The following is the opinion and analysis of the writers:
Elizabeth Jacobs
James Alwine
In a bid to restore 1920s-era healthcare, Arizona Republicans want voters to decide if the state constitution should be changed to no longer require children to get childhood vaccines to attend school. The framing, by its sponsor Representative Nick Kupper (R-Yuma), as a “medical freedom” proposition obscures the true impact of its passage. In reality, the proposition will undermine the entire vaccination program, increase vaccine hesitancy, and create even more confusion around vaccines. In turn, the result will be severe illness, permanent disability and death from vaccine-preventable diseases among a growing number of unvaccinated children, as well as undermining the state’s economy and health systems.
Let’s make it clear that vaccinations for school entry in Arizona are already, regrettably, optional. Parents may obtain an exemption for their child based on personal or religious beliefs or medical reasons. These exemptions are the reason that Arizona’s vaccination coverage has been plummeting, and the state is now among the top five for vaccine exemptions. It’s not surprising that Arizona has also been battling a continuing measles outbreak and in 2025 faced the highest number of whooping cough cases in 12 years.
The idea of “medical freedom” weighs one parent’s decision to refuse vaccines as more important than another’s decision to protect their own children from contagious, vaccine-preventable diseases. Ignoring the impact of vaccine effectiveness in establishing community (herd) immunity is a fatal flaw in “medical freedom.” Community immunity has never been achieved by natural infection; only through widespread vaccination can it be attained. Community immunity reduces the number of people susceptible to an infectious disease. This greatly limits the spread and replication of the virus or bacteria that causes the disease. This reduction in spread protects the most vulnerable - those who can’t be vaccinated, those too young to be vaccinated, and those who are immunosuppressed. It is a community effort that protects us all.
In turning against community immunity, its protective effects collapse. This is what is happening in our state right now as the number of unvaccinated children is rising, resulting in increased outbreaks of measles and whooping cough. But there is a more frightening consequence of losing community immunity through “medical freedom.” As the unvaccinated population increases, viruses or bacteria can grow and spread more readily, thereby increasing the odds of mutations. The more mutations that occur, the more likely it is that the viruses or bacteria will develop a way to evade our current vaccinations, which would make us all susceptible to the diseases whether we are vaccinated or not. This is the disastrous consequence of “medical freedom,” where the right to life and liberty is ignored in order to boost a selfish agenda.
“Medical freedom” is only freedom for someone who has consumed too much of the misinformation and disinformation that comes from the present US government and spreads through social media, fueled by Robert F. Kennedy Jr., a known anti-vaccine, anti-science advocate. And that freedom comes with a cost. The unacceptable cost of “medical freedom” is suffering and permanently disabled or dead children. Apparently, that is a cost that those who promote “medical freedom” are willing to pay.
As if the health impacts of such a dangerous situation weren’t enough, letting infectious diseases run rampant throughout the state comes with economic costs. The average cost to contain a measles outbreak is about $43,000 per case. Further, local public health departments have the authority and the duty to order unvaccinated children to stay home from school during an outbreak of a vaccine-preventable disease. For many families, this means that they may be required to miss work to stay home with children for up to three weeks — a period that could stretch into months in situations where cases continue to pop up.
Humans have lived together in communities since we first evolved in order to support, provide for and protect each other. We have a vested interest in protecting our communities and everyone in them. “Medical freedom” is the antithesis of community, but Arizona Republicans do not seem to care about that.
