Some pediatricians are stunned by the possibility that vaccines proven to save kids’ lives could be banned in a second Trump administration.

On Sunday, former President Donald Trump told NBC News that if he wins Tuesday, he’ll “make a decision” about whether to outlaw some vaccines based on the recommendation of Robert F. Kennedy Jr., a notorious vaccine critic without any medical training. Kennedy ran for president as an independent before he endorsed Trump. The president doesn’t have authority to ban vaccines but can influence public health with appointments to federal agencies that can change recommendations or potentially revoke approvals. 

Despite decades of evidence proving the safety and effectiveness of childhood vaccines, anti-vaccine discourse picked up steam when Trump indicated that, if he’s elected to a second term as president, he’d tap Kennedy for a “big role” in his administration, most likely to “work on health.”

The potential for a vocal vaccine opponent to be placed in a position to make pivotal decisions about the shots gravely concerns many pediatricians, who predict it would lead to deadly outbreaks not seen in the U.S. in decades by accelerating the number of parents who reject vaccinations for their kids.

“I have watched a child die in the hospital of a vaccine-preventable illness because her parents refused to vaccinate her. Many parents today have not witnessed that — yet,” said Dr. Catherine Ohmstede, a pediatrician at Novant Health in Charlotte, North Carolina. “If this trend continues, that is the reality we are going to face.”

Decades of research have proven the safety and effectiveness of vaccinating kids against a number of illnesses, including measles, chickenpox and polio. An August report from the Centers for Disease Control and Prevention found that routine childhood vaccines have prevented about 508 million illnesses and more than 1.1 million deaths among kids born in the past 30 years.

“It’s very sad to me that as a community, we have taken the most magnificent innovation in human health in the history of humanity and turned it into a political weapon,” Ohmstede said.

Falling vaccination rates

Kennedy has long spread unproven conspiracy theories about vaccine harms. Parents are prime targets.

“It’s much easier to scare people than to unscare them,” said Dr. Adam Ratner, director of the division of pediatric infectious diseases at Hassenfeld Children’s Hospital at NYU Langone in New York City. “Many people have a fear of doing something that may cause harm, but they don’t think a lot about the potential harm of not doing something.”

Some pediatricians in largely Republican states declined to comment.

The majority of parents in the U.S. support vaccination for their children, according to public health data. However, kindergarten vaccination rates had been falling in the U.S. for years before Trump embraced Kennedy and his anti-vaccine views. In 2022, Dr. Rochelle Walensky, then the director of the CDC, warned that vaccine misinformation was one of the biggest threats to children’s health in the U.S.

Last month, the CDC reported that the percentage of children exempted from vaccine requirements rose to 3.3%, up from 3% the previous year. That’s an all-time high.

As exemptions have risen, so have the number of cases of measles in the U.S.

There have been 15 outbreaks of measles this year for a total of 272 cases as of Nov. 1, according to the CDC. More than half were among little children under age 5, and a quarter were among children 5 to 19. Almost 90% of all patients were unvaccinated. About 40% of the people with measles were hospitalized with complications.

“Working in the pediatric ICU, we see the extremes of what happens when kids do not get vaccinated,” said Dr. Deanna Behrens, a pediatrician and representative for the Illinois chapter of the American Academy of Pediatrics. “I’m concerned about anything that would reduce either the number of parents who are willing to get their kids vaccinated or the number of children who get vaccinated in general.”

The onus would be on pediatricians to carefully and sensitively counsel parents who have heard from their favored political candidate that vaccines might not be necessary or even harmful.

Amy Pisani, CEO of the nonpartisan, nonprofit organization, Vaccinate Your Family, said she worries about the outcomes of the latest anti-vaccine sentiments.

Five or 10 years from now, she predicted, “people are going to send their kids to kindergarten and wonder whether or not they’re in a room that’s filled with children who aren’t protected against these very deadly diseases.”

“We will start having outbreaks,” she said. “It will be outbreak after outbreak.”