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 likeminded conservatives. In 2022, he joined the seven-member board of health of the Panhandle Health District, 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 issued a short announcement 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 United States 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.