Americans are losing confidence in the safety of vaccines. According to a recent Gallup poll, 20% of adults believe they’re more dangerous than the diseases they’re intended to prevent. That’s up from just 6% in 2001.
This growing skepticism is proving deadly. Recently, an unvaccinated school-aged child died in a West Texas measles outbreak, as did someone in New Mexico. As of now, 50 people in the region have been hospitalized with the virus.
This tragic story underscores the urgent need for better public communication about vaccines. Misinformation and fear can spread even faster than infectious diseases, and disregarding vaccine skeptics outright only deepens their distrust.
All too often, public health authorities reflexively dismiss people asking good-faith questions about vaccines’ safety and efficacy as anti-vaxxers.
I practiced medicine in Vermont for eight years prior to my political career. I know firsthand that sympathy, not sanctimony, is the best way to soothe concerns about vaccines. And since the facts around vaccines are so compelling, advocates should take every opportunity they have to share them.
Consider one common concern that I heard back when I practiced medicine: Vaccines can’t be trusted since they haven’t undergone “placebo-controlled” clinical trials.
It’s an argument with a clear flaw, but I wouldn’t have left a worried friend or patient to figure that out on their own.
Instead, I’d have acknowledged their reasoning and respectfully explained their error. In a placebo-controlled trial, one half of participants gets a real vaccine, while the other half gets a “placebo” — a sugar pill or injection with no medicinal properties — so that researchers can compare the results.
If there is already a safe and effective vaccine on the market, then it’s unethical to test a new vaccine against a placebo.
So placebo-controlled trials are appropriate only when no other inoculation exists, like during the Covid-19 pandemic and for a host of diseases early in the 20th century. As the pediatrician Paul Offit has written, “How did we know that Jonas Salk’s polio vaccine was effective? We knew because 16 children died from polio in that study — all in the placebo group.”
Today, when a vaccine for a particular disease already exists, new vaccines are tested by comparing performance against older, already approved shots.
Vaccines aren’t unique in this regard. Many new medicines are compared to the existing standard of care. It’d be deeply unethical to test the effectiveness of a new cancer medicine by requiring half the patients in a clinical trial to receive a sugar pill with no active ingredient — thus condemning the placebo recipients to an early grave. Instead, new cancer drugs are compared to existing cancer treatments.
In fact, vaccines are subject to more post-approval monitoring than virtually any other medical intervention. As a physician who used to help adolescents and parents of young children — and as someone with vaccinated children and grandchildren — I think it’s important to emphasize that patients and health care professionals are on the same side when it comes to keeping vaccines safe.
After a vaccine goes into production, the manufacturer tests each batch, with the results reviewed by the FDA. And the federal government operates the Vaccine Adverse Event Reporting System database, which seeks to track every single negative reaction. Furthermore, because the system relies on patient self-reporting, not every reaction in the database is necessarily vaccine-induced.
The government also runs the National Vaccine Injury Compensation Program, which awards monetary damages to patients who have rare adverse reactions to shots. From 2006 to 2022, Americans received more than 5 billion vaccine doses — and just over 9,000 patients experienced rare reactions that warranted payouts.
In other words, for every 1 dose that caused a rare allergic reaction or other adverse event, over 550,000 other doses were administered without incident.
By comparison, 1 in every 15,300 Americans will be struck by lightning in their lifetimes — meaning people are 36 times more likely to be struck by lightning than to be harmed by a vaccine.
Many Americans have also heard that the number of recommended childhood shots has increased significantly in recent decades. And that’s true — the Centers for Disease Control and Prevention now recommends immunization against 12 diseases, some spread over multiple doses.
Critics frame this increase as an inherently bad, or at least questionable, change. But it’s a positive one. Every new vaccine saves and improves lives.
For example, in 2023 the CDC started recommending that babies get immunized against respiratory syncytial virus, or RSV, the leading cause of hospitalization among infants. The shot is 90% effective at preventing those hospital trips.
Or consider the shot for human papillomavirus, HPV, which the CDC started recommending for pre-teens in 2006. It reduces recipients’ risk of later developing cervical cancer by 90%. In Australia, the HPV vaccine is on track to eliminate cervical cancer.
Nobody complains that we have more cancer medicines available today than in the 1980s. Why should we complain about having more vaccines available?
Finally, many people have heard alarming anecdotes, such as one involving a young adult in New York who contracted a strain of polio that had mutated from a vaccine in 2022.
The vaccine critics who highlight these stories usually leave out crucial information. For instance, that New York patient didn’t contract the virus from a vaccine he received —he was unvaccinated. He contracted the disease from another person, most likely someone who was carrying the virus but had no symptoms precisely because she was vaccinated.
Had the victim likewise been vaccinated, the infection almost certainly never would have occurred.
It’s normal for people to have reservations about medical procedures, including vaccination. And they shouldn’t be shamed for asking questions. To be sure, some Americans aren’t interested in the actual facts — but a much larger number sincerely want the truth.
The evidence is overwhelming that FDA-approved vaccines are not only safe, but essential for protecting individual and public health. By responding to our fellow Americans’ concerns with facts rather than dismissal, we can ensure a healthier future for all of us.
Howard Dean, M.D., is the former chair of the Democratic National Committee and former governor of Vermont.