Factually! with Adam Conover - RFK Jr is Going to Kill Many Children with Dr. Adam Ratner

Episode Date: February 12, 2025

Vaccines save lives—period. So why have so many people grown skeptical of one of the most scientifically proven medical advancements in human history? And how did vocal anti-vaxxer, conspiracy theorist, and all-around slurry-brained mush man Robert F. Kennedy Jr. end up on track to be nominated as Secretary of Health and Human Services in Donald Trump’s cabinet? This week, Adam sits down with Dr. Adam Ratner, head of pediatric infectious diseases at NYU and author of Booster Shots: The Urgent Lessons of Measles and the Uncertain Future of Children’s Health, to unpack how we got to this alarming point of science denial—and what it means for public health in America and beyond. Find Adam's book at at factuallypod.com/booksSUPPORT THE SHOW ON PATREON: https://www.patreon.com/adamconoverSEE ADAM ON TOUR: https://www.adamconover.net/tourdates/SUBSCRIBE to and RATE Factually! on:» Apple Podcasts: https://podcasts.apple.com/us/podcast/factually-with-adam-conover/id1463460577» Spotify: https://open.spotify.com/show/0fK8WJw4ffMc2NWydBlDyJAbout Headgum: Headgum is an LA & NY-based podcast network creating premium podcasts with the funniest, most engaging voices in comedy to achieve one goal: Making our audience and ourselves laugh. Listen to our shows at https://www.headgum.com.» SUBSCRIBE to Headgum: https://www.youtube.com/c/HeadGum?sub_confirmation=1» FOLLOW us on Twitter: http://twitter.com/headgum» FOLLOW us on Instagram: https://instagram.com/headgum/» FOLLOW us on TikTok: https://www.tiktok.com/@headgum» Advertise on Factually! via Gumball.fmSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This is a headgum podcast. Hey there. Welcome to Factually. I'm Adam Conover. Thank you so much for joining me on the show again. This week on the show, because of some events in the news, we're talking about vaccines. So I just want to start by, you know, making one thing very clear at the top of the show. We're going to say this as bluntly as possible. Vaccines are one of the great scientific triumphs in all of human

history. In the last 50 years, vaccines have saved an astounding 154 million lives and 100 million of those lives were infants, literal babies, 100 million baby lives saved in 50 years. Now you would think that this would be thought of in our society as a big win. Oh, we saved 100 million baby lives. Good job us. But unfortunately, as you well know, increasingly, that is not the case. A lot of Americans have decided that vaccines are bad. I guess they like dead babies.

I don't know. A movement that has existed on the fringes for many years has finally become mainstream. COVID has given us perhaps the greatest vaccine success story ever. We literally learned how to harness the very programming of our own cells to give our bodies resistance to a virus it had never encountered before, saving again untold millions of lives. But the environment of mistrust and misinformation surrounding these vaccines and vaccines generally

inculcated a serious doubt about them in the minds of many Americans. Today, nearly 17% of parents say that they have delayed or skipped a vaccine for a child, nearly one in five. And that number rises to 26% for Republican parents. And these numbers keep going up. And it gets worse because as I'm recording this, an anti-vax charlatan named Robert F. Kennedy Jr. is in the process of being confirmed by Congress to be put in charge of our entire public health apparatus. The man is not a doctor. The man is, in fact, an insane person with a worm

in his brain and he's about to run the entire healthcare system for the entire United States. Things are going off the rails in America. So you know what? This seems like a good time to step back and ask, hey, why exactly are vaccines so important? What was life like before them? And what world do we risk entering back into if we leave them behind?

Today on the show, we are going to give you the blunt truth about vaccines from a scientist who knows, and we are going to arm you with the vaccine yourself against misinformation so that you know the truth and you can spread it in your community where it can do some good. But before we get to that conversation, I wanna remind you that if you wanna support this show and all of the incredible conversations we bring you every single week, please support us on Patreon.

Head to patreon.com slash Adam Conover. Five bucks a month gets you every episode of this show ad free. We got a lot of wonderful community features as well. And if you wanna come see me do some standup comedy, you wanna have a little lightness in your evening, you're a little worried about the state of the world and you just wanna laugh and have a good time, come see me do some stand-up comedy. You wanna have a little lightness in your evening. You're a little worried about the state of the world and you just wanna laugh and have a good time.

Come see me on the road. On February 21st, I'm gonna be in Chicago at Talia Hall. On February 23rd, I'll be in Boston at the Wilbur, two wonderful historic theaters I cannot wait to perform in. March 6th through 8th, I'll be in Burlington, Vermont at the Vermont Comedy Club. March 22nd, I'll be in London at the Lester Square Theatre March 26th, Amsterdam at Boom Chicago. After that, I'm going to Providence, Rhode Island, Vancouver, Canada, Eugene, Oregon, Oklahoma City, Oklahoma and Tulsa, Oklahoma.

Head to AdamConover.net for all those tickets and tour dates. I would love to see out there. And now let's get to this week's episode to give us the honest truth about vaccines straight from the horse's mouth. We have someone who knows better than almost anyone else on the planet. His name is Dr. Adam Ratner and he's NYU's head of pediatric infectious diseases and the author of the new book Booster Shots, the urgent lessons of measles and the uncertain future of children's health. Please welcome Adam Ratner. Dr. Ratner, thank you so much for being here.

My pleasure, great to be here. So we're talking about vaccines today. There is a lot of misinformation and skepticism about vaccines that has only grown in recent years. So let's start out by just telling me a little bit about yourself and the credentials by which you speak on this. Sure, so my name is Adam Ratner.

I am a pediatric infectious diseases physician, meaning I did training first in general pediatrics and then in infectious diseases. My current position is as the head of pediatric infectious diseases at both NYU Hassenfeld Children's Hospital and at Bellevue Hospital Center. I'm speaking today not as a representative

of either of those places. I'm here speaking as an author. I'm the author of a book that's about to come out called Booster Shots, The Urgent Lessons of Measles and the Uncertain Future of Children's Health. So let's jump into it. How much have vaccines altered life for humanity, first of all, if we can take the big picture view.

Vaccines are arguably one of humanity's greatest accomplishments in terms of lives saved. They are up there with clean water and sanitation. It is, you know, our life spans are much, much longer than they were 100 years ago, 200 years ago. And that is in large part due to vaccines. Give us an example. Do you have any numbers of how many lives have been saved if that's even possible to

quantify? Sure. So thinking about the measles vaccine first, the measles is the most contagious disease known to man. Mill millions of cases a year, still hundreds of thousands of deaths a year from it. There's an estimate of somewhere around 60 million lives saved just in the past 20 to 25 years with measles vaccine. And going back further than that,

it's the effect is even greater. And why are vaccines especially important for children? And going back further than that, the effect is even greater. And why are vaccines especially important for children? So the things that we vaccinate people against in this country and in much of the world tend to be the infections that cause death or severe illness in young children. And it used to be that a large percentage of children died in the first five years of life. It's still much too large a percentage. It's still somewhere in the neighborhood of one in 17, one in 18 children die before age five. But it used to be something more

like one in four. And there was probably a time when it was more like one in two. And a lot of that early death is due to infection. And so we have been able to, with vaccines, provide protection against a subset of those infections. Not all of them. I wish we had vaccines against all of them, but it has been miraculous that we've been able to prevent some of these things that used to cause death commonly.

Yeah, there was sort of a presumption 200 years ago that if you had kids, a bunch of them were gonna die. You would have a whole bunch and it's like a numbers game. Well, I had 10 kids because I knew five to seven of them were gonna die, now I got three left. So I at least got a couple heirs. But now we have the opposite presumption that our children won't die. It's considered to be unusual. And of course it's a tragedy either way,

but it's, it's now much more of an unusual thing to have happen. Right. Absolutely. I think that there was much less certainty a hundred years ago that if you had a child that that child was going to grow up to be an adult. And I think we have that now and horrible things do happen, but they happen rarely. And a big piece of that is vaccination. So tell me a little bit about, you know,

the moment that vaccinations like this became common and routine, it's not that long ago, right? We're talking in the last 100, 150 years, right? Like what was the effect on the American population on the sort of national psyche? Tell us the before and after. Yeah, so I think that if you think back to the 1800s and what the causes of death were in children,

there were deaths from infections right around the time of childbirth, and we have strategies to prevent some of those. Now, we had a lot of children who died in early childhood from smallpox, which we now never see because it's been eradicated thanks to vaccines. It's been eradicated worldwide, right? Yes. So I'll draw a distinction

because I'm sure we'll talk about this later. There's eradication and there's elimination. And so eradication is wiping something off the planet. And that is, so you do not have to think about it again. You don't have to vaccinate against it anymore and so we did that with smallpox and we've only done that with one other disease and it's not even a disease of humans, it's a disease of livestock

called rinderpest and we managed to eliminate rinderpest as well. And can I ask, I'm sorry to interrupt you, I just wanna make sure, I've always wondered this, I remember reading as a kid about the eradication of smallpox and smallpox is like extremely communicable disease, killed tons of people. Measles, as you said, also very, you know, similarly,

or I don't know how contagious it is, but you know, very, very contagious, very, very deadly. Yet it has not been eradicated. What is special about smallpox or conversely, what is different about measles? Right, so some of it is when vaccines came around for these things. So the smallpox vaccine was really the first vaccine

and there was slow uptake at first and there were anti-vaxxers back then as well. There were people who thought that smallpox vaccine slow uptake at first and there were anti-vaxxers back then as well. There were people who thought that, you know, smallpox vaccine was interfering with God's will. There were people who thought that because the smallpox vaccine originated from a virus that was in cows that there are cartoons from back when it came out of people turning into cows after getting smallpox vaccine.

Would you rather be a cow or have smallpox vaccine. But the- Would you rather be a cow or have smallpox? That's my question. I think I might prefer to be a cow. It's a nice life. It's hard to know. Yeah. So I think that over time, it became clear

that the people who were getting vaccinated were not getting smallpox. And people started vaccinating their kids. And then there was this, it's incredible to think about now, given everything that's going on in the world, but there was this incredible international cooperative effort. Every country participated in this,

where we vaccinated essentially the entire world. And there were people looking for cases in the last few countries. And then if there were cases found, they vaccinated that person and then they vaccinated everyone around them. It was a strategy called ring vaccination. And finally in the 1970s, eradication was certified.

And so it's not that long ago, right? I mean, there was still smallpox in the world in the late 1960s. Wow. And if you, a generation before me, there was still smallpox in the world in the late 1960s. And if you, you know, a generation before me, everyone was vaccinated against smallpox. I was born right on the cusp. And so I did not get a smallpox vaccine because eradication had basically happened.

We don't get vaccinated against it anymore because it has been eradicated. Right. The vaccine did its job so well, it put itself out of a job. Wow. And that's what vaccines do. That's the curse and the blessing of vaccines, right? So when they work, nothing happens. People don't get sick.

Like, it just looks like regular life. Yeah. But the thing about that is then people forget how important it is to keep vaccinating because everything other than smallpox that's a human disease is still around. Even though we may have a vaccine against it, we may never or very rarely see it in this country. You know, measles, polio, like all sorts of things that the generation before us saw, thought about all the time, we now don't see. They're still there. There are still countries with polio.

There are still places with lots of measles. So it's, you know, it's, and that's the, that's the distinction between eradication and local elimination. Local elimination is amazing. It's a, it's a great accomplishment, but it's, but eradication is forever. Yes.

And so how did this change life and what was the public reception of these vaccines? I mean, for smallpox and polio, polio, by the way, being a disease that you would contract and then it would disable you for the rest of your life if you caught it as a kid, that was a very, very terrifying disease to have floating around, right?

And then for it to be eliminated or eradicated in this country, how did that change life for people? It's hard to even describe what a big change that was. And I think that's why in the mid 1950s, there was this enormous randomized controlled trial of the Salk polio vaccine, the first polio vaccine. And there were these kids called polio pioneers who got either the vaccine and we didn't know how well it would work or a placebo. And they saw an enormous difference in rate of polio between those two groups where the vaccine protected kids against getting polio.

And when those results came out in 1955, it was like a national holiday. Like people were celebrating this. It was all over the newspapers. People could not wait to get this vaccine for their kids because they had been terrified of polio. And if you read newspapers or books from back then, people talk about living in fear of polio because it would strike kids who were healthy, who were active. You look at Franklin Delano Roosevelt, who developed polio.

He was a young man when he did, but he was an active athletic guy. And it disabled him permanently. Yeah. And the disablement, I mean, everyone has that image of FDR in their head, but it could also be a lot more intense and disabling than that even, right?

Can you just? Yeah, absolutely. So there's a spectrum of what polio disease looks like, just like there's a spectrum of most diseases. And some people who came into contact with polio virus and got polio infection had a minor flu-like illness and then got better. And then some people had paralysis that lasted

but then got somewhat better over time but still maintained a deficit. Some people were permanently disabled. Some people ended up in, you know, you see the pictures of iron lungs from the 40s and the 50s where they, because their respiratory muscles were affected, they had to be in these giant cylinders

to help them breathe. That where the cylinder is like, your lung muscles have atrophied or have been paralyzed, and so the cylinder is breathing for you by changing the air pressure that your body is. And you basically have to live in that. I literally just saw, I think it's that one of the last people to live permanently

in an iron lung recently passed away. That this is like within living memory. We only have one or two people left who were affected by polio in that way where they're still living like that. But that's how recent it was. Right, and I know people, I have friends and colleagues who are people who had polio as children

and still have some deficit from it. And it was a frightening disease. And I think when the chance came along to prevent that, people jumped at it. Yeah, I mean, I can only imagine, you know, it's the mid 20th century must have been an amazing time to live because there are all of these incredible life-changing advancements that are happening

and are just good, not like our technological advancements today where we're like, oh, I got the iPhone, ah, now I'm addicted to the thing and oh, fuck it, that are happening and are just good. Not like our technological advancements today where we're like, oh, I got the iPhone. Ah, now I'm addicted to the thing. And oh, fuck it. Looks like it is contributing to the downfall of all forms of media and institutions and our democracy perhaps.

And oh boy, this is a little bit concerning. As amazing as it was. Oh geez, now a billionaire is in charge of it and he's fucking with me, et cetera. Back then it was like, Oh, somebody invented a vaccine. It's going to save millions of lives. Like they're all of these incredible advancements that are transforming life for the better. Uh, and vaccines were like one of the, you know, the, the main achievements of science in that time period.

Yeah. And I think, you know, I think of vaccines as close to just an unalloyed good as you can get. And that's not to say that they're perfect. There's no such thing. And there are, as the anti-vax people will happily point out over and over, there are some minor risks to vaccination. There was an incident early in the polio virus, the polio virus vaccine rollout called the Cutter incident, where,

instead of one company making all of the polio vaccine, the technology was given to multiple companies and they started making it. Basically, the way you make the Salk polio vaccine is you grow up a whole bunch of polio virus, you kill it with formaldehyde, you process it and that is your vaccine. And one of the companies had a quality control issue in a plant and some of the polio virus was not killed and caused paralysis in some of the kids who received the vaccine.

That was horrible. It was also discovered quickly. Those locks were recalled. The quality control was put in. And the polio vaccine that we use today and that we use subsequently doesn't have that issue. So there's unbalance. I think that the polio vaccine did tremendous good,

continues to do tremendous good, continues to do tremendous good today. But I think that vaccine safety is something to pay attention to. And it is something that contrary to what many of the anti-vaxxers say, it is something that people like me and my colleagues think about a lot.

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when you go to joindeleteeme.com slash Adam and use promo code Adam at checkout. That's joindeleteeme.com slash Adam, promo code Adam. I also think about before we had vaccine vaccines, we would practice inoculation. Is that the correct term for, and I know earlier in like the 18th or 19th century had vaccine vaccines, we would practice inoculation. Is that the correct term for, I know earlier in like the 18th or 19th century

was more like someone will come to your town and like smear some cowpox into an open wound or something like that. And that was semi-effective, but was a lot more dangerous, right? Like there were more dangerous forms of fighting these diseases before the vaccines. Right, they would do it with real smallpox. So the idea was they would take material from the

scars of people who had smallpox, little bit of it, scratch it into a wound or, you know, the earliest, one of the earliest ways that it was done was they would squirt it up the nose, like make a powder out of it and put it up the nose. And the idea was that people would get like make a powder out of it and put it up the nose. And the idea was that people would get a mild case of smallpox that would give them immunity. And it worked sometimes. The problem with it was it was the real virus and it had the potential to give someone actual smallpox.

Which is why when the idea of using a virus that gave you immunity to smallpox without the risks of smallpox came around, that was a much more appealing thing. I remember this scene from a little bit of a tangent for the John Adams mini-series on HBO. I don't know if you ever watched this. It's like over 10 years ago.

But what's amazing about this, with Paul Giamatti's in it, what's amazing about it is they spent a lot of time on how horrible medicine was then. Like there's a lot of stuff, George Washington had like very painful dentures. There's a lot of him like having a lot of time on how horrible medicine was then. Like there's a lot of stuff, you know, George Washington had like very painful dentures. There's a lot of him like having a lot of difficulty

talking because of his bad dental work. And there's like an inoculation scene where I believe one of John Adams relatives is like, you know, is inoculated and there's an adverse result. And it just really makes you dwell on, not a lot of films show you how disgusting the past was medically. They wanna sort of make things look nice and pretty.

This one is really invested in going like, no, no, no, they wore wigs because their hair was terrible and they all smelled bad and they were all sick all the time and there were no cures. And it really, really one of the side effects makes you very grateful to be alive in this time period after the creation of vaccines and all these other medical innovations that we've had.

Absolutely. It's, I think that, you know, the first attempts at vaccines were crude and they, you know, they worked, but they had substantial risks that went with them. And we're in a very different place now where, you know, where there's a lot of quality control and a lot of safety monitoring. So I can't really imagine a greater medical advancement than,

you know, eradicating smallpox and eliminating measles and polio in this country. Those three diseases combined millions and millions and millions of lives over the past century. Correct? Absolutely. So now though, millions and millions and millions of lives over the past century, correct? Yes, absolutely. So now though, in recent years, we've started to see measles come back in this country because people have not been vaccinated.

And of course we've seen the rise and now the virtual enthronement of the anti-vaccine movement in the person of Robert F. Kennedy Jr. who, as we're speaking now, just finished being grilled by the senators, looks likely to be appointed. He may be appointed to be the Secretary

of Health and Human Services by the time this airs. So how did that rise look from your perspective as a doctor, right? Because you've been practicing for the entire rise as a doctor, right? Because you've been practicing for the entire rise of this movement, right? Why has it happened and what does it look like from your view medically? Yeah, it's complicated, it's discouraging,

especially the last piece of what you talked about, which is where we seem to be heading now in this country and worldwide. You know, I came into medicine at an interesting time. Some of the vaccines that we talked about, polio vaccine for example, had been there for many years. By the time I came into medicine,

I didn't take care of children with polio when I was a resident because there was a vaccine against that. I didn't even take care of kids with, there's a disease called Hib, H-I-B, which is, it used to be one of the top causes of early life sepsis, of invasive bacterial disease in children. It killed many, many children in the US every

year. It causes bloodstream infections. It causes meningitis. And a vaccine against that came out in the mid 1980s and was in widespread use by the early 90s. And so by the time I was doing my training, Hib disease had basically disappeared. I would talk to pediatricians who were 10 years older than me, 15 years older than me, who used to spend an enormous amount of time thinking about Hib, taking care of children with Hib, and then it was gone. And during the time that I trained, in the early part,

we had invasive pneumococcal disease. Again, a bacterial infection, horrible in children, still something we see occasionally, but that was, we spent a ton of time on that, a ton of effort. I'd seen children die of invasive pneumococcal disease more times than anyone could ever possibly want to. And that's not completely gone, but much, much, much less common than it was a couple of decades ago because a vaccine against that came out. And so I got to see the effect of vaccines essentially in real time.

And I think the thing that really brought it home to me in terms of what we have the potential to lose is I went through a lot of my training never seeing measles and then seeing a couple of cases in returning travelers when I was an infectious disease fellow. And then in 2018 and 2019 in New York City, we had this huge outbreak of measles. There were 600 and something cases in New York City itself, another couple hundred up in Rockland County, which is just north of the city. And this was all in a community that had essentially

stopped vaccinating because they were targeted by the anti-vaccine movement. This was a very clear culturally targeted attempt by the anti-vaccine movement. In what way were they targeted? And yeah. So to be clear, I'm talking about Orthodox Jewish communities that live in sort of

a cloistered community in Brooklyn. Got it. This is a group of folks who tend not to get their information from the internet, to get it in lower tech ways. And there were specific pamphlets printed up in Yiddish and in English. They were distributed at supermarkets. There were hotlines set up for new mothers to talk about coping with being a new mother.

And they would have anti-vax speakers on these things. This was a very directed attack on this community. Who was doing this? So a lot of the early messages came from Andrew Wakefield and others who were, you know, who were prominent in that world. They were filtered through some of the other people who were prominent in that world, they were filtered through some of the other people who were prominent in the anti-vaccine movement, and then it was done with cooperation

of some people in the community. And there are pretty good histories of this that have been written, and I talk about it in detail in the book. But it's interesting because the overall vaccination rate among kindergartners in New York City at the time of this huge outbreak was about 98%, which is well over the 95% that you need to stop an outbreak. So it was confusing to me that we were seeing all of these kids coming into the emergency

room with measles, but it turned out that the vaccination rate in these specific communities in Brooklyn was about 50 or 60%. Right. And so you can have spread in these cloistered communities and yeah, the disease occurs in the unvaccinated. It occurs rarely in people who maybe have gotten one dose of measles vaccine instead of two, which is the recommendation.

But it's almost exclusively in the, in the kids who are unvaccinated and mostly in kids, in kids who are unvaccinated because their parents opted out. Wow. And so you, you're seeing this movement, the anti-vax movement target a specific community, right? The, they get infected by the anti-vax sentiment, right? By the propaganda, by someone from outside

converts someone inside the community to the anti-vax way and then they start propagandizing the community. The vaccination rate plummets and then almost immediately there's a major outbreak of measles that's sending kids to the emergency room. And that made national news, by the way. And so what I'm wondering is, why is that not the end of it? Right? If there's very clear evidence that everyone can see in front of their faces,

hey, this single community ceased vaccinating on a wide scale, and then a bunch of their kids went to the hospital. I assume some of their lives were threatened. Were there any deaths as a result? So fortunately, there were no deaths. There were children in intensive care units, but we were very lucky that both in Rockland and in New York City, there were no pediatric deaths

during that. There was a measles death in 2019 that was in an adult that was outside of those communities. But like, there's only so much you can plan on getting lucky. And the death rate from measles in the US is probably on the order of one per thousand cases. It depends a little bit on the age structure. It depends a little bit on the age structure,

it depends a little bit on who's getting infected, but you know, so it's not crazy that you would have an outbreak that had 700 cases or something like that and not see a death, but you know, there's only so much you can mess around. So why does this not cause, in any of the folks promoting this misinformation, a reevaluation of, okay, a whole community did what we said

and then there was a measles outbreak? Like it's... Right, right. I know. So, I mean, I think there are two pieces of it. We saw this with the Disneyland outbreak, to go to your side of the country for a sec, in 2015, where there were all of these cases

among unvaccinated folks in California and who had traveled to Disneyland. The initial response to this was, from the anti-vaxxers was, yeah, there are only 20 cases, there are only 30 cases, now there are only 100 cases. And there was a pretty strong pro-vaccine response at that time.

If you look at what was in the LA Times back then, and what was being written nationally, people were like, this is a problem. The anti-vaccine movement is a problem. I think there's less of that when there's targeting of very specific communities. We see this with the Somali community in the Twin Cities in Minnesota, where there have been measles outbreaks, again, because the anti-vaxxers, including Andrew Wakefield himself, went and visited that community multiple times

because it was a community that they thought was susceptible to this, to those kinds of ideas. That's, I did not realize that Wakefield, Wakefield, by the way, is the disgraced doctor from the UK who promoted the original idea that vaccines cause autism, which has been disproved time and time again. Is there anything else you'd like to say about Wakefield specifically?

There's a lot, but it's a family show. Ah, okay. Well, I was aware of him. I was not aware that he and people like him were specifically targeting what you would have to call vulnerable communities, right? Communities that have a limited amount of access to outside information or where something like this can spread really widely. That's repulsive. Yeah, agreed. And I think that they're

opportunists. And I think part of the issue also is you, if you talk to some of the people who have really bought into the anti-vaccine messages, you talk to people in Brooklyn who believe this, they'll say, yeah, there were, you know, 700 cases, nobody died, no big deal. But it is a big deal. And it's a big deal for a few reasons. The first is that if you continue to do this, someone is going to die. The second is that measles is weird. Measles is the most contagious disease we know.

And it also, if you have measles, it makes you more vulnerable to other infections for several years afterwards. So we've seen this in multiple studies. And so it puts those kids at higher risk of dying from other infections for a couple of years after measles. And then the third thing is, yeah, if it starts in a community that makes this decision, that's one thing. The problem is the only reason that it stayed in that community in New York City or within the Somali community in Minnesota is that we have this sort of wall of immunity around it where the rest of

of the population is vaccinated. But if you look at what has happened to childhood vaccination rates since 2019, you know, since the pandemic and since all of the very active outreach by the anti-vax folks, we used to have about 95% of kids in the US vaccinated against measles. So overall, it's now under 93%. That's kindergartners. And that's less than we need. And the trend is bad. Like it's less this year than it was the year before. We have fewer states with sufficient levels of measles vaccination now than we did last year and fewer than the year before that. The trend is bad.

So what explains that? I mean, at this time in 2019 that you're talking about, I remember this moment. And at the time, the anti-vaccine movement was kind of seen like, almost like the Flat Earth movement, this obviously incorrect movement of, And at the time, the anti-vaccine movement was kind of seen like, almost like the Flat Earth movement, this obviously incorrect movement of very deranged people, right?

People who really are either behaving very cynically or have really something wrong with their reasoning. And it's like a virulent way of thinking, but it's small, it's a niche, right? And it's causing individual problems in localized areas. That's how I treated it as that form of conspiracy theory. Now in 2025, it's absolutely mainstream and we're starting to see these levels dropping.

And again, Robert F. Kennedy Jr. is about to, or currently is, the head of our, you know, he's one of the people promoting these ideas and now is running our nation's healthcare system. So we can't just explain it as, hey, there's a small number of people who are spreading, you know, malicious misinformation. Something bigger is going on.

What has changed over that time? Yeah, I mean, I think the obvious big thing that was between 2019 and where we're sitting now is the COVID pandemic. Oh, of course, the COVID pandemic. Remember that? Oh, you know, I completely forgot about the COVID pandemic.

Did you miss that? I've kind of memory-holded for myself, and you know. So now that you bring it up, yes, how did that affect the anti-vaccine movement? Because it was a very clear before and after of that movement. Yeah, no doubt. And even during. And I think if you look at what the anti-vaccine movement

was saying, even at the very beginning of COVID, before there were vaccines available, they were saying, this is our moment. This is our chao. People are thinking about infection. People are thinking about vaccines and getting you know, getting out there, sowing doubt. If you, you know, RFK was speaking out against the COVID vaccines

before the COVID vaccines were available, before we knew whether there was going to be a COVID vaccine available. And then once there were vaccines available, almost immediately he was saying, oh, they're more dangerous than the disease. They're, you know, advising people not to take them, saying that, you know, COVID either, you know, doesn't affect kids or was good for kids, like lunacy. And I think that that got mixed up in people's other feelings about the pandemic,

some justified and some not. I think people were terrified during the pandemic. I certainly was. Went to work every day, took care of kids with COVID, took care of kids with things that weren't COVID. And I think that people were frustrated about the messaging, about masks, about schools, about all sorts of other things.

And my personal opinion on that is that the public health people that were at work during COVID were heroes and were doing the best that they could in terms of providing guidance. It is very difficult to know what to do with a disease that you've never seen before. Yeah. Where you're not even sure at the beginning how it transmits and you just want, you know,

and people are dying and you just want people to be safe. It's not to say that public health was perfect during COVID and I think we all learned a lot. But I think there is this carryover mistrust from that. And it bleeds into how people feel about routine vaccines. And some of that is expected, but I think that some of it also is very deliberate messaging by the anti-vaccine movement. Well, look, there was a resistance

to all of the public health measures during COVID-19, and to a certain extent, it's very understandable because there's, you know, at a moment like that, public health means getting the entire public to do or not do certain things, either asking them to or making them do it, saying, hey, you cannot go to school, you must wear a mask to enter the space, et cetera.

And if you are talking about the entire population, there's gonna be some part of the population that says, fuck you, don't tell me what to do, because that's human nature. And this is America, and this is a country where part of the culture of America, for better or for worse, is we don't like to be told what to do.

And so some of that response is understandable. But what I feel like really got missed, I'd love to dwell on for a second, I've talked about on this show before, the incredible scientific and health advancement that was the COVID-19 vaccines. Like we did episodes about this. The fact that we were able to develop a vaccine

for a disease that we had never even seen before within months by understanding our own bodies, we basically reprogrammed our own immune systems to fight a disease that I'd never encountered before via the RMNA molecule, excuse me. Just tell me a little bit about that from your point of view, because this looked to me on par with

the development of the polio vaccine. It was like magic. It was, I don't know that I've ever been prouder of us writ large than during that moment. Wow. I felt this incredible sense of relief when I got my first dose. I cried when my daughter got her first dose because I was so happy. I was so scared about her. My wife is also a physician. She was working during it. I was overjoyed when she got her

first dose. It's hard to remember, it was, it was like, it's hard to remember what the time felt like and how short the time was between the discovery of this virus and having a vaccine against it. And you know, you have people out there yelling, the vaccine kills more people than the virus, which is insane. Yeah.

And saying that people shouldn't take it. The COVID vaccine has saved tens of millions of people's lives, you know, potentially mine and yours. And I am grateful. I am grateful to the people who worked on it. I'm grateful for the people who worked on the mRNA technology for the 30 years before that, when they, you know, had trouble getting funding to on it. I'm grateful for the people who worked on the mRNA technology for the 30 years before that, when they had trouble getting funding to do it.

It's literally like, my understanding is, our ability to create a vaccine like that just came into being like literally a year or two before COVID-19. Like the technology was completed at almost the exact same moment that the disease arose in like a really fortuitous stroke of luck. Yeah.

I mean, it's a stroke. It was like a stroke of luck, like three decades in the making though. Like it was, it was fundamental science that was supported by NIH, which, you know, we were, we were talking about Kennedy and the new administration. Like this is what the NIH gets you. Like, like what we give to the NIH goes to fundamental discovery. And in the absence of that, we wouldn't have had the COVID vaccine.

We would have had millions more deaths, probably in the US, certainly worldwide. And it makes an enormous difference. And we're lucky that the timing of the mRNA technology maturing and the COVID pandemic were close to each other where we were able to use that technology to protect us. And my understanding is the real advancement is that as opposed to taking like, you know,

some sort of dead sample of the disease and turning that as opposed to taking like a, you know, some sort of dead sample of the disease and turning that into a vaccine, it's literally we are coding what our body needs to know in order to create an immune response without giving people a dose of the original disease itself. So it's actually safer and more advanced than a more traditional vaccine. Yeah, I mean, it's the one of the amazing things about it is that you don't even need a sample of

the virus to do it. You just need the information, like the genetic code. So when the genetic makeup of the virus was shared from the early cases in China and elsewhere, the groups here had the information that they needed to start making the vaccine. And that's part of the head start that got us the vaccine as early as we did. This episode is brought to you by Squarespace. You know, I've said it before and I'll say it again. Life happens online. And that is why it is crucial to put your best foot forward. Whether you're running a business, growing a brand,

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Worldwide hero. I know the guy, most people know the guy's name, even if they don't know what he did, because he was so famous. But was the story not told well enough? I mean, I think about the number of podcasts that have dudes interviewing astrophysicists and computer scientists about AI going like,

wow, that's so cool. Whoa, whoa, wow. Technology is amazing. Science is amazing. Why weren't those same people telling the story of how incredible this vaccine is? Instead, they were spreading misinformation about it. They were saying, I don't know if I wanna put that

in my body. Instead of lauding the scientists, which is what they do on the rest of their fucking episodes. Right, yeah. I mean, some of it, I think, came from people's individual experiences where you could envision that if someone was at work one day and then was told they had to stay home, stay in their bubble,

have their kids in their bubble with them, and didn't really see people getting sick or only saw the people around them who, you know, maybe got sick and then got better from the virus. Even if they saw what was on TV, they didn't experience it in the same way. I think polio was more of a shared experience because even if you didn't know someone with polio, you know, you had the issue where kids weren't going in the swimming pools in the summer because they were in a case of polio in the next town over or something like that. And so I think that people felt that more acutely.

And it's not that people didn't feel COVID. Of course, people felt COVID, but people felt it in their homes, having to work from home, having to watch their kids while their kids were doing Zoom school. And I think it made people angry, obviously. And who could blame them? And so I think it was wrapped up in that. And we also, we just have more access to fringe beliefs now.

And if you have people saying, this is a miracle, the vaccine is wonderful, but you also have all of these loud voices being like, this is completely bogus and you don't know who to trust. It's hard. And I think literally being made to stay inside broke people's brains because people were isolated and suddenly they have nothing but the internet.

And the social distancing as the initial approach to COVID-19, I think absolutely saved lives. I think what we maybe did not anticipate was how that was going to change our culture and our information diets and our politics in ways that were really negative and we're still feeling. I kind of wonder if the historians of the future might say, hey, public health wise, this made a lot of sense.

But if you look at how social distancing affected the worldwide culture and how it reverberated, maybe we, maybe there were, maybe the bad outweighs the good. I'm not saying we shouldn't have done it because it was the best information we had at the time, but like the amount of reverberation socially from that choice, so massive. And because it ends up supercharging an anti-vaccine movement that is going to result

in deaths now, right? Yeah, well, counterpoint. Please, please. There were literally refrigerated morgue trucks outside of hospitals in New York City because we didn't have room for the bodies in the hospitals. Yes. So it was an emergency. Yes.

And like, yes, so do we need to calibrate where the emergency ends and where you open things up? Sure, but we didn't know the end of the story at that point in the story. And we didn't have a vaccine at that point in the story. So it's very hard. You see yourself as a point, you see what's going on as a point on the curve, right? But you don't know if the curve is on the way up or about to peak or yes And so I it was okay that people had to stay indoors. It was okay that we closed schools

It was good that we closed schools. I'm not for that but pediatrician. I want what's best for kids Kids belong in school, but at the time, it was an emergency. Yes. And I don't say that to second guess. I'm not one of those people who's like, ah, learning loss, they shouldn't have closed the schools. They shouldn't have kept people home. It was clearly the best decision to make at the time.

But I think that we are still discovering how it broke our culture in ways that are also having material effects on our health. And I think that's something that we have to like acknowledge. And if you are, I make a distinction on this show a lot between medical technology or scientific technology and social technology, our understanding of how the decisions that we make

affect our society. And that's important to take into account in public health. And I guess the way I'll put it is, I think that the next time there's a pandemic emergency of this type, I think we'll have learned a lot about what these sort of public health measures, about other things that they do to our society and our culture,

that we are going to need to take into account next time. Okay, we need everyone to stay inside. We just need to remember 20% of the population is gonna lose their fucking minds when we do that. And that is also a public health outcome that we need to be cognizant of. Yep, 100%. Yeah. Completely agree.

And I think that part of the issue also was we had data from relatively early that you could get kids back in school and you could do it safely with masking and distancing and all the other things that made school uncomfortable. But we did have kids back in school and we did minimize spread in that way, but it took effort. And, you know, something that I said a lot at the time, I think a lot of us said at the time was maybe the balance

is that you have kids back in school, but you have fewer things open for, you know, you don't open restaurants at full capacity yet. Like you don't have to do everything all at once. You can prioritize the things where we think the public health outcomes, but the behavioral outcomes are gonna be the most impactful. And as you say, there's plenty of things

that we would do differently. That's one of them, where we do it now. But we were doing the best we had with the information we had at the time. I certainly believe that our public health system was, there's a lot of heroic work that people did, even though mistakes were made as they all are in any group enterprise.

So how did this change the anti-vaccine movement in ways that are affecting us now? Yeah, I mean, I think that we went from a situation where people, you know, in the pre-pandemic period, I think most people had a lot of trust in public health and in doctors to do what was right. And most people defaulted to doing the regular immunization schedule, because that was the regular schedule.

And I think that the pandemic, in large part due to the fact that the anti-vaxxers pushed both their messages about the COVID vaccines along with their messages about the COVID vaccines along with their messages about routine vaccines. I think a lot of people now are saying, hey, wait, you know, homeschool was really bad and there are all these people saying that the COVID vaccine was really bad. How do I know that the regular schedule, you know, how do I know that the polio vaccine is safe?

I think it bled over, but I think it bled over on purpose. What is the anti-vaccine movement's goal? You said they're opportunists, they took it as an opportunity to push it. I'm gonna assume that many of them believe what they're saying despite the fact that the evidence all contravenes it, but like what is the self-interested reason to do so

other than simply being a proselytizer and gaining followers, which I'm sure feels good. I also enjoy just having people listen to me. That's why I do this, but I'm not like, how does one profit from misinformation like this? So I think there are two things. I think there are the leaders in that movement, and then there are the people who receive the messages

and how they act on them. And I think for the second group, for the parents who are making decisions about what to do for their kids, these are people who love their kids. These aren't people who want harm to come to their kids. They're trying to make the best decision that they can for their kids in the face of some people saying, you know, you need to do this thing.

And some people saying this thing is very dangerous. So I think there there's not a, you know, a dedicated self interest there, even for parents who are really pushing the idea that that vaccines are unsafe. I think you're right. I think it's because they truly believe that, and they think that that's the right thing to say. And then there are the people kind of at the head of the movement, and we're talking about, you know, RFK Jr. and Del Bigtree and all of these folks,

who profit tremendously from this. So Kennedy makes millions of dollars from Children's Health Defense and from the anti-vax books that he writes and the books that cause people to make threats against Tony Fauci and Bill Gates. And there are movies and there are the onesies that Bernie Sanders was showing on the congressional hearings for RFK, the unvaxed, unafraid onesies that RFK's group sells. There's merchandise, there are followers,

there's advertising dollars, there are all of these things. And it is big money. And I think in large part, for the leaders of the movement, it's a grift. Which isn't to say that none of them believe what they're saying. I think that they do believe what they're saying. It happens to be wrong, but...

But the best script is one that you believe in, right? Probably. And both things can be true. But I also, I really want to dwell on that point that you're saying that many of the people who follow the movement have good interests at heart. You know, I remember receiving an email, I think it was, we had done a previous episode

on anti-vaxxers and I got an email from a parent who said, hold on a second, Adam, I'm not an anti-vaxxer. I just think that, you know, my kid shouldn't get the hepatitis B vaccine, or is it C, is it B, am I correct? B. My kid shouldn't get the hepatitis B vaccine, or is it C, is it B, am I correct? B. My kids shouldn't get the hepatitis B vaccine because that's a disease that only affects

heroin addicts and gay people. And I have a child, right? And I said to this person politely, well, but that is a piece of anti-vax propaganda that you have ingested. Actually, there's a very good reason for a child to receive a hepatitis B vaccine, which I hope you'll tell us. But this is someone who, you know,ested. Actually, there's a very good reason for a child to receive a hepatitis B vaccine, which I hope you'll tell us.

But this is someone who had just been, I don't know, heard some shit from other parents at the dog park or this information had gotten to this very well-meaning parent in a way that seemed very normal and natural. And to them was like, no, it's not anti-vax. It's just common sense. It's just something normal that I'm reading on Facebook

or Nextdoor, or again, I heard from a parent at a PTA meeting. And so that to me was the red flag of, oh, this has really been mainstreamed. This propaganda that is being spread as a grift has entered the mainstream consciousness of parents in America. Well-meaning, smart, reasonable people are have been infected with this stuff. Completely agree. And just to talk about the hepatitis B vaccine for one second, because it's

it's an important vaccine. It's a vaccine that we give to young children in part because hepatitis B virus is transmitted perinatally from moms or from other folks to children and it can happen early in life, including right around the time of birth. That happens commonly. It happened commonly before there was a vaccine available. Not everyone with hepatitis B knows that they have hepatitis B. And so there can be spread that way.

They're spread within households among children. hepatitis B knows that they have hepatitis B. And so there can be spread that way. They're spread within households among children. And the mother who you described, the logic would make sense if her facts were correct, but they're not. It's not a disease of only, you know, people who she considers morally deficient adults. It is a disease that is often acquired in childhood

and causes liver cancer, causes chronic liver failure. It is a major cause of disease. And it's an anti, like the HPV vaccine, it is an anti-cancer vaccine. It is one of a couple of vaccines that we have that prevent the development of a specific kind of cancer. That is freaking magic in a, in a, in a different way than the COVID vaccine is magic, but like that's amazing.

We should celebrate that. And we certainly should celebrate the HPV vaccine, which can prevent almost a hundred percent of cervical cancer and a large percentage of penile cancers and throat cancers and all sorts of other stuff. Imagine if we had a vaccine for breast cancer or any other. Oh my God, yes. Yeah.

Yeah, I mean. If we have the chance to wipe out a form of cancer, we should probably take it. And giving it to everyone is an important step in reducing that, not just like, oh, the bad people who you think get it more often, right? Right, and I think that some of this is the, some of the issue is the erosion of,

I wanna say respect, but that's not exactly what I mean. Valuing of expertise. Yeah. So, people critically looking at the source of their information. And some of the problem also is that there are people with fancy degrees after their name who will say insane anti-vaccine things. There's the Surgeon General of Florida who has stated that the COVID vaccine doesn't work, that it kills people.

And again, that's false and he knows it's false. I don't know what his grift is, but that is shameful. But for most people, I mean, I think that you probably shouldn't value the medical opinion of the person at the PTA meeting more than you value the medical opinion of your pediatrician. Yeah. And that's why I do some work within the AAP and other organizations because I think that the messages that come from pediatricians are generally still trusted and that we need to use that as a way of communicating. But it's hard, it's hard in the face of this just relentless torrent of information, much of which is crap.

Is part of the problem that people are shopping for their experts, that as you say, there is a critical mass of people with a couple letters after their name who are spreading the misinformation in a grift and so you can go find, I mean, look, here I am in LA. I'm sure I could find plenty of MDs in LA who if I was a vaccine skeptical parent

would give aid and comfort to that and say, no, no, no, you don't have to. No, those people are, not for your very rich child. Your very rich child will never have hepatitis B. So don't worry about that. No, you're much smarter rich child, you're a very rich child, will never have hepatitis B, so don't worry about that. No, you're much smarter than the other parents. I'm actually the smartest doctor. I'm the doctor with the most expertise.

That's a real phenomenon, right? Absolutely, yeah. I mean, I think that it's a problem. And I think that there is a lot of people being outside their lane in terms of their training. And there's a lot of valuing of opinions of people like RFK with no medical training at all and no scientific training at all.

Yes, he has no medical training. He's... Right. Did you see the headline about how his application to Harvard, he just wrote his name on the application, his entire application to Harvard. He just wrote Robert F. Kennedy Jr. on a piece of paper and got into Harvard.

And these are the people telling us that like, oh, DEI is causing an erosion of standards when the man's entire career is just based on the fact that he was the son of a murdered brother of a president who was also murdered. The murders are very bad, but. Of course. You know.

Yeah, can we agree to be against murder? I think we're against murder. We're against murder. But bizarre that this is seen as a piece of expertise when the man is literally only where he is because of a legacy. That's beside the point. Why do you think that, as you said,

in the days when polio was killing people and the vaccine came out, there are anti-vaxxers then? And it makes complete sense. Vaccination has a certain counter logic to it where, hold on a second, you're gonna come tell me that I have to put something into my body that is going, you're telling me it's gonna change my body forever in ways

that you think are good, what if they're bad? It's completely reasonable that some portion of the population is gonna say, huh, what? And that some smaller part of the population is gonna say, fuck you, I don't wanna do it. When you're talking about millions of people, that's gonna be the case. Why is it now taking root and changing our public health

in this large scale way, whereas it did not 70 years ago? Yeah, and to be clear, I'm not against people asking questions about vaccines or saying, are you sure this is safe? Or what is behind the fact that you're saying that this is safe? Of course, I want to be asked those questions and I want, you know, the pediatricians in

general are happy to talk to parents and explain why for those things. So it's not that that's a crazy question to ask. It's not. But I think that it's the combination of people's individual experiences with COVID and people's exposure to these bad information from all around. And I don't know, it is hard to be a pediatrician or to be someone, a public health person who is trying to put out a message. And sometimes the messages are to put out a message and sometimes the messages are nuanced and sometimes it's not as easy as saying something. One of the reasons I think that the vaccine autism thing will not go away is that it is

so simple. Vaccines cause autism. It's easy to remember and it explains incorrectly, but it explains something that is mysterious. And if you go to your pediatrician and you say what causes autism, a good pediatrician will say, well, autism is complicated. There are a lot of things that can cause it.

Some of them are infections, some of them are genetic, some of them are probably environmental. And that's a less satisfying answer. But it's the right answer. And the problem is that if you have someone feeding you in a loud voice with a fancy website, someone feeding you a simple explanation for an important question about your kid, it's easy to get sucked into that. Yes. I think that it's also the fact that right now, we have what I think of as a mainstreamed

counter reality political movement, where there's a number of issues where every scientist, or 98%, 99% of scientists tell us, here's what's happening in the world, and we have a mainstream political movement in this country that says about those things, fuck you, no it's not. Not just no it's not, but fuck you. And if you tell me that it is,

I have a whole strategy I use to fight back against that, to say you're corrupt, you're da-da-da-da, et cetera, et cetera. That is, it's a sort of weaponized form of ignorance and anti-science and oppositional, you know, defiant disorder almost, that is very, very successful at converting people. And it's become part of our political machine.

And Trump wrote it to power, right? And I don't wanna say it's exclusive to the Republican party because it's not, it's a more general political strain, but it has had a lot of success in our political culture. And what I saw in 2020 was vaccines getting sucked into it. Climate change was already part of it, right? Going back to like the nineties.

But vaccines, which previously were not part of this, it was like a fringe issue, became part of this mainstream political anti-reality, anti-science machine that then is very hard to eradicate. It's very hard to, I keep using infectious disease metaphors. But how did you feel when you saw that happening? Because it really was very clear how it was getting sucked into that, But how did you feel when you saw that happening?

Because it really was very clear how it was getting sucked into that, where now the counter reality parts of the media, hey, they're all anti-vax, whereas they used to not take a position on it just five, six years ago. Right, I mean, I will admit that at the point in COVID where the vaccines first came out, I was in retrospect, hopelessly naive

in the sense that I thought that this was gonna be a huge setback for the anti-vaccine movement because the vaccines were gonna save us, right? Because we were living in this hellscape and there was this hope. Here's the answer, yeah. Right, and that's all true except the opposite thing happened in terms of how people felt about vaccines.

I think some of it is that the messaging was not great and people didn't understand when we said, okay, you get two doses, that of course there weren't 10 years of data to know that the two doses was going to last for, you know, for 10 years because COVID had only been around for eight months. So it wasn't surprising when we needed booster doses. It's not surprising that it's not a 100% protective against infection, but it does protect you against hospitalization and death really, really well, just like it did at the beginning

of the pandemic. But I think that that was all lost. I think that those messages sort of primed people to distrust, and then it turned into, you're right, the routine vaccinations got sucked into the same thing. The degree to which it's now part of American political culture strikes me as something really new, the anti-vaccine movement, and very dangerous going forward. Actually, I want to dwell on COVID one more time before we get into that though. Because how much was the failure of the messaging a failure of our public health apparatus? I mean, you know, on my show,

The G-Word that I did for Netflix, we talked about the response to disease. We interviewed Francis Collins at the NIH. We talked about the incredible advancements in medical technology, but we highlighted again the failures of social technology. We went to places in the South that, Alabama, Mississippi, places like that,

that had very high COVID death rates. And it's because they didn't have the infrastructure to simply explain to people, you know, go door to door and say, hey, there's something called the COVID vaccine in a very caring one-on-one way. I'm gonna explain to you, hey, here's how this works.

It's really gonna be good for you and your kids. Here's a dose. We're gonna make sure that you have access to it in a way that actually met people where they were at rather than broadcasting and saying, go to CVS to get something from Pfizer, which is a different relationship. Like it is the American medical system

of which the government and our public health agencies are a part has a lot of fucking problems, Adam, you know? Is it not a failure of the system to some degree that allowed this malignancy to take root? Yeah, I mean, one of the, and I don't disagree that the system has problems. And on every side of that, on the public health side, on the technology side, there are things that, of course,

we could do better. I think that at the time for the COVID vaccine specifically, it caught the whole world unaware. And we were not prepared for that. People didn't know when the vaccine was going to be available, if it was going to work until we had the studies. And then all of a sudden, there had to be this enormous apparatus for getting it out to people

and getting messaging out to people. And you're right. It works better if you have people who are already trusted, delivering messages and answering people's questions. We saw that with the measles outbreak in 2019. The thing that worked was this sort of for helping parents make good decisions about vaccines is something that's almost impossible to scale, which is there was this group of nurses that went to people's living rooms

and Orthodox Jewish nurses who would go talk to families, explain things, show them studies. That's great, like that works in a small community. How do you scale that to a state or to a country? It's hard, especially because the whole thing with public health is that you have a crisis, people pour money into public health, things get better, and then people take the money away from public health and things are underfunded. And I think that's a fair point that in, you know, the mid 20th century, people were dying of smallpox

and polio and measles in a way that was really frightening. And so these public health measures were something that the public wanted and that was a present threat. And now we have eradicated or eliminated so many of these diseases. And it's not, you know, the importance of vaccines is not viscerally important to people. But I'll also say, you know,

what you were describing with smallpox, where it's, hey, we found some cases that we're gonna go door to door and identify people and et cetera. It is that one-on-one, you know, I don't know exactly what the measures were at the time, but that one-on-one attention to people is necessary medically.

And look, literally the previous interview I recorded of this podcast was with two ProPublica reporters about how much the health insurance industry screws people, right? And how bad it is for Americans. People do not have a good relationship with almost anyone in the medical community. A lot of people don't.

And so, you know, I'm talking to you and I respect your expertise and your point of view and I love the NIH and, you know, I have a nuanced enough understanding to know, hey, here are the bright spots of the American medical system that I treasure and respect. And, you know, our brave public health workers who are doing as much as they can with too little.

And also the part that sucks, right? But I know, I can tell the difference between which and which, but there's a lot of people who's experienced with the American medical system is simply bad. And they're like, I don't have anyone to talk to and why not turn to alternative medicine because at least those people listen to me, you know? At least those people treat me nice and flatter me

and make me feel better emotionally when the medical system fucks with me and steals my money. You know, it feels like these two things must be connected, right? You're right. And there are fixes that could be there that we don't do. And I agree with you about the insurance companies and I think we should have single payer. And I am on board with all of that.

When there's a crisis, we have to work with what we have. A hundred percent. But you're right. I think that if you think a little bit more broadly than I was saying, that we, in terms of a country, we don't do ourselves any favors in terms of health by setting up a system that is adversarial for the people we're trying to serve. And I have the same problems talking to my insurance company that everyone else does, and I hate it.

In your position, you have that much trouble. You would think that you wouldn't have trouble for the same reason, at least people who work at a restaurant get free food. You work in the industry, you'd think you'd have an easy time, but it's difficult for you as well. Yeah. I mean, for everyone, it's horrible.

Yeah. Well, so let's talk about, again, the mainstreaming of anti-vax. I just wanna end with your big picture view of, we're seeing vaccination rates drop. What are your fears for what this means for children's health going forward and the health of all of us?

Yeah, I mean, I am really worried about this. And I think we're not at a point where we're seeing the worst that's going to happen yet. If vaccine rates continue to drop, we're gonna start to see more vaccine preventable diseases, obviously. We're already seeing this with measles. So just in the last week,

there have been four cases of measles in Texas. There have been cases in Georgia, in Rhode Island. These are states that haven't had cases since before COVID. I think Rhode Island hadn't had a case in more than 10 years. And yeah, these are small numbers, sure. But the thing is that if you have a small number of cases, like someone who's not vaccinated, goes to another country, comes back with measles,

they have measles, hopefully they'll do okay, but then there's the wall of immunity around them. We don't have that wall of immunity anymore. And as our rates continue to drop, we'll see measles first because it's the most contagious, but like we're already, we're seeing more cases of Hib, which was the thing that I hadn't seen in the first 30 years of my career.

And, you know, was seen in the generation before mine. We're seeing more cases of lots of vaccine, preventable diseases. And the worst part about it is these are real kits. Like, you know, at the end of the day, these are preventable sicknesses and preventable deaths. And we should, not that there aren't any limits to public health, but I think the least that we can do for these kids is to provide them protection

against the things that we can protect them against. There are all sorts of things that can be dangerous in childhood, right? I start my book about measles, not with measles, but with a story of an accident in my home in which my younger brother, when I was a kid, was in grave danger of dying and fortunately did not. But there are these dangers for kids that you can't vaccinate against, that you can't protect against, but there are things that we can. And it's, it seems like we, as a, as a society, not just in the U S but, but you know, more and more globally that we're choosing not to provide kids with that kind of protection. And that is, that is sad and it's frightening.

What can we do about it? I mean, are there steps that you think we can be taking to reverse this trend? Yeah. Well, so first of all, thank you for having me on because I like the potential to bring this message to people. I think it's difficult in the current media environment to make sure that voices that are speaking about science and that are promoting things that are good for health like vaccines, that they're out there. It is, I think pediatricians and scientists in general

are not always people who are comfortable getting out there and being political or being, you know, targeting messages to large groups of people. I think we need to get better at that. I think what we're seeing now is, you know, in part a result of one side of this argument being much better at delivering their message than the other side. So I think a lot of that is on us, like it is on my colleagues and the public health folks

and pediatricians to get out there more. It is hard. There sadly isn't an easy answer to this. And I don't want it to be a situation where we have to go back to a time when we're seeing more children's deaths for people to realize that vaccines are valuable. Yeah, and it's part of a bigger problem of how do we fight back against this sort of

counter-reality strain in American thinking that is very, it's like a drug-resistant bacteria, you know, it's like a drug resistant bacteria, you know? It's like everything that we throw at it. I've spent my career trying to dispel misinformation on this very subject and I've only seen it grow and grow. And it seems to somewhat exceed our ability to dispel the misconceptions. The way that this has grown.

Till again now, Robert F. Kennedy Jr. leading the Health of Human Services, what is your fear for his tenure and what you think it might mean for public health? Yeah, I think it's potentially disastrous. I mean, if you look at his answers during his Senate testimony, just in the last couple of days,

he's on the track to get a job where he's in charge of Medicare and Medicaid. He couldn't say basic things about Medicare. He misidentified Medicare parts A, B, C, and D. And then at the end of that line of questioning said, I got all the answers right. And that's exactly it. That is the Trump plan.

That's the Kennedy plan is just, outright lie, say that you are correct about things. And he, as we were talking about, he not only has no, he doesn't value expertise, he is actively suspicious of expertise. And he thinks that all scientists and all pediatricians and everyone is conflicted and that there are multiple answers to anything.

It's a very lawyerly way of approaching things. He said many times during his testimony, how well only a jury can decide what the truth is in terms of whether vaccines are dangerous or something. And that's not who decides that. There is truth and you approach truth with science. And he doesn't value that. And I think he sees himself as, you know, his mandate as going in and destroying these

institutions. And, you know, we're even right now, we're in a point where the CDC isn't able to communicate with the WHO. That is horrible. That is dangerous for Americans in the short term and very much so in the long term. And I think that if you cripple these agencies, which he may do, you put us in a dangerous, dangerous position.

Do you have any hope that the people at these agencies, many of whom are science-based practitioners like yourself, you know, if put a guy in charge who actually doesn't know anything about what they do, you know, is there, is there a chance that there, you know, we'll be able to hold the line against someone who you have to hope that actual expertise and intelligence and truth is more powerful than lies and ignorance and falsity. In the long run, that is something that I do believe, that the truth is more powerful than a lie, that you are better equipped when you have real information

rather than false information. Is it possible that it'll win the day in the end? I hope so. Yeah. I'm concerned because I think that this is dangerous. This is different from the first Trump administration in the sense that there really seems to be this move to clear out federal workers, including federal workers with expertise. And I know

many people who work at CDC and NIH and FDA and these are good people, these are smart people, and I'm worried people, these are smart people, and I'm worried that those folks are gonna be cleared out in favor of people who wanna promote Kennedy's agenda, or if not Kennedy, whoever ends up in there. I'm very worried about that as well, and we're just gonna have to see how it plays out and continue to try to share the truth as best we can

and try to protect each other. I'm really grateful for your work, you know, protecting kids and try to keep kids safe. And for coming on the show to talk to us about it. The name of the book is booster shot. People can pick up a copy at our special bookshop factually pod.com slash books. Where else can people find your work at them? Great. So Adam Ratner,d.com is where I have some of the writing events, things like that.

That's a good place to look, and the book is available anywhere you find books. And I really, really appreciate your having me on. This was really fun. So grateful to have you, Adam. Thank you so much. Thanks. Well, thank you once again to Dr. Adam Ratner for coming on the show.

If you want to pick up a copy of his book, you can do so at FactuallyPod.com .com. And just a reminder that any book you purchase there will support not just this show, but your local bookstore as well. If you'd like to come see me on the road in Chicago, Boston,

Burlington, Vermont, London, Amsterdam, Providence, Rhode Island, Vancouver, Eugene, Oklahoma City or Tulsa, head to AdamConover.net for all those tickets. If you want to support the show directly, head to patreon.com slash adamkonover. Five bucks a month gets you every episode of the show ad-free. For 15 bucks a month, I will read your name in the credits of every single episode. This week I want to thank 90 Miles from Needles, Aaron Matthew, Andrew Harding, Alaska, Amy, Thor Tron.

If you want to join them, head to patreon.com slash Adam Conover. I want to thank my producers, Sam Roudman and Tony Wilson, everybody here at Head to Gum for making the show possible. Thank you so much for listening and we're going to see you next time on Factually. That was a HeadGum Podcast. Hey, it's Nicole Byer here. Let me ask you something. Are you tired of endless swiping on dating apps?

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