There's a return of antiquated-sounding illnesses in various parts of the country -- measles, mumps and whooping cough outbreaks are in the headlines.
And there are two distinct front lines in the public policy effort to get as many children vaccinated as possible. On one side, there are pediatricians concerned about a rise in preventable childhood diseases because of parents reluctant or refusing to vaccinate their children.
On the other side, there are parents with religious objections or other concerns who don't feel their worries are taken seriously by the medical establishment.
And never the twain shall meet, it seems.
Dr. Dyan Hes, medical director at Gramercy Pediatrics in New York City, received a call from grandparents who are at their wits' end. Their granddaughter has refused to vaccinate her 11-year-old, so they are bringing her to Hes' office to see if she can talk some sense into her.
"I'll ask her what her fears are," Hes said. Normally, she meets with prospective patients in her private practice and tells them upfront: "All my patients are vaccinated."
"We became pediatricians because we want children to be healthy, so it's never our intention to harm your child," she said. The previous fears about links between autism and vaccines have been completely debunked, she said. "I don't separate vaccines. I don't alter the schedule because no study shows there are reduced complications from doing so," she said.
While the overall childhood vaccination rate in America is still high -- at 90 percent or higher -- for many immunizations, there are pockets of unvaccinated children in certain communities.
One mother, who says she doesn't like to talk about her concerns about vaccinations publicly because of the reactions it can trigger, says her son began having seizures after getting the measles, mumps and rubella shot when he was barely a year old.
"Every doctor I've spoken to will get upset if you say the vaccination caused it. They will say it might have triggered it. He may have been predisposed to seizures already," she said. But the experience changed her view on vaccinations and has influenced some of her family members against getting their own children immunized.
This mom says she doesn't believe in combination shots, prefers to wait until children are a little older than the recommended age and avoids shots altogether when the child has a cold or any other illness.
Even though her husband is a physician, she says medical practitioners tend to have a view of "you're either with us or against us" when it comes to vaccines.
That may be due to cases such as the measles outbreaks in New York City and Texas this year. If trends continue, this may be the worst year for measles in America in a decade. The U.S. Centers for Disease Control and Prevention released a report earlier this month stating unvaccinated children or those with unknown vaccination status made up 92 percent of the 159 reported cases of measles between Jan. 1 and Aug. 24 this year.
"We don't really see childhood mortality anymore because we have vaccines," Hes said. "People don't remember what it's like to be in an iron lung because of polio." They haven't seen encephalopathy or death as a complication of measles.
Parents who don't vaccinate their children are exposing the larger public to risk, including babies too young to be immunized, she said. Hes has patients with cancer and other illnesses who cannot be vaccinated; having those kids share a waiting room with an unvaccinated child with measles could be fatal, she said. "Most of the parents forget that they are vaccinated, but they are choosing to expose their kids."
But for the mom who believes her son had a negative reaction to the MMR shot and never got another immunization for him, a position like Hes' will never sway her.
"I'm not trying to argue with someone who has spent years studying medicine," she said. "But they should try to understand where the other person is coming from. No one wants a sick world. Everyone wants what's best for their child."
A doctor scarcely has the time to answer every vaccination question a parent might have during an office visit. And the vast amounts of information online can range from reliable to completely false. But if the goal is to get as many children vaccinated as possible, the medical community needs to find a way to address parents' concerns about the risks -- without alienating the very people they seek to help.