This week, Canada officially lost its measles elimination status, which it held for nearly 30 years — a shameful consequence of falling childhood vaccination rates.

In normal times, Canada’s misfortune might serve as yet another wake-up call for public health leaders in the U.S., which is precariously close to losing its own measles-free status.

But these are not normal times. Anti-vaccine and anti-science rhetoric continue to grow more deeply entrenched — within our health agencies, through local and state policies, and in the public imagination — making the nation’s elimination status only one of many looming threats to public health.

That situation is the result of a years-long campaign by anti-vaccine activists, who once operated at the fringes of society. But with Robert F. Kennedy Jr. now leading the nation’s health agencies, these individuals are suddenly emboldened to push their agenda even further. Mark Gorton, president of the MAHA Institute, made that abundantly clear at an event earlier this month hosted by Children’s Health Defense, the nonprofit organization Kennedy founded. According to a New York Times report, Gorton told the audience, “I’ve come to this anti-vax conference with a message that we need to be more boldly anti-vax.”

Their strategy isn’t merely to sow doubt on social media, but to embed it in the fabric of local communities. They aim not only to change hearts — but more importantly, shape public policy and change the law.

A recent Associated Press investigation found that four groups connected to Kennedy — MAHA Action, Stand for Health Freedom, the National Vaccine Information Center and the Weston A. Price Foundation — are behind a proliferation of anti-science bills introduced this year. The legislation is focused on three of Kennedy’s signature issues — vaccines, raw milk and fluoride.

The vast majority of the 420 anti-science bills identified by the AP — 30 of which have already been signed into law — target vaccines. Many seek to make it easier to obtain exemptions from routine childhood immunizations or to protect people who refuse vaccines from discrimination. But some go much further, such as a proposed bill in Minnesota that falsely characterizes mRNA vaccines as “bioweapons” and seeks to criminalize their development.

Few of these proposals have become law. But the attention they attract is dangerous given their potential to shift public opinion — a shift that can, in turn, inspire more such bills and increase the likelihood of more eventually becoming law.

A chain reaction can occur where “one bill says something about the use or non-use of vaccines that leads you to another bill around education requirements, which leads to rules around training for medical students or whatever,” says Jevin West, cofounder of the University of Washington’s Center for an Informed Public.

“The cascading effect scares me the most,” West says. “What's at stake here is it's more than even just changing the laws … just having the discussion and having it be a ‘debate’ about the topic creates confusion about the scientific consensus.”

In some cases — such as with raw milk and fluoride — the proposed laws are turning previously settled topics into points of contention, normalizing controversy over issues that most people hadn’t previously considered debatable — or perhaps hadn’t considered at all, says Boston University political scientist Matthew Motta.

When the strategy works for the groups pushing this legislation, they can replicate it in other states. ProPublica recently detailed how activists in Idaho, following the passage this year of a “Medical Freedom” bill — which makes it illegal for businesses, governments and schools to require medical interventions — viewed the legislation as a model for success nationwide.

Of course, anti-science laws aren’t a new phenomenon, though evidence suggests they have gained momentum since the pandemic. A study led by Motta found states had introduced some 376 anti-vaccine bills in 2023, 42 of which were signed into law. Republican lawmakers were responsible for 84% of them.

But under Kennedy’s leadership, the U.S. no longer has a reliable institutional check on the misinformation being spread by these groups. While local or state lawmakers might have occasionally promoted policies endangering public health in the past, the Centers for Disease Control and Prevention and the Food and Drug Administration stood as the trusted authorities on everything from the benefits of fluoridation to the dangers of raw milk. And when it came to vaccines, the message from health agencies was unambiguous: vaccines save lives.

Since Kennedy took charge, both agencies have retreated from that clear and concise endorsement of shots, and replaced it with mixed messaging and policy shifts that appear designed to undermine public confidence in their safety and effectiveness.

Much worse, Kennedy now has a much bigger platform to encourage — whether overtly or subtly — states to adopt his MAHA agenda. “When RFK Jr. talks, state lawmakers listen,” Motta says. “He is constantly inserting himself into these policy debates that are constitutionally allocated to the states in order to influence what states are doing.”

When Kennedy visited a farm in Idaho this summer, ProPublica reported that he told reporters the state, “more than any other state in the country,” aligns with the MAHA campaign, calling it “the home of medical freedom.”

All of this contributes to a vicious cycle in which policymakers, and now the U.S. health secretary, sow doubt through laws that nudge public opinion further toward their extremist views — and then capitalize on that shift in opinion to introduce even more legislation. We should worry about where this ends. The U.S. losing its measles-free status could be just the first of many terrible consequences.

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This column reflects the personal views of the author and does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.

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