In September 2021, health care workers and vaccine skeptics protested outside Broadlawns Medical Center in Des Moines to air concerns about COVID vaccine mandates from their employers.
“What do we want? Medical freedom! When do we want it? Now!” they chanted.
The mandates came after the Food and Drug Administration gave the vaccine Emergency Use Authorization, a special measure that the FDA can use to approve unauthorized medical products in an emergency. This caused some people to question whether the COVID vaccine was safe.
Protests erupted across the country. It was an unusual time for state and county public health officials.
Danielle Pettit-Majewski, Johnson County’s public health director, said scientists were tasked with supplying the public with new information about the virus while trying to dispel online misinformation at the same time.
“We’re not used to seeing the scientific method in action. We’re used to something being researched and developed and tested for years and years, and then being rolled out,” she said.
The pace of the vaccine rollout led to questions about both the efficacy of the vaccine and the expertise of public health officials.
Religious exemptions to immunizations have nearly doubled since 2020.
“Because this was a novel virus, we kept learning more, and as we kept learning more, we would give people new information,” Pettit-Majewski said.
Natoshia Askelson, an associate professor of public health at the University of Iowa, said online misinformation amplified people’s distrust in the vaccine.
“All of this kind of contributed to the distrust in our public health system, the rhetoric from people like RFK [Robert F. Kennedy Jr.] around what they call ‘Big Pharma,’” Askelson said. “Anyone who’s concerned about their health or their children’s health might begin to be concerned.”
The idea that the COVID vaccine may not be safe translated to declining vaccination rates for other vaccines on Iowa's recommended schedule, like the whooping cough and polio vaccines.
The number of under-vaccinated children in the state’s school system has continued to climb since COVID, according to this year’s school audit by the Iowa Department of Health and Human Services. In five years, that number has grown by nearly 3 percentage points to 7.1% — a difference of roughly 14,000 kids.
Askelson said recent legislation also makes it easier for families to get around vaccine requirements for whooping cough and polio.
“Previously, for children to get an exemption from school, you had to have a religious exemption that was notarized, and that changed last year,” Askelson said.
Now, in many cases, she said it's easier to get an exemption than to get a vaccine. Religious exemptions to immunizations have nearly doubled since 2020. The largest increase happened since the notary signature requirement was removed in 2024.
Vince Hassel is a chiropractor in Clive, a suburb of Des Moines. His four kids are all unvaccinated. They are now in their 20's, and he says the religious exemptions were never that hard to get.
“I would just take my card to the bank and anybody that’s a notary can notarize it," Hassel said. “They weren’t notarizing anybody’s beliefs or anything else — they're just notarizing the signature on the card, which is the parent’s signature."
According to Iowa state code, there is no option to obtain a philosophical exemption. However, getting a religious exemption means saying that the immunization conflicts with a “genuine and sincere” religious belief.
Hassel said he was especially vocal online during the pandemic — or as he calls it, the “scam-demic.”
“I never realized until the pandemic how political health was in these health decisions. It’s crazy, I had no idea,” Hassel said.
Not all families with religious exemptions are vaccine hesitant, however. Elizabeth Faber, coalition director of Iowa Immunizes, says some file an exemption because it's easier and then get the vaccines later.
"We know that sickness doesn’t stop at state lines, and so we’re definitely concerned that, if we have these pockets of unvaccinated kids, those exemptions don’t protect them."Elizabeth Faber, coalition director of Iowa Immunizes
But Faber says over time, as vaccine rates fall, long-eradicated diseases could return. The recent measles outbreak in Texas is an example of this.
“We know that sickness doesn’t stop at state lines, and so we’re definitely concerned that, if we have these pockets of unvaccinated kids, those exemptions don’t protect them,” Faber said.
She said most Iowans do vaccinate their children and themselves according to the recommended schedule. But five years after the global pandemic, she's still reminding people that vaccines are well-tested and protect vulnerable populations.
