Health Secretary Robert F. Kennedy Jr.’s federally-focused campaign against vaccines is entering a new phase with allies intent on rolling back school and health care facility mandates.
Anti-vaccines advocates are now targeting Louisiana, Texas and Idaho, where they are pushing red state governors to follow Florida’s lead in removing requirements in schools for students to get certain shots. But those advocates, emboldened by recent victories in state legislatures, face steep political obstacles within their own party that will reveal how far GOP state leaders are willing to go to support the anti-vaccine wing of the Republican party.
That test for Republican governors and state lawmakers comes as the vaccine debate crescendos in Washington this week, with the charged testimony of ousted Centers for Disease Control and Prevention head Susan Monarez and the anticipated weakening of vaccine recommendations from its advisors. Kennedy had previously changed federal guidance advising Americans six months and older to get an annual Covid shot. The new guidance recommends it only for elderly people and those with underlying health conditions.
“They’re not going to want to run against the president’s policies, on one hand, but on the other hand, they also don’t want to eliminate the constituency which supports childhood vaccines,” Dorit Reiss, an attorney specializing in vaccine policy, said of the choice Republicans face. “So I think they’re going to have to sit down and do some math in an area that’s full of landmines.”
In Louisiana, lobbyists are planning to reintroduce a “medical freedom” bill that failed last year to ban vaccine mandates, but expanded to include schools.
“We feel like the climate is ready for it,” said Jill Hines, co-director of the anti-vaccine group Health Freedom Louisiana. “That conversation has already started with Florida’s foot in the door.”
In the Lone Star state – where Republican Gov. Greg Abbott capitalized on outrage over pandemic restrictions – Jackie Schlegel, president of anti-vaccine group Texans for Medical Freedom, promised “sweeping reforms in Texas in the coming years.”
“Putting parents as the sole decision maker and not the CDC or local school districts is what our legislators are talking about,” she added.
And Idaho lawmakers are expected to build upon an expansive “medical freedom” bill enacted earlier this year that prohibits businesses and schools from mandating “medical interventions,” including vaccines, although it allows for some exemptions.
But the politics of undoing vaccine requirements in schools – mandates that health experts credit with keeping injection rates high – are complicated. Polling shows Americans — including most Republicans — broadly support such mandates for schoolchildren. President Donald Trump’s own pollster warned Republicans against mistaking opposition to Covid shots among Republicans “as evidence that Republican voters are against all vaccinations. To do so would be folly.”
Yet the MAHA movement – which includes people who share Kennedy’s skepticism of vaccine safety – has emerged as a powerful force within the GOP, broadening the party’s tent and motivating some voters to turn out for Trump. Mothers comprise a large component of the MAHA coalition, and recent polling conducted by Bellwether Research revealed that nearly a quarter of women surveyed don’t believe vaccines administered in the U.S. are generally safe.
Months out from legislative sessions resuming across the country, no other state lawmaker or official has yet to step forward with plans to replicate Florida’s approach. But public health experts are fearful that Gov. Ron DeSantis could still set off a domino effect in GOP states. Florida is the first state to take sweeping executive action to remove school mandates, with its health department moving forward with rules to end requirements for four vaccines, including chickenpox. Removing mandates for measles and polio would require action from the state legislature.
“I would imagine that other red states are looking at this and trying to make an assessment about whether they want to follow Florida’s lead,” said Jennifer Kates, senior vice president at KFF, a health research group. “I don’t think it’s the end of the story.”
Following the pandemic, GOP states ushered in a wave of legislation allowing more exemptions to school vaccine mandates for religious or even personal beliefs. Pursuing outright bans in schools or medical facilities has long been anti-vaxxers’ on wishlists; now they believe Kennedy’s posture fosters a favorable political environment.
Aaron Siri, a vaccine injury lawyer who provides counsel for the Informed Consent Action Network, an anti-vaccine group that writes model state legislation, said “mandates are the tool of bullies, criminals and dictators.”
Like-minded groups may have trouble finding state lawmakers to propose their desired legislation though. Some legislators who have championed easing state requirements believe they’ve achieved most of what is politically feasible.
Louisiana Rep. Kathy Edmonston credited Kennedy’s MAHA movement for launching “a whole new way to look at public health.” But the Republican, who sponsored laws signed by GOP Gov. Jeff Landry prohibiting Louisiana schools from requiring Covid shots and requiring that they inform parents of their rights to an exemption, said she has “no plans to change what we’ve done.”
“We have everybody on the same page,” she said. “We’re requiring the parent to get your child vaccinated. But we’re telling you that if it goes against anything in your line of thinking, that you have the opportunity to exempt your child.”Louisiana already had one of the nation’s most lenient school vaccine policies, issuing exemptions on the request of a parent for any reason. No school system in the country requires Covid vaccination.
Alabama state Rep. Mack Butler recently reintroduced a bill to allow parents requesting a religious exemption to send a note to a child’s school instead of submitting a written objection and then getting approval from local health officials. Still, the Republican hasn’t heard of any initiative that would eliminate requirements altogether, and he called vaccines for mumps, measles and polio “tried and tested.”
Health care experts remain nervous about the potential for GOP leaders to bypass the legislature and act on their own to weaken vaccine policy. In Louisiana, Surgeon General Ralph Abraham last year directed the health department to no longer promote mass vaccinations. And while West Virginia lawmakers voted down a religious exemption bill in March, Gov. Patrick Morrisey signed an executive order that allows families to bypass vaccine requirements for religious reasons just hours after taking office this year. West Virginia is now mired in legal battles surrounding the implications of the governor’s order and the state Board of Education’s decision to continue requiring vaccines as the legal process plays out.
Rising anti-vaccine sentiment puts more pressure on state health officials to form a bulwark against efforts to chip away mandates, like in Mississippi, where its medical leadership has been steadfast.
“We have a really strong, educated legislature that values evidence-based medicine, and they’ve seen the importance of vaccines in preventing unnecessary deaths,” said Katherine Pannel, president of the Mississippi State Medical Association, a professional society for doctors. “They have been really valuable. So when any legislation to weaken the vaccine legislation has come up, they have been on target and have killed any kind of legislation.”
Florida is bound to face legal challenges that could slow or prohibit any repeal from going into effect, said James Hodge, an Arizona State University professor who specializes in vaccine law.
“We’re in a state of flux with Florida,” Hodge said. “We’re watching very carefully what and how far they go with this legally.”
Florida health care advocates intend to mount an aggressive campaign in opposition – and hope to send a warning about extreme political and health risks to other red states.
“I sincerely hope that other states don’t do this. We’re seeing at the national level an immense threat to the nation’s vaccine policy,” said Northe Saunders, president of American Families for Vaccines, an advocacy group that promotes immunization. “Any erosion at any level of government is going to put kids at risk and they’re going to get sick and unfortunately, people are going to die.”
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