April 21, 2025 • 36 mins
In Part 2 of my conversation with vaccine expert Dr. Paul Offit, we take a deep dive into the most frequent vaccine questions families ask pediatricians today. We cover concerns like giving multiple vaccines at once, whether it’s safer to space out shots, why certain vaccines are given at birth, and how to explain the roles of preservatives like aluminum and thimerosal. Dr. Offit offers clear, evidence-based answers while also showing understanding for the emotions and uncertainty many parents feel.
Dr. Paul Offit is a pediatric infectious disease specialist at Children’s Hospital of Philadelphia, a professor of pediatrics at the University of Pennsylvania, and the co-inventor of the RotaTeq vaccine. He’s served on the FDA Vaccine Advisory Committee and is one of the leading voices in vaccine education. His guidance has helped shape vaccine policy worldwide—and I couldn’t be more thankful he joined me for this conversation.
Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner.
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Episode Transcript
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Unknown (00:00):
Welcome back to your child is normal. I'm Dr Jessica
Hochman, and today we continueour conversation with Dr Paul
Offit, one of the leading voicesin vaccine education and a
renowned pediatric infectiousdisease specialist. Dr offit is
the CO inventor of the roto techvaccine. He's been a longtime
member of the FDA vaccineAdvisory Committee, and he's a
professor at the University ofPennsylvania. He has spent his
(00:21):
career advocating for evidencebased vaccine practices and
communicating with empathy,clarity and deep scientific
knowledge. I feel so grateful tohave had the opportunity to ask
Dr offit the questions that Ihear most often from parents in
my office, like questions aboutspacing out vaccines, concerns
over preservatives like aluminumand mercury, and why the
hepatitis B vaccine isrecommended at birth. We also
(00:43):
explore whether all vaccines aretruly necessary, and also how to
respond thoughtfully whenparents are unsure. Whether
you're a pediatrician trying tofind the right words, or you're
a parent looking for trustworthyinformation, this episode is for
you. And as a quick reminder, ifyou are enjoying your child as
normal, I would be so gratefulif you could take a moment and
leave a five star reviewwherever it is you listen to
podcasts, good reviews really domake my day. Now on to part two
(01:06):
of my conversation with Dr PaulOffit. I would love to pivot
this to asking you how we shouldrespond to parents when they
have concerns about vaccines. Alot of the same concerns come up
to us pediatricians that I thinkare good questions, and I would,
I'm just curious how you wouldrespond to educate hesitant
parents. So the first thing thatI hear all the time is a lot of
(01:29):
parents want a delayed schedule.
They they feel like it's toomany, too soon for a young
child. What do you think aboutthat?
Well, it's not. I'll explainwhy. And so we give 14 vaccines,
or vaccines to prevent 14different diseases in the first
years of life. And people lookat that and they think, well,
like 100 years ago, we just gotone vaccine. Now we're getting
(01:51):
all these vaccines and andreally another few vaccines. And
adolescents are really close to17, or vaccines to prevent 17
different diseases. And thatnumber is greater than one, but
it's really that's not thenumber that counts. The number
that counts is the number ofimmunological components in
vaccines, because that's whatyou're worried about. You're
worried about somehowoverwhelming or weakening the
(02:11):
immune system by givingimmunological challenges. So so
for example, the hepatitis Bvaccine contains one protein,
the SARS cov two vaccinecontains one protein. The
diphtheria, the tetanus vaccinescontain one protein. And if you
add up, then you have theviruses, you know, like measles,
mumps, rubella, if you add upthose three vaccines, it's 24
(02:32):
proteins. So when you add up allthe vaccine, all the all the
immunological challenges invaccines that children get
today, it adds up to about 160or so immunological challenges,
either viral proteins, bacterialproteins, or the complex sugar
coating of a bacteria called apolysaccharide. So let's look at
that one vaccine you got 100years ago, the smallpox vaccine,
that is the largest of themammalian viruses. It's the only
(02:55):
virus that can be seen by lightmicroscopy. Okay, it's that big,
and it has 200 separateimmunological components,
meaning structural and nonstructural proteins. It is much
greater immunological challengeto get the smallpox vaccine than
to get all the vaccines today.
And if you don't believe that,just look at what happens to
people that get the smallpoxvaccine. Because I had to do
that for for the WistarInstitute, which is a Research
(03:18):
Institute in Philadelphia. So Igave those vaccines. I gave the
smallpox vaccines. I mean, thosepeople invariably had fairly
large swelling of the lymph nodeunderneath the arm, the so
called axillary lymph node,fever, chills. And one person's
veteran sort of smallpox vaccineinoculator said, looked at and
said, Good take meaning, this iswhat happens. And the difference
(03:40):
is, we've had advances inprotein chemistry, protein
purification, recombinant DNAtechnology. I mean, that is why
we can make sort of these singleprotein vaccines. And I just
think that's what I try andexplain, that that it's, it's
actually a lesser immunologicalchallenge now than it was
then. And also, I feel like whenchildren are little, they're
(04:01):
more vulnerable to a lot ofthese illnesses that we're
trying to protect them against.
For example, the whooping cough.
Kids that are under six monthsof age have a much harder time
getting through the whoopingcough than an older child. So
for that reason, if we've deemedit safe to give it to a young
kid, that would be mypreference.
Also, you know, when you're inthe womb, in theory, you're in a
sterile environment when youenter the birth canal, and then
(04:21):
the world, you're not and youhave, very quickly, living on
the surface of your body,trillions of bacteria. You have,
actually 10 times more bacteriaon the surface of your body than
you have cells in your body. Ithink if somebody came from
outer space and saw us, theywould think we were just a way
of transporting bacteria fromone place to the next. And you
make an immune response to thosebacteria, because you want to
make sure that they stay on thesurface of your body and don't
(04:44):
cause harm, that they are socalled commensal so So you make
roughly 10 to the ninth, new Band T cells, immunological cells
every day pours out of your bonemarrow to handle the onslaught
that happens every day, the foodyou eat in sterile the dust. You
inhale, as in sterile, or whatdo you drink? Isn't sterile.
You're constantly being exposedback. If you really want to
(05:04):
scare yourself, just take aswab. You swab the inside the
nose, put it on a microscopeslide and look at it under the
microscope. It's teeming withbacteria, too much of what you
make an immune response,honestly, literally, the
vaccines that you get are notjust figuratively, but
literally, a drop in the oceanof what you encounter and manage
every day. I mean, if wecouldn't handle the immune
(05:26):
response from vaccines, wewouldn't survive as a species.
That's suchan interesting perspective. So
what you're saying is, it mayfeel to parents like we're
getting a lot early in life, butwe already are, and getting a
lot more, we're exposedconstantly, which is healthy for
our immune systems. That's howwe grow stronger, exactly,
right. So what do you thinkmyself as a pediatrician, should
say when a family says that itjust feels like a lot all at
(05:48):
once, our preference is to spaceit out. And it is true that if
we do more vaccines in one day,they're more likely to have a
fever, which, in my view, is nota bad response. It's a normal,
natural immunologic response,but nevertheless, I'm
sympathetic that that makes themnervous. Do you think that we
should be permitting spacing ofvaccines or allowing it?
(06:11):
I don't, and here's why, it's itfeels better. It feels better to
space them out. It feels betterfor the parent, but it isn't
better. I mean, you're, you'reyou're the minute you a
alternative schedule, if youwill, is really just a delayed
schedule. So now you'reincreasing the period of time
during which children are nowmore susceptible to these
diseases with no benefit. Imean, it feels better, but there
(06:34):
really is no actual benefit. Andyou're right about fever. I
mean, why do we make fever? Whydoes the mammalian species us
make fever because your yourimmune system works better at a
higher temperature, that's why.
But you pay a metabolic pricefor fever. It's not fun to have
fever. You don't feel goodhaving fever, and you burn off
more calories, etc. Sometimesyou get dehydrated, so you need
it's it's you pay a price forfever, but your immune system
(06:56):
works better at a highertemperature, that's why. There's
probably 20 studies showing thatwhen you treat fever, you
actually can delay or prolong oreven worsen certain infections.
Yes,I know they used to give Tylenol
at the same time that they gavevaccinations, thinking that it
would be easier and more gentleron the on the child, but then
they found that the pneumococcusvaccine didn't mount as much of
(07:16):
an immune response when you gaveit at the same time. So to your
point, you want your immunesystem to show that it's
working, which I think a lot ofpeople got that concept during
COVID, that it was explained tothe public that a fever was a
good thing, that meant thevaccine was working. Yeah, no.
I had a friend in North Carolinawho volunteered for one of the
COVID trials. So, you know, youdon't know what you're getting.
You're getting either vaccine orplacebo. This was in like 2020,
(07:39):
and so he gets a shot, doesn'tknow what it is then, like the
next day, or the day after that,he wakes up and he has, he has
fever, and he is, you know, itjust does have sort of achiness.
And he looks at his wife and hesaid, Yes, I got the vaccine.
That's right, you know, it'sworking. You know, he got
something.
Now, the other question that Ihear a lot parents want to know
about the preservatives that arefound in the vaccines.
(08:01):
Specifically, I hear a lot aboutconcerns for the aluminum that's
in the vaccinations and thethimerosal or mercury, or
mercury. How would you respondto that concern?
Alright, so, so thimerosal isethyl mercury. That's a
preservative has that has beenremoved from vaccines given to
less than four year olds since,really 2000 2001 so that's gone
for the most part, for youngchildren, but, but take it on
(08:23):
its face. I mean, the the ethylmercury never sounds good. It's
not like there's a nationalcenter for the appreciation of
heavy metals standing up indefense of mercury. And
certainly large quantities of ofmethyl mercury are harmful, no
doubt about it. And but rememberthat we Mercury's in nearest
crust on there, and mercury getsmethylated by bacteria, so now
(08:44):
it's organic mercury, so it cancross cell membranes. You drink
methylmercury every day,assuming you make you're
drinking anything made fromwater, including infant formula
or breast milk, you areingesting methylmercury every
day. And so the ethyl mercury isnot methylmercury. Ethyl mercury
has a much shorter half life, soit's eliminated from the body
much more quickly. So ethylmercury was never harmful, but
it just didn't sound good, sothey sort of took it out in
(09:06):
early 2000s the aluminum is notnot a preservative. It's an
adjuvant, which is to say it, ithelps the immune system make a
better immune response, whichenables you to give fewer doses
or lesser quantities of theantigen. Again, aluminum is a
the most abundant light metalyou're exposed to, aluminum all
the time. This is it. I mean,the minute you say that anything
with a chemical name, everybodyfeels you know that. Oh, my God,
(09:28):
I am avoiding that. Well, ifyou've only want to avoid these
things for the most part, youhave to move to another planet.
I was actually on. Had totestify in front of Congress
once, and I think was FrankPallone. It was one of the
congressman said I was Democratfrom I think it was Democrat
from New Jersey. But any case,he said, hey, when it comes to
Mercury, I have zero tolerance.
Well, you got zero tolerance.
Got to move to another planet.
On this planet, there's mercury,and you're just ingesting it all
(09:49):
the time. So it's always aperception issue more than a
reality issue. So I but Iunderstand it. I mean, Mercury
isn't going to sound good.
Aluminum doesn't sound good, butit's. Is, you're exposed to it
all the time. Andwhen people ask, I wish we could
make these vaccines withoutaluminum, I think what's not
communicated well enough is thatthe aluminum, as you're saying,
it potentiates the vaccine. Itactually makes it work better,
(10:11):
and it's at such it's such asmall amount that we found it's
not doing any harm,right? So live attenuated viral
vaccines live, weakened viralvaccines, like measles, mumps,
German measles, rotavirus, noneof those contain an adjuvant,
because the virus isreplicating. But when you when
you have to go to this sort ofsingle protein, vaccines like,
you know, hepatitis B or humanPapillon virus, that you need a
(10:34):
little bit more of a becauseyou're just giving one protein,
so you need to sort of boostthat response a little more, and
that's what the adjuvants do.
They enable you to give fewerdoses and lesser quantity of the
antigen, meaning the immunogen.
So when you explain it likethat, it sounds like a plus, and
it makes sense.
Okay, so the Now anotherquestion that I get all the
(10:55):
time, and I think this isbecause this is the first
vaccine that we introduce tochildren, but it's recommended
that we give the hepatitis Bvaccine right after birth. At
the hospital that I work at,they like to give it within the
first 12 hours. And I think alot of parents, that makes them
nervous, and I understand thatthey've just had a baby. Do we
really need this? You know, themothers in the area where I work
(11:15):
at good prenatal care, they'veall been screened for hepatitis
B, and they're negative, andthey want to know is this
necessary? And I will say, forme as a pediatrician, what I
find difficult is I want to Iwant to convince them that our
vaccine schedule is a trustedgood idea. And I have a hard
time when this is the first onethat we recommend, to be honest,
(11:37):
because I think they have somevalid points. And at the same
time, the counter to that is,when I do give the hepatitis B
vaccine, I don't think I've everseen a bad reaction from it.
It's very well tolerated tokids, and it's nice to know that
they're vaccinated and protectedfrom the beginning. And I know
it's more of a public healthconcern that not every mother in
the United States can getscreened for hepatitis B, but
(11:58):
what do you think about thatperspective on the Hepatitis B
that's recommended right out thegate.
Well, I certainly understand thefeeling. I mean, I mean, I
remember, my son was born, youknow, it's like, within the
first 24 hours he got thatvaccine. It's like, sort of the
first scratch when you do car. Imean, come on, give this kid a
break. He was just born, and nowyou're injecting him with
(12:19):
something. And injection, youknow, when you give a vaccine,
it's sort of a violent act. Imean, kids are pinned down
against their will, their jobwith a needle. I mean, it
certainly doesn't look good. Buthepatitis B, if you acquire
Hepatitis B in the first bythe way, and I so appreciate
that you show that empathy.
Because I think that's right,it's I can understand where
parents are coming from. Thekids just born, giving a vaccine
(12:40):
makes the child cry. We feelbad. Do they really need this?
So I, I do want to help, like acase for, for why, for why this
should be, and if it shouldn'tbe, have some consideration for
that. Theproblem with Hepatitis B is, it
is, if you get it in the firstfew months of life, you have a
very high chance of going on todevelop chronic liver disease, I
cirrhosis or liver cancer, avery high chance. And so you
(13:02):
would argue, Well, I mean, themother screen that makes two
assumptions. One is that thescreening test is 100%
effective, which isn't, which istwo of no screening test. Two,
that she doesn't acquireHepatitis B after the she was
screened, which is alsopossible. And three, that Uncle
Bob comes and kisses the babywhen he's when the child's
little and and, you know,Hepatitis B is known as a silent
(13:24):
epidemic. A lot of people haveHepatitis B and don't know it. I
mean, before there was a routinerecommendation for the hepatitis
B vaccine, in 1991 with the, youknow, the so called recombinant
DNA hepatitis B vaccine, everyyear in this country, there were
18,000 children less than 10years of age that would get
hepatitis B 18,000 not half ofthem would get it from their
(13:45):
mother passing through the birthcanal of their mother. The other
half got it from relativelycasual contact with sharing
toothbrushes or washcloths orUncle Bob coming and giving a
kiss. And with thatrecommendation in 1991 we have
basically eliminated Hepatitis Bin children less than 10. It is
a remarkable achievement, andwith that, have lessened the
instance of cirrhosis and livercancer. That is, was one of our
(14:07):
more remarkable achievementsthat really few people pay
attention to. But it's adangerous time. If you get
hepatitis B in those firstcouple months, you're in
trouble. And so as much as thatwas hard for me to watch my son
get that vaccine. I knew in myheart it was the right thing to
do. Andin Asia, it's a tremendous
issue. There's hundreds of 1000sthat have Hepatitis B from birth
(14:30):
that that they acquired frombirth. Yes,
about 9000 in this country, itwas about 9000 a year prior to
the vaccine. It was like, 9000you write in known Asia, it's
much, much higher. Yeah,absolutely.
Okay, all right. So as as apediatrician and as someone who
understands infectious disease,and as a grandparent, you're
(14:50):
sympathetic to not wanting toget the hepatitis B or to have
some hesitancy, but there's astill, but there still is a good
case for it that why not have azero risk chance of getting
some? That could cause a lot ofproblems to a baby.
I have a granddaughter and agrandson, and with my
granddaughter, I actually wentto her visit at two months of
age. I went with my son anddaughter in law to watch that,
(15:12):
but it was hard. It was hard towatch her get all those
vaccines. And one of them was,you know, the rotavirus,
actually, which we developed atChildren's Hospital
Philadelphia, which was sort offun, right? Because it's sort of
going full circle. Here I'mholding her while she's getting
her rotavirus vaccine, which isby mouth, and it's also
suspended in sucrose, so it'sdelicious, but congratulations
about that, by the way, I I'm soproud of you for for being for
(15:34):
playing such a large role indeveloping such an important
vaccination. Thank you. Andokay, and I want to ask you more
about that, because I find thatso fascinating. But just to
finish the other parent concernsthat I hear, and then I want to
ask you more. And then the otherquestion I get, I have some
families that move to the UnitedStates from other countries, and
they compare and contrast theUnited States with the country
(15:58):
that they came from. Sospecifically, I had a family
that moved here from the UK, andthey said, Oh, well, why? Why do
you guys give four Prevnarvaccines and we give three? Why
do you give four hip vaccinesand we give three? Can we just
stick to the schedule from thecountry that we came from? I
think the feeling is that wecontinue to add more and more
vaccines to the schedule. Wenever can. We hardly ever
(16:18):
consider taking away some ofthose vaccines. Do you think
that's a valid point to bringup?
So sometimes, so there aredifferences, and it's sort of
what the country was willing todo. So for example,
the there, should I say, Do youthink that's a valid
consideration?
Yeah, no, I think it's valid.
But let me tell you where itcomes from. It comes from some
(16:40):
countries. Most of thosecountries, like the UK, for
example, have a national healthservice so that so how much they
so how much they spend, mattersthat that is a consideration. In
this country. We really don'tconsider that if we think that
we just give the best vaccine interms of number of doses, and if
we think that X that additionaldose gives you another five or
(17:01):
10% protection, then we do it,whereas another country may not
choose to do it that way,because they think 90% is good
enough. We don't need to have98% you know. So I think that's
where that comes from. So mygeneral bias is to stick to what
we do here, because we that'swhy we do it. I remember
(17:22):
reading that one Prevnar dose,you got about 20% protection.
The second one boosted it up to40% the third to 70% the fourth
to 90% so that fourth dose didmake an impact,
right? And we value that. UKdidn't give the varicella
vaccine for chicken box vaccinefor a long time. Finally, I
think they do now, but they justthought, Okay, we'll just
(17:43):
grandfather in that disease.
They just want to pay for it.
They do now. That'sanother question I get a lot
from parents. Why do we need toget the chicken pox vaccine? We
all have the chicken pox. What'sthe big deal? We had a chicken
pox party. How would you respondto families that share that
concern? I'm sure you've heardthat a million times as well.
Well. So every year, chicken poxwould cause about 10,000
(18:03):
hospitalizations, usually fromthings like chicken pox
pneumonia, from something callednecrotizing fasciitis, which is,
you know that that flesh eatingbacteria under the skin, because
you disrupt skin integrity withthe with the chicken pox
blisters, and there'd be 100 to150 people who would die every
year from chicken pox in thiscountry, many of them children.
(18:23):
So when people say that that,look, they had chicken pox and
they were fine, the people whodidn't survive aren't around to
say that anymore. So whorepresents them? I think we
represent them because we it'spreventable. It's safely
preventable, and so we shouldprevent it. I mean, which is to
say it's survivor bias. I thinkwhen you say I had it was fine,
you're biased, because you didsurvive,
(18:46):
as myself, a child from the 80swho had the chicken pox and had
a chicken pox party and got overit. And I remember getting, you
know, missing a week of school.
It wasn't so bad. It wasuncomfortable, but not so bad. I
was sympathetic to thatperspective. But then, when I
was in residency, I remembertreating a baby who had a
tracheotomy, could not eat,could not talk, was
neurologically devastated,because their mother, who had
(19:07):
not had the chicken pox inchildhood, got it as an adult,
and then passed it on to thebaby in utero, and the baby had
severe complications from it.
And after I saw that child andtreated that child, I was
convinced that if there was away to eradicate this illness,
we should,right? We're, you know, we're
compelled by our experiences andand that's a part of the problem
(19:29):
now, is we don't see thisdisease right now. So people
think that's they're just no bigdeal because they don't remember
them. I mean, when you look atpolio, for example, everybody
thinks of sort of black andwhite pictures. But there was a
27 year old man in RocklandCounty, New York, who never left
this this country, who gotpolio, got paralyzed by
poliovirus. And remember, polioonly paralyzed one of every 200
people that infect. So he wasthe tip of a much bigger
(19:52):
iceberg, and the they coulddetect the virus in wastewater
samples, not only in his county,but surrounding counties. And if
you looked in Philadelphia. OrChicago or Los Angeles, you will
find that virus, which is to saya reverent type two vaccine
virus, that is in the watersupply. And it's because people
come in from this, from othercountries that get oral polio
vaccine. People are verycomplacent about these things,
(20:13):
but they shouldn't be. And thereason that happened in his
Rockland County area wasimmunization rate had dropped to
less than 30%and that wasn't very long ago,
2022Yes, I think, I think we're so
lucky. I mean, the polio in the1950s was really scary. And I
went with my family to the CDConce we saw the iron the iron
(20:34):
lung. And after I saw thatapparatus, I thought, I want to
see this. I don't want to, Ireally don't want polio to come
back into this country.
Well, here's how old I am,right? So I was at age five. I
was in a polio ward. I was athospitalized in CO man's
hospital for Crippled Children.
That was what it was called,because that was back in the
days when you could use wordslike crippled and feeble minded
(20:56):
to describe children'shospitals. But I didn't have
polio. Had a failed operation onmy right foot. I was born with
club feet, so I was in a polioward for about six weeks. And I
remember iron lungs. I rememberthe so called Sister Kenny hot
pack treatments, where theywould take these excruciating of
the hot packs and put them onwithered arms and legs. I
remember children screaming outin pain. There was one visiting
hour a week on Sundays from twoto three. And so I just remember
(21:19):
lying there and looking at thesechildren screaming out in pain,
watching children in iron lungs,and I felt like I was in a
Dickens novel. And I think ifyou ask me the question, Why did
I choose pediatrics, I thinkthat's why I think this scars of
our childhood invariably becomethe passions of our adulthood,
and that's why I think I becamea pediatrician.
(21:41):
Well, I'll say for the world,for anybody that's listened to
Dr offit and realizes veryquickly what, what a gem you
are, I would say that's lemonadefrom lemons, for sure. We all
benefited from you going intopediatrics. Thank you. Now, what
about the other question I getfrom parents all the time is
they want to know, What does mychild really need? Can I pick
the grade a most importantvaccines? They can't all
(22:04):
possibly be equally asimportant. So what do I think
they really need? And maybe wecould put the other ones to the
side. Are you sympathetic tothat perspective, and how should
I respond as a pediatrician?
It's sort of like a Sophie'sChoice. I mean, what you know
which which ones do you want toput yourself at risk for? I
mean, vaccines are safe andeffective. They're not
absolutely safe. They arecertainly the benefits clearly
(22:27):
and definitively outweigh therisk. I mean, there were times
when that wasn't true. I mean,so for example, with if you look
at the polio vaccine, we gavethe Jonas Salk vaccine, starting
in 1955 A killed viral vaccine.
We did that into the early 60s.
Then we chose the oral vaccine,the Sabin vaccine, the Sabin
vaccine, right? And so that wasa live weekend form of the
(22:47):
virus. Now, that virus was athat vaccine was a rare cause of
polio. Did I miss rare one per2.4 million doses, but real. So
we eliminated polio by 1979 inthis country, but throughout the
80s and throughout the 90s,every year, eight to 10 children
in this country would get poliofrom the polio vaccine. For 20
years, the only polio in thiscountry was caused by the polio
(23:10):
vaccine, which is to say itsbenefits were clearly outweighed
by its risks. So when I cameonto the Advisory Committee for
Immunization Practices in 1998my task, my interest was in
getting us away from the oralpolio vaccine. So I used to be
the head of the the polioWorking Group and and was and
for those two years, I triedvery hard, and ultimately
(23:31):
successfully, to have thathappen. And the thing that was
the key there was there was aguy named John Salomon, whose
son had gotten polio paralyzedby the polio vaccine, ultimately
died, and I brought him on thecommittee, even sort of the
birth of consumerrepresentatives, and brought him
on the Committee, said, Okay, ifyou think it's too expensive,
because it was much lessexpensive to give the oral
vaccine as a squirt in the mouththan to give a shot. But, you
(23:53):
know, tell him that. So there'san example where a vaccine's
risks had outweighed itsbenefits,
and good for you for beinghonest about that. I think
that's what people so muchrespect about you. What I so
appreciate from you is yourwillingness to acknowledge that
there are side effects fromvaccines, which I think, if you
think about it, if you want avaccine to actually work, to
(24:15):
mount an immune response, to doenough benefit, you're going to
see some side effects. But thequestion, as you pointed out,
is, do the benefits outweigh therisk? And I do believe the
benefits outweigh the risks.
Yes, clearly, I mean, or else weshouldn't give them. And I think
so. Look at the J and J vaccine.
The that vaccine was the J and JJohnson. Johnson COVID vaccine
was authorized in February of2021 so it was that's
(24:41):
such a good memory for dates.
It's impressive. That's becauseI was on the FDA vaccine
Advisory Committee. They're likebare little burn in my brain the
and so we recommended that. Sothere was the way that vaccine
worked. It was an adenovirusthat was live but couldn't
reproduce itself. Kind of an oddsounds like it's contradictory,
but it was a live virus thatcould. Do itself into which you
would clone. Now the gene thatcode for it coded for the SARS
(25:02):
COVID Two surface protein, orspike protein. So that vaccine
came on the market in February,2021 and it was found pretty
quickly to be an extremely rarecause of clotting. Like one in
250,000 people could sufferclotting, including clotting in
the brain, including fatalclotting in the brain. So there
were a handful of deathsassociated with that vaccine,
which ultimately drove it offthe market by March of 2023,
(25:23):
when that became clear, becausethe mRNA vaccines were safer. So
I think you're alwaysconsidering that, and sadly, you
always learn as you go. I mean,there's invariably a human price
to be paid for knowledge, andthat's something we have a hard
timeaccepting. Of course, science
isn't perfect. We're notperfect. Science isn't perfect.
We have to learn as we go. Sowhat do you think if you were to
(25:44):
give advice to pediatricians onhow we could better communicate
the benefit of vaccines toparents, what do you think we
should say? What is the approachwe should take?
Well, that first, we have a lotof experience with vaccines. I
certainly understand how hard itis to watch your child be laid
down and against their will,jabbed. I think that is hard to
(26:06):
watch and but again, what'sharder to watch is children
suffering preventable illnesses.
I mean to me, the thing thatbreaks my heart and makes me
want to cry is that six year oldgirl in West Texas who was
perfectly healthy, who died formeasles. That is just, I mean,
it is the worst thing in theworld is to lose a child. What's
even worse is if you lose achild because of something you
(26:27):
did or didn't do, and that'sthat's something that mother and
father have to live with, isthat this was a preventable
death. And I think, you knowwhat, what I guess, most
impresses me are these sort ofparent advocacy groups, you
know, like families fightingflu, meningitis, angels,
national meningitis Association.
These are parents who childrenhave suffered and died
occasionally from vaccinepreventable disease. And God
(26:49):
bless them. I mean, they get upin front of the puppy and think,
Okay, this happened to me for areason. I'm going to explain the
importance of the vaccine. I'mgoing to explain how devastating
this illness can be, becausethey all tell the same story. I
can't believe this happened tome until it happens to you. I
mean, I certainly notsurprisingly, vaccinated my
children. But do I ever, could Iever imagine that they would
ever suffer these diseases? No,it's too horrible to imagine,
(27:10):
but it's so it's a game of brushand roulette. I mean, it's not
five empty chambers in one bowl.
It's probably 100,000 emptychambers in one bowl. But why
play that game? Do you alsofeel like we should impress upon
people that for immunity towork, it takes the community to
be all involved, that if enoughpeople opt out, we're going to
start to see problems. That'swhat's
happening. I mean, Texas, someof you, that's exactly what's
(27:31):
happening. You have a Mennonitecommunity that had about 80%
immunization rates. That's notenough to stop measles, which
really requires about 95% ofpeople to be immune, to provide
herd immunity. But I don't thinkthe societal argument ever
works, not today. I think it did50 years ago. I don't think it
does today. I think you can'tsay to somebody care about the
person next to you, because Ithink they largely don't. I
(27:51):
remember, during the there was ameasles epidemic in California,
2014 2015 and it spread to sevenother states, as well as Canada
and Mexico. But it started inSouthern California, so sort of
the it was that was not thelibertarian crowd. That was more
like the all natural crowd.
Don't inject me with anythingthat has a chemical name, the
all natural crowd. So that wasthe epicenter of the outbreak.
(28:13):
So Richard Pan was a statesenator who took it upon himself
to eliminate the philosophicalexemption to vaccination in a
state that never had a religiousexemption, therefore eliminating
all non medical exemptions. Sothe anti vaccine folks were
there in force. This is theworst thing to them, is the
notion that they would bemandated to get vaccines. So
there was a little boy namedRhett crowd, who was seven years
(28:36):
old, had acute lymphoblasticleukemia. So he went to these
me. Said, you can see this onvideo. It's on YouTube. You can
see him. So they put him up on astool so he can reach the
microphone. And he says, helooks right at them. He's so
brave. This is older now,because this was like 10 years
ago. He looks at them and hesays, I'm My name is Luke. I
have leukemia. I can't bevaccinated. I depend on you to
(28:59):
protect me, don't I countthat's that tugs at your
heartstrings. To me, that's verycompelling.
And do you, do you feel like thepharmaceutical industry has too
big of an influence on thevaccinations that we give? Or do
you feel like there's enoughindependence and the way that we
(29:21):
view the schedule and what weadminister to kids. First of
all,pharmaceutical companies are the
only group that have theresources and expertise to make
a vaccine. I mean, usually theseare billion and a half dollar
programs, and not all of themend up in vaccines. So only they
can make vaccines and then theysubmit their data. I think if
their data are compelling, thenthat's influential. I mean, as
on the FDA vaccine AdvisoryCommittee, when I was on the CDC
(29:42):
vaccine Advisory Committee, youjust look at the data, you have
no relationship with thepharmaceutical company. You
can't You're not allowed to havea relationship with the
pharmaceutical companies if, forexample, you were part of a data
safety monitoring board. Youcan't vote on that product or
any product that that companymakes. So I think there's a
firewall there, and I think thepeople are. They're serious.
They're all, you know,virologists and immunologists
and epidemiologists, infectiousdisease specialists, etc.
(30:04):
They're there to they take thejob seriously. So I think
there's that catchment system.
And then once the vaccines areout, there's things like the
vaccine safety data link thatcan pick up even the rarest of
side effects. So there's nolying. I mean, if you choose to
lie in your in your submissionto the FDA, for example, there's
no hiding. It'll be found outlater. So it's never to your
(30:26):
advantage to lie. It's never toyour advantage to lie anyway. I
mean, if you lie to the FDA,you're screwed. So I don't, I
don't, I don't buy it. I knowit's an easy pharmaceutical
companies are never going tosound like the good guys.
There's always big pharma, butthey, they, they're the only
ones that can make them and youknow, you know, you can't. On
the one hand, praise vaccine.
It's not, at some level, praisethose who make them, and it is a
fragile industry. I don't thinkpeople realize that it's they
(30:46):
see COVID, which was a windfallfor Pfizer, a windfall for
moderna, but for most ofvaccines are something you give
just a once or a few times inyour lifetime, and they never
compete with like lipid loweringagents or psychiatric drugs or
neurological drugs, etc. Sothere were 27 companies that
made vaccine in 1955 there were18 companies that made vaccines
for American children in 1980today, there's four, and it's
(31:07):
less than 10% of what any ofthese companies do. They could
drop it in a second. They couldmake it difficult enough, and
they will,yes, and the truth is, to to be
properly incentivized. You do?
You do want people to make somemoney from what they're doing.
So it's not all bad. We'rebenefiting from it. That's
right. I mean, take out theproblem, we wouldn't have
(31:27):
vaccines. I mean, that's why wehave them. I mean, it's not an
altruistic act.
Now, if you could leave parentswith one clear message about
childhood vaccinations, whatwould it be
that they're they're welltested, that there are systems
in place to detect even therarest of safety problems, and
(31:49):
that your job as a parent, myjob as a parent now grandparent,
is to put your child in thesafest position possible. That's
your job, and that's whatvaccines do. They put you in the
safest position possible?
And just one last thing beforewe finish up, I would love to
can you tell everybody your rolein the roto tech vaccine?
(32:09):
Because I find this soimpressive, and I'm so grateful
to the work that you've done inroto tech. Can you tell
everybody what the diseaseburden was and and how often we
see rotavirus now since creationof roto tech.
Well, so rotavirus is a virusthat affects the small
intestine, primarily it causesfever, vomiting and diarrhea.
(32:29):
That's three ways to lose water,fever, vomiting, diarrhea, it's
also very hard to rehydratechildren who are vomiting, and
so it was a common cause ofdehydration. It would cause
about 70 to 75,000hospitalizations a year in this
country, about 20 to 60 deaths ayear, but it dominated my
residency. I mean, I would see,I worked, I was a resident
Children's Hospital inPittsburgh. We'd see 400
(32:50):
children every winter with this,this was the winter vomiting
virus. And so when I came toChildren's Hospital in
Philadelphia, they had, the yearbefore, started to work on
rotaviruses, just in general,with an interest in a vaccine.
But, but when you when, when Ifor the 25 years or so that I
did that, you never really thinkyou're making a vaccine. To
(33:11):
super clear, my interest was intrying to understand the virus,
which part of the virus makesyou sick, what part of the virus
is induced an immune responsethat is protective. How can you
construct viruses that can cando the both, both which can
induce immune response withoutconfirming virulence, meaning
making you sick. So that wasjust summarizing 25 years of
effort in 30 seconds. But thatwas that effort. But you, you,
(33:32):
let's like say, I never,although we in the first
paragraph of my grants, and Iwas funded for 26 years by NIH,
you would always say, look, it'sa terrible disease. It causes in
the world. It is the biggestsingle killer of infants, in
young children. This viruskilled before the vaccine,
500,000 children in the everyyear in the world. You
know, we're I'm lucky, becausewhere I work, my kid, the kids
(33:54):
in my community, have access toIV fluids. But if you live in
Africa, or certain areas of theworld where that's not so
accessible, it really ispossibly a life or death
illness, andthat's why they're done for
exactly that reason. So, so, so,you know, I was fortunate enough
to be part of a team withStanley Plotkin, who's the
inventor of the rubella, Germanmeasles vaccine, and Fred Clark,
who was a veterinarian and PhD,to create these strains that
(34:15):
became roto tech, which is sortof a combination between a
bovine rotavirus, which doesn'tcause disease in children, and
human rotavirus which does, butwe took out the virulence
factor, so therefore we had avaccine. But again, just so
we're clear, my goal was ingetting my papers published and
getting my grants funded, andwith always a goal toward a
vaccine, but you never thinkyou're making a vaccine. Just so
(34:37):
we're clear, but it happened tobe that the strains that that we
made did become a vaccine roadattack, and that was obviously,
but even then, I just like say,because I remember, this is
February, 2006 you know, youit's like, you know the guys are
angry. They grant your wish. Youknow you're still your hearts
and your throat. Is there goingto be a rare safety side effect
that we don't know about nowthat the phase three probably
(34:58):
was a 70. 1000 baby trial, butthat only means 35,000 babies
got that vaccine, and you knownow 10s of millions, hundreds of
billions, are going to get it.
Is there something you didn'tthink about? And so you're sort
of always tortured at somelevel.
What I so appreciate about theway you think and about the way
you talk is that you're humbled.
You're open to the idea that weare hopeful that this vaccine is
(35:19):
going to do what we want it todo, but there are also
possibilities that it might notwork as we were hoping. But I
have to tell you, as a generalpediatrician, I love giving the
roto tech vaccine. I lovestarting with it because the
babies love the way it tastes.
It feels nicer to give somethingoral rather than an injection.
So I'm very grateful. I'm veryI'm very I'm very grateful for
(35:41):
multiple reasons. Thankyou. The Sucrose is the
stabilizing agent. It'sdelicious, and it's the only
oral vaccine that we give tochildren. So that's my that's my
gift to children, right? Whata wonderful contribution. Well,
thank you. Thank you so much forall that you do. I am so
grateful for your time. Youreally are a doctor, hero of
mine. I've listened to hours andhours of you on podcasts. I read
(36:03):
a lot of your work, and I'm sothankful that you took the time
to be here on this podcast.
Thank you. It's my pleasure,Jessica, thank you. Thank you
for listening, and I hope youenjoyed this week's episode of
your child is normal. Also, ifyou could take a moment and
leave a five star review,wherever it is you listen to
podcasts, I would greatlyappreciate it. It really makes a
difference to help this podcastgrow. You can also follow me on
(36:25):
Instagram at ask Dr Jessica, seeyou next Monday. Bye.
Welcome back to your child is normal. I'm Dr Jessica
Hochman, and today we continueour conversation with Dr Paul
Offit, one of the leading voicesin vaccine education and a
renowned pediatric infectiousdisease specialist. Dr offit is
the CO inventor of the roto techvaccine. He's been a longtime
member of the FDA vaccineAdvisory Committee, and he's a
professor at the University ofPennsylvania. He has spent his
(00:21):
career advocating for evidencebased vaccine practices and
communicating with empathy,clarity and deep scientific
knowledge. I feel so grateful tohave had the opportunity to ask
Dr offit the questions that Ihear most often from parents in
my office, like questions aboutspacing out vaccines, concerns
over preservatives like aluminumand mercury, and why the
hepatitis B vaccine isrecommended at birth. We also
(00:43):
explore whether all vaccines aretruly necessary, and also how to
respond thoughtfully whenparents are unsure. Whether
you're a pediatrician trying tofind the right words, or you're
a parent looking for trustworthyinformation, this episode is for
you. And as a quick reminder, ifyou are enjoying your child as
normal, I would be so gratefulif you could take a moment and
leave a five star reviewwherever it is you listen to
podcasts, good reviews really domake my day. Now on to part two
(01:06):
of my conversation with Dr PaulOffit. I would love to pivot
this to asking you how we shouldrespond to parents when they
have concerns about vaccines. Alot of the same concerns come up
to us pediatricians that I thinkare good questions, and I would,
I'm just curious how you wouldrespond to educate hesitant
parents. So the first thing thatI hear all the time is a lot of
(01:29):
parents want a delayed schedule.
They they feel like it's toomany, too soon for a young
child. What do you think aboutthat?
Well, it's not. I'll explainwhy. And so we give 14 vaccines,
or vaccines to prevent 14different diseases in the first
years of life. And people lookat that and they think, well,
like 100 years ago, we just gotone vaccine. Now we're getting
(01:51):
all these vaccines and andreally another few vaccines. And
adolescents are really close to17, or vaccines to prevent 17
different diseases. And thatnumber is greater than one, but
it's really that's not thenumber that counts. The number
that counts is the number ofimmunological components in
vaccines, because that's whatyou're worried about. You're
worried about somehowoverwhelming or weakening the
(02:11):
immune system by givingimmunological challenges. So so
for example, the hepatitis Bvaccine contains one protein,
the SARS cov two vaccinecontains one protein. The
diphtheria, the tetanus vaccinescontain one protein. And if you
add up, then you have theviruses, you know, like measles,
mumps, rubella, if you add upthose three vaccines, it's 24
(02:32):
proteins. So when you add up allthe vaccine, all the all the
immunological challenges invaccines that children get
today, it adds up to about 160or so immunological challenges,
either viral proteins, bacterialproteins, or the complex sugar
coating of a bacteria called apolysaccharide. So let's look at
that one vaccine you got 100years ago, the smallpox vaccine,
that is the largest of themammalian viruses. It's the only
(02:55):
virus that can be seen by lightmicroscopy. Okay, it's that big,
and it has 200 separateimmunological components,
meaning structural and nonstructural proteins. It is much
greater immunological challengeto get the smallpox vaccine than
to get all the vaccines today.
And if you don't believe that,just look at what happens to
people that get the smallpoxvaccine. Because I had to do
that for for the WistarInstitute, which is a Research
(03:18):
Institute in Philadelphia. So Igave those vaccines. I gave the
smallpox vaccines. I mean, thosepeople invariably had fairly
large swelling of the lymph nodeunderneath the arm, the so
called axillary lymph node,fever, chills. And one person's
veteran sort of smallpox vaccineinoculator said, looked at and
said, Good take meaning, this iswhat happens. And the difference
(03:40):
is, we've had advances inprotein chemistry, protein
purification, recombinant DNAtechnology. I mean, that is why
we can make sort of these singleprotein vaccines. And I just
think that's what I try andexplain, that that it's, it's
actually a lesser immunologicalchallenge now than it was
then. And also, I feel like whenchildren are little, they're
(04:01):
more vulnerable to a lot ofthese illnesses that we're
trying to protect them against.
For example, the whooping cough.
Kids that are under six monthsof age have a much harder time
getting through the whoopingcough than an older child. So
for that reason, if we've deemedit safe to give it to a young
kid, that would be mypreference.
Also, you know, when you're inthe womb, in theory, you're in a
sterile environment when youenter the birth canal, and then
(04:21):
the world, you're not and youhave, very quickly, living on
the surface of your body,trillions of bacteria. You have,
actually 10 times more bacteriaon the surface of your body than
you have cells in your body. Ithink if somebody came from
outer space and saw us, theywould think we were just a way
of transporting bacteria fromone place to the next. And you
make an immune response to thosebacteria, because you want to
make sure that they stay on thesurface of your body and don't
(04:44):
cause harm, that they are socalled commensal so So you make
roughly 10 to the ninth, new Band T cells, immunological cells
every day pours out of your bonemarrow to handle the onslaught
that happens every day, the foodyou eat in sterile the dust. You
inhale, as in sterile, or whatdo you drink? Isn't sterile.
You're constantly being exposedback. If you really want to
(05:04):
scare yourself, just take aswab. You swab the inside the
nose, put it on a microscopeslide and look at it under the
microscope. It's teeming withbacteria, too much of what you
make an immune response,honestly, literally, the
vaccines that you get are notjust figuratively, but
literally, a drop in the oceanof what you encounter and manage
every day. I mean, if wecouldn't handle the immune
(05:26):
response from vaccines, wewouldn't survive as a species.
That's suchan interesting perspective. So
what you're saying is, it mayfeel to parents like we're
getting a lot early in life, butwe already are, and getting a
lot more, we're exposedconstantly, which is healthy for
our immune systems. That's howwe grow stronger, exactly,
right. So what do you thinkmyself as a pediatrician, should
say when a family says that itjust feels like a lot all at
(05:48):
once, our preference is to spaceit out. And it is true that if
we do more vaccines in one day,they're more likely to have a
fever, which, in my view, is nota bad response. It's a normal,
natural immunologic response,but nevertheless, I'm
sympathetic that that makes themnervous. Do you think that we
should be permitting spacing ofvaccines or allowing it?
(06:11):
I don't, and here's why, it's itfeels better. It feels better to
space them out. It feels betterfor the parent, but it isn't
better. I mean, you're, you'reyou're the minute you a
alternative schedule, if youwill, is really just a delayed
schedule. So now you'reincreasing the period of time
during which children are nowmore susceptible to these
diseases with no benefit. Imean, it feels better, but there
(06:34):
really is no actual benefit. Andyou're right about fever. I
mean, why do we make fever? Whydoes the mammalian species us
make fever because your yourimmune system works better at a
higher temperature, that's why.
But you pay a metabolic pricefor fever. It's not fun to have
fever. You don't feel goodhaving fever, and you burn off
more calories, etc. Sometimesyou get dehydrated, so you need
it's it's you pay a price forfever, but your immune system
(06:56):
works better at a highertemperature, that's why. There's
probably 20 studies showing thatwhen you treat fever, you
actually can delay or prolong oreven worsen certain infections.
Yes,I know they used to give Tylenol
at the same time that they gavevaccinations, thinking that it
would be easier and more gentleron the on the child, but then
they found that the pneumococcusvaccine didn't mount as much of
(07:16):
an immune response when you gaveit at the same time. So to your
point, you want your immunesystem to show that it's
working, which I think a lot ofpeople got that concept during
COVID, that it was explained tothe public that a fever was a
good thing, that meant thevaccine was working. Yeah, no.
I had a friend in North Carolinawho volunteered for one of the
COVID trials. So, you know, youdon't know what you're getting.
You're getting either vaccine orplacebo. This was in like 2020,
(07:39):
and so he gets a shot, doesn'tknow what it is then, like the
next day, or the day after that,he wakes up and he has, he has
fever, and he is, you know, itjust does have sort of achiness.
And he looks at his wife and hesaid, Yes, I got the vaccine.
That's right, you know, it'sworking. You know, he got
something.
Now, the other question that Ihear a lot parents want to know
about the preservatives that arefound in the vaccines.
(08:01):
Specifically, I hear a lot aboutconcerns for the aluminum that's
in the vaccinations and thethimerosal or mercury, or
mercury. How would you respondto that concern?
Alright, so, so thimerosal isethyl mercury. That's a
preservative has that has beenremoved from vaccines given to
less than four year olds since,really 2000 2001 so that's gone
for the most part, for youngchildren, but, but take it on
(08:23):
its face. I mean, the the ethylmercury never sounds good. It's
not like there's a nationalcenter for the appreciation of
heavy metals standing up indefense of mercury. And
certainly large quantities of ofmethyl mercury are harmful, no
doubt about it. And but rememberthat we Mercury's in nearest
crust on there, and mercury getsmethylated by bacteria, so now
(08:44):
it's organic mercury, so it cancross cell membranes. You drink
methylmercury every day,assuming you make you're
drinking anything made fromwater, including infant formula
or breast milk, you areingesting methylmercury every
day. And so the ethyl mercury isnot methylmercury. Ethyl mercury
has a much shorter half life, soit's eliminated from the body
much more quickly. So ethylmercury was never harmful, but
it just didn't sound good, sothey sort of took it out in
(09:06):
early 2000s the aluminum is notnot a preservative. It's an
adjuvant, which is to say it, ithelps the immune system make a
better immune response, whichenables you to give fewer doses
or lesser quantities of theantigen. Again, aluminum is a
the most abundant light metalyou're exposed to, aluminum all
the time. This is it. I mean,the minute you say that anything
with a chemical name, everybodyfeels you know that. Oh, my God,
(09:28):
I am avoiding that. Well, ifyou've only want to avoid these
things for the most part, youhave to move to another planet.
I was actually on. Had totestify in front of Congress
once, and I think was FrankPallone. It was one of the
congressman said I was Democratfrom I think it was Democrat
from New Jersey. But any case,he said, hey, when it comes to
Mercury, I have zero tolerance.
Well, you got zero tolerance.
Got to move to another planet.
On this planet, there's mercury,and you're just ingesting it all
(09:49):
the time. So it's always aperception issue more than a
reality issue. So I but Iunderstand it. I mean, Mercury
isn't going to sound good.
Aluminum doesn't sound good, butit's. Is, you're exposed to it
all the time. Andwhen people ask, I wish we could
make these vaccines withoutaluminum, I think what's not
communicated well enough is thatthe aluminum, as you're saying,
it potentiates the vaccine. Itactually makes it work better,
(10:11):
and it's at such it's such asmall amount that we found it's
not doing any harm,right? So live attenuated viral
vaccines live, weakened viralvaccines, like measles, mumps,
German measles, rotavirus, noneof those contain an adjuvant,
because the virus isreplicating. But when you when
you have to go to this sort ofsingle protein, vaccines like,
you know, hepatitis B or humanPapillon virus, that you need a
(10:34):
little bit more of a becauseyou're just giving one protein,
so you need to sort of boostthat response a little more, and
that's what the adjuvants do.
They enable you to give fewerdoses and lesser quantity of the
antigen, meaning the immunogen.
So when you explain it likethat, it sounds like a plus, and
it makes sense.
Okay, so the Now anotherquestion that I get all the
(10:55):
time, and I think this isbecause this is the first
vaccine that we introduce tochildren, but it's recommended
that we give the hepatitis Bvaccine right after birth. At
the hospital that I work at,they like to give it within the
first 12 hours. And I think alot of parents, that makes them
nervous, and I understand thatthey've just had a baby. Do we
really need this? You know, themothers in the area where I work
(11:15):
at good prenatal care, they'veall been screened for hepatitis
B, and they're negative, andthey want to know is this
necessary? And I will say, forme as a pediatrician, what I
find difficult is I want to Iwant to convince them that our
vaccine schedule is a trustedgood idea. And I have a hard
time when this is the first onethat we recommend, to be honest,
(11:37):
because I think they have somevalid points. And at the same
time, the counter to that is,when I do give the hepatitis B
vaccine, I don't think I've everseen a bad reaction from it.
It's very well tolerated tokids, and it's nice to know that
they're vaccinated and protectedfrom the beginning. And I know
it's more of a public healthconcern that not every mother in
the United States can getscreened for hepatitis B, but
(11:58):
what do you think about thatperspective on the Hepatitis B
that's recommended right out thegate.
Well, I certainly understand thefeeling. I mean, I mean, I
remember, my son was born, youknow, it's like, within the
first 24 hours he got thatvaccine. It's like, sort of the
first scratch when you do car. Imean, come on, give this kid a
break. He was just born, and nowyou're injecting him with
(12:19):
something. And injection, youknow, when you give a vaccine,
it's sort of a violent act. Imean, kids are pinned down
against their will, their jobwith a needle. I mean, it
certainly doesn't look good. Buthepatitis B, if you acquire
Hepatitis B in the first bythe way, and I so appreciate
that you show that empathy.
Because I think that's right,it's I can understand where
parents are coming from. Thekids just born, giving a vaccine
(12:40):
makes the child cry. We feelbad. Do they really need this?
So I, I do want to help, like acase for, for why, for why this
should be, and if it shouldn'tbe, have some consideration for
that. Theproblem with Hepatitis B is, it
is, if you get it in the firstfew months of life, you have a
very high chance of going on todevelop chronic liver disease, I
cirrhosis or liver cancer, avery high chance. And so you
(13:02):
would argue, Well, I mean, themother screen that makes two
assumptions. One is that thescreening test is 100%
effective, which isn't, which istwo of no screening test. Two,
that she doesn't acquireHepatitis B after the she was
screened, which is alsopossible. And three, that Uncle
Bob comes and kisses the babywhen he's when the child's
little and and, you know,Hepatitis B is known as a silent
(13:24):
epidemic. A lot of people haveHepatitis B and don't know it. I
mean, before there was a routinerecommendation for the hepatitis
B vaccine, in 1991 with the, youknow, the so called recombinant
DNA hepatitis B vaccine, everyyear in this country, there were
18,000 children less than 10years of age that would get
hepatitis B 18,000 not half ofthem would get it from their
(13:45):
mother passing through the birthcanal of their mother. The other
half got it from relativelycasual contact with sharing
toothbrushes or washcloths orUncle Bob coming and giving a
kiss. And with thatrecommendation in 1991 we have
basically eliminated Hepatitis Bin children less than 10. It is
a remarkable achievement, andwith that, have lessened the
instance of cirrhosis and livercancer. That is, was one of our
(14:07):
more remarkable achievementsthat really few people pay
attention to. But it's adangerous time. If you get
hepatitis B in those firstcouple months, you're in
trouble. And so as much as thatwas hard for me to watch my son
get that vaccine. I knew in myheart it was the right thing to
do. Andin Asia, it's a tremendous
issue. There's hundreds of 1000sthat have Hepatitis B from birth
(14:30):
that that they acquired frombirth. Yes,
about 9000 in this country, itwas about 9000 a year prior to
the vaccine. It was like, 9000you write in known Asia, it's
much, much higher. Yeah,absolutely.
Okay, all right. So as as apediatrician and as someone who
understands infectious disease,and as a grandparent, you're
(14:50):
sympathetic to not wanting toget the hepatitis B or to have
some hesitancy, but there's astill, but there still is a good
case for it that why not have azero risk chance of getting
some? That could cause a lot ofproblems to a baby.
I have a granddaughter and agrandson, and with my
granddaughter, I actually wentto her visit at two months of
age. I went with my son anddaughter in law to watch that,
(15:12):
but it was hard. It was hard towatch her get all those
vaccines. And one of them was,you know, the rotavirus,
actually, which we developed atChildren's Hospital
Philadelphia, which was sort offun, right? Because it's sort of
going full circle. Here I'mholding her while she's getting
her rotavirus vaccine, which isby mouth, and it's also
suspended in sucrose, so it'sdelicious, but congratulations
about that, by the way, I I'm soproud of you for for being for
(15:34):
playing such a large role indeveloping such an important
vaccination. Thank you. Andokay, and I want to ask you more
about that, because I find thatso fascinating. But just to
finish the other parent concernsthat I hear, and then I want to
ask you more. And then the otherquestion I get, I have some
families that move to the UnitedStates from other countries, and
they compare and contrast theUnited States with the country
(15:58):
that they came from. Sospecifically, I had a family
that moved here from the UK, andthey said, Oh, well, why? Why do
you guys give four Prevnarvaccines and we give three? Why
do you give four hip vaccinesand we give three? Can we just
stick to the schedule from thecountry that we came from? I
think the feeling is that wecontinue to add more and more
vaccines to the schedule. Wenever can. We hardly ever
(16:18):
consider taking away some ofthose vaccines. Do you think
that's a valid point to bringup?
So sometimes, so there aredifferences, and it's sort of
what the country was willing todo. So for example,
the there, should I say, Do youthink that's a valid
consideration?
Yeah, no, I think it's valid.
But let me tell you where itcomes from. It comes from some
(16:40):
countries. Most of thosecountries, like the UK, for
example, have a national healthservice so that so how much they
so how much they spend, mattersthat that is a consideration. In
this country. We really don'tconsider that if we think that
we just give the best vaccine interms of number of doses, and if
we think that X that additionaldose gives you another five or
(17:01):
10% protection, then we do it,whereas another country may not
choose to do it that way,because they think 90% is good
enough. We don't need to have98% you know. So I think that's
where that comes from. So mygeneral bias is to stick to what
we do here, because we that'swhy we do it. I remember
(17:22):
reading that one Prevnar dose,you got about 20% protection.
The second one boosted it up to40% the third to 70% the fourth
to 90% so that fourth dose didmake an impact,
right? And we value that. UKdidn't give the varicella
vaccine for chicken box vaccinefor a long time. Finally, I
think they do now, but they justthought, Okay, we'll just
(17:43):
grandfather in that disease.
They just want to pay for it.
They do now. That'sanother question I get a lot
from parents. Why do we need toget the chicken pox vaccine? We
all have the chicken pox. What'sthe big deal? We had a chicken
pox party. How would you respondto families that share that
concern? I'm sure you've heardthat a million times as well.
Well. So every year, chicken poxwould cause about 10,000
(18:03):
hospitalizations, usually fromthings like chicken pox
pneumonia, from something callednecrotizing fasciitis, which is,
you know that that flesh eatingbacteria under the skin, because
you disrupt skin integrity withthe with the chicken pox
blisters, and there'd be 100 to150 people who would die every
year from chicken pox in thiscountry, many of them children.
(18:23):
So when people say that that,look, they had chicken pox and
they were fine, the people whodidn't survive aren't around to
say that anymore. So whorepresents them? I think we
represent them because we it'spreventable. It's safely
preventable, and so we shouldprevent it. I mean, which is to
say it's survivor bias. I thinkwhen you say I had it was fine,
you're biased, because you didsurvive,
(18:46):
as myself, a child from the 80swho had the chicken pox and had
a chicken pox party and got overit. And I remember getting, you
know, missing a week of school.
It wasn't so bad. It wasuncomfortable, but not so bad. I
was sympathetic to thatperspective. But then, when I
was in residency, I remembertreating a baby who had a
tracheotomy, could not eat,could not talk, was
neurologically devastated,because their mother, who had
(19:07):
not had the chicken pox inchildhood, got it as an adult,
and then passed it on to thebaby in utero, and the baby had
severe complications from it.
And after I saw that child andtreated that child, I was
convinced that if there was away to eradicate this illness,
we should,right? We're, you know, we're
compelled by our experiences andand that's a part of the problem
(19:29):
now, is we don't see thisdisease right now. So people
think that's they're just no bigdeal because they don't remember
them. I mean, when you look atpolio, for example, everybody
thinks of sort of black andwhite pictures. But there was a
27 year old man in RocklandCounty, New York, who never left
this this country, who gotpolio, got paralyzed by
poliovirus. And remember, polioonly paralyzed one of every 200
people that infect. So he wasthe tip of a much bigger
(19:52):
iceberg, and the they coulddetect the virus in wastewater
samples, not only in his county,but surrounding counties. And if
you looked in Philadelphia. OrChicago or Los Angeles, you will
find that virus, which is to saya reverent type two vaccine
virus, that is in the watersupply. And it's because people
come in from this, from othercountries that get oral polio
vaccine. People are verycomplacent about these things,
(20:13):
but they shouldn't be. And thereason that happened in his
Rockland County area wasimmunization rate had dropped to
less than 30%and that wasn't very long ago,
2022Yes, I think, I think we're so
lucky. I mean, the polio in the1950s was really scary. And I
went with my family to the CDConce we saw the iron the iron
(20:34):
lung. And after I saw thatapparatus, I thought, I want to
see this. I don't want to, Ireally don't want polio to come
back into this country.
Well, here's how old I am,right? So I was at age five. I
was in a polio ward. I was athospitalized in CO man's
hospital for Crippled Children.
That was what it was called,because that was back in the
days when you could use wordslike crippled and feeble minded
(20:56):
to describe children'shospitals. But I didn't have
polio. Had a failed operation onmy right foot. I was born with
club feet, so I was in a polioward for about six weeks. And I
remember iron lungs. I rememberthe so called Sister Kenny hot
pack treatments, where theywould take these excruciating of
the hot packs and put them onwithered arms and legs. I
remember children screaming outin pain. There was one visiting
hour a week on Sundays from twoto three. And so I just remember
(21:19):
lying there and looking at thesechildren screaming out in pain,
watching children in iron lungs,and I felt like I was in a
Dickens novel. And I think ifyou ask me the question, Why did
I choose pediatrics, I thinkthat's why I think this scars of
our childhood invariably becomethe passions of our adulthood,
and that's why I think I becamea pediatrician.
(21:41):
Well, I'll say for the world,for anybody that's listened to
Dr offit and realizes veryquickly what, what a gem you
are, I would say that's lemonadefrom lemons, for sure. We all
benefited from you going intopediatrics. Thank you. Now, what
about the other question I getfrom parents all the time is
they want to know, What does mychild really need? Can I pick
the grade a most importantvaccines? They can't all
(22:04):
possibly be equally asimportant. So what do I think
they really need? And maybe wecould put the other ones to the
side. Are you sympathetic tothat perspective, and how should
I respond as a pediatrician?
It's sort of like a Sophie'sChoice. I mean, what you know
which which ones do you want toput yourself at risk for? I
mean, vaccines are safe andeffective. They're not
absolutely safe. They arecertainly the benefits clearly
(22:27):
and definitively outweigh therisk. I mean, there were times
when that wasn't true. I mean,so for example, with if you look
at the polio vaccine, we gavethe Jonas Salk vaccine, starting
in 1955 A killed viral vaccine.
We did that into the early 60s.
Then we chose the oral vaccine,the Sabin vaccine, the Sabin
vaccine, right? And so that wasa live weekend form of the
(22:47):
virus. Now, that virus was athat vaccine was a rare cause of
polio. Did I miss rare one per2.4 million doses, but real. So
we eliminated polio by 1979 inthis country, but throughout the
80s and throughout the 90s,every year, eight to 10 children
in this country would get poliofrom the polio vaccine. For 20
years, the only polio in thiscountry was caused by the polio
(23:10):
vaccine, which is to say itsbenefits were clearly outweighed
by its risks. So when I cameonto the Advisory Committee for
Immunization Practices in 1998my task, my interest was in
getting us away from the oralpolio vaccine. So I used to be
the head of the the polioWorking Group and and was and
for those two years, I triedvery hard, and ultimately
(23:31):
successfully, to have thathappen. And the thing that was
the key there was there was aguy named John Salomon, whose
son had gotten polio paralyzedby the polio vaccine, ultimately
died, and I brought him on thecommittee, even sort of the
birth of consumerrepresentatives, and brought him
on the Committee, said, Okay, ifyou think it's too expensive,
because it was much lessexpensive to give the oral
vaccine as a squirt in the mouththan to give a shot. But, you
(23:53):
know, tell him that. So there'san example where a vaccine's
risks had outweighed itsbenefits,
and good for you for beinghonest about that. I think
that's what people so muchrespect about you. What I so
appreciate from you is yourwillingness to acknowledge that
there are side effects fromvaccines, which I think, if you
think about it, if you want avaccine to actually work, to
(24:15):
mount an immune response, to doenough benefit, you're going to
see some side effects. But thequestion, as you pointed out,
is, do the benefits outweigh therisk? And I do believe the
benefits outweigh the risks.
Yes, clearly, I mean, or else weshouldn't give them. And I think
so. Look at the J and J vaccine.
The that vaccine was the J and JJohnson. Johnson COVID vaccine
was authorized in February of2021 so it was that's
(24:41):
such a good memory for dates.
It's impressive. That's becauseI was on the FDA vaccine
Advisory Committee. They're likebare little burn in my brain the
and so we recommended that. Sothere was the way that vaccine
worked. It was an adenovirusthat was live but couldn't
reproduce itself. Kind of an oddsounds like it's contradictory,
but it was a live virus thatcould. Do itself into which you
would clone. Now the gene thatcode for it coded for the SARS
(25:02):
COVID Two surface protein, orspike protein. So that vaccine
came on the market in February,2021 and it was found pretty
quickly to be an extremely rarecause of clotting. Like one in
250,000 people could sufferclotting, including clotting in
the brain, including fatalclotting in the brain. So there
were a handful of deathsassociated with that vaccine,
which ultimately drove it offthe market by March of 2023,
(25:23):
when that became clear, becausethe mRNA vaccines were safer. So
I think you're alwaysconsidering that, and sadly, you
always learn as you go. I mean,there's invariably a human price
to be paid for knowledge, andthat's something we have a hard
timeaccepting. Of course, science
isn't perfect. We're notperfect. Science isn't perfect.
We have to learn as we go. Sowhat do you think if you were to
(25:44):
give advice to pediatricians onhow we could better communicate
the benefit of vaccines toparents, what do you think we
should say? What is the approachwe should take?
Well, that first, we have a lotof experience with vaccines. I
certainly understand how hard itis to watch your child be laid
down and against their will,jabbed. I think that is hard to
(26:06):
watch and but again, what'sharder to watch is children
suffering preventable illnesses.
I mean to me, the thing thatbreaks my heart and makes me
want to cry is that six year oldgirl in West Texas who was
perfectly healthy, who died formeasles. That is just, I mean,
it is the worst thing in theworld is to lose a child. What's
even worse is if you lose achild because of something you
(26:27):
did or didn't do, and that'sthat's something that mother and
father have to live with, isthat this was a preventable
death. And I think, you knowwhat, what I guess, most
impresses me are these sort ofparent advocacy groups, you
know, like families fightingflu, meningitis, angels,
national meningitis Association.
These are parents who childrenhave suffered and died
occasionally from vaccinepreventable disease. And God
(26:49):
bless them. I mean, they get upin front of the puppy and think,
Okay, this happened to me for areason. I'm going to explain the
importance of the vaccine. I'mgoing to explain how devastating
this illness can be, becausethey all tell the same story. I
can't believe this happened tome until it happens to you. I
mean, I certainly notsurprisingly, vaccinated my
children. But do I ever, could Iever imagine that they would
ever suffer these diseases? No,it's too horrible to imagine,
(27:10):
but it's so it's a game of brushand roulette. I mean, it's not
five empty chambers in one bowl.
It's probably 100,000 emptychambers in one bowl. But why
play that game? Do you alsofeel like we should impress upon
people that for immunity towork, it takes the community to
be all involved, that if enoughpeople opt out, we're going to
start to see problems. That'swhat's
happening. I mean, Texas, someof you, that's exactly what's
(27:31):
happening. You have a Mennonitecommunity that had about 80%
immunization rates. That's notenough to stop measles, which
really requires about 95% ofpeople to be immune, to provide
herd immunity. But I don't thinkthe societal argument ever
works, not today. I think it did50 years ago. I don't think it
does today. I think you can'tsay to somebody care about the
person next to you, because Ithink they largely don't. I
(27:51):
remember, during the there was ameasles epidemic in California,
2014 2015 and it spread to sevenother states, as well as Canada
and Mexico. But it started inSouthern California, so sort of
the it was that was not thelibertarian crowd. That was more
like the all natural crowd.
Don't inject me with anythingthat has a chemical name, the
all natural crowd. So that wasthe epicenter of the outbreak.
(28:13):
So Richard Pan was a statesenator who took it upon himself
to eliminate the philosophicalexemption to vaccination in a
state that never had a religiousexemption, therefore eliminating
all non medical exemptions. Sothe anti vaccine folks were
there in force. This is theworst thing to them, is the
notion that they would bemandated to get vaccines. So
there was a little boy namedRhett crowd, who was seven years
(28:36):
old, had acute lymphoblasticleukemia. So he went to these
me. Said, you can see this onvideo. It's on YouTube. You can
see him. So they put him up on astool so he can reach the
microphone. And he says, helooks right at them. He's so
brave. This is older now,because this was like 10 years
ago. He looks at them and hesays, I'm My name is Luke. I
have leukemia. I can't bevaccinated. I depend on you to
(28:59):
protect me, don't I countthat's that tugs at your
heartstrings. To me, that's verycompelling.
And do you, do you feel like thepharmaceutical industry has too
big of an influence on thevaccinations that we give? Or do
you feel like there's enoughindependence and the way that we
(29:21):
view the schedule and what weadminister to kids. First of
all,pharmaceutical companies are the
only group that have theresources and expertise to make
a vaccine. I mean, usually theseare billion and a half dollar
programs, and not all of themend up in vaccines. So only they
can make vaccines and then theysubmit their data. I think if
their data are compelling, thenthat's influential. I mean, as
on the FDA vaccine AdvisoryCommittee, when I was on the CDC
(29:42):
vaccine Advisory Committee, youjust look at the data, you have
no relationship with thepharmaceutical company. You
can't You're not allowed to havea relationship with the
pharmaceutical companies if, forexample, you were part of a data
safety monitoring board. Youcan't vote on that product or
any product that that companymakes. So I think there's a
firewall there, and I think thepeople are. They're serious.
They're all, you know,virologists and immunologists
and epidemiologists, infectiousdisease specialists, etc.
(30:04):
They're there to they take thejob seriously. So I think
there's that catchment system.
And then once the vaccines areout, there's things like the
vaccine safety data link thatcan pick up even the rarest of
side effects. So there's nolying. I mean, if you choose to
lie in your in your submissionto the FDA, for example, there's
no hiding. It'll be found outlater. So it's never to your
(30:26):
advantage to lie. It's never toyour advantage to lie anyway. I
mean, if you lie to the FDA,you're screwed. So I don't, I
don't, I don't buy it. I knowit's an easy pharmaceutical
companies are never going tosound like the good guys.
There's always big pharma, butthey, they, they're the only
ones that can make them and youknow, you know, you can't. On
the one hand, praise vaccine.
It's not, at some level, praisethose who make them, and it is a
fragile industry. I don't thinkpeople realize that it's they
(30:46):
see COVID, which was a windfallfor Pfizer, a windfall for
moderna, but for most ofvaccines are something you give
just a once or a few times inyour lifetime, and they never
compete with like lipid loweringagents or psychiatric drugs or
neurological drugs, etc. Sothere were 27 companies that
made vaccine in 1955 there were18 companies that made vaccines
for American children in 1980today, there's four, and it's
(31:07):
less than 10% of what any ofthese companies do. They could
drop it in a second. They couldmake it difficult enough, and
they will,yes, and the truth is, to to be
properly incentivized. You do?
You do want people to make somemoney from what they're doing.
So it's not all bad. We'rebenefiting from it. That's
right. I mean, take out theproblem, we wouldn't have
(31:27):
vaccines. I mean, that's why wehave them. I mean, it's not an
altruistic act.
Now, if you could leave parentswith one clear message about
childhood vaccinations, whatwould it be
that they're they're welltested, that there are systems
in place to detect even therarest of safety problems, and
(31:49):
that your job as a parent, myjob as a parent now grandparent,
is to put your child in thesafest position possible. That's
your job, and that's whatvaccines do. They put you in the
safest position possible?
And just one last thing beforewe finish up, I would love to
can you tell everybody your rolein the roto tech vaccine?
(32:09):
Because I find this soimpressive, and I'm so grateful
to the work that you've done inroto tech. Can you tell
everybody what the diseaseburden was and and how often we
see rotavirus now since creationof roto tech.
Well, so rotavirus is a virusthat affects the small
intestine, primarily it causesfever, vomiting and diarrhea.
(32:29):
That's three ways to lose water,fever, vomiting, diarrhea, it's
also very hard to rehydratechildren who are vomiting, and
so it was a common cause ofdehydration. It would cause
about 70 to 75,000hospitalizations a year in this
country, about 20 to 60 deaths ayear, but it dominated my
residency. I mean, I would see,I worked, I was a resident
Children's Hospital inPittsburgh. We'd see 400
(32:50):
children every winter with this,this was the winter vomiting
virus. And so when I came toChildren's Hospital in
Philadelphia, they had, the yearbefore, started to work on
rotaviruses, just in general,with an interest in a vaccine.
But, but when you when, when Ifor the 25 years or so that I
did that, you never really thinkyou're making a vaccine. To
(33:11):
super clear, my interest was intrying to understand the virus,
which part of the virus makesyou sick, what part of the virus
is induced an immune responsethat is protective. How can you
construct viruses that can cando the both, both which can
induce immune response withoutconfirming virulence, meaning
making you sick. So that wasjust summarizing 25 years of
effort in 30 seconds. But thatwas that effort. But you, you,
(33:32):
let's like say, I never,although we in the first
paragraph of my grants, and Iwas funded for 26 years by NIH,
you would always say, look, it'sa terrible disease. It causes in
the world. It is the biggestsingle killer of infants, in
young children. This viruskilled before the vaccine,
500,000 children in the everyyear in the world. You
know, we're I'm lucky, becausewhere I work, my kid, the kids
(33:54):
in my community, have access toIV fluids. But if you live in
Africa, or certain areas of theworld where that's not so
accessible, it really ispossibly a life or death
illness, andthat's why they're done for
exactly that reason. So, so, so,you know, I was fortunate enough
to be part of a team withStanley Plotkin, who's the
inventor of the rubella, Germanmeasles vaccine, and Fred Clark,
who was a veterinarian and PhD,to create these strains that
(34:15):
became roto tech, which is sortof a combination between a
bovine rotavirus, which doesn'tcause disease in children, and
human rotavirus which does, butwe took out the virulence
factor, so therefore we had avaccine. But again, just so
we're clear, my goal was ingetting my papers published and
getting my grants funded, andwith always a goal toward a
vaccine, but you never thinkyou're making a vaccine. Just so
(34:37):
we're clear, but it happened tobe that the strains that that we
made did become a vaccine roadattack, and that was obviously,
but even then, I just like say,because I remember, this is
February, 2006 you know, youit's like, you know the guys are
angry. They grant your wish. Youknow you're still your hearts
and your throat. Is there goingto be a rare safety side effect
that we don't know about nowthat the phase three probably
(34:58):
was a 70. 1000 baby trial, butthat only means 35,000 babies
got that vaccine, and you knownow 10s of millions, hundreds of
billions, are going to get it.
Is there something you didn'tthink about? And so you're sort
of always tortured at somelevel.
What I so appreciate about theway you think and about the way
you talk is that you're humbled.
You're open to the idea that weare hopeful that this vaccine is
(35:19):
going to do what we want it todo, but there are also
possibilities that it might notwork as we were hoping. But I
have to tell you, as a generalpediatrician, I love giving the
roto tech vaccine. I lovestarting with it because the
babies love the way it tastes.
It feels nicer to give somethingoral rather than an injection.
So I'm very grateful. I'm veryI'm very I'm very grateful for
(35:41):
multiple reasons. Thankyou. The Sucrose is the
stabilizing agent. It'sdelicious, and it's the only
oral vaccine that we give tochildren. So that's my that's my
gift to children, right? Whata wonderful contribution. Well,
thank you. Thank you so much forall that you do. I am so
grateful for your time. Youreally are a doctor, hero of
mine. I've listened to hours andhours of you on podcasts. I read
(36:03):
a lot of your work, and I'm sothankful that you took the time
to be here on this podcast.
Thank you. It's my pleasure,Jessica, thank you. Thank you
for listening, and I hope youenjoyed this week's episode of
your child is normal. Also, ifyou could take a moment and
leave a five star review,wherever it is you listen to
podcasts, I would greatlyappreciate it. It really makes a
difference to help this podcastgrow. You can also follow me on
(36:25):
Instagram at ask Dr Jessica, seeyou next Monday. Bye.
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Are You A Charlotte?
In 1997, actress Kristin Davis’ life was forever changed when she took on the role of Charlotte York in Sex and the City. As we watched Carrie, Samantha, Miranda and Charlotte navigate relationships in NYC, the show helped push once unacceptable conversation topics out of the shadows and altered the narrative around women and sex. We all saw ourselves in them as they searched for fulfillment in life, sex and friendships. Now, Kristin Davis wants to connect with you, the fans, and share untold stories and all the behind the scenes. Together, with Kristin and special guests, what will begin with Sex and the City will evolve into talks about themes that are still so relevant today. "Are you a Charlotte?" is much more than just rewatching this beloved show, it brings the past and the present together as we talk with heart, humor and of course some optimism.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com