The 17th-century philosopher Thomas Hobbes famously described human life as “nasty, brutish, and short.” In his England, poverty and crime were rampant, and average life expectancy barely scraped 40 years, largely because of staggering infant mortality. In London, one in four babies died before their first birthday. Conditions in the early American colonies were often worse, especially in the malaria- and dysentery-ridden South.
Even into the 20th century, the story remained grim. Just 50 years ago, global infant mortality hovered around 100 deaths per 1,000 live births. In much of the developing world, fewer than one in 20 children received even a single vaccine dose. For parents there, childhood death was not an exception but an expectation.
Henry I. Miller is a physician and molecular biologist and the Glenn Swogger Distinguished Fellow at the American Council on Science and Health.
Today, the picture could not be more different. Global infant mortality has fallen to under 25 deaths per 1,000 births, and in the United States the figure is just 5.2. Clean water, sanitation, nutrition and better neonatal care have all contributed, but one tool stands above the rest: vaccines.
The World Health Organization’s Expanded Program on Immunization, launched in 1974, is credited with cutting global infant mortality by 40% over the past half century. Nearly 90% of children worldwide now receive at least one dose of the combined diphtheria, tetanus and pertussis vaccine — once unimaginable. Parents no longer resign themselves to the loss of children from once-common infectious diseases. Where epidemics once decimated towns, today’s doctors may never encounter a single case in their careers.
This transformation is among humanity’s greatest achievements. Yet at precisely the moment when the promise of vaccines has never been greater, political forces in the United States — long the global leader in biomedical science — are undermining it.
The success of immunization has always rested not just on scientific discovery and industrial production, but on public trust. That trust has never been absolute. When Edward Jenner pioneered smallpox vaccination in 1796, critics railed against his methods as unnatural or even blasphemous. George Bernard Shaw once dismissed vaccination as “a filthy piece of witchcraft.”
Such skepticism ebbed and flowed for centuries, sometimes fueled by rumor, sometimes by pseudoscience. What is new today is the scale of organized campaigns to dismantle confidence in vaccines entirely — and the willingness of high-level political leaders to indulge them.
American leadership once propelled the vaccine revolution. Public agencies invested in the research that made possible polio, measles and hepatitis B vaccines. American diplomacy supported immunization campaigns from Africa to Asia. Programs funded by U.S. taxpayers helped halve global child mortality in a single generation.
That legacy is now in jeopardy. Massive cuts to biomedical research budgets, the near-dismantling of the Centers for Disease Control and Prevention, withdrawal from the World Health Organization, and the shuttering of the U.S. Agency for International Development have eroded both domestic and global immunization efforts.
The appointment of Robert F. Kennedy Jr., one of the nation’s most outspoken — and deluded — vaccine skeptics, as secretary of Health and Human Services symbolized this dramatic reversal. He quickly disbanded the CDC’s highly respected Advisory Committee on Immunization Practices and replaced it with ideologues, most with no relevant expertise and many with glaring conflicts of interest.
Public health cannot thrive on mixed messages. When Kennedy advised against COVID-19 vaccination in pregnant women — contradicting the medical consensus — prominent professional societies took the extraordinary step of suing their own government, warning the decision would cost lives.
The toll is already visible. Measles, declared eliminated in the United States in 2000, has surged back. By mid-year, more than 1,300 cases and three deaths had been reported — the highest in a quarter-century. Kennedy’s suggestion that cod liver oil could substitute for measles vaccination sowed confusion even as the virus spread.
Globally, the stakes are higher still. Kennedy’s decision to withdraw U.S. support from Gavi, the Vaccine Alliance, jeopardizes immunization campaigns for 75 million children and risks more than a million preventable deaths. Gavi’s achievements — vaccinating nearly half the world’s children and slashing mortality — are now imperiled by political sabotage.
Vaccines are not relics of past battles. They are the frontline of modern medicine, with mRNA platforms promising rapid defenses against future pandemics and even novel cancer therapies. Yet in March, the administration canceled $500 million in federal grants for mRNA vaccine research — abandoning a technology that prevented millions of deaths during the COVID-19 pandemic.
The lesson of history is clear: child survival is not guaranteed. It is won through relentless, steady investment and collective trust. The arc of progress that transformed Hobbes’ world of “nasty, brutish, and short” lives into one where most children now reach adulthood is fragile. Ideological assaults on vaccines threaten to reverse it.
Henry I. Miller, a physician and molecular biologist, is the Glenn Swogger Distinguished Fellow at the Science Literacy Project. He was the founding director of the FDA’s Office of Biotechnology.
https://www.sun-sentinel.com/2025/09/10/the-fragile-triumph-of-vaccines-opinion/
