Americans’ faith in vaccines is fading, and it’s corresponding with a rapid rise in some diseases. Oregon recently experienced its biggest measles outbreak in five years: 30 cases, all among people who are not vaccinated. As of mid-August, the Centers for Disease Control and Prevention (CDC) has confirmed 219 measles cases in the United States, up from 59 last year—a 271% increase.

According to a new poll from Gallup, the percentage of Americans who say vaccinating their children is essential has dropped from 58% in 2019 to 40%. Only 51% believe the government should require children to be vaccinated, down from 62% in 2019. Meanwhile, a CDC report found that vaccination rates dropped from 95% among kindergarteners during the 2019-2020 school year to 93% two years later. Two percent may not seem like much, but for diseases like measles, herd immunity becomes threatened when the vaccination rate falls below 95%.

Dr. Erin Corriveau, an associate professor of family medicine and community health at the University of Kansas Health System and a practicing physician, believes that the COVID pandemic may have caused some people to question vaccinations. “There was a lot of misinformation and disinformation from internet sources like TikTok, Reddit, etc.,” she says.

Vaccines have done an excellent job of controlling outbreaks of several diseases, so younger generations have forgotten what’s at stake. Dr. Steven Furr, a family physician in Alabama and president of the American Academy of Family Physicians, notes that today, many people haven’t seen the diseases that vaccines prevent.

“I used to have to intubate children for epiglottitis,” Furr said. “Thanks to vaccines, I haven’t seen a case for 25 years.” He saw the same pattern play out for COVID in Alabama: “People were reluctant to get vaccinated until COVID rates went up, and then when people started dying, they got vaccinated. Rates dropped, and then people stopped.”

In addition to reducing Americans’ belief in vaccines, COVID-19 also chipped away at vaccine pipelines, making it harder for people to get vaccines or get information from their doctors. “Families got used to going to the ER or urgent care instead of meeting with their family physician or getting vaccines from schools,” said Furr. This meant fewer opportunities for doctors to follow up with patients and educate them.

The problem goes beyond in-person visits to doctors or school vaccine clinics. Furr notes that as vaccine technology has improved so they can target multiple diseases, vaccines have also become more expensive. Now, doctors’ offices have to lay out a significant amount of money to stock them because they have to pay for them upfront before getting reimbursed by insurance.

Still, physicians Corriveau and Furr see the family physician-patient relationship as the key to increasing vaccination rates. Furr notes that vaccination rates went up when doctors at his clinic used visits as an opportunity to ask patients if they were caught up on their vaccines.

Corriveau sees the current climate as an opportunity for doctors to listen to patients’ concerns, educate them, and show patients where to get evidence-based vaccine information.

She stresses the importance of listening: “Doctors are mostly very pro-vaccine,” she says. “I’ve heard my patients say their previous doctor wouldn’t let them into the clinic if they didn’t get regular recommended vaccines. We have to give patients more chances than that. People do need to get vaccinated . . . but we have to give people the time and opportunity to talk through decisions around vaccines so they can feel confident in their care.”