In the oil towns of west Texas a measles outbreak is spreading. At least 58 people have been infected and 13 are in hospital, the biggest surge in Texas in 30 years. Health officials reckon hundreds more cases have yet to be detected. Gaines County, where the flare-up began, had the state’s third-highest share of children exempt from measles and other vaccines for religious or philosophical reasons last year. In the decade to 2023 the rate of schoolchildren without the recommended jabs there more than doubled, from 7% to 18%.
But rather than addressing an incipient public-health crisis, Texas legislators meeting in Austin, the state capital, are debating new laws to relax vaccine rules, urged on by Texans for Vaccine Choice (TFVC). On February 18th activists in “Come and Make Me” shirts took to the Capitol to lobby and celebrate. As many as 45 vaccine-related bills have been introduced in the first month of the legislative session and 37 of them are anti-vaccine, according to the Immunisation Partnership, a non-profit. Two especially worry public-health experts: one would make it easier for parents to exempt their children from school mandates and the other would give politicians, rather than health officials, control over which are required.
Austin’s moment comes as Robert F. Kennedy junior, a vaccine sceptic, is taking charge as America’s health secretary. If such an appointment had been made two years ago “you would have thought we were crazy”, says Chip Roy, a congressman allied with the demonstrators. In the states, grassroots movements ride on the convictions of people like Carrie Bigford, the outreach director for TFVC. Her friend Kristin’s baby died suddenly after being vaccinated. The hospital said the shots were blameless and there is no contrary evidence. But on the day after what would have been the child’s second birthday Kristin killed herself. Twenty years on Ms Bigford is committed to “medical freedom”. She believes that vaccines pose intolerable risks. Even Botox goes through more rigorous clinical trials, she contends, falsely.
To achieve herd immunity for the eight primary diseases doctors vaccinate against, roughly 95% of the population must be immunised. Last year the share of five-year-olds entering classrooms fully vaccinated dropped below 93% nationally. Populous Texas is at 94% but would fall further if some of the proposed bills pass. Between 2013 and 2023 the share of kindergarteners who got the measles jab fell in 29 states (see map). Because vaccine sceptics tend to cluster in neighbourhoods, the risk of outbreaks is higher yet.
Before the covid-19 pandemic TFVC activists had to whisper in the halls of the Texas Capitol, says Rebecca Hardy, their leader. But in 2020, as people took to the internet to learn about getting jabbed, scepticism snowballed. By then the Texas mums had made rich and influential Republican friends and today they have lawmakers lining up to back them. For a long time Americans were more receptive to vaccines than Europeans; a decade ago the French were the most distrusting, according to research by the Vaccine Confidence Project. Now most of the world’s anti-vaccine digital content comes from America.
Heidi Larson, the Vaccine Confidence Project’s founder, reckons that the movement could have been stymied a decade ago with a stronger dose of empathy. “The medical community hardened these mothers’ views because we weren’t listening,” she says. Ms Bigford admits that trauma fuelled her vaccine anxieties. Had more people taken her fears seriously back then she would not be an activist today.■
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