Dr. Heidi Larson, the acclaimed expert on vaccine confidence at the London School of Hygiene and Tropical Medicine – and CSIS Senior Associate – speaks to how the external world is reacting to the changes in the United States in vaccine policy, the scientific R&D biomedical enterprise, and public health. “What has shocked people is the abruptness of these measures with little consideration of the implications.” An abrupt drop in trust has followed. The United States has for decades been seen as the most stable and trusted collaborator, based in scientific evidence. People are now turning inward and to other countries. For those scientists whose U.S. grants have been disrupted, “You can’t turn your lab off for six months.” We are seeing the outmigration of US-based scientists to Europe and elsewhere. The multilevel siege of American universities is fundamentally a matter of values. It has raised the question of whether it will be possible to sustain transatlantic scientific partnerships. How to break out of a liberal bubble? Finding a common space is most critical. Sometimes you just have to keep your head down and keep moving forward …. keep our center.