0:00

welcome back to show brother

0:02

thanks for having me it's great

0:04

be back it always my heart joy

0:07

throughout the pandemic you've been a a voice of rationality

0:09

reason, ability and someone is willing

0:12

to change your mind to have like stuff emerges,

0:14

that is different let me ask us

0:16

to start off with what everyone's asking about

0:18

the new by zealand

0:20

omagh cron be a for five boost

0:23

your dose that is been kind

0:25

of a push through and cdc says yeah give

0:27

it to all the people i'm just

0:29

let's start with that is their

0:31

data their show that this thing this actually something

0:34

that americans need and

0:36

if not what they would you like to see and would

0:38

you take it and so on there's a million questions

0:40

but i'll just toss it over toss you because you're you're

0:43

quite savvy this

0:45

okay to rise to the past few

0:47

days the cdc recommended that

0:49

dumb for that everybody over twelve

0:52

kid could receive far as vaccine their be

0:54

over eighteen can receive our readers i think

0:56

that everybody should be vaccinated sosa

0:59

the forget that abiding with as i just want to answer

1:01

that question on is true

1:03

i mean does everybody benefit from a bus or deciding

1:05

to thunder cns because i need to go

1:07

back to the beginning self self

1:10

and december twenty twenty or ft a vaccine

1:12

visor committee considered the use

1:14

of thighs of adonis vaccine ah

1:17

for uses the time in adults and and

1:19

and when that vaccine launched

1:21

on it , it was was

1:24

up fairly well and and

1:27

for the first year on the

1:29

question was did protection

1:31

hold up against serious illness cause that's the

1:33

golf that's the only reasonable golf is

1:35

especially seeing the attainable goal for this vaccine

1:38

you're not going to be able to protect against mild disease

1:40

for this kind of hours for any length of time

1:42

so some to don't so

1:44

, hold up on is it did the virus

1:47

that that the vaccine was made to

1:49

protect against the original strength the

1:51

will harm ones repair the ancestral

1:53

friend which was even the strength left china the string

1:55

the left on it was the so called the six fourteen

1:57

restraints but that's weird that's what

1:59

does novavax

2:03

all to protect against the wuhan once

2:05

trained so so, did it protect

2:07

well against the experience? so the very 48

2:09

was d614g replaced by the

2:12

very cuz it was more concerned with more contagious replaced

2:15

by the delta brain because it was more containers and

2:17

that was the the year so that was 2021

2:20

those three variants did that strain,

2:22

protect against to do with those? yes,

2:26

that is was cdc publication

2:28

by martell 10 for out of infectious

2:31

disease and whether was pfizer's

2:34

vaccine was with moderna vaccine, whether

2:36

you had one or more comorbidities for whether

2:38

you are over 65 years of age you were still

2:40

well protected through that first year then

2:43

omicron hits and omicron was different

2:46

omicron surprise people, i think people

2:48

didn't imagine me included that

2:50

a coronavirus could drift if

2:52

you will and a matter that similar influenza

2:54

this lourdes big

2:57

i mean there were fifteen mutations just

2:59

in receptor binding domain which is the kind

3:01

of business end of the spike protein molecule

3:04

that attaches to sell fifteen so that's a

3:06

lot and and so even if you've been

3:08

actually affected are vaccinated you could still that miles

3:10

is even if you relatively recently in fact

3:12

that are vaccinated you could still get mild disease

3:14

it was an immune evasive strain but

3:16

it wasn't immune evasive for protection

3:19

against severe disease it was not the reason

3:21

is is that severe disease is

3:23

is the the immunologic component

3:26

associated with protection against the beautifully is really

3:28

is t cells especially cytotoxic

3:30

t cells which are t cells that

3:32

killed [unk] sleeper cells and

3:34

those are those cells are generally long

3:36

live and more importantly they recognized conserved

3:39

regions so for all the mutations

3:41

that omicron and these undercurrents of variance have

3:44

they haven't really mutated away from

3:46

protection against severe disease because

3:48

that protects against severe disease isn't

3:50

mediated by neutralizing antibodies

3:53

it's mediated by it's cells so that's good

3:55

but nonetheless the cdc that

3:57

the critical studies the think that they

3:59

weren't but it we say they say answer

4:01

some questions were you better off

4:03

getting a third doses compared to it's a second

4:06

ocean they found that you were less likely to

4:08

be hospitalized you got three doses of the two

4:10

doses and into a lesser sand you

4:12

were less likely to be half was you got for doses

4:14

vs three doses they weren't perfect studies

4:16

by think the critical question is who

4:18

was being protected who was it that wasn't

4:21

getting hospitalized because they've received

4:23

a because they had received a third of so they had

4:25

received support those and the answer was not

4:27

everybody the people that really benefit

4:29

of we're number one foreign away

4:32

the elderly or as russia

4:34

will lynskey god bless her has said the

4:36

elderly elder which i appreciate as

4:38

i get older models on

4:41

, second was was people who had chronic

4:43

lung disease or chronic heart disease or chronic

4:46

kidney disease with chronic neurological disease

4:48

because even a mild illness could

4:50

cause them to to to land in hospital

4:52

and then third where people who were immune compromised

4:54

so they benefited from that additional dose

4:57

that dosing so i think think

4:59

it's it's hard for me to embrace on

5:01

our immunizing everybody up healthy

5:03

young people when we haven't really

5:05

show that they could be benefit from from

5:08

boosters and so that's that's number one number

5:11

he adds okay that's a great reese

5:13

summary of even that first booster discussion

5:16

that we had all those months ago is the third

5:18

dose something that's necessary for everyone

5:21

and you just answered to the best that that we

5:23

understand and this question of like the elderly

5:25

elderly people in a very high risk at a very solid if

5:27

they got a cold see would be tipped over into

5:29

the compensation theoretically having

5:32

those higher levels as boosted levels of neutralizing

5:34

antibodies that the third goes might have given

5:37

you in a in up in a time dependent

5:39

way that decays over time might be helpful

5:41

but your point that's the key cel immunity

5:43

that long lived that really pretext

5:46

most people against the more severe disease

5:48

that was that was causing havoc and twenty twenty

5:51

and beyond that the

5:53

first two doses seems to really

5:55

and still in a lot of men

5:57

most people that aren't the elderly alley and the people with alley

5:59

chronic disease issues that you just pointed out

6:02

is at a fair summary yeah

6:04

yeah yes and now and

6:06

one other thing i want to read reporting out that

6:08

you pointed out as omagh cron and these

6:10

new mutations emerged from the the

6:12

original ancestral states that is it seems

6:15

like even incubation time is shorter which

6:17

would make it even harder to prevent as

6:19

we talked about this on the show before and maybe it's worth to

6:21

three addressing real quick stated it

6:24

is if the incubation time is very short

6:26

for an illness you can replicate really

6:28

fast even before things like neutralizing

6:30

antibodies and other defense mechanisms

6:32

of immune system could kick in so you're not going to prevent

6:35

infections but you will still prevent severe

6:37

disease is that fair

6:39

yeah and also as as you get shorter incubation

6:41

periods and viruses that are progressively more

6:43

contagious you need even higher levels of neutralizing

6:46

advice to really prevent a mild illness so making

6:48

it all the more difficult but again the

6:50

goals preventing surrealist the goals keeping

6:52

people out of the hospital out of the i see you and

6:55

out of the morgue and and again

6:57

i remain encouraged that there has not

6:59

been a virus yet a source kobe

7:01

to virus very yet that has resisted

7:03

[unk] protection against severe disease which does happen

7:06

with flu and so that really hasn't happened at

7:08

least yet with this fire so that's

7:10

goodness can ask one other question so in

7:12

the early a data from those original

7:14

trials with madonna and pfizer there was a quite

7:17

aggressive protection against infection

7:19

as well it appeared in those trials what

7:21

do you think as why do you think that was why do you think

7:23

that's changed what

7:26

when we review date in december twenty twenty

7:29

with pfizer modern are they both had roughly

7:31

ninety five percent protection not only against severe

7:33

disease but even mild disease and

7:35

remarkable that was a remarkable level

7:38

of protection no way that was going

7:40

to last i mean and and in fact six months

7:42

later several studies show that while protection against

7:44

severe disease remain high protecting

7:47

its miles these dropped it was los fifty percent

7:49

so why was it so good with those initial

7:51

crossing the answer is those were three months

7:53

studies those participants had just received

7:55

their second dose so there are neutralizing

7:57

antibodies were high and again i i think if you could

7:59

back in time would you can do actually

8:02

if you mix dayquil with nightfall as usual

8:04

really upsetting to throw

8:07

little tylenol pm the in the mix

8:09

since then you're really traveling through

8:11

space and time yeah i would

8:13

wish we could go back in time and when that

8:15

that when those they were presented we could have said

8:18

this protection against miles is is not

8:20

going to less given the nature of this infection

8:22

given the way these trials redux that's not

8:25

going with and we did the opposite i think what

8:27

happened was six months later on

8:29

when say the was not break in provincetown

8:31

massachusetts right thousand men get together

8:33

celebrate the july fourth holiday of

8:35

those seven about seventy nine percent or a

8:38

to present we're we're going to me but nonetheless years

8:40

and operate and of the three hundred forty six

8:42

man who got six for rojas was

8:44

a hostels ocean of one point rate of one point

8:46

two percent that's of when that's

8:48

great arm but the other three hundred and

8:51

forty two men had milder a systematic and such

8:53

which the cdc unfortunately labeled

8:55

as breakthrough illnesses or

8:57

not this was a mistake breakthrough

8:59

in twice go you that was the guy that was a moment

9:01

actually celebrate the vaccine to celebrate

9:04

how amazing it was working here with his outbreak

9:06

industriously close space of a

9:09

cameo quote comes together community and

9:11

promise and we didn't do that we did the opposite

9:13

that the opposite ends of the term break

9:15

through was born i remember just a few days after

9:17

that was reported brett kavanaugh right

9:19

supreme court justice gets a nascent american

9:21

fashion if you watch the way that was carried on

9:23

national television you'd have thought he was in intensive care

9:25

is so we didn't we didn't

9:27

such communicate that will send a soul communications

9:30

that then led to a lot of mistrust and a lot

9:32

of people feeling my father told us one thing

9:34

and now they're telling us another thing another telling us another

9:36

thing it's and his whole idea that we can get vaccinated

9:38

and actually and on with our lives ah

9:41

is a lie and so i'm just not even gonna do

9:43

it and i don't trust anybody and and is it was anybody huge

9:45

problem so then pulling that back

9:47

now to where we are we with omagh

9:49

crimes were up to be a four and

9:51

five and now there's their work

9:54

there on to a different type of boosters tell

9:56

us about that and and where we are with that

9:59

you could make the argument

10:02

you know that that right now are vaccinated with

10:04

the woo hyun one strain to protect

10:06

against these home across of variance

10:08

be a for be a five does that make

10:10

a bit of sense will say i would argue that to say

10:13

you're still protected against severe disease because

10:15

those those immunological a distinct

10:17

regions are the epitopes that are on that

10:19

the sars coby to spike voting or shared

10:22

and has been published those are published a the have

10:24

at least eighty percent homology between

10:26

save move on one and this be

10:28

a for be a five of across up or in

10:30

terms of pisa recognition and t

10:32

cells are critical for protection against severe

10:35

disease so i would argue we're still good but

10:37

nonetheless we are going to even if you've got

10:39

the you know the woman vaccines are still at risk

10:41

of mild illness because of this

10:43

this these a how far

10:46

the beef would be a five have mutated in terms of protection

10:48

against neutralizing antibody so why not then put

10:50

that in their okay , so

10:52

and so on june twenty eighth you have to evacuate

10:55

advisory committee on which i said

10:57

were presented data by five from return

10:59

on their by family the vaccine now

11:01

the by bandwidth vaccine day to day presented work

11:04

on the vaccine that we're currently using they were

11:06

on the piping look vaccine was actually

11:09

be was want so the original overcrowded so

11:11

so and they did this study is they right way that

11:13

because remember the the hill the you're trying

11:15

to climb here is climb have to show that the

11:17

by families vaccine is better than

11:19

the moto valid acceded inducing better than

11:21

for be valid fox specific antibodies there

11:23

was antibodies paper by linda safe that was published

11:25

in the knowing the journal of medicine at the end of june which

11:28

she did when she looked at hospital workers who

11:30

had received two doses of of the

11:32

the pfizer but earn a vaccine and

11:34

found that that the the neutralizing

11:36

antibody levels against be a for be neutralizing five

11:38

was suboptimal but when you got the third

11:40

does it increase well before

11:42

but yeah five neutralizing antibodies increase

11:45

just with the ancestral strain so you have

11:47

to make sure when you do these studies that you show

11:49

the your by the on the vaccine is significantly

11:51

better than what in terms of bay for

11:53

be if i specific neutralizing antibodies than

11:56

it would be just with the ancestral spent alone so

11:58

in any case that's not the studies were done with they were

12:00

the of these studies were started like in february

12:03

by pfizer of a during the show was would still

12:05

won't be a one was predominant and so

12:07

that's the by been with vaccine they made a be

12:09

a one containing vaccine omicron

12:11

the original lama [unk] now and so

12:13

they did this that the way they did they study was to

12:16

people

12:19

three doses of being sessions training and the fourth

12:21

goes to the ancestral [unk] ore three dose

12:23

of the ancestral friend amanda porthos was the by

12:25

their strength with be a one and

12:27

so then they looked at neutralizing antibodies in

12:30

the bible vaccine vs monovalent

12:32

vaccine and you had about it depending on

12:34

which which company or we're looking at and and

12:36

and which dose with visors vaccine you were looking

12:39

at but about one point five to one point

12:41

seven five fold increase level

12:43

of neutralizing antibodies if you got the bible

12:45

like vaccine was ,

12:47

significant that is unlikely to be a clinically

12:50

significant difference and we know that

12:52

good because they go back to to december

12:54

twenty twenty and there was about

12:56

to fault and about a different clinical logging

12:58

into by difference for maternal vs pfizer but

13:00

nonetheless that didn't pan out to

13:02

be a difference in in in a a

13:05

a protection to get serious almost there were other

13:07

problems actually without those studies i think

13:09

one i think there were there there there

13:12

some assumptions that i think may

13:14

well think incorrect the first assumption

13:16

was that okay take me during this vaccine

13:18

for example normally if you're an adult

13:21

and your boosted with the dirt vaccine you get fifty

13:23

micrograms of amarna if

13:26

you get the by being on the vaccine you get twenty

13:28

five micrograms of the get twenty of strain

13:30

and twenty five micrograms would be a one at least

13:32

the data we were present in the thinking at the time

13:34

was walked twenty five posts twenty five equals

13:36

which is crew from and arithmetic

13:38

stamps yeah but i it isn't true

13:40

from a biological standpoint because those

13:43

are two separate vaccines and and

13:45

you're giving them at a child's booster

13:47

dose level i mean the twenty five micrograms

13:49

would not be an adult booster dose so i don't think

13:51

you can fairly add them up the second

13:53

thing is and with pfizer actually showed

13:55

us what pfizer did was a they gave

13:58

they did their their studies several ways

14:01

you're the adult those

14:04

are out of the ancestral same plus

14:06

thirty micrograms of be a one or

14:08

they just gave just be be

14:10

a one and you hadn't put a much

14:13

better antibody response with just given

14:15

be a one the giving it to supply them

14:17

with axes even at the same those which

14:19

is interesting is what that tells you is

14:21

that when you give it to combine your

14:24

and your to taken up in the germinal centers

14:26

of the local of knows you're competing for those

14:28

same be cells was when you give them at

14:30

separate sides you're not so i really

14:32

did it would be interesting to see if you just

14:34

gave you know is that the by the attacks instead

14:36

of you ancestral on n b

14:38

a one are now pay for be five in the same dose

14:41

whether if you separated and gave a different arms

14:43

would be different i suspect it would be that's not

14:45

a practical thing to do but i'm

14:48

that is something that you're up against wasn't

14:50

so so the as really answer the

14:52

question why even make it by vaillant why

14:54

not making monovalent new strain

14:56

is it because some people haven't gotten the third

14:59

dose of the original ancestry

15:01

of what's the what's the reason

15:03

the question i think i think you could reasonably

15:05

done that you could have reasonably introduces a be

15:07

a for be a five actually knowing that

15:09

they're still though share to potus with regard to

15:12

sell so you're still going to be enough not to city

15:14

so response to so i think that's

15:16

a perfectly reasonable classed as and then

15:18

it was oh god the

15:20

ending was a little concern is there were

15:22

really pretty good animal model studies on by

15:24

bob seger as as his lab at

15:26

an ice using non human primates

15:29

rhesus macaques and and what he did was he

15:31

sergei those animals two doses

15:33

of the ancestral frame and

15:35

then i'm either the third dose

15:37

was that again another dose of the ancestral faith

15:39

or did the the omagh cron only

15:42

and then sounds the animals with all micron a

15:44

but again and what he found was no difference there was

15:46

no difference in for to put a not in protection

15:49

of those animals against the or mater severe

15:51

illness so that that so therefore

15:53

the animal models that is also didn't make also case

15:55

for what we're trying to do

15:57

so is okay so this is in because

16:00

in and is there another immunological reason

16:02

why it's mixing the two strains

16:04

might reduce or might reduce and overall

16:07

responses or some other competition apart

16:09

from germinal centers and things like that they're

16:11

like nothing and and is there any effect

16:14

of that sort of it at the booty

16:16

call original antigen accent where it was already

16:18

exposed to the original

16:20

there's always that i think that's always that's

16:22

always the hill were trying to climb here because i think

16:24

if you took say a a twenty

16:26

year old who had never been asked by the never

16:28

been vaccinated and gave me just say be

16:31

a for be argued see it remains

16:36

well you know like me who's been sort of a

16:38

given your three doses of vaccine naturals in fact

16:41

that used to lock in to that

16:43

a lot original response and that's right so when you when

16:45

you then go to the germinal center the the b

16:47

cells that have already seen through the epitopes

16:50

on woo on one that are

16:52

also contain don't say be a for will be if

16:54

i those will be expanded much more readily

16:56

than will the new regions that

16:58

you're trying to promote which is why you just don't see

17:01

that could have an immune response interesting

17:03

is it and , this is a will talk about flu

17:05

but at some point i want to come back and go go

17:08

yearly flu vaccine how does that certify

17:11

involve this sort of antigenic imprinting

17:13

but i'm so okay so back to this a one

17:15

thing that you said was that the the the the trials that

17:17

you saw where the omicron first

17:20

o g m a cron strain is what they were testing

17:23

were in human trials and

17:25

that yeah this one point five fold increase in

17:27

neutralizing antibodies which again comparing

17:29

to the original modern versus

17:32

pfizer trials that was kind of the difference in

17:34

the anybody's between those trials but there was no clinical

17:36

difference so the concern is is there really a

17:38

clinical difference given that the t cells are protecting

17:40

against severe disease as it is and that's what we really

17:42

care about in most people maybe except

17:44

for the elderly elderly and a which

17:47

will talk about so what is the by violence

17:50

version we're actually getting now what's the data

17:52

saying that that works

17:54

though have you tried to the myths was

17:56

the bible effects as you're getting now for modern

17:58

is twenty five micrograms me essential strain

18:00

and twenty five micrograms would be a for ba five

18:03

the bible the vaccine you're getting from pfizer and

18:05

remember they presented data on thirty

18:07

and thirty it's the and sixty

18:10

but they're launching it fifteen fifteen so

18:12

there aren't even human data a human immunodeficiency

18:14

data even for be a one that is

18:16

completely novel on there would be

18:19

a been nice to have him you know to this the

18:21

data to show that you have your at least

18:23

a twofold you like to fold three fall

18:25

for for greater neutralizing antibodies against

18:27

before be five or will have hosted

18:30

danny so to be a mouse data is that

18:32

only have what do we have we

18:34

have mouth their logo young

18:37

and been shown in mice as you get you know that if you give

18:39

this by they'll have seen you get a dramatically

18:41

greater increase neutralizing antibodies against

18:43

before be if i try again i just i

18:46

, don't think that the mouse data

18:48

com or are always

18:50

going to be predictive i mean the was to vaccinate

18:53

people have a sandwich sousa my

18:55

flying monkeys exaggerate that's

18:58

true yeah and and humans

19:00

i don't know what they do but it's never good arms

19:02

but at least we should study it enough was so this is

19:04

interesting so we're now rolling out city

19:06

the rule the rolling the south's having

19:09

skip to the sta advisory

19:11

committee input yeah

19:13

the

19:15

and when right to cdc and city said

19:17

yeah twelve and above by vaillant this

19:19

fall

19:20

the fourth dos or as a third dose

19:22

if you've never been boosted or

19:24

as original ,

19:26

if you've never gotten it so one two and

19:28

three of this only a boost so

19:31

a boost would have had to have received always two doses

19:33

of the the current incestuous

19:36

rain before you would ever get this

19:38

is a booster doses only it's have been

19:40

approved as a booster does make

19:42

sense to the dosing different to so

19:45

now it it actually increases complexity

19:47

for administration right because you've got a store

19:50

at the ancestral vaccine for people have never

19:52

been vaccinated or haven't gotten the

19:54

the to fall odd doses yeah

19:57

that of your the of your feed it was they are

20:00

the movie emergence use authorization for

20:02

i'm for the the ancestral only

20:05

bush or does the monovalent the stasi to

20:07

that's not available anymore you you

20:09

really have to use as fargo folks who is a little sad

20:11

because there's a lot of that vaccine out

20:13

there are i feel like at the very least

20:15

we should know send it to places

20:18

that clearly would benefit and i just

20:20

think it's waist now so

20:22

back to their then their be a for five so we

20:24

don't have great mean urgent we don't have don't have in

20:26

a city data in humans on this particular formulation

20:29

we don't have any data saying that it

20:32

actually improves our outcomes in terms of severe

20:34

disease

20:37

is their safety concern at

20:39

all with this new formulation or do you think

20:41

that is would be overblown

20:44

so of my don't know

20:46

i mean i i i suspect that

20:48

the this by veil and m r

20:50

and a vaccine containing vaccines will will

20:53

have a similar safety profile to the

20:55

current our ancestral only

20:57

vaccine that would be my guess i'm

20:59

i think that's a fair guess i think that's biologically

21:02

reasonable but again you have to be open minded

21:04

i'm sure that this the cdc will

21:06

through places like the vaccine safety data like

21:09

the vaccine adverse events reporting system follow this

21:11

up and followed up well and i suspect

21:13

the by october we will have

21:15

sort of are immune human immune response

21:18

data for that the bible a taxi i'm

21:21

i'm optimistic that will be true and then

21:23

we'll we'll see with us cause they show maybe not maybe

21:25

it'll maybe surprised maybe we'll find it for

21:27

be a for be five i'm giving the

21:29

people who have already received you know at least or

21:31

two doses and and possibly three or

21:33

four that it's dramatically greater

21:35

than what we saw with be saw one of

21:37

that would be great but we'll see

21:39

so

21:40

then when the rubber hits the road and p edu city

21:43

saying take this would

21:45

you right now you've i imagine have

21:47

had two doses and a old school

21:49

booster would you sign

21:51

up to get this be a for five with what we know

21:53

right now at this time

21:56

this is why three doses plus a national

21:58

section and may so i think i have high

22:00

levels of of our memory be and he says

22:02

i don't think that i will benefit from

22:05

getting a boost just because i think that that that

22:07

the been it would benefit would be was

22:09

i think it would give me sort of a few more

22:11

months of protection against mild disease for

22:13

the sake of the winter months but i am

22:16

i'm i guess i'm willing to suffer miles is

22:18

i did once already and if anything it just gives

22:21

me broader hybrid immunity and attack

22:23

i feel better actually that i had enough of actually

22:25

even better that i survived it which is by

22:27

definition to someone your show bets

22:29

on stats assess heresy paul you can't

22:31

talk about national infection being a good thing at

22:33

all or you could be excommunicated

22:36

from this covidien church but i'm

22:38

it is i mean it's insane because we don't for example

22:40

we don't than revamps and eight

22:43

ah this is you had chickenpox

22:45

with vera sell it typically doing the

22:48

different scenario were people but

22:50

yeah but see is is some if

22:53

you chickenpox is around with a long incubation

22:56

period z's as as measles as his mom says rubella

22:58

so determined real so when you get

23:00

infected with those armed viruses

23:03

you you generally have memory bt cells

23:05

that are lifelong and that's enough room

23:07

to be protected even against miles is because

23:09

you're you know there's plenty of time for activation

23:11

and differentiation of those memory be sells her memory

23:14

tisa leaving to protect against miles is that's

23:16

why you can eliminate long incubation period

23:18

diseases from the face of the earth i mean

23:20

smallpox is a long incubation period

23:23

as is a rinder press pass

23:25

which is i for the like cow measles

23:27

has been eliminated from the face of the earth the because

23:30

it's a longing bush bruises i do

23:32

you know we eliminated needles undiscovered country

23:34

by two thousand came back because a critical

23:36

percentage of parents chose not to vaccinate their

23:38

tom wheeler made a rebel from this company

23:40

in two thousand five thousand pemba so

23:42

you can do that you're not gonna do that with espouse

23:44

this virus will continue to circulate cause mild

23:46

disease even if a hundred percent

23:48

of the world were vaccinated and even if it never

23:50

mutated coming out of china it with still

23:52

circulate and cause some you

23:55

know cause mild illness and in some severe

23:57

illness and it has animal reservoir

24:00

and you know on and on and on and on all

24:02

the reasons you can arrive that cove a zero is a fantasy

24:05

i'm it so okay so

24:07

then this becomes a question because the

24:09

government is already talking about you know like for example

24:12

bob kale of said say know if you get this thing

24:14

you might be more likely to attend big

24:16

winter gatherings if you get it by halloween

24:18

i mean do you think that's a reasonable

24:21

they've been or that wishful thinking

24:23

that that's not fair i mean is it is again

24:26

, the you can't set yourself up

24:28

as a goal of preventing transmission

24:30

or transmitting mild a preventing miles is for

24:32

shooting division currencies it's just not not

24:36

on gas and i think the

24:38

if if fantasies to come true if i could get

24:40

like the by them with axes of my choosing

24:42

the bible a vaccine i would like together just

24:44

model ballot boxes want to contain said i'm

24:47

on a against the ah sorry for

24:49

the two nuclear protein because that

24:51

that say has a is is often

24:53

literally express on infected cells

24:55

is definitely recognized by side attacks

24:57

a t cells i think i would really boost my side

25:00

attack se memory of

25:02

a repertoire and of and repertoire

25:04

probably get me longer live protection against

25:06

seriousness of that's the by that with i've seen

25:08

i want a bad way there are there were studies now

25:10

that recently one that was published and syrian hamsters

25:13

good news for the syrian answers and if if

25:15

we had isn't a human trouser be good news for us

25:18

you know that that it really does provide that's what

25:20

abroad immunity that that we're looking for

25:23

so the nuclear as bad as

25:25

and that's interesting i would imagine you'd need

25:27

new safety data trials in humans on that

25:29

though because there might be some something

25:32

oh yeah we just never know the using a different epitopes

25:35

so okay so this idea then off

25:38

extrapolating to making this a yearly

25:40

flu shot type saying it might

25:42

be worth kind of differentiating were

25:44

asked why why would we need to do that

25:46

for whom in other words who who even now would

25:48

you say it's should get this be a form

25:51

of five by vaillant vaccine is it's the elderly

25:53

the elderly the people with chronic disease for whom

25:55

even a mild infection which won't fully

25:58

prevent but we might like lower the chance there's

26:00

with the high levels of neutralizing antibodies at the gates

26:03

are those the only people should get it you think and

26:05

then should we really be talk talk about doing this

26:07

annually with the level of data we have currently

26:10

you know i think i'm it

26:13

, certainly if we're trying to

26:15

have an impact on preventing hospitalization

26:17

and i see admissions and death i i

26:19

think it makes sense to focus on those groups groups

26:22

most likely to be hospitalized for groups we've shown

26:24

are most likely to be hospital as if we if

26:26

they don't get sick a third dose report those i think

26:28

that's perfectly fair i was getting pregnant women

26:30

by the way in their third trimester will benefit

26:33

from a dose of vaccine that doesn't have to be

26:35

i mean if you said to me you know

26:37

would you prefer you know the sort of by villa

26:39

vaccine would be a for bay five or just

26:41

getting the monovalent vaccine it you know the

26:43

dose that is typically a booster dose i

26:46

don't really distinguish though so you can make a case for

26:48

the back of the amount of l a vaccine was

26:50

better for the reason that we talked about it is an

26:52

adult booster dose of you're not competing

26:54

at the the level of the journal center with

26:57

to lower dose vaccines but and

26:59

in any case i think in some

27:01

ways it's a it's a soft question i mean

27:03

if a mother of a twelve year old came into my office said

27:06

look i i want to get this vaccine vaccine

27:08

i think it's kind of low risk low benefit

27:10

and at some level it has it's it's

27:12

a it's a personality or to meet you know some

27:14

people would argue know if there's any risk

27:17

i and and benefits are small forget it

27:19

and others would argue out the rest of the low than that

27:21

there's any benefit i'll get it so i wouldn't

27:23

discourage the the the woman from getting it but i

27:25

i would want to tell her about her about

27:28

you know the you know potential side

27:30

effects i i think on your show a doctor

27:32

precise talked about that tie study

27:35

that was done and thirteen eighteen year olds and thailand

27:38

who had gotten sort of to do survivors

27:40

vaccine you software of a transient elevation

27:43

in , muscle enzymes like

27:45

proponent creatine kinase and

27:48

it was short lived there was self resolving

27:50

but you know you are making him he response

27:52

to your own heart for a brief period of time

27:55

and and you know will find whether or not there

27:57

suspect him of illness associated with

27:59

yeah brilliant sing hands and the as a fifth

28:01

gets to the question of if the benefit is

28:03

very small than any risk

28:05

even if small is magnified relatively

28:07

speaking and making that risk decisions

28:10

become something that you talk with your doctor like you said you're

28:12

not a so discouraging them a you're saying here's

28:14

what what we know about this and

28:16

and the ins and outs of it's it's it's which

28:19

again but by the way i still can't i'm still

28:21

i'm ready to cancel you paul because he said pregnant

28:24

women which is no no pain

28:26

and people okay ah

28:28

next the see

28:30

got yelled at for saying pregnant women apparent

28:33

the

28:34

yeah the cdc party line i was pregnant

28:36

people we won't get into that is will both get cancelled

28:38

spin i'll say this i'm the spit

28:41

it when kids vaccine one quick thing quick want

28:43

to ask do you think arm across there seems

28:45

to be quite a bit less m i see

28:47

now is that because i'm that chronic different because

28:49

more people have overall immunity or what he thinks

28:52

fun the cardinal

28:54

right because now i mean when when when

28:56

say this is fourteen three rapper delta

28:58

came into view hide says we were blank slate

29:00

and so i'm now we're not

29:03

we probably have ninety five percent population

29:05

community so it's hard to know whether there's ameliorating

29:07

effects of previous immunity with

29:09

astronomy there was a recent data south africa

29:11

they were they believe that over com was

29:13

like less likely caused busy with are missing

29:16

les mis and i'm at our house we're

29:18

seeing much less proceeding when this all started

29:20

but i suspect that has married to married population

29:22

immunity than the than the and

29:24

then let me ask another question because he knows he's on

29:26

twitter and you see people who are either

29:28

in public health or around the space

29:31

tweeting things like this new be a for

29:33

five by veil and vaccines

29:35

we'll see if you don't want to get long cove

29:37

it

29:38

you should get this vaccine or

29:41

enough had any risk of infection is too

29:43

much because of the risk of long cove it

29:45

a or the risk in a m i have seen other not talking

29:48

about as we're seeing much less of it and children but all

29:50

what are your what's your thinking around this is their data

29:52

that something like this would actually prevent

29:54

long of

29:55

further hundred and there was actually just a paper

29:57

and journal the american medical association other

30:00

the only and what are they looked at

30:02

work were people who had

30:04

received even no vaccine or one dose for

30:06

kudos for fritos them what they found was it

30:08

for and vaccinate people are listening

30:10

to lead the way they define long covered there

30:12

was a forty two percent and since as

30:14

long covenant people who got country that run

30:16

vaccine for people who had

30:18

one dose of vaccine that insincere

30:21

forty two percent dropped to thirty percent

30:23

the people were kudos to vaccine that

30:28

so good who for the third

30:30

does it went from seventy percent to six

30:32

people

30:36

that makes the case and producers

30:38

of a way of if it's gonna be author

30:40

does your four thousand doesn't or it's

30:42

in this those those italian data didn't support

30:44

the notion that going to dramatically less risk

30:46

among other stats fastening said the original

30:49

series yes you might reduce

30:51

risk and whether it's due to less infection

30:53

or whether still less severe disease we don't know because

30:55

we don't understand long cove it's but the idea

30:58

that an extra boost are now is gonna

31:00

somehow put a big dance in long cove it

31:02

is not supported by data that we have

31:04

available his affair

31:06

that

31:07

yes i don't think that's a good rationale for

31:09

say an eighteen year old to go run out

31:11

and get the be a for five by veil

31:13

and vaccine and so you've already kind of talked about

31:15

weiss even though it makes intuitive sense to

31:17

update for omagh cron ah they're

31:20

the read the reasons why that may be less

31:22

effective than we think have already been established

31:24

by what you've talked about and we've talked about on previous

31:26

shows so then what's the comparison

31:29

to influenza because now a lot of people talk

31:31

about going and getting the be a for five or

31:33

vaccine along with the flu shot

31:35

in the same visit etc why is it your

31:37

we annually vaccinate for flew

31:40

flew vaccinate what's flus incubation

31:42

period what's the deal with severe disease protection

31:44

and waning and stuff when we compare these two

31:46

things since comparing flew to cove

31:48

it is already another way to get

31:50

us cancel

31:52

so here's what i

31:54

would say on so

31:56

couple years ago when the as they've actually

31:58

advisory committee pick flu strains we

32:01

missed on a three and two there was

32:03

a mismatch and as a consequence a

32:05

three answer was no spread throughout this country

32:07

pretty much on check because we didn't have a vaccine

32:09

for granted if , was like

32:12

current of hours and then then then

32:14

it should have been true that there there are say

32:16

t help or sell epitopes rec of that are present

32:18

on either a three and two strains that

32:20

would have protected it's considered as easy easy

32:23

it with flu it's much more strain

32:25

specific and so you need those

32:27

those new strains every year those razor

32:30

circulating australia south america before

32:32

they committed united states or that

32:34

that matters i'm i still

32:36

think it's it's amazing since we've had to the vaccine

32:38

since nineteen forties there's so much

32:40

that you know out of much that we don't

32:42

know about superhuman see sell up

32:44

at how much do we don't know that's where the difference

32:46

between protection against miles isn't protected

32:48

species where we actually have a lot of they will not

32:51

with withdrawn of our says that we don't

32:53

have as as clearly defined with ah

32:55

with flu virus whether these two two two

32:57

viruses are are similar enough that one

33:00

could say that you could reasonably give a yearly

33:02

through that isn't as the earlier current

33:04

about cycling the same matter that we get

33:06

a girly flu vaccines as much that it's not

33:08

not but i do think that think

33:11

with one of ours to date it does

33:13

look like if you've been actually affected russia

33:15

you appear to be protected against to do disease and

33:17

and then the critical questions and and cd

33:20

seen this answer this question along

33:22

with academic immunologist if

33:24

you say a healthy young person who's

33:26

done to dose of as a three doses of vaccine

33:28

for us about seeing how long

33:30

does that protection against your disease less

33:33

so the epidemiologists can answer that question

33:35

and should and immunologist and also

33:37

the same time look at the frequencies a memory

33:39

being t cells one you later two

33:41

years later free as later barney look wonder

33:43

letter and now you're going to get now the one of the have your

33:45

later but let's let's look overtime and

33:48

see somebody like news had three doses

33:50

of vaccine have had an actual faction do had

33:52

ever need another dose of vaccine again vaccine think

33:54

you know those questions are answerable classes

33:56

i think we deserve those answers or cases

33:58

very important minute dammit

33:59

go back to everything you just send try to summarize

34:02

it because i think this is keith's when you're comparing

34:04

for it's funny you you're not allowed to compare crone

34:07

of arse influenza in the early days because that was

34:09

taboo but now is actually

34:11

the officials are saying it's

34:13

just like flu we're going to need an annual

34:15

prone annual virus vaccine and would

34:18

give it with the flu vaccine but the differences

34:20

as you're saying arts that the

34:22

influenza it is so strange

34:24

specific as to whether it causes severe

34:26

disease so a different strain will cause severe disease

34:28

even if you have anybody city other strains

34:31

whereas with current of ours we have yet to see

34:33

that in fact we might be seeing the opposite and

34:35

more data is needed for both obviously and

34:37

that it may be actually time to even look back at flu

34:39

and goalkeeper what is it in our approach that actually

34:41

works and what can be modified and thoughts

34:43

but the influenza is quite different

34:46

and the severe disease an influence on actually affects

34:48

our people of all ages typically although

34:51

typically the very young and old and immunocompromised

34:53

worse is is that affair summary of what you're saying

34:56

yes i mean i i think the other thing

34:58

is that because we talk about like pants or geico

35:00

virus vaccines let let's do what makes

35:03

sense let's find those shared a

35:05

epitopes of those conserved regions

35:07

among these different viruses you know source

35:09

but the one the forest rangers are pretty humid coronavirus

35:12

his ba strains that are currently circulating

35:14

in bat and happy to have a potential i

35:16

mean let's do that let's make a pants

35:18

or becca virus vaccine i think i guess

35:20

i my enthusiasm is tempered was

35:23

because i trained in walter earhart's

35:25

laboratory a and in the nineteen

35:27

eighties that the western soon philadelphia who

35:29

was the flu research has actually worked on your dell

35:31

also a train then and

35:34

he said something to something he was working at the time forty

35:36

years ago on ago universal flu vaccine

35:38

and he said you know if you want to research career that

35:40

last the rest of your life study influenza and

35:43

we got through the these are much much harder

35:45

things to do that then and you

35:47

would imagine the same thing with hiv thing mean when you're

35:49

infected with hiv you make an antibody

35:51

response it neutralizes that's great but the virus

35:53

continues to mutate during the same

35:56

infection it mutates same few types of you did

35:58

so those original antibodies don't work more

36:00

hi to doesn't make sense if you look at

36:02

conserve regions on on what i'm one

36:04

of the proteins and and make a vaccine

36:06

about what it would more did essentially didn't work

36:09

it's it's much easier to say this than than

36:11

to do it so , insane

36:13

and ends with influenza the other thing that people wonder

36:15

about as well if i get this dose

36:17

too early people say that the immunity

36:20

wayne's and is that again is that a foreign

36:22

of ours type thing where said influenza

36:26

incubation period is short and so you can

36:28

still get infected need high levels of anthony

36:30

sizing anybody says warded off or is there

36:32

something else going on going is that even truth does

36:34

even truth a the influenza shot

36:36

immunity wayne over the months or

36:38

what's your understand it does

36:41

i mean i have people who are vaccine

36:43

experts who choose to get to doses

36:45

movements like see that new interesting oh

36:48

yeah i , the answer self

36:50

so you can either get to and the vaccine

36:53

experts a do that or you can get one entire

36:55

try to time the market so to speak and say

36:57

okay we're not seeing a lot of influenza circulating

36:59

i'll get it in october say instead of august

37:02

when cbs has marketing it you know

37:05

pushing it really hard and really hard like while

37:07

by the time you know if there's a second phase

37:09

of influenza to do do we have we

37:11

have of course no sense what's gonna happen with influenza

37:13

this winter know

37:16

your we're was make our best guess we

37:18

we picked strains in march because six

37:20

my production cycle that this devices well

37:22

as september and with you know we're usually

37:24

pretty good at getting it right and as you should cover

37:26

those meeting actually you would be there up into the public

37:29

thumb are you can pump is my guess

37:31

oh those are you don't need out and into patios

37:33

guess you can def like us on

37:35

to the f b i and you'll be really impressed me you

37:37

get presentations from the department

37:39

of defense from the cdc from the world health

37:41

organization for this you know and and you got

37:44

a huge had this map of the world with all

37:46

these different strains and and substrates

37:48

enclaves that are circulating you wonder

37:51

how we ever prevent this disease at

37:53

all and anybody given how much this

37:55

virus mutates and this is not

37:57

grown of ours we current of ours is not that

38:00

and so we'll see i do

38:02

think the critical question the cdc

38:05

has the answer in concert with immunologist is how

38:07

are you protected against severe disease if you began

38:09

three those have you gotten for doses knowing

38:12

that today there has not been a virus

38:14

yet that that has a very yet

38:16

it has has has is so you take

38:18

it escapes protecting a serious is because when

38:20

that happens then we have to take

38:23

a step back and vaccinate everybody then

38:25

it's a little more like flu like a like

38:27

shifted streets we like and two thousand

38:29

and nine with the with one h one swine

38:32

flu appeared essentially no one had immunity

38:34

to that forest and that may have a with this virus

38:36

so it will set i doubt it settles it

38:38

really interesting is the naive a day of the

38:41

human immune system to a particular virus

38:43

and ah so

38:45

okay for speaking of this now

38:47

all this talk about vaccines

38:49

and everything this to sort of divided us during pandemic

38:52

and all this kind of communication from public

38:54

health officials and from scientists and then from people

38:56

that have decided that they're going to snort i

38:58

ever met in or whatever it is ah

39:01

we're in a situation now where i think just

39:03

trust is that hate don't knock it

39:05

till you've tried it paul snorting iver maximum iver in the eighties

39:07

it was cocaine nowadays it's it's you

39:10

know the anti parasitic i

39:12

am warm three i'll just say that

39:15

i've not or diver mack and were taken it's i'm

39:18

zeke the answer effect is

39:20

even our regular childhood vaccines now are

39:22

suffering uptake is suffering partially

39:24

because of shutdowns parsons people are afraid to go to the doctor

39:26

but percent think there's a growing distrust

39:29

of expertise and what you just pointed

39:31

out which he hates some of the of the a meeting and you look

39:33

at this data as is presented from around the world

39:35

you seats you need experts to

39:37

be able to parse through something that complex something the

39:39

fact that we're able to do it at all as at testament to the fact

39:41

the teams of people who study for years

39:44

able to come together they have their own biases

39:46

science is supposed to try to clean

39:49

up and see through bias on now

39:51

we're seeing resistance third even childhood vaccines

39:53

and what's going on with polio the

39:55

news coming out about seeing that vaccine

39:58

derived polio strains showing

39:59

the new york and a natural

40:02

paralytic case showing up in a younger person

40:04

in their twenties i believe what's going on

40:07

there and and how do you think about this right

40:10

to guess resorting to be any so so i'm

40:12

jealous of me to polio vaccine by taking poliovirus

40:15

grown up in calls for purifying it and killing

40:17

with a chemical a whole killed viral vaccine

40:19

we use that vaccine this country's midnight and

40:21

fifty still the early nineteen sixties that

40:24

was then replaced by vaccine my by average

40:26

save him which was made by taking poliovirus

40:28

weakening it my a passing

40:30

it in in a in monkey kidney cells and marketed

40:33

sixty one thousand a variety of other cell types so

40:35

that now you how to live virus but a live

40:38

weakened virus and

40:40

, the vaccine that we use from the early nineteen

40:42

sixties up until the year two thousand now

40:45

we eliminated polio from this country in

40:47

the nineteen seventies and but

40:49

throughout the nineteen eighties and throughout the nineteen

40:51

nineties every year in this country a potential

40:54

we get polio from the polio vaccine because

40:56

that virus like this spotlight source ui

40:58

to it's a single stranded on a virus

41:01

it's about seventy five hundred base pairs and lanes

41:03

but it's possible for

41:05

that buyers because it's really not attenuated

41:07

or weaken for growth in the indian in

41:09

the intestines it's attenuated

41:12

for grogan the nervous system so when you get

41:14

the oral polio vaccine that virus can reproduce

41:16

itself for weeks and months and

41:18

if it happens to be that that because

41:21

single stranded on a viruses are replicated

41:23

not terribly fateful you have a mutation

41:25

or mutations that essentially cause

41:27

the virus to be essentially refer to neuro

41:30

very much type or wall type then

41:32

you get polio from the polio vaccine that was rare

41:35

it occurred in about one per two point four million

41:37

doses but it was real and once you

41:39

weren't than once that happened once you were shedding

41:41

essentially a vaccine virus that

41:44

had reverted to neuro very when type

41:46

it was clinically indistinguishable from

41:49

the polio caused by you know by

41:51

while type virus natural poliovirus and

41:54

, so so countries that use the oral

41:56

polio vaccine and we haven't used the or polio vaccine

41:58

here for more than one years what when you

42:00

know when they use i've actually that's the

42:03

fast the and bargain that they're making which is

42:05

that you know that you're going to be you have a a a cheap

42:07

and easy way to prevent hollywood also i

42:09

think the attracts of your polio vaccine was on

42:11

the cortazar community not heard of

42:14

mean if you've actually somebody the harm the

42:16

virus can spread throughout the home and essentially

42:18

immunized other people would shield especially

42:21

low resource countries you know was

42:23

was traffic and was track of here actually

42:25

look at scandinavian countries never use

42:27

the world polio vaccine eliminated polio

42:29

from their country so we could have done that we could have stayed

42:32

with inactivate of accident never ask

42:34

those children as a potential

42:36

for never year to get poly from the polio

42:38

vaccine i was actually have one the advisory

42:40

committee civilization practice from like ninety

42:43

ninety six to two thousand one and

42:45

i was made head of the polio working groups

42:47

and it was my mission to get us

42:49

away from the oral polio vaccine because

42:51

i just thought it was unconscionable to to

42:54

to give a vaccine the you new cause

42:56

a potential into your polio every or knowing

42:58

you had a safer way of doing this and

43:00

it did to make that to make that happen

43:03

to make it easier to happen on i brought

43:05

up men and john salamone onto the committee

43:07

and he he was a this wonderful

43:09

man whose son had suffered polio

43:11

from the oral polio vaccine and he was he

43:13

was actually i think head of the italian american foundation

43:16

so he was used to dealing with congress all the time

43:18

he would to me was a true vaccine

43:20

safety activists i know the as have

43:22

i seen people often labeled himself smith

43:25

of that and safety activists but often

43:27

would they advocate for has nothing to do with us

43:29

and safety he was right he

43:31

wanted the oral polio vaccine to have a black box

43:33

warning on his son was paralyzed

43:35

by that that seats because he had no

43:37

idea that the rural polio vaccine

43:39

could do that and he was really iris i actually

43:41

have died a few years ago so i bought

43:44

him under the committee and dumb and

43:46

he was a powerful voice has helped moved

43:48

us away them from the oral polio vaccine

43:50

to the an activator vaccine which we've had

43:53

now for the last know twenty pushers if

43:55

if you go to scandinavian countries scandinavian

43:58

you look and wastewater presumably you by

44:00

any polio virus because the inactivity

44:02

vaccine shouldn't be detected weiss worse

44:05

but but in new york city what happened was

44:07

there was i'm a man i think twenty seven

44:09

year old men in rockland county arm who was part

44:12

of an ultra orthodox community it was under

44:14

vaccinated who got polio from

44:16

the polio vaccine caused by this type to

44:18

revert and virus now

44:20

that what what what percentage of

44:23

people who are infected with this virus

44:25

develop paralysis a very small

44:27

percentage i mean some estimates as choose

44:30

one in two thousand people who are infected

44:32

with stars actually paralyzed by the

44:35

national bars the natural virus natural

44:37

virus polio was common but not everybody

44:39

who got polio which was really mostly a

44:41

mild summer gastroenteritis

44:43

dot paralyzed by it and that's to

44:45

offer for these are words right so you see a case

44:47

of browsers assume is the tiger

44:50

much to very much bigger iceberg also

44:52

assume that these types to revert

44:54

viruses have been circulating in in the united

44:57

states for a while i think if you looked

44:59

in las vegas or san francisco

45:01

at the well waste what are you would also find

45:03

poliovirus their spears i think those those

45:06

strains always circulates the reason i think this

45:08

is half of likely reason happen next very

45:10

was under vaccinated community and

45:12

that's the lesson the lesson is maintain

45:15

high levels of vaccines because these

45:17

kinds of viruses are out there and

45:19

we're not and ever eliminate polio from this world

45:21

until we stop using your polio vaccine

45:24

wow

45:26

oh my gosh paul a

45:29

dad is an amazing story

45:32

so what is the disadvantage

45:35

of the in a inactivated apart from

45:37

the she the inability to shed and create

45:39

close contact immunization what's

45:41

the downside of and activated it's an injection

45:43

instead of aura

45:44

it's it's more expensive it requires her

45:46

medical personnel to give it that's

45:48

it is a highly effective vaccine

45:51

that has the capacity to them and a polio from

45:53

the swirl

45:55

wow so if

45:57

we had unlimited resources everyone would get

45:59

back and

45:59

eliminate polio but we have limited

46:02

resources a some gets the oral polio

46:04

vaccine which can mutate and

46:06

revert and rare instances and then be

46:08

sad and infect people who

46:10

would normally even one in two thousand

46:13

or two thousand and of i'm would do find even

46:15

normally on vaccinated but that one

46:17

the get paralyzed now vaccinated

46:20

you drop that to negligible

46:22

there you know if people the

46:25

term infant our paralysis which was an

46:27

alternative used to describe polio

46:30

this represents what that bought that disease was

46:32

i mean that the the polio was incredibly

46:35

common i what what what happened was

46:37

arm is in the same nineteen twenties

46:40

thirties polio wasn't as common

46:42

as it is now it became a a

46:44

r a common as a

46:46

result of increase sanitation and hygiene

46:49

because what happens there was normally

46:51

what would happen because polio was everybody got polio

46:54

usually you know and asymptomatic infection as

46:56

a mother is therefore had antibody

46:58

polio and devices they would pass we transfer to

47:00

their their newborns and and

47:02

in that first year or two of life that's

47:04

when the child will be exposed because sanitation

47:06

and hygiene wasn't very good once me improved

47:09

sanitation and hygiene and and

47:11

and people weren't exposed and in that first year

47:13

of life then it became a disease of the five

47:15

to nine year old i mean that that's why it's

47:17

as determined to tell process was never write a book

47:19

was really easy the five hundred because the

47:21

sanitation and hygiene that would

47:24

up and that is fascinating either because

47:26

valukas answer vaccine activists well off

47:28

and say oh the reason polio got

47:30

better was not the vaccine it's because of improved

47:33

sanitation and hygiene and

47:35

what you're saying is no actually when we were dirtier

47:38

ah everyone to get infected in the mom would passes

47:40

antibodies and a kid would then have at least some pass

47:42

protection when they were very young and that

47:45

is absolutely fascinating so

47:47

this this is an interesting story that again gets

47:49

back to why it's important to actually use

47:51

safe and effective vaccines in

47:54

childhood to prevent these diseases and like you said

47:56

when you have a safer up opportunity than

47:58

and then i won this less like the oral

48:00

polio vaccines are you want

48:02

to take that and scale up to city

48:04

that's so they're not brings us to monkey pox

48:07

affected everyone saw going about monkey pox said

48:09

they were saying always a if it's not one pandemic

48:11

it's another the government just wants to control us by

48:13

creating pandemics ah my

48:16

i did a video on monkey pox recently

48:18

and and

48:20

i'm just curious so what's interesting the

48:22

questions for you are are in this affects children

48:24

as well so it's a kind of broad it's in the

48:26

in the i'm sort of pox virus family

48:28

to teach us a little but monkey pox and let's talk about

48:31

vaccine option because i think it's interesting

48:34

right lose so many different

48:36

species have their own or

48:38

infections with the so called ortho

48:41

pox virus is pox virus is so there's

48:43

counterparts monkey pox rabbit

48:45

part horse pox i'm

48:47

, smallpox and and the the

48:50

good news is there energetically

48:52

similar so i not was the

48:54

first vaccine right edward jenner made the observation

48:57

are actually was made beforehand that that

48:59

milkmaid had fair skin that that that

49:01

if you look in southern england every two to three

49:03

years where i'd return or work the virus would

49:05

sweep through the southern english countryside and

49:07

cause of the devastation comes with smallpox

49:10

which has mortality rate of like thirty percent

49:12

i yelled and and and for those who survive

49:14

many are left line it is a terrible infection

49:17

i'm , milk milk face and and

49:19

in and when you're expected to survive you have

49:22

these sort of residual pockmarks because it's

49:24

a very deep seated blister on

49:26

but not based didn't seem to get that answer

49:28

term milkmaid hackers can because what what

49:30

he observed has actually observed by gun in benjamin

49:33

just the a couple of decades

49:35

before him on budget but

49:37

just he didn't do the experiment and the experiment dead

49:39

and so tender gets credit but the the what

49:42

would jenner realize and was will maybe there's

49:44

an association between these these

49:46

monsters that these milk mates are getting on

49:48

their their hands and wrists though uma

49:50

we now think of his nose counterparts

49:52

and the fact that they don't getting the smallpox

49:55

and so he then just of the blisters from

49:57

a woman who was in his employee of milk mean i'm

49:59

sorry nose and then inoculated

50:01

people including his son and then what

50:03

he did was he he valerie elated them

50:05

because you know really back from the early seventeen

50:08

hundreds of benjamin franklin regretted

50:10

the fact that he didn't give his son this

50:13

essentially a smallpox vaccine which was you could give

50:15

them smallpox you and your with her take

50:17

the the dried blisters

50:19

and you would make them into across interview with either inject

50:22

them are held them and that was very

50:24

elation but when you got ejected without it cause

50:26

a really intense blister so what does it

50:28

was the inoculated sound like what you know what we

50:30

think now is count box and then then

50:33

he very elated him but didn't see that

50:35

intense reaction so he said okay i think

50:37

there is protection here it's interesting if

50:39

you look back i'm not sure it actually was

50:41

countback there was recently a study in internal

50:44

medicine suggesting that might have been horsebox he

50:47

that that we were using as vaccinium

50:50

virus to protect against a human

50:52

smallpox was literally because that's worth

50:54

word vaccine comes from a word back to he

50:56

comes from you know b a c c a

50:58

latin there's no hard being latin so waka

51:01

means cow walk and i his

51:04

agenda form of the cow and that's

51:06

where the word vaccine comes from his [unk] cabinets

51:08

maybe we're gonna have to go back and change that i'll make it like

51:10

equines i

51:14

just had a nerve gas i'm listening to that

51:16

story that was amazing ah mans

51:18

a so all right so so

51:21

we can have the history of the smallpox

51:23

a history of vaccines we have of

51:25

rinsing immunology in their son out bring

51:27

us up to monkey pox which is enough family

51:30

and people will say well if you had

51:32

the original smallpox vaccine

51:35

which by the way poss i miss i was

51:37

born in nineteen seventy three so in miss the american

51:40

ah tail end of smallpox vaccinations

51:42

with eradicated advising nineteen seventy

51:44

with believe spot my mom

51:47

took me to india when i was six months old

51:49

and i stayed there for six months with the family

51:52

and they were like you know we have also

51:54

vaccines and i got the smallpox

51:56

vaccine and i still have

51:58

a big ass car from

51:59

the from that the i guess very elation

52:02

reaction i i don't have the same thanks bye

52:05

you know about vaccination ,

52:08

was very less than my that was back when

52:10

you got maximum yeah because i didn't get the crust

52:12

and inhale it or inhale a are injected

52:15

and i'm

52:17

who am i

52:18

the cross protection you said

52:20

is is pretty good you think i would still

52:22

be protected against monkey pox having had that

52:25

you remember the the was against his yes

52:28

for the most friends of the number that you hear people

52:30

talk about as a year the protection again is

52:32

is about eighty five percent protection

52:34

against much about but i think the answer the question would

52:36

you really care about is his gifts as much but

52:39

like all packed houses can be fatal i'm

52:41

are you protecting against you notice it's potentially

52:44

fatal are seriously writing away and

52:46

satellite as you get a sepsis like syndrome and a

52:48

million i think the answer is yes nice for the

52:50

same reason her mother the dick the current monkey

52:52

pox that caesar so vaccinate i mean

52:54

they're still like the original smallpox vaccine

52:57

on the the two that are available above

52:59

it on use one is called a camp two thousand

53:01

which is is essentially just kind of a purified

53:03

version of that that some you virus vaccine and and the

53:05

others the studios vaccine which basically

53:07

just take this up the ankle

53:10

restrain of what was the vaccine

53:12

he of are sexy three years and then modified

53:14

so some modifies that's and yet

53:16

ankara strain and ,

53:19

modified by best they see passing at like five

53:21

hundred times and chick embryo fibroblasts

53:23

also really can't reproduce itself anymore so

53:26

i live it's it's it's it's live

53:28

virus that it really can't reproduce itself a

53:30

similar assessor did awesome johnson or

53:32

source code the to vaccine it's ally virus but virus

53:34

can't reproduce and so reproduce

53:37

and and an interesting way that the when

53:39

we decided to give it up you know

53:41

to sort of because we didn't have enough axes

53:43

to give a safety of the intradermal route

53:46

you know i like that

53:48

idea on because member that would have actually you

53:50

got when you run into your i got because i was one well

53:53

before ninety seventy two when we sub using

53:55

smallpox that was an intruder with axes the

53:57

scarf occasion technique as intradermal

53:59

vaccine and your the area in your skin

54:02

is a rich source of so called

54:04

antigen presenting sounds like dendritic cells

54:06

so that's that's right way to go

54:08

vaccine i mean we don't we still lack

54:11

a critical mass of data spent i there's

54:13

every reason to believe that it would be affected

54:16

the when so so

54:18

we don't we don't look he's a couple questions why

54:20

do we do in for muscular at all

54:22

then are

54:24

you can argue that that week we should use more

54:26

denver and that thought we could use

54:28

more or intradermal back since

54:30

not as easy give up ,

54:33

demo vaccines his computer subcutaneous

54:35

intramuscular that is what we could certainly use or

54:37

and then and weeks there's always a talk

54:39

about the so called micro needles you know where

54:41

you have like a hundred little needles and

54:43

as a patch and you put that pattern that's

54:45

essentially an internal boxes that

54:48

and that we don't have a fully inactivated

54:51

killed and smallpox

54:53

type vaccine the digital

54:56

because you need for , intents and purposes

54:58

vs replicate degeneres vaccine

55:00

doesn't replicate so that's why it's much

55:02

safer the original vaccine the the

55:05

know the smallpox vaccine had you

55:07

from so he said it's a difficult

55:09

safety profile i mean it could cause very

55:11

crowded market i see other people who would occasionally

55:14

die for the smallpox vaccine and

55:16

what we watch the smallpox vaccine this country which

55:18

we did in early

55:20

two thousand right before we invaded

55:23

iraq there was an interesting by the bush administration

55:25

of initially vaccinating everybody and

55:27

as with takedowns it was vaccinated first responders

55:30

or i never thought that was a good idea i actually

55:32

voted now has he always the only

55:34

no vote on this is what i've i voted no when

55:36

it came up for many reasons i didn't

55:39

think we need to watch out for myself wishing erratic

55:41

mean make sure people knew how to get the vaccine

55:43

was if there was just one case somewhere

55:45

in the world you could make the case is

55:47

restarted is think we need to start doing that yeah

55:49

that yeah so we were seeing some my a card

55:51

addison air in military personnel

55:53

crack young people

55:55

yeah and and now

55:57

one one thing i was reading about the old smallpox

55:59

scene was a he occasionally you would

56:02

get a was it a disseminated

56:04

smallpox case or a replication

56:07

there's probably people have like near psoriasis

56:10

are you know houston disorders where you know

56:12

in allow for more that was i'm in

56:14

i was a fellow remember seeing a case of disseminated

56:16

smallpox or , know

56:18

to somebody that cydia in someone who was

56:20

in of to physician who had decided

56:23

to give the smallpox vaccine his

56:25

way through boosting immunity disrepair

56:27

immunity thing which is terrible idea and

56:30

and pretty frightened really interesting

56:32

and disseminate smallpox

56:34

like you said instead the vaccine the as the virus

56:36

that you're using ah when the same in

56:39

same similar family so okay

56:41

fascinating thank you paul so

56:43

one quick question i want to ask the or we've been

56:45

through this ride together it continues

56:47

ah what what are some things

56:49

that you think you

56:51

may have gotten over the past

56:53

because part of sciences figuring out when you're wrong and and

56:56

correcting are are incorporating that knowledge

56:58

and getting better instead of entrenching

57:00

defending and rationalizing who

57:02

seems to be what the public discourse is

57:04

often it's on what are some things that you

57:06

might have gotten wrong with our

57:09

during this whole course that you change

57:11

your mind about things that we've changed her mind about what

57:13

are some things that you think you kind of nailed

57:15

of right and are still

57:17

you're still really advocating media

57:20

what's really was wrong about how

57:22

devastating as far as would be any when

57:25

you , when it first the a raise his head in china

57:27

and then seems to settle down the new sweaty

57:29

on there were like three thousand us into population

57:32

five times where your nose in it goes italy which has

57:34

a a especially

57:36

in northern italy a on healthcare system

57:38

is on the service good as ours was

57:40

good was we'd like hours today i'm you know

57:42

the and you know sort of the figure for years you

57:44

know italy smart enough to transmit

57:47

and i see if you look i think we're going to have

57:49

fewer than sixty thousand deaths here and said

57:52

that actually on cnn international it

57:54

the early march of two thousand and twenty five only

57:56

off by like a million plus deaths on

57:59

f lee roth about that is

58:01

was gonna be i'm true see whether

58:03

i'm ah how it works out with

58:05

a to those innocent i fell by two doses

58:08

well he takes about what when in

58:10

december twenty one and we recommended

58:12

that madonna advisers actually be launches

58:14

into those vaccines some very

58:16

smart people vaccine how to snow com

58:19

he said this is rita sexy it is

58:21

because if you look at polio and inactivated

58:23

polio vaccine you look at at inactivated

58:25

hepatitis a vaccine ukip purified protein

58:28

vaccines the only way you can get adequate

58:30

frequencies high frequencies of memory

58:32

be cells remember it is else is the have a forty

58:34

six month window between doses

58:37

so you have to have that third dose later

58:39

at some point to get those levels up

58:41

a meal and so i

58:43

, that was was sort of waiting to see

58:45

it and didn't see it at the end of the for should remember

58:48

this these him on a vaccines were something with which

58:50

we had no experience so you know be open

58:52

minded way to see what you say i'm furious

58:54

the weather over time if you just guns

58:56

who doses and you were otherwise healthy young person

58:59

will do you really are at risk of serious

59:01

illness it's certainly true with up with that third

59:04

dose you get a boost in some you

59:06

get some more finity maturation you get

59:08

a broader me response can speak for gay five

59:10

that all true but does that also mean

59:12

that you're if you're not as well protected against

59:14

serious illness illness

59:16

see would have site i just really hope

59:18

that the immunologists and an epidemiologist get

59:21

together to to answer those questions who

59:23

really needs is to should also because like anything

59:25

in medicine weather's a biological or a or

59:28

it it's is if you have clear

59:30

evidence of benefit then you're willing to take the risk

59:32

but if there's not clear evidence of benefit and

59:34

don't ask people to take take any sort of risk

59:37

even if it's smaller theoretical so so

59:39

just make the case make the case

59:41

for it is all i'm saying yeah

59:44

so quick lightning question kind of related to that animates

59:46

ask earlier would you

59:48

mandate a be a four

59:50

five booster for healthcare

59:53

professionals yeah i mean

59:55

i can distinguish were not mandating

59:58

it it as well thought out

59:59

yeah

1:00:00

that the for all the reasons we talked about

1:00:03

and dumb

1:00:04

how about the last thing i'll ask

1:00:06

is for young children

1:00:08

what safe

1:00:10

to to are you know til

1:00:13

eleven that sort of range

1:00:15

on we have pretty abysmal up take us vaccine

1:00:18

the you think more people should be vaccinating

1:00:21

kids in that age or do you think we've reached enough

1:00:23

ah general sarah prevalence now

1:00:25

sad it's not necessary what are your thinking

1:00:27

on on the young kids that say say without

1:00:29

com morbidity

1:00:31

right i actually and i get a lot of hate mail for

1:00:33

this i i you know if you look at children

1:00:35

who are hospitalized or go to the i cu

1:00:37

arm or is it you know with

1:00:40

kobe only better third have third

1:00:42

have have com or bit is so so

1:00:44

an idea work and a housewife see this so

1:00:46

i i would really encourage

1:00:49

people to vaccinate their their young children i

1:00:51

think you're right and i've heard dot precisely

1:00:53

this on your show that you know that there definitely is

1:00:55

more i'm more i'm

1:00:57

population immunity i think that that protects

1:01:00

us all that but if you look at what's happening now

1:01:02

i'm and if you ensure with a the answer

1:01:05

the question what group is released vaccinated

1:01:07

people left in eighty years of age they're going

1:01:09

back to school now restoring to see an increase

1:01:11

in house was a sunday ruben at our child policy

1:01:13

lapis as now put out these data showing

1:01:16

you are starting to see more hospitalizations

1:01:18

in in children at because we have

1:01:20

this network or totals house with we follow for

1:01:22

you know not for series on been here for brought

1:01:24

to light as for croup you know for fever

1:01:27

and a young child so if you can if you

1:01:29

can avoid that safely which

1:01:31

i think vaccines to than i would say get a vaccine

1:01:33

then the question becomes what how long as it last

1:01:35

i mean if you get that vaccines are you going

1:01:37

to be obligated for you know for booster

1:01:39

sooner and for longer i me because you're

1:01:41

younger are you not responding as well time

1:01:44

will tell but i do think that if that i

1:01:46

would i certainly encourage vaccines

1:01:49

even a young children but because of the i think

1:01:51

the lesson five rolling as few with by percent

1:01:53

of that group was getting vaccinated

1:01:54

yeah it's very very small i'm

1:01:57

i just always love hearing your perspective

1:01:59

i know my audience as i learned so much

1:02:01

strength is dog i did see if you stick maybe

1:02:04

when i edited i'll put away to my face during summer

1:02:06

our conversation to them just like it's

1:02:08

really the insights on be a for

1:02:10

five on the boosters on influenza

1:02:13

on polio on monkey pox on all that's

1:02:15

really really tremendous paul anything else

1:02:17

you wanted to tell the audience us but you

1:02:19

can't say on cnn ah dropping

1:02:22

bombs anything you want the platforms yours

1:02:25

too the spelling

1:02:27

nordic i think i'm i think we're

1:02:29

getting there i think it'll be really interesting

1:02:31

to see what happens this winter i mean the

1:02:33

v interviewed her some pundits saying you know this

1:02:35

will be awful and others can have your before

1:02:38

be of has been a sweep across know because we're

1:02:40

never be indoors again and it's gonna be just

1:02:42

like it's been less to understand would really surprised

1:02:44

and we have such a high level population of units

1:02:47

we have you know monoclonal have as we're pack

1:02:49

slovenia we have antiviral agents i

1:02:51

would really be surprised if you saw

1:02:53

what we saw the last two winners read

1:02:56

see three thousand as a day for thousand

1:02:58

as i can imagine that would happen i'm

1:03:00

so cause i think we are getting there and

1:03:03

you know people it's different from where we were

1:03:05

early because we if you'd find

1:03:07

pandemic as a change the way you live

1:03:09

work or play you'd are you in most

1:03:11

areas his country we're past the pandemic

1:03:13

any most people just doing what they normally do now

1:03:16

and we'll see whether by doing that knowing

1:03:18

that the virus will circulate knowing that they're still population

1:03:20

in this country that's not vaccinated for under

1:03:23

vaccinated we'll see what happens but i

1:03:25

would think that if you look the last two anderson

1:03:27

and this winter's when are you would not see

1:03:29

that same level of bump but

1:03:31

we're gonna learn a lot this one

1:03:33

that's awesome oh thanks

1:03:35

a million

1:03:36

the guys who are watching the show

1:03:39

this , paul this is where i have to do the youtube

1:03:41

thing in order to stay afloat after

1:03:43

sites dice best that subscribe

1:03:45

button if you like paul said hit share

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hit like and leave a comment tell us what you think

1:03:50

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1:03:55

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1:04:00

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1:04:02

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1:04:04

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1:04:06

a tip for every donation i get

1:04:09

the next time when i go to visit him to go

1:04:11

to the f d a meeting on

1:04:13

ah influenza stuff which he invited me

1:04:15

to and i'm gonna hold him to it's ah

1:04:18

you got to have fun that trips sir paul

1:04:20

thanks a million guys and gals

1:04:22

and non binary pals we are out

1:04:25

peace