The Vaccine Post

Vaccine policy is changing quickly. I’m keeping this post free and updating it as information on new recommendations, policies, court decisions, and evidence becomes available.

_{A quick reminder: This post contains general information and is not intended as medical advice. Additionally, the information shared about kids is generally for healthy, typically developing, and growing, full-term children unless otherwise stated. I am a pediatrician, but interacting with or following this account does not establish a doctor-patient relationship, nor does this information replace the advice of your own doctor.}

August 26, 2026 update:

On Friday, 8/21/26, HHS requested public comment on the categories used in federal vaccine recommendations and the role of shared clinical decision-making. It is targeting the current framing of shared clinical decision-making, saying it is somehow implying that other vaccines do not come with informed consent. This is entirely false. Additionally, it is extremely concerning that there is no mention of ACIP involvement or how it will impact VFC.

I submitted the below public comment.

My name is Dr. Lauren Hughes. I am a board-certified pediatrician in private practice in Kansas City, Kansas. I'm the mother of three children and a fierce supporter of childhood health and safety, which includes vaccines. I have only ever practiced as a direct primary care physician. I have never been under contract with any insurance agency, received money from one, or from any pharmaceutical company.

Currently, the United States follows three main categories: universal, risk-based, and shared clinical decision-making. The importance of these categories lies not in where a specific vaccine is assigned, but in the evidence-based and transparent scientific process utilized in the assignment. The rigor of that process is critical as each category holds specific post-market consequences and accountabilities.

The ACIP has issued recommendations for the universal, risk-based, and shared clinical decision-making categories for the last 15 years. An important part of that vaccine categorization is separating the quality of evidence from the grade of recommendation.

The quality of evidence is based on the objective measurements of benefit vs harm for that specific vaccine. The strength of recommendation considers the reality of implications-- the impact on the public, the acceptance of the vaccine, the values and preferences of the population, health equity, and cost. Taking all of that in conjunction with the evidence results in the final recommendation, with all of the data behind these decisions being available. Any revision to categories should maintain this rigorous level of deliberation and transparency.

Randomized controlled trials (RCTs) are not the only, nor are they always the most appropriate, legitimate studies to determine vaccine policy. It would be extraordinarily difficult to have a double-blind randomized placebo-controlled trial for an improved version of a vaccine, as most of the population would have been previously vaccinated. This would result in paralysis of our quality improvement abilities regarding existing vaccines. Additionally, medical and human ethics would not permit the intentional withholding of a potentially life-saving vaccine from a group of children solely for the sake of evaluating long-term outcomes. The approach when a RCT is not available or is limited is to continue utilizing the GRADE system for the available evidence and utilizing that evidence to make recommendations.

In regard to individual autonomy and religious freedom, a presumption towards autonomy is the current guidance, recommendation, and practice at the clinical encounter level. This is the ability of a patient to decline a vaccine in the exam room, which every patient has the right to do. However, this does not work when utilizing public services in the community, as stated in Jacobson v Massachusetts:

"The liberty secured by the Constitution of the United States does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good.

The rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand."

Those who want to participate in community organizations such as public schools, will find that they have to follow specific rules to join. Part of the discussion in risks of not vaccinating should include that may violate the requirements of certain publicly available services resulting in the barring of utilization of said services. This level of nuance and patient-specific details cannot be incorporated at a federal or whole population level. Finally, no major world religion doctrine recommends against vaccination. The Pontifical Academy for Life made the following statement:

“As regards the diseases against which there are no alternative vaccines which are available and ethically acceptable, it is right to abstain from using these vaccines if it can be done without causing children, and indirectly the population as a whole, to undergo significant risks to their health. However, if the latter are exposed to considerable dangers to their health, vaccines with moral problems pertaining to them may also be used on a temporary basis. The moral reason is that the duty to avoid passive material cooperation is not obligatory if there is grave inconvenience. Moreover, we find, in such a case, a proportional reason, in order to accept the use of these vaccines in the presence of the danger of favouring the spread of the pathological agent, due to the lack of vaccination of children.”

The categorization of vaccines has enormous downstream results. The recommendations determine the coverage for Vaccines for Children, out-of-pocket cost, patient access, school/childcare entry requirements, and private insurance reimbursement. The balance of this system is precarious, and disruption to the categories and coverage could result in collapse of supply, availability, and coverage as well as eviscerate what is left of public trust in vaccines.

Clinical decision-making in practice is often confusing in terms of where the vaccine falls in coverage. Clearer communication in the categorization could help result in better communication for clinicians. It is imperative that the guidelines and recommendations include the weight of the evidence and consensus, acknowledge any genuine uncertainty, and are truthful about side effects. When discussing the data, science communicators should also pre-bunk possible areas of data manipulation that can be used as scare tactics later. Overstatement of certainty will erode trust, and honesty about the unknown helps restore it.

With this statement, my intent is to urge that any evaluations and/or revisions protect the critical scientific process that places vaccines into their respective categories and maintain the integrity of the recommendations by incorporating the voice of an appropriately chaired ACIP. It is only by following good science that is void of ideology and is solely based on objective data that we can provide the safest and best protection for children.

Respectfully,

Lauren Hughes, MD, FAAP, FABM, IBCLC

The second update comes out of Lancaster County, Pennsylvania, where unfortunately, two unvaccinated individuals have died from measles. Pennsylvania has reported nearly 400 cases of measles this year. Prior to this outbreak, which began last year in Texas, the most recent death from measles was of a 23-year-old in 2015. The most recent death of a child from measles was 2003. It is devastating that these individuals are dying from a disesase that easily could have been prevented.

This year, we have already surpassed the total number 2025 measles cases. In November, officials will meet to determine if the US and Mexico have lost their measles elimination status. I bet my bottom dollar it’s long, long, long gone, and measles is hella back.

I fucking hate this timeline.

I want to remind you all of the effects of a measles infection. While the disease process itself—runny nose, red eyes, cough, fever, fatigue, rash, sore throat—can feel like it’ll be the same as any other virus, I assure you, it is not the case. While the illness itself can be managed at home for most, what is unpredictable are the complications that can arise.

Complications such as:

• Immune suppression which results in increased risk of a serious bacterial infections in your blood, lungs, intestines, and ears.

• The complete wipeout of your immune system. That means all antibodies and protection to any illness or disease are gone entirely. You are essentially a newborn again.

• Swelling of the brain.

• Acute disseminated encephalomyelitis (ADEM) which happens during the recovery phase of measles. There is an autoimmune attack on part of the nerves that leads to paralysis of different parts of the body—sometimes including the diaphragm (the muscle that helps us breathe). Most recover after 2-4 weeks in the ICU but some experience long term issues.

• Subacute sclerosing panencephalitis (SSPE) is a perhaps the most catastrophic measles complication that can occur 7-10 years after a natural infection.

  • The first stage: mild changes in personality, strange behaviors, and fatigue. This can last anywhere from several weeks to several years.

  • As the disease progresses, the ability to move with purpose dimenishes and patients experience near constant involuntary jerks of their body. Dementia also worsens around this stage, which usually lasts no more than a year.

  • The final two stages are progressive deterioration of all bodily function.

  • Stage four is when a full vegetative state is reached and when death typically occurs.

We don’t know any other information about the deaths, including whether they died from a recent infection or if they had SSPE, nor do we know their ages. However, I want to take this moment to remind you all that we give more than 100 MILLION doses of the MMR vaccine worldwide every year and there has never been a death caused by it in a healthy person (someone who is severely immunocompromised should not receive the MMR vaccine since it is a live vaccine).

So please, check with your kid’s pediatrician vaccination status if you’re unsure of their protection. Kids cannot get their first dose until 12 months of age routinely. If you are traveling to an area with an active measles outbreak or traveling internationally, children 6 months and older can get a single “bonus” dose of the MMR vaccine but will need to complete the 2 dose routine series at 12 months and 4-6 years (in the US).

August 10, 2026, President Trump signed an executive order titled “Delivering Gold Standard Childhood Vaccine Recommendations for Americans.”

Here’s what the executive order does:

• It divides childhood vaccines into three categories: vaccines recommended for all children, vaccines recommended for certain high-risk groups, and vaccines recommended through shared clinical decision-making.

• Vaccines including hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, and COVID-19 are no longer included in the administration’s list of vaccines recommended for all children. This is the change made on the CDC page in January of 2026. The EO restates the CDC guidelines but does not change anything or add anything new.

• It says the combined MMR vaccine should eventually be offered as three separate vaccines for measles, mumps, and rubella once they are available in the U.S.

• It also states that childhood vaccines should be given at separate visits whenever feasible, and directs HHS to further evaluate the timing and sequencing of childhood vaccines.

What does this mean for us right now? Nothing. It is a big nothing burger.

An executive order can change federal vaccine policy, but it can’t change or create the science with a signature. This order doesn’t come with three separate measles, mumps, and rubella vaccines. Those products aren’t even available in the U.S. And simply saying vaccines should be given at separate visits doesn’t provide evidence that doing so is better or safer for your child. Nor does it consider the fact that more visits mean more copays and more time out of school/work.

The same goes for the vaccines the order emphasizes are now removed from the “recommended for all children” category. It provides no evidence showing us that hepatitis A, hepatitis B, rotavirus, flu, or meningococcal vaccines are suddenly unsafe, ineffective, or unnecessary. The AAP continues to recommend these vaccines for all children as we have been for years.

The executive order directs federal agencies to pursue and implement Bobby’s new vaccine policy. That is a policy change, NOT the discovery of new evidence.

Before we dive in, let’s establish where I’m getting my information from.

Throughout this post, I’ll link to studies and other relevant resources I reference so you can check them out for yourself. But for the most part, I start with the American Academy of Pediatrics (AAP) and the research behind its recommendations.

I also really like the Vaccine Education Center at Children’s Hospital of Philadelphia (CHOP). I think they do a great job of taking evidence-based vaccine information and explaining it in a way that doesn’t require you to have a medical degree to understand. Plus, we Stan Dr. Paul Offit.

I follow the childhood and adolescent immunization schedule recommended by the AAP. I never thought we’d be at a point where I have to repeat that as often as I do.

For decades, pediatricians in the U.S. have relied on a childhood immunization schedule developed through the federal vaccine recommendation process and endorsed by organizations including the AAP. If you went to your pediatrician and asked what vaccines your child needed, there generally wasn’t a meaningful distinction between “the CDC schedule” and “the AAP schedule.” That has, unfortunately, changed.

In 2026, the AAP published its own childhood and adolescent immunization schedule and announced that it would no longer endorse the CDC’s childhood schedule. That means that, depending on where you’re getting your information, you’re likely to come across different recommendations, which has quickly become very confusing for many people.

The question has now become, “Okay, so who am I supposed to trust?”

My answer is that I don’t recommend vaccines just because a particular organization tells me to, or because I make money off of them. In fact, if doctors were actually making money based on the number of vaccines we administer, you’d think we’d be pumped about increasing the number of doses in the vaccine schedule. One shot becomes three? Let’s go! Three separate transactions. Ka-ching!

I follow the AAP schedule because I believe it best reflects the evidence we have about protecting children from vaccine-preventable disease. It’s the schedule I follow for my children. Evidence-based medicine is not about siding with an authority and agreeing with everything they say for eternity. Neither the AAP nor the CDC, nor I, am infallible.

I also follow the schedule because I understand the science behind it. I listened to every hour of the FDA advisory meeting about the COVID vaccine–about 16 in total. I listened to the deliberations, criticisms, and the detailed inspection of the data.

These scientists weren’t making recommendations for a vague group of people they didn’t know. These recommendations would affect them, their parents, their friends, and their children too.

Listening to these scientists go back and forth about the interpretation of the data–challenging each other, discussing the real-world implications, and making those decisions in real time during a pandemic– gave me an entirely new appreciation for the process and the scientists doing the work. -

And I gave my kids that vaccine the day it became available.

The bottom line is I trust vaccines. I trust them with my children’s lives.

So the question should always be, “What does the evidence tell us?”

When experts make vaccine recommendations, they consider a lot more than whether a vaccine simply “works.” Researchers have to understand how common and to what severity the disease the vaccine is working to prevent is, which children are most vulnerable to that disease, how effectively the vaccine prevents infection or the severity of an infection, how long the protection it provides lasts, what are the known side effects, how often they occur, and how the risks of vaccination compare with the risks of remaining unprotected against the disease.

We also have to determine timing. When does a vaccine provide the best benefit? A vaccine that is effective at preventing a disease isn’t very helpful if we give it after the age when children are most vulnerable to contracting it. So now all of that evidence I just mentioned has to be considered together.

Another important thing to understand is that vaccine recommendations are not supposed to be permanent. Those recommendations may change as scientists continue to research and learn. We’ve added vaccines to the childhood schedule as science and technology have evolved to allow prevention of more diseases. We’ve changed the number or timing of doses when better data became available. We’ve changed recommendations when disease patterns changed. And we’ve changed or removed vaccines when safety monitoring identified a problem or a better option became available, as we should!

I don’t need an organization promising me that vaccines are perfectly safe. No medical intervention is without risk. I need them to ask the right questions. Questions like, what are the benefits? What are the risks? How good is the evidence? How certain are we? Are there particular groups for whom that calculation is different? Is there new evidence that should change what we’ve been doing? And then I need the recommendation to follow the science, even when new evidence emerges.

That’s also why changes currently happening at the federal level don’t automatically change what I recommend in my office. A policy can change very quickly. The president can sign 5 executive orders this week about vaccines. Evidence doesn’t change just because the policies change.

If tomorrow we get strong, reproducible evidence showing that one of the vaccines I currently recommend causes harm we weren’t aware of, I want to know about it. If the evidence shows that a different dosing schedule has better protection with fewer risks, I want to update the schedule. If a safer or more effective vaccine is developed, that’s the one I want my patients to have access to. If GOOD evidence and data support one of the changes proposed by the current administration, I will follow that evidence, too, because my commitment is to science, not politicians.

Currently, when I look at that evidence and weigh the benefits and risks for my patients, I am still standing ten toes down when recommending the AAP vaccine schedule for children because that’s what the evidence supports.

I see a lot of questions about vaccines that are some version of “Why do babies need so many vaccines so early?”

You bring home this tiny potato, spend the first few months trying to protect them from literally everything, and then you bring them to an office, and the doctor starts talking about sticking them with needles, and I’m sure it can feel like a lot. However, the timing of the childhood vaccine schedule isn’t arbitrary, and it isn’t designed to get as many vaccines into a baby as quickly as possible. Each vaccine is recommended at a specific age because we’re trying to protect your child when they need it most.

When scientists determine the timing of a vaccine, they’re looking at several things at once:

• When is a child most vulnerable to serious complications from this disease?

• At what age can we expect the vaccine to produce the immune response we need?

• How many doses are needed to build the necessary protection?

• How far apart should those doses be given?

• Does protection change over time?

The answers to these questions differ depending on the vaccine and the disease.

Most term babies aren’t born with zero antibody protection. During pregnancy, antibodies cross the placenta from parent to baby and provide some protection during those first months of life. If a baby is breastfed, breast milk can also provide additional antibodies for protection. However, that protection is finite. Those maternal antibodies we just talked about—they gradually decrease over the first 4-6 months of the baby’s life; they don’t provide equal protection against every disease, and eventually a baby’s immune system must develop its own protection.

At the same time, babies are particularly vulnerable to very serious complications from some infections and diseases. Pertussis, also known as whooping cough, is a perfect example. An older child or adult can become very sick from pertussis, but the youngest babies are at particularly high risk of severe infection, hospitalization, and death. So waiting until they’re older to start vaccination wouldn’t actually be the better option. It would leave them vulnerable and unprotected when they are most at risk for the disease.

And I get how hard this is. You see this tiny baby, and you want to protect them. Keep them safe until they’re bigger. Germs are not considerate of that. When you are that tiny, your immune system is still developing, and some infections can make babies really sick.

By vaccinating babies, you’re giving their immune system a preview of what to look for so that it’s better prepared if it encounters the real thing. Vaccination doesn’t mean they’ll never get sick. It means we’re doing what we can to minimize the severity of the disease by preparing their immune system to fight it.

By vaccinating them, you’re giving their immune system the sword and shield before it has to go into battle, so it stands a much better chance of defeating it.

That’s the reasoning in a nutshell. We want immunity in place before exposure happens.

I bet you’ve looked at your infant’s vaccine schedule and thought, “Wait, didn’t we already do this one?” You’re probably right. That’s because some vaccines require multiple doses, as a single dose doesn’t always provide the level or duration of protection needed.

The first dose acts as an introduction. Your immune system then learns to recognize the illness, begins to build a response, and then creates a memory so it knows what to do if that illness returns. Sometimes vaccines have boosters because immunity decreases over time, so we give another dose at a later date to strengthen that protection again.

This goes back to timing! Here, the timing between doses matters. Again, it’s not just some made-up schedule designed to maximize profit. These schedules are based on studies that examine how the immune system responds and when additional doses are required to achieve the protection needed for effectiveness.

So when you see the same vaccine show up more than once on your child’s schedule, it isn’t because the previous one didn’t work. Building lasting immunity is a process, and different vaccines require different numbers of doses to get there.

This is where, as a pediatrician, I enter mixed-view territory. Parents will sometimes say, “I’m fine with vaccines, but I don’t want all of these vaccines to be administered all at once.” Shots hurt. Kids usually cry. I get it. I GET IT. Spreading them out can feel like the safer or gentler option. But feeling safer and actually being safer aren’t the same thing.

Your baby’s immune system is doing a ridiculous amount of work every single day of their life. The minute they are born, they’re exposed to bacteria, viruses, other people, siblings with dirty hands, and germy but loving kisses. Their immune system is constantly recognizing and responding to these new things–and if they trigger an immune response, they’re called antigens.

The antigens in vaccines represent only a small fraction of what a healthy immune system can respond to at one time. Giving multiple vaccines at the same visit does not “overload” or “weaken” the immune system. And we don’t just assume vaccines can be given together because it’s convenient. We study them that way. When vaccines are recommended at the same visit, researchers examine whether administering them together affects their effectiveness or increases the risk of side effects. Some combinations even increase the efficacy.

Suppose certain vaccines need to be separated or given at specific intervals; that gets built into the vaccine schedule. So why give the rest together? Because it allows us to protect your child against multiple diseases without leaving them vulnerable longer than necessary.

Can we spread vaccines out just because it feels better for parents? Sometimes, sure. However, for a delayed or alternative vaccine schedule to be safer, we would need evidence showing that doing so reduces meaningful risk. We don’t have that. What we do have is evidence that delaying a vaccine delays protection.

Spacing vaccines out also means more appointments, and life happens. Your kid gets sick, or you go on vacation. You’re super busy, and you forget the appointment. Now all of a sudden a vaccine that was delayed for a few weeks has been delayed by a few months. And if you’re worried about stressing your child’s immune system, vaccination itself can cause a temporary cortisol response–but giving multiple vaccines at the same time hasn’t been shown to cause a meaningfully greater cortisol response. Spreading them out just means more visits and more separate experiences getting a shot. There are medical exceptions and reasons why a child might need or benefit from a delayed or modified vaccine schedule. Those are not the kids I’m talking about. But for an otherwise healthy child, I don’t recommend spreading vaccines.

First, it’s important to understand that when we say vaccines are “safe,” this does not mean there is a 0% chance of something bad happening. I won’t make that promise about vaccines, and I won’t make that promise about any medication or medical intervention. Vaccines can cause side effects. Rare and serious reactions can occur.

How do we figure all that out? We study the shit out of them. We look at what the risks are, how often they occur, and how those risks compare with the disease the vaccine is designed to prevent.

The FDA reviews the data before a vaccine can be approved in the U.S. That means that before a vaccine hits the vaccine fridge in my office, it’s gone through years of development and testing. That begins in a lab, moves into larger human clinical trials, and eventually involves thousands or even tens of thousands of participants. But the process doesn’t end at approval. Once it is available and millions of people start to get it, we keep studying it. This is important because we can’t find a one-in-a-million reaction until we’ve given it to a million people.

This is why understanding the term “adverse event” is critical. An adverse event is something that happens after vaccination. It doesn’t mean it happened because of the vaccine. An adverse event is different from an adverse reaction, which is a side effect we have reason to believe was actually caused by the vaccine.

In the U.S., we have multiple vaccine safety monitoring systems. I mention VAERS, or the Vaccine Adverse Event Reporting System, in my post on Vaccines and Autism. Systems like VAERS allow anyone to report an event that occurs after vaccination. It then uses that information to identify patterns we can investigate to determine whether there is an actual increase in risk.

Sometimes we find one! Let’s take a previous rotavirus vaccine as an example. It was withdrawn from the U.S. market after post-approval monitoring identified an increased risk of a rare intestinal complication called intussusception. So what did we do? We changed course because the evidence told us we should, and we updated our recommendations.

Finally, I don’t want to end this section without acknowledging the “what-about-isms” surrounding vaccines. What about thimerosal? What about aluminum? What about autism? I actually did answer that one, and because it’s a big one, it’s available to both free and paid subscribers. I will be covering thimerosal, aluminum, and other ingredients found in some vaccines that have caused panic, concern, and the spread of misinformation throughout the years.

If you’re interested in learning about that, make sure you subscribe and look out for my series, “The Dose Makes the Poison.”

While this might feel personal, I can assure you that it’s not. Pediatricians are not punishing parents for making a choice they disagree with.

Remember who else is sitting in these waiting rooms. Pediatricians care for newborns who are too young to be fully vaccinated, children receiving chemotherapy, and kids whose immune systems are suppressed for other reasons.

An unvaccinated child isn’t a walking infection, obviously. The concern is what happens when vaccine-preventable diseases are circulating. An unvaccinated child is more likely to become infected if they’re exposed, and that infection can then be passed along to someone who may be much more vulnerable to serious illness or disease.

At the same time, there is also a real downside to turning an unvaccinated child away from medical care. That’s why pediatricians don’t all handle this the same way. Some choose to keep those families in their practice and continue the conversation. Others prioritize limiting the risk to vulnerable patients in their office.

Neither decision is about punishing the child.

Point is, if a practice tells you they don’t accept unvaccinated patients, it’s usually not out of spite. They’re making a decision about how they believe they can best care for all of the children in their practice–including the ones who can’t protect themselves yet.

An internet rabbit hole will easily lead you to “Vaccine manufacturers can’t be sued, and the government has a fund that pays people who are injured by vaccines. Oh, and pediatricians make money every time they give a shot, so obviously everyone involved is financially motivated to keep adding vaccines to the schedule”

Let’s unpack that.

One: Vaccine manufacturers are not totally immune from lawsuits. The National Childhood Vaccine Injury Act of 1986, established by the National Vaccine Injury Compensation Program (VICP), was created in part because lawsuits and rising liability costs were threatening vaccine supply. This wasn’t an imaginary concern. In 1967, there were 26 FDA-licensed vaccine manufacturers in the U.S. By 1980, there were 17, and by the early 2000s, only a handful of companies were producing routinely recommended childhood vaccines. Liability wasn’t the only reason manufacturers left the vaccine market, but it was one of them.

The VICP created a different way to handle certain vaccine injury claims. Instead of starting with a traditional lawsuit against a manufacturer, someone who believes they were injured by a covered vaccine can file a claim through the program. It was designed to be less adversarial, less expensive, and less time-consuming than traditional litigation, and compensation can be awarded without proving that the manufacturer was negligent.

The fund is financed by an excise tax on covered vaccines paid by vaccine manufacturers.

So while vaccine manufacturers have significant legal protections–particularly for certain claims involving unavoidable side effects–“Vaccine companies can’t be sued” is a generous oversimplification of how the system actually works.

And yes, money changes hands when vaccines are given. Vaccines cost money to purchase, store, and administer, as well as salaries for the staff. And yes, everyone involved–including your pediatrician–has to make money to stay in business. But getting paid to provide a medical service is not the same thing as being financially incentivized to recommend it.

In a traditional pediatric practice, insurance reimburses the practice for the cost of the vaccine and for administering it. Because, well, the practice bought the vaccine. This is a normal economic transaction, not an antigen pyramid scheme.

I run a direct primary care (DPC) practice, so it’s different because I don’t bill insurance. My patients pay a membership fee for their care. That means whether your child gets every vaccine I recommend, none of them, or we fall somewhere in the middle, this does not change what you pay me.

But according to some parts of the worldwide web, here I am… swimming in my billions of vaccine kickback dollars while I continue to share information on social media just for a troll to tell me I need to meet my vaccine quota. (This is satire)

Evidence. That’s it.

My job is not to defend vaccines because I support vaccination. My job is to review the BEST available evidence and then make the recommendation I believe is best for the patient in front of me.

In fact, I have changed my recommendation before.

Let’s look at the COVID vaccine as an example. As millions of people became vaccinated, more data became available. A particular data set showed us that adolescent and young adult males had an increased risk of myocarditis –specifically after the second dose of the original mRNA COVID vaccine. That evidence changed my risk-benefit calculation regarding the recommendation to give additional COVID boosters for young men while I waited for additional data. Later, when the science showed that slightly increased relative risk of myocarditis from the vaccine had milder symptoms than from the infection itself, my recommendation resumed.

I didn’t become anti-COVID vaccine or decide the original recommendation was some giant conspiracy. We learned something new, so I updated my recommendation accordingly.

That’s how science should work. That’s what we want it to do. If good evidence shows us a risk we didn’t previously understand, we want to know more about it. We’ll research and determine what changes are necessary to improve our risk-benefit profile, or, if necessary, develop something new.

Believing strongly in vaccines doesn’t mean we have to shame people who have questions about them.

There’s a difference between deliberately spreading misinformation and being scared, uncertain, or trying to make sense of conflicting information. You’ve heard me say this a million times: parents are allowed to ask questions. I want you to ask questions.

If someone you love is hesitant about vaccines, I understand the instinct to prove them wrong. Believe me, I’ve spent years begging people to vaccinate their children. It turns out that going back and forth is not a very effective public health strategy. The best and most effective way to make your point is to share good information, answer their questions when you can, encourage them to talk to a doctor or medical professional they trust, and then give them room.

Changing your mind when you’re presented with better information is a good thing. If someone afraid of vaccines yesterday wants to vaccinate today, they don’t need an “I told you so.” They need, “Great. Let’s get you caught up.”

You’re allowed to change your mind, and you’re allowed to ask questions.

All in all, I want this post to be useful and to answer the questions you actually have, not just the ones I think you have. So if there’s something I didn’t cover here, ask me! While I can’t answer individual medical questions, and some questions are going to require a conversation with your own physician who knows your or your child’s medical history, if it’s something that would be helpful for other parents to understand, I’ll continue adding answers and resources to this post.

I don’t want you to feel like you have to choose between unquestioningly accepting what you’re told and figuring out the entire field of vaccine science on your own. There is a whole lot of noise between those two things right now, and it’s drowning out the conversations we should be having. So I hope I can help turn the volume down and provide clarity.

Thanks for being here!