Health and Human Services Secretary Robert F. Kennedy Jr. recently ordered the Centers for Disease Control and Prevention to halt its “Wild to Mild” campaign promoting the flu vaccine. Kennedy wants future vaccine communications to focus on “informed consent,” by which he means giving people information about the adverse events associated with vaccines. That’s a distorted view, one that demonstrates broader confusion about informed consent and the goals of public health. True informed consent requires an understanding of how people process information about risks, and public health must promote collective benefits rather than focus entirely on individual autonomy.
The CDC’s shelved campaign featured clever visual metaphors — grizzly bears transformed into teddy bears — to convey how vaccines reduce the severity of flu infections. The ads emphasized the harm-reducing functions of vaccines, especially for vulnerable populations like pregnant women, young children, and the immunocompromised. Kennedy wants to replace these persuasive messages with data about potential complications, even though the National Childhood Vaccine Injury Act of 1986 already requires health care providers to share that information with patients.
Promoting greater “informed consent” sounds uncontroversial. After all, it is fundamental to ethical medical practice: Patients must understand and agree to any interventions they receive.
But mere information — especially about frightening possibilities — tends not to make us better informed. Instead, it leads us to predictable kinds of irrationality. When we hear about a shark attack on the news or watch “Jaws,” we get nervous about swimming in the ocean, though the odds of an attack are infinitesimally small. Yet many of us text while crossing busy streets despite the much higher risk of being hit by a car. This is why giving people an uncontextualized list of possible vaccine side effects is not the kind of “informed consent” worth promoting. It is more like handing someone a list of everything that could go wrong on an airplane without mentioning that flying is far safer than driving.
The CDC’s messaging about flu was far more informative than offering lists of rare side effects that could skew our risk perceptions. “Wild to Mild” conveyed what matters most: vaccines’ power to transform deadly threats into manageable problems.
Kennedy’s stance also reflects a widespread confusion about public health ethics. For years, the public has been conditioned to see medical ethics through the lens of individual choice and autonomy, even when those values should sometimes be balanced against the importance of protecting the community. This confusion has been exacerbated by the bioethics revolution that began in the 1970s, which championed informed consent and individual autonomy so effectively that these values now dominate all health-related discussions.
Many Americans think of health primarily as an individual matter rather than a societal responsibility. But it is both. We cannot well understand the ethics of immunization policies, or of public responses to disease epidemics, if we rely only on individualistic ethical concepts like informed consent. The public’s narrow reliance on these ideas may help explain why even modest public health measures can now face fierce pushback. For instance, consider efforts to resist aerial mosquito spraying, the fluoridation of drinking water, or school vaccine mandates.
The timing of Kennedy’s decision makes this philosophical confusion particularly dangerous. Vaccine uptake has declined in the wake of the Covid-19 pandemic. For example, vaccination rates for the measles, mumps, and rubella (MMR) vaccine have decreased across the country, and only 23% of adults have received recent Covid-19 boosters.
Replacing persuasive public health messaging with dry disclosures of risks — even if they are technically accurate — is not merely a policy shift; it is a symptom of a broader ethical misunderstanding about the nature of informed consent and the demands of public health. If we want Americans to grasp that public health cannot always defer to individual autonomy, we need a new bioethics revolution — one that engages with health care needs beyond the exam room and moves into the public square.
Mark C. Navin, Ph.D., is professor and chair of philosophy at Oakland University. Lainie Friedman Ross, M.D., Ph.D., is dean’s professor and chair of the Department of Health Humanities and Bioethics and director of the Paul M Schyve MD Center for Bioethics at the University of Rochester. Jason A. Wasserman, Ph.D., is dean’s distinguished professor of foundational medical studies and founding director of the Center for Moral Values in Health and Medicine at Oakland University.