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Politics and Vaccines

Candice K. Smith, MD

May 14, 2026

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This presentation has no ineligible company content, promotes no ineligible company, and is not supported financially by any ineligible company.

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No conflicts of interest

Financial Disclosure

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Chaos???

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  • Shifts in Vaccine Policy and Public Health Systems

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  • 2025-2026

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ACIP Changes

Advisory Committee on Immunization Practices

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  • Dr. Kirk Milhoan is the new Chair of ACIP
  • Interviewer: “Do you think that vaccines are appropriately studied for safety?”
  • Milhoan: “No. They haven’t been. They’ve only been studied for efficacy.”
  • Milhoan: “I think also, as you look at polio, we need to not be afraid to consider that we are in a different time now than we were then. Our sanitation is different. Our risk of disease is different.”

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Many Anti-Vaccine New Members

New ACIP

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  • Measles Resurgence�

Milhoan: “Many of [the] risks of measles without having a vaccine, was in the 1960s. We take care of children much differently now. Our ability to have pediatric hospitals, children’s hospitals, pediatric ICU’s. What we’re going to have [now] is a real-world experience of when unvaccinated people get measles. What is the new incidence of hospitalization? What’s the incidence of death?”

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Utah Measles

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Even today, measles kills at roughly the same rate per case as it did before the vaccine. What changed is not the severity—it’s how often people get infected.�

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  • Vaccine Schedule Changes

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  • January 2026

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LESS NUMBERS

The revised U.S. schedule also recommends vaccines against fewer diseases than a range of other countries including Israel, Turkey, Saudi Arabia, South Africa, Brazil, China, Taiwan, and even the West African nation of Guinea-Bissau

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  • Large EHR study of >320,000 children with regular access to care
  • Key Findings (2021–2024)
  • Routine childhood vaccination coverage has declined across all vaccines
  • Vaccination timeliness is also decreasing

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Do We Want Input DATA?

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(CMS) has announced the removal of immunization measures from the Child Core Set and Adult Core Set 

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Breaks from the Core Set process:

-Typically involves clinicians, states, and public health experts

No:

-State consultation

-Public comment period

-Standard evidence-based review process

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Do We Want OUTPUT DATA?

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87% of paused databases tracked vaccination-related data.

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The Standard for our Federal Surveillance Systems?

  • Clear update status visibility (active vs paused)
  • A stated reason for any pause
  • A defined timeline or criteria for resumption

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Removing vaccination data while calling for better vaccine analysis is contradictory —�you cannot evaluate public health impact without measuring it.�

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Future?

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Utah? Movements for no vaccines required for school and no government monitoring of vaccines

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What can you do?

Normalize the Vaccinators

Use a Presumptive Approach

Tell the Story

Introduce full vaccinators as the majority

Example:

Patient: I am not sure about vaccines

Doctor: It’s normal to feel confused, especially with all the misinformation out there.

The majority of all the patients in my practice get all the available shots on time.

Introduce vaccines as the default standard of care

Example:

Say: “Your child needs three shots today.”

Avoid: “What do you want to do about shots?”

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Thank you!