Asking The Uncomfortable Questions About Vaccines | Dr. Paul Offit

It's understandable, right? I mean, children get in the first few years of life will get vaccines to prevent 14 different diseases, which can mean as many as 27 inoculations to prevent diseases. Most people don't see using biological fluids. Most people don't understand that there's pushback on vaccines makes.

Perfect sense. I get it. Honestly, I get it too. I want to cut through the noise. So I called a friend of the channel, Dr. Paul Offit, who's a world-renowned pediatrician specializing in infectious diseases, vaccines, immunology. and virology. But he's not just a medical expert. He's also a member of the FDA Vaccines Advisory Committee, a celebrated author, and a co-creator of the Rotatech vaccine, which has helped save the lives of hundreds of children every day.

Dr. Offit's commitment to making the world a healthier place, I was really excited to set the record straight on why China was actually responsible for COVID, the vaccine approval process, and I ended up even giving him my two cents on the value of transparency.

in medical communication pleasure having you back thank you very excited to talk about the idea of innovation in health care and how innovation comes with its own challenges And something that I've been seeing in the health space, especially when it comes to the health media space, is whenever there's a breakthrough, now people are talking about it earlier than ever before, meaning earlier in its stages of development.

What are the risks of getting too excited about new technology? Right. Well, it used to be that there were, in terms of the number of journal articles that were published per day internationally, it was about 4,000. journal articles a day. That has doubled in the time of COVID. And also there are many more preprints that are published. People will even reference preprints, meaning non-peer-reviewed preprints. I'm waiting for people to reference, you know, something I heard on

the bus on the way to work. They are saying. So there's sort of a little bit of a loss, I think, in terms of the degree to which there is oversight of that kind of information. So you're right. And we're very quick to jump to the next magical.

mystical thing that's going to make everything better, not realizing that all these innovations, historically, every single one of them have been associated with some human price. There's always a human price to pay for knowledge, always. And I don't think we accept that. We think we're so far along now. world of science and medicine, that that learning curve is finished and it's never finished. What is that human price that we have to pay for innovation?

that there were adverse events that followed something, whether it was vaccines or whether it was blood transfusions or whether it was chemotherapy, whatever it was that you didn't know about. And so... I think if you ask people, do you think we're going to know more about science or medicine 10 years from now, 15 years from now, 20 years from now, then we know now, everybody would say yes. But when it comes to their disease or...

most recently our pandemic, they want you to believe you know everything right now and you don't because you never do. Yeah. Like thinking about innovation right now, people's minds go to AI, CRISPR gene editing. Where do you think those scenarios play out in our lifetimes? Right. What worries me there is that there's it's. scientific innovation without conscience. I mean, without necessarily an overarching ethical moral conscience, which is...

historically true of scientists. I mean, scientists will see sort of science uber alice, and they don't necessarily see the bigger picture. I mean, if you look at people like William Shockley, you know, who invented the transistor. Or James Watson, who, you know, was with Francis Crick and Brosnan. Franklin and Maurice Wilkins figured out the structure of DNA. They saw that as the cure-all, you know, that we could, with eugenics and sterilization.

that we could make for a better population because they just saw science as a cure for everything, not realizing that there are ethical and moral problems with that kind of style. But you see it now. I mean, you see it now with... with our politics i mean the notion that people are coming to this country with bad genes so that still hasn't gone away this notion of sort of the genetics of intelligence still hasn't gone away which is frightening

Yeah. What have you seen on the CRISPR front? I know, for example, in Asia, there were some scientists that were sort of held in high regard that started experimenting with CRISPR in non... lethal conditions, potentially experimenting on young babies and trying to rid them of the ability to get HIV.

And the world that is in the CRISPR space, the community, was very upset about it because they said, you're experimenting genetically, not knowing how this is going to impact the rest of the child's life for a condition that was not life-threatening to them. Is that sort of the quandary you're discussing in the book? Right, exactly right. I mean, so there's an HIV researcher at the University of Penn named Jim Hoxie, who, as it turns out, doesn't have the HIV binding receptor.

Good news for him. And so could you genetically engineer children so that they don't have that binding receptor? Yes, you could. I mean, it's interesting that, again, to go back to James Watson, he... When he was asked about gene editing, he's still alive, actually. He's like 96 years old. He said, you know, we could make girls prettier. And what's wrong with that? This is why you don't want scientists weighing in on this stuff.

You know what's funny? It reminds me of listening to the difference of researchers speaking on advice to people versus clinicians. speaking on advice to people and how different that sounds. Because these days, the people who are doing some research or at least evaluating the research present the data as if it's done.

Like they've reached some sort of utopia. They said, this is what we know. This is the hard end. Now we know cold plunges will extend life. We know that if you take rapamycin, you will live longer. And yet... Despite knowing the research, they don't understand how that information is landing to the general public from a clinician standpoint. Do you ever see that play out?

Yeah, for sure. I'll give you a personal story. I was fortunate enough to be part of a team at Children's Hospital of Philadelphia that created the strains that became... the rotavirus vaccine rototech. So it's sort of like, you know, when the gods are angry, this is the old Chinese proverb that when the gods are angry, they grant you your wish. I mean, so we were working for whatever, 25 plus years on trying to make a vaccine to prevent this disease, which can...

causes roughly 2,000 children a day to die in the world. So an important thing. But, you know, you don't know. I mean, you know that you've done work in the 35,000 children have got babies have gotten that vaccine. And then, you know, The FDA licenses it, and then the CDC recommends it, and your heart is in your throat. I mean, you are waiting for the other shoe to drop. Remember, me and one of my co-inventors, Fred Clark, are just pouring through gene databases.

What weren't we thinking about? Are we making an immune response to the cells that line your joints? Are we making an immune response to the surface of cells in your pancreas that make insulin? I mean, is there where we could create diabetes? Is there something we didn't think about? Because you know you didn't think about everything.

because you can't think about everything. And now the vaccine is going to be given to hundreds of millions of people and you're going to find out what you didn't think about. So your heart's always in your throat. So- You're on, or at least you were on the committee for immune recommendations, right? So I am still on the FDA vaccine advisory committee. So being on the advisory committee.

How do you weigh making a recommendation of that caliber? What goes through your mind in a situation? Okay, so you know that your recommendation is based on the question, do you know enough? Not do you know everything. So for example, in December 2020, we were confronted with on the 10th. December 10th with the Pfizer's vaccine, Pfizer's mRNA vaccine, and a week later, the mRNA vaccine for Moderna. The way that works is you get, for the first vaccine, you'll get...

150 pages to 200 pages from the company where they go through all their phase one, phase two, phase three data, meaning bigger and bigger studies and ultimately the big definitive study, which was a 40,000-person prospective one-to-one placebo-controlled study.

And then you also get 150 to 200 pages from the FDA where they review those data to see whether there's any omissions or misrepresentation. So you're reading 400 pages for that first meeting. And how long do you have to read 400 pages? About a week.

And you read it. You read every word because your heart's in your throat. Because you really, you want to see if there's anything there. And there was. We thought that there was a statistically, the numbers were small, but there was a statistically significant increase in Bell's palsy in the vaccinated group versus the unvaccinated group.

one-sided facial paralysis. And so we were worried about that. I mean, that's a big price to pay for a disease that most people are going to get and not die from and not be permanently harmed by. And as it turns out...

when this vaccine was given to millions of people and there was enough on both sides to see that went away. That wasn't a real problem. And then the next week when you meet for Moderna's vaccine, you're getting another 400 pages to review and you read every word because you're afraid you're going to miss something. And then you recommend authorization. We're an advisory body, and you're in medicine. You know people can choose not to take your advice, and that's true of the FDA as well.

But they authorize then through emergency use authorization this vaccine. But you're always... always waiting for the other shoe to drop, but it did drop. I mean, with the mRNA vaccines, there was myocarditis, which is inflammation of the heart muscle, primarily in boys 16 to 29 years of age, primarily after the second dose, primarily within four days, but generally it was trans.

and self-resolving. So it really wasn't that bad. That was a very small price to pay, I think, for that vaccine. But you had J&J's vaccine, which we reviewed in February of 2021, the adenovirus vectored vaccine. That was, again, about a 30,000-person study. So you saw 15,000 people got that vaccine. Then millions of people got it. And it was found to be a cause of clotting, including severe clotting, including clotting in the brain that ultimately drove that vaccine off the market by market.

March of 2023. And everybody looks at that story and they say, how did you not know that? How did you recommend something like that, which now has caused deaths in some people? How could you not know that? And people then lose trust, which is in part sort of why I wrote this book, because I just think people have.

to have realistic expectations of the fact that you're going to learn as you go, which everybody agrees with, except when it comes to any personal experience they've had. For sure. Do you look at any members of the advisory committee?

and sometimes say to yourself, oh man, I don't think they're going to be reading all 400 pages. Or are they picking the top, the top people that you have full confidence in? Yes, I'm really impressed by the committee. I actually... I know COVID has become a difficult discussion for people, but I think that Operation Warp Speed... which is to say an $11 billion outlay to bet on six horses, six vaccines to win one race, and basically taking the risk out of pharmaceutical companies, right?

government's going to pay for your phase one trials phase two trials phase three trials they're going to pay to build the building they'll pay to you to make the vaccine and if the vaccine doesn't work you can throw it all away and this will be no financial risk to you i think that was

the greatest scientific or medical accomplishment in my lifetime. I mean, here's a virus that had unusual biological characteristics, unusual clinical characteristics, that was met with a technology, messenger RNA, which we had no previous experience with. None. And yet...

It was a very safe and very effective accident. I think it was the greatest accomplishment of the Trump administration. So the question is, why, if anything, does he distance himself from that? And I think it's because of his heart. He's a very modest man who doesn't like to put his name on things. But I could be wrong about that.

Yeah, I don't know. I've seen his name pop up in New York City a few times. When thinking about this collaboration between the private sector and the government in coming together and making these vaccines... It was a beautiful thing to see, and yet it's not held in such high regard with a big proportion of the community. Maybe not the majority of people, but a lot of people view the vaccine still with a lot of skepticism. They say that it was done prematurely before it was truly tested.

And to some degree, that's true. To another degree, it's not because we had MRNI technology before then, right? And we were using it maybe not for COVID-19, but for other uses. Is that right? Or am I mistaken on that? Well, certainly, I mean, so this year's Nobel Prize winners were Katie Carrico and Drew Weissman, University of Pennsylvania. I've actually known Drew for a while. They met at a...

copying machine. Ask your parents about it. It's where you physically could copy a piece of paper. But in 1997. And that's when they started their effort to do this. So you're right. I mean, this isn't something that just happened. And so mRNA has been around for a long time. Actually, the original studies...

that were done like in the late 1980s, where you showed that you could take messenger RNA, inject it into a mouse muscle, and that the muscle would take up the messenger RNA and make a protein. That was Robert Malone did those studies in 1989, who has since become a virulent anti-vaccine. activists which is sad but yeah um so so yeah i think that um it's been

An amazing story, and you're right. It's not when people say the technology was too new. It certainly was novel technology for a vaccine, but the technology itself wasn't new. And I think that... The size of those trials, 30,000 or 40,000 people, that's atypical.

pediatric or adult vaccine trial. The reason it happened so quickly was that the government took the risk out of it for the companies. I mean, we made a rotavirus vaccine in 26 years. I think if the government had completely paid for everything,

Everything had taken the risk out of it for all the companies that would have been a lot faster. Yeah. Yeah. You know, that's funny. When I practice medicine one-to-one with a patient, I try and get them comfortable with uncertainty. They ask me, do I have this condition?

I can only tell you what the tests have told me thus far or my physical exam has told me thus far. So I can never give you a 100% answer. I could say it's not likely. I see no signs of it. But I can never definitively say that you're not having a heart attack right now or you won't have one as you walk out of my office. That's one-on-one. But you're dealing with uncertainty on a whole other level because you're making a recommendation for a treatment that will affect millions of people that...

you're again making a decision with limited information. So how do you do that knowing that there will be another shoe to drop? The medical definition of safety for me is that the benefits have to clearly and definitively outweigh the risks. And I think what we found was that for the mRNA vaccines, that was clearly true.

I think what we found with the vaccine, the Johnson & Johnson vectored virus vaccine, that wasn't true. And even though that side effect of clotting occurred in roughly one per 200,000 people, that still was... not okay, but the main reason that wasn't okay was we had another vaccine. Yeah, we had other options. I mean, it's the same, you can make the same parallel for the polio vaccine. I mean, the...

Jonas Salk's vaccine was introduced in 1955. They'd take the virus, grow it up, kill it with formaldehyde. And that vaccine was used into the early 1960s. And then we used the Albert Sabin vaccine, the live attenuated oral polio vaccine. had a problem. The problem's rare, but it was real, which is one per 2.4 million doses were complicated by polio. I mean, that virus was not weakened, attenuated for growth in the intestine. It was attenuated for growth in the nervous system.

Therefore, it can continue to reproduce itself. And it's a single-stranded RNA virus, so it can have mutations that ultimately revert back to neurovirulent virus, wild-type virus, paralytic virus. And so one out of every 2.4 million people...

who were inoculated with that vaccine and some people who came in contact with them would be paralyzed by the polio vaccine. So we eliminated polio with that vaccine, the real polio vaccine, by 1979. And then for two decades, the 1980s and the 1990s, we continued. to give that vaccine. And the only cases of polio in this country were caused by the polio vaccine. Seven to 10 children every year were paralyzed by that vaccine.

That was unconscionable given that we had another vaccine. We had the inactivated vaccine, which Scandinavian countries had always used, and eliminated polio from their country without ever using the oral polio vaccine. And so I came on to the Advisory Committee for Immunization Practice.

CDC advisory committee. Now I'm on an FDA vaccine advisory committee. But when I came onto that committee, I asked the head of the group, the ACIP, if I could be head of the polio working group because I wanted to get us away from that vaccine because it was unconscionable. I just couldn't stand that we had another alternative. And so what was interesting at the time, there was enormous pushback.

from people who I respected, people who were the head of the AAP, people who, one person who was on the short list for the Nobel Prize. Is that because of the Cutter incident still? Like the remaining sentiment? That is a great question. And the answer shockingly is yes. There were still some people who... we couldn't make an inactivated vaccine by completely inactivating the virus, that there still may be residual live virus, even though this was, whatever, 45 years earlier.

So it was really hard. One person I remember said, think about it. We're going to be paying $4.5 million for every case of vaccine-associated paralysis prevented. Yeah, and I'm with you so far. So what I did was there was a guy named... John Salamone, who was the head of the Italian American Association, who...

was really good. I mean, he was a vaccine safety activist, an actual vaccine safety activist, because his son was paralyzed by the oral polio vaccine. His son subsequently passed away. And so I brought him on the committee at a time when we really weren't bringing... sort of non-MD PhDs onto the committee because I wanted those people who didn't want to make that leap back to the inactivated vaccine to tell him that it was too much money.

It was an interesting process, that whole process. Yeah, that was a scary time where... We actually had something that worked, but because of its implementation, we got rid of it and got something that was far worse. But I believe we're still using the oral vaccine in other areas of the globe where it's difficult remote areas to get access to the one...

completely inactivated vaccines. Is that true? So we haven't been using the oral vaccine in this country really since 2000. So it's almost 25 years. The advantage of the oral polio vaccine is one, you can just squirt it in the mouth so it doesn't require a medical person to do that.

It's not a shot. And there's also something called contact immunity, which is not herd immunity. Contact immunity, as you get the vaccine, it continues to reproduce and shed in the soul. So about 25% of people in the home, say, who weren't immune to polio will come in contact with the... the shed virus from that trial, and they too will become immunized. So you get immunization beyond the people that you immunize. What do you say to people who...

While you're overlooking the data of the number of 30,000 people, I believe you said, for the mRNA vaccines, when is it enough information? What's your barometer to say, oh, well, this was studied for a year. with 30,000 people, I feel comfortable recommending it. Or we need two years, three years. What's the cutoff for you?

Well, it's sort of arbitrary. I mean, at the time when we met in December of 2020, hundreds and to some extent thousands of people were dying every day. So the benefit was clear if this vaccine worked. And so the question, did we know about, was the same. Essentially, the first trial was 40,000, that's 20,000 that got the vaccine. The second trial was 30,000, that's 15,000 that got the vaccine. You had 35,000 people.

Was that enough? I think it was enough to tell you that you didn't have an uncommon side effect. But it wasn't enough to tell you you didn't have a rare side effect. But you did have... processes like the vaccine safety data link, this linked computerized medical record system, which involves about 9% of the country, where once the vaccine rolls out, you can very quickly tell who got it and who didn't. And if there was a problem that came up, you would see it.

And we were looking, and then myocarditis popped up, which occurred in roughly one per 50,000 people. But in people 16 to 29, it was one in 6,600. Not that small, but... you know, you were protecting against a disease that was potentially fatal. Now, you could argue for that age group, the 16 to 29-year-old, it's unlikely to be fatal in them. But, you know, there's about 1,800 children less than eight.

teen who have died of COVID. It's not like you can't die of COVID as a child. And the good news about the myocarditis was any Good news to be had was that it really was self-limiting and transient. Initially, we admitted those kids to the hospital, Children's Hospital of Philadelphia, but eventually they were just handled as outpatients as we got more and more use of it. Did you ever play poker?

in your life a lot as a teenager 16 17 18 i played poker all the time so did you get comfortable with the notion of doing the best with the limited information that you had at the time and then making your move and being okay with the consequences because you did the best with the limited number of information pieces you had. Yes. And I think I wish everybody who was on these committees also played poker as a child. Isn't it ironic that it's so...

replicatable, the theory of poker into real life, especially healthcare. Also, I grew up in Baltimore. I spent my life at the track, just so we're clear. Even early college, life at the track. So Bowie, Laurel, Pimlico, I spent my life at the track. But make your bet. Make your bet. Be willing to make your bet, realizing you may have to tear up your ticket at the end of the race. And there's something to be said for that.

personality if you will to realize that because you are making a bet i mean doing nothing is also making a bet correct doing nothing is doing something yeah and when we think about some of these procedures and treatments that we have available to us these days that are fairly commonplace blood transfusions chemotherapy what was the process what bet was being made by researchers that they would work

Well, the hope, I mean, is to take blood transfusion. Back in the old days, I mean, blood transfusions were done even using animal blood. I mean, because we didn't know anything about the fact that you could have what we call now a transfusion reaction when you're being inoculated with antigens that you've never seen.

seen before and you have this massive reaction so you learn each time that you go i mean look at the i mean the early transplants were brutal i mean solid organ transplants were brutal bone marrow transplants were brutal early on and even that was true when i was a resident at Children's Hospital in Pittsburgh, they were bone marrow transplants, were really in their early stages. And you learn as you go, because...

The choice to do nothing is also a choice. And for someone who has cancer or someone who needs an organ, that can be also a fatal choice. That's true. So vaccines are different because vaccines generally are given to healthy people. So there the bar is much higher. Yeah. So how do you, as an infectious disease specialist, speak to someone who is vaccine hesitant?

Right. So I would say they fall into two groups. The one group are people who really want to know whether or not there's a problem. They smell the smoke. They want to know whether there's any fire there. You try and find out what it is that they're worried about. Is it that they've seen that Joseph Ledapo, for example, who's the Florida State Surgeon General, has said that the vaccines are contaminated with...

with DNA and that that's going to insert itself into your DNA and cause cancer or autoimmune disease. So you can answer those questions if they have a specific question. But you have to find out what it is that they're worried about. Sometimes it's just free floating, but they need to be reassured.

They smell the smoke. Is there fire there? How do they decide in that scenario? Like, let's say I'm a person that comes in asking that question. And you say, well, Florida Surgeon General said this, but I'm saying this.

How are they supposed to judge which doctor is telling them the right thing? See, this is the biggest problem with this whole thing. I mean, so we're living in a misinformation, disinformation age, right? And it doesn't bother me so much when Marjorie Taylor Greene says that mRNA vaccines...

cancer. Or it doesn't bother me when RFK Jr. says that vaccines are causing all these chronic diseases. What bothers me is that when Joseph Ledapo, who's an MD-PhD from Harvard, gets up there and says that he's the Florida State Surgeon General and sends out a missive. a letter to every healthcare worker in Florida saying, don't give these mRNA vaccines for that reason. I mean, you know, he's, it's MD PhD from Harvard. I mean, it's a good school. It's not pan, but it's good school.

You know, I just, so how do you fight that? It's this enemy, you know, I've seen the enemy, Pogo, right? I've seen the enemy in the EROS. So I think that's what this is. And Robert Malone, who says the same thing. I mean, he did seminal work on mRNA vaccines. He could have been...

up for the Nobel Prize, and he says it in front of Congress. So that's the fight. So what is that person supposed to do? So how do you, I think- Like I'm a mother of three. I'm listening to Surgeon General on one side, Dr. Paul Offit on the other side. I'm like, both are very passionate. Both are distinguished. Both went to great schools. Do I just go with my gut? So I think that this is a good question.

I had to be on CNN about this issue. It was Brianna Keeler, I remember. It's CNN. And so for me, it was about trying to explain why it wasn't possible. Not only that it didn't, because when you say that it didn't and all the evidence is that there is no increased cancer in those who got the vaccine who didn't, what you're saying is, trust me, I think what you have to be able to do is to say, here's why it doesn't make sense. OK, first of all.

you know, these fragments of DNA are contained in anything that started with cells, whether it's the measles vaccine, the mumps vaccine, the German measles vaccine, the chickenpox vaccine, the rotavirus vaccine, anything that's, the Novavax vaccine, anything that started with cells will have fragments of DNA. Assuming you live on this planet and you eat anything made from vegetables or animals on this planet, which is pretty much everybody.

you're going to ingest foreign DNA, some of which will end up in your circulation, okay? But it won't get into your nucleus, which is where your DNA resides. One, because it's very hard to get across the cell membrane. Anyway, two, even if it gets across the cell membrane and it's in that area.

called the cytoplasm, which is sort of outside the nucleus, there are innate mechanisms that will destroy and recognize foreign DNA. If it gets across the cell membrane, which it can't because it doesn't have a nuclear access signal, it can't get across a non-device. cell it won't enter that nucleus even if it entered by some magical way it doesn't have any an enzyme that allows it to insert into your DNA so it's not possible it can't possibly happen which is basically what I said

on CNN. I mean, and so Brianna killer was nice. She said, well, how come everybody doesn't know this? I don't know. I don't know why, but because it's, I think. Because I've been dealing with this now for more than 20 years, trying to deal with anti-vaccine activists. And I think my best shot, so to speak, is when I can say, here's why it doesn't make sense. I remember back in the Andrew Wakefield, when he first launched.

The measles, mumps, rubella vaccine causes autism with that paper in The Lancet. I had to testify in front of Dan Burton's. Committee on Government Reform. So there was Wakefield and some sort of hucksters on one side talking about how they were going to prevent or cure autism. Wakefield was going to prevent it by having you not give the MMR vaccine. The other ones were going to have this series of sort of alternative medicines to cure it.

And then I was on the same side with Colleen Boyle from the CDC. So my job at that, my five minutes I had to speak was, here's why it doesn't make sense. Here's why what he said doesn't make sense. He makes this proposition and this proposition and this proposition, none of which makes sense. It's like.

You know, the Red Queen from Alice's Adventures in Wonderland, imagining six impossible things before breakfast. That's, I think, your most powerful argument. And at the end, and that was a packed meeting, I mean, a number of parents came up to me when it was over and said,

Thank you. They cared. I mean, they had children with autism. They wanted to understand what the cause or causes were. They didn't want to have other children that also meant they were going to have autism. Can they avoid autism by not getting a vaccine? So you're right. I mean, because in the end...

They're not going to look at all the papers that show innate mechanisms by which the cytoplasm destroys DNA. They can't do that. And so, for example, I'll give, I'm sorry, I'm ranting. No, this is very positive. When the varicella vaccine came out, chickenpox vaccine in 1995, I had a number of parents call me and say, I've done my research and I'm not going to get the vaccine. But what does doing your research mean?

To them, what it meant is going online and seeing other people's opinions about the vaccine. That's doing their research. But that's not what research is. And if you really want to do the research, you should read the roughly 300 papers that were published at the time on the varicella vaccine, which would have meant that you would have had to have

have an expertise in immunology, virology, statistics, epidemiology, which few parents have and few doctors have. And so they don't know either, really, the details of that vaccine. But at least collectively. The FDA Vaccine Advisory Committee and the CDC Vaccine Advisory collectively have read those papers. And they will often have experts on that particular subject there. We had the dengue vaccine. Are we going to recommend the dengue?

vaccine for Puerto Rico. So I'm not a dengue vaccine expert. But they brought on dengue vaccine experts, and at least we read all the papers that were associated with that. So collectively, there is that expertise. But that doesn't work. Trust us, we're experts, doesn't work. And so you just have to find another way to be believable by explaining to me, I think, why these things wouldn't make.

I mean, what the arguments are against the vaccine don't make sense. Some arguments against vaccines do make sense. I mean, the argument against the oral polio vaccine made sense, right? John Salomon was a true vaccine safety activist. His son was paralyzed. ultimately died from the oral polio vaccine. Can't we use another vaccine? Maybe the oral polio vaccine should have a black box warning. And people didn't treat him well.

They didn't early on. I mean, he would go to these American Academy of Pediatrics national meetings, and he would be in a corner with his group, informed parents against vaccine-associated paralytic polio, which was a tortured sort of acronym that he had, IPAV.

would have children who were paralyzed by that vaccine and they didn't like him there they didn't they thought he was an anti-vaccine activist but he wasn't he was a vaccine safety activist i mean it was like a scene out of kafka's the hunger artist you know just shoved into a corner and then you know

not treated well, but he should have been elevated, and he was, and he got his way, and ultimately the CDC gave him an award for his activism. Which nowadays, it seems like everyone just puts out their feelings more than... scientific research as to what they think is going on that's the that's the trouble i have these days with parents when they say you know there's a reputable doctor telling me x y and z and you're saying you disagree with him how can i make up my mind

And it's like you're deciding based on who you like more. And you look at people that make statements about the vaccine and worrying about kids getting too many vaccines during childhood. Like that's... Probably the number one concern that parents have when they bring their child in for their two month, four month, six month visits is why are we doing all these at the same time? And my constant answer to them is.

Children are exposed to way more in their daily lives while they're licking the table, while they're sticking their fingers in their mouth, way more particles of bacteria, viruses, et cetera, than whatever we're doing with vaccines. But on a... more scientific level. What exactly is going on that it's perfectly safe? Right. So it's understandable.

Right. I mean, children get in the first few years of life will get vaccines to prevent 14 different diseases, which can mean as many as 27 inoculations in that first few years of life. It can mean as many as five or six inoculations at one time to prevent diseases. Most people don't.

see using biological fluids most people don't understand, that there's pushback on vaccines makes perfect sense. I get it. But in terms of that issue, which makes sense, right? I mean, how can they handle all this? They're getting just firebombed with all of these. Trump said something about like, they give them the immunization the size of a horse. I know he didn't get that right. Sometimes he doesn't get things right. Well, in any case, but if you look.

Just, again, the way I tried to make the argument there, one is what you said, which is that, you know, that you are constantly exposed to...

You have 10 times more bacteria on the surface of your body than you have cells in your body. Going through the birth canal exposes you. Right, exactly right. I mean, if you really want to scare yourself, just take a swab of your nose and put it on a wet mound on a microscope slide. It's teeming with bacteria. And if you were born without an immune system...

severe combined immune deficiency, those bacteria can invade and do permanent harm. So you need an immune system because you're constantly exposed to that. I mean, just... trillions of sort of antigens. But the argument I try and make is that, so 100 years ago, we got one vaccine.

which was the smallpox vaccine. The smallpox is the largest of the mammalian viruses. So it has 200 structural and non-structural proteins. It's a big virus, okay. Now if you add up all the immunological components, 200, 100 years ago. If you add up all the immunological components, components today in vaccines with advances like recombinant DNA technology and protein purification. It comes out to about 150.

So you actually have a lesser challenge to your immune system today in vaccines than you had 100 years ago because of those advances. See, when you see that a child gets, say, You know, vaccines, again, 14 different disease. The number 14 is greater than one. I get that. But what matters is what's in the vaccine. And it's much, much, or it's less.

You don't have a greater chance from vaccines now than you did 100 years ago. And we don't give the smallpox vaccine anymore. That's interesting. What about the idea that... getting a vaccine like the flu shot is often talked about in this way, where it makes your immune system busy so that you become more susceptible to other viruses or a different strain of a virus. Any truth to that?

No. Well, I mean, certainly there are wild-type viruses, natural viruses that can suppress your immune system. Measles can do that. Varicella chickenpox can do that, true, but not the vaccine. The vaccines are too weak to do that. I mean, first of all, influenza is not... I mean, the nasal spray vaccine is a live, very weakened form of the virus.

But meaning during antibody formation, that because your body's pumping out these antibodies, it won't be creating antibodies for other viruses that are circulating. Right, so you make about 10 to the 9th a billion new BNT cells every day. to handle the onslaught that you have every day from coming in contact with the food you eat isn't sterile the dust you inhale isn't sterile you have

trillions of bacteria living on the surface of your body, many of which to which you make an immune response. I mean, you're constantly making immune response. The challenge from vaccines is not just...

figuratively, but I think literally a drop in the ocean of what you encounter and manage every day. But I think people don't understand. I get it. I don't think they should necessarily understand it. So that's our job to try and explain it. But see, the thing you brought up is the thing that is most upsetting to me now. It's probably why I'm talking too fast.

is that, you know, what do you do when really accomplished, intelligent people who have MDs or PhDs or both stand up and say these things? Because historically that has been true for a long time. Yeah, I would love to see, because we talked about on a previous conversation that...

We don't see value in debating with people who are not interested in debating science. They're talking about their feelings, magic, and there's no value in debating that because you say, I believe in it. And then you say, what evidence do you have? And they're like, I believe in it. That's the evidence.

situation like that, I feel like there might be some debate. I don't know what the Florida Surgeon General would say, necessarily, why he believes that mRNA can cause cancer and all these things. I think you probably point to some... studies, observational studies that have shown these turbo cancers, at least that's what I predict he would say. Have you seen any evidence showing that getting the mRNA vaccine speeds up cancers, creates more malignant cancers?

No. And this is Marjorie Taylor Greene's most recent thing. I mean, just in the last couple of days, she said that we need to look into this. There's just this dramatic rise in cancers and it's being caused by this mRNA vaccine because, you know, we're compelled by coincidence. I mean, the mRNA vaccines are designed to prevent.

the COVID vaccines. There's now an mRNA vaccine against RSV, but they're designed to prevent specific diseases. Not everything else that happens in life. And that's what you're up against. Got a vaccine, had a problem. I mean, my wife is a private practicing pediatrician, and she was in on a weekend helping inoculate children, helping the nurse inoculate. And so there was...

a four-month-old sitting on her mother's lap. And while my wife was drawing the vaccine up into the syringe, the four-month-old had a seizure. and went on to have a permanent seizure disorder, epilepsy, and at age five was dead of a chronic neurological condition. If she had given that vaccine five minutes earlier, I think there were no amount of statistical data in the world that would have convinced her of anything other than the vaccine.

Vaccine caused her problem. I'm the mother of a vaccine-damaged child. And you understand the emotion of that. And so you're trying to argue against emotion with statistics, which is hard to do. Yeah. I have patients that come in quite often and they say, doctor, why is my immune system so weak? I get sick all the time. And what they're talking about is they get every few months...

a runny nose, a mild cold. Is your immune system really weak? No, they're doing fine, right? They're staying out of the hospital. That's the goal. I mean, you know, these viruses, like... respiratory syncytial virus, influenza virus, influenza virus, rotavirus. I mean, those are all short incubation period mucosal infections. COVID, another short incubation period mucosal infection. And I think if there's...

One of the worst things we did early on in this COVID pandemic when the vaccine came out in December of 2020 was not explain that. This is a short incubation period disease, which is to say... that you are not going to be protected against mild disease for long. Even if you're naturally infected or vaccinated or both.

Six months later, you're going to be, because antibodies in your circulation will decline and antibodies are critical in protection against mild to moderate disease, you could get this disease again. And we should have explained that. We didn't. And I think we didn't because we were desperate to get people vaccinated.

You know, in 2021, you were 12 times more likely to be hospitalized if you weren't vaccinated, 12 times more likely to die. And we wanted people to get vaccinated. So I think we over promised because people would get the vaccine and it was mandated, which.

made people even angrier. And then they would get a mild or moderate infection, which wasn't easy, right? Fever, headache, I mean, joint pain, coughing. And they were saying, you know, they lied to me. Here, they told me to get this vaccine and I got sick, but you didn't get hospitalized. And that's the goal.

Keep you out of the hospital. Keep you out of the ICU. Keep you out of the work. That's what your immune system's role is. That's it. That's the goal. So what explains the variation from someone who never gets sick during a flu season versus someone who's constantly getting these mild...

upper respiratory symptoms. Yeah, I mean, we're an outbred population, so I think we do, you know, some of us are better than this than others. Flu is interesting, because flu is, the phrase original antigenic sin was... born of flu which was uh thomas francis's work in the late 40s but he said correctly that i can tell you

when you were born, based on how you respond to influenza virus, because you respond as if you were responding to your first one. We now call that imprinting. You sort of imprint to that. And that's a real phenomenon. And it's what makes SLU so hard. Because you're imprinted to that. Is that why I remember once we were coming out of lockdowns, children who were two, three years old were getting their first bouts of RSV and other upper respiratory viruses.

They were much worse that you normally wouldn't see in two or three-year-olds. My theory was that this was a delayed first episode that they would have had otherwise earlier on. And as a result, they were being exposed later. And that's why we're seeing this very timely spike. But it wasn't because they were locked down. It just was a timing issue more than anything else. Exactly. That was an amazing year, though, right? I mean, we...

We shut down schools, we shut down business, we restricted travel. And we eliminated influenza from this country. And we eliminated RS3 from this country. Our hospital is overwhelmed with those viruses starting around September, October, November. We didn't see anything. So this is a way to stop respiratory difficulties.

stop this, shut down the economy entirely and don't have children get educated. And when we do that, it doesn't necessarily make your immune system weaker. That was a big prevailing theory that- sounded like what I was saying because I was saying because of these lockdowns, we had this spike, but it wasn't because our immune systems were weaker. They just were...

underexposed for a period of time and when you get exposure again, it becomes worse. What is it specifically about that first episode that trains your immune system that makes it so much worse the first time you get it? So meaning natural virus, you're exposed to natural virus. So you haven't seen the virus before, so therefore its capacity to replicate, it replicates initially unrestricted until you click in and make...

antibodies that keep the virus from bounding to cells, and you make something called cytotoxic T cells, which once the virus enters the cell, the cell's quickly killed so that it can't reproduce itself. Now you've been exposed once, whether from natural infection or immunization. The next time you see it, your immune response comes much quicker. So to lessen the degree to which the virus reproduced itself. See, this is going to be a hard concept, but stop me if I'm not doing this well.

For long incubation period diseases, like measles, for example, you develop antibodies when you're vaccinated, and you also develop memory cells. memory cells. The good news about measles is a long incubation period disease. So therefore, it takes 7, 10, 14 days for you to get sick. That's plenty of time for activation of those memory cells to become... B cells that make antibodies or T cells that kill virus-infected cells. So you can prevent even mild disease.

So if you can prevent mild disease, then you can prevent transmission, and you can eliminate the disease from the face of this earth. So smallpox is a long incubation for your disease. Because it gives you a longer window for your immune system to kick in and act. That's right, to even prevent mild disease. So you can eliminate measles.

Eliminate smallpox, a long incubation period. You can eliminate rubella, which we did in this country by 2005. You can eliminate polio, which we did in this country by 1979. Those are all long incubation period diseases. But for short incubation period diseases,

You initially make an immune response, which gives you antibodies, which will protect you for four months or so against mild disease. Then the antibodies are gone, right, in your circulation. So now you have memory. But that's not enough time for those because it's a short incubation period.

from the time you're exposed to when you develop symptoms, that's not enough time for those memory cells to become activated and make antibodies, for example, to prevent mild disease. So you're always going to get mild disease again and again. I mean, we'll be living COVID with COVID for the rest of your life and my life and my children's life.

and my two new grandchildren's lives. I mean, so this is going to be around for a while. And I just think we have to get people to understand that you may still get mild disease again and again. The goal is to keep you out of the hospital. That's the goal. Does that incubation period, that window from when the virus enters your body until it starts truly causing symptoms, is that also why certain diseases you get lifelong immunity to?

because the next time your body sees it, you have that antibody response and that you don't see it again? Yeah, so if you're, as a general rule, memory cells are lifelong. So if there was a member study you had done with an isolated island nation that had a measles epidemic, then everybody got it and it faded away. and then that was it wasn't circulating anymore in the community and then like

40 years passed and some sailors from another country came and reintroduced it. And it would again cause disease in younger people who hadn't been exposed to the virus. But all those older people, 40, 50, 60 year old people never got it because they had immunological memory, which tells you. It is very long-lived. Memory cells are long-lived. They remember for a long time. So for long incubation period of diseases, you're protected for the rest of your life. I mean, I'm a child of the 50s.

I had measles, mumps, German measles, chickenpox, because I was born and was a child before any of those vaccines were introduced. I am protected for the rest of my life against those viruses. And... why does that immunity wane sometimes? Like I check titers on some of my patients that let's say get a job at the hospital so they need to get their MMR titers done. Why do in some patients...

that immunity does fade after 40, 50 years. You're testing for antibody, which will fade. But what you really want to be testing for is the frequency of memory B cells or the frequency of memory T cells, which are... research tools. That's not the kind of thing that's easily commercially available. But I think it's possible that if you test me, I'm not gonna have circulating antibodies against measles. But if you test me, I think I will, even at this age, still have memory.

T cells and B cells, which will protect me against those diseases. So is it fair to say that after, let's say, age 45, if we check people, if they still have circulating measles antibodies, they won't? Because I feel like most patients I check are good still. Many won't, though. Oh, really? Many won't, yeah. So they do start to fake. If you apply this to COVID, the current recommendation is that everybody over six months of age should get a COVID vaccine.

But the goal of the vaccine is to keep you out of the hospital, keep you out of the morgue, keep you from dying. So that's the question. Who's getting hospitalized? Who's dying? And if you look, it's really high-risk groups. So people who are over 75, people who have high-risk medical conditions, people who are pregnant, people who are immune-compromised, and anybody who's not vaccinated.

is at risk. And so we should, I think, target those groups. But what you really want to know, and what I'd love to see sort of both the CDC in collaboration with academic immunologists answer this question, which is, Who's getting, I mean, why are some people getting hospitalized? So for over 75, you're at greater risk. You are. So I'd like sort of immunologists to look at the question of.

How long do these memory T cells and B cells last? I mean, do you get to a certain age where they really do start to fade? Because as you get older, your immune system is less capable than when you're younger. And are there certain medical conditions where you don't...

don't have long-lived memory response, because it's really all about memory. I mean, think about it. We have the incidence of hospitalization and deaths is way down from where it was, yet the virus continues to evolve, right? And so that's always evolving, yet.

Those numbers are way down. Why? Because of T-cells. I mean, T-cells really are the main reason why, and we never talk about T-cells, including at our FDA Vaccine Advisory Committee. We never talk about T-cells. We should talk about them more. Yeah, that's funny that they never get the attention they deserve. The idea of certain conditions like mono, people say, I get it once, I shouldn't get it again. But there's a certain subset of my patients that are not immunocompromised.

that get another bout of mono. Why does that happen? Yeah, and that is a longer incubation period disease. I can only imagine that the immunity is incomplete, that when you get it, it's not. you don't, Epstein-Barr virus is a cause of mono, that you don't get a complete immunity. Which can happen sometimes. So mono, Epstein-Barr virus is a herpes virus, a herpes virus group.

Mono can, you know, those kinds of viruses can sort of hang out. Oh, really? Yeah, I mean, certainly varicella hangs out, herpes simplex virus hangs out. Yeah, it's very interesting. In talking about the COVID booster and the COVID vaccine, how it really should be targeting the vulnerable populations, those who are at high risk, it seems like the stance that the CDC and FDA take is...

More so, yes, people who are at risk should be getting it, but also everyone else should get it because at least temporarily will reduce even mild illness, right? Because you can... decrease it in the short term. So during a cold and flu season, you decrease mild illness. Therefore, you decrease transmission of the virus to those vulnerable populations as well. Is that a valid reason to recommend it for everybody? I don't think so. And here's why. I think that if you ask...

So only two countries recommended for everybody over six months of age, us and Canada, but Western Europe doesn't, Australia doesn't, the World Health Organization doesn't. So we're really one of only two countries that do this. If you ask... because I have sort of been...

nationally saying things like, I think we should target high risk groups. And that's meant that I have managed to alienate the few remaining friends I had actually in this business because I wasn't sort of towing the line. And so I saw actually Dr. Fauci recently at a meeting and I said, you know, Tony, Dr. Fauci, am I wrong?

Actually, I've done it for 30 years. Am I wrong? And he said, no, you're not wrong. I think we should target high-risk groups. The question is how best to do that. And he believed, and he may be right, that when you have a... targeted recommendation, that's a nuanced recommendation, and therefore a garbled recommendation, that you're much more likely to get those high-risk groups vaccinated if you recommend it for everybody. The problem I have with that is that...

Well, why do healthy young men need to be vaccinated if they're going to have little benefit? So then the question is, what is the benefit? So if you look at the most recent CDC data from Ruth Link-Gellis, which she presented both to our committee, the FDA committee, and the CDC committee, what she showed is that...

If you have a match to what you were vaccinated with to what you were challenged with, so for example, you got the XBB15 vaccine last year and you were challenged with XBB15, you decrease your chance of hospitalization, assuming you're in a high-risk group. by about 55% for three months. That's what you do. Beyond that, not as much because you've been previously vaccinated. So it's not...

It's not as much. If it's a mismatch, and it's likely to be a mismatch, because if you use the XBB15 from last year, that was very quickly replaced by JN1 by the winter. So you get XBB15, then you get the JN1 challenge. It's about 33%. for three months and then not as great. So this would be easier if it was like flu or RSVM was a winter disease, but it hasn't settled into a winter pattern yet. It's still a year round disease. So when you get it, say October, September, October, November.

you're going to be protected for that winter season, but then you still have the summer where it hasn't still settled into that pattern yet. So I think it's low risk, low reward. I think there's a benefit for those few months. And so therefore it becomes a style question. And I think the risks are low. So I think it's low risk, low reward. And is there any fear of the fact that the vaccine has been out now for less than half a decade?

That maybe we will see after 10 years some new sign pop out and there's going to be another shoe that drops? Or no? That historically has never happened. I mean, when you look at the side effects, severe and occasionally fatal side effects of vaccines, they invariably happen within a few weeks of getting a vaccine. So that's why the FDA enforces the fact that you have to wait till two months after the last dose before they will, you know.

consider approval or licensure. It's always been. The oral polio vaccine is a cause of polio. You would see that really within a few weeks. The measles vaccine is a cause of lowering platelet count, thrombocytopenia, occurs really very quickly. What else? Latex, allergies, or allergies associated with some components of vaccines. But given that this is an mRNA vaccine and it's different than those, is there any potential that this is going to be different? I don't think so. I mean, so...

When you get your mRNA vaccine, that vaccine will then enter your cell and join roughly 200,000 other pieces of mRNA that are making the proteins and enzymes necessary for life. And like all those other pieces of mRNA, it will largely be degraded within a few days.

So it's not like it sort of hangs out forever. What's interesting about this vaccine is this is the most potent immunization I've seen since smallpox. I mean, I had to, because I'm at the Whistler Institute and had to give smallpox vaccines for people who were... These were veterinarians who were taking a smallpox virus, an attenuated smallpox virus that had cloned into it a rabies.

gene that coded for a surface protein. So what they did was they soaked chicken heads with this, then brought it to Paramore Island, sort of off the coast of Virginia, because they wanted to try and eliminate rabies and wildlife there. That, that story. And so I had to give a lot of these guys, these veterinarians, these sort of Ansel Adams flannel shirt type guys, this vaccine. And they all had lymph nodes, they had fever. I think one guy thought.

Clearly, I'll never forget this story because I was still a young person. He had a massive swelling of a lymph node under his arm. He had fever, chills. So I brought him to my boss, Stanley Placken, who's the inventor of the rubella vaccine. I said, should we admit him to the hospital? Does he have this bacterial lymph node infection? And he looked at it and he said, good take.

Yeah. And this vaccine was that, mRNA vaccine also. Well, that's why we've had to sort of shift our mammogram recommendations because we were seeing that as well. I've had some patients, again, could be coincidence, could be not, raise up the issue of ringing in the ears post getting the vaccine. Have you seen that as a side effect? Yeah, so tinnitus. So tinnitus is common, especially in older people. I mean, I have tinnitus. And so the...

It's very easy to make that association. So then the question is, doing the right kinds of studies that answer the question, are you more likely to have TIN, especially because you're immunizing an older population, if you got the vaccine, if you didn't, and it hasn't. even though some prominent people have stepped forward and said this is clearly a side effect. I don't see the data for that as being clearly true. Yeah, my patients come to me at times and they say, I...

had one dose of the vaccine, it really created this bout of tinnitus that was terrible for a few months. My other doctor, my gynecologist, whoever else they're seeing, told me I shouldn't get the next dose. And there's someone who is at risk who would benefit. I don't know what I'm supposed to tell that person. Yeah. So it's always risk benefit. I mean, I think, I guess my, I would think that the, the, if they're in a high risk group, that COVID would be the greatest risk, greater risk.

Yeah, I guess at that point, I'm like patient preference. Here's what we know. There's a lot we don't know. What would you like to do? And ultimately let them be the decision maker for that. Can I ask you a question? This has been bothering me and you're really good at this. So you can ask this question.

It's the question of the value of transparency. Because I lived through this with this COVID vaccine. We always say you want to be transparent. But I think transparency might be overrated. And so I want you to tell me whether or not I'm wrong. When we had the... bivalent vaccine. So this is June of 2022, right? We're deciding what to do.

We had always used the ancestral strain, the original strain, the Wuhan strain. But then Omicron came into this country in December of 2021, which was a different virus. So even if you'd been vaccinated or naturally infected or both, you could still get mild disease. It was just you'd never... been vaccinated or naturally infected. Now you're still relatively protected against severe disease.

but not mild disease. It swept across this country. And the thinking was at the time sensible, which is why are we still giving this ancestral strain? Why don't we try and meet the strains that are currently circulating? And so the decision was, let's give a half a dose of Wuhan and a half a dose of the... one of the Omicron variants, which ended up being something called BA4, BA5. Thus was born the bivalent vaccine introduced in 2022. That vaccine was no better than Wuhan.

It wasn't. The immunological study showed it out of Harvard and Columbia. The clinical study showed it in US, France, and UK. It was no better. It was no worse, but it was no better. Do we tell people that? Because what ended up happening is we certainly didn't. I mean, doctors don't know this. Most people don't know this. I mean, there were two papers published in the New England Journal of Medicine saying...

This was no better. I wrote a perspective piece in New England Journal of Medicine saying, this is no better. And my feeling was, at least stop saying it's better. And we were. People were on national television saying it was better. I had to be on CNN for this. I remember with Ashish Jha, who's great. He's a brilliant guy, really smart. I think he's very good at explaining science and medicine. But he was...

Towing the line, which is we need to get this vaccine because it's better. This includes the Omicron strains. Therefore, those are the strains that are circulating. So it's better. And we've never used a bivalent vaccine again for that reason. Right. And so he was there. So it was Pamela Brown on CNN.

was a clip of Dr. Jha saying, better need to get it. So then she turns to me, I'm remote, but she turns to me and she says, well, was he wrong? See, that's not the question you want to ask, because it's not about him. Also, my hospital doesn't like it when you sort of criticize.

COVID response coordinators from the White House. They're not big on that. So my answer was, you know, it doesn't matter what he says. It doesn't matter what I say. The only thing that matters is what the data show. There's two papers in the Journal of Medicine showing it's not any better. It's not worse. So I think those at Hyrule should get it.

But do you tell people that? Because see, people would argue, see, you weren't transparent. So be transparent. So they say, OK, this was no better. We learned a lesson. And now we're not giving the bivalent vaccine anymore. And so the response is going to be, thank you for being transparent. Now I trust you more. Or it's going to be.

these people don't know what the hell they're doing i think the likelihood is b these people don't know what the hell they're doing but what do you think yeah it's so tricky i think you don't necessarily have to be Putting out all the data and drowning people in data because drowning people in data just creates overwhelming cognitive load Therefore people tune out

And you don't want people tuning out when you want them to tune in. So you give them relatively good data, meaning what they need to know, and you don't flood them with too much information. So if you know that it's no worse. You say, we have the new bivalent vaccine. We're giving the bivalent vaccine. Here's the reasons why we're giving it. You don't have to upsell it. You just make it like you're not marketing a new toy in Toys R Us.

You're telling them what product you have, the reason why you have it, and the reason why they need to get it. That didn't change, right? We still needed people to get vaccinated, the high-risk groups, people who previously weren't vaccinated. They would get the benefit.

And the worst thing that you can do is not be transparent by lying. So if you don't present all the information because you don't want to overload people, that's one thing. But if you start presenting information that's not true, that's debunkable. Now you're allowing the other side of the equation to do something called truth wrapped in a lie, where they point out a flaw when you were supposedly being honest, and the flaw is real.

And now off that flaw, they can build whatever narrative they want. And you don't want to give the truth that can be used to be wrapped in a lie. And I feel like we've done that so many times by over-promising things where it's now becoming too easy to debunk the CDC and FDA. And that should never be the case.

And if you're transparent, you don't need that to happen. There's just a lot of people in this space who are excellent researchers. And these researchers are now being put at the podiums because people think, oh, I want to hear it from the source. You actually don't. When I see the WHO come out and they want to make a statement that a lot of people are going to watch, they send Tedros, the organizer, the leader of the organization. Is that the best person to be making a really nuanced point?

Is he the most captivating speaker that's going to hold attention? Probably not. So you need to find that balance of give the right amount of information without too much cognitive load. In fact, that's what we do on the YouTube channel. When we make a video, there's all these analytics people look at to see what drives the algorithm because everyone talks about the algorithm. And really, there's two things that drive the algorithm. How often people click on a video when it's served to them.

And then how long do they spend watching that video? And the algorithm tries to pair that up. And then when both the click-through rate and the watch time goes up, it serves it to more people. And you can't really control the click-through rate because that's based on topic, seasonality, what the thumbnail title looks like. There's small tweaks you can do. But in general, once you come up with the concept, that's what matters.

But then the watch time, that retention graph that we see every second in our video gives us a lot of information of how people are dealing with information. And over the course of making thousands of videos on social media, I see that if you present too much information, how quickly the retention drops, and therefore you lost your buy-in. And when you lose buy-in with someone who you're trying to educate, you've lost the ability to...

help shape their opinion, to change their mind. And that's what our researchers aren't getting right. I feel like that's the biggest loss that I've seen with the CDC and FDA. Got it. Yeah. Right. Got it. So very dense. But it's something that we just see time and time again from the cognitive overload of let's present more data. And it's like, you just presented so much data. Some of it even untrue and oversold. And that's where it gets me worried. So let me ask you this then. When I was on...

The advisory committee for immunization practice was late 90s, early 2000s. It was sort of the one, two, three hit on vaccines. It was the false concern that measles, mumps, revalid vaccine caused autism, which wasn't true, but we had to vote on that.

We had to vote on whether or not the MMR vaccine should be separated into its three component parts because Dave Weldon was a Republican congressman from Florida who was on the Appropriations Committee. He knew Andrew Wakefield, and he believed that Andrew Wakefield was right, that we could avoid autism by...

separating that vaccine into its three component parts. So instead of children getting three shots or one, two shots, right, because it's a two-shot vaccine, they would get six shots, right, with no benefit. So we voted no, but it told me about the reader, which politics and sort of Trump signed.

And then there was Rotoshield, which was a rotavirus vaccine that was taken off the market because it was a rare cause of intestinal blockage called interception. And then there was Symarisol, right, this ethyl mercury-containing preservative vaccine.

that was where we basically put a gun to our head, even though all the evidence was that this was not a problem. It was an example of how not to communicate a theoretical risk, the way I saw this. But it was frightening, the degree to me, to which...

People weren't communicating the fact that in the case, at least for MMR or thimerosal, that this really wasn't a problem. Scientifically, this wasn't a problem. And the pediatricians were good. I mean, they were out there. Vaccines are good. Vaccine preventable.

are bad but so we formed this vaccine education center for the purpose of getting scientists together to try and learn to communicate the science to the public but see the minute you say that word science you know you've turned people off when when brianna keeler asked me on cnn to explain Why it was that MMR, mRNA vaccines or the.

the DNA fragments that are in that vaccine, because they use the word contamination, not contamination, it's just a part of the process. You're starting with cells, you're gonna end up with fragments of DNA. Why that wouldn't be a problem? You do have to explain the science at some level, I think. Maybe I'm wrong. Maybe you should just say, trust me, all the evidence doesn't support this. There's a way to explain the science where it's not too much, but it's enough.

What politicians do extremely well, which I want physicians and physician leaders and the CDC to learn from, is how well they can manipulate media with that truth wrapped in a lie. I'll give you an example. In this scenario... where you were forced to vote on whether or not MMR needed to be broken up into components. That, even though you guys ruled that it shouldn't be because it was ridiculous. Uniformly. Yeah, the fact...

That that vote happened. Right. Whoever that politician, Dave, what was his name? Weldon. Dave Weldon won. The reason why Dave Weldon won is he has a headline that's titled Advisory Committee Debating. on whether or not MMR should be broken up. You know, you guys weren't debating, but it's a truth wrapped in a lie. You technically had it up for a vote, so he's not lying that you're debating, but he got his headline.

and that's how the world works these days and you have to be very careful about allowing those people to come into the conversation hijack it where if there is reason to have that vote because there's some concern from within the scientific community you should have that vote

But if there's no concern and there's a politician trying to do it to score political points or headlines, I think we have to fight against that. Yeah, and it's not trivial. What happened then, this may be inside-based pollution, if it is, stop me, but... Thimerosal wasn't a problem. I mean, the ethyl mercury, the level contained in vaccines was never harmful. And it was easy to show that. I mean...

Preservative has been used in vaccines since the 1940s. When you have a multi-dose file, if you keep violating the rubber stopper with the syringe and needle, you could inadvertently introduce bacteria. So the person who gets the eighth or ninth or tenth dose could actually be inoculated with bacteria and cause serious problems.

So hence preservatives. And ethyl mercury is actually a very gentle sort of bacteria static agent, meaning keeps it from reproducing. And so you had... And breast milk contains some of this. First of all, assuming you live on this planet...

pretty much everybody, and you're going to be exposed to methylmercury. And methylmercury has a much longer half-life. Methylmercury is in anything made from water, including breast milk and infant formula, at far greater levels than you're ever going to get from this. Ethylmercury, which has a much shorter half-life, is actually not a natural problem. It's a synthetic product. So you go through all that. I mean, there was no sense in trying to take that out of vaccines. But nonetheless...

Mercury sounds bad, right? It's not like there's a National Center for the Appreciation of Heavy Metal standing up in defense of mercury. So therefore, we did. We put a gun to the public health service. I was never for this, but put a gun to the public, to the head of the pharmaceutical companies and said, take it. out. So all we did was made

Multi-dose vials into single-dose vials made vaccines much more expensive and made it more difficult for the developing world to get the vaccines that we needed. Waste, environment problems. Awful, right? The other thing that happened was when Rotoshield came up, which was a rare cause of intussusception, right?

which can be a serious illness, and the attributable risk was like 1 in 10,000, 1 in 30,000. And it's why we don't do a catch-up. It's why we don't do? A catch-up for the rotavirus vaccine. The catch-up schedule because of the worry of interception. Is that true? Not really. So there's two vaccines, Rix, which is given as two-dose vaccine, two and four months, and then two, four, and six for Rotatech. But then there's a...

there's a period after which you no longer can give it if a child never got the initial series because of the fear of interception. Oh, I see what you're saying. So now you're at month eight, month nine. So the concern was that natural interception occurred well before there ever was a rotavirus vaccine. primarily a disease around five, six, seven, you start to see it peak then. So the fear was, I was actually on this committee, is that-

The fear was that you would give a vaccine at a time when interception was becoming more common. So that people would make that association. That was why. Though you're right, yeah, that's why. But that... you were still five to 10 times more likely to die of rotavirus in this country, you know, where 60 children die of rotavirus, than ever from the rotavirus vaccine. So I tried to make a case for RotaShield. I mean, the vaccine we developed at CHOP was... wrote an attack, but that we shouldn't.

kill it here because the benefits still outweigh the risks. But that vaccine was sacrificed because we didn't vote to separate MMR into its proponent parts, and we pushed back very hard on thimerosal as a problem. We did, and so it looked like we didn't care.

So here, by basically taking Rotate Shield off the market, it looked like we cared. And what ended up happening was, here's a virus that kills 2,000 children a day in the world. It was seven years until the next vaccine came out. And four months later, the World Health Organization wanted to still keep this vaccine alive.

because 2,000 children die a day. And I went to that meeting in Geneva in 2000, and country after country stood up. Countries like, you know, in Southeast Asia or South America said, look, if it's not safe for...

for America's children, it's not safe for our children, even though the benefit-risk ratio was very different in countries where you'd have 2,000 children dying, you know, a day from this virus. And I just felt that we... that we sacrificed Rotashield and thus, I mean, 2,000 children dying a day for seven years till that next vaccine came out was an example of us trying to look like we cared and did more harm.

Far more harm than good. Look how often, even in this conversation, we've done that. We did that with the thimerosal, where we started making the vaccines more expensive, more waste. Cut our laboratories overreaction. We actually created... vaccine-caused polio with the oral vaccine. We're talking about it now with rotavirus. We have to be able to stand up to the people that are challenging us unfairly.

And I feel like that's part of that communication equation of not being afraid to say this doesn't make sense. And at the same time, correcting ourselves when we do make the mistake. So we have to own both ends of the equation. Stand up when it doesn't make sense to separate the MMR vaccine or take thimerosal out.

Because ultimately it doesn't win you anything. All it looks like is a win to them for making that change. The same way with the truth wrapped in a lie where people say, oh, this is a hormone disruptor. This is a hormone disruptor. And they point to some animal study or petri dish where substance X, whatever we're talking about at a given moment, act as a hormone disruptor. And they believe all natural is better.

But all you have to do is pull up any Endocrine Society press release and see that tea tree oil, lavender essential oil are also hormone disruptors in petri dishes. And yet those people still love them. But it's showing that hypocrisy and highlighting the honesty of it, I think, is what creates long-lasting buy-in. Because short term, you can create a lot of distrust very easily by doing the truth wrapped in a lie.

But if you highlight that strategy of someone's trying to get us to vote to separate MMR. when there's no value doing it, and actually it's going to create all these other problems, and you communicate that, I think the audience will have buy-in into that, long-term. Short-term, maybe not as great buy-in as Dr. Fauci says when you send a garbled message. But I think you create that long-lasting trust. Okay. The other thing I think that was hard in all this was...

understanding risk or relative risk because that's what it was. I mean, that vaccine was a cause of interception, but it was rare. Probably what was interesting about that when it all, when the dust settled on this whole thing was that, um, There were high use states and low use states. This was late 90s, 1998 to 1999. There were states that used a lot of rotor shield and then states that didn't. So the answer to the question was the incidence of interception greater.

in the high-risk states and the low-risk states, which you would have assumed was true, but it wasn't. And the reason is that rotavirus, natural infection, also was a rare cause of intussusception. So it was basically a wash. And now that we have much more data on this, it was a wash because the vaccine both caused and prevented an exception at roughly the same rate. So it was sort of the same thing. So basically you took this off the market and...

deprived not only this country's children, but the world's children of something that was highly, I mean, rotavirus, the problem with rotavirus is it's a vomiting illness, vomiting and diarrhea and fever, so you have three sources of water loss, but you vomit in that, so you can't rehydrate it.

with oral rehydration therapy, which is what the World Health Organization pushed unsuccessfully. So it's a rapid dehydrating illness. And there's nothing you can do other than bring the child to the hospital, give them IV fluids, which is less.

quickly done in the developing world, which is why the death rate was so high. And it just was hard to watch that Geneva meeting when sort of person after person stood up and said, it's not safe for Americans children, it's not safe for Americans because it's a matter of risk. So now I'm on the committee, right? I'm on the ACIP. And we were charged with what is an...

Unacceptable risk, because now you have this attributive risk of one in 10 to one in 30,000, one in 50,000, one in 100,000, one in a million. And it's an unanswerable question, because I think people, when you tell people that the risk is.

one in 50,000 or one in 100,000. All they hear is the one, right? So you're saying it's possible. It could be me. I mean, that's how people got in trouble going on television and saying things like, of course we have to reopen schools. So what? Some children will get sick and die.

that's not the way you do communication about a subject like that. You can't say, like, first of all, if you say that, that shows you have a disregard for life. But if you say it the way you just presented it, where it's unfathomable to even lose one child. But I'm not faced with that decision. I'm making a decision between losing one or 10. And that's how I'm going to have to decide this. That.

will put the image in the person's head of, okay, I understand the decision-making process, versus I can either do nothing and no one dies, or one dies. Yeah, right. And so when I made that presentation, the Advisory Committee for Immunization Practice was trying to save. wrote a shield. I said, here's a theoretical million children.

got the vaccine, didn't get the vaccine. You're 10 times more likely to die in this country if you didn't get the vaccine. But the way that this was heard was, it's sort of the sin of omission versus the sin of commission. The dying from getting the vaccine. is perceived as much worse than dying from just the wild-type natural virus because it's something you're doing, something we're doing, right? And so it's perceived as worse, I think. I wonder why that is.

Maybe because it's like, I brought this on myself. It was a choice that I made. You would think when people take ownership and make a decision, they would feel better about it that they're in charge. But in some cases, it kind of works the other way, where they feel like they brought the illness upon themselves.

Interesting how we can work backwards. When you give ownership, sometimes it makes it worse. You know, one thing I did want to talk about in these advisory committees, how often does corruption play a role? I don't think it plays a role at all. Because people oftentimes say pharmaceutical companies, they're corrupt, they're doing shady things on the back end and manipulating data. Have you ever seen any instances of this? No. First of all,

It wouldn't serve you well in the vaccine world to manipulate data because you will soon be found out. I mean, and I wish this was available on the drug side. It's not. It's the vaccine safety data link. The minute a vaccine comes out, you know that there are hundreds of thousands of children who get it.

it and don't get it. And so if there's a problem, you very quickly will find it out, as was true with rota shield and interception. That was true with the mRNA vaccines and myocarditis, as was true with Johnson & Johnson's vaccine. And these are rare side effects. I mean, the Johnson & Johnson was one in 200,000.

still fairly quickly picked up. There's no hiding. So if you're misrepresenting data, first of all, and you were ever found out to misrepresent data, you are screwed. I mean, the FDA, if you don't like... what the FDA decides. There's only one person you can go to above them. That's God. I mean, the FDA is it. Don't upset the FDA. So no, I mean, so on those committees, you have to.

show that you have no relationship to a pharmaceutical company, no relationship with the government. You're an independent advisory committee. I think those discussions are generally...

Really good. I think people are trying to get it right. They don't always get it right, but I think they're trying. So lobbyists don't play a role in this situation whatsoever. Not with those committees. I didn't see it. I've never seen it. But ultimately, the advisory committee is going to make their recommendation whether the FDA...

follows through on it and whether the government enacts it, that's a different story, right? Well, so the FDA has to license a product and then it goes to the CDC to decide whether or not to recommend it. So sometimes they'll license something that isn't necessarily recommended. Why does that happen?

Well, so the Lyme vaccine would be an example of that. So late 90s, early 2000s with the Lyme vaccine. So that was a licensed product, but it got a very soft recommendation from the CDC, which was that it could be considered. use, basically. Normally when it's recommended, it should, is the word they use when it's recommended. When they give it a very soft recommendation, it could be considered for use for people who live in high-risk areas.

bacteria circulating and, and engage in high risk activities like walking outside in the summer, you know, that would be a high risk activity. So I just, I don't, I thought that that vaccine was sort of killed with a soft recommendation. Fair. What's, what do you think? about the idea of mandating vaccines, whether it's school mandated vaccines, healthcare worker mandated vaccines, or how we had even with the COVID-19 vaccination protocol.

In a better world, you wouldn't need to mandate vaccines. People would be fully informed. I mean, I would argue that in December of 2020, having read those 800 pages on the Pfizer-Moderna vaccine, I was a fully informed citizen. One of the few. Could not wait to get that vaccine. So in the better world, people would get the right kind of information, the correct information.

scientific information and make the right decision. But we don't live in that world. So people are making a decision not to do that. I can tell you, I think if we did not have school vaccine mandates, you would start to see what you're seeing. The CDC recently put out data showing that there's clearly been an erosion in school vaccine mandates. people choosing non-medical exemptions, philosophical, religious exemptions. So you're going from like 95% to 93%, 92%. And with that,

What are you saying? You're saying that we've gone from 50 cases of measles last year to 200 this year. We have had more than 200 deaths from flu in children this year, which is very high. You've had an almost five-fold increase in whooping cough. We went from 3,000 cases last year to 17,000 this year. If you look back in the 70s, we've had school mandates for decades.

decades and decades, but they weren't really enforced early on until the 70s. In the 70s, what happened is you had massive outbreaks, Detroit, Alaska, Los Angeles. And with that, they enforced school mandates and the instance of measles went way down and we eliminated measles. by the year 2000. But it's these non-medical exemptions that people choose. And I think...

With COVID mandates, there was such a backlash to that that people are seeing vaccines as sort of, and vaccine mandates is a dirty word. And so measles is coming back. So you're seeing more than 200 cases of measles this year. Get to 1,000 cases. virus that has a mortality rate of 0.1% and you're going to start to see children dying of measles again in this country. It is unconscionable. And I wish we didn't have to have mandates. I wish we didn't have to have school mandates.

To me, I think the issue that the school mandates specifically solve is there's a lot of parents who are not against getting vaccines, but they may be busy, they're single parents, they have three jobs, and they just don't know or they forgot. It helps sort that out, which is a huge percentage that I think most people don't realize that mandates actually end up helping those kids a lot.

because they just otherwise would have went unchecked, not because they're against getting it, just because they never saw a doctor or they were busy, what have you. Right, no, here's a perfect story for that. I remember in the first year of COVID when the vaccine came out in December 2020, so this was like 2021.

There was a, and the vaccines were also available for children by May, children over 12. So we were seeing adolescents who were coming in severe respiratory disease. And we saw one child who came into the, initially on the floor, but then ultimately went up to the intensive care unit.

lived, but he was really sick. So I remember talking to, there were two other siblings who were old enough to have gotten the vaccine. The mother wasn't vaccinated, the two siblings weren't vaccinated, and the father was in the room, and I asked him whether he was vaccinated. He said, yeah, I had to for work.

Just kind of like this, you know, I just had to. Yeah, and that's the constant answer. And I don't think those people are against it. They're just like, oh, it's part of my protocol. Same thing with colleges as well. What about... The field of longevity. How do you view that right now? I'm probably not the best person to answer that question. But more of a personal side. Well, that's why from like a personal take, when you hear a lot of people talk about longevity and...

Some of the best-selling books right now are about longevity, outlive, you know, those types of books. Any interest on your side about this topic? Do you view it with skepticism, cynicism? No, I just haven't really followed it. I mean, I'm... willing to accept that I'm not immortal because every story should have an end and who the hell wants to be immortal, so. Got it. What about the supplementation world? I know you've written about the magic that people believe in when they take supplements.

how certain supplements in higher doses can actually cause harm. Any feelings on that? You know, I think it's basically an unregulated industry that's able to make claims, vague claims that are convincing. And I wish... I wish the word natural were applied more reasonably. I mean, at least from the infectious disease standpoint, Mother Nature has been trying to kill us ever since we crawled out of the ocean onto land. The term natural immunity has always bothered me, actually. Why?

Well, because it's fine as long as you live. I mean, I think actually if you get a COVID vaccine, you will have an immune response to that protein. the spike protein. If you're infected with COVID and you live, you'll have an immune response to all four proteins, including nuclear protein, which is a major site for cytotoxic T cell responses. Great, that's all great. You have to live. So I think we should call it survivor immunity.

I just think that's the better term. Okay, that is a better term. And is one better than the other? Like vaccine-mediated immunity versus survivor immunity? They're both excellent. But I really do think that if you've gotten a vaccine and you get a natural infection, you live. you're actually better off. So getting both. Yeah, because you've had now this immune response to all four proteins. And doesn't it feel like at this point in time,

everyone in the United States has either been exposed to the virus and or vaccinated? That's why the rates of hospitalization and death are so low. They are much, much lower than before. Why, despite the virus mutating and constantly changing, new variants, et cetera, our immune system is still able to deal with it? T-cells. T cells. Cytotoxic T cells are clearly correlated with protection against severe disease. And T cells, unlike B cells, because B cells are recognizing that...

part of the spike protein, the so-called receptor binding domain, which is the business end of the spike protein that binds the cells. That's always evolving. That's always mutating away from recognition by antibodies to some extent. And T cells are not selective in that way.

Conserve regions. I mean, those regions recognized by T-cells have not evolved from the Wuhan 1 strain right up to the current XCC strain. They've remained conserved. And so T-cells is... Dan Baruch, who's a Harvard... immunologist says t-cells are the unsung hero of this pandemic and i think that's right wow um for the wild virus that first started in 2020 Was there anything unique about that virus that was circulating then?

that made it so virulent or was it because we just never were exposed to it at that time and our T-cells weren't ready for it? We were a blank slate. There was no population immunity to this virus. And I think you can assume this isn't the end of it. We had SARS. one in 2002. We have MERS in 2012. Those are both pandemic coronaviruses that didn't really hit this country, but certainly could have.

And now we have this virus, SARS-CoV-2, which raised its head in 2019. That's three pandemic viruses in 20 years. I mean, as we do things like deforestation, we live closer and closer to animals, especially bats, which are a fairly large part of the mammalian population.

We are going to have another pandemic. And the thing that upsets me the most about this, we were talking about this a little earlier, is two-thirds of the American public believe this was a lab leak. And this was not a lab leak. This was an animal to spillover event. to human spillover event that occurred in the southwestern section of the Hunan Wholesale Seafood Market. There are two excellent publications that show clear evidence that that...

Actually, there were two separate strains, two separate lineages that both began there, either among bamboo rats or palm civets or raccoon dogs, because all the DNA from there and the genetic evidence is all... Right there. It's on the cages. It's on the...

tools that were used to brush the animals or kill the animals. It's on the tables that were there. It's all there. One paper called it stall A. Another one called it like stall 42 or something. But it was that stall where it started. Because otherwise you have to believe. One that's something that's never happened before, which is that a pandemic virus was created in a laboratory. We've had a lot of pandemics.

This has never happened before. Two, it had to happen in the Wuhan Institute of Virology, which is where people sang it happened. And then, so they created it. And then they just happened to go right to a place where you would have expected an animal to human spillover event to occur.

instead of the 10,000 other places they could have gone in Wuhan to do this. And it had to be two people because it was two separate lineages, and they had to both go to that spot. The animal to human spillover events occur all the time. Ebola is a bad virus. HIV is a chimp virus. Flu is a bird virus. I mean, probably 70% of the pathogens that cause our disease came from animals. Why is it so surprising this one also came from animals? So we need to know that. I mean, this matters.

because China is culpable that they were selling at least 31 different species of animals illegally. They were housing them in unhygienic conditions. They were bringing them from all over China. That's why, and that's probably where that SARS-CoV-2 originally came from. It didn't come from right there. It came from many kilometers away. And I just think it's going to happen again.

China was xenophobic. They didn't want outside investigators to come in, which I think gave rise to a lot of these conspiracies. But you have serious citizens getting up in front of Congress saying, like Christopher Wray.

the you know the fdi fbi saying this is credible evidence come on where's the evidence i mean if you're going to say something happened that never happened before you should have some evidence rather this is the carl siegen line right that extraordinary claims should be backed by extraordinary

evidence. This is an extraordinary claim backed by innuendo and conspiracy. And what they did also, sorry, one last thing. They killed all the animals. China killed all the animals. They didn't do that with SARS-1. With SARS-1, which happened in, I think, Foshan and then spread out.

They didn't kill the animals. They let them continue to sow. So they were still there, and you could see that they were the ones that were infected. And an animal in those markets will have like 50 human contacts a day. Michael Warby, Chris Anderson, Eddie Holmes, and Marion Groupmans, all the evolutionary biologists who really should be the ones testifying in front of Congress, not people who are head of the FBI or people who are surgeons at Hopkins to do that. Sure.

What can we do to decrease these animal spillover events where viruses go from animals to humans? Right. So those kinds of wet markets have to be really much better supervised and make it so that they're tested. First of all, there's always animal-to-human spillover events. I mean, if you look, for example, in China, if you look in rural China, where people are going to be exposed to bats, what percentage of them will have antibodies to bat viruses? About...

2.5%, 1 in 40. So that happens all the time. It's not a rare event. But if you look in urban areas where they're not exposed to bats, it's 0%. So know that. Know that these are where these viruses are coming from. And just be really careful about screening these animals when they come in and having them under hygienic conditions. And don't sell the illegal ones.

What makes those animals illegal? I don't know. There are certain protected animals. Oh, so it's an endangered species thing, more than a virus issue. I'm not sure it's endangered. It's just that you're not allowed to sell them for whatever reason. Oh, interesting. And they sell them anyway. Okay. I mean, China was culpable here, I think. And also, you had to depend on a whistleblower.

blower to tell you that there was a virus that was circulating that was killing thousands of people? Really? He ultimately died, this ophthalmologist. He's a hero, but shouldn't have had to come to that. What's the current stance on long COVID right now? Have we learned anything new since we last spoke? I think it's more than one thing, long COVID. I mean, I think there are clearly...

physiological explanations, you know, whether it's clotting or continued viral replication that explains to some extent. And I think there's a psychological component to long COVID, the same reason for that you have long flu. for people who are hospitalized for any length of time with flu. Also, they can have longer-term symptoms. I mean, I can say from the vaccine side that vaccines do decrease the risk of long COVID. There was one study in Italy that was probably the best study where they...

And this is their definition of long COVID. But they looked at people who got COVID. And then they had the instance of long COVID was like 42%. Then they looked at people who got one dose of vaccine and then got COVID. And the instance of long COVID went from 42% to 30%. And they looked at people who got two doses of vaccine, then got COVID. And the incidence of long COVID went from 30% to 17%.

What was their definition of long COVID? 42% of people were getting it. I know. It was loose. I mean, it was sort of persistent. Was it like neurologic symptoms like myalgias or something? And even looser symptoms. Oh, okay. Headaches or something. Brain fog. And then they looked at...

three doses and then got COVID and went from like 70% to 16%. So there was a couple other studies showing that there may have been a value for the third dose. For the people who are getting like their sixth and seventh and eighth dose because they think that's... lessening long COVID. Although if they have that little Pfizer loyalty card and you get your Tento, so I think you get free pizza or something like that. All right. So where is the next pandemic coming from?

I think it's coming from Southeast Asia, and it's going to be another coronavirus pandemic. I think that it's only getting worse. What is it about coronavirus that makes it so pandemic-y? I think it's bat virus. It's bats, which represent like 13% of the million population.

as we deforest we're getting closer and closer to them that's it and the other H5 is a fear you know the bird flu is a fear but that That's never been a pandemic because it doesn't – we're discussing this at our FDA vaccine advisory committees, H5, and they're discussing it at CDC advisory committees too, but it's –

There are flu pandemics, which occur several times a century, two or three times a century. And it's always H1, H2, or H3. It's never been H5 or H7, H9. And the reason is that those viruses have never learned. the H5 and H7 viruses and H9 have never learned to bind to cells in our upper respiratory tract. To shed.

Yeah, so they can bind in the lower respiratory tract. So if you get enough virus down into your lower respiratory tract, you can get pneumonia and die. I mean, the mortality rate with H5 virus is like 50%. It's not trivial. And we've had almost 1,000 cases over the last 20 years or so.

But until that virus learns to reproduce, normally the way it works is the virus reproduces itself in the upper respiratory tract, it amplifies, then it goes down to the lower respiratory tract, then it causes pneumonia. So if it doesn't replicate well in the upper respiratory tract, you're not going to shed the virus particularly well.

and you're not going to have human-to-human transfer, and therefore it's not going to be a pandemic. And they have to also not be as sick, which is what made COVID-19 so problematic, that you had people who were asymptomatic going around spreading. Right, and that's what made it so frightening. Anybody could kill you when you're walking down the street. Which is why I always talk about things that seem rather insidious and maybe not as bad.

on paper, lethality-wise, but can be even more devastating big picture-wise. Right, well, that's why SARS-1 and MERS were never a problem. Exactly. Because when you got that, you were really sick. There really wasn't asymptomatic. Isolation and death basically followed. All right. Well, where would you like to push people? Obviously, You Bet Your Life, many other books. What else? Where do you want people to listen? I guess I just want people to have... Are you still doing the Substack?

Oh, yeah, I do. I haven't done it in a couple weeks, but yeah, Beyond the Noise, it's called. It's fun. It gives me a chance to get out the angst. If Donald Trump's elected president, I'm going to do it three times a week. Okay, maybe you can get on his commission. doing some of the press conferences. I'm exactly the kind of person he wants, and I can tell. He likes when people disagree with him. He likes the argument. Yeah, that's him. He's so introspective that way. So circumspect.

You were saying something before I interrupted you. No, I think I just, I guess the goal of my books in some ways is to get people to have a realistic expectation of what medicine and science can and can't do. And I'm not sure they do. I think they expect more. And maybe it's because we try and sell it.

as being more than it is yeah i think it's it's uh it's the truth of we need to be able to say i don't know a lot more often and just sit in that uncomfortableness of saying i don't know right but um thank you Appreciate your work. Keep up the great work, as always. Appreciate it.

This is actually the third time I've had Dr. Offit on the show, and I'm always so grateful for his knowledge and experience, and most importantly, honesty. He's seriously such a rock star in the medical community. Another one of my favorite guests I've had on the channel multiple times is Jonathan Haidt. who has some very strong opinions about social media use for children.

that I don't always agree with, scroll on back through our library of episodes and download that one right now. I think you'll really like our conversation. If you enjoyed this episode, please don't hesitate to give us a five-star review, potentially leave a comment as it's the best. way for us to find new viewers and as always stay happy and healthy.