Almost 250 years ago, George Washington created America’s first mass immunization mandate, relying on science to protect public health.

Oh, how times have changed.

Back then, smallpox had just helped end the Continental Army’s invasion of Canada. Despite making it all the way to Quebec, thousands of soldiers contracted the disease. Washington feared the same would happen to his own troops, fresh from their surprise victories at Trenton and Princeton. As Washington wrote at the time, “Necessity not only authorizes but seems to require the measure, for should the disorder infect the Army, in the natural way, and rage with its usual Virulence, we should have more to dread from it, than from the sword of the enemy.”

The inoculation methods of Washington’s time were crude. No genuine vaccine existed. Instead, scabs or pus were taken from someone infected with smallpox and then placed into scratches or small wounds. Another option was to inhale it. Either way, those who experienced variolation inevitably developed fevers, rashes, and other symptoms of smallpox. At least 1% of those who received it died. Still, without his tough choice, the Continental Army might have failed entirely, and America with it.

These days, safe vaccines are available for diseases that ravaged our ancestors. Forms of influenza, hepatitis, chickenpox, polio, rubella, mumps, measles, and many other diseases can now be prevented. The smallpox virus that Washington dreaded has been eradicated.

The quality and availability of vaccines are a modern miracle, one that all humanity should be proud of.

Yet, according to data from the Centers for Disease Control and Prevention, vaccination rates for measles in the U.S. are declining, and the number of cases is climbing. More and more parents are opting against vaccination for their children, which gives these diseases room to spread.

Last year, two children in Texas died of the completely preventable disease. An outbreak in South Carolina has so far sickened almost 1,000 people, most of them children.

Pennsylvania, New Jersey, and Delaware have all slipped below the 95% vaccination rate the CDC says is necessary to keep measles outbreaks at bay. Despite being nearly eliminated in 2000, rates have reached their highest levels in decades.

According to CDC data, more than 90% of infections occur in people who are either unvaccinated or have unknown inoculation status. Given this group makes up less than 10% of the overall population, that’s a staggering concentration of sickness. It also isn’t a surprise — the vaccines work.

Parents offer a range of justifications for refusing vaccinations. Some cite religious faiths that discourage inoculation. Others feel that the schedule of shots is too concentrated. A number of them mention debunked fears of shots “causing autism.”

In some cases, existing health issues may lead to medical professionals advising against vaccination. (These children rely on what scientists call herd immunity for protection, and are endangered by rising rates of voluntary refusal.)

It doesn’t help matters that Health and Human Services Secretary Robert F. Kennedy Jr. is a leading skeptic of both vaccines and modern medicine. Kennedy has strong opinions about public health based on no formal medical training.

Under RFK Jr., the CDC has reduced the number of recommended vaccinations for children, and groups aligned with the secretary are working to overturn state vaccine mandates.

This is the kind of privileged ignorance that can only thrive in a post-vaccine world, where mass immunization has dramatically changed life for the better.

In 1900, 30% of all U.S. deaths occurred in children under the age of 5. In 1915, the infant mortality rate was 100 out of every 1,000 live births. As late as 1952, a polio outbreak killed more than 3,000 people.

Unfortunately, rising vaccine refusal rates may bring some of this suffering back. While city health officials urge calm in the wake of a possible exposure at Philadelphia International Airport earlier this month, these events will only increase as vaccination rates continue to fall. So will unnecessary deaths among children.

Instead of turning back the clock, our leaders and parents must learn from Washington’s example. Necessity requires that we vaccinate our children.

©2026 The Philadelphia Inquirer, LLC. Visit at inquirer.com. Distributed by Tribune Content Agency, LLC.