Q&A: How an anti-vaccine bill motivated a South Dakotan’s award-winning response
By: Seth Tupper - May 20, 2024
Dr. Allie Alvine went to Pierre in 2020 with a concern and came home with a mission.
At the state Capitol, she testified against a bill that would have repealed the immunization requirements that apply to most school children.
“I saw the anti-vaxxers there, and they were a large group,” she said.
Lawmakers rejected the bill, but Alvine, of Sioux Falls, feared the anti-vaccine movement was growing.
“I had to get more involved,” she said. “I had to create a presence at our state Capitol in Pierre to counter their presence, to be the pro-vaccine voice.”
Last year, she founded South Dakota Families for Vaccines, a state-level arm of the national Science and Families Engaged (SAFE) Communities Coalition.
As director of the state-level group, Alvine’s work includes talking to legislators and the public about the importance of vaccines, updating supporters about relevant legislation, and publishing local-level vaccination data and voter guides.
Those and other efforts earned Alvine the Excellence in Immunization Advocacy Award at the National Conference for Immunization Coalitions and Partnerships last month in Philadelphia. Another South Dakotan, Andrea Polkinghorn, received the Excellence in Immunization Collaboration Award for her work as president of Immunize South Dakota.
The two groups work together in the state. While South Dakota Families for Vaccines works at the grassroots level to influence policy, Immunize South Dakota works at the “grass tops” to raise immunization rates, Alvine said.
Alvine brings medical knowledge to her job: She went to medical school in Kansas and completed a psychiatry residency through the University of South Dakota Sanford School of Medicine. She now uses her medical education exclusively for advocacy.
Following are portions of South Dakota Searchlight’s recent interview with Alvine, edited for length and clarity.
Before your current work, you started the South Dakota chapter of the Arthritis Foundation in response to your son’s juvenile rheumatoid arthritis diagnosis. What role did vaccine advocacy play in that work?
Juvenile rheumatoid arthritis is an autoimmune disease where your body attacks its joints, and it’s very painful and destroys joints. So the goal is to treat the disease and save the joints as much as possible, but the medications decrease your immune system.
So part of what I did in the Arthritis Foundation was promote vaccinations, because that population has a lot of patients on immune-compromising medications, and it makes you much more vulnerable to all diseases, and these people depend on their communities being vaccinated — creating a community of immunity to protect them from these awful diseases, and especially the vaccine-preventable diseases. So that kind of started my journey in vaccine advocacy.
Did you get exposed to the anti-vaccine movement at that time?
I knew some people were hesitant — and that’s absolutely OK to be hesitant and to ask questions, and to talk to your doctor or experts or our organization about vaccines. But back then I was not aware of the anti-vaccine movement as much. I knew they were out there, but they were kind of not on my radar back then.
They came on my radar while I was a member, through the Arthritis Foundation, of Immunize South Dakota. And they asked me to testify in 2020 on the bill that was brought forth in the state House of Representatives that would have gotten rid of school vaccinations, which would be horribly detrimental and dangerous and a disaster for our state. So I agreed to go testify as an M.D. and as a parent of an immunocompromised child.
Two weeks after your testimony to the Legislature in 2020, South Dakota had its first confirmed case of COVID-19. How did the pandemic influence your thinking about vaccine advocacy?
During the pandemic, I was thinking, OK, we all went through such a hard time with masks, social distancing, schooling our children at home, work changes and isolation. It was really hard. I thought — and a lot of vaccine advocates thought — that with the rolling out of the vaccine, which was the only thing that was going to get us out of the pandemic and make life normal again, that maybe the anti-vaccine sentiment would die down.
But that was exactly opposite of what happened. The vaccine hesitancy increased, and the sharing of misinformation about the COVID vaccine, and people got more vaccine hesitant, and their feelings about the COVID vaccine started trickling down to childhood vaccines, and we’re seeing our rates drop across the country.
So what had happened was the SAFE Communities Coalition started in 2020 to counter the spread of vaccine misinformation and support pro-vaccine legislation. Immunize South Dakota talked with SAFE Communities, and they approached me to take on this role as director of South Dakota Families for Vaccines, and SAFE now has 11 states covered.
It’s truly a group effort. I work together with all the other directors in other states, and SAFE supports our work. And I also work a lot with other organizations and partners in our state and nationally.
On your website, you report that 93% of South Dakota kindergartners had all their recommended vaccines last school year (although vaccines are required, families can claim exemptions for religious and health reasons). How would you characterize the current atmosphere around vaccines in our state?
People say, “Well, 93%, that’s huge.” The problem is that very small drops in rates have big effects on vaccine-preventable diseases. So where we want to be is 95%, and that has dropped. We were there, but that has dropped since 2020 to 93%, and that’s all because vaccine misinformation is shared so rampantly.
Social media and the internet are great, but information is shared so fast, and a lot of people don’t know what’s a good source for medical information. TikTok is not a good source for this information. And people share things on Facebook and even websites, and they look professional and they look scientific, but you need to look at resources for the “studies” that they did, and who paid for it, and how many were in the study, and whether it’s been reproduced. It’s hard for people to figure out what’s good information, and a lot of the stuff that the anti-vaxxers are posting is really scary.
How do you explain the popularity and growth of the anti-vaccine message?
We always say now that vaccines are a victim of their own success. Older people in our communities can tell you about multiple family members that died of measles, and they remember polio and people living in iron lungs and dying, and multiple other vaccine-preventable diseases that have just ravaged people’s lives, but we don’t see that anymore because of vaccines.
And so some people think that those diseases are just gone, and they’re not. If we get below 95%, measles is the first one that rears its head, because it’s so contagious. And we’re seeing that in areas of the country that have lower vaccine rates. It’s expected. And if you drop any lower, other horrible diseases will start rearing their heads. And unlike what a lot of anti-vax people say, these diseases are not benign. You’re much safer to get the vaccine as opposed to getting any of these diseases.
How do you equip people to defend the safety and effectiveness of vaccines like you do?
We have lots of trainings. We have ways people can get involved and learn about how to do it. But the main goal is to keep the door open to conversation, and to be calm and not argumentative, because people just go into their corners when you argue. And to listen to their concerns. Ask them, what have you heard? What are you worried about? Then ask if you can give them the information that you have about vaccines.
That’s kind of the gist, because arguing doesn’t do anything. And just reiterate that it’s fine to have questions. And then just talk about how vaccines have such a long history. The first smallpox vaccine was over 200 years ago. We have decades and decades of research that have proven that vaccines are well studied and extremely safe.
How important is it to have people with medical expertise like you working in the vaccine advocacy realm?
We need to have people in our health care communities stand up, now more than ever. It’s so important to use their voice in this way, and a lot of people do. We have a lot of other medical professionals that do, but we need more — nurses, all medical professionals. We work with a lot of pharmacists, too. Public health experts are in the mix, too. It takes a group effort.
South Dakota Searchlight is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. South Dakota Searchlight maintains editorial independence.
