Vaccine hesitancy has evolved from a fringe concern to a mainstream phenomenon, and anthropologist Heidi Larson traces how it got there. Drawing on decades of fieldwork and her leadership of the Vaccine Confidence Project, Larson examines why increasing numbers of people in wealthy countries distrust immunization. The answer is not simply ignorance or conspiracy thinking but a broader breakdown in trust between publics and institutions. Larson spent years studying vaccine programs in conflict zones and developing countries before turning her attention to hesitancy in Europe and North America. She found that resistance often stemmed less from specific concerns about ingredients or side effects than from feelings of being excluded from decision-making. Parents wanted to be heard, not lectured. They resented being told what to do by experts who seemed dismissive of their questions. The book examines how vaccine hesitancy intersects with other forms of populist distrust, from opposition to genetically modified foods to skepticism of climate science. Larson traces how the internet enables communities of doubt to form and reinforce each other. She is critical of public health communication strategies that treat hesitancy as a deficit to be corrected rather than a relationship to be repaired. Readers seeking to understand why scientific consensus fails to persuade will find Larson's emphasis on listening over lecturing a corrective to technocratic assumptions.