'It has impact.' Iowa public health experts struggle with backlash over COVID-era policies.

As politicians continue their attacks on COVID-19 mandates and vaccines, fueling public resentment over pandemic-era policies, state health experts are retooling their message to try to sway skeptical Iowans to get boosted and take precautions as needed.

In recent months, some local entities across the U.S. have taken on scattered efforts, such as mask requirements, to stave off a late-summer wave of new coronavirus infections.

But they have become a popular punching bag for several Republican presidential hopefuls campaigning in Iowa, who have renewed attacks against strategies used to combat the coronavirus, such as masking and shutdowns.

Iowa Gov. Kim Reynolds has joined the growing chorus and slammed the door on a return to pandemic mitigation strategies in Iowa such as shutdowns and mandatory vaccinations, vowing in an August statement: "Not on my watch."

"In Iowa, government respects the people it serves and fights to protect their rights," Reynolds said. "I rejected the mandates and lockdowns of 2020, and my position has not changed.”

The growing resistance to the pandemic response threatens to bleed into other public health measures as skepticism potentially leads to lower vaccination rates and greater spread of communicable disease, officials fear.

“It has an impact," said Iowa Public Health Association Executive Director Lina Tucker Reinders. "Public figures often set public opinion, and public health needs the participation of the public. As public opinion shifts, so does the nature of our work and the level of difficulty to our work.”

Already, requests for the new COVID-19 vaccines are at all-time lows, and federal health data shows vaccination rates among U.S. kindergartners for diseases such as measles and polio have declined over the past two years.

And at a time when the public health workforce is already burned out and underfunded, its leaders worry a further degradation of trust could hurt their ability to respond to future crises.

Presidential candidates' targets include lockdowns, mask and vaccination mandates

Iowa public health officials defend their response to the coronavirus, pointing out that it was a novel virus in early 2020 and posed a serious risk to everyone.

And because they had no treatment and no way to prevent infections, public health training dictated that isolation, quarantine and masking, among other steps, were necessary to avoid mass hospitalizations and casualties.

“Sometimes, we’re looking back in the rearview mirror and we forget things," said Elizabeth Faber, director of the Iowa Immunizes Coalition. "We are looking at what happened in the past with the eyes of today and the resources and tools that we have at our disposal today. We did not have that. We had fear, and we had an unknown virus, and we didn’t know what was happening.”

But that has garnered little sympathy from some presidential candidates.

Florida Gov. Ron DeSantis has touted his resistance to lockdowns on the campaign trail in Iowa, and has vowed his state would never return to mask mandates.

South Carolina U.S. Sen. Tim Scott has said his supporters would take a stand against lockdowns and school closures.

And former president Donald Trump vowed that if reelected, he would cut funding to any entity that implements vaccine requirements or mask mandates.

Such rhetoric has raised concerns among some health officials that it could impact future policymaking efforts, which are critical in public health strategy. Tucker Reinders said public health's effort to reduce deaths has played a role in policies such as seat belt laws, nonsmoking requirements in public spaces and food safety inspections.

“That’s the difference when an issue becomes politicized. An issue can be about policy, but it shouldn’t be politicized," Tucker Reinders said.

Resentment over pandemic response has fueled anti-vaccine skepticism. How is public health responding?

The anti-vaccine movement, which once existed in the fringes, has gained greater prominence in Iowa, fueled by simmering resentment over lockdowns and rising skepticism over new COVID-19 vaccines.

Even before the pandemic, Iowa public health officials had been working to nullify this skepticism. In 2019, public health professionals formed the Iowa Immunizes Coalition in response to a growing number of anti-vaccine bills introduced at the Iowa Legislature and has been active ever since, said Faber, its director.

The coalition and other groups have worked to counteract public health backlash through community outreach, speaking with individuals about immunizations face-to-face at events across the state and conducting social media campaigns to provide education and awareness on the topic.

So far, they've seen greater success in addressing vaccine skepticism and resistance to public health measures at a local level, using trusted sources of information within the community. Polls show Americans overwhelmingly trust their health care provider, giving local public health experts hope they can stem the tide.

But as the presidential race ramps up, nurturing public trust may prove a long road for the state's public health advocates.

“I do feel we have a long way to go to rebuild the trust that we have in our scientific institutions, and I do think there’s unfortunately an attack on public health and an attack on science that could lead toward skepticism," Faber said.

"It’s not just politics at that point. It’s people’s lives. That’s what we have to keep coming back to. It’s not just politics. These are lives."

Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com, at (319) 339-7354 or on Twitter at @Michaela_Ramm

This article originally appeared on Des Moines Register: Iowa public health officials renew efforts to counteract vaccine doubts