Review: The return of vaccine-preventable diseases: Implications for pediatric surgical and perioperative care

Vaccine-preventable diseases (VPDs) have long been considered rare in modern pediatric practice, a success attributable to sustained high immunization coverage. However, recent declines in vaccination rates have reintroduced the possibility that surgical teams will encounter conditions once thought largely historical. This review examines the emerging intersection of vaccine hesitancy and pediatric surgical care, highlighting the clinical, perioperative, and systems-level implications of the increasing number of under-immunized children. The resurgence of VPDs presents new and renewed challenges across surgical specialties, including complex airway emergencies, invasive infections requiring operative management, and long-term reconstructive needs following disease sequelae. These conditions demand technical expertise, multidisciplinary coordination, and familiarity with disease processes that many contemporary trainees have not previously encountered. Beyond direct patient care, implications extend to infection control practices, perioperative risk stratification, and institutional preparedness for episodic surges in disease burden. This review also explores how vaccination trends affect surgical workforce training and capacity, emphasizing the need for simulation-based education and curriculum adaptation. Importantly, it frames the perioperative period as a critical opportunity for vaccination advocacy and intervention, positioning surgical teams as key stakeholders in broader public health efforts. As vaccine hesitancy reshapes the clinical landscape, pediatric surgeons and perioperative providers must adapt to evolving disease profiles while reinforcing their role in prevention. Addressing this challenge will require coordinated efforts in education, policy, and clinical practice to ensure preparedness for diseases that are no longer theoretical. CLINICAL TRIAL REGISTRATION: Not applicable.