Doc Discussions with Dr. Jason Edwards
THIS is the podcast you have been looking for! "Doc Discussions" are just what the title says they are: physicians from a wide range of specialties, talking about relevant, up-to-date medical topics, not to mention tips on habits to help you live your best life. Your host, Jason Edwards, MD, is a board-certified radiation oncologist with a PhD in cellular and integrative physiology at St. Luke's Hospital in St. Louis, Missouri. Dr. Edwards explores not only diseases but also suggests techniques to optimize mental and physical health for a long and good life. Real people. Real advice. Real good. This is Doc Discussions, with Dr. Jason Edwards!
Doc Discussions with Dr. Jason Edwards
Trust, Science, and Parental Fears: Part 2 of Navigating Childhood Vaccination Decisions
The science of vaccines has never been more contentious or politically charged than it is today. What started as a medical breakthrough has become a flashpoint in our cultural divide, leaving many parents confused about what to believe.
In part two of this thoughtful conversation with pediatrician Dr. Lisa Ryan, we cut through the noise to examine vaccine hesitancy from multiple angles. We begin by tackling common concerns about vaccine ingredients like thimerosal and aluminum, explaining what these substances actually do and why modern vaccine formulations have largely addressed these worries. Dr. Ryan shares her perspective as a healthcare provider, revealing the frustrations of trying to communicate evidence-based information to families whose minds are already made up.
The discussion takes a fascinating turn as we explore the mathematical approach to vaccine decisions, breaking down risk assessment using real numbers. How do you weigh a 27 in 100,000 hospitalization risk against a 1 in 10,000 chance of vaccine reaction? We distinguish between the decades of safety data behind childhood immunizations and the newer COVID vaccines, acknowledging that different vaccines warrant different considerations.
Perhaps most striking is Dr. Ryan's concern that we're witnessing a dangerous regression in vaccine acceptance. "My biggest fear is that these vaccines will be pulled off the market," she reveals, highlighting how the politicization of COVID vaccines has spilled over into attitudes about established childhood immunizations. We discuss reliable information sources like Children's Hospital of Philadelphia and vaccine expert Paul Offit, while exploring how even artificial intelligence struggles to find legitimate scientific evidence against vaccination.
Whether you're a parent making decisions for your child, a healthcare professional navigating difficult conversations, or simply someone trying to understand both sides of the debate, this episode offers a balanced, evidence-based perspective on what Dr. Ryan calls "done science" – areas where the research is so thorough that reopening debate serves little scientific purpose.
Okay, and so you know. Back to the topic at hand. You know some people are worried about specific agents within the vaccines, like thimerosal and aluminum. You know other ingredients in with the vaccine. What's the story with that?
Speaker 2:So the thimerosal is a preservative and we would see it in multivials, so vaccines that you. Basically it's like a I don't know a 50 vial or a 50 dose vial, gotcha. It probably wasn't probably made me like 10. I don't think we would do 50. But there would be a thin layer of thimerosal on the stopper so that when you were putting the needle in and pulling it out, you weren't introducing infection Gotcha and honestly we just don't have those anymore and introducing infection.
Speaker 2:Gotcha and, honestly, we just don't have those anymore. We everything, pretty much everything, I think, a single, single dose now. So it comes with its own bile. We put a needle on the end and we use it right away. So thimerosal really is not an issue, and even for a while we they. They would have ones that were, you know, specifically labeled thimerosal free.
Speaker 1:And what? What did the thimerosal do Do? What did the thimerosal do? Do you remember?
Speaker 2:Well, it was just that preservative to, to keep um, I mean, why was it bad?
Speaker 2:Oh, well, it wasn't it was just this was then another. You know people would say, hey, this is clearly because of thimerosal that we're having. You know they were basically blaming the thimerosal product Right. So because of those complaints, because of those concerns is why they then came out with the single vials, and I'm sure I am I don't know exactly that might even just have been within the last 10-ish years trying to think. And then the aluminum is what's called an adjuvant, it's something that it goes in with the vaccine to kind of help boost the vaccine's effects, kind of helps the immune system do what it's supposed to do. And so people were concerned about that too, because I mean, it sounds concerning, we're putting aluminum in your baby. But it was. It was very, very minimal amounts. And you know the argument would be as you walk down the street you're being exposed to more aluminum in the environment than you're being exposed to in this vaccine. For sure, being exposed to more aluminum in the environment than you're being exposed to in this vaccine.
Speaker 1:For sure you got, I'm sure, growing up in Southwest Missouri.
Speaker 1:I drank plenty of aluminum and you know probably a little lead here and there, Um the um and so, yeah, yeah, I mean you're, you're, you're, you don't want to um, introduce a lot of heavy metals into the body, but but I mean I consume aluminum and you know everything else. Um, you know to some degree and and so um the um and so and so, yeah, you can have these things that amplify the response. It's like kind of this foreign substance, that kind of turbo boost your immune system and so you can actually use less antigen, yep the so. So sometimes, you know, people think that we're like robots and that we never get like upset at work and stuff like that. But but like we're human beings and like I think I would think that kind of having some of the same conversations over and over again could lead to frustration.
Speaker 1:Same conversations over and over again could lead to frustration. There's in my job, you know, I work with cancer patients but there's a couple subjects that I'm like like I just, you know, I try to not, I try to hide that part of me and just have the conversation and just talk about the nuts and bolts, but it's just like. It's like the last thing I want to do is to talk about. You know some of these kind of nuanced things like people will say, hey, um, I've read mistletoe is like good for curing cancer, or like hedge apple, um, or you know there's all these things and I kind of got it.
Speaker 1:You know it's. I've developed a two-minute speech down but it took a while to like shorten it. Um, so it like it kind of accomplished this task, but does it ever get challenging or frustrating?
Speaker 2:Yeah, deal with this. I mean, like I said, our office, you know it, we kind of screen people. You know, when they call I want to be a new patient and one of the first questions is do you, do you plan to vaccinate? Yeah, we will happily see people for what we call a meet and greet, you know, before your baby comes and you have some questions and I think that's probably a little bit more where I'm talking about vaccines and it's just. I mean, I guess what's frustrating for me is the parents don't typically have like a specific question to me to address. It's usually like I'm worried about them or I just don't want to do them, and if I try and press a little further, I just don't get very far.
Speaker 1:So there's, there's kind of no underlying substructure to the thought, right yeah?
Speaker 2:So you know, I'll talk and I can talk about generics, about why vaccines are good and why I fully support them and those sorts of things, and sometimes that's enough and that's great. I mean, you know, honestly, I'd be happy to sit with you for an hour if you were going to change your mind at the end, but I've also never had that experience.
Speaker 2:You know, in my early career I did a lot more of that and I really I don't think I changed anybody's mind. I think people were really kind of already set in their ways and they I don't even know if they were listening to what I had to say.
Speaker 1:Yeah.
Speaker 2:And that alone is very frustrating. And, you know, truthfully, the Academy of Pediatrics has kind of taken the stance that that's really what we should be doing, that we should be bringing these people in repeatedly and we should continue to talk with them in hopes of changing minds. I think a lot of us have. Just, you know, it is. It's frustrating. I have to get through my day and I have to feel good at the end of the day that you know I took care of all my patients the best I possibly can.
Speaker 1:Yeah, and you've got a waiting room full of people. I mean, you don't, you don't. The truth of the matter is you don't have like a ton of time to to to, to spend towards something that's not going to be productive for you or the patient.
Speaker 2:Right, right. And, like you know, a lot of it just kind of comes down to at the end as being like look, you know, I've kind of explained this to you, this is our policy, and usually by then they've packed the baby up and they're halfway out the door.
Speaker 1:Yeah, so you know, and, like I, said they'll find that doctor that they trust more and hopefully can have a relationship with and go from there. Yeah, you know this is kind of a personal side and I'll tell you how I kind of looked at the COVID vaccine which is different than the childhood vaccinations. It was new. It was a newer technology with the mRNA vaccine.
Speaker 2:Which I think is really cool technology though.
Speaker 1:Yeah, it definitely helps you develop a vaccine a lot faster than the old way, because you just have to come up with a code. I think they did it in like 21 days.
Speaker 2:Yeah, it was amazing.
Speaker 1:And then run it through the ribosome Um, the um, so, um, yeah. So I definitely, you know, was like I knew that like either through herd immunity of like everybody getting COVID or vaccination, you know that was the only way out. And so so I was definitely like very happy to like get the vaccine initially and then the booster, but as like there was like many shots that went on, I was, I was not like as excited to continue get like I didn't get the eighth, you know, sure, covid vaccine and um and but but I tried to like really call balls and strikes like the best I could and like go at it as rationally as possible.
Speaker 1:And they, they're, they're in the, and the virus was weakening too.
Speaker 1:Right, right by the booster time, you mean, yeah, or even past the booster time, and so less people were going into the hospital. And so I looked at the risk of people, my age, and so the demographic was like 25 to 50. And so kind of a broad demographic. And it was like at that point it was like 27 out of 100,000 were going to the hospital and the vaccine was 90% effective at keeping you out of the hospital, right, and most of the people going into the hospital had multiple comorbidities. And I'm at the time I'm, you know, I'm early 40s at the time and and I had no medical comorbidities and you know, I thought of myself as healthy I guess you never know and so I was. So I did I like literally like broke it down, I think I think you got to break things down to math or physics, if you can yeah to make the best decision.
Speaker 1:So I was like, okay, so for like a nice round number, we'll say, like it took the 27 out of 100,000 and knocked it down to about 10. And then you know, if you get the vaccine, it's one, if you don't get it, you're nine out of 100,000. And then I looked up, like the risk of vaccine injury, which was like one in 10,000, which is also known as 10 out of 100,000. So it was about the same as print, you know, keeping you out of the hospital. Now that's just one component of it. Sure, there's a herd immunity component to you know, there's a patient component too. But like I tried to be as objective as I could, you know, and because I think people can be kind of an ideologue when they're anti-vaccine and I think that people can be an ideologue when they're pro-vaccine. Now, if you have to choose between the two, it's probably better to be a pro-vaccine ideologue, because it's vetted by all these systems.
Speaker 1:It's not for no reason that they're giving you the thing that they're giving you, and so you're probably going to win out if you just are an ideologue on that side. But sometimes I do wonder when people are getting like literally their eighth booster. To me that seems sometimes like a little much. But I mean, if you think I'm an idiot, tell me.
Speaker 2:No, no, no, I see where you're coming from. I mean, everything's different with kids and so my, my standpoint is always you know, from the kid and also as someone who's working with kids, I mean, I got my booster cause, I benefit the risk versus and you know, honestly, I I'm employed by WashU.
Speaker 1:If I'm employed by WashU, If I get COVID, they are sending me at home for a week, so that alone is worth it for me not to get COVID, and the data on the vaccines that they use in children has decades of studies or childhood ones.
Speaker 2:Yeah, for sure, for sure.
Speaker 1:And so but but so. So this is kind of not that you know Well, but.
Speaker 2:But so the thing with kids is, you know, most of them were doing well, Most of them, you know, were not landing in the hospital and there was the issue with the boys and the, the pericarditis and that sort of thing.
Speaker 2:So I think for me it was a lot more complicated making decisions for my kids. Yeah, then then it was for myself and I'll say actually so, myself and my two boys, we were actually part of the study, okay so, and I know my youngest maybe I don't remember now I know the youngest definitely got the shot, like I. You know cause they basically you come in and you get a shot and you don't know if it's placebo.
Speaker 1:Was it one to one or two to one? Do you remember?
Speaker 2:I don't remember.
Speaker 1:Isn't it crazy A lot of times I'll do one to one you know, half the people get not, you know a placebo and half the people get the shot. But sometimes I'll do two to one.
Speaker 2:Yeah, it might've actually been two to one.
Speaker 1:I don't remember.
Speaker 2:Um, but and, and they did it in in stages too. So, like my older son was part of the study first, and then the younger one, and I just remember, you know, they'd get the shot and they'd come home and I'd be like poking their arm hey, does that hurt? Does that hurt? You know, move your arm? Does that hurt? Does that hurt? And I remember the youngest being like, wow, that hurt. And I'm like, yes, he got the shot, and just being so excited that they were able to be vaccinated against this thing that was running rampant through the country at the time.
Speaker 2:And just being so grateful that there was a vaccine. And I remember with my oldest trying to get her a vaccine and okay, how far am I willing to drive to get this for her. Because I remember when they were really scarce and you had to sign up on Walgreens and be like the first one there.
Speaker 1:I've forgotten about that.
Speaker 2:I think it was trauma in my brain. But you know, and I remember going through that and a lot of us pediatricians were talking and we're like, yes, now the world is seeing what it's like when there's no vaccine and people are seeing how important vaccines are. We really thought that people would kind of come around then but it really was kind of the exact opposite. You know, people really started to distrust how important the vaccine was and how you know quickly they say it was put together and those sorts of things. And I think what we're seeing now in terms of vaccine hesitancy in some ways goes back to the COVID shot and the rollout of it.
Speaker 1:Yeah, I think so. And I mean one thing you know I did analyze the data a while back and I mean you definitely saw the people who are most at risk got the vaccine, you know, at the highest rate. You know people over 65 were way more likely to get vaccinated than an 18 year old. Yeah, and you know those are the people that were, you know, more likely than not going to be in the hospital. 18 year olds did kind of shockingly well and you know the young people tended to not get that sick.
Speaker 2:They were doing pretty well.
Speaker 1:One thing that was concerning to me is thinking back to the flu of 1920, where the young people actually, I think, got sick more often than the older people which is kind of a weird thing, but. But I mean, things like that are possible, possible too, and so there's a ton of unknowns and you just got to.
Speaker 1:You know. I would say I In a general sense I trust these large institutions, but I have some of the a little bit of skeptic in me. Sure, I know people in power tend to abuse power Fair and so if it's like a big company or things like that.
Speaker 2:I do sympathize with the skeptics.
Speaker 1:I do sympathize with the skeptics, but I think that if you're kind of in a data-free zone, I mean you really do got to trust the experts. Fortunately, with childhood vaccinations, it's definitely not a data-free zone and there's plenty of good data that supports it, and so I think it's okay to be skeptical, but take a good dive into the data, and that's one of the things that's great about AI too. It's kind of like the Oracle stone, I mean. You can go ask it any question and you can even cross-check it with multiple AIs and see if you get the right answer.
Speaker 2:Well and I think that's an important message to get across too is that there is lots of data on these vaccines, and I think it's just really important to point out. This has been looked at. This is done science, like there is such a thing as done science. We don't have to redo everything, we don't have to remake the wheel. This has been studied extensively.
Speaker 1:And.
Speaker 2:I think it's important that people get that information. I mean, my biggest fear is that these things are going to be pulled off the market.
Speaker 1:The yeah, I don't. I don't have a good sense of you know what's to come with that.
Speaker 1:I think it's a highly politically charged you know, obviously a highly politically charged environment, something like this, a generic statement like the science is not clear, you know, I think that you can say we've got a lot of science to back that up. One individual is not going to be able to go in and say I'm going to analyze all the science myself unless you have, like, a PhD, like you and I have, um, where you can like analyze the science and see.
Speaker 1:But I think, something like um, whether it's um open AI or grok or or anthropic um or um, even deep seek, if that's still legal, um, you know, but you can use these AIs to help point you in the right direction and they could have biases, but, um, but I doubt, like they all have the same bias, and so you run it through there and you see, okay, there's a lot of data that supports this and and we, we should feel good about moving forward. Um, I, I honestly do think that there um so so that that can be dangerous. You know, I think that it is important that we actually are focusing on our health, you know, and some of this stuff.
Speaker 1:And so I think there can be good and bad. As Alexander Solzhenitsyn said, the line between good and evil does not run on a map, it runs between every man's heart and so we all have some good and bad in us, and so I think it's good to talk about the health of America and stuff like that we don't. Yeah, there's doors that we don't need to open again.
Speaker 2:But I just think that's the biggest message that you know, because I think we're going to be hearing a lot of that.
Speaker 1:there is no evidence, and there is actually so where would you point people if they're looking for you know they're saying, hey, I want to do my own research. Where would you point them?
Speaker 2:to CHOP has a really good website Children's.
Speaker 1:Hospital of.
Speaker 2:Philadelphia. There's Vaccinate your Baby also a good website, and then one of my favorite vaccines guys is Paul Offit, and he's written several books about a lot of the things that we've talked about too, and I think he has a sub stack that has been pretty active recently to talking about some of these issues.
Speaker 1:And so to steel man, the other side. Ok, so that's the opposite of a straw man. If somebody were to say, yeah, but these are, these are people in the industry, they're going to believe all this through orthodoxy, do you? Do you think? Do you think it's reasonable to use the AIs to run it through there and say, hey, like what's the evidence of vaccine? Or do you trust that less?
Speaker 2:Um, I would want to try it myself first before saying something, but I mean, I feel like they should be coming up with the same stuff they do, they do, they're supportive.
Speaker 1:And so I like I said again, like I do trust the AIs a lot. I think that, and especially if you get the same answer from multiple AIs. So the question I asked was what's the strongest evidence that you have against vaccination? So I was trying to find, like, what's the strongest anti-vaccine argument for children? What?
Speaker 1:did it pull up Wakefield you know which just is not strong. And so I actually said no, that's a straw man argument, I want the strongest argument and it just couldn't really pull up. You know much else than that, which is. I actually thought that there would probably be some kind of just you know the P values P equals 0.05, you know for significance.
Speaker 1:So you'd think one out of every 20 studies is going to show some errant thing and like it couldn't really even show that, and so there wasn't a lot. When I searched for the strongest argument against it, there wasn't a ton of like scientific evidence against it that it could give me that.
Speaker 1:And so I think you really got to do red team, blue team and try to find the strongest argument on each side and then see how they kind of when you're solving any problem, whether it's running a business or science or whatever you want to call balls and straight, you want to be as objective as possible, you want to pretend like you know nothing. And because our experiences help us make a lot of decisions, but they also buy us as well. And so when I, when I ran it through, I just wasn't able to find anything, except for Wakefield's stuff, which has been largely debunked and he may have even admitted to I can't remember if he did or not, but he, I think he even admitted that there was some kind of malarkey going on.
Speaker 2:Yeah, I mean he.
Speaker 1:yeah, he lost his license and all of that and and and so well, lisa, I think we beat this with a hammer, but I very much appreciate you coming on and I appreciate your perspective and I think this is a timely and important thing to talk about and it's good to kind of go through, you know, the pros and the cons and the pluses and minuses, and try to dissect this as objectively as we can to give people as much accurate information as possible.
Speaker 2:Yeah, yeah, thanks for having me, this was fun.
Speaker 1:Thanks so much, Lisa.
Speaker 2:All right.