Most vaccines are so effective that they could lead to the control/elimination of the diseases they target and directly impact on intensive care admissions or complications. This is best illustrated by the use of vaccines against Haemophilus influenzae type b, Streptococcus pneumoniae, zoster, yellow fever, Ebola virus, influenza or measles-but also by third party strategies such as maternal, toddler and care-giver immunization. However, each of these vaccine-induced protection is threatened by insufficient vaccine uptake. Here, we briefly discuss how vaccine hesitancy has led to the resurgence of diseases that were considered as controlled and explore the effect of vaccine-hesitant healthcare workers on nosocomial infections. As intensive care physicians are in charge of polymorbid patients, we briefly summarize the current recommendations for vaccinations in high-risk patients. We finally give some perspective on ongoing research, and discuss how institutional policies and intensive care physicians could play a role in increasing the impact of vaccination, overall and in intensive care units. Take home message: Vaccinations are life-saving preventive interventions victims of their own success; the rise of vaccine hesitancy has led to the resurgence of vaccine-preventable diseases. Strategies to increase vaccine impact include improved awareness of patients and healthcare workers, the implication of health policies, and the vaccination of third parties, such as pregnant women (to protect newborns and mothers), toddlers (to reduce microbial carriage in the community at large), and caregivers (to reduce direct transmission).