New vaccine rules leave parents with more risk, less trust | Opinion

New vaccine rules strip away a clear national standard and inject more uncertainty into pediatric care at a critical moment.

Health and Human Services Secretary Robert F. Kennedy Jr. and his supporters in the so-called Make America Healthy Again movement just accomplished their long-sought goal of significantly revising the U.S. childhood immunization schedule.

The new schedule no longer universally recommends that children be vaccinated against influenza, hepatitis A and B, RSV, rotavirus and meningitis. Kennedy framed the changes as a way to restore choice and flexibility. But in reality, they remove a clear national standard and inject even more uncertainty into pediatric care at a critical moment.

It's time for an honest assessment of how we arrived here — and what comes next for parents, children and our entire public health system.

Consider the flu vaccine. This winter, influenza cases have surged nationwide. Hospitalizations continue to rise sharply, the Centers for Disease Control and Prevention is reporting more pediatric deaths and health systems are facing enormous strain. Yet HHS no longer recommends that all kids receive safe, generally effective flu shots. In fact, HHS officials have talked more about dye-free ice cream and airport pull-ups than the benefits of flu shots, sending mixed signals to families already navigating a fragmented health information environment.

The result has been predictable: lower vaccine uptake, more illness and more avoidable suffering.

Or consider measles. The disease has returned, threatening the hard-won elimination status that the U.S. has held since 2000. That's been a direct result of falling vaccination rates, largely due to misinformation. Measles is one of the most contagious viruses in the world — and when vaccination rates fall below the roughly 95% threshold needed for community protection (as has occurred in 39 states), transmission accelerates rapidly.

In 2025, more than 2,000 confirmed measles cases were reported across over 40 states, the highest total in 33 years. Nearly all of these cases have been in unvaccinated individuals.

These outbreaks have forced quarantines, led to numerous missed school days and disrupted families and workplaces alike. And they've led to major downstream costs: One review found a single measles case costs the health care system — and taxpayers — $43,000.

For decades, routine childhood immunizations have saved lives and billions of dollars in medical and societal costs. Weakening these programs does not enhance freedom. It redistributes risk, placing the greatest burden on children, the elderly and the medically vulnerable.

Yet it would be incomplete — and dishonest — to tell this story without acknowledging how we got here. The erosion of trust in public health officials did not begin in 2025.

During the COVID-19 pandemic, leaders too often communicated certainty when humility was needed and urgency when explanation was required. Guidance changed, sometimes abruptly, without sufficient transparency. Parents who raised concerns about school closures, mandates or rare vaccine injuries were frequently dismissed, rather than engaged.

That failure mattered. Trust, once lost, is difficult to regain. When institutions appear unwilling to listen, people seek answers elsewhere and look to those like Kennedy.

So, what comes next?

Simply complaining accomplishes little. Congress has shown limited willingness or ability to alter the current health policy trajectory, even as it undermines President Trump's prior accomplishments like Operation Warp Speed.

Rebuilding public confidence in vaccines therefore must begin outside Washington.

First, public health institutions must recommit to transparency and humility. That means acknowledging uncertainty, explaining risk honestly and addressing vaccine safety concerns without defensiveness. Admitting past mistakes is not a weakness. It is the foundation of credibility.

State leaders will also be central to this effort. Federal agencies issue recommendations, but states write and enforce vaccine policy, particularly for school entry. Governors, legislators and state health officials need clear, evidence-based guidance on the real-world consequences of any proposed policy changes — especially how any changes would impact the frequency of outbreaks, potentially strain school and health care systems, and increase economic costs.

Then, we must empower parents, not shame them. Families should feel confident and comfortable asking questions and receiving answers they trust. That requires accessible, credible information about vaccine benefits, risks and safety monitoring, delivered without jargon or judgment.

Finally, local health care providers must be supported. Physicians, nurses and pharmacists are among the most trusted sources of health information, with surveys consistently showing that adults and parents place especially high trust in their personal clinicians for vaccine guidance. They need time, training, institutional backing and public support to handle difficult, emotionally charged conversations about vaccines well.

As a former U.S. surgeon general, I have seen how quickly trust can erode and how painstaking the work of rebuilding it can be. The difficult question America now faces is whether public health institutions can learn fast enough, adapt humbly enough and speak clearly enough to win back the trust we've lost.

Dr. Jerome Adams served as U.S. surgeon general during the first Trump administration and is a practicing anesthesiologist.