Prior to the pandemic, the opposition to vaccines was apolitical. The true believers were a small population and confined to the fringes of both major parties, with no significant representation in the political mainstream. But over the past year, political opposition to vaccine mandates has solidified, with a steady stream of bills introduced attempting to block various ways of encouraging or requiring COVID vaccinations.
This naturally led vaccine proponents to ask why these same lawmakers weren't up in arms in the many decades that schools, the military, and other organizations required vaccines against things like the measles and polio. After all, pointing out logical inconsistencies like that makes for a powerful argument, right?
Be careful what you wish for. Vaccine mandate opponents have started trying to eliminate their logical inconsistency. Unfortunately, they're doing it by trying to get rid of all mandates.
The fact that this issue has become politicized and turned state legislatures into battlegrounds has a disturbing air of familiarity to it. For over a decade, I've been tracking similar efforts in state legislatures to hamper the teaching of evolution, and there are some clear parallels between the two. If the fight over vaccines ends up going down the same route, we could be in for decades of attempts to pass similar laws and a few very dangerous losses.
Vice signaling
To understand the parallels, you have to understand the history of evolution education in the US. Most of it is remarkably simple. In 1968, the Supreme Court issued Epperson v. Arkansas, ruling that prohibitions on the teaching of evolution were religiously motivated and thus unconstitutional. Two decades later, laws requiring that evolution be "balanced" with instruction in creationism (labelled "creation science" for this purpose) were declared unconstitutional for similar reasons. A further attempt to rebrand creationism and avoid this scrutiny was so thoroughly demolished at the District Court level that nobody bothered to appeal it to the Supreme Court.
Given all that precedent, you'd think that evolution education would be a throughly settled issue. If only that were true.
Instead, each year sees a small collection of bills introduced in state legislatures that attempt to undermine public education in biology. These tend to arise from two different sources. One is what you might call ignorant true believers. These are people who sincerely believe that evidence supports their sectarian religious views and are either unaware of Supreme Court precedents or believe that the Supremes would see things their way if given just another chance.
On their own, the true believers aren't very threatening. The bills they introduce are often comically unconstitutional and tend to die in committee. The problem is that these legislators and the people who elect them are all in the same political party.
That party has plenty of people in it who aren't true believers. They know that trying to smuggle creationism into schools is unconstitutional and that there's nothing traditionally Republican about trying to do an end run around the Constitution. But they recognize that the true believers are a major constituency of their party, and they want to signal to that constituency that they share values. So they engage in vice signaling, supporting things they know are wrong but will signal shared values.
In some cases, this includes disturbing levels of support for the clearly bonkers bills filed by the true believers. But in more insidious cases, the vice signaling can involve supporting bills that are carefully crafted to enable creationists without blatantly violating the Constitution. Two such bills, which claim to champion "academic freedom" while singling out evolution as in need of critical thinking, have become law in Louisiana and Tennessee.
This looks familiar
Prior to the pandemic, another group of true believers—the people who really think that vaccines are dangerous—was a tiny minority with no real home in either of the major political parties. But Republican opposition to vaccine mandates has now given anti-vaxxers a home. There, they've merged with another set of true believers: those who think that their personal freedom isn't balanced by a responsibility to respect the freedom and safety of others.
With all of these true believers in one party, the vice signaling has started. Florida Gov. Ron DeSantis has been vaccinated and has spoken of the value of vaccinations a number of times. Yet he's tried to enforce laws that interfere with private businesses that wish to require vaccines, an effort that initial rulings have found to be unconstitutional. He's also appointed a surgeon general who refuses to say whether he's vaccinated and spent two minutes dodging a question about whether vaccines are effective before acknowledging that they are.
But the problems aren't limited to Florida. Missouri's top health official was compelled to resign even though he opposed vaccine mandates. He ran afoul of state legislators simply for saying he'd like to see more citizens vaccinated.
The list of states with bills targeting COVID vaccine mandates is long: Mississippi, Oklahoma, Iowa, South Carolina, Alabama, and more. And then there's the bill circulating in Georgia we mentioned at top, which signals that this politicization isn't limiting itself to the COVID vaccines. A number of other states appear to be pondering related efforts that target vaccines generally.
What’s next?
If the parallels hold, then the US's experience with anti-evolution activism can tell us something about what to expect. Unfortunately, that experience tells us that we should expect bad things.
To start, we can expect the number of people who say they mistrust vaccines to grow dramatically. When it comes to public behavior—answering polls, attending protests, introducing legislation, etc.—people behave in ways that send signals about the cultural group they belong to. If that cultural group—in this case a political party—includes a sizable and vocal group of anti-vaccine activists, then more people are going to adopt an anti-vaccine stance in order to signal their affiliation. (This behavior has been termed cultural cognition.)
Some of that will be just as insincere as it sounds and lead to the sort of vice signaling we're currently seeing from politicians. But a lot of anti-vaccine sentiment won't be. In some people, the pressure to conform to the beliefs of their ideological peers will trigger a re-evaluation of their past beliefs on vaccines. The blizzard of misinformation out in the world will, at best, leave them confused and, at worst, leave them believing the wrong thing. Others will simply follow the guidance of their new peers and latch on to the decades of misinformation the anti-vaccine movement already has in place, becoming a new group of true believers.
Many won't bother to give the issue careful thought and will just follow the lead of the people they trust—which, unfortunately, includes politicians.
In practical terms, these distinctions don't matter. Regardless of the motivation, support for anti-vaccine measures will grow, and that support will trigger the same sort of things we see with evolution: an annual ritual of badly misguided bills introduced in statehouses around the country. Some of those bills will end up being enacted into law.
What’s different this time
That brings us to a disturbing difference between evolution and vaccines—a difference that's at the root of my worries. With evolution, there are very, very clear legal precedents that prevent badly misguided laws from having any impact. Try to outlaw teaching evolution, and the courts already have all the precedent they need to smack it down immediately. Pass a vague law, like the ones Tennessee and Louisiana have, and the first school district that tries to insert creationism into biology class will find itself at risk of losing a lawsuit and paying its opposing lawyers for the privilege of that loss.
There is absolutely nothing like that precedent that will protect things like childhood vaccinations. The Supreme Court has clear precedent that states can mandate vaccines for their entire population—not just school kids. But there's no precedent that states must protect their citizens from unnecessarily dying of infectious diseases. While some state constitutions could contain phrasing that will be interpreted as mandating this sort of protection, that's likely to be uncommon.
So, it seems inevitable that we'll end up with a few states that ditch existing vaccine mandates, like the ones that require children to be vaccinated before enrolling in school.
A grim future
Because we rely on herd immunity to protect us, a few states is all we need to cause problems. Unvaccinated children will mix with those from other states at family gatherings and vacation hotspots. People from unprotected states will move, bringing their vulnerabilities with them. People who are vulnerable or who belong to the few percent for whom the vaccine is ineffective will end up suffering. And our public health services, which the pandemic has revealed as overstretched and underfunded, will struggle with it all.
It would be nice to think that the ensuing chaos would return us to the world that our grandparents inhabited, where fear of these diseases had people lining up to receive their polio vaccines.
But the US has taken only two years to rack up more pandemic deaths than combat deaths in all of the nation's wars combined—yet people are still avoiding the vaccine. I suspect our grandparents' world is gone for good.
