WASHINGTON – The resistance of right-wing politicians to vaccination mandates extends far beyond vaccinations against Covid-19, a surprising new development that has broad implications for the future of public health.

In Idaho, a lawmaker introduced a bill that would define vaccination warrants – of any kind – as a form of assault. In Florida, a prominent state senator called for a review of all vaccine requirements, including those for vaccinations that have been widely accepted by the public for decades, such as polio and measles, mumps and rubella. And in Montana, the Republican governor recently enacted a new bill that prohibits businesses, including hospitals, from enforcing vaccination requirements as a condition of employment.

The bills represent the latest wave of resistance to pressure from the Biden administration to impose Covid-19 vaccine mandates on nearly all Americans. But the new widespread revolt against requirements for vaccines of any kind, experts told STAT, could begin to reverse a century of progress against diseases that, thanks to vaccines, are afterthought for most Americans. .

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“If you [challenge] all the childhood vaccinations that are necessary, we could be in a very serious situation with epidemics of diseases that should have been eliminated long ago in our society. We just can’t have this, ”said Anthony Fauci, government researcher and chief medical adviser on the Biden administration’s pandemic response, in an interview Tuesday at the STAT 2021 summit.

In many cases, resistance from right-wing lawmakers to vaccination mandates has been masked by rhetoric specific to Covid-19 vaccinations. On closer reading, however, many of the proposals they have launched – some of which have already been enacted – apply to all vaccines, not just the three currently authorized in the United States to prevent Covid.

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A Tennessee proposal to ban employer vaccination mandates, for its part, does not specify which vaccinations it would apply to, meaning it would effectively apply to any requirements. Alabama’s GOP governor recently signed new law banning any new vaccine mandates in schools, beyond those that already exist – a move clearly aimed at Covid but with potential impact on future vaccination efforts .

Public health departments have had enough trouble vaccinating the public even with the benefit of existing laws that support mandates, said Lily Kan, senior director of infectious diseases and informatics at the National Association of Health Officials. counties and cities. When lawmakers step in to overturn those warrants, she added, that task becomes even more difficult.

“When there is a direct lack of trust based on misinformation, misinformation and active efforts to undermine vaccination rates, it is really concerning,” she said. “We don’t want people to think that not getting the vaccine might be the norm. “

Pressure from various lawmakers to ban vaccination mandates altogether comes amid a double crisis. Most urgent is the ongoing pandemic: The United States still records well over 1,000 deaths from Covid-19 every day, and about 18% of adults in the country remain unvaccinated.

Now, public health experts are starting to openly alarm themselves at the drop in childhood immunization rates. In part, they stem from the pandemic itself: Many parents who have worked from home and whose children have attended school remotely simply made fewer trips to doctor’s offices for fear of exposure to Covid- 19.

In 2020, World Health Organizations reported that across the world, childhood immunization rates fall from 86% to 83%. About 23 million babies have not received basic, normally administered vaccines, the highest number since 2009.

“Even before the pandemic, there were worrying signs that we were starting to lose ground in the fight to immunize children against preventable childhood diseases, including with the widespread measles epidemics two years ago,” said Henrietta Fore, Executive Director of UNICEF, in a recent statement. declaration. “The pandemic has made a bad situation worse. “

Increasingly, however, these low vaccination rates may also be motivated by overfed vaccine skepticism and outright misinformation that has clouded parental judgment.

Even before Covid-19, some American communities had started experiencing disease outbreaks that most of the country has largely eradicated. In two recent high-profile cases, a Somali-American community in Minnesota and a largely Orthodox Jewish town outside of New York City experienced significant outbreaks of measles in 2017 and 2019, respectively. In both cases, the epidemics were triggered by below-ideal vaccination rates, which in turn resulted from active disinformation campaigns.

The new wave of resistance to vaccine mandates of all kinds, however, marks the beginning of a whole new era of vaccine policy.

“There are real conversations to be had about individual freedom from public health, government overreach, all of that,” said Nahid Bhadelia, a physician-researcher who heads the National Emerging Infectious Diseases Laboratories at the Boston University. “But the level to which it has been politicized – it is on purpose, and it is in order to continue to create conflict around the pandemic.”

Still, other experts have warned that governments should consider an inevitable backlash when imposing requirements for Covid-19 vaccines and other vaccinations. In situations where most of the population is already vaccinated, sweeping mandates could do more harm than good in the long run, argued Scott Gottlieb, former Commissioner of the Food and Drug Administration and member of the Pfizer board of directors.

“The risk is [that] organized opposition to this OSHA mandate is starting to transform into broader opposition to vaccination and vaccine mandates more generally, and the mandates long adopted by society are part of this new political fad ”, he wrote this month on Twitter, referring to the Biden administration’s recent requirement that large corporations must force their employees to either be vaccinated against Covid or tested weekly. “And a whole generation is starting to turn against vaccines.

But an anti-vaccine generation could already be reality. According to a recent poll, the partisan division on the Covid-19 vaccination has crept into the country’s annual flu vaccination campaign.

In 2020, an AP-NORC poll showed a gap of just 4% between Democrats and Republicans’ desire for flu immunity. Two surveys conducted in 2021, however, paint a darker picture: Now Democrats are more enthusiastic than Republicans about flu shots by a 24% or 25% margin, according to Axios / Ipsos and Kaiser Family Foundation, respectively.

“This is the perfect storm because there is a growing hesitation over vaccines, an increasingly powerful anti-vax lobby and this growing medium of disinformation,” Bhadelia said. “There is a general societal movement here in the United States to undermine public health recommendations. ”