Did COVID-19 Impact Distrust in Our Health Care System?
by Thomas Camilli & Steven Lippmann, MD
During 2023 to mid-2024, most people in the U. S. witnessed declines in vaccination rates. 1 This trend has occurred annually subsequent to the COVID-19 pandemic. It even included the accepted, routine and common vaccines like those for diphtheria, typhoid, tetanus and polio that have been administered with great health benefits for decades. These four diseases have been virtually eliminated from this country. What doctor can remember treating anyone here at home for acute diphtheria, typhoid, tetanus or polio? It’ s likely that only the oldest among us have seen these diseases in America.
This ongoing decline in vaccination documents the lack of trust in the U. S. medical establishment. How did COVID-19 convey less confidence in our doctors and health care systems? Why did we lose faith?
It is convenient to blame the internet and social media for distributing false information or skewed data, and indeed, it had a sizable influence. Skepticism has escalated in recent years. The answer may result much from the politicization of medical issues, especially during the COVID-19 pandemic. Initially, we could only offer isolation and masking; there was widespread fear but also extensive public resistance to wearing masks and social distancing. Our educational efforts were focused on keeping people apart. Isolation was initially all we had to offer, and isolation was not what the public was hoping for.
We were all learning as we went along. The first health advisory from the CDC was issued on Jan. 7, 2020, after Chinese scientists had confirmed the presence of a novel coronavirus. For months, hospitals were overwhelmed, and our doctors and nurses were themselves traumatized by both the fear of infection and the loss of huge numbers of patients for months on end. They lost each other to COVID-19; they lived with the fear of killing their loved ones through bringing the virus home; they gave their all. Our own Dr. Valerie Briones-Pyror was quoted in the Dec. 14, 2020, Washington Post.“ I just lost my 27th patient, today. So the vaccine I took today was for her family, and for the other 26 I lost.”
The first COVID-19 vaccine, from Pfizer, was released on Dec. 11, 2020, followed shortly by the Moderna vaccine, both under an Emergency Use Authorization from the FDA. The LouVax mass vaccination program in Jefferson County began in January 2021, spearheaded by Dr. Ruth Carrico, DNP, and the late Dr. SarahBeth Hartlage, then the medical director of our public health department. A large cohort of nurses and doctors and community volunteers vaccinated more than 100,000 people that winter at Broadbent Arena, via six lanes, with the large doors all open for ventilation: over 2,500 of us, working over 81,000 volunteer hours. GLMS and the Kentucky Nurses Association rounded up our volunteers.
How then could the public begin to lose faith in those caring for 24 LOUISVILLE MEDICINE and sacrificing all for them? Cynicism had already been increasing for decades, ever since confidence in government diminished during the 1960s. Others have cited the rise of self-interest and the expense and profit-driven motives in health care. This includes resentment of the corporatization of patient care, and of health insurance entities.
The proper vaccination rate for kindergarten aged children to receive the measles, mumps and rubella is 95 %, to achieve ongoing herd immunity. That target had been reached in this country until COVID-19 emerged. Vaccination rates subsequently declined to below 93 % by mid-2024.2 What was the influence of this pandemic on lost trust in our doctors and the health care system?
Medical care has been politicized in the past, but much more so since 2019. Social media spread misinformation about COVID-19, vaccines and health-related issues. Disseminated information began aligning with political ideologies and promoted uncertainty about immunizations. Instead of scientifically confirmed conversations on the benefits and risks of vaccinations, the dialogue became one of personal belief and / or political whim. This was not the first instance of public scrutiny; however, the negative effect on public health is clear. As of October of this year, over 1,500 cases of measles had been reported to the CDC. In contrast, in the year 2000, the World Health Organization had declared that measles had been eliminated in this country.
When immunization rates decline, disease incidence rises. After COVID-19 vaccines encountered resistance, compliance with future therapeutic regimens declined. Patient-to-doctor relationships became more compromised. Physicians have some difficulty at gaining better trust and adherence to recommended treatments. How can we return to a time of more confidence and improved health outcomes?
References:
1
Center for Disease Control and Prevention. Vaccination Coverage and Exemptions among Kindergartners. SchoolVaxView. October 2, 2024. www. cdc. gov / schoolvaxview / data / index. html. Accessed May 23, 2025.
2
Williams E, Kates J. Childhood Vaccination Rates Continue to Decline as Trump Heads for a Second Term | KFF.” KFF. November 15, 2024. https:// www. kff. org / policy-watch / childhood-vaccination-rates-continue-to-decline-as-trump-headsfor-a-second-term /. Accessed May 25, 2025.
Thomas Camilli is currently a senior at the University of Kentucky pursuing a biology degree. He is preparing to take the MCAT and working in a research lab.( non-member)
Dr. Lippmann is a retired psychiatry professor from the University of Louisville School of Medicine. Subsequently, he regularly provides primary medical care practice at the Family Community Clinic, clinically mentors lots of students, residents and international medical graduate physicians, and teaches scientific medical writing seminars.