Sawbones: MAHA Mess

Speaker 1 Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun.

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Speaker 1 Tom is about to books.

Speaker 1 One, two, one, two, three, four.

Speaker 1 We came across a pharmacy with its windows blasted out.

Speaker 1 Pushed on through the broken glass and had ourselves a luck around. The medicines, the medicines, the Escalant macabre for the mouth.

Speaker 4 Hello, everybody, and welcome to Sawbones, the Meridur of Miss Guy and Medicine.

Speaker 9 I'm your co-host, Justin McElroy.

Speaker 10 And I'm Sydney McElroy.

Speaker 5 Hey, I want to say something up front because I always forget to do this.

Speaker 11 On Thursday, we're going to be in Columbus with my brother, my brother, and me.

Speaker 12 That's right. New up-and-coming act.

Speaker 11 We're going to be supporting them.

Speaker 15 If you go to bit.ly forward slash McElroy Tours, you are going to be able to see a ticket link there where you can buy tickets to see that show.

Speaker 11 It's on June 19th at 7 p.m.

Speaker 12 Come on out. It's going to be fun.

Speaker 10 It's going to be a great time.

Speaker 16 Yes.

Speaker 13 Now, Sydney promised that when there was, we, we, if you'll remember the news from from a couple weeks ago, there was a real thorough purging of one of the nation's big councils on advising

Speaker 13 our sort of health policy in the nation.

Speaker 17 And they sort of wiped the wiped the slate clean with a lot of people who are pretty starn smart about vaccines.

Speaker 5 And we said that when we replaced them with a new crew of, I'm sure,

Speaker 14 real winners, qualified superstars in the healthcare world, that we would be back to, I mean, sing their praises and throw, you know, throw the matick or tape right.

Speaker 19 Sydney, I can't wait to hear about, I just saw the headline that they replaced all those people so quickly.

Speaker 11 And that's what was really exciting to me. I was surprised that almost as quickly as they had found a reason to get rid of all the other people, they had found new people to replace them.

Speaker 19 It must have been a very thorough search, I guess, beforehand.

Speaker 10 It was not a typical search, I will say. And we're going to get, I want to walk through the history of the search.

Speaker 10 They just asked ChatGPT to fill in the panel, and that was who they got.

Speaker 19 Who's the worst?

Speaker 10 So we are going to talk about the advisory committee on immunization practices. Who are the new members? I want to give you some background on it.

Speaker 10 We'll go through some history of why do we have it and why is it important.

Speaker 10 I did, I called this episode in my notes. We got an email from one of our listeners that was titled Maha Mess, as in Make America Healthy Again, Maha Mess.
And I just, I appreciated that, Christine.

Speaker 10 And so I use that as the title of this episode. This isn't the entire Maha Mess, but this is, I would say, a big piece of it.

Speaker 10 And I think that

Speaker 10 In the email that Christine wrote, there was a really great question about RFK Jr. that I think is important to

Speaker 10 understand as we talk about these new, these changes to the way government looks at health and science. Right.

Speaker 10 And that's that one of the things that he has recently stated support for is removing direct-to-consumer advertising of

Speaker 9 pharmaceuticals,

Speaker 10 which We here at Sawbones agree with, right? We've talked about that it doesn't make sense that we do that in this country. Most of the world doesn't.

Speaker 10 It is extremely difficult to tell from a commercial whether or not you need the medication. They're incentivized to convince you you do.
It's a commercial. It's an ad.

Speaker 10 So it really doesn't make much sense to advertise.

Speaker 10 a prescription medication directly to a i mean a consumer in that model but you can't just consume it you have to have it prescribed so that you know it doesn't make sense so like that's something that i would agree with yeah we shouldn't do that now we are coming at it from different perspectives.

Speaker 10 I think that I don't think that big pharma has an agenda to keep you sick in order to sell you things to make money. I think that it's a company, so it is designed to profit.

Speaker 9 Yes.

Speaker 10 I think tying insidious motives when the motives... I mean, they're pretty clear, like profit-making businesses want to make profit.
We should take profit-making out of medical care.

Speaker 10 But I think from RFK's perspective, it's part of some grander conspiracy. Everything is, right?

Speaker 17 It's all things.

Speaker 10 But that sort of grain of truth of a good idea within a lot of misinformation is exactly why he is dangerous and why the Maha movement is dangerous.

Speaker 10 Is that if you read the entire report, which I don't, I mean, unless you're having trouble going to bed, although then you might have nightmares, so maybe don't.

Speaker 10 The idea that we need to eat,

Speaker 10 you know, more vegetables is probably true. I mean,

Speaker 10 you know, we should. And like, there are good things in there in terms of like, we should all be active.
It's good for you. It feels good to move your body as much as you can.

Speaker 10 You know, it's good to eat a wide variety of foods. It's, I don't know, drink water.
Like, those are sort of standard things that, yeah, I mean, that's not bad advice.

Speaker 10 But then to tie that to the root of all disease and to insist that those are cures in a way that medicine isn't

Speaker 10 based on no evidence whatsoever. whatsoever.

Speaker 18 That's a recognition of the correct problems with like the absolute worst possible solutions.

Speaker 10 Exactly. So

Speaker 10 I think it's an important point to make. There are going to be things that he says or that doctors or people that he employ says that are true.

Speaker 4 Right.

Speaker 8 It's that grain of truth.

Speaker 12 Yeah.

Speaker 10 And, you know, it should be funny. There was a recent article that he may believe in miasma theory.

Speaker 9 Oh, wow. Yeah.

Speaker 10 We've covered miasma theory.

Speaker 10 It would be funny if it wasn't so terrifying.

Speaker 17 We live in.

Speaker 10 Yeah.

Speaker 10 But

Speaker 10 he may well believe in miasma theory. Although I also don't know that he knows what miasma theory is.

Speaker 10 I found the

Speaker 10 article where he talks about it.

Speaker 10 And he kind of, so the way that he describes miasma theory in a book he wrote four years ago called The Real Anthony Fauci, Bill Gates, Big Pharma, and the Global War on Democracy and Public Health, which I'm just sure is a really really very accurate, good,

Speaker 3 heavy book.

Speaker 10 Uh-huh. He writes, miasma theory emphasizes preventing disease by fortifying the immune system through nutrition and reducing exposures to environmental toxins and stresses.

Speaker 10 That's not what miasma theory was.

Speaker 8 Miasma theory is, if I may,

Speaker 5 bad air make you sick.

Speaker 19 Yeah. Bad air make you sick.

Speaker 10 Yeah, that disease is a sort of a floating cloud that you can contract. That that is, was not true.
And what he is saying is not true.

Speaker 10 So, and that should, I mean, I guess there is a world where maybe these things are funny.

Speaker 10 It's not this one. So let's talk about the Advisory Committee on Immunization Practices, or ACIP.
So

Speaker 10 what is it? This is a federal advisory committee. Okay.

Speaker 10 And its job is to provide expert advice to the CDC, to the Secretary of the HHS, on specifically on like biologics, vaccines.

Speaker 10 What vaccines should we use and who should get them and how strongly should we recommend them?

Speaker 10 And there's a lot of other consequences that come with the recommendations that come from ASIP, but that that is what its primary function is.

Speaker 10 It is how we get the vaccine schedules that you see posted in your

Speaker 10 primary care provider's office. So why do we have an ACIP? Well, this goes back to really the history of vaccines in this country.

Speaker 10 Back in the 40s and the 50s, anytime we would have something like a vaccine or some other sort of biologic that we might want to use widespread in

Speaker 10 the country, we would have to put together like an ad hoc committee, basically. Like the question is, we have this thing.
We think we should give it to people, but we really need a consensus opinion.

Speaker 10 We need to put a bunch of experts together in a room. They need to look at all the science that's available, all the data, and risk

Speaker 10 come up with a solid recommendation as to what the United States should do with this vaccine.

Speaker 10 Okay. And this really came into play the first time with the polio vaccine, the Salk vaccine, in 1955.

Speaker 10 They had to put together a huge committee of people to sit down in a room together and say, what should we do with this? Yeah, we should give it to everybody because it's great and it's fantastic.

Speaker 10 And we're all going to cry because it's so amazing.

Speaker 10 And as we entered sort of the vaccine era at that point, we had to convene more and more ad hoc committees to talk about the, you know, the inactivated polio vaccine that came next.

Speaker 10 And then we had to to talk about the measles vaccine. And it became apparent by the early 60s, we really just need a standing committee.

Speaker 10 We need a group of people whose job it is to come together several times a year, three times a year, look at all the available data on all the different vaccines that are out there and give us recommendations, right?

Speaker 10 Right. And we want some continuity in that.

Speaker 10 We want some people who understand the process because because they've already been part of it to continue to be part of it as opposed to having to like assemble the Avengers.

Speaker 22 And a political continuity of care that continues across. Yeah.

Speaker 10 And then at the time, they would provide regular recommendations to the CDC and actually to the Surgeon General initially.

Speaker 10 And that brings us to 1964 when they decided, the Surgeon General. of the United States Preventive Health Services

Speaker 10 decided to go ahead and establish the first ACIP.

Speaker 10 There was a proposal. It took them two years to put together the first committee.

Speaker 10 And the first ACIP meeting was held on May 25th and 6th, 1964. So my point with that two-year lag is that

Speaker 10 from when they decided to do it to when they convened their first meeting, it took them two years to find all the right people for the job.

Speaker 10 They really wanted to vet people. They really wanted to make sure that the people that they had in that room would be the best qualified.

Speaker 10 And we are talking about experts in the creation of vaccines, experts in healthcare, whether they be infectious disease specialists or pediatricians.

Speaker 10 obstetricians, family practice doctors, internal medicine doctors, all kinds of different areas of medicine, plus the scientists who make the vaccines, who understand immunization and understand, and then epidemiologists, people who would know how best to control the spread of a disease so you want all the best people in the room to do that and at that first meeting they sort of sat down and said okay what is going to be our job and they laid out sort of the boundaries of what the ACIP was so they are going to uh deal with bacterial rickettsial and viral agents toxoids as well so these are all the different things we make vaccines for basically okay so they kind of laid out the bounds of this is what this committee deals with they also deal with immune globulins so sometimes when you've been exposed to something we might give you an infusion of a bunch of antibodies against it.

Speaker 10 That happens. So they are also in charge of that.

Speaker 10 They'll come up with the immunization schedules. They set the dosages.
They set the routes of administration.

Speaker 10 I mean, we're getting to the nitty-gritty, like a vaccine that you would receive, you know, for the most part, we get them in our muscle. Yeah.

Speaker 10 But, you know, if for some reason we needed to do it subcutaneously, they would, they would decide that, like in the subcutaneous tissue. So they set all this stuff out.

Speaker 10 And then also like the priorities of

Speaker 10 who should get them. So first of all, are there any groups in the public that shouldn't get the vaccines because of some contraindication?

Speaker 10 You know, is it not good for a pregnant person or something like that? Or is it a live vaccine and we wouldn't want somebody who is immunosuppressed at that moment to get it?

Speaker 10 So they set those guidelines. And then they also set guidelines on, you know, this one we should recommend only for people 65 and older.

Speaker 10 This one we really need to get before you turn two because that's when you're most vulnerable to these diseases. This one we should give to everybody every year because of whatever.

Speaker 10 You know, I mean, they set all of those kinds of guidelines. And again, all of this was established back in 1964.
And really,

Speaker 10 that hasn't changed much in terms of what they are supposed to be doing since then.

Speaker 10 A little bit changed in that they initially would have the director of the CDC as the chair of the committee, and that isn't true anymore. It was initially only eight members.

Speaker 10 It is obviously expanded to 17 currently. So it got bigger over time, primarily because there were a lot more vaccines to consider.

Speaker 10 You know, the number of vaccines that people were receiving grew through the years because, you know, we got really good at making them and we made a lot more.

Speaker 10 Yeah. And so we needed more area of expertise to bring into the conversation and to bring in people who understood sort of the logistics piece of it too.

Speaker 10 That was something that was added over time, like population health experts. So not just like, what is the vaccine and the science and the medicine, but like, how can we get this?

Speaker 10 out to people, right? So we added people through the years with different areas of expertise.

Speaker 10 There are also ex officio members who represent other government bodies like the National Institute of Health, the FDA, the Department of Defense.

Speaker 20 This group sounds so impressive, Sydney.

Speaker 10 Yeah.

Speaker 8 So impressive.

Speaker 20 It is. It's nice that they put this much work into such a serious thing.

Speaker 10 It is an incredibly, it's an incredibly important, well, it is important for so many reasons. One, because vaccines are,

Speaker 10 if not the greatest public health achievement in history, one of the greatest public health achievements in history. I mean, hand washing is a big one too, but hand washing is so cool.

Speaker 10 Also, fluoride is really great. Again,

Speaker 10 sorry, RFK, but it is.

Speaker 10 But I mean, because they're so so important, it's not only important that we get it right and that we get them out there to people, but that people know that the vaccines they're getting were vetted, that they need them, because the experts all got together and worked their butts off to make sure they were giving them the best information possible.

Speaker 10 That's why it's taken so seriously. And by the way, that has worked well.
Contrary to what RFK would have you believe, the vast majority of Americans, over 80%,

Speaker 10 still

Speaker 10 believe vaccines are safe and effective and are in support of vaccines.

Speaker 10 So, this idea that it's this huge controversial issue and that, you know, there's two sides and half and half, and half the country isn't sure about vaccines, and the other half really loves them, that's a myth.

Speaker 10 That's not true. The majority of people go get vaccines.

Speaker 19 But have we talked about the new folks though? Because I'm sure they're going to do just as good of a job, right?

Speaker 10 I did want to mention one other

Speaker 10 thing that ASIP was put in charge of. So

Speaker 10 there was a concern

Speaker 10 back in the early 90s, there was a big measles outbreak in this country. And I believe around 250 people died during this measles outbreak.

Speaker 10 And what they found is that a lot of people who succumbed to measles were not able to access the vaccine because of costs or insurance coverage.

Speaker 10 And so what we have in 1993 is a new role that ACIP takes on called the Vaccines for Children program.

Speaker 10 And so this is an entitlement to provide free vaccines, children 0 to 18 years of age who are uninsured, Medicaid eligible, part of certain populations like American Indian, Alaska Natives,

Speaker 10 underinsured, who receive vaccines at FQHCs, rural health clinics. Like half of kids are eligible for this program.
So this was a huge advancement in health equity because now

Speaker 10 if ACIP convenes and says this vaccine is necessary for children, they now have the authority to provide that vaccine for free for children. Does that make sense?

Speaker 10 So the recommendation is tied to coverage now. So it's not just.

Speaker 11 They have the ability to provide the vaccines for free to a bunch of kids.

Speaker 10 Yes. And then this was reinforced later with the Affordable Care Act when health insurers were required to cover any ACIP recommended vaccine.

Speaker 10 So now all of a sudden we have all this policy around these recommendations. So those recommendations carry monetary benefit in that now you can afford these vaccines.

Speaker 10 And it also means that because they will be taken up by so many people because affordability won't be a problem, insurance or the vaccine manufacturers are incentivized to make them.

Speaker 10 I'm trying to set up the dominoes. Do you see how all this works?

Speaker 10 If you're on ASIP, you make a recommendation.

Speaker 10 That means that vaccine is going to be covered, which means that if you're the vaccine maker, you want to make more of it because you know you're going to get paid for them.

Speaker 10 You know you're not going to end up with a bunch of product that nobody can afford because now the government has ensured that people can afford it. So if you start working that backwards,

Speaker 10 if you're a vaccine manufacturer, and you don't know if people are going to be able to afford your vaccine, maybe you don't want to make as much of it because you don't want to create a bunch of product you can't move.

Speaker 10 I hate to talk about medicine this way, but this is the way it works.

Speaker 10 And so you make less of it. And so maybe they're not quite as accessible.
And then also, all these people who could afford it before maybe can't afford it anymore because it's no longer

Speaker 10 covered by the Vaccines for Children program because it's no longer recommended by ACIP.

Speaker 10 And so all of a sudden, our vaccination rates drop precipitously.

Speaker 10 These are the fears when we start talking about changes to the fundamental makeup of our ASIP.

Speaker 23 It's kind of like if you had a college bookstore that offered a discount on approved textbooks.

Speaker 11 So if you had a teacher that always

Speaker 16 used this great textbook for their class, then the students would go to buy it because they get a big discount on it.

Speaker 13 And then the book manufacturers would make more of the book.

Speaker 20 But they hired a new crummy teacher that's just pretending to be a teacher because his roommate is a teacher.

Speaker 20 And he got his mail accidentally and he always wanted to be a teacher but he's a failed musician but he needs a job so he goes and pretend to be a teacher and he says hey we don't need these books anymore let's just learn with music you know yeah and then all of a sudden that's great he said wait

Speaker 13 now they're not doing the discounted uh textbooks anymore so they're not making the textbooks they're only making guitar CDs or whatever, you know, whatever he's like, Van Halen CDs,

Speaker 20 he's recommending, but they're not making the good textbooks anymore.

Speaker 18 That's That's kind of what it's like.

Speaker 10 Justin, that's exactly it. You've got it.
That's pretty much what it's like. That's pretty much what it's like.
So that takes us.

Speaker 10 I wanted to outline who are ASIP, why do we have them? How did they come to be?

Speaker 10 And now that all 17 highly qualified members have been fired, who are the new, only eight have been named so far. Who are the new eight that have been named to this panel?

Speaker 10 And what does this mean for the future vaccines? We're going to tell you after the billing department.

Speaker 16 Oh, great.

Speaker 15 Well, let's go.

Speaker 1 The medicines, the medicines that escalate my cows for the mouth.

Speaker 6 I feel like I was never really able to make inroads with my cats, Olive and Amelia, until Smalls. Hi, I'm Justin McElroy, and my cats like my wife a lot better than me.

Speaker 6 But they have recently begun to tolerate me because, no, well, not recently, but we've been on the smalls train for quite some time, but ever since we made the switch over to these delicious packets of food, I'm extrapolating here.

Speaker 6 I haven't eaten them myself, but the cats are just wild about them.

Speaker 6 They have warmed up to me a little bit when they know that I'm the guy that can open these packages that came to us in a big box ready for the cats to enjoy, kept frozen on the way over.

Speaker 6 And

Speaker 6 you are really going to be impressed, I think, by the

Speaker 6 impact this has on your cat. I mean, just Sydney and I were talking a couple of days ago that we feel like since we've started giving our cats smalls, their coats are shinier and softer.

Speaker 6 And honestly, it's a lot easier to regiment their food than it was when we were using the dry stuff.

Speaker 6 And so with smalls has been great for our family. And if you haven't tried it yet, I think it is well worth a shot.

Speaker 6 For a limited time only, because you're a Sawbones listener, you can get 60% off your first Smalls order plus free shipping when you head to Smalls.com/slash Sawbones.

Speaker 6 That's 60% off when you head to Smalls.com/slash Sawbones, plus free shipping. Again, that's smalls.com/slash slash sawbones.

Speaker 24 Hi, I'm Alexis. I'm one of the co-hosts of Comfort Creatures, and I'm here with River Jew, who has been a member since 2019.
Thank you so much for being a listener and a supporter of our show.

Speaker 25 Yeah, I can't believe it's been that long. Yeah, right?

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Speaker 10 Can I ask what sort of made you decide to be a member?

Speaker 25 I used to work in a library, so I just used to listen to podcasts while I reshelfed all the books. Really helped with

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Speaker 10 Yeah.

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Speaker 26 Hey everybody, I'm Jeremy.

Speaker 3 I'm Oscar.

Speaker 10 I'm Dimitri.

Speaker 2 And we are the Euroevangelists for a weekly podcast spreading the word of the Eurovision Song Contest, the most important music competition in the world.

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Oh, okay. Cool.

Speaker 3 Okay, Sid.

Speaker 7 Y'all ready for this? I can't wait to meet these new superstars of medicine.

Speaker 10 So it was only like two days after he fired 17 that he named eight new ones. And I want to highlight, again, that it usually is a year, several year-long process.

Speaker 10 It's usually something that we take very seriously, and it takes a lot of time to name new members. So

Speaker 10 this is already concerning.

Speaker 10 So who do we have? Let's start with Vicki Pebbsworth.

Speaker 17 Okay.

Speaker 10 She is a regional director for the National Association of Catholic Nurses and she is a board member and director for the National Vaccine Information Center. Sounds very official, Sydney.

Speaker 10 I know, Justin. Now, This is, again, some of this stuff is so insidious.
The National Vaccine Information Center sounds like a great place to get information about vaccines nationally, doesn't it?

Speaker 12 Yes, Sydney. I mean,

Speaker 12 I'm in.

Speaker 10 Unfortunately, if you go to the National Vaccine Information Center,

Speaker 10 which I would not advise you to do if you're looking for helpful information, what you immediately find out are about the risks and complications of infectious diseases and vaccines.

Speaker 10 Take a stand to protect vaccine choices, donate to them.

Speaker 10 They have a lot of educational materials about the dangers of vaccines, protect religious exemptions to vaccines, keep the federal government out of state public health. It's disinformation.

Speaker 10 This is anti-vax.

Speaker 10 Yes. So she, so already we've got somebody who is known for spreading misinformation about vaccines for undermining public trust in vaccines on the committee to advise about vaccines.

Speaker 7 They're bad people.

Speaker 10 Dr. Robert Malone is another member.
Now, you, that name, we may have mentioned it. I'm pretty sure we did during the COVID episodes.
That's really where Dr. Malone made a name for himself.

Speaker 10 He was an mRNA researcher at one point and basically is very against any mRNA vaccines. So during the COVID-19 pandemic, he was opposed to vaccines.
He offered alternative treatments.

Speaker 10 He downplayed the deaths from the measles outbreak that happened recently. He had suggested that it is possible for some COVID-19 vaccines to cause AIDS or a form of AIDS.

Speaker 10 He has suggested that people got the vaccine because they were hypnotized. He was a proponent of hydroxychloroquine and ivermectin.

Speaker 10 I think he was banned from Twitter during the COVID pandemic for spreading COVID misinformation.

Speaker 17 We're up to two quacks so far, right?

Speaker 10 He runs a wellness institute, which is... Oh, yeah.
Yeah. I love that.
The word wellness.

Speaker 10 I'm not sitting here saying that the word wellness could never be tied to something that is evidence-based and good. I'm certain that it is in some cases.

Speaker 10 But man, if you are doing evidence-based something,

Speaker 10 don't use the word wellness.

Speaker 11 That word is a brownfield site, and it may eventually be reclaimed by future generations, but

Speaker 15 the land

Speaker 22 is scourged.

Speaker 10 When I hear wellness, it's just red flags, red flags everywhere. Okay, Dr.
Martin Koldorf is a biostatician and epidemiologist.

Speaker 10 I know we mentioned this name because do you remember our episode on the Great Barrington Declaration? Yep.

Speaker 10 This was during COVID. This was a document that multiple physicians, scientists got together to basically say that these shutdowns will do more harm than good and we should

Speaker 10 let the virus run rampant basically.

Speaker 13 We have a whole episode about it.

Speaker 15 Go enjoy that if you would like to know more about Dr.

Speaker 17 Martin Coldrell.

Speaker 10 Dr. James Hibblem

Speaker 10 was the head of the NIH group on nutritional neurosciences.

Speaker 10 He did a study at one point on

Speaker 10 if mercury consumption while you were pregnant could cause autism. This was kind of in the wake of the fake mercury vaccine autism claims.

Speaker 10 His study, I will say, did not say that. He said that they couldn't find a link.
And then he was a huge proponent of eating seafood while you were pregnant. So

Speaker 10 I don't have a lot of some of these people, it's just there's just not a ton else out there about.

Speaker 10 There's doctor, or there's a professor, Retzif Levi,

Speaker 10 who

Speaker 10 again

Speaker 10 was a COVID vaccine criticizer.

Speaker 10 He

Speaker 10 is mainly involved in like logistics and supply chain stuff for healthcare companies,

Speaker 10 but again, has gone on the record questioning the safety of vaccines.

Speaker 10 Who else do we have? We've got

Speaker 10 Dr. James Pagano, who's an ER physician from LA.
The only things I could find are that that he's written two fiction books, fictional books about healthcare, about medicine.

Speaker 10 I don't know if they're, I don't know anything about them, but

Speaker 10 there are those books out there.

Speaker 10 I couldn't really find any information one way or the other about his stances on vaccines. He's worked at several ERs, and I think he was

Speaker 10 possibly has like had some public criticism of the Affordable Care Act in the past, but I don't really have any vaccine information.

Speaker 10 Dr. Michael Ross, who's an obstetrician and gynecologist, who I really can't find much else about other than that he is a serial CEO and physician leader is how he has described himself.
So

Speaker 10 I am not sure what that means.

Speaker 14 James Pogana was born in San Francisco and now resides in Los Angeles, where he earns his living as an ER doctor.

Speaker 5 Over the course of his medical career, he has worked in a number of emergency departments in the greater LA area, including major trauma centers as well as smaller community hospitals.

Speaker 8 Bouncing around a lot, always a good sign.

Speaker 4 He has been the medical director of one ER or another for many years.

Speaker 8 Sounds good so far, Joe.

Speaker 14 The drain is a work of fiction about the business, the name of the book.

Speaker 15 The drain.

Speaker 11 The drain is a work of fiction about the business of hospital-based medicine.

Speaker 11 Though none of the characters are real, their personalities and situations in which they find themselves have been drawn from experience.

Speaker 8 The somewhat dark humor that permeates the book derives from the practice of emergency medicine and from the author's own wry sense of what exactly is funny.

Speaker 9 That's such a good...

Speaker 4 Helpful bit of context that I feel like I never get before I'm reading a book is wait a minute is the wry humor derived from what the author thinks is funny?

Speaker 7 And I think that that's cool that this guy has the guts to answer that.

Speaker 27 This takes up about a year after the end of his first novel, The Bleed. Many of the core characters return with the addition of a few new and interesting ones.

Speaker 20 In addition to practicing medicine and writing novels, the author is also an accomplished musician.

Speaker 27 He's recorded two CDs of acoustic.

Speaker 8 The CD has an unnecessary possessive apostrophe.

Speaker 27 C D's of acoustic guitar instrumentals. PS1 by Pagano and Saslo and Hopeless.

Speaker 14 Sorry, Pagano and Saslo.

Speaker 7 That's one.

Speaker 19 The other one is Hopeless Romantic by Jim Pogano.

Speaker 27 He has also composed and recorded music for motion pictures.

Speaker 10 Well, I mean, I mean,

Speaker 10 sort of a Renaissance

Speaker 10 position there.

Speaker 10 I know I was looking for this other information on the other doctor, Michael Ross.

Speaker 10 I thought this was weird. He's listed as having been faculty at George Washington University, Virginia Commonwealth University.

Speaker 10 A spokesperson for George Washington said he has not been on a fac on faculty since 2017.

Speaker 10 And then Virginia Commonwealth University said that he was an affiliate faculty member through a regional campus at another hospital system whose partnership with them ended in 2021.

Speaker 10 So I think they're having trouble. They've also found him listed as both an obstetrics and gynecology professor and a pediatrics professor.

Speaker 10 This just isn't, I think, I think what I'm driving at here,

Speaker 10 and just to round it out, there's also Cody Meisner, who probably, so he is a pediatric infectious disease expert

Speaker 10 who does have, he previously has been on ASIP and does have sort of the technical know-how and expertise that one would expect to sit on this committee and has sat on this committee before. He was

Speaker 10 opposed, I believe he voiced some opposition to masking during COVID. So I don't know what what that means.

Speaker 13 But it also doesn't, it shouldn't be surprising that they're going to have a few more temperate people on there.

Speaker 11 I mean, because they want the appearance of,

Speaker 10 you know, propriety. Yes.
And I mean, here's the thing.

Speaker 10 The reason I said earlier that

Speaker 10 public, I don't want to say belief, confidence in vaccines is so high is that it undermines RFK's entire argument for doing this.

Speaker 10 What he said is that ACIP has been so infiltrated by big pharma, big vaccine, by all these monetary interests, which by the way, there's no evidence for this.

Speaker 10 These statements are completely without any basis that anyone can find. But he made this claim that the public no longer has any faith in vaccines.

Speaker 10 And so we need to scrap it all, start from square one, brand new people, fresh faces, fresh ideas, a new take, and then we can rebuild public confidence in vaccines by making sure that one, we're using the ones that he thinks we should, which I don't know if that's any, and two, that the people behind it we trust.

Speaker 10 The entire basis for that is false.

Speaker 10 There was no evidence that ACIP had these

Speaker 10 conflicts to begin with that any of these members did. The public, by and large, does have faith in vaccines and the recommendations from ACIP.

Speaker 10 They are one of the most stringent and transparent of federal committees. a JAMA article that was just released,

Speaker 10 Advisory Committee on Immunization Practices at Crossroads goes through a lot of this history that I've talked about and sort of where we are now. And that's the thing about ACIP.

Speaker 10 It usually takes like two years for you to name somebody to it because they have to be so transparent with any possible conflicts, with any issues, with anything that would cause them to lose credibility because it is so vitally important that ACIP maintains credibility, which means therefore the CDC recommendations maintain credibility, which means our immunization guidelines maintain credibility so that people making decisions about their health care know that they're getting the best information possible.

Speaker 10 We already had that. We already had that with ACIP.
So RFK Jr.'s entire argument for doing this is based on false information, which leads you to wonder what his agenda is.

Speaker 10 Aside from, I mean, they could just stop recommending some of these vaccines. They could just do that, which would mean they wouldn't get paid for as easily.

Speaker 10 Perhaps vaccine manufacturers make less of them. They would be harder to obtain.
All of the negative consequences of the city.

Speaker 23 And it would reinforce this idea that

Speaker 16 they are dangerous.

Speaker 23 It is the greatest, I think.

Speaker 13 The legacy of this is going to be adding to vaccine hesitance, which was already a problem when it was the fringe, not the policy of the American government.

Speaker 10 You are exactly right. I think that is going to make a that is going to make a big difference.
That's going to be a problem.

Speaker 10 And I think, again, when we get back to that core idea of sometimes that grain of truth is what makes these lies so difficult to fight.

Speaker 10 One thing, as I was reading articles from different physicians about what could be the consequences, one thing that they could do, which would sound very reasonable, just like

Speaker 10 we talked about

Speaker 10 they would do placebo-controlled studies for vaccines, how that might sound reasonable, but it's not, is they might change the recommendations for vaccines from what we call a routine recommendation, meaning we think you should get this vaccine, to a vaccine that you should get with shared clinical decision making.

Speaker 10 That's the wording that you need to look out for. What that means, this sounds very reasonable, right? Instead of me saying, I recommend to you, my patient, you get this vaccine, I would say,

Speaker 10 The recommendation is that we engage in a conversation, a shared clinical decision about what's best for your health.

Speaker 10 Now, the problem with that is that if it's not your area of expertise, it's really hard to know if it's in your best interest. It's the same.

Speaker 10 There are tons of things that I don't go make decisions about because I don't really understand. I don't know how computers work.

Speaker 10 I trust that if I go to get my computer fixed, if the person fixing it asks me, how best, how do you want me to fix this?

Speaker 9 I don't know.

Speaker 10 And I'm not going to be able to decide in a 15-minute appointment, right? So that's going to be dangerous. But the other part of that is that if

Speaker 10 if a vaccine is a routine recommendation, it has to be covered under all these different funding sources we talked about.

Speaker 10 If it is a shared clinical decision-making one, it doesn't. So that will reduce the vaccine stock.
And this is going to hit rural areas the hardest.

Speaker 10 It's really challenging because, again, vaccines are not a big money maker for anyone involved.

Speaker 10 So it is really challenging for smaller clinics and especially rural clinics to keep stocked on vaccines. Usually the only ones that they can maintain a good supply of are the routine recommendations.

Speaker 10 The more you change to that quote-unquote shared clinical decision-making category, the harder it's going to be for rural areas to vaccinate people.

Speaker 10 So it's going to hit some of the most challenging areas to deliver health care. It's going to hit those areas the hardest.
I do want to say this.

Speaker 10 There are a lot of articles out there right now, which will tell you if you want the best information, and I know this doesn't fix the funding piece or the supply piece, but if you want the information piece, you can go to the American Academy of Pediatrics.

Speaker 10 The AAP has always been a strong source of evidence-based vaccine information. You can go to the American College of Obstetricians and Gynecologists.

Speaker 10 They're usually the first ones out there fighting this kind of disinformation. There's the National Foundation for Infectious Diseases.
All of these are easy, easy places to find online.

Speaker 10 The Vaccine Information Center, where you can get up-to-date, credible, evidence-based information on what vaccines you should get that is not going to be influenced by any sort of political agenda, or at least shouldn't be for the time being.

Speaker 16 Well, there you have it, folks.

Speaker 19 Sobering report.

Speaker 10 But you know what?

Speaker 19 There's nine more slots.

Speaker 20 And I'm holding that hope that those next nine are going to be some staunch vaccine supporters.

Speaker 13 And we'll get a nice, like, fair and balanced thing going there.

Speaker 10 But you're armed with this information. You are all armed with this information now.
And you can arm yourselves with more by going to those websites, learning about this stuff.

Speaker 10 Again, this JAMA article that I referenced lays it out really easily.

Speaker 10 And I was able to access it without a subscription to JAMA, but the Advisory Committee on Immunization Practices at Across Roads, it really lays out how solid of a federal advisory committee ACIP already was, why this change was not necessary, and the potential harms that may result, which you can share with vaccine-hesitant friends or guardians or parents if this begins to create more doubt in their minds.

Speaker 4 That's going to do it for us.

Speaker 3 Reminder, bid.ly forward slash McElroy tours.

Speaker 20 We're coming to Columbus Thursday night at 7 p.m.

Speaker 4 So be there or be square. That's going to do it for us until next time.

Speaker 20 Oh, thanks to the taxpayers for their song Medicines as the intro.

Speaker 18 Now I turn it over to our program.

Speaker 8 Thanks to you

Speaker 16 for listening.

Speaker 11 That's going to do it for us. Until next time, my name is Justin McElroy.

Speaker 3 I'm Sidney McElroy.

Speaker 16 And as always, don't drill a hole in your head.

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