In the past few decades, childhood vaccinations have been heralded as one of the greatest achievements in public health. Diseases that once killed or maimed children—like polio, measles, and whooping cough—have been drastically reduced or nearly eliminated in many parts of the world thanks to widespread immunization programs.
And yet, child vaccination rates are declining. Let’s talk about it.
I joined KABC-TV to talk about declining vaccination rates in children. I hope my perspective as a practicing nurse practitioner can help shine some light on the topic.
The first thing to note is that this isn’t just a passing trend or a pandemic-era anomaly. It’s a slow, creeping shift that health officials, pediatricians, and parents are starting to recognize—and worry about. But while the statistics tell us that fewer children are receiving their scheduled vaccines, the more pressing question is:
Why?
Why are people divided on vaccines? The real issue isn’t just vaccines, it’s trust.
This cuts to the heart of a complex issue. Vaccines themselves aren’t the sole focus of the debate anymore. The conversation has shifted. Now, it’s about who people trust, what information they believe, and how the medical system responds to concerns.
From Blind Trust to Healthy Skepticism
For decades, vaccination programs operated with a foundation of institutional trust. Parents took their kids to the doctor, followed the recommended immunization schedule, and rarely questioned it. But today, we’re living in a very different information environment.
People have access to more information than ever—but that doesn’t always mean they’re better informed. Misinformation is rampant, and competing narratives make it hard to know what’s true. More importantly, people have witnessed genuine failures in the healthcare system that have eroded the once-automatic trust placed in medical institutions.
People have seen pharmaceutical companies put profits over patients and they add in some lack of transparency. And of course people are skeptical.
From drug recalls to high-profile lawsuits, the pharmaceutical industry has at times prioritized financial gain over public health. Add to that inconsistent messaging during the COVID-19 pandemic, rushed vaccine approvals, and lack of clarity around side effects—and the result is a public that is cautious, if not outright distrustful.
This skepticism doesn’t necessarily mean parents are “anti-vaccine.” In many cases, they’re simply overwhelmed and unsure. They have questions. They want answers. And they don’t want to be shamed for asking about the risks of vaccination.
The Danger of an All-Or-Nothing Narrative
Unfortunately, instead of cultivating open conversations, much of the vaccine debate has turned into a binary fight: pro-vax vs. anti-vax. You’re either on one side or the other. You’re either enlightened or dangerous. There’s no room for nuance.
Instead of having an honest conversation, we’ve turned this into an all good or all bad debate.
But reality rarely fits neatly into such categories. Yes, vaccines save lives. Yes, they are overwhelmingly safe for the vast majority of people. But it’s also true that, in rare cases, vaccines can cause harm. And it’s okay to say that.
For most people, vaccines are safe. But for some, they do cause harm. Ignoring this reality only fuels more distrust.
By refusing to acknowledge the full picture, we risk alienating the very people we want to reach. Dismissing concerns as conspiracy theories or labeling hesitant parents as “anti-science” doesn’t build trust—it deepens the divide.
If we want to change the trend of declining vaccination rates, we need to change our approach.
Rebuilding Trust, One Conversation at a Time
So, how do we do that?
First, we need to start with transparency. Public health authorities and healthcare providers must be open about both the benefits and the risks—however small—of vaccines. Sugarcoating or oversimplifying the truth only backfires when people discover information on their own that wasn’t disclosed to them.
Second, we need accountability. When pharmaceutical companies or regulatory agencies fall short, there must be consequences—and visible ones. Holding institutions accountable helps restore public confidence that someone is looking out for their interests, not just profits.
Third, we need compassionate communication. It’s not enough to throw data and statistics at people. Parents want to be heard. They want to know that their concerns are valid, even if the evidence ultimately supports vaccination. Trust grows from respectful, empathetic conversations—not judgment or fear-based messaging.
Fourth, we need to make space for complexity. People are capable of holding multiple truths at once: “I believe in science” and “I’m concerned about side effects.” “I want to protect my child” and “I’m not sure I trust the system.” If we create a space where these concerns can coexist, we can help guide people toward informed, confident decisions.
What’s at Stake
Declining child vaccination rates don’t just put individual children at risk—they threaten community health. Diseases that were once rare are making a comeback. Measles outbreaks have occurred in areas with falling immunization rates. Pertussis (whooping cough) has seen resurgences. And it’s often the most vulnerable—infants, the elderly, and those with compromised immune systems—who suffer most.
But fear alone won’t solve this. People aren’t motivated by doomsday warnings. They’re motivated by trust, connection, and confidence in the systems that serve them.
We must recognize that the problem is not just one of information. It’s one of relationship. Rebuilding that relationship will take time, but it starts with honesty, empathy, and accountability.
The Path Forward
This issue isn’t going away. In fact, it’s likely to grow more complex as new vaccines are developed and more voices enter the conversation. But complexity doesn’t have to be a barrier—it can be an invitation to do better.
So let’s stop shouting across the aisle. Let’s stop reducing the vaccine conversation to black and white. And let’s start meeting people where they are—with facts, yes, but also with humanity.
Because at the end of the day, most parents aren’t anti-vaccine—they’re pro-their-kids. And if we remember that, we’ll be one step closer to restoring the trust we need to protect the health of the next generation.
If this resonated with you…
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