Vaccines against childhood diseases are safe and effective. So why are fewer kids getting shots?

How has vaccine use changed? 
Before the Covid pandemic, the U.S. was a world leader in vaccination, with 95 percent of the population covered. Since 2020, though, uptake for all of the 15 federally recommended childhood vaccines has slumped by at least 2 percentage points, representing more than 70,000 children. In 10 states, exemptions from the vaccines required for public school enrollment now exceed 5 percent, the threshold for herd immunity against childhood diseases. And that means more kids are now getting sick. Cases of chickenpox, whooping cough, and pneumococcal disease are all up, and measles—which had been entirely eliminated in the U.S. in 2000—has come roaring back. More than a dozen measles outbreaks sickened hundreds of kids this year, concentrated in Minnesota, Illinois, Oregon, and Florida. “If you asked me 40 years ago would I ever have to be defending vaccines like I do now, I’d say you’re crazy,” said pediatrician Peter Hotez of Baylor College of Medicine. “Everybody knows the life-saving impact of vaccination.” 

Why the drop in confidence? 
It’s partly a result of families’ concerns over Covid shots spreading to other vaccines. But the anti-vax movement started decades before the pandemic. In 1998, a little-known English gastroenterologist, Andrew Wakefield, published a study in The Lancet that linked the childhood measles, mumps, and rubella (MMR) vaccine with autism. Britain, which had recently mandated the MMR vaccine, was seeing a rapid rise in autism rates, with symptoms first appearing in toddlerhood—the age of vaccination. Concluding that the shot was responsible, Wakefield went on a media blitz in the U.K. and U.S., including an influential appearance on CBS’s 60 Minutes. A few years later, Wakefield’s research was thoroughly debunked: He’d studied just 12 kids, some of whom had developmental delays before they got the vaccine, and his work was funded by the very people who were suing vaccine companies. He was stripped of his medical license, but the damage had been done. Vaccine skepticism surged, and measles returned to Europe. 

Are vaccines actually risky? 
No. Over the past 30 years in America, vaccines have saved the lives of more than 1 million children and a lot of money: at least $540 billion in health-care costs and trillions more in social costs. They don’t cause autism: Scientists now believe that neurodivergence is 80 percent inherited, although factors such as advanced maternal age can also play a role. And adverse side effects (beyond a sore shoulder) are vanishingly rare. Fewer than one-thousandth of 1 percent of people who get the Pfizer or Moderna Covid vaccine, for example, go on to develop the potentially fatal heart condition myocarditis; Covid itself is seven times more likely to cause it. Still, some people say they have been harmed by vaccines. Just minutes after getting her Covid shot in 2021, neuroscientist Michelle Zimmerman felt pain rush up her left side; she was later diagnosed with brain damage and can no longer work. She believes she got one of 60 million contaminated doses of the since-recalled Johnson & Johnson vaccine. “The devastation of what this has done to my life,” said Zimmerman, “feels too hard to comprehend.” 

How did Covid spur anti-vaxxers? 
Anti-vaccine groups seized upon rare cases like Zimmerman’s, as well as anger over Covid vaccine mandates, to undermine confidence in all vaccines. Robert F. Kennedy Jr.’s anti-vaccine nonprofit, Children’s Health Defense, more than quadrupled its donation intake between 2020 and 2021 to over $15 million. Another group, Informed Consent Action Network, doubled its staff. Misinformation from foreign actors online also fueled vaccine opposition. And pre-existing anti-vax communities found new recruits on Facebook and TikTok, targeting parents concerned about their kids missing school as well as people angry over mask mandates. “Covid vaccines have been the foot in the door for the more general anti-vaccine movement,” said Dave Gorski, an oncologist at Wayne State University. “And unfortunately, that door is open pretty wide now.” 

How did the issue become partisan? 
The Republican Party embraced vaccine skepticism following the lead of Donald Trump, who repeated discredited claims on vaccines and autism during his first presidential campaign. “That took this fringe issue and made it a political issue associated with the parties,” said David Broniatowski, an expert in online misinformation. In Republican-led states, hundreds of vaccine-related bills have been introduced since 2020. While only a few of them passed, the ones that did expanded vaccine exemptions for workers, students, and even visitors to hospitals and nursing homes. Support among Republicans for requiring children to receive the MMR shot to attend public school dropped from 79 percent in 2019 to 57 percent last year, while the share of Republicans who believe parents should be allowed to not vaccinate their kids more than doubled to 42 percent. 

What will Trump do in office? 
The president-elect has pledged to “Make America Healthy Again” by putting Kennedy, who claims vaccines have “caused more deaths than they’ve averted,” in charge of Health and Human Services. There he would have the power to staff the CDC’s vaccine committee with anti-vaxxers or even dissolve it altogether. He could also pressure the CDC to stop recommending certain vaccines, which would eliminate insurance coverage for those shots. “What could change is potentially the cost of vaccines, the access to vaccines,” said former White House health adviser Tom Inglesby, “and also confusion around public messaging about safety.” On the news of Kennedy’s nomination, vaccine company stocks took a nosedive. If Kennedy does what he’s said he will, said Lawrence Gostin, a professor of public health law at Georgetown University, “he’ll make America sick again.”

How Russia fuels misinformation 
During the pandemic, Russia launched an online campaign to stoke vaccine anxiety in the U.S. Russian nationals hiding behind fake identities peppered far-right message boards and sites with anti-vaccine content. One cartoon they posted on the pro-Trump site Patriots.win, for example, showed cops in Biden-Harris gear battering down a door with a giant syringe. On Twitter, they questioned the safety of American mRNA vaccines—partly in an effort to squash competition for Russia’s own Sputnik V vaccine. And Russian bots on Facebook spread the conspiracy theory that the Covid vaccine would implant a microchip into your arm so the government could track you. Russia has had “tremendous success with social media platforms,” said Mitchell Orenstein of the Foreign Policy Research Institute. “They do shift people’s perception.”

The MAGA movement’s “hot-test new drink” is brimming with potential pathogens, Matt Stieb in New York magazine. Once “a cultural totem of the flower child,” raw unpasteurized milk has moved rightward into “the agenda of the next Republican administration.” Robert F. Kennedy Jr., President-­elect Donald Trump’s choice to head the Department of Health and Human Services, is an avid consumer of the white stuff and has vowed to end its “aggressive suppression” by the government, most likely by repealing the FDA’s ban on interstate sales. Raw milk fans claim the beverage boosts the immune system and that its health benefits are lost during pasteurization, when heat is used to kill dangerous bacteria and viruses. Those claims aren’t supported by any scientific evidence, but Americans are still lapping up raw milk, with sales climbing 65 percent in a year. Sales even kept rising after California officials announced they’d found bird flu virus in milk from major Fresno-based producer Raw Farm, whose boss says he’s been asked by Kennedy to serve as an FDA adviser on “raw-milk standards.” 

So far, there are no reports of people “becoming infected with bird flu after drinking tainted raw milk,” said Yasmin Tayag in The Atlantic. But raw-milk drinkers have become critically ill and died from other pathogens, including E. coli, campylobacter, and salmonella. “From 1998 to 2018, 202 foodborne-illness outbreaks were linked to raw milk; only nine were linked to pasteurized milk.” That’s why many states restrict its sale and the FDA bans shipping across state lines. Yet to anti-­establishment types such as Kennedy and podcaster Joe Rogan, raw milk’s semi-­outlaw status only enhances its “edgy appeal.” But raw milk isn’t “uniquely dangerous,” said C. Jarrett Dieterle in Reason. Raw oysters kill about 100 people each year, yet they remain a “completely legal and freely available food.” Why should regulators pick this particular fight instead of letting adults make their own choices? 

Because raw-milk drinkers are not simply risking their own health, said Alex Tey in Slate. The current H5N1 bird flu strain has infected at least 695 dairy cow herds across the U.S. and 57 people, but doesn’t seem “to have the ability to pass between humans—yet.” Influenza strains can mix and swap material to become more infectious, and maybe a raw-milk drinker with seasonal flu in their system “will gulp down some bird flu.” A new more transmissible strain of H5N1 could emerge and potentially “spark the next pandemic.” With each sip, raw-milk drinkers are “taking that chance on everyone’s behalf.”

Jesse Eisenberg recognizes the great irony of his childhood, said Olivia Ovenden in GQ: His mother was a birthday-party clown and yet he was a profoundly unhappy, anxious kid. The actor missed a year of school because he was institutionalized with mental health issues. He couldn’t understand why other children didn’t share his worries. “It was mystifying to me why we weren’t all crying all day long because it seemed like the world is so sad and scary,” says Eisenberg, 41. 
He’d watch his happy-go-lucky peers and think, “How are they existing? Don’t they know school is tomorrow as well?” 

At a young age, he embraced humor as a self-defense mechanism—“Nobody laughs at the funny guy”—and has since used comedy in the characters he plays, and in New Yorker humor pieces and a short-story collection. He figured everyone else also used jokes to hide their inner turmoil, until he met Ricky Gervais. “Are you depressed?” Eisenberg recalls asking the British comedian. “Is it that you hate yourself? And he goes, ‘It’s none of those things. I really love making jokes.’ It’s the first I ever heard that.” He’s still not sure Gervais was telling the truth, Eisenberg says, because his comedy is “really tinged with a lot of sadness. So I don’t exactly believe him.”