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Dr. Tracy Tyson at Monarch Maples Pediatrics in St. Albans on Tuesday, May 12, 2026. Photo by Glenn Russell\/VTDigger<\/p>\nDr. Tracy Tyson at Monarch Maples Pediatrics in St. Albans on Tuesday, May 12, 2026. Photo by Glenn Russell\/VTDigger<\/p>\n
Dr. Tracy Tyson, a pediatrician in St. Albans, has seen the prevalence of vaccine skepticism rise and fall in waves: first with the advent of social media in the early 2010s and then during the Covid-19 pandemic. The third wave came as soon as Robert F. Kennedy Jr. took the helm of the U.S. Department of Health and Human Services, she said.<\/p>\n
Since his confirmation in 2025, Kennedy has directed changes<\/a> to the vaccine panel that advises the federal Centers for Disease Control and Prevention on immunization. Since then, the CDC has scaled back the number of recommended childhood vaccines<\/a> and loosened recommendations for Covid shots<\/a>.\u00a0<\/p>\n \u201cMore now than ever before in my career, (parents) want to make up their own schedule,\u201d Tyson said. \u201cThey want to do things differently if they do them at all. They want to decide when the vaccines are due, or, sadly, they just completely refuse vaccinations and don\u2019t ask you questions.\u201d<\/p>\n In the face of these federal changes, Vermont has doubled down on its commitment to the vaccination schedule in place before Kennedy took over, one still recommended by the American Academy of Pediatrics and other physician groups. In March, Gov. Phil Scott signed legislation<\/a> that insulates the state against further federal changes to vaccine policy. The law allows the state to purchase vaccines from sources other than the CDC \u2014 previously the only source \u2014 and mandates insurers will cover the cost of vaccines.<\/p>\n Still, pediatricians are seeing the impacts of federal changes find their way into the clinic.\u00a0<\/p>\n Merideth Plumpton, who runs the immunization program for the Vermont Department of Health, said primary care clinics across the state are reporting more parents hesitant to vaccinate their kids. And, Plumpton added, the nature of the conversations has shifted drastically from community well-being to individual autonomy.<\/p>\n It will take time to see if and how this change in attitude shakes out in actual vaccine uptake, Plumpton said, since the full breadth of the pediatric schedule is administered over years.\u00a0\u00a0<\/p>\n The rate of Hepatitis B immunizations administered at birth has dropped slightly in Vermont. In December, the CDC formally stopped recommending<\/a> the birth dose. From 2021 to 2024, around 86% of Vermont infants received the vaccine within the first three days of life; in 2025, that rate dropped to 80%.\u00a0<\/p>\n Vermont\u2019s vaccination rate against other illnesses remains high and in line with previous national trends: In December 2025, 90% of the state\u2019s 2-year-olds received their vaccines<\/a> for polio and measles, mumps and rubella. National data is less up-to-date, but CDC data from 2018<\/a> showed that 92.5% of 2-year-olds had their polio vaccine, while 90.8% got their MMR immunization.<\/p>\n \u201cI don\u2019t think that we are significantly different than the rest of the country,\u201d Tyson, the pediatrician, said. \u201cI think that (vaccine hesitancy in Vermont) is more widespread than people realize, and I think it hit us harder than I even expected.\u201d<\/p>\n When Tyson encounters a family hesitant about vaccinating their child or confused about what is still recommended and available, she holds a vaccine counseling session, often midvisit.<\/p>\n She said she talks to patients as if they are her own family members: She tells them how she approaches vaccine science and that she immunizes her kids on the pre-RFK Jr. schedule. In those conversations, she often directs them to the Children\u2019s Hospital of Philadelphia website<\/a>, which she says has clear, digestible information on vaccine science. Out of the 70,000 vaccinations she\u2019s given over the 20 years in her career, she said she\u2019s never seen any adverse outcomes.<\/p>\n \u201cI\u2019ve never held a family\u2019s hand while they got through a vaccine injury, but I\u2019ve held their hand when (their child) died from vaccine preventable illnesses,\u201d she said.<\/p>\n The counseling sessions are exhaustive, sometimes emotional conversations in an already packed day, slotted alongside discussions of nutrition, sleep, family issues, screenings for depression and anxiety and medical exams, in a 20-minute visit.<\/p>\n \u201cI\u2019m always running behind, running into my lunch break,\u201d Tyson said.\u00a0<\/p>\n She said she used to do this vaccine counseling once a month but now has these conversations at least once a day. \u201cThere are days when it feels like half my time is discussing vaccine hesitancy,\u201d she said.<\/p>\n Up until 2026, she did not have to bill insurers for these conversations. Instead, insurers\u2019 payments were pooled into fixed monthly sums, as part of an experimental primary care payment reform in Vermont that sunset at the end of 2025<\/a>. Now, Tyson is back to billing for each individual service she provides \u2014 or doing it uncompensated.<\/p>\n But as Vermont\u2019s clinics transition back to a fee-for-service model, it\u2019s been a slow and confusing process to incorporate billing for these sessions. The American Medical Association recognizes the vaccine counseling sessions<\/a> as distinct, billable services. Both BlueCross BlueShield of Vermont and Medicaid said they reimburse for these vaccine counseling appointments where an immunization is not administered.<\/p>\n But, unaware of the patient\u2019s cost share and concerned about saddling them with extra costs, Tyson said her office only bills for them in situations where the conversation runs especially long. When she has listed vaccine counseling on a bill of services, families have become frustrated to see it there, she said.<\/p>\n Footing the bill for her time in these shorter conversations hasn\u2019t begun to affect the practice financially yet, but it could eventually, Tyson said.<\/p>\n Dr. Ashley Miller runs her own pediatric practice in Royalton. She agreed with Tyson that working in a fee-for-service model once again makes it that much harder to afford difficult conversations like those surrounding vaccines.\u00a0<\/p>\n Miller sees half the number of patients she did when working at a larger hospital. She spends 30 minutes, rather than 15 on each visit. It\u2019s a pay cut, but one she says is worth it in order to spend more time connecting with patients, she said.<\/p>\n Still, discussions of vaccination safety and hesitancy take some of the joy out of practicing, she said.<\/p>\n What\u2019s worse is when there\u2019s no discussion at all.\u00a0<\/p>\n \u201cThe hardest thing for me is when families come in and they just say, \u2018No, we\u2019re not going to do that,\u2019\u201d Miller said. Over the last two years, she\u2019s seen more of this \u201cfull-stop\u201d approach.<\/p>\n![\"A](\"https:\/\/vtdigger.org\/wp-content\/uploads\/2026\/05\/AP25087551074634-1200x800.jpg\")
Health and Human Services Secretary Robert F. Kennedy Jr. stands among young students during an event announcing proposed changes to SNAP and food dye legislation, Friday, March 28, 2025, in Martinsburg, W. Va. (AP Photo\/Stephanie Scarbrough)<\/p>\n