This conversation was a compromise. Many independent pediatrics practices had dismissal policies like the one this mom had come up against in Fall River. But amid these federal changes, some doctors wondered about the best tack. Should they double down? Should they allow parents wiggle room, given that the government was recommending one vaccine schedule and <\/a>the American Academy of Pediatrics another?<\/p>\n Middleboro Pediatrics wouldn\u2019t tell parents to go elsewhere if they didn\u2019t vaccinate. They welcomed those families. When a nearby clinic formalized a dismissal policy earlier this year, Middleboro got a flood of new patients. \u201cAlmost like a practice of last resort,\u201d said Martin Gross, one of Bornstein\u2019s partners.<\/p>\n They did have some stipulations, though. One was a meet-and-greet, so the pediatricians could understand a parent\u2019s concerns \u2014 but also just how far that fear had spread. \u201cIf I think your child\u2019s got a bad infection, will you reject my recommendations for antibiotics? Are you going to reject my ability to do an adequate evaluation?\u201d Bornstein said. \u201cI need a level of trust that you\u2019re coming here because you want my guidance. If you\u2019re going to reject all of that upfront because you don\u2019t trust anything about my incentives or my expertise, then this is not a match.\u201d<\/p>\n Misleading averages, alienated families<\/p>\n On the face of it, everything might not look so dire. Most parents report trusting childhood immunizations, and the most recent national coverage rate<\/a> for the measles, mumps, rubella vaccine is 92 percent, a seemingly small drop from the 95 percent around which it hovered from 2015 to 2020.<\/p>\n Not too shabby, you might say. Then again, 95 percent is the level of uptake needed to prevent outbreaks. More measles cases were recorded in the US in 2025<\/a> and 2026<\/a> than in the previous 24 years combined, leading to the first measles deaths<\/a> in nearly a decade<\/a>. \u201cThe average is not really representative,\u201d explained Rochelle Walensky, former director of the Centers of Disease Control and Prevention. \u201cI always say: Your head is in the fridge, your feet are in the oven, and on average, you\u2019re fine.\u201d<\/p>\n Take the measles outbreak that engulfed Spartanburg, S.C., from October to June. The state\u2019s MMR vaccination rate was 94 percent<\/a>. The county\u2019s was 89 percent. But at the school linked to the first cases, only 17 percent of students had proof of required immunizations<\/a>.<\/p>\n Like politics, disease risk is local: a vast public health problem that often fell to each doctor as an individual, no matter if each appointment was only supposed to last 15 minutes. \u201cThe amount of time and effort involved in dealing with these families became untenable,\u201d said retired pediatrician Jesse Hackell, who has authored AAP reports on vaccine hesitancy.<\/p>\n That is one argument for dismissal. Another is the contagion risk posed by having an unvaccinated child in a waiting room alongside infants and kids with immunodeficiencies. Yet another is to convey that getting your child vaccinated is the cornerstone of modern medicine and the best advice a pediatrician can give. <\/p>\n \u201cOver 20 years, we probably only dismissed a handful of families \u2014 because drawing a line in the sand seems to indicate to most families how seriously we take this,\u201d Hackell said. <\/p>\n But that could push away others who might\u2019ve come around. \u201cFamilies have been brave enough to come to health care, often feeling alienated from it, and then they get this coercive declaration, which then alienates them even more,\u201d said Julie Leask, professor at the University of Sydney.<\/p>\n Middleboro\u2019s meet-and-greets were a middle ground. They were inconvenient \u2014 uncompensated conversations, longer than appointments. They could be frustrating. There were sometimes insults, even threats. Practices could be penalized for taking such patients. Vaccination rates are among the metrics on which insurers measure physicians\u2019 success. <\/p>\n Then again, dismissal is unenforceable for any Massachusetts physician who sees patients on Medicaid. But Middleboro\u2019s reasoning was mostly philosophical. Kids don\u2019t choose their families; vaccine-hesitant parents are not a single bloc. Taking this unpaid time, Bornstein hoped, might even help convince some to vaccinate once there was a sense of trust.<\/p>\n \u201cWe don\u2019t kick people out. We work with people,\u201d he told that mother, who asked not to be named in this article. \u201cThe one thing I will say is this. If we have a family who chooses not to vaccinate, there\u2019s a form that we have you sign that just says we had that conversation. It helps protect us from liability.\u201d<\/p>\n \u201cUnderstandable. In case something did happen and she did get something that a vaccine could have …\u201d she paused, \u201cpostponed, or, you know\u2026 prevented.\u201d<\/p>\n She laughed, as if the idea were absurd. Bornstein didn\u2019t correct her. \u201cThat\u2019s exactly it,\u201d he said, going on: \u201cSo whooping cough and measles are both very contagious diseases \u2014\u201d<\/p>\n She interrupted him: \u201cYeah, but it\u2019s not just the measles vaccine, is it? It\u2019s MMR.\u201d<\/p>\n \u201cIt\u2019s MMR,\u201d he agreed. \u201cBut for those two, if a child has not been immunized by a certain age, we don\u2019t let you in the waiting room, we room you directly from the car.\u201d<\/p>\n She might have balked, or accused him of treating unvaccinated people as second-class citizens. There was still time for that. But now, all she said was, \u201cOK.\u201d<\/p>\n \u2018I want my child healthy\u2019<\/p>\n Bornstein could still feel the horror, over 25 years later. He was a medical resident in Chicago, working in the emergency room, when an unvaccinated infant arrived. The trouble was an abscess on the child\u2019s neck, swollen, red. This wasn\u2019t an illness that would have been prevented by a vaccine, but Bornstein could detect a through line of distrust. He needed to admit the kid, do blood tests, and start antibiotics, but the parents refused. Bornstein wasn\u2019t sure what to do. Without treatment, the illness could be fatal. Treating against the parents\u2019 wishes would entail calling authorities and requesting an emergency removal.<\/p>\n That was the sort of scenario he hoped to avert with these meet-and-greets. In that case, the conflict was resolved without child protective services. \u201cAn older, sager ER physician asked, \u2018Is this their first kid?\u2019\u201d Bornstein recalled. \u201cI said, \u2018Yeah.\u2019 He said, \u2018Have them call the grandparents\u2019 \u2014 and the grandparents made the kid stay in the hospital.\u201d<\/p>\n The worry he had about mistrust extending beyond vaccines wasn\u2019t just theoretical. More parents are now refusing the routine vitamin K shot to help newborns\u2019 blood clot, leading to an uptick in hemorrhages.<\/p>\n \u201cI got her vitamin K shot in the hospital because I\u2019m not dumb. I want my child healthy,\u201d the mother told Bornstein. \u201cBut I was like, can\u2019t I just do the preservative-free one?\u201d To her, the fact that they made shots without preservatives seemed like proof that the normal shots had unnecessary ingredients. She worried about those chemicals. But she also worried about seeming stupid for worrying, or being judged a negligent parent. She\u2019d hated how the nurses made her feel bad for refusing the first dose of the hepatitis B vaccine.<\/p>\n She was 29, a truck driver living in a former shipping hub in Southeastern Massachusetts. \u201cI was actually in school to be a doctor. I started college at 16,\u201d she told Bornstein. <\/p>\n \u201cYou are someone who clearly pays attention to detail,\u201d he said. \u201cYou\u2019ll be the right person for our practice, I think.\u201d He started gesticulating as he described the vaccine schedule, how whooping cough was most dangerous under the age of 1, which meant it was important for that vaccine to be given in infancy.<\/p>\n \u201cBut at the same time, everyone\u2019s body is different,\u201d the mother said. \u201cYou could have a majority of people that react perfectly fine to it, but there\u2019s still going to be people that probably don\u2019t react fine to it. But what happens if they just didn\u2019t test those people?\u201d<\/p>\n Bornstein smiled. Now he was getting somewhere. He wanted parents to bring up their specific concerns, something he could engage with. If they wouldn\u2019t tell him what they were worried about, there was little he could do. He explained that her question was one scientists had to address in designing vaccine trials: Did they have enough people enrolled to look for those rare side effects? Last year, for instance, there\u2019d been a big Danish study<\/a> of data from 1.2 million people over 24 years; it showed that the conditions vaccine-skeptical groups often blamed on immunizations \u2014 autism, say \u2014 were no more common in the vaccinated group than in the unvaccinated.<\/p>\n The mom piped up. \u201cI just feel it\u2019s weird. Like my baby\u2019s healthy. Why am I gonna then inject her with stuff?\u201d<\/p>\n \u201cIt\u2019s a great question,\u201d Bornstein said. \u201cOur job for you is to help interpret risk and benefit, right?\u201d<\/p>\n He was a father himself, he said. He wouldn\u2019t recommend anything that he wouldn\u2019t give his own kid. He wanted to talk through the risks and benefits of every vaccine with her \u2014 yes, the risks, because vaccines, like medications, could indeed have side effects, and she should know about them \u2014 while also weighing that against what might happen if her child caught a preventable disease that she hadn\u2019t been vaccinated against. But the choice would always be hers.<\/p>\n \u201cI don\u2019t have the authority to do anything to your child, right? I have the authority to give you advice,\u201d he said. \u201cWe encourage vaccines. But it\u2019s equally important that you feel comfortable with why we\u2019re doing it, and that the risks are low enough. Your question: Why would we give it to a healthy kid? You know, the silly analogy is, it doesn\u2019t help putting the seat belt in after the car crash has happened.\u201d<\/p>\n Statistical risks, anecdotal anxieties<\/p>\n The example that always jumped to mind for Bornstein was an earlier version of the rotavirus vaccine, first recommended as a routine immunization in 1998, to prevent tens of thousands of infants needing to be hospitalized for severe, potentially life-threatening diarrhea annually. But doctors noticed an uptick in a condition called intussusception in which one bit of intestine slides inside another, like the segments of a pirate\u2019s telescope. A study found the increase was linked to the vaccine, and it was taken off the market in 1999.<\/p>\n![\"One](\"https:\/\/www.newsbeep.com\/nz\/wp-content\/uploads\/2026\/09\/Q2BQHDH5RVF4RM6HFG4I7LQWBE.jpg\")
One of Aaron Bornstein\u2019s patients receives a vaccine.Lucy Lu for STAT<\/p>\n![\"Physician](\"https:\/\/www.newsbeep.com\/nz\/wp-content\/uploads\/2026\/09\/DP35QSIPGFEFRMVQ3OU3XFAC5M.jpg\")
Physician Aaron Bornstein at Middleboro Pediatrics in Lakeville, Mass.Lucy Lu for STAT<\/p>\n![\"The](\"https:\/\/www.newsbeep.com\/nz\/wp-content\/uploads\/2026\/09\/AMTZY5MGLZBOFIDZD5ROXHQKCM.jpg\")
The front reception at Middleboro Pediatrics.Lucy Lu for STAT<\/p>\n