Meidas Health, Episode 15: Dr. Demetre Daskalakis Speaks Out After CDC Resignation

This episode is brought to you by Progressive Insurance.

Fiscally responsible, financial geniuses, monetary magicians.

These are things people say about drivers who switch their car insurance to Progressive and save hundreds.

Visit progressive.com to see if you could save.

Progressive Casualty Insurance Company and affiliates.

Potential savings will vary, not available in all states or situations.

If you thought goldenly breaded McDonald's chicken couldn't get more golden, think colder!

Because new sweet and smoky special edition gold sauce is here.

Made for your chicken favorites.

I participate in McDonald's for a limited time.

High interest debt is one of the toughest opponents you'll face.

Unless you power up with a SoFi personal loan.

A SoFi personal loan could repackage your bad debt into one low-fixed rate monthly payment.

It's even got super speed, since you could get the funds as soon as the same day you sign.

Visit sofi.com/slash power to learn more.

That's sofi.com slash p-o-w-e-r.

Loans originated by SoFi Bank NA, member FDIC.

Terms and conditions apply, NMLS 696891.

Hello, Midas Mighty.

Welcome to September.

Really, really

impressive momentum that we've had here over the last 14 episodes.

We just had Dr.

Susan Krestley of the American Academy of Pediatrics on to talk about all things back to school and to really give evidence-based information.

Remember, she said to go to healthychildren.org if you had questions for all the parents out there with all the confusion.

If you have questions on what vaccines to get your child or there's basic fundamental issues that might arise when it comes to getting the flu vaccine, questions about the COVID vaccine, RSV, she went through all of that in episode 14, especially in the back half.

Highly encourage you to listen to that.

It's completely free.

And also, immunize.org, if you have questions questions and you're an adult or if you have a loved one that might be older, she recommended we go there to

get trusted resources that are easily navigable.

So please do do that.

And just as a reminder, MIDAS Health is not just trying to be another podcast.

We're trying to leverage.

the massive audience of the Midas Touch network to provide you a space to interact and to hear from the nation's best healthcare leaders, because unfortunately, a lot of them are no longer at the very top of the federal government.

And so that's exactly why I'm so thrilled to have Dr.

Dimitri Daskalakis here for episode 15.

He is a big-time healthcare leader for our country.

I've admired him for a very long time.

I really frankly consider him somebody to just emulate in terms of impact at scale, and especially as a physician trying to do or trying to

have impact at scale and trying to reach as many people as possible.

Dr.

Dimitri Daskalakis

is the very definition of that.

And so you're going to to see that really shine through in our conversation.

But without further ado, I really want to maximize our time here with Dr.

Dimitri.

I'm going to, we've agreed that we're just going to use first names here.

So Dimitri, thanks so much for joining Midas Health.

Thanks, but

that is an introduction that my mom would love.

So thank you so much for that.

Well,

you know, here we are, Labor Day, quite literally Labor Day.

So thank you for joining us on a holiday.

Last week was quite the week for you.

I wanted to see how you're, how are you doing?

I'm doing, I'm doing fine.

I mean, I think it was quite a week.

It's a whirlwind.

I think going from sort of leadership at CDC

to sort of trying to be a voice for, you know, raising a red flag for what's going wrong with public health in sort of a very immediate way.

You know,

it's been a lot, but I think I'm doing well for the most part.

There's a lot of emotions, lots of feels.

Do you feel safe?

I know that you gave a really,

I just thought a series of incredible interviews on broadcast TV,

a resignation letter that I thought, I mean, I'm still getting sort of pinged about.

It really resonated, but I'm wondering, just in this environment,

personal safety-wise,

any issues there?

Yeah, I mean, I think,

you know, I've, I've been sort of in a national

view before,

talking about some very sort of complex issues that have made some folks decide that it's appropriate to target me either in digital or other sort of media.

So I think that's happening now.

When I wrote that resignation letter, I knew it was going to happen because it happened before.

Do I feel

safe?

I mean, I'm looking over my shoulder a lot, I've got to tell you, but I think that this is the mission.

I have to do it.

was, I decided that if I was going to resign, I could either send a letter that says I resign or say, uh, send a letter that actually says why I resigned and then really, you know, share the details.

Um, again, the voices from the inside are different than the voices from the outside.

And there's like one moment in time when you go from the inside government to out where you're able to give a very specific point of view that could potentially affect some important change.

For our listeners who may not have tracked your career as closely as I have, although, you know, it's been, as you point out, Dimitri, a career filled with moments in the national spotlight in a really positive way, having incredible impact.

I do want to take some time just going through your background and what led you ultimately to

this high post at the CDC, infectious disease doctor, trained at Massachusetts Brigham for fellowship.

multiple stints in public service.

Wonder if you could take our listeners through your journey.

How did you end up leading the National Center for Immunizations and Respiratory Diseases?

Sure, I'll take you way back.

Everybody should get their kids a doctor's kit if you want them to be a doctor, because that's what made me want to be a doctor.

So, shout out to the doctor's kit.

So, all my life, I wanted to be a doctor, had no idea what that meant.

My parents were immigrants, they came from Greece.

My dad worked in restaurants, and my mom was an executive assistant, but they really helped mentor me into a place where I was able to go to undergrad, to Columbia University,

where I moved there in 1991 to New York City and immediately started doing things in the HIV space.

I decided to

volunteer and go to high schools and talk about safer sex and all of the things.

And so it became clear to me that I wanted to do something that would work in HIV space.

It was punctuated by my last year at Columbia when I helped put on a large display of the AIDS memorial quilt.

I'd had friends who passed away.

I I, you know, used to go out in New York City in nightlife.

I was a young kid in New York.

I would meet people.

They would disappear into Bellevue or St.

Vincent's, never to be heard from again.

But I, you know, I did that AIDS, the memorial,

the display of the AIDS memorial quilt.

And I, you know, met people who were mourning, people that they lost, and also people who were coming so sick, it was amazing they could walk in the door.

And like, I had this moment on College Walk where I said, you know, I don't want anyone to ever have this happen again.

Like no more death and dying, no more suffering from this, whatever I can do.

So that really became like my guiding star, my North Star to be able to sort of go into that and then go to med school, NYU.

That was great.

Was mentored by some great infectious disease doctors that let me see some clinical things that became very important to me in the HIV space.

Did my residency at Beth Israel Deaconess, surrounded by leaders in infectious diseases.

I'm going to shout out Bob Mullering, who was one of my very very early mentors, who just is a legend in infectious diseases.

Then I did the unthinkable, which was to leave the Beth Israel Deacon S system.

So, for those in Boston, knows that that's high treason, not really.

And I moved over to NASH General and the Brigham, where I did infectious diseases.

And again, got to work with some of like the brightest and the best scientists and clinical folks.

So

when that happened, I was working in a lab for a while doing basic science immunology.

Tom Frieden, another person you may know, came on my radio because we had radios then.

And the radio, he talked about there was like a case of HIV, multi-drug resistant and

fast progression in New York City in a gay man.

And I was like, what am I still doing here?

I need to go back.

So I reached out to New York City to my friend Judy Aberg, who brought me back as faculty at Bellevue.

And then instantly, I started doing things that were public health things.

I started doing testing in commercial sex venues for HIV.

I started post-exposure prophylaxis programs with taking pills after an HIV exposure to prevent it.

There wasn't prep.

So I did surveys about PrEP.

And so I all of a sudden was doing public health and didn't know it.

I got the opportunity to get my master's of public health at Harvard after a

family donated money to NYU to build a doctor's career or some doctor's career to make sure that no one died like their son.

So it resonated to my moment on college walk.

So I got my MPH.

And then my first job

out of the gate was to be the head of HIV prevention for New York City.

And there, you know, I got an influx of the things that you need, political will and resources, as well as really strong science to be able to implement some really significant programming that pushed the HIV epidemic down in New York City in a rapid way, faster than expected, and to a place that is, you know, enviable across the world.

Did a good job there enough where they made me the deputy commissioner for disease control in New York City.

And, you know, I remember when I was interviewed for it, they said, you know, you're going to do all the, you're going to be the chief of infectious diseases for New York City.

Every now and then you'll do an emergency response.

And then subsequently, I was in an emergency response the entire time.

So measles outbreak in Brooklyn, Legionella outbreaks all over the city, and then ultimately COVID-19, where I was incident manager of a lot of events,

stayed there, and then was recruited to CDC to be the head of HIV prevention.

Managed to stay in that.

Well, and actually, I was hired by Robert Redfield during the first Trump administration.

And I worked there for about three months and then got pulled back into the COVID space where I worked in the vaccine task force, got back to HIV briefly, then MPOCS brought me to the White House where I led, I think, what is considered like one of the most successful infectious disease responses in the last couple of decades.

And so that went great.

And after that, came back to CDC to work for National Center for Immunization and Respiratory Diseases, which is the home to vaccine programs around the country, as well as

as a place where the smartest scientists work that the entire world looks toward for vaccine preventable diseases.

And that brings me to today where I had to resign because it was getting weaponized.

You know, I want to say for our listeners, I had the first time I actually was on a call with Dimitri was during his tenure at the White House overseeing the impox response.

And I was saying this, you know, before we officially began the podcast, how

as he notes, he oversaw one of the greatest public health responses to a crisis in my lifetime, certainly.

But I, you know, Dimitri, you'll remember this.

There was moments where on those calls, you guys had to talk through the nuances of how to vaccinate and whether it was SUPQ or I, it was just even the nuances of like the angle in which a little complicated.

It was a little complicated.

And, but, and there was a lot of complications there, but you cut through that in

a way that I, you know, I try to emulate my own life when it comes to health and communication, but you're, you're,

you did something that is, I, I think, incredibly hard to do.

You don't necessarily get trained to do it in medical school.

You either learn it or you don't.

Some of it is just natural.

Some of it is, you know, it's hard to learn.

We did an amazing job.

And for our listeners here, everything that Dr.

Dimitri just pointed out, that's a lot of hard work.

And

those are long days.

I think you probably don't think as you're in the midst of it that you're going to end up where you just ended up, high post at the CDC, leading a really important center.

But,

you know, when you reflect back on the last week,

the decision to put the resignation letter out there.

Take us through that because there's a lot there.

And I'll also before

I do want to do a little tee up here for that resignation letter, I encourage all our listeners to go

Google Dr.

Dimitri Daskalakis' resignation letter to read it.

It's very easily discoverable on the internet.

But you talk about conflict with RFK's leadership, undermining public health, ideological bias in science, concerns for an increase in vaccine-preventable diseases, risks to our national security because of

being less prepared for the next bio-crisis.

There was a lot there.

I'm wondering your decisions and

what went into your mind before you wrote it, and what made you think, gosh, I got to write it?

Yeah, I mean, so I'll start by saying I'll take us back more than the week and take us back to the beginning of

Secretary Kennedy's stint at at HHS.

You know, I'm a government, a career government person.

And, you know, what we thrive on is kind of being like AI, right?

So our brains get trained on the information that we get so that we can actually like generate messaging that really is based on what that training and that input is doing.

So when Kennedy came, I was like, this is great.

because now we have like we're going to hear from him at his like hhs welcome talk and that's like the first time I'm going to hear like what he actually thinks now, as opposed to my impression of him before, which was definitely influenced by my experience leading the measles outbreak in Brooklyn, where I saw some of his sentiment toward vaccine come through.

So I really did that, you know, going in there open-minded.

I had everyone cancel their meetings in my center so we could listen to his

speech.

I had note takers avidly taking notes so that we could take what he said and say, how could we train that AI brain of our own?

How could we train ourselves to be able to figure out how like the things that we think are clinically and scientifically important, how we can meld that into the vision of what the secretary is expressing?

So it sounds like

when I'm hearing you say this in the pre prep for his comments, it sounds like you guys were open.

and

sort of willing to be perhaps proven wrong if you had preexisting sort of a sense of what might what he might say.

It sounds like you were open to a positive outcome here that maybe he was going to surprise you.

A hundred percent.

I was thrilled when he got on stage at that HH Just meeting and said, Um, you know, I'm not coming with preconceived notions, though you may hurt here that I have some.

You should not come with preconceived notions either.

And we were like, Shazam, that's the thing.

Like, that's what we need to hear.

And everyone was like, okay, we can work with that.

And, and, you know, I think also, like, we heard the words, you know, gold standard science.

and we're like, yes, science, since we felt that folks were trying to get away from it.

And we heard radical transparency and we're like.

yes, all of this is a yes.

So we know have had conversations like based on that transcript and other things we saw about how we could really plug in our stuff into that vision.

And, you know, we were all, we all sort of started there.

And then when we saw that the words and the actions didn't really correlate, we started to feel not so good about that.

So for me,

you know, as I saw that unfold, like my question was always, where is my line?

Like, what, what's going to happen where I'm like, I can't be here anymore.

Like, I think, you know, again, I'm a doctor.

I took the Hippocratic oath.

Like, I really do believe in that.

Like, if I feel like I'm about to do harm, then it's really not a thing that I can do.

And so, you know, I, you know, was really close and continue to be close with Dr.

Deb Howry

and Dr.

Dan Jernigan.

You know, we, we definitely, you know, my my um letter which has been sometimes criticized for being long sorry had lots to say um you know that letter so that's why we have ai yeah right um i should have summarized um so so that that you know like i i had prepared it and really had been chronicling like the things that got me close to my line and then a couple of things happened so the first for me was um when a uh the document that that sort of guides what's going to happen at the Advisory Committee for Immunization Practices, the work group, that small group that creates recommendations that go to the bigger meeting for discussion, like we gave loads of feedback, lawyers gave loads of feedback, and then ultimately what came back was this document that it wasn't about what they what they wanted to talk about in the meeting.

Everyone was great with that, but it was more about the fact that they wanted to say that, you know, that they wanted to remove CDC scientific bias from the work group, which is weird because like, I think that we have the most disimpassioned scientists who are the least biased.

And

they sort of made it clear that

the work group, that the members of CDC staff weren't actually reporting to the director anymore, that they were like really beholden to a vision of the um of the uh work group chair.

The lead of the work group for COVID-19 has a pinned tweet that says the evidence is clear, we should stop giving people COVID vaccines.

So, you know, and you know, call me crazy, but you know, we've seen that, you know, COVID vaccine helped end the pandemic.

all of the data in the world, except for sort of some sources that maybe these folks are citing

that are not

demonstrated to be valid sources,

that the COVID vaccine is safe.

There's always a risk for a vaccine.

Like, nothing is

zero risk.

But overall, it's a safe vaccine.

Definitely, there could be some side effects.

And again, there's been severe side effects of folks who had myocarditis, which is inflammation of the heart.

But that hasn't really been seen for a while.

And it was really related to a very sort of specific time where people were getting doses close together.

Anyway, so

that meant to me that there was no way that my scientists that were working for within CDC were going to be able to create science that was that was like that was not contaminated by the ideology since the ideologues were the one that were driving the conversation in a way that was unprecedented.

So that was my first, my first line.

And the second,

you know, was when we started to hear that Susan was potentially Susan Menarez, who is the who is the director of CDC,

the congressionally sort of approved director of CDC, confirmed.

When we heard that she was probably going to leave or be removed,

we were going back to the time before we had a director, months and months of having no scientific leadership where we were just getting these top-down recommendations with no ability to input.

We never briefed the secretary once, like not one NCIRD, no one from my center ever had briefed him ever, ever.

Not me, not anyone.

And so we were getting all this top-down stuff with no evidence backing it.

We were like, great, we have scientific leadership.

We're going to be okay.

And then that got pushed aside, which meant that like imminently we were coming to all these decisions and that there was all that could happen from my perspective was harm, no good.

And that's my line.

You led the National Center for Immunization and Respiratory Diseases.

That was, that was the post that you held.

And,

you know, we're having this conversation on Labor Day, day after a conversation that we just had with president of the American Academy of Pediatrics, Dr.

Susan Kresley.

And

what I find just

is hard to keep up, but it's my, you know, my wife's a pediatrician.

I'm a pulmonologist, and we

vaccines are what we do in our clinical lives in a variety of different ways.

And I was talking to Dr.

Cressley, and it was amazing to me that here is an organization, the AEP, that is now stepping into this void that is seemingly being created in a very, very rapid period of time.

And this just seems like this is all happening so quickly.

Can you speak to

what this means now for

our listeners who represent a broad swap in the general public?

Because, you know, we were trying to...

Dr.

Cressley was trying her darndest to represent 79 other medical societies and put good information out there.

You know, link towards the end to a few websites.

And it all felt,

it just felt tragic.

And it felt like no one podcast or entity is going to be able to fill the shoes of

what we've lost.

And what we've lost here is incredible expertise and leaders, servant leadership.

like you and your colleagues.

I'm just wondering

what do you think this all means?

Like where are we headed?

Yeah, Ben, I'm going to take it from high up to low down.

Please.

What this means is that there is going to be a clear effort to limit access to vaccines.

It's not going to be about improving the ability or freedom for people to choose.

It's going to be about the inability to access vaccines.

There may be bottles on the shelf, right?

There may be bottles, needles, whatever on the shelf that vaccine exists, but this is undermining two things.

It's undermining access from the perspective of coverage, and I'll talk about that in a second, but it's also undermining trust and confidence in vaccines.

Like this chaos, all of this noise creates an issue.

Like folks can't process all of this.

And so what happens with all the different pieces coming in and the way that it's coming is that you're like, well, I don't know who to believe.

Right.

So that's, so I like, you know, I applaud like the medical organizations that are trying to say, look, we are your trusted providers.

By the way, they are the trusted providers.

I mean, the secretary said, don't take his medical advice.

I agree.

Don't take his medical advice.

He is not an expert, nor has he listened to experts.

So I trust the

pediatricians.

I trust the obstetrics and gynecology folks.

I trust the medical doctors.

I imagine that there's more coming.

But here's the facts.

If the government, if the ACIP, if the Advisory Committee on Immunization Practices decides to somehow constrain who is able to get one vaccine or another for a reason that's not based in data.

Like there may be reasons, like there may be like, oh, you shouldn't give this vaccine to X, Y, or Z because the risk and the benefit, it doesn't make sense.

But for vaccines where the risk and benefit does,

if there is

some kind of ACIP recommendation that somehow makes it hard for someone to get vaccine or says this vaccine shouldn't be given to a six to 12 year old.

That's probably not going to happen with COVID.

But if that ACIP says that,

yes, AAP and all the other organizations can say, we, you know, we call inaccurate.

That's not right.

That's a false recommendation.

But if the recommendation is an ACIP recommendation that gets signed by whoever it is, I guess, you know, a speechwriter, O'Neill, or the secretary,

that then gets codified as a recommendation from CDC and HHS.

That recommendation triggers vaccine coverage in insurance.

So if that says do not give to six to 12 year olds, that means that that vaccine may no longer be covered by insurance.

Let me give you one more very scary thing, which people don't know, but hopefully I can express it in as clear a way as possible.

There is a program called Vaccines for Children.

It is the program that is the safety net program that gets vaccines to kids who are uninsured or uninsurable, who can't afford it, or who are on Medicaid.

Over 50% of kids in the United States get their vaccines through the Vaccines for Children program.

If the ACIP says this vaccine should not be given to six-month-old to 12-year-olds,

the VFC

won't buy it.

I see.

And that means that those kids will not get vaccine.

You know, it was really,

thank you for that.

It was illuminating just to look at the data on six months to 23 months of age, children that are those in that age group, otherwise healthy.

You know, as the AAP was pointing out,

that's a high-risk group still for ending up in the hospital, even if they don't have an underground condition.

And to your point,

what I think gets lost, I'm wondering

your view on this.

I think this level of detail,

all it takes is you having 60 seconds to lay it out for us and it's clear.

But it strikes me that a lot of these decisions are being made with perhaps the expectation that the general public won't grok what's actually happening.

You know, I look at some of the decisions that were made on the FDA,

you know, the FDA label changes the COVID vaccine.

And many people, and we did a lot of segments on broadcast for it.

And I got a lot of feedback saying, Vin, I didn't realize that this means my pharmacist cannot potentially do what they've been doing for the last five and a half years.

And it's amazing that through line that there's complexity in policy, that if people understood that, you know,

right below the headline, what this means for them, which you're, I mean, again, this is why you're so good at what you do i i do do you think that's what's missing here is the lack of ability because there's that a lack of a third line i a hundred percent i mean i but i feel like the the role of sort of us i'm going to sort of speak for for deb and dan like right now we can point at the thing and say this is the thing um that you need to look at and so i think there needs to be more voice voices of folks that understand sort of the policy nuances um that are able to say something i mean i'm just going to say i'm pretty i'm a a simple guy, right?

CBS and Walgreens say that they're not going to be able to vaccinate in some states.

And in other states, they say you're going to need a

prescription.

So, you know, if you look at our data, sorry, the data, that's sad, right?

The data at CDC,

what you'll see is that the majority of COVID-19 vaccination for adults happened in pharmacies.

So that's going to be not so good for your seniors who definitely are at risk for COVID-19 complications.

And if they're going to need to find a prescription or their state doesn't carry it in the

pharmacy, that's a problem.

And so, you know, the people, you know,

rural America, oh no,

right?

Right.

Like your best access is going to be a pharmacy.

And so yes, some of the pharmacies that have like doc, like a doctor's office kind of affiliated, you may be able to get that prescription, but are you also going to get charged for a doctor's visit to be be able to get the prescription and get the vaccine versus just go do the whole thing and be done?

So like, so this has like ramifications

that mean that people won't have access to vaccine.

So that's, that's the part.

Like, I think it's not about,

we don't want, you know, we don't want this to be like a mandate.

We don't want there to be this thing where you're like, you know, that ACIP is releasing something that says like you must vaccinate X, Y, or Z for something.

It doesn't say that.

It just says recommended for some population with some parameter.

And then, you know, physicians and patients and other clinicians, including pharmacists, are able to make decisions.

The way that we're going,

you know, there is going to be a clear decrease in access for vaccines.

And, you know, that is going to

look like people unable to get the vaccines that they want.

And I think that that's going to be highly problematic.

And depending on what happens with these infections, COVID-19 specifically, you know,

there may be potentially some pretty significant human toll if children and older adults end up getting hospitalized, going to the ICU, or worse outcomes.

For our listeners here, Dr.

Daskalakis referenced, you referenced CBS and Walgreens and prescriptions.

And, you know, I've seen some questions come through on social

about exactly what you just raised, Dimitri, which is, do you need now a prescription for vaccines?

And as CBS and Walgreens has reported late last week,

in 16 states, I believe, for CBS, they are actually not right now, they're pausing distribution of the COVID vaccine because it's not clear in the absence of a CDC endorsement of this vaccine from ACIP, which this committee that you're referencing,

they have to formally endorse

recommendations for then pharmacists to be able to actually immunize.

Do I have that right?

And right now, that mechanism is lacking.

You're almost 100% right.

Just to be clear, ACIP makes a recommendation to the director of CDC, and then the director of CDC endorses it.

So it's an advisory committee.

They do not set policy.

That means that when Susan had been there, there was a chance that there was going to be a balanced voice to sort of come up with like what that recommendation should be.

So they don't set the policy they recommend to the director who then signs off.

But what you said is right.

So that when you have an ACIP recommendation, that is not just a pretty piece of paper.

It actually opens the gate to all of the things that need to happen for a vaccine to be covered by insurance.

And in many states, as you heard, to allow pharmacists to give it.

So, there's some states where you have to have an ACIP recommended vaccine to be able to give it.

And there are other states that say

that, depending on what the recommendation is, you may need a prescription for it.

I just need to give one really good shout out to CBS and Walgreens.

This is not because they're not trying, right?

So this is so everybody who hears me, this is not the time to be angry at CBS and Walgreens.

This is the time to sort of question what's happening in government that has made the circumstance that these pharmacies are unable to provide a service that is so valuable to their patients.

They're not pushing a vaccine on anyone.

They're just offering it.

You know, like, I love, you know, I enjoy being reminded about my vaccines from CBS.

I don't always take them up on it and from Walgreens, but I mean, it's nice to get a reminder.

And I think that, you know, when I go pick up my toothpaste, that may be a great time for me to get vaccinated.

So I don't have to wait or drive to a doctor's office.

So I think that that's, you know, Americans don't like having inconvenience.

And I feel like we're getting to a place now.

Right, right.

No, and thank you for that call out and just elaborating on it, making sure that we have, you know, we want to make sure we're operating on all the correct facts and also

sort of helping us understand CES and Walgreens' place here.

They are responding to changes in policy the best they can.

And that's an important point.

I do want to,

you know, I was really struck, Dimitri, by a line that,

or something that you were quoted on that the New York Times published, I believe it was today or recently.

It was an article about everything that's happening.

And it said, quote, the panel, this ACIP panel, may curtail access to several vaccines, which is the statement.

And then your quote after that was, quote, it really is transparent that these decisions have all been predestined.

And

I'm curious

what you think that means playing it out.

Right now, we've talked about COVID.

It feels, you know, I saw something between Senator Rand Paul and Senator Bill Cassidy on the hepatitis B vaccine.

The latter was defending it, the former was questioning the need for it, the hepatitis B vaccine.

And for our listeners here, that's something that probably almost all of our listeners have gotten when they were infants.

And,

you know, I'm worried about where we're headed.

It seems like that's what you've been signaling directly

in the last few days.

Where do you think we are headed?

Yeah, I mean, so

I fear

that we are

to a couple of things.

So the first is the very overt

work to,

you know, curtail access to vaccine,

you know, by really calling into question data.

And I think that the other strategy there that I need to say is also questioning the quality of the data.

So this is something to watch out for very carefully.

I predict that at the ACIP meeting, there are going to be comments on the fact that there's not perfect data.

We don't know about the

reason for hospitalization for every child in America.

We don't know what every underlying condition for every child who's admitted for COVID-19 or every adult admitted for COVID-19.

There's going to be something there where they're going to undermine, I think, public health data as well as other data to make the point that it's not gold standard.

What everyone needs to know is some of that data is completely unknowable in the United States of America because we do not have a single payer system with some sort of universal data stream.

I cannot know.

the underlying conditions of every child based on like how our system works today.

So what I fear is, before we even get to vaccines, is that the strategy will be to undermine the data that is available, which is very high quality data and has been used for for decades to make decisions, if not decades, years, and is also looked at by other countries as very significant data.

There is going to be an attempt to undermine the scientists and the science that provide that data.

That will then downstream,

destabilize recommendations.

And that means that there will be people who will be using their non-expert expertise to make recommendations about what happens for vaccines.

You know, I don't tell people who do operational research how to do modeling around

supply chains.

So I think it's strange that an operational researcher is going to tell us like what child to vaccinate.

It seems strange.

And so I'm worried that there's going to be first, like, let's undermine science more and more and more, really call to question the data, not finishing the sentence and saying like, you know, this data is imperfect and there is no perfect data available in the U.S.

to make some of these decisions, but it's the data that we use and that's been so valid.

And that's going to mean decisions are going to be made based on

half-truths,

whim, things that will be called common sense.

There's a lot of things that are common sense that are not scientifically true.

And so that's really important.

But then, you know, and that will then translate into vaccine access problems, insurance not covering.

And then subsequently, all of this results in so much noise for people, so much noise that they just won't know where to go or what to trust.

Like, I'll give you one more example, which is like, you know, there is a thing on the on the notice that the ACIP meeting is happening, an agenda item that is called respiratory syncystral virus, RSV.

Nobody knows what that agenda item is about.

It's come from above down to the advisory committee.

Scientists at CDC have no idea what's going to be discussed or presented.

And so therefore, what that means is there's going to be a highly atypical discussion that doesn't include CDC science nor its assessment of other science to discuss something about RSV, which I predict will try to point at data and say that there's something that was not presented previously by ACIP that

would require people to consider not using the monoclonal antibodies that really shut down the RSV season for kids last year.

And that's going to mean more kids hospitalized in the intensive care unit during the holidays and parents completely worried out of their minds that those kids are going to be in the in the intensive care unit.

So it's going to be about

destabilizing data and destabilizing public health because that I think, is the mission.

And the output of that is going to be sick kids.

That is chilling.

Yet again, you clarified

how they're going to do this.

There's a vision, but then how do you execute on it?

And it's chilling to see that there's that through line.

You know, I have to just remark that, and for our listeners here, Dr.

Daskalakis and I.

as many of you listening in,

either know healthcare professionals, you may be a healthcare professional.

And, you know, what I'm always struck by just witnessing what's happening is when you practice medicine, to even be able to practice medicine in some form, as you well know, you have to, as a gauntlet, board exams, many, many years in training, many, many years in debt.

And

there's continuing medical education, there's recertifications, there's scrutiny on how you practice by your peers to get re-credentialed at a hospital.

There's so many steps to make sure that being a professional in healthcare is that there's accountability, that there's quality standards, and you can't do, bad things can't happen because people are not trained or doing the wrong things.

And

what's stunning to me, especially in this world of patient advocates and all these guardrails and checks and balances, is how quickly it seemingly can all devolve without any accountability.

I mean, it's stunning to me that

a set of ideologues, as you pointed out, really can impact science.

And I mean, you beautifully said in your resignation letter that blurring, there was a distinguishing between ideology and science, at least historically, and that's been entirely blurred.

I'm stunned, though, that in an institution or in the profession of medicine that is replete with accountability and guardrails and standards,

things can be undone so quickly.

I'm wondering your reaction to that.

I mean, I think in general, when you think about public health, there's three things that you need to be effective.

You need community engagement, understanding what people need.

You need political will and great science.

So, you know, if that sort of pedestal on which science lives, which is supported by community engagement and by political will, is compromised, the science fails.

And so that's what we're seeing.

The political will is not to uplift science so that we do best for the community.

The political will is political will only, and there's nothing that that pedestal is holding up except for individuals, their egos, and their motivations.

So, that's that's where we are.

And so, I think that you know, um, everything

in sort of government, all of the sort of safe checks and balances, I think exist if you have sort of this social contract that sort of makes sure that folks are approaching things in a way that sort of maintains the best for communities and for people.

So, when the emphasis is not about the people, but about some unseen master or some unseen motivation,

you can see exactly what happens.

It breaks down.

I mean, you know, there's folks who are reviewing data at CDC right now

that really is focused on, you know, the sort of epidemic of chronic disease, specifically autism, who historically had been disallowed from accessing data because

of their bad methodology and questionable ethics.

And so, like, that's happening now because there's political political will to let them have full access to CDC data.

And so, yeah.

Is

gosh, um, I could take this in so many different directions.

I do want to end,

you know, on a semi-positive note, if we can, uh, which is to say, two questions.

You know, as somebody that is

in the media space for part of my life, and especially in health journalism and communications, you know, I feel like I'm speaking to somebody that is an exceptional health communicator across the board um just communicator not even i don't have to uh qualify it by saying just on matters health

how do you envision the role of media today in covering these stories and in injecting truth into these discussions because media can be powerful i think media can be a force for good if used properly but i'm wondering your critique of media and things that we should be doing better

yeah i mean,

I think that media is going to be, is really important.

I think also leveraging sort of, you know, platforms that are not traditional media, like, you know, podcasts are great, thinking about other sort of social media.

I think that media, I think, needs to emphasize less the clickbait and more like what it means for people.

And so that's what I feel like a lot of what I've been doing the last week has been like, well, what this means for people is this.

And so I think not sort of taking the bait, I mean, like we all take the bait sometimes, but not taking the bait to sort of, you know, focus on, you know, this, this person is saying this thing and, you know, let's go for that person.

I think, I think that more saying like, what is this going to actually mean for a kid, their mom and dad, for an older adult?

And just like sort of using that, like, you know, say what you said to me before, really, like, take that 60 seconds, that 30 seconds.

And I know sometimes it's 20 seconds to somehow message, you know this is what's happening and and what that means for you is that you're going to have to pay 175 for a vaccine that was free last year like i think that that's because i think if people understood that

I think that they would have a different perspective on, you know, on getting involved in the noise that is about like individuals and personalities and characters and sort of be more like, well, how do we fix it?

Like, I didn't know that.

I feel like that's like the thing that I'm getting the most is I had no idea.

I didn't know that.

And so, is that a public health failure too?

Yes, but that involves public health being able to speak, which I think has been something that this HHS has limited pretty well as well.

Before we let you go, I wanted to get your take on places our listeners, the general public, should be going to to get critical information that I think now, and especially in this

chaotic space here, if they have questions about will they need a prescription, can their pharmacists prescribe or and administer a vaccine?

I know it's probably going to be harder to get one-stop shop when it comes to all the questions people have, but where do you go?

Or where would you recommend you go?

I do kind of have a one-stop shop, but it's not the perfect answer because, you know, not everybody has a physician or a clinician that looks after their health.

But this is the time where I would say that's really important.

I think, you know,

clinicians,

they don't don't get necessarily wrapped up in all this policy swirl.

They know what's the right clinical thing to do and they look to sources that are valid to be able to figure out what the path forward is for their patients.

So, you know, I think always good to do research.

I think looking at the AAP, at ACOG, at AMA, at the alphabet soup of professional organizations that serve people.

But I think that like actually speaking to the provider, talking to the pharmacist, talking to your doctor, talking to whoever in healthcare you have access to, I think is a great first step.

And I know this is like very operational, like sort of like silly

recommendation, but I see patients and sometimes you just have to be very straightforward.

Call before you go.

please, because I don't want people to go to the pharmacy and expect that it's business as usual and all of a sudden have like the swirl of chaos that is being created on purpose around them.

So call and say, hey, like I want to get this vaccine.

Do you do it?

Is it, here's my insurance.

Can you run a little test claim to see if it's covered?

So I know what I'm paying.

Like, so just things like that.

It's there.

It's going to be a little bit of extra work.

But I think that, you know, just a little bit of pre-calling, a little bit of pre-thinking is going to make it less complicated for people.

That's fabulous advice.

Later on, I couldn't agree more with speaking to your own, your child's pediatrician, to your medical provider.

Best advice.

I've got to say one more thing, Ben.

Like,

everybody who's telling you not to listen to your pediatrician, red flag.

It's not okay.

Right.

Like, bottom line of all of this,

anyone who's like, you know, that pediatrician, he's pushing vaccines.

No, that pediatrician is pushing health for kids.

Like, no one pushes the vaccine.

They're going to talk to you about the vaccine, and you can decide if you want to do it or not.

But anyone who tries to destabilize what i think is a really relationship between doctor and patient that that's a red flag warning something is horribly wrong oh so well said so well said my wife thanks you as does the ap uh healthy children atorg american academy of pediatrics very easily navigable accessible health information platform highly recommended immunize at org for adults uh

we are graced by your presidence uh the former head of the National Center for

Immunizations and Respiratory Diseases, Dr.

Dimitri Daskalakis, thank you for joining us on a holiday.

We're just grateful for your leadership and everything you've done for this country.

Thank you, Ben.

Nice talking to you, and thanks so much for having me.

Can't get enough, Midas.

Check out the Midas Plus sub stack for ad-free articles, reports, podcasts, daily recaps from Ron Filipowski, and more.

Sign up for free now at midasplus.com.

Trip Planner by Expedia.

You were made to outdo your holiday,

your hammocking

and your pooling.

We were made to help organize the competition.

Expedia made to travel.