In this episode of Wellness Unmasked, Dr. Nicole Saphier breaks down the latest vaccine updates from the ACIP, including changes to MMR and varicella scheduling, new risk-based recommendations for the COVID vaccine, and growing debates over acetaminophen use during pregnancy. She also addresses the public response to recent autism-related warnings and underscores why clear, consistent communication is critical for building trust in public health. Wellness Unmasked is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Tuesday & Friday.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to Wellness on Mass I'm doctor Nicole Safire and
we are going to dive right in. It has been
a really busy week the last couple of weeks, between
the two days worth of ACIP meetings with the CDC
and also the big press conference with President Trump and
essentially the entire HHS standing behind him. We have a
lot to cover, and I mean we only have thirty minutes,
(00:24):
so it's a lot to cover, but we're going to
do it. I am always very honest with everyone my opinions.
People sometimes get mad at me because they feel like
I'm not a loyalist, whether one way or the other.
But at the end of the day, I think my
role as a physician, as a human, as an American
is to kind of just tell you what I'm thinking
(00:46):
and kind of make some sense of all this mess.
We did that throughout COVID and we're going to keep
doing that right now. So the good news is during
the White House press conference, they kind of talked about
what those ACT meetings were all about, so we can
combine them all. One of the big things that came
out of the ACIP meeting was that the formal recommendation
is to separate the MMR vaccine that measles, mumps, and
(01:09):
rubella from the vericella vaccine. Aricella is chicken pox. It
was a formal recommendation saying for kids under four, so
that first dose of the vaccine they should be separated
into two separate injections. Well, this isn't really groundbreaking news.
In fact, that was already the recommendation from ASIP from
(01:29):
about a decade ago. They're just now saying insurance companies
are not going to cover it if you want to
choose to have that combined dose. The reason they recommend
having those two doses separated is because when they found
that they combined the four different vaccines, the measles, lumps, rubella,
and aricella, there was a slightly higher risk of febrile
(01:53):
and aphebrile post vaccination caizures and that's real. Thankfully, the
majority of children cover without incident from the seizures, but
they're still scary and if we can avoid seizures, I
think that would be the right thing to do. So
it makes sense they found children over the age of
four didn't have this risk of seizures following it, so
after the age of four, you can combine the vaccines.
(02:16):
So for about eighty five percent of all children for
the last eight to ten years or so, they've already
had these vaccines separated, meaning they have to come back
for two different doctor's appointments to get two different vaccines.
Fifteen percent of kids were still getting that combined dose,
even knowing there was a slightly higher risk of seizures.
(02:36):
So the pediatricians who were administrating the combined dose for
kids under four, they did this knowing there was a
slightly increased risk of seizures, but they were concerned, whether
they were concerned the parents wouldn't come back for the
second dose or whatever, the reasons being, they had to
weigh that risk with potential benefit of the vaccine. This
latest ACEIP is saying that is no longer an option.
(02:59):
You have to separate the doses. I don't see anything
wrong with this. In fact, I agree with it. If
we can avoid a risk of seizures, we should be
doing it. So this is great news. I think that's fine.
The other big issue that came out of the AST
meetings was what to do with the birth dose of
the hepatitis B vaccine. Should all children be given this
(03:19):
vaccine before they leave the hospital, the birth dose. You know,
this is something that I've talked about a lot. I
don't necessarily think it's necessary. I think this is one
of those vaccines that should be done based on risk.
Since the nineteen eighties nineteen nineties, when the hepatitis B
vaccine became available, yes, we saw cases of hepatitis B
(03:41):
go down. Another thing that was also happening during this
time was we started testing pregnant women for hepatitis B
virus to know what their status was. That could also
have contributed to the decrease in babies being born with
hepatitis B. For me, my opinion is if a woman
(04:01):
recently tested negative for hepatitis B and they're living a
low risk lifestyle, no IV drug use, not a sex worker,
they don't have it hepatitis BE positive person living in
the home, then the newborn probably doesn't need this vaccine
and we can have a conversation about whether or not
they should get the vaccine later in life. What the
(04:22):
ACIP was wanting to vote on was saying we're not
going to give that dose at birth. We just want
to give it at one month when the baby's slightly older.
The problem with that is there's no data that supports
or goes against the birth dose versus one month, So
how can you really have that conversation or even put
it forth a recommendation. The reality is you can't, which
(04:45):
is why they decided not to. There was a motion
to postpone the conversation indefinitely, so they didn't even vote
on that. President Trump brought that back up at the
press conference. I'm going to get to that. I just
want to mention the third thing that came out of
the ACIP meetings before we move on to the press conference.
The third thing that came out was all about the
(05:06):
COVID vaccine and this is what we were all kind
of waiting for what are going to be the formal recommendations.
And the big thing was ACIP finally is saying no
more universal recommendation for COVID vaccines and boosters. What was
the mantra of the entire Biden administration of every baby
six months and older to adulthood until the day you die,
(05:28):
you should be getting the full vaccine series of COVID
plus one, maybe even two boosters every single year into perpetuity. Obviously,
that makes no sense, as we have gone on to
show that the virus itself has starting to decrease in
severity and virulence. You have so much natural immunity, we
have a lot of vaccine induced immunity. And really this
(05:51):
should also be one of those risk vaccines. The higher
risk you are, the more you should consider the boosters,
and especially in the low risk populars like specifically adolescents
and school age kids, the risk benefit scenario with the
COVID vaccine just may not make sense. And that's essentially
what ACIP said. Now they did not go as far
(06:12):
to say that you can't access the vaccine if you
are a healthy young adult or a healthy adolescent. They
didn't say that at all. In fact, they tried to
vote saying you needed a prescription, and they tried to
decrease access to the vaccines, but those votes failed. The
only votes that passed in ACIP regarding the COVID vaccine
is just to change the recommendations that it should be
(06:35):
risk based and anyone else considering the vaccine should have
a conversation with their doctor about the risks and benefits
of this vaccine. And I think how could anybody argue
with that of course you should always have that conversation,
and physicians should be forthcoming with the you know, perhaps
very low benefit of vaccines in a healthy individual and
(06:58):
the very real risk, especially an adolescent boys, with this vaccine.
I think these conversations, this information, these are all good things.
I think it's great that the votes didn't pass restricting access.
If the vote for requiring a prescription for this vaccine
would have passed, it would have been a logistical nightmare,
(07:19):
but it didn't, so there's really nothing bad you can
say about. I think everything that happened was good. It
was very frustrating to watch some of the ASIP meetings.
Clearly a lot of the people who are putting together
the votes and some of the talking points have no
idea what it's like practicing medicine. They have only worked
in a lab or have only been surrounded by data,
(07:40):
which you need those people. You need people who are
very good at data, but you also have to balance
that with the practicality of what it's like working in
real world healthcare. Didn't feel like we had much of
that balance. Definitely felt like a lot of ideology was
being presented, a lot of flawed data that in the
real world of academia. We would never even consider because
(08:02):
a lot of it was not legitimate. Some of it was,
but a lot of it was not. It was very frustrating.
But we don't need to get into the details of that,
you know, I because the granular details don't even matter
because the results were fine. And I think all of
those results are fine, and anybody who's causing an uproar
over it don't really understand the implications. Nothing major has changed.
(08:24):
It's all going to be okay. Now, let's fast forward
to the big White House press briefing or announcement that
just came Monday night. This was this was a big deal,
and let me tell you, it was really painful to watch.
President Trump came out. He was flagged behind him by
(08:46):
HHS Secretary RFK Junior FDA Commissioner Marty McCarey, NIH director
Jay Bodicharia, and CMS director Memet Oz. There was a
lot of information presented at this press conference. Some of
it was factually correct, some of it was factually incorrect.
(09:06):
The problem I had was it was full of hyperbole.
And not only do facts matter, but the messaging matters too.
And I can only say this so many times. The
overarching message of this press conference is that autism rates
are on the rise. They are. Yes, some of that
has to do with the expanded diagnostic criteria of autism
(09:28):
spectrum disorder and including Aspergers and others. So yes, that
contributes to it. You can't deny that that absolutely contributes
to it. But something more is going on. There are
more children being born with neurodegenerative diseases than before. That's
also undeniable. So the question is why is that? The
(09:48):
conversation about acetaminifin commonly known as paracetamol or thailool, but
acetaminifin in pregnancy and associated with ADHD and the baby
or autism spectrum disorder. This is not a new conversation.
In fact, we've been having it for decades. Why is that?
Because there have been a lot of observational studies that
(10:11):
have looked at women who have taken a stamnifin and
the potential risk of autism. There have been a good
amount of observational studies looking at women who have taken
a staminifin during pregnancy and a slight increased risk of
autism spectrum diagnosis and ADHD in their babies. Now these
are what we call observational studies. Meaning one of the
(10:31):
bigger ones was I think twenty nineteen from Johns Hopkins.
They looked at cord blood analysis, you know, the blood
in an umbelical cord, and they found higher metabolites from
a staminifin in the children who were born with autism.
So does that correlation mean that the acetaminifhin cause the autism? Well, again,
(10:52):
correlation does not mean causation. And I think you're probably
going to hear that a lot of times. We heard
a lot of that during COVID and you're going to
hear it now. But it's true. Correlation means that, Okay,
there was a staminifin there and now the child has autism.
So it's a corelate. But was it the acetaminifin that
caused the autism? And that's what the studies haven't proven
(11:14):
yet Because why are people taking acetaminifit? Well, yes, we
take it for a pain reliever. We also take it
for fever. So if a woman, a pregnant woman gets
an infection and then she gets all that inflammation and
that inflammation causes the fever, it's the body's natural response
to try and fight off that infection. Oftentimes they'll take
(11:35):
taileanol to reduce that fever. So what is it exactly
that's causing autism? Is it the infection, is it the inflammation,
or was it the tileanol? All of these things are
potential correlates. They have not actually figured out what is
the cause. You're listening to Wellness and Mass. We'll be
right back with more. At this press conference, no new
(11:58):
data was presented. Yes, they highlighted this recently published study
just last month that included some Harvard professors in it
public health, and what that was was a meta analysis.
It wasn't new data. They just said, look at all
of these studies. All of these studies have shown that
there may be a correlate between a set of menifin
(12:20):
use and autism. That's undeniable. You cannot deny that that exists.
But you also can't deny the flip side of that,
which is there have been studies, specifically a very large
one out of Sweden that included about two point five
million kids where they tried to control for that correlation.
They looked at siblings, and they looked and they tried
(12:42):
to remove some of those confounding factors and what they
found was before they removed those confounding factors, there was
about a five percent increased risk of a child being
born with autism spectrum disorder ADHD if tylinol was used,
but when they removed some of those other factors, that
risk went down to zero. So they found there was
(13:05):
no causal link of acetamnifin and autism spectrum disorder. So
no one has been able to prove causative link between
aceta minifin and autism spectrum disorder. FDA Commissioner Marty mckarey
quoted this Harvard study and he said that they were
(13:26):
able to find a causal link, but I have to
be honest with you if you read the study, No
they didn't, and they say they didn't. They said, and
I want to actually just quote it here because I
don't want to give you my opinion. I want to
quote exactly what the study says. Our analysis demonstrated evidence
consistent with an association between exposure to a state of
(13:48):
minifin during pregnancy and offspring with neurodegenerative disorders including a
SD and ADHD, though observational limitations preclude definitive causation. So
again there are studies showing there's a correlation, but there
is not a strong study showing causation. And even though
(14:10):
what was said at the press conference yesterday was that
they have found a study pointing to causation, that's just
not true. Now the takeaway isn't, well, we should just
take as much, say to minefit as we want in pregnancy. No,
absolutely not. There are still enough studies there, there's enough
correlation that we have to err on the side of caution.
(14:31):
And that is really what the message should be. It
should be that for minor aches and pains, you have
to try other things. You want to try, massage, acupuncture, aromatherapy, anything,
just trying to relax. Don't grab for the tit bottle
anytime you want. But we have to really do away
from that paternalistic culture where the President came out and said,
(14:54):
you just have to toughen it out. It's really hard,
I'll be honest for a woman to hear as, oh,
we can't toughen it out. I'll be honest. I think
women are much more tough than men, specifically when it
comes to physical ailments. But it's not about toughing it out,
certainly not when pregnancy when we're talking about pregnancy, there
are a lot of physiological changes that occur. And while
(15:16):
I think for the majority of aches and pains, we
can toughen it out, and we should, especially because there's
a potential correlative link of neurodegenerative disorder and a set
of minifin. However, I can also tell you when it
comes to high fever, there should be no amount of
toughing it out, because when women have fever and pregnancy,
they have up to a forty percent risk of a
(15:38):
child with neurodegenerative disorder. If they have multiple fevers during pregnancy,
especially in that second and third trimester, that risk triples.
That is significantly higher than any risk that has ever
been reported using a set of minifin when it comes
to neudegenerative disorder. So my biggest fear is that the
message at this press conference was women should not consider
(16:01):
a set of minefit in pregnancy no matter what. They
have more fear now from that medication, and they don't
have the fear of a high fever, which is a
much bigger risk for not only than mother, but that
baby that's forming too. So the messaging was wrong in
my opinion. The President continued to come out and saying
tailan all's bad, tialan all is bad. The message should
(16:23):
have been tilanyl should be used sparingly in pregnant women.
There's research there, but it's unfinished research. We need to
put more time and effort into this because we have
to make sure that pregnant women have something safe to
take during pregnancy, and the constellation of research right now
tells us that using thailan al sparingly at the lowest
possible effective dose is what's safest for the mother and baby,
(16:47):
especially in cases of high fever. That message was lost
at the press conference yesterday, and I think that it
was un very unfortunate because when we're in a time
of chaos and public public trust erosion, messaging matters. It
really does. Now there's a firestorm across the country that
(17:09):
is just creating this massive divide, and the reality is
it shouldn't have been. This was a great message that
came out of the White House. What it was was
reinforcing and already existing warning when it came to a
sayamnifin use and pregnancy, that there are some concerns there,
but still it remains the safest medication when it comes
(17:30):
to treating high fevers full stop. That should have been
the message. It tumbled a bit throughout, and like I said,
there were some factual interacuracies that were presented. Moving on
from tilnal more was said, and it kind of just
evolved from there. The President also mentioned hepatitis B. He
(17:51):
said that maybe hepatitis B should be given at the
age of twelve, that vaccine that we had kind of
heard about during ASIP. That was a first. I havn't
heard anybody else mentioning twelve. I haven't seen any data
showing that twelve is the right age. My guess is
maybe that is because hepatitis B can be sexually transmitted
and that is the time pre prereessence where maybe sexual
(18:13):
activity is starting. So maybe that's the mindset behind that recommendation.
We haven't heard from the CDC or the ASIP about it,
or the FDA or really anybody, so it was kind
of off the cuff by the President. I'm sure we'll
be hearing more about that in the future. Maybe age
twelve makes more sense than a birth those. For me
(18:34):
that it sounds a little bit more reasonable because if
it's sexually transmitted, then maybe that's it. More. Coming up
on Wellness Unmasked with doctor Nicol Sapphire and he mentioned
the MMR vaccine and the vericellas separating them. That also
makes sense. I already said that, But then he kind
of got into he brought the tilent all back, saying
(18:57):
and don't give talent all to your babies after your
vaccine means. This was very confusing because that had nothing
to do with what the FDA was talking about. The
FDA was specifically talking about talinl and pregnant women and
its role in brain development. So it would be nice
if the FDA kind of clarified a little bit more
(19:17):
what they were meaning. As the President saying that the
formal recommendation is not to give talinol at all and
infants and toddlers and school age children, I think that
left a lot of people very confused, and so it
would be great to have some clarification there on what
they were talking about and if there was actually some
data to support what was being said. They didn't point
(19:41):
to any. Another big thing that did came out, which
I was very excited about, was the conversation around treating
children born with autism spectrum disorder with something called luco
vorren or which is essentially a reduced version of folate folate.
(20:02):
If you think of folic acid, that's the big thing,
and all the prenatal vitamins. We already know that folate
and fullic acid is extremely important for the development of
the fetus in a pregnant patient, which is why prenatal
vitamins are so strongly recommended. Children born with autism spectrum
disorder oftentimes are found to have low folate levels. They're
(20:24):
also found to have autoimmune antibodies against folate receptors in
the brain, and several studies have shown when you increase
folate in the mother, you actually decrease the risk of autism.
So the fact that the conversation around that is now
being amplified, that's an incredible thing. Lucoborin is a prescription
medication that can potentially treat these children who are born
(20:47):
with the autoantibodies to the leucovorin receptor or just low
folate acid fullic acid levels. Studies have shown that it
does help improve some of the verbal communication obvious. These
are small studies and more studies will need to be done,
but at this point I think any parent who has
a child born with autism spectrum disorder, they just want anything.
(21:10):
They want anything that might be able to help. So
I think it's wonderful to amplify this. And then doctor
Oz came out and said CMS will cover it as well,
because obviously it's great to have a medication, but if
you can't afford it and you can't access it, that's
a big problem. Marty McCarey said that they've already talked
to the drug manufacturer and they are going to increase production,
and then Mema Oz said CMS is going to cover it.
(21:32):
Half of our children are on Medicaid or CHIP programs,
so they get their medications and healthcare through government assisted
program so at least half a children are going to
have access to it and have it be covered. I'm
sure private insurers will follow suit, as they tend to
do so, I'm sure with lobbying efforts that'll happen. So
these are great things. Again, if we could just take
(21:57):
the press conference and say you need to use tilan
all sparingly during pregnancy and only under the advice of
your obstetrician if you have a high fever. These are
the times to consider taking tilent all if you have
minor aches and pains, try everything else first. This should
(22:17):
have been the messaging when it comes to the vaccines.
I think they should have left this one out. I
don't understand why there was much conversation about vaccines in
this press conference. It really didn't have much to do
with anything that they were talking about. There is a
succent way to talk about what the conclusions were at
the AST meeting last week. This press conference did not
(22:39):
do it. It created more fear, more doubt, and really
riled up the whole back and forth when it comes
to people who are pro vaccines and those who are
against vaccines. The reality is there's a happy medium there,
and we need to make sure that we're harnessing that
happy medium because the country is already divided enough. And
(23:00):
when it comes to luc O varn again, this is
a great thing. This is a potential treatment for autism.
If you're not promising it's going to cure all autism,
but just to have the conversation around it, it's really important.
So I will tell you I walked away from that
press conference very disheartened, very disappointed. I think there's a
lot of great things happening in the White House and
(23:21):
the AHHS right now. I think that the messaging is crucial,
and I think that they're failing miserably at the messaging.
And it's not that they're failing because we all know
how President Trump is and why people vote for him
is because they trust him to just say what he's thinking,
not be reserved, and not bend to anyone else. I
(23:43):
get that, and by the way, that's one of the
things I like about him too. My concern is that
these are very complicated topics. Lives are on the lines,
and nuance really matters, and I think it is really
important to have strong messages that is fact base and
that's delivered in an understandable manner when you're going to
(24:06):
have these conversations. And I think that, unfortunately, that press
conference failed to do pretty much all of that, even
though the messaging was strong, as demonstrated by my ex
account immediately following the press conference. If I say anything
that goes against or even gently criticizes the administration, people
(24:32):
automatically think that, oh, I am anti Trump, anti RFK Junior,
you know, anti Maga, anti Maha. But the reality is
I am pro human I am pro Americans. I am
pro healthy living, pro science, pro whatever it is that
you want it to be. And the only way for
(24:54):
me to be honest with myself and with those who
are listening to me is to push back when I
see it. I will always criticize when I think something
is handled incorrectly. That doesn't mean that I think that
I'm perfect. I mess up all the times. I mean,
look at what happened through COVID. I got some stuff wrong,
I got a lot right. And when I was speaking
(25:15):
out against people, I got criticized then too. So I'm
okay being criticized as long as I know that what
I am saying is fact based, then your criticism can
be whatever it is you want it to be. I
think that the message from the White House about using
tailanol sparingly in pregnancy is a great thing. The messaging failed.
(25:38):
I think having the conversation about hepatitis B vaccines being
risk based and potentially not having it be a birth dose,
I think that's a great conversation. The messaging has failed.
The MMR plus B vaccines, I think it's a good
thing to separate them, ASIP did too, which is why
they did it. Ten years ago, the messaging has failed.
I think that when it comes to public health, messaging
(26:00):
is crucial. It's just as crucial as the science that
it's supposed to be communicating. And that's what I ask
for this administration is to focus on the messaging. Focus
on someone who can get in front of the camera,
who can take what's being done behind the scenes and
communicate it in an effective way that decreases the amount
of fear and decreases the amount of confusion. That's all
(26:23):
I'm asking. Thanks for listening to Wellness Unmasks on America's
number one podcast network, iHeart. Follow Wellness unmass with doctor
Nicole Safire and start listening on the free iHeartRadio app
or wherever you get your podcasts, and we will catch
you next time.
Welcome to Wellness on Mass I'm doctor Nicole Safire and
we are going to dive right in. It has been
a really busy week the last couple of weeks, between
the two days worth of ACIP meetings with the CDC
and also the big press conference with President Trump and
essentially the entire HHS standing behind him. We have a
lot to cover, and I mean we only have thirty minutes,
(00:24):
so it's a lot to cover, but we're going to
do it. I am always very honest with everyone my opinions.
People sometimes get mad at me because they feel like
I'm not a loyalist, whether one way or the other.
But at the end of the day, I think my
role as a physician, as a human, as an American
is to kind of just tell you what I'm thinking
(00:46):
and kind of make some sense of all this mess.
We did that throughout COVID and we're going to keep
doing that right now. So the good news is during
the White House press conference, they kind of talked about
what those ACT meetings were all about, so we can
combine them all. One of the big things that came
out of the ACIP meeting was that the formal recommendation
is to separate the MMR vaccine that measles, mumps, and
(01:09):
rubella from the vericella vaccine. Aricella is chicken pox. It
was a formal recommendation saying for kids under four, so
that first dose of the vaccine they should be separated
into two separate injections. Well, this isn't really groundbreaking news.
In fact, that was already the recommendation from ASIP from
(01:29):
about a decade ago. They're just now saying insurance companies
are not going to cover it if you want to
choose to have that combined dose. The reason they recommend
having those two doses separated is because when they found
that they combined the four different vaccines, the measles, lumps, rubella,
and aricella, there was a slightly higher risk of febrile
(01:53):
and aphebrile post vaccination caizures and that's real. Thankfully, the
majority of children cover without incident from the seizures, but
they're still scary and if we can avoid seizures, I
think that would be the right thing to do. So
it makes sense they found children over the age of
four didn't have this risk of seizures following it, so
after the age of four, you can combine the vaccines.
(02:16):
So for about eighty five percent of all children for
the last eight to ten years or so, they've already
had these vaccines separated, meaning they have to come back
for two different doctor's appointments to get two different vaccines.
Fifteen percent of kids were still getting that combined dose,
even knowing there was a slightly higher risk of seizures.
(02:36):
So the pediatricians who were administrating the combined dose for
kids under four, they did this knowing there was a
slightly increased risk of seizures, but they were concerned, whether
they were concerned the parents wouldn't come back for the
second dose or whatever, the reasons being, they had to
weigh that risk with potential benefit of the vaccine. This
latest ACEIP is saying that is no longer an option.
(02:59):
You have to separate the doses. I don't see anything
wrong with this. In fact, I agree with it. If
we can avoid a risk of seizures, we should be
doing it. So this is great news. I think that's fine.
The other big issue that came out of the AST
meetings was what to do with the birth dose of
the hepatitis B vaccine. Should all children be given this
(03:19):
vaccine before they leave the hospital, the birth dose. You know,
this is something that I've talked about a lot. I
don't necessarily think it's necessary. I think this is one
of those vaccines that should be done based on risk.
Since the nineteen eighties nineteen nineties, when the hepatitis B
vaccine became available, yes, we saw cases of hepatitis B
(03:41):
go down. Another thing that was also happening during this
time was we started testing pregnant women for hepatitis B
virus to know what their status was. That could also
have contributed to the decrease in babies being born with
hepatitis B. For me, my opinion is if a woman
(04:01):
recently tested negative for hepatitis B and they're living a
low risk lifestyle, no IV drug use, not a sex worker,
they don't have it hepatitis BE positive person living in
the home, then the newborn probably doesn't need this vaccine
and we can have a conversation about whether or not
they should get the vaccine later in life. What the
(04:22):
ACIP was wanting to vote on was saying we're not
going to give that dose at birth. We just want
to give it at one month when the baby's slightly older.
The problem with that is there's no data that supports
or goes against the birth dose versus one month, So
how can you really have that conversation or even put
it forth a recommendation. The reality is you can't, which
(04:45):
is why they decided not to. There was a motion
to postpone the conversation indefinitely, so they didn't even vote
on that. President Trump brought that back up at the
press conference. I'm going to get to that. I just
want to mention the third thing that came out of
the ACIP meetings before we move on to the press conference.
The third thing that came out was all about the
(05:06):
COVID vaccine and this is what we were all kind
of waiting for what are going to be the formal recommendations.
And the big thing was ACIP finally is saying no
more universal recommendation for COVID vaccines and boosters. What was
the mantra of the entire Biden administration of every baby
six months and older to adulthood until the day you die,
(05:28):
you should be getting the full vaccine series of COVID
plus one, maybe even two boosters every single year into perpetuity. Obviously,
that makes no sense, as we have gone on to
show that the virus itself has starting to decrease in
severity and virulence. You have so much natural immunity, we
have a lot of vaccine induced immunity. And really this
(05:51):
should also be one of those risk vaccines. The higher
risk you are, the more you should consider the boosters,
and especially in the low risk populars like specifically adolescents
and school age kids, the risk benefit scenario with the
COVID vaccine just may not make sense. And that's essentially
what ACIP said. Now they did not go as far
(06:12):
to say that you can't access the vaccine if you
are a healthy young adult or a healthy adolescent. They
didn't say that at all. In fact, they tried to
vote saying you needed a prescription, and they tried to
decrease access to the vaccines, but those votes failed. The
only votes that passed in ACIP regarding the COVID vaccine
is just to change the recommendations that it should be
(06:35):
risk based and anyone else considering the vaccine should have
a conversation with their doctor about the risks and benefits
of this vaccine. And I think how could anybody argue
with that of course you should always have that conversation,
and physicians should be forthcoming with the you know, perhaps
very low benefit of vaccines in a healthy individual and
(06:58):
the very real risk, especially an adolescent boys, with this vaccine.
I think these conversations, this information, these are all good things.
I think it's great that the votes didn't pass restricting access.
If the vote for requiring a prescription for this vaccine
would have passed, it would have been a logistical nightmare,
(07:19):
but it didn't, so there's really nothing bad you can
say about. I think everything that happened was good. It
was very frustrating to watch some of the ASIP meetings.
Clearly a lot of the people who are putting together
the votes and some of the talking points have no
idea what it's like practicing medicine. They have only worked
in a lab or have only been surrounded by data,
(07:40):
which you need those people. You need people who are
very good at data, but you also have to balance
that with the practicality of what it's like working in
real world healthcare. Didn't feel like we had much of
that balance. Definitely felt like a lot of ideology was
being presented, a lot of flawed data that in the
real world of academia. We would never even consider because
(08:02):
a lot of it was not legitimate. Some of it was,
but a lot of it was not. It was very frustrating.
But we don't need to get into the details of that,
you know, I because the granular details don't even matter
because the results were fine. And I think all of
those results are fine, and anybody who's causing an uproar
over it don't really understand the implications. Nothing major has changed.
(08:24):
It's all going to be okay. Now, let's fast forward
to the big White House press briefing or announcement that
just came Monday night. This was this was a big deal,
and let me tell you, it was really painful to watch.
President Trump came out. He was flagged behind him by
(08:46):
HHS Secretary RFK Junior FDA Commissioner Marty McCarey, NIH director
Jay Bodicharia, and CMS director Memet Oz. There was a
lot of information presented at this press conference. Some of
it was factually correct, some of it was factually incorrect.
(09:06):
The problem I had was it was full of hyperbole.
And not only do facts matter, but the messaging matters too.
And I can only say this so many times. The
overarching message of this press conference is that autism rates
are on the rise. They are. Yes, some of that
has to do with the expanded diagnostic criteria of autism
(09:28):
spectrum disorder and including Aspergers and others. So yes, that
contributes to it. You can't deny that that absolutely contributes
to it. But something more is going on. There are
more children being born with neurodegenerative diseases than before. That's
also undeniable. So the question is why is that? The
(09:48):
conversation about acetaminifin commonly known as paracetamol or thailool, but
acetaminifin in pregnancy and associated with ADHD and the baby
or autism spectrum disorder. This is not a new conversation.
In fact, we've been having it for decades. Why is that?
Because there have been a lot of observational studies that
(10:11):
have looked at women who have taken a stamnifin and
the potential risk of autism. There have been a good
amount of observational studies looking at women who have taken
a staminifin during pregnancy and a slight increased risk of
autism spectrum diagnosis and ADHD in their babies. Now these
are what we call observational studies. Meaning one of the
(10:31):
bigger ones was I think twenty nineteen from Johns Hopkins.
They looked at cord blood analysis, you know, the blood
in an umbelical cord, and they found higher metabolites from
a staminifin in the children who were born with autism.
So does that correlation mean that the acetaminifhin cause the autism? Well, again,
(10:52):
correlation does not mean causation. And I think you're probably
going to hear that a lot of times. We heard
a lot of that during COVID and you're going to
hear it now. But it's true. Correlation means that, Okay,
there was a staminifin there and now the child has autism.
So it's a corelate. But was it the acetaminifin that
caused the autism? And that's what the studies haven't proven
(11:14):
yet Because why are people taking acetaminifit? Well, yes, we
take it for a pain reliever. We also take it
for fever. So if a woman, a pregnant woman gets
an infection and then she gets all that inflammation and
that inflammation causes the fever, it's the body's natural response
to try and fight off that infection. Oftentimes they'll take
(11:35):
taileanol to reduce that fever. So what is it exactly
that's causing autism? Is it the infection, is it the inflammation,
or was it the tileanol? All of these things are
potential correlates. They have not actually figured out what is
the cause. You're listening to Wellness and Mass. We'll be
right back with more. At this press conference, no new
(11:58):
data was presented. Yes, they highlighted this recently published study
just last month that included some Harvard professors in it
public health, and what that was was a meta analysis.
It wasn't new data. They just said, look at all
of these studies. All of these studies have shown that
there may be a correlate between a set of menifin
(12:20):
use and autism. That's undeniable. You cannot deny that that exists.
But you also can't deny the flip side of that,
which is there have been studies, specifically a very large
one out of Sweden that included about two point five
million kids where they tried to control for that correlation.
They looked at siblings, and they looked and they tried
(12:42):
to remove some of those confounding factors and what they
found was before they removed those confounding factors, there was
about a five percent increased risk of a child being
born with autism spectrum disorder ADHD if tylinol was used,
but when they removed some of those other factors, that
risk went down to zero. So they found there was
(13:05):
no causal link of acetamnifin and autism spectrum disorder. So
no one has been able to prove causative link between
aceta minifin and autism spectrum disorder. FDA Commissioner Marty mckarey
quoted this Harvard study and he said that they were
(13:26):
able to find a causal link, but I have to
be honest with you if you read the study, No
they didn't, and they say they didn't. They said, and
I want to actually just quote it here because I
don't want to give you my opinion. I want to
quote exactly what the study says. Our analysis demonstrated evidence
consistent with an association between exposure to a state of
(13:48):
minifin during pregnancy and offspring with neurodegenerative disorders including a
SD and ADHD, though observational limitations preclude definitive causation. So
again there are studies showing there's a correlation, but there
is not a strong study showing causation. And even though
(14:10):
what was said at the press conference yesterday was that
they have found a study pointing to causation, that's just
not true. Now the takeaway isn't, well, we should just
take as much, say to minefit as we want in pregnancy. No,
absolutely not. There are still enough studies there, there's enough
correlation that we have to err on the side of caution.
(14:31):
And that is really what the message should be. It
should be that for minor aches and pains, you have
to try other things. You want to try, massage, acupuncture, aromatherapy, anything,
just trying to relax. Don't grab for the tit bottle
anytime you want. But we have to really do away
from that paternalistic culture where the President came out and said,
(14:54):
you just have to toughen it out. It's really hard,
I'll be honest for a woman to hear as, oh,
we can't toughen it out. I'll be honest. I think
women are much more tough than men, specifically when it
comes to physical ailments. But it's not about toughing it out,
certainly not when pregnancy when we're talking about pregnancy, there
are a lot of physiological changes that occur. And while
(15:16):
I think for the majority of aches and pains, we
can toughen it out, and we should, especially because there's
a potential correlative link of neurodegenerative disorder and a set
of minifin. However, I can also tell you when it
comes to high fever, there should be no amount of
toughing it out, because when women have fever and pregnancy,
they have up to a forty percent risk of a
(15:38):
child with neurodegenerative disorder. If they have multiple fevers during pregnancy,
especially in that second and third trimester, that risk triples.
That is significantly higher than any risk that has ever
been reported using a set of minifin when it comes
to neudegenerative disorder. So my biggest fear is that the
message at this press conference was women should not consider
(16:01):
a set of minefit in pregnancy no matter what. They
have more fear now from that medication, and they don't
have the fear of a high fever, which is a
much bigger risk for not only than mother, but that
baby that's forming too. So the messaging was wrong in
my opinion. The President continued to come out and saying
tailan all's bad, tialan all is bad. The message should
(16:23):
have been tilanyl should be used sparingly in pregnant women.
There's research there, but it's unfinished research. We need to
put more time and effort into this because we have
to make sure that pregnant women have something safe to
take during pregnancy, and the constellation of research right now
tells us that using thailan al sparingly at the lowest
possible effective dose is what's safest for the mother and baby,
(16:47):
especially in cases of high fever. That message was lost
at the press conference yesterday, and I think that it
was un very unfortunate because when we're in a time
of chaos and public public trust erosion, messaging matters. It
really does. Now there's a firestorm across the country that
(17:09):
is just creating this massive divide, and the reality is
it shouldn't have been. This was a great message that
came out of the White House. What it was was
reinforcing and already existing warning when it came to a
sayamnifin use and pregnancy, that there are some concerns there,
but still it remains the safest medication when it comes
(17:30):
to treating high fevers full stop. That should have been
the message. It tumbled a bit throughout, and like I said,
there were some factual interacuracies that were presented. Moving on
from tilnal more was said, and it kind of just
evolved from there. The President also mentioned hepatitis B. He
(17:51):
said that maybe hepatitis B should be given at the
age of twelve, that vaccine that we had kind of
heard about during ASIP. That was a first. I havn't
heard anybody else mentioning twelve. I haven't seen any data
showing that twelve is the right age. My guess is
maybe that is because hepatitis B can be sexually transmitted
and that is the time pre prereessence where maybe sexual
(18:13):
activity is starting. So maybe that's the mindset behind that recommendation.
We haven't heard from the CDC or the ASIP about it,
or the FDA or really anybody, so it was kind
of off the cuff by the President. I'm sure we'll
be hearing more about that in the future. Maybe age
twelve makes more sense than a birth those. For me
(18:34):
that it sounds a little bit more reasonable because if
it's sexually transmitted, then maybe that's it. More. Coming up
on Wellness Unmasked with doctor Nicol Sapphire and he mentioned
the MMR vaccine and the vericellas separating them. That also
makes sense. I already said that, But then he kind
of got into he brought the tilent all back, saying
(18:57):
and don't give talent all to your babies after your
vaccine means. This was very confusing because that had nothing
to do with what the FDA was talking about. The
FDA was specifically talking about talinl and pregnant women and
its role in brain development. So it would be nice
if the FDA kind of clarified a little bit more
(19:17):
what they were meaning. As the President saying that the
formal recommendation is not to give talinol at all and
infants and toddlers and school age children, I think that
left a lot of people very confused, and so it
would be great to have some clarification there on what
they were talking about and if there was actually some
data to support what was being said. They didn't point
(19:41):
to any. Another big thing that did came out, which
I was very excited about, was the conversation around treating
children born with autism spectrum disorder with something called luco
vorren or which is essentially a reduced version of folate folate.
(20:02):
If you think of folic acid, that's the big thing,
and all the prenatal vitamins. We already know that folate
and fullic acid is extremely important for the development of
the fetus in a pregnant patient, which is why prenatal
vitamins are so strongly recommended. Children born with autism spectrum
disorder oftentimes are found to have low folate levels. They're
(20:24):
also found to have autoimmune antibodies against folate receptors in
the brain, and several studies have shown when you increase
folate in the mother, you actually decrease the risk of autism.
So the fact that the conversation around that is now
being amplified, that's an incredible thing. Lucoborin is a prescription
medication that can potentially treat these children who are born
(20:47):
with the autoantibodies to the leucovorin receptor or just low
folate acid fullic acid levels. Studies have shown that it
does help improve some of the verbal communication obvious. These
are small studies and more studies will need to be done,
but at this point I think any parent who has
a child born with autism spectrum disorder, they just want anything.
(21:10):
They want anything that might be able to help. So
I think it's wonderful to amplify this. And then doctor
Oz came out and said CMS will cover it as well,
because obviously it's great to have a medication, but if
you can't afford it and you can't access it, that's
a big problem. Marty McCarey said that they've already talked
to the drug manufacturer and they are going to increase production,
and then Mema Oz said CMS is going to cover it.
(21:32):
Half of our children are on Medicaid or CHIP programs,
so they get their medications and healthcare through government assisted
program so at least half a children are going to
have access to it and have it be covered. I'm
sure private insurers will follow suit, as they tend to
do so, I'm sure with lobbying efforts that'll happen. So
these are great things. Again, if we could just take
(21:57):
the press conference and say you need to use tilan
all sparingly during pregnancy and only under the advice of
your obstetrician if you have a high fever. These are
the times to consider taking tilent all if you have
minor aches and pains, try everything else first. This should
(22:17):
have been the messaging when it comes to the vaccines.
I think they should have left this one out. I
don't understand why there was much conversation about vaccines in
this press conference. It really didn't have much to do
with anything that they were talking about. There is a
succent way to talk about what the conclusions were at
the AST meeting last week. This press conference did not
(22:39):
do it. It created more fear, more doubt, and really
riled up the whole back and forth when it comes
to people who are pro vaccines and those who are
against vaccines. The reality is there's a happy medium there,
and we need to make sure that we're harnessing that
happy medium because the country is already divided enough. And
(23:00):
when it comes to luc O varn again, this is
a great thing. This is a potential treatment for autism.
If you're not promising it's going to cure all autism,
but just to have the conversation around it, it's really important.
So I will tell you I walked away from that
press conference very disheartened, very disappointed. I think there's a
lot of great things happening in the White House and
(23:21):
the AHHS right now. I think that the messaging is crucial,
and I think that they're failing miserably at the messaging.
And it's not that they're failing because we all know
how President Trump is and why people vote for him
is because they trust him to just say what he's thinking,
not be reserved, and not bend to anyone else. I
(23:43):
get that, and by the way, that's one of the
things I like about him too. My concern is that
these are very complicated topics. Lives are on the lines,
and nuance really matters, and I think it is really
important to have strong messages that is fact base and
that's delivered in an understandable manner when you're going to
(24:06):
have these conversations. And I think that, unfortunately, that press
conference failed to do pretty much all of that, even
though the messaging was strong, as demonstrated by my ex
account immediately following the press conference. If I say anything
that goes against or even gently criticizes the administration, people
(24:32):
automatically think that, oh, I am anti Trump, anti RFK Junior,
you know, anti Maga, anti Maha. But the reality is
I am pro human I am pro Americans. I am
pro healthy living, pro science, pro whatever it is that
you want it to be. And the only way for
(24:54):
me to be honest with myself and with those who
are listening to me is to push back when I
see it. I will always criticize when I think something
is handled incorrectly. That doesn't mean that I think that
I'm perfect. I mess up all the times. I mean,
look at what happened through COVID. I got some stuff wrong,
I got a lot right. And when I was speaking
(25:15):
out against people, I got criticized then too. So I'm
okay being criticized as long as I know that what
I am saying is fact based, then your criticism can
be whatever it is you want it to be. I
think that the message from the White House about using
tailanol sparingly in pregnancy is a great thing. The messaging failed.
(25:38):
I think having the conversation about hepatitis B vaccines being
risk based and potentially not having it be a birth dose,
I think that's a great conversation. The messaging has failed.
The MMR plus B vaccines, I think it's a good
thing to separate them, ASIP did too, which is why
they did it. Ten years ago, the messaging has failed.
I think that when it comes to public health, messaging
(26:00):
is crucial. It's just as crucial as the science that
it's supposed to be communicating. And that's what I ask
for this administration is to focus on the messaging. Focus
on someone who can get in front of the camera,
who can take what's being done behind the scenes and
communicate it in an effective way that decreases the amount
of fear and decreases the amount of confusion. That's all
(26:23):
I'm asking. Thanks for listening to Wellness Unmasks on America's
number one podcast network, iHeart. Follow Wellness unmass with doctor
Nicole Safire and start listening on the free iHeartRadio app
or wherever you get your podcasts, and we will catch
you next time.
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