Should I be Vaccinated?

Carl Leibowitz: What are some of the exciting new vaccines that they're working on right now? What it is that's bothering them that has them concerned, 'cause it's great to target and to pre bunk some of these things. But then when you're in that one and one, really important to listen and find out, okay, for you, what what are your concerns? I think about trust a lot and one big concern I have is around rumors and falsehoods that are sowing Doubt and mistrust in a patient and physician relationship. When people say, I wanna, I wanna see the research, I don't know if they really want to see the research, but they would love to have someone take the time and the respect and explain to them. And it's actually interesting when you sit down with someone who comes in, you know, and presents themselves. I'm I'm anti-vaccine, I don't trust this conspiracy, the doctors and big pharma, they're just here to make money. They're gonna put poison in my body, they're not gonna test it safely, they never look at safety issues. The science never reaches us. And so I was like, you know, PS, like you can just go Google something, but what they're saying is exactly what Dr. Griffin was saying is that like I don't know where to go to actually understand and someone to trust. We are in a in a much better place with HIV because of science, but vaccines are not for every infection. Once we get it, do we need to Do we need like boosters for polio? I don't think I ever got a bo a booster for polio and I drank it when I was a kid, like in the early sixties. We just had a pandemic. There was a lot of competing interests. There was a lot of people messaging and people had difficulty with some of the messaging aro around schools and lockdowns and it hurt them. And I think we have to look back and have humility and discuss what was went right and what didn't go right during the pandemic. Did we overreact? No, we just were political. A red state would do this, a blue state would do this. Like we were totally different in our recommendations. How do we fix the problem in the US? That's an easy question. Hello and welcome back to a conversation with Carl. Remember to like, follow, and subscribe for the latest content. Today I am honored to have my co-host, my former colleague Beth Karis, who is joining me today. She is also currently the host of The Curious Case of On HBO Max and is Musty TV. So after you listen to this, you can go watch that. Today we're talking about the vital importance of vaccines, a cornerstone of public health that saves millions of lives, yet faces unprecedented challenges in the modern era. While the science behind vaccines is robust and clearer than ever, the landscape of public information is increasingly fractured. We are navigating an environment where misinformation spreads rapidly. Public trust is wavering and access to accurate education is consistently challenged. I'm joined by three leading experts on the front lines of medicine, epidemiology, and public health communication. They are working tirelessly not only to care for patients and analyze data, but also to translate complex science into terms we can all understand. Doctor Monica Gandhi, a prominent Harvard trained infectious disease specialist and professor of medicine at the University of California, San Francisco. She's also serves as the director of the Center for AIDS Research and Medical Director of the Historic Ward eighty six HIV Clinic. Dr. Daniel Griffith, a board certified infectious disease specialist and physician scientist based in New York. He serves as the chief of the division of infectious disease at Island Infectious Disease Medical, and he's also president of the nonprofit Parasites Without Border, and is an instructor in clinical medicine at Columbia University. And doctor Caitlin Jadalina. An epidemiologist, data scientist, and leading scientific communicator. Dr. Jetalina is the founder and the CEO of your local epidemiologist, a premier public health newsletter that translates ever evolving science for the public. She's also an adjunct professor at the Yale School of Public Health and former senior advisor to the White House and the CDC. And she currently is named one of Time One Hundred's most influential people in health. Thank you guys all so much for being here today. Let's start with my first question. Misinformation isn't new, but its speed and reach today are unprecedented. From the unique perspective in clinical medicine and epidemiology, what are the most damaging or persistent vaccine myths you are currently fighting on the ground? And I would say let's start with Dr. Gandhi. I think there are two, and these actually stem from the choice of the Department of Health and Human Services Secretary, which was A terrible mistake given his l RFK Jr.'s long history of questioning vaccines. I think the two biggest myths are any connection between vaccines and autism, which is absolutely not true. Autism is very complicated and not a result of vaccines. There was a sort of you know, very suspect, fraudulent study in Lancer that was immediately withdrawn after this happened with this question of this putative link. And so really been debunked again and again. And the second is the COVID vaccine and the obsessive kind of focus on the COVID vaccine causing deaths and excess deaths and which actually has not been shown to this day in multiple analyses. So I think those two there's lots of other ones, but I think those are the two highest ones that have led to you know really high level statements from the DHHS secretary that and changes in the CDC childhood vaccination schedule and other changes that make people in this country question vaccines. Dr. Griffin? So I do think that you know, the the biggest right is this connection with you know, neurodevelopmental disorders in children, right? And that that's been around for a while. And and I think as as you ask the question, it's right. The attacks on science, the attacks on vaccines, they go all the way back. This this is nothing new, but what is new is is the power of social media, the the power to to spread this misinformation. The other side, and this goes back in history as well, is the whole idea that getting infected is somehow better, safer than the vaccines. And the vaccines have all kinds of bad things, but somehow there's something natural or good about getting infected. You know, and even people use the terminology. They say natural infection. I guess natural is sort of that, you know, we all want natural things, but I'm not sure we want natural infections. So That that last part is kind of a bigger picture. And I do want to sort of say, like I'm answering your question, but I'm also going to spin it a little. It's really important when we talk to I'm gonna say vaccine hesitant patients, parents, individuals, it's that we we don't go into it thinking we know why they they distrust vaccines. It's really important to listen, right? Because everyone is pro-vaccine is pro-vaccine in the same way. But everyone who's anti-vaccine might be anti-vaccine in a slightly different way. So it's really important to listen, find out. What it is that's bothering them that has them concerned. Because it's great to target and to pre-bunk some of these things. But then when you're in that one and one, really important to listen and find out, okay, for you, what what are your concerns? And Dr. Jadalina? Yeah, I mean, I think we can just go through a long list. What Monica and Danielle said are completely right. I think to add on to that is one one of my concerns is the rumors and falsehoods. That people are using around COVID and flu that is bleeding into routine childhood vaccinations, around vaccines don't work, they're not effective, they're not safe, et cetera. That's one thing that concerns me. The second kind of theme that has been and mRNA, right? MRNA is being used now for a number of even cancer treatments. And so really concerned about that connection people are making. And then the second is. I think about trust a lot. And one big concern I have is around rumors and falsehoods that are sowing doubt and mistrust in a patient and physician relationship. physicians are the most trusted source of health information and so rumors around, hey, your physician is getting rich off of the vaccines or they don't know what they're talking about, or they're after you, or whatever is I think one of the biggest themes I'm I'm starting to see and especially in this low trust environment. I have a follow-up question to this one. And it has to do with the COVID vaccine. People think the vaccine was fast tracked. It didn't go through as many studies maybe as some vacc stages of studies as some vaccines do. I don't know if I'm right about that. So I want to know if the science behind the COVID vaccine was actually in the works for a while already. The RNA. Am I right about that? It was. you know, the MERS pandemic. So there was SARS Covid one, and then that was two thousand two and then there was MERS in two thousand eleven, Middle East respiratory syndrome, and then there was SARS CoV two. And the RNA vaccine was started for MERS, which was ten years prior to this. Didn't need it 'cause it actually didn't spread. of I mean there's actually one or two cases still a year, but it's it's a very low it though it's a very high mortality virus, it's luckily not very easily transmissible. So it wasn't needed, but the technology was started a while ago and then as Kathleen said, it's really been looked at in other fields, cancer treatments, and we're really excited about it actually in the HIV vaccine field. It's actually just a way to produce so much protein. You know, you can either put protein in the body Or you can produce the give the recipe, the template for the body to produce protein from the mRNA template. So higher levels of exposure to the antigen because the mRNA makes the protein and then that way you can get a really robust response. And it's been really great to see its level of efficacy in those with immunocompromise. So mRNA vaccines, very exciting technology, not new, had been looked at for a while and certainly we're excited about it for the next I mean, hopefully there's not a next pandemic, but But it should be you it because you can adapt it very quickly, we're really interested in using it for the next pandemic. So all of that means that this focus on mRNA vaccines as if it created spike protein that was dangerous was surprising. And I I think you know, one thing is that some of the advisors to RFK Junior, like Robert Maloney, didn't develop this this vaccine, but has been s saying that he did and and said it was dangerous. So again, I think It's misinformation, but this is a good and exciting vaccine technology. And the one good thing Trump did, I have to say, is that whole fast track process, that was a really smart idea. Public private partnerships to make things happen quickly. That's exactly what we want. And the fact that the first declaration of the pandemic was March of twenty twenty and December ninth we had our first EUA for a for the Pfizer MRNA vaccine, that was so fast and that's So we want in the future. And remember, Misles was described in the ninth century and we got a Misles vaccine in nineteen sixty five. So we're we're really fast tracked with the MRDA vaccine. Dr. Griffin, I wanna follow up on something you said. Listening is very important. During COVID, one thing I would hear from a lot of people over and over again was I need to see the research I need before I do the vaccine. If I looked at the research and I looked at the peer review studies, I would have no idea what I'm looking at. And when I listen to people say that, I would think to myself, they're not going to understand the science any more than I am. So what how would you talk to someone like that? Very honest and humble of you to to actually say that. I mean, those of us here, right, are talking I've spent years and years being taught learning how to read and interpret and understand the scientific literature. It's not easy. And it takes time. It's not something you do sitting on the toilet on your iPhone, you know, frankly. But it can be communicated. And I think this was an own goal in part during this period of time when the vaccines were being developed and rolled out and marketed, operation warp speed, how much of our national budget went to education. Really none. Really? It was up to sort of, you know, media and volunteers to communicate. When people say, I wanna, I wanna see the research, I don't know if they really want to see the research, but they would love. To have someone take the time and the respect and explain to them. And it's actually interesting when you sit down with someone who comes in, you know, and presents themselves, I'm I'm anti-vaccine, I don't trust this, a conspiracy, the doctors and big pharma, they're just here to make money. They're gonna put poison in my body, they're not gonna test it safely, they never look at safety issues. If you actually sit down and talk to people and create that relationship, create that trust. You know, I think that you can actually really give them what they want, you know. And when they say, I wanna I wanna, you know, understand the research, I wanna see the data, they don't mean I wanna see a fifteen page, you know, journal of experimental medicine paper with graphs and statistics. They wanna actually get the information in a way that they can understand it. And I think that it's on us to communicate effectively. So that's a good segue to Dr. Jettalina when you run you have this newsletter. Is this what your newsletter does? Does it help to translate this complex information for the layperson? It is. You know, and you know, I wouldn't say it's the layperson. At first I thought I was talking to Joe on the corner, but it is, I would say, trusted messengers in the community, whether they're pastors or physicians or teachers or grandparents or really anyone That Dr. Griffin was talking about that really just want to understand the science. You know, I learned about this very deeply over the past year when I've been working with the Maha group, Make America Healthy Again. And what they kept telling me is like, Caitlin, the science never reaches us, never reaches us. And so I was like, you know, BS, like you can just go Google something. But what they're saying is exactly what Dr. Griffin was saying is that like I don't know where to go. To actually understand and someone to trust. And so together we I asked them, like, what do you need? And they did want the links to actual studies, even if they couldn't really read them as well, but they want to know where it was coming from. They want to know why we're putting more weight on one study versus another study. And the thing that I've continued to come out of my experience over the sep past seven years is never underestimate the intelligence of the public. Right. Even if they don't know what wastewater surveillance is or Omicron is or you know mRNA is, that doesn't mean they don't want to know, and it doesn't mean they don't deserve to know either. And what I have learned is that from listening, like Dr. Griffin said, if we truly understand what people's questions are and we can walk them through what we are seeing and how we're weighing the evidence and how we're weighing risk in our own lives, it's incredibly incredibly helpful to all types of people, whether they and regardless of where they land on the political spectrum. Dr. Gandhi, I want to follow up on something you said about HIV vaccines. One of the things that when I'm having conversations with people, I will year that the reason the HIV vaccine isn't out there yet is because it's more profitable for these companies to keep giving the drugs out to keep people not You know, once if they get sick, they can get the drugs and they can do that. And I always find that like I can't believe medical companies or pharmaceutical companies would be that evil. So there's these conspiracies that you hear that are out there. How do you counter that? And then also where are we on the HIV vaccine? Yeah. Because I know that's something that people want to do. Yeah, I think it's going back to what Dr. Griffin and Gedalina both said that speaking down to people and not acting like you're a scientist so you know the truth and just listen to me, that is exactly not the way to talk to patients or the public. I think there's ways to really explain things really simply. And beyond explaining it simply, there were too many papers during COVID, meaning like it was actually the the most generation of papers and preprints and that you know some of them were inaccurate. And so people can gravitate towards those. So that was just a crazy time. There's no there's never been a time where there could be that much information and then social media also putting out misinformation. But going back to the HAV vaccine, it's it's just as simple as the fact that the virus affects the very immune system that you're trying to harness to generate a vaccine. It's a very clever virus and so it's very hard to develop a vaccine. And second is that it's something called a retrovirus and All that means is that the virus stays in your body, like actually intercalates into your DNA and just stays there, which is very different than RNA viruses like influenza and SARS-CoV-2. So it's been an attempt, but it's been very difficult to develop an HAV vaccine just because of the nature of the virus. And the attempts have been, you know, really incredibly heroic, but it we just don't have one yet. And that's why the MRNA vaccine is of interest actually. So we it's it and in on the other hand, the HIV medications were developed not fast. I mean it went till nineteen ninety six and the and the the a pandemic was described in nineteen eighty one. But once we got them, these antiretroviral therapies are amazing and lifesaving and incredible and easy to easier and easier to take. So we are in a in a much better place with HIV because of science. But vaccines are not for every infection. I have a question that's not on the list here. Are vaccines are they as effective in our b once we get it, do we need a do we need like boosters for polio? I don't think I ever got a bo a booster for polio and I drank it when I was a kid, like in the early sixties, right? I mean, are they do they stay as effective? I know we need boosters for COVID, but the other big ones. I'll jump in because I like I like the fact that you were drinking your polio. You know, right. With with the Kool-Aid and everything else. 'cause it wasn't it like a sugar cube. Like I mean that was that was from no, but they do. There is there is a liquid, but you know, that was the what's that, Mary Poppins, the spoonful of sugar was a little sugar cube with the pink. They basically squirted it on a sugar cube. So you could have asked for your liquid to be served on a sugar cube. But it it depends, I think is the big thing. Is there a certain infections that once you get that infection, that most people will then be immune for the rest of their their life. So, you know, does not require a vaccine. but you brought up certain things, the flu, COVID. The immunity that you get after an infection does not make you impervious to get infected again. And that was something we didn't know, right, early on in COVID. There was sort of this idea that once you had COVID You're good. You're not gonna get it again. You know, it's survivor core, all these people, they're gonna be help everyone else because they had survived. They now are gonna have lifelong immunity. And there can be different issues. Sometimes it's it's the immune response we get. Sometimes it's the pathogen changes enough. So it does actually depend. Measles, if you had measles, survived measles, we're not gonna vaccinate you. If you had polio, unfortunate. you're you're you're not gonna get vaccinated after that. so it kind of depends what you're what you're talking about. Tetanus, like I spend time in Africa and I hang out with the Maasai. They're dressed all in red. They're a little anti-vaccine. So I feel like I'm, you know, in some parts of America. But they get tetanus over and over again because getting tetanus, again, doesn't make you immune. So you gotta vaccinate. so it it really depends. I'll just add on to that. You know, I think it depends and also things change over time too as we learn about how immunity shifts. One I know big question we have with measles immunity. Is how long does the vaccine last if there's no co-infection with measles infection? Right. And we just don't know. Like we've r we're entering sort of a new period right now. We're very confident that, you know, 96% of people that get infected right now are unvaccinated. But I mean, that's an important thing to keep going as well. And so there's a level of humility here with viruses, especially as our environment changes as well. And that Complexity and nuance, it's really hard to bring the public along for. but it is the sorts of questions people are asking right now. Okay, but I do have I we we boosted too much. And and the the United States ha was an outlier in how often they recommended boosters and that did decrease trust. So, you know, there's kind of cell mediated immunity, which are your T cells and B cells and They actually lasted pretty long time. And that's why the WHO, Canada, UK, Australia really recommended regular boosters for those who would need a boost in their immune system. That would be older people, 65 and older, those with immunocompromise. And they had this kind of very steady re set of recommendations for who needed boosters. And the United States basically said everyone should need a booster from six months and up every six months or every time there's a new variant. And that was complicated why they said that, but that can and and one idea is why that happened from the C D C is because we don't have a national healthcare insurance plan. So if you put the idea of a booster on, then insurance has to cover it. But what that did, I think, did decrease trust in the in the COVID vaccine in this country. Like why would we be saying boosting every six months and you know the WHO is giving a very steady set of recommendations for those who needed it. So I d I think it's it it's behooves us to look back and when there were mistakes made during the pandemic or where there were we were outliers, that what that would make someone think is is there some kickback that the doctor's getting? Is there some reason why my six month old has to get boosted every six months when no other country said that? So I do think this is a very important time in public health history. We just had a pandemic. There was a lot of competing interests. There was a lot of people messaging and I think and and people had difficulty with some of the messaging a w around schools and lockdowns and it hurt them. And I think we have to look back and have humility and discuss what was went right and what didn't go right during the pandemic so that we can help increase our trust in public but wouldn't that just be normal because we were living it in real time? And we didn't know what to expect. I mean, no what when at the beginning of COVID, people were washing their fruit. We didn't know what to do. And all of that happened in real time. It is that other countries were not as fractured as ours. For example, I was in India right after the pandemic and the head of the WHO leaned over and said, You guys had the craziest response. You were just so completely political about your response. And the UK, the the Europe. India like India had really high rates of vaccination. It was amazing after the Delta variant. And and they had a lot of vaccine options, by the way. DNA, mRNA and protein based and old virus vaccines. So they gave people choice. The point is that we were more political, I think, than any other country. We were divided along political lines as opposed to, I think, just giving good science. And the US had poor outcomes partially because we were more political. So did Brazil, by the way. So I think we do have to look at Where there was more steady and unified response in other countries. Did we overreact? No, we just were political. A red state would do this, a blue state would do this. Like we were totally different in our recommendations. I don't what it what was the financial? we just didn't have the the trust if everyone was doing something different. And I just that's just not what happened in Europe. That's not what happened in the UK. It is what happened in Brazil. So do keep in mind that it had to do with the government. But in Brazil had poor outcomes as a as well. There was this really, really interesting study that came out, I would say, a few years ago, and it compared all of the countries across the world and like how they did, and they compared like whether how fast they got the vaccine and they compared Whether they have universal health care and they can like all of the density, they get compared all of these factors. And the one factor that really differentiated between whether a country did well or not was actually none of those. It was trust in each other and trust within the government. And what it that still to this I mean, even right now, when everyone asks, Are you Are we prepared for the next pandemic? It's not I don't think it's necessarily because we need to get a vaccine faster or whatever. I think it's because of the trust issue. And what we have seen over the past six years and even the past two years is the trust continues to decline. And that really hurts responses. It really hurts people's understanding on what the heck to actually do, who to listen to. And I hope that. We learn from that. The challenge is it's really hard to fix that and it takes time and it's gonna take a concerted effort. Your point is so important because actually the single most important predictor of how countries did is how the rate of vaccination in those sixty and older. And what we saw in Norway, and this is a very good example, is Norway had really high rates of vaccine uptake in those who were sixty and older, really excellent outcomes as a result. And if anything, they increased their trust in vaccines and their childhood vaccination rates right now are phenomenal. Like they just they they by essentially focusing on who was most at risk, they got people vaccinated. People were willing to trust the vaccines and they had really wonderful outcomes. So and the post pandemic results are not bad. They're wonderful in terms of trust in childhood vaccines. So how do we fix the problem in the US? That's an easy question. So I I was gonna say things like this, right? Like when you ask questions about, the HIV vaccines, conspiracy, that's why we're pushing the drugs. If you actually meet people who are working on these, like unfortunately, we lost Scott Hammer, who was the head of our division at Columbia. You meet Scott Hammer, who spent decades trying to create a successful HIV vaccine, doing trials, you know, beloved through sub-Saharan Africa because of all his efforts. you you meet the individual, you're like, He's not a crazy scientist like I hear about on social media. This is like a genuinely incredibly compassionate, kind person who really wants to make a difference. They're they're not here for the money. If if you wanted if you wanted the money, you don't go into vaccine research, by the way, just in case people are thinking that that's how they're gonna, you know, own that Lamborghini. So, and I think a lot of it is is you know, podcasts like this, communication. You meet us, you meet the epidemiologists, you meet the clinicians, you meet the researchers, and you're like, These seem like really nice, caring people. They're doing these pro bono podcast appearances. At least mine's pro bono. I don't know if other people are getting paid. But anyway, they're they're not in it for the bucks. They're in it because they actually care. They want to make a difference. And so I think that's a lot of it. Put a human face on it, be nice, be kind, be patient, be respectful. I think if we can build that trust back, then they're gonna come and ask us. And say, Hey, I saw this this post on X or Twitter or Instagram or YouTube Shorts or wherever people are going these days on on the social media. And nobody's going to the Facebook any anymore, by the way, because that just means you're old, according to my kids. But no, I think there's I think there's a lot. I think we need to just keep communicating. We need to take the narrative away from the politicians and get it back to those of us who are here because we really care about the health of of our fellow citizens, our friends. focus on social media. We we do have to mention the role of social media in in what happened because Norway, yeah, I keep on going back to that country, they didn't allow this kind of misinformation to be on social media, or they didn't give a platform for people on TV to say the mRNA vaccines were causing mass death. And that wasn't in that wasn't called oppressive. That was called following science. So I'm wondering if it's important to just say that How do you without stifling academic freedom, which is always happening anyway, whether it what administration right now what's happening in social media is you hide things get hidden that that doesn't work for the current administration. How do you control social media and how do you not allow that to to for misinformation to be propagated to millions of people? I actually really want to ask that. Dumb now yeah, but now you're you're going into the the legal the legal area. There have been lawsuits and I mean Norway They can set a national policy. In the United States, we don't set a national policy. We leave it to the states. So there's fifty different policies, right? You know, the red and the blue. And then when it comes to First Amendment, I mean, there were all sorts of lawsuits about, you know, who could post what. And the owners of those platforms, you know, were sued. And then they ended up coming over and they're all sitting behind Trump when he was inaugurated the second time. So they all, you know, got their hands slapped and, you know, were sued. And Now they're sort of more in line with him. Letting people post what they want is what I guess what I'm saying. Yeah, I w I was gonna also say it's sort s sort of tough. Like when when I've done lectures in in Thailand, Taiwan, Singapore and parts of Asia, I always say, like, you know, we're the united fifty states and we're really not that united, right? So you compare us to Norway. I mean, more people live on the east side of Manhattan than the entire country of Norway. So it it's kind of hard to take four hundred million people. And you know, have have one consistent message. So but we can keep having, you know, kind, caring, respectful messages. And I think I don't even know if if it needs to be legislated as much as, you know, there's a lot of money in the anti science. There's a lot of money on in the misinformation. There's a lot of money in go to my website and buy my nutraceutical packet, you know, when you get measles instead of getting that vaccine ahead of time. I don't think we've really organized and and put the funds and put the effort in on our side and and maybe we need to do that. Yes, we do. And Caitlin's been doing great because as mentioned, I quote her too. I go there for trusted information. So it's not just, you know. Yeah, it's not Joe's on the corner. I will say I love your point, Dr. Griffin, about being human. Humans trust humans, right? They don't trust brick walls. And so When if someone opens up my newsletter, I hope they hear my voice come through that there is someone on the other end that really cares, or podcasts like Dr. Griffin's or this one. I mean, it's really important. I think the other thing I will say is I'm I'm hoping one of the biggest questions that institutions have, rightfully so right now, is they're all asking how do you build trust? And I actually think that's the wrong question. I think the right question is what makes you trustworthy? And from a system on an institutional level, that's really hard. But one thing I think that makes someone trustworthy is not only being human, but also listening, like really listening. And w traditionally public health systems, academia, CDC, you name it, it's a very top-down approach, right? The ivory tower says something and then eventually it just trickles down. There is no feedback loop from the bottom up. So to understand what the questions, concerns, and confusion are on the ground. And because of that, people are we're just talking past each other. There's like no sort of grounding in the framing and the values and the decisions people have to make every single day. And so one thing that I've been building is these listening infrastructures for the state of California, for the state of Connecticut or Utah or whoever. poor health systems to actually understand where people are coming from so they can see themselves in the work and the decisions that are being made on the top. I actually want to jump up to a a question for Dr. Griffin about your work with parasites without borders and clinical practice. I mean vaccine access around the world is an issue right now. I understand that. But do what kind of barriers do we have in our country regarding vaccine access? So it's kind of a big question to To pull it in. So I'll just start off with a few like stories, engaging stories. So I do a bunch of overseas work, a little less now. I think my wife was getting a little tired with me being overseas a third of the year. But there's an area down in Panama that I go to, floating doctors. And it's down by the Costa Rican border. It's in the Boca del Toro archipelago. And we were talking to a Nobe woman with a number of children and about vaccines. And she was asking, and we said, you know, in the US, sometimes we have parents that decide not to vaccinate your children. And her comment was, they must not love their children. And I was like, no, no, it's not that, right? But that was her perception because she had seen children die. So for her, vaccine preventable illnesses were were a reality where seeing the children die. Now, meanwhile, I also go to Uganda. I own some cattle in Uganda. We have a clinic near the Kenyan border. And it had always been a very similar, very, you know, pro-vaccine. How do we get access? But now they have smartphones. Now they've actually started to see social media. So I saw a really bad case of this poor boy with with measles. And again, the mother had decided to to not do vaccinations because of this German doctor that apparently had been on the social media, and she had decided, you know, not not to do it. So, you know, in these areas of the world. There is a little bit of a misinformation issue starting to happen, but it's tiny. It's still at this point. I mean, it don't worry. It's it's got a little bit of legs to it. So I'm worried about that. Here in the US, I think it's really more the information and the trust that we've been talking about. I don't think there are big barriers in the way. Like if if a person wants to get their their child or themselves vaccinated, it could be in the clinician's office, it could be at pharmacies now. There really are a lot of programs. When I was out in Colorado, a colleague of mine created a relationship with the state where the vaccines were being supplied to the pediatricians and the primary care providers, because you don't make money on vaccines, by the way. And I think that's really important for people to know because that that's part of this anti science, antitrust is doctors, pediatricians, family practice people, they're giving out vaccines because they make a lot of we don't. I mean, we we would sort of try to calculate when I was you know, running my primary care practice in Fort Collins, Colorado, how many flu shots to buy? And you never really knew exactly. So you usually kind of overbought because you didn't want to run out and people would want them. And you you, you know, you you never made money and you laid out the money ahead of time. So I think we do a lot in the US to provide access. The big challenge for us is is the barrier of misinformation of people not deciding to get the vaccine. I think another interesting thing thing that's happening in the United States is affordability of health care. And so with more and more debt and health care bills, people are or losing health insurance like Medicaid, like fewer people are wanting to go to a physician. And so that's where we see when people go to kindergarten kids go to kindergarten, there's a lot of uptake on the vaccine, not necessarily because not because they're being forced, but because they just haven't been to a physician. for a few years to get their childhood routine vaccinations. But it is very complex and complicated sort of landscape here in the United States, especially given a lot of systems around us are not really working for us, but working for others. That's why the CDC guidance for or recommendations for childhood vaccines had all of them on there prior to this administration, because then it was required if ACIP recommended a vaccine for insurance to cover those vaccines. So if you take away the newborn hepatitis B vaccine from the vaccine schedule, then insurance doesn't have to cover that. So that was we have such a we because we don't have a national healthcare system, which of course we need, that that was the reason that the C D C guidance mattered so much. And the the HHS secretary changing it is very disturbing. Also, they just cut out Medicaid for all California and Minnesota yesterday, but that's a whole other comment. it's really hard to be here when they just froze Medicaid yesterday. I'll say I love going to the doctor and you guys can pop down to me as much as you want, and you guys can give me as many vaccines as I need. So I I don't I'm not there to argue because I'm like I have no idea, but I don't want to get sick. I think that's an important point you make though, right? And I don't want us to lose it either, is that like eighty to ninety percent of Americans get vaccinated for a child. I mean, there's a when was the last time eighty percent of Americans agreed on something, right? Like it's actually a very wide big thing. I think more people are having questions, right? We have general amnesia for some of these diseases. We don't want more people slipping, but like Let's not lose sight of that too, is that there is actually a lot of support for vaccines. And we just need to keep it that way so we don't move backwards as a society and it can move forward. What are some of the exciting new vaccines that they're working on right now that Andrew you guys are all looking forward to? Actually, I would say that we have really good vaccines for almost every childhood preventable disease that I want. It really depends on what's upcoming. For example, When the Hontavirus Cruise outbreak happened, depending on what would happen, you'd want a vaccine. Thank God you don't. And we didn't need it. Ebola, the current strain in the DRC outbreak, unfortunately we don't have a vaccine for, which is why monoclonal antibody trial just started along with an antiviral that we use during COVID, Ramdesivere. But we do need a vaccine for the current strain of the what's what's happening in the DRC Ebola outbreak. So I would say that we don't it it it really depends on what's emerging. We have a terrible cyclospora outbreak right now, which is an intestinal protozoa, terrible and in there's five thousand one hundred cases that haven't even been evaluated by the C V C because of the C V C cuts. So sixteen forty five cases as of yesterday and still can't get to the other cases. You know, right now we do have an antibiotic for it, luckily. so it really depends on what's emerging. We have really good vaccines for what we need vaccines for. We just haven't seen people like Dr. Jedelina said, like we forget that vaccine preventable illnesses used to be the leading cause of mortality in children. We forget we haven't seen them. We haven't seen Mumps, measles, rubella. We didn't well, now we're seeing measles. But unfortunately we we I mean, good thing we hadn't seen those and the reason we didn't see it is because of vaccines. So the the you have to keep up with those vaccines. So I would say that the way to think about vaccine technology right now is things are going to change depending on what's emerging. There was a moment with maybe an influenza. Did we need a specific vaccine for H5N1? It's just gonna depend on what's happening in the world. But it's too prompt. It's developing new vaccines and then it's you know, getting people to take them. And that is exactly what the focus of your podcast is today, that we have to figure out how to help with trust. Because I would so much rather have my child have a measles vaccine than measles. One thing I will just say as a anecdote is when my child got lots of vaccines I have two children and when they got lots of vaccines one time it was like five shots in one day and the pediatrician was like, Wait, don't you want to space them? And I'm like, No, the more vaccines the better. I don't care. I'll give Tylenol. It's okay. I just loved it. I love that he you know, I just love vaccines. I have a list And I'll go through it quickly, Jalee, because my gosh, I'm excited about a lot of vaccines. Malaria, right? Won't it be exciting when malaria is a vaccine preventable illness? And it's been really exciting development there. Just think how much that's going to change the world. You know, we're really interested in Lyme. Lyme is spreading like wildfire, like the Tixon climate warming here in the Northeast. So that'll be exciting. Schistosomiasis. There's there's actually been some movement in some of our Parasitic helmets. No one wants parasites. And just think of just the hundreds of millions of people that are suffering from these parasites, you know. And so, yeah, there's a list. There's so many exciting vaccine targets out there. It's kind of crazy that there's this this fringe group that's anti-vaccines when really it's it's the nuclear option when it comes to these diseases. And so, yeah. And we're our vaccines are just gonna get better and better, like Monica was saying, right? So like one I'm excited. I don't know, maybe this is nerdy of me of the mRNA flu vaccine that was just licensed at FDA and should be available this fall, even though we don't have an ACIP. It's all very confusing, but it like protects more of you know older Americans from the flu. And I don't like getting the flu. Like so there's that, you know, one other really exciting thing is watch, my God, watching the numbers in the UK from the HPV vaccine. And cancer like going to zero in some places, like that's insane. That means that if we get a big enough uptake and the trend continues, right? data can change, that means we could possibly eliminate cervical cancer among women in places. Like to me, that's just incredible achievement. And so some of it is these incremental changes, like you said, Dr. Griffin, some of it's just for new diseases. Lyme disease would be amazing. And some of it's just to to see the long term benefits of vaccines finally starting to play out with some of these diseases like HPV. But yeah, we're all nerds here. We'll get excited for our vaccine. I I know we're wrapping up, but Dr. Griffin said something that reminded me of something that this it can't be a long answer because we're going we're wrapping up. But The t somebody was had a a bit by a tick in their head and it the whatever happened with the the the the the tick, he developed something that made him allergic to meat and he ate meat and he died and there they say there's something going around that's like I don't eat meat. I'm like, Alpha Yeah, alpha gal. Yeah, alpha gal. It's true. And it's we're s we think it's up to about 300,000 affected people in the US. She get bit by a tick. There's a substance in the saliva that Basically gives you an allergy and it can be to the point of anaphylaxis, where someone eats red meat, anaphylaxis, they die. So yeah, this is, you know, conspiracy by the vegans out there, right? No. It's it's but it is kind and it's an issue. This tick is spreading and you're minding your own business and you get bit by a tick, and next thing you know, you're you're vegan. Wow. Wow. Thank you for that. as we wrap up, is there any Thing that we should I should have asked you or that Beth should have asked you that we did not ask you. We'll start with Dr. Jadalina. Yeah. No, I mean I think my final thoughts are we're in a r magnetic storm right now of mistrust, of the information environment, of shake up and leadership, of people making a lot of money. It's very confusing and it's really hard to find a North Star. But I think I hope you hear from us three guests here that we're out there trying to help. navigate trying to help answers and really trying to help fight for the people on the ground that really are caught up in this storm and truly confused on what best to do. And we'll continue to do that as long as I'm standing. I'm gonna keep doing that. but that's I think that's my final thoughts is there's a lot of people out there trying really hard to do things differently to try to meet the moment and try to help navigate out of this mess. Dr. Gandhi? Yeah, I think that we should have the courage to know that we shouldn't be appointing people in government who have long histories of denying very basic scientific facts. And that means that things will change. If you ask someone in a question, did you like the CDC's recommendations in during on schools in the COVID pandemic, they may say no. If you say to someone, Do you want life saving research? that will save your family's lives, they will say yes. It depends on how you ask the question. I don't actually think there's terrible distrust in the NIH. I do think that again and again that's what people want is life saving medical research. So we have to ask the questions right and pose it in a way that everyone wants scientific advance. And we don't need to go back to to witch hunt and conspiracy theories. That's silly. We want scientific advance and we all want to live longer, healthier lives. So Pose the questions correctly when you ask these surveys of the American people. And Dr. Griffin? Yeah, I was going to say this this podcast may be coming to a close but close, but our scientific communication is not going to come to a close. I I a little plug for the local epidemiologist, Dr. Jetlina. I I'm a subscriber. I go there all the time. If you ever, Dr. Gandhi is ever on the media, which she's quite a bit. She's got a lot of intelligent, great things to say. So listen. I'll keep producing, you know, our podcast over there at Microbe T V This Week in Virology, free stuff at parasitesoporders dot com. Yeah, we we want to make a difference and hopefully those of you that have listened, watched, you know, we're we're human beings, we're trying to make a difference. We have dogs and cats and kids and families and yeah, we're not mad scientists trying to end the world. We're we're hopefully trying to inform and answer your questions. That wraps up Our discussion today, a huge thank you to Doctor Monica Gandhi, Doctor Daniel Griffin, and Doctor Caitlin Jadalina for sharing their time, clinical insights, and dedication to keeping our community safe and informed. And thank you to Beth Karas for joining me today. To our listeners, stay curious, check out our sour your sources, and we'll see you all next time. Thank you. Thank you. Thanks.