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Speaker 1: What's a jackalope.

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Speaker 2: A jackalope is a mythological creature, a sort of iconic

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Speaker 2: to the American West. It's a combination of a jack

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Speaker 2: rabbit and a prong horn antelope. So it's a jack

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Speaker 2: rabbit that has antlers or horns, and it exists richly

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Speaker 2: in the imagination of Americans, especially in the West. But

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Speaker 2: it is a mythological creature.

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Speaker 1: This is Michael Branch, a man who loves the jackalope

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Speaker 1: so much that he wrote a book about it. It's

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Speaker 1: called On the Trail of the Jackalope. Is that a

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Speaker 1: jackalope on your shirt? Or am I mistaken?

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Speaker 2: Yeah, that's a jacalobe. Of course. Jacoalobe kitch is a

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Speaker 2: huge part of the phenomenon. And so you know, if

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Speaker 2: you've ever seen a jacalobe bumper stick or t shirt,

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Speaker 2: shot glass, taxidermy mount, you're part of the hoax. You're

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Speaker 2: in on the joke.

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Speaker 1: The jackalope is a myth, but there are in fact,

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Speaker 1: real horned rabbits. Is an expert on these two, and

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Speaker 1: those horned rabbits led to a key breakthrough in understanding

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Speaker 1: how viruses cause disease. Today on the show Horned rabbits,

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Speaker 1: human papilloma virus AKAHPV, and a vaccine backlash. This is incubation.

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Speaker 1: I'm Jacob Goldstein. So there's this myth of the jackalope

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Speaker 1: in the US. There are mythological horned rabbits, and in fact,

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Speaker 1: there are real horned rabbits in the world. Right, we've

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Speaker 1: been talking only of myth. But tell me about tell

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Speaker 1: me about real horned rabbits.

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Speaker 2: So called horned rabbits are actually various species of rabbits

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Speaker 2: that develop these weird, grotesque growths on their heads, sometimes

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Speaker 2: on their faces, and they're produced by a papilloma virus.

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Speaker 2: And both hunters and common people and also naturalists have

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Speaker 2: noticed these forever without having any idea what caused them.

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Speaker 1: And what does it look like.

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Speaker 2: Let me put it this way. When the slide of

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Speaker 2: an actual horn rabbit comes up when I'm doing book talks,

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Speaker 2: you can hear a collective groan from the audience. I mean,

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Speaker 2: it is quite grotesque. And if you can just imagine bumpy, wordy,

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Speaker 2: caratinous black growths all over the face or head of

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Speaker 2: an animal, that's what it looks like.

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Speaker 1: So you mentioned that that these horns, these growths are

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Speaker 1: caused by a papolloma virus, which turns out to be

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Speaker 1: important in the history of understanding viruses and ultimately in

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Speaker 1: the history of human health.

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Speaker 2: Right yeah, And it involves a guy named Richard shop

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Speaker 2: who had actually been involved in trying to figure out

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Speaker 2: what had caused the global pandemic of nineteen eighteen. By

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Speaker 2: the time he got interested in horn rabbits, he was

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Speaker 2: already a well known virologist. This would have been the

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Speaker 2: late nineteen twenties early nineteen thirties, and he had come

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Speaker 2: from his home in Iowa to Princeton to take up

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Speaker 2: this research position as a medical researcher. And he heard

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Speaker 2: stories from his friends back in Iowa and Kansas who said, hey,

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Speaker 2: you know, sometimes when we're out rabbit hunting, we kill

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Speaker 2: these rabbits that have these weird growths on them. And

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Speaker 2: of course, you know, being a scientific researcher guy interested

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Speaker 2: in viruses, you know, he immediately wanted to see one

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Speaker 2: of these rabbits. In fact, he wanted to see him

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Speaker 2: so badly that he made a special trip back to

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Speaker 2: Iowa with a hunter who had claimed to have shot

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Speaker 2: a number of these rabbits, and Shope himself hunted specifically

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Speaker 2: to try to get one of these rabbits with the

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Speaker 2: strange growths. After four days, he was unsuccessful and he

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Speaker 2: had to go back to Princeton. There was a young

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Speaker 2: young kid who had been hunting with them, and he

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Speaker 2: told that kid, Hey, I'm going to leave you a

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Speaker 2: five dollar bill and a bottle of glycerol solution, and

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Speaker 2: if you can find one of these rabbits, cut off

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Speaker 2: its horns, put him in the solution, mail them to me,

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Speaker 2: and I'll give you another five dollars. He could see

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Speaker 2: from the very beginning that if he could demonstrate a

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Speaker 2: link between viruses and cancer in a mammal that he

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Speaker 2: would be opening the way to research that might ultimately

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Speaker 2: address that question in human beings.

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Speaker 1: Ah. So he wants to find out whether a virus

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Speaker 1: is causing these growths, these horns to grow out of

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Speaker 1: the heads of rabbits exactly.

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Speaker 2: And soon as Chope left Iowa, this kid just made

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Speaker 2: it his mission to get one of these rabbits, and

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Speaker 2: he did so. He mailed Shope the horns in the

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Speaker 2: glyceral solution. He got his other five dollars, and after

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Speaker 2: that the word get out among the communities of hunters

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Speaker 2: in Kansas and Iowa, and people began to literally mail

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Speaker 2: specimens of horn rabbits to shop in Princeton.

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Speaker 1: So he's there in Princeton and he goes down and

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Speaker 1: gets his like whatever, his insurance bill, and then a

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Speaker 1: box with a dead rabbit in it, exactly.

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Speaker 2: And he started working on horn rabbits there at the

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Speaker 2: Rockefeller Inns Institute in nineteen thirty two with the goal

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Speaker 2: of understanding what caused those odd growths. He is especially

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Speaker 2: interested in viruses, and he is doing his work at

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Speaker 2: a time when the consensus in the scientific community is

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Speaker 2: that it is impossible that a virus could cause cancer,

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Speaker 2: especially in a mammal. And at the time, you know,

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Speaker 2: nobody knew what caused these weird growths, and he wanted

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Speaker 2: to find out what caused them, but he suspected that

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Speaker 2: it was a virus, and so he set out to

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Speaker 2: sort of test that hypothesis through his own experimental method.

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Speaker 1: So when you say his own experimental method, what do

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Speaker 1: you mean, what do you do?

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Speaker 2: Well? First, he samples these weird growths on the rabbit's heads,

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Speaker 2: and he takes those samples and pulverizes them, adds them

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Speaker 2: to a saline solution and then runs them through a centrifuge.

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Speaker 2: And then he takes the fluid that has been produced

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Speaker 2: by that process and then does what is really the

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Speaker 2: most important thing. That is, he takes that fluid and

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Speaker 2: puts it through a filter. Now, back in the nineteen thirties,

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Speaker 2: in the kind of pioneering era of viral research, these

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Speaker 2: porcelain filters were very important because they could filter out

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Speaker 2: bacteria and other larger things. The only thing small enough

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Speaker 2: to go through these filters was a virus. Huh.

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Speaker 1: It's interesting, right, because that it seems sort of primitive

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Speaker 1: to us on a certain level, but also kind of ingenious, right, Like,

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Speaker 1: they know not that much about viruses at the time,

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Speaker 1: but they know they're way smaller than bacteria and that

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Speaker 1: those are the two main kind of disease causing pathogens, right,

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Speaker 1: And so they're like, Okay, let's just make a filter

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Speaker 1: that will take out bacteria and anything else that can

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Speaker 1: cause a disease, but that will allow viruses to pass

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Speaker 1: through that we know that that's the only pathogen that

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Speaker 1: could be left in here.

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Speaker 2: Exactly exactly the fact that he uses this technique to

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Speaker 2: make sure that the only thing that can come through

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Speaker 2: that porcelain filter. Is a virus is kind of a

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Speaker 2: key moment.

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Speaker 1: Okay. So now he has his whatever, his gou his

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Speaker 1: solution that we know has no bacteria in it that

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Speaker 1: he's going to do something with. What's he do with it?

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Speaker 2: Okay? So he takes live rabbits that are healthy. He

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Speaker 2: shaves a little bit of their fur off and then

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Speaker 2: scarifies their skin, just roughs it up just a little

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Speaker 2: bit with some sandpaper, and then he takes that fluid

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Speaker 2: that has gone through the filter and applies it to

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Speaker 2: that little spot on the rabbits. And the idea is

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Speaker 2: right that since this fluid has been taken from the

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Speaker 2: horns of disease rabbits, and since it's been filtered to

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Speaker 2: make sure the only thing that can be in it

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Speaker 2: is viruses, he has essentially applied a fluid to these

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Speaker 2: healthy rabbits. So the whole idea is to wait and see.

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Speaker 2: Having no idea if virus is the cause, or if

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Speaker 2: it is what the incubation period might be, he applies

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Speaker 2: this to these patches on his test rabbits, and sure enough,

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Speaker 2: after about ten days, all of the rabbits that he

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Speaker 2: has inoculated with this fluid begin to develop exactly the

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Speaker 2: same kinds of growth that were present on the diseased rabbit.

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Speaker 2: And that's sort of the Eureka moment in the story,

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Speaker 2: because that's the moment at which Shope has essentially proven

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Speaker 2: that the growths on horned rabbits are in fact caused

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Speaker 2: by a virus.

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Speaker 1: Does he publish the results? How does this finding land?

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Speaker 2: He publishes his work the following year, which is nineteen

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Speaker 2: thirty three, in a watershed article in the Journal of

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Speaker 2: Experimental Medicine, and you know, outside of fellow researchers in

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Speaker 2: the virology community, it really doesn't go far at all,

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Speaker 2: even though it's a huge breakthrough.

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Speaker 1: After his paper comes out, do people recognize that viruses

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Speaker 1: can cause cancer in mammals?

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Speaker 2: They do, but it takes a while, you know. I

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Speaker 2: think that the scientific community was so thoroughly resistant to

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Speaker 2: this idea that it wasn't as if everyone realized right

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Speaker 2: away what the implications of the work were. That's going

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Speaker 2: to be left to other researchers, most importantly a guy

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Speaker 2: named peyton Us who was a colleague of Shops at

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Speaker 2: the Rockefeller Institute. Peyton Russ will go on to do

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Speaker 2: the extended studies that will prove the hunch that showpad

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Speaker 2: all along, which is that some of those growths can

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Speaker 2: become cancerous.

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Speaker 1: Aha. So that's ultimately showing Shope's work and the work

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Speaker 1: of his colleague shows that in fact, a virus is

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Speaker 1: causing cancer in a mammal.

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Speaker 2: That's the kind of big breakthrough exactly. And so that's

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Speaker 2: sort of the first step toward working on viruses as

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Speaker 2: cancer causing agents in human beings. It's going to take

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Speaker 2: several generations of scientists to explore the implications fully.

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Speaker 1: In the decades after Shope did his studies on rabbits,

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Speaker 1: scientists kept studying papillomaviruses. They discovered a human version of

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Speaker 1: the papaloma virus, which reasonably enough, they called the human

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Speaker 1: papalomavirus or HPV, and in work that wound up winning

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Speaker 1: a Nobel Prize, another researcher definitively HPV to cervical cancer. Eventually,

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Speaker 1: we learned that over ninety percent of cervical cancer cases

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Speaker 1: are caused by HPV, and that HPV is also a

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Speaker 1: common cause of throat cancer. Despite all that, when a

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Speaker 1: new vaccine promised to prevent HPV, infection. Not everybody was excited.

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Speaker 1: That's after the break the first HPV vaccine was rolled

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Speaker 1: out nearly twenty years ago. People in the vaccine world,

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Speaker 1: in the public health world, and the cancer world were

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Speaker 1: very excited. This was a vaccine that could prevent cancer

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Speaker 1: or at least some kinds of cancer, and HPV vaccines

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Speaker 1: are in fact used around the world today. As it

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Speaker 1: turned out, though back when the vaccine was first approved,

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Speaker 1: many people were not excited.

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Speaker 3: Support was coming from everywhere, but backlash was coming from

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Speaker 3: everywhere too, like all over the political spectrum. Exaggeration to

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Speaker 3: say it's a total mess.

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Speaker 1: This is Elena Konis. She wrote a book called Vaccine Nation,

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Speaker 1: America's Changing Relationship with Immunization, and she told me that

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Speaker 1: the controversy over the HPV vaccine was really part of

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Speaker 1: this much bigger story. She said, it was the culmination

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Speaker 1: of this deep seated conflict that had been building for decades.

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Speaker 3: In my view, you really can't understand what happens with

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Speaker 3: the HPV vaccine in the early two thousands unless you

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Speaker 3: rewind the clock back to the nineteen fifties actually, and

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Speaker 3: that was because that was a decade when we got

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Speaker 3: a new vaccine, the polio vaccine that was desperately hoped

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Speaker 3: for the entire public. Really in some level was invested,

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Speaker 3: and when that vaccine was developed and rolled out to

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Speaker 3: the public in nineteen fifty five, it ushered in a

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Speaker 3: new era of vaccination in the US. We started vaccinating kids,

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Speaker 3: especially against a wide range of diseases. We started ensuring

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Speaker 3: that they were vaccinated by making vaccines required for kids

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Speaker 3: to enroll in school. We made them required by passing

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Speaker 3: laws and regulations at the state level, and we did

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Speaker 3: all of this with a lot of federal support. Polio, smallpox, measles, mumps, rubella.

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Speaker 3: What's important about this list of diseases is that they

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Speaker 3: were really different in kind. Polio and smallpox were widely

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Speaker 3: feared dreaded diseases. The policies that we developed for polio

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Speaker 3: ended up being applied to these other vaccines.

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Speaker 1: Policies meaning state laws requiring them for kids to go

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Speaker 1: to school, and the federal government supporting and even subsidizing

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Speaker 1: those laws.

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Speaker 3: Yes, and this is happening in the nineteen sixties. It's

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Speaker 3: coinciding with the rise of all of the social movements

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Speaker 3: of that decade that are encouraging young people in particular

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Speaker 3: to question authority and to ask for more information and

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Speaker 3: to push back against institutions.

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Speaker 1: I mean, very broadly, more distrust of authority. Right plainly, Yes,

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Speaker 1: Certainly in the nineteen seventies, if not before, people in

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Speaker 1: many domains began to trust institutions and authority less, and

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Speaker 1: that persons.

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Speaker 3: Absolutely, And that actually leads into a kind of ironic

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Speaker 3: moment in this late twentieth century history of vaccination, because

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Speaker 3: by the nineteen eighties we have an organized vaccine safety movement,

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Speaker 3: and I should say this is how they describe themselves.

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Speaker 3: They don't call themselves anti vaccinationists. They lobbied for and

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Speaker 3: ultimately succeeded in getting a change in federal legislation. In

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Speaker 3: nineteen eighty six, Reagan signs a new law to provide

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Speaker 3: compensation to individuals and families who have suffered injuries from

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Speaker 3: mandated vaccines, and also creates the infrastructure for a nationwide

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Speaker 3: system to monitor the public for vaccine injuries. So we

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Speaker 3: get to the end of the eighties with the very

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Speaker 3: organized and very successful national movement, and in the meantime,

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Speaker 3: a handful of other childhood vaccines come out in the background. However,

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Speaker 3: this organized self described vaccine safety movement has not stopped.

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Speaker 1: So tell me the story of the HPV vaccine and

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Speaker 1: it's rollout.

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Speaker 3: So the HPV vaccine is so interesting in the history

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Speaker 3: of vaccination because it comes out in the early two

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Speaker 3: thousands and its rollout really represents a turning point. And

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Speaker 3: when I talk about the HPV vaccine, initially, I'm talking

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Speaker 3: about Merk vaccine Gardasil.

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Speaker 1: That was the first HPV vaccine approved in the US.

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Speaker 3: Yes, that was the first one approved for use in

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Speaker 3: the US. It protected against four strains of HPV, and

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Speaker 3: scientists knew very well that those four strains were linked

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Speaker 3: to a very high proportion of cases of cervical cancer

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Speaker 3: in the US. So there's multiple ways of getting cervical cancer,

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Speaker 3: but one really important way is infection with HPV, and

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Speaker 3: this vaccine protected against four strains known to be linked

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Speaker 3: to cervical cancer. Mirke was excited about this. Reproductive health

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Speaker 3: advocates and providers were excited about this, but Mirk knew

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Speaker 3: that it faced a problem. HPV was not a virus

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Speaker 3: that the public knew much about at all. In fact,

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Speaker 3: they had hardly even heard of it, and that meant

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Speaker 3: that they really didn't know about the link between HPV

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Speaker 3: and cervical cancer. So before the HPV vaccine was approved,

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Speaker 3: Merk ran an ad campaign, and the ad campaign specifically

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Speaker 3: targeted women and told them that there was a virus

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Speaker 3: called HPV and that it was linked to cervical cancer.

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Speaker 1: I don't know why people don't know about this.

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Speaker 2: I don't know why I didn't know.

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Speaker 1: I've never heard of this. I'm just shocked. I just

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Speaker 1: found out that cervical cancer is caused by certain types

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Speaker 1: of a common virus, HPV.

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Speaker 3: Merk knows that without awareness of this virus or its

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Speaker 3: link to cancer, it's not going to get anywhere in

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Speaker 3: the marketplace. So it makes sense why they do this.

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Speaker 3: Reproductive advocates are thinking, hey, here is a vaccine that

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Speaker 3: is not only a new tool against reproductive cancer, but

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Speaker 3: a way of eliminating disparities in who gets cancer. In

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Speaker 3: other words, there at the time were racial and income

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Speaker 3: disparities in cervical cancer rates, and so the thinking on

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Speaker 3: the part of reproductive health advocates were use a vaccine,

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Speaker 3: administer it alongside other vaccines, and then people will be

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Speaker 3: protected against cervical cancer, regardless of wealth, or race or ethnicity.

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Speaker 3: Everybody's excited. Everybody's expecting a seamless rollout of this vaccine.

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Speaker 3: So FDA approves guard to CEL, and the CDC Advisory

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Speaker 3: Committee concludes that since the vaccine was tested in women,

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Speaker 3: it should be administered only to females, and because HPV

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Speaker 3: is sexually transmitted, it should ideally be administered to females

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Speaker 3: as young as say sixth grade.

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Speaker 1: So, just to be clear, the idea is to vaccinate

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Speaker 1: people before they have sex and are therefore exposed to the.

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Speaker 3: Virus exactly exactly, yeap, catch them before they're sexually active,

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Speaker 3: so that there is little to no chance that they

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Speaker 3: would have encountered this virus otherwise.

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Speaker 1: And then, as I understand it, right, there was this

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Speaker 1: like sample legislation that was drafted to encourage states to

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Speaker 1: mandate the vaccine. And this is essentially the playbook of

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Speaker 1: how vaccines had been rolled out for decades at this point.

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Speaker 3: Right, absolutely, absolutely, The only change really is that this

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Speaker 3: is a very new vaccine targeting and infection that the

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Speaker 3: public really wasn't aware of yet, and that they were

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Speaker 3: targeting only girls.

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Speaker 2: Well.

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Speaker 3: As soon as lawmakers introduced these bills, debates erupted in

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Speaker 3: state houses and what happened was the anti pharma backlashed,

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Speaker 3: combined with a conservative trend in sexual education, combined with

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Speaker 3: the advent of kind of religious conservatism, meant that there

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Speaker 3: was pushback coming from a handful of different spheres, all

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Speaker 3: of whom had their own reasons for arguing against these

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Speaker 3: HPV vaccination mandates. They said, vaccines are for children to

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Speaker 3: protect them against diseases that are spread in the school environment.

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Speaker 3: HPV is not. Let's leave it out of it. The

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Speaker 3: best protection against sexually transmitted infections anyway, they said, was abstinence,

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Speaker 3: not vaccines, and were probably quote unquote encouraging promiscuity if

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Speaker 3: we use this vaccine. It made some people, especially a

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Speaker 3: bunch of people who self identified as feminists and women's

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Speaker 3: rights activists, say, hold on, why should it be women's

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Speaker 3: or girls sole responsibility to prevent the spread of a

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Speaker 3: sexually transmitted infection. That's sexist and unfair. And so what

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Speaker 3: this did was it contributed another argument to the backlash,

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Speaker 3: and it's another part of why the HPV story is

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Speaker 3: so interesting because support was coming from everywhere, but backlash

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Speaker 3: was coming from everywhere too, like all over the political spectrum.

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Speaker 1: And clearly there are a lot of particular things, things

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Speaker 1: that are particular to this vaccine. But when you zoom

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Speaker 1: out and you think about the bigger historical arc, why

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Speaker 1: is this an important moment beyond this one vaccine.

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Speaker 3: It's an important moment for this reason. About two dozen

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Speaker 3: states considered laws or regulations to make HPV mandatory for

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Speaker 3: young girls, and this was between two thousand and six

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Speaker 3: and two thousand and eight, and only one of them succeeded.

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Speaker 1: So was that the first time that this decade's old

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Speaker 1: sort of playbook of a new vaccine comes out and

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Speaker 1: it's mandated in state after state? Was it the first

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Speaker 1: time that had failed?

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Speaker 3: Yes? What happened was all these lawmakers in these states

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Speaker 3: and then others that were watching, they rolled back and

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Speaker 3: they took the mandates off the table. So it's a

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Speaker 3: really important moment because we see the public being really

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Speaker 3: successful in pushing back against this era of child vaccination mandates.

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Speaker 1: So the rollout does not go as planned. The HPV

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Speaker 1: vaccine does not join all the other childhood vaccines that

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Speaker 1: are mandated in many states.

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Speaker 3: What happens, Yeah, So what happens next is really interesting.

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Speaker 3: Epidemiologists who weren't studying HPV before started to say, hmm,

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Speaker 3: this is interesting. Does it make sense to only vaccinate girls?

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Speaker 3: What about boys? What about other forms of cancer other

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Speaker 3: types of Researchers too, start asking questions about it. In

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Speaker 3: other words, the existence of the vaccine invites further scientific

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Speaker 3: study and scrutiny of its target infection. What we learn

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Speaker 3: with HPV is that, yes, there's a link to cervical cancer,

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Speaker 3: but males get infected with HPV two, and it can

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Speaker 3: cause forms of reproductive cancers in males, and it can

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Speaker 3: cause cancers in other parts of the body as well.

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Speaker 3: So what's interesting about what happens next is that slowly

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Speaker 3: we change HPV's reputation and we change or start to

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Speaker 3: change public understanding and scientific understanding first of HPV's relationship

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Speaker 3: to cancer generally, males are eventually added. Another HPV vaccine

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Speaker 3: is approved for market, and there are more and more

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Speaker 3: efforts promoting education and an awareness of both HPV and

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Speaker 3: the vaccine for males and females. After a decade on

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Speaker 3: the market, there is way more knowledge about the vaccine's

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Speaker 3: safety profile. HPV becomes normalized. For about the first ten

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Speaker 3: years of the HPV vaccine's existence, we were stuck at

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Speaker 3: below fifty percent, like around forty percent uptake of this vaccine,

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Speaker 3: and a lot of lawmakers and a lot of parents

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Speaker 3: just kind of unwilling to touch it or talk about it.

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Speaker 3: But the trajectory is pretty steadily upward, and in fact,

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Speaker 3: it's continued upward since then. By the early twenty twenties,

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Speaker 3: uptake is over sixty percent across young teens male and

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Speaker 3: female in the US.

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Speaker 1: So most teenagers now, even in the absence of mandates,

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Speaker 1: largely are getting vaccinated against HPV.

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Speaker 3: Yeah, most teenagers, and in fact, I think that in

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Speaker 3: the last couple of years the numbers have continued to

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Speaker 3: march upwards.

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Speaker 1: If we sort of think here about you know, what's

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Speaker 1: happened with the HPV vaccine and this longer history of

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Speaker 1: vaccine mandates in general, what do you think at this

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Speaker 1: point about state mandates for vaccines.

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Speaker 3: This is one of those things where this is so

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Speaker 3: politicized that I want to be very careful about what

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Speaker 3: I say. Mandates are political tools, and in this country,

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Speaker 3: since the era of mandates began at the turn of

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Speaker 3: the twentieth centuries, we have included exemptions to those mandates.

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Speaker 3: Three kinds of exemptions historically a medical exemption, a religious exemption,

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Speaker 3: and a philosophical exemption or a belief based exemption. Those

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Speaker 3: exemptions are to me an indication of how political a

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Speaker 3: tool vaccine mandates are. We knew from the outset that

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Speaker 3: mandates were the best way of ensuring the broad and

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Speaker 3: widespread use of a vaccine, But we also knew that

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Speaker 3: there was going to be resistance because this is a

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Speaker 3: country that was founded on enlightened principles of individual liberty

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Speaker 3: and autonomy, and these ideas about individual rights were in

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Speaker 3: an inherent conflict with the idea of a state mandated

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Speaker 3: vaccination program. The exemptions reconciled those two things. So my

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Speaker 3: feeling is that mandates are an incredibly powerful tool, and

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Speaker 3: that when you have a disease as horrifying as smallpox

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Speaker 3: was in its earliest forms, they are a really important

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Speaker 3: way of stopping this of those diseases. When I, as

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Speaker 3: a historian of medicine, think about the history of disease,

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Speaker 3: I look at COVID. It's a horrible, horrible disease, and

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Speaker 3: then I think about things like smallpox and yellow fever,

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Speaker 3: kinds of diseases we can't even imagine in this country

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Speaker 3: today because of the depth of suffering.

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Speaker 1: Way worse than COVID, just to way.

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Speaker 3: Worse than COVID. Bodies disfigure from internal bleeding, reeking skins

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Speaker 3: sloughing off like left in the street to die. And

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Speaker 3: this is what I see in the past. This is

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Speaker 3: what we were trying to prevent with vaccination. That is

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Speaker 3: what we were trying to prevent with mandatory vaccination. So

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Speaker 3: this is a really, really sticky question, and it's not

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Speaker 3: a question that, in my view, any one individual can

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Speaker 3: come to. It's about a community or a nation state

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Speaker 3: deciding how do we want to balance our values in

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Speaker 3: the pursuit of public health.

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Speaker 1: Thanks to my guest today, Michael Branch and Elena Konis.

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Speaker 1: Next week another show, another virus HSV aka Herpes.

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Speaker 3: When I was diagnosed with herpes, I was like, am

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Speaker 3: I going to have an outbreak forever?

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Speaker 1: And no?

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Speaker 3: Viruses are weird and they don't behave the way you expect.

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Speaker 1: Incubation is a co production of Pushkin Industries and Ruby

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Speaker 1: Studio at iHeartMedia. It's produced by Gabriel Hunter Chang, Ariela Markowitz,

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Speaker 1: and Amy Gaines McQuaid. Our editors are Julia Barton, and

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Speaker 1: Karen Chakerjie mastering by Anne Pope, fact checking by Joseph Friedman.

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Speaker 1: Our executive producers are Katherine Girardeau and Matt Romano. Special

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Speaker 1: thanks to Ian Fraser. I'm Jacob Goldstein. Thanks for listening.