Regarding the Dec. 5 front-page article “Broken promises on road safety”:
As a military veteran and engineer, I know a plan without resources is just a slogan. A good idea is worthless without a budget and the will to execute it. That’s true whether you’re running a military operation or building infrastructure. The mission matters, but so does following through.
The data proves this. The U.S. government launched Vision Zero in 2016 with $1 million a year — a rounding error in the federal budget that shows exactly how seriously policymakers took it. Annual pedestrian deaths were up 70 percent between 2010 and 2023 nationwide. Los Angeles adopted Vision Zero in 2015, pledging to eliminate traffic deaths. Pedestrian deaths went up more than 60 percent between 2015 and 2024.
Europe backed its 2011 commitment to Vision Zero with redesigned roads, enforcement and real funding. Road deaths there dropped 25 percent since it was adopted, even as car use increased.
This is about execution. We know what works. Lower speed limits save lives. Better crosswalks save lives. Prioritizing safety over traffic flow saves lives. What we lack is the courage from legislators to implement these solutions. They’re choosing driver convenience over pedestrian lives.
I’ve worked in 44 states as an engineer. I’ve seen good roads and dangerous ones. When you design a road for speed instead of safety, people die. That’s not an accident: It’s a choice.
Government should be effective, not just well-intentioned. When leaders adopt a plan to save lives in name only, and people like Cecilia Milbourne die on roads we know are dangerous, that’s not just a policy failure; it’s also a moral failure.
Will McCutcheon, Richland Hills, Texas
The government efforts I have seen as someone who walks, rides her bike and drives through her city ignore some of the simpler ways to move toward Vision Zero.
Public service announcements exclusively targeting drivers and changes to streets and speed limits will not protect pedestrians who jaywalk at night while reading their texts and pushing strollers, or bicyclists who ride at night in a car’s blind spot. Yes, drivers are legally responsible for car accidents. But winning a settlement will not allow a pedestrian or bicyclist to walk without pain in the future.
What can help pedestrians avoid the front of a car is remembering our mothers’ lessons to look both ways before we cross the street instead of looking at our phones when walking through intersections. Wearing brightly colored coats at night (instead of ones that match the color of a winter’s night) can alert a driver to one’s presence in or out of a crosswalk. Clothing reflectors and helmet lights can help bicyclists be seen.
We all have a personal responsibility to pay attention to how we move through a city, whether or not we are behind a wheel.
Will the attention of walkers and bikers be enough to achieve Vision Zero? No. But everyone paying attention to their own actions and safety, as well as to that of others, will help.
Susan Zinder, New York
Better vaccine guidance
Regarding the Dec. 6 front-page article “Sweeping revision to vaccine schedule”:
We are a retired nurse and a retired physician, with decades of experience providing frontline health care for children. In horror, we learned last week that the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices stopped recommending the hepatitis B vaccination for babies born to mothers who test negative for the virus.
This is the most significant change to the childhood vaccine schedule since Health and Human Services Secretary Robert F. Kennedy Jr. purged the panel in June and appointed new members. This new panel of so-called experts is dismantling the system of routine childhood vaccinations that has proved over decades to be both reassuringly safe and remarkably effective. According to the American Public Health Association, the universal hepatitis B vaccine recommendation has prevented an estimated 90,100 childhood deaths since it took effect in 1991. Alternative schedules of vaccine administration leave too many babies at risk.
To minimize unnecessary suffering following this action, we recommend the following steps be taken promptly:
1. Parents and providers should follow the vaccine guidance of organizations that rely on thoroughly vetted science, including the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.
2. Insurance companies should continue to provide coverage for the immunization schedule as articulated by those organizations, and ongoing coverage should be widely publicized to consumers.
3. Concerned citizens should show support for reestablishing federal government backing of public health.
Adriana van Breda and John C. Ring, Alexandria
Tens of thousands of cases of hepatitis B in children were reported annually in the U.S. before universal vaccination of newborns was recommended, after which the number dropped precipitously. Such infections in unvaccinated infants were frequently lifelong, with increased incidences of cirrhosis, liver cancer and other complications. Infected individuals can also spread the virus to others.
The decision by ACIP to steer away from universal vaccination exposes infants to the possibility of unrecognized hepatitis B infection in the mother, infection after her testing or inaccurate testing. In the fog of creating different categories of mothers with differing categories of viral histories and of maternal prenatal testing, as well as differing recommendations and abilities to comply with such recommendations, there will be an increased incidence of infants falling through the cracks. This coupled with increased hepatitis vaccine hesitancy will have even more adverse ripple effects, including against other vaccine protocols and agents.
Max Cohen, Potomac
The writer is a former senior staff member at the National Institutes of Health.
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