[5 min read]
- With the ongoing controversy around vaccines, parents are being whipsawed between physician guidance and government recommendations.
- Major medical organizations, including the American Academy of Pediatrics, successfully sued to stop the implementation of new vaccination guidelines. Government officials have signaled that they'll to appeal.
- Providence Swedish pediatric infectious disease expert Frank Bell, M.D. discusses the gravity of the situation and why a relationship of trust betweeen parents and doctors is essential to kids' health.
Recent changes to federal vaccination guidance have brought significant challenges for physicians in their work with parents—and a rebound of preventable infectious disease across the United States.
Major medical organizations, led by the American Academy of Pediatrics (AAP), warned that fragmented government vaccine recommendations undermine evidence-based care and sued to stop their implementation. In mid-March, a U.S. District judge in Boston agreed with the AAP and other plaintiffs, halting government efforts to scale back vaccine recommendations, finding that recent changes to the Advisory Committee on Immunization Practices (ACIP) ran afoul of federal guidelines. The verdict is unlikely to be the final word, with government officials signaling that they are prepared to appeal.
In the meantime, pediatricians are reporting increased resistance to routine vaccination amid rising measles outbreaks, record pediatric influenza deaths, and continued COVID-19 morbidity. And parents find themselves buffeted by a storm of opinions as they wrestle with the best choices for their children and their families.
The consequences of childhood vaccine changes
Since early 2025, the federal government has narrowed routine childhood vaccine recommendations. Several longstanding, universally recommended vaccines—including influenza, COVID-19, hepatitis A, hepatitis B, rotavirus, and meningococcal vaccines—have been moved to shared clinical decision making or risk-based categories. This dangerously benign messaging has led many parents to interpret “optional” as “unnecessary,” and even “dangerous.” Pediatricians are now too often in the position of championing evidence-based care during already constrained visits. The timing could not be worse.
Vaccine hesitancy is supporting a measles resurgence
A decline in post pandemic vaccination rates is driving a resurgence of measles.
Spartanburg, S.C., is in the midst of the worst U.S. measles outbreak in more than 25 years. By early March, officials had reported nearly 1,000 cases and extremely low vaccination coverage in affected school communities. At the same time, the United States is on the brink of losing its measles elimination status.
Last year, the United States recorded 2,144 confirmed measles cases across 45 jurisdictions, with 49 distinct outbreaks—an eightfold increase from 2024’s reported 285 cases. And with only a few months of 2026 behind us, the U.S. is already on track for a record-breaking annual total.¹ This data represents a severe clinical and financial burden. The cost of measles and measles containment puts an enormous strain on public health departments who are unable to manage other critical demands. Not to mention the human cost. According to the World Health Organization (WHO), approximately 17% of measles patients in the 2025 outbreak required hospitalization, and measles-related deaths occurred in the U.S. for the first time in a decade. The WHO also confirmed that most cases occurred in unvaccinated or under-vaccinated children, underscoring the direct relationship between declining coverage and morbidity.
Influenza: Historic levels of pediatric death
Influenza is another stark example. The 2024–2025 U.S. flu season was among the most severe in recent history, associated with an estimated 43 million illnesses, roughly 500,000 hospitalizations, and approximately 38,000 deaths nationwide.
For children, the toll was unprecedented. At least 266 pediatric deaths were reported during the season—one of the highest totals ever recorded in the U.S. Critically, about 90% of children who died were eligible for influenza vaccination but were not vaccinated. Pediatric hospitals across the country reported sustained capacity strain during peak respiratory season, driven largely by preventable flu complications. Despite these outcomes, misinformation continues to target influenza vaccination, with clinicians left to manage the downstream consequences in emergency departments and inpatient units.
Infant and pregnant patient outcomes
Pregnant patients have not been spared from the effects. Respiratory viruses pose well-documented risks during pregnancy and early infancy. Respiratory syncytial virus (RSV) remains the leading cause of infant hospitalization in the United States, accounting for an estimated 58,000–80,000 hospitalizations and 100–300 deaths annually among children under five—most of them infants.
The CDC and professional societies recommend a single dose of maternal RSV vaccine (Pfizer’s Abrysvo) between 32 and 36 weeks’ gestation to protect infants during their first RSV season. At the same time, false narratives questioning the safety of maternal vaccination are spreading rapidly online, forcing increasing reliance on post birth monoclonal antibody products.
Influenza vaccination during pregnancy has also become a target of antivaccination rhetoric. Pregnant people face higher risks of severe flu-related complications, and vaccination is well established to reduce both maternal hospitalization and infant influenza illness in the first months of life. Yet declining confidence fueled by misinformation has compromised prevention, putting mothers and babies at risk for severe illnesses with the potential for lifelong consequences.
Professional opposition and the cost to clinical care
Major professional organizations—including the AAP and the American Medical Association—have publicly opposed recent federal actions that weakened routine vaccine recommendations and sued to stop them, warning that the guidance undermines clinician authority, confuses patients and costs lives. A federal judge in Boston recently sided with the plaintiffs, putting the changes on hold. Federal officials are planning to appeal.
At a February press conference, South Carolina State Epidemiologist Linda Bell, M.D., described the pace of Spartanburg’s measles outbreak: “This is not normal. This is unprecedented.”
Dr. Bell is correct. It is unprecedented. Vaccine-preventable diseases are resurging not because the science has changed, but because public trust has been eroded. To protect children and families, we must demand stable, evidence-based vaccine policy clearly aligned with professional expertise. Until we do, vaccination rates will continue to fall—and illness, hospitalization and deaths will continue to rise.
Learn more and find a physician or advanced practice clinician (APC)
When you have questions or concerns about your child’s wellness, Swedish Pediatrics is here to help. Call today to schedule a visit.
You can also contact Swedish Primary Care to schedule an appointment with a primary care physician. If you or your child has an illness, you can connect virtually with your care team who can review your symptoms and give instructions and follow-up care as needed. With Swedish ExpressCare Virtual, you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections and more. You can use our provider directory to find a specialist or primary care physician near you.
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