Health and human services secretary Robert F. Kennedy Jr needs to stop saying vaccines are “a personal choice”.

They’re not. Speed limits aren’t a personal choice. Smoking on airplanes isn’t a personal choice. Paying taxes isn’t a personal choice. In wartime, the draft isn’t a personal choice. (Kennedy, who was born two weeks before me, is old enough to remember those days.) Sacrifices are what make the United States a nation instead of 340 million selfish hunter-gatherers. Each of us gives up some personal freedoms so we all stay alive. Opposing life-saving mandates is childish libertarian nonsense.

Sadly, the country’s top health official is a childish libertarian.

Just because there are no cops or smoke detectors around, or just because tax loopholes or conscientious-objector laws or religious exemptions exist, doesn’t change the fundamental principle: if enough of us refuse to obey a sensible protective law, people will die.

School vaccine mandates are the law in all 50 states, and in most cases have been so for more than 100 years. Such laws were passed starting in the 19th century, when the Industrial Revolution filled cities and public schooling gathered children together. Epidemics exploded. There was only one vaccine then, against smallpox, and it was unquestionably dangerous; in rare cases, it led to encephalitis, amputation of the vaccinated arm or death. However, since smallpox killed 30 per cent of its victims and left some survivors hairless and scarred, the risk was regarded as worth it.

Courts upheld mandatory vaccination. The most important case was 1905’s Jacobson v Massachusetts, in which the Supreme Court ruled 7-2 that a state could punish a citizen who refused to be vaccinated. Compulsory measures to protect public health, the justices held, were “within the police power of a state”.

That “police power” aspect is important. Religion was not an issue — even though Jacobson was a minister. The Reverend Henning Jacobson could be fined for the same reason you can be arrested for firing a gun in a Walmart even if the Second Amendment says you can own one: having a transmissible disease makes you dangerous to others. Your personal preferences aren’t relevant.

In the 1960s, state legislatures filled with politicians who had never seen a child die of measles, polio or diphtheria foolishly began poking loopholes in school vaccine laws. First, religious exemptions were adopted in New York to accommodate Christian Scientists. Then, to avoid the appearance of favouring Christian Science — which would violate the First Amendment’s provision against establishment of religion — exemptions for “philosophical” reasons or “personal beliefs” were added.

It was all ludicrous. Vaccines are a medical procedure. There is nothing religious about them, any more than a hernia operation or a root canal is a religious act. Seatbelts aren’t religious; there is no faith-based exemption to laws requiring that we buckle up.

Moreover, it was a fallacy. Every major religion is adamantly in favour of vaccination. The Vatican and top Jewish and Muslim scholars have studied vaccine ingredients and endorsed them — even though some contain trace amounts of pork gelatin stabiliser or DNA from aborted foetuses — because they save lives. Nonetheless, after 1998, with the start of the false “measles vaccines cause autism” rumour, the anti-vax movement encouraged parents to abuse what were meant to be very rare exceptions. Sham “churches” were even founded to hand them out.

At one time, conservative states such as Mississippi and West Virginia forbade any nonmedical exemptions for school vaccines because the anti-vax movement was seen as liberal goofiness. In the past decade, however, liberal states including California and New York have eliminated religious exemptions after suffering the consequences: the Disneyland and Brooklyn outbreaks. Perhaps Texas will be next.

Don’t assume the First Amendment allows believers to do anything they want. The Supreme Court squashed that fantasy in 1879 in Reynolds v United States, when the Church of Jesus Christ of Latter-day Saints argued that the First Amendment made anti-polygamy laws unconstitutional. (George Reynolds, Brigham Young’s polygamous secretary, volunteered to test the law.) The court unanimously disagreed, saying such logic would force it to also permit human sacrifice and bride-burning.

Kennedy also needs to stop recommending cod-liver oil, budesonide and clarithromycin. He is shilling for patent medicines. Five years ago, Richard Bartlett, a physician Kennedy praised in a Fox News interview, was claiming that budesonide was a “silver bullet” for Covid-19. This happens in every epidemic: profiteers appear with nostrums that make no biological sense and are never seriously tested. Once it was blood-letting. In the 1910s, it was radium solution. In the 1970s, it was vitamin C for colds and cancer. During the Aids epidemic, it was Kemron and Pearl Omega in Kenya, and oxytherapy and Virodene in South Africa.

Miracle Mineral Solution has been touted as a cure for malaria, Lyme disease, autism, acne and many other ills. For 25 years, every time I covered an epidemic, someone would tout its nonexistent benefits to me. (It’s a bleach, and I suspect someone mentioned it to Donald Trump in 2020 just before he suggested injecting disinfectant.) During the pandemic, of course, the fake cures that got the most traction were hydroxychloroquine and ivermectin.

There is an easy explanation for the persistence of “miracle cures”: most patients recover, even from smallpox. Just because you give them something and they don’t die doesn’t mean it cured them.

Kennedy also needs to stop saying that a healthy diet protects against measles. That is the magical thinking used by the health foods industry to empty the pockets of suckers. (And since when do French fries cooked in beef tallow qualify as healthful?)

As a 71-year-old child of the Sixties who grew up in San Francisco, Santa Cruz and Berkeley, I know plenty of ageing hippies who have been eating organic and/or vegetarian for 50 years. They are now dying of cancer, heart disease and Alzheimer’s just like the rest of us. Statistically, they do live a little longer — although having a 78-year-old president who subsists on junk food belies that — but nutrition will not stop measles, nor will it keep Kennedy and me from racing each other to the exit when our time comes.

Everything our leading health official has said about measles is somewhere on the spectrum from incomplete to tendentious to outright mendacious, and it’s seducing some Texans into avoiding care that could save them. He should shut up or step down.

• Donald G. McNeil Jr, a former global health reporter for The New York Times, is the author of The Wisdom of Plagues