Trump leads, and his party follows, on vaccine skepticism

More than four years ago, the development and rollout of the covid-19 vaccine was accelerated. The project likely saved millions of lives. However, a substantial number of Republican voters now identify as vaccine skeptics — and the former president rarely mentions what’s considered one of the great public health accomplishments in recent memory.

Instead, on at least 17 occasions this year, the former president has promised to cut funding to schools that mandate vaccines. Campaign spokespeople have previously said that pledge would apply only to schools with covid mandates. But speeches reviewed included no such distinction — raising the possibility of also targeting vaccination rules for common, potentially lethal childhood diseases like polio and measles.

The former president has presided over a landslide shift in his party’s views on vaccines, reflected this campaign season in false claims by Republican candidates during the primaries and puzzling conspiracies from prominent conservative voices. Republicans increasingly express worry about the risks of vaccines. A poll showed a narrow majority of those voters cared more about the risks than the benefits of getting inoculated.

A surge in anti-vaccine policy in statehouses has followed the rhetoric. Preliminary data shows that states enacted at least 42 anti-vaccine bills in 2023 — nearly a ninefold surge since 2019.

In some states, it has the look of a crusade: The 2024 Texas GOP platform, for example, proposes a ban on mRNA technology, the innovation behind some covid-19 vaccines that scientists believe could have significant applications for cancer care.

The former president recently made an appeal to anti-vaccine voters by landing the endorsement of a prominent vaccine skeptic — and appointing him to his transition team. The skeptic said he was ‘going to be deeply involved in helping to choose the people who run FDA, NIH, and CDC.’

The former president’s outreach can be more discreet: He recently met with a delegation of vaccine-skeptical activists — including one group pushing an end to mandates and certain types of vaccines — at his New Jersey golf club.

The former president has options in advancing anti-vaccine goals as president, such as by sowing further doubt and undermining the federal government’s ability to make vaccine recommendations. He has promised to appoint a panel exploring chronic diseases, some of which have been linked to inoculations by certain groups.

Currently, the Department of Education lacks the power to turn off public school funding all at once, meaning a second administration would have to take away money program by program. The legal basis for such a move isn’t clear, and it would probably require congressional action.

All 50 states have a vaccine requirement tied to school attendance.

This outreach to anti-vaccine constituencies comes as vaccine hesitancy increases and preventable disease surges. This summer, Oregon experienced its worst outbreak of measles since 1991.

The situation could get worse: In the Nineties, during a time when vaccine skepticism also proliferated, the U.S. saw thousands of measles cases. The number of measles cases recorded this year is already quadruple that of last year.

Worldwide, the disease killed over 100,000 in 2022, mostly among children under age 5.

Polling shows a substantial minority of Americans, concentrated in the Republican Party, hold vaccine-skeptical positions. And skepticism about covid vaccines is blossoming into suspicion of vaccines generally among that group.

Vaccine opposition has divided the GOP. Some governors and candidates have made opposition to vaccines a core part of their campaigns. In states such as Wyoming and Missouri, pitched primary campaigns centered on anti-vaccine themes this year.

Anti-vaccine candidates typically become anti-vaccine policymakers. The impact can be seen in Texas, where vaccine politics were once a bipartisan matter. From 2009 to 2019, legislators there passed 19 pro-vaccine bills, such as a measure allowing pharmacists to administer immunizations.

But that consensus began to shift toward the end of the decade. Small groups, often nurtured on social media, made their influence felt. One such group spurred testimony before the state legislature in 2021 and targeted pro-immunization legislators, some of whom fell in their GOP primaries.

Misinformation has fueled the anti-vaccine turn in Texas, alongside traditional conservative attitudes about individual autonomy.

In addition to calling for a ban on mRNA technology, the Texas GOP’s 2024 platform features a laundry list of policies that could undermine vaccination, including allowing medical residents and physicians the ability to opt out of administering shots for religious reasons. It also calls for enshrining a patient’s ability to opt out of vaccine mandates in the state’s Bill of Rights.

Nationally, anti-immunization policies could take an aggressive turn under a second administration.

Some proposals include clipping CDC authority to issue vaccine or quarantine guidance of a ‘prescriptive’ nature, targeted at schools or elsewhere.

Some Republican intellectuals have spun dystopian visions surrounding vaccines. One yet-to-be-published book imagines that the federal government would somehow use alleged new capabilities to ‘deplatform drivers’ of cars for ‘failing to follow the latest vaccine mandate.’