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A political battle over school-based Covid protocols in early 2021 quickly turned personal for one Colorado family, whose son’s cystic fibrosis – a life-threatening genetic disease affecting the lungs and other vital organs – made him susceptible to complications from the virus.
Kate Gould said the classroom became a dangerous place for her son after hardline conservatives took over the Douglas county school board and the district removed masking requirements.
After a prolonged back-and-forth, involving a pulmonologist and a special education attorney, district leaders finally agreed to an accommodation for his classroom, mandating masks. But mere weeks later, the superintendent was fired and, under new leadership, the district again removed the masking accommodation without consulting doctors or Gould, she told the 74 in a recent interview.
Almost four years later, Gould and her family live in southern California – where they moved during the pandemic for the mask and vaccine requirements in place at the time – and they and other parents, advocates and health experts are gearing up for what could be the next front of the school culture wars: a broader attack on school vaccine mandates by the incoming Trump administration.
Currently, all 50 states have vaccine requirements for children entering childcare and schools. But with Robert F Kennedy Jr – who has peddled baseless conspiracy theories and once said: “There’s no vaccine that is safe and effective” – potentially at the helm of the Department of Health and Human Services, advocates and parents are right to fear a rollback of requirements, enforcements and funding, according to interviews with about a dozen experts.
“The anti-vax warriors have made it inside the castle walls,” said Richard Hughes, a George Washington University law professor who teaches a course on vaccine law.
Kennedy’s legitimization and the different levers he could pull, experts told the 74, could have an immense impact on vaccination rates and the spread of preventable, contagious diseases in school-aged children.
If confirmed by the US Senate, Kennedy would take control of an agency with a $1.7tn budget and 90,000 employees spread across 13 agencies, including the Food and Drug Administration and the Centers for Disease Control and Prevention (CDC). Dave Weldon, nominated by Donald Trump to head the CDC, has also endorsed debunked theories, blaming vaccines for autism and some chronic diseases.
Kennedy, whose nomination faces an onslaught of opposition from health professionals and scientists and questioning by at least one GOP senator, did not respond to requests for comment. He has said he would not take away vaccines but look to make more of their safety and efficacy data available.
“We don’t know what he’s going to do,” John Swartzberg, a professor at the University of California at Berkeley’s School of Public Health, told the 74. “But if he tries to carry out the things that he’s publicly stated – not just recently but over a long, long time – then the implications for our children in school are dire.”
While most school vaccine requirements come from states, the recommendations they’re based on begin with federal agencies, such as the CDC, and enforcement is often left up to local districts. This leaves room for both federal influence and “a hodgepodge of enforcement”, said Northe Saunders, executive director of the pro-vaccine Safe Communities Coalition, who sees battles around school-vaccination mandates playing out at the federal, state and school board levels.
Experts agreed the federal government is highly unlikely to attempt to take vaccines off the market or categorically ban mandates, and most don’t anticipate individual states will do away with their long-standing requirements.
But James Hodge, a public health law expert at Arizona State University’s Sandra Day O’Connor College of Law, pointed out: “You don’t actually have to pull the vaccine for people to stop using it. You have to raise doubts about it.”
That can happen by planting seeds of misinformation, he said, or by starting to require that vaccines be assessed differently for approval or federal funding. Any slight drop-off in parents vaccinating their kids entering schools or daycare can result in disease outbreaks, an outcome Hodge said he expects to see over the next year or so. Such declines are already taking place.
The coming school board wars
Even in Democrat-controlled California, Gould, the mom whose son has cystic fibrosis, said she’s concerned about shifts in vaccine rhetoric, particularly at the school board level.
“I think what I have learned from my experience in Douglas county, Colorado, is that when these individuals take over majorities on school boards, it really affects everyone,” she said. “Despite the fact that we are a highly educated, very liberal, coastal section of southern California, you definitely have people that are trying to make inroads – and these are people who are anti-science.”
Parents across the country are able to apply for exemptions if their children are unable to get vaccinated for medical reasons. Most states also have religious exemptions, and 20 have some form of personal belief exemptions, leaving a varied landscape.
School vaccine mandates have been around for more than a century, and while some pushback has always existed, it wasn’t until Covid that there was a real spike in vaccine hesitancy, according to Kate King, president of the National Association of School Nurses and a school nurse in Ohio.
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The source of the skepticism has shifted, too. Hodge, of ASU, said: “Rarely have we seen the federal government behind those debates in a way that this next administration could be.”
Randi Weingarten, president of the American Federation of Teachers, sees the potential “unraveling of decades and generations of protective vaccines”.
For a vaccine to get approved, it must first go through an advisory committee at the FDA. Another committee at the CDC then develops recommendations for vaccine schedules, which state legislators rely on to determine their school policies. Kennedy would have an enormous impact on who serves on these committees, and he could stack them with anti-vaccine advocates.
Kennedy could also request a review of all vaccines that have been previously approved by the FDA and subject them to new requirements.
Many vaccines are paid for by the federal government. If Congress – under HHS’s direction or on their own – were to begin pulling that money, some of the most vulnerable children across the country could lose access to immunization. Trump has threatened to defund schools requiring vaccines for students.
“The moment you start tacking on any price tag to a vaccination – any price tag whatsoever, even fairly minimal – you do see vaccination rates go down,” said Hodge.
Beyond policy actions, experts warned of the power of rhetoric. The mere presence of a federal official who is skeptical – or outright hostile – towards vaccines gives the opposition more credibility.
Since the enforcement of these policies is typically left up to a school district, some advocates are anticipating increased pressure on school board members to take anti-vaccine positions.
Hughes, the George Washington University law professor, said he’s already seen some groups use vaccines as a wedge issue, much like the debate over critical race theory – an academic framework used to examine systematic racism – that convulsed school boards a few years ago.
In Louisiana, public health workers were recently forbidden from promoting shots for Covid, flu and mpox – previously known as monkeypox – according to a recent NPR investigation. And a regional public health department in Idaho is no longer providing Covid vaccines to residents in six counties after a narrow decision by its board.
While the image of vaccine-skeptical parents is often one of young, white “crunchy moms”, Keri Rodrigues, president of the National Parents Union, also pointed to “well-earned” trepidation among Black and Latino parents.
Historically, she noted, significant harm has been done to Black communities through the weaponization of medical trials, and families of color have had particularly negative experiences with the healthcare system – especially Black mothers.
During the pandemic, Children’s Health Defense, Kennedy’s anti-vaccine advocacy organization, seemed to tap into this distrust when the organization put out a film targeting Black Americans with disproven vaccine claims.
Using social media and other mechanisms, the anti-vax movement has also targeted fairly insular groups around the United States with misinformation, Swartzberg noted. These include New York’s Orthodox Jewish community and the Somali community in Minnesota, both of which have seen recent measles outbreaks.
Gould, the California mom, said that if she were still living in more conservative Douglas county, she’d fear that people would “believe the disinformation [and] stop vaccinating their children. For kids with chronic illnesses – or like my son, a life-limiting illness – that has massive consequences. It has life-or-death consequences.”
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This story was produced by The 74, a non-profit, independent news organization focused on education in the US
