Vaccine conversations have changed. Sure, there have always been skeptics, but since the COVID-19 pandemic — and especially since Robert F. Kennedy, Jr., has headed Health and Human Services (HHS) — debates have only intensified.

For physicians, what used to be occasional questions in the exam room have become daily conversations that are more emotional, more complex and more consequential for public health.

Paul Offit, M.D., one of the nation’s leading vaccine experts, joins the show to talk about the state of vaccine and public health skepticism we’re in — and what it means for physicians.

Offit explains why confidence in vaccines has slipped, how federal advisory processes have become more politicized and why rising outbreaks of measles, pertussis and other preventable diseases are a warning sign of things to come.

He discusses how misinformation shows up in the exam room, what’s worked for him when talking with hesitant patients and what physicians should keep in mind as they navigate these increasingly complex conversations.

This interview was conducted in preparation for Medical Economics November-December cover story, "Medicine under attack: How physicians can help their patients navigate the disinformation age."

Read more: https://www.medicaleconomics.com/view/medicine-under-attack-how-physicians-can-help-their-patients-navigate-the-disinformation-age

Music Credits:
After Hours by Yigit Atilla - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 — Cold open
Dr. Offit on public health being “under siege.”

0:21 — Intro
Austin sets up the episode on vaccine skepticism and the rise of patient uncertainty.

1:18 — Where trust in science stands now
Offit describes the erosion of confidence in medicine and the rise of “make-your-own-truth” thinking.

2:06 — Vaccine skepticism before and after COVID
How distrust long predates the pandemic — and why mandated vaccines have always faced pushback.

2:38 — Vaccines as “victims of their own success”
Why younger parents must rely on faith, not firsthand memory of disease.

4:22 — Do people need to see disease return to believe in vaccines?
The Maurice Hilleman story and why outbreaks often precede attitude shifts.

6:37 — The politicization of immunization
Why Offit says vaccine science has collided with politics in unprecedented ways.

8:05 — What’s happened to ACIP
Offit’s concerns about expertise, bias, and the breakdown of federal vaccine guidance.

10:04 — Following ACIP’s recent votes
Why Offit saw “anti-science” decisions in 2025 influenza and hepatitis B deliberations.

12:20 — Debating unproven harm vs. studying real risk
How flawed research diverts attention, funding, and global vaccine support.

14:28 — P2 Management Minute
Keith Reynolds with practical, daily practice-improvement insights.

15:19 — Global ripple effects of U.S. vaccine misinformation
How America’s internal debates are shaping vaccine attitudes overseas.

16:26 — Communication strategies for frontline clinicians
How physicians can respond when patients bring vaccine misinformation into the exam room.

19:10 — How vaccines continue to be monitored
Why post-approval surveillance is essential — and how rare events are detected.

19:35 — Where COVID vaccine communication went wrong
Offit on “warp speed,” emergency-use confusion, breakthrough infections, and lost public trust.

21:30 — Will young scientists avoid vaccine research?
How funding cuts and political hostility may shift innovation overseas.

24:07 — States stepping in with their own guidance
Fragmented recommendations and the risks for states that do nothing.

25:08 — Surveillance breakdown and rising outbreaks
Why the U.S. is undercounting measles, flu, and pertussis — and the consequences of “see no evil” policies.

27:32 — Responding to conflict-of-interest accusations
Offit addresses claims about patent profits and ACIP voting.

29:11 — What changes things now?
Why Offit says the turning point will come from parents, not politicians.

30:41 — Closing with Richard Payerchin
Final thoughts and thanks.

31:01 — Outro
Austin wraps with credits and where to find future episodes.

S1 Ep110: Vaccine skepticism, with Paul Offit, M.D.

Off the Chart: A Business of Medicine Podcast

S1 Ep110: Vaccine skepticism, with Paul Offit, M.D.