My uncle looked exhausted as he told me one of his biggest challenges as a pediatrician — one that had nothing to do with medical issues. “I spend about half a million a year on vaccines,” he explained. “After all is said and done, I’m not even sure I break even on them.” After providing care to children in Virginia for 25 years, my uncle was describing a financial trap that is undermining our country’s pediatricians.

Vaccines consistently make big headlines these days. But this broken financial model, in which pediatricians front enormous costs and absorb incredible risk just to inoculate their patients, is a silent threat to childhood vaccination programs across the United States — and all the children, families and communities who benefit from them.

An impossible burden

Vaccines ar

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