It is much more than a battle over vaccines in the United States.
It has become a proxy war about trust, freedom, and the role of government in public health.
The debate about childhood immunisations, once a matter of bipartisan consensus, is now a defining clash between federal government, state leadership and the medical community.
At the centre of it is the federal government’s sharp policy shift under US health secretary Robert F Kennedy Jr.
He has rolled back vaccine recommendations and reshaped advisory committees with sceptics.
States have responded along ideological lines – Florida planning to abolish all vaccine mandates; California, Oregon, and Washington forming a “Health Alliance” to safeguard them.
The western states felt they had to act when the head of the agency tasked with disease prevention was sacked.
‘You’re putting Americans’ health at risk’
Susan Monarez had only been in the job for a month when Donald Trump told her she was no longer required.
“She didn’t bend the knee, so you fired her,” Democratic Senator Elizabeth Warren told Mr Kennedy during a heated committee hearing on Capitol Hill.
“You’re putting American babies’ health at risk, American seniors’ health at risk, all Americans’ health at risk, and you should resign,” she added.
Democratic Senator Raphael Warnock described the health secretary as “a hazard to the health of the American people.”
“For the first time, we’re seeing deaths of children from measles. We haven’t seen that in two decades. We’re seeing that under your watch,” he said.
Mr Kennedy told the hearing America had done “worse than any country in the world” in terms of COVID deaths.
“…the people at CDC who oversaw the process, who put masks on our children, who closed our schools, are the people who will be leaving,” he said.
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Jab mandates compared to ‘slavery’
Several senior figures at the Centers for Disease Control and Prevention have resigned since Susan Monarez was removed.
The turmoil in public health has led to a fragmented system where Americans’ access to vaccines and the rules governing them, largely depend on where they live.
Likening vaccine mandates to “slavery”, Florida’s surgeon general Joseph Ladapo said the government had no right to dictate them.
“Your body is a gift from God. What you put into your body is because of your relationship with your body and your God,” he said.
It is a tug of war between collective responsibility or individual choice and one that will redefine public health in this nation.
