“Can you explain each of these?” my patient’s father asked, handing me a crumpled sheet of paper. It was a list — a long list — of vaccine ingredients.
The baby boy nestled in his mother’s arms was quiet, oblivious to the conversation unfolding around him. The parents had come for a routine two-month well-child visit, and they were uneasy about one thing: the vaccines their child was scheduled to receive.
“319 mcg aluminum from aluminum salts,” the list read. “<0.0056% polysorbate 80. <14 mcg formaldehyde. <50 ng glutaraldehyde …”
The list went on with several chemicals and components familiar to a scientist or doctor, but daunting to a parent.
“I’m really worried about what’s in these shots,” the father exhaled, scrolling through parenting blogs on Facebook. “I’ve read so much about vaccines here, and it’s making me nervous.”
As a pediatrician, I’ve had conversations like this countless times. Parents ask questions, express doubts, and seek reassurance. But today, something felt different. The questions weren’t just about child safety — they were rooted in the overwhelming flood of misinformation that has fueled growing vaccine skepticism. This skepticism, amplified by social media, viral videos, and politicians’ voices, has morphed into a belief system influencing public policy and medical decision-making.
The danger of this misinformation is real. In the U.S., diseases like measles — declared eliminated in 2000 — are resurging, particularly among unvaccinated and under-vaccinated groups. Measles is preventable with two doses of the MMR vaccine, yet over 22 million children missed their first dose in 2023. Globally, only 83% of children received the first dose, and 74% received the second. A vaccination rate of 95% is necessary to prevent outbreaks in communities. In the U.S., kindergarten vaccination rates have not returned to pre-pandemic levels. For the 2022-2023 school year, 12 states and Washington, D.C. had MMR vaccination rates below 90%, and 10 states had exemption rates over 5%, preventing them from reaching the 95% target. As a result, around 250,000 children were unvaccinated and at risk for measles. The fear of vaccines has led to a decline in vaccination rates, leaving children vulnerable to vaccine-preventable diseases. Data collected before and during the COVID-19 pandemic shows a decline in the perceived importance of childhood vaccines in many countries, including the U.S.
Parents, despite the overwhelming scientific consensus, have started to question vaccines not just for themselves, but for their children. And in doing so, they risk the health of future generations.
The history of vaccine hesitancy is not new. From the very beginnings of smallpox vaccination, there have always been voices of opposition. In early 19th-century England, resistance to Edward Jenner’s smallpox vaccine came primarily from working-class communities, religious groups, and political figures. Concerns were widespread, with many fearing the safety of the new vaccine, particularly the use of cowpox material. Fears were rampant about the risks of the vaccine and how it could lead to ‘cow mania’ or cause harm and other deformities. The mandatory nature of vaccination further fueled opposition, as many saw it as an infringement on personal liberty. In the 1990s, Andrew Wakefield’s fraudulent study falsely linking the MMR vaccine to autism ignited a firestorm that still burns today. Despite the study being retracted and Wakefield’s medical license revoked, the myth of vaccines causing autism in children persists. And with the rise of the internet and social media, the misinformation has only spread faster.
Many vaccine skeptics are not ill-intentioned. They are parents who love their children and want the best for them. Unfortunately, many find themselves confused, frightened, and misinformed. They read ingredient lists, watch videos, and listen to high-profile figures in the media who perpetuate false narratives. These aren’t “anti-science” parents — they are parents who have been exposed to a steady stream of fear, and fear is a powerful motivator.
This isn’t just a conversation about science anymore. It’s a conversation about trust — trust in the scientific process, trust in the medical community, and trust in each other. Pediatricians are tasked with guiding families through the complex and sometimes intimidating landscape of medical decisions. Our role is to help parents make informed choices, not just about vaccines, but about every aspect of their child’s health. But how do we do that when misinformation is so widespread?
The first step is understanding the root of the fear. Vaccine hesitancy is often not about rejecting science, but rather about protecting children. Parents who are hesitant to vaccinate simply don’t want to make a decision they believe might harm their child.
This is where we as physicians come in. As experts, we must meet families where they are, not where we want them to be.
Dismissing their concerns or belittling them only deepens the divide. Instead, we should listen — really listen — to their fears, acknowledge their worries, and provide clear, evidence-based information. This isn’t about winning an argument; it’s about building a bridge of trust that allows us to form meaningful relationships with families, and usher them toward informed decisions over time.
In the case of the parents in my office, we had a conversation about the specific components of the vaccine they were most worried about — aluminum, formaldehyde, and the like. I explained how vaccines work, and how they protect children from diseases far more dangerous than any of the ingredients in the shots. I didn’t expect a change of heart after a single conversation – and I didn’t get one. But I scheduled a follow-up visit, and another one after that.
Over time, our relationship strengthened, and these parents could see that their concerns were being heard, their questions were answered, and as a result, their trust in me deepened. Vaccine hesitancy isn’t something that can be solved with one short discussion. It’s a process that takes time, patience, and continuous dialogue that spans the course of a child’s life. We must share evidence on vaccines in a compassionate, accessible way. We must reassure parents that vaccines are not just safe — they are essential for their child to thrive.
Together, we can build a world where vaccines are seen not as a threat, but as the critical, lifesaving tool they are. A world where parents no longer fear vaccines, but embrace them as key to keeping their children — and our society — safe and healthy.
By the time of their child’s six-month visit, those parents, after thoughtful discussion and consideration, agreed to follow the recommended catch-up vaccine schedule. By the time of their child’s six-month visit, those parents, after thoughtful discussion and consideration, agreed to follow the recommended catch-up vaccine schedule.
What are your recommendations for navigating vaccine hesitancy with patients? Share in the comments!
Dr. Tasia Isbell is a Harvard-trained general pediatrician in Phoenix, AZ. She enjoys cycling, traveling, and using writing as a tool to advocate for children's health equity. She tweets at @DrTasiaIsbell. Dr. Isbell is a 2024–2025 Doximity Op-Med Fellow.
Illustration by Diana Connolly
