A white KN95 mask sits on a table. Photo by Marcus Dieterle.
The federal rollback of COVID-19 vaccine recommendations is fueling skepticism for vaccines in general and chipping away at trust in the health care system, said emergency medicine physician Dr. Dara Kass.
“We’re seeing vaccine rates drop across the country for MMR (measles, mumps, and rubella), and it’s interesting because this is the collateral damage of vaccine skepticism,” Kass told Baltimore Fishbowl. “When you tell people vaccines are suspicious, and you tell them that they can’t trust what’s in a vaccine … you undermine the confidence in our entire public health system and in vaccines writ large.”
This year, the Food and Drug Administration restricted its approval of the updated 2025–2026 COVID-19 vaccines to high-risk individuals, and the Centers for Disease Control and Prevention stopped recommending for healthy children and pregnant women to get the COVID-19 vaccine.
“Those decisions are meant to impact access to the vaccine,” Kass said. “Just like the recommendations are meant to increase access to the vaccine, when you don’t recommend a vaccine you are expecting people will not take it.”
Kass is the founder of the FemInEM Foundation and is the former Region 2 Regional Director at the U.S. Department of Health and Human Services. Last week, she was part of the national public radio program “Open to Debate,” which came to the Johns Hopkins School of Nursing for a debate on the question “Was COVID a Public Health Failure or Did Society Fail Public Health?”
The other debaters included Jerome Adams, former Surgeon General under the Trump administration; Tom Frieden, former CDC director under the Obama administration; and family medicine physician Dr. Mikhail Varshavski, better known as “Doctor Mike” for his medical information videos on social media.
Answering that question at the center of the debate, Kass told Baltimore Fishbowl that the response to the COVID-19 pandemic was “the best we could do at the time.”
“In the moment, everyone I knew, everywhere they were working, was trying to do the best they could to both understand the virus, contain the virus, keep people healthy, keep society moving, keep things going, keep our peers alive,” she said.
But Kass also acknowledged that “our public health infrastructure was not nearly as strong as other countries” and that leaders often gave or amplified misinformation about the virus and protections against it.
In April 2020, for example, President Donald Trump suggested that sunlight and injections of disinfectant could be used as treatments for coronavirus — claims which medical experts debunked.
“People like me had to sit and then counter that narrative and say, ‘Actually, wait, that isn’t what you should be doing,’” Kass said.
The failures of the pandemic were rooted in a push for individualism, she said.
“Why society failed during COVID was that we forgot to care about each other,” Kass said. “The first couple of weeks, everyone was [saying] ‘Healthcare workers are heroes,’ and got banging on pots and pans, and we stayed home together and all the things.”
But protocol intended to slow the spread of the virus went out the window “the minute that it got uncomfortable or inconvenient or really hard,” she said.
At the debate event, Adams said the public health failure of the pandemic was due, in part, to communication missteps.
“As you frequently hear lamented, schools were closed but restaurants and bars stayed open,” Adams said. “That lack of clarity and consistency fractured public trust. And when you lose trust in a crisis it is impossible to regain. Worse, our communication often came with a heaping helping of shame and blame.
Varshavski, too, raised issues with public health communication, but he highlighted the inability for many health professionals to engage the public effectively.
“How do you expect to have the general public trust you when you put zero emphasis in talking to the human that is across from you with a public health message?” Varshavski said. “We have amazing books, sure. We go on TV shows that no one watches, sure. But are we ever gonna care about the fact that this message is not landing for anybody?
Frieden said “one of the core issues does have to do with communication and humility.”
“Trust is the one thing that you can’t surge into a community during a crisis,” he said. “You can surge in ventilators and doctors and hospital beds and medicines and vaccines and other things. But you can’t surge trust. Trust is easy to break and hard to build. And it has been breaking for a long time, and COVID broke it a whole lot more.
During the pandemic, Kass appeared on national and local news programs to provide information about the COVID-19 crisis.
In her interview with Baltimore Fishbowl, Kass said doctors should correct messaging that runs counter to the interest of public health, but it can be difficult to get ahead of misinformation.
“Misinformation travels much further than accurate information,” she said.
Changing federal guidance is putting more responsibility of state governments to take a stand for vaccine access, Kass said.
She said health workers should advocate for their state’s governor to approve the vaccine for children 6 months and older so that families can get it covered by their insurance.
Kass said people should be allowed to decide for themselves whether to get vaccinated – as long as they do not work among people at higher risk. But she added that the federal government’s decision to not recommend vaccines and instead defer to supposed personal freedom is, in reality, reducing people’s access to choice over their own health.
“It’s ironic to me that we’re currently seeing a world where we’re now removing access to a vaccine under the guise of freedom or flexibility, when in fact it’s doing the exact opposite,” she said.