A doctor administers a vaccine against measles, rubella, mumps and...

 A doctor administers a vaccine against measles, rubella, mumps and chicken pox to an infant. The number of kindergartners up-to-date on routine immunizations has again declined, according to the Centers for Disease Control and Prevention. Credit: Getty Images/Sean Gallup

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners. Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.

In the aftermath of the COVID pandemic, U.S. politicians aren’t just bad-mouthing vaccines — they’re pushing through laws that undermine them. If the trend continues, we risk losing the layer of protection we enjoy from preventable diseases like the measles. And we risk losing more lives to seasonal illnesses like the flu and COVID.

A new report by Boston University researchers documents the problem. The team, led by political scientist Matthew Motta, found 376 anti-vaccine bills introduced in states around the country in 2023. The vast majority, 84%, were introduced by Republicans; 42 have been signed into law. Although Motta’s research can only provide a snapshot of a single year, several vaccine experts I spoke with sense that such legislation is increasing.

The trend comes amid a groundswell of data suggesting weakening interest in vaccinations. The latest evidence came last week from the Centers for Disease Control and Prevention, which said that the number of kindergartners up-to-date on routine immunizations had yet again declined. HPV vaccination rates among teens still have not returned to their pre-pandemic levels. And pregnant women appear increasingly reluctant to get the kind of immunizations that can protect both themselves and their infants from things like the flu and COVID.

Both the rise in anti-vaccine laws and the falling rates of vaccination underscore a worrisome and growing partisan divide. While survey data from the Pew Research Center shows that Americans' views on the measles, mumps and rubella vaccine remained relatively steady between 2016 and 2023, with the vast majority of the population believing its benefits outweigh any risks, a deeper look at the numbers tells a more nuanced story. In 2023, 42% of Republicans said that parents should be able to decide whether their child receives the MMR shot — that’s twice the number as before the pandemic, and three times the number of Democrats who oppose public school vaccine requirements.

All of this can create what’s called a policy feedback effect, says Motta. Policymakers amp up the anti-vaccine rhetoric, influencing public opinion about their safety and efficacy. That shift in opinion, in turn, creates an incentive for politicians to propose laws they think their constituents will support.

We’re seeing that vicious cycle in action with vaccines right now, Motta says. “Quite concerningly, this isn’t the end. This is the beginning of the anti-vaccine legislation.”

Take Florida, where Gov. Ron DeSantis has pushed through a number of laws and executive orders around COVID vaccines. Meanwhile, the state Surgeon General Joseph Ladapo has habitually undermined vaccination efforts, whether by spreading misinformation on the mRNA technology behind Pfizer Inc. and Moderna Inc.’s COVID shots or by his disturbingly blasé response to a recent measles outbreak in his state.

Floridians are taking note. Last year brought an alarming drop in MMR vaccination rates among kindergartners in the state. Around 94% kindergarteners had been vaccinated pre-pandemic, but last year just 88% were up-to-date on the shot, according to the CDC. Meanwhile, the number of kindergarteners with an exemption for one or more vaccine had risen to nearly 5% last year. (Vaccination rates below 95% are associated with a greater risk of outbreaks.)

What can get us out of this mess? Let’s start with the easiest and most immediate fix, which is improving access. The majority of people still want to get their children vaccinated, but some parents simply find it too difficult to obtain routine shots. Finding ways to ensure families can keep kids on track with their vaccines should be a priority.

Unfortunately, solving the polarization problem is a whole different beast and, depending on the outcome of the November election, could only get harder. Former President Donald Trump has expressed skepticism around the safety of vaccines and has repeatedly mentioned a desire to cut funding to public schools that require shots. Another reason for serious concern: Trump’s seeming willingness to offer an administration job to vaccine denier Robert F. Kennedy Jr.

COVID offered a preview of what happens when Trump vocalizes unscientific theories about health care — some segment of the population buys into it, sometimes to their detriment. For example, calls to poison control centers spiked after Trump talked about ingesting bleach to eradicate COVID.

In theory, pro-vaccine policies, or ones that increase access to and funding for shots, could mitigate some of the cultural shift. And Democrats and some Republicans did introduce such bills, the Boston University researchers found. But, at the same time, challenges to pro-vaccine laws now are being entertained by the courts, in some cases with worrisome outcomes, says Richard Hughes IV, a health law expert and lecturer at George Washington University.

Unless we can reverse these trends quickly, we’ll see a resurgence in entirely preventable infectious diseases. “Probably the first thing we’ll see is measles — lots of measles,” Sean O’Leary, a pediatric infectious diseases specialist at the University of Colorado who studies barriers to vaccination. Cases of pertussis, more commonly known as whooping cough, will likely rise, too. That puts infants too young to be vaccinated at greater risk of hospitalization and even death. Ultimately, that could lead to a backlash that prompts a shift back to policies that support vaccination.

Getting to that terrible turning point could take years, though. And in the meantime, children will suffer the consequences.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners. Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.

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