When the US government changes long-standing childhood vaccine recommendations, parents deserve clarity: what changed, why it changed, and what it means for their children’s health. Instead, the recent revamp of the US childhood immunization schedule was announced abruptly by the Department of Health and Human Services (HHS) with limited explanation and evidence, and little transparency about how decisions were reached or how they are expected to improve health outcomes. 

One thing, however, is clear: HHS Secretary Robert F. Kennedy Jr. achieved his intended goal. He created even more confusion about and distrust in the use of vaccines. When purposeful confusion leading to doubt is the goal, the consequences show up quickly, not in abstract debates, but in pediatric wards, neonatal intensive care units, and grieving families.

Much of the public commentary since the announcement has focused on the remaining policy levers available to HHS to reduce access to vaccines, such as changes to insurance coverage, liability protections, or federal programs for under- and uninsured children. Those concerns are real. But they obscure a more immediate and troubling reality: vaccine uptake is declining, not because access has disappeared, but because vaccination itself is being steadily de-normalized through uncertainty, mixed messages, and the spread of inaccurate information coming from the political appointees at HHS. 

HHS Secretary Robert F. Kennedy Jr. achieved his intended goal. He created even more confusion about and distrust in the use of vaccines.

In an environment already saturated with inaccurate information, silence or ambiguity can be as damaging as falsehoods. When official health guidance lacks transparency and consistency, inaccuracies fill the vacuum.

Real consequences from unclear guidance

HHS’s restructuring of the childhood immunization schedule illustrates the problem. A single, clear set of routine recommendations was replaced with a complicated three-tiered framework: routine vaccination, vaccination for high-risk children, and vaccination based on “shared clinical decision-making.” For parents already navigating an overwhelming volume of health information, this approach introduces ambiguity where clarity is paramount. And the accompanying documents, including a decision memo and assessment, did little to explain the rationale for the changes or demonstrate how they would improve health outcomes. 

Confusion of this kind has predictable effects: When parents are uncertain, many delay. Some opt out entirely. And as vaccination rates fall, preventable diseases return.

HHS has widely circulated accusations about vaccine risks without accompanying data, corrections, or context, and we are already seeing the consequences with decreasing pediatric vaccination rates and an increase in life-threating diseases. 

For example, pertussis (whooping cough) outbreaks are increasing, putting infants who are too young to be fully vaccinated at particular risk. Outpatient visits for respiratory or “flu-like” illness are at their highest in nearly 30 years, and 32 children have died this season after contracting influenza, according to the latest FluView report from the Centers for Disease Control and Prevention. And measles, which was officially eliminated from the United States in 2000, is making a comeback, with 2,242 cases reported in 2025, and 171 cases reported in the first two weeks of 2026. 

These are not failures of modern medicine; they are the result of elected officials, those who lead our federal health agencies, sowing confusion and raising doubt about vaccines’ safety and effectiveness. Now, their plans are expanding, with efforts to fund questionable research that seems designed to yield predetermined outcomes under way in Africa.

Crucial next steps

So, what can be done?

First, the country needs renewed investment in large-scale public education about vaccination as disease prevention. Effective public health campaigns require research, message testing, community-level outreach, and evaluation. They are expensive and resource-intensive, but they work. Government alone cannot shoulder this responsibility; philanthropy and private partners can play an essential role.

Second, professional and non-governmental organizations must continue to provide clear, evidence-based guidance. Medical societies (e.g., the American Academy of Pediatrics) and independent groups (e.g., the Vaccine Integrity Project) are stepping in to synthesize data and communicate what is known about vaccine safety and effectiveness. This work helps parents and clinicians make informed decisions in the absence of federal clarity.

Professional and non-governmental organizations must continue to provide clear, evidence-based guidance.

Third, the media can better serve the public by centering coverage on health impacts rather than on procedural changes alone. Reporting on disease outbreaks, hospitalizations, and pediatric deaths alongside explanations of how vaccination prevents them helps ground abstract policy shifts in reality. Scrutiny should focus not just on what recommendations changed, but on whether the evidence supporting those changes has been made public, a practice that has been in place for decades.

Finally, Congress has a responsibility to ensure sustained funding for immunization programs and to insist on transparency, rigor, and accountability from federal health agencies, standards that should apply regardless of who is in leadership.

Vaccines remain one of the most effective tools in modern medicine. When they are undermined, not through bans or shortages, but through confusion and doubt, the harm is quiet at first, then unmistakable. The question before us is not whether vaccination still works. It is whether we will communicate its value clearly enough, consistently enough, and responsibly enough to protect the children who depend on us to get this right.

Dr Michael Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota and is executive director of the Vaccine Integrity Project.

Sarah Despres is a public health policy expert who serves on the Vaccine Integrity Project’s Board of Advisers.