“No vax, no problem.” “Pharma-Free.” “Unvaxxed, unafraid.” Slogans like these praising the decision to remain unvaccinated decorate the shirts, caps, and onesies found in the Children’s Health Defense’s online shop. The nonprofit organization was founded and headed — until recently — by Robert F. Kennedy Jr., the United States secretary of Health and Human Services (HHS), who has a history of discouraging vaccine use. Non-medical vaccine exemptions are encouraged online, popularized in communities, and debated in government legislature.
Kennedy wants to “Make America Healthy Again.” In his recent confirmation hearing, he faced a series of questions about his history of anti-vaccine rhetoric; his voiced support of the theory that the measles, mumps, and rubella (MMR) vaccine causes autism; his comments doubting the effectiveness of the COVID-19 vaccine; and his criticisms of the government’s response to the pandemic. When presented throughout his hearing with his previous statements doubting immunization efficacy, he denied being against vaccines. Despite promising Louisiana Sen. Bill Cassidy that he would not change the nation’s current vaccination schedule, Kennedy stated in his first address to HHS employees that, “Nothing is going to be off limits,” and promised to investigate vaccines, the childhood vaccination schedule, antidepressants, and pesticides.
Critical attitudes towards medical products or treatments are not inherently negative; unbiased analysis can ensure that manufacturers are producing ethical, effective products. Monitoring and regulating the $640 billion U.S. pharmaceutical industry is necessary to mitigate potential harm to consumers — that’s why government agencies like the U.S. Food and Drug Administration have regulations to ensure the quality and safety of drugs. However, skepticism toward medicine can lead to misinformation that causes preventable damage.
This was demonstrated in 1998 when discredited British physician Andrew Wakefield and 12 of his colleagues published a case series in The Lancet, a reputable medical journal, hypothesizing that the MMR vaccine caused intestinal inflammation, proteins harmful to the brain to enter the bloodstream, and the consequent onset of developmental disorders such as autism. Although the study was conducted unethically, the paper received widespread publicity, and parents began to be concerned about a link between vaccination and autism. Other researchers quickly discredited his claim, and his paper would eventually be retracted 12 years later. Wakefield’s study was funded by lawyers working for an anti-vaccine organization that was in active legal proceedings against vaccine manufacturers. He was later found guilty of ethical violations and deliberate fraud, including the falsification of facts. Despite this eventual reckoning, the damage was already done.
Some parents and professionals today still link the MMR vaccine to autism. Dr. Darryn Sikora, a retired licensed psychologist who has done diagnostic work with families and children, explains why this is still a commonly-held belief: “Whenever there is a disease or a disorder that is difficult to understand and doesn’t have a clear-cut cause, there’s going to be all sorts of ideas as to what is happening.” Autism symptoms often become clear around the same point in childhood as when children get the first dose of the MMR vaccine, at around 12-15 months old.
In her 37 years of professional experience, Sikora has seen how being unable to identify a direct cause of autism can be challenging for some parents with the desire to understand exactly why their child is autistic. “If you think your child was ‘normal’ and then ‘became autistic’ you’re going to look for something in [their] environment, something in the world that we live in — not genes, and not before birth — that caused that,” says Sikora, “and you’re going to look wherever you can.”
While it’s understandable for questions about correlation to present themselves, Sikora clarifies, “There is no causative relationship.” She emphasizes the importance of not letting questions about vaccines interfere with the safety of children, saying that by avoiding vaccination, “You’re then putting your child at risk for other diseases that may be life-threatening. Autism is not a life-threatening disorder.”
Specific beliefs about immunization are often shared within a community. Speculative and biased information from studies like Wakefield’s can cause preventable harm and distrust in the medical establishment. This speculative research can confirm concerned parents’ fears, leading to community-wide buy-ins to anti-vaccination beliefs.
It’s natural for parents to be worried about their children’s healthcare, including immunization. Watching their child get vaccinated, especially with shots like Hepatitis B — the first dose of which is usually given within 24 hours of birth — can be scary. Medical science is not always widely available or presented in accessible language, leading to unanswered questions about the safety and scheduling of vaccines. Parents can feel pressured into making a healthcare decision they don’t understand. Many low-income communities and communities of color have had negative experiences with vaccination that have broken their trust in the medical industry.
Caroline Nguyen Ticarro, the executive director of Boost Oregon, aims to, “Empower our community to make decisions based on science.” Boost Oregon uses the technique of motivational interviewing, which focuses on hearing and addressing the specific concerns of a patient to produce beneficial change rather than immediately correcting them. Ticarro explains that addressing vaccine skepticism in this way is more productive, commenting, “The fact that we are willing to not talk and just listen to what their concerns are is enough to build that trust.”
Many Americans choose not to vaccinate their children for religious or personal reasons. According to the Centers for Disease Control and Prevention (CDC), in the 2023-24 school year Oregon kindergarteners had one of the highest non-medical vaccine exemption rates in the U.S., behind only Idaho, Alaska, and Utah. This concerns officials like Multnomah County Commissioner for District 1 Meghan Moyer, who explains, “For everyone who is opting out, it weakens our ability to prevent that outwork.” When vaccination rates drop, it can endanger herd immunity — the percentage of the population that needs to be immune, naturally or through vaccination, to slow or stop the spread of a disease. This percentage is at different thresholds for different diseases and protects vulnerable groups in the population who physically cannot get vaccinated. “We have an obligation to the public, particularly to the public who is at higher risk,” explains Moyer.
The CDC recommends a schedule of child immunization to protect adolescents and the population from vaccine-preventable diseases. In Oregon, school-age children are required to have received these immunizations to enter public or private schools. However, some, like Christina Hildebrand, the president and founder of A Voice for Choice Advocacy, do not believe in any medical mandates such as these. She founded her organization in response to California Senate Bill 277, which stated that non-medical vaccine exemptions would not be accepted for school entry. Hildebrand took issue with this, saying, “Children should have a right to go to school and not be forced to take a medical treatment if their parents don’t want it.” Moyer disagrees, “Adults have the right to make that decision. It doesn’t mean that it doesn’t have consequences.”
As a mother who chooses not to vaccinate her children, Hildebrand believes that other forms of preparation need to take the place of vaccines, saying, “You need to do your research so that if your kid got the measles, or if they got chicken pox, or if they got some other disease, you would know what the disease is and how you would go about treating it.” Hildebrand states that “everyone should make an informed choice” regarding the immunization of themselves or their children.
While everyone has the right to make their personal medical decisions, the choice an individual makes about vaccination can affect those around them. This is especially true for contagious, vaccine-preventable diseases like measles, whooping cough, and polio. In 2024, Oregon reached the state’s highest whooping cough count in 74 years, with 80% of reported cases among those 18-years-old or younger. “Our society does not always value collective good as much as individual freedom,” says Moyer, adding, “Sometimes it is lost on people the role that each of us play — not just in our own health, but in the health of those around us.”
During the COVID-19 pandemic, residents in some cities, including Portland, were required to be vaccinated to enter certain restaurants and shops. Hildebrand believes individuals should “not be mandated to take something in order to get a service.” Moyer supports mandates, stating, “Your actions have consequences for others. Therefore, maybe you aren’t the only decider about what is and isn’t okay.”
Vaccines can be emotional and controversial, but as Moyer states, “Strong feelings don’t necessarily equal fact — there are real consequences.” Vaccine-preventable diseases can be serious, even fatal, so it’s crucial to make informed medical choices. Identifying personal beliefs, and investigating them with credible sources ensures that the decision reached is safe, beneficial, and based on science.
