Analysis of: Fears of polio resurgence as US vaccine adviser questions need for childhood shots
The Guardian | February 23, 2026
TL;DR
Trump's vaccine advisers are openly questioning childhood immunizations, threatening to resurrect diseases like polio that were eliminated through public health infrastructure. This is neoliberalism's endgame: dismantling collective health protections so the costs of disease fall on individual families and workers.
Analytical Focus:Historical Context Contradictions Material Conditions
The potential rollback of routine childhood vaccine recommendations represents a stark manifestation of neoliberal governance reaching its logical conclusion: the systematic dismantling of collective public health infrastructure in favor of individualized risk and privatized care. The Advisory Committee on Immunization Practices chair's suggestion that vaccines for diseases like polio should be reconsidered because risk levels have dropped reveals a profound ideological blindness—those reduced risks exist precisely because of universal vaccination programs. This is not merely scientific illiteracy but reflects a deeper material logic of capitalism's contradiction between short-term cost reduction and long-term social reproduction. The testimony of polio survivors like Art Caplan and Grace Rossow exposes what is at stake in concrete human terms. Their accounts reveal two interlocking crises: the loss of institutional medical knowledge (surgeons who could perform complex post-polio procedures are retiring with no successors) and the degradation of healthcare infrastructure that would be needed to respond to outbreaks. This knowledge erosion is not accidental—it reflects decades of healthcare financialization that prioritizes profitable procedures over maintaining capacity for rare but catastrophic diseases. The article inadvertently documents how public health achievements become ideological weapons against themselves. The very success of vaccination programs in eliminating visible disease creates conditions where capital and its political representatives can argue such programs are unnecessary—privatizing the benefits while socializing future risks onto working-class families who will bear the burden of caring for disabled children without adequate medical support. This represents a transfer of reproductive labor costs from the collective (public health) to individual households, disproportionately affecting women and working-class communities.
Class Dynamics
Actors: Working-class families (primary vaccine recipients and disease burden bearers), Medical professionals and specialists (knowledge holders facing institutional erosion), State health advisers (implementing policy reflecting ruling-class interests), Pharmaceutical industry (implicit stakeholder in vaccine production), Religious and anti-vaccine movements (cross-class ideological formations)
Beneficiaries: Capital interests seeking reduced public health expenditures, Private healthcare systems positioned to profit from treating preventable diseases, Political actors mobilizing anti-establishment sentiment
Harmed Parties: Working-class children who will contract preventable diseases, Families (especially women) who will bear care burdens, Future disabled individuals who will lack medical infrastructure, Healthcare workers facing impossible conditions during outbreaks
The state apparatus, through bodies like ACIP, mediates between capital's drive to reduce collective social spending and the working class's need for public health protection. The survivors quoted in the article possess experiential knowledge but lack institutional power to shape policy. Medical professionals hold technical expertise but operate within healthcare systems increasingly subordinated to profit logic. The fundamental asymmetry is that those who will suffer the consequences of policy changes have virtually no input into those decisions.
Material Conditions
Economic Factors: Healthcare system financialization prioritizing profitable procedures, State budget pressures driving public health austerity, Pharmaceutical industry profit calculations around vaccine production, Reproductive labor costs of caring for chronically ill family members, Loss of specialized medical training as unprofitable investment
Healthcare under capitalism operates as a commodity system where medical knowledge and capacity are produced only when profitable. The 'lost art' of post-polio surgical techniques described by Dr. Allan illustrates how medical knowledge—a form of productive force—atrophies when not valorized by capital. The relations of production in healthcare mean that training specialists for rare diseases represents a cost without adequate return, leading to systematic disinvestment. Meanwhile, the reproductive labor of caring for disabled individuals falls outside commodity production entirely, absorbed by families (predominantly women) as unpaid work.
Resources at Stake: Public health infrastructure and institutional capacity, Medical knowledge and specialist expertise, Vaccine stockpiles and production capacity, Workers' health and productive capacity, Family resources devoted to care work
Historical Context
Precedents: Post-WWII expansion of public health infrastructure and vaccination programs, Neoliberal healthcare restructuring from 1980s onward, Historical elimination of smallpox and near-elimination of polio through coordinated public health, Reagan-era attacks on collective social programs, COVID-19 pandemic exposing healthcare system fragility
This moment represents the culmination of four decades of neoliberal restructuring of public health. The post-war period saw significant state investment in collective health infrastructure—vaccination programs, disease surveillance, specialist training—reflecting both Cold War competition and working-class political power demanding social provisions. The neoliberal turn from the 1980s onward systematically eroded this infrastructure through privatization, funding cuts, and the reframing of health as individual responsibility rather than collective right. The current policy consideration is not an aberration but the logical endpoint of this trajectory: once public health succeeds in eliminating visible disease, that very success becomes the justification for dismantling the programs that achieved it. This mirrors the broader neoliberal pattern of appropriating collective achievements while destroying the collective mechanisms that produced them.
Contradictions
Primary: The fundamental contradiction is between vaccines as a collective public good (requiring universal adoption to maintain herd immunity and eliminate disease) and capitalism's imperative to reduce collective social expenditure and individualize risk. Vaccines only work through collective action but are being evaluated through individualist cost-benefit logic.
Secondary: Contradiction between healthcare as commodity and healthcare as necessity for social reproduction, Contradiction between short-term fiscal savings and long-term costs of disease resurgence, Contradiction between medical professional ethics (do no harm) and institutional pressures, Contradiction between scientific knowledge (vaccines work) and ideological formations (anti-vax movements) serving political mobilization
These contradictions are likely to sharpen rather than resolve within the current system. Disease outbreaks in unvaccinated communities will create localized crises that may temporarily restore support for vaccination—but without addressing the underlying structural issues of healthcare commodification and public health disinvestment. The tragic possibility is that only significant loss of life will create political conditions for rebuilding collective health infrastructure. Alternatively, these crises could deepen working-class consciousness about the necessity of collective social provisions, potentially fueling movements for healthcare as a universal right rather than commodity.
Global Interconnections
This domestic policy shift cannot be understood in isolation from global public health dynamics and imperial relations. The article notes that Grace Rossow contracted polio in India before vaccination reached most children there—a reminder that the global eradication effort requires coordinated international action. US policy retreat undermines global vaccination efforts and reflects a broader pattern of imperial powers withdrawing from collective international commitments while continuing to extract value from the Global South. The uneven geography of disease elimination mirrors broader patterns of unequal development. Moreover, this connects to the global crisis of neoliberal governance. From healthcare privatization to climate inaction, ruling classes increasingly demonstrate inability to address collective challenges that require collective solutions. The anti-vaccine movement, while appearing as irrational rejection of science, reflects genuine working-class alienation from institutions that have repeatedly failed them—a distorted expression of legitimate grievances channeled into reactionary politics. This ideological formation serves ruling-class interests by directing anger away from systemic critique toward individualized 'health freedom' that leaves workers more vulnerable, not less.
Conclusion
The threatened vaccine policy rollback reveals a fundamental truth about capitalist governance: the system cannot sustainably maintain collective social goods when they conflict with capital accumulation imperatives. The medical knowledge to treat polio is disappearing not because it is impossible to preserve, but because preserving it is not profitable. Working-class families will bear the costs of this abandonment through disease, disability, and unpaid care work. This creates both danger and opportunity—danger in the immediate suffering that policy changes will cause, opportunity in the potential for these crises to demonstrate the necessity of collective health infrastructure and build support for healthcare as a universal right. The testimony of polio survivors offers not just warning but also a model: those with lived experience of capitalism's failures speaking truth about what is at stake. Building class consciousness around healthcare as a collective necessity, rather than individual commodity, remains essential to any progressive political project.
Suggested Reading
- The Shock Doctrine by Naomi Klein (2007) Klein's analysis of how crises are manufactured and exploited to implement unpopular neoliberal policies directly illuminates how public health 'success' is being weaponized to justify dismantling vaccination programs.
- Women, Race & Class by Angela Davis (1981) Davis's examination of how reproductive labor burdens fall disproportionately on working-class women and communities of color is essential for understanding who will bear the care costs when preventable diseases return.
- The State and Revolution by V.I. Lenin (1917) Lenin's analysis of the capitalist state helps explain why bodies like ACIP ultimately serve capital's interests in reducing social expenditure rather than protecting working-class health.