A medical school leader fears rising vaccine skepticism

Healthcare leaders have expressed growing alarm over the federal government changing guidance on COVID-19 vaccines and making other changes in vaccine policy.

Dr. James Hildreth is president and CEO of Meharry Medical College, one of the nation’s oldest historically Black medical schools. He says he’s gravely concerned about the policy changes pushed by the Department of Health and Human Services and Health Secretary Robert F. Kennedy Jr.

“When the agency that is charged with protecting the health of the public, abandoned science in doing so, I'm not sure there's anything that could scare me more than that,” Hildreth tells Chief Healthcare Executive®.

Like other healthcare leaders, Hildreth says he was troubled by Kennedy’s ouster of all the members of a key panel advising the government on vaccine policy, and the choice of vaccine skeptics and less qualified members as replacements. In 2020, Hildreth served on a Food and Drug Administration advisory committee that reviewed COVID-19 vaccine candidates.

Hildreth points to the Oval Office press conference where Kennedy joined President Trump, who cited the debunked theory that vaccines and Tylenol cause autism.

“It's unfortunate to me that the president of the United States should ignore decades and decades and decades of, in some cases, really superb science refuting any connection between vaccines and autism,” Hildreth says. “And I've been doing my best to advise the communities that we care about here at Meharry to let them know that if you're a parent of a school-aged child, you should get them vaccinated.”

Hildreth says that he is worried that the government’s changes in vaccine guidance are only going to increase vaccine hesitancy, at a time when vaccination rates have been dropping. He says that undercuts the government’s stated plan to “Make America Healthy Again.”

He talks about the challenges ahead for healthcare leaders, and ways to help build trust with those who are skeptical of vaccines.

(See part of our conversation in this video. The story continues below.)

• Read more: Vaccine hesitancy: Doctors and health systems face more skepticism

‘Trust is everything’

The federal government has advised Americans 65 and over to get the COVID-19 vaccines, but has not recommended them for healthy adults.

Hildreth says he’s worried that if fewer Americans get vaccines for COVID-19, the flu, or other diseases, more people will suffer from preventable diseases.

He also stresses the need for even healthy adults to get vaccinated to protect more vulnerable people, including seniors and those with other health complications.

“When you get vaccinated or vaccinate your child, you're not just protecting the individual or yourself,” Hildreth says. “You're contributing to protecting the whole community, and that's one of the things that we worry about. If the vaccination rates drop off sufficiently, we'll lose herd immunity, and so viruses that have been suppressed for a long time will re-emerge and cause some pretty significant problems.”

Doctors have been seeing patients who have expressed more misinformation about vaccines. Hildreth says physicians and healthcare leaders need to speak out about the safety and importance of vaccines.

“Of all the interventions of medicine, vaccines certainly have to rank among the most impactful that we've ever come up with, in terms of the lives that have been saved, and it helped to strengthen economies in some parts of the world. It's just done a lot of things for humankind, and for us not to be supporting vaccines and promoting them, just seems to me something out of a science-fiction horror movie,” Hildreth says.

He worries about the erosion of trust patients have not only in vaccines, but in physicians.

“In health care, trust is everything,” he says. “We talk about it all the time, that if patients don't trust that their providers have their best interest in mind, they won't fill prescriptions, they won't follow the directions they've been given, take the advice they're given. And I think in some ways, that's where we’re headed, having our leadership tell us that vaccines are not safe.”

Engaging trusted leaders

While healthcare leaders and doctors must do their part, Hildreth suggests that alone won’t be enough to connect with patients skeptical of vaccines and their safety.

He talks about the need to partner with respected community leaders and trusted neighborhood voices that have the trust of those around them. A well-known researcher of HIV, Hildreth says that approach paid dividends years ago, when he was doing early research on the virus that causes AIDS.

“I think that's what we have to do in this case, is just make sure that those opinion leaders or influencers or whatever they're called these days, that they're joining in the conversation to make sure the message gets out to those that it needs to get out to,” he says.

Some Black Americans have had mistrust of the medical establishment, for understandable reasons, Hildreth says. But he actually sees progress in restoring trust with Black Americans when it comes to vaccines.

Hildreth points to some lessons from the COVID-19 pandemic.

“It gave us an opportunity to bring the African-American community to a place it had not been, which is to be far more trusting or accepting of medical research, vaccines and all of that,” he says. “We still have work to do, mind you. There's still some folks who are not convinced.”

Hildreth points to the value of connecting with Black church leaders, who are trusted in their communities.

“If you meet people where they are, answer their questions, provide some data to them, and all this, I think we can convince people, reasonable people, that vaccines should be taken,” Hildreth says.

“And one of the things that seemed to especially resonate in the African-American community was the idea that by vaccinating yourself, you're protecting the larger community,” he says. “And maybe that's related to a deep grounding in faith or religion, or this idea that we're all each other's keeper. But that's one thing that seemed to emerge from the work that we did in the COVID-19 pandemic.”