In Camden, anti-vaccine rhetoric threatens community health | Expert Opinion

My young patient cheerfully jumped down from the exam table following a routine checkup and reached for his mother’s hand. Then I asked if we could proceed with a vaccine that was recommended at his age. His mother’s smile faded. “Let’s wait till next time,” she said.

As a medical student, just a few weeks into a rotation in pediatrics at a clinic in Camden, I was still learning how to lead a well-child checkup. But the ”vaccine question” is one we all knew to ask. As a medical student working in an urban community, I’ve had the opportunity to care for patients from widely diverse backgrounds, including many not well served historically by the health-care system. I have seen how responses to the vaccine question — both in pediatric and adult care clinics — can vary. Some parents agree without hesitation, beyond bracing themselves or their child for the dreaded needle prick. But often, my recommendation to give a vaccine is met with a flat, unyielding “no.” End of discussion.

Since the onset of the COVID-19 pandemic, vaccination rates for both children and adults have declined. Public trust in vaccines was deeply shaken by politics during the pandemic, and unfortunately, that skepticism continues to grow. Under the new administration, the Department of Health and Human Services has shifted its focus away from once-standard vaccine outreach efforts, leaving gaps in public health education and access. We are already seeing the consequences of declining childhood measles vaccination rates — Texas, for example, is currently facing a measles outbreak surpassing 250 cases, and a school-aged child there died, the nation’s first death related to the disease in a decade. But beyond a large-scale outbreak, vaccine hesitancy is eroding the foundation of community-physician relationships in smaller communities, like the one I serve in Camden.

Preventive care is a cornerstone of good health, whether it’s smoking cessation to reduce the risk of lung disease and related harm or dietary counseling to prevent heart disease. Yet when it comes to vaccines — arguably one of the most effective preventive measures — my conversations with patients are often guarded and the dialogue tense. Many refuse them outright but hesitate to explain why, perhaps because they are reluctant to share their political viewpoints, which often complicate their stance.

I have seen this happening not only in Camden but also in my medical school rotations through outpatient clinics in the South Jersey suburbs. In both settings, patients seem far more comfortable discussing blood pressure management than their risk of contracting COVID-19 or the flu. There’s plenty of debate over who or what is responsible for the rise in vaccine hesitancy, but at the end of the day, there is a tremendous cost. I am especially concerned about communities where many people lack access to healthy food, stable housing, and reliable health care, issues that I see too often among my patients in Camden. Communicable infections that vaccines protect against may result in mild illness for someone with a strong immune system and access to care, but can lead to prolonged hospital stays and serious or even life-threatening complications for patients with underlying health conditions.

To improve health outcomes, we must separate politics from science and create space for honest, fact-based discussions with patients. Physicians and medical students like me have a role to play in pushing these conversations forward, and we need national health leaders to step up.

Ian Millstein is a third-year medical student at Cooper Medical School of Rowan University.