Ep 168 ｜ Vaccines Part 2 with Dr. Paul Offit
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Summary
Dr. Paul Offit is a pediatrician, author, and co-inventor of the Rotating Virus Vaccine. He is also the author of The Cutter Incident, a book about Polio and the polio vaccine. In this episode, Dr. Offit discusses the other side of the vaccine debate: the "anti-vaccine" side.
Transcript
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Hey guys, welcome to Relatable. Happy Friday. I hope everyone has had a wonderful week. Today,
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we are going to do, as promised, the other side of the vaccine debate with Dr. Paul Offit.
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Okay, without further ado, here is Dr. Offit. Dr. Offit, thank you so much for joining us.
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Could you tell everyone who doesn't know, although I think there are a lot of people
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listening who already do, who you are and what you do?
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Sure. I'm an attending physician here in the Division of Infectious Diseases at the Children's
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Hospital of Philadelphia and a professor of pediatrics at the University of Pennsylvania
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And you have been studying vaccines for a long time, correct?
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Yeah, I'm actually the co-inventor of a vaccine, the bovine human reassortant vaccine Rotatech.
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We created those strains in our lab in the 80s, and that became a routinely recommended vaccine in 2006.
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So what inspired you? Maybe that's not the right word, but what encouraged you to go into this
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realm? Why have you dedicated so much of your career, not just to studying vaccines and creating
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a vaccine, but also talking about the importance of vaccines?
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I think the real answer to that question is, you know, when I was five years old, I was in a polio ward.
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So I didn't have polio, but I had had a basically unsuccessful operation on my right foot for
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a congenital deformity. But I remember that. I mean, this was back in the 1950s. You know,
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it's not like there were play dogs and TVs and therapeutic pets. There was just a ward where there
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were 19 children with polio. And I just think I saw them as vulnerable and helpless and alone.
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There was only one visiting hour a week. It was pretty grim. And I think that image always stuck
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with me. And it certainly propelled me to go into pediatrics and ultimately actually to write a book
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about polio and the polio vaccine, which I wrote about nine books ago called The Cutter Incident.
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But yeah, I think that's it. I think it's just this. I guess we at some level are always treating
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ourselves. I think that's true for me, too. And I said that image of me as a child always stuck with me.
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Yeah. You have plenty of detractors in this day and age. This is obviously a very passionate debate,
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especially over the last few years. Your detractors say, oh, you can't listen to anything he says
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because he's bought and paid for by the pharmaceutical companies. Is that true?
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What should I have done differently? I mean, we created strains that we thought could prevent a
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disease that causes about 75,000 children to be hospitalized every year and about 60 children
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to die every year in the United States. It kills 2,000 children a day in the developing world.
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So I'll ask you, what should I have done differently? When we had the strains that we thought could be a
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vaccine to prevent all this suffering and hospitalization and death, several things are
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true. Only pharmaceutical companies have the resources and expertise to make the vaccine.
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That was a $1.2 billion effort on the part of the company that made it. They're not going to make it
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unless the technology is protected, which is, say, patented. I mean, should I just have just stopped
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right there when we created strains that we thought could be a vaccine and left it at that? I mean,
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I think people just think that any time you ever associate with a pharmaceutical company,
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you're evil. Now, I mean, the fact of the matter is, I was never paid by that pharmaceutical company.
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I mean, my funding always came from the National Institutes of Health via a series of grants. And
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even when we padded that vaccine, I work at Children's Hospital of Philadelphia. I am the
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intellectual property of this hospital. They own that patent, not me. So they're the ones who sold
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the patent out more than 10 years ago. I don't make a penny from pharmaceutical companies. I don't make
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a penny from vaccines. Talk to me about this vaccine-hesitant movement or people who are very
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concerned about vaccines. Do you think you've dealt, you know, you've dealt with them a lot and
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you've dealt with their arguments a lot. Do you think that there is a whole lot of legitimacy to
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this side? I think that parents should be skeptical of anything they put into their children's bodies,
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including vaccines. So I think it's perfectly reasonable to ask the question, especially now.
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I mean, you know, when I was little, I had measles. I had mumps. I had German measles. I had
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chicken pox. I was a child of the 50s and 60s. But my parents, who were children in the 20s, had,
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you know, they saw diphtheria as a routine killer of teenagers. They saw polio as a crippler.
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My children are like you. I mean, they're in their mid-20s. They, you know, they don't see these
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diseases today. They didn't grow up with these diseases. So I think with that, knowing that the
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disease is much less common, it's, I think, safety becomes paramount. So I think it's perfectly
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reasonable to ask the question, yes, I think you should, I mean, should ask that we, you know,
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today we ask parents like you to, in the first few years of life, to prevent 14 different diseases.
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That can mean as many as 26 inoculations during that time. It can mean as many as five shots at
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that time to prevent, or at one time, to prevent diseases most people don't see using biological
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fluids most parents don't understand. So I think it's perfectly understandable how it can be confusing.
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But there's a difference between being skeptical and being cynical. I think that if, for example,
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one has the question, look, my child was fine. They got a vaccine. Now, months later,
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they're developing signs and symptoms of autism. Could the vaccine have done that? That's a fair
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question. The good news is it's an answerable question. So when study after study after study
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shows that, in this case, for example, vaccines don't cause autism, then you should believe it.
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I mean, I think that the public health community and the academic community, when parents have
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questions about vaccines, do respond to those questions by spending tens of billions of dollars
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to answer that question. So it's very frustrating, I guess, for people like me, that when those
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studies are done and then people still don't believe it, that's when they cross the line from skeptic
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to cynic or worse, sort of conspiracy theorists. And I think, you know, your question before about
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am I in the pocket of industry, right? I mean, it's if the only reason that I would ever stand up on
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behalf of children would be because I would be in the pocket of industry. Isn't it remotely possible
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that I stand up for the children for the same reason that I went into pediatrics, for the same reason
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that I devoted 25 years of my life to make a vaccine to help children? Right. Wouldn't that
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also be a reasonable explanation? Right. Do you think that part of the problem or part of the
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reason why these fears can kind of snowball sometimes is not only because of some people's
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own experiences, like you mentioned, but also because some pediatricians just maybe aren't
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equipped to talk about vaccines and how they how they work. Do you think that could be part of the
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problem? Yeah, I think time is also it too. I mean, I think for my wife is a private practicing
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pediatrician, you know, so she'll see sometimes 40 or 45 patients in a day. It's hard, I think,
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to really devote time to answer the question that all parents have, or many parents have about
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vaccines. So I think it's frustrating on both sides. I think it's frustrating for the parent
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because they have reasonable questions and don't feel they're given necessarily the time to have those
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questions answered. And it's frustrating on the part of the pediatrician that often there isn't that
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time, which is why at Children's Hospital of Philadelphia, we created the Vaccine Education
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Center to try and at least provide information for parents that have questions about vaccines,
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and frankly, for doctors that also that have questions about vaccines.
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A really big concern that I've heard a lot of parents say is about the ingredients in vaccines. So
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they cite aluminum, formaldehyde, even human fetal cells. They're worried about that. They think that
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these are neurotoxins that we're injecting into our pure little babies and that they will lead to all
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kinds of things either down the line or either within 24 hours. What do you say to parents who
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are worried about ingredients that sound kind of bad? Well, I think it's perfectly reasonable to ask
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the question. I mean, you know, we take children, for example, at two months of age, we pin them down
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against their will and we inoculate them with five different, as many as five different shots that
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contain agents that sound scary. So is this doing harm? I mean, take formaldehyde, for example,
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you mentioned that. I mean, you know, when people hear the word formaldehyde, they think this is used
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to preserve people when they're dead. I mean, why would we ever give this to a child? Remember,
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though, that formaldehyde is a product of single carbon metabolism. We've been making formaldehyde in
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our bodies ever since we crawled out of ocean onto land. You have 10 times more formaldehyde in your
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circulation than you would ever get from a vaccine. I mean, similarly, aluminum is the most common heavy
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metal on the Earth's crust. Assuming you live on the Earth's surface and you drink the water that
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or anything made from water, including breast milk or infant formula, again, you'll be exposed to
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logarithmically more aluminum than you would ever be exposed to in vaccines. So this notion of that
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your child, once they enter the, once they leave the birth canal and enter the world, are in this
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sterile, free, you know, sort of toxin-free environment is not true. I mean, the dose always makes
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the poison, which is to say, certainly aluminum at high concentrations can be dangerous, but, you know,
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you're not exposed to anything near those concentrations in vaccines. Remember, you're
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exposed to aluminum every day, assuming you live on the Earth's crust. And you think that right now,
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the CDC schedule that is suggested for infants is totally safe. I know that's a huge worry that a lot
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of new parents have. I think nothing is totally safe. I think that anytime you give a medical product,
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whether it's a biological-like vaccines or a drug like ampicillin or moxicillin, you know,
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we would only recommend that if the benefits clearly and definitively outweigh the risk. But
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do vaccines have risks of course they do? I mean, you're asked to stay in the doctor's office 15
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minutes after you get a vaccine to make sure that your child doesn't have a so-called allergic or
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hypersensitivity reaction, so-called type 1 immediate hypersensitivity reaction, which can cause a lower
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blood pressure. It can cause shock. It's extremely rare. But, you know, the doctor's
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office has the epinephrine in hand were that ever to happen. Measles-containing vaccine can cause a
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lowering of the platelet count. It's transient. Platelets are these small cells in your bloodstream
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that help the blood to clot. That can cause a lowering of the platelet count, which can cause
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these little, what looks like little broken blood vessels on your skin. It doesn't have permanent
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harm, but it certainly is frightening. I mean, vaccines can cause fever. Fever can cause febrile
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seizures, which is primarily seeing children less than five years. My daughter had a febrile seizure
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when she was two associated with the DTAP vaccine. So it's certainly hard to watch. It doesn't have
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permanent sequelae, but again, it's scary. The oral polio vaccine, which we gave in this country
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from 1963 up until 2000, could itself cause polio. That vaccine could itself cause polio. It was rare.
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It occurs in one per 2.4 million cases, but it was real. So no, I think nothing is absolutely safe. I mean,
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walking outside on a rainy day, you can be struck by lightning. People die in shower and bath-related
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accidents every day. Nothing is absolutely safe. So the issue is always do the benefits outweigh the risks?
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But you obviously believe that in most cases, the benefits do outweigh the risks in vaccines.
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I think assuming there's not a medical contraindication to getting a vaccine, like
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if you're severely immune compromised because you have cancer, because you're getting
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immune suppressive therapies for a chronic disease, if you're not, you don't have a medical
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contraindication, yes, I think the benefits of every vaccine outweigh its risks.
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Even something like polio that has been, I guess, I don't know if scientifically you even used the word
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eradicated ever, but seems to have been eradicated in this country. You feel like it's better for someone to
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get the vaccine, even though they probably won't get the disease.
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Well, so polio hasn't been eradicated from the world. I mean, there are still three countries
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in which polio is endemic. And so do I think that there are people, remember, only about one of every
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200 people with polio will have symptoms of paralysis. So yet they'll be shedding bacteria
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in their stools. Do I think that polio, people shedding poliovirus in their stools occasionally walk
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into LA airport or New York's LaGuardia airport every year? Yes, I think they do. If you lower immunization
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rates here far enough, polio could come back. But the point you make, though, that smallpox has
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been eradicated. We haven't seen a smallpox, a case of smallpox, any in the world since the 1970s.
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And that's why we stopped giving that vaccine. So I think, could we stop giving the polio vaccine
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if polio is eradicated? Absolutely. And I think we're getting there, just not quite there yet.
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Some people say that it has nothing to do with vaccines at all, that actually things like polio,
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smallpox, all of that were starting to dwindle before the vaccines were actually introduced.
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And so they say, you know, there's really no purpose in vaccines. We've got all the other
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stuff kind of taken care of just by other forms of modern medicine. What do you say to that?
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Well, so if you look at the curve, as sanitation in the home or hygiene generally in the country got
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better, you did start to see a slight decline. However, once you introduced the vaccine, there was a
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dramatic decline. And if you look at a disease like Haemophilus influenzae type B, which is a
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bacterial infection that causes meningitis and bloodstream infection and pneumonia, I mean,
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that was a common disease. There were 25,000 cases a year. That dominated my residency. I mean,
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I was a resident in pediatrics at Children's Hospital in Pittsburgh in the 1970s, late 1970s.
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That vaccine didn't really come into existence until the 1990s. When you saw that vaccine come into
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existence, the instance of that disease virtually eradicated the disease. I mean,
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no vaccine has been more powerful in my medical lifetime since that. We've gone from 25,000 cases
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a year to fewer than 50 cases a year. I mean, I saw a case of meningitis caused by that bacteria
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every week when I was a resident. And now it is the rare doctor in this hospital who's ever seen a
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case of that disease. Gotcha. There are a lot of parents who claim that their child has been
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irrevocably harmed by a vaccine and they feel like there's really no place where
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they can be listened to. They kind of feel like the mainstream world thinks that they are lying,
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that they're making it up. But of course, to them, it is very much real. What do you say to someone who
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feels like they're kind of isolated in their fear and concern about vaccines because of what
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has happened to their child? I'm sure it's frustrating for them. But the fact is,
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is that just because one event follows another, it doesn't mean it's caused by the other. I mean,
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my wife gives a perfect example. When she was in the office helping the nurse give vaccines once on a
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weekend morning, while my wife was drawing that vaccine up into the syringe, there was a four-month-old
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sitting on the mother's lap. So she hadn't given the vaccine yet. She was just drawing it up into the
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syringe. That four-month-old had a seizure and went on to have a permanent seizure disorder and
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was dead by age five of a chronic neurological disease. I think if she had given that vaccine
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five minutes earlier, and then the mother, and then the child had a seizure, and then the child
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went on to have a permanent seizure disorder, i.e. epilepsy, and then went on to die of a chronic
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neurological disease, I think there are no amount of statistical data in the world that would have
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convinced that mother of anything other than the vaccine caused it. You know, we think I'm stupid.
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My child gets a vaccine, five minutes later has a seizure, and now has this permanent seizure
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disorder. I know what I saw. In fact, but as it turns out, she was just drawing the vaccine up into
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the syringe. But I can understand the compelling nature of anecdote. But the fact of the matter is
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not all anecdotal associations are causal associations. But I think it raises the question.
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So when a parent says, could this vaccine have caused permanent harm, I think it's then incumbent upon
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the medical community, the public health community to do studies to answer that question. And when the
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answer is then no, I think parents have to believe it. But many or some don't.
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Have there been studies to show I know we talked about studies associated with vaccines and autism,
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have there been studies to show that for example, vaccines don't cause SIDS or don't cause
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Yes, over and over again. I think when the SIDS issue came up, which was primarily with the
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hepatitis B vaccine in the 90s, you know, because that was the first vaccine we were giving to
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newborns, you know, I think people were concerned. And so it's not hard to do these studies. You just
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have to take large numbers of children, retrospectively see who got the vaccine, who didn't,
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make sure you control for those two groups in terms of all other things like healthcare seeking
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behavior, medical background, socioeconomic background, so that you can isolate the effect of
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that one variable, in this case, receipt of a vaccine, and then see whether there's a greater
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incidence in one group versus another. I mean, these are very sensitive studies. When I said
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before that the oral polio vaccine could cause polio in one per 2.4 million children, that's a
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very rare event, yet it's easily picked up in a retrospective analysis. So these retrospective
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analysis are quite powerful. And I guess the frustration for me is when, you know, parents are upset and
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certainly they get upset at me occasionally. It's just all I can say is, you know, that we've looked
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and in our website, you know, the Vaccine Education Center website, we have a place called Vaccine Safety
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References. And then we list all the things parents are concerned about. And then we list all the
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references with like a two or three sentence description of that reference. So parents can
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look at the original data if they want. I think a concern is even if a parent does go to that page and
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reads all the FAQs and things like that. The concern is liability. That's a question that I've
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received a lot is what about the liability for these companies who are making the vaccines? Do
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you think that there is enough accountability there for safety? Yes. So right now we have in
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place something called the Vaccine Injury Compensation Program. So if you want to, if you want to sue a
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vaccine maker, you can, you just have to go through this program first. So let's say you believe that
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your child's autism was caused by vaccine. You can try and go through the Vaccine Injury
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Compensation Program. You won't get compensated there because there's too much data showing that
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it doesn't cause autism. But you can still sue the company directly. There's nothing that stops you
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after going through the program from suing the company directly. Nothing. And I think that's a
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misconception people have. They think that these companies are protected from liability. They're
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not. You have to go through this Vaccine Injury Compensation Program first. And frankly, the bar is
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quite low. I mean, they will occasionally, you know, compensate people for harms that really aren't
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caused by vaccines just because they want to keep the bar low. Right. If you can, let me say it this
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way. If you can't win in the Vaccine Injury Compensation Program, you're going to have a hard
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time winning in civil court. Yeah. They probably have a lot of difficulty because like you said,
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correlation doesn't necessarily prove causation. But for parents who believe that it was the vaccine
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that causes that caused epilepsy or SIDS or something like that, I do think that they have a hard case
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before them, even if they happen to be correct in a particular scenario, because you did say that
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vaccines can cause fevers that did that then cause seizures. So is it not possible that a reaction like
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that could cause permanent harm? And so we've looked, I mean, you know, certainly febrile seizures,
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meaning seizures associated with fever, children, you know, between six months and five years of age,
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or primarily two years to five years of two to five years of age, are especially prone to febrile
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seizures. That does not cause permanent harm. It's, it is, they're usually 30 second seizures.
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They're tonic-clonic meaning generalized seizures. And study after study has shown that doesn't cause
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permanent harm. So again, when this issue first came up, I'd say in the early eighties,
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with associated with a film called DPT vaccine roulette, the question was, could the whole cell
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pertussis vaccine, which we don't use anymore, but was used then, could that cause permanent harm?
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Could it cause epilepsy? Could it cause developmental delay? Study after study looked at children who
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received the whole cell pertussis vaccine? I mean, some of them who would have febrile seizures
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and found that they didn't. Now, now the, the children who had quote unquote permanent harm,
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when you looked at, when we finally had the genetic tools in hand to answer the question,
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why did those children have, have sort of permanent seizure disorder, permanent developmental delay?
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And the answer was invariably that they had something called Durvet syndrome, which is this SCN1A
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mutation. It's a sort of sodium channel transport defect, which is not caused by vaccines. It's genetic.
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And so, um, you know, it's just, it's, it took a while, I think to understand that, but I can
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understand how that these anecdotal associations are powerful. And we were always looking for a
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reason for why something caused something else, but, and vaccines are kind of the universal scapegoat
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because they're given to healthy children and 90% of people in the United States will have their
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children vaccinated. And, you know, the problem with vaccines is they only prevent vaccine
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preventable diseases. They don't prevent everything else that can happen in the first few years of life,
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life, but there's always going to be those associations.
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Some people say that really they don't have a very long lasting effect. So I've heard
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about herd immunity. Some people say that herd immunity is a myth because, uh, by the time people
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are adults, their immunity has worn out from the childhood immunizations that they've gotten.
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Depends on the vaccine. So, so the whooping cough vaccine, for example, um, even though you get the
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vaccine at two months, four months, six months, again, at 12 to 15 months of age, again, at four
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to six years of age, again, at 11 to 13 years of age, that's six doses, still three to five days,
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sorry, three to five years after that sixth dose, immunity will start to fade. The mumps vaccine,
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which was given as a two dose series, primarily 12 to 15 months of age, again, at four to six years of
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age, 10 years after dose one and 10 years after dose two, immunity will start to fade. Measles,
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on the other hand is an excellent vaccine. I mean, a single dose of that vaccine provides 93%
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protection for the rest of your life. The second dose provides 97% protection for the rest of your
00:21:18.280
life. And if you want to know that herd immunity is real, just look at what's happening now with
00:21:21.880
measles because a critical number of people have chosen not to vaccinate their children
00:21:25.880
for this highly contagious vaccine preventable disease. And that's why it's come back. I mean,
00:21:30.520
if we get immunization back rates back up again, in certain communities, you'll see that disease
00:21:34.920
disappear. That's the perfect example of herd immunity, the reality of herd immunity.
00:21:39.880
And what I've heard to that, the people who I would say are vaccine hesitant, they've said,
00:21:44.920
okay, it's not the children who are immunized, who are getting and spreading the disease. It's
00:21:48.840
actually adults who were immunized as children, but they are no longer immune anymore. But you're
00:21:55.240
saying that that's not possible or true. Measles, measles vaccine immunity is durable and long
00:22:01.880
lasting as distinct from the mumps component of the MMR vaccine. Measles and rubella are
00:22:06.680
quite long. That's why we eliminated measles from this country in the year 2000. That's why we
00:22:10.440
eliminated rubella or German measles in the year 2005. We've never eliminated bumps because immunity
00:22:16.440
is not, you know, is only about, it lasts for about 10 years after each dose. No, it's, it's the
00:22:21.800
perfect, if you look at what percentage of children who are currently, who currently have measles,
00:22:26.120
you know, are unvaccinated. It's about 90%. If they were vaccinated, they wouldn't get measles.
00:22:32.200
And some parents say to that, well, it's better that they have natural immunity than they have
00:22:37.960
unnatural immunity from vaccines. What would you say to that parent?
00:22:42.360
Well, if the question is, do you have a higher titered immune response following natural infection,
00:22:48.200
then immunization answers yes. You have about threefold higher antibody levels in your bloodstream if
00:22:52.760
you get naturally infected and then if you're vaccinated. But so the question with vaccines
00:22:56.680
is not, is it the same as natural immunity? The question is, is it good enough? I mean, remember,
00:23:01.960
occasionally people have to pay a high price for natural immunity. Before there was a measles
00:23:05.960
vaccine. And remember, I had measles. I mean, anybody my age had measles. Every, every year,
00:23:10.920
two to three million children would get measles. 48,000 would be hospitalized and 500 would die.
00:23:15.800
It's kind of like my generation with chicken pox. We all had chicken pox when we were little.
00:23:19.640
Yeah, that's because you're still alive. I mean, remember, every year about 100 people would die
00:23:26.040
from chicken pox. I mean, you're not going to have those people on your show and they're not
00:23:29.240
doing shows like yours because they're dead. So again, if natural infection, if you can survive
00:23:34.760
natural infection, great. But for vaccines, what you hope is that the vaccines can induce at least
00:23:39.320
can induce a level of immunity that's good enough to prevent disease, which certainly was true with
00:23:43.560
measles. We eliminated measles with vaccination, i.e. immunization was good enough to prevent this
00:23:49.560
disease. But now people are choosing to not vaccinate their children and put them in harm's
00:23:55.000
way unnecessarily. One of the most scandalous vaccines, scandalous as in just the reputation
00:24:01.400
or just the PR surrounding it has been Gardasil, the HPV vaccine. I guess just what are your general
00:24:08.360
thoughts on that? There's a lot of fear surrounding that particular vaccine.
00:24:12.120
The HPV vaccine, which was introduced initially for girls in 2006 and boys in 2010, 2011,
00:24:18.600
is a disease that prevents cancer. It will prevent 30,000 cases of cancer a year and 5,000 deaths a
00:24:25.480
year, head, neck, anal, genital cancers. That vaccine is the most studied vaccine post-licensure.
00:24:32.120
It's been formally studied in more than a million people. The only thing that vaccine causes is
00:24:37.400
fainting. And you don't even have to get it to fain. You can be just the unsheathing of the needle
00:24:42.680
sometimes can do it or being second in line. I mean, I don't understand this. I mean, if you ask the
00:24:49.080
question, what vaccine preventable disease kills more people than any other, the answer is influenza.
00:24:55.800
The second vaccine is HPV. I mean, HPV will prevent 5,000 deaths a year, but only about half of girls
00:25:04.120
and half of boys who were recommended to receive that vaccine, i.e. adolescent boys and girls,
00:25:08.280
get it. Therefore, 2,000 to 2,500 of those children will grow up and die from a preventable cancer
00:25:14.440
because of the misinformation that surrounds that vaccine. And I don't understand it. I mean,
00:25:18.840
it doesn't cause rheumatoid diseases. It doesn't cause chronic disease. It doesn't cause chronic pain
00:25:24.040
syndrome. It doesn't cause chronic fatigue syndromes. Nonetheless, people are compelled
00:25:28.120
by, you know, by the fact that there's been these sort of temporal but not causal associations to
00:25:33.080
continue to try and damn this cancer preventing vaccines. And it's our children that are suffering
00:25:38.120
that misinformation. Well, honestly, I don't even know what the misinformation is. I just keep hearing
00:25:44.440
the scariness surrounding the HPV vaccine, but I haven't actually found any stories or
00:25:49.320
any research about what people think is so scary about it. So what are people saying about the HPV
00:25:57.240
vaccine? Yeah. So when Katie Couric did a show about this a few years ago, she had a couple of
00:26:02.040
mothers on the show who claimed that it caused chronic pain or chronic fatigue syndromes. But again,
00:26:06.840
that's not true. Well studied in large numbers of people. Of all the vaccines that we've talked about
00:26:13.240
so far today, that's the one that upsets me the most. I mean, it's a cancer preventing vaccine.
00:26:19.240
What do people want from vaccines? Is this going to save 5,000 lives a year every year in the United
00:26:25.240
States? And yet people are hesitant. It's really, really frustrating. One question that I have just
00:26:30.920
as a mom of a newborn is about the Hep B vaccine that we give newborns. Is there a reason why it's
00:26:39.080
recommended even if neither of the parents are Hep B positive? That just always confused me of why
00:26:45.640
that's necessary for a newborn that doesn't seem to be really at risk of getting Hepatitis B.
00:26:50.200
Right. So it makes certain assumptions. We assume that when we test you to see whether or not you're
00:26:56.440
infected with Hepatitis B, that that test is 100% accurate. And it's close, but no test is 100%
00:27:03.960
accurate. Secondly, it assumes that you don't acquire Hepatitis B between the time when you're tested to the
00:27:08.760
time that you deliver. Third, it assumes that the child would never be in contact with someone
00:27:13.560
who has Hepatitis B. Remember about a million people in this country have Hepatitis B and don't
00:27:17.800
know it. And when they come by and they kiss your child, they may be shedding Hepatitis B in their
00:27:22.760
saliva and you don't know it. So because this disease is deadly, if it affects newborns, because
00:27:28.760
that's the child that's most likely 90% chance if they get infected as a newborn to grow up to develop,
00:27:34.360
you know, either liver cancer or chronic liver disease, that's why it's really important. And it's a safe and
00:27:38.680
effective vaccine. So there's no reason not to give it. The flu shot. How effective is that?
00:27:44.840
There's a lot of controversy, I think, just not even from people who are vaccine hesitant. I know
00:27:49.560
a lot of people who will not get the flu shot. They claim it gives them the flu, claim that it gives
00:27:55.320
them all kinds of terrible symptoms and they just won't do it. They'll get every other vaccine,
00:27:58.920
but the flu shot they won't get. How important is it, do you think, to get the flu shot?
00:28:03.320
Well, again, influenza kills 30,000 to 40,000 people a year in this country. I mean,
00:28:09.080
it's primarily, you know, the extremes of age. So those over 65 or those very young, but
00:28:15.720
flu's hard. I mean, I studied in a flu lab actually at the Wistar Institute here in Philadelphia in the
00:28:20.280
early 1980s. And the guy who was the head researcher said something to me, I'll never forget. He said,
00:28:24.680
if you want to have a research career that lasts for the rest of your life, study influenza. I mean,
00:28:29.000
it's a moving target. But again, and last year, last year we missed. I mean, last year, the so-called
00:28:34.760
H3N2 strain that came up towards the end of the year was not covered by the vaccine. So the vaccine
00:28:40.200
was only about 30% effective. But when you're talking about a virus that causes, you know,
00:28:45.480
millions of people to be, or hundreds of thousands of people to be hospitalized and tens of thousands
00:28:50.360
to die, 30% is still something. Typically it's 40 to 60% effective, but it's never 100% effective.
00:28:55.800
I mean, the best you're going to do is about 40 to 60% effective. But when people say, you know,
00:29:00.360
I got the flu from the flu vaccine, what are they talking about? I mean, it's just two proteins from
00:29:04.760
the influenza virus, the hemagglutinin and normidase. That virus that's given as a shot
00:29:08.520
cannot possibly reproduce itself. It's dead. Therefore it can't possibly cause symptoms of
00:29:13.080
influenza. I think what happens is people go to a doctor's office, get, get the flu vaccine at the
00:29:17.720
doctor's office or exposed there to somebody who has an upper respiratory tract infection, and then say,
00:29:23.080
you know, I got flu from the flu vaccine. It's not possible to get flu from the flu vaccine shot.
00:29:28.040
Or maybe could they have gotten maybe a low grade fever from the vaccine and they kind of assume,
00:29:37.080
Yeah. Well, as, as was said, when I was a medical student, if medical students want to
00:29:40.760
learn what it's really like to be getting sick, get influenza. Influenza is not a subtle disease.
00:29:44.840
I mean, you can date the hour in which you start to get it. It's, you have an intense headache,
00:29:48.760
you have fever and shaking chills, and then it occasionally spreads to your lungs and causes
00:29:52.680
pneumonia. Influenza knocks you on your butt. You miss days of work or days of school with
00:29:57.320
influenza. It's not like a low grade fever. No.
00:30:00.520
Okay. We're almost finished. I want to ask you about one of the most contentious topics,
00:30:05.160
and I'm definitely not assuming that we agree on politics, but as a conservative,
00:30:10.120
someone who's pro-life, a question that I get all the time is about fetal cells in vaccines.
00:30:17.400
Some people say that it's completely a myth, but it's not actually a myth. Tell me about it,
00:30:23.480
how that all works. Well, so it's not a myth. I mean, there are two cell lines that were generated,
00:30:28.600
one in England and one in Sweden in the early 1960s, where those cells were obtained from
00:30:33.400
what were therapeutic or not even therapeutic. They were elective abortions. Both were elective
00:30:37.800
abortions. Those cells had then been used to make the chicken pox vaccine, the hepatitis A vaccine,
00:30:43.880
the rubella or German measles vaccine, and one of the rabies vaccines. So there are four
00:30:47.240
vaccines that are made using human fetal cells. Now, I can understand, I mean, from the standpoint,
00:30:52.600
say, of a Catholic, that that's abhorrent. I mean, abortion is a sin, a sin worthy of
00:30:59.320
excommunication, where you don't get to participate in the sacraments of the Catholic Church. And so,
00:31:04.920
reasonably, I think when this became an issue in the 1990s, really, people asked the Pontifical Academy
00:31:11.880
for Life, which is the major policy-making body of the Catholic Church, can I do this as a Catholic?
00:31:16.520
Can I reasonably vaccinate my child as a Catholic? And the answer was yes. I think primarily because
00:31:21.400
the Catholics, like all Christians and Jews and Muslims, all religions care about their children.
00:31:26.760
They care about the health of their children and vaccines, you know, put the children in the
00:31:30.440
healthiest position possible. So I think that, you know, the Pontifical Academy for Life at the time,
00:31:35.480
the person who made that decision was Joseph Ratzinger, you know, who ultimately became Pope Benedict XVI.
00:31:40.120
So I think there is a ruling from this, from this, you know, advisory body. But I understand the
00:31:47.160
question. But the reason that fetal cells were used was that you always worried that these cells
00:31:52.440
that were obtained from, say, monkey kidneys, which were used to make the polio vaccine,
00:31:56.440
you know, could be contaminated with another virus, whereas fetal cells, you know, are sterile.
00:32:01.400
So no other fetuses have been used since these two fetuses from the 1960s.
00:32:06.040
Because a lot of people, I don't even know necessarily the sources. But when I was preparing
00:32:12.120
for this and kind of asking my audience, OK, what's a question that you would ask Dr. Offit?
00:32:16.280
There were a few people who said, no, it's not true that there were only two fetuses used in the 1960s.
00:32:21.000
There have been multiple fetuses that have been experimented on and used, which is part of why
00:32:25.320
some people just wholesale reject vaccine to the vaccine industry.
00:32:32.040
Gotcha. OK, one last question. I think it's one last question. Another concern that people have
00:32:41.480
is that they say that vaccines are not tested for causing cancer or impairing infertility. Is that true?
00:32:47.640
So here's the way. So typically, take the HPV vaccine, for example. So that vaccine was tested
00:32:54.440
for seven years pre-licensure in about 30,000 people to show that you can induce a protective
00:32:59.960
immune response, to show that it protected against so-called SYN2, SYN3, which is sort of a requisite
00:33:04.920
step to developing cancer of the cervix, and to show that it could prevent infection. So that's what
00:33:11.000
you had. You had 30,000 people that were tested. But that's, you know, it's not 10 years of study.
00:33:15.160
It's not 20 years of study. So do we study those vaccines then decades later? Yes. So I guess,
00:33:22.040
I mean, I think it's reasonable for people to say, you know, but do you know everything? And
00:33:27.000
the answer, I think, invariably in medicine is no. You never know everything. The question is,
00:33:31.480
why do you know enough? When do you know enough in this case to say it's reasonable to get the HPV
00:33:35.880
vaccine? I mean, you knew you had seven years of data. You knew that the vaccine was made using the
00:33:39.960
same technology that was used to make the hepatitis B vaccine, which had been around for a lot longer
00:33:44.680
and was shown to be, you know, safe and at least over long term effective and protective and didn't
00:33:49.400
cause anything else. Plus, it doesn't make sense. I mean, why this HPV vaccine would cause a problem
00:33:54.920
since it's just made from the outer surface protein of the virus? I mean, HPV can cause cancer. And so,
00:34:00.920
you know, if you're giving the HPV vaccine, could that cause cancer? First of all, remember that it's
00:34:04.760
not a live virus, so it can't reproduce itself. Second, the two proteins of HPV that cause cancer,
00:34:10.200
so-called E6 and E7, are not in that vaccine. Therefore, it doesn't make biological sense it
00:34:14.600
would cause cancer. So the question when we launched that vaccine, when it was recommended
00:34:19.080
by the CDC and the American Academy of Pediatrics in 2006, was not, do you know everything? You never
00:34:24.200
know everything. The question is, do you know enough? You certainly know it caused cancer.
00:34:27.560
You certainly know that 30,000 people were getting cancer every year and 5,000 were dying every year,
00:34:32.120
and that a choice every year not to give it was a choice to condemn those children to those cancers
00:34:36.840
and to those deaths. The question is always, when do you know enough?
00:34:40.600
Delayed vaccine schedule. Your thoughts on that?
00:34:45.160
Vaccines are tested in combination before they can be put onto the market. So with that rotavirus
00:34:51.960
vaccine, for example, we had to prove that the vaccine didn't affect the safety or immunogenicity
00:34:55.800
profile of existing vaccines and vice versa. Those are called concomitant use studies, and there's
00:35:00.040
hundreds of them. So these are well-tested schedules, well-hewn schedules. When people make up their own
00:35:05.560
schedule, i.e. a delayed vaccine schedule, all they're doing is increasing the period of time
00:35:09.800
during which children are susceptible to these diseases with no benefit. So they may feel better.
00:35:14.520
It may feel like it's better, but it's not better. I think you've answered a ton of questions and
00:35:19.880
concerns that a lot of people have. Not necessarily people who are anti-vaccine, but are reading a lot of
00:35:26.200
information online and just aren't sure what to think. So I really appreciate that. Are there other
00:35:31.320
resources that you would direct people to for good, solid information on vaccines?
00:35:37.240
Sure. I think while our Vaccine Education Center at Children's Hospital of Philadelphia,
00:35:40.280
we've spent a lot of time and money trying to create, you know, trying to show these studies
00:35:45.080
in a way that's understandable to people who don't necessarily have a science background.
00:35:49.560
The Centers for Disease Control and Prevention, the American Academy of Pediatrics,
00:35:53.240
a group called Vaccinate Your Family, a group called the Immunization Action Coalition out of
00:35:57.880
Minnesota. They all have great websites, all for the purpose of trying to explain ourselves again.
00:36:03.800
I mean, I think the fact of the matter is that we don't see most of these diseases today anymore.
00:36:09.160
So for young people like you, you're less compelled by these diseases. I mean, there was not an anti-vaccine
00:36:14.600
movement associated with a polio vaccine. People desperately wanted that vaccine. I mean,
00:36:19.480
we're living in a different time. So I do think we need to step back and re-explain ourselves,
00:36:23.080
and we're trying to do that. And so I think, see, I separate these groups into two groups. I think
00:36:28.520
there's sort of the vaccine skeptic, which is fair. I think I'm a vaccine skeptic. I mean,
00:36:32.840
I'm on the FDA's Vaccine Advisory Committee. All of us that sit around that table are vaccine skeptics.
00:36:37.720
We want to see the data. And I think that when there's data, that's fair. But I think that the
00:36:43.160
other group, and that's the group I call anti-vaccine, are vaccine cynics. They think that there's
00:36:47.480
just a conspiracy that people like me are part of that conspiracy, and therefore we're not to
00:36:51.800
be believed. And rather, you should just believe what that you find on the internet,
00:36:55.320
which often can be enormously misinformative. So I think that's the frustration is the conspiracy
00:37:00.520
theorists. There's a whole other debate that we won't get into, but that is a huge part of this,
00:37:05.480
is the mandates or the so-called mandates coming down from state governments that people,
00:37:12.280
that kind of makes people, I think, even more skeptical. People who are questioning before
00:37:17.240
they're already worried about big pharma. They're already worried about what's in vaccines. Well,
00:37:20.840
now you've got another group of bureaucrats telling you, well, this thing that you're skeptical about,
00:37:25.320
this thing that you're not so sure about, you have to do it in order to go to public school
00:37:29.000
or even private school in California. And if a doctor writes five medical exemptions,
00:37:33.800
then that flags the board to have to review it. And I think some people are scared. Some people are
00:37:38.920
worried, okay, if there was nothing for me to be scared of, then why would I be being bullied by
00:37:44.840
these bureaucrats saying that I have to do this? I think that's another huge point of concern as
00:37:49.640
well. Yeah. I mean, I think in a better world, you wouldn't need mandates. I mean,
00:37:53.800
I think in a better world, people would get good information and make good decisions for their
00:37:57.640
children, which would be good decisions for society. Unfortunately, there's so much bad
00:38:01.000
information out there that people make bad decisions for their children that put them in harm's
00:38:04.840
way, I guess. And when there's outbreaks, you know, it's like that we're seeing now with measles and
00:38:10.520
the United States next year will lose its status from the World Health Organization as a measles-free
00:38:15.960
country. That's just what's about to happen. So should the state in any sense care for those
00:38:23.080
children who are being affected? I mean, remember of the 320 million people in this country, 500,000
00:38:27.960
can't be vaccinated. They depend on those around them to protect them. Do we have any responsibility
00:38:33.960
to those children? I mean, for example, at our hospital, we mandate vaccines. We mandate the flu vaccine.
00:38:39.880
If you work in our hospital, no matter who you are, whether you're a doctor or a nurse or nurse
00:38:43.720
practitioner or environmental services or dietary services, you have to get the flu vaccine. Why?
00:38:49.400
Because you can spread flu in this hospital. And remember, we take care of a vulnerable population
00:38:54.440
of children, many of whom can't be vaccinated. There are children who occasionally get influenza
00:38:58.680
in this hospital, even though they didn't come in with it. And they are especially susceptible
00:39:02.120
because they're sick and often immune compromised. Do we, as a healthcare worker,
00:39:06.520
have a responsibility to them since they're in our care? Do we have a responsibility for those
00:39:10.680
children? Are hospitals decided correctly? Yes. I think that's a microcosm of the bigger macrocosm,
00:39:16.200
which is society. Do you, as a society member, have a responsibility to those with whom you come
00:39:21.400
in contact or with whom your child comes in contact? Do you have a responsibility? Or said another
00:39:25.480
way, is it your right to have your child catch and transmit a potentially fatal infection? And I think
00:39:30.840
you'd like to think in a better world, well, first of all, I think the answer is no. But I do think
00:39:34.600
that, you know, in a better world, we should need mandates. But there's so much bad information out
00:39:38.840
there that's causing people to make bad decisions for their children and for those with whom they
00:39:42.920
come in contact, that that's, I guess, what it's come down to. It's too bad. I wish it didn't come
00:39:47.240
down to that too. And I think you're right. I think it does sort of harden those people who believe
00:39:51.640
that, you know, sort of big pharma or big government are overstepping their bounds. But what do you do?
00:39:56.520
I mean, what do you do when there's five children in the intensive care unit in New York with severe
00:40:01.000
pneumonia caused by measles because their parents made that decision? And some of whom, you know,
00:40:05.480
may have just been exposed for, you know, because other parents made a decision for them. As a parent,
00:40:09.560
you're making decisions for other people's children. When did, when did, when did we cross the line?
00:40:14.200
I have a lot of thoughts on that. That could be a whole other part two different conversation
00:40:18.520
because there's so much there. But I want you to direct people if there's anywhere where people can find
00:40:25.880
you or find your books, I want you to be able to give that information. Well, now they can find me
00:40:32.120
here in my office. That's where I am here at Children's Hospital. But you know, you can, I mean,
00:40:36.120
all the books that I write are all on Amazon, easy enough to find them. Just look at my name,
00:40:41.240
you can find them. Okay, they're around. Perfect. Well, thank you so much for taking the time to talk to me.