In recent years, however, Americans have become more skeptical of the safety and efficacy of vaccines – the effect of which has been to reduce their uptake – making the United States more susceptible to unpleasant and in many cases deadly illnesses. While individuals have reasons for their worries, these concerns have been repeatedly studied and central claims of this skepticism have been addressed.
This leads to two key recommendations for addressing vaccine skepticism in the United States: transparent, plain-language, and proactive communication about vaccine development, testing, approval, and post-licensure monitoring; and modernization and promotion of vaccine safety infrastructure.
Vaccine development is one of the most rigorous and carefully regulated processes in modern medicine. On average, it takes 10 to 15 years for a vaccine to move from preclinical research to full regulatory approval. It begins with preclinical research, where scientists identify a target pathogen and test candidate vaccines for safety and immune response. Only promising candidates advance to human trials, which occur in three phases. If a vaccine proves safe and effective in each of the trials, manufacturers submit data to the FDA for licensure. Independent FDA advisory panels review the data, and the FDA often holds public meetings to promote transparency. Only then is a vaccine approved.
Policymakers should enhance and modernize vaccine safety infrastructure, as well. This includes expanding data integration between federal and state immunization registries, upgrading monitoring platforms, and funding independent research into rare adverse events. Even after approval, vaccines undergo post-marketing surveillance. Emphasizing real-time safety surveillance systems – such as the Vaccine Adverse Event Reporting System (VAERS) and the newer V-Safe platform – can help reassure the public that vaccine safety is an ongoing priority. These systems ensure continued monitoring and rapid response to any unexpected issues, reinforcing public safety long after rollout. Increased transparency around safety data and adverse event investigations will help counteract the perception of secrecy surrounding vaccine research and production that fuels conspiracy theories.
Both of these efforts – improved literacy and modernization of vaccine safety mechanisms – combined with acknowledgement of the positive, communal (sometimes invisible) impacts of vaccination, are important steps to ensure that skepticism is addressed and declining uptake is slowed.
In the United States, vaccination efforts have significantly reduced disease burden, prevented millions of deaths, and saved billions in health care costs annually. To preserve these benefits, vaccine confidence must be restored. It will not be remedied overnight; it is earned through transparency and sustained engagement. By modernizing safety systems, improving access, and fostering trust, federal policymakers can protect the country’s health and preserve the life-saving legacy of vaccination.
Michael Baker is Director of Health Policy at the American Action Forum.