Opinion | Pro-Vaccine Views Are Winning. Don’t Fear the Skeptics.

With Robert F. Kennedy Jr.’s bid for the Democratic presidential nomination, vaccine skepticism has been back in the headlines. Though Kennedy has said he isn’t anti-vaccine and that his children have had vaccines, and his campaign manager (the former Democratic congressman and presidential candidate Dennis Kucinich) says calling Kennedy “anti-vax” is a “left-handed smear,” Kennedy continues to suggest a link between vaccines and autism — a link that has leaned heavily on flawed and retracted science. He’s also been a vocal opponent of Covid vaccines.

When a flurry of April polls indicated that Kennedy would enjoy double-digit support in a Democratic primary, I wondered if the respondents knew about his views on vaccines and agreed with them, if they were intrigued about the possibility of a contested primary or if they just had warm feelings about the Kennedy name. I worried that Covid vaccine skepticism had potentially sullied Americans’ feelings about all vaccines: If a meaningful slice of the Democratic electorate was either vaccine hesitant or indifferent to vaccine skepticism, I’d be concerned about dangerous diseases like polio, diphtheria, measles and mumps making a comeback.

I was relieved, then, to see a survey from Pew Research in May that found that in 2023, 88 percent of American adults believe that the benefits of the M.M.R. (measles, mumps, rubella) vaccine outweigh the risk — the same percentage that Pew found in 2016 and 2019. Per Pew, there’s been some softening in vaccine trust, particularly among Republicans and white evangelical Christians (who lean Republican), and this jibes with Republicans’ negative views of the Centers for Disease Control and Prevention and several other government agencies. But overall, the picture isn’t dire.

When you look at rates of vaccination among young children for potentially dangerous infectious diseases, the data is encouraging. According to a study published in January in the C.D.C.’s Morbidity and Mortality Weekly Report:

Vaccination coverage among young children has remained high and stable for most vaccines, although disparities persist. The National Immunization Survey-Child identified no decline overall in routine vaccination coverage associated with the Covid-19 pandemic among children born during 2018-2019, although declines were observed among children living below the federal poverty level and in rural areas.

Per the C.D.C., for children born in 2018 and 2019, coverage was over 90 percent for the polio, M.M.R., hepatitis B and varicella (chickenpox) vaccines. A major barrier to receiving vaccines seems to be access to health care — according to the C.D.C., “The proportion of children who were unvaccinated by age 24 months was eight times higher for uninsured compared with privately insured children.”

Even for children who missed routine visits and vaccine doses in the darkest days of 2020, the C.D.C. “did not identify any consistent or persistent decline in vaccination coverage associated with the Covid-19 pandemic.” When there were “transient declines” in coverage of some vaccines, children appeared to catch up with their doses at later dates.

Acceptance of Covid vaccines is also one the rise in the United States. In a survey of Covid vaccine acceptance in 23 countries in 2022, published in January in the journal Nature, researchers found that 80.2 percent of Americans accepted the Covid vaccine, higher than the global average of 79.1 percent. (Vaccine acceptance was defined as “having received at least one dose of a Covid-19 vaccine and, if not, willingness to take the Covid-19 vaccine when it is available to them.”)

Still, parents in the United States are more hesitant about getting the vaccines for their kids than for themselves. Though 33.1 percent of American parents were hesitant about the vaccine in 2022, that was a nearly 12.9 percent decrease in hesitancy from 2021 — with time, more parents are able to trust that the vaccines’ benefits matter. (Hesitancy for children among parents was defined as “having reported ‘no’ to the question of whether children received at least one dose of a Covid-19 vaccine and also ‘unsure/no opinion’, ‘somewhat disagree’ or ‘strongly disagree’ to the question of whether children will take a Covid-19 vaccine when available to them.”

That it was going to take time for parents to get comfortable with Covid vaccines for their kids was predictable. As Dr. Aaron Carroll, a pediatrician and the chief health officer at Indiana University, wrote for The Atlantic in 2021: “Parents tend to be skeptical of new vaccines. Whenever one is introduced, many of them are initially hesitant to adopt it.” He went on to explain that though the highly effective varicella vaccine was approved in 1995, “uptake levels were initially low, with only 34 percent of eligible adolescents fully immunized by 2008,” despite recipients showing few side effects. But now, as noted above, the vaccination rate for varicella is over 90 percent.

Two years ago, when I talked to parents who were skeptical about Covid vaccines for their children, they weren’t broadly anti-vaccine. They were worried about the newness of the vaccines, about allergies and about side effects. As one mom put it, “I’m not anti-vax but this all seems just too fast for me. I don’t want my children to be responding to those lawyer ads you see on TV 25 years from now. You know the ones: ‘If you were under the age of 16 in the years 2021-2022 and received the Covid-19 vaccination you could be entitled to compensation …’.”

I know there’s some concern that amplifying Kennedy’s beliefs about vaccines will make the vaccine hesitant even more hesitant. But I wonder if all of the attention paid to vaccine skeptics in recent years could be having the opposite effect — that people are being exposed to skeptics’ unfettered theories on podcasts and social media and ultimately finding those views unconvincing. In June, my Opinion colleague Michelle Goldberg went to a Kennedy rally to talk to some of his supporters and she wrote: “As media coverage has made Democrats more aware of Kennedy’s conspiratorial views, his support has fallen; a recent St. Anselm poll had him at only 9 percent” among registered voters in the early and influential primary state of New Hampshire.

Many scientific experts have worked to promote accurate and up-to-date information about vaccines, including Covid vaccines. In some cases, they’ve spent a lot of social capital in their efforts to debunk falsehoods. Many journalists have asked vaccine skeptics tough questions. Simply shaming those who don’t want to get their children vaccinated, for whatever reason, is not effective.

What does work? As Dr. Katelyn Jetelina and Dr. Kristen Panthagani write for the newsletter Your Local Epidemiologist, some people have serious, good-faith questions about vaccines, and they shouldn’t be dismissed out of hand:

Legitimate concerns exist. In fact, the vast majority of people who have questions or doubts about vaccines don’t outright deny vaccines as beneficial. They are somewhere in the middle of the spectrum.

Answering people with valid questions needs to be scientists’ priority. We need to meet them where they are, answer their questions from a place of empathy not condescension, equip trusted messengers, and anticipate concerns so we can prevent information voids that will otherwise be filled with false rumors.

This is happening all the time. And looking at the data, I have confidence that it’s working.