RFK, Jr’s vaccine policy is healthcare noblesse oblige of the most craven, grievous and callous variety. It’s also an opportunity to advance vaccine acceptance. Really.
Fact: Americans overwhelmingly embrace vaccines for themselves and their children – and they vote with their arms. During the 2023 to 2024 school year, 92.7% of kindergartners received the MMR vaccine. This is lower than the 93.1% seen in the previous school year and the 95.2% seen in the 2019 to 2020 school year, prior to the COVID-19 pandemic – but it’s important for context. Americans believe in vaccines.
Context is crucial considering that, on January 5th, the Centers for Disease Control (CDC), citing practices in other wealthy nations (including Denmark, Germany, and Japan) reduced the number of recommended childhood vaccinations from 17 to 11. The CDC said parents could choose to have their children receive some previously recommended vaccines, including those for flu, rotavirus, Covid-19, meningitis, and hepatitis A and B, after “shared clinical decision-making.” What’s the opposite of shared decision making? That would be “informed decision making” – physician informs/patient decides. To most people, most parents, and most physicians, that translates to “doctor knows best.” Ah, for the days of Marcus Welby, MD.
Bottom line is that the halcyon days of “trust me, I’m a doctor” are over. The inconvenient truth is that, in post-COVID America, trust must be earned. Pearl clutching and name-calling on social media and in medical journals is a gift to anti-vaxxers who enjoy the attention. It is the public health equivalent of farting into the wind. We need to live in the present. Healthcare providers are going to have work harder – and (at least at present) without commensurate reimbursement for this crucial counseling. Life is unfair.
It's time to recognize that when we stop feeding the beast, RFK, Jr. reverts to his prior status as Puff the Looney Tunes Dragon.
Here's the headline, “Sound Science + Shared Decision Making + Respectful Engagement = Victory for Vaccines.”
The battle isn’t going to be won on the traditional playing fields of academic white papers and expert advisory panels. RFK, Jr’s stacked CDC Advisory Committee on Immunization Practices (ACIP) defines shared clinical decision-making vaccinations (on a web page dated January 7th, 2025) as “individually based and informed by a decision process between the health care provider and the patient or parent/guardian.” In other words, patients (otherwise known as “people”) should discuss vaccinations with their primary care physicians, nurse practitioners, registered nurses, pharmacists, and anyone else they view as a trusted healthcare resource. If the pro-vaccine establishment can’t accept that premise, we lose. And there’s no victory in going down with the ship. The stakes are too high and the opposition too low.
It's important to note that the ACIP’s shared clinical decision-making recommendations do not suggest patients get vaccines without talking to their health care provider. What they do state that is that healthcare providers should decide with which patients they should discuss vaccinations. Pro-vaxxers can and should go beyond that and aggressively encourage people (also known as parents) to proactively begin these conversations. When we do that, sound science-based decision making prevails. We must own rather than deride shared decision making.
According to a survey by the Annenberg Public Policy Center, more than two-thirds (68%) know shared decision-making means they should review their or their child’s medical history with their health care provider before deciding whether the vaccine is right for them or their child. The same proportion (68%) say this regarding a Covid-19 vaccine for healthy children and teens.
When asked about “shared decision-making” with a “health care provider,” many Americans were not sure who would be included among that group. Survey respondents were provided with six options and asked to select as many as apply.
Most U.S. adults (86%) choose a physician. Two-thirds (66%) choose a physician assistant or nurse practitioner. But only half (50%) choose “registered nurse,” and just a third (33%) choose “pharmacist.” “With many vaccines available at pharmacies without a prescription, it is important for Americans to know they can talk to their pharmacist directly about their vaccination decisions,” said Ken Winneg, the APPC’s managing director of survey research.
Welcome to 2026. It's not about what experts say. (Sorry, bow-tied experts!) It’s about what patients (otherwise known as “the people”) think and (more importantly) how they choose to act.
Peter J. Pitts, a former FDA Associate Commissioner, is President of the Center for Medicine in the Public Interest and a Visiting Professor at the University of Paris School of Medicine.
