Restore Vaccine Confidence for US Public and Economic Health

This brief is part of “Election 2024: Policy Playbook,” a series by the Baker Institute and Rice University that offers nonpartisan, expert analysis and recommendations to equip policy leaders governing the United States and Texas in 2025.

The Big Picture

• Vaccines are an important public health tool that save millions of lives each year and billions of dollars in health care expenses.
• Misinformation campaigns and mitigation strategies during the COVID-19 pandemic negatively affected childhood immunization rates, as well as trust in vaccine development and related emerging technologies.
• Existing and new cancer-preventative vaccines could protect future generations from cancer, but their success depends on support from policymakers.
• Policymakers should restore confidence in vaccines by highlighting past public health successes that have protected children from childhood diseases
• At the same time, they should foster a positive policy climate that nurtures innovation, research, development, and deployment of vaccines.

Summarizing the Issue

Between 1994 and 2023, childhood vaccinations protected more than 500 million Americans from illness and saved more than a million lives. They also saved the U.S. health care system an estimated $540 billion in direct costs and more than $2 trillion in societal costs. Despite these gains, there are increasing efforts to limit access and requirements for vaccines, putting lives at risk.

How COVID-19 Changed Vaccine Attitudes

In 2020, the world experienced a public health crisis of a magnitude not seen in a century. The race to develop a vaccine began soon after the COVID-19 virus was isolated. Leveraging existing vaccine research and development, scientists were able to develop a vaccine in record time to help the U.S. and the rest of the world end the COVID-19 pandemic. Despite this accomplishment, misinformation campaigns and COVID-19 mitigation strategies negatively affected long-standing, routine childhood immunization rates and have led to a distrust in vaccines.

The Cost of Not Vaccinating

While most vaccine-preventable diseases lead to a limited number of deaths, they can still lead to severe short- and long-term effects, especially for children. For example, measles — a highly infectious vaccine-preventable disease — can cause ear infections, pneumonia, blindness, and brain swelling with temporary and permanent effects, especially for children. Unfortunately, measles is no longer a disease of the past. Thirteen measles outbreaks and more than 200 cases occurred across the U.S. during the first eight months of 2024 alone. With decreasing immunization rates, researchers anticipate more outbreaks of vaccine-preventable diseases across the country, resulting in disabilities and death to those exposed.

Expert Analysis

Strengthening State Policies

In the U.S., the majority of vaccine policies are formed at the state level. One type of policy — school entry immunization requirements — has been in place for more than half a century. These policies improve immunization coverage rates, open access to existing and new vaccines, and protect the overall health of individuals and the public. However, misinformation campaigns surrounding COVID-19 vaccines, as well as pandemic response and mitigation strategies, led to tensions that affected state immunization policies in Texas and across the country.

As President Biden finishes his term, the incoming administration has an opportunity to strengthen the country’s immunization program by ensuring state immunization programs are resourced, and public and private partnerships are advancing policies to support vaccine innovation — such as funding vaccine development and preventing and treating cancer through vaccination.

Confronting the Cost of Cancer

Through the National Cancer Institute, the U.S. has spent more than $60 billion to help treat, cure, and prevent cancers over the past decade. Cancer also costs individuals and families physically, financially, and emotionally. It is a disease society cannot afford, personally or economically. New technologies and medicines are available today for treatment, but more progress is needed. In the meantime, cancer-preventative vaccines remain a powerful tool for minimizing its impact.

Currently, there are two cancer-preventative vaccines on the market: the Hepatitis B (HepB) and HPV (human papillomavirus) vaccines. HepB vaccines have been available since the 1970s and prevent the HepB virus-related liver disease that leads to the majority of liver cancers. The HPV vaccine, approved in 2006, prevents HPV infection, which can cause several cancers, including cervical, anal, and head and neck cancer. In fact, HPV affects more than 42 million Americans and leads to 36,000 new cancer cases per year. Since its introduction, the vaccine has been linked with an 88% reduction in HPV cancers in teen girls.

Despite their effectiveness, Hep B and HPV immunization rates in the U.S. are below other developed countries, leaving individuals at risk for cancers in the future. Other cancer-preventative vaccines are in development, but these will have limited impact if the U.S. continues to see a decline in immunization rates and the public’s trust in vaccines.

Policy Actions

Vaccines are vital for protecting people, especially children, against infectious diseases — such as measles and whooping cough — that are resurging in the U.S. Achieving high immunization rates from long-standing vaccination laws such as school entry requirements could serve as an example for future policies. In addition, Alabama’s campaign to eliminate cervical cancer by 2033 through various interventions, including HPV vaccination, could serve as a model for Texas and other states.

As medical technology advances, novel approaches using vaccines are being explored to prevent more infectious diseases, but also treat diseases such as cancer. Fostering vaccine innovation should be protected through reasonable and sound policies that allow for vaccine research, development, and deployment. Thus, policymakers should consider the following: 

• Maintain support for existing state vaccine school requirements, which have been shown to achieve high immunization rates in school-age children and protect them against infectious diseases.
• Promote vaccine research, access, and availability. It is particularly important to protect novel vaccine platforms as well as the use of the most appropriate cell cultures for research purposes.
• Continue federal funding for vaccine research to develop new preventative tools and encourage state investments in vaccine research and development.
• Conduct more research on effective ways to implement public campaigns that combat vaccine misinformation.
• Fund state programs, through public and private partnerships, for awareness campaigns and expand access, particularly for childhood and cancer-preventative vaccines, to increase immunization rates.

The Bottom Line

Vaccines are a valuable, cost-effective public health tool to prevent the spread of infectious diseases. It is vital that the next U.S. administration fosters innovation and expands vaccination programs to prevent outbreaks, save lives, reduce health care costs, and promote a healthier, more resilient society.

This material may be quoted or reproduced without prior permission, provided appropriate credit is given to the author and Rice University’s Baker Institute for Public Policy. The views expressed herein are those of the individual author(s), and do not necessarily represent the views of Rice University’s Baker Institute for Public Policy.