Sawbones: A Marital Tour of Misguided Medicine - The Malaria Vaccine

Episode Date: October 12, 2021

As an intro to new listeners, we’re bringing you science unfolding in real time that’s actually really good: the malaria vaccine. Let’s get the bad news out of the way first: It’s called Mosquirix. Doesn’t exactly trip off the tongue. But the good news? It could save tens of thousands of children’s lives every year.

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, two, three, four. Hello everybody and welcome to Sobo. It's a marital tour of misguided medicine.

I am your co-host, Justin McRoy. And I'm Sydney McRoy. And a special extra triple welcome to you this week for the Maximum Fun Block Party. That's right. If you don't know, if you haven't heard, this is your first interaction. This week on Maximum maximum fun our podcast network

Everybody's putting out shows. They're gonna be a perfect place to start listening to a Max fund program So if you've never listened before you want an episode that's not gonna anticipate anything of you that does not expect you to know anything about the show This is the week to listen to it. That's what we're doing doing with cell phones too. We started off strong by saying who we are. Yes. There's one hurdle. Huge. Overcome.

We're really married. Yes. I'm really a doctor. I'm a family, I'm a doctor of medicine. We used to do a podcast about two and a half men and then we did one about television. And now we do one about medicine and we've been doing it since 2013. It used to be a lot of just old medicine, the ways people have tried to treat people

over the years of their weird stuff. And it's evolved recently as well, unprecedented times as the press releases like to say. His history is happening. History is happening all around us and has been for quite some time. So we'll talk about those sorts of things. We'll talk about sometimes there's wellness trends,

things like eating. Thank you, Tick, Talking, or a paltrow. Or sending your a perineum. What? That was good. You use the right word there. Yes, I did use the right word, Sydney.

I'm very proud of myself. So this week we are talking about, this is sort of a blend of history and the modern. So it's a serve a little bit of everything that's all about this is doing right now. Well, Justin, there's so much that we've been watching science happen in real time in the last. It was like I've been saying in the last year and then I started saying the last, it was like, I've been saying in the last year, and then I started saying the last year and a half, and now I'm saying going on two years, which is accurate, but also hard, difficult. And watching science and real time and history happening and all of this unfolding has been

hard and stressful. But here's some science unfolding in real time that's good. Well, it has like a happy note. Like fun, rewarding science in real time. Yes. How about that? Yes. We need a good story. We need some happy science. Write this very minute. That's right. Beakers in the window. What's another science thing? Flask, test tubes, Bunsen burner. No, no, no, no. Microscope, electron microscope.

It's a little, chemicals in the pipette. Yes, we need some happy science. Right, this is very mean. I love pipettes. We need some happy science. I like micro pipettes micro pipettes That sounds like something we'd see advertised to us on Nick Jr Micro pipettes are the cutest pets, but they hide a secret. They're actually USB drives full of all Wikipedia

Be cool I'd be cool. I would be good if I could get some kids. Why would you feel like a video to USB? Just to warn, sorry, it's in the net. It's an educational tool. It's in the net. But it's an educational tool now. MicroPriPets are an educational tool with full with tiny pies. It's like in Carter. It's just like in Carter. It's just like in Carter.

Back to science and real time. We have had some big vaccines come out this year. And there were some of us who believed when these big vaccines came out that there would be like celebrations, like people sobbing and like joy and just like running to the pharmacies, like, get me my vaccines. And like it would be a new era for vaccine love. And because most people are already pro-vax. This is a really important point we make on the show. It's not easy and pro-vax.

Pro-vax, I think is an honor, I know we have a pin that says pro-vax, I think we should strike from the record. I don't think you should be. I think there's a few. Well, there's not two sides to this. No, there's not two sides. There are vaccines are safe and effective and you should get them.

And then there are people who are wrong. And those are the two sides. Some things don't have two sides. But I thought that it would really help us fight some of the misinformation. Didn't happen exactly. No, just like I thought. I don't feel like that.

But here's a vaccine that just came out. Last week's episode, we referenced that there was a malaria vaccine in the works two days after that episode. Yeah. Yeah. A vaccine. All of a sudden, just like that.

Is approved for malaria. Well, the World Health Organization, the who officially endorsed and recommended this new vaccine from malaria. The first one to be used widely, not the first one to be studied. Many, many, many attempts have been made at a malaria vaccine. But the first one that has been approved, recommended and hopefully will be widely dispersed. That was on October 6th. It was from Laxo Smith Klein Biologicals.

They released the vaccine. RTS, S-S-A-S-O-1. Got a spice. It's got a spice. They already did. Don't worry. I got a name for you. Sydney.

Do you see it? Are you already looking at it? It's right there. It's not good. I didn't make it up. This is really the name. I know. This is really the name. Mos- Mos- Mos- Ge-Rix. Mos- Ge-Rix. It's like mosquito, but then- It sounds like a pesticide. Rick's. Yeah. Mos- Ge-Rix. Mos- Ge-Rix. Because as you may or may not know, malaria is spread by mosquitoes. We, by the way, I should mention, especially if you're new to the show, we have done an

entire episode about malaria before, which is why I will not get into the details because there's a whole episode about malaria that you can listen to and enjoy. And I mean, malaria, if you live in the US, you are not as aware of what a huge problem malaria is worldwide. You're not aware of what a huge problem malaria is worldwide. You're not aware of malaria. Okay, sure. Anyway, this is to miscarriage. I don't know. I think RTS comment S is better, but it is the first vaccine to make it out of all the testing and into common use. They're actually just for a

little bit of context. This vaccine, the first data that showed that this could be effective was published back in 2015. And it was sufficient for at that time the European Medicines Agency recommended it in July of that year and said like, yeah, this looks good. Cool. That this this works. But a few months after that in like October of that year, the World Health Organization said, you know, I think we need a pilot study to see if like implementation is possible. And we'll kind of get into that.

That was always one of the big questions about a vaccine like this. Not just could you make it, but then could you get it to people effectively? So they did finally start. They recruited. They have to, you know, a study of that size and and in humans, it takes a while. You can't just do it. It takes a while to create. And so it wasn't actually begun until 2019. And they did this gigantic pilot study in Ghana, Malawi, and Kenya. It was planned to continue until 2023. But they have decided they have enough data. They don't. They can continue the study. But in the meantime, they already have enough data to say, this is this works. This is good. And that's what we just just had announced. The story of the malaria vaccine, though, dates back to the 1960s.

Because as I said, malaria is a huge problem worldwide. Even though in the US, we are not as aware of it, there are about 229 million cases of malaria worldwide each year. Lots of malaria. Lots of malaria. Great problem. Lots of malaria. Lots of malaria, they probably. Yes. And about 410,000 people or so die each year from malaria. And now those numbers have gone down since they started work on vaccines, but they're still,

obviously, that's a lot of people that die each year from malaria. And most upsettingly, I think, for a lot of people, about two-thirds of those are children under five. Oh, my gosh. So you can see why when you hear those numbers, the question that I had was why haven't we come up with a vaccine earlier? Because a lot of the vaccines that we have in common use in most parts of the world, including here in the US, are aimed at childhood diseases, right? Right.

Yeah. Like so many of the vaccines that we've created, and we talk about this a lot on the show, were because the first five years, and even you could even narrow down to the first two years of human life for a long time, were scary. Because there were so many childhood diseases that could, you know, result in mortality in that age group that, you know, you make it out of birth, that's one success because that was, you know, that was a terrifying condition for most of human history. So you get, you, you, both the pregnant person and the baby make it out alive. And then those next two years are just cross your fingers and hope.

And then vaccines came and we didn't have to feel that way. So why have we not had a vaccine in malaria? Well, there are a lot of barriers for us to overcome for this specific illness that aren't quite there for other diseases that we have conquered with vaccines, so to speak. Okay. Although I say conquered with vaccines, but then I think like did we conquer measles

because then people don't get it, get the vaccine and we get measles. But we could have. Malaria first of all is caused by a parasite. So a lot of the vaccines, all the vaccines we're familiar with are caused by viruses or bacteria. This is caused by a parasite. So this is totally, this is very different in that sense. It's a lot more complex of an organism. So that makes a vaccine more challenging to create. The parasite, and again,

we have a whole episode going in to all of the life cycle of malaria and how it causes disease, but to kind of sum up, the parasite is called plasmodium. There are a lot of different types of plasmodium. Well, there are five. It's not a lot. Compare to what? Matter of fact, there are five different types of Plasmodium, but the one that is most deadly and causes the most of the disease burden is called Plasmodium Phasiparam. Phasiparam, I don't know. I said Phasiparam, Phasiparam, either way.

I think that this intent carries over. It's carried by mosquito, specifically the Anopheles mosquito, and it can be passed to a human when the mosquito bites you, right? As I said, there's a huge disease burden worldwide the need for a vaccine is clear. We do have Effective treatments for malaria. We talked about that on the episode. There are ways that we can address malaria They're obviously not a hundred percent curative or we wouldn't have anybody Diav malaria. And we have other methods of prevention.

Most famously, you've probably heard of mosquito nets in many places in the world where you have mosquitoes that carry malaria. It is useful to sleep at night under a mosquito net. In some of my travels, I have slept under mosquito nets. Yes. They're nice. You know, honey, they keep out the mosquitoes, they also keep out the lizards. Oh, double, double do me.

I would wake up at night and sometimes see a lizard hanging on my mosquito net on the outside. Don't seem fair, you need to have me hanging your arm. Well, no, I mean, not like in a bad way, you just sort of hanging out there. He just wants to crawl over you. I don't want him to crawl on me. I was thankful for the mosquito net

because the lizard was outside the net. And I could like, that was a perfect viewing for me. I could see them through the net, but he didn't crawl on me. I got you. So we did have other methods of prevention, but again, this is not enough to save all those lives. Why has it taken so long?

Well, first of all, as I already said, it's complicated. Not as straightforward as a virus or a bacteria. The other reason though that you'll often find sighted is what's called the lack of a traditional market. Ah, yes, yes, I can parse that out pretty easily. This is something that we address periodically on sobonsones as well. Medical history, as many times as it's full of just

some wacky wild stories that we like to share with you, is also, unfortunately, also full of lots of times where marginalized people have been neglected or abused by the medical systems we have in place. Here's one. This is one just like that. This is one. What do you think it means, Justin, when I say there's a lack of a traditional market? Well, said what I would say is that they can't make as much money carry a certain amount of it. If you look at the parts of the world where malaria is common in parts of Africa and Sub-Saharan Africa and parts of Central and South America, if you look at these specific

areas, you have a lot of people living in poverty. You have a lot of people who are black people, who are people of color, and who are not necessarily as able to pay and communities and governments that aren't able to pay for vaccines and medications, the way that a richer country or a whiter country may be able to. This is what, this is a counterfeit breach sidebar, two minute sidebar. This is what upsets, one of the things that upsets me so much about the anti-vax people is because they want to,

you know, the villain of it is always shifting because it's fake, right? So the bad guy is the government, but for a lot of these people, I can't believe you trust big pharma like that. You're just letting big pharma do it. It's so irritating to be cast on the side that's like pro big pharma. The vaccines don't change the fact that big pharma is actually super bad with hearts as black as night. That does not, that they just don't want to put microchips in you or poison you with vaccine.

They just want to sell you say it's not complicated. They want to sell you stuff They want you to buy things and make money like that's yes. It's the evil Dark black side of capitalism 100% no question. Yes. That's the big conspiracy. That's the conspiracy The same conspiracy since time immemorial golden rule. He to go to my stools. Like, is not, is not any more interesting than that. They're bad. They're like actively bad. Well, I think for me, this is the way I would, I would advise if, if you have someone who's reluctant to get the vaccine or to, um, to trust these sorts of things in their life, uh, the way

I parse it is this. I'm a physician. I am part of, I mean inherently, I'm part of the medical system in the United States of America. I can't help but be. I am a doctor. Oh, you're just another bricky wall. I know my intentions.

I know my motivations. I know why I do the things I do and why I recommend treatments to patients that I recommend. I know my motivations. I know why I do the things I do and why I recommend treatments to patients that I recommend. I know that I know I have I am following the oath that I took when I started medical school. Embryter's day and black as night. And just like there are lots of people like me in the healthcare profession who maybe the system around us is bad, but we are doing the right thing for people. There are scientists and researchers working for these pharmaceutical companies who are whose intentions are good, who are on the side of saving lives, who want to make something with all of their knowledge and expertise that will prevent sickness and death.

And that is what they're trying to do. And maybe the company they work for, like many companies that many people work for, sucks. But they're good honest people who are doing good honest science. And I think that's what you have to remember is it's not this faceless entity. There are people there.

And like you can still be mad at Big Pharma for overcharging for drugs, which they do. And trust that the scientist who sat in a lab and helped figure this out, and the whole team of scientists, it's never just one. We're doing the right thing, and that the product is sound. Like, those two things can both be true.

Yes. And that is the case with the, but we're talking about the malaria vaccine. I was getting me off track on the COVID vaccine. So not many developers were bouncing on the opportunity for this, right? Even if scientists wanted to and a lot of doctors wanted to and a lot of like activists and a lot of well-intentioned people wanted this and governments were willing to pay for it, you had to convince somebody to make it so that they could, you know, get money.

Gotcha. So, Justin, I want to talk about, like, the story of the development of this vaccine, how these barriers were overcome. But before I do that, we got ahead to the billing department. Okay, so the billing department is the part of the show that's our clever name for an ironic considering the past five minutes where we sell you stuff. It's also the part of the show that confuses all of our listeners who live in countries with universal health care.

The medicines, the medicines that ask you let my God before the mouth. I'm Lisa Hannah Walt and I'm Emily Heller. Nine years ago, we started a podcast to try and learn something new every episode. Things have gone a little off the rails since then. Tune in to hear about Low Stakes' Neighborhood Drama, Garden Hang, the sort of nasty underbelly of the horse girl lifestyle, Hot Sauce, Addiction to TV and Sweaty Takes on Celebrity Culture, and the weirdest grossest stuff you can find on Wikipedia.org. We'll read all of it no matter how gross.

There's something for everyone on our podcast, Baby Geniuses, hosted by us, to horny adult idiots. Hang out with us as we try and fail to retain any knowledge at all. Every other week on Maximum Fun. -♪ B-B-G-G-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S-S itself, making a vaccine against a parasite. Okay. This is a little trickier. The Plasmodium parasite has a life cycle and it changes forms in that life cycle. That's not usually true of viruses and bacteria, you know, to the, like this. Inside the human host, it has two different general stages. So it gets inside a human and it's a pre-arithraceid or what we usually call the liver stage. It gets to your liver first And then there's an arith recite which is a blood cell stage and then it gets into your blood cells. Those are two different

forms and then there's a third there's a whole other form that it takes in the mosquito Where it goes through sexual reproduction those are asexual that sexual it's complicated. It's a complex organism when you're comparing that to a virus That just infects a cell and builds copies of itself, this is a whole other thing, right? So what form should we target with a vaccine? Well, there's lots of opportunities there, which one is going to work best. The other thing that's tricky about malaria is that you can get malaria over and over again. I'll get out of the immunity too. Unlike many of the other vaccine preventable illnesses, which we kind of were, that was the whole idea, right? When we talk about the beginning of vaccines, Edward Jenner noticed, well, and this had been

done in many cultures again. We have a whole episodes on this. But the whole concept of giving someone cowpox to prevent smallpox was once you got cowpox and got better, you didn't get smallpox. So something was happening within a natural, you were building some sort of immunity. If with malaria, if you can get malaria over and over again, which is true, you can get it over and over again. Now typically when you get it in close proximity, like you get it and then you get it again a month or two later or whatever, it's not quite as bad, right? The people who get really sick are usually travelers

who have never had it before, who don't come from places in the world where it's endemic. Or if you have someone who's from a place where it's endemic and they leave for like a year and then come back, they're just as vulnerable all over again. This is also why it's worse in kids. They're getting it for the first time. Okay, yeah. Does this all make sense? sense? Okay, so this makes it trickier. This research started in 1967.

That was the first time that we see like these attempts at what could we do to make a vaccine against this parasite. The first researcher, Austrian-Brasil Brazilian researcher, Ruth Sontag, Nusen's Wig, was one of the first ones who tried to make a vaccine by basically taking the sporesite form of the parasite. This is the form that infects you, that the mosquito has in its salivary glands and then kind of like that injects into, do you like that noise? Charming, yeah. Injects into your... kind of like that in Jax. Do you like that noise? Charming, yeah. In Jax. So, like, it doesn't look like. Basically, they tried to attenuate it.

So, make it so it couldn't be dangerous to you, but it would still stimulate an immune reaction. And there are some vaccines made this way. It's still the virus, but it's been like made weak. Okay. So, they radiated it, and then injected the sporezoid into mice. And it worked. The mice didn't get sick and then they didn't get malaria later. Problem solved.

So it seemed like this was something we could do. But there were a lot of barriers like, so do we radiate mosquitoes and this was just in mice It wasn't repeated in humans and how long will this last? I mean like this was just like the very early seeds and this is how scientific research goes right you do this early stuff and Start to see what works what doesn't start to get ideas But it takes a long time right to figure out what that looks like in a human body So it wasn't until 2002 that you really see progress made. So look at that huge jump where other stuff was going on. That's why. But again, that's the symptom of not having

market pressure pushing this thing through. Yes. You will note that a lot of vaccines were made for diseases that certainly can affect these parts of the world, but also affect places like the United States or the UK or other countries that were invested in other vaccines. So in 2002, again, they sort of go back to this idea of like, let's radiate the mosquitoes basically so that these sporozoites that are in them can be radiated or we can radiate this sporozoites themselves. Either way, but they tried it again and they saw that once again, they can trigger an immune reaction,

but they don't mature past that liver stage so they never make you sick and you're immune to malaria. And they did it in humans then. They actually like let mosquitoes radiate in mosquitoes by humans to give them malaria. But it worked. It seemed to work. It was really good results. Most of the participants did not get sick and seem to be immune to malaria

for at least some period of time. Still were radiating mosquitoes. So it wasn't cost-effective. It was deemed that, well, okay, there's some promise here, but this is probably not the right time. Would you have to radiate all mosquitoes for this to be effective? Well, the idea was if we could irradiate the spores, if we could make this form of the spores, oh, that is irradiated, but the way that they tested it was irradiated mosquitoes.

Okay. Got it. I mean, obviously, if we could irradiate all mosquitoes, that would be great, but that would be a heck of a... We talk about this on the malaria podcast, our on the malaria episode. There have been attempts made to like, what if we could just... Kill all these mosquitoes. Kill all these mosquitoes. I listen to the way the nature is a delicate web, friends.

You don't want to play in that. Who knows what rung on the lotter that is. So, based on this idea, researchers thought this might be something to investigate. And you see throughout the early 2000s, a lot of different pathways start to be explored for a vaccine. Okay. The first is this what we call pre-arithrocytic vaccine. It focuses on this same phase that I just talked about, the sporzoite phase. Okay. We can somehow, we can, from the time the sporzoite gets in you to when it infects the liver, you've got like an hour. we can, from the time the spores oac gets in you to when it infects the liver, you've got like an hour. So it's like, it's a tricky window. But if we can stop you at that point,

if we can stop it there, that would be best, but also triggering immune response so that you're, you know, immune to it moving forward. So that was one thought. There was the, the erythrocyte stage, which is called the merizoia, but basically this is when it's invading your red blood cells This is when you can get sick actually get symptoms from it. Can we stop it there? Like stop that reproduction part could we do that and then finally there was this transmission blocking pathway We're like we would create these antibodies in a human that when the mosquito bites you would they would attack the parasite in the mosquito Which doesn't help you at the time you got bitten, but it would help to reduce transmission by killing the mosquitoes or rendering them not infective.

So all of these pathways start being explored and you see all, I mean, there's over 30, I think, different candidates that have been tried in the last 20 years since then, about 20 years, where they have been like taking the last 20 years since then, about 20 years, where they have been like taking them through phase one or phase two and then having stopping like seeing, like, that didn't really work very well. Let's take it back to the drawing board. So a lot of exploration has been done in all three of those pathways since then. Building on that 2002 research, some scientists realize that there was a certain antigen called

the Circumse Borizoide protein, SCS protein, that was good at generating protection. So this was building on the same 1967 research, goes to this 2002 research, and then here, they're building on it further. And what they found is like, if we could get this protein into people, this would help stimulate an immune response, so your body will recognize malaria, right? But it doesn't, it doesn't generate a strong immune response. Like you don't get a big burst of immune response, right? Like you need to generate lifelong protection, or long term protection at least.

So they combined it with an antigen from hepatitis B, the surface antigen, which we know is good at stimulating the immune system. Because that's what we use in the hepatitis B vaccine. Yes, now I have it. So, they combine these two things together and then through an adjuvant, which an adjuvant is just something that helps stimulate an immune response. Okay. They put all this together into a vaccine and created the RTS, coms, most georics vaccine that we're talking about today. So it was tested finally, so it goes through

based on this 2002 research, they're building it slowly, it takes a long time. It was tested in phase three trials, and that's when they start actually, phase three, as you may remember from the last going on two years, is when you actually start giving it to people It was that well you can before that but wider Studies to actually give to people right so they started doing that in 11 different countries in Africa

It was released in October 2011 the results from that that showed good results was released in October 2011, the results from that that showed good results, that it reduced the risk of malaria and severe malaria by 56 and 47% respectively. So, you know, that, again, this is such a serious illness in kids, and then we're talking about kids ages five to 17 months, that this is this kind of impact is huge. Is it everything, no, but is it something? Absolutely, yes. What they did find is that for the results released in 2012 that showed that in infants six to 12 weeks, there wasn't a huge response after those first vaccines. What they're trying to do is figure out how many shots are we going to need to make it

something that's effective, right? Like how early can we give it and how many shots are needed so that we can protect kids from severe malaria? They kept refining it and they finally showed and their results that were published that it can reduce clinical malaria by 26% for little kids, up to 36% for kids age 17 months. Anyway, this was compelling enough data

that at that point, they decided like after all these studies were released, they put all this data out there and that's where we get to 2015 when the European medicine agency is like, yeah, this is enough stuff that we think that this is good, right? Well, like I said, the World Health Organization said

this is really good, but we wanna pilot it because even though this would be a huge impact, it's not everything, but it's something. Even though this would be a huge impact, the delivery of the vaccine was the next big step. They didn't know if you could effectively get these, if you had the infrastructure to get these vaccines to all

the kids who need them in this part of the world. So that's the great thing about this Who Pilots Study. It's unfortunate that we had to delay the vaccine more with the pilot study, except in it, they did give the, it was huge, so they did give the vaccine to, you know, tens of, hundreds of thousands of kids. But what they prove from this pilot study is not only is the vaccine effective, but it's totally feasible. It totally works. They guess they can deliver this vaccine to the places they need it, get all the doses to them and reduce, them and reduce cases and fatalities from malaria.

So from this pilot study, they showed that it's totally feasible to deliver, that they can reach people who are really difficult to reach typically with medical care, with like sustainable healthcare and continuity of care and stuff like that, that it is incredibly safe. They've given more than 2.3 million doses of the vaccine. Wow, fantastic. Incredibly safe. That it did not. This was another argument against it.

We hear this again and again sometimes in medicine like well, we have this effective intervention that could really reduce mortality from this deadly disease. And then people go, well, won't people be more risky with their behavior? We need a, we need like a term for this. Because that exact supposition was made last week, in last week's episode, when we were talking about pre-exposure prophylaxis for HIV.

Yes. So a lot of people are like, well, people will stop using bed nets. They won't use the bed nets. And the vaccines aren't perfect, right? And so like, you still want to use the mosquito nets Even if you get the vaccine But nobody will do that if they get the vaccine. Well, no that wasn't true It did not in any way negatively impact the use of bed nets

Getting other childhood vaccinations the other thing they said as well, but Since the vaccine isn't completely effective if you get the vaccine and then like let's say your kid gets sick You're gonna assume it's not malaria. You won't take your kid to the hospital And then they could maybe they did get malaria and they'll die. Nope people still responded to February on us to fever causing illness the exact same way they did before none of this was changed significantly Right what they showed was not only do the vaccines work not only are are they feasible to get to people, it won't negatively impact behavior. And it really does in this sort of setting,

it does reduce the rate of kids getting hospitalized and dying from malaria. So all of this was good. It was a significant reduction. It was also cost-effective. Of course, if you're a pharmaceutical company, if you're a company, if you're in a business, if you're a capitalist economy, you care about that. So it was cost-effective. There was this big concern, this was really impactful to me, that it's a foreshot

regimen, okay? Which I know that I know a lot of people like those, seems like a lot. Think about if you have had, you've been a kid, you probably don't remember this, but if you've been around kids, if you have kids, kids get a lot of vaccines when they're little and some of those are three and four shot regimens. You just don't think about it because you just keep bringing them back for their boosters, right? So it's a four shot regimen. You give it between five and 17 months and then there's one last dose 18 months later and there was this big argument that we're like, okay, we timed the first three doses with other childhood vaccines. And so we think that won't be a problem.

Like people are already bringing their kids in for these vaccines. And so they'll get them. But like this last one, they're never going to get because it's on its own and nobody will care about it and whatever. It wasn't a problem. People still came back and gave their to make sure their kids got the last vaccine. It shows an understanding of the impact that these sorts of like medical innovations and interventions can have when faced with a deadly disease that can affect children, which we saw historically with polio,

we saw the same impact right when the polio vaccine came out, thousands of parents lined up with their children to allow them to get the vaccine even early on when it was so experimental, because when you're faced with childhood mortality as the alternative, you do it. We have not seen that same impact, unfortunately, with the COVID vaccines.

But the malaria vaccine has. It's not a done deal. The next step is there's a gavi, the global vaccine alliance, which decides if the vaccine is a worthwhile investment. And so that's the next step. Basically, they have to approve it and then purchase the vaccine for any country that wants it. So if a country requests it and Gavi approves it, then they can get them the vaccine.

That will take about a year. So it's not like bam, snap your fingers, vaccines are everywhere. But this is obviously a gigantic step in that direction. And in the background, it's worth noting there are other vaccines that are still being developed because a lot of people have said like, this isn't as effective as we wish it was. It is good. But it's not like, for instance, the COVID vaccines, which are, you know, by comparison, more effective at reducing serious illness and death. It's not to that level. And we wish it was. It's better, but it's not there. There is an Oxford vaccine that is very similar, but possibly a little more effective.

It's been altered in some ways to make it maybe more effective that is being tested and might go into phase three trials soon. They actually used an adjuvant that they used developing the Nova Vs, which is one of the COVID vaccines that was in development. So, and then in addition, earlier this year, I think in like February of this year, researchers at Yale patented an RNA technique, the same vaccine approach that we've seen with the COVID vaccines with the Pfizer and the Moderna COVID vaccines, an mRNA, an RNA-based vaccine that could possibly be an avenue. So they have tried to take that approach. So maybe that will come out sometime in the future. This is still early, but the point is nobody is saying that like this is the vaccine that will in malaria, but it will make a huge dent.

Sure. In a very deadly, dangerous disease, the impact. If you're the person who's child or, you know, self is inflicted by this like every single step forward is massive. And millions of cases, you're millions of millions of cases of malaria a year, and it's not just about those that are fatal, although it is about that. It's not just that Malaria makes you very sick. I've cared personally for people with malaria in parts of the world where it is endemic You're incredibly ill. You can't work. You can't go to school You can't take care of your family. You know, you can't do all the things that as humans we have to do day to day, it takes you out of that while you're sick with it.

And so it's not just about mortality, it's the morbidity burden of malaria on all the people who live in parts of the world where it exists. So if we can decrease any of that, that's a huge impact and totally worth the time and money and effort and everything that it's taken over decades to get us to the point where we can say we have a vaccine against malaria. It's amazing. It's fantastic.

And I feel like now I've played my role in this grand chain. You know what I do? I feel like I've done my little part, you know, more than not as much as as many, but more than most, I would say in moving this form. I just tell you people about it. I'm a spread of the word. We all have our part to play in. This has been ours.

Huh. I guess hero feels like a strong word to use, but I don't know. It was just a podcast, but was, you know, was it just? Uh-huh. Well, I'm gonna think about it. Yeah, I'll think about that later. In the meantime, please think about getting vaccines that may be applicable to you. Yeah, hey, why not just go get a vaccine

if you haven't gotten the vaccine and get some novel coronavirus, but it's a bad one, folks. Yeah, there's this virus. I don't know if you've heard about it, but it's a bad one folks. Yeah, there's this virus. I don't know if you've heard about it, but it's a stinker. There are two great vaccines out there you could get right now. Oh yeah, don't forget that flu shot.

That's right. You get a vaccine against COVID-19, you get a flu vaccine, just get them. Just get them. You know, just get them. Hey, here's a thought, just get them. And if you know somebody who's hesitant, talk to him about it. We've done many episodes about vaccines generally about the COVID-19

vaccines, about the flu vaccine. Yeah, we have so many episodes addressing that here at Sawbones, we love vaccines and are happy to give you all the information we can that we are capable of giving you to encourage you to get them. Thank you so much to the taxpayers for these song medicines as the intro and outro of our program. Hey, if you're a regular listener,

first a new listener, welcome, hope you enjoyed yourself. If you're a regular listener of ours, why not go check out some of the max fun shows? This is the week to do it. If there's one you think you've been interested in checking out, Sydney does one of their siblings called still buffering about culture. I do it with my brothers about advice.

Our dad and I played nudges and dragons, whatever. Those are called my brother, my brother, me and the adventures known. Yeah, and still buffering. You didn't say the name. Well, you said mine, but I was returning the favor. Yeah, thank you. So go check those out.

That is gonna do it for us. Until next week, my name is just Mac. I'm Sidney Mac. And as always, don't draw a hole in your head. A man goes to the doctor and says that he's depressed and that life seems cruel. The doctor says, ah, the treatment is simple. The great clown, Bagliacci, is in town tonight. Go and see him, and you will surely feel better. The man bursts into tears and says, but Doctor, I am Padliacci.

Ah, okay, says the doctor. In which case, try listening to the Beef and Dairy Network podcast. The Beef and Dairy Network podcast is a multi-award-winning comedy podcast and you can find it at maximumfund.org or wherever you get your podcasts.