Experts from the Food and Drug Administration (FDA) in the US are warning that the country is close to a vaccination tipping point: a point where there aren't enough vaccinated people to protect the unvaccinated, leading to deaths that would otherwise have been prevented.

A new commentary, written by FDA Commissioner Robert Califf and FDA vaccine regulator Peter Marks, highlights COVID-19, influenza, and respiratory syncytial virus as three diseases where vaccinations are crucial in protecting communities.

Measles also gets a mention, with a record number of people no longer getting vaccinated against it. That has meant a number of recent outbreaks, including one in Ohio where 36 children had to be hospitalized because of complications from the measles infection.

"An increasing number of people in the US are now declining vaccination for a variety of reasons, ranging from safety concerns to religious beliefs," write the FDA experts.

"Population immunity against some vaccine-preventable infectious diseases is at risk, and thousands of excess deaths are likely to occur this season due to illnesses amenable to prevention or reduction in severity of illness with vaccines."

Marks and Califf point out just how much work and research goes into developing vaccines that are safe enough to be approved for use, and how that work continues while the vaccine is being distributed and administered, to make sure it stays effective.

They also suggest that higher socioeconomic populations are becoming complacent about the need for vaccinations – compared to poorer countries where vaccines simply aren't available, leading to thousands of deaths that could've been prevented.

Research shows that COVID-19 vaccinations have helped to prevent tens of millions of deaths, and many more hospitalizations, since the pandemic started. However, social media misinformation means many are opting out of more than just these vaccinations.

"Vaccines have been so successful in achieving their intended effects that many people no longer see the disturbing morbidity and mortality from infections amenable to vaccines," continues the commentary.

"For example, smallpox has been eradicated, and polio has been eliminated from the US, through effective vaccination campaigns."

The commentary calls on clinicians, pharmacists, and all healthcare professionals to continue the work of educating people about the benefits of vaccination, and the hospitalizations and deaths that will occur without it.

"We believe that the best way to counter the current large volume of vaccine misinformation is to dilute it with large amounts of truthful, accessible scientific evidence," write the authors of the commentary.

"We will do our part at FDA by continuing to provide health care clinicians and the general public with timely and accurate information in plain language to help explain the benefits and risks of vaccination."

While we're yet to see any widespread waves of illness caused by a lack of vaccinations, there's no doubt the risk of one is increasing. We don't want to find out what that would look like.

Among the associated comments on the published article, retired University of California Davis physician Stuart Stolp commends the authors' efforts while arguing that improved critical thinking skills are the only way to immunize the population from growing misinformation.

"To overcome the influence of such enormous volumes of faulty information with even larger volumes of accurate information is comparable to attempting to halt a pandemic by treating infected individuals rather than immunizing a population with an effective vaccine," Stolp says.

"The most effective way to counter a literally "infinite" number of mis- and disinformation messages is to preemptively build public health literacy in the population as an essential component of primary and secondary education."