Jess Brownsberger intended to vaccinate her baby, just like her parents had done with her.
Then the Tennessee mother saw how her daughter — who was born with a heart defect — experienced body rashes following some newborn shots. A rash can be a normal reaction to vaccines, but it spooked Brownsberger given her daughter’s medical diagnosis, which would later require open heart surgery.
Brownsberger, a self-proclaimed “MAHA mom” who tries to avoid toxins in her food and products, told her pediatrician she no longer wanted shots. Her doctor, according to Brownsberger, warned that she would need to seek care elsewhere if she chose not to vaccinate. Brownsberger viewed it as an ultimatum and found someone who was willing to delay vaccinations.
Five years later and now with three children, the 30-year-old Brownsberger chooses not to vaccinate any of her kids. She visits a nurse practitioner who she calls “vaccine friendly” — terminology used interchangeably in some online spaces with “vaccine neutral” to describe medical professionals who will care for children irrespective of parents’ vaccine views. Brownsberger found her on a site that advertises alternative medicine and maintains a list of preferred practices by state.
“I don’t feel like I have to hide anything,” said Brownsberger of her care provider.
Some pediatricians who support vaccines question the “neutral” or “friendly” branding, which has sprouted up in posts across platforms like TikTok, Reddit and Facebook as parents share tips on where to find health care providers who allow selective vaccinations or don’t require any.
More concerning, these pediatricians say, is that it’s creating a false narrative about their own willingness to listen to parents who may be hesitant about shots — a dynamic that is playing out while some doctors at private practices require families to vaccinate as disease outbreaks increase.
It’s difficult to gauge or define the scope of these vaccine neutral services, and the “friendly” description can seem contradictory. Some parents claim on social media that these clinics don’t bring up vaccines. (Board certified pediatricians caution it would be a red flag if infectious disease prevention through vaccines isn’t being discussed at all.)
And not all pediatricians, family physicians, nurse practitioners or other medical professionals who offer an alternative approach skip vaccines altogether — they may just advertise that they will also care for families who want delayed shots or do not want to vaccinate their children. Some do not embrace the “neutral” label, either.
It’s a false binary about what kind of doctor parents with vaccine skepticism can turn to, said Dr. Susan Kressly, who was president of the American Academy of Pediatrics (AAP) in 2025. The professional organization of 67,000 pediatricians and related specialists has policies on how its members should communicate with parents who are hesitant of vaccines or refuse them. It’s a growing group: Data shows a smaller percentage of children entering kindergarten are vaccinated, with a drop starting in 2020 amid distrust over COVID-19 vaccine mandates.
“It’s not that either pediatricians are open to listening and working with families who have questions or they aren’t,” she said. “That’s a great social media soundbite, but it’s actually very far from reality.”
This comes as health misinformation spreads online and parents may also feel more empowered to seek alternative options. They have growing assurance from President Donald Trump’s administration, and in particular Health and Human Services Secretary Robert F. Kennedy Jr., an anti-vaccine activist who has promoted parental choice around vaccines.
Brownsberger, who uses social media platforms including Instagram to share snippets of her life as a stay-at-home mom, voted for Trump in 2024 in part because of his support for Kennedy. She likes how the health secretary is elevating parents’ vaccine skepticism.
“I think there’s honestly a lot of moms that are in that boat too, where they would probably have never voted for Trump in their life,” said Brownsberger, who clarified that she still would have because Trump aligned more with her conservative views. “But they care about their kids, and they care about what is going into our bodies and our air and our water and our food.”
Pediatricians say they also care about those kids. AAP has in the past year upped its messaging to further acknowledge some parents’ concerns about vaccines. They are debunking claims about the dangers of vaccines — while also balancing how to care for communities impacted by disease outbreaks among largely unvaccinated children.
“The environment has changed. There’s more and more people with questions,” Kressly said. “We are no longer speaking with one voice with policymakers, and so we are meeting the moment with what families need and deserve in order to make the best decisions for their kids.”
Parents who are hesitant about vaccinating their children have always existed. But while previous generations might have felt isolated in those beliefs, parents today have a welcoming internet at their disposal.
A network of online advice around vaccines has flourished on everything from which pregnancy-related shots to take to the hepatitis B vaccine series. It’s also where parents share what clinics they trust with infant check-ups. Keywords include “neutral,” “vaccine friendly” or a cupcake emoji — a short-hand way for some parents to avoid perceived censorship.
Brownsberger noted her nurse practitioner offers vaccines — she just generally steers clear of talking about them with Brownsberger.
“She’ll never be like, ‘You want to do vaccines today?’ She doesn’t really ask anymore, because she knows our stance,” she said. “But she’s always: ‘If you want more information on what we give usually at this age, we’re happy to talk about it.’ Which I love. I love that they’re so willing to actually inform parents.”
That approach — of not requiring vaccines but instead leaving the conversation open — carries weight for parents who are skeptical of vaccines, especially as some doctors enforce clinic policies that require them.
“We do respect that it is a parent’s choice to vaccinate their child,” one Illinois clinic posted last year on its Facebook page, as it confirmed it would not accept patients who choose to delay or skip vaccines. “Please recognize that it is also a physician’s duty to provide evidence based care.”
Dr. Tracy Tyson works at a clinic in rural Vermont that accepts Medicaid patients and does not turn patients away if they decline vaccines. She’s part of the medical workforce that practices within safety net systems and is unable to dismiss such patients. Pediatricians who work at hospitals or large health care organizations are also often beholden to organization policies. Many who can issue dismissal policies over vaccines are in private practice.
Tyson previously worked at a clinic in Florida with a vaccine requirement, so she has seen firsthand its impact on care outcomes for vaccine-hesitant parents and their kids.
“It just led to parents not coming in for well visits. Then they would come in, and they’d say, ‘Well, can I come back next week for vaccines?’ And then they would never show back up,” she said. “It just meant that there were never open and honest conversations, and we were leaving families without a lot of support.”
Before some of these families left, Tyson began suggesting delaying some shots.
Medical groups have long noted that spacing out vaccines increases the period of time that a child is susceptible to disease. But Tyson said her approach led to more families agreeing to some vaccines instead of none at all.
Tyson clarifies that she “philosophically and scientifically” believes in vaccinations. She supports the AAP vaccine schedule and vaccinated her own children. She also does not consider herself vaccine neutral or vaccine friendly.
“I am extremely pro-vaccine. I think that I’m just pro-family and pro-kid,” she said.
Tyson’s practice in Vermont provides vaccine counseling for patients, which essentially means staff tries to bring up the topic during visits. She said because some pediatricians can’t dismiss families over vaccines, more offices like hers might be deemed vaccine neutral in online spaces. In Florida, after she started working with delayed vaccine scheduling for some families, she got described online as an alternative vaccine friendly doctor.
“I was not. I just was willing to have the conversation, as opposed to not having it,” she said. “So I think that terminology has been around — I think social media just amplifies it.”
AAP used to generally caution its members against dismissal policies. But under current guidelines, pediatricians may consider dismissing families who refuse vaccination “as an acceptable option.” The group warns that the decision “is not one that should be made lightly, nor should it be made without considering and respecting the reasons for the parents’ point of view.”
There is limited data on dismissal policies, but survey information collected in 2013 and 2019 shows an increasing percentage of pediatricians who say they dismiss patients who refuse vaccinations. Among the key reasons cited is concern over trust.
“If the parent doesn’t trust my recommendations about vaccines, which have so much evidence behind them, what will happen if we need to navigate something very complex and difficult together?” Kressly said.
AAP has raised ethical concerns of dismissal policies on the well-being of an unvaccinated child, especially if a clinic or practice is rural and there are fewer treatment options. On the other end, pediatricians must also weigh how parents whose children are too young to be vaccinated or are immunocompromised feel about potential exposures.
The American Medical Association guidelines state “a patient’s vaccination status in and of itself is not sufficient reason, ethically, to turn that individual away.” But the guidelines also include a series of considerations, including the risk to other patients in a physician’s practice.
While pediatricians view this as a gray area, the Trump administration and its supporters see it as black and white.
“I know many parents who have been dismissed from pediatric practices for wanting to discuss timing or spacing of vaccines,” said Hillary Blackburn, a pharmacist and member of a vaccine panel handpicked by Kennedy, during a two-day meeting in December. “So if our goal is to support childhood safety and promote thoughtful informed decision-making, then we must acknowledge this reality.”
Putting into practice the idea that no family should face a vaccine dismissal policy could be complicated as the federal government steps back from encouraging mass vaccination and more disease outbreaks are reported.
Kressly, now retired, is still in frequent contact with doctors in the field. She said a colleague recently faced measles exposure at her practice, requiring a weekend of contact tracing patients, siblings and caregivers who were in the office. Her colleague had to check immunization statuses, offer vaccine aftercare when appropriate and recommend self-quarantine.
“That’s really hard to have those conversations,” Kressly said. “How do we wrestle with that as pediatricians, and say that we’re being good pediatricians for all those kids?”
Meanwhile, the online ecosystem around health information may be hardening views around vaccines, said Lisa Fazio, associate professor of psychology and human development at Vanderbilt University who studies how people process information.
“If one in every 100 moms is somewhat vaccine hesitant, if that stays in a local community, it’s going to be a really small population, and so maybe it’s unlikely that you run into other moms who have that belief or who kind of reinforce those ideas,” she said, using a hypothetical number. “But in an online space, especially online spaces that are specifically for moms who have concerns about vaccines, suddenly those numbers are much bigger, and so you’re just exposed to these ideas a lot more than you would be if these kinds of conversations were actually happening just at a local level.”
That has potency, and it starts with something Fazio calls the illusory truth effect: When information is repeated multiple times, people are more likely to think it’s true.
Trump, who has one of the biggest bully pulpits, has promoted misinformation about vaccines, including that they cause autism. Research shows they do not.
Then there’s another concept where a person tries to judge whether some sort of event is likely or unlikely by considering how many instances come to memory.
“We tend to think of shark accidents as being more common than some other forms of death because they get a lot of media exposure,” Fazio said. “If you’re in a community where you’re seeing a lot of reports of harms of vaccines or things like that, you’re going to think that that’s more common than it actually is.”
The concept is being tested in real time, as anti-vaccine groups use social media to post about vaccine injuries, which the federal government has acknowledged are rare. Republican lawmakers are also holding events focused on vaccine injuries.
Fazio said there’s real value in doctors having ongoing conversations with people who are vaccine hesitant, though she recognizes concerns about outbreak exposures.
“Lots of people really do just have questions, and they’ve heard things online, and they’re uncertain what to do,” she said. “So with repeated interactions and trust, you can move their attitudes and can get them to a better place where they’re more likely to follow scientific recommendations.”
In March, a federal judge blocked a series of changes that Kennedy has made to vaccine policy, including a reduction in the number of universally recommended childhood vaccines. A lawsuit filed by AAP and other medical groups challenged the legality of Kennedy’s actions, and the federal government has indicated plans to appeal.
This vacuum of trusted information is one that groups like AAP are also trying to fill. The organization has been in closer communication with medical groups to more collectively respond to federal policy announcements. It has expanded its social media presence to more quickly dispel rumors about vaccine safety. It’s also featuring more doctors on its platforms to help parents with questions. The number one advice for parents: Talk to your pediatrician.
Kressly worries that advice could be complicated if a health care practitioner skips all discussions about vaccines. She also hopes pediatricians who support vaccines are leading with compassion.
“Meet parents as people first, assume nothing. Be curious, remember or imagine how difficult it must be to be a parent and make hard decisions — and really listen,” she said. “But that also means that parents, if we’re going to be good partners, need to also lead with curious questions.”
Brownsberger, who doesn’t call herself “vaccine hesitant” or “anti-vax,” said she does try to ask hard questions of pediatricians and it’s the very thing that made her seek a different kind of provider. She acknowledges getting critical comments online over her views — as well as private messages from supportive parents on where to find similar care.
“The ball is in every parent’s court, and they just have to do that research for themselves and learn a little bit other than blindly going into trusting the system that we have,” she said.
Tyson, who herself has started posting more content online, wants parents to come to her with any questions about vaccines. She believes many other pediatricians do, too.
“Our advice hasn’t changed,” she said. “We’re still here and we care about your kids. At the end of the day, we’re on the same side.”
Still, Tyson worries about burnout, with online health misinformation requiring doctors to spend more time with patients — time they must find amid growing caseloads.
But she tries to focus on glimmers of hope. A mother who has been meeting with Tyson for two years — who transferred to her office because their previous clinic had a vaccine requirement — said she wanted to revisit vaccinating her children. A whooping cough outbreak was worrying her.
“I never ever thought that this family would vaccinate, ever,” she said. “And through earning trust by just being there for them, not even talking about vaccines, but just being there for them with parenting and colds and everything else, I am someone that she trusts more than what she reads on the internet, and I think that is huge.”