Vote as if your children’s health depends on it. Antivaxers are on the ballot.

It’s election day, finally. After months of enduring endless political ads, attack ads, mailings, text messages, and more, it’s finally time to vote. So go out and vote. If you need motivation, just consider: Antivaxers have become increasingly active in politics. I’ve actually been documenting this for years, going back to the backlash in California to SB 277, the law that eliminated nonmedical “personal belief exemptions” to school vaccine mandates, which unleashed a firestorm of antivaccine activity. I also think that, probably more than anything else, SB 277 accelerated the alignment of antivaxers with conservative, small-government groups who view regulation as evil and over the last five years or so have started to lump school vaccine mandates in with hated regulation, viewing them as unholy assaults on “freedom” and “parental rights.” I have to admit that antivaxers have played conservatives well, presenting their antivaccine beliefs in conservative-friendly terms as being about the “rights” of parents to raise their children as they see fit and portraying school vaccine mandates as unacceptable assaults on freedom. Never mind the rights of children, as Peter Hotez notes:

“We’ve got kids dying of the flu, an enormous risk of a measles outbreak, over what?” says Hotez, who has been one of the loudest voices to condemn the modern anti-vaccine movement. “Over crap. Over nothing. These phony terms that anti-vaccine groups have claimed like ‘medical freedom’ or ‘parental choice’ ignores the fact that children have a fundamental human right to be protected against deadly diseases.”

Yes, they do. But antivaxers don’t see it that way. Many view their “right” to raise their children as they see fit to be basically absolute.

This sort of antivaccine activism has been particularly pernicious in Texas, where the antivaccine group Texans for Vaccine Choice has been quite effective. So, if you’re in Texas, you really need to pay attention to where your candidates stand on school vaccine mandates. But antivax political influence is not limited to Texas or California. Indeed, just yesterday, there was a long article in WIRED by Megan Molteni, How antivax PACs helped shape midterm ballots. It starts with Oklahoma::

IN EARLY 2015, Sen. Ervin Yen, an anaesthesiologist who became Oklahoma’s first Asian American state legislator, introduced a bill to require all schoolchildren to be vaccinated, unless they had a medical reason not to. California had recently debuted similar legislation after an outbreak of measles in Disneyland sickened 147 people and led to the quarantine of more than 500 others. At the time, California’s vaccination rates were below the 94 percent threshold needed to establish community immunity for measles. Oklahoma’s vaccination rates were even lower than California’s. Yen, a moderate Republican, felt like he had to do something.

But his bill never made it out of committee. The next year, he tried again, modifying the language to allow for religious objections. It failed too. So did the one Yen introduced in 2017. In 2018 he tried yet again, along with a resolution that would have placed the elimination of all non-medical vaccine exemptions on the general election ballot in November.

Yen is Republican. (It is, after all, Oklahoma.) As has happened often during the last few years, as a comparative “moderate” he was also primaried by an outsider Republican candidate, Joe Howell, and lost. Why? Here’s what he thinks:

If you ask Yen why he lost, he’ll offer a variety of reasons in his soft, Oklahoma City twang. But he suspects the biggest factor was the influence of local anti-vaccination activists. According to campaign finance filings, Oklahomans for Vaccine and Health Choice were the second biggest donor to Howell’s campaign, after only Howell himself. “They weren’t the only reason I lost, but there’s no question the anti-vaxxers were important in my defeat,” says Yen.

Also, did I mention that the Republican candidate for governor of Oklahoma, Kevin Stitt, is an antivaxer?

As I said, it’s not just Oklahoma, either:

But in the last few years, the modern anti-vaccination movement has evolved into a new chapter: the political action committee. In the 18 states that currently permit parents to send their unvaccinated children to public schools on the grounds of philosophical objections, “Vaccine Freedom” PACs are increasingly flexing political muscle to keep it that way. By making a broader appeal to parental rights, some groups are now pushing agendas that would eliminate vaccine mandates of any kind. And as they shape this year’s election ballots to be more favorable to their cause, the nation creeps ever closer to an infectious disease outbreak as inevitable as it will be tragic.

Of course, I’ve been warning about the increasing politicization of school vaccine mandates for years. This politicization became undeniable during the Republican primaries for the 2016 election, where Donald Trump, Rand Paul, Chris Christie, Ben Carson, and others seemed to vie for the title of best panderer to antivaccine beliefs. (Rand Paul won, from my perspective, with his line about how, “The state doesn’t own the children. Parents own the children, and it is an issue of freedom.” Yes, that’s what “parental rights” mean to him and, sadly, a lot of other antivaxers. Indeed, after Donald Trump’s victory, I was concerned enough to ask if 2017 would be the antivaccine year. (The answer: Mixed.)

I alluded to Rep. Jason Villalba, a three-term Republican state legislator from Dallas, who was similarly primaried by an antivaccine-approved candidate:

In 2015, Villalba filed legislation to end religious and philosophical vaccine exemptions, a loophole in state law dating back to 2007. Like Yen, he was concerned about a potential measles outbreak, especially with a two-month-old son at home.

In response, a mother named Jackie Schlegel, who says that one of her kids was injured by vaccines, formed a Facebook group of “mad moms in minivans” to kill the bill. The group quickly grew into a political action committee called Texans for Vaccine Choice determined to protect their right to medical freedom.

After the bill’s defeat, the group turned its efforts to unseating Villalba, backing primary challengers to his re-election campaign in 2016 that ran largely on the vaccine exemption issue. According to Villalba, every time he’d show up at the polls to greet people, two or three people from TFVC would be there to confront him and yell insults. “They just wanted to ridicule me and make me look foolish,” says Villalba. “I didn’t think that was an effective way to win hearts and minds.”

Villalba admits that Texans for Vaccine Choice wasn’t the only factor in his defeat: Beto Fever. In his wealthy, educated district, which Clinton won by 14 points in 2016, about a fifth of the district’s Republicans switched over to vote Democratic in this year’s primaries, thanks to the appeal of Democratic Senate candidate Beto O’Rourke. According to Villalba, that left all the residual voters who hail from the farthest of the far right fringes as the main Republican voters in the primary, in an example of the law of unintended consequences.

It’s not just Villalba’s unseating, either. Antivaxers have been very busy in Texas. For example, during the flooding of Houston after Hurricane Harvey last year, Barbara Loe Fisher’s National Vaccine Information Center (NVIC) did its best to make sure that make sure that the parents of children temporarily displaced to other schools due to flooding could maintain their children’s personal belief exemptions to school vaccine mandates by pointing out how schools can’t require documentation of vaccination status from children made temporarily homeless by the hurricane. In addition, I’ve written about Texans for Vaccine Choice on multiple occasions. It is a virulently antivaccine group that’s played a pivotal role in blocking any efforts in the Texas legislature to tighten school vaccine requirements and make it harder to obtain personal belief exemptions. Indeed, it’s a group that has led me to conclude that, most likely, when the next big outbreaks of vaccine-preventable disease happen, they’ll happen in Texas.

The WIRED article doesn’t mention it much, but we have a similar, albeit fortunately weaker phenomenon in Michigan. For instance, my state senator, Jeff Noble, appeared at an antivaccine panel discussion, where he touted his efforts to eliminate a state requirement that parents seeking personal belief exemptions travel to their local county health office and undergo an education program on vaccines, or, as I put it, to make measles great again. Tellingly, he pointed out that it was only the Republicans who were responsive to antivax proposals to weaken school vaccine mandates, while all the Democrats on the committee were completely opposed.

Speaking of RFK, Jr., just before the election, he released an advertisement attacking California Senator Richard Pan, the architect of SB 277 and a vocal pro-vaccine advocate, in his bid for reelection and endorsing someone named Richard Frame, who appears to be a progressive:

So, yes, there are definitely antivaxers on the left. As I’ve pointed out many times, antivax is the pseudoscience that knows no political boundaries, with luminaries on the left such as Jill Stein having pandered to antivaxers and Robert F. Kennedy, Jr. being a leader in the antivaccine movement.

However, right now, in 2018, the loudest and most influential voices in the antivaccine movement have overwhelmingly aligned themselves with the right because they’ve found a message that resonates with the right: Deceptively conflating “vaccine choice” and “vaccine freedom” with freedom from government regulation and “parental rights.”

If you didn’t need another reason to vote this year, there you have it. Just make sure to check your candidate’s views on vaccines before you go to the polls and make sure you’re not voting for someone who will work to enact policies that can lead to the resurgence of vaccine-preventable diseases.