Public health advocates are watching in growing alarm as former President Trump increasingly embraces the anti-vaccine movement.
"I will not give one penny to any school that has a vaccine mandate or a mask mandate," Trump said in a recent campaign rally in Richmond, Va.
It's a line Trump has repeated, and his campaign said he is only referring to school COVID-19 vaccine mandates — but that hasn’t eased fears that the GOP leader could accelerate already worrying trends of declining child vaccination.
Trump “is an important voice. He has a big platform. And he uses that platform, in this case, to do harm. Because he's implying by saying that we shouldn't mandate vaccines, vaccines are in some ways ineffective or unsafe,” said Paul Offit, a pediatrician and vaccine expert at the Children’s Hospital of Philadelphia.
The ironic part, Offit noted, is that the Trump administration kickstarted Operation Warp Speed, which helped drug companies use a relatively new technology to make two very effective and safe COVID-19 vaccines in less than a year.
Throughout the campaign, Trump has performed a complicated tap dance regarding COVID vaccines. He simultaneously wants to take credit for their speedy development but has also criticized their use and knocked his now former rivals for being too pro-vaccine.
In a post on Truth Social reacting to Biden's State of the Union speech on Thursday, Trump again claimed credit for the COVID-19 shots.
"You're welcome, Joe, nine month approval time vs. 12 years that it would have taken you!"
Every state and the District of Columbia requires children to get vaccinated against certain diseases before they start school, including measles, mumps, polio, tetanus, whooping cough and chickenpox. A plan to withhold federal funding would have widespread impact.
“Like most states, Virginia requires MMR vaccine, chickenpox vaccine, polio, etc. So Trump would take millions in federal funds away from all Virginia public schools," former GOP Rep. Barbara Comstock (Va.) wrote in response to his campaign threat on X, formerly Twitter.
Since the public health emergency ended last May, no state requires students to get the COVID-19 vaccine, while 21 states have laws specifically banning schools from requiring COVID-19 shots.
Trump’s campaign says his comments only apply to states that mandate COVID-19 vaccines — making it essentially an empty threat.
“If you actually listen to the entire section, and also if you’ve been following his speeches for the past year, he’s talking about COVID vaccines in addition to masks in the same breath. This isn’t anything new,” Trump campaign spokesman Steven Cheung said in an email.
Experts say the politicization of vaccines has led to an increase in hesitancy and is sparking more outbreaks of preventable diseases like measles.
There have been measles outbreaks in 15 states this year, most recently in Florida, where state Surgeon General Joseph Ladapo did not recommend parents vaccinate their children or keep unvaccinated students home from school as a precaution.
Instead, he sent a letter to parents advising them to make their own decisions about school attendance.
Ladapo was appointed by Gov. Ron DeSantis (R) in 2021 and has since aligned himself with anti-vaccine sentiments, primarily about the COVID-19 shots.
Ladapo told people not to get the most recent shot and has drawn sharp rebukes from the medical community — as well as federal health agencies — for claims that the shots alter human DNA, can potentially cause cancer, and are generally unsafe.
Georges Benjamin, executive director of the American Public Health Association, said he worries that Trump is signaling he will empower more people like Ladapo if he wins reelection.
“I worry about any administration that doesn't follow good evidence and good science, that they will put more and more people like them in their administration,” Benjamin said.
“We know that Trump had some extraordinarily competent people [in his first term]. But we also know that he had some extraordinarily incompetent people, and that in many situations, some of the really incompetent people carried the day because they aligned with his philosophy,” Benjamin added.
Robert Blendon, a professor emeritus of health politics at the Harvard School of Public Health, said the experience in Florida and the comments from Trump are part of a much broader Republican backlash against public health expertise and government mandates that can be traced to anti-COVID policies.
“It isn't that he's just going after these anti-vaccine votes,” Blendon said of Trump.
Trust in public health authorities has dropped precipitously among Republicans since 2021, and Blendon said Trump is a symbol of that. The anti-vaccine movement has never been associated with one particular political party, whereas the public health backlash is strongly Republican-centric.
“That's made it very, very powerful,” Blendon said. “There are Republicans in the House and Senate, who when they're not investigating public health, want to cut back the budget ... so it has caught on within the Republican base very widely.”
Whether it’s anti-vaccine specifically or anti-public health more broadly, the sentiment is growing.
According to the Centers for Disease Control and Prevention, the percentage of kindergartners whose parents opted them out of school-required vaccinations rose to the highest level yet during the 2022-2023 school year.
Robert F. Kennedy Jr., a well-known vaccine skeptic who is running for president as an independent, has gained a major platform to spread misinformation and widely debunked claims about vaccines.
He has falsely claimed vaccines cause autism, falsely declared the coronavirus shot is the world’s deadliest vaccine and questioned the safety of shots’ ingredients.
Offit, the vaccine expert, said he thinks public health officials could have done a better messaging job on the COVID-19 shots, and that by mandating vaccines they “inadvertently leaned into a Libertarian left hook.”
Still, Offit said he is concerned about the increasing anti-science rhetoric from politicians like Trump.
"I feel like we're on the edge of a precipice here ... you have the most contagious of the vaccine preventable diseases coming back to some extent, and with Donald Trump basically casting aspersions on vaccines, that's only going to worsen.”
