How the anti-vaccine movement pits parental rights against public health

Gayle Borne of Springfield, Tennessee, has fostered more than 300 children. In January, she took a foster baby, born extremely premature at just over 2 pounds, to her first doctor’s appointment. But the health providers said that without the consent of the child’s mother, they couldn’t vaccinate the newborn against diseases like pneumonia, hepatitis B and polio.

It’s due to a law Tennessee passed last year that requires the direct consent of birth parents or legal guardians for every routine childhood vaccination. Foster parents and social workers cannot provide permission. Nor can grandparents and other caregivers who take children to routine appointments when parents can’t.

The foster baby’s mother hasn’t been located, so a social worker is now seeking a court order to permit the immunizations. “We are just waiting,” Borne said. “Our hands are tied.”

The Tennessee law claims to “give parents back the right to make medical decisions for their children.” Framed in the rhetoric of choice and consent, it is one of more than a dozen recent and pending pieces of legislation nationwide that pit parental freedom against community and children’s health.

In actuality, these laws create obstacles to vaccination, the foundation of pediatric care. And they have a second effect: seeding yet more doubt about vaccine safety in a climate rife with medical misinformation, where politicians and influencers make false claims about risks, despite studies showing otherwise.

Childhood vaccine rates are already at their lowest in a decade.

Dorit Reiss, a vaccine policy researcher at the University of California Law–San Francisco, fears the revived parental rights movement may eventually abolish routine immunizations to attend school. At a recent campaign rally, presumptive Republican presidential nominee Donald Trump said, “I will not give one penny to any school that has a vaccine mandate.”

Seven in 10 U.S. adults said public schools should require vaccination against measles, mumps and rubella in a 2023 Pew Research Center poll. But numbers have been dropping.

“People who promote parental rights on vaccines tend to downplay the rights of children,” Reiss said.

When lawmakers silence experts

In Tennessee, anti-vaccine activists and libertarian-leaning organizations railed against the state’s health department in 2021 when it recommended COVID-19 vaccines to minors, following CDC guidance. Then the state’s immunization director reminded doctors that a Tennessee law called the Mature Minor Doctrine didn’t require parental permission to vaccinate consenting adolescents 14 or older.

Backlash ensued. State legislators threatened to defund the health department and pressured it into scaling back COVID-19 vaccine promotion, as revealed by The Tennessean, part of the USA TODAY Network. The immunization director was fired. By mid-2022, Tennessee’s COVID-19 death rate climbed to one of the nation’s highest.

When lawmakers introduced a bill to reverse the Mature Minor Doctrine, the health and children’s services departments were silent.

“Children belong to their families, not the state,” Republican Rep. John Ragan said as he presented the bill in April 2023.

Democratic Rep. Justin Pearson did speak out, saying the bill “doesn’t take into account people and children who are neglected.”

Rather than address the concern, Ragan referenced a 2000 Supreme Court ruling in favor of parental rights, where justices determined that a mother had legal authority to decide who could visit her daughters. Yet the Supreme Court has also done the opposite. For instance, it sided against a legal guardian who removed her child from school to proselytize for the Jehovah’s Witnesses.

The bill swiftly became law.

Deborah Lowen, then deputy commissioner of child health at the Tennessee Department of Children’s Services, was flooded with calls from doctors who now face jail time and fines for vaccinating minors without adequate consent. “I was and remain very disheartened,” she said.

Jason Yaun, a Memphis pediatrician and past president of the Tennessee chapter of the American Academy of Pediatrics, had to decline to administer a first series of vaccines to an infant accompanied by a social worker. The experience shook him, he said.

“That child is going into a situation where they are around other children and adults,” he said, “where they could be exposed to something we failed to protect them from.”

“We have had numerous angry grandparents in our waiting room who take kids to appointments because the parents are at work or down on their luck,” said Hunter Butler, a pediatrician in Springfield, Tennessee.

He has called a rehab facility to request verbal consent from a mother to vaccinate her baby. “And it’s unclear if that was OK,” he said.

A right to health

Unvaccinated people put others at risk, including babies too young to be vaccinated and people with weakened immune systems.

“There’s a freedom piece on the other side of this argument,” said Caitlin Gilmet, communications director at the vaccine advocacy group SAFE Communities Coalition and Action Fund. “You should have the right to protect your family from preventable diseases.”

In January, Gilmet and other child health advocates offered free fried chicken biscuits at the Tennessee Statehouse, handing out flyers as legislators and aides drifted in to eat. One pamphlet enumerated the toll of a 2018-19 measles outbreak in Washington state that sickened 72 people, most of whom were unvaccinated: $76,000 in medical care, $2.3 million for the public health response and an estimated $1 million in economic losses due to illness, quarantine and caregiving.

Barb Dentz, an advocate with Tennessee Families for Vaccines, repeated that most of the state’s constituents support strong policies in favor of immunizations.

“Protecting kids should be such a no-brainer,” Dentz told Republican Rep. Sam Whitson later that morning in his office. Whitson agreed.

“Dr. Google and Facebook have been such a challenge,” he said. “Fighting ignorance has become a full-time job.”

Whitson was among a minority of Republicans who voted against Tennessee’s vaccine bill last year. “The parental rights thing has really taken hold,” he said, “and it can be used for and against us.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – an independent source of health policy research, polling and journalism.

This article originally appeared on USA TODAY: How the anti-vaccine movement pits parental rights against public health