Public health efforts have eradicated disease, extended life expectancy, and reduced disabilities and injuries. Immunization is among the most cost-effective of public-health measures, and scientific advances have led to the prevention of infectious diseases and even some cancers through vaccination. Support for and suspicion of science and immunization have varied over the decades, but the pandemic and post-pandemic period in the United States have seen a deepening of anti-science sentiment unprecedented in the last century. How did we get here? What can be done? With over three decades of leadership experience at the US Centers for Disease Control and Prevention, Anne Schuchat brings a long view to public health — its advances, its setbacks, and today’s anti-science backlash. Her perspective helps place current challenges in historical context and suggests possible paths forward.