Blog Article
More than half a century of vaccine progress, dubbed the “immunization era,” is swiftly being undone because of politics and propaganda.
Published November 19, 2025
By Syra Madad, D.H.Sc., M.Sc., MCP, CHEP
In public health, most victories arrive quietly. No headlines mark the measles case that never happened, or the child spared from polio paralysis. But a landmark analysis released 50 years after the Expanded Programme on Immunization gives voice to those silent triumphs: since 1974, routine immunization has saved 154 million lives and added 9 billion years of human life, making vaccines the single biggest driver of infant survival in the modern era.
For those of us who have worked through outbreaks the study confirms what we already knew: vaccines are the closest thing we have to a time machine. They don’t just prevent death in the present – they create futures, unlocking on average 66 additional years of health.
Courting Amnesia
As a public health and healthcare leader, I’m moved by the evidence. As a mother of four, I’m grounded by something simpler: peace of mind. My kids are up to date on every recommended shot. That doesn’t make our family special; it makes us fortunate to live in a place and time where protection is possible.
And yet we are courting amnesia.
Just a couple months ago, Florida announced plans to become the first state to ban all vaccine requirements, including for schoolchildren. Earlier this year, the United States formally withdrew from the World Health Organization (WHO). In June, it pulled back funding from Gavi, the Vaccine Alliance that helped vaccinate a generation of children and built outbreak stockpiles for cholera, yellow fever, meningitis and Ebola. These reversals, paired with rhetoric that clouds evidence-based policy at home, are eroding the infrastructure that protects vulnerable families abroad. When the U.S. steps away, the ripple effects are felt immediately: in last-mile clinics, health workers are left to decide whether limited cold boxes hold lifesaving measles doses or nothing at all.
The Impact of Preventative Services
As a board member of Project HOPE, which operates in many of these communities abroad, I’ve seen the consequences firsthand. When routine immunization falters, measles resurges first, then polio eradication gets harder and already strained health systems lose the “tugboat” that pulls in preventive services. Vaccines create the scaffolding on which stronger health systems are built, expanding capacity to tackle everything from cancer care to ensuring safe deliveries. Remove that foundation, and decades of progress can collapse almost overnight.
This is not an abstract budget debate. Gavi’s most recent replenishment fell short of its goal. Without U.S. support, an estimated 75 million children will miss out on routine vaccinations and 1.2 million children in low- and middle-income countries will die over the next five years.
I welcome counterarguments so long as we follow where the data leads. The world’s most comprehensive modeling shows vaccines save lives at scale across continents and generations. Since the introduction of polio vaccines in 1955, worldwide cases have dropped by over 99% – from an estimated 350,000 cases in 1988 to just 6 reported in 2021. This massive reduction has saved millions of lives and spared countless children from lifelong paralysis.
Rigorous economic analyses demonstrate that immunization pays for itself. In low- and middle-income countries, returns on investment range from roughly 16:1 to more than 26:1, depending on how you count the benefits, a yield greater than any other health intervention.
A Call to Action
So here is the call, from a public health leader, a humanitarian, and a mom:
- Congress should restore sustained U.S. support for Gavi and codify predictable funding for outbreak stockpiles. This is low-cost insurance against pandemics we’d prefer never to fight.
- The Administration should reverse course on WHO. Walking away from the body that coordinates global monitoring, and response doesn’t make Americans safer; it makes us blind.
- States should align with evidence-based recommendations and invest in trusted messengers to rebuild vaccination confidence.
- The CDC must be insulated from politics and provide public health guidance anchored in science, communicated with clarity, and humility. If Americans lose trust in our own health agencies, compliance will erode, inequities will widen, and we’ll be more vulnerable when the next crisis strikes.
Fifty years into the immunization era, the proof is irrefutable: vaccines are time restored, measured in millions of children reaching birthdays they would have otherwise missed. My kids’ protected tomorrows are no more precious than those in Kinshasa, Karachi, or Kansas City. For decades, U.S. support helped eradicate smallpox, drive polio to the brink of extinction, and build the global vaccine architecture that made those tomorrows possible. We should not be the ones to dismantle it home or abroad.
* The views and opinions expressed in this article are those of the author and do not necessarily reflect the views or opinions of The New York Academy of Sciences.*
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Author
Syra Madad, D.H.Sc., M.Sc., MCP, CHEP
Chief Biopreparedness Officer, NYC Health + Hospitals
Syra Madad, D.H.Sc., M.Sc., MCP, CHEP is an internationally renowned epidemiologist in special pathogens preparedness and response, biosecurity advisor, and science communicator. She serves as the Chief Biopreparedness Officer at NYC Health + Hospitals, the U.S.’s largest municipal healthcare delivery system. Dr. Madad is a Fellow at Harvard University’s Belfer Center for Science and International Affairs, where she leads the Women in STEM and Diversity in STEM series. She is Core Faculty at the National Emerging Special Pathogens Training and Education Center (NETEC) and Affiliate Faculty at Boston University’s Center on Emerging Infectious Diseases.
Dr. Madad’s work focuses on the prevention, preparedness, response, and recovery from infectious disease outbreaks, with an emphasis on healthcare and public health biopreparedness. She is known for her innovative strategies, which integrate emergency management principles with epidemiological methods, significantly contributing to the development of robust healthcare systems capable of responding to emerging disease threats.
She is also the founder of Critical Health Voices (Subscribe here: https://criticalhealthvoices.substack.com/), a platform dedicated to amplifying the voices of those on the frontlines of healthcare and public health. Critical Health Voices exists to cut through misinformation and disinformation by providing trustworthy, evidence-based insights directly from professionals working at the intersection of science, medicine, and health security.