Vaccine hesitancy is not a new phenomenon. In 2019, before the pandemic, the World Health Organization named it one of the top ten global health threats, alongside air pollution, antimicrobial resistance, and Ebola. But in the years since the advent of COVID-19, something has shifted in the vaccine conversations between clinicians and patients.

Vaccine hesitancy has become more emotionally charged and politically fraught, many physicians say, and more and more parents arrive at the pediatrician’s office with genuine questions, deep anxiety, or a patchwork of information gathered from social media, podcasts, online forums, artificial intelligence (AI) chatbots, and wellness influencers.

Clinicians are also seeing shifts in vaccination practices. “Since COVID, things have really changed,” Kathryn Schaefer, MD, a pediatrician at South Lake Pediatrics in Minnetonka, Minnesota, tells CIDRAP News. “We have several families that have kids, maybe that are 8-ish and 5, and then a newborn. The first child will be fully vaccinated. The second child, it’ll be a little bit slower.”