After the U.S. Senate confirmed Dr. Erica Schwartz as the next director of the Centers for Disease Control and Prevention, The New York Times sent out a revealing news alert.
“Childhood vaccine supporter confirmed as C.D.C. director,” the alert said.
A public-health official supporting childhood vaccines wouldn’t have been a headline a decade ago. But a fleeting needle prick has become a lasting point of contention in the culture wars, thanks to Americans’ declining levels of trust in government, the media, the medical system and the pharmaceutical industry.
The Trump administration’s actions on vaccines, including an executive order the president signed Monday, has signaled that long-standing vaccination recommendations are being reevaluated, at least by some.
Most Americans say they believe vaccines are effective in preventing disease, but vaccination rates in the U.S. (and elsewhere) have fallen in recent years across most age groups. Republicans in particular are more likely to express doubts about the safety of vaccines, and the COVID-19 pandemic caused some people to question CDC recommendations.
“It used to be, you got a handful of vaccines for polio, for diphtheria, for very serious diseases. Now, at every turn, at every visit to the doctor, some vaccine is being pushed on you or your healthy child,” said Alex Berenson, an author and former reporter for The New York Times who now writes Unreported Truths on Substack, where he is a critic of mRNA vaccines.
While some of the new resistance to vaccines has to do with residual anger over COVID-19 mandates, some has to do with fear that vaccines do more harm than good, that they can cause everything from sudden infant death syndrome to autism.
A study released in July found no association between autism and the measles, mumps and rubella vaccine in 2.5 million children, but President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr. have said more research is needed on the vaccines given to children in the first six months of life.
There have been times when vaccines have done devastating harm, as in 1955, when more than 200,000 people were mistakenly injected with a live polio virus; 164 people were paralyzed and 10 died in what became known as the Cutter Incident.
That tragedy, however, led to stricter regulation of vaccines, and trust soon rebounded, aided in part by pictures of Elvis Presley being vaccinated the next year. Within a quarter century, polio was virtually eliminated in the United States — which is part of the reason some people don’t feel the need to get vaccinated today.
“People don’t fear these diseases,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “We eliminated measles from this country by the year 2000, and with that, I think we eliminated the memory of measles. People don’t remember how sick or dead that virus can make you, and I’m talking about young doctors, too, who haven’t seen this.”
But some people are more worried about getting sick or dying from vaccines.
When news was announced last week that the Food and Drug Administration has approved a mRNA vaccine for the flu, there was a flurry of social media posts expressing alarm, with some even suggesting that not only would it be dangerous to get the mRNA vaccine, but it would be unsafe to be around others who had been vaccinated.
Vaccine dissent may be loudest on social media, where it’s not always clear if extreme anti-vaxxers are real people or bots. But it’s also showing up in the Trump administration.
Earlier this year, the federal government reduced the number of recommended childhood vaccinations from 17 to 11. The U.S. Armed Forces ended its flu vaccine mandate in April, making the shots optional. And on Monday, Trump signed an executive order that recommends “separating the measles, mumps and rubella (MMR) vaccine into three different shots administered in separate visits, and directs the nation’s health department to improve vaccine research,” per The Associated Press.
Meanwhile, the number of parents requesting vaccine exemptions for their school-age children has risen in recent years, pushing many states below the 95% vaccination rate that health officials say is optimal for preventing the spread of disease.
And measles has rebounded in the U.S., killing three unvaccinated people (two of them children) in 2025 and hospitalizing 161 people this year, according to the CDC.
It’s either a really good time, or a really bad time, for this to be National Immunization Awareness Month, depending on your stance on vaccines.
But with the approval of the mRNA flu vaccine and the confirmation of Schwartz to head the CDC, are vaccines going to be great again? Don’t count on it, some analysts say. Here’s why.
What Robert F. Kennedy Jr. said
Last week, Health and Human Services Secretary Robert F. Kennedy Jr. engaged in a contentious conversation with CNN’s Dana Bash, in which Bash called Kennedy “the most famous vaccine skeptic on the planet.”
Some might say that title should go to Andrew Wakefield, the British author of a 1998 study published in The Lancet that suggested a link between the measles, mumps and rubella vaccine and autism.
While that study was later retracted and Wakefield lost his medical license, it sowed seeds of doubt that still provide oxygen to today’s anti-vaccination movement, which Dr. Tyler Evans, an infectious disease specialist, calls “a very formidable challenge” for public health.
“In this era of social media, and with a lack of conventional news sources, people are getting their information from people without a clear understanding of what they’re talking about. It’s really unprecedented,” said Evans, who was the chief medical officer for New York City’s COVID-19 response and is the author of “Pandemics, Poverty, and Politics.”
But even when looking to conventional news sources, viewers can walk away feeling even more confused about who to believe. Witness a widely circulated clip in which Kennedy and Bash sparred on “State of the Union,” with Bash suggesting that Kennedy was doing harm to people by causing them to be hesitant about vaccines, while Kennedy said that Bash was parroting talking points of other people rather than trying to get at the truth.
The 20-minute exchange laid bare the nationwide divide about who can be trusted, with Bash citing unspecified medical experts and studies, and Kennedy holding up Dr. Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases, as an example of why people shouldn’t trust everything that medical experts say.
Bash did, however, get Kennedy to say that people should get their children their MMR vaccine. “The measles vaccination is effective,” he said.
Offit described that admission as akin to a “hostage video,” saying, “We’ve had the biggest outbreak of measles last year in the past 30-plus years, we’ve had 3 people die of measles, we’ve had the first child die of measles since 2003, and we’re happy that the secretary of Health and Human Services said get a measles vaccine? I mean, the bar has sunk pretty low here.”
In his conversation with Bash, Kennedy pushed back on the idea that measles cases are rising because of Americans’ negligence. It’s an international outbreak, he pointed out, noting that other countries have higher rates of measles than the U.S. currently has.
Kennedy also told Bash that COVID-19 lockdowns contributed to children not being vaccinated.
Others have said that unvaccinated immigrants are contributing to the spread of measles, which is highly contagious and spreads through the air. Earlier this year, there was a measles outbreak at an Immigration and Customs Enforcement facility in El Paso, Texas, Scientific American reported.
With regard to Kennedy’s assertion that pandemic policies led to the current measles outbreak, Evans agreed that there was an effect on childhood immunizations worldwide because of the pandemic. Nearly 40 million children missed a measles dose in 2021, he said.
But after the lockdowns ended, vaccination rates did not rebound to where they were before the pandemic. “This is not a backlog. This is a change in behavior,” he said.
How Americans feel about vaccines
In research released in December, Pew Research reported that 63% of Americans are “highly confident” that childhood vaccines are effective in preventing illness. Fewer, however, expressed confidence that the childhood schedule of vaccines is safe, and that vaccines have been adequately tested.
The most skeptical of respondents were Republicans: 48% said that vaccines were effective at preventing illness, compared to 80% of Democrats. And just 32% of Republicans expressed high confidence in the safety of the childhood vaccine schedule, compared to 71% of Democrats.
The numbers likely reflect some Republicans’ exposure to Kennedy’s views through podcasters Megyn Kelly, Tucker Carlson, Theo Von and others. Those on social media may also be influenced by posts that point out the changes in the vaccine recommendations over the years. While some consider that progress, others call it a red flag.
Speaking to a Senate committee during her confirmation process, Schwartz signaled that she supports vaccination but also takes seriously the concerns that some people have about them.
“I don’t want to be the CDC director just for Americans that believe in vaccines. I want to be the CDC director for people that have concerns about vaccines,” she said.
Evans, now CEO of the Wellness Equity Alliance, said it’s too soon to tell if the selection of Schwartz marks a change in the administration’s direction with regard to health policy. But given the rise in measles, the Cyclospora outbreaks and new cases of Legionnaires’ disease, he said the administration is probably “looking for some wins” when it comes to health.
“The reality is, it’s hard to find public health professionals or leaders who don’t believe in vaccinations. It’s a relatively small list. They were bound to run out of candidates,” he added.
How mRNA complicates the vaccine debate
On the heels of the Kennedy interview and the Schwartz confirmation came another headline that roiled the vaccination debate: the FDA’s approval of the first mRNA flu shot for adults 50 and older.
Messenger RNA vaccines introduce a molecule into the body that directs it to produce a fragment of a virus, allowing it to launch an immune response without the introduction of bacteria or a virus, live or dead, as in traditional vaccines. Several of the COVID-19 vaccines employed this technology, and two scientists won a Nobel Prize in 2023 for their work in the field.
But there are known risks. As Bruce Goldman, writing for Stanford Medicine, reported, “One rare but real risk of the mRNA-based COVID-19 vaccines is myocarditis, or inflammation of heart tissue. Symptoms — chest pain, shortness of breath, fever and palpitations — appear in the absence of any viral infection. And they happen quickly: within one to three days after a shot.”
Berenson wrote on SubStack that Moderna’s trial of its flu shot shows that “severe side effects from the mRNA shot dwarfed whatever protection against flu it may offer.”
“Compared to a standard flu shot, the mRNA jab prevented about 1 hospitalization in every 5,000 people who received it. But compared to the standard shot, the mRNA jab caused severe after-injection side effects such as vomiting or a 102- to 104-degree fever in an extra 1 out of 18 people.”
“In other words, Moderna’s own data show that about 270 people will suffer severe vaccine side effects from its shot to stop a single flu hospitalization. In what world does that risk ratio make sense?” Berenson wrote.
In an interview, Berenson questioned why anyone would choose the mRNA vaccine over a traditional one that has been long tried and tested. “I think it’s a bad day for the FDA, I think this is regulatory capture, and I wish they hadn’t approved it. I think there was this idea that RFK Jr. was going to make changes at the FDA and unfortunately he has not been able to do that.”
Offit, however, called the mRNA flu vaccine an “advance” and said it is 25% more effective than traditional flu vaccines.
“Presumably, the CDC will recommend it, but you never know. You never know in this administration what’s going to happen,” Offit said.
Last fall, Health and Human Services cut $500 million in funding for research on mRNA vaccines, The Associated Press reported.
Flu vaccination rates, meanwhile, have fallen in recent years, for both adults and children, despite the CDC’s recommendation that everyone over the age of 6 months get one.
The agency reported that in the 2024-2025 flu season, about half of children 6 months to age 17 got a flu vaccine, a decline of 5.3 percentage points over the previous year and a decline of 13.5 percentage points from 2019. It was the lowest vaccination rate in 15 flu seasons.
Among adults, just under 42% got a flu vaccine, down by 3 percentage points from the previous year, and the lowest rate since the 2017-2018 flu season, the CDC said.
How to rebuild trust
Evans, whose organization works to improve health care among people with limited access, said that in the first two years of the pandemic, “the two groups with the highest COVID-19 vaccine hesitancy in this country were Black Americans and registered Republicans. Those communities share very little except a well-earned distrust of institutions that did not serve them.”
For Americans to regain trust in matters of health, we need competent leaders who are able to communicate with people through “trusted messengers,” which include faith organizations, Evans said. During the pandemic, for example, many people received COVID vaccines through mobile units that went to churches.
But Offit, at the Children’s Hospital of Philadelphia, said it may take more than education.
“In a rational world, the world in which we don’t currently live, you could try and educate people hard about how important these vaccines are and about how dangerous these diseases are. And as a component of that, it has to be emotional.”
He described being at a conference where a mother described what it was like to watch her unvaccinated child die of the flu at the age of 4.
“No one in that room wasn’t crying,” he said. “I think that’s what we need to do. We need to feel this more. Instead of saying there were 2,300 cases this year and X number died, we need to feel it.
“And the second thing is,” he added, “we have to see these diseases come back at some level. We have to be scared of them again.”
Berenson, however, believes it all comes down to common sense. He believes COVID vaccines did not work “as promised” and should never have been given to children.
“There was a deep suspicion about COVID vaccines, and I think also about mRNA. People aren’t super sophisticated about this stuff, but there were suspicions.”
But despite what Berenson believes are Americans’ reasonable questions and doubts, people have not turned away en masse from the childhood vaccine schedule, even if rates have fallen below the 95% rate that the government says is necessary.
Vaccines like MMR and polio have been around for decades and have good track records, he said, adding that his own three children have the standard recommended schedule, which is what he tells other parents to get. (He skips the flu and COVID shots.)
“You can do a little work if you want, and look at the Danish vaccine schedule. But these vaccines exist for a reason, and the older ones are pretty low risk. I know it’s confusing, I know the noise is loud. But I think people have been pretty sensible, and I think we see it in the numbers,” he said.
“Your kids are going to be OK. Get them outside, get them off screens. But get them the polio shot, too.”
Per KFF, the current childhood schedule of 11 vaccines recommended by the CDC after changes earlier this year are: MMR; whooping cough, tetanus, and diphtheria; a bacterial disease known as Hib; pneumonia; polio; chickenpox; and human papillomavirus, or HPV.