作者：丹·莱文、本杰明·莱瑟和卡特·斯塔福德
2026年3月18日 美国东部时间上午10:02 更新于1小时前
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[1/2] 美国密歇根州庞蒂亚克市奥克兰县办公楼内，奥克兰县卫生官员凯特·古兹曼和免疫项目主管莱莎·马丁站在疫苗储存冰柜前，2025年12月4日。路透社/丹·莱文 购买授权，新标签页打开
- 摘要
- 路透社数据分析显示，幼儿接种率迅速下降
- 密歇根州官员将接种率下降与肯尼迪的政策和言论联系起来
- 特朗普的驱逐政策使拉丁裔家庭远离卫生诊所
- 密歇根州接种率下降引发对更广泛全国影响的担忧
庞蒂亚克，密歇根州，3月18日（路透社） – 路透社对州数据的分析显示，在特朗普政府执政的第一年，密歇根州幼儿疫苗接种率急剧下降，这为怀疑疫苗安全性的卫生部长小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）如何影响美国免疫接种实践提供了早期迹象。
密歇根州作为美国选举中的关键摇摆州，为观察肯尼迪拆除数十年来成功预防大规模疾病爆发的疫苗政策所带来的影响提供了独特视角。与许多其他州不同，密歇根州每月都会提供详细的接种率更新。全国范围的估计要到今年晚些时候才能得出。
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报道显示，特朗普第二任期内美国麻疹病例卷土重来之际，路透社的分析聚焦于该州幼儿在3岁前完成包括麻疹腮腺炎风疹（MMR）、百日咳和乙肝等七项疫苗接种系列的比例——这是联邦卫生官员设定的基准。
从2025年1月到今年1月，该系列完成率下降了近3个百分点，从70%降至67%（注：原文数据为66.5%，此处按前文表述调整）。这一降幅约为过去18年平均年变化的13倍。唯一降幅更大的年份是2020年新冠疫情期间和2008年美国金融危机期间（密歇根州受创尤为严重）。
[图片：密歇根州疫苗接种率下降趋势线图]
路透社发现，在数据中被识别出种族和族裔的儿童中，最大降幅出现在白人幼儿（最大人口群体）和西班牙裔儿童中。对该州二十多位公共卫生官员、家长、研究人员和社区倡导者的采访显示，肯尼迪对疫苗的频繁抨击是白人家庭的主要影响因素，而特朗普政府针对移民的驱逐运动则让拉丁裔家庭远离公共诊所。
斯坦福大学流行病学助理教授马修·江（Mathew Kiang）表示，尽管无法预测全国接种率，但密歇根州的趋势因其规模和多样性而令人担忧。
“那里发生的事情几乎肯定也在其他州发生，”江教授说。
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根据州数据，2025年密歇根州的下降意味着约有4,500名额外幼儿面临严重疾病风险增加。卫生官员称，这些儿童还可能对年龄太小无法接种疫苗的婴儿和免疫功能低下的成年人构成威胁。
“即使某一种疫苗的公共卫生影响微乎其微，每个未接种疫苗的孩子都面临风险，”密歇根州奥克兰县流行病学家劳伦·芬克（Lauren Fink）在电子邮件中表示。
小肯尼迪的反疫苗宣传
多年来，肯尼迪一直宣扬一种与科学证据相悖的观点，即常规儿童疫苗接种与自闭症和慢性病发病率上升有关，认为疫苗带来的危害大于其预防的疾病。
自成为美国最有权势的卫生官员以来，肯尼迪将这种反疫苗言论进一步推广。这些观点曾主要局限于小众社交媒体群体，如今却通过联邦政府广泛传播。
“人们开始更愿意质疑，因为小肯尼迪在主流媒体上从未真正传播过这些信息，”密歇根州西部长期持怀疑态度的家长雷切尔·阿特伍德（Rachel Atwood）说。
阿特伍德同意肯尼迪的观点，即美国在预防传染病上投入了过多时间和金钱，应该更多关注糖尿病和肥胖等慢性病的防治。
肯尼迪还颠覆了儿童疫苗推荐流程，解雇了一个全国性顾问委员会，并以持相同观点的人取而代之。新委员会最近促使美国政府减少常规推荐的儿童疫苗数量，尽管缺乏新的危害证据。联邦法官周一阻止了这些变更，支持主要医学协会的观点，即这些变更会增加对疫苗的不信任并降低接种率。
卫生与公众服务部发言人安德鲁·尼克松否认肯尼迪对接种率下降负有责任。他表示，密歇根州官员在新冠疫情期间采取了特别激进的应对措施，包括学校关闭和口罩强制令，这损害了公众对卫生政策的信任。
“随着时间推移，重建公众对公共卫生的信心，而不是重复疫情时期的错误和密歇根州等州失败的政策，才是提高疫苗接种率的正确途径，”尼克松说。他没有评论西班牙裔幼儿接种率下降的问题。
密歇根州首席医疗官娜塔莎·巴格达萨里安博士（Dr. Natasha Bagdasarian）表示，该州2025年免疫接种趋势与往年不同，疫情后接种率已趋于稳定。她指出，新变化是肯尼迪的言论和政策，在家庭中播下了怀疑和困惑的种子。
“密歇根州没有失败，”巴格达萨里安说。“我认为我们正被国家层面传播的某些言论所误导。”
公共卫生的挫折
美国在2000年因当时较高的疫苗接种率被宣布消灭麻疹。但日益增长的疫苗犹豫情绪正在削弱这一成果。
去年，美国爆发了数十年来最严重的麻疹疫情，首先在德克萨斯州，最近在南卡罗来纳州。至少有两名儿童死亡，数十人住院，其中大部分未接种疫苗。密歇根州百日咳病例在2024年激增，并在2025年持续居高不下。
肯尼迪非但没有推广广泛接种以遏制这些疫情，反而称接种决定是个人选择，应在与医生商议后决定。
密歇根州兰辛市的两个孩子的父亲诺亚·斯利瓦（Noah Sliwa）表示，肯尼迪的政策让他和妻子感到安心。他们已决定延长孩子的疫苗间隔时间以减轻副作用，并跳过了两个孩子的乙肝初种——这与肯尼迪上任前的美国推荐做法相反。
“我们感到被理解，”斯利瓦说。“这感觉很正常。”
接受路透社采访的密歇根州卫生官员表示，他们看到肯尼迪的观点直接影响了接种率。例如，全州数据显示，2025年完成MMR（麻疹腮腺炎风疹）第一剂接种的幼儿比例下降了近3个百分点，而MMR正是肯尼迪经常抨击的目标之一。
白人幼儿的七项疫苗系列接种率从2025年1月到今年1月下降了4个百分点，从71%降至67%；西班牙裔幼儿的接种率下降了4.6个百分点，从74.4%降至69.8%。联邦官员十年前将80%的系列完成率作为全国疾病预防目标，但自疫情以来，联邦政府一直专注于提高特定疫苗的使用率。
底特律北部奥克兰县的免疫接种主管莱莎·马丁负责培训护士如何与对接种持怀疑态度的家长沟通。根据路透社的审查，这个人口众多、以白人为主的郊区县幼儿接种率从2025年1月到2026年1月下降了2.9个百分点。
马丁表示，家长们经常以疫苗安全为由质疑，并寻求豁免州疫苗强制令。现在，家庭开始引用肯尼迪的论点，例如声称疫苗临床试验未正确测试副作用。
“这些担忧非常具体，”马丁在采访中表示。“
Child vaccination rate drops sharply in Michigan under RFK Jr’s influence | Reuters
By Dan Levine, Benjamin Lesser and Kat Stafford
March 18, 2026 10:02 AM UTC Updated 1 hour ago
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Item 1 of 2 Oakland County Health Officer Kate Guzmán and Immunization Program Supervisor Letha Martin stand in front of vaccine storage coolers at a county office building in Pontiac, Michigan, U.S., December 4, 2025. REUTERS/Dan Levine
[1/2]Oakland County Health Officer Kate Guzmán and Immunization Program Supervisor Letha Martin stand in front of vaccine storage coolers at a county office building in Pontiac, Michigan, U.S., December 4, 2025. REUTERS/Dan Levine Purchase Licensing Rights, opens new tab
- Reuters data analysis shows swift fall in inoculations of toddlers
- Michigan officials link vaccination decline to Kennedy’s policies and rhetoric
- Trump’s deportation policies keep Latino families away from health clinics
- Drop in Michigan rate raises concerns about broader national impact
PONTIAC, Michigan, March 18 (Reuters) – Vaccination rates among young children in Michigan dropped sharply during the first year of the Trump administration, a Reuters analysis of state data shows, providing an early indication of how vaccine-skeptic Health Secretary Robert F. Kennedy Jr. is influencing immunization practices in the United States.
Michigan, an influential battleground state in U.S. elections, offers a unique view into the impact of Kennedy’s dismantling of vaccine policies that had successfully prevented large disease outbreaks for decades. Unlike many other states, Michigan provides detailed, monthly updates on vaccination rates. A national estimate isn’t expected until later in the year.
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The Reuters analysis comes amid a resurgence of measles cases in the U.S. during President Donald Trump’s second term. The analysis focused on the rate at which toddlers in the state completed a series of seven vaccinations – including the combined measles, mumps and rubella (MMR) shot as well as whooping cough and hepatitis B – before their third birthday, a benchmark set by federal health officials.
The series completion rate fell nearly three percentage points, to 66.5%, from January 2025 to January this year. That decline is about 13 times greater than the average annual change over the last 18 years. The only years the rate dropped more steeply were during the COVID-19 pandemic in 2020 and the U.S. financial crisis in 2008, which hit Michigan especially hard.
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A line chart shows the declining vaccination rates in Michigan.
Among children whose race and ethnicity were identified in the data, the biggest declines were among white toddlers, the largest demographic group, and Hispanic children, Reuters found. Kennedy’s frequent attacks on vaccines were the primary influence among white families, while the Trump administration’s deportation campaign against immigrants has kept Latino families away from public clinics, according to interviews with more than two dozen public health officials, parents, researchers and community advocates across the state.
The trend in Michigan is concerning given its size and diversity, even if it can’t predict rates nationwide, said Mathew Kiang, an assistant professor of epidemiology at Stanford University.
“What’s happening there is almost certainly happening in other states,” Kiang said.
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The Michigan drop in 2025 represents about 4,500 additional toddlers with an increased vulnerability to serious illness, according to state data. These children can also pose a risk to infants too young to be vaccinated and immunocompromised adults, health officials said.
“Even if the public health impact of one vaccine in one arm is unmeasurably small, every unvaccinated child is at risk,” Lauren Fink, an Oakland County, Michigan, epidemiologist, said in an email.
RFK JR’S ANTI-VAX MESSAGING
Kennedy has for years promoted the view, contrary to scientific evidence, that routine childhood shots are linked to rising autism and chronic disease rates, posing more dangers than the illnesses they prevent.
Since becoming the nation’s most powerful health official, Kennedy has elevated that anti-vaccine messaging. Such views, once largely limited to narrow social media communities, are now broadcast by the federal government.
“People are becoming a little more open to questioning things because RFK Jr is pushing out information that has never been really readily available on mainstream media,” said Rachel Atwood, a longtime vaccine skeptic in western Michigan.
Atwood agrees with Kennedy that the U.S. spends too much time and money on preventing infectious disease and should focus more on combatting chronic conditions like diabetes and obesity.
Kennedy has also upended the process for recommending childhood vaccination, ousting a national advisory board and replacing its members with people who share his views. The new board recently led the U.S. government to reduce the number of routinely recommended childhood shots, despite lacking new evidence of harm. A federal judge on Mondayblocked those changes, siding with leading medical associations who argued that they would increase distrust in shots and lower immunization rates.
Health and Human Services Department spokesman Andrew Nixon denied that Kennedy had a role in declining vaccination rates. He said Michigan officials pursued a particularly aggressive response to the COVID pandemic, including school closures and mask mandates, that eroded public trust in health policies.
“Restoring confidence in public health, not repeating the mistakes of the pandemic era and failed policies from states like Michigan, is the path to stronger vaccination uptake over time,” Nixon said. He did not comment about the drop among Hispanic toddlers.
Dr. Natasha Bagdasarian, Michigan’s chief medical executive, said the state’s 2025 immunization trend is distinct from previous years because vaccination rates had stabilized after the pandemic. What’s new, Bagdasarian said, is Kennedy’s language and policies, which have sown doubt and confusion among families.
“Michigan is not failing,” Bagdasarian said. “I think we are being failed by some of the rhetoric that is being put out at the national level.”
A PUBLIC HEALTH SETBACK
The United States was deemed to have eliminated measles in 2000 thanks to high rates of vaccination at the time. Growing vaccine hesitancy has chipped away at that achievement.
In the last year, the country has battled its worst measles outbreaks in decades, first in Texas and more recently in South Carolina. At least two children died and dozens have been hospitalized. Most of them were unvaccinated. Cases of whooping cough in Michigan surged in 2024 and remained elevated in 2025.
Rather than promote widespread inoculation to curb these outbreaks, Kennedy has said the decision to vaccinate is a matter of personal choice after consultation with their doctors.
Noah Sliwa, a father of two in Lansing, Michigan, said Kennedy’s policies have given comfort to him and his wife. They had already decided to extend the time between shots given to their children to better manage any side effects, and they skipped a birth dose of the hepatitis B vaccine for both, contrary to the U.S. recommendations that existed before Kennedy took office.
“We felt more understood,” said Sliwa. “It felt normalized.”
Michigan health officials interviewed by Reuters say they see a direct impact from Kennedy’s views on vaccination rates. For example, the statewide data for 2025 shows a decline of nearly three percentage points in the share of toddlers receiving their first dose of the MMR shot, a frequent target of Kennedy.
Among white toddlers, the statewide vaccination rate for the series of seven shots dropped four points to 67.5% from January 2025 to January this year. For Hispanic toddlers, the rate fell 4.6 points to 69.8% over the same period. Federal officials had set an 80% series completion rate as a nationwide goal for disease prevention over a decade ago, but have focused on improving use of specific shots since the pandemic.
Letha Martin, an immunization supervisor in Oakland County north of Detroit, trains nurses in how to speak to parents who are hesitant about vaccinating their kids. The toddler vaccination rate in the populous, predominantly white suburban county dropped 2.9 percentage points from January 2025 to January 2026, according to the Reuters review.
Parents have often raised safety concerns about shots for their toddlers while seeking exemptions from state vaccine mandates, Martin said. Now families cite Kennedy’s talking points, such as the claim that vaccine clinical trials are not designed to properly test for side effects.
“Those are very, very particular concerns,