Your Biggest Vaccine Questions with Dr. Richard Besser

what to expect every step of the way. To say the vaccines are a hot button topic is an understatement In a time when vaccine misinformation on social media spreads faster than a virus in a pandemic, it's understandably harder for parents to sort science fact from science fiction, or not to feel shamed or blamed by others in the

online community as they do their information gathering. Today, we're giving you the facts about vaccines, from how they work to why they're so important and pregnancy and for your baby. No game, no blame, no judging, no spin, nothing but the facts. I'm so excited to welcome one of the best people to have this conversation with. Dr Richard Besser's the former acting director for the CDC under the Obama administration. He's been a chief medical correspondent for ABC News and

is currently President of the Robert Wood Johnson Foundation. And he's a pediatrician who is passionate about making the world a safer, healthier place to live for all our children. Thank you so much for being here today, Dr Besser. One of the many things you said that spoke to me was about the role of the pediatrician as translator, taking complicated medical topics and turning them into plane language that parents can relate to. Do you want to tell

us a little bit about why that's important. Yeah, I did more than seven hundred views last year, and I've never had that question. That's that's a that's a great one, but it's it really speaks to um to kind of my approach to health and what I really enjoy. I'm a general pediatrician and normally I see kids a half day a week, and what I really love about the experience is how much I learned from the families that

that I'm with. And I do see my role as a pediatrician as translating complex information helping people make more informed decisions about their lives. And what I learned in pediatrics was that you need to treat people with respect and that you, as a healthcare provider, have a specialized language of jargon that may be good for talking to other people in healthcare, but it puts up an immediate

barrier to your patients. And it is recognizing as well that when people are frightened, when people are scared as they are during a pan emoic or when they're child sick, their ability to take in complex information goes down dramatically, And so you have to repeat, you have to simplify still with that that air of respect, and you have to check back in and say that makes sense. Did

you understand what I was saying there? Yeah? Absolutely. Another premise that I always start with is knowledge is power. It's especially powerful when you're pregnant, you have a new baby, you're a new parent, and what you don't know can actually hurt you or hurt your child, and also can make you suspicious. So of course they're going to be worried about a vaccine. How would you come them down and explain that vaccines in fact, do not hurt an

unborn baby. It's natural to worry about an unborn baby a life that's developing, And so one of the things scientists look at is there any concern about this vaccine doing any harm? And if they see any signal of that, then that's it. It's It's not something that would be given to someone who is pregnant, and so by the time of vaccine is recommended or approved, you can feel comfortable that you are not doing harm to your baby, but you're in fact helping to protect them by protecting

yourself and your baby from a potentially dangerous infection. So, you know, it's one thing to say to our parent, vaccines work, But how do they work? Can you give the simple science behind that vaccines are pretty miraculous? Before vaccines, I mean, many of the most families experienced the loss of children because they're infectious diseases that are so dangerous

and deadly to kids. Vaccines, you know, at out of the simplest level, they fool your body into thinking that you've been infected with a virus or back bacteria, a germ that could cause disease, and they cause your immune system to react like it's seeing that bad virus, are that that bacteria, But it's not. It's not seeing something that's harmful to you. But your body is saying, oh wow, I'm seeing whooping off. The immune system kicks into gear

to fight it off. And what that does is it means that if you ever see the real thing, So the real whooping cough bacteria, or catanus or I mean rotavirus. Are so many vaccines now that prevent against serious infections. Then when your body sees that, the immune system is ready and it fights it off like it's seen it before and it knows what to do, and that is I think absolutely incredible. You know, they're all different ways that it's done. You know, there are different approaches, and

even now with COVID. Right now we have vaccines that are either in trial or on the market that use three different mechanisms, three different approaches to fooling your immune system. So what kind of research goes into making a vaccine these days? So the process for making vaccines usually takes any many years early research first to say how can you fool the immune system into thinking it's being attacked

by a particular agent. And then okay, if that's the way you're gonna fold the immune system, is that safe? Is that a safe way to do it? And so when there is what's called a candidate vaccine, something that scientists think, yeah, we think this will fold the immune system and we think, well, we know what will be saved. Then it's tested in a small number of people to look to see early on, well how much of it

we have to give. That's called a dosing study. And then the next level of studies looks to see, okay, in maybe several hundred people, is it safe or we're seeing reactions or side effects, you know, sore arms or fevers or anything that we need to be concerned about um and then it moves on to bigger trials. And these the trials all tend to start in adults, and then it's looks to say, okay, does it protect from the illness that we wanted to protect from? Then how

long does the protection last? Those studies can take years to do, often because the infection that you're trying to protect against while out there isn't common enough that you can do those kind of studies quickly in order to see if it protects from a certain infection, that infection has to be out about that can take time to do. And then once a vaccine is found to be safe and effective in adults, then they'll look in younger and younger populations. This is what's going on with COVID safe

and adults. Now their studies being done, is it safe in teens? And then as a queens? And then younger than that younger down. You know, occasionally for diseases that only occur in children, where the risk of those diseases it's really really severe, you'll do some initial safety studies indults,

but then you'll go to your trials right away. When I was in training to be a pediatrician, UM there was something called h flu or havoflos influenza and UM it would cause a very very serious form of meningitis. And I remember in my train seeing kids who died from that, children who had brain damage or lost their hearing,

had various of your illness. And then I remember, I think it was in the last year my training that a vaccine came out and it was miraculous because all of a sudden we weren't seeing this horrible, horrible disease. It was so devastating to children and their families. It was gone. And when you've seen that progression from something that just causes so much devastation to all of a

sudden it's gone, it's amazing. And when you work in countries that don't have as a robust of vaccine program and you see diseases that have been pretty much wiped out in the United states, it's just an eye opener to the power of vaccination to to really change the prospects of cod We're in a pandemic like any other public health emergency. This led to a drop in vaccination

rates and by the way, in maternal healthcare. By November of routine childhood vaccines have fallen by as much as twenty and parents are also afraid to bring their kids in for routine appointments. And another reason beyond that, of course, is the vaccine skepticism, which I think has been fueled not only by the Internet. I mean, vaccine skepticism has always been around since they were vaccines, but it's kind of reached a fever pitch, and the Internet has accelerated

the anti science fiction. And also, you know, maybe the speedy development of the COVID nineteen vaccine. People are like, well, it should take time and this isn't possible. What are your thoughts about this and what concerns you most about these dropping vaccination rates. Well, when it comes to COVID vaccine, I think it's important to recognize that most people want to get vaccinated. There are some people who have concerns who don't want to get vaccinated. And I wouldn't lump

all those people together. And the reason for that is that, you know, even when it comes to childhood humanizations, where you know plus percent of children get get fully vaccinated, there's a hardcore group of people there who are anti vaccine, anti science, who will never, no matter what you say, willingly let their children get vaccinated and won't get vaccines themselves.

But there are also some people who say, you know what, I understand that these vaccines are really effective, and I understand that they were reviewed and approved by the Food Drug Administration, and I understand COVID's bad, but I also understand that they were approved based on two months of safety data, and I kind of like to wait until they've been in some more people, and people perception of risk will vary, and it's important to respect that and

and not say to someone who's a little hesitant today that it's here's your one chance, and it's done. I think it's people know more and more of their friends and family members who have been vaccinated, they're gonna want

to get vaccinated. And we're seeing that. We're seeing the numbers go up in terms of people wanting wanting vaccine, and part of that is also you know, now that it's been given to more than twenty million people, that's different than the trials where it's tens of thousands of people, and the CDC and FDA are doing follow up look and see are there any side effects that we're not picked up In the smaller studies, they've been able to share data on severe allergic reactions to show how really

rare they are and how easily managed they are to get vaccinated in the clinic setting. When it comes to COVID vaccine, I think the numbers are going to continue to go up and up, and I think some of that has to do with how the vaccines last year.

We're talked about the phrase work speed. Well, it's good for rockets, it's good for for really high speed trains, but in terms of making people feel comfortable that all of the safety steps were taken the terms of little challenging it's absolutely miraculous that we have safe and effective vaccines this quickly, you know, within a year of a new virus being discovered, that is that's never happened before, and that's absolutely incredible, But you need to recognize that

with that kind of speed comes some some sense of woe was just too fast, and there wasn't I think, enough attention to the full story that scientists have been working on what are called m RNA vaccines for more than a decade and so it's all of that science that was done over decades that allowed them to create within a year this this vaccine. So it wasn't as

speedy as it seemed. It was really speedy from from day of discovery to the development, but the science that led them to be able to do that, it took place over a long period of time. What what gives me comfort in this whole process is, you know, I watched the review committee for FDA UH and I listened to their deliberations, and I read the materials that FDA posted, and I believe that the vaccines that are have been approved for emergencies are safe and effective. I can't wait

until I get called and I can get vaccinated. My parents, who are you know, both over ninety, have both been vaccinated. But I also recognized that some people want to see a little bit more data. And in particular, although the majority of Black Americans want to get vaccinated, the rates of hesitancy and concern are higher, and I think a lot of that reflects you disrespect from the healthcare system, historical experimentation on people of color by our health care

system and the public health system. I think it also can be addressed by ensuring that people are hearing from people they trust and in different communities, trusted voices will vary. So at our foundation, Robert Johnson Foundation, we're supporting a lot of outreach work so that people can hear from

trusted voices in their communities. I think it's going to be the kind of the same kind of efforts that are used for get out the vote will will be effective here hearing from people they know and they trust. You know that effective grassroots connection is going to I think, build the desire for more people to effect them. So I do want to ask so many moms on what

to expect. Of course, the questions are coming in so that I get the COVID nineteen vaccine when it's offered, If it's offered, and I know that a lot of health care professionals who are pregnant have already received it, and in some states it's being offered in a higher order of priority. But there are of as a lot of concerns from pregnant women. Is it safe now? Of course, the infection itself has been shown not to be particularly

safe for pregnant women, especially those with comorbidities. If you have just saial diabetes or if you have hypertension, that puts you a greater risk if you're a mom of color. So I know that the medical community has had you know who came out with certain recommendation, CDC came out with others, And basically the bottom line is always talked to your doctor, which is what I would say, But

what would you say? I think you've hit the critical points is that you're balancing risks here, and that's really important because it's human nature to put more value on the risk from something that you intentionally do. So, you know, we see that with children's vaccinations as well. So I know somebody who had this incredible allergic action to a vaccine that was so severe. Wow, yeah, you know, that's

that kind happen. But it's so incredibly rare. The disease that it's preventing killed thousands of children each year, you know, So it's it's balancing those risks here. With COVID, we are learning that there is some increased risk for pregnant women when you need to balance I think, and in talking with your doctor, because this is one of those personal decisions that you have to make, is what is

your risk of exposure? So you know, if you're someone who is working in a setting where you're more likely to be exposed, whether it's in healthcare or you know, food production or transportation or anything where you're out and about and you're pregnant, you have a real risk of being exposed and getting COVID, you know, in that setting. I think that personally, if it were my family member,

I would say, yeah, I would recommend getting vaccinated. Their studies being done, but there's theoretically there's nothing that we would see with this vaccine that would make us think ahead of time that it could pose an increase risk to someone who is pregnant. If, on the other hand, you are at home, you are not out at all, and your risk is really really low, You're you're not exposed to very many people, and you may say, well, now you know what, I'm not going to get vaccinated.

Of course, I have to ask will trials be done on pregnant women or is this just always like an extrapolation My understanding is that companies are doing trials in in pregnancy. And the reason for that is that you know, this pandemic is widespread, it's rampant, uh, and we know that there is increased risk during pregnancy. And so you know, given you've got a vaccine that has a terrific safety profile,

very safe, then you're gonna want to do that. You know, it's not hear to me how they're gonna do those studies because you don't want to withhold vaccine. It may be historical data so that they'll vaccinate and they'll be able to compare people who got vaccinated now to those who didn't before. There are some pregnant women who were

in the initials trials right became pregnant. Yeah, And it may be that across the numbers of trials there are enough women who got pregnant during the trial that they'll be able to answer to answer that question that way too. It again, it's the balance for women who have who have a particular medical condition that can be life threatening, the balance between stopping your medication or your treatment and potential risks. Both you know, have the benefits and potential risks.

But one of the things that we're learning though, which I think is really interesting, is that just like with other vaccines, the flu shot, moms pass on protective factors to their babies, which is so amazing. I think that's such an incredibly important point, and you are protecting that

very vulnerable newborn baby. I wanted to ask you about the t DApp because I get questions about that all the time, and of course I give the recommendation that you should get it with every pregnancy, so even if you've had it before, even if you had a booster before, and dad's got to get in and grandma's gotta get it,

everybody's got to get it. The flu vaccine is another vaccine that every pregnant woman should get, and that again is not only to protect her baby, but because even more so, as far as we know then with COVID influences really dangerous potentially for pregnant women and they're more risk for hospitalization. Yeah, now, those are those are all

key points. I remember when I was at ABC News doing a story on a mom on a family that lost their newborn to whooping cough and she hadn't been offered yeah during pregnancy, and you know, she had other kids. They're not sure you know how whooping toff got into the into the home, But to lose a child to something that's preventable, it was devastating. And she's gone on now to become a real advocate around this issue. That's the ap THET. Yeah, that can be a really severe

infection in really young kids. And we start vaccinating about two months, so in a really early period's the only protection that the baby has is from their mom. Absolutely. Now, of course we can't talk to you your pediatrician, without

talking about childhood vaccines. I think we've already established why they're so safe, because they've gone through so many years of testing and there's so much data, and yet these miss persist, and these concerns persist again understandably because you want to keep your baby safe, and there are so many vaccines headed your baby's way in that first year and beyond, and it seems, oh, isn't it going to

overwhelm their immune system? All of this it can be really hard to tell the difference out there between what's good science and what someone's opinion and what is just false is a hoax, And so you see all this information. I mean, I remember as a new parent. It was a long time ago. Our oldest is twenty six. I remember with the first shot that he got feeling really nervous, and it's like, oh my, you know, feeling good because we're doing it, but also it's like, well, we're giving

a shot. We're doing something, and whenever you're doing something, you always have in this mind, well, wow, you know, I know that this is the right thing to do. I just hope it's that everything goes really well, and that's a natural feeling to to have. I think it's so important for parents to have trusted sources of information. I think that having a healthcare provider who you trust, who you can ask anything to, can be really really valuable.

And knowing what sources of information online are trusted, are good science can be really really valuable, and it can help you avoid some of the noise it's out there. Because there's so much noise, it can be overwhelming. And when there's that much information coming out at you, a lot of people's reactions we are I'm just gonna wait. Can't take it all in, so I'm just gonna wait. And a waiting itself can be a dangerous thing for

a little baby. Exactly, and so a lot of parents are like, oh, well, maybe I'll just you know, have a few here, a few there, but not lump them all together, like delay the schedule a little bit. What do you say to parents who are concerned about so many thoughts at one appointment or in one year. You know, our mutism are amazing, They're incredible. We are barraged all day long, all night long by germs that are around us.

They're on our skin, they're on our nose, they're they're on our dogs and our cats, and they're everywhere, they're on surfaces, and our immune systems react to those constantly. So getting a dozen more exposures to different things over those those first months is not in any way, shape or form going to overwhelm your immune system. Part of the testing that's done with vaccines, they're looking to see which vaccines can you give together? Are there any that

you can't give together at the same time? There are, and so doctors don't administer those at the same time. But the goal and pediatrics is to protect children as quickly as possible for things that they may face early in life, and so that's why you do them. And I'm always really nervous about measles. And it's not because we give it so young. It's because we can't give

it younger. You know, around hew measles is the big killer of children, But we don't give it to children until they're one year old because your immune system is developing constantly, and won't we act enough to give you the right level of protection until about a year. But if we had a measles vaccine that could work, you know, right at birth, I'd be all for me too. And I just want to share a personal story. My grandson, Lennox, who's about to turn eight, was three weeks old when

he was hospitalized with SEPs us. It was a staff infection that it had started at his umbilical site. Super super rare, new parents out there, but it happened and he was hospitalized. During that time. He was exposed to measles three weeks, way too young to be vaccinated. They gave him some immunoquobulin as precaution, but it was terrifying. And that's that's my cautionary tale. If it could happen to my grandson, it could happen to your child, It

could happen to someone else's child. Do you love right, Yeah, My recommendation is vaccinate your child fully and on time. It doesn't overwhelm the immune system. It means that your child is protected as soon as they possibly can be, and haven't forbid your child where to get something where you belate. So that's the approach I I take. It's

the way to go. There's no science to show that there's benefit to a child of spacing vaccines out beyond what the current recommended schedule is, and all I see with that is a longer period before a child is it's fully protected. And you know, we vaccinated to protect our own children, but also to protect those who can't be vaccinated or those who don't get a good immuniverse US.

So we talk about vaccines being really terrific. They are, but not everybody who gets the vaccine will be fully protected. Right now, when we're talking about COVID, the two vaccines, the fisor MODERNA, that are available in the United States are about protective. So that basically says that five out of a hundred people who are who get vaccinated will still be at risk. But if everyone around them is fully vaccinated, the chances that they're gonna get COVID go

way way, way, way down. We have a new hashtag be heard as an h g r D right, part of the herd that protects your community, all the little ones in your community, all the elderly in your community who are most vulnerable. Yeah, that's right. Thank you so much for joining us today and for helping alleviate the fears and make us feel really really good about rolling up our sleeves and rolling up well our babies pant legs. Yes, you know it's it's a quick cry and then you're

done exactly for them. Oh yeah, thank you so much. I really appreciate it. It's a pleasure, really nice to talk with you. Who baby below, my baby below? I need you, Oh how I need you. Thanks for listening. Remember I'm always here for you. What to Expect is always here for you. We're all in this together. For more on what you heard on today's episode, visit what to Expect dot com slash podcasts. You can also check out what to Expect when You're Expecting, What to Expect

the First Year, and the what to Expect app. And we want to hear from you. Connect with us on our community message board or on our social media You can find me at Heidi Murkoff and Emma at Emma Being wt E and of course at What to Expect. Baby Love is performed by Riley Peter. What to Expect is a production of I Heart Radio. From more shows from I Heart Radio check out the I Heart Radio app, Apple podcast, or wherever you listen to your favorite shows.

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