Woman's Hour - Measles and childhood vaccinations, epilepsy research, the women who back Trump

Episode Date: February 12, 2019

Measles cases in Europe have tripled between 2017 and 2018, the highest number recorded this decade according to the World Health Organisation. We discuss parental attitudes to vaccinating children and what parents should know with Helen Bedford, Professor of Children’s Health at University College London's Great Ormond Street Institute of Child Health and Samantha Vanderslott, social sciences researcher at Oxford Vaccine Group. There are 600,000 people in the UK with epilepsy and one third of them find that current treatment options do not fully help them to control their seizures. Many of those are women who find that their condition worsens in pregnancy or experience increased seizure frequency around their menstrual cycle. Jane talks to Fran Thomas who has epilepsy and to Dr Simona Balestrini who is undertaking research into improved diagnosis and treatment options that may benefit women. President Trump has attracted regular criticism from left of centre women, not least at last month’s women’s marches across the US. But what of those women who already back his party, the Republicans? We hear about the many women who support him and his policies. And, what’s the secret to hosting and delivering a great speech, presentation or event? We hear from Mariella Frostrup and Viv Groskop.

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hi, this is Jane Garvey and this is the Woman's Hour podcast, Tuesday the 12th of February 2019. On the podcast today, we'll talk about vaccinations, a topical subject, that one. We'll speak to Sarah Elliott, who's the chair of Republicans Overseas UK, on the women who continue to fully endorse President Donald Trump, who is on a roll, at least among Republicans. His overall rating's not so hot, but his core base

absolutely love him. They say he delivers. And we'll discuss epilepsy as well and the particular impact on women, obviously, and public speaking or just being a woman and hosting and owning the room and being the boss of an event like Joanna Lumley at the BAFTAs on Sunday night. Do women do it differently? Is it harder for women? How can you absolutely nail it? More on this subject at the end of the pod as well. But we start this morning with measles cases in Europe, which have tripled between 2017 and 2018. That's the highest number recorded this decade, according to the World Health Organization. And in America at the moment, two states are experiencing an outbreak of measles.

Helen Bedford is here, Professor of Children's Health at UCL, Great Ormond Street Institute of Child Health. Welcome, Helen. Hello. And Samantha Vanderslot is a social sciences researcher at the Oxford Vaccine Group. Good morning. Welcome, Helen. Hello. And Samantha Vanderslott is a social sciences researcher at the Oxford Vaccine Group. Good morning. Welcome. Hello. Let's start, Helen, with why you think people, and there aren't many people we should say, but why some people are dubious about vaccinations. Most people get their children immunised, that's the first thing to say. But those who don't, it tends to be the big issue for parents is, are these vaccines safe?

So safety of vaccines has always been prominent right since vaccination came in. Some people are very vehement in their beliefs about vaccination and they have no vaccinations for their children at all. But actually, that's a very small proportion. It's only about 2% and it's been the same for decades. So most people get their children immunised and think it's the normal thing to do. Does that suggest then, bearing in mind it is such a tiny proportion, that there's over publicity of that minority who go against the general, the majority feeling, the anti-vaxxers? Certainly there's a very powerful anti-vaccine sentiment on social media. So they have a very loud voice, but they don't reflect the majority view.

And you don't think they ever will or ever come close to reflecting it? I think the problem is that some parents have concerns and questions about immunisation, and it's totally unsurprising. And the worry I have is that they may be influenced by these more extreme views. Samantha, what do you think influences parents or just concerned people? Yeah, I definitely think there's an over-representation of anti-vaccine sentiments. So you often see in media stories a portrayal of there's an increase in anti-vaccine movements and groups but it doesn't really drill down to the many complex issues why people might refuse vaccination and that is attached to not trusting the government, not trusting pharmaceutical companies,

also having an appeal of other very persuasive ideas, such as alternative health and natural products. So there are lots of reasons why people might not vaccinate, and that differs over time in different countries and in relation to different vaccines. Yeah, tell me, first of all, about the different approaches in various different countries and in relation to different vaccines. Yeah, tell me first of all about the different approaches in various different countries. Yeah, so either you have compulsory vaccination where it's the law, it's a legal requirement to vaccinate, or you have mandatory vaccination where vaccination is associated with state services, so going to school, getting childcare.

And then finally, what we have in the UK is vaccination being recommended by the government. Recommended but not insisted upon. Exactly. But what about panic or hysteria or campaigns against immunisation? How do countries differ in that area? There's been a lot of controversies over vaccination and the government responses do vary. Whenever a government decides to look into ideas about problems with vaccination, that tends to be labelled as a ban. So you do see governments listening to populations about having adverse effects from vaccination. And during that time, the government might recommend that vaccination to be better explored.

But then that gets labelled as a ban. And we've seen that in Japan. We've seen that in France. OK, what's that in Japan. We've seen that in France. OK, what's happened in Japan? So in Japan, the HPV vaccine, the human papillomavirus vaccine, which protects against cervical cancer and other types of cancers, in 2013, the government didn't recommend that vaccine while it was exploring claims of adverse effects of the vaccine. So neurological effects that were reported by girls who were taking the vaccine. And then that got widely reported as a ban. I see. OK. Some vaccines get a free pass, it would appear.

Nobody worries much about diphtheria, for example. Is that true? Yeah, in the past, there was a scandal about diphtheria. So nearly every vaccine has had some concerns. So I was wrong. In fact, there have been questions about diphtheria. Yeah, it was quite a long time ago. So in the 1970s in the UK, where a possible link with, again, a neurological condition was raised.

But nobody's mentioned it recently. Yeah, no one's mentioned it recently. However, I think it's important to say this. And Helen, you're a good person to answer this question. Sally on Twitter says there is a vaccine damage payment unit because vaccines are not 100% safe. That's true, isn't it? It's true that there's a unit. There is a unit. And when people say vaccines aren't 100% safe, nothing is 100% safe. But vaccines have a very high safety profile and they have to have that because they are given to healthy children, to all healthy children. So more than many medications, you have to be absolutely certain

that the vaccine is as safe as possible. And before a vaccine comes into use, there will be lots of trials. And after it comes in, safety monitoring continues. And it's really important. And there are lots of examples of things happening. So in America, there was a vaccine introduced, rotavirus vaccine, and it emerged very quickly that some children were getting a particular bowel complication and the vaccine was withdrawn. So these safety monitoring is taken very, very seriously. Let's go back to what measles, for example, can do to a child or to a person. I didn't have it because I had the vaccinations. I don't actually

know anyone who did. But what does measles do? Well, I did have measles because I was too old to be vaccinated. And I remember it now. I was very unwell. It makes children very unwell. So it's a viral infection. And what it does is it gives you a high fever, a rash, a cough and complications can occur. So about one in 200 children will have febrile fits, about one in a thousand will have inflammation of the brain and it kills about a one in a thousand people with measles. And we've seen a lot of deaths. We've seen 70 deaths in Europe last year from measles, which is a shocking statistic. But you say that because that tiny number of people are not getting their kids vaccinated, how is that, forgive me, I'm not a statistician or a medical person,

how is it possible then? We need to have about 95% of the population immune to measles. Oh, I see, go on. But we have pockets where there's much lower uptake. So although across the board about 2% decline, if you go to certain areas, there will be a lower uptake. And what we've also got is because some people were scared about the safety of MMR about 20 years ago, lots of young adults, older teenagers were never vaccinated. And they are pockets of susceptibility.

And we've had outbreaks amongst those groups. I also know that around that time, because my eldest child is 19, so I'm in exactly that group of parents, people were having the single jabs, weren't they? They were having the three separate jabs instead of MMR. Presumably those children are entirely, they're fine, they'll be all right if they've been immunised that way. If they've had two doses of measles vaccine, then they will be protected. But some of the other single vaccines that were available at that time weren't so effective. And this is part of the problem, why the government never introduced single vaccines. So these clusters then, Samantha, that Helen refers to, the places where there are more likely to be more people who haven't had their children vaccinated. Where are they in Britain?

So in Britain, the lower uptake happens in London, but there's quite a lot of disparity across London. So some parts of London will have very high rates and others quite low rates. But what sort of parts of London and what sort of parts of Britain are susceptible to these sorts of views? So it can be certain groups which are deprived, so travelling communities and also religious groups where you might not have that much of an outside influence coming in. And then you could get carried by anti-vaccine views.

Linda has a question for you, Helen. This is on Twitter, at BBC Women's Hour. Why aren't kids vaccinated against chickenpox? A vaccine does exist and that can be pretty serious. It is complicated. Lots of countries do vaccinate against chickenpox and this is one of the vaccines that's on the list that the Independent Advisory Committee

that advises on vaccination looks at from time to time. One of the issues with chickenpox is if you introduce the vaccine and you don't get very good uptake of the vaccine, what you tend to do is get more people getting it when they're older. And chickenpox is much more severe in adulthood. So you have to be very, very sure that you're going to have very high uptake in young children. Another question from a listener here. What about those who have recently died from measles? Actually, were they vaccinated? Most of the cases of measles that have occurred have been in unvaccinated people.

Though not all? Not all. Some of them have had one dose, but you really need two doses to be best protected against measles. Herd immunity is an expression that people will be familiar with, but what can you strictly define it for us, Helen? Well, I prefer the term community immunity because our children aren't little cows. Basically, it means when you immunise somebody, they are protected. If enough people in the community are immunised, then you have community protection. So people who can't be immunised, maybe very young babies or old people or people with severe conditions that suppress their immune system will be protected because of so little disease around.

And actually, that means that herd immunity will protect. Sorry, I've carried on using the expression you don't like, will protect those individuals whose parents didn't vaccinate them. Absolutely. It's very powerful. So they get that protection too. And importantly, it also protects the people who didn't get full protection even though they've been immunised because no vaccine is 100% effective. This is very sad. From Sally, when I was six in 1967, my best friend died of measles

and I've never forgotten about her. That was my first experience of somebody dying. Measles still very dangerous and the vaccine is very important. From Fiona, I lost my hearing in one ear because of measles at the age of six. It was a big decision to give my children the MMR in 2001 with adverse publicity around at the time. But my own experience meant that it was a no brainer. To what degree, Samantha, is the panic around vaccinations restricted to pampered Western societies? You can get it in a lot of different societies. It doesn't have to be just in the West,

especially rising middle classes. They're very influenced by views that are held in other countries and you see anti-vaccine ideas travel right across countries so in Japan the panic about the HPV vaccine that spread to the Philippines and even further away to Nigeria. It's interesting isn't it I'm looking at Twitter and this is totally honest because it's live and it's right in front of me. This is from Hannah. One-sided discussion. There's no balance amongst your guests on this subject. Helen? Well, there's no balance because the science is firmly in favour of vaccination. There's absolutely no question. And if we think about in the period between the year 2000 and 2017, measles vaccination prevented 20 million deaths. There's no argument that vaccine is the best thing to do.

It is interesting. I mean, fundamentally, I guess we're now, you could argue, and many will, that we're being sidetracked into worrying about the possible side effects of a vaccination because we aren't seeing the illnesses and the diseases anymore, are we? Absolutely. Now, I've got two children. They're young adults. And I was just reflecting on their childhood. The worst thing they got as children were coughs and colds. And they had chickenpox, but they weren't really ill with that, although you can be, obviously. We are not used to seeing children being really ill at all because of vaccination. They just don't experience these childhood diseases anymore. We're incredibly fortunate. Donald Trump has, President Trump has made an intervention in this area, I think, hasn't he? I believe he did in the past tweet some anti-vaccine sentiment. Okay, thank you very much. We're only moving on to talk about

President Trump, which is why I mentioned it there. Helen Bedford, Professor of Children's Health at UCL and at Great Ormond Street Institute of Child Health. And you also heard from Samantha van der Slot, social sciences researcher. Thank you both very much. Really appreciate your involvement today. And people do have views on this. I've tried to give, honestly, a fair sample of what's been coming in as we discussed it. At BBC Women's Hour on Twitter and on Instagram as well if you want to pitch in you can email the programme whenever you like bbc.co.uk slash Women's Hour. So to President Trump who's attracted all kinds of criticism over the last couple of years from left of centre women not least at last month's women's marches across the states when he

delivered his delayed State of the Union address last week, he got applause from the white-suited Democrat women, and not all of it was sarcastic. No one has benefited more from a thriving economy than women who have filled 58% of the newly created jobs last year. You weren't supposed to do that. Thank you very much. All Americans can be proud that we have more women in the workforce than ever before. Don't sit yet, you're going to like this. And exactly one century after Congress passed the constitutional amendment giving women the right to vote, we also have more women serving in Congress

than at any time before. He is working that crowd. And we are talking later in this show, actually, about working the room and getting your message across. Sarah Elliott, chair of Republicans Overseas UK, what exactly was going on in that State of the Union address? Well, I think the President was touting his successful economic record, which with his tax cuts back in December 2017, the economy is now moving the fastest, growing the fastest it has since the Second World War and unemployment is at historical lows for blacks, Hispanics and for women. So that message, who was it aimed at in that address? Well, I think it was aimed at women.

I think it was going, you know, saying 58% of the new jobs, of the 5 million jobs that have been created in the last 18 months have gone to women. And this is a good thing. And, you know, his numbers among women are not overall are not very strong. Well, no, he has historically low approval ratings across the board, but he's still hugely popular with his core vote and with many, many Republicans. That's right, because he has fulfilled his campaign promises. So he is focused on the economy. He's focused on border security. And he's also focused on the cultural conservative elements of that base. You know, promoting Christians in the Middle East, making sure that they are being protected

in the aftermath of ISIS, but also his judicial nominees. Now you talked about security. President Trump was at a rally in El Paso, which is on the America-Mexico border last night, and a BBC cameraman was knocked over. There was a bit of a flurry of activity. The guy was knocked over. I gather he's going to be all right, but it wasn't pretty and it was a pretty unpleasant incident. President Trump had attacked the media during the course of that rally. Doesn't all that make you feel, to put it mildly, a bit uncomfortable? Well, you know, his method is to, he is representing the forgotten men and women in America, and they've often been overlooked by the media. And also the media has not always given him a fair hand. So that's his style. And I think with a lot of women, a lot of women like that, Republican women, but also Republican I can't defend him personally, just like the Democratic women who supported Bill Clinton, despite his transgressions against women. I don't think anyone would ever suggest that Bill Clinton was some sort of saintly figure that we must all admire for his probity and moral decency. I don't think we'd ever say that about Bill Clinton. But there is no doubt

that some of the things that President Trump has said about women and some of the tone of the rally last night, it's worse than unbecoming. This man's supposed to be the leader of the free world. That may be true, but this is Trump. And I think people generally are kind of tired talking about the rhetoric of Trump because we just accept this for him. This is who he is. You were, I think it's fair to say, a reluctant Trumper, weren't you? You're a relatively late convert. Yeah. I mean, I didn't vote for the man. I didn't vote for Hillary either. I couldn't vote for her. I'm sorry. She just doesn't represent my politics. And I was a supporter of Marco Rubio in the primary, but I am now a because quite frankly, his policies are more conservative than policies we got under Bush, either Bush's or possibly a Romney presidency. It's reminiscent of Ronald

Reagan's presidency. That was the last time we had significant tax cuts and the economy boomed and jobs were created. Now, he's galvanized women. There's absolutely no doubt about that. There are five women already in the running to be the Democratic candidate, as well as women already, as he referred to in that State of the Union address, already sitting in the House of Representatives more than ever. How do you explain that? Actually, is that a good thing, too, as far as you're concerned? I think women participation in politics is key, and I'm very supportive of that. But the Republicans have got work to do on this side of the argument. Well, you know, they had Carly Fiorina, who ran in the last go-around.

Yeah, well, we talked about her on the programme, but she didn't get far, did she? No, but you know what? She got a lot of attention, and I think she brought up a lot of really good points for women as well. But I do think that actually possibly Hillary Clinton in her run obviously gave way to more women feeling like they can run on the Democratic side. But it'll be very interesting to see how these women play off each other. But what about the Republicans?

What efforts are they making to increase their female representation? Well, I think you have great leaders such as Nikki Haley, the former governor of South Carolina and former UN ambassador. Yeah, so did she resign purely to make sure she was in the right place to run? Well, I hope so. I like her. Well, that suggests that Donald Trump might not run another time. Well, you never know with Trump, do you? Well, you certainly don't. And that brings me to the Robert Mueller investigation. How concerned are you about that?

You know, what I'm concerned about with the Mueller investigations, there's no parameters put on it. And taxpayer money is completely funding this. It's over 20 million taxpayer funds have already been spent on this investigation. And there's no deadline for the man. And so basically what I think he's going to dig. He's going to dig till he finds something, I think, if there is anything to find. But I don't think it's going to be Russian collusion, to be honest with you. You don't? No, I'm not. I think they would have found it by now. I think they would have found it by now. Now, will they find, I don't know, some kind of deals he did with the Russians? Perhaps.

I don't know. But I don't think it's going to be Russian collusion. Okay. Well, that's the view of Sarah Elliott. We also know that President Trump has appointed a number of women into key roles at the White House. There's Kellyanne Conway, senior councillor to the president. She, of course, ran his campaign. Sarah Sanders, press secretary. And let's hear from all of them. We'll start with Ivanka Trump, first daughter and advisor. To address the many challenges we face,

we don't need talk. We need action. My father is the opposite of politically correct. He says what he means and he means what he says. He's the president of the United States and he should, not only does he have the ability to give his opinion, he should give his opinion. That's why the people elected him, is because they trusted him to make decisions on policy matters. People on Twitter and elsewhere right now are saying, oh, how could she work for Donald Trump? I work for President Trump because he's so good to the women who work for him and he's so good to the women of this country

who are much better off with security and prosperity because of his leadership. So I don't want to hear it. We know, Sarah, that his female supporters do get attacked a lot. They get a lot of criticism. How do they tackle it? Oh, I think a lot of women tackle it with pride. A lot of women go, well, you know, he's president, he won,

and I'm proud that he's there and he's doing a great job. And, you know, as someone who lives in metropolitan London, sometimes I just keep my mouth shut. Why? Is it simply not safe to express your support for President Trump? Sometimes I want to be judged for who I am and not for my political beliefs, because I think there's such animosity towards the president. I mean, you saw the huge protests that happened when he came to visit. And, you know, some days you just don't want to deal with it. But we know that President Trump's critics look at the discourse around him, look at, for example,

the rally last night, the nature of much of what he was saying, the way in which he conducts himself, the things he said about women, and not just women, the things he said about Hispanic people, all of this stuff. Has it forever lowered the status of the role of American president? And does it mean that future American presidents will be able to behave in this way and not be criticized? I hope not, in all honesty. I also think Donald Trump is probably one of the few people that can carry it off. I think we're going to deceive people. So he can be, some would say, uniquely terrible. Yeah.

He's got a free pass. I don't think, I think he's, he is representing people. He is like the defender of the people who have been forgotten, the forgotten men and women of the United States, the working class, middle class Americans who haven't had a say, been told they have to buy a certain light bulb, they have to drive a certain car, they can't, you know, they can't pray in certain places. These are people who just want to be left alone to raise their children. Maybe it's homeschool, go to church on Sunday. You know, they want to see a culture of life in the United States. They want to see an end to abortion in the United States. And so these President Trump represents these people and they see him as their warrior. They see him as their cultural warrior who's going out and taking them going into battle for them. And that's why they support him. And it's a culture war out there. Really, really interesting to get your insight. Thank

you very much. And your opinion as well, I should say. Sarah, good to meet you. Sarah Elliot, Chair of Republicans Overseas UK at BBC Women's Hour, if you've got a view on that. Now, later in the week, we've got Tracey Neville with us. She's the England netball coach, of course, highly successful. And on Friday, what it is like to stop breastfeeding. I know I've mentioned that we are talking about this before, and then we didn't talk about it. We are going to talk about it on Friday of this week. So if you've got any questions on that, you can ping them in. Probably email is best for that.

And yesterday, I think the line up, when you looked at the line up on Twitter for Women's Hour yesterday, I think it just read, porn sewing, Nelson Mandela's PA. And somebody drew my attention to this because I hadn't actually written that myself. And I did point out the variety on this show is emphatically not dead. So if you missed yesterday's programme, you can catch up with all those conversations. The podcast, of course, is available via BBC Sounds. Make sure you subscribe to the Women's Hour podcast there. You will get additional material every single day. Now, you may not know, but there are 600,000 people in the UK with epilepsy and the impact of it on women tends to be

certainly different. You could argue much greater. There are issues around medication and pregnancy and of course, the menstrual cycle as well. Now, the Epilepsy Society is hoping that a new 2.5 million pound genomic research programme is going to bring some hope of a life without seizures for people with epilepsy. We can talk to Fran Thomas whose condition is linked to her cycle. Fran good morning and welcome to the programme. Morning. And also with us Dr Simona Balestrini who's an expert on epilepsy and part of this research project. Welcome, Simona. Thank you. Fran, can you just tell us a little bit about epilepsy and the impact it has on the way you live your life?

I have lots of different kinds of seizures. So I have grandma seizures, so the ones that people normally associate with epilepsy, the ones where you fall to the ground and chew your tongue, quiver. They happen once a month in general, follow my menstrual cycle. At what point in your menstrual cycle? So if you think about the average menstrual cycle

for a woman, let's just say is 28 days. Mine's actually 26. Generally speaking, for me, they happen between day four and seven. So it is literally quite distinct as to where they come. And what do you do around that time? Do you stay in? Do you save your life? Well, you can't really, can you? You've got two small children, especially you've got two boys who are 11 and nine. I'd like to see them try. They give you a special drug, which is a valium based drug called clobazam, which you can take during that time, but it doesn't always work. It doesn't always help.

And you can only take it for a certain number of days every month, because then it becomes completely redundant. On top of that, I also have partial fits. Now these partial fits can be anything from two seconds to a minute, or even slightly longer. And they happen, I just came out of the epilepsy centre in the Chalfont Centre in just in Gerrard's Cross and the video telemetry showed that I have between 7 and 15 seizures in any 24 hours. So those fits obviously. But these can happen. You were explaining earlier

you can be walking the boys home from school and then? Yeah, I've had a conversation with Oscar and Kurt recently. So Oscar's 11 and Kurt's 9 and I said to them, well, can you give me a couple of examples of the kinds of things I do?

And they said, well, look, the thing that you do the most at the moment is that when we're walking home, you go into the wrong house. And if you see something like a cat, you'll pick up the cat and say, oh, look at this cat. I didn't know we had a cat.

And I'll be standing there saying, mummy, this isn't our house. We don't live here. This isn't our cat. It's just like, oh, right, OK. But when you were pregnant, I gather, you didn't have... No, I didn't have any fits at all. And actually, the interesting thing was,

is I developed epilepsy at 15, and I spent years, and I do mean years, even over a decade, trying to explain to the doctors that my fits followed my menstrual cycle, and they got much worse whilst... Did they not want to hear that? They just didn't listen. They didn't believe me. And when I got pregnant and the fits disappeared, they sent me to an endocrinologist,

which obviously is a doctor who looks after hormones. And that endocrinologist said, well, obviously you've got catamenial epilepsy, which is epilepsy which follows your menstrual cycle. And I just looked at him and thought, nobody could have told me this like 15 years ago. It would have been quite useful. And what was it about pregnancy that protected you? Well, progesterone. Your progesterone goes up enormously during pregnancy. And that's actually

an anticonvulsant, progesterone. It's a natural anticonvulsant. And that's what happens when you're pregnant. The progesterone, as it goes up, will just stop the seizures. Right. Lots of questions for Simona. First of all, why didn't the doctors listen when Fran was pointing out that her menstrual cycle was absolutely pivotal here? Well, probably they should have listened to this. I mean, in women, it's quite common that the hormonal pattern does play a role in seizure occurrence. The direction can be variable, really, because actually in some women, seizure can get worse during pregnancy. So it's not always the case that seizure improves.

The link between hormones and seizure is still to define. And so I think it is one of the direction where our research should go, really, because, of course, in women, this is a very important aspect. We've discussed on this programme before that a lot of medical research is not done on women or doesn't take into account women's hormonal cycles. Is that going to carry on being the case or are we really going to start to change this? No, no, we should definitely change this. Well, we should, but are we going to? Yes, yes, it's part of our programme. So what we are focusing now in our research programme at the Epilepsy Society in Chalfont is to try to understand much better the mechanism leading into epilepsy.

And we are specifically looking at our genome, so at how all the information about our body function, how this information is stored in the genes, and obviously is in our gene where is where it's written how our hormonal pattern works and so we really hope that trying to explain in better this mechanism between genes and hormone we will then also able to explain identify mechanism on how to target the dysfunction. I see. Did Fran, did you inherit epilepsy? No, no, no, not at all. They don't actually know where it came from. I mean, there are two

possibilities. I had a febrile convulsion at 18 months. And I had a deoxygenated birth. But there's a recent test being done. And this is the possibility now that they're looking at the the idea that i may have it might be genetic and if it if these if i can if they do do the tests and if they do find that it's genetic then that will obviously open up a massive you know will open up a massive group of ideas for me because at the moment I take four different kinds of medications. It's virtually impossible. Well, it's impossible to control it. Can I just ask, sorry to interrupt because I know we just haven't had much time. Just from the point of view of the hormones, I'm just thinking, I mean, the menopause,

will that mean the end of this form of epilepsy for Fran? Well, again, this is at the moment difficult to answer because again, it's very variable. There are women that go much better after the menopause, but there are women where unfortunately the seizure continues after the menopause. So it's very difficult to predict. And okay, sorry, carry on. I was actually listening to a producer at that point, which is unbelievable and quite rare as my colleagues will testify. Carry on, Simona, did you finish that? Do forgive me. Yeah, so at the moment, it is unbelievable and quite rare, as my colleagues will testify. Carry on, Simona. Did you finish that? Do forgive me. Yeah. So at the moment, it's really difficult to predict the course after the menopause.

OK. And because Fran has had sons, they can't pass this on or they could? Well, if we find a genetic change in Fran, there is a risk that this will be inherited. Although we need to be careful because genetic doesn't always mean inherited. It could also happen that a change in the genes happen as kind of a new change in the person and has not been necessarily inherited by the parents. Right. So if this research project goes the way you want it to, people like Fran won't carry on for the rest of their lives taking four drugs a day because, as she says, she just doesn't want to do this. Of course. No, our target is, first of all, understanding the mechanism and then targeting

the treatment to the mechanism, try to reverse what the change in the gene has caused. So that's our really main goal in our genetic programme. And can individuals help in any way? Well, they can definitely help for our research. We are recruiting more and more people into our genetic programme because every person's epilepsy is different, really. So we are really trying to correlate the genome with the characteristics of each person's epilepsy.

And so the more people we have, the better. The easier that will be, obviously. Thank you so much. Well, if anybody wants to get involved, I'm sure there'll be links on the Women's Hour website, bbc.co.uk slash womenshour. Thank you, Simona. Thank you very much, Fran.

Best of luck to you. Thank you. Having a real cat is one thing. Having imaginary cats is something else altogether, especially when they belong you very much, Fran. Best of luck to you. Thank you. Having a real cat is one thing. Having imaginary cats is something else altogether, especially when they belong to your neighbours as well. That must be very confusing. Right.

The BAFTA awards ceremony, when was it? It was Sunday night, wasn't it? And there has been a lot of criticism levelled at the ceremony itself and particularly at the script. This year, that script was delivered by the host and that was Joanna Lumley. Here's just a reminder of that. Star of Stan and Ollie, Steve Coogan is here! He was utterly amazing as Stan Laurel, wasn't he?

And I'm also indebted to him for helping me on with my Queen Anne outfit earlier. Thank you, Steve. That's another fine dress you got me into. And we're honoured to have the director and one of the stars of Black Klansman here, Spike Lee and Adam Driver. It's an incredible film. It's already won many awards, though to be honest, I'm surprised that it did so well at the Klan Film Festival yes all right

comedian and author of How to Own the Room Women and the Art of Brilliant Speaking Viv Groskopp is with me and we also have Mariella Frostrup who's able to join us in a moment or two as well now she has I think co-hosted the BAFTAs in the past so she's not someone who doesn't know about this it's a hard gig isn't it, to put it mildly, this? Well, I'm actually laughing at the Klan Film Festival. I don't think there's any shame in that joke. Don't you? Nor that's another fine dress you've got me into.

Well, it's just so interesting. I think Joanna Lumley did a fabulous job. I mean, she's absolutely gorgeous and a brilliant actress, wonderful presence, charisma. But it's so difficult to carry off this kind of humour. And I sort of feel as if people have kind of got what they deserve now, because after so many years of complaining about any kind of irreverence or off-colour jokes at all, this is what you get. You know, you get sort of cracker jokes yeah and I think if if it had been introduced as oh sorry about these jokes you know they were written by my seven-year-old son

um then it might have worked so it's the fact that we're all so eager to be offended that makes these things so anodyne well I think so you know Stephen Fry stepped away from hosting the BAFTAs as I understand it after having made a joke about the costume designer looking like a bag lady. And they turned out to be old friends. Yeah, they were old friends and it was very amicable. But he got absolutely crucified for his supposed misogyny. He also made a joke about Eddie Redmayne and said, you know, he's played every character under the sun, but the character I most want him to play is a man trapped in my basement, which presumably is supposed to be offensive to murder victims. I mean, everything is offensive and irreverent in this context. And yeah, this is the result is to get this very anodyne kind of humour, which then people

complain about and get offended by. Is that the problem there, Mariela? It's just impossible to do these gigs, basically. They're obviously not impossible to do. But I do think there is an awful lot of truth to what Viv's saying about, you know, the idea of comedy by committee, you know. And I think as a host, you know, one of the things, I mean, and Viv will know this better than anyone, actually being capable of standing up and being incredibly funny and holding a room as she does, is that it's got to be comedy that you find funny. I think the golden rule is if the jokes don't make you laugh, don't repeat them. And I think for a lot of people, you know, one of the hardest things really about, you know, delivering, presenting award ceremonies and things like that is that you are required to be a little bit of a comedian because, you know, for those of us who aren't, you know, that's quite a tall order. And I often see the role more really with me as a sort of facilitator

to kind of keep things going and keep things moving. And I'm often surprised that so many actors take on those jobs because actors invariably, and I think this would be the only comment I would make about Joanna, are very tied to a script. And if things aren't going well with the script, it's not their fault, but there's also very little they can do about it. Whereas people like Viv and I are used to having to think on our feet.

You know, you sort of adapt, you know, and if those jokes are going down like a lead balloon, obviously you make a joke about the fact that they're terrible and try and carry on. And I think, you know... Yeah, I don't know. What do you think about that, Viv? Making a joke about how badly it's going it's yes it's that why it's very very thin ends of the wedge there

yeah it's very difficult there's there's a really fine line between admitting what's going on in the room and having that spontaneity and being able to respond to you know Bradley Cooper's grumpy nervous looking face and actually commenting on your own failure, which then reduces your status and makes everybody feel really uncomfortable, which is in itself actually quite funny, but not in necessarily the correct way. That's one of the awful things about the BAFTA,

is that generally, if you're presenting an award ceremony, there isn't a camera cutting in onto the faces of the winners, you know, making their garning, grumbling, you know, uncomfortable moves. So you're sort of the audience is being fed in very sharp relief. The television audience is being fed in very sharp relief, the audience in the room's reactions, which wouldn't normally happen. And I have to say that the absolute silence, I thought they were a very ungenerous audience. Well, I agree actually about that. I mean, there is an element in, I thought they were a very ungenerous audience. Well, I agree, actually, about that.

I mean, there is an element in... I think they're a particularly tough crowd because they sit there with their arms folded looking... They really impressed me. Yeah, exactly. At that time, that really actually quite, you know, unpleasant. Yeah, they're all wearing about seven pairs of Spanx, including the men, so they can't even breathe, let alone laugh or smile.

Very briefly, if you can, Viv, top tips for making that public appearance, doing a speech like that. What are your top tips? Well, obviously you're not going to be on the level of Joan Lumley. And there she's playing two audiences because she's got the entirety of that room

and a television audience. But for general consumption, for your Q4 marketing report, remember you're not going to be Martin Luther King or Marielle Frostrup. You just need to relax and be you and get through it recognizing the limitations of the task and not I think so many people think it needs to be this kind of Oscar star production and they've got to make some jokes and make it brilliant for everyone no you don't you just turn up do what you've got to

do stay within the limitations don't try to over deliver I want more of you in the podcast can you stay yes of course. Of course, nobody ever turns me down. Actually, some people do turn me down. My first ever public speaking gig was the Kemsie Evergreens and the entire front row fell asleep. That was the early 1990s in Worcestershire. I don't think they'll still be around.

It was probably just what they needed at that moment in their life, Jane. You performed a service. Thank you. Well, that was the live show, which ended my wonderful memory of the Kemsie Evergreens. I think the average age in that room, Viv, was... I mean, it was going back... They must have been 85, 86.

It's your people, Jane. It's your people. It was. I was a local radio presenter at the time. I think they may have been, the radio station's people. But I don't think they were, because they weren't that interested in what I had to say about it. So there you go. I'd just like to apologise to everyone listening for the quality of today's output, which I am blaming on the temperature in this room. Can you say today's output? No, don't be rude. Do you feel hot in here? I'm worried because I thought I was getting

a little perimenopausal, but I don't feel that warm in this room. You don't? No. I'm concerned. Okay, maybe I'm running a fever. I don't know. Right, no, I think there's something wrong with our air con, seriously. You don't sense it at all? I don't, no. Maybe I'm just peculiarly cold-blooded.

Or irritatingly young. Perhaps. Who can say, Jane? Now, what we have to do is get some tips on public speaking because women in the past, women have. Well, do they find it hard or are we just told we find it hard? And so we start to panic about it. Yes. Well, I think context is really important. And that is the thing that most people understand when we talk about the difference between men and women.

I don't think that there is a literal difference that women find it actually harder than men. But we all know that we operate in this context where perhaps women might feel that they're being more judged. They might feel it's more difficult for them to get opportunities. I was speaking yesterday to a woman who'd been asked on a panel for the first time and she was already thinking about how she could pull out. You know, it's all of those things of... Why was she thinking that? Well, because she didn't like the pressure of it and she was already thinking about how she could pull out you know it's all of those things of why was she thinking that well because she didn't like the pressure of it and she knew she would probably be the only woman on the panel and then she felt this pressure to represent so there's all of that stuff going on that I think does make it slightly different for women but I think those things also present opportunity because they mean that you often can stand out a bit more

you have the chance to do something a bit different. You know, I'm always talking about Michelle Obama and the style that she has, something we would never have seen 10 or 15 years ago. Go on, what is it? Well, it's that informality, this way of being quite relaxed and very much herself with an audience, not seeming to heck to you ever, but still by being quite forceful. And that's a style that we've never really seen before. If you think of traditional women's leadership and speaking styles like Margaret Thatcher, Angela Merkel, someone like Christine Lagarde, it's much more controlled and stayed, and maybe a sort of old fashioned headmistress

kind of feel. But now we've got all these amazing younger speakers coming through who have these much more relaxed, easygoing styles that feel as if they're sort of making it up as they go along. I'm thinking of a TED Talk style or Chimamanda Ngozi Adichie, Amy Cuddy with her power poses on her TED Talk, Elizabeth Gilbert, all those kind of women who speak in this very natural unaffected unpolitical way that is something really new and exciting. In fact sometimes I speak to

people might find this hard to believe sometimes I speak to radio presenters about how they could do radio and I always I got better as a radio presenter when I stopped worrying about making mistakes. And I think if you can, as a public speaker, if you don't focus on cocking up or even think about it, then you'll be a much better performer in that arena. And you have to accept as a radio presenter that you are going to make mistakes. And people aren't listening to hear your stumbles or to hear you not being able to find a word because it's conversational essentially or it should be yeah i think that's genius advice and i i would yes indeed you are a genius jane but it's it's not only that they're not listening for the mistakes it's that they're not listening for perfection either no no absolutely not expecting it to be some kind of

hello this is the BBC. You know, it's so interesting. You know, we were talking about the BAFTAs earlier, and I was thinking how difficult it is now for people in these quite formal situations, like an awards ceremony, because we're so used now to seeing informal speech and people doing Instagram stories, YouTubers. The whole convention of how we present ourselves publicly has changed radically in the last five to ten years. You know, ten years ago, most of us would never even be on film.

You know, people don't even like necessarily listening to their voice on a cassette in the 1980s, if people can remember that. And now we have to hear ourselves and watch ourselves, especially the younger we are, all of the time. And so then when you get these formal settings like the BAFTAs, I found it really interesting that a lot of the even the men stumbled over their acceptance speeches because they couldn't quite come down on the side of, shall I be formal and say something very moving? Or shall I just be a bit shambolic and informal and a bit crazy like Olivia Colman you know and I love how Olivia Colman has been giving all her acceptance speeches they're completely unprepared they're a total mess they're absolutely from the heart and people love them and

they work because of that messiness but that's something very new and you would have never seen you know a Hollywood star giving that kind of speech in the 60s or the 70s. That's interesting. I hadn't thought about that, but you're absolutely spot on, I think. This is a good take from Eva. I teach public speaking skills, this is on Twitter, using belly dance techniques and employing the concept that the speaker is the host of an event. I thought I was going to say the speaker is the host of their own belly. I'm definitely the host of my own belly. I love that.

Well, belly dancing is excellent. I'm doing a bit of a belly move now. It's because it's all about the breathing and feeling relaxed in your body. I think that sounds wonderful. So can we just, I want to really get the point across that it doesn't matter if you stumble. It doesn't matter if you say, uh, does it? No, I don't think so. No.

Just pick it up. It does matter how you feel er does it no I don't think so no just pick it up it does matter how you feel about it that's the difference so as long as you don't care that you've made that mistake it doesn't matter but if the audience can feel you berating yourself even in the expression on your face or in the hesitation hesitation in your voice then it's going to be a problem if you're doing a presentation in a relatively problem. If you're doing a presentation in a relatively small room, or you're making a speech in a big hall, is it a good idea to pick on one individual and focus in on them? Well, I know in a good way and aim the stuff at them. I think for people who are not very experienced, that can be a really great way in. And I always say to people,

look for the warmth in the room, you know, look for the person who is listening. Now, I'm a really great way in. And I always say to people, look for the warmth in the room. You know, look for the person who is listening. Now, I'm a really, really fantastic audience member. There are many moments when I think I should not be on stage. I should be in the audience giving love to the performer. I'm really good at doing that. And there's always somebody in the room who is on your side and who's listening to you.

And if you can find that person and try and almost in sort of ready break kind of way like feed off their warmth and do it for them then you can ignore all the other people who have what i would call strange listening faces many people have a strange listening face they certainly do and in my experience they're often on the front row and they will fold their arms. Yes. Don't look at those people. No, don't look at those people. You can't feed off their negative energy. It's going to destroy you.

But also you can hear surprising things even after comedy. You know, you can sense negativity in a room very easily. You know, we're all drawn to the negative. I mean, that's why social media is such a mess. Like negative emotion spreads really easily and you have to protect yourself against it and when you're doing comedy you can feel negativity sometimes and often I've spoken to people afterwards and said you really didn't look like you were enjoying that and they'll say no I loved it it's just I don't really laugh that's something well don't go to comedy then no but you know just I think let people enjoy

things in the way they want to. So thinking of your experience with the Evergreens, they perhaps needed to have a little nap at that moment in their lives. I mean, I feel like having a nap now in this heat, but apparently it's not impacting on you. I can see your eyelids drooping. I mean, I'm willing to say what my worst speaking thing was. What's your worst one been?

My worst is when I stumbled through a very early Edinburgh preview. I've done five years of Edinburgh show. That's comedy, that's so hard, Viv. Yeah, I've done five years of it now, so I'm kind of getting there. But first or second year, I did a preview and this man came up to me after I'd performed for an hour

and just said, It didn't work! And I cried all night. Who was that man? He was a red trousered man. That's all we need to know. Yeah. There was a website or there is still a website,

isn't there, for looking at pictures of men in those raspberry coloured trousers? What's your worst speaking nightmare? It was at a prison, which, and this is very serious, I mean, I was invited in, I'm not quite sure why I was invited in, and it turned out, well, to be absolutely honest, three quarters of the room at this women's prison

just got up and walked out during the course of my talk about women in radio. And, yes, it was, I carried on because what else can you do? And I certainly don't blame them for walking out. I mean, they walked out the room, they didn't walk out of prison. And it certainly made me ponder on, but you've just got to, you've got to plough on. Well, you've also got to set your expectations correctly.

So, for example, there probably wasn't a speech that you could have done. No, I don't think there was. In any universe, you know, that was their free time that you were encroaching on. Absolutely. And who can blame them? I don't. Who knows where they went, but not to be in your presence is clearly, but there are moments when you have to accept that this is not going to be amazing

and I just have to get through it and it's not the end of the world. It isn't. So let's focus on the positive to finish. What about your best experience? Our best experience is when you're doing comedy and you know that people just get it and they get you and you've got more good stuff coming up and you know that you're all on that must be an incredible you're

all on the same wavelength that's absolutely amazing and then sometimes actually when I've done other public events where it's got quite serious for no particular reason or quite emotional and sometimes there can be this hush that descends over the room and you can feel oh no I've lost them this is no and then there'll be a release like the applause at the end or almost a sigh and you feel oh no we had a moment then I've sounded a little bit Oprah now but um she's a good speaker oh she's an amazing speaker I've seen her live it's just like an hour passes in in a minute it's incredible yeah, it's the moments where you feel understood. Because I think that's the only reason anybody does any of this is like, I think these things, do you think them too? Or am I all alone in this terrible world? And that moment where you feel, oh, no, I'm not alone. This is going to be fine. That's what it's really about. Viv, thank you very much. I think I wanted to end on a positive. And actually, if you are concerned about making a speech in the next couple of weeks or a presentation, there are some people doing those TED Talks who, not all TED Talks are brilliant, but they're always worth looking at, aren't they?

They are worth looking at. They've become a bit of a cliche. And I think people are a bit tired of them now. But always in the top 10 TED Talks, there are at least six or seven women. They change all the time. Have a look. I find it fascinating. It's always more women. They change all the time. Have a look. I find it fascinating. It's always more women than men in those top 10.

That's interesting. Viv, thank you very much. Really appreciate you hanging around in these temperatures, although not impacting on you, as you've made very clear. So let's just pick up on some of the thoughts about our conversation on vaccinations. I've been told that there were a fair few emails saying that, frankly, vaccinations are a very bad thing

and they didn't like the idea that we had two pro-vaccination contributors on the programme today. Although, as Helen Bedford made very clear, she believes there's simply no argument against vaccinations. So let's pick up on a few of those emails. This is from Carol Ann, who has a daughter actually had a very specific experience and a very unpleasant one, I should say. My eldest daughter had the MMR vaccine and had an allergic reaction to it. This was very rare,

about one in a million. We didn't do the second shot, but split out and she had the measles separately. We lived in Europe at the time. Her siblings are likely to have the same allergic reaction, so we tried to get vaccines separately here in the UK for them, but we weren't allowed. We were advised here in the UK to risk our children. So we have to fly to Europe to get the measles vaccine for each of them because we aren't willing to risk. We are not anti-vaccine at all, but we could do with a little support from the NHS. From Nicky, I think the BBC should look at the part played by the media, including the BBC, in perpetuating anti-vaccine fears. When the big MMR controversy was raging some years ago, some BBC programmes were guilty of giving equal airtime to pro-MMR, supported by 99.9% of all evidence and experts around the world, as to anti-MMR views, supported by one doctor who has been comprehensively discredited and by some worried parents.

This was an improper interpretation of balance by the BBC and effectively and irresponsibly spread the scaremongering. That from Nikki. And if you were around at the time, and I was, Nikki, I think it's fair to say, has a point there. And from Elizabeth, it's very worrying for parents of children with compromised immune systems. During the last measles scare, my four-year-old was being treated with chemo for leukaemia

and was utterly terrified that she would catch measles from immunised children at school. Elizabeth, I'm sorry to hear that you and your daughter had that experience. I hope things are better for all of you now. Thank you to everybody who took part today, enjoyed the programme as ever. Jenny is here tomorrow. Amongst many other things, she's talking about female friendship as we approach, well, I think it is tomorrow, in fact, officially, Galentine's Day, when the world, the female world, unites in celebration of female friendship. That's tomorrow on the programme and the podcast.

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