About 13 years ago, well before I became a parent, I had a conversation with my aunt. She was the kind of aunt a young person could talk to: hilariously frank, slow to judge, and not easily scandalized. We were seated in her rumpus room, me on the couch and her on the floor, as one of her four children (she now has five) toddled back and forth. The topic turned to motherhood. “I’m not sure I like kids,” I said. If she was offended, she didn’t show it. In fact, she seemed to get what I was saying. “Yeah,” she replied, as she looked at her son, “I don’t think I used to like kids either. But I like my own kids.”

Neither of us meant any harm by our bluntness. My aunt, I’m sure, was attempting to be reassuring, and I was just trying to make sense of my ambivalence. In adolescence and early adulthood, I wasn’t someone whom anyone described as being “good with kids.” When a family friend or relative was looking for a babysitter, it wasn’t unheard of for them to ask my younger sister before they asked me. Little kids didn’t usually gravitate toward me, and when they did, I found feigning interest in whatever game they wanted to play a bit laborious. Our interactions often felt nerve-racking or forced, and I wasn’t sure what to make of this; I sensed—or perhaps just assumed—that most women felt otherwise.

Of course, people frequently use reductive language when talking about children: They “like,” “do not like,” or even “hate” kids. Sometimes, particularly in fringier corners of the internet, people appear to mean exactly what they say: They don’t like children as a class of human. But most of the time, I think people are attempting to express more complex emotions in language that feels intuitive. For example, they might be using “I don’t like kids” as shorthand for why they don’t want to become a parent—or regret becoming one. I’ve heard people speak this way to explain why they’d rather not hold a child, or even use the phrasing as a compliment: “I don’t usually like babies,” a young man once told me, “but yours is pretty cool.”

Probably more than anything, people say “don’t like” to express irritation over the disturbances that inevitably occur when children occupy public space: the whining, the shrieking, the knocking-over of things. In those situations, even people who rush to kids’ defense can end up leaning on language that focuses on likability. Children are lovely, they might say, and if you can’t see that, then something is wrong with you.

Stepping back, though—doesn’t something about this feel weird? When you talk about kids in terms of “like” or “don’t like,” you’re basically treating them as objects, the same way you’d talk about cars or handbags or a specific brand of Scotch. But kids aren’t commodities that we accessorize our life with. They’re humans.

In general, I don’t think it’s terribly useful to micromanage the way people speak. But over time, I’ve become convinced that we do need to scrutinize the language many people use to talk about kids, because it reflects and reinforces a view of children as somehow “other”—a view that gets in the way of conversations we ought to be having about children’s place in society and who is responsible for them.

More people than not (I hope) understand that it’s wrong to write off entire categories of humans based on superficial characteristics such as height, weight, skin color, and age. If I were to hear someone say they “don’t like old people,” I wouldn’t hesitate to call them out on it. Yet people talk about children that way all the time. Such broad-based, categorical phrasing effectively functions as a linguistic sleight of hand, allowing people to implicitly dismiss kids as a matter worthy of their concern. If kids are commodities, then responsibility for them falls on the owner and the owner alone. If kids are commodities, then it’s reasonable for me to feel violated when a child who isn’t “mine” throws a tantrum anywhere near my personal space.

I don’t think it’s wrong to be frustrated when a baby cries in the seat behind you on a plane, or when a toddler talks more loudly than social norms would consider polite. Kids do have a tendency to disrupt the tranquility of public life. Yet I believe that as a society, we genuinely need to discuss how adults—parents and nonparents—should engage with and accommodate children, and having that conversation becomes more difficult when people stake out black-and-white positions on kids’ likability.

[Read: An ode to crying babies]

This is a point that most people seem to understand in other circumstances. For instance, whether someone ought to help a blind person cross a busy road has essentially nothing to do with whether you like blind people. What any of us owe to our fellow humans, with all their different capacities and at various stages of life, is a matter of morals—the social contract we share—and not of preference. The goal here, in focusing on language, is not to shame anyone or to make people self-conscious about their use of words. It’s to open up discussion in a way that reduces the likelihood of endlessly speaking past one another.

As a person who spends quite a bit of time writing about the challenges of modern parenting, I want to talk with other people about, say, their hesitation to raise children. In my view, the interests of parents and the child-free are intimately bound together; we each, in our own way, resent the attitude that parenthood is something to be taken for granted. As a parent, I’d like American policy makers to stop taking my domestic labor as a given, to start appreciating the work that mothers and fathers do to raise decent members of society, and to pair that appreciation with more material support. I also get the sense that a lot of child-free people—in particular, child-free women—are bothered by those who believe that parenthood is a default condition, and who suggest, as our new vice president once did, that people who aren’t raising kids “don’t really have a direct stake” in what happens in our nation. But as soon as someone who is ambivalent about children declares that they “don’t like” kids, a wedge is driven between parents and nonparents. We’re no longer on the same team.

[Read: Cultural shifts alone won’t persuade people to have kids]

This goes for all of the other pressing concerns about child-rearing that Americans ought to be discussing. Is the country’s threadbare family-policy framework, with its nonexistent paid parental leave and meager funding for child care or other financial support, adequately addressing the needs of children? (No? Then let’s talk about it.) Do we owe it to kids to take their needs into consideration when we’re setting workplace policy? Is the way we’ve divvied up our public resources—with the country spending far more on the elderly than on the young—truly just? Parent or not, whether you “like kids” or not, decisions about policy at some point wind up affecting all of us. And discussing these concerns would be easier if we could dispense with the “don’t like” language and strive to use words that reflect children’s humanity.

I won’t try to offer readers a set of scripts to use in place of our more objectifying terminology. But I would like to propose an experiment: If you find yourself moved to say you don’t like kids, swap in another group of people and see whether that feels like an acceptable thing to say. If it doesn’t, consider thinking in more nuanced terms about the idea you’re trying to express—terms that make clear you’re talking, with all due respect, about your fellow humans. Most likely, doing so will help your position sound a lot more reasonable. And it will certainly improve your odds of being heard.

Becoming a public-health expert means learning how to envision humanity’s worst-case scenarios for infectious disease. For decades, though, no one in the U.S. has had to consider the full danger of some of history’s most devastating pathogens. Widespread vaccination has eliminated several diseases—among them, measles, polio, and rubella—from the country, and kept more than a dozen others under control. But in the past few years, as childhood-vaccination rates have dipped nationwide, some of infectious disease’s ugliest hypotheticals have started to seem once again plausible.

The new Trump administration has only made the outlook more tenuous. Should Robert F. Kennedy Jr., one of the nation’s most prominent anti-vaccine activists, be confirmed as the next secretary of Health and Human Services, for instance, his actions could make a future in which diseases resurge in America that much more likely. His new position would grant him substantial power over the FDA and the CDC, and he is reportedly weighing plans—including one to axe a key vaccine advisory committee—that could prompt health-care providers to offer fewer shots to kids, and inspire states to repeal mandates for immunizations in schools. (Kennedy’s press team did not respond to a request for comment.)

Kennedy’s goal, as he has said, is to offer people more choice, and many Americans likely would still enthusiastically seek out vaccines. Most Americans support childhood vaccination and vaccine requirements for schools; a KFF poll released today found, though, that even in the past year the proportion of parents who say they skipped or delayed shots for their children has risen, to one in six. The more individuals who choose to eschew vaccination, the closer those decisions would bring society’s collective defenses to cracking. The most visceral effects might not be obvious right away. For some viruses and bacteria to break through, the country’s immunization rates may need to slip quite a bit. But for others, the gap between no outbreak and outbreak is uncomfortably small. The dozen experts I spoke with for this story were confident in their pessimism about how rapidly epidemics might begin.

[Read: How America’s fire wall against disease starts to fail]

Paul Offit, a pediatrician at Children’s Hospital of Philadelphia and co-inventor of one of the two rotavirus vaccines available in the U.S., needs only to look at his own family to see the potential consequences. His parents were born into the era of the deadly airway disease diphtheria; he himself had measles, mumps, rubella, and chickenpox, and risked contracting polio. Vaccination meant that his own kids didn’t have to deal with any of these diseases. But were immunization rates to fall too far, his children’s children very well could. Unlike past outbreaks, those future epidemics would sweep across a country that, having been free of these diseases for so long, is no longer equipped to fight them.

“Yeah,” Offit said when I asked him to paint a portrait of a less vaccinated United States. “Let’s go into the abyss.”

Should vaccination rates drop across the board, one of the first diseases to be resurrected would almost certainly be measles. Experts widely regard the viral illness, which spreads through the air, as the most infectious known pathogen. Before the measles vaccine became available in 1963, the virus struck an estimated 3 million to 4 million Americans each year, about 1,000 of whom would suffer serious swelling of the brain and roughly 400 to 500 of whom would die. Many survivors had permanent brain damage. Measles can also suppress the immune system for years, leaving people susceptible to other infections.

Vaccination was key to ridding the U.S. of measles, declared eliminated here in 2000. And very high rates of immunity—about 95 percent vaccine coverage, experts estimate—are necessary to keep the virus out. “Just a slight dip in that is enough to start spurring outbreaks,” Boghuma Kabisen Titanji, an infectious-disease physician at Emory University, told me. Which has been exactly the case. Measles outbreaks do still occur in American communities where vaccination rates are particularly low, and as more kids have missed their MMR shots in recent years, the virus has found those openings. The 16 measles outbreaks documented in the U.S. in 2024 made last year one of the country’s worst for measles since the turn of the millennium.

But for all measles’ speed, “I would place a bet on whooping cough being first,” Samuel Scarpino, an infectious-disease modeler at Northeastern University, told me. The bacterial disease can trigger months of coughing fits violent enough to fracture ribs. Its severest consequences include pneumonia, convulsions, and brain damage. Although slower to transmit than measles, it has never been eliminated from the U.S., so it’s poised for rampant spread. Chickenpox poses a similar problem. Although corralled by an effective vaccine in the 1990s, the highly contagious virus still percolates at low levels through the country. Plenty of today’s parents might still remember the itchy blisters it causes as a rite of passage, but the disease’s rarer complications can be as serious as sepsis, uncontrolled bleeding, and bacterial infections known as “flesh-eating disease.” And the disease is much more serious in older adults.

Those are only some of the diseases the U.S. could have to deal with. Kids who get all of the vaccines routinely recommended in childhood are protected against 16 diseases—each of which would have some probability of making a substantial comeback, should uptake keep faltering. Perhaps rubella would return, infecting pregnant women, whose children could be born blind or with heart defects. Maybe meningococcal disease, pneumococcal disease, or Haemophilus influenzae disease, each caused by bacteria commonly found in the airway, would skyrocket, and with them rates of meningitis and pneumonia. The typical ailments of childhood—day-care colds, strep throat, winter norovirus waves—would be joined by less familiar and often far more terrifying problems: the painful, swollen necks of mumps; the parching diarrhea of rotavirus; the convulsions of tetanus. For far too many of these illnesses, “the only protection we have,” Stanley Plotkin, a vaccine expert and one of the developers of the rubella vaccine, told me, “is a vaccine.”

Exactly how and when outbreaks of these various diseases could play out—if they do at all—is impossible to predict. Vaccination rates likely wouldn’t fall uniformly across geographies and demographics. They also wouldn’t decrease linearly, or even quickly. People might more readily refuse vaccines that were developed more recently and have been politicized (think HPV or COVID shots). And existing immunity could, for a time, still buffer against an infectious deluge, especially from pathogens that remain quite rare globally. Polio, for instance, would be harder than measles to reestablish in the United States: It was declared eliminated from the Americas in the 1990s, and remains endemic to only two countries. This could lead to a false impression that declining vaccination rates have little impact.

A drop in vaccination rates, after all, doesn’t guarantee an outbreak—a pathogen must first find a vulnerable population. This type of chance meeting could take years. Then again, infiltrations might not take long in a world interconnected by travel. The population of this country is also more susceptible to disease than it has been in past decades. Americans are, on average, older; obesity rates are at a historical high. The advent of organ transplants and cancer treatments has meant that a substantial sector of the population is immunocompromised; many other Americans are chronically ill. Some of these individuals don’t mount protective responses to vaccinations at all, which leaves them reliant on immunity in others to keep dangerous diseases at bay.

If various viruses and bacteria began to recirculate in earnest, the chance of falling ill would increase even for healthy, vaccinated adults. Vaccines don’t offer comprehensive or permanent protection, and the more pathogen around, the greater its chance of breaking through any one person’s defenses. Immunity against mumps and whooping cough is incomplete, and known to wane in the years after vaccination. And although immunity generated by the measles vaccine is generally thought to be quite durable, experts can’t say for certain how durable, Bill Hanage, an infectious-disease epidemiologist at Harvard’s School of Public Health, told me: The only true measure would be to watch the virus tear through a population that hasn’t dealt with it in decades.

Perhaps the most unsettling feature of a less vaccinated future, though, is how unprepared the U.S. is to confront a resurgence of pathogens. Most health-care providers in the country no longer have the practical knowledge to diagnose and treat diseases such as measles and polio, Kathryn Edwards, a pediatrician at Vanderbilt University, told me: They haven’t needed it. Many pediatricians have never even seen chickenpox outside of a textbook.

To catch up, health-care providers would need to familiarize themselves with signs and symptoms they may have seen only in old textbooks or in photographs. Hospitals would need to use diagnostic tests that haven’t been routine in years. Some of those tools might be woefully out of date, because pathogens have evolved; antibiotic resistance could also make certain bacterial infections more difficult to expunge than in decades prior. And some protocols may feel counterintuitive, Offit said: The ultra-contagiousness of measles could warrant kids with milder cases being kept out of health-care settings, and kids with Haemophilus influenzae might need to be transported to the hospital without an ambulance, to minimize the chances that the stress and cacophony would trigger a potentially lethal spasm.

[Read: Here’s how we know RFK Jr. is wrong about vaccines]

The learning curve would be steep, Titanji said, stymieing care for the sick. The pediatric workforce, already shrinking, might struggle to meet the onslaught, leaving kids—the most likely victims of future outbreaks—particularly susceptible, Sallie Permar, the chief pediatrician at NewYork–Presbyterian/Weill Cornell Medical Center, told me. If already overstretched health-care workers were further burdened, they’d be more likely to miss infections early on, making those cases more difficult to treat. And if epidemiologists had to keep tabs on more pathogens, they’d have less capacity to track any single infectious disease, making it easier for one to silently spread.

The larger outbreaks grow, the more difficult they are to contain. Eventually, measles could once again become endemic in the U.S. Polio could soon follow suit, imperiling the fight to eradicate the disease globally, Virginia Pitzer, an infectious-disease epidemiologist at Yale, told me. In a dire scenario—the deepest depths of the abyss—average lifespans in the U.S. could decline, as older people more often fall sick, and more children under 5 die. Rebottling many of these diseases would be a monumental task. Measles was brought to heel in the U.S. only by decades of near-comprehensive vaccination; re-eliminating it from the country would require the same. But the job this time would be different, and arguably harder—not merely coaxing people into accepting a new vaccine, but persuading them to take one that they’ve opted out of.

That future is by no means guaranteed—especially if Americans recall what is at stake. Many people in this country are too young to remember the cost these diseases exacted. But Edwards, who has been a pediatrician for 50 years, is not. As a young girl, she watched a childhood acquaintance be disabled by polio. She still vividly recalls patients she lost to meningitis decades ago. The later stages of her career have involved fewer spinal taps, fewer amputations. Because of vaccines, the job of caring for children, nowadays, simply involves far less death.

Figures shared exclusively with BBC News show 504 reported offences took place in hotels in 2023.

The children's commissioner says children often made impulsive decisions to become involved in the riots.

Robert F. Kennedy Jr., President Donald Trump’s nominee for secretary of Health and Human Services, is a longtime conspiracy theorist and anti-vaccine activist. He thinks Anthony Fauci and Bill Gates are leaders of a “vaccine cartel” that intentionally prolonged or even started the coronavirus pandemic in order to promote “mischievous inoculations.” Kennedy also blames immunizations for autism and obesity (among other chronic diseases) in children. In the meantime, he isn’t really sure whether HIV causes AIDS, or whether vaccine-preventable diseases such as measles are actually dangerous.

As a doctor, I have spent years following—and fighting—anti-vaccine falsehoods. Along the way, I’ve learned an important lesson: Despite RFK Jr.’s fringe beliefs, he often seems to make sense. Kennedy’s defenders celebrate his fondness for, and facility with, evidence. His real talent, though, is for the clever manipulation of facts. Kennedy is not just a conspiracy theorist; he’s a very good conspiracy theorist. When his confirmation hearing starts on Wednesday, we can expect that he will do what he’s always done, which is to apply a veneer of erudition to nonsense. He may even come off as almost … reasonable.

To witness how this works, read the letter he sent to the prime minister of Samoa on behalf of the anti-vaccine nonprofit Children’s Health Defense in November 2019, during that country’s deadly measles outbreak. Kennedy offers his condolences for the tragic deaths of “precious Samoan children,” and then suggests the need to study the outbreak carefully, so as to “thoroughly understand its etiology.” What might have caused thousands of Samoans to get sick? The letter poses two possibilities: “It is critical that the Samoan Health Ministry determine, scientifically, if the outbreak was caused by inadequate vaccine coverage or alternatively, by a defective vaccine.”

At first glance, and for nonexperts, this letter may appear well reasoned and well sourced. It weaves in historical elements and biomedical data, and includes a list of peer-reviewed references at the end. The letter’s main request—that Samoan officials do nothing more than perform genetic testing on the circulating virus—sounds prudent. Prior research has indicated that vaccinated individuals may shed the virus and infect others, the letter says. Wouldn’t it be good to know if that produced the outbreak?

[Read: We’re about to find out how much Americans like vaccines]

In reality, of course, the epidemic was caused not by the vaccines but by the lack of them. (A vaccine-administration accident the year before had produced a scare that led vaccination rates to decline dramatically.) Although the letter’s implication that vaccines were to blame seemed wrong on its face, only when I dived into the cited scientific articles could I see the problems with its details. Kennedy incorrectly claims that genetic sequencing of a large measles outbreak in California from about four years prior found that at least one-third of the cases were due to the vaccine. “Alarmed CDC officials documented this emerging phenomenon,” he wrote. The referenced articles show this to be a fundamental misrepresentation. Although they do describe how the vaccine may, in rare cases, produce a dangerous case of measles, they specifically note that there is no risk of its being transmitted to another person. The genetic testing that Kennedy referenced is used, in part, to distinguish among people who have experienced mild vaccine reactions such as rash and fever from those who have true measles infections. This is important during active epidemics when public-health officials are widely immunizing people, while at the same time trying to isolate infectious individuals. (Kennedy’s press team did not respond to emailed questions about his letter to Samoa, or about other issues with his credibility that are raised in this article.)

A complete refutation of the Samoa letter would run many pages. That may be the point. With his ample, erroneous allusions to scholarship and appeals to authority, Kennedy has perfected the art of the Gish Gallop: a debate strategy in which the speaker simply overwhelms the listener with information, not all of it true. Kennedy’s skill at flooding his audiences with specious claims that sound logical or highbrow was on full display during his 2023 interview with the podcaster Joe Rogan. Over the course of three hours, Kennedy regaled the host with stories about vaccine safety, Albert Camus, Wi-Fi radiation, and the sexual health of frogs, among other subjects. He offered up a bounty of scientific arguments: The words study and studies came up 70 times during the conversation. And, as he has done elsewhere, he encouraged the audience to fact-check everything he said. “Nobody should trust my word on this,” he declared. “You know, what I say is irrelevant. What is relevant is the science.”

[Read: The new Rasputins]

Most of Rogan’s listeners—like most U.S. senators—aren’t likely to have the scientific expertise to assess each of his claims, and certainly not in real time. I caught some errors in the Rogan interview only by virtue of my medical training. For example, Kennedy criticized the inclusion of the hepatitis B shot in the childhood vaccine schedule. The virus is primarily a problem for intravenous-drug users, prostitutes, and homosexuals, he suggested. “Why would you give it to a one-day-old baby, you know, or a three-hour-old baby, and then four more times when that baby is not going to be even subject to it for 16 years?” he asked Rogan. Kennedy’s story sounds informed: He is facile with epidemiology and vaccine regulations; he can describe historical machinations that supposedly took place between Merck and the CDC. But the truth is that most chronic hepatitis B infections are contracted during early childhood, or through mother-to-child transmission. That’s why the World Health Organization recommends immunizing babies, and it’s why nearly every country has chosen to do so.

Kennedy does, at times, say true things about vaccines. He was not wrong, for example, when he told the podcaster Lex Fridman that early batches of the polio vaccine were contaminated with a virus called SV40. But he magnifies and distorts such flaws to the point of absurdity. SV40-containing vaccines did not cause an “explosion” of cancers, as he has argued. Kennedy is also right to say the MMR vaccine doesn’t always provide lifelong immunity to the mumps virus. However, his more extreme assertions—that the shot is causing mumps outbreaks in the military or that the disease is harmless in children—are wrong. (Before vaccination, service members routinely suffered from infections, and kids were at a heightened risk of developing brain inflammation and hearing loss.) Kennedy relies on scraps of truth to construct an alternative reality in which vaccines don’t work, their harms outweigh their benefits, and the diseases themselves aren’t so bad.

At his confirmation hearing, senators will ask him to defend that dangerous, alternative reality. He is likely to do so with impressive-sounding falsehoods, delivered with aplomb. Heed his own advice. No one should trust his word on this.

For more than 60 years, vaccination in the United States has been largely shaped by an obscure committee tasked with advising the federal government. In almost every case, the nation’s leaders have accepted in full the group’s advice on who should get vaccines and when. Experts I asked could recall only two exceptions. Following 9/11, the Bush administration expanded the group who’d be given smallpox vaccinations in preparation for the possibility of a bioterrorism attack, and at the height of the coronavirus pandemic, in 2021, the Biden administration added high-risk workers to the groups urged to receive a booster shot. Otherwise, what the Advisory Committee on Immunization Practices (ACIP) has recommended has effectively become the country’s unified vaccination policy.

This might soon change. Robert F. Kennedy Jr., one of the nation’s most prominent anti-vaccine activists and the likely next secretary of Health and Human Services, has said that he would not “take away” any vaccines. But Kennedy, if confirmed, would have the power to entirely remake ACIP, and he has made clear that he wants to reshape how America approaches immunity. Gregory Poland, the president of the Atria Academy of Science and Medicine and a former ACIP member, told me that if he were out to do just that, one of the first things he’d do is “get rid of or substantially change” the committee.

Over the years, the anti-vaccine movement has vehemently criticized ACIP’s recommendations and accused its members of conflicts of interest. NBC News has reported that, in a 2017 address, Kennedy himself said, “The people who are on ACIP are not public-health advocates … They work for the vaccine industry.” Kennedy has not publicly laid out explicit plans to reshuffle the makeup or charter of ACIP, and his press team did not return a request for comment. But should he repopulate ACIP with members whose views hew closer to his own, those alterations will be a bellwether for this country’s future preparedness—or lack thereof—against the world’s greatest infectious threats.

[Read: ‘Make America Healthy Again’ sounds good until you start asking questions]

Before ACIP existed, the task of urging the public to get vaccinated was largely left to professional organizations, such as the American Academy of Pediatrics, or ad hoc groups that evaluated one immunization at a time. By the 1960s, though, so many new vaccines had become available that the federal government saw the benefit of establishing a permanent advisory group. Today, the committee includes up to 19 voting members who are experts drawn from fields such as vaccinology, pediatrics, virology, and public health, serving four-year terms. The CDC solicits nominations for new members, but the HHS secretary, who oversees the CDC and numerous other health-related agencies, ultimately selects the committee; the secretary can also remove members at their discretion. The committee “is intended to be a scientific body, not a political body,” Grace Lee, who chaired ACIP through the end of 2023, told me. ACIP’s charter explicitly states that committee members cannot be employed by vaccine manufacturers, and must disclose real and perceived conflicts of interest.

HHS Secretaries typically do not meddle extensively with ACIP membership or its necessarily nerdy deliberations, Jason Schwartz, a vaccine-policy expert at Yale, told me. The committee’s job is to rigorously evaluate vaccine performance and safety, in public view, then use that information to help the CDC make recommendations for how those immunizations should be used. Functionally, that means meeting for hours at a time to pore over bar graphs and pie charts and debate the minutiae of immunization efficacy. Those decisions, though, have major implications for the country’s defense against disease. ACIP is the primary reason the United States has, since the 1990s, had an immunization schedule that physicians across the country treat as a playbook for maintaining the health of both adults and kids, and that states use to guide school vaccine mandates.

The committee’s decisions have, over the years, turned the tide against a slew of diseases. ACIP steered the U.S. toward giving a second dose of the MMR vaccine to children before elementary school, rather than delaying it until early adolescence, in order to optimally protect kids from a trifecta of debilitating viruses. (Measles was declared eliminated in the U.S. in 2000.) The committee spurred the CDC’s recommendation for a Tdap booster during the third trimester of pregnancy, which has guarded newborn babies against whooping cough. It pushed the country to switch to an inactivated polio vaccine at the turn of the millennium, helping to prevent the virus from reestablishing itself in the country.

[Read: We’re about to find out how much Americans like vaccines]

I reached out to both current ACIP members and the Department of Health and Human Services to ask about Kenndy’s pending influence over the committee. ACIP Chair Helen K. Talbot and other current ACIP members emphasized the group’s importance to keeping the U.S. vaccinated, but declined to comment about politically motivated changes to its membership. The Department of Health and Human Services did not return a request for comment.

Should ACIP end up stacked with experts whose views mirror Kennedy’s, “it’s hard not to imagine our vaccination schedules looking different over the next few years,” Schwartz told me. Altered recommendations might make health-care providers more willing to administer shots to children on a delayed schedule, or hesitate to offer certain shots to families at all. Changes to ACIP could also have consequences for vaccine availability. Pharmaceutical companies might be less motivated to manufacture new shots for diseases that jurisdictions or health-care providers are no longer as eager to vaccinate against. Children on Medicaid receive free vaccines based on an ACIP-generated list, and taking a particular shot off that roster might mean that those kids will no longer receive that immunization at all.

At one extreme, the new administration could, in theory, simply disband the committee altogether, Schwartz told me, and have the government unilaterally lay down the country’s vaccination policies. At another, the CDC director, who has never been beholden to the committee’s advice, could begin ignoring it more often. (Trump’s choice to lead the CDC, the physician and former Florida congressman Dave Weldon, has been a critic of the agency and its vaccine program.) Most likely, though, the nation’s new health leaders will choose to reshape the committee into one whose viewpoints would seem to legitimize their own. The effects of these choices might not be obvious at first, but a committee that has less academic expertise, spends less time digging into scientific data, and is less inclined to recommend any vaccines could, over time, erode America’s defenses—inviting more disease, and more death, all of it preventable.

The internet, a friend of mine once argued to me, is like a sprawling city: Everyone knows there are neighborhoods you shouldn’t wander into, but it would be wrong to prohibit people from entering them.

The problem with my friend’s view is that whereas one has to go looking for bad neighborhoods, the internet’s dangers—specifically and most perniciously, pornography—come looking for you, even if you happen to be a child. A recent Wall Street Journal investigation found that dummy accounts that specified their age as 13 were regularly served up soft porn by Instagram’s algorithms. Upon the accounts’ creation, Instagram began showing the imaginary users “moderately racy” content, such as women dancing seductively or dressed provocatively. Once these accounts lingered on such videos, Instagram began introducing more graphic videos and posts. “Adult sex-content creators began appearing in the feeds in as little as three minutes,” the Journal reported. “After less than 20 minutes watching Reels, the test accounts’ feeds were dominated by promotions for such creators, some offering to send nude photos to users who engaged with their posts.”

In fact, porn is so ubiquitous online that it’s tempting to dismiss the preponderance of porn available to children as mainly harmless in most cases—a rite of passage for kids growing up on the internet. But childhood exposure to porn is a public-health concern with serious, long-term ramifications for children. Their interests are essentially collateral damage in adults’ right to consume porn as they please, and a massive industry’s interest in preserving its billions of dollars a year in revenue.

[Read: The age of AI child abuse is here]

Some websites take greater care than Instagram or X in preventing minors from accessing sexual content, and recent legislation across the South has begun requiring age verification before a user can browse sites such as Pornhub. But whatever safeguards are in place to protect minors online, they don’t seem to be working. A 2023 report by Common Sense Media found that the average age of first pornography exposure in American children is 12, and another 2023 survey conducted for the Children’s Commissioner for England revealed that a quarter of British youths ages 16 to 21 had been exposed to porn for the first time in primary school. An Australian survey last year, meanwhile, placed the average age of first pornography exposure at a little over 13. Just more than half of the American minors surveyed said that they had encountered porn accidentally; 38 percent of the British young people surveyed reported the same. If safeguards are in place to protect children from coming into contact with porn, they appear laughable.

Childhood experiences with pornography can be distressing for children and can negatively affect their sexual development. Research presented at the 125th Annual Convention of the American Psychology Association in 2017 found that the earlier a man’s first exposure to porn was, the more likely he was to desire power over women, suggesting that contact with porn at an early age may contort a child’s sexual development. One 12-year-old interviewed for the British survey said that her boyfriend had strangled her during their first kiss—part of a trend teenagers I interviewed in 2021 also brought up. A Taiwanese longitudinal study of youths further found that early porn exposure predicted an earlier sexual debut and participation in unsafe sex. A third of respondents in the Australian study indicated that they relied on porn for information about sex, a concerning substitute for proper education—the sort provided by people who know and care for children, not by people attempting to sell them sex. Along with these specific risks, children are also subject to all of the usual problems cited with the adult use of porn: internalizing unrealistic standards for sex, developing excessive consumption habits, becoming desensitized to sexual violence. The main difference is that when porn use begins in childhood, it steps in to miseducate desires that have yet to fully form.

Proponents of porn use generally crusade under the banner of free speech—the Free Speech Coalition, an organization currently fighting a Texas law that would require porn sites to collect proof that users are over 18, is a porn-industry lobbying group. On Wednesday, the FSC argued against the state of Texas over these age-verification laws before the Supreme Court, claiming that these laws abrogate the exercise of free speech. (Pornhub, along with other major porn distributors, has already withdrawn operations from several southern states with age-verification laws on the books.) Even an FSC attorney admitted at the Supreme Court that the organization recognizes the government’s compelling interest in preventing porn from reaching minors.

My friend who analogized the internet to a city with good and bad neighborhoods perhaps failed to consider that the people traversing those streets are in many cases children, and in our society, children’s issues are especially fraught—see recent conflicts about which books should be available to children in their school libraries, and about whether children should be allowed to change their identity at school or their body. All of these debates really are, as the scholar Rita Koganzon wrote in a Yale Law Journal article published last year, “part of an ongoing culture war between factions of adults.” It’s unfortunate that arguments over how to protect children from exposure to porn are very likely to be proxy battles between adults’ differing views on whether porn is good, bad, or neutral—each debate deserves to play out separately, without the interests of children being made subordinate to the interests of adults. The risks associated with childhood porn exposure are real, and worthy of society’s special attention.

Children account for more than half of Haiti's displaced population, which has tripled amid relentless gang violence.

A politically powerful opponent of birthright citizenship railed that the United States cannot “give up the right” to “expel” dangerous “trespassers” who “invade [our] borders,” “wander in gangs,” and “infest society.”

Was this Donald Trump speaking in 2024? No, the quote is from an 1866 speech on the Senate floor by Senator Edgar Cowan of Pennsylvania, a leading opponent of adding a provision to the U.S. Constitution granting citizenship based solely on birth on U.S. soil. Who were the “invaders” that Senator Cowan so feared? “I mean the Gypsies,” Cowan explained, despite offering no evidence that Roma migration posed a risk to the United States.

Senator Cowan lost the fight. In 1868, the nation ratified the Fourteenth Amendment, the first sentence of which guarantees birthright citizenship. The amendment invalidated the Supreme Court’s infamous 1857 decision in Dred Scott v. Sandford, which declared that no Black person could ever be a U.S. citizen. Equally important, the Constitution now guaranteed citizenship to the children of immigrants born on U.S. soil, “no matter from what quarter of the globe he or his ancestors may have come,” as one senator later put it in a speech to his constituents.

[Martha S. Jones: Birthright citizenship was won by freed slaves]

More than 150 years later, Trump has vowed to end birthright citizenship on “day one” of his new administration for children without at least one parent who is a citizen or green-card holder. He made that announcement in a three-minute video prominently posted on his campaign website, which he repeated in an interview with NBC’s Meet the Press last month.

In 2025, the end of birthright citizenship is more than just an applause line at the Conservative Political Action Conference. It has a genuine, if slim, chance of making its way into law. If it does, it will upend the lives of millions, and create a caste system in which a new set of people—native-born non-Americans—can never work or live in the open.

This prospect ought to be taken seriously. How would President Trump implement such a plan? Is it constitutional? And would the U.S. Supreme Court back him up?

The first question is easy, because Trump has told us exactly how he intends to proceed. In the video, the president-elect commits to issuing an executive order on January 20, 2025, that would deny citizenship not only to the children of undocumented immigrants but also to those born to parents who both are legally in the United States on a temporary visa for study or work. (Trump’s order as proposed would apply only to children born after it is issued.)

The consequences would be immediate. Trump says he will order government officials to deny these children passports and Social Security numbers. They will be prohibited from enrolling in federal programs such as Medicaid, the Children’s Health Insurance Program, and the Supplemental Nutrition Assistance Program, and likely state benefits as well.

As adults, if all goes according to Trump’s plan, they will be barred from voting, holding elected office, and serving on juries. States could deny them a driver’s license and block them from attending state universities. They would be prohibited from working in the United States, and any U.S. citizen who employs them could be fined or even jailed under federal immigration laws. Many would be rendered stateless. Perhaps worst of all, they would live in perpetual fear of being deported from the only country in which they have ever lived.

[Read: Trump’s murky plan to end birthright citizenship]

Ending birthright citizenship for these children would affect everyone in America. Everyone would now have to provide proof of their parents’ citizenship or immigration status on the date of their birth to qualify for the rights and benefits of citizenship. The new law would necessitate an expanded government bureaucracy to scrutinize hospital records, birth certificates, naturalization oaths, and green-card applications.

Lawsuits are sure to follow, which leads to the second question: Will Trump have the constitutional authority to end birthright citizenship for the children of undocumented immigrants?

Per the text of the Constitution, the answer is a hard no. Some constitutional provisions are fuzzy, but the citizenship clause is not one of them. It states: “All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.”

Even the deeply racist Supreme Court back in 1898 couldn’t find any wiggle room in that language. Just two years before, in 1896, the Court had somehow read the Constitution’s equal-protection clause to permit “separate but equal” in Plessy v. Ferguson, ushering in the Jim Crow era. But when the U.S. government argued in United States v. Wong Kim Ark that the children of Chinese immigrants were not birthright citizens, the justices balked. The language granting citizenship to “all persons born” in the United States was “universal,” the Court explained, restricted “only by place and jurisdiction.” More recently, the Supreme Court reaffirmed that point, stating as an aside in a 1982 opinion addressing the rights of undocumented children to attend school: “No plausible distinction with respect to Fourteenth Amendment ‘jurisdiction’ can be drawn between resident aliens whose entry into the United States was lawful, and resident aliens whose entry was unlawful.”

Despite the clear text and long-standing judicial precedent, Trump claims that undocumented immigrants and their children are not “subject to the jurisdiction” of the United States, and so fall within the exception to universal birthright citizenship.

That is nonsense. Undocumented immigrants must follow all federal and state laws. When they violate criminal laws, they are jailed. If they park illegally, they are ticketed. They are required to pay their taxes and renew their driver’s license, just like everyone else. Trump certainly agrees that undocumented parents of native-born children can be deported for violating immigration laws at any time. So in what way are these immigrants and their children not subject to U.S. jurisdiction?

The citizenship clause’s exception for those not “subject to the jurisdiction” of the United States applies only to children born to members of American Indian tribes and the children of diplomats, as Congress explained when drafting that language in 1866. In contrast with undocumented immigrants, both groups owe allegiance to a separate sovereign, and both are immune from certain state and federal laws. (Native Americans were granted birthright citizenship by federal statute in 1924.)

As nonsensical as they are in an American context, Trump’s ideas didn’t come out of nowhere. In 1985, the law professor Peter Schuck and the political scientist Rogers Smith wrote an influential book, Citizenship Without Consent, arguing that the Fourteenth Amendment’s citizenship clause did not apply to the children of undocumented immigrants. These scholars asserted that “immigration to the United States was entirely unregulated” before the 1870s, and so there was no such thing as an “illegal immigrant” and likewise no intent to grant birthright citizenship to their children. Many scholars and commentators, including some members of Congress, have repeated that same claim. In 2015, the law professor Lino Graglia testified before the House Judiciary Committee that “there were no illegal aliens in 1868 because there were no restrictions on immigration.” Then-Representative Raúl Labrador repeated the same point at that hearing, asserting as fact that there was “no illegal immigration when the Fourteenth Amendment came into being.” In an op-ed in June 2023, a former Department of Homeland Security policy adviser declared, “There were no immigrant parents living unlawfully in the United States” in the 19th century.

These critics have their facts wrong. In a recent law-review article, the legal scholars Gabriel Chin and Paul Finkelman explained that for decades, Africans were illegally brought to the United States as slaves even after Congress outlawed the international slave trade in 1808, making them the “illegal aliens” of their day. The nation was well aware of that problem. Government efforts to shut down the slave trade and deport illegally imported enslaved people were widely reported throughout the years leading up to the Civil War. Yet no one credible, then or now, would argue that the children of those slaves were to be excluded from the citizenship clause—a constitutional provision intended to overrule Dred Scott v. Sandford by giving U.S. citizenship to the 4.5 million Black people then living in the United States.

[Read: Birthright citizenship wasn’t born in America]

Even so, these ideas have gained traction in the right-wing legal community—a group that will be empowered in Trump’s next term. The Fifth Circuit judge James C. Ho, who is regularly floated as a potential nominee to the Supreme Court, recently said in an interview that children of “invading aliens” are not citizens, because “birthright citizenship obviously doesn’t apply in case of war or invasion”—a reversal of his previous position on this issue. (This is the judicial equivalent of shouting, “Pick me! Pick me!”) Never mind that undocumented immigrants—a majority of whom entered the United States legally and then overstayed their visa—don’t qualify as invaders under any definition of the word. And never mind that there is no support for that idea in either the Constitution’s text or its history. In 1866, Senator Cowan opposed granting citizenship to the children of the “flood” of Chinese immigrants into California, as well as to Gypsy “invaders” of his own state. His colleagues pointed out that the only invasion of Pennsylvania was by Confederate soldiers a few years before. Birthright citizenship, they explained, would ensure that the United States would never revert back to the slave society that the Confederates invaded Pennsylvania to preserve.

In truth, all of these baseless arguments are window dressing for the real goal. The Fourteenth Amendment’s overarching purpose was to end a caste system in which some people had more rights under the law than others. To be sure, that ideal has always been a work in progress. But many opponents of birthright citizenship don’t even hold out that ideal as a goal; they would rather bring caste back, and enshrine it in our laws.

If birthright citizenship were to end tomorrow for children without at least one parent who was a citizen or lawful permanent resident, it would bar from citizenship hundreds of thousands of people each year. These people wouldn’t be eligible to participate in our democracy, and they would be forced to live and work in the shadows, as would their children and their children’s children. The end of birthright citizenship would create a caste of millions of un-Americans, locked in perpetuity into an inferior, exploitable status. Ironically, if Trump were to succeed in ending birthright citizenship, he would preside over the most dramatic increase of undocumented immigrants in U.S. history.

That brings us to the third question: Would five members of the Supreme Court uphold Trump’s proposed executive order?

No sitting justice has addressed this question directly. At his confirmation hearing in 2006, Justice Samuel Alito was asked whether he thought the children of undocumented immigrants qualified for birthright citizenship under the Fourteenth Amendment. He refused to answer on the grounds that a future case might come before him, but he also observed: “It may turn out to be a very simple question. It may turn out to be a complicated question. Without studying the question, I don’t know.” Justice Amy Coney Barrett declined to respond to the same question for the same reason. (These two justices also dodged questions about whether they would overturn Roe v. Wade on those grounds.)  

The Georgetown law professor Steve Vladeck, an expert on the Supreme Court, believes that, at most, “two” or “maybe … even three justices” on the current Court would vote to end birthright citizenship. But all it takes is five, and the Court’s composition may well change. Trump appointed three justices during his first term in office, and he could appoint a few more before the end of his second. It is they who will have the last word.

Two children were among three Palestinians from the same family killed in an Israeli drone attack in Tammun.