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      John Leddy swings his 2-year-old daughter, Vanessa, with wife Christy Lambertson, at a park in Culver City, Calif. When the couple found out that the day care center they were considering for their daughter had a low measles vaccination rate, they decided not to enroll her there.

      Robert Gauthier/Los Angeles Times via Getty Images

      While many vaccine opponents believe vaccines are unsafe, others make a different argument: Parents are best positioned to determine whether their child needs a particular vaccine and are better qualified than health experts or public health agencies to decide what is in their family’s best interests.¹⁵

      But Fentiman says it is not that simple. “No matter how much a parent tries to educate themselves, most are not physicians and aren’t able to assess the risk because there is so much misinformation,” she says. In addition, “When a parent decides not to vaccinate their child, other children are … being put at risk.”

      Several well-known people, ranging from President Trump—before he took office—to Hollywood celebrities, have at times used their highly visible platforms to spread doubts about vaccine safety and oppose mandatory vaccinations. In June 2019, actress Jessica Biel lobbied California state legislators against a proposed bill that would make it more difficult to claim a medical exemption, arguing that vaccine decisions should be left to parents, not mandated by the state. Other performers who have opposed mandatory vaccinations include Robert DeNiro, Jenna Elfman, Jim Carrey and Juliette Lewis.

      “Celebrities have always had an exaggerated and often unwarranted influence on society,” said Andrew Selepak, a media professor at the University of Florida. “That we place such high value on the uninformed opinions of celebrities is one problem, but the bigger problem is when we act on these uninformed opinions and it puts ourselves or others in danger.”¹⁶

      In 2014, before entering electoral politics, Trump, a Republican, lent credence to the discredited claim that vaccines can cause autism, tweeting: “Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn’t feel good and changes—AUTISM. Many such cases!”¹⁷ Shortly before he was sworn in as president, Trump met with vaccine skeptic Robert F. Kennedy Jr., who later said Trump asked him to lead a commission on vaccine safety. However, the commission was never formed.¹⁸

      But after this year’s measles outbreaks, the president urged parents to vaccinate their children. “They have to get the shots. The vaccinations are so important,” Trump told reporters in April. “This is really going around now. They have to get their shots.”¹⁹

      Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital, says Trump’s mixed message is harmful. “You need clear, consistent messaging. One slip-up and we’re back to the conspiracy theories,” says Blumberg. “Every time a respected public figure waffles on the issue, that is a definite setback that will take years to overcome.”

      In addition, if the Trump administration succeeds in its effort to overturn the Affordable Care Act, insurance companies will no longer be required to pay for federally recommended vaccinations with no out-of-pocket costs, making them unaffordable for many families, wrote University of Connecticut law professor John Aloysius Cogan Jr. in a piece for the medical news website Stat.²⁰

      U.S. health officials are using a variety of strategies to improve measles vaccination rates and halt the disease’s spread, starting with repeatedly debunking widespread misinformation. Fauci, of the NIAID, says it is important to involve community and religious leaders and health care workers so skeptics can get reliable information from their peers rather than from government officials.

      “Public health officials can’t pejoratively confront them because that will turn them off,” says Fauci. “We have to present the communities with the facts in a measured way and get them to understand that they need to make health decisions based on facts, not on distorted and false information.”

      Background

      Foundations Laid Early

      Vaccines can be traced to 10th-century China, when the first precursor of today’s immunizations was used to guard against smallpox.²¹

      In 1796, English country doctor Edward Jenner inoculated an 8-year-old boy with pus from a cowpox lesion on a milkmaid’s hand. Six weeks later, when Jenner infected the boy with smallpox, the disease failed to take hold, laying the foundation for modern vaccinology.