Joe Rogan won’t give us all measles but he’s one part of a bigger problem

Measles outbreaks are occurring around the world, including in Australia. With the new Trump administration white-anting vaccine confidence and public health, the US can expect to see more. But we are also witnessing the return of a persistent narrative: that outbreaks are due to vaccine refusal, fuelled by misinformation and societal amnesia of the diseases.

This is partly true. Large outbreaks can occur in communities where vaccine refusal is common enough to allow disease transmission. In West Texas, where a large Mennonite community resides, vaccination rates sit at 82 per cent, far lower than the 95 per cent needed for herd immunity. Research has found that members of insular communities tend to influence each other. They are not worried about different things from other vaccine-hesitant parents, but their worries fill an echo chamber that health experts and the government struggle to address.

Joe Rogan and Donald Trump have contributed to an increase in vaccine scepticism.Credit:

Australia has had its own prior crises of vaccine-preventable diseases. During the 1990s, measles and whooping cough outbreaks sparked thousands of newspaper articles lamenting Australia’s immunisation rates. Astoundingly, from today’s vantage point, only 52 per cent of children in 1995 had all their vaccines by age five. Media articles mostly blamed parents who, they said, failed to immunise because they were ignorant, complacent and selfish.

By 2012, our childhood vaccination rates were above 90 per cent. This was not because parents changed but because governments fixed the back end. The federal government introduced a national register, which enabled better feedback and accountability at all levels. They also introduced financial incentives to GPs and parents, better program coordination, a measles control campaign, education and policy research. It turned out the parents weren’t the main problem after all.

Public attitudes are a concern today, however. Around the world, the pandemic supercharged organised opposition to vaccination. Restrictions on personal freedoms and financial distress fed a mistrust of public health. An increasingly well-funded and organised anti-vaccination movement, now infected with political partisanship, has taken on a level of power and prominence unseen since the late 19th century. Podcaster Joe Rogan – with one of the world’s highest listenerships – is mainstreaming vaccine scepticism. In June last year he gave Robert F. Kennedy Jr three hours of unchallenged talk time, with claims that vaccines contain toxic mercury, among others seamlessly woven into part facts and compelling themes.

Is Joe Rogan causing measles? Not really. But Trump’s presidency has and will play a role. Before the pandemic, Trump revived long-refuted ideas about vaccines causing autism. During the pandemic he promoted the COVID-19 vaccines but undermined public health more generally. As one example, once he had decided that his senior medical advisor Anthony Fauci was no longer useful, his White House backgrounded journalists in an attempt to discredit him.

Now Trump is back, with Robert F. Kennedy Jr set to create even more damage. Under his purview as health and human services secretary, the Centres for Disease Control and Prevention are said to be planning a new study into “potential connections between vaccines and autism”.

When an Italian judge ordered an inquiry into this non-existent link in 2012, it predictably found nothing. However, the negative publicity contributed to a wave of non-vaccination that resulted in Italy mandating the measles vaccine for children to attend daycare and kindergarten in 2017.

Disinformation about vaccines damages confidence, but RFK Jr’s most insidious way of undermining vaccinations will be through the system. There is a risk the administration could strangle systems of support that enable people to access free and convenient vaccination services. In the US, the lowest immunisation rates are in children from families who are uninsured, receive Medicaid, live in poorer areas, rural areas or are black or Hispanic. Threats of cuts to schemes like Medicaid present immediate threats to accessibility of vaccines. Researchers and agencies will not be permitted to use the necessary words to describe these inequities, let alone respond to them.

RFK Jr’s most insidious way of undermining vaccination rates will be through the system.Credit: Getty Images

Australia is somewhat insulated from this reset of language and power but the American case is still salient. The far right and other disgruntled factions are capitalising on post-pandemic discontent here, too. In Western Australia, a member of the Legislative Council, Dr Brian Walker, has been returned on his platform for the legalisation of cannabis. Unexpectedly, he used the spotlight to unearth the long discredited “vaccines cause autism” idea. He also used “cancel culture” language to tap into contemporary concerns about free thought and speech. He might be a fringe politician but he is using his platform (and his medical qualifications) to sow doubt about measles vaccination.

We are already getting measles, with travellers bringing the disease back to Australia from overseas. But there is some resilience against the onslaught coming to the US and locally. Our high vaccination rates and swift public-health responses control outbreaks rapidly. Also, Australians still value vaccines and will defend them strongly.

Even if we forget their value, the truth about the preventive power of vaccines will prevail through bitter experience. When vaccination rates go down, measles rates go up. It is unfortunate that we may have to learn these lessons again and again. In the meantime, amid the focus on the anti-vaxxers and misinformation, we should not let governments off the hook. They need to provide services, support and encouragement to keep our communities safe against diseases and those who would unleash their return.

Julie Leask is professor of public health at the University of Sydney. Katie Attwell is a professor in the school of social sciences at the University of Western Australia.

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