The History and Widespread Impact of Distrust in Public Health

Mid-2025, U.S. Health Secretary Robert F. Kennedy Jr. removed all 17 members of the federal vaccination guideline advisory panel and replaced them with eight of his own picks, many of whom are vaccine skeptics.¹ ​​Kennedy described the sweep as a step toward rebuilding the nation’s trust in federal vaccine policy. He noted that the Department of Human Health Services (HHS) will prioritize restoring “...public trust above any pro- or antivaccine agenda.”

Kennedy is not mistaken that much of the American public has lost faith in a federal vaccination strategy. In fact, since the COVID-19 pandemic, the public has grown to distrust public health institutions at large. According to a KFF poll, less than a quarter of Americans have “a great deal” of trust in the National Institute of Health (NIH), Centers for Disease Control and Prevention (CDC), HHS, and state and local health officials; all core players in maintaining national health.²

Skepticism in public health and scientific research is not a new phenomenon, starting long before the COVID-19 pandemic. During the mid-1800s, germ theory, the understanding that disease is spread by microscopic pathogens, was rejected by many doctors who claimed that disease could not spread through invisible microorganisms.³ Even just 75 years ago, Charles Darwin’s theory of evolution was not widely accepted by the American public, and teaching it in some public schools was considered a crime.

In part, this conflict stems from the scientific community having never created successful communication channels to the public. In the early 20th century, the consequences of this weakness grew as researchers began surveying the consumer product landscape and found public health hazards in many everyday products. Meanwhile, the public relations (PR) industry, which sprouted from war-inspired propaganda, had nearly perfected these communication channels in the early 1900s. Public relations, which sprouted from war-inspired propaganda, was developed on the belief that the public must be controlled by government and business through limiting information for society to exist peacefully.⁴ To protect the sales of their clients, PR teams began to discredit and misrepresent scientific knowledge, cultivating a general sentiment of distrust in science. This type of messaging can be seen in PR campaigns in almost all industries: lead, oil and gas, food, drugs and alcohol, beauty products, and most infamously, tobacco.⁵ 

Edward Bernays, known as the “father of public relations,” first mixed public relations with health and science when attempting to increase bacon sales for the Beech-Nut Packaging Company. He convinced a network of trusted physicians to spread a new belief that Americans needed a heavy, hearty breakfast with bacon and eggs to stay in optimal shape. Bernays took advantage of the public’s trust in their physicians, increasing the demand for bacon through a new “scientific discovery,” in turn driving up Beech-Nut’s sales.⁶ Bernays began a movement of carefully constructing information, leading the public to act however his clients found beneficial.

Throughout the growth of PR, public opinion, interest, values, and beliefs became something to be sold, bought, and exploited.⁷ Distrust of science and expert opinion is embedded into the fabric of American consumerism, the epicenter of American culture today. Scientific denial does not only take place on the industry level – it is often validated on the interpersonal level. The validation – or invalidation – of scientific claims can threaten a person’s core beliefs, values, and identity, which stems back to their social groups. Individuals are likely to follow the beliefs of their families and communities, so when the denial of scientific knowledge becomes widespread, it grows into a shared ideology of an entire group.⁷ This explains how denialism has become an overarching quality of one side of the aisle in American politics. The distrust in the government, a notion rooted in American conservatism, has morphed into a dangerous distrust of science and public health.

Today, one of the most direct impacts of the growing distrust of public health is a decrease in vaccination rates and the rise of disease in America. Childhood coverage for measles, mumps, and rubella (MMR), diphtheria, tetanus, and pertussis (DTaP), polio, and varicella vaccines dropped among kindergarteners during the 2023-2024 school year. Immunization against MMR has dropped to 92%, well below the 95% threshold necessary for herd immunity. As a result, over 2,200 cases of measles were reported in the U.S. in 2025 — the highest number seen since the disease was declared eliminated in the U.S. in 2000.⁸

What has so many public health experts concerned about the future of America is the consistent denial of scientific evidence by political leaders. A few months ago, President Trump claimed that acetaminophen, the primary ingredient in Tylenol, causes autism, and urged pregnant people not to take the over-the-counter painkiller.⁹ In a similar vein, when RFK took office as U.S. Health Secretary, his team changed a CDC page on vaccine safety to include false claims about autism and vaccines. The page formerly said “no links have been found between any vaccine ingredients and Autism spectrum disorder.” Now, the page reads, “The claim ‘vaccines’ do not cause autism’ is not an evidence-based claim…,” a statement that contradicts decades of scientific findings.¹⁰ Policy changes are growing as well as Florida announced a plan to end all vaccine mandates, including those required for school attendance.¹¹ While state leaders have been criticized for the change, many public health experts in the state are staying silent for fear of losing their positions.

Immunization and the eradication of disease are some of public health’s greatest achievements, having significantly increased life expectancy and quality of life across the globe.¹² Nevertheless, the escalation of distrust, the spread of misinformation, and growing polarization in the U.S. are undoing decades of public health progress.

As the current administration continues to manufacture doubt in public health, scientific knowledge, and research, it’s crucial that the whole of society find a role to play in addressing misinformation, ensuring that we keep the growing health impacts at bay. Systems leaders should implement policy changes to slow the spread of misinformation online, or expand education programs to improve information literacy. Individuals have a paramount role of on-the-ground work, beginning by uplifting trusted messengers, engaging with spreaders of misinformation, and fighting the ongoing distrust of public health. In doing so, you’re protecting decades of crucial scientific research, and life-saving public health discoveries.

References

1. Benadjaourd, Y., Kekatos, M. (2025, June 11). RFK Jr. appoints 8 new members to CDC;s vaccine advisory committee, including some critics of shots. ABC News. https://abcnews.go.com/US/rfk-jr-appoints-8-new-members-cdcs-vaccine/story?id=122750907#:

2. Kearney, A., et al. (2025, Jan 28). KFF Tracking Poll on Health Information and Trust: January 2025. KFF. https://www.kff.org/health-information-trust/kff-tracking-poll-on-health-information-and-trust-january-2025/#4d1ce026-cf5e-4323-8f73-a46773451074

3. Belshe, S. (2023). Why Do So Many Americans Distrust Science? Kansas Medicine + Science. https://www.kumc.edu/communications/about/publications/kansas-medicine-and-science/spring-summer-2023/why-do-so-many-americans-distrust-science.html

4. Maniates, M. F. (2001). Individualization: Plant a Tree, Buy a Bike, Save the World? Global Environmental Politics, 1(3), 31–52. https://doi.org/10.1162/152638001316881395

5. The Disinformation Playbook. (2018, Oct 10). Union of Concerned Scientists. https://www.ucs.org/resources/disinformation-playbook

6. Fletcher, F. (2014). The Career, Times, and Legacy of Edward L. Bernays. Academia. https://www.academia.edu/8417816/The_Career_Times_and_Legacy_of_Edward_L_Bernays

7. Jacquet, J., Dietrich, M., & Jost, J. T. (2014). The ideological divide and climate change opinion: top down and bottom up approaches. Frontiers in Psychology, 5. https://doi.org/10.3389/fpsyg.2014.01458

8. Across the U.S., Childhood Vaccination Rates Continue to Decline. (2025, Aug 20). International Vaccine Access Center. John Hopkins. https://publichealth.jhu.edu/ivac/2025/across-the-us-childhood-vaccination-rates-continue-to-decline

9. Pearson, H., Ledford, H. (2025, Sept 22). Trump links autism and Tylenol: is there any truth to it? Nature News Explainer. https://www.nature.com/articles/d41586-025-02876-1

10. Autism and Vaccines. (2025, Nov 19). Vaccine Safety. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccine-safety/about/autism.html

11. Allen, A. (2025, Oct 22). DeSantis moves to end Florida’s childhood vaccination mandates. Doctors brace for impact. ABC News. https://abcnews.go.com/Health/desantis-moves-end-floridas-childhood-vaccination-mandates-doctors/story?id=126719452

12. Sáfadi M. A. P. (2023). The importance of immunization as a public health instrument. Jornal de pediatria, 99 Suppl 1(Suppl 1), S1–S3. https://doi.org/10.1016/j.jped.2022.12.003

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More about the author!

Jamie Epstein holds a Master of Public Health in Environmental Public Health Sciences from New York University. She is currently a Population Health Coordinator at Wellfleet, where she works on initiatives to improve student health and well-being. Jamie is passionate about developing sustainable and equitable solutions to address health disparities caused by environmental degradation and social injustice.