Vaccines are among the best tools we have to protect people’s health. And yet, public confidence in vaccines is under threat as never before. So what can we do to stop this dangerous trend and rebuild public trust? A new global policy approach is needed, one that takes public concerns seriously, builds more time for dialogue and patient consultation into increasingly stressed health services, supports public health officials and professionals to build their own confidence and have the answers they need when confronted with questions and concerns. At the same time, we must not shy away from confronting those who undermine the facts behind vaccine safety, real risks and benefits. Otherwise, there is a serious risk that global immunization goals could be undermined and public health compromised.