Brooke Gladstone: I'm Brooke Gladstone, and thanks for tuning in to the midweek podcast. The Washington Post this week published the results of a poll it conducted with the health information nonprofit KFF. The poll found that one in six parents have delayed or skipped vaccines for their kids. 9% have skipped the measles, mumps, and rubella shots. About half said they lacked the basic faith in the federal health agencies to ensure vaccine safety. Health experts fear that this faith will only further sink with the current leadership at HHS.

News clip: Health and Human Services Secretary Robert F. Kennedy Jr. announced he is replacing the entire independent committee that advises the CDC on vaccine usage, claiming members had too many outside conflicts.

Brooke Gladstone: Back in June, Kennedy signaled a shakeup.

News clip: He announced these eight new picks, most of whom are either allies of him or have clearly criticized COVID-19 vaccines and requirements of vaccine safety in the past. That he also removed all of the career officials who set the guardrails around this process, who set the agenda, who vet them, who planned the meetings. All those people are gone, too.

Brooke Gladstone: Soon, his revamped vaccine advisory committee made its presence known.

News clip: CDC's immunization panel voted 5 to 1 today to recommend against flu vaccines containing thimerosal.

News clip: Thimerosal is a mercury-based preservative used in multi-dose vials to prevent contamination.

Brooke Gladstone: Though some anti-vaccine advocates continue to spread misinformation that there's a link between the preservative and autism, it's just not true.

News clip: The panel's decision came after one presentation, not by the usual CDC process, where the staff of the CDC convene all these experts to really vet the evidence and come to a conclusion about what the impact and need for certain changes in the recommendations are. Instead, it was a presentation by Lyn Redwood. She's the former head of Children's Health Defense. That's a group that a lot of folks have criticized as anti-vaccine, and that Health Secretary Robert F. Kennedy Jr. is the founder of. She is concerned, and she aired a lot of those debunked concerns about thimerosal at today's vaccine meeting.

Brooke Gladstone: Lyn Redwood believes childhood vaccines containing thimerosal led to her son's autism. No surprise, RFK Jr. hired her to work in the CDC's vaccine safety division. Back in February when he took the post of Secretary of Health and Human Services, which leads the National Institutes of Health, the Food and Drug Administration, and the Centers for Disease Control he said this.

Robert F. Kennedy Jr.: There's no vaccine that is safe and effective. Vaccines are inherently unsafe. You cannot make them safe.

Brooke Gladstone: Kennedy's restaffed CDC Advisory Committee on Immunization Practices, or ACIP, is chaired by Martin Kulldorff.

Martin Kulldorff: The number of vaccines that our children and adolescents receive today exceed what children in most other developed nations receive and what most of us in this room received when we were children. We will be establishing a work group that will look at the cumulative childhood vaccine schedule as well as the adolescent schedule.

Brooke Gladstone: Paul Offit is the director of the Vaccine Education Center and a physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia. He's also co-inventor of the rotavirus vaccine. He served on ACIP, that vaccine advisory committee. When I spoke to him back in June, I asked, what it actually do?

Paul Offit: If a company, for example, has a vaccine they think is safe and effective, they submit it to the FDA. The FDA, if they agree, will license it, now can be sold. It's really the CDC, and specifically the Advisory Committee for Immunization Practices, or ACIP, that recommends it. Insurance companies won't cover a vaccine until the ACIP says, "Okay, here's who should get it."

Brooke Gladstone: Let's consider the COVID vaccine for pregnant women. ACIP recommended it before RFK Jr. stood up. In a video on X, he says.

Robert F. Kennedy Jr.: I couldn't be more pleased to announce that as of today, the COVID vaccine for healthy children and healthy pregnant women has been removed from the CDC recommended immunization schedule. We're now one step closer to realizing President Trump's promise to make America healthy again.

Brooke Gladstone: Then it dropped off the immunization schedule.

Paul Offit: Right. We know that women who are infected with COVID and pregnant are one and a half to two times more likely to be hospitalized, to require intensive care unit admission and ventilation, and die, than women of the same age who have COVID who aren't pregnant. That's why the World Health Organization recommends it. That's why every country in this world recommends that vaccine for pregnant people, and it's why the CDC recommended it. Robert F. Kennedy Jr., unilaterally and behind closed doors, simply made a decision that he didn't want to recommend this vaccine for pregnant people, so it dropped off the immunization schedule.

Now the question is, will insurance companies cover it? Will physicians or pharmacists feel that they are exposed to some liability if they give a vaccine which is not recommended? It certainly does nothing to make America healthy again. All it does is put pregnant women at unnecessary risk.

Brooke Gladstone: How did RFK Jr. justify it?

Paul Offit: He wrote a letter to Congress, so-called Frequently Asked Questions letter. He said that, "Look, here's all this evidence that pregnant people, when they get a COVID vaccine, are more likely to have miscarriage, more likely to have placental blood clots." If you looked at the papers that he referenced, they said exactly the opposite. Those papers showed that pregnant people who receive a vaccine are not more likely to have a miscarriage, not more likely to have preterm labor, not more likely to have placental blood clots. It was all exactly the opposite of what he had said in that memo that he sent to members of Congress. I assume he counted on the fact that no one in Congress would actually read the papers. It was that cynical and frankly dishonest.

Brooke Gladstone: A couple of weeks ago, he published an op-ed in the Wall Street Journal under the headline "HHS Moves to Restore Public Trust in Vaccines," where he announced that he was retiring, which is to say firing all 17 members of ACIP. You were on that committee from 1998 to 2003. What do you make of his claim? That, "Most of ACIP's members have received substantial funding from pharmaceutical companies, including those marketing vaccines."

Paul Offit: To be on the ACIP, you have to declare any potential conflict of interest. For example, if you're part of a data safety monitoring board for a company on a vaccine, you have to declare that. You wouldn't be allowed to vote on that product, nor any product that that company made. No one has a conflict of interest that would in any way influence their vote. He completely made it up. It was a bogus claim. What he should do is he should list each of those 17 members of the ACIP and say specifically what it is that they're being fired for. He didn't do that because he couldn't do that because he didn't have a leg to stand on regarding his false allegations.

Brooke Gladstone: At Kennedy's confirmation hearing for the job he now has, Republican Senator William Cassidy, a doctor. He expressed clear concern in his questioning of the nominee.

Senator William Cassidy: Fear of autism is a major driver for vaccine hesitancy among those with a college education or higher, influenced by Internet social media narratives over physician-based vaccine information. There's a lot of people that look to you for, "Do I get vaccinated or not?" I'm a doc. Convince me that you will become the public health advocate, the influencer for people to believe, "No, there's 1.25 million kids studied, and there's no autism associated with measles."

Brooke Gladstone: He ultimately cast a key vote for Kennedy after having received this assurance.

Senator William Cassidy: It confirmed he will maintain the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommendations without changes.

Paul Offit: He immediately broke that promise. He stood up and said, "I'm changing the recommendation for pregnant people. I'm no longer recommending they get a COVID vaccine. I'm changing the recommendation for young children. I'm no longer recommending they get a vaccine." He went on to say that he had agreed, according to Senator William Cassidy from Louisiana, that he wouldn't alter these committees and then proceeded to fire 17 members on a committee and stocked that committee with people who were like-minded to him, which is to say had an anti-vaccine bent or an anti-science bent.

Brooke Gladstone: Could you run through some of the new members of the ACIP, who they are, what they believe, and want to start with Vicky Pebsworth.

Paul Offit: Vicky Pebsworth is a member of the National Vaccine Information Center, which is an anti-vaccine group. She has for decades been lobbying states to eliminate school entry requirements for vaccines. She's a well-known anti-vaccine activist.

Brooke Gladstone: How about Dr. Robert Malone? He went on Joe Rogan's podcast in February of 2022. He said this stuff about the COVID vaccine.

Dr. Robert Malone: Our government is out of control on this, and they are lawless. They completely disregard bioethics, they completely disregard the federal common rule. They have broken all the rules that I've been trained on for years and years and years. These mandates of an experimental vaccine are explicitly illegal. They are explicitly inconsistent with the Nuremberg Code, they're explicitly inconsistent with the Belmont Report. They are flat-out illegal, and they don't care. Hopefully, we're going to be able to stop them before they take our kids.

Brooke Gladstone: The interview is at the center of that controversy when a handful of big-name artists, Neil Young was among them, left Spotify in protest of the streaming service continuing to carry The Joe Rogan Experience. What has Malone been saying recently?

Paul Offit: Robert Malone is an MD who's also a scientist. In the late 1980s published papers in an excellent journal called the Proceedings of National Academy of Sciences, looking at mRNA and predicted accurately that mRNA could be used as a drug, mRNA could be used as a vaccine. Then something happened to Robert Malone. I don't know what it was, but he now puts out information that's clearly wrong. He testified in front of Congress that the mRNA COVID vaccines caused cancer, caused heart attacks, caused autoimmune disease. All of which is clearly untrue.

Anyone who listened to him, either in that congressional hearing or on Joe Rogan's show, would be misled to make a bad decision for themselves or their child. There's no question that he is an anti-vaccine activist who now is on the Advisory Committee for Immunization Practices and will be giving advice to this country about what vaccines they should or shouldn't get.

Brooke Gladstone: How about the Swedish biostatistician Martin Kulldorff?

Paul Offit: Like Robert Malone, Martin Kulldorff has testified as an expert witness on behalf of Robert F. Kennedy Jr.'s lawsuits against Merck, specifically in the case of Kulldorff, his lawsuit against the human papillomavirus vaccine Gardasil. He was a principal author of the Great Barrington Declaration, which said we should just let this virus run wild. After natural immunity, we'll be much better off, thus putting people in harm's way unnecessarily.

Brooke Gladstone: How about Retsef Levi? He's a new face on the panel. He's part of an Israeli anti-vax group, and he has a pinned video on X where he says--

Retsef Levi: I'm filming this video to share my strong conviction that at this point in time, all COVID mRNA vaccination program should stop immediately. They should stop because they completely failed to fulfill any of their advertised promise regarding efficacy. More importantly, they should stop because of the mounting and indisputable evidence that they cause unprecedented level of harm, including the death of young people and children.

Brooke Gladstone: Where did he get that from?

Paul Offit: Not from any good data. What's amazing to me is, if you'd asked me at the beginning of this pandemic, how did I think vaccines would be viewed, I would imagine they would have been viewed as what they are, which is lifesavers. Here's a virus that came into this country in early 2020. We isolated it, sequenced it. Within 11 months, we did two large prospective placebo-controlled trials, 40,000 people for Pfizer, 30,000 people for Moderna, to show that the vaccine was safe and effective. Then, within the next 7 months, we distributed it to 70% of the US population. A remark achievement and no doubt saved about 3 million lives.

At least 250,000 people who chose not to get this vaccine chose to end their life. I think, frankly, it is the greatest scientific or medical achievement that has occurred in my lifetime. My lifetime includes the development of the polio vaccine. We somewhere in 2021 created this enormous backlash against vaccines that allow people like Martin Kulldorff to make the misstatements he makes about vaccines. He published a paper that was methodologically horribly flawed, claiming that it basically caused heart deaths in young people, and that's still out there. This notion that this vaccine killed healthy young athletes is just wrong. He is the executive director now, the head of the ACIP.

Brooke Gladstone: When you have someone talking about a vaccine killing children, causing sudden heart attacks, no wonder people are scared.

Paul Offit: It's a shame because people are still at risk. People are still getting hospitalized and dying from this virus. This virus isn't going anywhere. It's going to be with us for decades, if not centuries. Right now, because there's so much misinformation and disinformation out there, we're putting people in harm's way. The irony of all this is this group of people who have specifically been putting us in harm's way will now be making recommendations.

The anti-vaccine activists have been around for decades, if not arguably centuries, since the first vaccine, the smallpox vaccine, and they have been shouting from the sidelines. Now, with Robert F. Kennedy Jr. as Secretary of Health and Human Services, they are making policy.

Brooke Gladstone: That he might use the National Vaccine Injury Compensation Program to cash in. This is a program that was created to let the government compensate people who can make a claim that they were injured by a vaccine, rather than putting undue pressure on manufacturers.

Paul Offit: If you really want to destroy vaccine programs in this country, all you have to do is mess around with the vaccine injury compensation program. In the early 1980s, there was this false notion that the whooping cough or pertussis vaccine caused permanent brain damage. Subsequent studies showed that that wasn't true. That while the pertussis vaccine could cause fever and could cause even febrile seizures, short-term seizures, that never caused permanent harm. Studies showed that. It led to a flood of litigation.

In 1980, there were 18 companies that made vaccines. By the end of that decade, there were four because they were all driven off the market by litigation. Now, the Reagan administration stepped in, in 1986, created the National Childhood Vaccine Injury Act, which included the Vaccine Injury Compensation program, which, at least, stopped the bleeding. Mess around with that program, which is what RFK Jr., I think, is about to do. He just hired a law firm from Arizona that had an expertise in the vaccine injury compensation program.

All you have to do is just add things to the list of compensable injuries, even if they aren't actual injuries caused by the vaccine, or worse, take certain vaccines out of that protection of the Vaccine Injury Compensation program, put them in front of the slings and arrows of outrageous civil litigation, and you will drive them out of the business. Because it's a fragile market. Vaccines are something you give once or a few times in your lifetime. They are never going to compete with drugs like lipid-lowering agents or neurological drugs, or psychiatric drugs. Make it onerous enough for these companies to make vaccines, and they'll leave the business.

Brooke Gladstone: How would Kennedy get rich? Because he's a lawyer?

Paul Offit: He would get rich from suing. That's what he's been doing. The last two years, he made $2.5 million whilst trying to sue Merck for Gardasil. He does it with his personal injury lawyer friends, like the law firm of Wisner Baum. To Elizabeth Warren's credit, if you actually watch her four or five-minute questioning of Robert F. Kennedy Jr., she said, you could do this.

Elizabeth Warren: You could publish your anti-vaccine conspiracies, but this time on US government letterhead. You could appoint people-

Robert F. Kennedy Jr.: I don't understand that.

Elizabeth Warren: - to the CDC vaccine panel who share your anti-vax views and let them do your dirty work. You could tell the CDC vaccine panel to remove a particular vaccine from the vaccine schedule. You could remove vaccines from special compensation programs, which would open up manufacturers to mass torts. You could make more injuries eligible for compensation even if there is no causal evidence. You could change vaccine court processes to make it easier to bring junk lawsuits.

There's a lot of ways that you can influence those future lawsuits and pending lawsuits while you are Secretary of HHS, and I'm asking you to commit right now that you will not take a financial stake in every one of those lawsuits so that what you do as secretary will also benefit you financially down the line.

Robert F. Kennedy Jr.: I'll comply with all the ethical guidelines.

Elizabeth Warren: That's not the question. You and I-- You have said repeatedly-- [crosstalk]

Robert F. Kennedy Jr.: Senator, you're asking me not to sue vaccine-- [crosstalk] pharmaceutical companies.

Elizabeth Warren: No, I am not.

Brooke Gladstone: Kennedy's new ACIP had its first meeting this week, and on the agenda was something that may not mean a lot to laypeople, but it means a lot to those people in the vaccine skeptic community. It was a presentation regarding thimerosal in vaccines, blamed for causing autism. Right?

Paul Offit: Right. I was on the ACIP from 1998 to 2003. This was considered then. We were adding more and more vaccines to the vaccine schedule. As some of those vaccines contained the ethylmercury preservative thimerosal, there was a concern that children were being exposed to too much mercury and that that might cause harm. Now, there were a number of studies that were done at the time to show that the mercury contained in vaccines did not add in any appreciable way to the amount of mercury that you normally have in your bloodstream.

Because we live on this planet, and anything made from water on this planet, including breast milk and infant formula, and anything made from water contains methylmercury. That has a much longer half-life than ethylmercury, which is what's in thimerosal. You knew that it didn't contribute in any important way to what you already were exposed to. You already had studies that were done at that time because Western Europe took thimerosal out of vaccines.

In the early '90s, there were Canadian provinces that used thimerosal-containing vaccines right next to Canadian provinces that used the same vaccines that didn't contain thimerosal. You saw that there was no difference in neurodevelopmental outcomes, including autism. Ironically, the instance of autism at that time was 1 in 150. Thimerosal was taken out of vaccines by 2001 for young children, today, the instance of autism is 1 in 32. The instance of autism since removing thimerosal from vaccines has increased dramatically.

Brooke Gladstone: Why the rise in autism? I read it was because of the way it's been reclassified in the DSM.

Paul Offit: I think that's probably the most important thing, which is that the definition has been broadened from more profound autism to autism spectrum disorder. I think there are also better diagnostic tools. I think there's increased recognition of that disorder, hence the increase. I think it certainly has nothing to do with vaccines.

Brooke Gladstone: Flu vaccines were reduced from multi-dose vials to single doses in response to this fear over thimerosal.

Paul Offit: That's exactly right. By going from multi-dose vials to single-dose vials, that became an issue of storage because it's easier to store a multi-dose vial. It also became an issue of expense. The vaccines, therefore, became less available and more expensive. For the developing world, it was really tragic because that increase in price really affected them more than anyone else. There was a child who died of hepatitis B because the mother was so scared of thimerosal that she refused to give the vaccine.

Thimerosal was taken out of vaccines as "the precautionary principle." The precautionary principle, which is exercising an abundance of caution, assumes no harm. We did do harm. Two anti-vaccine groups were created by that episode. Generation Rescue or Moms Against Mercury were created because any reasonable person looking at what the CDC did at that time, which was precipitously taking thimerosal out of vaccines, could reasonably say, "Well, they wouldn't have done it unless it was harmful," but it wasn't harmful.

I think probably the best quote at the time, because it was the most ironic, came from the American Academy of Pediatrics, which stated, "All the evidence to date shows that thimerosal at the level contained in vaccines is safe. To make safe vaccines even safer, we're going to ask companies to take it out." If it's safe, taking it out doesn't make it safer. All it does is make it perceived to be safer, which is a very different thing.

Brooke Gladstone: Although if it enables people to take it more readily, I guess that's a benefit.

Paul Offit: I would argue the opposite was true, Brooke, because we scared people about vaccines. The sense was, these people don't know what they're doing. They're putting it in, they're taking it out. If anything, we lessen vaccines uptake because we scared them about this harmless preservative. See, the problem is it's called ethylmercury. Mercury never sounds good. It's not like there's the National Center for the Appreciation of Heavy Metals standing up in defense of mercury.

Brooke Gladstone: Kennedy edited a book about thimerosal, didn't he? It was called Thimerosal: Let the Science Speak.

Paul Offit: In which the science didn't get a chance to speak. That's right.

Brooke Gladstone: What else is on the ACIP agenda besides reviewing thimerosal and flu vaccines? Aren't RSV vaccines both for adults and kids on that docket?

Paul Offit: Respiratory syncytial virus is a respiratory virus that in young babies causes bronchiolitis, which is inflammation of the small breathing tubes in the lung. It's actually the most common reason for a baby to come into the hospital, typically children less than three months of age. Because very young children get this virus and occasionally are admitted to the hospital, so much so that we have 60,000 to 80,000 hospitalizations a year and 100 to 300 deaths a year, we have a vaccine for pregnant mothers, so then they develop an immune response. They passively transfer through the placenta the antibodies which will protect that child in the first six months of life.

There's another vaccine that's given to babies in the first few days of life called nirsevimab. That is a long-acting monoclonal antibody that also protects against respiratory syncytial virus. What's interesting is that the CDC published data recently looking at the effect of this, because it's really just in the past year, 2024 to 2025, that we've had those two products. They compared, how are we doing? Are we decreasing hospitalizations in babies as compared to, say, pre-pandemic 2018-2020? The answer was yes, there's been more than a 50% decrease in little babies getting admitted to the hospital.

In fact, it actually decreased the infant mortality rate. It was that impactful. What are they doing? Are they going to prefer the maternal vaccine versus the monoclonal antibody or vice versa? I don't know. That's the problem. There's such chaos now.

Brooke Gladstone: At least the data is there, right?

Paul Offit: Right. I have a friend in the Respiratory Diseases Branch who told me specifically that HHS, i.e., Robert F. Kennedy Jr., told the Respiratory Diseases branch not to do what they would normally do. When you would get data that impactful, normally, what you would do is you would embargo the study for a day. You would send out talking points to a variety of media outlets. You would give those media outlets a chance to interview the authors or to talk to people at the CDC before the paper was released, and then that would create more impact for the paper. They were told not to do that at all, to essentially suppress that information.

In many ways, that's what worries me the most. Although this committee worries me, many in the medical and scientific community will not trust them. There are other committees. I mean, the American Academy of Pediatrics, for example, has its Committee of Infectious Diseases, which is composed of experts, which also gives recommendations who have been talking to insurance companies. That doesn't worry me as much. What worries me more is whether the data that you're getting from the CDC will be manipulated or suppressed.

There's an old W.H. Auden quote which is, "When all the mass and majesty of this world, when all that carried weight and always weighed the same, lay in the hands of others. They were small and could not hope for help, and no help came." That's what I feel like this is. We're at a time when people declare their own truths, including scientific truths. Normally, we rely on good scientific evidence to make decisions. Now you're having people, specifically Lyn Redwood from Safe Minds, which is an anti-vaccine group, present about thimerosal at this meeting. A virulent anti-vaccine activist. Everything that used to matter doesn't seem to matter anymore.

Lyn Redwood: There has been unrelenting, very fear-mongering coverage of the couple hundred cases of measles that was diagnosed over the past few weeks. What you need to keep in mind when you see these headlines is that Big Pharma spends a ton of money to have the influence over the media companies to get narratives written in a very specific way. Under the new HHS Secretary, RFK Jr., they're going to be looking at repealing immunity for these companies, which is going to be a very big deal for them. They're trying to get out in front and create a lot of fear in the population to make people scared.

Brooke Gladstone: In the caption, she wrote, "1 measles death in 10 years. 100,000 deaths from diabetes per year." That seems a bit of a non sequitur, but I think this touches on a lot of the big narratives right now around vaccine skepticism. What do you think about the claim that the measles outbreak has been overblown by the media?

Paul Offit: I think it's been underblown by the media. Really, if you look at the CDC website today, it'll say that there are roughly 1,200 cases of measles that have occurred over the past year. In truth, if you talk to people on the ground, people in health departments, they think that number is at least 3,000 cases and probably 5,000 cases. You know that three people have died from measles. You also know that that equals the total number of deaths for measles in this country over the last 25 years. You know that two young children, six and eight-year-old healthy little girls in West Texas, died from measles.

You know that we haven't seen a measles death in a child in this country since 2003. That's more than 20 years ago. This isn't overblown at all. What you would like to see in some ways is the story of those two children who died unnecessarily of measles. What did that feel like? We need to make this come alive. Were RFK Jr. an actual Secretary of Health and Human Services who cared about the health and well-being of children in this country, he would stand up and loudly and clearly proclaim, "Vaccinate your children." It is unconscionable that two healthy children just died from a vaccine-preventable disease in the United States of America.

Brooke Gladstone: I feel like what's happening in public health right now is getting swallowed up in all the other crises on the front page. What is the risk of not really understanding or paying attention to what Kennedy's up to?

Paul Offit: I think that what will happen over time is that he will destroy vaccine programs bit by bit. It's already happening. He's like the Velociraptor in Jurassic Park, testing where the weaknesses in the fence are. For all his talk about decreasing obesity in this country, and we do need to decrease obesity in this country, we are more obese than other countries, and as a consequence, we have higher rates of hypertension, high blood pressure, higher rates of type 2 diabetes. All true. I don't hear anything about that from him.

He's talking about taking red dye out of Skittles and destroying vaccine programs. That's not making us healthy. I don't think people realize how far out there he is. If you read his book, The Real Anthony Fauci, what you'll find on pages 285 to 288 is he doesn't believe in the germ theory. He doesn't believe that specific germs cause specific diseases like viruses or bacteria, and that therefore the treatment or prevention of those germs will matter or will be life-saving. That's who he is. It's really that crazy.

Brooke Gladstone: You say these MAHA narratives seem to be having sway on many sectors of the public, nevertheless. It's certainly having sway we see on the government generally promoting things like healthy eating and exercise as public health solutions, but encouraging skepticism of medical and scientific institutions. What does all this tell us about the overall state of the public perception of expertise in general?

Paul Offit: I think it's a dangerous time. What should worry people is that someone like Fiona Havers at the CDC recently quit. Fiona Havers is a 13-year veteran at the CDC. She presented to the ACIP in April what the impact of COVID was in the United States over the past year in children. What she found was that there were about 7,000 children hospitalized with COVID, that 1 in 5 of those children was sent to the intensive care unit, that 152 children died of COVID, that about half were previously healthy, and that virtually all were unvaccinated.

Now, the impact of that presentation should have been that the CDC once again underlined how important it was for children to get a primary vaccine. I'm not talking about yearly vaccines, a primary vaccine. The opposite happened. RFK Jr. stood up on that one-minute video presentation on X and said, "We are no longer recommending the COVID vaccine for healthy young children." Which was the opposite of what one would conclude from those data, and so she quit. She said, "I am worried about the way that data are being handled by the CDC. I am worried that American children now are at greater risk of vaccine-preventable diseases." That should worry people.

Brooke Gladstone: Did the experts, the CDC, alienate people during the pandemic? Is that part of this?

Paul Offit: Yes, I think it is, the experts in the public health system in general. I think what happened in 2020 when we didn't have anything and we were dealing with a virus that was killing hundreds or thousands of people a day and that could be spread asymptomatically is we shuttered schools and we closed businesses and we restricted travel, and we isolated and masked and quarantined and social distanced because we didn't have vaccines till the end of the year.

I think that was seen as massive government overreach, especially the shuttering of schools, especially for children who were in high risk. Then the following year, when we had a vaccine, by early 2021, you couldn't go anywhere without your vaccine card. You couldn't go to your favorite bar or restaurant or sporting event or place of worship, and you could have been fired from your job. Again, that was seen as massive intrusion in my "medical freedom." I think that we leaned into this libertarian left hook, and I think we're feeling the punch of that hook now.

Brooke Gladstone: What do you mean we leaned into the libertarian left hook?

Paul Offit: I think there is a tension between public health and individual rights and freedoms. Public health does consider that you have to care about your neighbor. If you're just saying, "I want to do what I want to do and the hell with my neighbor," that is an anti-public health stance. There was one moment, actually, in California in 2014 that signified this to me. There was a measles epidemic that started in Southern California, spread to 25 states, involved a few hundred people. The state senator named Richard Pan, who was a pediatrician by training, actually, wanted to eliminate the philosophical exemption for vaccination in that state, a state that didn't have a religious exemption.

Therefore, he would have eliminated all non-medical exemptions. It was a fight to do that. Certainly, the anti-vaccine people were up in arms, but there was a little boy, a little seven-year-old boy who spoke at those meetings where the anti-vaccine people were out there screaming. He had to stand on a chair so he could reach the microphone, and he said--

Rhett Krawitt: "My name is Rhett Krawitt. Leukemia is cancer in my blood."

Paul Offit: "I can't be vaccinated. I depend on you to protect me. Don't I count?" To me, he was the voice of society.

Brooke Gladstone: If you look at Trump's appointments across HHS, there are all these people who came to prominence as COVID skeptics. Of course, devaluing expertise seems to be part of his project, actually, if you consider his appointments across all of his agencies. The impact seems to be specially onerous in this case.

Paul Offit: I agree. Marty Makary, who's head of the FDA, said that the government was hiding the fact that the mRNA COVID vaccines were a rare cause of myocarditis when they didn't hide that at all. I was on the FDA vaccine advisory committee. The minute those data became available, they were disseminated widely. I don't know what he's talking about. People have asked me the question, do I think Robert F. Kennedy Jr. will cause distrust in public health? I think the answer is no.

I think that he was brought in because he distrusts public health. He has disdain for the agency he's heading, he has disdain for the FDA, the NIH, National Institutes of Health, the CDC. That's why he's there. He represents our disdain for the federal government, and we will suffer this.

Brooke Gladstone: I guess there's an important lesson to be learned here then, from COVID and how science communication could improve.

Paul Offit: Yes. I think we need to explain what we're doing and why we're doing it. I think we can't assume that people understand. If we make it broad recommendation that involves a lot of groups, we need to make it clear why each of those groups do need to be vaccinated and include the public in that decision-making. I think we underestimate what the public can handle. For example, I think very early on with the COVID vaccine, we should have obviously recommended initial vaccine for everyone. In terms of yearly vaccine, it made more sense to target high-risk groups. Pregnant people, people who are immunocompromised, people who are elderly, people who had high-risk medical conditions.

You didn't have to give a yearly vaccine to everyone. I think the reason that we did that was we thought that if we target high-risk groups, which most other countries in this world did, it was a nuanced message. A nuanced message would be seen as a garbled message. I think we should have had more trust that the American public could understand all that. Also, we needed to make it clear that when decisions were made, they were based on what you knew at the time.

Brooke Gladstone: Yes, like the requirement to wear masks.

Paul Offit: We should have explained that it wasn't going to be 100% effective. We should have explained that when you got this vaccine, it was going to protect you against serious disease for a fairly long time, but it wasn't going to protect you against mild to moderate disease, probably for more than six months. Moderate disease is not trivial. You could be home for a few days, coughing with fever, chills, body aches, and that's not fun. I think people were compelled to get the vaccine, mandated to get the vaccine, then they got the vaccine, then six months later, a year later, got a moderate infection and thought, "These people lied to me. They made me get this vaccine. I'm still sick."

Brooke Gladstone: You mentioned Fiona Havers, who very publicly resigned from the CDC in protest of the manipulation and suppression of data. Five CDC leaders left in March. I guess we can assume they won't be the last. Can we also assume that this brain drain will have an impact on medical research in the US.

Paul Offit: That's already happened. You've seen the Trump administration cancel grant after grant after grant, certainly all grants related to how we perceive vaccines, grants related to the human immunodeficiency virus vaccine, grants related to anything mRNA related regarding vaccines, or even regarding cancer. It's been this attack on the research infrastructure. Certainly, any possible university has felt this, and it's going to take us a long time to come back from this. We will come back from this, but we have to get through this period when, frankly, there is an attack on public health in this country.

Brooke Gladstone: How are you feeling these days, Paul?

Paul Offit: Pretty sad. I wake up every day sad that the things that I care about, which is the health and well-being, particularly of children, because I'm a pediatrician by training, is putting kids at risk. I have two grandchildren who are two and a half and nine months old. I feel badly for at least their immediate future in terms of being able to protect themselves from diseases that should be easy to protect against.

Brooke Gladstone: They could still get the vaccines. They won't be covered by insurance. Again, it falls on the shoulders of the poor.

Paul Offit: Always.

Brooke Gladstone: Thank you so much.

Paul Offit: Thank you.

Brooke Gladstone: Paul Offit is the director of the Vaccine Education Center and a physician in the Division of Infectious Diseases at the Children's Hospital of Philadelphia. Thanks for listening to the midweek podcast. On the show this week, we'll be trying to understand the right's sudden love of cancel culture. Also, I speak to a librarian who brought a gun to protect herself from the free speech crowd. See you Friday. I'm Brooke Gladstone.

 

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