK Jr. — who has spent years objecting to school requirements for [measles, mumps and rubella] — saw significant audience growth on platforms like Instagram during the pandemic. Many likely begin to follow these longstanding anti-vaccine activists because their opinions on COVID mandates align,” she said. “However, the activists saw this as an opportunity to then make the connection back to school shots. Some see it as an opportunity to convince the broader public that all of the science for all vaccines is bad, and believe that those opposed to COVID mandates can be ‘awakened’ to that broader fact.”
She also said longstanding anti-vaccine activists were entrenched in the QAnon community before the pandemic, giving them “a pathway into some of the more conspiratorially-inclined right-leaning communities on social media.”
Neil Johnson, a professor at George Washington University who tracks this issue, said he’s seen a 20% increase in “community interconnectivity” between anti-vaccine groups and mainstream communities online, meaning parents looking for information are more likely to run into an anti-vaxx message.
“These mainstream communities have been reaching out for info online and now receive feed from many of these other communities, including anti-vaxx, but also now alternative health and even non-COVID conspiracy communities,” he said in an email.
The Biden administration has offered tips on how people should navigate media sources and speak to family members who are skeptical of the COVID-19 vaccines, and the White House has prodded social media platforms to do more to combat misinformation about the shots.
Some public health experts say the government should have been more proactive in preparing for the backlash to the vaccines.
“Basically nothing is being done about it, and all of this should have been initiated before the launch of the COVID vaccines knowing there was a strong anti-vaxx U.S. movement,” said Eric Topol, a professor of molecular medicine and executive vice president at Scripps Research.
Others warned President Biden that issuing mandates from the federal government might be self-defeating, in that it could turn vaccination into a partisan issue.
“I think the downside of this mandate, in terms of hardening positions and taking something that was subtly political and making it overtly political, could outweigh the benefits we hoped to achieve,” former Food and Drug Commissioner Scott Gottlieb, who is pro-vaccine and sits on the board of Pfizer, a top COVID-19 vaccine maker, told CBS’s “Face the Nation” in September.
The Supreme Court recently blocked Mr. Biden’s most controversial mandate, which would have required large companies to identify unvaccinated employees and test them weekly.
All the while, immunization managers said routine vaccinations for things like measles have declined slightly. One study found 74% of infants turning 7 months old in September 2020 were up to date on their vaccinations, a drop from 81% in September 2019, though the Centers for Disease Control and Prevention said it believes disruptions from the pandemic were to blame and not anti-vaccine sentiment.
“CDC continues to investigate the impact of the COVID-19 pandemic on other vaccination efforts, but does not have evidence at this time that suggests COVID-19 vaccine hesitancy is directly impacting confidence in routine childhood and adult vaccines,” the agency told The Washington Times. “While we know the COVID-19 pandemic has impacted routine vaccination coverage, we believe the decline is associated with disruptions caused by the pandemic rather than a decline in vaccine confidence.”
Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, is worried the combination of disruptions and hesitancy around vaccines could lead to new outbreaks.
“We’ll know later this winter, spring,” he said, “when measles epidemics historically occur.”