2 weeks Ago
Last month, for the first time in two decades, a 6-year-old child in the U.S. .
Just a few weeks later, a . Both were unvaccinated, making them part of a worrying trend that public health experts have seen increase since the COVID-19 pandemic. The pandemic upended life in one way or another for just about everyone in the U.
S. and across the globe. Five years later, experts worry that vaccine misinformation and barriers to health care that emerged during the pandemic have weakened trust in one of our most valuable public health tools — vaccines — with devastating consequences we're only just beginning to see.
“This is a tragic and devastating loss,” Dr. Sue Kressly, pediatrician and president of the American Academy of Pediatrics, tells TODAY.com.
“Even one death from a preventable disease is one too many.” Not only are we witnessing the resurgence of previously eliminated diseases, like measles, but the country may also be much less equipped to handle whatever the next inevitable pandemic threat may be, the experts tell TODAY.com.
So far this year, the U.S. has seen more measles cases than any entire year since 2019.
through poultry and cattle, and is in charge of the Department of Health and Human Services. While the vast majority of students still receive their state-required vaccines on time, recent research from the Centers for Disease Control and Prevention shows a growing minority is missing out on those potentially life-saving immunizations. Now is the time to focus on “how we can strengthen vaccine confidence and remove barriers to getting vaccines to every child in every community so they can benefit from the vaccine success story,” Kressly says.
"Vaccines really are an American success story," Kressly says. The vast majority of people in this country support vaccines, Kressly emphasizes, and the majority of children receive their recommended vaccines on schedule. But there have been notable declines in the number of children who are fully vaccinated, especially since the pandemic began.
For instance, recent shows that children born in 2020 and 2021 are less likely to have received all recommended vaccines than those born in 2018 and 2019. Other confirms that the rate of vaccine exemptions among kindergarteners has . During the 2023 to 2024 school year, vaccination coverage of kids in this age group was only 93%, compared to 95% during the 2019 to 2020 school year.
Vaccine exemptions, which allow kids to attend school without all their state-required immunizations, can be medical, when a health condition prevents a child from receiving a vaccine, or non-medical, sometimes called “philosophical” or “religious” exemptions. While all states allow exemptions for medical reasons, not all parts of the country allow for non-medical exemptions. And even among states that that allow non-medical exemptions, exact policies vary.
The CDC research also found that 3.3% of kindergarteners received an exemption for at least one state-required vaccination, the highest percentage ever reported, the authors state. And more than 7% of kindergarteners did not have documentation that they received two doses of the measles, mumps and rubella (MMR) vaccine, possibly putting them at risk for measles.
And the number of states with a greater than 5% exemption rate for the MMR vaccine has been steadily increasing. That matters because is 95% vaccinated in order to maintain elimination of measles. Just two states were below 95% in 2020, then 10 in 2022 and up to 14 in 2023.
That presents a risk — potentially a life-threatening one — for the kids who aren't vaccinated, of course, Kressly says. But it's also a threat to people in the community who simply can't get vaccinated. For instance, cancer patients often cannot get vaccinated, and their treatment may reduce the immune system's ability to protect them from pathogens.
People who've had organ transplants are similarly at risk, Kressly explains. "While they're dealing with horrible illnesses and fighting for their lives, they're depending on their neighbors to get vaccines so they can benefit from the community," she says. "They aren't necessarily visible to us, but they are among us and are our friends and our neighbors and our community members," Kressly continues.
"If we all work together as a community to strengthen our , then everybody wins." Multiple things contributed — and are still contributing — to mistrust in vaccines and a decline in vaccination rates, experts say. “What the COVID pandemic did was expose and widen existing cracks in multiple systems in society,” Dr.
Megan Ranney, emergency medicine physician and dean of the Yale School of Public Health, tells TODAY.com. First, in the early days of the pandemic, there were the basic logistical challenges of getting to the doctor in person.
Many people delayed , and others . While those challenges affected just about everyone, COVID-19 had a disproportionately large effect on some groups of people, such as , as well as those who are and . “Families struggled to have access to many needed services during the pandemic,” Kressly says.
“And it didn’t just go back to what the baseline was before then. There are lingering logistical and access issues," such as a of primary care providers and . Ultimately, those challenges have led to a widening of pre-existing disparities in access to crucial care, including vaccines.
Another piece of the puzzle is the proliferation of vaccine that fuels vaccine hesitancy, Kressly says. "Families are having a hard time sorting out what is the most trusted source and what is the best information as they want to make the best decision for their child," she explains. Before COVID, people would opt not to get vaccinated due to faulty risk perceptions, Rupali Limaye, Ph.
D., associate professor at George Mason University and an expert in vaccine behavior and decision-making, tells TODAY.com.
They might say, "I'm not susceptible to this because I've never heard of it," or, "Even if I get measles, it's not that bad," Limaye explains. There were also persistent falsehoods about vaccine ingredients or a between vaccines and autism that convinced some people to skip the shots. "Since COVID, we still have those reasons (people report for not getting vaccinated), but now we have added more reasons, unfortunately," Limaye says.
"And one of the main reasons has really been misinformation." Today, the spread of vaccine misinformation is part of a larger science denialism movement in the country, she explains, which has led to a loss of trust in public health and medical establishments. Vaccines "got swept up" in the larger anti-mask and anti-lockdown movements until they, too, were seen by some as "just another way for the government to tell you to do something," Limaye says.
"So now (vaccination) becomes a symbol of oppression. It becomes a symbol of 'attacking my liberty.'" Misinformation, combined with a climate of extreme political polarization, lack of access to primary care doctors and declining trust in health care professionals created a "perfect storm" for vaccine hesitancy, Limaye says.
"All of these together is really leading to people that have more concerns about vaccines than we've ever seen in the past." That lack of trust “leaves people prey to unscrupulous actors who then come in and promote snake oil at best, harmful solutions at worst, that then make the health of individuals and communities worse,” Ranney says. In their , the parents of the 6-year-old Texas child who died due to measles told fellow parents not to get the MMR vaccine, NBC News reported this week.
Instead, they credited unproven alternative remedies, like cod liver oil, for the recovery of their other children. (The family did not respond to NBC News' request for comment.) On the ground, the situation is frustrating for experts because they have to spend time combatting misinformation about long-established scientific facts, rather than talking about proactive health advice.
It's also a missed opportunity for parents and patients. “If I, as a physician, am having to spend 20 minutes talking about a vaccine that millions upon millions of people have gotten and that we know is safe and that we know protects you from potentially deadly diseases, that’s 20 minutes that I don’t get to spend with you talking about good nutrition or your mental well being," Ranney says. While there are important debates and discussions to be had in medicine, “whether the measles vaccine is safe and whether it works is not one of those things,” Ranney adds.
"I really worry that we are currently seeing an outbreak of measles, which is 100% preventable," Limaye says. And in terms of another pandemic, "it's not if, it's ," she says. One of the effects of climate change is that we will be interacting more with animals as we encroach on their habitats, which makes it easier for a spillover event to occur, she explains.
The are another “good reminder that there are infections out there in animal populations that infect humans,” Dr. David Heymann, infectious disease epidemiologist and former assistant director-general for health security at the World Health Organization, told TODAY.com previously.
“We just have to be aware that there’s a whole animal kingdom out there with organisms that can come into humans.” Limaye says bird flu is on her mind right now, and other experts concerns that bird flu could begin to transmit between humans more readily. “It might take years, or it could take weeks.
And it only has to happen once for it to become a much more widespread problem,” Dr. Stuart Ray, professor of medicine and oncology at Johns Hopkins University School of Medicine, told TODAY.com in February.
This type of major change in the way a virus spreads is often a “precedent for a pandemic,” Ray said. Whether the next public health challenge is bird flu or something else entirely, “we’re going to continue to see pathogens emerge," Limaye says. "We are going to be dealing with more pandemics, and we are just woefully and inadequately prepared for them,” Limaye says.
And the changes we’re seeing now — like the , and to choose the strains to be targeted in next year's flu shot without explanation — are only "going to further destroy and fracture trust" in those institutions, Ranney says. After a , some CDC pages were restored. in a closed-door meeting without input from the FDA's vaccine advisory committee.
The CDC vaccine advisory committee meeting, which was scheduled for late February and "postponed to accommodate public comment," according to an HHS spokesperson, is rescheduled for mid-April, reported. Even when basic public health measures become politicized, patients still tend to trust their individual doctors — especially if there is already an underlying relationship there, Kressly says. "We have the most impact when we have a trusted relationship," she adds.
Vaccine requirements for school attendance have helped increase coverage, too, she says, which is especially beneficial in protecting the kids who can't get vaccinated for medical reasons. Outside of the pediatrician's office, Limaye stresses the importance of seeking out evidence-based information when making health decisions, which is challenging when on social media. There's a sort of "contagion effect" to misinformation, Ranney explains.
"If your best friend or your cousin starts to question some health recommendations, you trust (those people), so then you start to question them, too," she says. When that happens, there are specific techniques you can use to help in your conversations with friends and family, Limaye told TODAY.com previously.
Highlighting the stories of people who have been impacted by is crucial, too, she says, "so people understand this isn't just a statistic. This is a person. This is a family.
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