The Megyn Kelly Show - Truth About the HPV Vaccine: A Megyn Kelly Show Debate and Discussion, with Dr. Kristen Walsh and Allison Krug | Ep. 565

Episode Date: June 5, 2023

Megyn Kelly is joined by medical experts Dr. Kristen Walsh, a pediatrician, and Allison Krug, an epidemiologist, for an in-depth discussion and debate about the HPV vaccine, pros and cons to whether boys and girls should get the vaccine, silent symptoms of the virus, the reality of natural immunity, whether women need pap smears every year  side effects and risk factors, one dose vs. more than one, "emotional blackmail" in Merck's ads pushing their HPV vaccine, how long the HPV vaccine lasts, what trial data and studies show us, an active lawsuit now, the importance of women talking about these issues, whether boys and adults should get the vaccine, and more.Krug: https://twitter.com/KrugAlliMore from the CDC: https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html Follow The Megyn Kelly Show on all social platforms: YouTube: https://www.youtube.com/MegynKellyTwitter: http://Twitter.com/MegynKellyShowInstagram: http://Instagram.com/MegynKellyShowFacebook: http://Facebook.com/MegynKellyShow Find out more information at: https://www.devilmaycaremedia.com/megynkellyshow 

Welcome to The Megyn Kelly Show, your home for open, honest, and provocative conversations. Hey everyone, I'm Megyn Kelly. Welcome to The Megyn Kelly Show. Today, we're taking a deep dive into the debate surrounding the Gardasil vaccine. vaccine and if you have a adolescent or teenage child you've been spoken to about this but it can affect adults too you can get this thing up to age 45 the vaccine was first developed for use in american children in 2006 the drug is said to help protect against the human papillomavirus better known as hpv hpv can eventually lead to cervical cancer, at least some strains of it. So this vaccine has often been touted as a vaccine against cancer. Sounds amazing, right? Who wouldn't want that? But even before all the controversies surrounding the COVID vaccine, parents were becoming concerned about Gardasil. It is something my friends and I have discussed at

length. My core friend group in New York, we all made friends when our daughters were two and in preschool together. And now they're all 11, 12, right around there. And we are all being asked to make this decision for our kids. And you met one of them, my friend Yael. She came on in the Vegas show and she and I were talking and she's like, OK, you've got to do a show on this because there are a lot of parents out there who don't know what to do. And you know what? I am one of them. I've got a 13 year old boy and a 12 year old girl and I haven't gotten this vaccine for them yet, but I've been told by the pediatrician I should. So what's the story? Do we do we just trust a pediatrician who says that to us or do we have to do our own

research? Because those same pediatricians told us to get the COVID vaccine for our kids and now I'm very glad I didn't. Anyway, that's the reason we're bringing you this show today. We're not here to tell you what to do. This is not medical advice. I have a jurist doctor, not an MD, kind of like Dr. Jill Biden. She's a fake doctor and so am I. The real doctors are the MDs. But we're trying as a news item to break down what we know and what we don't know about this vaccine and give you some things to think about and then write down your own questions for the people you trust, whether it's your doctor and maybe it's not even your pediatrician. Maybe it's somebody outside of that particular field. We have both sides well represented for this discussion. Dr. Kristen

Walsh is a board-certified pediatrician in New Jersey. She graduated from Harvard and then went on to receive her medical degree from the University of Missouri School of Medicine. She's been practicing for over 20 years. Dr. Walsh is the mother of twin teenagers, and she believes parents should get the vaccine for their kids. Also with us today, Allison Krug. Allison is an epidemiologist who earned her master's degree in public health from the University of Virginia. During the COVID pandemic,

Allie worked with some of the doctors whose names you've come to know and likely trust, including Vinay Prasad and Marty McCary, to try to help parents understand the potential risks of the COVID vaccine, including myocarditis, at a time when you weren't allowed to utter that word. She is the mother of two teenage boys, and she believes this decision for parents is far more complicated than the CDC, FDA, and Merck, again, the manufacturer of Gardasil, would have you believe. Kristen and Allie, thank you both so much for being here today.

Thank you, Megan. Thanks for having us. Sure. It's great to see you. So this is, I really do appreciate it because all my mom friends and I have been debating this and we don't know, you know, we don't, we don't do this for a living. Usually you do what your pediatrician tells you. And I think this vaccine kind of had a rap that was more controversial, as we said in the intro, even before COVID, but during the whole COVID debacle and being misled so many times by the public health officials in particular about vaccines, many of us who were not previously vaccine skeptical, like yours truly have become

a little vaccine skeptical. Like I don't, I don't just trust my pediatrician with a knee jerk reaction now. Um, so anyway, I really do appreciate you guys coming on and actually debating because so many people don't like that either. So anyway, we'll, we'll kick it off. All right, let me start with you, uh, Dr. Kristen Walsh. Can, can you give us can you give us the short sell for why you like this vaccine and you think it is valuable for parents to have with respect to their children? Yeah. I mean, I think it's like every medical decision we make for kids. You're weighing the pros and the cons. And for me, I have a lot of experience with this vaccine. I've been a pediatrician for a while. I've been giving it to my patients ever since it basically was recommended and came out around 2006. And I think that the cancer burden from HPV is so high. If you look at unvaccinated adults,

about half of them are carrying strains of HPV and not all of them cause cancer. Some of them cause genital warts, but it's just not, it's not a very easily avoidable virus. I think if you're going to be sexually active, it's, it's, it's pretty, you know, common. It's pretty much out there. And I, in other words, you don't really have to do anything crazy to get this virus. And, you know, you can be from a very religious family and do everything right and wait to have sex till you're married and still get it, honestly. So I think in that scenario, the disease burden is such and the vaccine safety is such, from my experience, from the data, that it's a pretty straightforward decision for most kids that the benefits outweigh the risks.

Okay. And when you say half of adults are carrying HPV, this was one of the stats that I read in the packet and getting ready for this, that it could be even higher than that, that it could be like the vast majority of adults walking around out there have HPV. Now, what does that mean, doc? What does it, what does it mean if you have HPV? What do you have? Yeah, well, I mean, viruses, we sort of live in this relationship with viruses all the time. You know, if you've ever had chicken pox like I did as a kid, that virus is still around somewhere hiding in your nerves of all weird places. So some viruses, your body just clears and gets rid of. And actually, quite often, the body clears HPV within a couple years. But sometimes it doesn't clear as easily. Sometimes it causes just sort of bad cytolatical changes

in your cells that lead to cancer. Sometimes it causes genital warts. So many of us are carrying HPV and we'll never have symptoms. We'll never have cancer. We'll never have genital warts. So, you know, many of us are carrying HPV and we'll never have symptoms. We'll never have cancer. We'll never have genital warts. We'll never know we have it and our body will clear it. And that's great. But the problem is you just don't know if you're going to get one of the benign strains or one of the bad strains. And there are the bad strains.

There are multiple of them. They're common enough that you want to try to avoid them if possible. When we say the bad strains, do we mean the cancer causing strain or? Cancer. And I would say genital warts too, because, you know, I know that's not cancer, but it's also not pleasant. And the problem is you can get those things treated, lasered off, whatever, and you're still carrying the virus. You didn't clear it just because the warts got treated. Your body will clear it or not, but until then, your partners are very susceptible. You can't really prevent transmission with a condom because a lot of times it's just close skin-to-skin contact. So there's these viruses that cause cancer and there's the viruses that cause genital warts and they're just different

strains of the same virus. And then is there some other group of strains that's like benign that causes neither one of those things? Yeah. And they all have numbers. So like the cancer causing strains are like, I think 16 and 18 are the big ones. I always forget which ones cause genital warts because the numbers don't get thrown around as much. But I think for oral cancer, it's always like either 16 or 18. And there's nine of them that cause cancer, which is why Gardasil 9 has the name 9 in the end, because that's the newest strain of the or the newest iteration of the HPV vaccine. It protects you against nine cancer causing strains. I think there's actually maybe even 12. Allie would know the answer to that. Probably.

25. Yeah. Okay. So isn't this the line of HPV that famously Michael Douglas and Catherine Zeta-Jones admitted they were dealing with that caused his throat cancer? Ali, good time to bring you in. I'm sure you're familiar with that case. I mean, I only mentioned them because they went public with it. And he said he caught cancer. I mean, he said not to be too graphic, but I think from oral sex with his wife who had HPV. I mean, I don't know that case, to be honest, Megan, I live under a rock a little bit. So it's really an honor and a privilege to be here. And certainly with Dr. Walsh as well, who I know I've known through the COVID pandemic, and she's been a phenomenal pediatrician and very fortunate to share this time with her talking

about this important issue. My children were vaccinated prior to COVID. I marched my kids into the immunization clinic and we got our vaccines. I really did not think about vaccines other than rotavirus, and I did decline that one, but every other vaccine we've marched right in and we've gotten them. We're a military family. When we go overseas and move, we have to get marched in and get Japanese encephalitis and other things. The way that the COVID vaccines were handled, the oversight and specifically the way that the severe adverse event myocarditis was handled, actually a serious adverse event, really caused me to lose confidence in the FDA and the CDC and the ACIP, quite frankly, because they were pushing it for kids going to camp before we really had settled whether or not

myocarditis was a serious signal. So my confidence was shaken. And following that time, I decided that it was important to actually really look into other vaccines and decided to look into the HPV vaccine, quite frankly, because it was the one that I had heard virologists and others talk about as being the most unassailable cancer preventing vaccine that we have, the very best that we have. So I decided to look into it and try to figure out whether or not I had full confidence in the city, my OBGYN was like, you're definitely giving it to your daughter and you, you should give it to your boys too. And she gave it to her daughter. She was practicing what she preached, you know, saying as, as in, you know, Kristen's

a pediatrician, but my OBGYN is of course in women's reproductive health. And she was saying, you, you don't know how devastating it is when cervical cancer happens to somebody. And it potentially could have been avoided with this shot, you know, or a double shot, or if you, depending on how late in life you get it, it's a triple shot, but that's her point. She was coming in from the dealing with the women once they have the cancer point. So why isn't that just ballgame right there? Yes, it can prevent cancer. Done. I'm getting it. Right. And it should have been. And that's the notion I brought into actually even looking into this vaccine in the first place, because who wouldn't want to prevent cancer? But then the more I started digging, I've spent over 100 hours on this and I've really only scratched the surface, I believe, in beginning to understand my clear position on this. But I came away asking more

questions than I felt were answered. For instance, as Dr. Walsh alluded to, 90% of all of these infections are handled by the immune system within a year or two. So you build actually natural immunity, which is another lost story that we saw happen with the pandemic as well. We neglected to discuss the importance of natural immunity. And quite frankly, I'm a huge fan of mucosal immunity. This is another virus that, you know, begins on the other side of the mucosa. And that's where the first battle is fought is at the mucosal layer of the cervix. Let me clarify that and then I'll give you back the floor. So what you're saying is you may catch HPV and never know, as Kristen was saying, you may never know. You have it. You had intercourse, you have it. But your body is resolving strains without even knowing it, just the same way a lot of us did with COVID. Some of us had COVID and didn't even have any symptoms and wouldn't have even known we had COVID if it weren't for the constant testing, and therefore we had natural immunity. You're saying

same thing here. Same thing here. Yeah. I mean, your cervix, I'm sure most people have been through health ed in school and they know what the cervix is and where it is. And so it's outward facing at the top of the vagina. And so when you do have sex, I mean, you actually are exposing the cervix and the vagina to organisms, including the HPV virus. And so that's where the first battle is actually fought. Oh, sweet. We do have that picture. We have a medical picture of a cervix. Very nice. I asked for that. So it's just really important to think about the mucosal layer, which is, you know, our airways lining our nose all the way down, you know, through our gut, which quite frankly constitutes most of your immune system in your gut. And that's why it matters what you eat. But also in the vagina as well.

You can hear I have a cold. I'm recovering from a cold. That battle is being waged in my upper airways before it gets to my lungs. Same thing is true here with HPV. That battle is being waged in the epithelium of the cervix. And yes, some of these really bad strains do find a way to wedge themselves between the cells and get down to the basal layer where they do get into the cells at the basal layer of the epithelium and they start to cause mutations. And that can cause the warts

that you might see rise up to the surface, right? If you have warts on your hand or somewhere else, you can actually see them. Hard to see on the cervix unless you go and get screened, which gets to my next point. The first point, point one was 90% resolve on their own. Point two is getting the vaccine actually doesn't remove the importance of getting routine pap screenings. So that's something I wasn't frankly aware of either. We still need to ask women to go in for screenings every three years. And so if we are giving them like essentially false hope that, you know, boom, you're done, this is a home run, you're not going to get cancer. We're actually giving them some misleading information that they do need to keep going in and get screenings. And the women, unfortunately, who are getting cervical cancer and dying of cervical cancer are the same women who face structural barriers to care that

put them at higher risk for either not getting screened or not being able to follow up on important treatments for abnormal screens. So I have a couple of other points to make. That was one of my questions, Allie, in reading your talking points before this segment and the data, which was if you are a woman in America, you likely are encouraged to go to your OBGYN for your annual, right? That's what we all call it. We go in for our annual. And they give you a pap test every time. They're constantly doing that. I mean, it's unpleasant and you don't really love it.

But I think in America, under most health plans, you get one of those a year. So if you're somebody here in the modern, you know, first world of the United States, and you're doing that, it really did make me wonder whether you need this vaccine at all, because that will, maybe it's not going to detect one of the quiet strains and you don't really care. I imagine it'd be nice to detect, or, you know, I'm talking about the vaccine. It'd be nice to avoid any of this nonsense. But my point is, the one you really care about is cancer. And are the pap smears, have they been working effectively to save the lives of any woman who might have cervical cancer? Kristen, do you want to talk? Well, there's a couple points I would have about that. So first of all, going back to natural immunity for a second, like I definitely agree that I don't think we got good public health messaging about natural immunity regarding COVID. I think that

natural immunity for COVID is durable, long lasting. It seems to me to be as at least as good as vaccine immunity, if not better. I mean, I think if anything, the signs are pointing to better, but unfortunately that does not seem to be the case with HPV. And it's partly, I think, because of some of the stuff Allie was highlighting, it's a virus that stays in your sort of your epithelium, like the mucous membranes. And if it gets, you know, if it worms its way down, it can sort of cause cancerous changes in those cells right where it infected you. But it doesn't really get into the bloodstream very much so that actually your body doesn't mount as good of an immune response against it.

So it's just in this case, I think it's pretty clear cut that natural immunity is not great, and certainly not even close to what vaccine immunity gives you for the HPV virus. As far as pap smears go, so there's a few things to unpack here. And actually, I think Ali found the study that I had remembered reading, which there was one sort of European group that said, hey, you know, if you are vaccinating young girls before they're sexually active, they really don't need many pap smears because the HPV vaccine is so effective. If you know, if you can get people vaccinated before they're exposed to any strains, I think this study recommended like three pap smears in your lifetime. And I think, you know, that's actually what I tell people is what I think. But the problem is, it's very difficult to tease out, right? When we make, we have to make sweeping recommendations for society. And I think it would get a little difficult to be like, well, did you get the HPV vaccine before you started having sex? And then

it's unclear, like, is it oral sex? Was it like French kissing, which, you know, has been known to transmit HPV in very rare cases. So it gets very dicey trying to figure out who this population is. And I mean, I think that I have plenty of the patients who are that population. And honestly, I tell their mothers about that study. And I say, that's what I think, you know, your daughter really needs is only three pap smears probably in her lifetime. But the other point is that we do way, way too many pap smears in this country. I've had the same experience every time you go, you know, and they pretty much make you go every year, they want to do a pap smear. And the recommendations are not even, you know, I think the recommendations are every three years, you know, for most of us, most of

the time. So I didn So we do way too much. I didn't even know that. Why have I been subjecting myself to this year after year? I think I have overly aggressive doctors. Well, I guess we all do because I think we've all had that experience. I've never, I mean, maybe next time I go, you know, I have sort of a new OBGYN. So maybe she'll be like, hey, you had this last year. You don't need it for another two years. And then I'll be so happy, but we'll see. I mean, thrice in a lifetime sounds magnificent because it's, you know, as I say to the audience, the males, it is not a pleasant experience and I hell on earth or anything, but it's not something if you could take a pass on it,

you'd probably say yes. So that's so three times in a lifetime. If you've gotten the HPV vaccine prior to your first sexual encounter, that's something you tell your patients? I say that's probably all you need. That's not probably all that people are going to propose to do to you, but that's probably all you need. And then the other point here is that, unfortunately, this is not a great experience. Like if you like, yes, if we are doing extremely frequent pap smears, we will probably pick up, you know, these, uh, precancerous

lesions early and, uh, you know, we can save a lot of lives that way, but you know, trust me, if you ever know anybody, like, thank God I haven't had to do this myself, but if you ever know anybody who's had to have one of those leap procedures to take off, like sketchy precancerous cervical tissue, cervical scraping. Cause I was just talking to a friend of mine, no one who I've mentioned on this show, and she was saying she got the HPV vaccine, then they detected after the vaccine, nonetheless, they've detected possible problematic cells on the cervix, and then she had to have a cervical scraping, which sounds just awful. And she said, indeed, it was. Is that what you're talking about? No, there's even worse stuff than that. There's stuff where they have to take a

laser and excise like part of your cervix. And I've actually known people like normal people who didn't do anything crazy in college that the rest of us weren't doing, you know, who had to have that done. And it's extremely painful. So I think, you know, all of us, you know, I don't have a daughter, but if I did, I would certainly not want her to go through that. So I think the more of that we can prevent the better. And it's also just scary, you know, if you get a pap smear result, and even if they're like, hey, this is questionable, we need to do this again in two months, then you're like, sitting around for two months hoping you don't have cancer. And, you know, I think the more of that we can prevent the better. All right. So this, this is exactly where I was when I was reading the packet in advance of this

alley. I was like, I'm getting it. I'm going to get it. I'm too, I'm too old to get it, but I'm going to get it for all three kids because the Michael Douglas thing, I did go back and check. Yes, he did. He did indeed in 2013 reveal to the guardian that his illness was the result. His, he had cancer, stroke cancer. His illness was the result of contracting HPV, which experts believe can be brought on by cunnilingus. So it was sort of a very revealing moment for the couple, but kind of a good one, you know, net net, because it called attention to the issue. And I think most people thought this was a female issue only, and it's not. It can affect men as well, as outlined there. So this is the point where I was like, I'm getting it. But then you've taken a deep dive into some of the side effects.

And indeed it's, it's dark because there's a mass litigation going on right now. It's been consolidated in the state of North Carolina. And in that case, and they're going to have to prove their case. They're going to have to prove most importantly, causality related to the vaccine. People have died. Kids, you know, young kids, 12, 13 years old, died, boys and girls after getting the vaccine. That's enough. It's one in a million, they say, but that's enough to make most parents say, and I'm out. So talk about the side effects. Well, I mean, if I could, I could just circle back for just a second. I do agree with Dr. Walsh that it is a battle at the mucosal layer, a battle that is generally won. But interestingly enough, the studies show that the antibodies following natural infection and vaccination end up

approximating each other after about a year. The battle is really not fought systemically. And we are also neglecting to talk about the T cells and their involvement in protecting us against, you know, the HPV 16 and 18, which are the worst. There are nine that Gardasil protects against, but there are 12 oncogenic strains, meaning cancer causing strains. And so we're just not really talking about the full picture that our immune system provides as far as protection for us. The other thing that I wanted to bring up is that studies have looked at the protection of natural immunity and actually using the control group in a trial in Costa Rica and found that there was 50% protection against neoplasias that do lead to cancer. So cervical intraepithelial neoplasia

two or higher, CIN two or higher. I don't understand a word you're saying. Yeah, I understand. So those are precancers. But if your audience is trying to look up these studies and understand what CIN is, it took me a little bit to figure that out. So CIN is precancers and the grading is one, two, and three. Three is worse. So what we're trying to do is measure outcomes that are meaningful.

And the outcomes that are meaningful are cancer. And so CIN3 leads to cervical cancer a fraction of the time, somewhere between 0.5% and 4% within 12 months. Not all of the CIN3s even lead to cancer. So again, I just think full disclosure to parents is important about the full spectrum of potential risks. And getting to your point, Megan, about side effects. The side effects that they are talking about for this vaccine, beyond what the CDC acknowledges, which is anaphylaxis, which is 26 per million, syncope, which is fainting, is 82 per million. CDC admits in its own studies that those are much higher than other vaccines. Clotting is about two per million.

I think those are some things that really, if we were smart about reducing harms and really optimizing the benefit, I think that it would make sense to talk about risk factors for clotting. So family risk factors, hereditary risk factors, even using birth control are risk factors for clotting. Those potentially could be conversations you could have. You could run a blood test before you give the vaccine. And finally, probably the most obvious thing we should talk about is, do we really need two doses or three doses, as you mentioned earlier, Megan, depending on age. So the World Health Organization just released in November 2022 an updated recommendation acknowledging that the evidence is very good for the protection of one dose as far as antibodies as well as long-term outcomes. So, you know, the option exists for

what they call an off-label one-dose recommendation. And I think parents should be informed of that. But here in the U.S., we're just simply not talking about a CDC ACIP AAP. Even in the AAP's Red Book, it still says the routine, you know, on label, two or three doses. And as a matter of fact, I was really surprised to find that they even say, hey, if the interval is too short between any of the doses, you should restart, which is frankly, just crazy. There's no reason I would ever advise anyone to do that. Because the longer the interval, the better, which we found with COVID too. So maybe maybe Redbook's in the middle of revising that. I don't know. I just, I found it and it struck me as, you know, yet another indication that we're not really providing parents in the U.S. with full disclosure. And I apologize for my voice, I got sick.

There's a lot I want to go over there and also give it back to Dr. Walsh in a second. But let me just ask you, the reason some believe they're having adverse reactions to this vaccine is in this vaccine, as I understand it, there's a form of aluminum. It's like a special form of aluminum that Merck dreamed up. And we've had RFK Jr. on this show repeatedly to talk about how he has nothing against certain vaccines. What he does have against certain vaccines is when they put mercury in them or as a preservative or when they put aluminum in them. And that's, you know, he says it's a neurotoxin. And I think we can agree that it's a neurotoxin. I don't think even his critics would dispute that aluminum is a neurotoxin,

but there's also something in there that, that helps it cross the blood brain barrier. So there's something in this vaccine that helps it cross the blood brain barrier, according to what I read, and it also has this form of aluminum. So now you're basically injecting aluminum into your kid's brain and trying to make it as easy as possible, which is, I believe, why some think we get a high percentage of adverse reactions to Gardasil. Is that correct? Well, it's somewhat correct. I would say that, you know, aluminum has been used for, you know, a very, very long time as an adjuvant to get the attention of the immune system. And that's not really very shocking. I think the difference with this Merck AAHS, which is a different one, I'm not going to say the full word,

but AAHS is their adjuvant. It is a proprietary adjuvant and it was used. The thing that frustrates me most probably about this is the clinical trials are not all that helpful. So they enrolled a good number of people up to 18,000, if you look across all the studies, but it was an active comparator. Only 306 had a saline placebo. The rest of them had this adjuvant, which we know may cause harms because looking at the adverse event rates, they're roughly comparable between vaccine and placebo, which tells you that adjuvant is not terribly safe. So I do wish that the trials had been done better. Just clear that up because the placebo had the adjuvant in it. It just didn't have the thing that prevents HPV.

Right. It didn't have the little VLPs, the virus-like particles. So that's the worst case scenario. So you don't even get the cancer causing thing if you're in the placebo group and you get the aluminum thing. Right. And then, and then what I, what I heard, Ali, is that then post that, because the trial participants were like, hey, the people who got the actual drug, they're not going to

get cancer. You were in the placebo drug, drug group. And so those people were like, oh, give me the real deal. So then they had, what, four, maybe six shots of a shot that had the aluminum in it, which I'd be very upset if I were in the placebo group and later found out, holy shit, how much aluminum did they stick in me? Sorry, go ahead. Yeah, no, I think it's a good question. You know, Mark's own package insert shows that roughly 2.3% in both the vaccine and the placebo group had new onset autoimmune issues. Like I had to read that twice. 2.3% is a big deal. So I just wish that the FDA oversight had, was more

stringent. I wish that they weren't allowed to do active comparators. I wish that they had been forced to publish every single study. I wish that people had not had to invest three years of their lives combing through clinical study reports and petitioning the manufacturers to release data so that we could actually do the proper meta-analyses to look at these adverse events. It's just really very frustrating to try to get to the bottom of the equation, which matters, which is risk versus benefit. And I don't feel as an epidemiologist to, you know, cut my teeth on this during COVID looking at myocarditis. I don't feel like I have enough data to really fairly square this up. I know that's the search. So Kristen, can you speak to what Allie was just

saying? She challenged you on your statements about the immunity is really not that great from catching one of these early HPV strains. You know, you were suggesting I wouldn't rely on it. And, I really tried to sort of start from zero. I didn't know anything about this vaccine. I went to all sort of the top quality medical journals and pulled a bunch of studies on safety and efficacy. So this one is the International Journal of Gynecological Cancers. And what they say about that is the natural immune response for HPV is insufficient to control for new infections and is far lower when compared with the high levels of seroresponse and the high efficacy observed against persistent infections after HPV vaccination. And I saw that across like five or six different papers that I looked at. And I was really looking at the big summary, you know, papers, the meta analysis. And I see this over

and over. So I, and I'm the first to tell you, like I said, like, I think natural immunity works great for some things, not so great for others, works great for chickenpox. That's why we don't make kids get the chickenpox vaccine if they've had chickenpox. But natural immunity to the flu is pretty crummy, which is why I personally choose to get a flu vaccine every year. And I think HPV is one of the ones that it just doesn't work that great. And the vaccine works so much better. And, you know, regarding the aluminum, I think, you know, some of this is unavoidable because vaccines, what do they do? They stimulate the immune system, right? So they're teaching your immune system to fight off these diseases without you getting

sick or dying. So it's sort of like if we don't want vaccines that have any adverse events whatsoever or adverse effects or side effects or, you know, not one tiny unpleasant thing happens. I think it's sort of like sending a bunch of military recruits to West Point and being like, but we don't want them to get any bruises. Okay. Like it's not very realistic. You know, you are, I don't, I don't like the oversimplified analogies, which we saw so many of during COVID sort of humanizing viruses. But the immune system is like it's there to fight off nasty little microbes who want to infect you. So I think we do have the technology, which is so great. I mean, vaccines are pretty much one of the

greatest public health interventions of all time, like somewhere behind clean water and, you know, clean sewers and stuff. But you do have to stimulate the immune system for a vaccine to work. You know, the same is for, it goes for measles vaccine, all the vaccines have to do that. And that's why I think, you know, as far as some of the stuff RFK Jr. says, there's some problems with that everything should be up against a saline placebo. It's hard to do a blinded trial that way because, you know, pretty much everybody's going to know that all they got was saline if nobody, you know, ever gets any soreness in the injection site or, I mean, so that's one problem. But also, if you're talking about going back and redoing a bunch of safety trials, it's not ethical to

compare, you know, a vaccine that's known to be pretty well safe and effective, which is the standard of care against a placebo that's not the standard of care for diseases that we know are already killing people. So, you know, you can talk about, and this is not my area, but you can talk about what should be the placebo for a brand new vaccine that we don't already have a standard of care for. But I mean, I don't know, you know, I try to, like. I'm a general pediatrician. Whatever brand Merck is using, I will tell you this. Everything is proprietary with the pharma companies. They are constantly updating vaccines. They're constantly updating adjuvants. They're constantly updating everything. So I don't know anything about that particular brand of aluminum. But I do know that

kind of aluminum is in everything. I think probably Allie would acknowledge this too. We all eat seven to nine milligrams of aluminum each day. It's found in antacids, aspirin, antiperspirants. So we all get a lot of exposure to aluminum. It's one of the elements in the earth's crust. Your immune system doesn't necessarily differentiate whether you ate it or it was injected. So I, well, I mean, the big thing, but what about this thing? I mean, like my understanding is that there's something in the, in the Gardasil vaccine that helps it pass, as I said, the blood brain barrier and, and my, my deodorant doesn't have that. So it seems like it's extra risky to be injecting aluminum

alongside something that allows that facilitation. Yeah. I mean, I, again, like I'm not a vaccine developer and sometimes my patients are like, do you know every last ingredient in this vaccine? I'm like, no, you're drinking a Diet Coke. Do you know every last ingredient in that? I drink Diet Cokes too.

I probably don't want to know all the ingredients, but, you know, we do have to have some trust in the safety of the manufacturing process. I will say that I've been giving the Gardasil 9 vaccine for pretty much as soon as it came out too. I have not noticed, and that was like the big difference between the, whatever we were using before in the Gardasil 9, like they updated the adjuvant. I have not noticed anything with my patients as regards increased severe effects. Now, when I looked at this data, and I think there are some areas where, you know, Ali and I would probably agree. So I looked at a bunch of safety data, and I saw like, I think, you know, serious adverse events.

I mean, that's going to be the case for any vaccine. With the flu vaccine, I think there's a one in a million chance of Guillain-Barre syndrome. I think it's a little higher with this vaccine. I actually saw sort of wildly differing numbers. You know, one study I found from France, which was like 2 million people thought it was several per 100,000 and another said, you know, eight per million. But I think these serious adverse events, if you're in the single digits per million vaccines given, that's really not very significant. I mean, I'm not here to tell you that a vaccine's given, that's really not very significant. I mean, I'm not here to tell you that a vaccine's not a medical intervention, never has any serious reactions. Obviously, that's not true. But they're exceedingly rare. And they're so much more rare than the chance of getting this kind of cancer, you know, which is now preventable. And I think that's what most parents want to know. They want

to know, like, which is the bigger risk for my child? And whether we're talking about what adjuvant they use or serious adverse reactions, I don't, you know, I think that it's still so clear to me that the benefits outweigh the risks. I actually think that they probably, you were saying the number per million of syncope, I think that's probably a gross underestimate. I mean, that's the one thing that I tell parents about. There's two things. One, the vaccine is a little more painful than most. And I mean, the studies I pulled say it's something to do with the salts they use in the actual, you know, vaccine components. But either way, it does hurt a bit.

And that, to me, gets to the syncope question. Adolescents tend to pass out. I mean, I know I did. When I was 16, like, you know, when I would get my period, I would just drop like a stone. And my dad is a physician. He got pretty sick of that. So he dragged me to the gynecologist just because of that. That's inconvenient. So adolescents tend to not need much of an excuse to pass out anyway. So you introduce a painful stimulus like a vaccine. Yes, I have seen that that is the one like adverse event that I have actually seen on the ground after, you know,

however many years it is since 2006, giving this vaccine, I have had a patient pass out, you know, it helps to if I always tell parents, like, you're really supposed to give it lying down anyway, most of us maybe don't do that every time. But we do. I do ask, I say like, does your kid get woozy at the sight of blood or, you know, have they ever passed out before for any reason? And if they have, I will give the vaccine line down and make them stay there for 15 minutes, you know, just to make sure that doesn't happen. That doesn't seem like one of those deal breakers. I mean, it's not pleasant, but it doesn't seem like a deal breaker. You get down to the list of the other alleged adverse events, the more severe ones, and then you've got our attention. But I understand just because they allege it in

a lawsuit, just because they, people go to Merck and complain doesn't mean that they've proven causality, you know, and, and in the same way, now you have so many people saying, I have long COVID, I have long COVID. And you say, do you, or are you just kind of lumping preexisting mental health and other issues into this umbrella? Those claims have to be tested now in a court of law to see if, in fact, they were caused by this vaccine. And indeed, even if they were, how how rare are they to your point? Like there some risk will be acceptable to a lot of parents to avoid these potential cancers. All right. There's much, much more to to discuss, including how is Merck marketing this?

Were they solving a problem that really wasn't that widespread? Did they lead us to believe it was more widespread than it actually is? And does the government have a stake in this vaccine being mandated? We're seeing a bit more of those mandates, even with respect to this vaccine,

and we'll talk about that and much, much more next. Let's spend a minute on Merck, because I do think the stake that the drug manufacturer has in pushing the vaccine is relevant. Just ask Pfizer or Moderna. So Merck, they're the ones who came out with this drug in 2007. And by 2008, they decided to market it this way. We'll take a look at the original ads pushing it. I chose to get vaccinated because I'll do everything I can to help protect myself from cervical cancer. I chose to get vaccinated when my doctor told me HPV can affect women my age and how Gardasil can help protect me. Gardasil is the only cervical cancer vaccine that helps protect against four types of HPV. Two types that cause 70% of cervical cancer and two more types that cause other HPV diseases.

I chose to get vaccinated after my doctor told me cervical cancer isn't the only HPV disease Gardasil helps prevent. I chose to get vaccinated because my dreams don't include cervical cancer. Gardasil. Gard cancer. Gardasil. Gardasil. Gardasil. You have the power to choose. It's very effective. Choose no to cancer. Okay. Yes, I agree. I also would like to choose to say no to cancer. Well, then it became more controversial. This one in particular got a little sticky in terms of parental blogging and, you know, just the internet being what it is. And now they've changed their approach. Here's a more recent pitch by Gardasil. And it's the only vaccine that's out there. There was another

one for a while, but now this is it. If you want to get the HPV vaccine, it's Gardasil by Merck. 2016 found a different way of messaging. Here it is. I have cervical cancer from an infection, human papillomavirus. Who knew HPV could lead to certain cancers? Who knew my risk for HPV would increase as I got older? Who knew that there was something that could have helped protect me from HPV when I was 11 or 12, way before I would even be exposed to it? Did you know, mom, dad? Oh my God. I'm sorry sorry but that is too much uh that's just too much kristen i'll start with you on it as as the pediatrician that's absurd that's trying to guilt you you gave your kid cancer by not getting them this vaccine i i do find the emotional blackmail of parents disturbing

and i think we're seeing it in um other arenas now like you, not to go into a whole rabbit hole, but some of the message parents of kids with gender issues are getting about if it's either aggressive gender-confirming therapy or you're choosing your child's suicide, I think that's horrible. And I am not for any of that. I mean, I guess companies can market the way they wish, but I am always going to disapprove of emotional blackmail of parents. And honestly, it also reminds me of a lot of the ways that public health chose to communicate during COVID, right? It was less about sort of giving factual information and being honest about what's known and not known. And it was more about

what can we say to make people behave a certain way? And that was their whole thing. And I, to me, when you talk about medicine, that's, that's the paternalistic way of practicing medicine. It was very common in pediatrics when I started out. And I always said to myself, like, I am not going to practice this way. I'm just going to tell people like the facts and the truth and invite them to make their own decision and, you know, give my opinion where appropriate. But I am really not a fan of that heavy handed, you know, way of trying to make people do what you want them to do. You know, there's there's a question, Ali, about Merck and whether this drug was a savior because it had been involved in a bunch of litigation over what was it? It was Vioxx. Yeah, Vioxx. And there was a suggestion that this drug may or may not stop HPV, but it definitely stopped the bleeding from the Vioxx litigation that Merck

was facing. And that sort of desperation in that 2016 ad only makes me suspicious of them. It makes me say like, you're pushing that hard to guilt parents. That sounds like a financial motivation more than, I don't know, that doesn't sound like altruism to me. I don't know. I mean, full disclosure, I worked for Merck. I really appreciated the approach the company took to training. I worked for the Merck vaccine division. I sold to public sector, correctional facilities, military bases, health departments. I hold the company in high regard. So just letting you know that my bias is pro-vaccine here. If we get a chance, I'd love to talk about meningitis vaccine before college because that one is clearly a no-brainer for me. So I don't know that it makes any sense to assume a purely financial motive. Vaccine pipelines are many,

many years in development. I do also agree with Dr. Walsh, though, that the emotional blackmail of parents and that one campaign in particular about who knew or did you know mom was terrible. So I really think that we need to talk to parents about the facts and make sure that there's, you know, truly informed consent. I think we ought to talk about the risks of disease. We ought to also be able to talk about the risks of vaccines, because there are risks. Anytime you do a medical intervention, there are risks. And in particular for vaccines, you're introducing these to previously healthy people. So I think it is paramount that we be clear on what they are and that we really do good risk benefit analyses, which honestly, I'm very surprised to find coming at this now, for both COVID and now for HPV, taking a really hard look at it. I'm really surprised to find that the math is just not there. And here I am in my kitchen doing the math. And that's not acceptable. We actually really need to have a third party, non-biased, not FDA affiliated, you know, open source, maybe, you know, recruit citizens and do an open, you know, access, you know, best modeling effort. What is the real risk

benefit analysis here and bring our best minds to this. So I don't, I don't know that I necessarily agree it's profit motive entirely there. We're also seeing that Merck is building a new plant in Virginia, Elkton, Virginia, to ensure that access to this vaccine is available globally, which I totally support. I think that's another thing we haven't talked about is low and middle income countries. Well, that's a different thing. If you're in some third world country and you don't get any pap screening at all. Yes. I mean, I think everybody can, and then the risk benefit analysis changes. But as we talked about here in the,

you know, first world country of the United States, very different calculation where they're forcing the pap around you. Every time you turn around, my God, I was like, next time I go to my OBGYN, I'm going to cross my legs.

Stay away. I don't need this. I had no idea. I had that power that this was perhaps not necessary. Well, we can, we can all try it and see how it goes. Why does he keep coming at me? Oh, oh, no. All right. Listen, a moment of levity. We're going to come back and we are going to get into those side effects in detail and some of the more disturbing allegations. And what about boys? What about boys? I mean, our eldest is a boy.

This is how it first got suggested to me that we should give our then 12-year-old boy this vaccine. What are the risks to them? And have they done in-depth studies on the risks for our boys? Kristen and Ali, stay with me. Don't forget, folks, go ahead now while you have a second and subscribe to us over at youtube.com slash megankelly. If you want to watch this show with your eyes instead of listen just with your ears on Sirius XM radio live every day at noon east. So on the subject of Merck, in the first quarter of 2023 alone, Gardasil sales rose 35% to $2 billion, above expectations of $1.7 billion are children who start the vaccine series before they're 15 can get two doses.

Those who start it at age 15 or older, it's three doses. And the FDA in 2018 approved Gardasil 9, the one that does the nine strains of potential cancer, for individuals 27 to 45. So up to 45-year-olds can get it. And then they say no. However, in 2009, CBS News ran a story hosted then by our friend, Dr. Cheryl, or not doctor, but Cheryl Atkinson. Now she's independent in which Dr. Diane Harper, one of the lead researchers for the original Gardasil Merck drug, she helped in design and carry out the phase two

and phase three safety and effectiveness studies for Gardasil. She spoke out. And her main issue was that the data showed Gardasil lasted only five years. And again, we've been discussing the parallels with the COVID vaccine. That's what it reminds me of.

It's like, what am I gonna take these risks for if the immunity runs out after a couple months in the COVID vaccine and maybe five years for Gardasil and I'm giving it to my 11-year-old, who ideally will not be having sex in the next five years. But even if she does, it's only going to protect her, what, for maybe one partner? Is that worth it? And she says, if we vaccinate 11-year-olds and the protection doesn't last, we've put them at harm from side effects, small but real, for no benefit. She says the benefit to public health is nothing. There's no reduction in

cervical cancers. They're just postponed unless that protection lasts for at least 15 years and over 70% of all sexually active females of all ages are vaccinated. And then points out that the number of women who die from cervical cancer in the US every year is small, but real, but it's small because of the success of the PAP screening program. That's what's been catching the cases and helping women stop dying from cervical cancers. So how about that? Does it last? That's the question. I'll start with

you on that doc. Does, does it last? Do we know? I think it does. I mean, we have a lot more experience now than we did before. You know, we've been giving this vaccine. I think the, the pre-licensure trials started, I think it was like 1997, but the, it was licensed in 2006. So I think we definitely have information now that there's really no waning of immunity after at least 15 years. This vaccine is based on the same technology as the hepatitis B vaccine, which I think immunity has been shown to last like 30 years. So I don't have any concerns about this. All the data I reviewed show that it, it does seem to last a long time, long enough. We don't know how long, but actually you were talking about the extent of the age. And I actually made the decision right before I turned 45 to, to get the Gardasil

vaccine under the wire, because I mean, I I've been happily married. It'll be like 25 years next year, but you know, unfortunately you don't know what can happen in life. You know, you never really know if you're going to ever be out there on the dating scene again. And I just thought, you know, I don't have any safety concerns. I've been giving this vaccine for a long time. Why wouldn't I do it? Just why wouldn't I take that extra step to protect myself in case?

So I did that for myself, actually. What do you think of that, Allie, of the subject of does it last? I mean, are we now in a situation where they're going to have to get boosted every five years or 15 years or what have you? I don't think so, honestly. I agree with Dr. Walsh. We know, and Dr. Harper, I think, was interviewed a couple years ago on that note. And so we do have more data now.

We do have three different studies in the UK, Denmark, and Sweden, looking at 10 years of real world data. And it looks really, really promising if we vaccinate young girls. But again, I think that we're not paying attention to the big picture. The big picture is 0.7% lifetime risk of cervical cancer. It's not in the top 10 for cancers for women, cancer rates or deaths. The death rate was 2.4 per 100,000 in 2006. So pre-vaccine era, it's now 2.4 per 100,000. So we've dropped 0.2 per 100,000 or one in 500,000 or two in a million over that time. And I just, I do wonder, you know, granted some would say, time. And I just, I do wonder, you know, granted, some would say, hey, Ali, we've only vaccinated, you know, 40 to 50% of kids that will only get better. That's true. But, you know, it's protecting against nine of 25 oncogenic strains. And we do

know that, you know, the U.S. is already doing very, very well with cancer prevention using screening and treatment. The big concern is in other areas. So I just, I do think that we are doing again with this, what we did with the COVID vaccine, and that is not risk stratify. We are not really talking about who's at high risk for progression. You know, persistent HPV infection is what's necessary to cause cancer. And you increase the odds of persistent HPV infection. If you do a couple things, for instance, having multiple sex partners, three or more is kind of where they looked at in the literature. That changes the vaginal microbiome, to be honest. Now we're talking about the microbiome quite a lot.

Wait, can I just ask you, do you mean like at once? Three or four, that's a small number over a lifetime. Yeah, that's over a lifetime. But again, I mean, most of the HPV exposure is in the younger girls is what they're finding. And so actually the risk of cancer goes down in the late 20s. The risk of new infection, I should say. The odds of picking up cancer actually are later. So it takes a decade or more for this persistent infection to turn into cancer. So it's really difficult.

You know, the vaccination is important early on, really, hopefully before you start having sexual encounters to prevent infection. It doesn't do much if you've already been infected. So that's where natural immunity comes in. If you've already been infected, then you're counting on that to protect you. But again, it's 0.7% lifetime risk, even with that prevalent rate of HPV in the population, which some would say it's 80% lifetime odds that you're going to get HPV. So it's just not, it's not a guarantee that you're going to get cancer.

In fact, far from it. I don't know why we don't talk about 90% protection from natural immunity more than we do. We almost present it as the odds are nearly certain that you're going to have cancer. And I just find that that's such a flawed way of presenting the data. We're talking a lot about relative risk reduction, not absolute risk reduction, which is something we did with COVID as well. So we're magnifying risk to try to solve. Merck leads us to believe, and it's its advertising and elsewhere that it is solving a crisis of cancer that is killing young women in America. And that is not true about cervical cancer. In fact, the average age for the development of cervical cancer is 50, 50 years old. It is not something that typically strikes

young women. And to your point, now, this is from the National Cancer Institute. We were talking about how many people are going to get HPV and you might, you know, the odds are you, you have it or had it and you don't even know that what they say is nearly all sexual active, sexually active people are infected with HPV within months to a few years of becoming sexually active. This is from the National Cancer Institute. Around half of those infections are with a high-risk HPV type. So you've got, yeah, like they say, low-risk HPVs cause genital warts or do nothing. High-risk HPVs can cause increased risk for cancers of the cervix, anus, oropharynx, which is the throat

and the back of the tongue, vulva, vagina, and penis. None of those sounds enjoyable, of course, obviously, but the odds of contracting are very, very slim. High-risk HPVs cause 3% of all cancers in women and 2% of all cancers in men. But Merck comes on the scene like, watch out. Young women are in danger and we've got the solution. And here's our ad to show you all the women who are flocking to it. And now here's our ad to guilt the parents who aren't getting it. And to your point there, Allie, it's not entirely honest the way they're marketing it and the way they're talking about this problem that they're trying to solve. Right. And if I could just add, I know I threw a lot of numbers at you, but the thing that strikes me is, you know, over a decade of time watching our cancer rates, our death rates, mortality rates, they're not really budging a lot.

And, you know, we've had this vaccine for quite some time now, over 13 years. And, you know, granted, if we vaccinated more people, maybe we'd see it budge more, but we would have to vaccinate many, many people in order to prevent one cancer. And that's the math that I'd like to see people talk about more. I haven't seen anybody other than one Canadian model calculate this. I've done my own math.

The Canadian model says we need to vaccinate between 309,000 people to prevent one cancer, between 309,000 people. And that depends on the modeling data. So how effective is the vaccine? Does it last for a lifetime? So I did my own math using the UK study, a fair comparison of two cohorts, the same age, screened at the same amount of time, one vaccinated, one unvaccinated. I come up with 7,500, probably reasonable. There's probably a range, but again, around 7,500 people to prevent one

cancer. What I have not seen discussed thoroughly is how many harms are caused when we vaccinate that many people. And if you use the Merck data, if you use the package insert rate of 0.04% of serious adverse events, which are defined by law as a hospitalization or a disability, new onset hospitalization or prolonged hospitalization or death, then we're coming up with maybe three harms if I'm vaccinating 7,500 people to prevent one cancer. So again, like we need somebody to actually go through all of the available data and give us this math. What about that, Doug? Because the low number of people actually getting cervical cancer i mean especially if you look at the young people but even if you look at people who are 50 plus it's

a relatively low number and it's not one of the cancers that it's not i mean i think breast cancer's got a 10 to 1 ratio over cervical cancer in terms of its frequency that's that's one everybody is worried about. You know, is it worth the risk of these side effects that we're going to get into? Well, it's interesting you say that. I mean, I consider the HPV vaccine a safe and effective vaccine against cervical cancer. You know, what if we had a safe and effective vaccine against breast cancer? Wouldn't that be great? So, you know, I do actually think part of the, I'll circle back to what you were saying about the disease burden, but I think part of the hesitation, and I've always felt this way since we started giving this vaccine and I saw the reactions to

parents. I was a psychology major and I do think that Freud was onto something. And, you know, people talk about how there's two groups of people that never have sex and it's your parents and your children, right? So like your kid is 11, they're 12. You don't want to hear about them having sex someday. And anything that sort of is attached to that or alludes to that, you're like, no, no, none of that. No, thank you. But at the same time, if you ask most parents, would you like to have grandchildren someday? They almost always say yes. So I do think that some of the sort of reflexive opposition that I see from parents is a little bit Freudian in nature. And I don't know that there's any way to get around that. But my sweetheart, what's that?

You're like, not my sweetheart. No, exactly. Exactly. Also regarding disease burden, you know, when I was reviewing data for this, one crazy statistic I came across is that when we look at the most common childhood vaccines that we're giving in this country, we lose like less than 100, you know, people a year to like, you know, pertussis, tetanus, measles, if you add them all together. But if you look at cervical cancer, it's about 4,000, you know, women a year. So that's a crazy disease burden in terms of death compared to even, you know, things that we consider serious diseases that we all know we want to prevent with vaccines like measles and mumps. And so I think that's important to acknowledge.

To round that out, the breast cancer numbers are just around 40,000 a year. Keep going. Right, right. So to me, it would be great if we round that out, the breast cancer numbers are just around 40,000 a year. Keep going. Right, right. So to me, it would be great if we had a safe, effective breast cancer vaccine for girls. Wouldn't that be amazing? But the number's not 4,000 a year in the cervical cancer department because of Gardasil. You know, no. I think that it is partly due to Gardasil and partly due to screening. But I will say, you know, there are now studies.

Gardasil has been out long enough. I mean, the main problem with determining efficacy for the endpoint of cervical cancer is exactly what you guys were talking about. It takes 20 to 25 years to develop after you're exposed to HPV. But now Gardasil or HPV vaccines in various forms have been around long enough that the studies are starting to come out that do show actual cervical cancer prevention. There was a 2020 study that showed that risk of cervical cancer among participants who initiated vaccination prior to age 17 was 88% lower.

And there's a few bigger studies that I came across that are actually looking at the ultimate endpoint of cervical cancer and showing incredible efficacy of the vaccine. And, you know, there's other epidemiologists that like I follow on Twitter that I trust, and they pretty much all have that take too, that, you know, this vaccine is pretty much a home run in terms of safety and efficacy. Now, back to what you said before, Megan, I think that it is indisputable that there have been a small number of children or young people who have died within days to weeks of receiving this vaccine. And the research that I did, the studies that have been or the cases that have been investigated, they were not shown

to be related. So, you know, you and I both know that a train can go by at noon, but the train didn't make me hungry for lunch, you know, so there's that, you know, we don't want to make a false association between correlation in time and causation. So I do think that's important to acknowledge as well. And that's going to be the case for any vaccine, like, you know, somebody is going to die after any given vaccine. And it is important to find out if it was from the vaccine, obviously. But I think a lot of these cases that have been investigated regarding HPV, it was determined not to be related so far anyway. No, it's true. It's like whenever you're, I was talking about this last April of 22, I got Lasix on my eyes. And I was talking to the doctor about how if anything were to happen to my eyes, let's say in May or June or July, I, I was talking to the doctor about how, if anything were to happen to my eyes,

let's say in May or June or July, I was, I knew I was going to be blaming the LASIK, you know, even though who, who the hell knows. And he said, that's a risk doctors think about all the time. It's like, whatever bad happens to this patient within X time from the surgery or whatever the procedure is, I'm going to get blamed. And that's why we have to look at what are the common side effects? What, how many cases did this side effect happen in? How closely to the vaccine? There are ways of, you know, being able to tie it as opposed to just this, this one weird event, this one random, um, you know, God forbid death or what have you, you do need more proof. That's

why I actually liked the lawsuit in a court of law. These plaintiffs are going to have to prove it. You don't get away with a big judgment without proving causality. This vaccine caused the death. So it's a good forum in which to do it. Can I ask, though, about one of the biggest, I don't know if we call this a side effect or what, but one of the arguments against the vaccine, and I'll ask you this, Kristen, is that if you do already have one of those HPV strains in you, you know, your body fought it off, nothing happened to you.

You've got some level of natural immunity in there. Maybe it's not great, but it's in there that if you then get Gardasil, so, you know, you're not the 11 year old who's never had sex. You're, you're an adult who's had sex and you have the strains in you already without knowing it, that you are increasing your risk of cancer. The number I was given here is that there's up to a 44.6% increased risk of developing advanced abnormal pre-cancer cells or worse. In other words, Merck's studies suggest that its vaccines may cause cancer in women previously exposed to HPV. This is citing information from 2006 that's got red flags on it. I just don't know. Like if that's a thing, we should definitely talk about it.

Well, first, I think, you know, this is a pretty complicated thread to unwind because, you know, one thing that I think we've already alluded to is that the home run area for this vaccine is for sure, you know, both boys and girls who haven't been exposed to any strains of HPV. And in my mind, if you're able to vaccinate them, then like that's pretty, we don't have many guarantees in medicine, but I can almost guarantee that that child is not going to get an HPV related cancer. But however, if you've already been exposed to certain strains of HPV, it will not, you know, negate the effects of the strains you were already exposed to. I do think that the

efficacy in, you know, women 25 to 44, like that next group where clearly, you know, a lot of them have already been sexually active, possibly been exposed to some strains. I actually thought that efficacy was pretty good. The number I saw was 41%. Now that doesn't sound great if we're talking about like the flu maybe, but if we're talking about a potentially deadly cancer, I'll take a 40% or 41% risk reduction. I did not come across, you know, what the only thing I did come across relating to what you're saying is there was a question of whether the HPV vaccine, I mean, I think that it has some fancy immunological name, which probably Allie knows, but essentially,

like, the question is, do you make someone more susceptible to non-vaccine serotypes, you know, sort of pathogen substitution? Is that negative vaccine efficacy? Right. We've had some of those same discussions around the COVID vaccines too. And I think there's a lot that's not known. Like, are you more susceptible to strains that aren't covered by the vaccine? But, you know, when I looked into it, what had been researched showed no clear association, but I'm not, I'm not saying that's not a thing and it shouldn't be looked at further. Well, let me ask you this. Do you know if you've got one of those HPV strains in you, but you, it didn't do anything to you? Is it knowable? Would you be testing negative for HPV? So there's separate, so there's pap smears, but then there's also direct HPV tests.

And I think the recommendations get very murky. Like I just looked at them yesterday and they're very hard to remember because it's something like a pap smear every three years or a pap smear every six years, but an HPV test every three years. So they're separate and you can do those tests. And I think that it doesn't, to me, it didn't give you like a lot of great information. I mean, I think when most people are answering this question for themselves, and I think what you're really asking is like, if I've already been sexually active, and I'm a woman in my 20s, like early 20s, let's say, is it still worth it for me to get this vaccine? And I personally would say yes, because I think it has shown good, like you probably, even if you have one of the bad strains, you probably don't have all of them. You probably don't want any more of them. You probably don't want genital warts. And so to me, like when I really looked at all the safety issues and everything, I still thought there was a clear benefit for sexually active women up to a certain age. And I even saw like, you know, there's probably people are living longer and I,

this is not my area, like elderly people are not my area, but I, I looked at a, you know, some study looking at increasing STDs among elderly people. And they were asking like, should we be giving elderly people the HPV vaccine too? Cause some of them are, you know, getting STDs at an older age. They're out of control down there. It says hashtag goals so ali what about that because this is based on in part um rfk jr his group children's health defense they they cite a 2006 vaccine and related biological products advisory committee uh discussion on the results submitted for the license application for the clinical development program of guarda. So this is from a license application from Gardasil. And they say there was potential shown for Gardasil to enhance disease among a subgroup of subjects who had evidence of persistent infection with the vaccine-relevant HPV types at baseline. So in other words, these are people who did have the HPV strain, then they got the vaccine,

and then they had this sort of negative efficacy where they were more likely to get it than they would have been if they hadn't gotten the vaccine. However, in 2013, the Journal of National Center Cancer Institute wrote up those 2006 results and said, regarding the suggestion, there's evidence that HPV vaccination may enhance disease among some who have been already infected with an HPV vaccine type. They say these results from the clinical trials must be interpreted with great caution. The observed negative vaccine efficacy was not statistically significant, and the group had more baseline risk factors for the development of one of these cancerous strains than the placebo group. So back again, we're sort of at like, huh, that sounds scary. Let's not do it. And then you hear

something that's like, no, this balances it out. Use caution. They haven't proven anything. But it still leaves me like, huh? What should I believe? Yeah. No, I agree with you. It's a good question to ask. And I do think I agree with Dr. Walsh. We should keep an eye on that. But I looked at that data, too. And it did look like that, you know, once you dig down into really tiny subgroups, there are imbalances between the subgroups that might also be associated with those folks having a higher risk. So I'm not sure what to think about that in particular. What I do care about is a couple of things. One is Cochrane. The Cochrane review takes a look at evidence, all of the evidence, and, you know, makes, declares its point of view on lots of things. Like, for instance, you remember the most recent Cochrane review of masks and the brouhaha that erupted after that. Cochrane also looked at HPV vaccine in 2018. And that review really struck me because there was internal dissension over the findings and

a complaint that the Cochrane review team had not actually looked at all of the available evidence. And one of the team members actually went out and spent three years trying to gather more evidence and did a meta analysis of the adverse events and also the outcomes that we care about, like cancer. And I found, you know, speaking to this question of older women and should they get the vaccine or not, the thing that kind of jumped out at me there had more to do with adverse events and possible cardiac risk than anything else. So when I dug down into the 200 pages of supplemental data, I noticed that something that correlated also with the CDC findings from a JAMA article, which was a two-year study, and that's where they found 32 deaths. And again, to Dr. Walsh's points, it's very hard to decide is it vaccine related or not. That causal association is not there. But of the 32 deaths, 20 had records, 70% were after the HPV vaccine alone.

And in looking at the trial data, which I think is even better than real world data in VAERS reports, the trial data, which randomizes people to vaccine or again, this active placebo, the excess cardiac risk was among the women who got Gardasil versus the adjuvant. There were zero cardiac disorders in the adjuvant group, which is really interesting to me because remember we were saying, wow, it's kind of

problematic that it was an active comparator. So for me, I am not sold on older women getting this. And I think that that should be looked at more. And again, so look at Getcha, Jefferson, and Jorgensen. Those were three people who were involved in the original Cochrane Review, took a great issue with how it was conducted, and then invested considerable time in petitioning the manufacturers for all of the data. And there's some also discussion about, as you alluded to earlier, did the participants know that they were given a placebo or not? They were led to believe it was saline, but it really wasn't. So I have a lot of issues with the trials and the way they were conducted and the transparency of the data. And you don't want to have issues.

You want to be able to trust the drug manufacturer. You want to be able to trust the FDA, but we don't. I mean, a lot of us don't after the whole COVID debacle and how they misled. And the cardiac issues were arrhythmia and it was myocarditis that was noticed. And that's something I care a lot about having researched myocarditis now for three years following COVID. And I did actually meet the mother of a girl who died and she actually won in vaccine court. And it was an arrhythmia after her third dose. So, you know, I do think there's something there. And I do think we need to look at this. And if we're not convinced that it's efficacious, I think that the way forward is Dr. Harper mentioned self-testing for HPV infection. I think that the way forward is Dr. Harper mentioned self-testing

for HPV infection. I think that's something really interesting we should take a look at. She told me that it's, I interviewed her as part of my preparation. She told me that it is covered by insurance. So I think women should ask about HPV testing. What is that? Is that like a COVID test except you stick the swab someplace else? I want to say it's more like a tampon, but it's beyond my scope. But I really, I would love it if the two of you looked into that. The other crazy thing that women should think about is, you know, one of the most common elective procedures and medically required is hysterectomy. If you have a hysterectomy, you no longer have a cervix. So I think that's something

that women also need to think about because this may be TMI, Megan, but a lot of women I know, myself included, went through terrible menorrhagia in my late 40s. After my childbearing years, I was on an iron drip, like getting a bag of iron because I hate surgery so much. I'd never been under general anesthesia. I'm a marathon runner. I'm out there with acute anemia running marathons on the base in Yokosuka because we were in lockdown and I still didn't want to get a hysterectomy. I was so freaked out about it. And I eventually did. So, you know, I do think that women who are going through terrible anemia because of menorrhagia should talk about that. And I, forgive me, I don't know what menorrhagia is. What is that? It's like terrible bleeding. Okay.

It's like a pint and a half. So if you're, if you're in that situation, don't ignore it, talk about it. And, you know, the incidents that we've been talking about is of cancer in mid forties is, you know, kind of thirties to forties is where it's highest. It's worth taking the whole picture into consideration, I think. You know what? Thank you for telling us that and revealing something personal. I will, I will. No, no, no. I will respond in kind. Years ago, after I had all my kids, I had an ovarian cyst. It was benign. It wasn't cancerous at all, but it needed to come out because it was growing. And if those things burst, it's rather unpleasant. So it could be done laparoscopically.

It was like an absolute nothing. I couldn't believe the ease with which they took it. And they said, when we go in, if it's too intertwined with the ovary, we're going to take the ovary. And I said, that's fine. I'm done having my kids, but I'll have the other ovary anyway. Fine, fine, fine. Everybody agreed that was the plan. And then the doctor said, because even though it wasn't cancer, it was like a cancer doc or the reproductive system, one of those guys. And he said, while I'm in there, do you mind if you're

done having your kids? If I take your fallopian tubes, I'm like, well, why do you want my fallopian tubes? Why are you interested in those? And he said, the research shows that all, at that time, he said all of the most pernicious forms of ovarian cancer begin in the fallopian tubes. And then my OBGYN told me, not all the most pernicious, all, all the ovarian cancer begins in your fallopian tubes. So if you're done having kids and it doesn't put you into early menopause. So I'm the guy took, took out the cyst. He took out the left ovary and he took out my fallopian tubes. I was, I was done having kids. So it wasn't an issue for me with one. You can't even tell there's not even an incision mark anymore. It's, it's like it never

happened. And it's not to say you don't have to worry about that at all, because you had cells in you. God forbid they'd been cancerous. It's not to say he got every single one and he got the other ovary. But it's such an easy way of reducing risk. Yeah. I'm thankful. One thing, we were talking before about Vinay Prasad, and I follow him too. And I think he's made some great points. And I mean, just to tie together a couple of things, like for me, this is part, partly gets to why I do support the HPV vaccine, like we talked about before. I don't want these young girls to have to go

through these painful excisions and, you know, various things done to their cervix. But it also speaks to things Ali was talking about, like, we really need to make clear that, you know, certain people don't need these procedures. If you don't have a uterus, you don't have a cervix. And also, you know, it's just one of these things about pap smears that we should be addressing. You know, that's something that we could use HPV testing for. I have found, and Dr. Prasad talks about this too, just sort of like at some point saying, no, I think for me, you know, I had never had an abnormal past smear. I had been married for many years.

I didn't have a great reason to go to the OBGYN. I just stopped going. You're not supposed to do that. But that was sort of my way of opting out of all these things. I was like, I think I'm good for right now. And when I finally did go back, of course, they were horrified and they yelled at me and doctors are the worst patients and everything else. But I do think we do too much of a lot of things in this country. And, um, but, but that's part of the reason, like this, I think this is a good vaccine because

hopefully we can prevent some of these painful, you know, invasive sort of unpleasant procedures in, in young girls. Hmm. All right. Now the question is, do we give it to boys? And also I just want to spend a little time on the most severe side effects because, you know, they are alarming and, you know, you, you're use the D word death and it has a way of just shutting down the whole, like, forget it. It's not worth it. Well, I'll get annual pap smears. I'm not doing that. So we'll spend some time on that right after this. So what about boys? I've got two in addition to my girl doctor. Did the boys need it? And if so, why? I have a fun story about that, actually. So I was already a pediatrician for several years when the

HPV vaccine came out. And my aunt, who is also a physician, but not a pediatrician, called me at the time. So if you remember, HPV was only licensed for women and girls initially, and later boys were added on. And so she called me sort of in between time when her two boys were, I think, around your boy's age. And she was like, should I give this to my sons off label? And I was like, I think you should, because I'd already seen a lot of the data, you know, on the on the safety and efficacy in men from the trials. And I was like, you know, I knew already that men got HPV related cancers, and that the vaccine looked safe and effective for them. So I told her to do it, I she ended up being very happy she did, I vaccinated my boys when they were 12, actually.

And, you know, these days, men account for 42% of the HPV-related cancers that are diagnosed. So it's like 92% of anal cancer, 63% of penile cancer. These are HPV-related, so there's other causes of penile cancer. 89% of oral and oropharyngeal cancers are HPV related now. My gosh. I mean, that's pretty persuasive, but is the response to that, Allie, that the overall numbers are low? Well, that gets into absolute risk reduction versus relative risk reduction. So yes, that's one concern. The other one that I have as a mother of boys is who vaccinated her boys because I was back in my pre-COVID trust, you know, trust the FDA and the CDC. And that's a place, frankly, I'd like us to get back to. Dr. Walsh and I were just talking about, you know, how that is probably the biggest problem that we have is loss of trust. But I don't think that there's enough data out there for us to really understand what the risks are for boys. Because most, understandably, most of the emphasis has been on girls in the trials. So I would have to say I'm

undecided there. I want to take a call. Let's see. Hold on a second. We've got Amanda calling in from Oklahoma, and she's got a question for you. Amanda. Hi, what's on your mind? Hi, thanks for taking my call. And honestly, I can't even believe I'm calling in to spare, uh, share my health on national radio, but we're all doing it. I know, right. Just kind of listening to this conversation. I want to add a different angle. So, um, I was married for 22 years. My husband was my high school sweetheart. I'd never been with anybody else. And I went through a divorce and lo and behold, at my very next pap smear, I had HPV. And clearly it was either given to me during my marriage or maybe my husband, I know he had another partner before me and maybe the

stress of the divorce, you know, caused it to be active, whatever the case, it was the most aggressive kind. And, um, I had to have a hysterectomy. Uh, it actually did not take it all away. I still had vaginal HPV. Thank goodness. After about a year that cleared up. I mean, I was like, gosh, we can't take my vagina out, you know? Anyway, when I see,

so I have the HPV vaccine. I was nearing my 44th birthday. She crammed that third dose in, because I believe as an adult, you get three doses. And I'm grateful to have had it. I had zero issues. And when I see moms on Facebook posts that they don't want their daughters to have it, I have to tell you, I cringe because I thought I would be with one person my entire life. And if that had happened to me at a younger age and I had to have a hysterectomy, I wouldn't be able to have kids. And I'm just kind of curious the doctor's thoughts and what she's seen. Like, is this a trend? You know, again, something I never thought I'd have to deal with. Well, thank you for telling us that story and raising the question.

These are good points from somebody who's lived it. Dr. Walsh, what do you think? Yeah, so a lot of times, you know, by the time we are diagnosed with HPV, we have no idea when we were exposed because as you pointed out, it can kind of come out, you know, many years later. And the other thing is, like I said before, you can really lead a very conservative life and still be exposed because you're sort of at the mercy of anyone your partner was with before you.

And things take years and years to emerge. And so that's why having given this vaccine for 17 or whatever years now, and I mean, my patients, I feel like my patients are very communicative with me, even like the babies who get fevers after their routine childhood vaccines. I hear about it. My patients tell me what's up. And so I definitely, I mean, yes, one day in the office is anecdotal, but 20 years of experience, you know, giving this vaccine has given me really great confidence in the safety. Being totally honest with people, yes, the syncope is an issue, a minor one, pretty much solvable by having the patient lie down when they get the vaccine. But

that's why in my mind, I view this vaccine as a home run because if we can catch kids before they're exposed, boys and girls, we can really prevent a lot of problems, I think. Let me thank you so much, Amanda, for calling, and I hope you stay well. Love that you listen to the show. Let's get Jane in Wisconsin in. She's got some interesting thoughts. Hi, Jane. What's on your mind? Hi. Thank you so much for taking my call, Megan. I'm a board-certified orthodontist and mother of five kids, and I just wanted to readdress the importance from an oral health perspective. There's definitely been an uptick in oral cancers amongst young people, like in their 40s, people that normally wouldn't get throat and mouth cancer. And it has been attributed to HPV, the virus.

And these are people that, you know, historically it was drinkers, smokers, heavy, you know, heavy drinkers and smokers that would get throat and neck cancer. And Michael Douglas is a great example. I think Phil Kilmer is another one. But there are all of the unnamed people that are also going through throat and neck cancer, which is even more miserable than probably cervical cancer because, I mean, you're on a feeding tube. It really, you know, I've seen tongue resections. It's really, it's really devastating. So you're giving us some perspective there on, yes, these are risks, you know, I mean, if the real risk is fainting, like who cares?

And some pain from the needle because the injection hurts more. Well, too bad, right? It's like the things you're outlining would far outweigh those other things. It's these other reports, right, of like, I'm going to give you a couple of examples from the lawsuits. And I want the audience to remember, these are people making allegations. It doesn't mean that they've been proven or that it will happen to your child. If this were happening on a mass scale, we would know. We would know. But you hear, for example, the case of, hold on, let me get a Noah Foley, now deceased, part of his parents

are part of this lawsuit two days after his 11th birthday. He was totally fine. They say before the Gardasil shot, no autoimmune diseases, nothing extremely healthy. Roughly two weeks after the Gardasil shot, they say experienced fevers that reach as high as 102.9. His mother recalled the 35 days between the discovery of swollen lymph node and then a report that ruled out cancer as long and tortuous, but then things went south. His left leg went numb, his face and tongue went numb. He started vomiting and then he was completely non-responsive, almost completely brain dead. And eventually he passed away, um, some, sometime later. Now they say he died of encephalitis caused by an autoimmune auto-inflammatory dysregulation process, which was caused in fact, according to the plaintiffs by the Gardasil vaccination. Um, they say Merck never

told us this was even possible. Again, I guess I'll give that to you, doctor, because I hesitate to even read it, right? Because I think that's, I don't want that to be everybody's takeaway. Like my kid's going to die. It hasn't been proven, but it is, that's the stuff that really gets a parent's attention. Yeah, I think those are outlier risks. And it's just like the cases where you hear of a child dropping dead on the basketball court playing basketball. Are we all stopping our kids from playing youth sports? No. So if that was a real legitimate risk, they wouldn't be offering this vaccine. So I think,

you know, I agree with the pediatrician that you have on. I really, really believe that the benefits outweigh the risks. And I intend on vaccinating my five children. Jane, thanks for calling. Yeah, go ahead. I definitely agree with all those points. I would add also that, and first I'm going to preface this by saying like regarding autoimmune disease, you know, there've been some large population-based studies that compare vaccinated and unvaccinated patients for HPV and they find no difference in the rate of autoimmune diseases. However, you know, it is important. And this is one of the things that really hit home for me during COVID. I think it's very important to be honest with people about risks. And a vaccine is a medical intervention. You know, it's like a medication. And every once

in a while, somebody has a severe fatal allergic reaction to medication. It's why, for example, I'm pretty stingy about doing, I'm only going to do a strep test on a kid if I think they actually have strep, not to make the parent feel better, because I don't want to give a kid antibiotics who doesn't really need it, because I don't want them to have an allergic reaction that could be fatal. So I think the same way about vaccines. And as we were discussing before, vaccines do stimulate the immune system. So I think the same way about vaccines. And as we were discussing before, vaccines do stimulate the immune system. So I think that there's a medical premise there for both vaccines and viral infections to trigger autoimmune conditions. And, you know, some kids with severe autoimmune

conditions, like they can't get live virus vaccines, for example. And I think that, you know, we do need to be honest about those things. I do not see a special risk here regarding the HPV vaccine versus other vaccine, but I do think it's important to say any vaccine could trigger an autoimmune disease, just like any viral infection could, you know, number one, I want to remind the audience about your point about maybe one, maybe one shot, one shot. And we kind of got to that with COVID with children too. And I know Vinay Prasad, uh, who you work with doctor was, he was somebody who said on myocarditis, if you're in the risk group, one shot, uh, could be the one for you. Um, so that's a possibility, but also when Jane said, you know, I trust the officials, you know, I like my spidey senses went

out because I too trusted the officials. And I remember when the, when the COVID vaccines first came out, I said, I trust in Pfizer and I trust these brilliant doctors who came up with this vaccine. If there are massive side effects, they'll come up with the cure for those. And like, that's not what happened. People started getting myocarditis and they started denying it. They broke the public trust. And so now I like millions of others, no longer trust these officials. I trust you too. You know, like I trust data, real data, but you're, you've been talking all show about how hard it is to get. So your thoughts on all that. Yeah. I mean, my spidey sense went off too, because I, like you, I trusted people implicitly who has the time to spend hundreds of hours digging into every vaccine,

right? I mean, that's why we have the experts do this. And this is why we have trusted agencies to run the trials and to ensure that vaccines are safe. That's what they are charged to do. Unfortunately, I don't really feel like we're in that place anymore. And I do think that it is reasonable to ask questions. I think that the atmosphere in which we are now, where I am painted as an anti-vaxxer for asking questions and ending

a Twitter thread with, I think maybe one shot is justifiable. It got me just absolutely annihilated. I think that's a difficult atmosphere to have reasonable conversations, and that's not where we should be. I think it might be possible to mitigate potential harms, however rare they are, by considering a person's history before vaccination. You know, do they have a history of autoimmune issues? Do they have a history of reactions to prior vaccines? And what is their

risk likelihood going forward? Are you catching them before they've been exposed to these HPV viruses? So I do think that that's difficult. And I just want to also reiterate that it's not like annual screenings. It really is a lifetime seven pap smears that we're talking about potentially being reduced to three. So Because all we've been talking about is syncope passing out and the shot will hurt. And then I went to the more extreme allegations of a kid dying. But what does your research show are the risks? I mean, nobody wants autoimmune. You kind of touched on that one. What are the other ones? Yeah, well, I did speak to an expert who works in a very, very interesting area, and he's working on autonomic issues like POTS, postural orthostatic tachycardia syndrome. You've probably heard of POTS. It's something that affects people with long COVID as well. And he's in New Jersey. So I had a really

great hour-long chat with him because he actually does try to treat people who have this. And that is one of the potential adverse events that's been noted, chronic regional pain syndrome as well. And, you know, it's very interesting. I think as we understand long COVID, the potential is that we could understand who's at risk for having an adverse event related to autonomic dysfunction. So I do think that there's could predict better based on what he told me about lifestyle, not lifestyle, PTSD, like traumas and other things that cause our sympathetic and parasympathetic nervous systems to be constantly at war with each other. He described it as like driving with the brake on. So, you know, those two are trying to keep you in stasis and trying to keep you in equilibrium. Well, if you have a lot of stressors in your life, then your parasympathetic system is always on

and always trying to help regulate. And there's only so much he was describing that your body can really take over time and then vaccine or a virus could potentially be one more insult to that. So I think that the time for strategic vaccination is here. I think it's long since passed. I'm not the first asking for that.

Back in 2018, there was a study saying, hey, we really need to think about, you know, minimizing harms of vaccination. Vaccine harms are there. They are real. They are rare. But if we are more strategic in our thinking and personalize our vaccine recommendations, I think we can minimize the harms and maximize the benefits of vaccination. And I think that's really what I think is, you know, the ultimate goal from where I stand as an epidemiologist concerned about population health. So we have one minute left. So I'll give you 30 seconds closing argument on your positions. I'll start with you, Dr. Walsh. Go ahead. Yeah, I mean, I do think we do have to regain trust in public health by being honest. But I am being honest when I say I have long

experience giving this vaccine. I've really reviewed all the safety data. And I still think in terms of risks and benefits, it is a home run. I gave it to my two boys. I can't think of too many patients who I would counsel not to get it. So that's my take on it. Okay. Allie, how about you? Yeah, I started thinking it was a home run actually. And now I think possibly I could justify one dose. So I'm, I wouldn't say I'm all the way on the other side of the continuum, but I am much more circumspect. My co-author in the Epoch Times, Dr. Yuhong Dong feels very strongly. She's an MD, PhD. She feels very strongly that it's a hard no. On any doses? Any doses. Yeah. Okay. Well, I don't know if we've

answered the questions for people, but we've given them the questions to think about. And that's, that's our mission. Kristen, Allie, thank you both so much. Really appreciate this fair debate. You guys were both awesome. Thanks for having us. Yeah. Thank you very much. And I guess we'll figure out what we're going to decide. All you moms and dads out there, I'm in it with you. And stay tuned. We'll see you for more tomorrow. Thanks for listening to The Megyn Kelly Show.

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