Speaker 1: I am one of the increasingly rare old timers who
Speaker 1: lived during the pre vaccination era. I am the second
Speaker 1: to the last of thirteen siblings, five of whom died
Speaker 1: of vaccine preventable diseases in infancy, born to poor immigrant parents.
Speaker 1: I remember well my mother's account of the causes of
Speaker 1: their deaths, three from pertussis and two from measles. Even
Speaker 1: after many years had passed, she spoke of the death
Speaker 1: of her angels with a great deal of emotion. Imagine
Speaker 1: losing not one, two, three, or four, but five babies.
Speaker 1: It was common in the pre vaccine era. Like our family,
Speaker 1: many families lost several children to these diseases. We forget
Speaker 1: time blurs are memories of these common tragedies of yesteryear.
Speaker 1: I remember well, during the winter and spring of each year,
Speaker 1: hearing the whoop of pertussis in movie theaters, school assemblies,
Speaker 1: and assorted gatherings. Today have ever heard this, and those
Speaker 1: who have forget. I remember the summer outbreaks of polio,
Speaker 1: the crippled children who could no longer walk, or walked
Speaker 1: with limb distorted limps. As a third and fourth year
Speaker 1: medical student, I remember answering the appeals of hospital administrators
Speaker 1: who could not find the nursing staff for special duty
Speaker 1: tending to the needs of polio patients in iron lungs.
Speaker 2: We forget.
Speaker 1: I remember the awful cases of measles my own children experienced.
Speaker 1: I remember the children with smallpox during the years my
Speaker 1: family lived in Pakistan. I remember those who lost their
Speaker 1: sight from lesions in their eyes. I remember those who died.
Speaker 1: We forget. It's just such an incredibly powerful letter.
Speaker 3: Yes, this is, I mean, this is the second time
Speaker 3: that we have included this first hand account. The first
Speaker 3: time was in our one of our vaccines episodes back
Speaker 3: in eighteen.
Speaker 4: Yeah, and it is.
Speaker 3: It has stuck with me so much, shame same because
Speaker 3: it is such a powerful personal story of what we
Speaker 3: have gained and what we stand to loose.
Speaker 2: Right actly.
Speaker 1: This was a letter from EJ. Gene Gangorosa to the
Speaker 1: Immunization Action Coalition.
Speaker 4: Uh.
Speaker 1: They were a professor emeritus from Emory University and wrote
Speaker 1: that letter all the way back in the year two thousand.
Speaker 4: Yeah, and it's still so relevant today.
Speaker 1: It is and such just an important piece of sort
Speaker 1: of that like living memory that that we do we
Speaker 1: forget yep.
Speaker 3: Yeah, and we have to we have to remember.
Speaker 4: Yeah, Hi, I'm.
Speaker 2: Aaron Welsh and I'm Erin Allman Updyke.
Speaker 3: And this is this podcast will kill you.
Speaker 1: It sure is, and we're the second part as our best.
Speaker 3: Yes. Yeah, So last week we took you through just
Speaker 3: a refresher course on vaccines, how they worked, and then
Speaker 3: we did a very quick tour through each of the diseases,
Speaker 3: the many diseases that these vaccines protect us from.
Speaker 2: We call it quick.
Speaker 4: We called it quick. Yep.
Speaker 3: We closed out that episode with a big picture of
Speaker 3: view of why vaccination is so very important, not just
Speaker 3: at the individual level, not just for yourself, for your kids,
Speaker 3: but also to protect our communities. Vaccines are truly one
Speaker 3: of science's greatest achievements, and as our firsthand just demonstrated,
Speaker 3: there are increasingly fewer of us who know what it's
Speaker 3: like to live in a world without vaccines. And the
Speaker 3: amazing thing is that we don't have to.
Speaker 1: Write we have these incredible vaccines, and even better, we
Speaker 1: have highly knowledgeable, well trained scientists who consider all the
Speaker 1: aspects of the data that we have to tell us
Speaker 1: which vaccines we should take and win.
Speaker 2: That's right, everyone, Today we're talking about the ACIP.
Speaker 1: Yes, Advisory Committee on Immanization Practices here in the US YEP.
Speaker 3: In this episode today, we're going to talk so much
Speaker 3: more about the ACIP.
Speaker 4: We're going to talk about.
Speaker 3: How we came to have our childhood vaccine schedule that
Speaker 3: we do have today, what goes in to making it,
Speaker 3: and where things stand with vaccine preventable illness around the
Speaker 3: world today, Because despite the existence of safe and effective vaccines,
Speaker 3: we are still seeing outbreaks of diseases like measles, like
Speaker 3: whooping cough, like rebella, diseases that can seriously injure or
Speaker 3: even kill those who get it.
Speaker 1: Yeah, a lot of these outbreaks are happening in regions
Speaker 1: of the world that lack access to vaccines or lack
Speaker 1: the infrastructure to deliver vaccines to everybody who needs them.
Speaker 1: And undoubtedly we'll be seeing more and more of these
Speaker 1: outbreaks and preventable death and suffering due to the attacks
Speaker 1: and dismantling of USAID, which is a huge problem. But
Speaker 1: some of these outbreaks, especially in high income countries like
Speaker 1: the US, are directly attributable to the rise in vaccine
Speaker 1: hesitancy and declining vaccination coverage.
Speaker 3: Vaccine hesitancy is one of the biggest threats to global health,
Speaker 3: and it's not something that's just going to go away
Speaker 3: on its own. It needs to be directly addressed in
Speaker 3: every possible way, at every possible level. And in this regard,
Speaker 3: all of us can truly make a difference. And so
Speaker 3: we really can. And that's what we want to round
Speaker 3: out this episode with. It's just going through some evidence
Speaker 3: based methods. We love evidence still, evidence based things for
Speaker 3: having conversations with those who might be wary of vaccines.
Speaker 4: We've got a lot to go through. So should we
Speaker 4: start with quanquarantine time?
Speaker 2: We should?
Speaker 4: What are we drinking this week? We're still drinking Boosted.
Speaker 2: We are still drinking getting in those booster shots.
Speaker 3: Yeah it is. It's delicious. It's got gin and raspberries
Speaker 3: and lemonade. And we'll post the full recipe for Boosted
Speaker 3: the Quarantine as well as our alcohol free plas sy
Speaker 3: Barrita on our website This Podcast will Kill You dot Com,
Speaker 3: as well as on all of our social media channels,
Speaker 3: so make sure you're following us.
Speaker 1: Make sure you are and on our website This Podcast
Speaker 1: will Kill You dot Com, you can find just so
Speaker 1: many incredible things that you'd love to find we've got
Speaker 1: merch We've got transcripts from all of our episodes. We've
Speaker 1: got a link to a Goodreads account and a bookshop
Speaker 1: dot org affiliate account. We've got our music from Bloodmobile.
Speaker 1: We've got sources for evidence from all of our episodes,
Speaker 1: including this one.
Speaker 4: So many sources.
Speaker 1: We've got to contact us form. We've got a first
Speaker 1: hand account form if you'd like to submit your first
Speaker 1: hand account. Just so much there there, There's a lot,
Speaker 1: there really is, And if you haven't already, we would
Speaker 1: love to encourage you to rate, review, and subscribe so
Speaker 1: that you don't miss any of our things. And because
Speaker 1: it does really help us when other people can find
Speaker 1: our work.
Speaker 2: We like taking this podcast.
Speaker 4: It does. We appreciate it. Uh, are we ready?
Speaker 2: I think so?
Speaker 1: Should I take a quick break? And then Aaron walk
Speaker 1: us through the history of the ACP.
Speaker 4: I'm really excited I did.
Speaker 2: To learn about this. Oh.
Speaker 3: I really had a really fun time digging into the details.
Speaker 3: So yeah, let's just take a quick break so we
Speaker 3: can get right to it. Okay, what goes into creating
Speaker 3: a vaccine schedule? Like why do we have the one
Speaker 3: that we do here in the US, and who decides that.
Speaker 2: Such a good question, right.
Speaker 3: Vaccine schedules are different in different countries, and they take
Speaker 3: into account things like how prevalent a certain diseases and
Speaker 3: how much of a threat it poses, and so that
Speaker 3: explains why some of high risk countries use the BCG
Speaker 3: vaccine for tuberculosis, for instance, and others might not use
Speaker 3: that vaccine or include it in routine immunizations. In the US,
Speaker 3: the federal body that makes decisions about which vaccines to recommend,
Speaker 3: at what ages, and how many doses is the Advisory
Speaker 3: Committee on Ammunisation Practices the ACIP. This committee is made
Speaker 3: of up to nineteen voting members who vote on vaccine recommendations,
Speaker 3: and they include independent medical and public health experts who
Speaker 3: do not work at the CDC, as well as one
Speaker 3: consumer representative. This is a volunteer position and members serve
Speaker 3: staggered four year terms. Prospective members have to apply and
Speaker 3: then they have to undergo the screening process that includes
Speaker 3: things like disclosing conflicts of interest and this is like
Speaker 3: routinely done and maintained that's fairly important. Ultimately, they are
Speaker 3: selected by the Secretary of Health and Human Services, who
Speaker 3: at the time of recording is RFK junior, who, as
Speaker 3: probably most people are aware, has a long and vocal
Speaker 3: history promoting anti vaccine propaganda, including during a measle's outbreak
Speaker 3: in Samoa that led to the deaths of ai eighty
Speaker 3: three children, mostly under the age of five.
Speaker 1: Yep, and they he ultimately is going to be choosing
Speaker 1: who sits on ACIP.
Speaker 3: Yeah, and so I will say that, like there are
Speaker 3: there are a certain number of people right now whose
Speaker 3: terms will be up, and so it might not be
Speaker 3: I mean unless ACIP gets completely dismantled.
Speaker 4: Whole right, can of worms arn questions.
Speaker 3: As to like how much damage can someone do who
Speaker 3: has mal intent?
Speaker 1: I would hope that there are stop gaps in place.
Speaker 1: But tell me more, Aaron.
Speaker 4: Yes, yes, Okay.
Speaker 3: So the ACIP Charter, which allows for its continued functioning,
Speaker 3: has to be renewed and approved every two years by
Speaker 3: the Department of Health and Human Services.
Speaker 2: Okay, Okay.
Speaker 3: Currently there are fifteen members active members on this committee,
Speaker 3: with four whose terms are up.
Speaker 4: In twenty twenty five.
Speaker 3: Okay, okay, So in theory, in twenty twenty five he
Speaker 3: could replace four people.
Speaker 2: Okay.
Speaker 3: There are other non voting members of this committee who
Speaker 3: represent other federal institutions such as the Centers for Medicare
Speaker 3: and Medicaid Services and the Indian Health Service, as well
Speaker 3: as organizations like the American Academy of Pediatrics and the
Speaker 3: National Foundation for Infectious Diseases and many others.
Speaker 1: Yeah.
Speaker 3: Yeah, ACIP meets three times a year, three times a year.
Speaker 1: Three times a year. Yeah, more than I anticipated.
Speaker 4: I know. It is. It's it's a lot.
Speaker 3: They're constantly viewing data and voting on recommendations. Like this
Speaker 3: is a con because things happen. Things have moved very
Speaker 3: quickly in medicine.
Speaker 2: Yeah.
Speaker 1: Well, and it's so low at the same time, exactly.
Speaker 4: Yeah, but like to keep up to date.
Speaker 3: This is not just like oh, let's you know, dust
Speaker 3: off the piles of data. It's like constant regilance.
Speaker 2: Okay, awesome.
Speaker 4: Yeah.
Speaker 3: So there was a meeting scheduled for February twenty six
Speaker 3: to twenty eighth of this year, and it was postponed.
Speaker 3: Ok And there has been, as of the time of recording,
Speaker 3: no updated meeting date. And maybe maybe it will get rescheduled,
Speaker 3: maybe it won't, but you should know that if it
Speaker 3: does get rescheduled, and if any one of the subsequent
Speaker 3: meetings do take place that I want everyone to know
Speaker 3: that there are opportunities, at least at this point in time,
Speaker 3: to submit public comments, Okay, and.
Speaker 4: Like, well we can do we can.
Speaker 3: Yes, We'll link to the page that has more info
Speaker 3: on this. But in the past, the public was able
Speaker 3: to submit a written comment and request to make an
Speaker 3: oral public comment during the meeting. So there are written
Speaker 3: comments that you can make, and you could also request
Speaker 3: to make an oral comment during the meeting itself.
Speaker 2: Awesome, right, So.
Speaker 3: This is an opportunity for all of us to demonstrate
Speaker 3: how much vaccines mean to us, right writing, our health,
Speaker 3: our safety, our freedom.
Speaker 1: We love them, Thank you love them, Please take them
Speaker 1: most yeap.
Speaker 3: If the February meeting does not get rescheduled, there will
Speaker 3: be another one, maybe, I guess June twenty sixth, June
Speaker 3: twenty fifth, twenty six Okay, okay, So what is what
Speaker 3: is the ACIP looking for precisely during these meetings?
Speaker 4: Right? What do they do?
Speaker 1: Right?
Speaker 3: So, broadly speaking, they consider quote, disease epidemiology and burden
Speaker 3: of disease, vaccine efficacy and effectiveness, vaccine safety, economic analyzes,
Speaker 3: and implementation issues. Okay, so a whole lot of different
Speaker 3: things like all.
Speaker 1: Of the different thing picture that you could think of
Speaker 1: when it comes to vaccines, the disease itself, how good
Speaker 1: the vaccines works, the economics of it all makes sense.
Speaker 3: Yeah, yeah, And so this is what they are looking at.
Speaker 3: These are the types of questions that they're looking at. Now,
Speaker 3: what are they voting on? Right, So they are voting
Speaker 3: on They vote on final recommendations. Right at the end
Speaker 3: of this are recommendations and they include quote, the number
Speaker 3: of doses of each vaccine, timing between each dose, the
Speaker 3: age when infants and children should receive the vaccine, and
Speaker 3: precautions and contraindications.
Speaker 4: So who should not.
Speaker 3: Receive the vact scene Okay, that's what they vote on.
Speaker 3: And these are just recommendations, recommendations. It is then the
Speaker 3: CDC who has to decide whether or not they adopt
Speaker 3: the recommendations from ACIP right, right. And then there's also
Speaker 3: like the American Academy of Pediatrics also decides what to incorporate.
Speaker 4: It's like there are a lot of the thing is
Speaker 4: this is.
Speaker 3: A constant conversation, right that is going on, and there
Speaker 3: is one shared goal, which is to how.
Speaker 2: To best ensure the health of the public.
Speaker 3: The public that's that is the goal public health. How
Speaker 3: about that.
Speaker 2: That's the goal.
Speaker 4: So the acip is not a new committee.
Speaker 3: It was first organized in nineteen sixty four, and at
Speaker 3: the time of its first meeting, the only organization that
Speaker 3: was making recommendations on vaccines in the US was the
Speaker 3: American Academy of Pediatrics Committee on Infectious Diseases, and their
Speaker 3: recommendations were included in a publication called the Red Book,
Speaker 3: which you I know, you know the Red Book. Many
Speaker 3: people out there may have heard of it and still
Speaker 3: exists to It's a really important resource for physicians as
Speaker 3: well as the icip Like these, these recommendations that are
Speaker 3: included in the Red Book are also considered by the ACIPKA.
Speaker 3: At the time of the first Red Book, which was
Speaker 3: nineteen thirty eight, the included recommendations were fairly limited. Part
Speaker 3: of the reason for this was because there were far
Speaker 3: fewer vaccines available than there are today. So the only
Speaker 3: ones that they officially recommended in terms of the timing
Speaker 3: for when a child should receive them were smallpox. Of course,
Speaker 3: before it was eradicated. Diphtheria tetanus pertussis also known as
Speaker 3: whooping cough, typhoid fever vericella and tuberculosis. Okay, so I
Speaker 3: mean compare that to what we went through yesterday. We
Speaker 3: have lot and so so many more. I just don't
Speaker 3: We don't include typhoid fever regularly, or smallpox obviously, or
Speaker 3: smallpox of course.
Speaker 4: Yeah.
Speaker 1: It's so interesting too, though, that they had versella back then,
Speaker 1: because then we didn't have it for so long.
Speaker 2: It's just so interesting.
Speaker 3: I have so many questions, I know, and we may
Speaker 3: have even touched on that in our veracell.
Speaker 2: We probably did, you know, I don't remember things same.
Speaker 3: But then the introduction of the polio vaccine in nineteen
Speaker 3: fifty three the prompted passage of the Polio Vaccination Act
Speaker 3: a couple of years later, and then this provided funds
Speaker 3: to what was then the Communicable Diseases Center later became
Speaker 3: known as the CDC, and this helped states buy and
Speaker 3: distribute polio vaccines. But there was still no formal process
Speaker 3: for the federal government to make recommendations for vaccines and
Speaker 3: the timing of vaccinations at a national level. Vaccines were
Speaker 3: recommended for licensing at the federal level, like by the
Speaker 3: Surgeon General. They would say, okay, yes, this, we recommend
Speaker 3: this for licensing prove but mostly the government was focused
Speaker 3: on vaccines only as far as the military was concerned,
Speaker 3: got it tracking efficacy and outbreaks and so on. So
Speaker 3: it was like that is where the data collection was,
Speaker 3: That's where the decision making was.
Speaker 4: That was the main intro.
Speaker 1: That makes sense, It makes your protecting assets in that case.
Speaker 3: Sorry, and I think especially the timing close to World
Speaker 3: War two and then Korea. Yeah, so there was like
Speaker 3: a lot of that. Yeah, there was context for that.
Speaker 3: But then the polio vaccine was came out in nineteen
Speaker 3: fifty two, nineteen fifty three, and then the Musles vaccine
Speaker 3: ten years later in nineteen sixty three. It was clear
Speaker 3: that there was a need for a national immunization policy,
Speaker 3: especially with two more vaccines MOMPS and rubella on the
Speaker 3: horizon for the rest of the nineteen sixties, Like they
Speaker 3: were like clearly, you know, there was most something. It was, yeah,
Speaker 3: these things were going to happen. Yeah, And so things
Speaker 3: really got started with the Vaccination Assistance Act in nineteen
Speaker 3: sixty two, and this provided support for mass vaccination campaigns,
Speaker 3: especially targeting school aged children, which is where most of
Speaker 3: the spread and harm from these diseases was concentrated, and
Speaker 3: ultimately it led to the formation of the ACI in
Speaker 3: nineteen sixty four. So like, instead of having one meeting
Speaker 3: for measles and one meeting for polio and one meeting
Speaker 3: for this, it.
Speaker 2: Was like, why don't we just do them all at once?
Speaker 4: Do this all at once?
Speaker 2: Yeah?
Speaker 4: Efficiency? How about that?
Speaker 2: I can't.
Speaker 4: I'm sorry.
Speaker 1: I was going to make like a government efficiency joke,
Speaker 1: but I because it's too real, too close.
Speaker 4: Yeah, yeah, I know.
Speaker 3: At the first meeting, the committee considered measles, influenza, rubella,
Speaker 3: and smallpox vaccines for recommendation. I think there was still
Speaker 3: at this point a separate committee for polio. Okay, But
Speaker 3: since the beginning, the ACIP has worked closely with professional
Speaker 3: organizations like the American Academy of Pediatrics, the American Academy
Speaker 3: of Family Physicians, the American College of Ctatricians and Gynecologists,
Speaker 3: and others. Together, the ACIP and all of these organizations,
Speaker 3: both federal and professional, carefully evaluate all of the available
Speaker 3: data to make recommendations on how to best protect the
Speaker 3: health of Americans.
Speaker 1: Yeah.
Speaker 4: Again, that is the goal.
Speaker 2: That is the goal.
Speaker 4: That is the goal.
Speaker 3: So what does this look like in practice and I
Speaker 3: want to share a real life example of how one
Speaker 3: of these recommendations is made and what information is considered
Speaker 3: when weighing whether or not to change a recommendation.
Speaker 4: Okay, so let's talk about measles.
Speaker 2: It is timely. Yeah, unfortunately timely topic.
Speaker 3: So since the introduction of the first measles vaccine in
Speaker 3: nineteen sixty three, researchers have developed new versions of the vaccine,
Speaker 3: each of which has been and continues to be evaluated
Speaker 3: for safety, efficacy, ease of administration, and so on. So
Speaker 3: like live versus killed with or without certain adjuvants in
Speaker 3: a combo shot or solo, the timing for the best
Speaker 3: immune stimulation, like all those sorts of things are considered
Speaker 3: for each of these vaccines regularly, continuously, and on occasion,
Speaker 3: the ACIP has changed their recommendation for which measles vaccine
Speaker 3: to include, such as in nineteen sixty eight when they
Speaker 3: changed the recommendation from the less attenuated vaccine, which was
Speaker 3: the Edmonston B strain, to one that was based on
Speaker 3: a more attenuated strain, the Moratin vaccine. The Moratin vaccine,
Speaker 3: the more attenuated strain, was as effective as the previous vaccine,
Speaker 3: but it produced fewer side effects, right.
Speaker 1: So it was like an even weaker version of a
Speaker 1: measles virus compared to an older vaccine, but it protected
Speaker 1: you just as well, had fewer side effects, so that.
Speaker 3: They also revisited what age to give the vaccine. So
Speaker 3: initially their recommendation was nine months of age, and then
Speaker 3: that changed to twelve months and then fifteen months. And
Speaker 3: the reason for these changes was not about safety, but
Speaker 3: more about efficacy because researchers had found that babies that
Speaker 3: were vaccinated earlier tended to lose immunity a bit more
Speaker 3: than if they were vaccinated later. It's probably due to
Speaker 3: maternal antibodies circulating.
Speaker 1: Yeah, or just like you know, babies in their weird
Speaker 1: immune systems.
Speaker 4: Right exactly.
Speaker 3: These are things that they that they will look at monitoring.
Speaker 3: They were looking out for, yeah.
Speaker 1: Because of basic scientific research that was going on in
Speaker 1: clinical research that's going on where people are actually like
Speaker 1: testing people who get these vaccines for their antibody response,
Speaker 1: for example, and then collecting and gathering off that data.
Speaker 3: And connecting that to epidemiological research that was monitoring outbreaks
Speaker 3: and in what ages and what birth cohorts and all
Speaker 3: of these different Yeah, all of these different things.
Speaker 4: All of this amazing research.
Speaker 3: Yep, yes, yeah, okay, okay, But starting in nineteen sixty three,
Speaker 3: the ACIP had recommended only one dose of the measles vaccine,
Speaker 3: or later a few years later, when mumps and rubella
Speaker 3: came along MMRKA, they had recommended one dose, just one dose.
Speaker 3: And this is of course different from the two shot
Speaker 3: series that we get today that we discussed last week.
Speaker 3: How did one shot become to outbreaks? Within the first
Speaker 3: five years of the measles vaccine, incidents of the infection
Speaker 3: had dropped to five percent of pre vaccine levels within
Speaker 3: five years, within five wow years.
Speaker 4: Yeah.
Speaker 3: With this incredible success, measles elimination in North America seemed like.
Speaker 4: A very achievable goal.
Speaker 3: Yeah, yep, I mean like really, like first it was
Speaker 3: like a pipe dream, and that it was like, oh wait, actually.
Speaker 4: Wow, we couldn't do this thing, reasonable dream? Yeah okay.
Speaker 4: And even as progress towards this goal.
Speaker 3: Was made, a few outbreaks in the late nineteen seventies
Speaker 3: and into the nineteen eighties slowed that progress, but they
Speaker 3: also provided an opportunity to ask how was measles spreading?
Speaker 1: Right?
Speaker 3: Who was getting the infection. Was it teenagers, was it
Speaker 3: young kids? Had they been vaccinated before? And what the
Speaker 3: CDC found was that those who were involved in the
Speaker 3: outbreaks were often either unvaccinated children under five years old
Speaker 3: or older children such as high school and college student
Speaker 3: who had been vaccinated but only once, only with one dose.
Speaker 3: And that was again the recommendation at the time, and
Speaker 3: there had been some debate about whether to include a
Speaker 3: second dose. This was, you know, kind of brought up
Speaker 3: at different meetings, and it was this trade off, this weighing,
Speaker 3: well what are we actually getting with that second dose
Speaker 3: of the vaccine, And up until this point, up until
Speaker 3: the late well nineteen eighty the late nineteen eighties, really
Speaker 3: the decision seemed to fall on, well, one dose is
Speaker 3: probably enough. One dose protects you, Like I think you
Speaker 3: said erin last week, three ninety three percent, Do we
Speaker 3: really need that extra four to five percent? Turns out,
Speaker 3: what these outbreaks showed us is that yes, we do,
Speaker 3: especially when having that extra four to five percent protects
Speaker 3: those who are vulnerable who cannot be vaccinated.
Speaker 4: Right.
Speaker 3: And so there was an outbreak in nineteen eighty nine
Speaker 3: that led to a twenty percent hospitalization.
Speaker 2: Rate, which is what we pretty common.
Speaker 3: I've seen I've seen today and one hundred deaths. And
Speaker 3: this really demonstrated that waning immunity or under vaccination could
Speaker 3: have dire consequences for those who are too young to
Speaker 3: be vaccinated. So in nineteen eighty nine, both the ACIP
Speaker 3: and the AAP the American Academy of Pediatrics changed their
Speaker 3: recommendation to include two doses of MMR for all children,
Speaker 3: and that decision is what helped to eliminate measles entirely
Speaker 3: from the US in two thousand, yeah, and the Western
Speaker 3: hemisphere in twenty sixteen.
Speaker 1: I mean, yeah, that's so interesting too, just in the
Speaker 1: context of like the biology of measles, right, because you
Speaker 1: need such high vaccination coverage to be able to achieve
Speaker 1: herd immunity and protect everyone around you. So it makes
Speaker 1: sense that a second dose, where now you're getting ninety
Speaker 1: seven percent efficacy in like lifelong at a bodies, that
Speaker 1: that is what's going to allow you to achieve herd
Speaker 1: immunity rather than a ninety three percent. And yeah, how
Speaker 1: interesting and cool, Aaron.
Speaker 3: It was such an enlightening like exercise to go through,
Speaker 3: like what does this look like? We know that they're
Speaker 3: making decisions. We know that they're considering all of these
Speaker 3: different things, but like, how does new data influence a recommendation?
Speaker 1: Yeah, like walking an example of that, it was yeah, yeah,
Speaker 1: because it's something we don't think about. We're just like, oh,
Speaker 1: here's the schedule.
Speaker 2: And you're like okay, but like what who and why
Speaker 2: and how did you come up?
Speaker 1: Why do we need four doses of tea DAP and
Speaker 1: then a booster and because that's what the data says
Speaker 1: we need.
Speaker 3: What that's I mean, evidence based, evidence based medicine.
Speaker 2: Is that interesting?
Speaker 4: Which? Yeah?
Speaker 2: I mean?
Speaker 1: And then they change their recommendations on adults getting like
Speaker 1: a pretess's booster a tea DAP rather than just a
Speaker 1: TD a few years back because of circulating protessis I
Speaker 1: mean science?
Speaker 4: Science changes by design? It doesn't. It's like right, like
Speaker 4: this is part of what.
Speaker 3: Science is, Why why science works is because we evaluate
Speaker 3: and consider.
Speaker 1: And consider and then change recommendations.
Speaker 3: And chased on that on that these are not arbitrary decisions.
Speaker 3: Like that's the message that we really wanted to get across.
Speaker 3: The ACIP takes an evidence based approach that weighs many
Speaker 3: different factors to come to a final recommendation. There is
Speaker 3: data and reason and logic and evidence backing up each
Speaker 3: one of these recommendations, such as timing when to get
Speaker 3: the first dose of a vaccine. This is determined by
Speaker 3: the disease itself and when a child might be at
Speaker 3: highest risk for an exposure to the disease, is at
Speaker 3: high risk for complications from the disease, and also how
Speaker 3: well they're going to respond to the vaccine in terms
Speaker 3: of are they going to mount an adequate immune response
Speaker 3: that will protect them long term, Like we talked about
Speaker 3: with maternal antibodies sort of circulating in baby for a
Speaker 3: while after birth, so that vaccines don't induce this long
Speaker 3: term immunity. Right, Typically, it is recommended that a child
Speaker 3: gets a vaccine as soon as possible. Multiple doses are
Speaker 3: determined by how well one dose induces an immune response.
Speaker 3: Some vaccines need too to create long lasting immunity. Others
Speaker 3: like t DAP or DETAP require periodic boosters. FLU of
Speaker 3: course as annual and I can understand that it feels
Speaker 3: like there are a million vaccines and a million jobs,
Speaker 3: but each one of these vaccines is so critical and
Speaker 3: combo shots like MMR and T DAP helped to cut
Speaker 3: down on the number of jabs that your kid gets.
Speaker 1: I love combo vaccine combo, but even each one of
Speaker 1: the combo vaccines has to be studied and tested in
Speaker 1: all the different age groups and in all the different scenarios,
Speaker 1: which is why some are used for some age groups
Speaker 1: and not others. Like the MMR vercella vaccine technically is
Speaker 1: not recommended to be given to kids at the twelvemonth visit,
Speaker 1: but is at the four to five or six year old?
Speaker 2: Is it?
Speaker 1: And it's because of the data on the risks versus benefits.
Speaker 4: These are carefully made decisions.
Speaker 2: Yeah, right, Like.
Speaker 3: The bottom line is that the childhood vaccine schedule that
Speaker 3: we have here in the US has been and continues
Speaker 3: to be continuously evaluated multiple times a year by a
Speaker 3: team of highly qualified individuals who have the best interests
Speaker 3: of the American public at heart. That is historically then
Speaker 3: its role. Yeah, I hope that that is what its
Speaker 3: role will.
Speaker 4: Be in the in the years to come.
Speaker 1: It's protected us for so long. I hope that it
Speaker 1: continues to do so.
Speaker 3: The childhood vaccine schedule is safe, it is effective, and
Speaker 3: it has saved and continues to save millions, not an exaggeration,
Speaker 3: millions of lives of some of the most vulnerable members
Speaker 3: of our society every single year.
Speaker 4: Yeah.
Speaker 2: Yeah, it's amazing.
Speaker 4: Eron so erin. Yeah.
Speaker 3: Now that we know the history of the ACIP and
Speaker 3: how they make these decisions and why it is so
Speaker 3: vital that they do what they do, can you tell
Speaker 3: me why we might see some differences in the US
Speaker 3: compared to other countries around the world.
Speaker 1: Yeah, I can, And then get into what we know
Speaker 1: about what these vaccine preventable diseases look like across the
Speaker 1: gub H. We'll take a quick break and then get
Speaker 1: into it. So, the World Health Organization has a list
Speaker 1: of vaccines that are recommended for all children and that schedule,
Speaker 1: and those recommendations are essentially the same as what the
Speaker 1: CDC recommended schedule is in the US, which again is
Speaker 1: mostly influenced by recommendations from ACIP, except there are a
Speaker 1: few big exceptions. One is that we in the US
Speaker 1: do not use the BCG vaccine, which is a vaccine
Speaker 1: against tuberculosis and is recommended by the World Health Organization
Speaker 1: to be given at birth for all children. We don't
Speaker 1: do this in the US because historically rates of tuberculosis
Speaker 1: have been relatively low. I mean not historically historically, but
Speaker 1: in recent times at this point in time. That could
Speaker 1: change in the future, but that's the recommendation right now.
Speaker 1: So we don't use the BCG vaccine here in the US,
Speaker 1: but overall, the World Health Organization recommends vaccines for all
Speaker 1: children that include hepatitis B, polio, diphtheria, tetanus, and pertussis,
Speaker 1: the detap hib or, the homophlus influenza, new macaucus, rotavirus, measles, rubella,
Speaker 1: and HPV, and then the World Health Organization goes on
Speaker 1: to have a number of other recommendations because of course,
Speaker 1: the World Health Organization is having to kind of stratify
Speaker 1: across the globe, where they might recommend certain vaccines only
Speaker 1: for children who live in certain regions or who are
Speaker 1: in certain high risk populations either geographically or just population wise,
Speaker 1: or in countries that have vaccine programs with certain characteristics,
Speaker 1: and the US falls into that.
Speaker 4: What does that mean?
Speaker 1: Let me tell you about it.
Speaker 4: Okay, okay, So there are.
Speaker 1: Some vaccines that we went over last week that we
Speaker 1: give in the US that weren't on that list. I
Speaker 1: just read from the World Health Organization specifically that is mumps, vericella, flu, meningitis,
Speaker 1: and HEPA. The reason that we give those vaccines in
Speaker 1: the US and they're not on the recommended for every
Speaker 1: single child across the globe list is number one. Mumps, veriicella,
Speaker 1: and flu are recommended by the World Health Organization for
Speaker 1: all kids if they live in a place that has
Speaker 1: an immunization program that can actually get at least eighty
Speaker 1: percent or more of vaccination coverage, or if they have
Speaker 1: access to combination vaccines. So in parts of the world
Speaker 1: that are still struggling to even get kids access to vaccines,
Speaker 1: or who can't get or can't afford, or maybe can't
Speaker 1: like don't have the storage capacity, if vaccines have to
Speaker 1: be refrigerated, et cetera, for whatever reason, if they can't
Speaker 1: get combination vaccines, or they just don't have the capacity
Speaker 1: to vaccinate, then the World Health Organization says prioritize measles, rubella, mumps,
Speaker 1: and vericella come later. Essentially, does that make sense. Similarly,
Speaker 1: hepatitis A and meningitis, which are on the vaccine schedule
Speaker 1: in the US, are on the World Health Organization list
Speaker 1: of recommended for high risk populations, which, based on our
Speaker 1: data in the US, the US is one of them.
Speaker 1: We had really high rates of hepatitis A and meningitis,
Speaker 1: enough so that the CDC said, Hey, we're going to
Speaker 1: vaccinate all of our kids to prevent morbidity and mortality
Speaker 1: from these diseases. And then there are a lot of
Speaker 1: other vaccinations that are given in other countries, like for
Speaker 1: Jepanese encephalitis or for dange or yellow fever, that we
Speaker 1: don't give in the US on an everyone basis because
Speaker 1: they do not circulate in as high as numbers here
Speaker 1: in the US.
Speaker 4: Yeah, so that's why our.
Speaker 1: Schedule looks a little bit specific to our country.
Speaker 4: Yeah. Yeah, And we've said it a.
Speaker 1: Few times, I think, maybe more than a few times
Speaker 1: last week in this week, but I do think it
Speaker 1: bears repeating. It is very easy, because of the incredible
Speaker 1: success of vaccines to think that these diseases that we
Speaker 1: are vaccinating against are a thing of the past. Yeah,
Speaker 1: because it is true that the rates of illness and
Speaker 1: severe illness and death from almost all of these childhood
Speaker 1: vaccine preventable diseases have plummeted, both here in the US
Speaker 1: but also across the globe and that is incredible.
Speaker 4: It is, it is amazing. It is such a huge feat.
Speaker 4: I think back, like okay.
Speaker 3: You know, like, okay, I'm trying to think of a
Speaker 3: time travel movie Kat and Leopold, for instance, which that's
Speaker 3: a deep cut. That's a deep cut, right, Okay, somebody
Speaker 3: comes from the Hugh Jackman is like a time traveler
Speaker 3: from the past.
Speaker 4: Anyway.
Speaker 3: I always think about if someone were able to travel
Speaker 3: to the present day from the past. One of the
Speaker 3: things that would instantly be so magical is vaccines, Like
Speaker 3: not magical, but just profound right in what it has done.
Speaker 2: I'm sure it would feel magical.
Speaker 3: Quite Yeah, Leopold would really have appreciated vaccines.
Speaker 4: Maybe he did. Did they talk about it?
Speaker 3: I have not seen it since it was in theater
Speaker 3: at the Dollar Theater like twenty years ago.
Speaker 4: Oh that's hilarious.
Speaker 2: I'm gonna go watch it now.
Speaker 4: But it's true.
Speaker 1: Vaccines save today in twenty twenty five and estimated four
Speaker 1: million lives every single year.
Speaker 4: Four million.
Speaker 1: Yeah, the World Health Organization actually estimates three and a
Speaker 1: half to five million.
Speaker 2: So, like, I mean, it's.
Speaker 3: Incredible conservatively four million exactly, which.
Speaker 1: Is why conservatively, But The thing is that we could
Speaker 1: be saving even more because while we have made huge
Speaker 1: strides in reducing the burden of these diseases, we have
Speaker 1: not eradicated any of them, aside from smallpox, which we
Speaker 1: no longer vaccinate for anywhere across the globe because it
Speaker 1: has been eradicated, and also under which is a disease
Speaker 1: of cattle like well, actually story I wrote underpest down.
Speaker 1: But until we can actually eradicate these other preventable diseases,
Speaker 1: a case anywhere represents the risk of disease everywhere, especially
Speaker 1: because in the face of growing anti vaccine sentiment in
Speaker 1: the US and around the globe, vaccine preventable diseases are
Speaker 1: on the rise. As we record this, which is early
Speaker 1: March twenty twenty five, in the US, we are in
Speaker 1: the midst of a very significant measles outbreak that is
Speaker 1: continuing to spread. Yeah.
Speaker 4: Band numbers are way out of date already, I know.
Speaker 1: Yeah, by the time this episode comes out, they will,
Speaker 1: unfortunately I'm sure, be much worse. And the current outbreak
Speaker 1: is not typical, It is not common. Nope, And like
Speaker 1: you mentioned already aarin in the US, measles was declared
Speaker 1: eliminated in the year two thousand, which essentially means that
Speaker 1: we had had no continuous transmission of measles for an
Speaker 1: entire year, which meant that from that point forward, any
Speaker 1: cases that popped up, like anything more than three cases
Speaker 1: of measles is considered an outbreak in the US. And
Speaker 1: that was huge, and it wasn't just the US, like
Speaker 1: you said. In twenty sixteen, the World Health Organization declared
Speaker 1: measles eliminated from the entire Western Hemisphere, and around that
Speaker 1: time the World Health Organization European Region also reached its
Speaker 1: lowest point.
Speaker 2: Ever in Europe.
Speaker 1: And then and then things started to get worse again
Speaker 1: in the US between two thousand and twenty ten, so
Speaker 1: shortly after we were declared eliminated. There were only three
Speaker 1: years in that ten year period where we had more
Speaker 1: than one hundred measles cases in the US, between twenty
Speaker 1: eleven and twenty twenty one. In that ten year period,
Speaker 1: seven years had more than one hundred cases, including six
Speaker 1: hundred and sixty seven cases in twenty fourteen, three hundred
Speaker 1: eighty one cases in twenty eighteen, twelve hundred seventy four
Speaker 1: cases in twenty nineteen, and last year in twenty twenty four,
Speaker 1: we had two hundred and eighty five cases. Right now,
Speaker 1: it's early March, and the CDC last updated their Measles
Speaker 1: disease outbreak surveillance on February twenty eighth.
Speaker 5: Not often enough, every one Friday, every Friday, yeah, yeah,
Speaker 5: But as of February twenty eighth, there had been one
Speaker 5: hundred and sixty four confirmed cases and one child died.
Speaker 1: That is the first time that a child has died
Speaker 1: of measles in the US since twenty fifteen in the
Speaker 1: current outbreak. And again I know these numbers are outdated
Speaker 1: by the time this episode comes out. Twenty percent of
Speaker 1: these kids and I say kids because eighty two percent
Speaker 1: of these cases are in children, twenty percent of them
Speaker 1: have been hospitalized, and ninety five percent of cases were
Speaker 1: in either unvaccinated individuals or people whose vaccination status is unknown.
Speaker 1: And in every case, whether an individual is vaccinated or unvaccinated,
Speaker 1: this is a preventable illness, yes, and it's not just measles, like.
Speaker 4: It's not just measles.
Speaker 3: And before we move on to the other diseases that
Speaker 3: are vaccine preventable in these outbreaks that are happening, I
Speaker 3: want to talk about something that I think can generate
Speaker 3: some confusion when it comes to looking at these numbers.
Speaker 3: So you'll see in an outbreak like measles, like these
Speaker 3: measles outbreaks, that there is a number of people who
Speaker 3: are vaccinated who contract measles. And that could be for
Speaker 3: a million different reasons, right, Like some of US measles,
Speaker 3: vaccines don't induce a strong of an immune response. Again,
Speaker 3: why herd immunity is so important, and because in an
Speaker 3: area the general population is much more vaccinated than unvaccinated.
Speaker 1: Right, it can see eighty percent vaccination coverage in the US.
Speaker 3: Yes, it can seem like there is a high number
Speaker 3: or an equal number of people who are vaccinated compared
Speaker 3: to those who are not vaccinated.
Speaker 4: Does that make sense?
Speaker 3: But that's that is actually disguised as what is truly happening.
Speaker 3: And that is, if you look at the proportion of
Speaker 3: people who are unvaccinated, what at the likelihood that they
Speaker 3: will get that that they will get measles much much
Speaker 3: much higher than if you are vaccinated.
Speaker 1: Right, I think you said last week here and it
Speaker 1: was like one hundred and seventy times.
Speaker 3: Forty times higher they're unvaccinated. And so but like, just
Speaker 3: reporting on these sheer numbers only tells part of the story,
Speaker 3: right right, Like we it doesn't tell us what proportion
Speaker 3: of unvaccinated individuals in a community are infected compared to.
Speaker 2: Those who are vaccines exactly exactly, And.
Speaker 3: I think it kind of is these numbers are sometimes
Speaker 3: used to undermine the power of vaccines in protecting you.
Speaker 1: I remember that happening especially a lot during the mumps
Speaker 1: outbreak a few years ago, because especially mumps, we see
Speaker 1: more waning immunity than we see with measles as well,
Speaker 1: and so it kind of compounded that same problem.
Speaker 4: But it is yeah, that.
Speaker 1: The proportion, the likelihood that you get one of these
Speaker 1: illnesses is significantly higher if you are unvaccinated or under
Speaker 1: vaccinated compared to if you are vaccinated fully.
Speaker 3: And on top of that complications exactly. This isn't just
Speaker 3: about whether or not you are getting the disease. It
Speaker 3: is about how sick you are getting in your chances
Speaker 3: of dying, and vaccines protect you from these things exactly.
Speaker 1: And it is not just measles, it's not just rtussis cases.
Speaker 1: Whooping cough has been on the rise year over year
Speaker 1: in twenty twenty four, there were thirty five thousand cases
Speaker 1: of pertussis in the US and over twenty seven hundred
Speaker 1: of those were babies under one year old, and six
Speaker 1: of those babies under one year old died in the
Speaker 1: US in addition to four other kids that were over
Speaker 1: one year old. That's ten children who died last year
Speaker 1: alone in the United States from a vaccine preventable illness.
Speaker 4: Yep, did not have to happen.
Speaker 3: Yeah.
Speaker 2: Yeah.
Speaker 1: Polio is another example that made headlines back in twenty
Speaker 1: twenty two here in the US. So we eliminated polio
Speaker 1: in the US in nineteen seventy nine, and there is
Speaker 1: of course a huge campaign to try and eradicate polio
Speaker 1: across the globe and were not there yet, And yet
Speaker 1: there was a case of paralytic polio in twenty twenty
Speaker 1: two in the US, and in conjunction with that case,
Speaker 1: there was enough virus being detected in the wastewater in
Speaker 1: surrounding areas that the US was actually added to the
Speaker 1: World Health Organization list of countries with endemic circulating vaccine
Speaker 1: derived strains of poliovirus. Now, this is a strain of
Speaker 1: the virus that has evolved from the vaccine strain of
Speaker 1: the oral poliovirus vaccine. So this is a disease that
Speaker 1: people get not from the vaccine itself, not from getting
Speaker 1: the vaccine, but from a mutated version of this virus
Speaker 1: that can persist in the environment, from the vaccine derived
Speaker 1: strain that evolves to regain virulence or infectiousness, and then
Speaker 1: can infect other people and get them sick. We do
Speaker 1: not use this oral polio vaccine in the US, and
Speaker 1: we haven't since the year two thousand, but there are
Speaker 1: some other countries across the globe that still do because
Speaker 1: it's a much less expensive vaccine. It's easier to administer
Speaker 1: because it's oral rather than injected. You have to have
Speaker 1: less public health investment or infrastructure. And in some other
Speaker 1: places that still had circulating like wild typled toliovirus, it
Speaker 1: provided good protection, but it comes with this potential cost,
Speaker 1: and that cost has now been more vaccine derived strains
Speaker 1: circulating and globally. In twenty twenty three, which is the
Speaker 1: latest year that the World Health Organization has these global
Speaker 1: dashboard numbers, there were over twenty four thousand, seven hundred
Speaker 1: reported cases of diphtheria, certainly more that were not reported.
Speaker 1: Over six hundred and sixty nine thousand cases of measles globally,
Speaker 1: over one hundred and sixty three thousand cases of pertussis,
Speaker 1: three hundred and eighty seven thousand cases of mumps, thirty
Speaker 1: five thousand cases of rubella, and over twenty one thousand
Speaker 1: cases of tetanus, and the list goes on. So all
Speaker 1: of these diseases that we are protecting our children against
Speaker 1: with vaccines still circulate around the globe. And because of
Speaker 1: global travel, that means that many of these diseases can
Speaker 1: circulate anywhere. And I mean the case of tetanus, those
Speaker 1: bacteria are just everywhere already, right, I.
Speaker 4: Mean, and so much of this is just like it is.
Speaker 3: These numbers are saggering, and they're so hard to absorb,
Speaker 3: to like actually wrap your head around. And this I
Speaker 3: think speaks to how why it is so important that
Speaker 3: an investment in global public health and global health is crucial,
Speaker 3: And it's just it's just something that is so obvious.
Speaker 2: I know, so clear. I know.
Speaker 1: Vaccines are not only the best thing that you can
Speaker 1: do to protect yourself and your children from infectious disease,
Speaker 1: but also the best thing that you can do to
Speaker 1: protect your community. Because vaccines are protecting us a against
Speaker 1: communicable diseases. These are things that are spread from person
Speaker 1: to person. So it is, like we said last week,
Speaker 1: our social responsibility to vaccinate, like for the health of ourselves,
Speaker 1: yes I don't want to get sick and end up hospitalized,
Speaker 1: but also for the health of our communities. And it
Speaker 1: is for this reason, because of the health of the public,
Speaker 1: that there are vaccine requirements for participation in public life
Speaker 1: like public schools. Right, and when these requirements are waived
Speaker 1: or changed to recommendations rather than requirements, or if they're
Speaker 1: done away with altogether, we are putting both individual and
Speaker 1: public health at risk. We then see children hospitalized and dying,
Speaker 1: and resurgence of diseases that have previously been eliminated. So
Speaker 1: understandably there is a lot of interest in addressing vaccine hesitancy.
Speaker 4: How the heck do we do it, that's a great question.
Speaker 1: The World Health Organization actually named vaccine hesitancy one of
Speaker 1: the top threats to global health in twenty nineteen, and
Speaker 1: that's alongside like climate change and air pollution, anti microbial resistance,
Speaker 1: the next global influenza pandemic. Like big scary things include
Speaker 1: vaccine hesitancy hesitancy.
Speaker 2: Yeah, so lucky for us.
Speaker 1: There's a lot of research that has been done and
Speaker 1: that continues to be done on how to best try
Speaker 1: and address this. And we started out last week's episode
Speaker 1: like this whole vaccine series. Part of what we wanted
Speaker 1: to be able to talk about is just how prevalent
Speaker 1: vaccine misinformation is and how easy it is to believe
Speaker 1: it because of the way that misinformation and disinformation praise
Speaker 1: on our fears and anxieties, especially when it comes to
Speaker 1: our kids. Yes, and we are all susceptible to misinformation.
Speaker 2: Ehudding us do you hate to admit it, But it's true.
Speaker 1: That's true, and we know that when it comes to
Speaker 1: vaccine hesitancy, which is defined as the reluctance or refusal
Speaker 1: to vaccinate despite the availability of vaccines, there is a
Speaker 1: spectrum of belief. But I want to first set the
Speaker 1: record straight. The vast majority of parents still vaccinate their
Speaker 1: kids on time according to the ACIP schedule period period.
Speaker 3: Yay, that's amazing, And part of that is because we
Speaker 3: do have these childhood vaccination requirements for school exact. Yeah, yeah,
Speaker 3: it's yeah, it's great, it's amazing.
Speaker 1: But when we are looking at the minority of people
Speaker 1: who meet these criteria of vaccine hesitancy. There is a spectrum,
Speaker 1: and there are some people, many of whom are the
Speaker 1: spreaders of disinformation, who are profiting heavily off of vaccine
Speaker 1: hesitancy in one way or another, or who have wrapped
Speaker 1: up their identities in these false beliefs to a point
Speaker 1: where there really is no changing their mind. But there
Speaker 1: are also a lot of people who are vaccine hesitant,
Speaker 1: who just have questions or or herd scary things on
Speaker 1: TikTok and they just don't know who to believe. And
Speaker 1: recognizing this idea that we can all fall prey to misinformation,
Speaker 1: what that does is allow us to approach all of
Speaker 1: our conversations about vaccines from a place of understanding and empathy.
Speaker 1: It allows us to actually have productive conversations about vaccines
Speaker 1: rather than just combative ones with my uncles.
Speaker 4: I'm sorry it's.
Speaker 1: True, though, But we also know that a lot of
Speaker 1: parents rely on their healthcare providers as primary sources of
Speaker 1: information when it comes to their children's health, and that's great.
Speaker 1: We should all have a healthcare provider that we can
Speaker 1: trust to ask our questions and get answers without fear
Speaker 1: of judgment or reprisal, and studies show time and again
Speaker 1: that a strong recommendation from your health care provider drives
Speaker 1: vaccine uptake, as do strategies like motivational interviewing, which is
Speaker 1: a technique that relies on like open ended questions and
Speaker 1: affirming and reflecting back statements and concerns and then summarizing
Speaker 1: information and then advising, but all in a way that
Speaker 1: actually requires that you listen.
Speaker 4: Yeah, I mean google it.
Speaker 3: It's like it's a really important and technique and I
Speaker 3: think that there's a lot more to it. Yeah, you're
Speaker 3: interested in learning more about it, definitely, And the.
Speaker 1: Search requires that you start from a place of empathy
Speaker 1: from where a person is coming from and the concerns
Speaker 1: that they legitimately have.
Speaker 4: Ye.
Speaker 1: But a lot of us and a lot of you
Speaker 1: listening feel like maybe you feel like you'll never be
Speaker 1: in a position to directly like advise someone on whether
Speaker 1: or not to get vaccinated. That does not mean that
Speaker 1: we can't all be working towards increasing vaccine acceptance in
Speaker 1: our own communities. Most parents still vaccinate their kids. The
Speaker 1: majority of kids in the US are getting their vaccines
Speaker 1: on time, according to the ACIP schedule. If we start
Speaker 1: talking about this fact, like normalizing this, talking about getting
Speaker 1: your vaccines, about when you got your kids vaccinated, how
Speaker 1: you just got your flu shot in your arms a
Speaker 1: little bit sore, but you're feeling great about it. That
Speaker 1: is one way that we individually can help to move
Speaker 1: this needle back towards vaccine acceptance and away from this
Speaker 1: idea of vaccine hesitancy.
Speaker 4: Yeah, we collectively talk.
Speaker 1: A lot about vaccine hesitancy, but I think we don't
Speaker 1: talk enough about getting vaccinated. And like I normalizing this process.
Speaker 3: I love this because I feel like I have done
Speaker 3: this with friends where I'm like, oh, yeah, I got
Speaker 3: my flu shot and my arm is still a little
Speaker 3: bit sore, and they're like, oh, that reminds me I
Speaker 3: have to go get my flu.
Speaker 4: Shot exactly exactly. Something as simple as that, I I
Speaker 4: love it.
Speaker 1: I also love things that make it easier, like one
Speaker 1: time I got my flu shot and my COVID shot
Speaker 1: this year when we went to the YMCA where my
Speaker 1: kids are doing gymnastics, and they had a table there
Speaker 1: and we went early because we thought my kids wanted
Speaker 1: to play in a thing, and then they didn't want
Speaker 1: to and we're like, well, we're just going to get
Speaker 1: our vaccines.
Speaker 3: Then you made it so easy, yes, yes, but breaking
Speaker 3: down those barriers to just make it easy when you're
Speaker 3: just out because there are so many other things that
Speaker 3: are that that do stand in the way of someone
Speaker 3: being able to take time off to go get rationeated
Speaker 3: when our clinic hours open. And I know that there
Speaker 3: are a lot of different organizations that really push towards this,
Speaker 3: Like we're having you know, a van that comes and
Speaker 3: does like on site vaccination.
Speaker 4: Yeah, that's great, that's great.
Speaker 1: Talking about this and normalizing this process and talking about
Speaker 1: how incredible the benefits of vaccination are is so helpful.
Speaker 1: And we can all start having these conversations with our
Speaker 1: friends and family who already vaccinate and maybe those who
Speaker 1: might be more towards hesitant.
Speaker 3: Yeah, and I think it's important to you wonder what
Speaker 3: might that conversation look like? Yeah, what what could it
Speaker 3: look like? And I mean who knows, right, Like, there's
Speaker 3: a huge spectrum. Yeah, and if it depends a lot
Speaker 3: on how receptive someone is to changing their mind or
Speaker 3: to hearing conflicting information something that conflicts with what they've
Speaker 3: heard or what they hold in their hearts, right, But
Speaker 3: it does start, like you said, Aaron, with empathy and
Speaker 3: with asking questions. So if you know someone who's vaccine hesitant,
Speaker 3: or you learn that someone is, you could start by
Speaker 3: asking why, like what what do you know about vaccines?
Speaker 3: What specific worries do you have? And then asking you know,
Speaker 3: can can I talk with you about this? Can I
Speaker 3: share my thoughts there? Can I share some information that
Speaker 3: I have learned with that convation? Can we engage in
Speaker 3: this way?
Speaker 4: Yeah? And maybe it's a flat no.
Speaker 3: Maybe they're like, not interested, do not talk to me
Speaker 3: anymore about this?
Speaker 2: Okay, right, that's fine, But maybe it's not.
Speaker 3: Maybe they're like, actually, yeah, I have been really nervous
Speaker 3: and I don't know where to turn.
Speaker 4: And maybe you can help to answer their questions. Or
Speaker 4: maybe you can't.
Speaker 3: Maybe you're like I too, I don't know where to turn,
Speaker 3: but you can at least look together. You can help
Speaker 3: them find where to look. That is how this has
Speaker 3: proven to be how progress is actually made on this
Speaker 3: front human to human interaction. People who have social capital community, right,
Speaker 3: like people who are trusted, people who are like, no,
Speaker 3: I get it, I know where you're coming from.
Speaker 4: I can relate to you, and I will relate to you.
Speaker 3: I won't stand here in a position of power and
Speaker 3: tell you and look down on you and condescend to
Speaker 3: you right like I will say, okay, I hear you right.
Speaker 3: And this, all of us having these conversations, is how
Speaker 3: we can make progress. Each of you has the most
Speaker 3: sway and reach within your own community. And research does
Speaker 3: show that this community based activism, even if it's just informal,
Speaker 3: even if it's just chatting with a neighbor, this has
Speaker 3: the greatest opportunity of making an impact. And one really
Speaker 3: important thing to remember and I think that, especially as
Speaker 3: our bandwidth grows ever more shorter these days, speaking personally, yes,
Speaker 3: is that you you should pick your battles right like
Speaker 3: you can pick your battles if you're not in the headspace,
Speaker 3: or you feel like someone is just super resistant and
Speaker 3: it's only going to drain you further so that you
Speaker 3: don't have the emotional bandwidth to take care of yourself.
Speaker 3: Or if you feel yourself getting heated and you're like,
Speaker 3: this is not going anywhere, I'm just getting angry at
Speaker 3: this person. Yeah, don't be afraid to take a step back,
Speaker 3: try another day. This is a constant, constant battle. But
Speaker 3: we truly can make progress.
Speaker 1: Yeah, we really really can't. We maybe sound very cheesy,
Speaker 1: but genuinely we believe that we do.
Speaker 2: Also data backs it up.
Speaker 3: So yeah, evidence based, speaking of evidence, speaking.
Speaker 4: Of evidence, great transition. Thank you. We've got more sources
Speaker 4: for this.
Speaker 3: Let me see if I can shout out any in
Speaker 3: particular that I found helpful. If I can find this tab,
Speaker 3: here we go. Yeah, there is a pa by Walton
Speaker 3: at All from twenty fifteen called the History of the
Speaker 3: United States Advisory Committee on Immunization Practices, and it was
Speaker 3: really insightful in terms of how this committee came to be.
Speaker 3: And then I have a bunch of other websites for
Speaker 3: our a bunch of other sites from CDC and who
Speaker 3: that can help sort of put more context into this.
Speaker 1: I used a lot the World Health Organization Global Dashboard,
Speaker 1: their data portal, so we will link to that. I
Speaker 1: also really enjoyed a paper by friend of the Pod
Speaker 1: Peter Hotes from twenty nineteen titled America and Europe's New
Speaker 1: Normal the Return of vaccine preventable Diseases, And I also
Speaker 1: had a number on that whole idea of how we
Speaker 1: talk about vaccine hesitancy and kind of moving the needle.
Speaker 1: So we will post the list of all of our
Speaker 1: sources from this episode and every one of our episodes
Speaker 1: on our website, this podcast withekille dot com under the
Speaker 1: episodes tab.
Speaker 3: We will a big thing YouTube Bloodmobile, who provides the
Speaker 3: music for this episode and all of our episodes.
Speaker 2: May sure do you.
Speaker 1: Thank you so much, Bloodmobile. Thank you to Leona Scolacci
Speaker 1: and Tom Bright Focal for the incredible audio mixing, and
Speaker 1: thank you to Brent and Pete and the whole video
Speaker 1: editing team as well.
Speaker 3: Thank you, thank you, and thank you to you listeners
Speaker 3: for listening, for listening, please watching or watching, Please do
Speaker 3: reach out with more what you want to hear? Yeah,
Speaker 3: what you want to learn about?
Speaker 1: I want to know so we can make our season better. Yes, truly,
Speaker 1: And thank you as always to our patrons. Your support
Speaker 1: means so much to us. Thank you, thank you, thank you.
Speaker 4: Thank you. Well.
Speaker 6: Until next time, wash your hands, you filthy animals.
Speaker 1: Mum