The collapse reflects widespread and mounting distrust of public health authorities, and the reason for that distrust is no mystery.
During the COVID-19 pandemic, officials from President Biden and Anthony Fauci down to state health departments and local mayors issued a string of heavy-handed mandates, decrees, and lockdown orders that were inconsistent and at times contradictory. Closing beaches? Mandating masks outdoors? Encouraging employers to fire workers for non-compliance? It was all too much.
COVID fatigue and burnout left the public uncertain, confused, and angry. The mistrust extended to the point at which tens of millions of Americans were suddenly willing to hear out those pushing doubts about all kinds of routine vaccinations. People began to speculate that public health authorities were overselling the benefits and downplaying the risks of childhood immunizations writ large.
That’s a shame, because those vaccines really are safe and effective. They’ve saved millions of lives and trillions of dollars.
Decades of evidence show that childhood vaccination programs are safe and effective. Before public distribution, vaccines undergo a rigorous three-stage clinical trial process: initial safety tests with 20 to 100 volunteers, expanded immune response evaluations with hundreds of participants, and final safety and effectiveness trials involving thousands of volunteers. After approval, an extensive surveillance network — including the Vaccine Safety Datalink and Clinical Immunization Safety Assessment Project — continues monitoring data from over 190 million people.
This process has stood the test of time. Consider the MMR (measles, mumps, rubella) vaccine. It has been safely administered for over 50 years, with countless studies confirming its benefits. The polio vaccine tells an equally compelling story: It prevents paralysis in more than 99% of cases, and widespread vaccination has resulted in “herd immunity” that effectively eliminated the virus from the United States.
Yet despite these safeguards and documented positive outcomes, some vaccine skeptics now demand measures that could unravel decades of progress. For instance, they misleadingly claim that unlike other drugs, vaccines don’t undergo traditional placebo-controlled trials.
In reality, new vaccines are tested in the same way that advanced new treatments for cancer and other dangerous diseases are. They’re compared against a “control” group of volunteers who’ve received the existing standard of care, rather than a placebo “sugar pill.”
It’d be deeply unethical to give half the patients in a clinical trial for a cancer treatment a placebo injection containing no actual medicine — thus potentially condemning them to serious illness or even death. The proper trial question is how a new treatment matches up against existing treatments.
The same is true for new vaccines. In testing a new vaccine for polio, we can’t let half the participants go unvaccinated, thus exposing them for life to the ravages of the disease. We have to determine whether the candidate vaccine works better than what’s currently available.
Already, we’re seeing the consequences of rising vaccine skepticism: measles outbreaks in previously well-protected communities, and the return of diseases we had nearly eliminated.
We need to protect against new threats as well. As a physician, I have a front row seat to our fight against an ever-growing number of diseases. We’ve had great success developing vaccines to protect against these evolving threats — but we can’t let public distrust undermine these efforts.
The path forward requires rebuilding trust through honest dialogue. We must acknowledge that the handling of the COVID-19 public health emergency damaged public confidence — while also defending the scientific and ethical foundations of routine vaccination.
Dr. Wolfgang Klietmann is a former clinical pathologist and medical microbiologist at Harvard Medical School. This article originally ran in the Washington Examiner.