“the number of people who reject all vaccines is quite small — so small that they are unlikely to compromise public health.
The greater issue, the one we don’t discuss often enough, is the many parents who don’t identify as being opposed to vaccines but don’t always consent to them.
Even before the Covid-19 pandemic, one-quarter to one-third of American parents were delaying vaccines or picking and choosing them cafeteria-style, deciding certain vaccines weren’t relevant to their family because they believed the risk for the disease was low. Some parents design their own vaccine schedules, often customizing for each child based on their perceptions of risk, benefit and how they believe their child will handle it.
[..] my research suggests that this approach to vaccines is entirely logical in a culture that insists that health is the result of hard work and informed consumer decisions and too often sees illness as a personal failure.
In many ways, especially now, parents who reject vaccines are following expert advice. Myriad parenting books and specialists have encouraged women, starting during pregnancy, to see themselves as experts on their children and to trust their instincts. This matches public health messaging, which over the past several decades moved away from collective aims like improving the quality of air and water toward a focus on behavior modifications, like diet and exercise. It also echoes the recommendations of the health and human services secretary, Robert F. Kennedy Jr., whose Make America Healthy Again campaign insists Americans can take control of their own health with wider use of wearable technology and more focus on nutrition.
[..] Vaccines, they reason, should feel relevant to their lives — and when they don’t, universal recommendations and mandates for school attendance can feel unnecessary or even oppressive. The impact of their vaccine choices on others is not necessarily part of their calculation. And why should it be? There are few other arenas in which parents are asked to consider the effects of their choices on other children.
But collective investments make personal choice possible. High-quality food is possible because of public investment in food inspection and testing. Crosswalks and traffic rules, maintained and enforced collectively, make it possible for kids to walk safely to school. Vaccines are often taken for granted, and their widespread use has prevented countless miscarriages, serious illnesses and child deaths. [..]
Across all vaccine decisions, parents share the desire for healthy children and healthy communities. The real solution is better public investments and clearer information that can make parents feel confident in their choices. Instead, parents are left to figure out on their own whether the ingredients in their cleaning supplies are safe, whether their food supply can be trusted and now whether giving their child Tylenol is wise. Against that backdrop, deciding whether to vaccinate a healthy child against a hypothetical future risk feels increasingly high stakes, especially when official advice is so confusing.
Most parents choose to vaccinate their children. Yet the growing unease with vaccines reflects how many parents now feel they must trust their own judgment rather than expert advice that feels generic, impersonal or politicized. What leaders should be communicating is that while a healthy lifestyle and good parenting are important, they are not adequate protection against infectious disease. This was made tragically clear when one unvaccinated child died of measles this year while her siblings in the same house recovered.”
Full editorial, J Reich, New York Times, 2025.9.30