Relatable with Allie Beth Stuckey - Ep 168 ｜ Vaccines Part 2 with Dr. Paul Offit

00:00:00.000 Hey guys, welcome to Relatable. Happy Friday. I hope everyone has had a wonderful week. Today,

00:00:04.540 we are going to do, as promised, the other side of the vaccine debate with Dr. Paul Offit.

00:00:11.120 Okay, without further ado, here is Dr. Offit. Dr. Offit, thank you so much for joining us.

00:00:16.960 Thank you.

00:00:17.880 Could you tell everyone who doesn't know, although I think there are a lot of people

00:00:21.060 listening who already do, who you are and what you do?

00:00:23.960 Sure. I'm an attending physician here in the Division of Infectious Diseases at the Children's

00:00:30.000 Hospital of Philadelphia and a professor of pediatrics at the University of Pennsylvania

00:00:34.000 School of Medicine here in Philly.

00:00:35.960 And you have been studying vaccines for a long time, correct?

00:00:40.640 Yeah, I'm actually the co-inventor of a vaccine, the bovine human reassortant vaccine Rotatech.

00:00:46.860 We created those strains in our lab in the 80s, and that became a routinely recommended vaccine in 2006.

00:00:51.940 So what inspired you? Maybe that's not the right word, but what encouraged you to go into this

00:00:59.160 realm? Why have you dedicated so much of your career, not just to studying vaccines and creating

00:01:04.200 a vaccine, but also talking about the importance of vaccines?

00:01:08.620 I think the real answer to that question is, you know, when I was five years old, I was in a polio ward.

00:01:14.800 So I didn't have polio, but I had had a basically unsuccessful operation on my right foot for

00:01:20.880 a congenital deformity. But I remember that. I mean, this was back in the 1950s. You know,

00:01:25.260 it's not like there were play dogs and TVs and therapeutic pets. There was just a ward where there

00:01:31.500 were 19 children with polio. And I just think I saw them as vulnerable and helpless and alone.

00:01:37.320 There was only one visiting hour a week. It was pretty grim. And I think that image always stuck

00:01:43.240 with me. And it certainly propelled me to go into pediatrics and ultimately actually to write a book

00:01:48.940 about polio and the polio vaccine, which I wrote about nine books ago called The Cutter Incident.

00:01:55.040 But yeah, I think that's it. I think it's just this. I guess we at some level are always treating

00:01:58.900 ourselves. I think that's true for me, too. And I said that image of me as a child always stuck with me.

00:02:04.780 Yeah. You have plenty of detractors in this day and age. This is obviously a very passionate debate,

00:02:12.040 especially over the last few years. Your detractors say, oh, you can't listen to anything he says

00:02:17.580 because he's bought and paid for by the pharmaceutical companies. Is that true?

00:02:22.920 What should I have done differently? I mean, we created strains that we thought could prevent a

00:02:26.920 disease that causes about 75,000 children to be hospitalized every year and about 60 children

00:02:33.760 to die every year in the United States. It kills 2,000 children a day in the developing world.

00:02:38.400 So I'll ask you, what should I have done differently? When we had the strains that we thought could be a

00:02:42.580 vaccine to prevent all this suffering and hospitalization and death, several things are

00:02:47.360 true. Only pharmaceutical companies have the resources and expertise to make the vaccine.

00:02:51.600 That was a $1.2 billion effort on the part of the company that made it. They're not going to make it

00:02:56.820 unless the technology is protected, which is, say, patented. I mean, should I just have just stopped

00:03:01.900 right there when we created strains that we thought could be a vaccine and left it at that? I mean,

00:03:06.040 I think people just think that any time you ever associate with a pharmaceutical company,

00:03:09.900 you're evil. Now, I mean, the fact of the matter is, I was never paid by that pharmaceutical company.

00:03:15.000 I mean, my funding always came from the National Institutes of Health via a series of grants. And

00:03:18.780 even when we padded that vaccine, I work at Children's Hospital of Philadelphia. I am the

00:03:23.080 intellectual property of this hospital. They own that patent, not me. So they're the ones who sold

00:03:27.900 the patent out more than 10 years ago. I don't make a penny from pharmaceutical companies. I don't make

00:03:32.400 a penny from vaccines. Talk to me about this vaccine-hesitant movement or people who are very

00:03:39.320 concerned about vaccines. Do you think you've dealt, you know, you've dealt with them a lot and

00:03:45.340 you've dealt with their arguments a lot. Do you think that there is a whole lot of legitimacy to

00:03:50.660 this side? I think that parents should be skeptical of anything they put into their children's bodies,

00:03:57.420 including vaccines. So I think it's perfectly reasonable to ask the question, especially now.

00:04:02.000 I mean, you know, when I was little, I had measles. I had mumps. I had German measles. I had

00:04:08.200 chicken pox. I was a child of the 50s and 60s. But my parents, who were children in the 20s, had,

00:04:13.140 you know, they saw diphtheria as a routine killer of teenagers. They saw polio as a crippler.

00:04:18.460 My children are like you. I mean, they're in their mid-20s. They, you know, they don't see these

00:04:25.000 diseases today. They didn't grow up with these diseases. So I think with that, knowing that the

00:04:29.300 disease is much less common, it's, I think, safety becomes paramount. So I think it's perfectly

00:04:35.180 reasonable to ask the question, yes, I think you should, I mean, should ask that we, you know,

00:04:40.120 today we ask parents like you to, in the first few years of life, to prevent 14 different diseases.

00:04:45.520 That can mean as many as 26 inoculations during that time. It can mean as many as five shots at

00:04:50.160 that time to prevent, or at one time, to prevent diseases most people don't see using biological

00:04:55.240 fluids most parents don't understand. So I think it's perfectly understandable how it can be confusing.

00:05:00.120 But there's a difference between being skeptical and being cynical. I think that if, for example,

00:05:03.800 one has the question, look, my child was fine. They got a vaccine. Now, months later,

00:05:08.200 they're developing signs and symptoms of autism. Could the vaccine have done that? That's a fair

00:05:12.580 question. The good news is it's an answerable question. So when study after study after study

00:05:17.220 shows that, in this case, for example, vaccines don't cause autism, then you should believe it.

00:05:21.860 I mean, I think that the public health community and the academic community, when parents have

00:05:25.800 questions about vaccines, do respond to those questions by spending tens of billions of dollars

00:05:30.660 to answer that question. So it's very frustrating, I guess, for people like me, that when those

00:05:34.940 studies are done and then people still don't believe it, that's when they cross the line from skeptic

00:05:39.660 to cynic or worse, sort of conspiracy theorists. And I think, you know, your question before about

00:05:45.080 am I in the pocket of industry, right? I mean, it's if the only reason that I would ever stand up on

00:05:49.600 behalf of children would be because I would be in the pocket of industry. Isn't it remotely possible

00:05:53.760 that I stand up for the children for the same reason that I went into pediatrics, for the same reason

00:05:57.860 that I devoted 25 years of my life to make a vaccine to help children? Right. Wouldn't that

00:06:03.220 also be a reasonable explanation? Right. Do you think that part of the problem or part of the

00:06:08.980 reason why these fears can kind of snowball sometimes is not only because of some people's

00:06:14.740 own experiences, like you mentioned, but also because some pediatricians just maybe aren't

00:06:19.400 equipped to talk about vaccines and how they how they work. Do you think that could be part of the

00:06:24.360 problem? Yeah, I think time is also it too. I mean, I think for my wife is a private practicing

00:06:29.520 pediatrician, you know, so she'll see sometimes 40 or 45 patients in a day. It's hard, I think,

00:06:34.400 to really devote time to answer the question that all parents have, or many parents have about

00:06:39.200 vaccines. So I think it's frustrating on both sides. I think it's frustrating for the parent

00:06:42.880 because they have reasonable questions and don't feel they're given necessarily the time to have those

00:06:46.480 questions answered. And it's frustrating on the part of the pediatrician that often there isn't that

00:06:51.520 time, which is why at Children's Hospital of Philadelphia, we created the Vaccine Education

00:06:56.020 Center to try and at least provide information for parents that have questions about vaccines,

00:07:01.140 and frankly, for doctors that also that have questions about vaccines.

00:07:04.300 A really big concern that I've heard a lot of parents say is about the ingredients in vaccines. So

00:07:10.420 they cite aluminum, formaldehyde, even human fetal cells. They're worried about that. They think that

00:07:17.520 these are neurotoxins that we're injecting into our pure little babies and that they will lead to all

00:07:25.340 kinds of things either down the line or either within 24 hours. What do you say to parents who

00:07:29.760 are worried about ingredients that sound kind of bad? Well, I think it's perfectly reasonable to ask

00:07:35.400 the question. I mean, you know, we take children, for example, at two months of age, we pin them down

00:07:40.400 against their will and we inoculate them with five different, as many as five different shots that

00:07:45.480 contain agents that sound scary. So is this doing harm? I mean, take formaldehyde, for example,

00:07:51.440 you mentioned that. I mean, you know, when people hear the word formaldehyde, they think this is used

00:07:55.160 to preserve people when they're dead. I mean, why would we ever give this to a child? Remember,

00:07:59.360 though, that formaldehyde is a product of single carbon metabolism. We've been making formaldehyde in

00:08:03.440 our bodies ever since we crawled out of ocean onto land. You have 10 times more formaldehyde in your

00:08:08.240 circulation than you would ever get from a vaccine. I mean, similarly, aluminum is the most common heavy

00:08:13.820 metal on the Earth's crust. Assuming you live on the Earth's surface and you drink the water that

00:08:18.600 or anything made from water, including breast milk or infant formula, again, you'll be exposed to

00:08:23.020 logarithmically more aluminum than you would ever be exposed to in vaccines. So this notion of that

00:08:27.800 your child, once they enter the, once they leave the birth canal and enter the world, are in this

00:08:32.480 sterile, free, you know, sort of toxin-free environment is not true. I mean, the dose always makes

00:08:38.300 the poison, which is to say, certainly aluminum at high concentrations can be dangerous, but, you know,

00:08:43.920 you're not exposed to anything near those concentrations in vaccines. Remember, you're

00:08:47.660 exposed to aluminum every day, assuming you live on the Earth's crust. And you think that right now,

00:08:53.180 the CDC schedule that is suggested for infants is totally safe. I know that's a huge worry that a lot

00:08:58.960 of new parents have. I think nothing is totally safe. I think that anytime you give a medical product,

00:09:05.400 whether it's a biological-like vaccines or a drug like ampicillin or moxicillin, you know,

00:09:10.780 we would only recommend that if the benefits clearly and definitively outweigh the risk. But

00:09:14.880 do vaccines have risks of course they do? I mean, you're asked to stay in the doctor's office 15

00:09:19.700 minutes after you get a vaccine to make sure that your child doesn't have a so-called allergic or

00:09:24.760 hypersensitivity reaction, so-called type 1 immediate hypersensitivity reaction, which can cause a lower

00:09:30.360 blood pressure. It can cause shock. It's extremely rare. But, you know, the doctor's

00:09:35.200 office has the epinephrine in hand were that ever to happen. Measles-containing vaccine can cause a

00:09:41.340 lowering of the platelet count. It's transient. Platelets are these small cells in your bloodstream

00:09:46.160 that help the blood to clot. That can cause a lowering of the platelet count, which can cause

00:09:49.980 these little, what looks like little broken blood vessels on your skin. It doesn't have permanent

00:09:54.700 harm, but it certainly is frightening. I mean, vaccines can cause fever. Fever can cause febrile

00:10:00.820 seizures, which is primarily seeing children less than five years. My daughter had a febrile seizure

00:10:06.000 when she was two associated with the DTAP vaccine. So it's certainly hard to watch. It doesn't have

00:10:12.080 permanent sequelae, but again, it's scary. The oral polio vaccine, which we gave in this country

00:10:16.520 from 1963 up until 2000, could itself cause polio. That vaccine could itself cause polio. It was rare.

00:10:24.780 It occurs in one per 2.4 million cases, but it was real. So no, I think nothing is absolutely safe. I mean,

00:10:31.400 walking outside on a rainy day, you can be struck by lightning. People die in shower and bath-related

00:10:36.380 accidents every day. Nothing is absolutely safe. So the issue is always do the benefits outweigh the risks?

00:10:43.120 But you obviously believe that in most cases, the benefits do outweigh the risks in vaccines.

00:10:48.200 I think assuming there's not a medical contraindication to getting a vaccine, like

00:10:53.200 if you're severely immune compromised because you have cancer, because you're getting

00:10:57.000 immune suppressive therapies for a chronic disease, if you're not, you don't have a medical

00:11:01.200 contraindication, yes, I think the benefits of every vaccine outweigh its risks.

00:11:06.040 Even something like polio that has been, I guess, I don't know if scientifically you even used the word

00:11:12.420 eradicated ever, but seems to have been eradicated in this country. You feel like it's better for someone to

00:11:16.740 get the vaccine, even though they probably won't get the disease.

00:11:19.840 Well, so polio hasn't been eradicated from the world. I mean, there are still three countries

00:11:23.420 in which polio is endemic. And so do I think that there are people, remember, only about one of every

00:11:29.120 200 people with polio will have symptoms of paralysis. So yet they'll be shedding bacteria

00:11:34.200 in their stools. Do I think that polio, people shedding poliovirus in their stools occasionally walk

00:11:39.700 into LA airport or New York's LaGuardia airport every year? Yes, I think they do. If you lower immunization

00:11:45.360 rates here far enough, polio could come back. But the point you make, though, that smallpox has

00:11:51.320 been eradicated. We haven't seen a smallpox, a case of smallpox, any in the world since the 1970s.

00:11:57.520 And that's why we stopped giving that vaccine. So I think, could we stop giving the polio vaccine

00:12:01.700 if polio is eradicated? Absolutely. And I think we're getting there, just not quite there yet.

00:12:06.080 Some people say that it has nothing to do with vaccines at all, that actually things like polio,

00:12:11.040 smallpox, all of that were starting to dwindle before the vaccines were actually introduced.

00:12:16.200 And so they say, you know, there's really no purpose in vaccines. We've got all the other

00:12:20.120 stuff kind of taken care of just by other forms of modern medicine. What do you say to that?

00:12:25.680 Well, so if you look at the curve, as sanitation in the home or hygiene generally in the country got

00:12:30.560 better, you did start to see a slight decline. However, once you introduced the vaccine, there was a

00:12:35.960 dramatic decline. And if you look at a disease like Haemophilus influenzae type B, which is a

00:12:40.620 bacterial infection that causes meningitis and bloodstream infection and pneumonia, I mean,

00:12:45.120 that was a common disease. There were 25,000 cases a year. That dominated my residency. I mean,

00:12:50.680 I was a resident in pediatrics at Children's Hospital in Pittsburgh in the 1970s, late 1970s.

00:12:56.980 That vaccine didn't really come into existence until the 1990s. When you saw that vaccine come into

00:13:01.840 existence, the instance of that disease virtually eradicated the disease. I mean,

00:13:07.240 no vaccine has been more powerful in my medical lifetime since that. We've gone from 25,000 cases

00:13:13.680 a year to fewer than 50 cases a year. I mean, I saw a case of meningitis caused by that bacteria

00:13:19.020 every week when I was a resident. And now it is the rare doctor in this hospital who's ever seen a

00:13:25.120 case of that disease. Gotcha. There are a lot of parents who claim that their child has been

00:13:31.800 irrevocably harmed by a vaccine and they feel like there's really no place where

00:13:37.100 they can be listened to. They kind of feel like the mainstream world thinks that they are lying,

00:13:44.480 that they're making it up. But of course, to them, it is very much real. What do you say to someone who

00:13:50.380 feels like they're kind of isolated in their fear and concern about vaccines because of what

00:13:56.860 has happened to their child? I'm sure it's frustrating for them. But the fact is,

00:14:02.440 is that just because one event follows another, it doesn't mean it's caused by the other. I mean,

00:14:07.040 my wife gives a perfect example. When she was in the office helping the nurse give vaccines once on a 1.00

00:14:15.700 weekend morning, while my wife was drawing that vaccine up into the syringe, there was a four-month-old

00:14:21.060 sitting on the mother's lap. So she hadn't given the vaccine yet. She was just drawing it up into the 0.94

00:14:24.960 syringe. That four-month-old had a seizure and went on to have a permanent seizure disorder and

00:14:29.640 was dead by age five of a chronic neurological disease. I think if she had given that vaccine

00:14:34.640 five minutes earlier, and then the mother, and then the child had a seizure, and then the child

00:14:38.960 went on to have a permanent seizure disorder, i.e. epilepsy, and then went on to die of a chronic

00:14:43.560 neurological disease, I think there are no amount of statistical data in the world that would have

00:14:47.920 convinced that mother of anything other than the vaccine caused it. You know, we think I'm stupid. 1.00

00:14:51.540 My child gets a vaccine, five minutes later has a seizure, and now has this permanent seizure 0.99

00:14:56.080 disorder. I know what I saw. In fact, but as it turns out, she was just drawing the vaccine up into

00:15:01.840 the syringe. But I can understand the compelling nature of anecdote. But the fact of the matter is

00:15:07.600 not all anecdotal associations are causal associations. But I think it raises the question.

00:15:13.060 So when a parent says, could this vaccine have caused permanent harm, I think it's then incumbent upon

00:15:17.940 the medical community, the public health community to do studies to answer that question. And when the

00:15:22.920 answer is then no, I think parents have to believe it. But many or some don't.

00:15:28.500 Have there been studies to show I know we talked about studies associated with vaccines and autism,

00:15:32.880 have there been studies to show that for example, vaccines don't cause SIDS or don't cause

00:15:38.120 permanent epileptic disorder?

00:15:40.160 Yes, over and over again. I think when the SIDS issue came up, which was primarily with the

00:15:46.640 hepatitis B vaccine in the 90s, you know, because that was the first vaccine we were giving to

00:15:50.580 newborns, you know, I think people were concerned. And so it's not hard to do these studies. You just

00:15:56.040 have to take large numbers of children, retrospectively see who got the vaccine, who didn't,

00:16:01.120 make sure you control for those two groups in terms of all other things like healthcare seeking

00:16:05.480 behavior, medical background, socioeconomic background, so that you can isolate the effect of

00:16:09.560 that one variable, in this case, receipt of a vaccine, and then see whether there's a greater

00:16:13.560 incidence in one group versus another. I mean, these are very sensitive studies. When I said

00:16:18.140 before that the oral polio vaccine could cause polio in one per 2.4 million children, that's a

00:16:23.780 very rare event, yet it's easily picked up in a retrospective analysis. So these retrospective

00:16:28.840 analysis are quite powerful. And I guess the frustration for me is when, you know, parents are upset and

00:16:35.180 certainly they get upset at me occasionally. It's just all I can say is, you know, that we've looked

00:16:41.500 and in our website, you know, the Vaccine Education Center website, we have a place called Vaccine Safety

00:16:46.800 References. And then we list all the things parents are concerned about. And then we list all the

00:16:50.720 references with like a two or three sentence description of that reference. So parents can

00:16:54.740 look at the original data if they want. I think a concern is even if a parent does go to that page and

00:17:00.440 reads all the FAQs and things like that. The concern is liability. That's a question that I've

00:17:05.960 received a lot is what about the liability for these companies who are making the vaccines? Do

00:17:11.100 you think that there is enough accountability there for safety? Yes. So right now we have in

00:17:16.740 place something called the Vaccine Injury Compensation Program. So if you want to, if you want to sue a

00:17:21.260 vaccine maker, you can, you just have to go through this program first. So let's say you believe that

00:17:25.880 your child's autism was caused by vaccine. You can try and go through the Vaccine Injury

00:17:29.720 Compensation Program. You won't get compensated there because there's too much data showing that

00:17:34.360 it doesn't cause autism. But you can still sue the company directly. There's nothing that stops you

00:17:39.000 after going through the program from suing the company directly. Nothing. And I think that's a

00:17:43.160 misconception people have. They think that these companies are protected from liability. They're

00:17:47.000 not. You have to go through this Vaccine Injury Compensation Program first. And frankly, the bar is

00:17:52.200 quite low. I mean, they will occasionally, you know, compensate people for harms that really aren't

00:17:56.760 caused by vaccines just because they want to keep the bar low. Right. If you can, let me say it this

00:18:01.400 way. If you can't win in the Vaccine Injury Compensation Program, you're going to have a hard

00:18:05.480 time winning in civil court. Yeah. They probably have a lot of difficulty because like you said,

00:18:11.400 correlation doesn't necessarily prove causation. But for parents who believe that it was the vaccine

00:18:17.720 that causes that caused epilepsy or SIDS or something like that, I do think that they have a hard case

00:18:23.240 before them, even if they happen to be correct in a particular scenario, because you did say that

00:18:28.040 vaccines can cause fevers that did that then cause seizures. So is it not possible that a reaction like

00:18:35.640 that could cause permanent harm? And so we've looked, I mean, you know, certainly febrile seizures,

00:18:41.880 meaning seizures associated with fever, children, you know, between six months and five years of age,

00:18:46.040 or primarily two years to five years of two to five years of age, are especially prone to febrile

00:18:50.920 seizures. That does not cause permanent harm. It's, it is, they're usually 30 second seizures.

00:18:56.360 They're tonic-clonic meaning generalized seizures. And study after study has shown that doesn't cause

00:19:01.160 permanent harm. So again, when this issue first came up, I'd say in the early eighties,

00:19:05.080 with associated with a film called DPT vaccine roulette, the question was, could the whole cell

00:19:09.880 pertussis vaccine, which we don't use anymore, but was used then, could that cause permanent harm?

00:19:14.200 Could it cause epilepsy? Could it cause developmental delay? Study after study looked at children who

00:19:19.000 received the whole cell pertussis vaccine? I mean, some of them who would have febrile seizures

00:19:23.000 and found that they didn't. Now, now the, the children who had quote unquote permanent harm,

00:19:27.640 when you looked at, when we finally had the genetic tools in hand to answer the question,

00:19:31.880 why did those children have, have sort of permanent seizure disorder, permanent developmental delay?

00:19:36.920 And the answer was invariably that they had something called Durvet syndrome, which is this SCN1A

00:19:42.440 mutation. It's a sort of sodium channel transport defect, which is not caused by vaccines. It's genetic.

00:19:48.520 And so, um, you know, it's just, it's, it took a while, I think to understand that, but I can

00:19:53.960 understand how that these anecdotal associations are powerful. And we were always looking for a

00:19:59.160 reason for why something caused something else, but, and vaccines are kind of the universal scapegoat

00:20:03.560 because they're given to healthy children and 90% of people in the United States will have their

00:20:08.760 children vaccinated. And, you know, the problem with vaccines is they only prevent vaccine

00:20:13.000 preventable diseases. They don't prevent everything else that can happen in the first few years of life,

00:20:17.160 life, but there's always going to be those associations.

00:20:19.080 Some people say that really they don't have a very long lasting effect. So I've heard

00:20:25.000 about herd immunity. Some people say that herd immunity is a myth because, uh, by the time people

00:20:31.320 are adults, their immunity has worn out from the childhood immunizations that they've gotten.

00:20:35.880 Is that true?

00:20:36.600 Depends on the vaccine. So, so the whooping cough vaccine, for example, um, even though you get the

00:20:42.600 vaccine at two months, four months, six months, again, at 12 to 15 months of age, again, at four

00:20:46.520 to six years of age, again, at 11 to 13 years of age, that's six doses, still three to five days,

00:20:51.960 sorry, three to five years after that sixth dose, immunity will start to fade. The mumps vaccine,

00:20:57.240 which was given as a two dose series, primarily 12 to 15 months of age, again, at four to six years of

00:21:02.200 age, 10 years after dose one and 10 years after dose two, immunity will start to fade. Measles,

00:21:07.960 on the other hand is an excellent vaccine. I mean, a single dose of that vaccine provides 93%

00:21:13.000 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 0.98

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,

00:29:34.040 oh my gosh, I've gotten a version of the flu.

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 0.97

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 0.99

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 1.00

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.

00:32:30.280 Two fetuses.

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.

Relatable with Allie Beth Stuckey - September 27, 2019

Ep 168 ｜ Vaccines Part 2 with Dr. Paul Offit

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