"Rupali Limaye, director of behavioral and implementation science at the International Vaccine Access Center based at the Johns Hopkins Bloomberg School of Public Health, has made similar findings as it relates to the difficulty of squaring public health realities with differences in political opinions. "There is a really stark divide between states that have more heavily Democratic-leaning leadership versus those that have more heavily leaning Republican leadership," she said. Limaye said that particularly among Republicans, the idea of freedom — a core tenet of the American ideal — has given people a basis on which to pin anti-science rhetoric. "This idea of liberty and autonomy — this comes up a lot as those underlying values of individuals that feel as though we don't really need to be mandating vaccines," she said, "I don't think it's an issue that they hate vaccines themselves. They hate the idea that vaccines are essentially forcing them into doing something they don't want to do. Vaccines are just sort of the casualty of all this.""