February 17, 2021 • 28 mins
Dr. Richard Besser is the former acting director for the CDC, and is currently president of the Robert Wood Johnson Foundation. He’s also a pediatrician. This week, he joins Heidi to answer your biggest questions about vaccines. Dr. Besser explains how vaccines are tested for safety, along with the latest recommendations on the Covid-19 vaccine and pregnancy. Heidi and Dr. Besser also cover the maternal and childhood vaccines you ask about most—from the flu shot, to the TDAP, to the first year of vaccinations for your baby.
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Episode Transcript
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Speaker 1 (00:00):
Who baby A baby? I need you, Oh how I
need you? What to expect? As a production of I
Heart Radio, I'm your host Heidi Murkoff and I'm a
mom on a mission, a mission to help you know
what to expect every step of the way. To say
(00:25):
the vaccines are a hot button topic is an understatement
In a time when vaccine misinformation on social media spreads
faster than a virus in a pandemic, it's understandably harder
for parents to sort science fact from science fiction, or
not to feel shamed or blamed by others in the
online community as they do their information gathering. Today, we're
(00:51):
giving you the facts about vaccines, from how they work
to why they're so important and pregnancy and for your baby.
No game, no blame, no judging, no spin, nothing but
the facts. I'm so excited to welcome one of the
best people to have this conversation with. Dr Richard Besser's
(01:11):
the former acting director for the CDC under the Obama administration.
He's been a chief medical correspondent for ABC News and
is currently President of the Robert Wood Johnson Foundation. And
he's a pediatrician who is passionate about making the world
a safer, healthier place to live for all our children.
(01:34):
Thank you so much for being here today, Dr Besser.
One of the many things you said that spoke to
me was about the role of the pediatrician as translator,
taking complicated medical topics and turning them into plane language
that parents can relate to. Do you want to tell
(01:54):
us a little bit about why that's important. Yeah, I
did more than seven hundred views last year, and I've
never had that question. That's that's a that's a great one,
but it's it really speaks to um to kind of
my approach to health and what I really enjoy. I'm
a general pediatrician and normally I see kids a half
(02:16):
day a week, and what I really love about the
experience is how much I learned from the families that
that I'm with. And I do see my role as
a pediatrician as translating complex information helping people make more
informed decisions about their lives. And what I learned in
pediatrics was that you need to treat people with respect
(02:40):
and that you, as a healthcare provider, have a specialized
language of jargon that may be good for talking to
other people in healthcare, but it puts up an immediate
barrier to your patients. And it is recognizing as well
that when people are frightened, when people are scared as
they are during a pan emoic or when they're child sick,
(03:01):
their ability to take in complex information goes down dramatically,
And so you have to repeat, you have to simplify
still with that that air of respect, and you have
to check back in and say that makes sense. Did
you understand what I was saying there? Yeah? Absolutely. Another
premise that I always start with is knowledge is power.
It's especially powerful when you're pregnant, you have a new baby,
(03:25):
you're a new parent, and what you don't know can
actually hurt you or hurt your child, and also can
make you suspicious. So of course they're going to be
worried about a vaccine. How would you come them down
and explain that vaccines in fact, do not hurt an
unborn baby. It's natural to worry about an unborn baby
(03:48):
a life that's developing, And so one of the things
scientists look at is there any concern about this vaccine
doing any harm? And if they see any signal of that,
then that's it. It's It's not something that would be
given to someone who is pregnant, and so by the
time of vaccine is recommended or approved, you can feel
(04:09):
comfortable that you are not doing harm to your baby,
but you're in fact helping to protect them by protecting
yourself and your baby from a potentially dangerous infection. So,
you know, it's one thing to say to our parent,
vaccines work, But how do they work? Can you give
the simple science behind that vaccines are pretty miraculous? Before vaccines,
(04:33):
I mean, many of the most families experienced the loss
of children because they're infectious diseases that are so dangerous
and deadly to kids. Vaccines, you know, at out of
the simplest level, they fool your body into thinking that
you've been infected with a virus or back bacteria, a
(04:55):
germ that could cause disease, and they cause your immune
system to react like it's seeing that bad virus, are
that that bacteria, But it's not. It's not seeing something
that's harmful to you. But your body is saying, oh wow,
I'm seeing whooping off. The immune system kicks into gear
to fight it off. And what that does is it
means that if you ever see the real thing, So
(05:18):
the real whooping cough bacteria, or catanus or I mean rotavirus.
Are so many vaccines now that prevent against serious infections.
Then when your body sees that, the immune system is
ready and it fights it off like it's seen it
before and it knows what to do, and that is
I think absolutely incredible. You know, they're all different ways
(05:39):
that it's done. You know, there are different approaches, and
even now with COVID. Right now we have vaccines that
are either in trial or on the market that use
three different mechanisms, three different approaches to fooling your immune system.
So what kind of research goes into making a vaccine
these days? So the process for making vaccines usually takes
(06:00):
any many years early research first to say how can
you fool the immune system into thinking it's being attacked
by a particular agent. And then okay, if that's the
way you're gonna fold the immune system, is that safe?
Is that a safe way to do it? And so
when there is what's called a candidate vaccine, something that
(06:20):
scientists think, yeah, we think this will fold the immune
system and we think, well, we know what will be saved.
Then it's tested in a small number of people to
look to see early on, well how much of it
we have to give. That's called a dosing study. And
then the next level of studies looks to see, okay,
in maybe several hundred people, is it safe or we're
seeing reactions or side effects, you know, sore arms or
(06:42):
fevers or anything that we need to be concerned about
um and then it moves on to bigger trials. And
these the trials all tend to start in adults, and
then it's looks to say, okay, does it protect from
the illness that we wanted to protect from? Then how
long does the protection last? Those studies can take years
to do, often because the infection that you're trying to
(07:05):
protect against while out there isn't common enough that you
can do those kind of studies quickly in order to
see if it protects from a certain infection, that infection
has to be out about that can take time to do.
And then once a vaccine is found to be safe
and effective in adults, then they'll look in younger and
younger populations. This is what's going on with COVID safe
(07:27):
and adults. Now their studies being done, is it safe
in teens? And then as a queens? And then younger
than that younger down. You know, occasionally for diseases that
only occur in children, where the risk of those diseases
it's really really severe, you'll do some initial safety studies indults,
but then you'll go to your trials right away. When
I was in training to be a pediatrician, UM there
(07:49):
was something called h flu or havoflos influenza and UM
it would cause a very very serious form of meningitis.
And I remember in my train seeing kids who died
from that, children who had brain damage or lost their hearing,
had various of your illness. And then I remember, I
think it was in the last year my training that
(08:10):
a vaccine came out and it was miraculous because all
of a sudden we weren't seeing this horrible, horrible disease.
It was so devastating to children and their families. It
was gone. And when you've seen that progression from something
that just causes so much devastation to all of a
sudden it's gone, it's amazing. And when you work in
(08:33):
countries that don't have as a robust of vaccine program
and you see diseases that have been pretty much wiped
out in the United states, it's just an eye opener
to the power of vaccination to to really change the
prospects of cod We're in a pandemic like any other
(09:03):
public health emergency. This led to a drop in vaccination
rates and by the way, in maternal healthcare. By November
of routine childhood vaccines have fallen by as much as
twenty and parents are also afraid to bring their kids
in for routine appointments. And another reason beyond that, of course,
(09:26):
is the vaccine skepticism, which I think has been fueled
not only by the Internet. I mean, vaccine skepticism has
always been around since they were vaccines, but it's kind
of reached a fever pitch, and the Internet has accelerated
the anti science fiction. And also, you know, maybe the
speedy development of the COVID nineteen vaccine. People are like, well,
(09:48):
it should take time and this isn't possible. What are
your thoughts about this and what concerns you most about
these dropping vaccination rates. Well, when it comes to COVID vaccine,
I think it's important to recognize that most people want
to get vaccinated. There are some people who have concerns
(10:10):
who don't want to get vaccinated. And I wouldn't lump
all those people together. And the reason for that is that,
you know, even when it comes to childhood humanizations, where
you know plus percent of children get get fully vaccinated,
there's a hardcore group of people there who are anti vaccine,
anti science, who will never, no matter what you say,
(10:32):
willingly let their children get vaccinated and won't get vaccines themselves.
But there are also some people who say, you know what,
I understand that these vaccines are really effective, and I
understand that they were reviewed and approved by the Food
Drug Administration, and I understand COVID's bad, but I also
understand that they were approved based on two months of
(10:53):
safety data, and I kind of like to wait until
they've been in some more people, and people perception of
risk will vary, and it's important to respect that and
and not say to someone who's a little hesitant today
that it's here's your one chance, and it's done. I
think it's people know more and more of their friends
(11:14):
and family members who have been vaccinated, they're gonna want
to get vaccinated. And we're seeing that. We're seeing the
numbers go up in terms of people wanting wanting vaccine,
and part of that is also you know, now that
it's been given to more than twenty million people, that's
different than the trials where it's tens of thousands of people,
and the CDC and FDA are doing follow up look
(11:37):
and see are there any side effects that we're not
picked up In the smaller studies, they've been able to
share data on severe allergic reactions to show how really
rare they are and how easily managed they are to
get vaccinated in the clinic setting. When it comes to
COVID vaccine, I think the numbers are going to continue
(11:58):
to go up and up, and I think some of
that has to do with how the vaccines last year.
We're talked about the phrase work speed. Well, it's good
for rockets, it's good for for really high speed trains,
but in terms of making people feel comfortable that all
of the safety steps were taken the terms of little
(12:21):
challenging it's absolutely miraculous that we have safe and effective
vaccines this quickly, you know, within a year of a
new virus being discovered, that is that's never happened before,
and that's absolutely incredible, But you need to recognize that
with that kind of speed comes some some sense of
woe was just too fast, and there wasn't I think,
(12:43):
enough attention to the full story that scientists have been
working on what are called m RNA vaccines for more
than a decade and so it's all of that science
that was done over decades that allowed them to create
within a year this this vaccine. So it wasn't as
speedy as it seemed. It was really speedy from from
(13:04):
day of discovery to the development, but the science that
led them to be able to do that, it took
place over a long period of time. What what gives
me comfort in this whole process is, you know, I
watched the review committee for FDA UH and I listened
to their deliberations, and I read the materials that FDA posted,
and I believe that the vaccines that are have been
(13:28):
approved for emergencies are safe and effective. I can't wait
until I get called and I can get vaccinated. My parents,
who are you know, both over ninety, have both been vaccinated.
But I also recognized that some people want to see
a little bit more data. And in particular, although the
majority of Black Americans want to get vaccinated, the rates
(13:50):
of hesitancy and concern are higher, and I think a
lot of that reflects you disrespect from the healthcare system,
historical experimentation on people of color by our health care
system and the public health system. I think it also
can be addressed by ensuring that people are hearing from
people they trust and in different communities, trusted voices will vary.
(14:13):
So at our foundation, Robert Johnson Foundation, we're supporting a
lot of outreach work so that people can hear from
trusted voices in their communities. I think it's going to
be the kind of the same kind of efforts that
are used for get out the vote will will be
effective here hearing from people they know and they trust.
You know that effective grassroots connection is going to I think,
(14:34):
build the desire for more people to effect them. So
I do want to ask so many moms on what
to expect. Of course, the questions are coming in so
that I get the COVID nineteen vaccine when it's offered,
If it's offered, and I know that a lot of
health care professionals who are pregnant have already received it,
and in some states it's being offered in a higher
(14:56):
order of priority. But there are of as a lot
of concerns from pregnant women. Is it safe now? Of course,
the infection itself has been shown not to be particularly
safe for pregnant women, especially those with comorbidities. If you
have just saial diabetes or if you have hypertension, that
puts you a greater risk if you're a mom of color.
(15:19):
So I know that the medical community has had you
know who came out with certain recommendation, CDC came out
with others, And basically the bottom line is always talked
to your doctor, which is what I would say, But
what would you say? I think you've hit the critical
points is that you're balancing risks here, and that's really
(15:39):
important because it's human nature to put more value on
the risk from something that you intentionally do. So, you know,
we see that with children's vaccinations as well. So I
know somebody who had this incredible allergic action to a
vaccine that was so severe. Wow, yeah, you know, that's
that kind happen. But it's so incredibly rare. The disease
(16:03):
that it's preventing killed thousands of children each year, you know,
So it's it's balancing those risks here. With COVID, we
are learning that there is some increased risk for pregnant
women when you need to balance I think, and in
talking with your doctor, because this is one of those
personal decisions that you have to make, is what is
(16:23):
your risk of exposure? So you know, if you're someone
who is working in a setting where you're more likely
to be exposed, whether it's in healthcare or you know,
food production or transportation or anything where you're out and
about and you're pregnant, you have a real risk of
being exposed and getting COVID, you know, in that setting.
I think that personally, if it were my family member,
(16:47):
I would say, yeah, I would recommend getting vaccinated. Their
studies being done, but there's theoretically there's nothing that we
would see with this vaccine that would make us think
ahead of time that it could pose an increase risk
to someone who is pregnant. If, on the other hand,
you are at home, you are not out at all,
and your risk is really really low, You're you're not
(17:09):
exposed to very many people, and you may say, well,
now you know what, I'm not going to get vaccinated.
Of course, I have to ask will trials be done
on pregnant women or is this just always like an
extrapolation My understanding is that companies are doing trials in
in pregnancy. And the reason for that is that you know,
(17:31):
this pandemic is widespread, it's rampant, uh, and we know
that there is increased risk during pregnancy. And so you know,
given you've got a vaccine that has a terrific safety profile,
very safe, then you're gonna want to do that. You know,
it's not hear to me how they're gonna do those
studies because you don't want to withhold vaccine. It may
(17:52):
be historical data so that they'll vaccinate and they'll be
able to compare people who got vaccinated now to those
who didn't before. There are some pregnant women who were
in the initials trials right became pregnant. Yeah, And it
may be that across the numbers of trials there are
enough women who got pregnant during the trial that they'll
(18:12):
be able to answer to answer that question that way too.
It again, it's the balance for women who have who
have a particular medical condition that can be life threatening,
the balance between stopping your medication or your treatment and
potential risks. Both you know, have the benefits and potential risks.
But one of the things that we're learning though, which
(18:34):
I think is really interesting, is that just like with
other vaccines, the flu shot, moms pass on protective factors
to their babies, which is so amazing. I think that's
such an incredibly important point, and you are protecting that
very vulnerable newborn baby. I wanted to ask you about
(19:10):
the t DApp because I get questions about that all
the time, and of course I give the recommendation that
you should get it with every pregnancy, so even if
you've had it before, even if you had a booster before,
and dad's got to get in and grandma's gotta get it,
everybody's got to get it. The flu vaccine is another
vaccine that every pregnant woman should get, and that again
(19:31):
is not only to protect her baby, but because even
more so, as far as we know then with COVID
influences really dangerous potentially for pregnant women and they're more
risk for hospitalization. Yeah, now, those are those are all
key points. I remember when I was at ABC News
doing a story on a mom on a family that
(19:54):
lost their newborn to whooping cough and she hadn't been
offered yeah during pregnancy, and you know, she had other kids.
They're not sure you know how whooping toff got into
the into the home, But to lose a child to
something that's preventable, it was devastating. And she's gone on
(20:15):
now to become a real advocate around this issue. That's
the ap THET. Yeah, that can be a really severe
infection in really young kids. And we start vaccinating about
two months, so in a really early period's the only
protection that the baby has is from their mom. Absolutely. Now,
(20:38):
of course we can't talk to you your pediatrician, without
talking about childhood vaccines. I think we've already established why
they're so safe, because they've gone through so many years
of testing and there's so much data, and yet these
miss persist, and these concerns persist again understandably because you
(21:00):
want to keep your baby safe, and there are so
many vaccines headed your baby's way in that first year
and beyond, and it seems, oh, isn't it going to
overwhelm their immune system? All of this it can be
really hard to tell the difference out there between what's
good science and what someone's opinion and what is just
false is a hoax, And so you see all this information.
(21:21):
I mean, I remember as a new parent. It was
a long time ago. Our oldest is twenty six. I
remember with the first shot that he got feeling really nervous,
and it's like, oh my, you know, feeling good because
we're doing it, but also it's like, well, we're giving
a shot. We're doing something, and whenever you're doing something,
(21:43):
you always have in this mind, well, wow, you know,
I know that this is the right thing to do.
I just hope it's that everything goes really well, and
that's a natural feeling to to have. I think it's
so important for parents to have trusted sources of information.
I think that having a healthcare provider who you trust,
(22:04):
who you can ask anything to, can be really really valuable.
And knowing what sources of information online are trusted, are
good science can be really really valuable, and it can
help you avoid some of the noise it's out there.
Because there's so much noise, it can be overwhelming. And
when there's that much information coming out at you, a
(22:28):
lot of people's reactions we are I'm just gonna wait.
Can't take it all in, so I'm just gonna wait.
And a waiting itself can be a dangerous thing for
a little baby. Exactly, and so a lot of parents
are like, oh, well, maybe I'll just you know, have
a few here, a few there, but not lump them
(22:48):
all together, like delay the schedule a little bit. What
do you say to parents who are concerned about so
many thoughts at one appointment or in one year. You know,
our mutism are amazing, They're incredible. We are barraged all
day long, all night long by germs that are around us.
(23:09):
They're on our skin, they're on our nose, they're they're
on our dogs and our cats, and they're everywhere, they're
on surfaces, and our immune systems react to those constantly.
So getting a dozen more exposures to different things over
those those first months is not in any way, shape
(23:30):
or form going to overwhelm your immune system. Part of
the testing that's done with vaccines, they're looking to see
which vaccines can you give together? Are there any that
you can't give together at the same time? There are,
and so doctors don't administer those at the same time.
But the goal and pediatrics is to protect children as
quickly as possible for things that they may face early
(23:51):
in life, and so that's why you do them. And
I'm always really nervous about measles. And it's not because
we give it so young. It's because we can't give
it younger. You know, around hew measles is the big
killer of children, But we don't give it to children
(24:11):
until they're one year old because your immune system is
developing constantly, and won't we act enough to give you
the right level of protection until about a year. But
if we had a measles vaccine that could work, you know,
right at birth, I'd be all for me too. And
I just want to share a personal story. My grandson, Lennox,
(24:34):
who's about to turn eight, was three weeks old when
he was hospitalized with SEPs us. It was a staff
infection that it had started at his umbilical site. Super
super rare, new parents out there, but it happened and
he was hospitalized. During that time. He was exposed to
measles three weeks, way too young to be vaccinated. They
(24:57):
gave him some immunoquobulin as precaution, but it was terrifying.
And that's that's my cautionary tale. If it could happen
to my grandson, it could happen to your child, It
could happen to someone else's child. Do you love right, Yeah,
My recommendation is vaccinate your child fully and on time.
(25:17):
It doesn't overwhelm the immune system. It means that your
child is protected as soon as they possibly can be,
and haven't forbid your child where to get something where
you belate. So that's the approach I I take. It's
the way to go. There's no science to show that
there's benefit to a child of spacing vaccines out beyond
(25:39):
what the current recommended schedule is, and all I see
with that is a longer period before a child is
it's fully protected. And you know, we vaccinated to protect
our own children, but also to protect those who can't
be vaccinated or those who don't get a good immuniverse US.
(26:00):
So we talk about vaccines being really terrific. They are,
but not everybody who gets the vaccine will be fully protected.
Right now, when we're talking about COVID, the two vaccines,
the fisor MODERNA, that are available in the United States
are about protective. So that basically says that five out
of a hundred people who are who get vaccinated will
(26:23):
still be at risk. But if everyone around them is
fully vaccinated, the chances that they're gonna get COVID go
way way, way, way down. We have a new hashtag
be heard as an h g r D right, part
of the herd that protects your community, all the little
ones in your community, all the elderly in your community
who are most vulnerable. Yeah, that's right. Thank you so
(26:46):
much for joining us today and for helping alleviate the
fears and make us feel really really good about rolling
up our sleeves and rolling up well our babies pant legs. Yes,
you know it's it's a quick cry and then you're
done exactly for them. Oh yeah, thank you so much.
(27:07):
I really appreciate it. It's a pleasure, really nice to
talk with you. Who baby below, my baby below? I
need you, Oh how I need you. Thanks for listening.
Remember I'm always here for you. What to Expect is
(27:27):
always here for you. We're all in this together. For
more on what you heard on today's episode, visit what
to Expect dot com slash podcasts. You can also check
out what to Expect when You're Expecting, What to Expect
the First Year, and the what to Expect app. And
we want to hear from you. Connect with us on
our community message board or on our social media You
(27:50):
can find me at Heidi Murkoff and Emma at Emma
Being wt E and of course at What to Expect.
Baby Love is performed by Riley Peter. What to Expect
is a production of I Heart Radio. From more shows
from I Heart Radio check out the I Heart Radio app,
Apple podcast, or wherever you listen to your favorite shows.
(28:16):
In my arms right, don't just stay Nija Knija, Baby Baby,
Who baby A baby? I need you, Oh how I
need you? What to expect? As a production of I
Heart Radio, I'm your host Heidi Murkoff and I'm a
mom on a mission, a mission to help you know
what to expect every step of the way. To say
(00:25):
the vaccines are a hot button topic is an understatement
In a time when vaccine misinformation on social media spreads
faster than a virus in a pandemic, it's understandably harder
for parents to sort science fact from science fiction, or
not to feel shamed or blamed by others in the
online community as they do their information gathering. Today, we're
(00:51):
giving you the facts about vaccines, from how they work
to why they're so important and pregnancy and for your baby.
No game, no blame, no judging, no spin, nothing but
the facts. I'm so excited to welcome one of the
best people to have this conversation with. Dr Richard Besser's
(01:11):
the former acting director for the CDC under the Obama administration.
He's been a chief medical correspondent for ABC News and
is currently President of the Robert Wood Johnson Foundation. And
he's a pediatrician who is passionate about making the world
a safer, healthier place to live for all our children.
(01:34):
Thank you so much for being here today, Dr Besser.
One of the many things you said that spoke to
me was about the role of the pediatrician as translator,
taking complicated medical topics and turning them into plane language
that parents can relate to. Do you want to tell
(01:54):
us a little bit about why that's important. Yeah, I
did more than seven hundred views last year, and I've
never had that question. That's that's a that's a great one,
but it's it really speaks to um to kind of
my approach to health and what I really enjoy. I'm
a general pediatrician and normally I see kids a half
(02:16):
day a week, and what I really love about the
experience is how much I learned from the families that
that I'm with. And I do see my role as
a pediatrician as translating complex information helping people make more
informed decisions about their lives. And what I learned in
pediatrics was that you need to treat people with respect
(02:40):
and that you, as a healthcare provider, have a specialized
language of jargon that may be good for talking to
other people in healthcare, but it puts up an immediate
barrier to your patients. And it is recognizing as well
that when people are frightened, when people are scared as
they are during a pan emoic or when they're child sick,
(03:01):
their ability to take in complex information goes down dramatically,
And so you have to repeat, you have to simplify
still with that that air of respect, and you have
to check back in and say that makes sense. Did
you understand what I was saying there? Yeah? Absolutely. Another
premise that I always start with is knowledge is power.
It's especially powerful when you're pregnant, you have a new baby,
(03:25):
you're a new parent, and what you don't know can
actually hurt you or hurt your child, and also can
make you suspicious. So of course they're going to be
worried about a vaccine. How would you come them down
and explain that vaccines in fact, do not hurt an
unborn baby. It's natural to worry about an unborn baby
(03:48):
a life that's developing, And so one of the things
scientists look at is there any concern about this vaccine
doing any harm? And if they see any signal of that,
then that's it. It's It's not something that would be
given to someone who is pregnant, and so by the
time of vaccine is recommended or approved, you can feel
(04:09):
comfortable that you are not doing harm to your baby,
but you're in fact helping to protect them by protecting
yourself and your baby from a potentially dangerous infection. So,
you know, it's one thing to say to our parent,
vaccines work, But how do they work? Can you give
the simple science behind that vaccines are pretty miraculous? Before vaccines,
(04:33):
I mean, many of the most families experienced the loss
of children because they're infectious diseases that are so dangerous
and deadly to kids. Vaccines, you know, at out of
the simplest level, they fool your body into thinking that
you've been infected with a virus or back bacteria, a
(04:55):
germ that could cause disease, and they cause your immune
system to react like it's seeing that bad virus, are
that that bacteria, But it's not. It's not seeing something
that's harmful to you. But your body is saying, oh wow,
I'm seeing whooping off. The immune system kicks into gear
to fight it off. And what that does is it
means that if you ever see the real thing, So
(05:18):
the real whooping cough bacteria, or catanus or I mean rotavirus.
Are so many vaccines now that prevent against serious infections.
Then when your body sees that, the immune system is
ready and it fights it off like it's seen it
before and it knows what to do, and that is
I think absolutely incredible. You know, they're all different ways
(05:39):
that it's done. You know, there are different approaches, and
even now with COVID. Right now we have vaccines that
are either in trial or on the market that use
three different mechanisms, three different approaches to fooling your immune system.
So what kind of research goes into making a vaccine
these days? So the process for making vaccines usually takes
(06:00):
any many years early research first to say how can
you fool the immune system into thinking it's being attacked
by a particular agent. And then okay, if that's the
way you're gonna fold the immune system, is that safe?
Is that a safe way to do it? And so
when there is what's called a candidate vaccine, something that
(06:20):
scientists think, yeah, we think this will fold the immune
system and we think, well, we know what will be saved.
Then it's tested in a small number of people to
look to see early on, well how much of it
we have to give. That's called a dosing study. And
then the next level of studies looks to see, okay,
in maybe several hundred people, is it safe or we're
seeing reactions or side effects, you know, sore arms or
(06:42):
fevers or anything that we need to be concerned about
um and then it moves on to bigger trials. And
these the trials all tend to start in adults, and
then it's looks to say, okay, does it protect from
the illness that we wanted to protect from? Then how
long does the protection last? Those studies can take years
to do, often because the infection that you're trying to
(07:05):
protect against while out there isn't common enough that you
can do those kind of studies quickly in order to
see if it protects from a certain infection, that infection
has to be out about that can take time to do.
And then once a vaccine is found to be safe
and effective in adults, then they'll look in younger and
younger populations. This is what's going on with COVID safe
(07:27):
and adults. Now their studies being done, is it safe
in teens? And then as a queens? And then younger
than that younger down. You know, occasionally for diseases that
only occur in children, where the risk of those diseases
it's really really severe, you'll do some initial safety studies indults,
but then you'll go to your trials right away. When
I was in training to be a pediatrician, UM there
(07:49):
was something called h flu or havoflos influenza and UM
it would cause a very very serious form of meningitis.
And I remember in my train seeing kids who died
from that, children who had brain damage or lost their hearing,
had various of your illness. And then I remember, I
think it was in the last year my training that
(08:10):
a vaccine came out and it was miraculous because all
of a sudden we weren't seeing this horrible, horrible disease.
It was so devastating to children and their families. It
was gone. And when you've seen that progression from something
that just causes so much devastation to all of a
sudden it's gone, it's amazing. And when you work in
(08:33):
countries that don't have as a robust of vaccine program
and you see diseases that have been pretty much wiped
out in the United states, it's just an eye opener
to the power of vaccination to to really change the
prospects of cod We're in a pandemic like any other
(09:03):
public health emergency. This led to a drop in vaccination
rates and by the way, in maternal healthcare. By November
of routine childhood vaccines have fallen by as much as
twenty and parents are also afraid to bring their kids
in for routine appointments. And another reason beyond that, of course,
(09:26):
is the vaccine skepticism, which I think has been fueled
not only by the Internet. I mean, vaccine skepticism has
always been around since they were vaccines, but it's kind
of reached a fever pitch, and the Internet has accelerated
the anti science fiction. And also, you know, maybe the
speedy development of the COVID nineteen vaccine. People are like, well,
(09:48):
it should take time and this isn't possible. What are
your thoughts about this and what concerns you most about
these dropping vaccination rates. Well, when it comes to COVID vaccine,
I think it's important to recognize that most people want
to get vaccinated. There are some people who have concerns
(10:10):
who don't want to get vaccinated. And I wouldn't lump
all those people together. And the reason for that is that,
you know, even when it comes to childhood humanizations, where
you know plus percent of children get get fully vaccinated,
there's a hardcore group of people there who are anti vaccine,
anti science, who will never, no matter what you say,
(10:32):
willingly let their children get vaccinated and won't get vaccines themselves.
But there are also some people who say, you know what,
I understand that these vaccines are really effective, and I
understand that they were reviewed and approved by the Food
Drug Administration, and I understand COVID's bad, but I also
understand that they were approved based on two months of
(10:53):
safety data, and I kind of like to wait until
they've been in some more people, and people perception of
risk will vary, and it's important to respect that and
and not say to someone who's a little hesitant today
that it's here's your one chance, and it's done. I
think it's people know more and more of their friends
(11:14):
and family members who have been vaccinated, they're gonna want
to get vaccinated. And we're seeing that. We're seeing the
numbers go up in terms of people wanting wanting vaccine,
and part of that is also you know, now that
it's been given to more than twenty million people, that's
different than the trials where it's tens of thousands of people,
and the CDC and FDA are doing follow up look
(11:37):
and see are there any side effects that we're not
picked up In the smaller studies, they've been able to
share data on severe allergic reactions to show how really
rare they are and how easily managed they are to
get vaccinated in the clinic setting. When it comes to
COVID vaccine, I think the numbers are going to continue
(11:58):
to go up and up, and I think some of
that has to do with how the vaccines last year.
We're talked about the phrase work speed. Well, it's good
for rockets, it's good for for really high speed trains,
but in terms of making people feel comfortable that all
of the safety steps were taken the terms of little
(12:21):
challenging it's absolutely miraculous that we have safe and effective
vaccines this quickly, you know, within a year of a
new virus being discovered, that is that's never happened before,
and that's absolutely incredible, But you need to recognize that
with that kind of speed comes some some sense of
woe was just too fast, and there wasn't I think,
(12:43):
enough attention to the full story that scientists have been
working on what are called m RNA vaccines for more
than a decade and so it's all of that science
that was done over decades that allowed them to create
within a year this this vaccine. So it wasn't as
speedy as it seemed. It was really speedy from from
(13:04):
day of discovery to the development, but the science that
led them to be able to do that, it took
place over a long period of time. What what gives
me comfort in this whole process is, you know, I
watched the review committee for FDA UH and I listened
to their deliberations, and I read the materials that FDA posted,
and I believe that the vaccines that are have been
(13:28):
approved for emergencies are safe and effective. I can't wait
until I get called and I can get vaccinated. My parents,
who are you know, both over ninety, have both been vaccinated.
But I also recognized that some people want to see
a little bit more data. And in particular, although the
majority of Black Americans want to get vaccinated, the rates
(13:50):
of hesitancy and concern are higher, and I think a
lot of that reflects you disrespect from the healthcare system,
historical experimentation on people of color by our health care
system and the public health system. I think it also
can be addressed by ensuring that people are hearing from
people they trust and in different communities, trusted voices will vary.
(14:13):
So at our foundation, Robert Johnson Foundation, we're supporting a
lot of outreach work so that people can hear from
trusted voices in their communities. I think it's going to
be the kind of the same kind of efforts that
are used for get out the vote will will be
effective here hearing from people they know and they trust.
You know that effective grassroots connection is going to I think,
(14:34):
build the desire for more people to effect them. So
I do want to ask so many moms on what
to expect. Of course, the questions are coming in so
that I get the COVID nineteen vaccine when it's offered,
If it's offered, and I know that a lot of
health care professionals who are pregnant have already received it,
and in some states it's being offered in a higher
(14:56):
order of priority. But there are of as a lot
of concerns from pregnant women. Is it safe now? Of course,
the infection itself has been shown not to be particularly
safe for pregnant women, especially those with comorbidities. If you
have just saial diabetes or if you have hypertension, that
puts you a greater risk if you're a mom of color.
(15:19):
So I know that the medical community has had you
know who came out with certain recommendation, CDC came out
with others, And basically the bottom line is always talked
to your doctor, which is what I would say, But
what would you say? I think you've hit the critical
points is that you're balancing risks here, and that's really
(15:39):
important because it's human nature to put more value on
the risk from something that you intentionally do. So, you know,
we see that with children's vaccinations as well. So I
know somebody who had this incredible allergic action to a
vaccine that was so severe. Wow, yeah, you know, that's
that kind happen. But it's so incredibly rare. The disease
(16:03):
that it's preventing killed thousands of children each year, you know,
So it's it's balancing those risks here. With COVID, we
are learning that there is some increased risk for pregnant
women when you need to balance I think, and in
talking with your doctor, because this is one of those
personal decisions that you have to make, is what is
(16:23):
your risk of exposure? So you know, if you're someone
who is working in a setting where you're more likely
to be exposed, whether it's in healthcare or you know,
food production or transportation or anything where you're out and
about and you're pregnant, you have a real risk of
being exposed and getting COVID, you know, in that setting.
I think that personally, if it were my family member,
(16:47):
I would say, yeah, I would recommend getting vaccinated. Their
studies being done, but there's theoretically there's nothing that we
would see with this vaccine that would make us think
ahead of time that it could pose an increase risk
to someone who is pregnant. If, on the other hand,
you are at home, you are not out at all,
and your risk is really really low, You're you're not
(17:09):
exposed to very many people, and you may say, well,
now you know what, I'm not going to get vaccinated.
Of course, I have to ask will trials be done
on pregnant women or is this just always like an
extrapolation My understanding is that companies are doing trials in
in pregnancy. And the reason for that is that you know,
(17:31):
this pandemic is widespread, it's rampant, uh, and we know
that there is increased risk during pregnancy. And so you know,
given you've got a vaccine that has a terrific safety profile,
very safe, then you're gonna want to do that. You know,
it's not hear to me how they're gonna do those
studies because you don't want to withhold vaccine. It may
(17:52):
be historical data so that they'll vaccinate and they'll be
able to compare people who got vaccinated now to those
who didn't before. There are some pregnant women who were
in the initials trials right became pregnant. Yeah, And it
may be that across the numbers of trials there are
enough women who got pregnant during the trial that they'll
(18:12):
be able to answer to answer that question that way too.
It again, it's the balance for women who have who
have a particular medical condition that can be life threatening,
the balance between stopping your medication or your treatment and
potential risks. Both you know, have the benefits and potential risks.
But one of the things that we're learning though, which
(18:34):
I think is really interesting, is that just like with
other vaccines, the flu shot, moms pass on protective factors
to their babies, which is so amazing. I think that's
such an incredibly important point, and you are protecting that
very vulnerable newborn baby. I wanted to ask you about
(19:10):
the t DApp because I get questions about that all
the time, and of course I give the recommendation that
you should get it with every pregnancy, so even if
you've had it before, even if you had a booster before,
and dad's got to get in and grandma's gotta get it,
everybody's got to get it. The flu vaccine is another
vaccine that every pregnant woman should get, and that again
(19:31):
is not only to protect her baby, but because even
more so, as far as we know then with COVID
influences really dangerous potentially for pregnant women and they're more
risk for hospitalization. Yeah, now, those are those are all
key points. I remember when I was at ABC News
doing a story on a mom on a family that
(19:54):
lost their newborn to whooping cough and she hadn't been
offered yeah during pregnancy, and you know, she had other kids.
They're not sure you know how whooping toff got into
the into the home, But to lose a child to
something that's preventable, it was devastating. And she's gone on
(20:15):
now to become a real advocate around this issue. That's
the ap THET. Yeah, that can be a really severe
infection in really young kids. And we start vaccinating about
two months, so in a really early period's the only
protection that the baby has is from their mom. Absolutely. Now,
(20:38):
of course we can't talk to you your pediatrician, without
talking about childhood vaccines. I think we've already established why
they're so safe, because they've gone through so many years
of testing and there's so much data, and yet these
miss persist, and these concerns persist again understandably because you
(21:00):
want to keep your baby safe, and there are so
many vaccines headed your baby's way in that first year
and beyond, and it seems, oh, isn't it going to
overwhelm their immune system? All of this it can be
really hard to tell the difference out there between what's
good science and what someone's opinion and what is just
false is a hoax, And so you see all this information.
(21:21):
I mean, I remember as a new parent. It was
a long time ago. Our oldest is twenty six. I
remember with the first shot that he got feeling really nervous,
and it's like, oh my, you know, feeling good because
we're doing it, but also it's like, well, we're giving
a shot. We're doing something, and whenever you're doing something,
(21:43):
you always have in this mind, well, wow, you know,
I know that this is the right thing to do.
I just hope it's that everything goes really well, and
that's a natural feeling to to have. I think it's
so important for parents to have trusted sources of information.
I think that having a healthcare provider who you trust,
(22:04):
who you can ask anything to, can be really really valuable.
And knowing what sources of information online are trusted, are
good science can be really really valuable, and it can
help you avoid some of the noise it's out there.
Because there's so much noise, it can be overwhelming. And
when there's that much information coming out at you, a
(22:28):
lot of people's reactions we are I'm just gonna wait.
Can't take it all in, so I'm just gonna wait.
And a waiting itself can be a dangerous thing for
a little baby. Exactly, and so a lot of parents
are like, oh, well, maybe I'll just you know, have
a few here, a few there, but not lump them
(22:48):
all together, like delay the schedule a little bit. What
do you say to parents who are concerned about so
many thoughts at one appointment or in one year. You know,
our mutism are amazing, They're incredible. We are barraged all
day long, all night long by germs that are around us.
(23:09):
They're on our skin, they're on our nose, they're they're
on our dogs and our cats, and they're everywhere, they're
on surfaces, and our immune systems react to those constantly.
So getting a dozen more exposures to different things over
those those first months is not in any way, shape
(23:30):
or form going to overwhelm your immune system. Part of
the testing that's done with vaccines, they're looking to see
which vaccines can you give together? Are there any that
you can't give together at the same time? There are,
and so doctors don't administer those at the same time.
But the goal and pediatrics is to protect children as
quickly as possible for things that they may face early
(23:51):
in life, and so that's why you do them. And
I'm always really nervous about measles. And it's not because
we give it so young. It's because we can't give
it younger. You know, around hew measles is the big
killer of children, But we don't give it to children
(24:11):
until they're one year old because your immune system is
developing constantly, and won't we act enough to give you
the right level of protection until about a year. But
if we had a measles vaccine that could work, you know,
right at birth, I'd be all for me too. And
I just want to share a personal story. My grandson, Lennox,
(24:34):
who's about to turn eight, was three weeks old when
he was hospitalized with SEPs us. It was a staff
infection that it had started at his umbilical site. Super
super rare, new parents out there, but it happened and
he was hospitalized. During that time. He was exposed to
measles three weeks, way too young to be vaccinated. They
(24:57):
gave him some immunoquobulin as precaution, but it was terrifying.
And that's that's my cautionary tale. If it could happen
to my grandson, it could happen to your child, It
could happen to someone else's child. Do you love right, Yeah,
My recommendation is vaccinate your child fully and on time.
(25:17):
It doesn't overwhelm the immune system. It means that your
child is protected as soon as they possibly can be,
and haven't forbid your child where to get something where
you belate. So that's the approach I I take. It's
the way to go. There's no science to show that
there's benefit to a child of spacing vaccines out beyond
(25:39):
what the current recommended schedule is, and all I see
with that is a longer period before a child is
it's fully protected. And you know, we vaccinated to protect
our own children, but also to protect those who can't
be vaccinated or those who don't get a good immuniverse US.
(26:00):
So we talk about vaccines being really terrific. They are,
but not everybody who gets the vaccine will be fully protected.
Right now, when we're talking about COVID, the two vaccines,
the fisor MODERNA, that are available in the United States
are about protective. So that basically says that five out
of a hundred people who are who get vaccinated will
(26:23):
still be at risk. But if everyone around them is
fully vaccinated, the chances that they're gonna get COVID go
way way, way, way down. We have a new hashtag
be heard as an h g r D right, part
of the herd that protects your community, all the little
ones in your community, all the elderly in your community
who are most vulnerable. Yeah, that's right. Thank you so
(26:46):
much for joining us today and for helping alleviate the
fears and make us feel really really good about rolling
up our sleeves and rolling up well our babies pant legs. Yes,
you know it's it's a quick cry and then you're
done exactly for them. Oh yeah, thank you so much.
(27:07):
I really appreciate it. It's a pleasure, really nice to
talk with you. Who baby below, my baby below? I
need you, Oh how I need you. Thanks for listening.
Remember I'm always here for you. What to Expect is
(27:27):
always here for you. We're all in this together. For
more on what you heard on today's episode, visit what
to Expect dot com slash podcasts. You can also check
out what to Expect when You're Expecting, What to Expect
the First Year, and the what to Expect app. And
we want to hear from you. Connect with us on
our community message board or on our social media You
(27:50):
can find me at Heidi Murkoff and Emma at Emma
Being wt E and of course at What to Expect.
Baby Love is performed by Riley Peter. What to Expect
is a production of I Heart Radio. From more shows
from I Heart Radio check out the I Heart Radio app,
Apple podcast, or wherever you listen to your favorite shows.
(28:16):
In my arms right, don't just stay Nija Knija, Baby Baby,
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