Anti-vaccine activism melded with US antisemitism - study

Because of rising anti-vaccine activism and some key global policy missteps, more than 70 years of global health gains are in danger of being eroded, according to a physician writing in the peer-reviewed Rambam Maimonides Medical Journal published by the Rambam Health Care Campus in Haifa.

This phenomenon, wrote the author, is occurring through an “enabled and empowered anti-science ecosystem, with antisemitism and the targeting of Jewish biomedical scientists at its core.”

Entitled “Global Vaccinations: New Urgency to Surmount a Triple Threat of Illness, Antiscience, and AntiSemitism,” it was written by Dr. Peter Hotez of Texas Children’s Hospital Center for Vaccine Development.

How did rising anti-vaccine activism endanger decades of global health gains?

“To understand how this situation evolved or devolved, it is helpful to first appreciate the transformative properties of vaccines and vaccinations,” Hotez wrote in a seven-page article. “As public health interventions, no other technology has been more effective. From widespread and global use of a vaccine, the late 1970s saw the eradication of smallpox, and polio neared elimination as a public health problem.”

In the 1980s, as a young house officer in the pediatric department at Boston’s Massachusetts General Hospital, he routinely admitted infants and children with Haemophilus influenzae type b (Hib) bacterial meningitis, which even after antibiotic treatment often left them with permanent neurologic impairments. “At the end of my pediatrics training, an improved Hib vaccine was developed by Drs. John Robbins [whose family name was changed from Rabinowitz] and Rachel Schneerson [who earned her medical degree in Israel] at the US National Institutes of Health and was then introduced into pediatric practice; within a few years that disease also largely disappeared."

The power of vaccines extended beyond their direct health benefits and into the sphere of international relations, he continued. Dr. Albert Sabin was born in Bialystok, Poland before emigrating to New York with his family and graduating New York University (NYU) medical school in 1931. At the time, NYU was among the few American medical schools enacting liberal policies for admitting Jews. As a pediatrician-scientist heading a vaccine research laboratory at Cincinnati Children’s Hospital in the 1950s, Dr. Sabin developed three strains of the poliovirus that could be safely administered by mouth to induce protective immunity.

However, his discoveries became an actual vaccine only through back-channel diplomacy between the US State Department and their Soviet counterpart. The arrangement permitted Sabin to bring his poliovirus strains to the USSR, where they were first produced at an industrial scale and administered to millions of Soviet schoolchildren. The oral vaccine now achieving global polio elimination was ultimately developed through vaccine diplomacy between two Cold War foes.”

Fueled by such 20th-century successes, beginning in the 2000s, the Gates Foundation and international agencies of the UN, including the World Bank, UNICEF, and the World Health Organization (WHO), built a new global alliance for vaccines and immunization, known as Gavi. Through Gavi-sponsored activities the number of pediatric lives lost from vaccine-preventable diseases declined dramatically, he wrote.

“So it was with vaccines and global vaccinations. Just as Gavi activities began to accelerate, an antivaccine countermovement took shape. It asserted that vaccines caused autism, even though the biomedical scientific community conducted study after study refuting such claims. Through the outsized reach of social media, antivaccine activists soon commanded substantial online reach. They gained strength and funds by learning to monetize the web through the sale of phony autism cures, nutritional supplements and even entire books, which climbed to the top of the Amazon.com booklist in the vaccination category. A first wave of anti-vaccine groups either expanded or gave way to next-generation actors. For instance, a Washington DC-based watchdog group, the Center for Countering Digital Hate, recently identified 12 empowered or well-financed individuals.”

TRAGICALLY, FIRST- and second-generation anti-vaccine groups achieved a slew of gains as multiple pockets of school-entry vaccine refusal and resistance emerged across the US.

“The backlash from anti-vaccine groups was rapid and severe,” Hotez continued. “They launched a media campaign against me on the Internet, encouraging threats through email and social media. Since I make no secret that I am Jewish, I eventually experienced first-hand multiple antisemitic statements and threats online First there were overt threats or expressions of hatred because I was Jewish. More frequently, however, there were hurtful attempts to accuse me as well as my colleagues who vaccinate of perpetrating crimes equivalent to those committed during the Holocaust. Anti-vaxxers love their Nazi analogies, and I was ultimately compared to the infamous Dr. Mengele because I am a scientist who conducts vaccine research.”

Later emails appearing in his inbox openly expressed their desire to him hang after some sort of new-age Nuremberg tribunal. “I was not alone – a pattern emerged in which Jewish physicians and scientists who conducted vaccine research or advocated for vaccinations were singled out and targeted with Nazi imagery,” Hotez said.

“Nevertheless, our scientific community’s efforts to debunk vaccine and autism assertions may have had some beneficial impact, at times even taking some of the wind out of the sails of the anti-vaccine movement. But this also meant that to continue, antivaccine groups needed a new angle, and they found it through extremist or libertarian politics. By invoking health freedom or medical freedom propaganda they found a political home and donor support. Although it may have begun in California with the passage of [State] Senate Bill 277 that outlawed exemptions to school immunization mandates, health freedom propaganda found its greatest welcome in Texas where an antivaccine political action committee (PAC) formed, and vaccine exemptions escalated.”

In time, health freedom and anti-vaccine sentiments were embraced by many mainstream conservatives or their elected leaders. The Texas Medical Center where he works “is the world’s largest and perhaps most-sophisticated collection of biomedical institutions…, but a dark side in Texas also emerged, the state becoming an epicenter of the antivaccine movement in America. In April 2019, activists demonstrated in front of the Texas State Capitol in Austin, wearing yellow Jewish stars with the words “No Vax” in letters stylized to resemble Hebrew... ”

The Auschwitz Memorial Anti-Defamation League condemned such protests for mocking the Holocaust and attempting to intimidate Jewish communities. Despite these condemnations, antivaccine attitudes became entrenched, and activists persuaded parents in Texas to apply for vaccine exemptions in unprecedented numbers. More than 70,000 schoolchildren were denied access to at least one vaccine according to the Texas State Department of Health Services. “In parallel, anti-vaccine activists targeted insular Orthodox Jewish groups in New York and New Jersey, holding town hall meetings while distributing pamphlets with disinformation. Vaccination rates declined and an outbreak of more than 300 measles cases ensued among these groups in Rockland County and elsewhere in New York in 2018–2019, requiring multiple hospitalizations and intensive care unit (ICU) admissions, the Texas pediatrician wrote.

The extent of antivaccine activism among haredi communities and how much it arose organically versus deliberate targeting by outside forces requires additional study.

AS THE COVID-19 pandemic unfolded, the health-freedom language used to oppose childhood immunizations was repurposed to galvanize opposition to COVID vaccines… Extremist members of the US House of Representatives disparaged vaccines, as did several US Senators and governors. On Twitter, one House Member compared vaccinators to “medical brown shirts.” Tragically, anti-COVID vaccine rhetoric and sentiments were amplified nightly in 2021 by the conservative media. In time, the Proud Boys, a group described as having members and who “regularly spout white nationalist memes and maintain affiliations with known extremists,” began marching at antivaccine rallies.

“The consequences were devastating – health analyst Charles Gaba as well as multiple news outlets analyzed data to find a sharp partisan political divide in vaccination rates, with overwhelmingly high rates of COVID deaths in Republican-majority states, the so-called Red States, and counties where COVID vaccination rates were the lowest.”

Hotez disclosed that he was “stalked at a Houston shul during a High Holiday service. Increasingly, antisemitism converged with a growing anti-science ecosystem. "Despite such distractions, I co-lead a team of scientists at the Texas Medical Center that develops new vaccines for orphaned or neglected diseases. A decade ago, we began developing coronavirus vaccines for SARS and MERS because at that time there was little commercial interest in such vaccines. However, when the COVID virus sequence became available in January 2020 we were able to pivot our program to developing a low-cost COVID vaccine technology.”

Past approaches that focused on providing timely and accurate vaccine information remain essential, he concluded, “but increasingly, they are inadequate to overcome this powerful new force now firmly embedded in the politics of the US and authoritarian governments worldwide. The same is true for its antisemitic leanings. Because antivaccine activism is now firmly embedded in national political infrastructures and has moved beyond the health sector, we must recognize how traditional public health approaches will not be adequate for a counter-response. Therefore, we must look beyond the health sector to experts in modern socioeconomics and geopolitics. The stakes are high, given that antivaccine activism is rapidly expanding and taking on an increasingly dark and sinister element.”