Science Vs - Vaccines - Are They Safe?

Episode Date: September 14, 2017

Autism, seizures, and overloaded immune systems. Could these really be side effects of vaccines? This week, we dive into the science to find out how safe vaccines really are. We also talk to public health researchers Prof. Dan Salmon and Prof. Amy Kalkbrenner and neurologist Prof. Ingrid Scheffer. Check out our full transcript: http://bit.ly/2PrqtX3 Our Sponsors:Cole Haan | Google Cloud, Maker of GSuite | Ziprecruiter | WPEngine Credits: This episode has been produced by Heather Rogers, Wendy Zukerman, and Shruti Ravindran. Production help from Rose Rimler. Our senior producer is Kaitlyn Sawrey. We’re edited this week by Blythe Terrell and Annie-Rose Strasser. Fact checking by Michelle Harris, with help from Rose Rimler. Sound design by Martin Peralta. Music written by Bobby Lord. For this episode we also spoke with Dr. Saad Omer, Dr. Neal Halsey, Dr. Paul Offit, Dr. Frank DeStefano, and Prof. Alison Buttenheim. And an extra thanks to Bonnie Stanway,Ivona Stamatoska, Reese and Walter Ludwig, the Zukerman Family, Joseph Lavelle Wilson and - of course! - Leo Rogers. Selected References:The National Academies (aka Institute of Medicine) report on vaccine safety A report on the genetic underpinnings of epilepsyThis study looked for neurologic disorders after the MMR shot in half a million kids This one looked at all children born in Denmark between 1991 and 1998 Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus. On today's show, vaccines. This is the show that pits facts against tickling. And that's Heather Rogers, our reporter, and her little kiddo, Leo. We're sharing a microphone. Is that okay, or should I? You have to talk into your own microphone. He is four years old now. Oh my gosh.

He has these beautiful big eyes, and he likes stories. Scary stories, funny stories, spooky stories. And he likes to snuggle in the morning. I do. So has Leo gotten vaccinated? He's got some of his vaccines, not all of them. Back when Leo was little, some people in Heather's family had brought up questions about vaccines. And around the same time, she'd heard from some friends that they weren't getting their vaccines exactly as their pediatrician told them to. I knew some parents who had spaced them out and who said, like, no, I don't want to give my baby vaccines

all at once, like on the way that the doctor wants you to do it. And then I was like, well, should I have done that? Like, is that smart? So why are parents worried about this now? So if you took your baby to get shots in the 1980s, like by the time they were one, they would have had something like five shots. And today, you take your baby to go get shots and they get something like 20 shots before the time they're one. So next time Heather took Leo in for his routine vaccination, she asked her doctor about it. And I said, you know, can you tell me about the side effects? And the doctor looked at me and kind of like scoffed. And she said, are you serious? It was very disorienting.

I was just like, why do I feel like I did something wrong by asking? So I have to be honest with you. I'm on the pediatrician side. Yeah. I would expect you to say that, Wendy. But the thing is, a lot of parents are worried about this. So a Pew survey just came out that said 43% of parents of young children think that vaccines come with a medium or high risk. 43%? Yeah, getting close to half. Okay, so parents have questions. And as fears about

vaccines grow, vaccine rates can drop. And we've seen the consequences of this in pockets of the US, where diseases that we thought we'd gotten rid of have come back. The measles outbreak at Disneyland has proven it's a small world after all. Fifteen years after US health officials declared measles had been eliminated from our country, the virus is roaring back into the headlines tonight. What started at the Orange County theme parks has spread to Colorado, Washington, Utah, and now Mexico. As the number of measles cases continues to climb in Minnesota.

Measles, once eradicated in theicated in the US is now exploding in Minnesota's Somali community, where many parents won't vaccinate. And so for parents who worry about the risks of vaccines, it can feel like they're stuck between a really hard choice, expose their kids to diseases or potentially dangerous vaccines. And for parents like Heather, who just want to know the risks, she says it's hard to get good information. You know, in doing this story, I've gotten to talk to experts, to researchers, and I've been able to do things like, okay, look, I have this question. Like, can you answer this for me?

Like, I'm a parent and I want to know the answer to this question. A lot of parents want to do that and like don't have the opportunity. So today, Heather and I and the team at Science Versus, we are going down the rabbit hole on childhood vaccines to answer the following questions. One, is there any link between vaccines and autism? Two, are kids getting too many shots too young? Three, can vaccines cause seizures? And four, what can happen if you don't get your kid vaccinated? When it comes to vaccines, there are lots of... Scary stories, spooky stories.

But then there's science. Science vs Vaccines is coming up just after the break. After decades of shaky hands caused by debilitating tremors, Sunnybrook was the only hospital in Canada who could provide Andy with something special. Three neurosurgeons, two scientists, one movement disorders coordinator, 58 answered questions, two focused ultrasound procedures, one specially developed helmet, thousands of high-intensity focused ultrasound waves, zero incisions, and that very same day, two steady hands.

From innovation to action, Sunnybrook is special. Learn more at sunnybrook.ca slash special. It's season three of The Joy of Why, and I still have a lot of questions. Like, what is this thing we call time? Why does altruism exist? And where is Jan 11? I'm here, astrophysicist and co-host, ready for anything. That's right. I'm bringing in the A-team. So brace yourselves. Get ready to learn. I'm Jana Levin.

I'm Steve Strogatz. And this is... Quantum Magazine's podcast, The Joy of Why. New episodes drop every other Thursday, starting February 1st. What does the AI revolution mean for jobs, for getting things done? Who are the people creating this technology and what do they think? I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI with the most human issues at the center.

Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. Welcome back. So today we're talking about the risks and the benefits of vaccines. And there are a couple of fairly common risks to vaccines, and these are pretty minor. You can get a fever, some pain and stiffness in the joints, and about one out of 20 kids who get the measles, mumps and rubella shot can get a mild rash. For the other vaccines, it's pretty rare, but some kids can vomit.

But for parents who are sceptical or really worried about vaccines, it's pretty rare, but some kids can vomit. But for parents who are sceptical or really worried about vaccines, they often have bigger issues. They're worried that vaccines will cause long-term problems to their kids. So let's dive into these issues. A big worry right now is that vaccines can cause autism. And this fear really took off in 1998. In fact, let me set the scene for you.

Monica Lewinsky had just become the world's most famous intern. Everyone was laughing at Cameron Diaz's hair in There's Something About Mary. And this was the song of the summer. Don't wanna close my eyes. and this was the song of the summer. Anyway, back to vaccines. As more and more kids were getting vaccinated, a curious thing was happening. More and more kids were getting diagnosed with autism. In California, a report compiled by the Department of Developmental Services

documented a 273% increase in autism cases in the state over the past 11 years. And some parents were freaking out. It felt like all of a sudden, autism was everywhere. You couldn't tell anyone without them saying, oh, I have two autistic kids in my class or our next door neighbor has a child with autism. Kids seemed normal until they were toddlers and suddenly they would start having these problems communicating and interacting with people. And a really unnerving part of all this is that no one knew, and in fact, we still don't know, what causes autism.

Some parents, and even some scientists, started wondering. What if these shots that are supposed to protect kids against disease actually hurt your child? Soon, several theories cropped up as to how vaccines could cause autism. And one that got a lot of attention was that the vaccine for measles, mumps and rubella was the culprit. So, can it cause autism? The person who first championed this idea

was a British doctor by the name of Andrew Wakefield. And you might have heard of him. He's since become a big campaigner against vaccines. Here he is speaking last year on Infowars. Yes, this is the same show that called the Sandy Hook school shooting a hoax. One in two children born in 2032 are going to have autism. That is absolutely unacceptable. So whatever the media say about me, whatever the politicians say, I mean, it doesn't matter. What matters is the future of this country and the future of this country is its children.

But that's the Andrew Wakefield of today, back in the late 1990s. Don't wanna close my eyes. Andrew was quite different. He was a gastroenterologist working at the Royal Free Hospital and School of Medicine in London, and his research, which connected the measles, mumps and rubella vaccine to autism, was being published in a prestigious journal, The Lancet, and it was being taken seriously. So let's take a close look at it. Andrew and his

colleagues studied 12 kids, some of whose parents said that they had gotten autism soon after getting the vaccine. Now specifically, Andrew was looking at the kids' guts and he found that some of them had a bit of inflammation in there. Now from that, he thought, ha ha, that vaccine must have caused the inflammation, which then led to their autism. Now, even though this was a really small study, which when you think about it, it didn't really prove anything. Andrew drummed up a lot of media attention and started telling parents not to vaccinate their kids with the measles, mumps and rubella vaccine, also called the MMR. He hears on ABC News. There is a great deal of evidence stacking up to suggest that the parents, their contention

that their child regressed after NMR is indeed correct. Scientists scrambled to figure out if Andrew was right and that the measles, mumps and rubella shot could cause autism. The first studies that put Andrew's theory to the test came out about a year later. And while that's fast in the world of science, it wasn't fast enough. Science takes time.

I think that time was not on our side. Daniel Salmon is a professor of public health at Johns Hopkins University. And he says those studies were too late for public opinion. If we would have had good, solid data sooner, I suspect that public concerns wouldn't have grown as quickly as they did. And people may have been reassured by those data. One of the first follow-up studies looked at every kid diagnosed with autism in a part of the UK. This was almost 500 kids.

And it found no link between the measles, mumps and rubella vaccine and autism. Soon, more and more studies would come out involving well over a million children, all showing no connection between getting the vaccine and kids getting autism. Those studies were done by different investigators, different scientists in different countries using different methods, and they were all negative. Meanwhile, Andrew Wakefield's original paper was retracted. It turned out that he had messed around with facts about the patient's medical histories and by 2011, an editorial in the British Medical Journal called the paper, quote,

fatally flawed both scientifically and ethically, end quote. He lost his licence to practise medicine. And now Andrew goes on shows like InfoWars where the hosts say things like this. What do I do, Lord? Destroy the child. Corrupt them all. This is their plan, people. These are demons. They're fricking interdimensional invaders, OK?

Hillary Clinton is a goddamn demon! Conclusion. Lots of work has been done looking for a connection between autism and the measles, mumps and rubella vaccine. And none has been found. But that's just one vaccine and one theory. There's another idea about how vaccines could be causing autism, and that's mercury.

Mercury is sometimes used as a preservative in vaccines in a form called thimerosal. And in the mid to late 1990s... I don't want to fall! ..Americans started getting really worried about Mercury. The FDA was issuing warnings to pregnant women not to eat certain fish. There were moves to get Mercury out of thermometers. Even Neil deGrasse Tyson tried to stop Mercury from being a planet.

OK, so we made up that last one. But seriously, officials wanted to rid the US of Mercury. And that's because Mercury is a big deal when people are exposed to a lot of it. It can damage the nervous system and the brain, making people kind of kooky. Which is actually where the term the mad hatter comes from, because hatters used to use mercury to make their hats. But seriously, mercury exposure is serious. It can affect how people talk and move, which to some sounded like the symptoms of autism. So could the little bit of mercury that's used as a preservative in vaccines cause autism? Amy Korkbrenner is a public health researcher at the University of Wisconsin in

Milwaukee, and she looks at various things that might cause autism, from vaccines to even pollution. And Amy says that her mum saw this career coming. She actually claims that pollution was an early word of mine. So sometimes I do have to smile about that. No way. So it was like mama, dada, pollution. That's what my mom claims, yes. So to find out if that type of mercury, thimerosal, in vaccines was linked to autism,

Amy combed through a raft of studies. One followed nearly half a million kids, some of whom got vaccines with thimerosal and others who got vaccines without it. And the researchers found that there was no difference in autism rates between the groups. And Amy found that same result in studies over and over again. The long story short is that there's not evidence

that vaccines containing thimerosal were associated with autism. And Amy says that it's important to know that the form of mercury that's used in vaccines, thimerosal, is actually less dangerous than the mercury that's found in fish or in thermometers. So the science on this one is settled. The research is good. It is decent enough to say that we're not showing associations and it's time to move on. And another thing. These days, mercury isn't even in most childhood vaccines. It was taken out of them while America was freaking out

over mercury more than a decade ago. Now, while mercury is still in the influenza vaccine, parents can ask their doctor for a version without it. But Amy says that she can understand why this idea that vaccines cause autism is so hard to shake. When you are heartbroken that your child is suffering and is disconnected from you, and you are doing everything you can not only to help your child, but to understand what happened here, I can say definitively, no, it's not your fault.

Conclusion. The idea that mercury causes autism has been studied over and over again, and there is very convincing evidence that it doesn't. Next question. Is it safe for kids to get a lot of vaccines at once? Kids these days get vaccinated for hepatitis B, measles, mumps, rubella, diphtheria, pertussis, tetanus, chickenpox, polio and more by the time they're two years old. And some parents are worried that this is just too many vaccines.

In fact, this is what Donald Trump was talking about on the campaign trail. I had my children taken care of over a long period of time, over a two- or three-year period of time, same exact amount. But you take this little beautiful baby and you pump. I mean, it looks just like it's meant for a horse, not for a child. OK, so these syringes might look scary, but the important question is this.

Could having a lot of different vaccines over a short period of time be harmful to kids? There are fears that, again, all of these vaccines could be causing autism. And on this particular scientific question, there actually aren't a lot of long-term studies. One that we did find looked at the immune response to vaccines of about 1,000 young kids. And from that, it suggested that there was no link between how many vaccines a kid got and whether that kid developed autism.

And to Daniel Salmon, our professor at Johns Hopkins University, he says that while more research is always good, the idea that kids getting too many vaccines are now what's causing autism just feels like the latest claim in a debate that won't die. Part of what's happened with autism, it's a bit of a whack-a-mole game. The first theory was that it was the MMR vaccine. And when the evidence became compelling that it wasn't the MMR vaccine,

then people said, oh, it's a preservative thimerosal. And then people said it was the number of vaccines given at once. But Heather, our reporter, had heard about risks other than autism that parents were worried about. Like that all these vaccines were just too much for a baby's immune system to handle, which could mean that the baby would be at an increased risk of getting allergies or asthma. So we got Heather to look into this. So, Heather? Yes, Wendy?

What did you find on this question? I found a big 2013 report from the Institute of Medicine, and it said that while each new vaccine is thoroughly tested individually, these vaccines aren't necessarily tested together with all the other vaccines. That's kind of surprising, I've got to say. It is, yeah. Yeah. So there have been a few studies, quite large studies actually with several thousand people, that are testing to see if getting a lot of vaccines increases the risk of things like asthma or allergies in kids. And what they're finding is that these vaccines don't cause those things. Yes. So while there are some unknowns here about the safety of all these vaccines, parents have to weigh those risks against the possibility that their kid won't be protected from a potentially

really horrible disease. Don't be fooled by measles. For centuries, measles has disguised itself as a harmless childhood disease. And that's coming up after the break. Plus, another concern, that vaccines are causing seizures. Welcome back. So far, we've found no evidence of a link between autism and vaccines,

despite a lot of research looking into it. But what about the idea that vaccines can cause seizures? According to the Centers for Disease Control and Prevention, this is one of the most common concerns about vaccines that parents have. And we'll tell you right up the front... ..that, yes, vaccines can cause seizures. And here's how likely that is for two of the most common childhood vaccines. About one person out of every 3,000

who get the measles, mumps and rubella vaccine will have a seizure. That's coming from the CDC. And the chance of getting seizures from another common childhood vaccine, DTaP, which protects you from diphtheria, tetanus and whooping cough, is even rarer. It's one in 14,000. We called up Professor Ingrid Scheffer, a neurologist for kids at the University of Melbourne,

to find out how serious these seizures are. Professor Scheffer's office. Ingrid is a busy lady. Hello, it's Ingrid Scheffer speaking. Oh, hello. Hi, this is Wendy. Hi. In more than 20 years of researching epilepsy, Ingrid has seen a lot of patients.

In my office here, I'm looking at a wall full of patients' faces. Beautiful children, some very sick, some thankfully not sick. She told us that when a child has a seizure from a vaccine, that while it's rare, it can be frightening. The baby starts going stiff, often with jerking down one side. They have loss of consciousness and they go often a terrible grey-blue colour. And the parent looks at their child and thinks that their child is dying. The main reason that vaccines can cause seizures is because when our immune system ramps up to respond to the little bit of virus or bacteria in the vaccine, it can cause a fever.

And fevers of any kind can actually trigger a seizure. But here's the thing. Ingrid says that as best as science can tell, the baby is actually fine after getting one of these seizures. No brain damage, no learning disorders. It still doesn't stop it being terrifying for mum and dad, but it doesn't cause any harm to the baby, thank goodness. But a few clicks on the internet and you'll find claims that vaccines don't just trigger one seizure but that they can cause severe epilepsy and developmental disorders. And in the 1970s a lot of doctors actually thought this too. Reports were being published of rare cases where kids who were totally healthy would get a seizure soon after getting vaccinated.

And then they'd get another seizure and another seizure, eventually developing severe epilepsy and permanent brain damage. Doctors even had a name for this. They called it vaccine encephalopathy. In other words, brain damage caused by vaccines. Vaccine encephalopathy was rare but was certainly diagnosed around the world and there were... So the pronunciation of encephalopathy, encephalopathy? In the US you say encephalopathy, in Australia and England you say encephalopathy,

but thankfully we all understand each other. Oh man, they've even got a different... Why would they have different pronunciation for such a specific word? Well, potato, potato, tomato, tomato, what do you mean? And when Ingrid told us this, it really got us thinking. Who says potato? More to the point. Through the 1990s...

Don't want to close my eyes! more to the point. Through the 1990s, as doctors were diagnosing the rare patient with vaccine encephalopathy, epilepsy researchers were working out that there were different types of epilepsy, some really severe. And critically, they were finding out that these epilepsies could be caused by your genetics. And this is where Ingrid and her colleagues thought. Hey, maybe vaccine encephalopathy isn't due to the vaccine at all. That is, maybe these kids had a genetic mutation which gave them epilepsy. By the early 2000s, the specific gene for a very severe type

of epilepsy, Dravet's syndrome, had been identified and now Ingrid could test her idea. She did genetic tests on 14 of her patients who were diagnosed with vaccine encephalopathy and she was searching for that Dravet syndrome gene. She found it in 11 of the patients. We put together all the pieces of the puzzle and showed that it really had been a misdiagnosis. These children had Dravet syndrome and they were destined to have Dravet syndrome. So Dravet syndrome accounted for 11 of the 14 kids that Ingrid looked at.

What about the other three? Well, Ingrid thinks that they have some other kind of genetic epilepsy tied to a gene that we just haven't discovered yet. Now, that is speculative, but new genes that lead to epilepsy are being discovered fairly regularly. And while Ingrid's was a small study, since then, other researchers backed up her idea. And it's not just Dravet syndrome.

Researchers have found that other kids previously diagnosed with vaccine encephalopathy actually had other types of epilepsy, such as Deuces or West syndrome. And so when you say vaccine encephalopathy, then does that condition exist? I don't really think it does. I don't think vaccine encephalopathy exists.

How can you be so confident since we don't have sort of two views of history? We can't take that baby and not vaccinate it and then take the same baby and vaccinate it. You know, how can you be so sure? Well, I guess it's an experiment that would be very hard to do because if you don't vaccinate a child, then you put them at risk of a whole range of nasty diseases. But we also know of families where two siblings have had it and one hasn't been vaccinated and they've still had Dravet syndrome. So I guess they've given us that answer. Now, this isn't totally cut and dry.

The Institute of Medicine published a huge report on the adverse effects of vaccines in 2012 and they weren't prepared to rule out that vaccine encephalopathy exists. Now, that's partly because not all kids who have ended up with severe epilepsy soon after their first vaccination have a genetic diagnosis. But overall, their assessment has lined up with Ingrid's, that in most cases where there are adverse reactions, they come from a pre-existing condition.

Heather was in on the interview and she told Ingrid that some people, particularly those in the anti-vaccination community, don't buy that there are a bunch of different types of epilepsies. They're still convinced that vaccines are to blame. I talked to a woman who, she's a pretty big, well-known anti-vaccine activists. She said to me, these scientists are making up all these new kinds of epilepsy to explain away the effects of vaccines. What's your response to that? I think that's tragic. I think that's absolutely tragic because these disorders have existed since time immemorial, that these children and adults with severe epilepsy, many seizure types and intellectual disability were around. They're nothing new about these disorders. When I trained, actually, they were thought to be

acquired. So it's sort of very old fashioned thinking, you know, you've got a bump on your head and you've got these severe disorders. Now with the new genetics, we actually can find the mutations. So I think it's tragic that somebody would say we would make up diseases. I mean, that undermines our whole life's work. But for Ingrid, there's one more thing that's really important here. She says that while vaccines aren't causing the epilepsy, they could be triggering a child's first seizure. You see, from what we know about epilepsy, seizures get sparked by something. It could be a fever, an infection, flickering lights, stress.

And if they hadn't been vaccinated at that point, the next fever or viral illness would have triggered their first seizure. So there's no way you can avoid that. Even if you put your baby in a bubble and made sure they avoided all infections, it would still happen. Conclusion. In rare cases, kids do have seizures after a vaccine. These are scary, but as best we can tell, they're harmless. And there is very little evidence that vaccines cause epilepsy. The science suggests that these diseases are due to genetic conditions. Now, there's a very different condition that we want to tell you about

that can be caused by vaccines, and that's an infection in the brain. Now, the name of this infection sounds a lot like encephalopathy, but it's actually called encephalitis. These cases are so rare that we only mention this because the anti-vaccination community make it sound like the condition is way more common than it really is. Of the millions and millions of kids who have gotten vaccinated against measles, that big Institute of Medicine report found only three cases. Three cases of babies who got permanent brain damage from the vaccine. It's believed that the measles virus, which is in this weakened form in the vaccine, somehow got into the kids' brains. Any risk of brain damage to a kid is absolutely scary for parents. But they also have to compare

that tiny, tiny risk, one out of millions, to the risk that we haven't told you about yet. And that's what happens if you don't get vaccinated. And this is actually what really convinced Heather as she was doing research for this episode. I mean, and it was very simple. When I found out that measles kills one or two people for every thousand people who get it, I was like, oh, my God. You know, I compared that can happen if Leo got one of these diseases. I was like, forget it.

Like, get the vaccines. And the thing is, the measles is really contagious. It can live in the air for up to two hours. That's insane. And that's just one disease that we vaccinate for. There's also vaccinations for pertussis or whooping cough, which leads to bouts of debilitating coughing and kills one out of every hundred people who get it. Or diphtheria, a bacterial infection that can kill one in every 10 people.

And we have vaccinations for tetanus, which causes severe muscle contractions that can make it so hard to breathe that up to two in every 10 people who get it will die. And this is what's happening now, even with our medication and good hygiene. These diseases are really scary. So, when it comes to science versus vaccines, do they stack up? First up, do vaccines cause autism?

No. There are large population studies that have looked at the measles, mumps and rubella vaccine as well as the preservative thimerosal and all of the well-done studies show no relationship between vaccines and autism. And while there is less research about kids getting a lot of vaccines at once, the evidence we have says that this is safe too. Next, can vaccines cause seizures? Yes, but it's rare. And although they might be really scary for parents, as best as science can tell,

these seizures don't cause long-term harm. And finally, are the risks of vaccines higher than the risks of the diseases themselves? No. Really, we know this and the answer is no. And the thing is that although the risk of getting some of these diseases, like measles, is pretty low right now, that's because so many people get vaccinated. As less and less people get the shots, your chances of getting these diseases go up. In fact, a study published this year found that if there is a 5% drop

in the number of kids getting the measles, mumps and rubella vaccine, it could lead to three times more kids getting measles each year. With so much known about how horrible these diseases are and a lot of good science telling us that vaccines are safe, why are people still afraid of them? Where does this idea that vaccines are dangerous come from? And why is it so powerful? That's coming up next week on Science vs Vaccines, part two.

And oh boy, it's going to get gory. People sucking the vaccine out like you would suck the venom out of a snake bite and spitting it out. Also, if you want to get more information on this episode and have a look at all the research that we do, we're now going to start releasing full transcripts of episodes so you can read all the footnotes to everything that I say. In this episode, there's 86 of them. To get access to this, all you have to do is sign up to our newsletter by clicking in the show notes. There's the details. Or you can head to gimletmedia.com slash newsletter.

That's gimletmedia.com slash newsletter. This episode has been produced by Heather Rogers, me, Wendy Zuckerman, and Truti Ravindran. Production help from Rose Rimla. Our senior producer is Caitlin Sori. We're edited this week by Blythe Terrell and Annie Rose Strasser. Fact-checking by Michelle Harris with help from Rose Rimla. Sound design by Martin Peralta. Music written by Bobby Lord. For this episode, we also spoke to Dr Saad Omar,

Dr Neil Howsey, Dr. Paul Offit, and Dr. Alison Buttenheim. An extra thanks to Bonnie Stanway, Ivona Stamatotska, Rhys and Walter Ludwig, the Zuckerman family, Joseph Lavelle-Wilson, and of course, a huge thanks to Leo Rogers. Hi, I'm Leo Rogers and you're listening to Wendy's Versus. Wendy's Versus.

Good Ray brand, buddy.