There is something profoundly sad about the moment we find ourselves in.
For much of the past century, parents in America were given an extraordinary gift: the expectation that their children would grow up, grow old and very likely outlive them.
The near-conquest of childhood mortality
In “A Good Time to Be Born,” pediatrician and author Perri Klass describes the remarkable transformation that made this expectation possible. Not long ago, childhood was shadowed by the possibility of death from diseases that we now rarely think about: cholera, measles, diphtheria, meningitis, diarrhea and pneumonia. Clean water, sanitation, antibiotics, vaccines and other advances in public health changed that world. The near-conquest of childhood mortality, Klass argues, may be one of humanity’s greatest achievements.
We sometimes forget just how extraordinary that achievement was.
Our parents and grandparents did not defeat childhood disease through wishful thinking. They did it by learning. They observed, tested, argued, measured and tested again. They built institutions whose purpose was to accumulate knowledge and apply it for the benefit of everyone. And when science discovered that something could make children safer, we generally celebrated the discovery.
Vaccines are perhaps the clearest example. Diseases that once filled children’s hospitals and cemeteries became rare. Parents stopped routinely worrying about whether their child would survive measles, polio, meningitis or whooping cough.
That should be a story of triumph.
Instead, we are watching an erosion of confidence in the very system that produced those triumphs.
The rise of distrust in vaccines
There have always been people who distrusted doctors, government or vaccines. There have always been friends, neighbors and relatives with strongly held opinions that were unsupported by good evidence. That is nothing new.
What is new is the megaphone.
Social media can place an uninformed opinion beside the considered conclusions of thousands of scientists and make the two appear to have equal weight. Algorithms learn what frightens us, angers us or confirms what we already believe, and then feed us more of it. We increasingly choose our news from boutique sources designed for people who already share our assumptions.
The result is not simply disagreement. It is the disappearance of a shared information environment.
There was a time when a parent could reasonably turn to a pediatrician, a public health department, a medical journal or a major newspaper and assume that someone had done the difficult work of sorting evidence from anecdote. Those sources were not infallible. Science is never infallible; the essence of science is continual reexamination of what has been accepted as fact. Experts sometimes make mistakes, institutions sometimes fail and recommendations should change when evidence changes.
But there was a shared understanding that evidence mattered.
That understanding is now under extraordinary pressure.
The federal government’s recent actions surrounding childhood immunization are particularly painful because they come from institutions that were created to protect the public’s health. The Centers for Disease Control and Prevention has historically relied on scientific review and expert committees to develop recommendations intended to protect children from vaccine-preventable diseases.
Yet, we are now witnessing federal intervention in the childhood immunization system that has left many physicians and parents questioning whether scientific expertise will continue to be the primary basis for those recommendations.
The difference between questioning science and abandoning expertise
This is not an argument that vaccines should never be questioned.
They should be questioned. Every medical intervention should be. Scientists should continue to study vaccine effectiveness and safety. Physicians should listen carefully when parents have concerns. And recommendations should change when good evidence tells us they should change.
That is precisely what science is supposed to do.
But there is an enormous difference between questioning science and abandoning expertise.
And there is another loss that deserves our attention.
Public health has always depended upon a bargain between the individual and the community. We vaccinate our children partly to protect them, but also to protect the newborn too young to be fully vaccinated, the child receiving chemotherapy, the pregnant woman, the elderly neighbor and the person whose immune system cannot respond normally to infection.
We used to understand that these responsibilities were not in conflict.
Protecting my child and protecting your child were part of the same moral obligation.
That sense of common purpose seems increasingly fragile.
We shouldn’t throw away the valuable things we inherited
Perhaps that is why the current moment feels less like a political dispute than a tragedy. We inherited a world made dramatically safer by people who believed that knowledge could improve human lives. We inherited clean water, antibiotics, vaccines, safer cars, safer workplaces and public-health systems built through generations of accumulated experience.
We inherited something less tangible but equally important: trust in the idea that we could learn enough to make tomorrow safer than today.
We should not surrender that inheritance so easily.
Our children deserve better than a world in which the loudest voice is mistaken for the most knowledgeable one, in which fear is amplified because it generates clicks, or in which expertise is dismissed simply because it is inconvenient.
They deserve the benefits of everything previous generations learned.
And perhaps, most of all, they deserve what earlier generations of parents finally came to expect: not merely that their children will survive childhood, but that we will do everything reasonably within our power to give them a longer, safer and healthier life than our own.
That was one of the great achievements of modern society.
It would be heartbreaking to forget how we got here.