2025: A year of fewer vaccines and increasing distrust

This year in pediatric medicine, vaccines have been the headline. From major shake-ups at the CDC,1 to updated recommendations related to the COVID-19 vaccine for pediatric patients,2 and more recently, the updated recommendation for the hepatitis B vaccine,3 as well as the measles outbreaks observed this year,4 there is a fear among the health care community that such changes will continue to sew distrust in vaccines and misinformation among patients. Experts we spoke with stated, in 2025, we saw some ramifications.

“We started out 2025 with an environment that was rife with myths and disinformation, and we’ve seen some of that institutionalized through some of the changes in leadership in [the Department of Health & Human Services (HHS)],” said Robert H. Hopkins, Jr., MD, medical director, National Foundation for Infectious Diseases, professor of Internal Medicine, Pediatrics, University of Arkansas for Medical Sciences. “We’ve seen basically the Advisory Committee on Immunization Practices, ACIP, that all of us know and have used as a prime reference for decades, taken apart and moved to a way of making recommendations that no longer follow the science.

“The biggest challenge is all of the vaccine hesitancy, and that has skyrocketed,” added Tina Q. Tan, MD, FAAP, FIDSA, FPIDS. Tan is the immediate past president of the Infectious Diseases Society of America (IDSA), an attending in the Division of Infectious Diseases at Lurie Children’s Hospital of Chicago, and the editor-in-chief of our sister publication Contemporary Pediatrics.

“People are having major issues speaking to their patients about getting vaccines. The other thing is all the misinformation coming out of the ACIP now is causing mass confusion,” added Tan.

As 2026 approaches, experts are advising families to look to other long-standing and reputable medical societies for accurate, science-based recommendations.

“Parents look to their pediatrician for best information, and typically the pediatrician would look at the advice from the ACIP and the CDC, but they are not anymore, because I think the ACIP and the CDC are no longer a trusted source of information,” said Paul A. Offit, MD, director of the Vaccine Education Center and attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia (CHOP). “

“The good news is a lot of people have stood up,” said Offit. “The American Academy of Pediatrics (AAP) has stood up and made it very clear that young children who’ve never been vaccinated should get vaccinated, because thousands of young, healthy children are still getting hospitalized and going to the intensive care unit, and we had 150 deaths in children last year from COVID. They provide good information, and I think they’ve worked with insurance companies to make sure insurance companies will pay for that good medical practice. I think the physician is the key here, and I think most physicians understand that there are a lot of reliable sources of information out there about how we can best immunize our children and basically, largely ignore the ACIP and CDC.”

“First and foremost, the thing that gets me up every day—and I think most of my colleagues that are in practice—is the relationships that we have with patients and families,” added Hopkins. “We have the joy of seeing these children from early in life, seeing them grow, seeing them develop, helping their families understand what we can do to best protect those children from preventable disease, what we can do to help those children develop to their full potential, and doing so in a way that is respectful of the patients’ and families’ wishes. It’s done in a way where we are showing our value for the science and not just doing something for the sake of doing something.”

Hopkins added the importance of the explanation, and the understanding that parents are navigating media headlines, the actual updated recommendations from government agencies, and several forms of information via social media.

“It is critical that we continue to provide presumptive recommendations—meaning ‘I recommend this vaccine’ or ‘We’re going to give Johnny this vaccine today because.’” A presumptive recommendation with a reason is important,” Hopkins continued. “But we also need to be aware that parents have questions. Parents have seen what’s in the media; they’ve seen what’s in social media, and when they have those questions, we need to respectfully address those questions using tools that we have. We need to understand where they’re coming from. We need to let them know where the science stands. We need to have conversations that lead them to the correct decision: to get their children vaccinated.”

Communication is also ever-evolving, making it all the more important for providers to have an understanding of certain trends and how trust has changed in recent years, especially in 2025.

“In the old world, or the old way of communicating trust was really granted by credentials,” added Lori Handy, MD, MSCE, associate director, Vaccine Education Center, attending physician, Division of Infectious Diseases, CHOP. “What we’re realizing now is that trust is actually a lot more complicated. It means that you are an individual who will have bidirectional conversations. You will come back over time and share more information. You will be dynamic. You will update things. You will engage with humans, with their feelings and emotions, and you do that over time,” said Handy.

Above all, as you have continued to navigate the changes to the pediatric vaccine schedule, misinformation, and questions from families, experts implore you to continue being the voice for vaccines.

“We need to be strong advocates,” said Tan. “So you need to advocate on the local level. You need to talk to your state health department and state representatives and all your congressional representatives to get them to fight for you on a national level. You have to do what’s best for your patient, so please rely on scientifically sound evidence.”

“Yes, take heart,” Offit stressed. “A lot of people are standing up. A lot of scientific and medical societies are standing up. States are standing up to make sure that we can have access to the best information about how to, for example, vaccinate our children. So take heart. People are standing up in this troubled time,” he concluded.

References:

1. Fitch J. Tina Tan, MD, on ACIP meeting postponement, public vaccine information reports. Contemporary Pediatrics. Published February 26, 2025. Accessed December 9, 2025. https://www.contemporarypediatrics.com/view/tina-tan-md-on-acip-meeting-postponement-public-vaccine-information-reports
2. Ebert M. FDA pulls clearance of Pfizer-BioNTech COVID-19 vaccine for children under 5. Contemporary Pediatrics. Published August 27, 2025. Accessed December 9, 2025. https://www.contemporarypediatrics.com/view/fda-pulls-clearance-of-pfizer-biontech-covid-19-vaccine-for-children-under-5
3. Fitch J, Ebert M. ACIP votes to update hepatitis B vaccine recommendation for infants. Contemporary Pediatrics. Published December 5, 2025. Accessed December 9, 2025. https://www.contemporarypediatrics.com/view/acip-votes-to-update-hepatitis-b-vaccine-recommendation-for-infants
4. Lynfield R. Ruth Lynfield, MD, on rebuilding MMR vaccine confidence. Contemporary Pediatrics. Published November 4, 2025. Accessed December 9, 2025. https://www.contemporarypediatrics.com/view/ruth-lynfield-md-on-rebuilding-mmr-vaccine-confidence