Barriers to Immunizations Among Children in the US and Worldwide, with Arthur Reingold, MD

In an interview with HCPLive at the 2025 American Thoracic Society (ATS) International Conference, Arthur L. Reingold, MD, professor of epidemiology at UC Berkeley Public Health, spoke about the biggest takeaways from his presentation ‘The Global Immunization Divide: Overcoming Barriers to Universal Vaccine Coverage.’

Reingold is known for his research into the prevention and control of infectious diseases at both the national level and in low-income countries across the world. He spoke with the HCPLive team about what he sees as the current state of affairs in vaccination barriers.

“We've made great progress in preventing illness and death from diseases like measles, whooping cough, and pneumococcal disease,” Reingold said. “But first of all, we know that there are still a lot of kids we don't reach in, particularly in low-income settings, for a variety of reasons. Secondly, there's been much less attention paid to adult immunization, something that we certainly promote in wealthy countries, but hasn't gotten a lot of attention in low and middle income countries…Then on top of all that, we certainly have the clear effect of the COVID-19 pandemic on, frankly, day-to-day immunization.”

Reingold highlighted several points from his ATS presentation, noting that the responses to the COVID-19 pandemic among many in the US have resulted in diminished immunization coverage. He also highlighted barriers observed in low and middle-income countries.

“We have, in low and middle-income countries, just a lack of wherewithal and, frankly, with current threats to ongoing support of [Gavi, The Vaccine Alliance] and ‘global health’, the support that is there seems likely to decline in 2025 and beyond, which will certainly make it all the harder to sustain any progress we've made and to make more progress,” Reingold said. “So funding, it appears, is going to shrink. The immediate future does not look bright for expanding financial support for these activities in low and middle-income countries; in wealthier countries, there also may be reduced funding.”

The reduction in funding Reingold discussed may be felt in wealthier countries such as the US. He highlighted reductions in vaccinations in many states within the US in recent years.

“So if you take the United States, the reality is that our 50 states and our half a dozen territories are responsible, in many ways, for getting kids immunized in partnership with clinicians, but half of those immunizations are covered by or paid for by a federal program called Vaccines for Children,” Reingold said. “If those funds decline, it's hard to see how individual states and territories will make up that difference. So I'm very worried about the funding of basic immunization programs for kids in the United States. Secondly, the work that's been done to achieve high levels of childhood immunization through school entry requirements and the like seems to be going in the wrong direction, and so many states are softening the constraints they put on children entering school. Providing a laxer standard and making it easier to get a religious or philosophical exemption.”

To find out more about Reingold’s views and presentation information, view his full interview segment above. For more from ATS, view our latest conference coverage.

The quotes contained in this interview were edited for the purposes of clarity.

Reingold’s disclosures include having served as a consultant for AstraZeneca and GlaxoSmithKline.