Immunization — a matter of life and death

Talking Points

Misinformation and political polarization regarding vaccines have led to vaccine hesitancy and lower immunization rates. The recent COVID-19 pandemic and the growing measles outbreak are just two examples how vaccine hesitancy threatens public health safety.
It has been proven that vaccines save lives. Per the World Health Organization, immunization efforts have saved more than 150 million lives over the past 50 years.
Vaccines are safe. Contrary to common myths, vaccines do not cause illness or autism, and the odds of having a severe reaction are minimal compared to the odds of suffering severe consequences from an illness.
The current administration has appointed a known vaccine opponent to lead the Department of Health and Human Services. In addition, the Trump administration has taken several actions that harm the health of communities including eliminating DEI programs, canceling grants and closing programs that support health, removing research data, making drastic cuts to HHS staffing and budgets, and intentionally sharing disinformation on science and transparency.
It is imperative that Democrats continue to combat misinformation and support efforts to educate the public and to encourage immunization.
Democrats must also continue to support government-funded vaccine programs that provide free or affordable vaccines and initiatives to increase access to immunizations for underserved communities.

Overview

Immunization hesitancy is a complex issue that is influenced by social, cultural, political, and personal factors. Mistrust in authorities, safety concerns, and misinformation all play a role in the growing rejection of vaccines, which has led to substantial concerns for public health.

The polarization of health-related issues became especially prevalent during the COVID-19 pandemic. Statements by leading politicians that minimized the seriousness of the illness, conflicting media coverage, and partisan division regarding the vaccine contributed to the politicization of the pandemic and potentially preventable deaths.(i) A study released by the School of Public Health at Brown University estimates that nearly 318,000 deaths from COVID-19 between January 2021 through April 2022 were vaccine-preventable. (ii)

Currently, an outbreak of measles has spread to more than 30 states. With more than 1,000 confirmed cases, 2025 is already the second-most active year for measles. The vast majority of these cases (96%) are in individuals who are either unvaccinated or whose status is unknown.iii In 2000, measles was officially declared eliminated from the U.S. thanks to an effective vaccination program, a designation that means the disease has not spread continuously for 12 months.

However, anti-vaccine stories persist, and many parents now refuse to vaccinate their children, putting them at serious risk and increasing the possibility of future outbreaks.

Background

Vaccines are one of the most important advances in modern medicine. Vaccines have saved millions of lives and have made a tremendous impact on quality of life globally. In addition, vaccines are incredibly safe. Numerous myths continue to influence the rate of immunizations and to negatively impact public health.

Vaccines Save Lives

The following data are taken from a study released in May 2024 by the World Health Organization (WHO). (iv)

Global immunization efforts have saved an estimated 154 million lives — or the equivalent of six lives every minute of every year — over the past 50 years. The vast majority of lives saved (101 million) were those of infants. Immunization has made the single greatest contribution of any health intervention to ensure babies see their first birthdays and continue to lead healthy lives into adulthood.
The measles vaccination had the most significant impact on reducing infant mortality, accounting for 60% of the lives saved due to immunization. Over the past 50 years, vaccination against 14 diseases has directly contributed to reducing infant deaths by 40% globally.
Vaccinations have led to the eradication of smallpox.
The world is on the verge of eradicating polio. As the result of polio vaccination, more than 20 million people are able to walk today who would otherwise have been paralyzed.
For each life saved through immunization, an average of 66 years of full health were gained – with a total of 10.2 billion full health years gained over the five decades.

Vaccines are Safe

The process for ensuring that vaccines are safe involves multiple stages of rigorous testing, regulation, and monitoring. The CDC provides detailed information on the process for development, approval, and ongoing monitoring of vaccines. (v)

Before FDA licensing, vaccines go through four main phases of human clinical trials, with increasing numbers of participants in each phase. Each phase assesses how effective the vaccine is at causing an immune response and identifies any potential side effects.

After clinical trials, the vaccine manufacturer submits a Biological License Application to the FDA that includes clinical data and details about the manufacturing process. The FDA’s Vaccines and Related Biological Advisory Committee (VRBPAC), a group of independent scientific and health experts, provides input on scientific data related to safety and effectiveness of the vaccine. Manufacturers are required to conduct a series of tests and submit the results even after approval.

The Advisory Committee on Immunization Practices (ACIP) is a group of medical and public health experts who develop recommendations for vaccines that are approved by the FDA for use in the U.S. After APIC recommends a vaccine, the CDC Director decides whether to approve the recommendation and determine public health guidance for safe use of the vaccine.

After a vaccine is approved and distributed to the public, monitoring continues to ensure safety. The Vaccine Adverse Event Reporting System (VAERS) collects data on adverse events or side effects, while the Vaccine Safety Datalink (VSD) allows ongoing monitoring and searches of vaccine-related data. CDC’s Clinical Immunization Safety Assessment Project (CISA) conducts clinical research on vaccine-related health risks in certain groups of people. In addition to national bodies, global organizations like the WHO also provide oversight to ensure the safety and efficacy of vaccines worldwide.

Common Myths Regarding Vaccines

Myth 1

Vaccines cause autism and sudden infant death syndrome (SIDS). (vi)

Fact

This myth originated from a 1998 study by Andrew Wakefield that has been discredited due to fraudulent data. Multiple large-scale studies have found no link between vaccines and autism or SIDS. (vi)

Myth 2

Vaccines contain harmful toxins.

Fact

Vaccines contain small, safe amounts of ingredients like preservatives and stabilizers, all of which are carefully tested for safety and are important for enhancing immune response. The amounts used are far below harmful levels.

For example, a pear contains 13 times more formaldehyde than any vaccine, while breast-fed infants consume about 100 times more milligrams of aluminum daily compared to 0.125 milligrams in vaccines. There is no evidence that thimerosal, a mercury-containing compound used in vaccines, poses a health risk. Individuals are naturally exposed to mercury in milk, seafood, and contact lens solution. (vii)

Myth 3

Natural immunity is better than vaccine-acquired immunity.

Fact

While natural infection can lead to immunity, vaccines provide immunity with substantially lower risks of complications, including death.

For example, 1 in 500 individuals who become infected with measles will die,while the number of people who have had a severe reaction from the measles vaccine is one-in-1,000,000. (viii)

In addition, the number of cases required to achieve the herd immunity threshold may not be possible. Smallpox and polio have circulated throughout the population for centuries without ever achieving this threshold. The National Library of Medicine estimates that it would have taken, at a minimum, double or triple the cases of COVID-19 and at least two to three years to decrease community transmission without the vaccine. (ix)

Myth 4

Vaccines, including the flu shot, cause the diseases they are meant to prevent.

Fact

Vaccines, including the flu vaccine, contain either inactivated viruses, weakened live viruses, or pieces of the virus/bacteria. These cannot cause the actual disease but help the immune system recognize and fight it. Some mild side effects, like soreness or low-grade fever, may occur with the flu vaccine but are not the flu. (viii)

Myth 5

Too many vaccines can overwhelm the immune system.

Fact

The amount of antigens in vaccines is minimal compared to what the body naturally handles on a daily basis. Based on the number of antibodies present in the blood, a baby would theoretically have the ability to respond to around 10,000 vaccines at one time. Even if all 14 scheduled vaccines were given at once, it would only use up slightly more than 0.1% of a baby’s immune capacity. (viii)

Myth 6

Vaccines are unnecessary because of herd immunity and because diseases have mostly disappeared.

Fact

Many diseases have become contained due to the collective effort of vaccination, but they can return if vaccination rates drop. Herd immunity only works when a high percentage of the population is vaccinated. Relying on others to get vaccinated weakens community protection and increases the risk of outbreaks. For example, herd immunity requires 95% measles vaccination coverage, a threshold that is not met in many communities. (vi)

Myth 7

COVID-19 vaccines were rushed and are unsafe.

Fact

COVID-19 vaccines were developed quickly due to unprecedented global collaboration and funding, but they still went through rigorous safety trials. Additionally, scientists had many years of development and testing of vaccines for previous coronaviruses similar to those that cause COVID-19. Ongoing monitoring continues to confirm their safety. (vi, vii)

Current Issues and Challenges

In its first 100 days, the Trump administration took multiple actions that potentially harm the health of communities, including: (x)

Appointing a known vaccine opponent, Robert F. Kennedy, Jr., to lead the Department of Health and Human Services. Secretary Kennedy has taken several actions that sow doubt about vaccines and spread false information. This includes his failure to strongly endorse measles vaccination and his promotion of dubious cures during a measles outbreak, canceling studies on mRNA vaccines and vaccine hesitancy, and closing a network of centers working to prevent future pandemics. He also fired all 17 APIC members and replaced them with several outspoken vaccine skeptics. (xi)
Eliminating DEI programs. This may lead to discrimination and lack of support for underserved communities.
Restructuring HHS. The federal government’s ability to provide important services has been seriously undermined by drastic cuts in essential funding at HHS. These services include leading research and delivering technical assistance, approving safe and effective drugs, and tracking and identifying health issues and trends. The development of science-based guidance and the department’s ability to share key health information for the public to make critical health decisions is also in question.
Cancelling previously approved grants and closing programs aimed at supporting health research and initiatives.
Removing research data that does not support the administration’s objectives. Data has disappeared, and further data collection by federal agencies may be limited or non-existent. These actions limit the ability to measure progress on promising research and lead to questions regarding the validity of future research data. Research advisory committees are also losing independence and influence.
Discrediting science and spreading harmful misinformation. Conspiracy theories supported by the administration thrive on social media platforms and continue to undermine and threaten immunization efforts.

The FDA has also implemented new rules for the approval of vaccines, which has slowed the approval for new vaccines, such as Moderna’s combination vaccine for flu and COVID-19. New rules include the use of a placebo control in vaccine trials, raising the ethical issue of causing harm to participants if they receive a placebo and are sickened from a disease which the use of the vaccine being tested could have prevented. (xii)

Another concerning development involves potential pandemic illnesses such as the H5N1 influenza or “bird flu.” The federal government just cancelled a contract with Moderna for the development of a promising vaccine for the virus, leaving the company to seek funding elsewhere and possibly putting Americans at risk.

Under the direction of HHS, the CDC recently limited recommendations for COVID-19 vaccinations to people over age 65 or those with high-risk conditions, while stating ambiguously that the vaccine “may” be given to pregnant women and healthy children. (xiii) CDC recommendation is crucial because it helps insurance companies decide which vaccines to cover at no cost to patients. Per GoodRx, the COVID-19 vaccine currently costs approximately $200 per dose. In addition, with the proposed cuts to Medicaid, there are concerns that other vaccines may no longer be covered for the more than 72 million Americans who rely on Medicaid for health insurance each year. This could have profound impacts on public health.

The 2024 document, “Best Practices for Improving Pediatric Immunization and Well-Child Visit Rates for NC Medicaid Standard Plans” (xiv) states that two in five children in NC are covered by NC Medicaid. This same document also states that vaccinations are essential in helping make sure children stay healthy and in preventing disease outbreaks.

The North Carolina Division of Public Health publishes immunization data that includes vaccination rates for young children, children in kindergarten, teens, adults, flu, and COVID-19. (xv) The site also includes numerous resources for vaccine information and links to data sources.

Vaccine coverage for school children across the U.S., including NC, decreased during the 2023-2024 school year. For example, 92.7% of kindergartens received the MMR vaccine (measles, mumps, rubella), a decrease of 0.4% from the previous year. In NC, 93.8% of kindergarteners received the MMR vaccine in 2023 compared to 94% in 2022 and 96.1% in 2021.

Statewide, 92.5% of kindergarteners are considered up to date with vaccinations. Chatham County reports 94.1% of students being up to date. (xvi) More information is located on the Chatham County, NC website under Immunizations.

Conclusions/Policy Implications or Reccomendations

Misinformation regarding vaccines continues to threaten the health and safety of all people, especially children, throughout the world. While it is difficult to quantify the exact number of lives lost due to vaccine hesitancy, studies strongly suggest that a significant number of deaths can be prevented with higher vaccination rates.

Public health policy plays an important role in supporting efforts to ensure high compliance with immunization. This includes transparency in the sharing of key health information and pro-vaccine policies to prevent diseases and reduce outbreaks. Additionally, government-funded vaccine programs, such as the Vaccines for Children Program, provide free or affordable vaccines and initiatives to increase access to immunizations for underserved communities. Changes in vaccine recommendations and Medicaid cuts threaten to limit the availability of these life-saving vaccines for children. Educating the public and increasing trust in the safety and effectiveness of vaccines is imperative for current health conditions, as well as for future public health preparedness.

Additional Reading and Resources

APIC (Association for Professionals in Infection Control and Epidemiology) Vaccination Resources https://apic.org-vaccination-resources/
Immunize.org - Resources for the Public https://vaccineinformation.org; Resources for Healthcare Professionals https://www.immunize.org/
American Academy of Pediatrics (AAP)- Vaccine Myths www.healthychildren.org
Vaccinate Your Family www.vaccinateyourfamily.org
Vaxopedia www.vaxopedia.org

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