Got Polio? No? Thank Vaccines!

Jacqueline H. Wolf

Vaccines work. They work so well that at least two generations of Americans have never heard babies gasping for breath due to whooping cough. At least two generations of Americans have never seen paramedics removing neighbors from their homes on stretchers because polio paralyzed their respiratory or leg muscles. Only Americans old enough to qualify for Medicare remember these once-common events. In fact, because vaccines work so well, and are so safe, a collective complacency toward debilitating and deadly vaccine-preventable diseases is one reason that an anti-vaccination movement has been able to mushroom in the United States.

In 1900, the leading causes of death in the U.S. were infant diarrhea, tuberculosis, and pneumonia—all infectious diseases. In 2000, the leading causes of death were all non-infectious, chronic conditions—heart disease, cancer, and stroke. Except for Covid-19, which was the third leading cause of death in 2021, we must go back to the 1920s to find any infectious disease listed as a leading cause of death in the U.S. We owe this epidemiological shift to two public health efforts—sanitizing the environment (building sewer systems, purifying water, pasteurizing milk) and developing and administering vaccinations. Yet now we have a secretary of Health and Human Services (HHS) who devalues these efforts as both a leading vaccine critic and a champion of unpasteurized (“raw”) milk. Robert F. Kennedy, Jr., the person responsible for safeguarding the health of U.S. residents, is a danger to us all.

From the late 19^th century through WWI, years now known as the Progressive Era, public health reformers vanquished infant diarrhea, cholera, and typhoid as top killers long before physicians had any means of curing these deadly gastro-intestinal illnesses. They did this by regulating milk, water, and food, among many other reforms instituted in the wake of rapid industrialization. Then the vaccines developed after WWI, and especially after WWII, ensured even greater population health by conquering still more infectious diseases. From the 1920s to 2000, Americans saw a 100% decline in smallpox, a 99.9% decline in diphtheria; a 99.8% decline in mumps; a 95.4% decline in whooping cough; a 100% decline in polio; and a 99.7% decline in rubella, all thanks to vaccines.

Measles saw a similar decrease—99.98%—until recently. Before 1963, when a measles vaccine became available, an estimated 3 to 4 million people, mostly children, contracted measles annually in the United States. In 2000, there were only 81 cases. But since January 2025, when the anti-vaccination movement obtained its largest public platform yet, 35 states have reported 1,197 cases of measles as of June 13.

Going Backwards?

Thanks to Kennedy, we are likely in for a resurgence of many deadly infectious diseases. Indeed, he appears to be actively pursuing that goal.

On June 9, Kennedy fired the 17 members, all vaccine and infectious disease experts, of the Advisory Committee on Immunization Practices (ACIP). The ACIP, established in 1964, recommends current vaccines and vaccine schedules to the Director of the Centers for Disease Control and Prevention (CDC). The CDC Director then approves or rejects the recommendations. The bad news for us is that the CDC directorship is currently vacant and so Kennedy himself currently approves or denies the ACIP’s recommendations.

The list of ACIP/CDC-approved vaccines, and when to administer them, carry great weight. Insurance plans must cover the full cost of recommended vaccines. Even the uninsured are affected by ACIP recommendations. Roughly half of American children are eligible for the Vaccines for Children program, which provides free vaccines to un- and under-insured children—but only if the ACIP recommends the vaccine. And Kennedy’s new appointees to the ACIP will almost certainly recommend far fewer vaccines because many, if not most Kennedy appointees, are vaccine critics.

Kennedy defended his purge of the ACIP in an editorial in the Wall Street Journal on June 9. He denounced the ACIP for having “persistent conflicts of interest” and for being “little more than a rubber stamp for any vaccine.” The following day, the Wall Street Journal editorial board refuted Kennedy’s claims, pointing out that ACIP members had always recused themselves from approving any products they helped to develop or that they profited from, and that the committee traditionally recommended a narrower use of a vaccine than the vaccine industry requested, especially for RSV, HPV, and Covid boosters.

In contrast to the Kennedy-ousted ACIP board members, who were all recognized vaccine and/or infectious disease experts, his eight new appointees are vaccine critics and/or have no experience with vaccine-preventable diseases. Martin Kulldorff is the co-author of the 2020 Great Barrington Declaration advocating for allowing Covid to spread and forgoing vaccine development altogether. Robert W. Malone is a biochemist and a well-known vaccine critic. Vicky Pebsworth is a nurse with a PhD in public health and a member of the oldest anti-vaccine organization in the United States. Retsef Levi is a professor of operations management at MIT who slammed Messenger RNA (mRNA) vaccines on X in 2023; as of June 11, that post remained pinned to the top of his X account.

mRNA vaccines, which include most Covid vaccinations, have been a special target of the anti-vaccination movement. But mRNA technology works safely and simply. Rather than contain a weakened or dead bacteria or virus that triggers the immune system, as traditional vaccinations always have, mRNA vaccines use a molecule (mRNA) that corresponds to a viral protein on a virus’s outer membrane. The immune system recognizes the molecule as foreign and produces antibodies against the virus. The mRNA introduced by a vaccination does not alter DNA and is quickly broken down by the body.

For more than 60 years, ACIP members have been selected for their expertise in immunology, epidemiology, infectious diseases, and public health. Dr. Helen Chu, one of the ACIP members fired by Kennedy, notes that the ACIP has been admired worldwide “as an international gold standard for vaccine decision making.” Now, she laments, the ACIP will be shaped by “one person’s beliefs”—Kennedy’s.

Protecting Women and Children or Harming Them?

Throughout his years-long crusade against vaccines, Kennedy has defended his stance as one that safeguards children’s health even though, perversely, his position on vaccinations undoubtedly harms children—the 2025 measles outbreak is only one example. And for a taste of more outbreaks to come, one need look no further than Kennedy’s announcement in late May that he has removed Covid shots from the federally recommended immunization schedule for healthy children and pregnant women.

As is customary for Kennedy, his recommendation ignores facts. Early in the Covid-19 pandemic, public health officials identified pregnant women as a high-risk group. The 1918 flu pandemic also disproportionately affected pregnant women; that’s because a pregnant woman experiences natural immune suppression so that her immune system will not attack her developing fetus. Thus, unvaccinated pregnant women who come down with Covid are more likely to become severely ill, are more likely to need hospitalization, are more likely to end up in ICUs, are more likely to need a ventilator, and are more likely to die than non-pregnant women of the same age and demographics. Since its development, the mRNA Covid vaccine has not only protected pregnant women from severe illness but also has protected their babies for six months after birth; now, almost 90% of babies hospitalized with Covid are born to unvaccinated mothers. As the director of the Infectious Diseases in Pregnancy Program at UCLA observed, “No matter what the politics say, the science is the science, and we know that, objectively, pregnant patients are at substantially increased risk of having complications” from Covid.

Removing healthy pregnant women (and their children!) from the Covid vaccine recommended list denies them insurance reimbursement for a life-saving vaccine. Kennedy’s move is reminiscent of the days when insurers did not reimburse for any medical care related to pregnancy and birth. Before 1978, insurance companies declared pregnancy a “voluntary condition” rather a medical one. Only since the U.S. Congress passed the Pregnancy Discrimination Act mandating that pregnancy and birth be treated as medical conditions, like any other medical conditions, have patients and their families been covered for the medical expenses associated with pregnancy and childbirth.

Kennedy’s vaccination policies promise to increase not only out-of-pocket medical expenses but also death rates. In 1900, 20 percent of children died before their fifth birthday. Almost one percent of birthing women died in childbirth. Progressive Era reforms vastly lowered infant, maternal, and child mortality. Vaccinations lowered death rates even more. Now the Trump Administration would turn the clock back.

The road to vaccine development, testing, and eventual approval is a long one, involving many levels of government oversight that include personnel at the Food and Drug Administration, the Centers for Disease Control, and the National Institutes of Health—all institutions that Kennedy and Trump have weakened dramatically. The Trump administration, in destroying public health infrastructure, abandoning regulations, ignoring science, and firing the experts who evaluate vaccines, is returning us to an era without the Progressive Era regulations that have silently and stalwartly kept us relatively healthy and safe for the last 100 years.

Jacqueline H. Wolf is professor emeritus of social medicine, Ohio University.

Sources

Alan R. Hinman and Walter A. Orenstein, “A Shot at Protection: Immunizations Against Infectious Disease,” in John W. Ward and Christian Warren, eds., Silent Victories: The History and Practice of Public Health in Twentieth-Century America (Oxford University Press, 2007): 63-80.

CDC, “Measles Cases and Outbreaks,” available online here.

Lena H. Sun and Lauren Weber, “RFK Jr. purges every vaccine adviser on CDC panel, will pick replacements,” Washington Post, June 9, 2025, Available online here.

Robert F. Kennedy Jr., “RFK Jr.: HHS Moves to Restore Public Trust in Vaccines,” Wall Street Journal, June 9, 2025, available online here.

The Editorial Board, “RFK Jr. Conducts His Vaccine Purge: His claims about conflicts of interest proved to be nothing,” Wall Street Journal, June 10, 2025.

Lena H. Sun and Lauren Weber, “RFK Jr. picks new members of influential vaccine committee after purge,” Washington Post, June 11, 2025, available here.

Annika Kim Constantino, “RFK Jr. names some vaccine critics to key CDC committee after ousting entire panel,” CNBC, June 11, 2025.

“RFK Jr. Picks Covid Skeptics for CDC Vaccine Advisory Panel,” KFF Health News, June 12, 2025, available here.

National Library of Medicine, “What are mRNA vaccines and how do they work?”, MedlinePlus, available here.

Jake Goldstein-Street, “WA doctor among those fired in RFK Jr.’s purge of vaccine panel,” Washington State Standard, June 12, 2025, available here.

Jackie Fortier, “RFK Jr. Says Healthy Pregnant Women Don’t Need Covid Boosters. What the Science Says,” KFF Health News, June 2, 2025, available here.

Lena H. Sun and Lauren Weber, “How vaccine critics appointed by RFK Jr. could limit access to shots,” Washington Post, June 13, 2025, available here.

Jacqueline H. Wolf, Cesarean Section: An American History of Risk, Technology, and Consequence, (Johns Hopkins University Press, 2018): 168-170.

Edwin J. Asturias, Noel T. Brewer, Oliver Brooks, et al, “Advisory Committee on Immunization Practices at a Crossroads,” JAMA Network, June 16, 2025, available here.