Vaccines, Trust, and Responsibility
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Colleagues:
Few medical advances have done more to improve human health than vaccination. Across generations, vaccines have reduced suffering, prevented disability, and saved countless lives. Diseases that once routinely killed or disabled children and adults, such as polio, measles, diphtheria, and many others were dramatically reduced through widespread immunization. Diseases that once filled hospital wards and permanently altered families became uncommon not through chance, but through scientific discovery, physician leadership, and public trust. Yet in recent years this trust has been shaken, in part due to the recent pandemic.
The COVID-19 pandemic changed the relationship between medicine, public messaging, and public confidence. Scientific discussions moved from medical journals and professional meetings into daily headlines, social media feeds, political debates, and statements made by leaders in organized medicine and public health officials.
Some of the public messaging surrounding COVID-19 created expectations that medicine could not consistently fulfill. Patients were not simply exposed to more information; they were exposed to contradiction and misinformation. Many will remember hearing statements that if they received the vaccine, they would not contract COVID-19 and would not transmit it to others. Many also remember hearing messages that framed vaccination as essentially risk-free and broadly appropriate for everyone.
Those messages created expectations that proved difficult to sustain.
Every medical intervention carries some degree of risk, and vaccines are no exception. The overwhelming experience with the Covid-19 vaccination remains favorable for most patients, but adverse events, including myocarditis, pericarditis, allergic reactions, and other uncommon complications have been identified.
When people were told something that sounded definitive and later experienced breakthrough infections, saw vaccinated individuals transmit infection, or saw or experienced an adverse event, some felt that they had been misled and lost confidence not only with the Covid-19 vaccine, but with vaccines in general.
The loss of confidence continues today and the debate surrounding vaccination has recently intensified. Health and Human Services Secretary Robert F. Kennedy Jr. has challenged various aspects of vaccine oversight and public health decision-making. Kennedy and the CDC, the Centers for Disease Control and Prevention, attempted to reduce routinely recommended childhood vaccinations from 17 to 11, without any new evidence-based information. Universal recommendations for vaccines like the flu, rotavirus, and hepatitis A and B were downgraded, suggesting they only be given to high-risk groups or after consulting a doctor. Conflicting reports of vaccine safety and necessity have emerged, further eroding public confidence.
As physicians and scientists, we should welcome scrutiny and continuously evaluate evidence.
But there is an important distinction between healthy scientific inquiry and creating the perception that established evidence-based medicine is uncertain or unreliable. When that line becomes blurred, the public may conclude that expertise itself cannot be trusted. When errant and potentially harmful medical practices, including to some extent the Covid-19 vaccine, are discovered or suggested, we must urgently and openly recognize and address the concerns.
Vaccination remains one of the safest and most effective preventive tools available in medicine. That does not mean every question is inappropriate or every concern should be rejected. The public deserves thoughtful discussion, individualized recommendations, and honest communication. But restoring public confidence requires physicians to communicate honestly, acknowledge uncertainty when appropriate, and reaffirm evidence-based medicine.
This is where organized medicine can play an essential role.
The Medical Society of the State of New York has long supported physician-led care and evidence-based public health policies because our obligation remains unchanged: to advocate for what best serves patients. That responsibility extends beyond legislation and policy debates. At a time when information is abundant, but trust is reserved, physicians remain uniquely positioned to bridge the divide between scientific evidence and public understanding.
Our responsibility is not to suppress questioning or stop skepticism. It is to explain evidence honestly, acknowledge limitations openly, and communicate recommendations with both confidence and humility. If we remain committed to these principles, we will not only strengthen confidence in vaccination, but we will also strengthen confidence in the practice of modern medicine and recover some of the lost trust that we have recently experienced.
All the best,
Mark J. Adams, MD, MBA, FACR
MSSNY President
