By the time the world was welcoming 2025, US was crippling with many diseases, some seasonal and some from animals. And as 2025 unfolds, US faces an increasing risk of such diseases, and the reason is also the declining vaccination rates, policy shifts and coming of new pathogens. There are speculations that if Robert F Kennedy Jr is confirmed to head the Department of Health and Human Services (HHS), then it may lead to further decline in vaccination.The Decline in Vaccination RatesChildhood vaccination rates in the U.S. are already declining. Schools have also allowed vaccination exemptions and it is on the rise. As per the Centers for Disease Control and Prevention (CDC), the unvaccinated and undervaccinated populations provide opportunities for outbreaks of diseases like measles. This also saw a significant resurgence in 2024. The CDC also reported over 280 measles cases, the highest in 5 years, seen among unvaccinated individuals. Experts also warn that declining immunization rates may lead to further outbreaks of vaccine-preventable diseases.Poliovirus - a threatWhile Polio is eradicated in the US, it also remains a concern. Right now, it persists in parts of Pakistan and Afghanistan. The virus also has the possibility to resurface domestically if vaccination rates continue to drop. It can also affect populations that have never experienced the devastating impact of diseases like polio, mumps, and rubella.Ongoing Threats: COVID-19, RSV, and Bird FluCOVID-19 and respiratory syncytial virus (RSV) still pose a serious risk as it continues to spread even now. Both these diseases have the potential to cause serious illnesses and could be lethal too. Experts also point out the need for vaccination and public health intervention to prevent the diseases. Meanwhile, avian influenza remains a serious threat. In 2024, the CDC reported over 60 human cases, including the first serious sickness in the United States. Although human-to-human transmission has not been established, scientists underline the need for surveillance, especially given the gaps in responding to outbreaks in animal communities like dairy farms.Emerging Diseases and MpoxNewly found infections, including as more virulent strains of mpox, are another source of concern. Mpox, a virus similar to smallpox, has largely impacted males who have intercourse with men, but it can be transmitted through personal contact. With the government stockpile no longer providing free vaccines starting in April 2024, monetary constraints may dissuade underprivileged people from obtaining protection.Experts also closely monitor the idea of "Disease X," which refers to hypothetical, unknown infections capable of producing pandemics. Recent incidents, such as severe malaria previously recognized as Disease X in the Congo, highlight the significance of pandemic preparedness.Looking out for 2025Public health experts point towards another pandemic. They are calling it inevitable. The reasons are globalisation, climate change, and decline in vaccine rates. While the specific pathogen and timeline remain uncertain, global health organizations are calling for preparedness, vigilance, and readiness. There are ongoing research, investments and vaccine development, along with public awareness which are increasing to mitigate the risks of the next pandemic. The lessons can be learnt from 2024 to be prepared in the new year. It also highlights the need for a robust public health system along with evidence-based policies on health, widespread vaccine coverage and also addressing the resurgence of certain infections.