Thinking About Ob/Gyn
A fresh and evidence-based perspective of all things related to obstetrics and gynecology. Follow us on Instagram @thinkingaboutobgyn or visit thinkingaboutobgyn.com for show notes and more.
Thinking About Ob/Gyn
Episode 11.9 Vaccine Q&A
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We answer vaccine questions head-on, using real numbers to separate online fear from how vaccines, immunity, and public health actually work. We break down why diseases feel “gone,” what the modern schedule really exposes babies to, and how to spot misleading claims around ingredients, autism, and VAERS. Featuring Kate Moloney and our vaccine-hesitant friend Anah.
• why vaccine success makes diseases look eradicated while risk returns when coverage drops
• Stanford modeling estimates for measles, diphtheria, polio, and rubella without vaccination
• meningococcal meningitis basics, who is most at risk, and why outcomes can be catastrophic
• why clean water and sanitation do not explain protection from droplet-spread viruses
• what antigens are and why antigen exposure is far lower than decades ago
• downsides of delaying vaccines including longer vulnerability and more office visits
• aluminum, formaldehyde, and mercury claims explained with real-world comparisons
• “natural immunity” tradeoffs including measles pneumonia, immune amnesia, and SSPE
• long flu and post-viral inflammatory syndromes as quality-of-life consequences
• how vaccine schedules change, why the autism claim is debunked, and what profit incentives really look like
• what VAERS can and cannot tell you, plus how bias and viral claims distort reports
• why newborn hepatitis B vaccination exists, screening gaps, and true serious side effects
• rubella history and why vaccination primarily protects fetuses
1:05 Do We Vaccinate Too Much
3:32 Modeling A World Without Vaccines
6:20 Meningitis And Fast Catastrophes
8:28 Clean Water Is Not A Vaccine
11:02 Antigens And The Modern Schedule
15:44 Why Spacing Shots Can Backfire
16:53 Aluminum Formaldehyde Mercury Facts
22:00 Natural Immunity And Measles Damage
26:16 Long Flu And Post Viral Illness
28:26 Profit Fears And Autism Claims
31:26 VAERS Limits And Bad Math
38:39 Why Newborns Get Hepatitis B
45:09 Real Side Effects And Detox Scams
48:37 Rubella And Protecting Fetuses
51:57 Final Takeaways And Next Steps
Be sure to check out thinkingaoutobgyn.com for more information and be sure to follow us on Instagram.
Follow us on Instagram @thinkingaboutobgyn.
Welcome And How This Works
SPEAKER_00Welcome to Thinking About OBGYN. Today's episode features Howard Harrell and Kate Maloney answering Anna's questions about vaccines.
SPEAKER_01Howard?
SPEAKER_03Kate?
SPEAKER_01What are we thinking about on today's episode?
SPEAKER_03Vaccines. For our listeners, let's welcome back Kate Maloney, our infectious disease expert. And also we're welcoming back Anna, our vaccine hesitant friend of the show. And we're going to discuss some common claims about vaccines that we're hearing from our patients and discuss some talking points about each of those.
SPEAKER_02Hi guys. I just want to start by saying that I'm not anti-vax. I'm pro-information. I've just seen a lot of TikToks and Instagram reels that have given me a lot of pause and concern about what's going on with pumping our children full of toxins and poisons. And I just don't see a lot of good information out there. So I'm just asking questions.
Do We Vaccinate Too Much
SPEAKER_03Okay, well, Anna, thanks for playing along here. And the rules are you're going to ask some questions, and then Kate and I will respond to them and discuss each issue you raise. So why don't you give us your first one?
SPEAKER_02Sure. One thing I see a lot of is we're just vaccinating against too many things. Even if there is minimal risk with some of these vaccines, we're vaccinating against diseases that no one gets anymore. So how do we understand if there's even a point in vaccinating against some of these diseases that have basically been eradicated?
SPEAKER_01This is actually a really valid point. And we don't want to use vaccines for diseases that have actually been eliminated because any risk in that case isn't worth taking. But there's a new study from Stanford University that looked at four major vaccines and what might happen if vaccination rates continue to drop or go away altogether in terms of injuries, in case numbers, and deaths from those diseases. So I guess I would summarize by saying that the reason why these diseases are very rare today is because vaccination has been so successful. But if we start to eliminate them from the vaccine schedule, then what might happen? So the Stanford uh researchers modeled this with various simulations to try and come to an understanding of that.
SPEAKER_03Yeah, and before you get into that data, Kate, I would just say that vaccines, in a sense, are victims of their own success. This is true of a lot of preventative health measures. There are all sorts of things that over time have been built into the systems that we have to promote safety. Think about safety devices in cars or, I don't know, elevators or gas water heaters. They're there, they do their job quietly, they do a great job, and you don't see people dying of gas water heater explosions or elevators that crash out of control down ten stories. Many of our listeners have just never met a patient with polio, and reading about that disease or diseases like that in a historical context frankly doesn't do it justice. So before you get into the simulated data from the Stanford study, I'd also just point out a couple of things. One, we have a greater density of population and a lot more interconnectedness, so it's easier to travel over long distances, and we move around a lot more than we've ever done in the history of the world. So if we were to have outbreaks today, we undoubtedly would have more cases than in historical times where people lived relatively isolated lives in less dense areas. But we also have better intensive care treatments. We're much more able to save lives today than we could have a hundred years ago. So we've seen an improvement in mortality rates. Their number of cases would likely be significantly higher. So what did this Stanford simulated simulation show?
Modeling A World Without Vaccines
SPEAKER_01All right, and I'm gonna summarize here. So this will be a rapid fire of just a few of the diseases, but I do encourage you to go and look at this if we get a website posted. It's it's fascinating, it's straightforward, very informative. So I'm just gonna bring some highlights. Let me tell you about the first one. So measles. In the last 25 years, only six people in the U.S. died from measles. Without vaccines, the model predicts 290,000 deaths over the next quarter century. Measles is so contagious that the model shows it would explode almost immediately. Diphtheria. Its other name is called the strangling angel. So this disease creates a thick leather of dead tissue in the throat that can actually suffocate children. It comes, that's where the diphtheria is the Greek word for leather. It's rare now, but the vaccine, if it vanished, the model predicts an average of 138,000 deaths, with a worst-case scenario reaching over one million deaths. Polio. We associate this with 1950s iron lungs. Modern medicine still can't reverse paralysis that it causes. The model predicts that without vaccines, 23,000 Americans would be paralyzed by polio over 25 years, the equivalent of 1,000 kindergarten classes. Rubella, this is mild for adults, but devastating for fetuses. The model shows that after about 15 years, as unvaccinated children reach childbearing age, we would see a surge in congenital rubella syndrome. About 41,000 babies could be born blind, deaf, or with heart defects.
SPEAKER_03Yeah, and those are those are devastating numbers, taking in and they take into account the fact that we actually can treat them when they get sick better than we ever could before. And despite that, that is just insane. Those numbers are crazy. So again, this isn't assuming that the diseases would be as deadly or as devastating, which is a criticism sometimes that people point out, like we well, we can intubate people, we can do that. This is taking into account the fact that we're better at treating these diseases. But again, with population density and and proximity, today this would just be these sorts of diseases would just be outrageous. And I think it's unexpected by people that those numbers are that high, and especially if if there are folks who question the efficacy of vaccines.
Meningitis And Fast Catastrophes
SPEAKER_01And those are just four examples of vaccines. Of course, somewhere between where we're at now and zero vaccine use is where reality likely will fall, because most of us will still get vaccinated. But we're really close to falling below herd immunity for a number of vaccines, and that's why we're seeing an increase in cases. But I think the point here is that few people are prepared to imagine a world in which we don't have any vaccines. So let's talk for a minute about a different disease and vaccine, meningitis. Meningitis is relatively uncommon in the US, but certain bacterial forms are increasing. On average, 3,000 to 4,000 cases of bacterial meningitis occur annually. However, there has been a fairly sharp increase in meningococcal disease cases, which is meningitis specifically caused by Nceria meningitis since 2021, with 503 confirmed or probable cases in 2024, which was the highest since 2013. Infants aged zero to two months have the highest incidence, followed by adolescents and young adults, with groups age 11 to 24, who account for nearly 30% of the cases. Bacterial meningitis has a high fatality rate, that's roughly 10 to 15%, and can cause severe permanent disabilities such as hearing loss or limb amputation. We've touched on that idea before that death isn't the only consequence of vaccine preventable disease. So while rare, outbreaks can occur, particularly in enclosed settings like college dorms or military barracks. Picture sending your son or daughter to college and he or she opts to stay in a dorm. Though the risk is relatively low, in a time without vaccinations, there would be a higher chance of him or her contracting Niserium meningitis. And if they don't know what the symptoms are, they may just think they have a bad stomach bug with nausea and vomiting, muscle aches, and just maybe trying to sleep it off. This disease can be fatal within 24 hours. And even with prompt treatment, 10 to 15% of the cases are fatal. Survivors can face long-term consequences, including brain damage, hearing loss, limb amputations, or cognitive impairment. You might be familiar with Amy Purdy, and she's a paralympian who did contract Nisurium meningitis at age 19. She was actually on life support within 24 hours and then later had to have bilateral below-the-knee amputations. She also lost her spleen and hearing in her left ear. So, Anna, to get back to your original question, though the numbers are relatively low, the potentially devastating outcomes of some of these cases are still a good reason to vaccinate.
SPEAKER_02Fine. So maybe vaccines serve some purpose. The reels I've watched say that most of the benefit comes from improved waste management and water purification processes, along with things like refrigeration and pasteurization. Although I'll admit a lot of the reels I watch also say we shouldn't be pasteurizing milk. So that's a little weird. But does that model account for that?
SPEAKER_03Well, it definitely does. And that is a common retort that vaccines aren't why a lot of things have gotten better, but our improved water purification and waste management systems, our septic processes and things like that, all these public health measures, which are incredible, have been very important for a lot of diseases and for life expectancy. But those are diseases like cholera and dysentery and other waterborne diarrheal type illnesses. So that's not really the scope of vaccines that we're discussing when we discuss childhood vaccines. So when you hear people mention those issues, it is very true that water purification and sewage systems and pasteurization of milk and a lot of those things have contributed and gone a long way to decrease our total infant and child mortality rates. It's absolutely true. But we're not talking about those diseases. We're talking specifically about vaccine preventable illnesses. So it's really that's really a red herring argument.
SPEAKER_01Like Howard said, public health measures certainly have helped to reduce waterborne illnesses, usually the ones that cause those diarrheal illnesses. But again, that doesn't cover the gamut of illness or the means by which they're spread. So take the flu, for instance. If the water purification systems are as beneficial as they say, then why hasn't this virus essentially been eliminated? It spreads in droplets, so water purification should be able to filter it out, right? It's obviously not that simple, as the 2024-2025 flu season was estimated to have 47 to 82 million illnesses, 610,000 to 1.3 million hospitalizations, and 27,000 to 130,000 deaths. Refrigeration alone helps reduce bacterial growth on food, but it doesn't change the modes of transmission, like the fecal oral route. And fun food fact ketchup was used in the late 19th and 20th centuries to mask the taste of odor and spoiled or low-quality rancid meat due to lack of modern refrigeration. The uh strong, sweet, and acidic profile of ketchup hid the meat's poor quality, making it edible. Just for the uh ketchup and refrigeration fans out there.
SPEAKER_02Okay. Uh I think the 2026 vaccine schedule is still too heavy, though. These babies are small, and all the information I'm reading says that getting five shots at once or a shot with five different things in it, and all of this exposure will fry their developing immune systems. So what's wrong with spacing them out? Isn't it true that the vaccine schedule, all of these things in it at one time, has never been studied? Wouldn't it be reasonable to think that this is why we're seeing so many bad effects from them? We're just giving way more vaccines than we did when I was little or when our parents were growing up.
SPEAKER_03Well, that too is a common claim, and it's simply false that we're taxing the immune system of babies more than we did 20 or 40 years ago. This, I think, is one of the most common things I see misrepresented or misunderstood. So, Kate, do you want to talk about the concept of total antigen numbers? Because that's what's important here.
SPEAKER_01For sure. Let's start with a definition. So, what is an antigen? An antigen is any substance such as a protein, polysaccharide, or lipid that the immune system recognizes as foreign or harmful and triggers a targeted immune response, such as producing antibodies. So, how many antigens are in an actual vaccine? In 1960, children were exposed to more than 3,200 antigens in the combined total of the recommended vaccines at the time. Twenty-five years later, in 1986, the vaccine the vaccines children received still expose them to over 3,200 antigens, mostly from a single shot of the whole cell DTP, the diphtheria tetanus protosis vaccine, that contain roughly every protein the protosis bacterium could produce. As technology and innovation have improved, the current immunization schedule allows children and adolescents to be protected from more disease while receiving smaller amounts of the vaccine components. Today's expanded schedule protects against 16 to 18 diseases, but the total antigen count is about 165. That's about a 95% reduction in the antigen exposure, thanks to precision engineering that strips vaccines down to only the components necessary for protection. Just for numbers' sake, here's a few more antigen components. The uh Hemophilus influenza B vaccine contains two antigens. Hepatitis B has one, MMR has 24, TDAP or the DTAP has two to five. So, according to the American Academy of Pediatrics, babies and young children are exposed to about 2,000 to 6,000 immune-triggering substances, also called antigens, every single day. One scrape on their knee can expose a child to more antigens than the entire CDC vaccination schedule.
SPEAKER_03Yeah, and I think that's an important concept, an incredibly important concept. So we've reduced in my lifetime, for the numbers you just gave, the amount of antigen exposure that children get in the vaccine, which is what triggers the immune response and is what quote unquote taxes their immune systems, we've reduced it by 95% while basically tripling the number of diseases that we protect them from. So any correlations that folks make with just temporal association with vaccines and trends in health or other things like that, or maybe with things like asthma or autism or allergies or things that they think of as being immune related is inherently wrong because we've diminished the amount of immune burden, if you will, by 95%. But this is where I think a lot of folks just don't understand how vaccines work or the difference between the modern vaccines that we have today and older vaccines and the way that they activate or quote tax our immune systems.
SPEAKER_01Yeah, and I really like the way to have some numbers, I think that does help people understand more. I mean, that's what I've said to many patients. You know, they say, well, what if I go and I'm around somebody sick, and I say, What if you walk through the grocery store and somebody sneezes and you walk through that cloud of droplets? I think having some of those numbers and just having people be more aware of that does help them understand that, as we've said, this there's been a huge reduction in overall antigens in vaccines. So it's really no more in that than a daily exposure to what we think of as germs.
Why Spacing Shots Can Backfire
SPEAKER_03And let me reiterate what you said. A child who scrapes their knee is exposed to more antigens in that single event than their immune systems are exposed to in the entire childhood vaccination series over many different years. So anyone who's talking about the concept of overtaxing the immune system simply doesn't have a honestly a basic science understanding of immunity or how vaccines work or how the immune systems work. No disrespect, Anna. On the other hand, what would be the dangers in spacing it out? So this is this is the way these this logic works is well, what's the harm? What's the so what are the harms, Kate, in spacing it out?
SPEAKER_01Spacing out vaccines or using an alternative vaccination schedule is really the practice of delaying or spreading childhood immunizations over a longer period than the standard schedule recommended by the CDC and the AAP, and done due to fears of overwhelming a child's immune system or to reduce the number of shots per visit. The problem with this leaves children unprotected against dangerous diseases like pretussis for a longer period of time. Children's delayed schedules are up to 28 times more likely to get pretussis. This method requires more visits to the doctor's office, which can increase the chances of being exposed to other sick patients in the waiting rooms where they're all still building immunity. And it can also lead to sometimes what we've said more anxiety with kids having to come to the doctor's offices more. The recommended vaccination schedule has been extensively tested, while the alternative schedules are generally untested and they're not evidence-based.
Aluminum Formaldehyde Mercury Facts
SPEAKER_02Okay. Well, Howard, I do feel like I have a basic understanding of science, but we'll get on with this, I guess. Assuming that what you all are saying is true, maybe the difference is that we've put all of these different ingredients in the vaccines. I see a ton of information about aluminum and formaldehyde and even DNA fragments in these vials. Why would we want to inject these known neurotoxins into an infant? I mean, maybe the old vaccines didn't have these toxins in them.
SPEAKER_03Yeah, and I think at the root of this sort of claim about ingredients, you know, read the ingredient list is what we might call chemophobia, or just fear of everything that's made out of a chemical, which is everything in the universe. So a lot of people would be afraid of water if they knew that it was also called a hydrogen monoxide. There's also this purity doctrine that believes that there are pure things or pure ingredients or pure elements, and that that feels wholesome. And then there are these combinations of things that are complex and beyond our understanding, and therefore they must be scary and dangerous. So for example, raw milk sounds wholesome, or I guess even pasteurized milk. It sounds like a natural single ingredient, and you'll even see food companies market their products that contain milk, and the only thing listed on the ingredients list is milk. It's one simple, simple ingredient. But in fact, milk contains hundreds of different chemical compounds, including virtually everything that chemophobes are scared of. It contains water and lactose, of course, and glucose and galactose, but other oligosaccharides that essentially are all what constitute high fructose corn syrup that people won't eat, that everybody's afraid of. Plus, it contains all sorts of lipids and phospholipids and sterols and dozens of different proteins and enzymes, even insulins in it in milk that you buy, dozens of minerals and vitamins, along with a ton of bioactive enzymes and a lot of different hormones. It has several dissolved gases, it has several non-protein nitrogens, and more importantly, virtually everything that you see on an ingredients list for products that people are scared of is contained in milk. And more to the point to this question, milk that you get from your cow contains formaldehyde, aluminum, and mercury, and a lot more than vaccines do.
SPEAKER_01Speaking of formaldehyde, did you know it's a natural byproduct of human metabolism? And a baby actually has higher levels of formaldehyde naturally in their body than what's in a vaccine. So just for some numbers again, formaldehyde, an average two-month-old infant naturally has about 1.1 milligram of it in their blood at all times. And to be specific, it's a byproduct of DNA synthesis. A vaccine contains less than 0.1 milligrams of formaldehyde. The body's metabolism doesn't distinguish between natural and injected molecules. So another for reference, if you take a pear, you get at the grocery store, a 200 gram pair contains up to 12,000 micrograms of formaldehyde. Vaccines contain up to 100 micrograms of formaldehyde in a pair. Now let's talk about aluminum. It's the most common metal in Earth's crust. Babies ingest more aluminum through breast milk or formula in the first six months than they receive in all the vaccines combined. For numbers again, compare the 4.4 milligrams of aluminum a baby gets from vaccines in the first six months to the 7 milligrams from breast milk, 38 milligrams from standard formula, or the 117 milligrams from soy-based formula in that same period. And mercury. Let's talk a bit about mercury. First of all, it's one of the chemical elements you find on the periodic table. Look for the HG symbol, and it's the only one that's the liquid metal at room temperature. Humans have used mercury for medicinal, industrial, and artistic purposes for centuries. It used to be used as a treatment for syphilis, and there's an old phrase, a night with Venus, a lifetime with mercury. For all the fans of Lewis Carroll out there, the ever favorite character of the Mad Hatter, will hearken back to the time when habitashers or hat makers use mercury to help make the felt that went into hats. Unfortunately, that exposure could lead to neurologic symptoms, and that's again, if you're familiar with that character, that's what that was based off of. There are different types of mercury. There's methylmercury and ethylmercury, which are both organic mercury compounds, but they differ significantly in toxicity and metabolism. So the methylmercury accumulates in the body. It's got a long half-life, approximately 50 to 70 days. And this is the bad kind that's found in fish and can cause harm. The ethyl mercury found in some flu multidose files breaks down and clears from the body quickly in only about 10 to 20 days, making it far less likely to accumulate.
SPEAKER_03And most of us aren't getting any mercury exposure in modern vaccines because most of us are getting single dose flu shots and single dose vaccines. So you don't have to give your child any mercury and you don't have to get any mercury if you don't want it. But if you did, it's completely safe.
SPEAKER_02For some of these milder diseases, why don't we just allow children to get infected and develop natural immunity? After all, isn't natural immunity stronger and more robust than some lab-grown shot? Why aren't we letting our kids build up real immune systems? Our parents all had chickenpox and measles and they turned out just fine.
Long Flu And Post Viral Illness
Profit Fears And Autism Claims
SPEAKER_01So our parents who had chickenpox and measles turned out fine because they survived the illnesses and had us as children. The problem is an individual has to survive those illnesses in order to have children to be able to talk about the parent. Unfortunately, that's the problem here. We don't hear the stories of the people that didn't survive, and they don't have the children to continue the legacy. Take measles. Besides the disease itself, there are significant complications associated with it. Measles pneumonia is a severe respiratory complication from that condition and can potentially be fatal. It's the leading cause of measles-related deaths in young children and can actually occur in about one to twenty children with the infection, which is a pretty high statistic. These kids can get high fever, severe cough, and respiratory distress, also causing a high rate of hospitalizations. So going back to the original question, our parents did just fine. Like I said, the ones that got through the disease okay did fine, but there were plenty of kids that didn't or suffered a lot of these complications going through the disease. There's also an immune phenomenon that measles can induce, and it is called immune amnesia. This is where measles, the measles virus actually has the ability to destroy the body's immune memory cells, those B and T lymphocytes, and it causes it to forget how to fight off infections that they previously encountered. So basically, as we go through life, we build up our own immune library based on those exposures. This library can all get wiped out due to one virus, the measles virus. So it's basically going back to square one as far as someone's immunity. You also become more vulnerable to those infections that you previously had and built up the immunity to. If that happens in a child, it can take another three to four years to build back up that immunity that they had through their memory cells. So did you have chicken pox once when you were little and told that would be it? Well, unfortunately, if you happen to get measles and the immune phenomenon, be ready for it again. Let's go over another really devastating effect associated with measles. It's got a big long name. It's called subacute sclerosing panencephalitis or SSPE for short. This is a fatal progressive brain disorder caused by a persistent mutated measles virus, usually occurring six to ten years after an initial infection in children or adolescence. Symptoms include cognitive decline, personality changes, severe myoconic jerks, and later loss of consciousness going into a persistent vegetative state. And it's incurable, typically fatal within the one to three years. Keep in mind it's characterized by what appears to be a normal, unremarkable recovery from measles, and the symptoms can appear years later. For every 100,000 children or adults who get measles, between four and eleven of them will develop the SSPE. Again, it's relatively rare, but if measles numbers increase, it will also increase. Large outbreaks were driven by low vaccine coverage and imported cases, with significant activity reported from South Carolina, Texas, New Mexico, and Arizona. Most of these cases involved unvaccinated individuals prompting extensive public health responses. So this is another case too, all just good reminders. Anna's brought up good points and say, why don't we try natural immunity, et cetera? But hopefully this is really telling about look how one illness, look how measles, how much problems it causes in the disease itself, and look at the aftereffects. Speaking of after effects, I do want to talk about another phenomenon that people may be more familiar with. And this actually just involves some of our more common respiratory illnesses. So think of influenza, think of the flu. There's been a change or a shift in what we're describing now, and it's something called the long flu. You've heard long COVID before, and even RSV, respiratory sensational virus, can have the same thing. And what this is a kind of lingering set of symptoms that can persist for weeks or even months after an initial influenza infection. And often includes a persistent cough, profound fatigue, and shortness of breath. Similar to long COVID, it's a postviral state that can involve like a brain fog, anxiety, rare cases affect other organs, cardiovascular kidneys. I've actually seen a good bit of this in adult infectious diseases. One person even had severe renal issues afterward, briefly on dialysis. I've seen cardiac issues. In one sense, this actually helps me explain to people what a post-infectious inflammatory inflammatory state is. Some people come and they want more treatment, they want another round of Paxlovid. But unfortunately, I tell them you can swab that nose all day long. The PCR, the actual virus, is no longer there. What's left is just this inflammatory state or process. It's similar to what's gone on for many years with Lyme disease. People that become infected with the richetial illness have the initial symptoms, but then afterward, and when it's no longer detectable in our tests, they can have chronic symptoms, fatigue, joint pains, uh, some of that same brain fog. So in in my job, the long flu or long COVID actually has been more prevalent for people, and it does help them understand a little bit more about what people have gone through for some of these other chronic diseases that almost result in a rheumatologic process. So again, these are things that certainly affect quality of life. You may not have the actual disease anymore, but this is another really good reason. There's reasons for kids, there's reasons for adults, for people to still continue to get vaccinated. It's not just the disease itself, it can be some of the long-term sequelae as well.
SPEAKER_02Another thing I wanted to bring up is that it feels like it's all for profit. If the CDC is changing the rules in 2026, how do I know they're not going to change them again in 2027? And what about the link to autism that keeps being brought up by influencers?
SPEAKER_03Well, vaccine schedules are constantly changing. And one of the reasons is we create better vaccines with fewer numbers of antigens, like we've discussed, safer vaccines. And for some diseases like the flu and pneumonia, and we're also constantly changing or refining which strands or types we want to cover in anticipation of how those diseases change. So we do have to change it, and we're making them safer and more effective and preventing more illnesses. I think one of the most powerful concepts to understand is this idea, again, about the number of angens that we're exposing children to today compared to when I was little. So we're very much interested in minimizing adverse vaccine reactions and giving fewer shots on a more schedule that's easier to follow with fewer antigen exposures. And so we've been very successful in doing that, and that's why we changed the vaccine schedule.
SPEAKER_01And as far as autism goes, I would invite listeners to go back to the last time I was invited on the podcast on season 10, episode 12, where we talked about the different types of vaccines, and specifically we spent more time on the autism link, which has been thoroughly debunked, and no legitimate scientist believes it at all. As far as profit is concerned, for most companies, vaccines are actually lower profit than the blockbuster drugs that use to treat chronic illnesses caused by the viruses. So there's a lot more money in letting hundreds of thousands of people get sick every year than there is in preventing it with inexpensive vaccines. On the other hand, the supplement and alternative health industry is worth almost four and a half trillion dollars a year selling unproven detoxes and supplements and other treatments without any scientific evidence of efficacy or safety.
SPEAKER_03I think one good evidence of that too is insurance companies. They're very happy to pay for the full vaccination schedule and every vaccine people are wanting to get because their profit motive is to save money. And every they know the return of an investment of every time they give a vaccine, how much money they save in the long term on hospitalizations and things like that. They know the numbers needed to treat, they know the numbers needed to harm, and they know that vaccines save them trillions of dollars in expenses, and that's why they pay for them. So I think it's always fair to look at profit motives, and I don't think that Kate and I are fans of big pharma or fans of big insurance or fans of anything else, but we are fans of science. And vaccines save lives and save money, and we should be proud that we're producing safer vaccines with fewer shots and protecting against more diseases with fewer antigen exposures.
VAERS Limits And Bad Math
SPEAKER_02Okay, I hear you all. But you also didn't talk about the VARES database. Most of the stuff I see about potential harms from vaccines comes from that government database.
SPEAKER_03Okay, so the vaccine adverse event reporting system, or VARS, V-A-E-R-S, is a government program that was created to allow patients and physicians and other healthcare providers to report adverse events that might potentially be related temporally or otherwise to vaccines. So anyone is free to go there and report literally anything that you want to and what vaccine you think is involved with that and what happened. Now, if you that means if you believe that your child, I don't know, tripped and fell down the stairs and twisted her ankle due to receiving a vaccine a week before, you can go there and you can file that report. Child got MMR and a week later they made them weak and they twisted and fell down the stairs. Whatever you want to say, you can put on there. So this isn't a scientific database, and it was never intended to be. So there are claims made about the VARES database that are simply outrageous in the anti-vax community. So, for example, there are widely reported claims that almost 50,000 children per year are killed by vaccines, and folks use the VARS database to make that claim. And how they do it is they say that in every in any given year of data, there's about four to five hundred children who are reported as dead for some reason into the database, and then they say take separate data that says that only 1% of adverse events are even reported, and then they just multiply 4,500 kids a year dying by 100, and they come up and claim that 40 to 50,000 children every year are dying from vaccines. And that's crazy.
SPEAKER_01And while I do appreciate the use of mathematics, that's absurd at its face. Only about 9,000 children under the age of 14 die each year in the United States of all causes. And the causes of death for these children are almost always known. Most of them are accidents. There's a famous example of how easy it is to report anything you want on that database. Dr. Jim Laidler, who was the anesthesiologist in Oregon, he filed a report that was accepted into the database that claimed he received a vaccine, the flu vaccine, and it turned him into the incredible Hulk. He facilitated this being removed later on, but the point is that anybody can go on there and say anything in the reports, and it's accepted in the database, and they really are unverified. They're not checked for any medical medical accuracy, and they don't require any assessment or confirmation at all.
SPEAKER_03He didn't have to submit a picture of him ripping through his shirt with his powerful green arms.
SPEAKER_01Apparently not, or that might have caught him.
SPEAKER_03Yeah.
SPEAKER_01So but uh in theory, the database captures the adverse events uh following immunizations. And even when there is when this is true, where someone legitimately goes on to report that their child received a vaccine and then had a seizure or an allergic reaction or something like that, we still have to distinguish between association and causation. This happened a lot with the COVID vaccine. In any large population, a number of strokes, heart attacks, and deaths occur every day, simply by chance. So if you vaccinated 100 million people, thousands will coincidentally have a medical emergency shortly after. But these sorts of associations have been taken as solid evidence that the COVID vaccine causes these diseases. But you need a control group. You at least need to understand what the background rates are of the adverse events that you're examining.
SPEAKER_03Yeah, there's a couple of other areas where this database is subject to significant bias. So you can see trends or upticks in certain diseases or complications or problems in the database right after or shortly after there are media reports or social media viral posts that report about a specific claim side effect of a certain vaccine. So maybe paralysis after, I don't know, the HPV vaccine. Maybe a story goes viral, and then you can look in the database and you can see a rush to report all sorts of these sorts of claims, and it makes it look like the number of cases are increasing or complications are increasing. It makes the association look stronger, or things like that. But again, there's no denominator. So people are just reporting because sometimes because they want to make the numbers look better, or they were just reminded, or they think that there's a solid link and they remember back that maybe their child had a problem like that and they rush in and report it, and then people derive data from that and say, oh, the rates are increasing and going crazy. The anti-vaccine community has a special interest in reporting in the database. Anything that they hear, secondhand, third hand, fourth hand, sometimes reporting the same case over and over again because people have heard about it in the community, and they all go on and make similar complaints. But this sort of what we'll call contagious reporting can lead to apparent spikes in side effects or other complications that aren't actually real. There's also a lot of evidence that a significant number of reports specifically related to conditions like autism and thymrosol, which was the mercury-containing additive that is no longer present in single dose vaccines and flu shots, that these were filed by personal injury attorneys or individuals involved in active litigation rather than by the parents or by healthcare professionals. And remember, this is actually RFK Jr.'s industry, his job and how he's made money, he works for personal injury attorneys, and his job is referring vaccine injury cases to these personal injury attorneys, and he uses his reputation and his platform to solicit these cases. And so if somebody like RFK Jr. goes out and says that Tylenol, for example, causes autism, then patients come to him and say, Well, my child had autism and I took a lot of Tylenol while I was pregnant. Or if he comes out and says that the Gardasil vaccine causes seizure disorders, then every mom in America hears that, and if their child happened to develop a seizure disorder in some type of proximity at all to the gardacil shot, then they'll rush to the VARIS database and report it, and they'll go to him, and he sells these cases to trial lawyers. So that's that VARIS database is used for bias, but it's really meant to be an early warning system to help legitimate scientists find possible problems.
Why Newborns Get Hepatitis B
SPEAKER_01Yeah, the best use of the database is as a hypothesis generating tool. So we use this during COVID to understand that the Johnson ⁇ Johnson code vaccine was associated with thromboembolic risk due to a signal that was being observed. And then the researchers were able to use closed loop systems like the vaccine safety data link to look for actual causation. That's why the database exists, but it's being misused and misinterpreted. It was just supposed to be an early warning system.
SPEAKER_02But doesn't the fact that the CDC just removed six routine vaccines from the required list prove that they recognized that children were being given too many vaccines? I mean, a year ago the hepatitis B vaccine was mandatory, but now it's just a conversation with mutual decision making or shared clinical decision making, I think is what they call it.
SPEAKER_03Well, this is definitely one that I'm hearing all the time now as an obstetrician. So long before the current change to the government's vaccine schedule, patients routinely wondered why. I mean, my whole career, why would you give your newborn a hepatitis B vaccine while they're still in the hospital when we have already tested the mother and her hepatitis B status was known and it was negative. She doesn't have hepatitis B, and you're giving my baby the hepatitis B vaccine. And I think talking about this concept or this vaccine a little bit more detail is actually a good example of how we make vaccine policy and how we design public health systems to combat disease. And if you understand why we do or encourage hepatitis B vaccine, a lot of the other ones will make more sense. So, first of all, if an infant uh becomes infected at birth, there's a 90% chance that that infection will become chronic. And of those infants who are infected chronically, about a quarter of them will die prematurely from cirrhosis or herpatocellular carcinoma.
SPEAKER_01Yeah, it's much worse for an infant to acquire it than an adult. Only about 5 to 10% of adults who are infected become chronically infected. You can see that uh as evidenced when you do a hepatitis serology panel, and you'll see people that have cleared it on their own. But the newborns lack that mature T cell response that's required to clear the virus, so you've got a really narrow window of time to make that difference.
SPEAKER_03Okay, so it's an important disease, I think, is the point. And if we can prevent it, we should, and we can prevent it, most of it. Then there's just problems with screening. And so in a country where millions of babies are born every year, there are going to be babies born to mothers who have not correctly been identified, the mothers, as being hepatitis B negative. We've missed this out. There are several reasons why this might happen. First, there's just screening gaps due to a lack of prenatal care or late or poor prenatal care. We think that actually about 12 to 18% of pregnant women in the United States don't ever receive a prenatal hepatitis B surface antigen test because of a lack of prenatal care or late entry into care. And they may show up and have a baby and have hepatitis B and we didn't know about it. And giving the child the vaccine will help. Then there are just mistakes in medical records where the result of the lab is just recorded incorrectly. It's rare, but it happens. And again, over millions of tests and millions of births, even rare mistakes add up. It also happens that clinicians will just order the wrong test. They may order the hepatitis B surface antibody rather than the hepatitis B surface antigen, and this will lead to a false sense of security in a chronically infected mother because the one test will be negative, and if they don't order the right test, it'll be positive. Then, of course, there are also mothers who acquire hepatitis B infection late in the third trimester after they've already been tested early in their pregnancy, and their test was negative, but now they've acquired an active infection in the third trimester and they go on to have a baby. And again, we wouldn't give the vaccine if we were just going off of that early test.
SPEAKER_01Yeah, no test is perfect. And Harold, what you just said, hepatitis B is particularly tough to interpret. There's about four different parts, and you'll you need to know what the positive and the negative in chronology to get the interpretation correct. So you talk a lot about how people get too much in the habit of thinking in binary terms when interpreting tests. Lay people certainly do this, but clinicians do too. But the false negative rate for the Eliza kids is as high as 0.6%. And for more rapid tests, it can be as high as 6%. In other circumstances, it can be even worse. Up to one in 10 women who have HIV can actually have a false negative result from some of these tests. And there are even patients who will have an extremely high titer, and this will cause a false negative result. This is called the hook effect, and you and Antonia actually talked about it when you discussed syphilis testing on a previous episode, which I listened to as well and give it the ID stamp of approval.
SPEAKER_03Oh, thank goodness. Okay, yeah, so the saving grace here is only that hepatitis B is relatively unusual in the United States. There are only about 0.6 cases per 100,000 Americans, but there are perhaps a couple of million Americans who live with chronic infection. Many of these are older patients, and so they're not of reproductive age. But we do think that about 25,000 babies, because we're dealing with millions of births, about 25,000 infants are born annually to mothers with a hepatitis B infection in the United States. And this rate's been slightly increasing. So if 0.6% of them have a false negative test, then at least 150 women, if everybody got screened, 150 women and their infants will be missed by the best testing done prenatally. But of course, in this population, we're also talking about the risk factors of less prenatal care and other things like that. So a lot of them don't get tests. And so when you add all that together, we think that about a thousand. Infants a year are born in the U.S. to mothers who have hepatitis B infections, and we didn't know it at the time of birth. And therefore, we're sparing a significant number of those newborns chronic hepatitis B infection by giving people, giving the babies a hepatitis B immunization in the hospital after birth.
Real Side Effects And Detox Scams
SPEAKER_01So from a public health perspective, the question is only, what are the negatives of giving the hepatitis B vaccine to newborns? Because it is clear that some number of children are safe from a lifetime of hepatitis B and early deaths by routinely giving everyone the shot. So it's a risk and a benefit assessment. And the question then is only what's the negative of giving the shot? And I think that's really what people like Ana are asking. But the true negative events that do occur are being magnified on social media. But most of the disinformation and misinformation about vaccines that's on a scene are just lies that either come from genuinely interested people who don't understand the science or from bad actors who are looking to make money by scaring people and creating fear.
SPEAKER_03Okay, so then the question is what are the true negatives? And we can stick with hepatitis B, because what's true for hepatitis B is true for most vaccines. The common things are mild side effects like redness or swelling at the side of the injection. Sounds like a TV commercial, and perhaps a mild elevation in the temperature that's usually of no consequence, almost never of any consequence. And of course, the baby may be more irritable or fussy shortly after the administration. Some may get diarrhea or even a temporary loss of appetite. And if these things sound similar to what might happen to a child who gets the common cold, well, they are, and they happen for the same immunologic reasons. It's just an immune response. It's not associated with any long-term adverse effects. The more serious adverse events are essentially anaphylactic or allergic reactions. So we think that anaphylaxis occurs in about one out of every million doses for a newborn who would receive it. And we're ready for that when it happens. And this almost never results in death or permanent injury, because we're prepared for that one in a million cases when it happens. They're getting this in an office or hospital setting in case they have an anaphylactic reaction. But here's the real bottom line. If the hepatitis B vaccine does cause an anaphylactic reaction in what, four babies a year in the United States, we have about 3.0 million births, but it saves a thousand children from chronic hepatitis B infection and early deaths and cancers potentially associated with that, then that's a great investment.
SPEAKER_01And social media will of course talk about sudden infant death syndrome and autism and multiple sclerosis and autoimmune disorders. But we have multiple and extensive peer-reviewed research that shows no link between the hepatitis B vaccine and any of those conditions, including things like type 1 diabetes or asthma.
SPEAKER_02Well, my rules are also full of heavy metal detox protocols for kids. But I guess what you're saying is those are probably not going to do anything since the combined amounts of aluminum and mercury in all vaccines is less than what children normally receive in their normal diet, even in breastfeeding.
SPEAKER_03Yeah, as a general rule, anyone who's selling anything that mentions the word detox is a con artist. Our bodies do all the detoxification necessary with our liver and kidneys.
SPEAKER_01And Anna, if you want your liver to continue to be able to detox, then you don't want to have hepatitis B, and you certainly don't want your children to have hepatitis B. The truth is we live healthier and longer lives than we've ever experienced in human history. And there are lots of reasons for that. But vaccines are certainly a big part of it. By the time your child is two years old, vaccines have already protected him or her from 14 deadly diseases: mumps, measles, rubella, polio, hepatitis A, whooping cough, rotavirus, varicella, hepatitis B, influenza, diphtheria, tetanus, haemophilus influenza, and pneumonia. All of these vaccines have been subject to placebo-controlled trials for both safety and efficacy. And all of these vaccines are safer today than they were 20 years ago or 40 years ago when there were more antigenic parts to them, meaning that newborns will have fewer side effects, and if you have problems receiving the vaccines, there'll be fewer shots. These are all good things, not bad things.
SPEAKER_03As an optetrician, I want to talk for another minute about Rebella. So when you're we're going through that list earlier, this reminded me of the principle of, again, out of sight, out of mind. Most people on social media today don't personally know anyone who's had any of those diseases except maybe the flu or pneumonia or or things like that, and that predominantly among individuals who were likely unvaccinated. But rebella is one I think we should talk about again for just a minute, because that article that we started the show with said that if we didn't have the Rebella vaccine, as many as forty-one thousand kids a year would be born blind, deaf, or with heart defects. I've never seen a pregnancy personally affected by Rebella. But up until about 1940, the German measles was something that most children, if they had it, they had minimal symptoms like a mild fever or a bit of a rash. It was called the German measles, by the way, because German physicians in 1814 distinguished it from regular measles or rubiola and from scarlet fever. But in 1941, Norman McAllister Gregg, an Australian ophthalmologist, noticed a cluster of congenital cataracts in infants, and he went back and looked at 78 cases and found that almost all the mothers had contracted rebella in the first trimester following a 1940 epidemic in Australia. Prior to that, it wasn't known that viral infections could affect a developing fetus. So he established this idea of the congenital rebella syndrome and proved that what otherwise was thought of as a minor virus could have devastating developmental consequences for pregnant women. In 1964 and 1965, there was a huge global pandemic of rebella. In the United States, there were about twelve and a half million cases and twenty thousand cases of congenital rebella syndrome that followed. This resulted in 11,000 miscarriages, or in some cases therapeutic abortions, and 2,100 neonatal deaths. And we learned about the blueberry muffin baby, which is a term used to describe the purpura resulting from extramedullary hematopoiesis in the skin as the fetal system struggles to compensate for the damage caused by the virus. Greg gave us the Greg triad that we learn about, which were ocular defects like cataracts, glaucoma, and microthalmia, cardiac defects, including patent ductosoteriosis or pulmonary artery stenosis, and auditory defects, including sensory renal deafness.
Final Takeaways And Next Steps
SPEAKER_01Yeah, I guess we got a history segment in there after all. But it's a great example of a virus that people think of as minor because most of the children or adults who would acquire it had very limited symptoms, and those pandemics were not necessarily deadly for the children or adults, but they were absolutely devastating for pregnant women, killing tens of thousands of babies worldwide. Every time there was an epidemic and blinding or deafening thousands more. But we think that the mortality rate for the postnatal rubella is less than one and two hundred thousand infections. That compares to a mortality rate of about one and five hundred and one in a thousand for measles. So the goal of vaccination is to protect the fetus. But all of this is a great example of an absolutely tremendous benefit of vaccination that most modern people are completely unaware of.
SPEAKER_02Well, I appreciate you all both answering my questions and you know letting me ask it in a safe space. You've certainly given me a lot to think about. And I've got to say I'm pretty optimistic that maybe I'll be able to come on the podcast another time because I have plenty more questions.
SPEAKER_01All right. Anna, thanks. And Harold, thanks for letting me join once again.
SPEAKER_03All right. Well, thanks again, Anna, for being on and being a great sport, and Kate for your expertise. And we certainly have another episode for Kate planned a little bit later on where we get into the management of some infectious morbidity from obstetrics and gynecology. So we'll look forward to that, and we'll see you guys in a couple of weeks.
SPEAKER_00Thanks for listening. Be sure to check out thinking about obgyn.com for more information and be sure to follow us on Instagram. We'll be back in two weeks.