Idaho Rethinks Health Freedom and Vaccines
As trust in public health plummets across the U.S., Idaho has become a testing ground for a big question: What does it look like to put a vision of individual health freedom into practice?
Some 280,000 people live in the five northernmost counties of Idaho. One of the key public officials responsible for their health is Thomas Fletcher, a retired radiologist who lives on a 160-acre farm near Sandpoint.
Fletcher grew up in Texas and moved to Idaho in 2016, looking for a place where he could live a rural life alongside like-minded conservatives. In 2022, he joined the seven-member board of health of the Panhandle Health District (PHD), the regional public health authority, and he was appointed chairman last summer.
PHD handles everything from cancer screenings to restaurant hygiene inspections, and the business of the board is often mundane, almost invisible. Then, this February, Fletcher wrote a short letter that circulated online.
Parents, he wrote, should be informed of the potential harms of common childhood vaccines. It was time for the board to discuss how best to communicate those risks, rather than “withholding information contra the CDC narrative.”
Fletcher invited everyone who believes in “full disclosure and transparency when providing informed consent on childhood vaccines” to attend the next monthly meeting of the board on a Thursday afternoon.
PHD board meetings tend to be sparsely attended. This one was standing-room only — the start of a monthslong debate over vaccine safety and the question of what, exactly, it means to provide informed consent.
Versions of that debate are playing out across the U.S. in the aftermath of the COVID-19 pandemic, which many Americans believe was badly mismanaged. The backlash has upended longstanding norms in public health: The nation’s top health official, Robert F. Kennedy Jr., publicly questions the value of common vaccines.
Prominent vaccine skeptics now sit on a key advisory committee that shapes immunization practices nationwide. Polls suggest that trust in health authorities is politically polarized — and perhaps historically low.
Immunization rates are dropping across the country. And many advocates are promoting a vision of public health that’s less dependent on mandates and appeals to authority, and more deferent to individuals’ beliefs.
Much of that energy has been reflected in Kennedy’s Make America Healthy Again, or MAHA, movement. The coalition is diverse — and has sometimes fractured over vaccination issues — but often channels a long-running argument that Americans should have more freedom to choose or reject vaccines and other health measures.
The backlash against traditional health authorities, said Columbia University medical historian James Colgrove, is unprecedented in recent U.S. history.
“It’s been a very, very long time since we’ve been in a place like this,” he said.
Perhaps more than anywhere else in the country, Idaho has experienced these shifts — an ongoing experiment that shows what it looks like to put a vision of individual health freedom into practice.
And places like the PHD have become testing grounds for big questions: What happens when communities move away from widespread and mandated vaccination? And what does it mean to turn MAHA principles into local public health policy?
During a recent visit to Idaho, Kennedy described the state as “the home of medical freedom.” In April, Gov. Brad Little signed the Idaho Medical Freedom Act, which bans schools, businesses and government agencies from requiring people to participate in medical interventions, such as mask-wearing or vaccination, in order to receive services.
It’s the first legislation of its kind in the country. The bill has a carveout that keeps school vaccine requirements in place, but those requirements are already mostly symbolic: The state’s exemption policy is so broad that, as one Idaho pediatrician told Undark, “you can write on a napkin, ‘I don’t want my kids to get shots because of philosophical reasons,’ and they can go to kindergarten.”
Overall, reported vaccination rates for kindergarteners in Idaho are now lower than in any other state that reported data to the federal government — especially in the PHD, where fewer than two-thirds arrive with records showing that they are up-to-date on common shots.
“It’s really kind of like watching a car accident in slow motion,” said Ted Epperly, a physician and the CEO of Full Circle Health, which operates a network of clinics in the Boise area.
Public health leaders often ascribe the low vaccination rates to the work of bad-faith actors who profit from falsehoods, to the spread of misinformation or to failures of communication. If only leaders could better explain the benefits of vaccination, this thinking goes, more people would get shots.
In interviews and public statements, health freedom advocates in Idaho describe a far deeper rift: They do not believe that public health institutions are competent or trustworthy. And restoring that trust, they argue, will require radical changes.
Fletcher, for his part, describes himself as an admirer of RFK Jr. and the MAHA movement. With the recent appointment of a new member, he said, MAHA supporters now hold a majority on the board, where they are poised to reimagine public health work in the district.
In the U.S., public health is mostly local. Agencies like the Centers for Disease Control and Prevention conduct research and issue influential recommendations.
But much of the actual power rests with the country’s thousands of state, local and tribal public health authorities — with institutions, in other words, like the PHD, and with leaders like Fletcher and his fellow PHD board of health member Duke Johnson.
Johnson says he grew up in Coeur d’Alene, Idaho, in the 1960s, the descendant of homesteaders who arrived in the 19th century. He attended medical school at the University of California, Los Angeles and eventually returned to Idaho, where he runs a family medical practice and dietary supplement business in the town of Hayden.
In Idaho, health boards are appointed by elected county commissioners. The commissioners of Kootenai County gave Johnson the nod in July 2023. Johnson took the role, he said, in order to restore trust in a medical system that he characterized as beholden to rigid dogmas and protocols rather than independent thinking.
Last winter, Johnson took a tour of one of the PHD clinics. Among other services, it provides routine childhood immunizations, especially for families with limited access to healthcare.
As is standard in pediatric practices, the clinic hands out flyers from the CDC that review the potential side effects of common vaccines, including “a very remote chance” of severe outcomes.
Johnson was unimpressed with the CDC write-up. “I thought: This isn’t completely covering all of the risk-benefit ratio,” Johnson said.
He felt families could be better informed about what he sees as the substantial risks of common shots.
Johnson is an outlier among physicians. The overwhelming majority of laboratory scientists, epidemiologists and pediatricians who have devoted their lives to the study of childhood disease say that routine immunizations are beneficial and that serious side effects are rare.
Large-scale studies have repeatedly failed to find purported links between the measles-mumps-rubella, or MMR, vaccine and autism, or to identify high rates of severe side effects for other routine childhood immunizations.
The introduction of mass vaccinations in the U.S. in the 1950s and 1960s was followed by dramatic declines in the rates of childhood diseases like polio and measles that once killed hundreds of American children each year, and sent tens of thousands more to the hospital.
Similar declines have been recorded around the world.
Children can suffer side effects from common shots like the MMR vaccine, ranging from mild symptoms like a rash or fever to rare, fatal complications. Public health agencies and vaccine manufacturers study and track those side effects. But today, many Americans simply do not trust that those institutions are being transparent about the risks of vaccination.
Johnson shares some of those concerns. The website for his clinic, Heart of Hope Health, describes offering services for “injection-injured” patients, encouraging them to receive a $449 heart scan, and advertises “no forced masks or vaccinations.” (During a PHD board meeting, Johnson said that one of his own children suffered an apparent bad reaction to a vaccine many years ago.)
“The lack of trust in established medicine is probably 10 times bigger than the people at Harvard Medical School realize,” Johnson told Undark during an evening phone call, after a long day seeing patients.
Top medical institutions have brilliant scientists on staff, he continued.
But, he suggested, those experts have lost touch with how they’re seen by much of the public: “I think sometimes you can spend so much time talking to the same people who agree with you that you’re not reaching the people on the street who are the ones who need the care. And I’m in the trenches.”
Many public health experts agree that restoring trust is an urgent priority, and they are convinced that it will come through better communication, a reduction in the circulation of misinformation and a rebuilding of relationships.
Johnson and others in the health freedom movement frequently adopt the language of restoring trust, too. But for them, the process tends to mean something different: an overhaul of public health institutions and a frank accounting of their perceived failures.
At the board meeting in February, Johnson laid out the proposal for a change in policy: What if the board wrote up its own document for parents, explaining the evidence behind specific vaccines, and laying out the risks and benefits of the shots?
The goal, he told Undark, was “to make sure that the people that we’re responsible for in our in our district can make an informed decision.”
Fletcher was also hoping to change the way the PHD communicated about vaccines. Why did a push for informed consent appeal to him? “I can summarize the answer to that question with one word,” Fletcher said. “Covid.”
Idaho is ideologically diverse, with blue pockets in cities like Boise and texture to its overwhelming Republican majority. (Latter-Day Saint conservatives in East Idaho, for example, may not always be aligned with government-skeptical activists clustered in the north.)
Parts of the state have a reputation for libertarian politics — and for resistance to perceived excesses of government authority.
People came West because “they wanted to get out to a place where nobody would tell them what to do,” said Epperly, the Boise-area physician and administrator.
That libertarian ethos, he said, can sometimes translate into a skepticism of things like school vaccination requirements, even as plenty of Idahoans, including Epperly, embrace them.
Like all U.S. states, Idaho technically requires vaccination for children to attend school. But it is relatively easy to opt out of the requirement. In 2021, Idaho lawmakers went further, instructing schools to be proactive and notify parents that they had the option to claim an exemption.
“Idaho has some of the strongest languages in the U.S. when it comes to parental rights and vaccine exemptions,” the vaccine-skeptical advocacy group Health Freedom Idaho wrote in 2021.
In the 2024-2025 school year, more than 15 percent of kindergarten parents in the state claimed a non-medical exemption, the highest percentage, by far, of the states that reported data.
The pandemic, Epperly and other Idaho health care practitioners said, accelerated many of these trends. In his view, much of that backlash was about authority and control.
“The pandemic acted as a catalyst to increase this sense of governmental overreach, if you will,” he said. The thinking, he added, was: “‘How dare the federal government mandate that we wear masks, that we socially distance, that we hand-wash?’”
Recently, advocates have pushed to remove medical mandates in the state altogether through the Idaho Medical Freedom Act, which curtails the ability of local governments, businesses, and schools to impose things like mask mandates or vaccine requirements.
The author of the original bill is Leslie Manookian, an Idaho activist who has campaigned against what she describes as the pervasive dangers of some vaccines, and who leads a national nonprofit, the Health Freedom Defense Fund.
In testimony to an Idaho state Senate committee this February, she described feeling shocked by mitigation measures during the COVID-19 pandemic.
“Growing up, I could have never, ever imagined that Idaho would become a place that locked its people down, forced citizens to cover their faces, stand on floor markers 6 feet apart, or produce proof of vaccination in order to enter a venue or a business,” Manookian told the senators.
Where some public health officials saw vital interventions for the public’s well-being, Manookian saw a form of government overreach, based on scant evidence. Her home state, she argued, could be a leader in building a post-COVID vision of public health.
“Idaho wants to be the shining light on the Hill, that leads the way for the rest of the nation in understanding that we and we alone are sovereign over our bodies, and that our God-given rights belong to us and to no one else,” Manookian said during the hearing.
This is taken from a long document. Read the rest here childrenshealthdefense.org
Header image: Medpage Today
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