Traditionally, vaccines have not been a partisan issue. In the 1960s and 1970s, all states—with a variety of political views—adopted school immunization requirements for a variety of diseases. In the early 2000s, both left-leaning California and right-leaning Texas offered very easy-to-get exemptions from those school mandates. At the other extreme, left-leaning New York used a relatively hard-to-get religious exemption, and West Virginia never offered a non-medical exemption, while Mississippi’s religious exemption was struck down by its Supreme Court in 1979 and never revived.
In 1986, President Ronald Reagan signed a bill to protect the vaccine supply by creating a no-fault program that provided limited liability protections to vaccine manufacturers—though with reservations. The bill was supported by other members of his administration (though opposed by civil servants in the Department of Justice) after being drafted by a Democrat chair of a congressional committee.
In the past few years, struggles around vaccine mandates have become politicized. In many states—including Maine, California, Colorado, Connecticut, and New York—votes on laws regarding school vaccine mandates were along party lines. School vaccine mandates are not just about science; they involve a discussion of values and address views about the balance of parental rights with public health. But the discussion in legislatures often drew on conflicting views of the science. More often than not, opponents of bills aiming to change mandates (not all from one party) echoed or repeated misleading claims made by the anti-vaccine movement. For example, speaking about a bill that would have required doctors to give parents seeking to vaccinate the CDC’s excipient list, Republican Senator Bob Hall from Texas expressed inaccurate statements about vaccines ingredients, for example alleging vaccines contain “fetal parts” and expressing concerns about aluminum in vaccines. The first comment refers, inaccurately, to the fact that a small number of vaccines use viruses grown on cells descended—at long remove—from fetal cells deriving from abortions performed in the 1960s. The remoteness convinces even the most of pro-life commenters that using these vaccines to prevent harm is morally permissible and does not create complicity with abortions. But that is not how anti-vaccine groups present it, including to supporting legislators. As to aluminum, many vaccines contain tiny amounts of aluminum salts to help the vaccine work better—but extensive data supports the experts’ consensus that these tiny amounts of aluminum salts, far smaller than what we are exposed to through food, are not a danger.
In these cases, it is hard not to see the position as the result of misinformation legislators were provided by the anti-vaccine movement rather than a value choice. School mandates work; they reduce rates of outbreaks in the state. When legislators are led to weaken them because of anti-vaccine claims, they may be inadvertently causing direct harm to their constituents—without intending to.
Politicization is already affecting the COVID-19 vaccines’ legal environment, at least to some degree. All states—regardless of political leanings—have arranged for COVID-19 vaccinations, and governors from different parts of the political spectrum—from Democrat Governor Gavin Newsom in California to Republican Governor Kristi Noem in South Dakota—have posted pictures of themselves getting the vaccine. But polls show that vaccine hesitancy is higher among conservatives. This is not a coincidence: The same channels of information that promote claims that the elections were stolen, or QAnon claims, have shared some of the misinformation about COVID-19 vaccines. For example, these sites have shared unverified reports submitted to the government’s passive reporting system—the Vaccine Adverse Events Reporting System (VAERS)—as if they show the vaccines’ risks. In reality, VAERS is a database where anyone can report anything to, and the number of reports, without verification, cannot be reliably used. Further, the number of reports by itself is not enough to show a vaccine caused a specific harm; for example, if in one week 20 people are reported dead within 48 hours after a vaccine, that statistic tells us little without information on how many people would die in those 48 hours regardless of vaccination.. An analysis of VAERS by the expert Advisory Committee on Immunization Practices found no safety signal—no indication of more harms than expected without vaccines—after either the Moderna or Pfizer vaccines (at the time of writing this article, the J&J vaccine was just authorized for use and was not yet in use) This kind of misinformation—misrepresenting the number of VAERS reports as showing the vaccines to have high risks—undermines the ability of people to make informed decisions, and if it is present on sites used more by one political group than the general public, it can lead that group to make ill-founded decisions. The people using these sites are not making a value-based decision to avoid the vaccine: They have been misled and are making their choice based on bad facts.
In response to the idea of vaccine passports or employer vaccine mandates, several Republican-controlled legislatures have proposed bills to prohibit businesses from requiring proof of vaccination from customers or employees. Several governors have acted to prevent private entities from requiring vaccines. We can see these as value-based decisions, but, traditionally, the Republican groups valued the freedom of private businesses to make decisions. These measures are directly prohibiting businesses from deciding whether or not to require vaccines—imposing a limit on the market. A reasonable interpretation is to see these measures as a response to the higher level of concern about vaccines among conservatives, linked directly to misinformation of the type described above. The result could be a delay in the ability to safely open some businesses or even an increase in COVID-19 cases in states that do this compared to others.
Values matter, but politically motivated science denial undermines rather than enables people to make valid value-based choices. When people end up with bad facts because the sources they were led to trust are blatantly misleading them, they are not working to achieve their values—they are simply victims of deceit. When misinformation feeds into policy decisions, the result can be decisions that achieve no one’s values and simply lead to harm.