How North Dakota Advocates Are Defeating Anti-Vaccination Bills

In North Dakota, this approach contributed to a coalition of health advocates, conservative ranchers, local faith leaders, business executives, and community organizers defeating nine anti-vaccine bills over the past three years, while amending the few that passed to avoid negatively impacting community wellness. These bills proposed expanding exemptions, reducing mandates, and, in one instance, even criminalizing health professionals administering vaccines. We didn’t defeat them by shouting across the aisle but by sitting down and listening.

This wasn’t easy. We live in an environment in which misinformation thrives, trust in institutions erodes, and everyone talks past one another. That distrust is the result of not just bad information, but also a sense of feeling left out, overlooked, or unheard.

We developed “five keys to navigating misinformation,” a framework we began working on during the Covid-19 pandemic and have since honed. It’s not intended to counter every piece of disinformation, but rather to work further upstream, mending the media ecosystem.

We came to this approach from different directions. At the start of the pandemic, Sandy, who served 13 years as a city commissioner in Mandan, North Dakota, was alarmed by adversarial tensions in public discourse. She launched the Foundation for a Healthy North Dakota in response. Simultaneously, Josh had been working on a health communication campaign through his agency, Odd Duck, that had been derailed by disinformation.

Together, our mission was to confront misinformation through messaging and trust-building at the grassroots level.

Key 1: Validate feelings, address concerns  

We started by holding listening sessions in community spaces: church basements, community organizations, and town halls. We invited everyone — outspoken anti-vaxxers, pro-vaccine parents, skeptical neighbors — and we didn’t come armed with PowerPoints and the intent to persuade. Instead, we came with questions. What are you worried about? Who do you trust? What would it take for you to feel safe?

You can’t fact-check fear. Many opposed to public health policies weren’t irrational. They were reacting to a long history of institutional neglect and manipulation. From Indigenous communities with generational memories of forced sterilization to rural ranchers skeptical of government land seizures, what we heard repeatedly was, “We don’t feel like this system is for us.”

The common refrain was that people didn’t necessarily distrust vaccines — they distrusted systems, government overreach, pharmaceutical profits, and experts who didn’t look or sound like them. This wasn’t ignorance. It was a response to feeling left out of the conversation.

We created “judgment-free zones,” where people could discuss their hesitations without being shamed. One conservative parent shared that the shift in her thinking around vaccines stemmed from a quiet conversation with a pediatric nurse at church.

Key 2: Strategic storytelling

Disinformation campaigns are successful because they wrap those lies in emotionally resonant narratives. We countered with our own storytelling strategy: showing how public health isn’t about control but care. We highlighted “journey” stories of local families who were once hesitant but chose to vaccinate after personal losses.

We collected genuine community voices, including a pastor in western North Dakota, a tribal advocate in Bismarck, a chiropractor in Fargo, and others, in a series of video testimonials. We shared stories at community events, on webinars, and in newsletters. That kind of strategy isn’t just persuasive; it’s personal.

Key 3: Be a trusted source

Credentials matter less than character in a low-trust environment. We tapped into the foundation’s reputation as a local, deeply embedded partner.

We also acknowledged the messy legacy of public health. From smallpox blankets to underfunded tribal clinics, history casts a long shadow. Rather than avoid that discomfort, we named it. These open, honest community conversations became a central part of the wellness events and health fairs hosted by the foundation. Being real about past harm helped open doors to future collaboration.

Key 4: Right messenger, right message

Livestock vaccinations are a way of life on ranches. When we began having conversations about the parallels between herd immunity in cattle and in schools, something clicked. These weren’t abstract concepts. They were rooted in the practical experience of people who depend on vaccination for the survival of their livelihoods.

We knew we were making progress when one rancher, initially an outspoken critic of vaccine requirements, told us he had seen what happens when disease is allowed to run unchecked, which the U.S. can’t afford for our animals or our kids, and agreed to testify against the anti-vaccine bills. 

We recognized the messenger matters as much as the message. By amplifying trusted rural voices grounded in lived experience, we could reframe the issue as a shared responsibility, not as a partisan wedge.

Key 5: Data democratization

When we started working with tribes throughout the state, we frequently heard the term “helicopter research.” It is common practice for academics to reach out to a reservation when working on a project, take advantage of the local knowledge, and then disappear. A paper is published, but the participants’ lives do not change. We were often told that many never even saw the final product that resulted from their time, energy, and insight.

We adopted a policy of data democratization, making information, listening session results, interview content, and evaluation accessible to any community with which we partnered. We shared and discussed the findings, often resulting in the community using the data directly for their own efforts.

Beyond those five principles, we kept several ideas in mind:

• • We didn’t lead with persuasion. We led with curiosity.
  • We didn’t push vaccines. We framed them as part of a broader commitment to health.
  • We didn’t debate. We built trust through dialogue.
  • Our approach is slow. It requires rebuilding a culture of care in the face of polarization. We didn’t just beat the bills, we repaired relationships. If there’s one thing we’ve learned, it’s this: If you want to defeat disinformation, begin by listening harder, not talking louder.