Addressing a vaccine-sceptic fellow Republican, Governor Scott said, “We’re in the middle of a pandemic. One of the front-runners on the Democratic side has questioned the science of vaccines. Do you accept, like I do, that vaccines are essential to public health and getting us out of this economic crisis that we’re in?”

Governor Scott is on the side of vaccines. His claim was that Lt Governor David Zuckerman, a pony-tail wearing Democrat who is now the challenger for the Governor’s job in the November election, is an anti-vax candidate.

Now, Vermont politics is rather incestuous and sometimes downright weird. One of the questions asked of the Governor by a fellow candidate during the debate was: “How do you justify not speaking up against the Department of Corrections forcing people to masturbate and measure their penis size or having undocumented strip searches called the naked monkey dance?” But putting that eccentricity to one side, there can be no doubt that David Zuckerman, a Democrat who may well become the Governor of the state of Vermont, or in the future a replacement in the Senate for its most famous political son, Bernie Sanders, has sided with people who do not approve of vaccines.

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During a debate in the Vermont Senate in 2015, about efforts to force more parents to vaccinate their children, Mr Zuckerman said the pharmaceutical companies were in it for the money, rather than the health benefits. He maintained this gave parents the right to keep their children un-vaccinated:

“For me, as long as there’s the extreme financial conflicts of interest out there that are driving much of this debate and discussion, I have to maintain the individual right for someone to do their own research as well and make that decision,”

It was the classic vaccine-sceptic position. Yes, vaccines can help, but let’s go slow. Let’s open the door to talk of money, of freedom of choice, of ‘research’ that might lead to the conclusion that politics drive the vaccine movement. Let us, in other words, muddy the waters.

Fast-forward to now. What is the position, the official position, of the Democratic party, when it comes to vaccines against the Coronavirus, SARS-CoV-2? Muddier than it could be, some are saying.

In a series of interventions, senior Democrats have cast doubt on the reliability of any vaccine available soon. Let’s start at the very top with Joe Biden, the presidential candidate. “Let me be clear: I trust vaccines,” Mr. Biden said. “I trust scientists. But I don’t trust Donald Trump, and at this moment, the American people can’t either.”

Mr Biden said later that he would take a vaccine before election day, if the doctors told him it was safe. But the implication was clear: an early vaccine could be suspect.

Kamala Harris, his choice for vice-president, went further. When CNN’s Dana Bash asked whether Harris would trust a vaccine released by the end of the year, or sooner, the candidate responded, “I think that we have learned since this pandemic started, but really before that, that there’s very little that we can trust that comes out of Donald Trump’s mouth.”

Which was not exactly no, but not exactly yes. She received backing from another hugely well-known and respected Democratic politician, the Governor of New York Andrew Cuomo, who announced that his state would carry out independent tests on any vaccine: “Frankly, I’m not going to trust the federal government’s opinion and I wouldn’t recommend to New Yorkers based on the federal government’s opinion.”

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And just in case Donald Trump were to find a way of importing a vaccine from Britain, that base was covered off too by Nancy Pelosi, the speaker of the House of Representatives, just last week, with a suggestion that British medical regulation was suspect: “My concern is that the UK’s system for that kind of judgment is not on a par with ours in the United States. So if Boris Johnson decides he is going to approve a drug and this president embraces that, that is a concern that I have.”

It is worth saying clearly that the Democratic party, around the United States and for many years, does have a record of backing vaccines. The Republican record is more mixed, and Donald Trump himself has flirted with the anti-vax movement. But what worries some enthusiastic backers of vaccine science is that the Democrats risk undoing the work they have done in the past – and of damaging Americans’ already shaky trust in science and medicine.

The view that Donald Trump might be untrustworthy on medical matters is hardly controversial.   It might make political sense for the Democrats to point this out so that the White House cannot make some baloney claim that a vaccine is ready and if you vote Trump you will get a jab in a few weeks time and your job back and everything will go back to normal. You can see why Joe Biden and his team might want to inoculate themselves against that.

But this is (relatively) subtle politics. What if most people just don’t concentrate that hard on the detail? The risk is that the message they get is less “Donald Trump is dodgy when he promises a vaccine” but more: “the vaccine is dodgy.”

It’s the dodginess, stupid.

One of Americas most prominent anti-vax campaigners isn’t complaining. For Robert F Kennedy, JFK’s nephew, the Democrats’ attitude has been helpful to his cause: “There is undeniably a lot more scepticism about vaccines,” Kennedy said. “It’s gone from maybe 5 to 10 percent to up to 50 percent range.”

He seems to have got that about right. In a national poll conducted for CNBC/Change Research at the end of last month only 42% said they would definitely or probably receive the inoculation when it first became available. That figure has fallen from 58% in July.

And who, politically, has had the biggest change of heart?

An extraordinary collapse in support from registered Democrats contributed to the overall change: only 30% said they would definitely get a vaccine, down from 57% in July.

Mr Zuckerman in Vermont is still an unusual Democrat but scepticism about vaccines – or at least about this potential vaccine – is widespread among the party’s supporters. It has been encouraged by the leadership. If Joe Biden becomes president and a vaccine becomes available he will be accused by the anti-vax movement of raising a legitimate set of doubts, and then ignoring them. It could be a powerful message.

It is pretty certain that no vaccine will actually be available before the election, or in its immediate aftermath. But the political fight may have done more long-term damage, and that is damage that the United States could do without. As Andy Slavitt, a former Obama administration health official, put it recently: “Done right, vaccines end pandemics. Done wrong, pandemics end vaccines.”

The politics of vaccination is a high-risk area, with a danger of unintended consequences. The Democratic party has done what it felt it had to do, but American doctors have been given yet another reason to furrow their brows.

Nearly 75,000 people have already voted for a Democratic candidate in Nevada — an extraordinarily high number: the overall turn out four years ago was 84,000. There are 36 delegates in play. Heading into the Paris Theatre for the final match-up before tomorrow’s caucuses, Vermont Senator Bernie Sanders looked the favourite to take the state.

The debate did little to change that. Instead, the Democratic frontrunners honed their fire on Bloomberg, with Senator Elizabeth Warren of Massachusetts particularly fierce in her attacks on the former New York Mayor. Warren talked of a “billionaire who calls women fat broads and horse-faced lesbians”:

“No, I’m not talking about Donald Trump. I’m talking about Mayor Bloomberg.”

The Sanders campaign received a big boost ahead of the caucus debate when it won the backing of Mijente, a grass-roots Latino group. The group has a 300,000-person email list of supporters whom it will now mobilise to canvas for the Vermont senator. Sanders has already raised four times as much money from Latino contributors as any other Democratic candidate.

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A victory for Sanders in Nevada would stand him in good stead for the Democratic nomination, after victories in the popular vote in Iowa and New Hampshire. The campaign of his biggest challenger, Joe Biden, is visibly flailing. Indeed, a voter asked Biden bluntly during an event in Nevada “What the hell is going on with your campaign?”

Eric Lee, a joint coordinator of the Sanders 2020 campaign in the UK, told me that Sanders will win the Nevada caucuses “because he understands better than any other Democrat the two things that have changed in American politics in this century”.

“The first is that the economic crisis of 2008 dealt a death blow to the ‘American dream’, with rising inequality, poverty wages and a trade union movement in terminal decline. The second is that with the collapse of Communism, democratic socialism — which was never a dirty word here in Europe — is no longer a dirty word in America either, especially among young people.”

For some, it may be comforting to put the rise of Bernie Sanders (and Jeremy Corbyn, for that matter) down to youthful irresponsibility and even historical amnesia when it comes to socialism. But there is a real material base for disillusionment with contemporary capitalism.

As Sanders pointed out during a speech at George Washington University in the summer, “the average wage of the American worker in real dollars is no higher than it was forty-six years ago”. He also noted that “life expectancy is declining for the first time in modern American history”.

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Nevada — and specifically Las Vegas — is often associated with the vulgar trappings of the free market. Vegas is home to giant casinos, bottle service clubs, prostitution, pawnshops and ostentatious wealth. Yet trade unionism remains strong — built into the sprawling casinos, hotels and restaurants. Nearly a quarter of North America’s powerful UNITE HERE union members are based in Nevada, forming a branch known as the Culinary Workers Union; the northwestern city of Reno, like Vegas, is a union stronghold.

The Las Vegas skyline is dominated by the giant, gold-coloured hotels belonging to the Wynn group — of Steve Wynn, the long-time Vegas hotelier who opened the first big hotel on the Strip, the Mirage, back in 1989. It was Wynn who struck the first big neutrality agreement with The Culinary (as the Culinary Workers Union is known), ensuring that the union would not be persecuted by management during attempts to sign up members. Other hoteliers soon fell into line.

Today, virtually every hotel on the Las Vegas strip is organised. This bodes well for the Sanders campaign, with much of the Vermont Senator’s rhetoric focusing on issues of class and economic justice.

Yet The Culinary — which is the most powerful union in the state — dislikes Sanders’ Medicare for all bill, which it fears will eliminate the private insurance it won for members. As it did in 2016, the Culinary has declined to endorse any of the candidates (in 2008, it backed Obama). After the announcement on Friday, two leading Culinary officials received threats by phone and online from Sanders’ supporters.

Michael González, a 45-year-old housekeeper who works for MGM resorts and has already voted, told me over the phone that he hadn’t voted for Sanders because of specific concerns he has over the Senator’s healthcare plans. “The plan I [currently] have through the union works for me,” González said.

“I see why the people with no healthcare at all are liking Bernie and what he’s saying, but when you’ve already got a good … plan you’re not gonna necessarily take a gamble on this Medicare for all. My plan could get worse [under Sanders’ vision] and it’s hard for me to vote for something like that.”

The row highlights a friction between ‘fortress unionism’ and the universalist, social democratic message of the Sanders campaign. But he nevertheless remains on course: a NPR/PBS NewsHour/Marist poll released on Tuesday gave Sanders a double-digit lead over the rest of his competitors in the Nevada primary.

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Still, it was Warren who undoubtedly ‘won’ Wednesday’s debate. It is probably too late for her to take the primary, however (though she did reportedly raise $425,000 in just 30 minutes). Meanwhile, Sanders didn’t slip up: he did a good job of deflecting attacks on him, and so finished the debate as he started it — as the frontrunner.

And so the Nevada caucus probably won’t be the game-changer hoped for by the underdogs. We’ll find out for sure when the post-debate polls start coming in. An improved showing for Warren seems likely, with Bloomberg faltering as the attacks on the billionaire business tycoon gain traction (many younger Democrats will not have known that Bloomberg supported George W. Bush in 2004 until Sanders raised the point in Wednesday’s debate). In the background, Biden continued to flail, and Pete Buttigieg, the 38-year-old politician from Indiana, failed to set the stage alight as some hoped he would.

Following the vote-counting debacle in Iowa earlier this month, the Nevada Democratic Party will mainly be hoping that the vote-counting process runs smoothly after tomorrow’s caucus. As things stand, the nomination looks increasingly like Sanders’ to lose.