René Najera

A College Fellow since 2022, Dr. René Najera currently serves as Director of Public Health and Editor of History of Vaccines at The College of Physicians of Philadelphia. In his role as Director, he collaborates closely with the Section on Public Health and Preventive Medicine. In addition to the College, Dr. Najera also teaches public health courses at Johns Hopkins University and George Mason University.

In this Fellow Spotlight, during Hispanic Heritage Month, we speak to Dr. Najera about what drew him to the College, how education has evolved, and how living on both sides of the border shaped his work and understanding of public health.

What drew you to the College to seek Fellowship?

When I started working with Karie Youngdahl on the History of Vaccines Project in 2010, I got to know The College of Physicians and the many initiatives that came from it. I had been aware of the Mütter Museum, but meeting Karie and the staff in Philadelphia made me realize that the College was more than the Museum. I also learned about the Fellows, many of whom are my professional role models, especially those involved in vaccine science and public health. As I gained experience through working as an epidemiologist at the state and local level, and with the CDC during the Zika response, I found myself aspiring to become a Fellow. I wanted to connect and work on projects with the Fellows.

As a Professor of Epidemiology and Public Health at Johns Hopkins and George Mason University, how has the curriculum evolved since the time you were a student?

There is a growing emphasis on the social determinants of health, evolving technologies (such as social media, large language models, and wearable devices), and the increasing focus on the impacts of climate change on population health. The basics are still there, though. Students in public health, particularly those in epidemiology, need to understand bias and confounding, effect modification, infectious disease dynamics, and the fundamentals of research studies. But they also need to learn how to communicate their findings in a world of short-form communications like X, YouTube, or TikTok.

How has our access to information changed the way we learn? Or how has the way we share information affected its results?

Yes, because students today learn material presented in shorter “bursts” of information. Long lectures with slides filled with words are going out of style. A more narrative approach, where the instructor tells stories and gives plenty of relatable examples, is becoming the norm. With the advent of large language models (also known as “AI”), we as instructors need to rely less on long essays or convoluted written assignments to measure how well students have learned the concepts. Instead, we are moving to more practical and applied ways of testing their comprehension.

Can you tell us about a time when your research changed your or your colleagues’ understanding of a topic or issue?

In 2007, when I started working at the Maryland Department of Health as an epidemiologist, the influenza surveillance strategy for the state was based on receiving reports from three physicians in the Baltimore metro region, and on reports of influenza testing by cell culture at the state laboratory.

That needed to change because we were not getting information that was representative of the whole state. I collaborated with physicians across all regions of Maryland to obtain their weekly reports on influenza-like illness, with clinical laboratories to receive reports on rapid influenza testing, and with hospitals to receive reports on hospitalizations for influenza. That wasn’t enough to fully understand the impact of flu and other respiratory conditions.

I ended up talking to researchers in Australia who launched a community-based project for influenza surveillance. Based on their model, I designed and implemented the Maryland Resident Influenza Tracking Survey, which polled Maryland residents every week about any signs or symptoms of influenza, their vaccination status, and their self-reported illness severity if they reported any symptoms. That system went online just as the 2009 H1N1 influenza pandemic started. (The system still exists, now as Outbreaks Near You and at a national level.)

From that novel surveillance system, we learned that most people who report influenza-like illness do not seek medical care. Many of them didn’t seek care because they lacked affordable care, but they did seek care for their children because Maryland covers children for medical care through Medicaid. We also learned during the 2009 pandemic that connecting to the community through the system made community members more comfortable with public health recommendations. According to colleagues, in 2020, during the COVID pandemic, the same effect was observed, where survey participants were more likely to be thankful and happy to follow recommendations compared to those who refused to comply or were hostile toward public health recommendations. 

What are the short-term and long-term goals of the Center for Public Health at The College of Physicians of Philadelphia? How about the History of Vaccines?

In the short term, we support the Section on Public Health and Preventive Medicine with their event planning and other projects. For example, in response to the numerous threats to public health implemented by the Federal Government recently, we provide reports and support to the Section for their statements and activities.

Long-term, the center is developing initiatives aimed at supporting students in their voyage into medicine, public health, and other healthcare and science careers. We are creating a mentoring program for graduate public health students and capstone projects for students looking to do applied epidemiology. We are also planning some lectures on public health topics, such as vaccines and community health. We are also producing the third season of the “Philly Public Health Chats” podcast.

Of course, the world of public health changes quickly, so we are ready to rise to any challenge and work in collaboration with Philadelphia’s amazing public health community to meet those challenges.

Hispanic Heritage Month is currently underway. As a member of this community, how has this impacted your work and how you think about health disparities?

I was born in Mexico and came to the United States at the age of 10. Even then, I lived on the border (El Paso, Texas - Juárez, Chihuahua) until I graduated from college at age 20. Throughout that time, I saw the stark differences in health, healthcare, and public health between Mexico and the United States. One country had socialized care, where everyone could afford their care, but the care was underfunded and difficult to access. The other had a business model offering the best care available, but at a significant cost.

As a result, for Latinos on either side of the border, it came down to affordability and accessibility. From that, I saw that the problem is the acquisition of wealth, which is generational for many in the United States who are not part of minoritized communities. Even with that understanding, peeling back the layers of health disparities also reveals other issues, like a lack of health literacy, historical mistrust of health institutions, and institutionalized racism that perpetuates unscientific bias towards some groups out of “respect for tradition” or because the bias is so widespread as not to be recognized.

Can you tell us about one of your favorite items in the Library or Museum, or your favorite aspect of the College? 

A few months ago, I had the opportunity to hold in my hands a letter from Edward Jenner that is in the collection at the Historical Medical Library. While we know now that Dr. Jenner didn’t come up with the idea of vaccination on his own, we see that he was the first one to publish his results to different medical societies and to push for vaccination as a means to end the scourge that was smallpox.

That letter makes me wonder what will happen with all of my writing 200 years from now. Most of my notes are digital, but I also have some handwritten ones from work and school. Will those be in the collection? Are they worthy of being there someday? I don’t know the answers to those questions, but I do work and write my thoughts as if they will one day be studied by my children and grandchildren. That’s how inspirational that one letter from Dr. Jenner was to me. It also makes me happy to see that the works of Fellowship members are being stored and will be available for future generations to see. 

What do you wish more people knew about the College? 

I wish more people knew that The College of Physicians of Philadelphia is much more than the Mütter Museum. Don’t get me wrong. In terms of educational potential and outreach, the Mütter is unrivaled. Still, the College is involved in so many other projects and initiatives that are genuinely aimed at improving the lives of Philadelphians and people beyond the city. We have Sections that develop programs to communicate and educate on medicine and public health-related topics, and they also elevate the work of community organizations. We have the Fellowship, comprising hundreds of experts from various fields, including medicine and other subjects. We also offer the Youth STEM programs, providing a safe space for children to explore the numerous opportunities in medicine and other sciences, regardless of their background. And the people of Philadelphia should be proud of the veritable treasure of knowledge and wisdom that resides within the College.