Buckle up: Navigating the noise around routine vaccination
It's only the beginning, but be sure to come up for air
The arguments against routine vaccination are already escalating. Just last week, it was unearthed that a prominent lawyer on the RFK Jr. transition team questioned the safety of the polio vaccine, and the long-debunked measles-autism myth is finding new life online due to several high-profile interviews.
This is happening before the new HHS Secretary—a figure with a well-documented history of sowing doubt about vaccines—is confirmed. If confirmed, the noise will only intensify. In other words, this is just the beginning.
But as we navigate this storm by examining the data together, it’s equally important to come up for air and ground ourselves in perspective.
Recognize successes
The next four years are going to be a volume problem. Fake controversies and minor concerns will dominate the headlines, while the monumental successes of vaccination will remain largely invisible.
But make no mistake: Vaccines have saved more lives in the past century than any other medical intervention. The data is clear and compelling:
Consider smallpox—once a global scourge, eradicated thanks to vaccination.
Or polio, which paralyzed tens of thousands annually in the U.S. alone before vaccines turned the tide.
Deaths from measles, diphtheria, and tetanus have plummeted to near-zero in most parts of the world with high vaccine uptake.
These successes are so profound that they’ve become invisible—people rarely see the diseases vaccines prevent and, as a result, sometimes fail to appreciate their value. This data visualization by Jia You at Science perfectly sums up vaccines' dramatic positive impact.
The silent majority still trusts vaccines
An essential truth to hold onto through the storm is that the vast majority of people trust and support vaccination.
The loud voices questioning vaccine safety or necessity do not represent the broad population. While vaccine hesitancy may grab headlines, the overwhelming majority of parents and communities still believe in the importance of immunization:
93% of kindergarteners in the U.S. are up to date on their childhood vaccines.
88% of parents believe the MMR (measles, mumps, rubella) vaccine is important for their children.
Polio vaccination rates remain high, with over 90% of children fully vaccinated.
We cannot let this slip backward. One way is by not allowing perspectives on routine childhood vaccines to become a part of a cultural identity, as they did with Covid-19 vaccines or climate change. This will require strong voices from both sides of the aisle.
You may start to have questions yourself
One of the most insidious effects of this constant amplification of rhetoric is that it can make reasonable people feel isolated and wonder if they are missing something. It can create the illusion that these doubts are more widespread than they actually are. It’s easy to start doubting yourself when bombarded with false information, even if you’ve always supported vaccination.
It’s okay to have questions. Vaccines are complex, and in today’s world, where rumors can outpace facts, even the most well-intentioned people can start to feel uncertain. Many vaccine myths contain a kernel of truth that’s been distorted or taken out of context. Understanding this can help us untangle fact from fiction.
For example, regarding questions on the polio vaccine last week: Yes, the newer polio vaccine hasn’t had a randomized controlled trial with a placebo. A placebo approach would mean more iron lungs and permanent disability. Withholding proven protection during known and ongoing exposure is unethical.
If you have questions, seek out trusted experts for clarity.
Trusted messengers, we need you
Trusted messengers—pediatricians, family doctors, community leaders, and friends and family—always play a vital role, and this will be especially true with vaccines in the upcoming years. Let’s leverage these relationships to ensure accurate, evidence-based information rises above the fray. People don’t need more data; they need educators, storytellers, and people to listen. They need an invitation to join the science.
Here is an FAQ we put together that can help guide conversations, anticipating concerns coming down the pipeline.
One in two people get healthcare-related information on social media. YLE is testing a new project—short videos that explain why we get the vaccines we do and show the data on what happened before and after the vaccines. The one below is on polio. Let Kristen Panthagani, the lead for this project, know if you have any input or advice. And share this video on YouTube, Instagram, and Facebook.
This is not Covid all over again
The challenges over the next four years will differ from those we faced during the Covid-19 pandemic.
Covid-19 unfolded rapidly, with new science emerging in real-time and, in turn, legitimate uncertainties that took time to resolve. At its height, 3,500 people were dying of Covid per day. Recommendations changed when the science changed.
Routine vaccinations are backed by decades of research and robust safety data. These vaccines have undergone extensive testing, with millions—if not billions—of doses safely administered worldwide. And we have mountains of data on the harms of the diseases—in fact, some places are still facing the detrimental impact of these diseases, like polio in Afghanistan and Pakistan.
This isn’t a situation where we’re figuring data out as we go. The data are clear. What is changing is the sheer volume of questions at a time when values are deeply divided. This means that the way public health leaders approach routine vaccines will have to be very different from before.
Bottom line
The next few years will feel noisy and chaotic, but be sure to come up for air. Buckle up, stay informed, and remember to stay grounded in data: vaccines save lives, the benefits far outweigh the risks, and the majority of people still support them.
Love, YLE
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. During the day, Dr. Jetelina runs this newsletter and consults with several nonprofit and federal agencies, including CDC. YLE reaches more than 290,000 people in over 132 countries with one goal: “translate” the ever-evolving public health science so that people feel well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
There is an art to vaccine counseling. I suspect it varies based on geography, community, and personality of the counselor and the parent.
I will say the singular insurmountable obstacle is the dissenting parent not present at the visit. “Well, I think it’s a good idea but my (spouse/partner etc)!is very opposed, so not today.”
I have almost never seen that person accept an invitation to come to a visit, speak on the phone, or otherwise participate in the child’s medical visits. If I cannot counsel, educate, I am stuck.
I suspect occasionally it’s a way to deflect as well.
I still offer education even when they decline. “Ok, well we will not be doing that today then, but is it ok if I just provide you with some background information that you can think about in the meantime?” Every once in a while they even change their mind on the spot… sometimes…
Separating and layering recommendations help- well, your 6 month old has a much greater need for the flu shot than your healthy teen, but let’s look at why you might consider for each of them… it’s different, we have to acknowledge that. It improves discussion and uptake. It’s time consuming. But it’s worth it.
But we are fielding more aggressive calls from anti vaccine families in the last few weeks. It’s going to be bad. Without a doubt.
FWIW here's an editorial I submitted to a local paper:
How would you like it if half your children died of preventable diseases before reaching high school?
This was the norm up until a century or so ago when vaccines for common, highly contagious, deadly
childhood diseases began to be available. In those days, parents gave thanks for such a merciful
development and rushed to the doctors' offices to get their children these precious shots. These days,
not so much. How soon we forget!
Just a quick reminder of the real villains in this story: (1) Measles vaccine was licensed in 1963; prior
to that, we lost around 500 children a year to this nasty disease, and tens of thousands were
hospitalized. Two doses are 97% effective in preventing symptoms, but we need 95% coverage to
prevent an outbreak. Some communities have fallen well below this level. (2) Diphtheria infected
100,000 American kids annually as recently as a century ago. About 10% died of suffocation from this
nasty problem. Thanks to vaccines, there is now fewer than one case a year in the U.S. (3) Tetanus
germs are found in the soil and need only a skin cut to enter a person's blood. Without immediate
treatment, up to 20% of infected people die in agony. The tetanus vaccine came out about 80 years ago
and lowered the U.S. case rate from more than 500 annually to fewer than 50. (4) Mumps is especially
nasty because you can be without symptoms for a month while spreading your infection to lots of
family, friends, and neighbors. We got our first mumps vaccine in 1967 and the rate of infection
dropped 99%, though case rates have recently gone up ten-fold. Mumps is no joke because even when
it doesn't kill you, it can leave you with deafness, sterility, seizures, and strokes. (5) Rubella can
devastate a fetus if the mom gets it. Some 32,000 babies are born each year with Rubella and about a
third of them die before their first birthday. There's no good treatment for this problem, but the vaccine
licensed in 1969 cut the U.S. rate from 47,000 to six cases each year. Fortunately, there's now a single
shot that protects against measles, mumps, and rubella! (6) Polio killed or paralyzed 21,000 people in
the U.S. in 1952, but the vaccines eliminated it here, though it still spreads in poorer countries. If you
doubt any of these figures, please have a chat with a licensed medical professional.
We're more vulnerable now because vaccination rates have gone down for all the diseases on this list.
This problem apparently relates to fears of vaccination side-effects. It is possible that diseases could be
virtually eliminated through universal vaccination so that vaccine side-effects become a bigger problem
than the diseases... for a while. The problem with this reasoning is that these diseases spread very
rapidly among unvaccinated people. That leaves us at risk for massive outbreaks that could very
quickly dwarf any possible problems from the vaccines.
I suppose the risks and benefits are like those facing a person who chooses to drive while drunk.
Chances are you'll get away with it, but your risk of a serious accident goes way up. You may not care
if you live or die, but don't you owe something to all the other drivers who might suffer from your
careless behavior?
Please consider carefully the fact that some people, through no fault of their own, are more likely than
others to die or suffer crippling after-effects from the diseases listed above. These include the young,
the old, and anybody already weakened by a chronic illness. Grown-ups, especially those who follow
Christian teachings or those of most other religions, understand that they have a responsibility to
protect those who are less fortunate, even at some cost to ourselves.
Finally, we need to carefully consider the reasons why some celebrity-wannabes exaggerate the harms
of vaccination while minimizing its benefits. Some of these folks care only about their own fame and
fortune. Some are actually working for our national enemies and are getting paid to weaken us. Many
are so uneducated that the history of preventable childhood diseases is unknown to them. Please don't
you be one of these!