“We did it everybody!” exclaimed Leslie Manookian, “We passed the first true medical freedom bill in the nation!” Ms. Manookian and other members of the anti-vaccine group Health Freedom Idaho were celebrating the Idaho Medical Freedom Act being signed into Idaho state law on April 4, 2025, which protects those who refuse to take medical interventions like vaccines from being excluded from activities of daily life such as obtaining a service from a business or attending school.
Idaho is the first state in the country to enact a law protecting personal medical freedom which includes these types of protections for people who are against getting vaccinated, but other states may attempt to implement similar laws and public health policy changes due to vaccine skepticism present throughout the nation. For example, Florida’s current Surgeon General Joseph Ladapo has expressed a desire to eliminate vaccine mandates throughout the state of Florida despite broad medical and religious exemptions. Mr. Ladapo’s rhetoric regarding eliminating vaccine mandates seems less based on science and more based on morals and principle. When describing vaccine mandates Mr. Ladapo stated, “every last one of them is wrong and drips with disdain and slavery,” he added that forcing vaccine mandates “immoral” and “wrong”, and he proclaimed “Your body is a gift from God.” Similarly, when asked about her motivations to help codify the Idaho Medical Freedom Act, Ms. Manookian stated that she and others pushing for freedom from vaccine mandates believe that “our immune systems, given to us by God, are perfect as long as they’re well nourished.” Ms. Manookian also insisted that it was “not accurate” that the implementation of the measles vaccine was what led to the eradication of measles, instead citing improvements in clean drinking water and waste management which helped quell spread of the disease. These types of moral statements regarding vaccine use reflect a growing population of people who see public health interventions such as vaccines more as an issue of personal freedom rather than an issue of safety. These statements made by Mr. Ladapo and Ms. Manookian highlight a crucial ideological issue that public health officials must learn to address more effectively to reduce vaccine skepticism. Global health organizations are beginning to provide targeted guidance to assist healthcare professionals in combating vaccine skepticism not just by providing accurate information but by building trust and a deeper understanding of community perceptions, social norms, and potential logistical barriers to vaccination.
So far in 2025 the United States had had over 1,600 measles infections, which is the most measles infections in the country since 1992, and in 92% of cases the patients are either unvaccinated people or their vaccine status is unknown. Prior case law on the issue of vaccine mandates in the United States, such as the landmark Supreme Court case Jacobson v. Massachusetts, have allowed state public health departments to compel their citizens to be vaccinated despite ideological opposition to the vaccine, but if the legislatures and health departments themselves buy into ideological opposition to vaccines then a key safeguard against disease transmission will be dismantled. It may not be enough to simply combat vaccine misinformation with accurate science, as surveys have shown that false or unproven claims about vaccines are more widely accepted today than two to three years ago despite concerted efforts to combat misinformation with accurate science. The American College of Allergy, Asthma, and Immunology has urged policymakers to weigh the unintended public health implications if vaccine mandates were to be eliminated, but public health officials and medical professionals should be prepared going forward to find new ways to address skepticism to vaccines once a major legal enforcement tool is eroded.