Most mornings, my pediatric office follows a familiar rhythm. I check on newborns, reassure exhausted parents and celebrate developmental milestones. Between those, I squeeze in kids with coughs, ear infections and stomach bugs. It’s busy, but I love it.

What’s harder to fit in is a 15-minute conversation about vaccines when a parent hesitates. These talks are delicate. They often begin with a simple, “I’m not sure about this shot,” but underneath is a web of worry from social media posts, political debates or something they heard from a neighbor.

And lately, I’ve noticed those conversations are happening more often.

I remember one mom who brought her 4-year-old in for her pre-K physical. She showed me a Facebook article about doctors getting bonuses for giving vaccines and asked “Is that true?” I could feel her anxiety — and her distrust. I explained that no, pediatricians don’t get “kickbacks,” and that my only bonus is her child being protected from serious illness. But even as I spoke, I could see doubt linger in her eyes.

That’s what worries me most. Parents who used to trust me with everything — from feeding advice to when to start solid foods — are now questioning whether to follow basic vaccine schedules. And when trust in vaccines erodes, trust in all preventive care starts to crumble.

The consequences aren’t theoretical. In Virginia, we’ve already seen measles this year — three cases so far in 2025. We’ve had more than 200 cases of whooping cough, and last year we saw mumps and meningitis too. These aren’t just statistics. I think about the child I cared for with pertussis (whooping cough), coughing until their little body turned blue. Their parents sat helplessly in the intensive care unit, wishing they had known how serious this could be.

Vaccines could have prevented that.

As pediatricians, we’ve long relied on the American Academy of Pediatrics (AAP) to back up what we say in the exam room. The AAP has stood for childhood vaccinations for nearly 100 years and helped shape the currently used vaccine schedule. But recently, changes in how the U.S. Centers for Disease Control and Prevention talks about vaccines — especially COVID-19 vaccines — have made things murkier.

I know from the data that young children (younger than 2) are most likely to be hospitalized with COVID-19. I’ve seen it in my own practice. Vaccinated children in that age group rarely end up needing hospital care, but unvaccinated children sometimes do. Despite that, the CDC’s current recommendation to parents is vague: “Discuss the benefits with your doctor.” That doesn’t capture the urgency or evidence.

For the first time in decades, the AAP publicly took a different stance than the CDC, urging COVID vaccines for children based on the science. I support that decision, but it has created uncertainty. Will insurance cover these vaccines if federal recommendations are watered down? Will families have access if the messaging stays mixed?

This is what I want parents to know: I hear your fears. I know you’re bombarded with information that’s confusing, scary and sometimes flat-out wrong. I don’t dismiss those fears — I try to answer them. But what keeps me up at night is knowing that while we’re debating, diseases are spreading.

Vaccines are not about politics or profit. They are about protecting your children, my patients, my own kids. They are one of the greatest success stories of modern science, and yet they only work if families trust them enough to use them.

So the next time your pediatrician brings up vaccines, know this: We aren’t trying to check a box or push an agenda. We are just trying to keep your child safe. Because when I roll up my own kids’ sleeves for their shots, it’s not out of obligation — it’s out of love.

And that’s what I want for every child I care for.

Dr. Erin Brickley of Marion is immunization chair of the Virginia Chapter of the American Academy of Pediatrics.

https://www.pilotonline.com/2025/09/27/column-why-i-worry-about-vaccine-hesitancy-every-day/