What is old is new again with childhood vaccines, unfortunately

In the 1970s, pediatrician Dr. Robert Haggerty coined the term “the new morbidity” to describe a new era in American pediatrics, one in which infectious diseases were no longer the leading cause of illness and death among children. Nearly universal access to clean water, antibiotics and vaccines had transformed children’s health. Pediatricians were able to devote more time to identifying and addressing the behavioral, developmental and psychosocial issues affecting their patients. As I began my pediatric residency at Grady Memorial Hospital in Atlanta, Georgia, in 1989, I was witness to the evolution in pediatric health that Dr. Haggerty described decades earlier.

Nonetheless, there was at least one notable exception: The wards at Grady were full of children who had been infected with the bacteria Haemophilus influenzae type B, or Hib. During that first year of my training, every third infant and child assigned to me had developed pneumonia, meningitis, permanent deafness or other lifelong neurological complications from Hib. Others did not survive. While a vaccine against Hib had been developed in 1985, it could not be given until 18 months of age, long after the most vulnerable would die from the disease.

A new version of the vaccine was introduced in 1989 and disseminated shortly after. By the time I completed my residency in 1992, Hib infections among children had become rare in Atlanta and across the country. One simple, safe and cost-effective vaccine changed everything.

Now, what is old is becoming new again … and not necessarily in a good way.

Why the nation is at a critical point

The United States must address vaccine misinformation and current federal policy immediately, lest we return to a time when infectious diseases were a major cause of childhood illness and death. Vaccine misinformation has spread through social media for years and escalated during and after the COVID-19 pandemic. We have reached a critical point.

At the same time, leadership from federal agencies responsible for protecting the public’s health is doubling down on misinformation while ignoring decades of data derived from robust scientific research. There is no gray zone here. If we do not reverse course quickly, we risk returning to a time when infectious diseases were a major cause of pediatric illness and death. The rapidly growing number of measles cases we are currently witnessing is just the beginning.

The United States has already recorded more than 2,400 known measles cases this year, surpassing the record number reported in all of 2025. Forty-five states and Washington, D.C., are known to be affected. Once considered eliminated in our country in 2000, this highly contagious virus continues to spread like an uncontrolled wildfire through at least 38 known and distinct outbreaks. Predictive models indicate that it is about to get much worse, as preventing widespread transmission of this highly contagious virus requires that 95% of children be fully vaccinated. Coverage below that level means we are left constantly playing catch-up.

What comes next?

Are outbreaks of mumps and German measles (rubella), the other two vaccine-preventable diseases included with measles in the MMR vaccine, next? What about more insidious diseases, such as hepatitis B?

A federal vaccine advisory panel recently voted to move away from universal hepatitis B vaccination for newborns before they are discharged from the hospital. This comes despite a 99% reduction in hepatitis B cases since universal vaccination went into effect in 1991. What science, if any, justified reversing a policy with such a strong record of success?

More bad information, fewer vaccines

These concerns are not merely theoretical. As president and CEO of a national organization that has provided health care services to children and families within their communities for nearly 40 years, I am hearing something for the first time in our history: murmurs of vaccine hesitancy among groups of people who have traditionally supported vaccination.

Families cite confusing and conflicting information about vaccine safety and effectiveness. This warning of a potential escalation in disease spread is supported by a 10% decline between 2024 and 2025 in the number of vaccines provided through our national network.

Beyond the health and well-being of our children, we must also consider the economic implications. Repeated studies have shown that every dollar spent on vaccines saves between $7 and $14, depending on the vaccine. Preventing disease protects children while also avoiding the far greater costs of emergency care, hospitalization and outbreak response.

There is still time to save lives

We still have time to prevent the old morbidity from becoming the new reality in our country, but we must act quickly. Leadership from the federal Centers for Disease Control and Prevention and state health departments must sound the alarm and encourage vaccination against measles and other vaccine-preventable diseases.

States and territories must stand strong and reject federal policies that undermine long-standing vaccine guidance, as many already are. School districts must also remain firm on vaccination requirements for school entrance, allowing only rare medical exceptions approved by pediatricians and other qualified health care professionals.

We still have time to reverse course and keep what is old in the past. But we must act now, and that action must begin at the top with the federal agencies responsible for keeping the public safe.

Arturo Brito, M.D., is a pediatrician and the president and CEO of Children’s Health Fund (CHF). He leads the organization’s efforts to expand access to comprehensive health care for children and families, particularly those living in under-resourced communities. His perspective is informed by his experience caring for children as a physician and leading a national organization dedicated to bringing health care directly into communities where children live and learn.

CHF is a national nonprofit organization that works to ensure children and families can access quality health care regardless of where they live or the barriers they face. Headquartered in New York City, CHF leads a national network of 24 programs across 15 states, Puerto Rico, and Washington, D.C. For nearly 40 years, CHF and its national network have delivered medical, dental and behavioral health care through mobile clinics, schools and other community-based settings and via telehealth, meeting children and families where they are.