Ever since the antivaccine movement rose to previously unattained prominence as a result of the COVID-19 pandemic, resistance to COVID-19 vaccine mandates (not to mention to all public health mandates to slow the spread of the coronavirus, such as masks and “lockdowns”), and the increasing affinity between antivaxxers and fascists, those of us who have been following the antivaccine movement have become increasingly concerned that anti-COVID-19 vaccination has been metastasizing to cover all vaccines. Unsurprisingly, it’s been doing exactly that. The endgame of the antivaccine movement has always been the elimination of all vaccine mandates of any kind, and increasingly right wing politicians are pushing for laws and policies that bring us closer to such a world.
Even as one who has been warning about the increasing alliance between the far right and antivaxxers for years (which has become increasingly part of the Republican mainstream), I must admit that the speed and scope with which even the most bonkers antivax conspiracy theories and pseudoscience have become mainstreamed shocked me, with even old-time antivax conspiracy theorist Robert F. Kennedy, Jr. cozying up to Republicans, the far right, and even fascists. I feared the metastasis of antivax views from COVID-19 to all vaccine and underestimated the power of social media and astroturf groups to get us here. Basically, the pandemic turbocharged a trend that had been going on for at least a decade before.
It’s gotten so bad that the mainstream press has been starting to notice. The latest example of this is a Wednesday New York Times article by Moises Velasquez-Manoff, The Anti-Vaccine Movement’s New Frontier, which notes in its blurb, “A wave of parents has been radicalized by Covid-era misinformation to reject ordinary childhood immunizations — with potentially lethal consequences.” Again, it was ever thus, and COVID-19 era antivax misinformation was going to metastasize, but the scope has been disturbing. Overall, this story is a very good overview, but, me being me, you know that won’t stop me from pointing out little tropes in it that have annoyed me for years and years whenever I read articles about the antivaccine movement in the mainstream press.
The first on the list of annoying tropes is impossible to miss, although it can’t be blamed on Velasquez-Manoff. It’s a trope that mainstream news outlets can’t seem to resist any time they publish an article about vaccines, vaccine hesitancy, or the antivaccine movement. Specifically, the image that accompanies the story is a disturbing and dangerous cliché, a stereotypical photo of a baby and a syringe, but arranged in such a way that the syringe looks huge compared to real vaccine syringes and needle. Bad NYT graphics department! This, too, is such a hack move that serves to inadvertently amplify the fear of vaccines, even when the story is lamenting how antivax views are metastasizing from COVID-19 vaccines to childhood vaccines.
The story starts, as many of these stories do, with an anecdote. In this case, the anecdote comes from a pediatrician and is clearly intended to illustrate how much worse antivaccine sentiment has become. Before the pandemic, I used to write about how antivaxxers targeted pediatricians and nurses all the time and attacked them as “bullies” for trying to persuade them to vaccinate their children. The pediatrician is Dr. Robert Froehlke, and the anecdote goes like this:
The mother of four brought her children, ranging in age from grade school to high school, to the doctor’s office last summer for their annual checkup. When their pediatrician, Robert Froehlke, said that it was time for shots and several boosters and then mentioned the Covid vaccine, her reaction stunned him. “I’m not going to kill my children,” Froehlke recalls her saying, as she began to shake and weep. He ushered her out of the examination room, away from her children, and tried to calm her. “We’re just trying to help your kids be healthy,” he told her. But he didn’t press the issue; he sensed that she wasn’t persuadable at that moment. And he didn’t want to drive her away from his practice altogether. “That really shook me up,” he says.
In his 14 years of practicing medicine in Littleton, a Denver suburb, Froehlke had seen parents decline their children’s vaccines for the sake of a more “natural” lifestyle. He had also seen parents, worried about overstressing their children’s bodies, request that vaccinations be given on different schedules. But until the past nine months or so, he had rarely seen parents with already vaccinated children refuse additional vaccines. Some of these parents were even rejecting boosters of the same shots they unquestioningly accepted for their children just a few years earlier.
So far, the story notes, the number has been relatively small; so one has to take it with a grain of salt. Confirmation bias could well be at play here:
Froehlke estimates that he has faced around 20 such parents, maybe more: a father who said he had done his own research and sent Froehlke a ream of printouts from right-wing and anti-vaccine websites to prove it; a mother (who is a nurse) who adamantly refused routine boosters for a kindergarten-age daughter — and then later, when the child got sick with Covid-19, asked Froehlke without success to give the deworming drug ivermectin to her. The overall number of these new doubters in his practice hasn’t been large, he says, but considering it was almost zero before the pandemic, the trend is both notable and worrisome.
Or maybe not.
Velasquez-Manoff goes on to note how these parents are not uneducated and some of them are even literally rocket scientists at a nearby Lockheed Martin facility. (As an aside here, I tend to get very tired of throwaway bits in news stories and pop culture holding up rocket scientists as examples of people who are so very much smarter than everyone else. Ditto brain surgeons. It’s such hack. But then I am a cancer surgeon and researcher. I’ve also come across some very, very scientifically ignorant brain surgeons before.)
Apparently antivax views haven’t just been metastasizing in Colorado, either:
Southern California; Savannah, Ga.; rural Alabama; Houston — pediatricians in all these places told me about similar experiences with parents pushing back against routine vaccines. Jason Terk, a pediatrician in Keller, Texas, called the phenomenon “the other contagion” — a new hesitation or refusal by patients to take vaccines they previously accepted. Eric Ball, a pediatrician in Orange County, Calif., said the number of children in his practice who were fully vaccinated had declined by 5 percent, compared with before the pandemic. He has been hearing more questions about established childhood vaccines — How long has it been around? Why give it? — from parents who vaccinated older children without much hesitation but are now confronted with the prospect of vaccinating babies born during the pandemic. Some of these parents end up holding off, he says, telling him they want to do more research. “There’s a lot of misinformation about the Covid vaccines, and it just bleeds into everything,” he says. “These fake stories and bad information get stuck in people’s heads, and they understandably get confused.”
After this launching off point, Velasquez-Manoff goes on to discuss how childhood vaccinations have fallen 1% since the pandemic began, which might not seem like a lot, but in areas where vaccine uptake had fallen to the point of endangering herd immunity that could matter, particularly if the trend continues. He also notes, as have many, the politicization of COVID-19 and COVID-19 vaccines. Unfortunately, he falls into a trap that a lot of journalists do. Citing the “infodemic” around COVID-19, he suggests:
Now the pandemic has given anti-vaccine advocates an opportunity to field-test a variety of messages and find new recruits. And one message in particular seems to be resonating widely: Vaccines and vaccine mandates are an attack on freedom.
Unfortunately, antivaxxers have been “field testing” the message that vaccine mandates are an attack on “freedom” and “parental rights” at least since antivaxxers teamed up with the East Bay Tea Party back around 2012 to promote that very message. As a reminder, let me quote yet again Sen. Rand Paul (who is very much antivax and has been for a long time):
“The state doesn’t own the children. Parents own the children, and it is an issue of freedom.”
— Senator Rand Paul (R-KY), February 2, 2015
This message first really started resonating in 2015 in response to the drive to pass SB 277, the California law that banned nonmedical exemptions to school vaccine mandates. That was when antivaxxers pivoted from messaging that was primarily about “toxins” in vaccines and the false claim that vaccines caused autism, autoimmune disorders, sterility, and death to messaging that primarily emphasized “vaccine choice,” “freedom,” “parental rights,” and resistance to government mandates. It was a winning message that rapidly started metastasizing to attract those of a conservative/libertarian bent, and many of the groups formed in the wake of that political struggle were clearly conservative, such as Texans for Vaccine Choice, Empower Texans, Michigan for Vaccine Choice, and others. By 2018, I was personally observing this rightward shift and infiltration of conservatism, including the Republican Party, in my neck of the woods, when a candidate for the Republican nomination for my district’s Congressional seat held an antivaccine “vaccine choice roundtable” that I attended incognito and documented, and openly antivax candidates were running for state governor and other offices. By 2019, Republicans in Oregon were openly opposing anything resembling tightening school vaccine mandates, and the Ohio Statehouse was rife with antivax legislators, to the point that antivaxxers were bragging about them. Also, to bring it around, antivaxxers in California were openly marching with the California State Militia, specifically the California State Militia, First Regiment, California Valley Patriots and the State of Jefferson.
In fairness, Velasquez-Manoff is certainly not wrong that the pandemic provided an even larger, wider, and more amplified platform to use to promote the message that vaccines and vaccine mandates are an unacceptable assault on “freedom” and “parental rights.” He just seems to think that SB 277 was when this shift in messaging happened. It wasn’t, although the shift certainly accelerated during the battle over SB 277. Vaccines and vaccine mandates have long been attacked as assaults on “freedom” going back at least the 19th century. Indeed, the antivaccine movement is but a subset of the larger “health freedom” movement, a movement that has opposed any sort of pesky regulation that stands between people and their quackery. Personally, I started noticing a marked shift from antivaxxers portraying vaccines are toxic and the cause of autism as their primary message to appeals to freedom and parental rights around 2012, which means that it was probably happening before that. Similarly, the “crossover” between antivaxxers and Tea Party activists predates SB 277 by at least a few years.
Another part of the article that irritated me was the common trope that I see in such articles that the “modern iteration” of the antivaccine movement began with Andrew Wakefield. It is, of course, a convenient narrative that provides a neat starting point to the modern antivax movement of 1998, with a single bad study and charismatic personality. (As much as I hate to admit it, a lot of people find Andrew Wakefield charismatic.) Anyone who’s read Paul Offit’s book Deadly Choices: How the Anti-vaccine Movement Threatens Us All knows that the modern iteration of the antivaccine movement didn’t start in 1998 with Wakefield, but rather at least 16 years earlier with the airing of a television “investigation” called DPT: Vaccine Roulette. That documentary ignited the scare over the DPT vaccine containing the cellular pertussis vaccine, led to the National Childhood Vaccine Injury Act of 1986 that produced the Vaccine Court, and launched the antivax career of a woman whom I like to call the grande dame of the antivaccine movement, Barbara Loe Fisher, founder of the Orwellian-named antivax group National Vaccine Information Center (NVIC). Let’s just say that Fisher was known for invoking Nuremberg and the Nazis before COVID-19 made that gambit cool. I could go on and say that arguably the modern antivax movement originated in the UK in the 1970s, which is where the DPT fear mongering that metastasized to produce Vaccine Roulette began, but I’ll stop.
On the good side, Velasquez-Manoff does correctly note that RFK Jr.’s narrative in 2005 started with an obvious conspiracy theory:
Seven years after the notorious Lancet paper, Robert F. Kennedy Jr., son of the assassinated senator, jumped into the vaccine-autism fray. In 2005, Rolling Stone and Salon, an online publication, co-published an article by Kennedy in which he argued that thimerosal, the mercury-laden preservative used in some vaccines, was damaging children’s brains and could be driving what many had come to call the “autism epidemic.” Kennedy has said that his exploration of vaccine science that led to the article was spurred by a conversation with a mother of an autistic boy who, armed with stacks of scientific papers, persuaded him that the onset of her son’s autism coincided with his early-childhood vaccinations. He was already familiar with mercury’s toxicity from his work as an environmental lawyer.
Kennedy’s article, which opens with a description of a secretive government meeting supposedly convened by the C.D.C. where the use of mercury compounds in vaccines was discussed, had all the makings of a thriller about government malfeasance. But soon after it appeared, the article, which had been fact checked by Rolling Stone, required several corrections. Kennedy got numbers wrong. He took quotes out of context, making them seem more sinister than they really were. In 2011, after the journalist Seth Mnookin brought more attention to the article’s flaws in his book “The Panic Virus,” Salon removed the article from its site entirely.
He also lists Joe Mercola, a doctor who no longer practices but has become what I like to call a “quack tycoon” (he’s worth ~$110 million) selling supplements and quackery with antivaccine activism and conspiracy theories of all stripes. Unsurprisingly he’s moved into COVID-19 denial and conspiracy theories. He’s also been a major funder of Fisher’s NVIC for at least a decade. Other sources of funding for antivaccine groups are listed as well, such as those funding Del Bigtree, and the article correctly points out that a lot of people are grifting off of antivaccine propaganda. Even more importantly, just because they make money off of it doesn’t mean that they don’t believe it, something I’ve long pointed out. Indeed, from my experience, I’d argue that the the most effective profiteers are the true believers, rather than those who are just in it for the grift.Then there’s a whole section on the social media contribution to the spread of antivax disinformation.
My quibbles aside, here’s the message that people really need to see about the antivax movement, about how it’s becoming more violent and how conspiracy theories about COVID-19 vaccines are metastasizing back on old antivax conspiracy theories that inspired them:
On the ground, violence related to vaccines appears to be escalating. In December, an enraged man attacked workers at a mobile vaccine clinic in Tustin, in Orange County, calling them “murderers.” It took seven police officers with tasers, aided by workers and patients, to subdue him. Late last year, another man used his car to strike a vaccine worker in Los Angeles. In Colorado, unknown assailants have tossed firecrackers into mobile vaccine tents, forcing the companies in charge to hire security. Last spring, a woman plowed her minivan through a vaccine tent in Tennessee as she shouted, “No vaccine!”
Perhaps most ominous, from a public-health perspective, is that school mandates have started to come under attack in state legislatures. Numerous states have already passed laws restricting or prohibiting mandates for the Covid-19 vaccine. And in a few, including Ohio and Pennsylvania, bills have been proposed that would weaken school vaccine mandates or even prohibit them altogether. “I’m not sure that the people fighting for these bills truly believe in them, but they’re doing it because it’s politically expedient,” Jason Terk, the pediatrician in Keller, Texas, told me. “It matters not to them that there might be consequences to these bills passing.”
None of these legislative efforts have succeeded in becoming law yet, but they highlight a broader development that’s easy to overlook. “During the pandemic, the antivax movement was able to springboard to the mainstream,” Koltai says. “I don’t think it’s that taboo anymore to be vaccine-hesitant.”
That last part reminds me of Ben Carson. You might remember that Ben Carson was a strong supporter of school vaccine mandates; that is, until in 2015 Donald Trump became a serious contender for the Republican nomination and other GOP candidates started cynically pandering to the antivaccine movement, which at the time was fighting SB 277 with messages of “freedom” and “parental rights.” By the GOP debates in the fall of 2015, Carson had abandoned his previous strong support of school vaccine mandates and joined the rest in pandering.
It’s important to remember that the endgame of the antivaccine movement was always the elimination of all vaccine mandates of any kind. Before the pandemic, such a goal appeared to be impossible Since the pandemic has fueled the metastasis of antivax misinformation and conspiracy theories back onto childhood vaccines, the possibility of school vaccine mandates being repealed in some states looks terrifyingly possible.