Anti-Science Bills Are Being Considered In State Legislatures

0:07More than 400 bills challenging longstanding public health practices have made their way through state houses across the country. According to an Associated Press investigation that tracked this legislation, these bills would do everything from ban certain types of vaccines to making the sale and consumption of unpasteurized or raw milk more accessible. But anti-vaccine bills were by far the most common ones. At least 350 of the 420 bills were related to vaccines. Eleven states have already adopted more than two dozen laws restricting vaccine access. Who are the highly organized groups behind this wave of anti-science legislation?

0:46And how did these bills fit into the broader dismantling of the country's public health system? We get into it after the break. I'm Jen White. You're listening to the 1A Podcast, back with more in a moment.

1:01Joining us in studio to talk about it is Julie Rovner. She's Chief Washington Correspondent at KFF Health News. She's also the host of their health policy news podcast, What the Health? WAMU is a co-producer and distribution partner for the podcast. Julie, welcome back to the program. Thanks for having me, as always. Also with us is Laura Unger. She's a science and medical reporter for the Associated Press. She's one of the journalists who led AP's investigation into the anti-science bills being introduced across the country. Laura, welcome. Thank you very much. And Dr. Paul Offit. He's a pediatrician specializing in infectious diseases and vaccines.

1:37He's also the director of the Vaccine Education Center at Children's Hospital of Philadelphia. He was previously a member of the CDC's Advisory Committee on Immunization Practices. Dr. Offit, it's always great to have you. Thank you, John. And we want to hear from you, too. What changes to public health have you seen in your community? And what questions do you have about those changes? If you work in the public health sector, what's your reaction to bills seeking to undo longstanding public health standards? Email us at 1a at wamu.org. Now, Laura, you and your colleagues at AP examined more than 1 ,000 bills to track the spread of anti-science legislation across the country this year.

2:16Tell us more about the kinds of bills you found. Sure. Yeah. So we actually searched legislation in all 50 states and analyzed the bills for whether they undermined science-based protections for human health. And what we really focused on was three particular public health policies, vaccines, fluoridation of water and milk safety, which all have clear medical evidence behind them, yet are targets of the Make America Healthy Again movement. Um, anti-vaccine bills were by far the most common, um, with more than 350 of them, but we also found, uh, more than 70 that would roll back access to, uh, fluoride or make it easier to consume or sell raw or unpasteurized milk products.

3:06Well, there's been a lot of attention paid to what's happening with public health at the federal level, but why did the AP want to specifically look at legislation at the state level? Well, we wanted to look at the states because that's really where public health hits home. It's not just playing out far away in Washington, but in, you know, your own state house in your own community. So that was one thing. Also, it shows how far these anti-science ideas are spreading. And public health authority really ultimately rests in the states. So, you know, those are really why we chose that route. So, Julie, what does this say to you about the current health landscape under the Trump administration?

3:50You know, all these anti-vaccine and pro-raw milk and fights over water fluoridation views have persisted for decades, for as long as I've been covering health care. What we've seen this year, though, is having it, A, rise to the fore like this, and B, people with the power to do things about it. We had not seen, as the AP investigation showed, a lot of this is a very organized campaign. We've always seen people with these views. We've never seen it organized in a way that we're seeing so much policy being changed so rapidly. Now, Dr. Offit, as we said, anti-vaccine bills are by far the most common.

4:30And this includes placing additional regulatory barriers or restrictions on vaccines or making it easier to get vaccine exemptions. What are the implications of these kinds of policies? Well, the implications is that children will now be less safe. I mean, you're seeing it this year. We've had the biggest measles outbreak in this country in 33 years. We've had three people die. That equals the total number of measles deaths in this country over the last 25 years. We've had two healthy little girls die in West Texas. That's the first child death since 2003. We've had more deaths in children from influenza this year than since the last influenza pandemic.

5:09There are states experiencing pertussis or whooping cough deaths that hadn't experienced them for years. So I think you're seeing an erosion in vaccine rates, an erosion in public trust. And these bills are just further evidence of that. Well, here's the message we got from Emily in Kansas. I'd love to know what the new rules are around COVID vaccines. and if our local pharmacies are able to give us those still without having to ask in particular. I know that RFK Jr. has done some work to make that harder, but I don't really understand all that's going on with that in Kansas. Thank you. Emily, thanks for that message.

5:43Dr. Offit, can you give Emily any guidance? It's confusing. I think that where the ACIP was heading back in April of 2025 was to recommend that this vaccine be given as a yearly vaccine for those in high-risk groups. So, you know, pregnant women, people who are immune-compromised, people who are elderly, or people who have medical conditions that put them at highest risk, like chronic lung or heart disease. What the current ACIP recommends, and this is not an ACIP that I think is legitimate, frankly. And we should say that's the Advisory Committee on Immunization Practices. The Committee for Immunization Practices, which advises the Centers for Disease Control and Prevention, they basically said punt it.

6:24They really don't have a recommendation. They're just saying shared clinical decision-making, talk about it with your health care professional, and then make a decision. So even if you're in a high-risk group and should be vaccinated, they don't recommend it. I do think, however, that there are a number of scientific and medical advisory committees, as well as states who have formed coalitions, to make sure that they put out their best medical advice. And I do think insurance companies will cover those people who really should be getting vaccinated because they're in the highest risk group. So I think because that makes sense.

6:54It's just a good financial decision for those insurance companies because it's much cheaper to pay for a vaccine than hospitalization. But it is a confusing time. Well, Julie, where can people find reliable information about their state? Well, as something Laura said that was very important is that most public health authority lies within states, to some extent, also localities. We've seen various, you know, places that people go to get their vaccines, mostly drug stores these days. And people, it's much more easy. But now we don't have really national recommendations. So the big drugstore chains are varying by state for a while.

7:31You know, if you were an adult, if you were a healthy adult, you couldn't get a COVID vaccine in the District of Columbia. But if you went over the line to Maryland, you could. Now, you can now get one in D.C. So the first place to start is your state public health agency and see what they say. Then it's a question of, can you find a vaccine? And then it's a question of, will the vaccine be reimbursed? Although I should add that the health insurance industry writ large said they would cover COVID vaccines for most people, at least for another year. They're trying to figure out how to balance off what's happening with the ACIP.

8:04Now, Laura, most of the bills we're discussing haven't passed. But where are we seeing these bills not just being introduced, but actually passing? So we found around 30 bills have been enacted or adopted in 12 states. And some of those states are Texas, Florida, North Dakota, Montana, Alabama, Arkansas, and others. So, you know, that's 12 states total. And what are some of the more stringent bills we've seen introduced so far? So there's bills in numerous places. that target mRNA vaccines in particular, which as you know, we're credited with saving millions of lives during the COVID-19 pandemic.

8:47And two bills in Minnesota actually designate them as, quote, weapons of mass destruction. That's the language in the bill. And these bills come at the issue from various angles, from like barring discrimination against unvaccinated people, creating an actual criminal offense of vaccine harm, requiring blood banks to test for evidence of vaccination, and instituting a 48-hour vaccine waiting period, for example. So since 2019, 77 % of counties and jurisdictions in the U.S. have experienced a decline in childhood vaccination rates. That's according to an NBC News data investigation from earlier this year.

9:30Laura, you spoke to a family in Indiana who lost their eight-year-old son to a type of vaccine-preventable influenza because of low vaccination rates in their community. Tell us about that family and what you heard from them. So Liam Dahlberg is the little boy's name. He was eight years old when he lost his life. And he had a vaccine-preventable disease called Hib. And he was vulnerable. He had asthma, severe asthma and allergies. And his parents talked about how, you know, he was vaccinated against Hib and they thought having vaccines would protect him and their other children. But his dad said, you know, unfortunately, it did not because other kids, other adults need to be vaccinated as well in order for it to work.

10:22It's called Hib, I mean, herd immunity. so he really got very sick quickly his brain swelled and he died within two days after he first complained of a headache and so it was just tragic and his mom said you know there's no pain worse than the pain of losing a child and you know it was just really hard to you know to see what they've been through. We'll hear more about that story in a moment. We'll be right back.

11:02Dr. Offit, before the break, Laura was sharing Liam Dahlberg's story. And I'd love to hear your reaction to that, especially when we think about the impact of changing vaccine policy, not just on falling childhood vaccination rates, but also for unvaccinated children and vaccinated and immunocompromised children as well. Right. It was a painful story, the story of a child who dies from haemophilus influenzae type B. I mean, when I was a pediatric resident in the late 1970s, every year that bacteria would cause 20 to 25 ,000 cases of meningitis, bloodstream infections, epiglottitis where a child could die of suffocation and pneumonia and then in the late 1980s and early 1990s we created a vaccine that virtually eliminated that disease i mean i would do two to three spinal taps every night when i was a resident on call in the emergency department today residents at our hospital children's hospital philadelphia generally don't know how to do spinal taps because especially because of that vaccine so interventional radiologists do the spinal tap.

12:07And the notion that a child would have to today suffer from a preventable disease like that is really heartbreaking. But I think part of the problem is not just that we've largely eliminated these diseases, we've eliminated the memory of these diseases. People don't remember how sick or in this case or other cases dead these bacteria can make you. Well, Julie, this legislation may be happening at a state level, but why does it matter? Why do we need to pay attention to it even if we don't live in a state that's considering or passing this legislation? Well, because we know that public health doesn't honor state lines.

12:39And, you know, particularly with contagious diseases, which is what public health has been most successful in slowing the spread of. You know, we are now seeing it. This is a big concern in Florida, for instance, which is one of the leaders in getting rid of vaccine requirements. Think of all the people who travel to Florida every year. It's a state that basically the economy is based in large part on tourism. So people come in and out. People get on airplanes. I mean, this is why we monitor public health threats in other countries, because people come here. And, you know, I know I say this every time we have this conversation, but public health is invisible when it works.

13:19It's only when it doesn't work, when it starts to break down, that you see things like this. And I think Dr. Offit is exactly right. People don't remember the bad things that happen when you don't have these public health protections in place. So they think that we don't need them. Laura, it's important to note that you didn't just track the bills in your investigation. You also looked at the groups that are pushing them. Who's behind these bills and what strategies are they using? So we basically looked at four groups that are connected to Kennedy that are supporting some of these bills. One is Maha Action.

13:59Another is Stand for Health Freedom. Another is the National Vaccine Information Center. And then the fourth is the Westin A. Price Foundation. And these groups also oppose dozens of science-driven bills. And they're part of a well-organized effort, we found, with a clear strategy to change policies. And all of them have connections to Kennedy in some way. And there's a web of connections among the groups as well. We got this question from Jay who asks, what input did medical experts have into public health policies in the past? And what input did those experts have in these bills? So, Julie, I'm going to ask you to take the first half of that question and then ask Laura to take the back half.

14:46Yeah, you know, public health experts have often been turned to by lawmakers who are not, in general, public health experts. We've seen, you know, individuals and groups and professors. And, of course, Secretary Kennedy likes to say that they're all in the pocket of, you know, big pharma or big food or big whatever. But, you know, and I think Laura will get into this. Most of these groups that are pushing this anti-science legislation also have a profit motive. They also stand to make money from selling supplements and various other things, raw milk in some cases. So I posed this question on the podcast last week.

15:24Is it fair to say that some of these groups that are pushing this legislation are in the pocket of big wellness? And Laura, so what input do health policy experts have in this current round of bills? So with the anti-science bills, you know, not much at all. So, you know, it's not really the same as in the past. Some of these bills that are more the science-driven bills, there is, you know, experts behind some of those. Well, Dr. Offit, you have, in the past, helped advise the federal government on vaccine policy. And I'm wondering what you observe through your experience, how the voices of public health experts, how their presence has shifted over the last 10 months.

16:19Right. So I was on the Advisory Committee for Immunization Practices, which advised the CDC from 1998 to 2003. I was on the FDA's vaccine advisory committee from 2017 to 2025. And it's a wonderful experience. I mean, you discuss data with people who have expertise in the field, like experts in virology or immunology or bacteriology or statistics or epidemiology, and you look at data and try and then come to a conclusion to make the best recommendations for this country. And the data that you're looking at are generated by agencies that you trusted, like the CDC or like the FDA. Now things have been turned on their head.

16:57I think as Rochelle Walensky, former CDC director, Tom Friedens, former CDC director, said, they don't trust the CDC anymore. And I agree with that. And because Robert F. Kennedy Jr. fired 17 members from the ACIP who had an expertise and replaced them with those who didn't, people don't trust the ACIP anymore. So that's why you're seeing these sort of fractionated voices out there, whether it's from states or medical or professional societies, that are trying to step in and provide that expertise. But I think we are living in a dangerous time. People now simply declare their own truths, including scientific truths.

17:31And every time the ACIP has had a meeting since RFK Jr. has replaced that committee with non-experts, we're all just holding our breath, waiting for the next dangerous, non-science-based thing that they say. Well, we also have to place this within the broader context of the Trump administration's attacks on public health infrastructure, from mass layoffs at the nation's major health agencies to billions of dollars in federal funding cuts to science research. Julie, how do you see these state-level bills fitting into that broader undermining of public health infrastructure? I think it's even broader than that.

18:03We are seeing this attack on expertise in general across society. You know, we keep hearing the president talking about using common sense. Well, common sense would suggest that the earth is flat. There is common sense and science don't necessarily go together. That's why we have science. But I really do think since COVID, and I think that President Trump has really sort of used this to come back into power, there has been this rejection of expertise. Sort of, you know, the pointy-headed intellectuals don't know what they're talking about or they are corrupt. I mean, that's basically been the theme throughout this administration.

18:41And I think where we're really starting to feel it is in public health and in science. Laura, your team also looked at federal cuts to public health funding. What kind of programs have been cut? So there's just a lot of programs across the country. For example, we found specialists who were confronting a measles outbreak in Ohio are now gone. Workers who drove a van to schools in North Carolina for vaccinations. a program that provided free tests to sick people in Tennessee. So a lot of different programs in individual states. And really, a lot of this comes out of the$11 billion of direct federal support that was pulled earlier this year.

19:35And so how do those funding cuts intersect with these state-level bills challenging public health standards? Where are the gaps lining up to create holes in the system? So these cuts, on top of cuts in earlier years, turn the entire system into a shadow of what it once was. So that threatens to undermine even the routine work of these health departments at a time, you know, very difficult time. You know, we have measles outbreaks, et cetera. and they reflect a shift that Americans may not fully realize, which is kind of away from the whole idea of public health. I mean, public health is doing the work that no individual can do alone to safeguard the population as a whole.

20:22And so it's undermining that and creating sort of a vacuum in which some of these anti-science ideas can rush into. Well, Julie, we also should not overlook the fact that we are currently in a government shutdown. It's been four weeks. Nearly 1 ,000 Health and Human Services employees were slated to lose their jobs as a result of the shutdown. But yesterday, a federal judge blocked President Trump's move to lay off thousands of government employees and admit the shutdown indefinitely. But when you think about everything that's happening at the same time right now, what short-term and long-term effects is the shutdown in particular having on the country's public health system?

21:09I think, you know, it's creating this sense of uncertainty and anxiety among health workers. You know, I live in an area with a lot of federal workers who are on furlough, some of whom have been called back. Everything is sort of, no one can plan long-term. I mean, that's the other, I think, big theme of this administration is that things change on a dime. Every morning I wake up and, you know, something new has happened. So everybody is sort of wondering what's going, you know, what shoe is going to drop next. Are they going to have a job? Are they going to have funding? If you're in a university or in a public or a local public health agency, everything is just in this sort of state of limbo.

21:49And what about the questions about health care coverage and cuts to Medicaid, Medicare, whether the Obamacare subsidies are still going to be around, whether people might just opt out of having health insurance at all? That's right. And that's also a big concern. And November 1st, which is this Saturday, is the beginning of open enrollment for the Affordable Care Act. And Congress hasn't decided yet whether or not they're going to extend the additional subsidies that were put in place during COVID, which, if they don't renew them, could double or even triple out-of-pocket spending for premiums for millions of people.

22:23And we're already seeing, you know, they made, the Republicans made these big Medicaid cuts in the bill that passed over the summer. they weren't supposed to take effect for another couple of years, but we're already seeing planning hospitals and other health care facilities cutting back because they can see down the road that they're not going to have this money. So we're starting to see cuts in lots of places. And again, between the cuts and the uncertainty, everything is really just up in the air. And just for the record, when I say Obamacare, of course, I'm referring to the Affordable Care Act, but it's called many different names depending upon the state you're in.

22:57Let's take a quick pause here. We'll be back with more from our guests in just a moment. Stay with us.

23:07Now back to our conversation, and let's turn to this question we got from Carol, who says, can your guests re-explain herd immunity? If I get my vaccinations and my children get theirs, are we not safe from those diseases? I was confused about the child who died after contracting influenza, even though he had been vaccinated. And she's referring there to Liam Dahlberg, who had asthma, Dr. Offit, which means he would be more susceptible to respiratory illness. But first, just explain, again, what do vaccines do? So vaccines provide the immunity that is a consequence of natural infection without having to pay the price of natural infection.

23:46That's what they do. I just want to clarify one thing. The story that you told about, Liam, it was Haemophilus influenzae type E, which is a bacteria, not a respiratory virus. So the herd immunity issue is important. What herd immunity means is that enough people have been vaccinated around you so that it would be very hard for that virus to get to you. So, for example, there was an outbreak of measles in the Netherlands in the early 1990s. And what they found may seem counterintuitive, but when you think about it, it does make sense. You are actually more likely to get measles if you were vaccinated living in a highly unvaccinated community than if you were unvaccinated living in a highly vaccinated community.

24:27Because no vaccine is 100 % effective. And the more likely you are to be exposed to the virus, the more likely you are to get sick. So that's what herd immunity is. It sort of provides that sort of moat around you, which we need. Because remember, millions of people in this country can't be vaccinated because they're immune suppressed or getting cancer chemotherapy or other reasons. They depend on those around them to protect them. And I think they count too. And just, this is a place where I think people got very confused during COVID. Because the COVID vaccine prevented people from getting severe illness.

25:02It didn't necessarily prevent you from contracting SARS-CoV-2. Correct, Dr. Offit? That's right. The goal of that vaccine was to keep you out of the hospital, out of the intensive care unit, and out of the morgue. It doesn't prevent, not for long, mild or moderate illness. And I don't think we made that very clear early in this pandemic. Well, we got this message from Michael who writes, I want to thank Dr. Offit for his science advocacy and ask that he continue pushing concise information on Children's Hospital of Philadelphia's website. I'm not a doctor, but I use CHOP's website constantly to combat anti-vax disinformation on social media.

25:36I think we're all foot soldiers in the war against deadly conspiracy theories. Now, Dr. Offit, public trust in science was slightly higher in 2024, but it's still lower than before the pandemic. That's according to a survey from Pew Research. How did the pandemic rattle some people's trust in the country's public health system? I think it was the first two years. I think that first year when we didn't have anything, we didn't have antivirals till October of 2020, we didn't have monoclonals till November of 2020, we didn't have vaccines till December of 2020, to try and stop a virus that was killing people, killing hundreds of people, and then ultimately thousands of people a day, and was spread asymptomatically.