There are more than 72 million Americans whose immune systems cannot fully protect them. In fact, some cannot mount a real response to a vaccine. Others cannot safely receive certain vaccines at all. For these individuals, staying healthy depends less on their own vaccination status and more on everyone else’s.
That is what makes this current moment so difficult for the immunocompromised Americans that we at the Immune Deficiency Foundation represent. The clinicians in our network tell us that conversations about vaccines continue to require longer, more nuanced conversations, and families who once trusted a physician’s guidance now walk in unsure of whom to believe.
Parents ask whether the schedule their older children followed is still recommended. Adults managing chronic conditions want to know whether last year’s guidance still applies. People are struggling to do right by their families and are not sure what or who to believe as guidance keeps shifting.
When vaccination rates stay high, illness and infectious diseases have fewer places to spread, and those who cannot be directly protected are shielded by those who can. When rates slip, that protection unravels.
A skipped routine measles vaccine affects more than the child who missed it. It reaches the classmate beside them living with leukemia, the teacher down the hall on chemotherapy, and the newborn sibling still too young to be vaccinated. These 72 million people are much more than a statistic, and we encounter them in our daily lives whether we are aware of it or not.
There is a part of this story that draws far less attention. Vaccination ranks among the safest things we do in medicine. It is also one of the best financial decisions the country makes. The Centers for Disease Control and Prevention (CDC) estimates that for children born from 1994 to 2023, routine childhood vaccines will prevent roughly 508 million illnesses and more than a million deaths, saving about $2.7 trillion in societal costs. In plain terms, every $1 spent on childhood immunization returns close to $11.
Outbreaks also have a major financial impact in the other direction. When measles spread through Clark County, Washington, in 2018 and 2019, containing it cost an estimated $3.4 million, nearly $47,000 for every case. Behind those numbers are parents losing paychecks, children losing weeks of school, and hospitals absorbing illnesses that a routine vaccine would have prevented.
Those benefits hold only if vaccines remain available and affordable, and that depends on two federal safeguards most people never encounter. The first is the Advisory Committee on Immunization Practices, the independent panel inside the CDC that has set the nation’s vaccine standards for more than 60 years. Its recommendations guide clinicians on which shots to give and when, and they also decide what insurance must cover at no cost.
That review has been disrupted. The committee was overhauled last year and the childhood schedule scaled back; though a federal court has since paused those changes, the uncertainty remains. This epitomizes the confusion so many families have to navigate these days.
The second safeguard is the National Vaccine Injury Compensation Program. It is a no-fault system that compensates people for vaccine injuries and gives manufacturers liability protection that keeps them in the market and holds supply and prices steady.
Two efforts would weaken it. One would broaden the program’s list of covered injuries beyond what the evidence supports, which could drain the fund that pays legitimate claims. The other, a bill called the End the Vaccine Carveout Act, would strip that protection outright and return manufacturers to the litigation risk that predated the program.
Both put the same thing at risk: a steady, affordable vaccine supply. And the people least able to weather a shortage or a price spike are the immunocompromised.
For the community I serve, these are worrisome times. The stability of these safeguards is part of what keeps them safe. I’ve spent more than two decades working for organizations focused on protecting the health of vulnerable populations. I am a nonprofit executive by trade and an advocate for the immunocompromised by choice, and my request to lawmakers is simple.
Please protect the independent scientific review that has guided vaccine policy for decades. Protect the programs that keep vaccines within reach of every family. Keep in mind the neighbor, the classmate, and the newborn whose safety depends on the choices the rest of us make. And remember that so many of these difficult conversations going on across our country are, themselves, a policy choice.
Jorey Berry is President and CEO of the Immune Deficiency Foundation.
