At Middleboro Pediatrics in Lakeville, Massachusetts, children who haven't been immunized by a certain age don't sit in the waiting room with other patients. Staff room them directly from the car instead. It's a workaround, not a rejection: the nearly 50-year-old practice has made a deliberate choice not to dismiss families who refuse to vaccinate their kids, even as measles cases climb nationwide and other clinics turn vaccine-hesitant parents away.
The practice was founded by Dr. Neal Bornstein, who died on February 28, 2025, and pediatrician Dr. Aaron Bornstein is among the physicians involved. As reported by The Boston Globe, Middleboro Pediatrics has become something of a practice of last resort, absorbing a flood of new patients after a nearby clinic formalized its own dismissal policy. Bornstein was among the physicians involved in the practice.
Conversations about vaccine hesitancy at the practice have jumped from about once a month to two or three times a week, per the Globe's reporting. Coverage has focused on the practice's handling of vaccine hesitancy.
A National Backslide in Childhood Immunization
The Lakeville practice's approach comes against a grim national backdrop. MMR vaccination coverage among kindergartners was 92.4% for the 2025–2026 school year, according to CDC data published in August and detailed by CIDRAP, below the level needed to prevent spread and leaving roughly 280,000 children under-protected.
Vaccine exemptions among kindergartners have also hit a record 4.2% nationally, driven mostly by non-medical exemptions, per the same CIDRAP report. The United States has recorded a historically high number of measles cases, and the country has experienced its first measles deaths in nearly a decade, according to the Globe. South Carolina is also discussed in connection with measles cases and vaccination coverage.
Federal Policy Shifts and a Court Fight
The backdrop has been complicated by federal action. President Trump signed an executive order in August demanding that combined childhood immunizations be separated, following a January move by his administration to slash the number of recommended childhood vaccines, the Globe reported. A judge struck down the new childhood vaccine schedule in March. The discussion also turns to vaccination-coverage figures.
Trust in immunizations also differs along political lines. The debate over how to address vaccine hesitancy appears to inform Middleboro's approach of engagement over expulsion.
Why Some Doctors Draw a Harder Line
Why Some Doctors Draw a Harder Line Not every pediatrician shares that philosophy. Physician Jesse Hackell has discussed vaccine exemptions. The AAP has issued guidance on vaccination policy.
A physician survey published in Pediatrics and archived by the National Institutes of Health examined how pediatricians and family physicians handle families who refuse vaccines. The AAP reaffirmed its formal policy in July 2025 calling on states to eliminate all non-medical vaccine exemptions for daycare and school attendance; as of the publication of the July 2025 report, only five states—California, Connecticut, Maine, New York, and West Virginia—accepted only medical exemptions for school immunization requirements, according to MedPage Today.
Massachusetts' Own Push and Legal Guardrails
Massachusetts has a long-running debate over school vaccine mandates. Today, state lawmakers are weighing Senate Bill 1557 and House Bill 2554, which would eliminate non-medical and religious exemptions for routine childhood immunizations required for school entry, according to Massachusetts Families for Vaccines.
State rules and immunization records are part of the broader policy landscape.
Weighing Risks Doctors Say Get Overlooked
The broader discussion includes vaccine safety and parents' concerns.
The debate playing out in Lakeville also raises questions about less obvious consequences of vaccine refusal. The debate echoes similar tensions elsewhere: Hoodline has reported on rising exemptions in Illinois.
