Rates of Childhood Vaccination Hit 10-Year Low, Putting Kindergartners at Risk for Measles
According to the Centers for Disease Control and Prevention, rates of routine childhood vaccination have reached a 10-year low in 2023. This alarming trend puts approximately 250,000 kindergartners at risk for measles, a highly contagious disease that can lead to hospitalization and even death. Recent reports have indicated that an ongoing measles outbreak in Philadelphia has resulted in the hospitalization of an infant and two young children, further highlighting the potential consequences of low vaccination rates.
This dangerous shift in vaccination rates can be attributed to a growing number of individuals who reject decades of scientific evidence supporting the safety and effectiveness of childhood vaccines. These individuals have successfully influenced legislators and courts in various states to ease regulations surrounding vaccine requirements for children entering kindergarten, citing religious, spiritual, or philosophical beliefs.
The rise in vaccine hesitancy is just one aspect of a broader rejection of scientific expertise, which could have far-reaching consequences. These consequences include disease outbreaks and reduced funding for research that leads to the development of new treatments. Peter Hotez, a vaccine researcher at Baylor College of Medicine in Texas, describes this phenomenon as an organized political movement, leaving the health and science sectors uncertain about how to address the issue.
According to a study conducted by the Pew Research Center, changing views among Republicans have influenced the relaxation of childhood vaccine requirements. In 2019, nearly 80% of Republicans supported these rules, but today, fewer than 60% do. On the other hand, Democrats have remained consistent, with approximately 85% supporting childhood vaccines. Mississippi, which previously had the highest rates of childhood vaccination in the country, began allowing religious exemptions last summer. Similarly, West Virginia, another leader in vaccination, is also considering implementing religious exemptions.
During the pandemic, an anti-science movement gained momentum as Republican and Democratic perspectives on science diverged. In 2019, 70% of Republicans believed that science has a mostly positive impact on society, but this number decreased in a November poll from Pew. With presidential candidates and members of Congress spreading anti-vaccine messages and criticizing scientists and public health policies, the partisan divide is expected to widen leading up to the upcoming elections.
Dorit Reiss, a vaccine policy researcher at the University of California Law San Francisco, draws parallels between the current backlash against public health and the early days of climate change denial. She notes that both issues started as nonpartisan fringe movements and eventually gained mainstream attention when they appealed to conservatives and libertarians who advocate for limited government regulation. Reiss explains that even individuals who were not initially anti-vaccine may shift their views when the argument aligns with their beliefs.
Even certain actors are the same. In the late '90s and early 2000s, a libertarian think tank, the American Institute for Economic Research, undermined climate scientists with reports that questioned global warming. The same institute issued a statement early in the pandemic, grandly called the "Great Barrington Declaration." It argued against measures to curb the disease and advised everyone — except the most vulnerable — to go about their lives as usual, regardless of the risk of infection. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, warned that such an approach would overwhelm health systems and put millions more at risk of disability and death from COVID. "Allowing a dangerous virus that we don't fully understand to run free is simply unethical," he said.
Another group, the National Federation of Independent Business, has fought regulatory measures to curb climate change for over a decade. It moved on to vaccines in 2022 when it won a Supreme Court case that overturned a government effort to temporarily require employers to mandate that workers either be vaccinated against COVID or wear a face mask and test on a regular basis. Around 1,000 to 3,000 COVID deaths would have been averted in 2022 had the court upheld the rule, one study estimates.
Politically charged pushback may become better funded and more organized if public health becomes a political flashpoint in the lead-up to the presidential election. In the first few days of 2024, Florida's surgeon general, appointed by Republican presidential candidate and Florida Gov. Ron DeSantis, called for a halt to use of mRNA COVID vaccines as he echoed DeSantis' incorrect statement that the shots have "not been proven to be safe and effective." And vaccine skeptic Robert F. Kennedy Jr., who is running for president as an independent, announced that his campaign communications would be led by Del Bigtree, the executive director of one of the most well-heeled anti-vaccine organizations in the nation and host of a conspiratorial talk show. Bigtree posted a letter on the day of the announcement rife with misinformation, such as a baseless rumor that COVID vaccines make people more prone to infection. He and Kennedy frequently pair health misinformation with terms that appeal to anti-government ideologies like "medical freedom" and "religious freedom."
A product of a Democratic dynasty, Kennedy's appeal appears to be stronger among Republicans, a Politico analysis found. DeSantis said he would consider nominating Kennedy to run the FDA, which approves drugs and vaccines, or the CDC, which advises on vaccines and other public health measures. Another Republican candidate for president, Vivek Ramaswamy, vowed to gut the CDC should he win.
Today's anti-science movement found its footing in the months before the 2020 elections, as primarily Republican politicians rallied support from constituents who resented pandemic measures like masking and the closure of businesses, churches, and schools. Then-President Donald Trump, for example, mocked Joe Biden for wearing a mask at the presidential debate in September 2020. Democrats fueled the politicization of public health, too, by blaming Republican leaders for the country's soaring death rates, rather than decrying systemic issues that rendered the U.S. vulnerable, such as underfunded health departments and severe economic inequality that put some groups at far higher risk than others. Just before Election Day, a Democratic-led congressional subcommittee released a report that called the Trump administration's pandemic response "among the worst failures of leadership in American history."
After the change in administration, Republican lawmakers who had previously supported COVID vaccination began to shift their stance, raising concerns about the safety of the vaccines and introducing numerous bills to block vaccine mandates. In a subcommittee investigation launched by House Republicans, scientific institutions and once nonpartisan scientists were heavily criticized for their handling of the pandemic. Anthony Fauci, a prominent infectious disease researcher who has advised both Republican and Democratic presidents, was questioned by the group on January 8 and 9. Without providing any evidence, committee member Marjorie Taylor Greene (R-Ga.) accused Fauci of supporting research that created the coronavirus to promote vaccines, stating that he should be imprisoned for his actions.
In an effort to combat the strategic and well-funded attempts to hinder public health regulations, researchers like Hotez emphasize the need for supporters who are knowledgeable in legal and political arenas. These groups would work to challenge policies that limit the power of public health, provide advice to lawmakers, and offer legal assistance to scientists who face harassment or are called to testify in politically charged hearings. Other initiatives aim to present the scientific consensus clearly, countering the practice of presenting opposing viewpoints as equal when the majority of researchers and evidence support one direction. This tactic has been effectively used by industries such as oil and tobacco to sow doubt about the scientific evidence linking their products to harm.
Kathleen Hall Jamieson, director of the Annenberg Public Policy Center at the University of Pennsylvania, emphasizes the need for improved communication from the scientific community. It is not enough to rely solely on expertise when there is a lack of trust in the motives of experts. According to a Pew Research study, nearly 40% of Republicans have a declining trust in scientists and hold negative views of science.
In a study published last year, researchers identified attributes the public values beyond expertise, including transparency about unknowns and self-correction. Researchers might have better managed expectations around COVID vaccines, for example, by emphasizing that the protection conferred by most vaccines is less than 100% and wanes over time, requiring additional shots. And when the initial COVID vaccine trials demonstrated that the shots drastically curbed hospitalization and death but revealed little about infections, public health officials might have been more open about their uncertainty.
As a result, many people felt betrayed when COVID vaccines only moderately reduced the risk of infection. "We were promised that the vaccine would stop transmission, only to find out that wasn't completely true, and America noticed," said a congressman at a July hearing.
The study also advises repetition. It's a technique expertly deployed by those who promote misinformation, which perhaps explains why the number of people who believe the anti-parasitic drug ivermectin treats COVID more than doubled over the past two years — despite persistent evidence to the contrary. In November, the drug got another shoutout at a hearing where congressional Republicans alleged that the Biden administration and science agencies had censored public health information.
The author of a new book on the rise of the anti-science movement fears the worst. "Mistrust in science is going to accelerate," he said.
And traditional efforts to combat misinformation, such as debunking, may prove ineffective.
"It's very problematic," the study author said, "when the sources we turn to for corrective knowledge have been discredited."
KFF Health News, previously known as Kaiser Health News (KHN), is a national newsroom that focuses on providing comprehensive coverage of health-related topics. It is a key component of KFF, an independent organization dedicated to health policy research, polling, and journalism.
