Vaccines are considered one of the top 10 health innovations of the 20th century [1]. However, as a result of the COVID-19 pandemic, there has been a large and sustained decline in childhood vaccinations [2]. Furthermore, vaccine requirements for school, work, and public spaces have become a political flashpoint linked with anti-mandate sentiment [3]. These concerns about vaccines come during a time of political polarization in the US, often promoted by conservative media and leaders [4].
Texas is an ideal case study for understanding how politics impact vaccine bills. It is the second largest state in the US based on population, geography, economy, and birth rate [5], [6], [7]. One out of every 10 babies born are in Texas [6]. The gross state product rivals many countries including Australia and Canada [7], [8]. Politically, it has a significant rural–urban divide, and all state leadership positions for the past decade have been held by Republicans.
Efforts to weaken Texas school vaccine requirements over the past 20 years have been some of the most organized and politically engaged in the US. Anti-vaccine advocates actively campaign and support candidates for office espousing anti-vaccine positions under the guise of medical and personal freedom [9], [10]. Supporters from a vocal anti-vaccine group, Texans for Vaccine Choice, frequently testify before vaccine-related hearings and organize visits to the capitol during the state legislative sessions. They have aligned themselves with far-right conservatives and the broader libertarian ideology that promotes limited government and mistrust of government institutions and modern medicine [11], [12], [13]. Furthermore, Andrew Wakefield, who falsely linked autism and vaccines, lived in Austin for several years where he broadened the anti-vaccine movement visibility through the 2016 movie Vaxxed [14]. The Informed Consent Action Network (ICAN), a national anti-vaccination medical freedom organization, also relocated their headquarters to Austin. In addition, the state has garnered increased national attention after a series of laws and executive orders restricting abortions, public health mandates, and transgender access. These activities and policies are models for other conservative legislatures.
Despite the organized anti-vaccine movement within the state and their perceived links to conservative state politics, overall the Texas Legislature was supportive of immunization programs in the past. From 2009 to 2019, of the 21 vaccine-related bills passed 19 were considered pro-vaccine [15]. Legislators over the past decade have consistently passed bipartisan bills, including requiring meningitis vaccine for college students and allowing pharmacists to administer vaccines [15].
In this paper, we analyze witness statements during vaccine-related hearings for vaccine resistant and hesitant rhetoric during the 2021 Texas Legislative Session. The goal of the paper is to better understand the types of arguments being proposed, data witnesses present to validate their arguments, and how often witnesses testify to multiple hearings. We focused on five hearings on bills filed that related to vaccine requirements or vaccine transparency laws. From the 128 witnesses, 153 statements were cataloged and analyzed. Many claims were related to safety and effectiveness of vaccines (n = 76), but others were concerned with medical freedom and the right to opt-out of a medical procedure (n = 65) or made arguments that vaccine requirements are discriminatory (n = 42). In addition, several witnesses believed vaccine requirements went again informed consent guidelines (n = 30). Interestingly, a number of witnesses (n = 30) mentioned specific studies, researchers, or data sets, often inaccurately, to justify that vaccines were unsafe or unnecessary. Overall, the data suggest that pro-vaccination advocates will continue to face challenges in the future promoting vaccine requirements with growing anti-vaccine rhetoric following the COVID-19 pandemic.