'Don’t get lost down a rabbit hole':  Major anti-vaxxer talking point destroyed in analysis

It makes sense to approach some marketing efforts with skepticism. Scams, deepfakes, and deceptive social media posts are common, with people you don’t know seeking to profit from your behavior.

But should people extend this same skepticism to pediatricians who advise vaccines for children? Health and Human Services Secretary Robert F. Kennedy Jr. said financial bonuses are driving such recommendations.

“Doctors are being paid to vaccinate, not to evaluate,” Kennedy said in an Aug. 8 video posted on the social platform X. “They’re pressured to follow the money, not the science.”

Doctors and public health officials have been fielding questionson this topicfor years.

A close look at the process by which vaccines are administered shows pediatric practices make little profit — and sometimes lose money — on vaccines. Four experienced pediatricians told us evidence-based science and medicine drive pediatricians’ childhood vaccination recommendations. Years of research and vaccine safety data also bolster these recommendations.

Christoph Diasio, a pediatrician at Sandhills Pediatrics in North Carolina, said the argument that doctors profit off vaccines is counterintuitive.

“If it was really about all the money, it would be better for kids to be sick so you’d see more sick children and get to take care of more sick children, right?” he said.

Is Your Pediatrician Profiting Off Childhood Vaccines?

It costs money to stock, store, and administer a vaccine.

Pediatricians sometimes store thousands of dollars’ worth of vaccines in specialized medical-grade refrigeration units, which can be expensive. They pay to insure vaccines in case anything happens to them. Some practices buy thermostats that monitor vaccines’ temperature and backup generators to run the refrigerators in the event of a power outage. They also pay nursing staff to administer vaccines.

“Vaccines are hugely expensive,” said Jesse Hackell, a retired general pediatrician and the chair of the American Academy of Pediatrics’ Committee on Pediatric Workforce. “We lay out a lot of money up front.”

When a child with private insurance gets a vaccine, the pediatrician is paid for the vaccine product and its administration, Hackell said.

Many pediatricians also participate in a federal program that provides vaccines free of charge to eligible children whose parents can’t afford them. Participating in that program isn’t profitable because even though they get the vaccines for free, pediatricians store and insure them, and Medicaid reimbursements often don’t cover the costs. But many choose to participate and provide those vaccines anyway because it’s valuable for patients, Hackell said.

When discussing vaccine recommendations, pediatricians don’t make different recommendations based on how or if a child is insured, he said.

Jason Terk, a pediatrician at Cook Children’s Health Care System in Texas, said a practice’s ability to make a profit on vaccines depends on its situation.

Terk’s practice is part of a larger pediatric health care system, which means it doesn’t lose money on vaccines and makes a small profit, he said. Some small independent practices might not be able to secure terms with insurance companies that adequately pay for vaccines.

Suzanne Berman, a pediatrician at Plateau Pediatrics, a rural health clinic in Crossville, Tennessee, said that 75% of her practice’s patients have Medicaid and qualify for the Vaccines for Children program, which the practice loses money on. When she factored in private insurance companies’ payments, she estimated her practice roughly breaks even on vaccination.

“The goal is to not lose money on vaccines,” Terk said.

So What’s Driving Your Pediatrician’s Vaccine Recommendations?

Pediatricians typically recommend parents vaccinate their children following either the American Academy of Pediatrics’ or the Centers for Disease Control and Prevention’s recommended vaccine schedule.

Diasio said the driving force behind pediatric vaccine recommendations is straightforward: Trained physicians have seen kids die of vaccine-preventable diseases.

“I saw kids who died of invasive pneumococcal disease, which is what the Prevnar vaccine protects against,” Diasio said. “We remember those kids; we wouldn’t wish that on anyone.”

Still, your pediatrician will consider your child’s health holistically before making vaccine recommendations.

For example, a few children — less than 1% — have medical reasons they cannot receive a particular vaccine, Hackell said. This could include children with severe allergies to certain vaccine components or children who are immunosuppressed and could be at higher risk from live virus vaccines such as the measles or chickenpox vaccine.

“When people have questions about whether their kids should get vaccines, they really need to talk to their child’s doctor,” Diasio said. “Don’t get lost down a rabbit hole of the internet or on social media, which is programmed and refined to do whatever it can to keep you online longer.”