Published online April 15, 2026.
The vaccine conversation no longer begins in the examination room. Many parents come with fear and confusion that is shaped long before the visit by social media, political rhetoric, and, increasingly, actions and messaging from the federal government that inflate risks, obscure benefits, and erode trust in the systems meant to protect the public.1,2
Family physicians meet these parents at the end of that information pipeline. They listen to parents as they try to reconcile what they have heard with what they want most: keeping their children and families safe. But when upstream messaging misrepresents evidence and amplifies doubt, parents are placed in a fraught position and asked to make high-stakes decisions in an informational environment that confuses rather than clarifies. Addressing this problem requires family physicians to move upstream into advocacy spaces.
For decades, parents had reason to trust that national vaccine guidance reflected careful review of the evidence, safety monitoring systems existed to identify real harms, and rare risks were communicated in context.2 That trust has eroded; only 47% of the public now say they trust the Centers for Disease Control and Prevention to provide reliable vaccine information, down from a prepandemic high of 85%.3 Today, adverse event reporting systems are presented as proof of causality rather than tools for signal detection.4 Long disproven claims, including links between vaccines and autism, are resurfacing through official federal channels.5 At the same time, the well-documented benefits of vaccination, including prevention of millions of deaths and cases of disability worldwide, are minimized.6
The consequences for communities are not theoretical. The United States recorded more than 2,280 measles cases in 2025, the highest annual count in more than 3 decades. As of late March 2026, more than 1,500 additional cases have been confirmed.7 Pertussis has surged at the same time, with more than 28,000 cases and 16 deaths, 10 of them infants, in 2025.8 Measles, mumps, rubella coverage among kindergartners has fallen from 95% in 2019–2020 to 92.5% in 2024–2025. Coverage with the combined seven-vaccine series by age 24 months has declined in recent years, with persistent disparities by race, insurance status, and geography.9,10
Family physicians are among the most trusted sources of vaccine information.11 But they cannot counter, one visit at a time, an environment that exposes patients to misleading narratives at scale. This is why family physicians must engage beyond the bedside to advocate for the evidence and policies that shape patient decisions long before they arrive at the clinic.
What can family physicians do? Advocacy does not require a national platform or a policy background. Most of the important work happens at the state and local community level.
- Engage state immunization coalitions. Most states have active coalitions advocating for vaccinations that welcome clinician input on policy, messaging, and legislation.12
- Act through professional societies. The American Academy of Family Physicians has called on members to oppose proposed federal changes that would weaken evidence-based recommendations.13 The American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and others are also actively engaged in advocacy.14 Contact your chapter and get involved with ongoing efforts.
- Provide testimony or written comments. When state legislatures consider bills to weaken school vaccine requirements, which is increasing in response to federal pressure, clinicians’ voices carry disproportionate weight.
- Amplify evidence-based information on social media and in the office. Organizations such as The Evidence Collective, American Academy of Pediatrics, Immunize.org, and Children’s Hospital of Philadelphia Vaccine Education Center offer credible, accessible resources for patients and clinicians.
- Educate the community in context. Vaccine concerns vary and are rooted in distrust, belief, or specific safety questions shaped by local context. Tailored conversations and education are more effective and far more durable than generic reassurance. Consider volunteering to discuss vaccinations at community events, such as at schools or churches.
- Support state-level vaccine requirements. As states diverge from federal guidance in both directions, family physicians have standing to explain why vaccine requirements in schools and certain workplaces improve community safety for all.
Academic medical centers and health systems also have a responsibility to equip clinicians, starting early in training, with the skills and protected time to engage effectively as public communicators.15
Importantly, patient-centered advocacy does not mean denying uncertainty or silencing debate. Vaccines, like all medical interventions, carry risks, and patients deserve honest, transparent communication about them. An article published in a recent edition of American Family Physician demonstrates that pharmacovigilance science takes rare adverse events seriously, even when they are misrepresented publicly.16
Family physicians see the downstream effects of vaccine misinformation: illness and death from vaccine-preventable diseases. This lived experience confers both credibility and responsibility. Protecting patients in this moment requires more than excellent counseling in the examination room, it requires collective action to ensure that vaccine policy remains grounded in evidence. Family physicians do not need to choose between caring for individual patients and speaking up for health policies that benefit the community. They can, and must, do both.
