Midway into 2026, the most overt attacks on vaccines in the United States have stopped. With the midterm elections looming, the White House reportedly asked Health Secretary Robert F. Kennedy Jr. to quiet his anti-vaccine rhetoric—publicly, at least. But protections against infectious disease are continuing to falter, both domestically and abroad, through sheer neglect. Although the full impact of the U.S.’s disinterest has only started to play out, one effect is already clear: When vaccines’ reach is eroded, the poorest, least well-served people feel the brunt of that loss first. Paring back the CDC’s national childhood immunization schedule, for instance, has limited more Americans’ access to shots; Kennedy’s haphazard reconstitution of the nation’s top vaccine advisory panel led to that expert group being put on hiatus, imperiling immunizations for children from underinsured families. When the White House dismantled the U.S. Agency for International Development, accusing the organization of waste and abuse, it compromised efforts to deliver vaccines around the world; when it stopped funding the World Health Organization, citing the group’s mishandling of the coronavirus …