Before the onset of the COVID-19 pandemic, achievements in childhood vaccine coverage in the USA and globally appeared imperiled. Misinformation about vaccines was pervasive.1 Vaccine hesitancy––a motivational state of being conflicted about, or opposed to, vaccination––was a top ten global health threat.2 And vaccine-preventable diseases, such as measles, re-emerged following decades of successful control.3 Since the arrival of COVID-19, disruptions to childhood vaccine delivery have further jeopardised childhood vaccination efforts.4
However, the effects of the pandemic on childhood vaccination have the potential to extend beyond disruptions in vaccine delivery. What will be the legacy of the COVID-19 pandemic for childhood vaccination? In this Viewpoint, we discuss how the pandemic might affect trust, risk perception, mandates, and health equity in the context of childhood vaccination. We then propose several recommendations to mitigate potential negative effects and help sustain confidence in childhood vaccines.