The connection between vaccines and autism has been a persistent myth, one that has fueled vaccine hesitancy for decades despite the overwhelming evidence from the scientific community, experts said. This misconception continues to circulate, influencing public opinion and undermining efforts to maintain public health.

With the COVID-19 pandemic largely in the past and a new administration approaching with prominent vaccine skeptic Robert F. Kennedy Jr. as President-elect Donald Trump’s pick to lead the Department of Health and Human Services, vaccine hesitancy is on the rise, particularly in New Jersey. Experts are worried about the public health implications as misconceptions about vaccines persist, including the myth of a link between vaccines and autism.

The national debate surrounding vaccines has been reignited by Trump’s nomination of Kennedy, who has repeatedly claimed a link between vaccines and autism. However, New Jersey vaccine and autism researchers have stated that these claims are not supported by the available evidence.

One expert from New Jersey is emphasizing the importance of education in combating this harmful myth, which has gained traction in recent years. “We’re seeing numbers not just for people refusing the COVID vaccine but also refusing measles, mumps and rubella, and routine childhood vaccines,” said David J. Cennimo, an infectious disease specialist at Rutgers New Jersey Medical School. “That’s become a significant concern because it can lead to newer outbreaks, and you’re seeing it right now across the country with measles. Numbers are up, so we are seeing this, unfortunately, a lot.”

The idea of vaccines causing autism originated with a 1998 study published in the medical journal Lancet by Andrew Wakefield. This study linked the measles, mumps, and rubella (MMR) vaccine to autism, sparking widespread concern. However, the study was retracted, and Wakefield was discredited. Since then, numerous large-scale studies have been conducted, including a 2019 Danish study involving over 650,000 children and a 2014 analysis of 1.2 million children, all of which have found no connection between vaccines and autism.

“There is conclusively no link between vaccination and autism,” said Cennimo. “The original study was erroneous, and subsequent research has consistently shown that vaccines are safe.”

“There are many causes of autism,” including genetic and environmental factors, according to Autism Speaks, a research and advocacy group for people on the autism spectrum. But, the organization adds on its website, “scientists have conducted extensive research over the last two decades to determine there is no link between childhood vaccinations and autism. The results of this research are clear: Vaccines do not cause autism. Additionally, vaccination can protect children from many preventable diseases like measles.”

While the myth of a connection between vaccines and autism persists, it remains unsupported by scientific evidence. The public must understand that the causes of autism are multifactorial and not related to vaccination.

New Jersey has the third-highest rate of autism among 8-year-olds in the U.S., with 2.9% diagnosed in 2020, according to data from the Centers for Disease Control and Prevention (CDC) coauthored by researchers with the New Jersey Autism Study at Rutgers University. California leads with 4.5%, driven by early diagnosis efforts in San Diego, and Minnesota ranks second at 3%.

For years, New Jersey had the highest autism rate in the nation, although it has since been overtaken by California. The rise in autism diagnoses has been a subject of debate for many years, but the cause is still unclear, fueling suspicions about a range of potential causes, both substantiated and unsubstantiated.

What’s “difficult to ascertain is why ASD prevalence continues to climb,” researchers with the New Jersey Autism Study at Rutgers wrote last year, referring to autism spectrum disorder. “While there are known risk factors for autism, including age of parents, multiple-gestation birth, prematurity, C-section delivery and care in the intensive care unit after delivery, these perinatal factors have remained relatively stable even as the rate of ASD has continued to surge.”

Cennimo, who was not part of the research group, attributed the state’s higher autism rates to its robust medical and educational systems, which excel at early diagnosis.

“New Jersey has excellent medical resources and school systems,” he said. “This likely contributes to higher autism diagnosis rates. Our schools are particularly adept at recognizing children who are at risk or showing signs of autism. From a pediatric perspective, early intervention is crucial, because many children with autism can benefit significantly from timely support services. This creates a strong incentive to diagnose as early as possible.”

However, Walter Zahorodny, director of the New Jersey Autism Study, disagreed with the idea that increased awareness and medical services were the primary drivers behind the surge. The increase has been widespread across all subtypes of autism spectrum disorder, from mild to severe, and across all demographic groups, Zahorodny said.

“This is not just a phenomenon of becoming more sensitive to subtly impaired kids,” he said.

While vaccine hesitancy has existed for decades, it has grown more widespread since the COVID-19 pandemic. In 2018, New Jersey reported that 71.5% of school-age children had received recommended vaccinations. By 2020, however, that figure had dropped to 68.7%, according to state data.

“We’re seeing hesitancy not just for COVID vaccines but also for routine childhood vaccines like MMR,” said Cennimo. “This hesitancy has broadened significantly and is becoming a major public health concern.”

Cennimo expects vaccination rates to decline or stagnate until there is a resurgence of infections that were once relegated to history.

“We will see measles again, and we’ll see chickenpox,” he said.

Declining vaccination rates pose significant risks to public health. Herd immunity — the concept of having enough vaccinated individuals in a community to prevent the spread of disease — requires about 95% coverage for diseases like measles.

In certain areas of New Jersey, vaccination rates have fallen below this threshold, making those communities vulnerable to outbreaks. Measles, for example, remains highly contagious and can lead to severe complications, including death.

Measles has a fatality rate of about 1 in 1,000 cases and can cause severe complications like encephalitis or pneumonia, the World Health Organization states.

“Vaccines are so effective that people don’t see these diseases anymore,” Cennimo said, calling trust in vaccines a “victim of success.”

“Our grandparents remember the horrors of polio or whooping cough, but younger generations have no frame of reference. That’s why public health education is so critical,” he said.

Misinformation, especially on social media, plays a significant role in fueling skepticism about vaccines. “People trust what they see in their social networks, even if it’s false,” Cennimo said. “Social media magnifies fear and misinformation, making it harder to reach individuals with accurate, evidence-based information.”

The politicization of vaccines has further exacerbated the issue, with some framing vaccines as an infringement on personal freedoms.

Cennimo, while avoiding overt political commentary, acknowledges the concern within the medical community regarding Kennedy’s nomination as health secretary. “We have to see how policies unfold, but the focus must remain on evidence-based science to protect public health. Misleading information about vaccines puts lives at risk,” Cennimo said.

In a recent interview, Trump considered the connection between vaccinations and rising autism rates and said he would task Kennedy with investigating the issue.

To move forward, experts agree that a multifaceted approach is needed. Combating misinformation, strengthening public health infrastructure in underserved areas, and fostering trust through education and transparency are essential steps in addressing vaccine hesitancy. Cennimo remains optimistic about New Jersey’s ability to lead the charge in tackling vaccine hesitancy while continuing to support people with autism.

“Public health is a collective responsibility,” he said. “Vaccination decisions might seem personal, but their impact is shared by everyone in the community. It’s up to all of us to prioritize science and protect one another.”

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