In deep blue Colorado, one of the only states that did not shift right in the 2024 presidential election, vaccine advocates see openings for Robert F Kennedy Jr.
An environmental lawyer and the nation’s most prominent propagator of vaccine misinformation, Kennedy is now the embodiment of where left meets right – the scion of a political dynasty who first ran as a Democratic presidential candidate and is now slated to join president-elect Trump’s administration as the nominee to head the Department of Health and Human Services.
If confirmed, Kennedy would lead a sprawling health and science agency with oversight over everything from publicly funded basic research to insurance programs that cover 137 million Americans’ healthcare.
But his agenda is decidedly more “crunchy” than the traditional Republican nominee, and includes experimental and even risky propositions: “psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma”, he said in a social media post.
“You could walk down any street in Boulder and bring up nutraceuticals and psilocybin,” said Lindsay Diamond, a vaccine advocate who volunteers in local hospitals answering parents’ vaccine questions, about parents in a town where Democrats just swept local elections. “That’s casual coffee conversation for a lot of people in Boulder.”
The overwhelming majority of US parents vaccinate their children. A recent study from the Centers for Disease Control on Prevention (CDC) found that more than 90% of parents had vaccinated their children with the measles, mumps and rubella (MMR) vaccine, a shot that has been the subject of misinformation for decades. The childhood disease hospitalizes about one in five unvaccinated people who catch it.
But advocates also worry that the state’s focus on wellness, and a well-founded distrust of chemical and pharmaceutical companies, could make people vulnerable to misinformation, especially at a time when a vaccine skeptic could have one of the world’s biggest microphones as a cabinet secretary.
The same CDC study shows how vaccination rates – key to preventing outbreaks – can be eroded. Researchers found small declines from 2018-2018 to 2020-2021 – perhaps due to the many and profound disruptions of the pandemic, but perhaps due to vaccine misinformation, researchers said.
And Kennedy’s agenda reflects one more typically thought of as left-leaning – associated with wellness, openness to nontraditional health treatments and “slow food”. In Colorado, people like Diamond are concerned about the ways Kennedy’s anti-vaccine rhetoric could make inroads in left-leaning communities.
“Things like obesity and making sure children are exercising and eating healthy foods – that feels more pressing for people certainly around here,” said Diamond, adding that because people of childbearing age have lived through the modern era of vaccinations, the overwhelming majority do not have personal experience with polio or measles, and therefore have no “muscle memory”.
Colorado is considered one of the healthiest states in the nation. It leads the country in educational attainment and, while not the richest state, has among the lowest in rates of economic hardship (only New Hampshire fares better).
Both are highly correlated with health outcomes, which likely helps explain Colorado’s high performance on other broad-based measures of health, such as life expectancy at birth. Colorado performs similarly well on specific health measures, such as having one of the nation’s lowest obesity rates in the nation – a statistic locals credit to the easy access to the outdoors and culture of fitness.
Diamond’s concerns about the audience for unfounded wellness information have been echoed in articles on national health and wellness influencers, some of whom have surprised followers by announcing their support for Trump and their opposition to other scientifically proven medications, such as GLP-1 weight loss drugs.
She fears that many left-leaning residents, especially those with good access to healthcare, are vulnerable to the “medical freedom” movement, especially when it is wrapped around a wellness agenda that promises to combat chronic diseases such as obesity and diabetes.
“They start going to a yoga studio, they start going to a CrossFit studio, and all the sudden that new wave of health information starts coming in,” she said.
People of color are often the focus of vaccine information campaigns, with the traditional public health understanding being that lower vaccination rates are because of distrust of the scientific establishment due to a history of racist abuse and experimentation.
“When the pandemic hit, I kept hearing, ‘Latinos are vaccine-hesitant,’” said Julissa Soto, a commissioner of the office of health equity for the Colorado department of public health and environment. “I knew it was not hesitancy – I knew it was access.”
“I said to the state health department: ‘I’m going to organize one clinic and based on the numbers I bring, you guys are going to stop labeling us as vaccine-hesitant,’” she said. “You’re going to open your eyes to access to care.” In a one-day event after a Spanish-language Catholic mass, Soto’s clinic vaccinated 1,279 people.
Some studies on vaccine hesitancy, and anecdotal reports of progressive Waldorf schools as a bastion of anti-vaccine fervor, show how highly educated and white communities can also be vulnerable to vaccine misinformation.
“We analyzed multiple studies that looked at parental intention or views of beliefs surrounding the MMR vaccine for their children, and we did observe from the studies almost a two-pronged association,” said Mike Goates, a life sciences librarian at Brigham Young University in Utah who co-authored a review of studies on MMR vaccine hesitancy in the journal Vaccines.
“One of the groups appeared to be predominantly white, higher education, higher income – that those parents compared to other groups tended to have higher levels of hesitancy,” said Goates, who added these parents tended to be well connected on social media.
Like many states nationally, Colorado is also facing a surge of vaccine-preventable diseases such as pertussis, colloquially known as whooping cough, now that people have dropped most pandemic-era precautions. Although the overwhelming majority of people survive the disease, it can be harrowing for new parents to watch, as more than a third of infants need to be hospitalized for treatment.
Alexis Burakoff, Colorado’s deputy state epidemiologist, said that it was “hard to know whether [vaccine hesitancy] plays a role in national and Colorado trends right now”, as pertains to whooping cough.
“We’re seeing increases across the state concentrated in what we call the Front Range,” said Burakoff, about Colorado’s most populated corridor including cities such as Denver and Boulder. “Again, unsurprisingly, we’re seeing circulation in schools and childcare settings, which is what you would expect.”
For Diamond, she is looking forward to continuing her work with parents in prenatal hospital clinics, where she sees hesitancy as a spectrum. Sometimes, people are just worried about the number of vaccines; others want to space out the administration of vaccines to their children.
“This follows white wealth and privilege,” said Diamond. When vaccination comes under attack, “my fear, as somebody who cares deeply about immunization, is: what happens to the programs that serve underserved populations?”
• This article was amended on 30 November 2024. It now correctly states that Brigham Young University is in Utah, not Colorado, as it originally said.
