Combating Vaccine Misinformation: Q&A With Amesh Adalja, MD

Vaccine misinformation continues to challenge public health, with false claims spreading quickly on social media and even from political figures. In this exclusive Patient Care® interview, infectious disease physician Amesh Adalja, MD, discusses the latest changes in US vaccine policy for COVID-19 and influenza, practical strategies for countering common myths, and the vital role of primary care physicians in building vaccine confidence. Dr Adalja shares communication approaches that preserve trust, explains how to address patient concerns about ingredients like aluminum and thimerosal, and offers guidance on navigating differing recommendations from professional organizations during National Immunization Awareness Month.

Question: What are the most important changes in US vaccine policy this year that primary care physicians should know about?

Dr Adalja: The biggest change is that new COVID-19 vaccines will now be recommended primarily for individuals at higher risk—those with certain medical conditions or in older age groups—rather than universally. This may lead to insurance coverage challenges for lower-risk patients who still want the vaccine.

For influenza, there’s a recommendation to avoid vaccines containing thimerosal, which are typically in multi-dose vials. This affects only about 4% of flu vaccines but could create logistical issues for mass vaccination settings, such as nursing homes. Otherwise, guidance remains largely the same, though ACIP’s current situation adds uncertainty.

Question: How can clinicians effectively counter misinformation about vaccine safety, especially concerns around aluminum or preservatives like thimerosal?

Dr Adalja: It’s important for clinicians to remember that the science is on their side. Concerns about aluminum, thimerosal, and mRNA vaccines have been studied extensively and debunked. While time during visits is limited, addressing specific patient concerns directly and pointing to credible sources is key.

For example, if a patient raises concerns about aluminum, explain that the amount in vaccines is less than what they ingest daily through food. Having quick references to relevant studies can help.

Question: What communication strategies work best to address vaccine hesitancy without damaging the patient–clinician relationship?

Dr Adalja: The approach depends on the setting. In media appearances, I’m more forceful to counter the anti-vaccine movement broadly. In the exam room, the goal is persuasion through trust. Ask patients what specifically concerns them, address that directly, and leverage the trust they have in you as their physician.

Studies show that a PCP’s recommendation is one of the most effective tools for influencing health-promoting behaviors.

Question: How should PCPs respond when patients cite social media posts or high-profile anti-vaccine figures?

Dr Adalja: Address the claim itself with factual data. For example, if a social media post claims someone died after a COVID-19 vaccine, show evidence disproving it. Explain the difference between ethylmercury (in thimerosal) and methylmercury, and reference the studies that have refuted autism claims. Avoid prolonged debates about individuals—focus on the facts.

Question: With professional organizations issuing independent guidance, how should clinicians navigate differing vaccine recommendations?

Dr Adalja: Given ACIP’s current composition, which includes anti-vaccine advocates, I recommend relying on guidance from professional medical organizations. For children, follow the American Academy of Pediatrics’ schedule. For adults, use recommendations from groups such as the National Foundation for Infectious Diseases, the American College of Physicians, and the American Academy of Family Medicine. These are evidence-based and clinically relevant.

Question: What do you see as the most urgent threat to public trust in vaccines today, and how can PCPs address it?

Dr. Adalja: The greatest threat is having an anti-vaccine advocate—RFK Jr.—as Secretary of Health and Human Services. His policy decisions, appointments, and public statements have undermined vaccination efforts, even during a record measles outbreak. With the anti-vaccine movement holding political power, PCPs must be ready to counter misinformation with science and reason at the point of care.

Question: What is one action every physician can take during National Immunization Awareness Month to strengthen vaccine confidence?

Dr Adalja: Celebrate vaccines as the remarkable technology they are—like a new smartphone that helps you navigate life. Encourage patients to view vaccines as essential tools for thriving in a world full of microorganisms. Changing the narrative in this way makes anti-vaccine arguments less persuasive.

Question: What are your go-to resources for vaccine information?

Dr Adalja: The American Academy of Pediatrics, the American College of Physicians, and the National Foundation for Infectious Diseases are all excellent. A newer resource, the Vaccine Integrity Project at the University of Minnesota, is also worth following.