Transcript

The Doctor is In · Mom Wars

0:01
Speaker 1: From the front lines of the Mom Wars. Here's Bethany
0:04
Speaker 1: Mandel and Kara Kennedy.
0:08
Speaker 2: Hello, and welcome to another episode of your favorite podcast.
0:12
Speaker 2: We promised you that we would be back. You hopefully
0:15
Speaker 2: listened to our last episode, which we taped only a
0:17
Speaker 2: few hours ago, but in real life you probably listened
0:20
Speaker 2: to it last week. And now we're back and we're
0:24
Speaker 2: talking very uncontroversial things this week. Just vaccines, you know,
0:32
Speaker 2: just literally the origins of mom Wars. I am your
0:36
Speaker 2: American co host. My name is Bethany Mandel. I'm a
0:39
Speaker 2: mom of six. We homeschool and I frequently write for
0:42
Speaker 2: places like The New York Post and The Washington Examiner.
0:46
Speaker 2: And I am joined by my accented co host, Kara Kennedy.
0:54
Speaker 3: Who is thirty one weeks pregnant now and ready to
0:58
Speaker 3: never be pregnant again.
1:00
Speaker 2: Of two almost one and a half, one.
1:02
Speaker 3: And a half, one in three quarters. Maybe it's the
1:06
Speaker 3: size of a coconut.
1:07
Speaker 2: Oh, that's substantial. That's a good sounds like two to me,
1:12
Speaker 2: and we enjoined. We are joined by our first second
1:16
Speaker 2: time guest, So this is the first time we've had
1:19
Speaker 2: someone back again. Please introduce yourself.
1:23
Speaker 4: Hi, I'm doctor Alli Kareen from Columbus, Ohio. I'm a
1:26
Speaker 4: pediatrician who's been deep in the mom wars of such
1:30
Speaker 4: for many years.
1:31
Speaker 2: And we're so thrilled that you kept up our text
1:35
Speaker 2: chain and have been keeping us informed. And I feel
1:39
Speaker 2: like I should utilize that text chain for my own
1:42
Speaker 2: personal benefit.
1:43
Speaker 5: You're fine to do that just to ask.
1:45
Speaker 2: You medical questions. Lord knows, I do that with other
1:48
Speaker 2: friends who are pediatricians. I texted a pediatrician friend today actually,
1:52
Speaker 2: and she was confused because my greeting didn't come with
1:56
Speaker 2: a question at the end of it. It was just
1:57
Speaker 2: me saying hi to her, and she was like, oh,
2:02
Speaker 2: here is my friend. You don't need medical advice. I'm like, no,
2:04
Speaker 2: I just want to check in. We do you doone
2:07
Speaker 2: to say hi? So she was disoriented by that, which
2:10
Speaker 2: indicates that I'm maybe not the best of friends and
2:12
Speaker 2: I should I should improve.
2:14
Speaker 4: Or maybe she's just accustomed to always getting questions.
2:18
Speaker 5: There's two pieces to this part to exchange.
2:21
Speaker 2: So we want we originally had you planned to come
2:25
Speaker 2: on to talk about the change in the CDC schedule,
2:28
Speaker 2: and then at the eleventh hour for us, there was
2:32
Speaker 2: a second curveball thrown in with a change in food.
2:38
Speaker 2: What would we call it food recommendations? Food triangle, pyramid, Yeah.
2:43
Speaker 4: I mean dietary recommendations, I think is what they call it. Yeah,
2:46
Speaker 4: we had the pyramid and then we had the plate.
2:48
Speaker 4: I actually really kind of liked the plate.
2:50
Speaker 2: Just to our listeners, know, I sometimes co host morning
2:53
Speaker 2: radio here in Washington, DC, and I did it today.
2:56
Speaker 2: And so I was awake at three am and it
2:59
Speaker 2: is now eight pm. So if I sound drunk.
3:04
Speaker 5: To me too, Yeah, but you're just pregnant care Yeah,
3:08
Speaker 5: So that's what that is.
3:09
Speaker 3: This is the first night that I've been awake after
3:12
Speaker 3: eight pm.
3:14
Speaker 6: In a couple in a good couple of weeks.
3:17
Speaker 5: Gosh, we should probably talk about that.
3:19
Speaker 6: So I just sort of tweet about the food pyramid
3:22
Speaker 6: that says the highest recommendation is a whole milk and meat.
3:26
Speaker 1: It feels it feels kind of Jordan Peterson, MICHAELA. Peterson,
3:32
Speaker 1: you know the family that only eats steaks. Yeah, it
3:36
Speaker 1: feels a bit crazy like that.
3:39
Speaker 4: I've been through so many like debates about food throughout
3:43
Speaker 4: my career and my life really that I kind of
3:46
Speaker 4: feel like the like fights about food become almost like.
3:51
Speaker 5: Like the weather. It changes all the time.
3:54
Speaker 4: So I don't know what to make about it. I
3:57
Speaker 4: don't know if anybody really pays attention to the CDC's
4:01
Speaker 4: food recommendations anymore anyway. I mean, our biggest problem in
4:05
Speaker 4: society is that people are like drinking juice like water
4:08
Speaker 4: all day and eating snacks and processed foods every hour
4:12
Speaker 4: or two hours with their children. And that's not on
4:15
Speaker 4: the pyramid it used to be, actually, I mean, it
4:17
Speaker 4: would say that we had like eight to ten servings
4:19
Speaker 4: of grains a day, which was definitely not good for us.
4:23
Speaker 5: So I'm glad that's gone.
4:25
Speaker 4: But the reality is is I find it very hard
4:28
Speaker 4: to believe that the societal pressures around feeding your child
4:32
Speaker 4: junk every hour to two hours in the day is
4:35
Speaker 4: going to change based on this pyramid. But you know,
4:38
Speaker 4: maybe people will take it to heart. I don't know,
4:40
Speaker 4: it's unchure. I do know that children need a lot
4:43
Speaker 4: more carbohydrates than adults. So my families that are very
4:45
Speaker 4: into like functional holistic medicine that are obviously RFK and
4:49
Speaker 4: his friends are who raise their children in like a
4:52
Speaker 4: paleo style diet without a lot of grains, So I
4:55
Speaker 4: have a lot of families who like live grain free.
4:58
Speaker 4: Adults feel really good grain for a variety of reasons.
5:01
Speaker 4: I mean a lot of times, you know, they have
5:03
Speaker 4: the highest calories, so you know, you don't gain as
5:06
Speaker 4: much weight as an adult, and so there's lots of
5:08
Speaker 4: reasons why adults may.
5:09
Speaker 5: Feel good grain free.
5:11
Speaker 4: But children who are grain free, in my experience, don't
5:14
Speaker 4: grow well interesting, and so there are growth curves.
5:17
Speaker 5: It's just very hard, Like if you.
5:19
Speaker 4: Ever counted your calories, you know, a slice of bread
5:22
Speaker 4: is like one hundred and twenty calories and a chicken
5:23
Speaker 4: breast is like eighty, and then like the other stuff
5:26
Speaker 4: is like free, you know, like an apples like fifty,
5:29
Speaker 4: and you know a pepper is like thirty. You know,
5:32
Speaker 4: you add that together and a sandwich is going to
5:35
Speaker 4: be like three times the calories that some steak and
5:39
Speaker 4: vegetables are. And that's great when you're an adult you
5:43
Speaker 4: don't want to gain weight, but we actually need to
5:46
Speaker 4: gain mass as a child. So I also think vegan
5:49
Speaker 4: diets are terrible for children. They're trying to build an
5:51
Speaker 4: entire brain and body, and they don't get enough protein
5:54
Speaker 4: and amino acids to do that.
5:55
Speaker 3: So yeah, I mean, these parents just must be so confident,
5:59
Speaker 3: because I am paranoid that if my toddler is like
6:03
Speaker 3: throwing food off the table, I'm like.
6:05
Speaker 6: Oh my god, she's gonna stop.
6:06
Speaker 3: And I'm like offering her a hundred other different things
6:09
Speaker 3: because I'm like, you have to grow. And her favorite
6:13
Speaker 3: thing is outmeal. She will literally just like shovel it
6:16
Speaker 3: in amount. So I don't know how these people that
6:20
Speaker 3: feeling confident in themself just offering their kids like vegin stink.
6:26
Speaker 4: I have had families that tell me they're raising their
6:28
Speaker 4: children kind of war. I'm like, that's really bad for
6:30
Speaker 4: like their kidneys. They're literally like I had one woman
6:33
Speaker 4: who fed her kid three like beef sticks. In the
6:36
Speaker 4: short appointment I had with her.
6:37
Speaker 2: Oh my gosh, here's some labs. But sure, that's a
6:41
Speaker 2: good idea. And what did the labs say.
6:44
Speaker 5: I don't think she got them done.
6:45
Speaker 4: She thought I was crazy and she was so confident, Kara,
6:48
Speaker 4: so comfordent. But her meat a Terrrian diet for her
6:52
Speaker 4: three year old was great.
6:53
Speaker 2: It's funny because Car, you're panicking about your toddler. I'm
6:57
Speaker 2: panicking presently actually about my twelve year old who's about
7:01
Speaker 2: to fall off the growth curve. She's third percentile BMI
7:05
Speaker 2: right now. Oh no, and it's because she doesn't eat.
7:10
Speaker 5: Oh well, what you need the touch chain for. I
7:13
Speaker 5: can talk to you about that later.
7:14
Speaker 2: Yeah, she just doesn't she It was funny because we
7:17
Speaker 2: went to the pediatrician and you know, we waited and
7:20
Speaker 2: all those things, and I was like, oh, third percent
7:23
Speaker 2: of them. And then I'm bringing her to a work event,
7:26
Speaker 2: and so I had to, you know, tell the people
7:28
Speaker 2: who were catering it, I'm bringing along an extra person.
7:31
Speaker 2: But she doesn't eat, So don't worry about catering for her.
7:35
Speaker 2: You just if you could just get sunflowers and air,
7:39
Speaker 2: that's really all she needs.
7:41
Speaker 6: I will say.
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Speaker 3: I was kind of like, this is a teenage girl
7:45
Speaker 3: and didn't really gain anyway for like ten years, and
7:49
Speaker 3: then I was fine, So no are and I ate
7:53
Speaker 3: like a bird. I just like picked its stuff throughout
7:55
Speaker 3: the day and didn't really eat meals and I was fine.
7:59
Speaker 4: Yes, some kids have like introspection issues where they don't
8:02
Speaker 4: read their sensory cues around even things like appetite and
8:06
Speaker 4: stuff right, and they'll like actually end up at a
8:08
Speaker 4: low BMI and there are some tricks around that, like
8:11
Speaker 4: people say, oh, they'll eat when they'll eat what they need,
8:14
Speaker 4: and I'm like, that's not always true. Some kids will
8:16
Speaker 4: overeat and some kids will under eat, and if you
8:19
Speaker 4: ask them, they'll say like, well, I'm just not hungry,
8:21
Speaker 4: like I just don't want to eat, and it's like
8:23
Speaker 4: their brain isn't signaling right.
8:25
Speaker 5: So we can talk about that more later. But it
8:26
Speaker 5: does happen. It does happen.
8:29
Speaker 4: Some kids just don't eat good and the biggest thing
8:31
Speaker 4: you have to do is like not be like, oh
8:32
Speaker 4: my gosh, you didn't eat so here, just eat your
8:34
Speaker 4: favorite junk food and don't even eat good food.
8:37
Speaker 5: So tempting to do.
8:39
Speaker 2: Then that's what I do with my four year old. Actually,
8:43
Speaker 2: I'm like, what I think? He eats his weight in
8:47
Speaker 2: granola bars. That's I hide the granola bars normally really high.
8:53
Speaker 2: But I was when the groceries came in, I was
8:57
Speaker 2: they were put in a low shelf, and I was like, oh,
8:59
Speaker 2: well they'll be gone in two days and then they'll
9:02
Speaker 2: be gone.
9:02
Speaker 1: I literally just had this conversation with Nick because my
9:05
Speaker 1: baby was throwing her food off and I cooked her
9:08
Speaker 1: fish in mashed potato and broccoli. And then he was like, oh,
9:11
Speaker 1: it's fine, I'll just give her a pouch of apple sauce.
9:14
Speaker 3: And I'm like, no, no, because then she's going to
9:18
Speaker 3: throw her food off every time and just expect apple sauce.
9:21
Speaker 4: I always would always tell parents, and this what I
9:23
Speaker 4: did with my kids. If they didn't want to eat
9:24
Speaker 4: the food, I just took it off the table, but
9:26
Speaker 4: left them in the high chair and made them watch
9:29
Speaker 4: us eat. And then I'd be like, I want to
9:30
Speaker 4: try again, and I like, so you could sit with
9:33
Speaker 4: your tree with no food, or I can give you
9:36
Speaker 4: some food. But I didn't want them to teach that
9:38
Speaker 4: throwing food mint they got to get down, because then
9:40
Speaker 4: otherwise it would be like throw the food and then
9:42
Speaker 4: they get down or throw the food, someone gives you
9:44
Speaker 4: something else. So I'd be like, oh, well, if you
9:46
Speaker 4: don't want to eat this, you know, I mean, you
9:48
Speaker 4: can sit in the chair, but like okay.
9:50
Speaker 5: And the truth is toddlers really only eat about one
9:53
Speaker 5: good meal a day. They kind of pick at the others.
9:55
Speaker 6: Yeah, it's terrified everybody. It's really stressing me out. So
9:58
Speaker 6: I'm glad to know that it's not just me.
10:00
Speaker 4: No, and the biggest mistake parents make is like panicking
10:03
Speaker 4: and then like trying to shove whatever the kid will
10:05
Speaker 4: eat in their mouth and like, don't do that, don't
10:08
Speaker 4: do that. They'll be fine. Most of them will be fine.
10:10
Speaker 4: And let's they have introspection issues and don't even know.
10:12
Speaker 2: Yeah, we chase the three year old around seth will
10:16
Speaker 2: just with a piece of chicken, and once we treat
10:19
Speaker 2: it like a fishing line. Once we once we get
10:23
Speaker 2: the first bite in, he's like hmmm, and then that's
10:26
Speaker 2: how we like lure him. Then we reel him into
10:28
Speaker 2: the table, but that first bite is always like chased,
10:32
Speaker 2: and then he's like, I could go for some food
10:37
Speaker 2: and maybe work. We treat it like a fishing line.
10:41
Speaker 6: Awesome. Hi, this is a young Culter. Welcome to my
10:52
Speaker 6: Ricochet podcast.
10:54
Speaker 7: And Coulter every week on Ricochet.
10:57
Speaker 5: You're home to center right conversation.
10:59
Speaker 6: Hey, that was pretty good.
11:08
Speaker 3: I feel like we should get onto vaccines now, I think, so, yeah,
11:13
Speaker 3: are we ready?
11:14
Speaker 5: Are you ever ready?
11:16
Speaker 2: I just wrote a column actually for the New York
11:18
Speaker 2: Post and it just came out like two minutes ago
11:20
Speaker 2: actually about this. But I'm very curious to hear what
11:23
Speaker 2: you think.
11:25
Speaker 4: Well, I think that for me personally, I see it
11:30
Speaker 4: probably differently than the majority of my pediatrician friends, because
11:35
Speaker 4: I have allowed patients who don't vaccinate in my practice
11:37
Speaker 4: for a long time under the premise that I really
11:40
Speaker 4: believe that it's like kind of a sacred right to
11:42
Speaker 4: control what's injected in your body and to have choice
11:45
Speaker 4: over your medical decisions. I think there's a lot of
11:47
Speaker 4: reasons why I feel that way, and so I have
11:50
Speaker 4: always felt like mandates or doctors that kicked you out,
11:54
Speaker 4: or schools that kicked you out, or in some states
11:57
Speaker 4: still even withhold like food stamps in Medicaid, if you're
11:59
Speaker 4: not vaccinated, coercion is definitely not consent. Our court has
12:03
Speaker 4: always said that, and I do believe those are coercive effects.
12:08
Speaker 4: So for me, the biggest thing about this new announcement
12:11
Speaker 4: is that it basically takes away a lot of those
12:16
Speaker 4: mandates that are in place in other states. So when
12:18
Speaker 4: you see it, it comes out it says like these
12:20
Speaker 4: are the recommended ones, these are at risk, and these
12:22
Speaker 4: are discussed with your doctor, And the practicality of what
12:28
Speaker 4: just happened is that those mandates, which I mean in
12:31
Speaker 4: New Jersey you have to have a flu shot to
12:34
Speaker 4: go to daycare at six months. So yeah, if it's
12:37
Speaker 4: on the schedule in some states, every single thing which
12:41
Speaker 4: we saw in COVID right, like you lose your job, you.
12:44
Speaker 5: Can't go to school, as kind of things.
12:47
Speaker 4: Yeah, and so the implications of what's written on that
12:50
Speaker 4: schedule are pretty profound for families in.
12:53
Speaker 5: States where it's enforced.
12:55
Speaker 4: The federal government doesn't enforce that, but the states enforce
12:59
Speaker 4: it at the state level and their schools, and then
13:02
Speaker 4: of course employers and colleges and stuff like that can too.
13:06
Speaker 2: There's a private school here where I live that they
13:08
Speaker 2: require the flu shot, and I think that's wild.
13:13
Speaker 4: That's a whole discussion that we could get into, but
13:16
Speaker 4: I think it's not as important as the others. But
13:18
Speaker 4: so that's the biggest change practically, that's the biggest change.
13:22
Speaker 4: I'm disappointed with the communication style of the HHS again
13:28
Speaker 4: in how they announced it. They didn't even upstate the
13:31
Speaker 4: website at first, they didn't explain themselves very well. They
13:35
Speaker 4: certainly didn't communicate to pediatricians that it was coming. So
13:39
Speaker 4: now we're being in flooded with conversations from families that
13:44
Speaker 4: we weren't prepared with paperwork or anything. That's what I've
13:47
Speaker 4: been working on this week. So that's super frustrating. If
13:52
Speaker 4: I were to speak from like the way the AAP
13:54
Speaker 4: sees it is, every single vaccine is amazing. Everyone should
13:57
Speaker 4: have it, and they should all be on the mandatory schedule.
14:01
Speaker 5: I was part of a.
14:03
Speaker 4: A like physician group that went out to Santa Fee
14:07
Speaker 4: when they were launching a whole bunch of new vaccines
14:09
Speaker 4: than an actor, the aut of cell, and the flu vaccine,
14:12
Speaker 4: and they were kind of asking physicians like, Okay, we're
14:15
Speaker 4: going to do these new vaccine recommendations, how do we
14:17
Speaker 4: explain them to parents? So they were kind of asking
14:19
Speaker 4: for a physician feedback kind of on marketing and selling
14:21
Speaker 4: of the new plan. And I was invited out because
14:25
Speaker 4: they knew that I had more deniers in my practice
14:27
Speaker 4: than most and I was just shocked at the time,
14:32
Speaker 4: and this was quite some time ago that the rest
14:34
Speaker 4: of the colleagues in my room in the room when
14:36
Speaker 4: they were asked, you know, what could you do to
14:39
Speaker 4: convince parents of this new change being a good change?
14:42
Speaker 4: And they were like, just make it managory because they
14:46
Speaker 4: won't do what we say, so just make it manageoring.
14:49
Speaker 5: And I remember saying at the time, like that's really.
14:51
Speaker 4: Slappy, Like we we should Yeah, it's lazy, and as
14:57
Speaker 4: a public health establishment or patrisan or whatever, I feel
15:02
Speaker 4: like we should be able to sell our policy better.
15:06
Speaker 1: It just doesn't work, Like it makes people more conspiratorial
15:11
Speaker 1: or feel more like they'd be enforced into something. You know,
15:14
Speaker 1: it's like it's not only sloppy, but it's just not effective.
15:19
Speaker 4: And as they've added more and more and more and
15:21
Speaker 4: more and more to that list, it felt more and
15:24
Speaker 4: more oppressive. Right Like when it was just MMR in
15:27
Speaker 4: polio and d TAP, people were like, Okay, that makes sense.
15:31
Speaker 4: But then when they put on rotavirus and hippabectitis BEE
15:35
Speaker 4: for babies, and you know, they just started adding all
15:38
Speaker 4: of these and then linking those to the mandates, people
15:42
Speaker 4: started becoming increasingly more frustrated. Which is interesting to me
15:47
Speaker 4: because the medical community doesn't seem to be taking any
15:50
Speaker 4: responsibility for that frustration, and they, you know, really think
15:56
Speaker 4: the mandates are the right thing, and I mean to
15:59
Speaker 4: the credit. The truth is is a lot of families
16:02
Speaker 4: do do it because they're forced to. If you were
16:05
Speaker 4: to do it, an evidence based trial of you know,
16:08
Speaker 4: how do you increase vaccination rates? Mandates are effective. They
16:13
Speaker 4: also actually published a study once that said that if
16:16
Speaker 4: you tell a parent that a vaccine is mandatory, they're
16:20
Speaker 4: more likely to vaccinate than.
16:22
Speaker 5: If you tell them they have a choice.
16:24
Speaker 4: And I was like, well, yeah, it's not true.
16:30
Speaker 2: That's wild. I've also found, you know, there's places that
16:36
Speaker 2: it's mandatory, but then there's other situations I make In
16:39
Speaker 2: summer camp, they have the COVID and the flu on
16:42
Speaker 2: the list as if they're mandatory, and I asked them,
16:46
Speaker 2: I was like, before I apply and give you one
16:49
Speaker 2: thousand dollars, is this actually mandatory? Because if it is,
16:53
Speaker 2: then we're going to find another summer camp. And they
16:56
Speaker 2: were like, oh no, Alex, so why is it on
16:58
Speaker 2: your list? And I think it's give the illusion of mandatoriness.
17:02
Speaker 2: And so I think, I mean that's another sort of
17:06
Speaker 2: I guess, coercive way that they're enforcing this kind of
17:10
Speaker 2: stuff in public health is the illusion of mandatory, even
17:14
Speaker 2: if it's even if they don't really care. And I
17:16
Speaker 2: wonder why they do that.
17:19
Speaker 4: I think there's different reasons for different people, because I've
17:24
Speaker 4: been in those conversations where the pediatricians were discussing the policy.
17:30
Speaker 4: I believe the pediatricians do it because they just want
17:33
Speaker 4: to have their job easier. I mean they basically said that, like,
17:36
Speaker 4: if you make it mandatory, then they'll have to get
17:38
Speaker 4: it and I won't have to argue with.
17:39
Speaker 5: Them about it.
17:40
Speaker 4: But like schools and stuff like like daycares and camps,
17:45
Speaker 4: I think most of that is just the nurse is
17:48
Speaker 4: given some paperwork and it's just easier for her to
17:51
Speaker 4: tell you you need it, and then it's kind of like,
17:55
Speaker 4: you know, oh yeah, well maybe not. Now we have
17:58
Speaker 4: we have in Ohio one of thirteen states where you
18:01
Speaker 4: are allowed to go to school without vaccines completely a
18:04
Speaker 4: public school.
18:05
Speaker 5: And the way it's.
18:06
Speaker 4: Written is there is a mandate for vaccinations at school,
18:12
Speaker 4: but you can sign this waiver, which includes a philosophical exemption.
18:16
Speaker 4: Some states only have religious or medical. We have a
18:19
Speaker 4: philosophical exemption. But there are still nurses and I do
18:23
Speaker 4: think they're being deceptive on purpose to tell parents no,
18:25
Speaker 4: it's on the mandatory list, and the parent has to
18:28
Speaker 4: know that they're allowed to turn in a waiver. And
18:31
Speaker 4: I've had families that have come in really upset. A
18:35
Speaker 4: variety of reasons, and the nurse was giving them the
18:39
Speaker 4: impression that they were wrong about the law when they
18:42
Speaker 4: definitely were not wrong.
18:44
Speaker 2: And so what does that do to your vaccination rates
18:46
Speaker 2: in Ohio versus a state like New Jersey.
18:49
Speaker 4: I'm sure that they're slightly lower. I haven't looked at
18:52
Speaker 4: the numbers recently, especially since COVID it's going to be
18:55
Speaker 4: all messed up. But prior to I remember thinking, well, gosh,
19:00
Speaker 4: for all that work, ours aren't that much lower?
19:03
Speaker 5: You know it was.
19:04
Speaker 4: I don't think it's been dramatic in the school based
19:07
Speaker 4: population that has changed. I mean the number of non
19:10
Speaker 4: vaccinators has skyrocketed. And I always stay, yeah, public health
19:15
Speaker 4: is either trust or tyranny, and you can build takes
19:20
Speaker 4: many years to build trust in a very short time
19:22
Speaker 4: to destroy it, and we've seen that that's what happened.
19:25
Speaker 4: What was interesting about that was that when COVID vaccine
19:28
Speaker 4: came out and they approved it for use, and then
19:30
Speaker 4: they put it on the schedule, and then that made
19:33
Speaker 4: it become mandatory, the whole population was watching that process,
19:38
Speaker 4: and I had all these families coming in and saying, like, clearly,
19:40
Speaker 4: this is really political and COVID is just really like whatever.
19:44
Speaker 4: And then the pediatricians were like, I don't understand whatever
19:47
Speaker 4: is problem is.
19:47
Speaker 5: This is what we always do.
19:49
Speaker 4: And I was like, right, this is this is what
19:51
Speaker 4: we always do, which is as soon as the FDA
19:53
Speaker 4: approves a vaccine like rotavirus, it's then so the ACIP
20:01
Speaker 4: gets put on the list, goes on the CDC schedule.
20:04
Speaker 4: It's like a very seamless process, FDA ACIP, CDC done.
20:08
Speaker 2: So I watched all the hours of those of those
20:13
Speaker 2: conversations actually about the COVID shot for kids, and every
20:18
Speaker 2: single person said, I don't think almost any kid needs this,
20:25
Speaker 2: but we should make it available to people. But our
20:28
Speaker 2: concern with making it available is that it will become
20:31
Speaker 2: mandatory and it absolutely should not be. And then that
20:34
Speaker 2: is exactly what happened. And when I heard pediatricians say
20:39
Speaker 2: this is how every shot happened, I was like, I'm sorry,
20:41
Speaker 2: do I have to watch eight hours of the MMR hearings?
20:45
Speaker 2: That I mean was that was before YouTube when I
20:47
Speaker 2: could sit down and watch eight But I don't feel
20:49
Speaker 2: like I should have to do that. But then after
20:52
Speaker 2: I watched that whole progression because I wrote columns about it,
20:57
Speaker 2: I watched it twice. I don't want to watch that twice,
21:02
Speaker 2: and then I did, and watching what happened absolutely nuked
21:08
Speaker 2: my trust in public health.
21:11
Speaker 4: So there's a really important history point on this, because
21:14
Speaker 4: I started med school in ninety four, and there was
21:18
Speaker 4: a lot of rapid changes between that and about two
21:23
Speaker 4: thousand and eight around the Obama H one N one
21:26
Speaker 4: epidemic that we had. The schedule as just released was
21:32
Speaker 4: very similar when I started. In practice, what Kennedy just
21:37
Speaker 4: put out was very very similar to the way it started,
21:41
Speaker 4: and the ones that are still on the recommended list.
21:44
Speaker 5: Were there then.
21:46
Speaker 4: And then we had a bunch of vaccines that they
21:49
Speaker 4: didn't use the term shared decision making, which actually I
21:53
Speaker 4: really liked that word. They used the term high risk
21:56
Speaker 4: populations or optional. And the vaccines which included like flu
22:01
Speaker 4: and vericella and things like that. The problem was that
22:06
Speaker 4: insurance wouldn't pay for things that were on the not
22:09
Speaker 4: recommended list, right, And as we see with a lot
22:12
Speaker 4: of things with our legislature, they're sloppy and they're lazy,
22:17
Speaker 4: and so they defer to the executive branch. I was
22:19
Speaker 4: actually listening to a whole commentary about this recently. It's
22:21
Speaker 4: fascinating that we've degraded how much legislation can actually get done,
22:26
Speaker 4: and so the executive branch is doing more and more.
22:28
Speaker 4: And so instead of doing the right thing, which would
22:31
Speaker 4: be to pass a law that says insurance has to
22:33
Speaker 4: pay for vaccines, they just said, we'll make them all
22:37
Speaker 4: mandatory or recommend.
22:39
Speaker 2: I remember you saying this story our last time.
22:41
Speaker 6: That is scandalous.
22:42
Speaker 4: Yeah, and so you noticed in the release of case,
22:49
Speaker 4: you know, like we were making a provision that at
22:52
Speaker 4: least through twenty twenty six, they were all get paid for.
22:54
Speaker 5: And my entire staff were like, what about after twenty six,
23:00
Speaker 5: what's going to happen?
23:01
Speaker 2: I mean, I think what's going to happen is they
23:02
Speaker 2: don't anticipate these being there.
23:08
Speaker 4: Well, I mean, we've got probably three more years. I mean,
23:11
Speaker 4: do you really think.
23:14
Speaker 5: So anyway? I about that?
23:18
Speaker 6: Do you think it's going to be overturned?
23:21
Speaker 4: In if I turned will be just like if Trump
23:23
Speaker 4: goes out of office and RFK goes out of office, like
23:25
Speaker 4: then it'll just be someone else and then it's.
23:28
Speaker 6: That's not going to be before twenty twenty seven. Right.
23:31
Speaker 2: Oh, No, I thought I thought that the I thought
23:34
Speaker 2: that the CDC. The CDC fact sheet said hold on,
23:38
Speaker 2: I'm going to pull it up right now because I
23:40
Speaker 2: was just reading it. Actually, it says that ensures that
23:46
Speaker 2: all the diseases covered by the previous immunization schedule still
23:49
Speaker 2: be available to anyone who wants them through the Affordable
23:51
Speaker 2: Care Act insurance plans and federal insurance plans. Families will
23:55
Speaker 2: not have to purchase them out of pocket. So that's
24:00
Speaker 2: I didn't see like a time limit on when insurance
24:02
Speaker 2: has to cover. Oh wait, here we are. It looks
24:08
Speaker 2: like it's they're recommending that they're still being covered.
24:11
Speaker 4: Yes, yes, there was some phrase that said at least
24:13
Speaker 4: through twenty twenty six on one of the things that
24:15
Speaker 4: I saw, and I was like, okay, well the one thing.
24:17
Speaker 5: My staff got worried about it.
24:19
Speaker 4: Today we were discussing it, and I said, there's one
24:21
Speaker 4: thing I know for sure, and that is the vaccine
24:23
Speaker 4: lobbyist groups are pretty effective, and I'm sure stuck in
24:29
Speaker 4: some bill in the next year will be a phrase
24:32
Speaker 4: where they actually get something put in writing that it
24:36
Speaker 4: will apply to the other vaccines as well.
24:38
Speaker 2: Yeah, see a time limit written here on the fact
24:43
Speaker 2: sheet at least?
24:45
Speaker 6: Okay, so I have a question.
24:49
Speaker 1: Four moms who and parents who generally just kind of
24:54
Speaker 1: follow the rules and don't really know much care much.
25:00
Speaker 6: Now, just like they just do the thing.
25:02
Speaker 5: Well, you care, You just don't want to spend the
25:04
Speaker 5: time doing all your research.
25:05
Speaker 6: Yeah, yeah, you just you just do the thing that
25:08
Speaker 6: they tell you to do, you know.
25:10
Speaker 1: And basically I want to ask, is this decision, the
25:17
Speaker 1: kind of the updated vaccine schedule?
25:20
Speaker 6: Is it good? Is it bad? Should we be doing
25:23
Speaker 6: it anyway?
25:24
Speaker 2: Should just give us the cliff nuts?
25:26
Speaker 6: Yeah?
25:26
Speaker 5: Yeah, I know you're going to like this like good
25:30
Speaker 5: bad answer.
25:30
Speaker 4: But I think that the problem is is that when
25:32
Speaker 4: you make decisions for public health for an entire group
25:36
Speaker 4: of people, many times that decision is made for the
25:38
Speaker 4: lowest common denominator. Right, So, why do we give sex
25:42
Speaker 4: vaccines in one day? It's not because sex vaccines in
25:45
Speaker 4: one day is medically good, even though people tell me
25:47
Speaker 4: it is.
25:48
Speaker 5: I'm like, that doesn't make any sense.
25:49
Speaker 4: We do it because if you're driving a little vaccine
25:53
Speaker 4: van around Appalachia and you're stopping, you're going to give
25:56
Speaker 4: them everything you can while you're there. Yeah, and so
26:00
Speaker 4: so the problem we have is that we do this
26:01
Speaker 4: one size fits all policy that says there's an assumption
26:07
Speaker 4: that parents aren't very smart, there's an assumption they're not
26:09
Speaker 4: very compliant. There is assumption that if the kids cry
26:12
Speaker 4: too much, they won't want to do them. And so
26:16
Speaker 4: they tried to get.
26:16
Speaker 5: The trull in too, and like nope.
26:21
Speaker 4: So they tried to get as many as they can
26:23
Speaker 4: in under eighteen months, because then the kids start having
26:26
Speaker 4: more opinions and you know, protesting more, and so they're like,
26:29
Speaker 4: let's just get them all done.
26:31
Speaker 5: You know, it is a very efficient.
26:33
Speaker 4: Way to accomplish your goal if you want to get
26:36
Speaker 4: all those things in kids. We have an alternative schedule
26:38
Speaker 4: we've done for years, and I'll actually a lot of
26:40
Speaker 4: the things that are on that shared decision making are
26:42
Speaker 4: the same things that we were like, uh, you know.
26:44
Speaker 5: We can do hepby later, we can do heavy later.
26:47
Speaker 5: So we have moved for years.
26:49
Speaker 4: We have moved a lot of those things on the
26:50
Speaker 4: shared decision list out so that they could space out
26:54
Speaker 4: their vaccines more. And my families are really good about
26:58
Speaker 4: coming in and doing it. But I will tell you that, like,
27:01
Speaker 4: you know, you start doing vaccines at three and four
27:03
Speaker 4: and the kids are like, hold on, to.
27:04
Speaker 5: The door, and you know, it's a little bit more dramatic.
27:07
Speaker 2: It is.
27:08
Speaker 5: I kind of missed the days where like, you know,
27:10
Speaker 5: the kids had four to six visits and they were done,
27:14
Speaker 5: you know, and you just got them all out of
27:16
Speaker 5: the way. It was like practically a lot easier.
27:19
Speaker 2: I think that I think that one of the biggest
27:20
Speaker 2: problems when we talk about public health just in general,
27:24
Speaker 2: is that all of us are privileged. Everyone here came from,
27:30
Speaker 2: you know, a fairly good upbringing with loving parents, and
27:33
Speaker 2: that's why we're all sitting here as functional adults. But
27:39
Speaker 2: I think, and this was a real frustration of mine
27:41
Speaker 2: during COVID, people don't seem to understand just how bad
27:45
Speaker 2: a lot of parents are, and so a lot of
27:49
Speaker 2: these public health conversations are predicated on you know, bad
27:54
Speaker 2: parents one of my.
27:57
Speaker 5: Or maybe unresourced parents. Right, you're being generous.
28:02
Speaker 2: It's not hard. It's not like there's a free clinic
28:05
Speaker 2: like you're we're in America.
28:07
Speaker 5: I consider resources like IQ emotional stability.
28:11
Speaker 2: It's not a resource.
28:13
Speaker 4: Yeah, I mean, I think that people kind of come
28:16
Speaker 4: to the table with different abilities, and that's why money
28:20
Speaker 4: doesn't fix it, right, Like you can give them free
28:22
Speaker 4: medicaid and like the clue down the street.
28:25
Speaker 2: And yeah, but they're still a hot mess.
28:27
Speaker 5: They're still hot mess.
28:28
Speaker 1: Yeah.
28:28
Speaker 2: Yeah. Our daughter, our oldest daughter, actually had this like
28:32
Speaker 2: bizarre freak staff infection in her face years ago, and
28:37
Speaker 2: it was at the peak of when COVID and RSV.
28:42
Speaker 2: It was like, I think the winter of twenty twenty one,
28:44
Speaker 2: and all of the hospitals were absolutely filled to the gills.
28:48
Speaker 4: Yeah, it would be like twenty twenty two winter.
28:53
Speaker 2: It was. It was that winter of twenty twenty one.
28:55
Speaker 2: And I love my pediatrician deeply, We're besties. And he was,
29:01
Speaker 2: you know, keeping track of her and everything, and her
29:04
Speaker 2: fever wasn't going down. It was spreading across her face
29:06
Speaker 2: and like a staph infection in your face, I'm like
29:10
Speaker 2: not messing around with. And so Seth went with her
29:14
Speaker 2: to the emergency rum on a Friday night, which like
29:15
Speaker 2: he broke sh bot and brought her to the emergencyerum,
29:18
Speaker 2: and he overheard a conversation between our pediatrician and the
29:22
Speaker 2: emergency um pediatrician and the emergency pediatrician was like, under
29:27
Speaker 2: normal circumstances, I would admit this kid like I think
29:30
Speaker 2: she needs to be on an ivy for a week
29:33
Speaker 2: for antibiotics. If we send her home, we're gonna send
29:36
Speaker 2: her home with like a large shopping bag full of
29:40
Speaker 2: really just crazy antibiotics. But they have if we if
29:46
Speaker 2: I did that, they I have to know that they
29:48
Speaker 2: are not going to miss a Jose and they're not
29:50
Speaker 2: gonna I mean, like, it was so much antibiotics that
29:55
Speaker 2: we were giving her like a cup of grape juice
29:57
Speaker 2: because it tasted so bad. It was a crazy the
30:00
Speaker 2: amount of antibiotics. And he said, we can't discharge her
30:03
Speaker 2: unless you give me an assurance that they will be responsible.
30:07
Speaker 5: And that's the other thing.
30:08
Speaker 4: So like so say, say you get measles, right, And
30:13
Speaker 4: I actually have a bunch of people in this anti
30:16
Speaker 4: vaccine community who are like, I'd rather have measles in
30:18
Speaker 4: the vaccine.
30:19
Speaker 5: I'm like, ooh, no, measles is not good.
30:22
Speaker 4: You do not want to do that it is And
30:24
Speaker 4: they say, well, most of the kids don't die because
30:27
Speaker 4: we have better medical care.
30:29
Speaker 5: True, but they might spend a week in the ICU.
30:31
Speaker 5: Do what you're kid a week in the ICU.
30:34
Speaker 2: I was about to say. I was like, isn't it
30:35
Speaker 2: one in four hospitalizations.
30:37
Speaker 4: And it's a lot, and it like depletes your immune
30:41
Speaker 4: system and your red your bone marrow, and so you
30:44
Speaker 4: become almost kind of like you have leukemia for a while.
30:47
Speaker 6: Afterwards.
30:47
Speaker 4: It's a terrible disease, yeah, and you do die from it,
30:53
Speaker 4: mostly from lack of medical care. Like the parent doesn't
30:57
Speaker 4: recognize how sick they are until they're really really sick,
30:59
Speaker 4: and then they bring them in and then they can die.
31:03
Speaker 4: Sometimes that's neglect and sometimes that's just they don't understand
31:06
Speaker 4: what they're dealing with. And so a lot of pediatric
31:10
Speaker 4: illnesses that maybe could be treated and like probably costs
31:17
Speaker 4: a lot of money and effort to treat, like a
31:19
Speaker 4: kid with measles or something, and you might survive, it
31:21
Speaker 4: doesn't mean you want it.
31:23
Speaker 5: And then when you apply that to the entire population
31:26
Speaker 5: and you say.
31:29
Speaker 4: Will, like when they say children will die without these vaccines,
31:33
Speaker 4: and people are like, oh, hardly anybody dies of measles,
31:35
Speaker 4: And I'm like, well, like when you apply it to
31:37
Speaker 4: a whole population, and there are parents who will not
31:41
Speaker 4: understand when their kid needs to go to the hospital.
31:44
Speaker 2: But also if there's no hospital beds, like what happened
31:47
Speaker 2: to us, then my kid who has a freak staff infection.
31:52
Speaker 2: The emergency and pediatrician is like rolling the dice hoping
31:56
Speaker 2: that we're responsible enough and he doesn't have to admit
31:58
Speaker 2: her because he can't admit her because the whole hospitals
32:01
Speaker 2: filled to the gills with COVID and OURSV.
32:04
Speaker 4: I did part of my training right on the edge
32:07
Speaker 4: of Appalachia in southeast Ohio. When we were we would
32:10
Speaker 4: spend a month there as residents, and part of our
32:12
Speaker 4: job was that we had to actually drive into the
32:15
Speaker 4: er when we were on call if we were worried
32:18
Speaker 4: about a kid, because we weren't completely sure that the
32:21
Speaker 4: ear physicians really.
32:22
Speaker 5: Knew what to do with kids.
32:23
Speaker 4: And it was a really eye opening experience. I mean,
32:26
Speaker 4: first of all, they didn't If we didn't go in there,
32:30
Speaker 4: there was a good chance something was going to get
32:31
Speaker 4: mismanaged because kids are not little adults, we always say.
32:35
Speaker 4: And if I had to send them to the hospital,
32:37
Speaker 4: it was a really hard decision because it was two
32:40
Speaker 4: hours away, and if I life flighted the kid or
32:44
Speaker 4: send them by ambulance, did the parents go with the
32:47
Speaker 4: child and then end up over there and they had
32:49
Speaker 4: no car to get back. What if they had other children,
32:52
Speaker 4: and they were a single mom and one kid's getting
32:54
Speaker 4: life flighted two hours away, So there's obstacles. Also, like
32:58
Speaker 4: we think of our healthcare as like we're all living
33:01
Speaker 4: in big cities with these great hospitals right down the street,
33:03
Speaker 4: but that just isn't the case. And so yes, you can,
33:07
Speaker 4: you know, not get vaccinated for measles and you'll be
33:11
Speaker 4: good with good medical care, but like that's not where
33:14
Speaker 4: everybody lives, and that's not what everybody does.
33:18
Speaker 5: So I do.
33:19
Speaker 4: Think that the kind of slant towards this anti vaccine
33:24
Speaker 4: mentality has real implications to our population, and particularly around
33:30
Speaker 4: patients who don't have as many resources as I would
33:33
Speaker 4: call it.
33:34
Speaker 5: And that's not necessarily a money issue.
33:36
Speaker 4: It's a do they know when their kid is too sick?
33:41
Speaker 5: Did they notice?
33:43
Speaker 4: Maybe they're drunk, maybe they're high, maybe their IQ is low,
33:46
Speaker 4: maybe they have a bunch of kids, Maybe they are
33:50
Speaker 4: working and their kids are home alone.
33:52
Speaker 5: I mean, like there's just lots of reasons.
33:53
Speaker 2: I had a kid covered in hives last night and
33:56
Speaker 2: I only found out because another kid noticed it, and
34:00
Speaker 2: we were like, how long have you had this? Who
34:02
Speaker 2: can know? That? Was her answer? Who can know? You?
34:08
Speaker 2: Can know. Yeah, yeah, I would just tell us that
34:11
Speaker 2: you're covered in hives.
34:22
Speaker 7: Hello, I'm James Lanwix and I'm at the diner, you know,
34:26
Speaker 7: classic American diner chrome long boomerang pattern for my co
34:29
Speaker 7: accountter with little jukeboxes. We love these and you can
34:32
Speaker 7: join me here every Saturday, where we talk about whatever
34:35
Speaker 7: happens to spring into my mind at the moment. There's
34:37
Speaker 7: no predicting where it will go, except that it'll be
34:39
Speaker 7: done in about thirty minutes. Join me, won't you, every
34:42
Speaker 7: Saturday from the Ricochet Audio.
34:44
Speaker 5: Network Ricochet, Yeah, join the conversation.
34:57
Speaker 1: I want to play Devil's advocate a little bit because
35:00
Speaker 1: I think that there is some aspects of Maha that
35:05
Speaker 1: I really like and some aspects that I think is
35:07
Speaker 1: like incredibly dangerous and awful. But I do think that,
35:11
Speaker 1: like in the political sphere, there's kind of a group
35:16
Speaker 1: of people who will just automatically say, like, oh, anything
35:21
Speaker 1: Maha does is terrible and dangerous and awful and shouldn't
35:23
Speaker 1: be listened to. But I do think with like some
35:26
Speaker 1: of the vaccine stuff, some of it has been common
35:31
Speaker 1: sense for years and you just don't hear it from
35:36
Speaker 1: your pediatrician. If you don't have a good relationship with
35:38
Speaker 1: them or your obd yn or whatever, because like, particularly
35:41
Speaker 1: hep B I'm thinking of. I feel like Mayo wed
35:46
Speaker 1: Yn was like, oh yeah, don't get the newborn shot
35:50
Speaker 1: of hep B, and like everybody else kind of knows
35:53
Speaker 1: that if you if you've talked about it.
35:56
Speaker 6: You know it just don't make sense.
35:59
Speaker 4: So I mean, I feel like I'm some ancient person
36:02
Speaker 4: when I say I remember when they launched it and
36:05
Speaker 4: it came with debate. People were, you know, pedatricians actually
36:09
Speaker 4: open debated things more in the past. And one of
36:12
Speaker 4: the things that upset me about the hepatitis B announcement
36:15
Speaker 4: was they said, you know, you do a high risk population,
36:18
Speaker 4: and the moms who are positive or have be the
36:21
Speaker 4: babies would get a shot.
36:22
Speaker 5: That seems very logical.
36:24
Speaker 4: We tried it in the nineties and it doesn't work
36:28
Speaker 4: because the most infectious time for hepatitis B is when
36:32
Speaker 4: you have just caught it. So like, if you got
36:34
Speaker 4: hepatitis B in the last month before you deliver, you
36:37
Speaker 4: don't have tighters and positive stuff yet, so we can't
36:40
Speaker 4: test you and you're most contagious, and so you would
36:43
Speaker 4: have to have that conversation in the delivery room with
36:47
Speaker 4: a mom, have you done drugs?
36:49
Speaker 5: Have you had sex?
36:50
Speaker 4: Have you had sex with your husband who hasn't had
36:53
Speaker 4: an affair or done drugs? They're like the kind of
36:55
Speaker 4: questions people aren't going to be honest about. So everybody
36:58
Speaker 4: was like, we can't trust the answers here. Kids are
37:00
Speaker 4: still getting infected, and so they were like, that's it.
37:03
Speaker 4: Everybody gets one again, back to the like lowest common denominator.
37:06
Speaker 4: There really is people that aren't at risk. But then
37:09
Speaker 4: we come forward twenty some years and we have this
37:12
Speaker 4: whole population of mothers who are fully vaccinated for hep B,
37:16
Speaker 4: and so one of the things that upset me about
37:18
Speaker 4: their initial recommendations around het B was what they didn't
37:21
Speaker 4: need to go backwards to nineteen ninety five and do
37:24
Speaker 4: what we used to do because we already tried that
37:26
Speaker 4: and it didn't work. They needed to evolve and say
37:30
Speaker 4: something new, which makes me think he's got like what
37:32
Speaker 4: old doctors on this committee or something that they're like, well,
37:34
Speaker 4: just what the way we used to But we can
37:38
Speaker 4: test mothers to see if they're immune, and you get
37:40
Speaker 4: other things like rubella when you're pregnant, we can we
37:43
Speaker 4: can test to see if a mother's immune.
37:45
Speaker 5: The protocol should be if.
37:46
Speaker 4: Mom is showing immunity to hepatitis B, she doesn't need
37:49
Speaker 4: a hepatitis B shot and her baby.
37:52
Speaker 2: You know, also, like what if we just don't do
37:55
Speaker 2: it at birth? I mean, I guess if the mod.
37:58
Speaker 4: For the Yeah, it's the transmission from mom to baby
38:01
Speaker 4: that birth dose.
38:02
Speaker 2: Yeah.
38:02
Speaker 4: But the other thing about that was that when we
38:04
Speaker 4: gave the birth dose and then we gave another dose
38:06
Speaker 4: and another dose, the kids aren't converting as well. So
38:10
Speaker 4: we actually have a lower rate of teens and young
38:13
Speaker 4: adults now that have converted because it doesn't work as
38:17
Speaker 4: good under six months. Like all vaccines, you kind of
38:19
Speaker 4: need a booster after a year. So the decision to
38:22
Speaker 4: move all three doses under six months actually caused harm
38:26
Speaker 4: to the kids who didn't need the birth dose because
38:29
Speaker 4: they are percentage wise not converting as well. So there
38:33
Speaker 4: actually was a bad.
38:35
Speaker 5: Component to it.
38:36
Speaker 4: So I just feel like we need to have a
38:38
Speaker 4: more honest discussion and back to the communications problems of
38:42
Speaker 4: this AHHS department. That wasn't what he said, That's not
38:46
Speaker 4: what the AGHS said. They said at risk people who
38:49
Speaker 4: test positive reapetise B and you're like, there's so many
38:52
Speaker 4: other considerations here that could have been in this announcement
38:55
Speaker 4: when they made the heptiz be at birth dose optional,
38:59
Speaker 4: that they just left out of the entire conversation that
39:03
Speaker 4: needed to be had.
39:04
Speaker 2: So anyway, I wonder, how, like, so, what realistically is
39:09
Speaker 2: this announcement going to change for people in their actual lives, Like,
39:14
Speaker 2: the AAP is not going to change.
39:16
Speaker 5: No, the AP is not going to change.
39:18
Speaker 4: Pediatricians are not going to change their opinions about it.
39:21
Speaker 4: It's going to change the laws in the states for
39:23
Speaker 4: school attendance. Lot of the states that don't have philosophical that's
39:26
Speaker 4: the main meaningful thing in the short run that it's
39:29
Speaker 4: going to change.
39:29
Speaker 2: Let's take New Jersey for example. You said that at
39:32
Speaker 2: six months old you have to have a flu shot.
39:34
Speaker 2: Is that going to be no longer the case?
39:35
Speaker 4: I don't know exactly how their laws are written. Each
39:38
Speaker 4: state has different laws, of course, but a lot of
39:42
Speaker 4: them it's written as anything that's on the ACIP recommended schedule.
39:46
Speaker 4: Because it used to be they would pass a new
39:48
Speaker 4: law with each vaccine, and they the state legislators were
39:50
Speaker 4: getting kind of annoyed with that. So a lot of
39:52
Speaker 4: them went back and said, we'll just align our policy
39:55
Speaker 4: with the ACIP.
39:57
Speaker 2: I wonder if they're going to rewrite it and say
39:59
Speaker 2: aligned with the AA.
40:01
Speaker 5: Who knows. I mean, you know, it'll be really interesting.
40:04
Speaker 4: And Florida had one of the most oppressive vaccine laws
40:08
Speaker 4: until COVID, and so it was really interesting. And they
40:12
Speaker 4: said they're the only only state in the country to
40:15
Speaker 4: take away school mandates, which I thought was kind of
40:17
Speaker 4: an interesting phrase because it's worded in Ohio that we
40:22
Speaker 4: have a school mandate, but we can sign exemptions right right.
40:27
Speaker 4: Actually like it that way because parents can't just be
40:29
Speaker 4: lazy and have not taken your kid to the doctor.
40:32
Speaker 4: They have to like physically make a decision, you know,
40:34
Speaker 4: like I have to fill out this form and say
40:36
Speaker 4: I didn't give them these vaccines. You can't just not
40:39
Speaker 4: do it. So, I mean, it does provide a little
40:42
Speaker 4: bit of check and balance there.
40:44
Speaker 2: Interesting. So is this going to change anything that you're
40:48
Speaker 2: doing in your practice with your patients.
40:51
Speaker 4: It won't change the recommendations we have towards our patients.
40:54
Speaker 4: Our recommendations are still the same as they used to be.
40:57
Speaker 1: Anything is that anything you recommend that has been taken off.
41:05
Speaker 4: I think they weren't very clear about the RSB bay
41:08
Speaker 4: fortis that is actually new. The wording in the way
41:12
Speaker 4: that they put it into the announcement made it sound
41:15
Speaker 4: like it was just for quote high risk babies.
41:17
Speaker 5: All yeah, RSB.
41:20
Speaker 4: And then when you read in the fine print, my
41:22
Speaker 4: staff realized today they meant the high risk babies are
41:25
Speaker 4: the ones where the mom didn't get the vaccination in pregnancy,
41:29
Speaker 4: which is a lot of ever babies.
41:31
Speaker 5: Yeah, it's pretty much everywhere.
41:32
Speaker 6: Well, I'm now terrified of RSB. My one of my
41:35
Speaker 6: best friend's newborns ended up in ice you last week.
41:40
Speaker 5: Terrible. It's absolutely terrible, absolutely terrifying.
41:43
Speaker 4: I had to call the squad on my own baby. Wow,
41:46
Speaker 4: you guys like to tell stories, I'm going to tell
41:48
Speaker 4: you what story. So our hospital, because it runs out
41:51
Speaker 4: of beds, like you said, Bethany, like literally waits until
41:56
Speaker 4: the kids are like about to almost crump before they'll
42:00
Speaker 4: admit them. And I know that, so I could tell
42:03
Speaker 4: he was getting worse and worse and worse. He was
42:05
Speaker 4: having trouble nursing, he was breathing faster, and I actually
42:10
Speaker 4: called my friend in the er, and I was like,
42:12
Speaker 4: can I come over and give him some fluids because
42:14
Speaker 4: he's not nursing well enough. I know he's gonna crumple
42:17
Speaker 4: my friend in the ear. I said sure, but then
42:19
Speaker 4: they changed. By the time I actually got in a room,
42:21
Speaker 4: the ear attending had changed and the next one came
42:24
Speaker 4: in and said.
42:25
Speaker 5: Do you really think so, Ali? I mean, he looks okay.
42:27
Speaker 4: I'm like, literally, I'm the one nursing him, and I'm
42:29
Speaker 4: telling you he's having trouble nursing because he can't.
42:31
Speaker 5: Breathe please just give him some fluids. And I was right.
42:34
Speaker 4: The fluids bought him like twelve hours. The next morning,
42:37
Speaker 4: he was so hypoxic he was sitting on my lap going.
42:43
Speaker 5: And passing out.
42:45
Speaker 4: And I was so stubborn about not wanting to have
42:49
Speaker 4: to go to the hospital that I called my staff
42:52
Speaker 4: because all he needed was oxygen. I called my staff
42:54
Speaker 4: and I was like, can you bring the oxygen tank
42:56
Speaker 4: over to the office. And my partner at the time
42:59
Speaker 4: got on the phone.
43:00
Speaker 5: He was like, God, damn it, Ally call mine one
43:03
Speaker 5: one and take your good to the hospital.
43:04
Speaker 4: I'm like, fine, you know, so, so I called that
43:08
Speaker 4: I don't want to take them. But the important part
43:10
Speaker 4: of that story is RSV is so bad and there's
43:13
Speaker 4: literally nothing we can do until which time we give
43:16
Speaker 4: them oxygen. So you literally are watching your baby get worse,
43:22
Speaker 4: and the pediatrician the parents are.
43:23
Speaker 5: Calling us like, I'm worried, I'm worried.
43:24
Speaker 4: I'm like not bad enough yet, Like it's just an
43:26
Speaker 4: awful situation. And some of them never get bad enough
43:29
Speaker 4: to go to the hospital, and some of them do,
43:31
Speaker 4: and you don't know which ones it'll be.
43:32
Speaker 5: It's terrible.
43:33
Speaker 4: It also triggers a cascade of inflammatory systems changes that
43:38
Speaker 4: lead to asthma, So if you get a severe case
43:41
Speaker 4: of RSB, you are most likely an asthmatic afterwards, which
43:45
Speaker 4: is what happened with my son too. So I'm a
43:47
Speaker 4: big fan of baefor this and this season has been
43:50
Speaker 4: great because our patients, even the ones who don't get vaccinated,
43:53
Speaker 4: we've been explaining to them it's actually not a vaccine,
43:56
Speaker 4: and it isn't. It's a passive immunity. It's better tolerated,
43:59
Speaker 4: has very little side effects, So some of our non
44:01
Speaker 4: vaccinators are actually getting bay fortis And we've had hardly
44:05
Speaker 4: any knock on woods in our RSB season this year,
44:08
Speaker 4: so we're so excited.
44:09
Speaker 6: Great when does RSV season ends?
44:12
Speaker 4: Like blue season right, so you know, like fluid, I'll
44:16
Speaker 4: go in these waves. What we've noticed is this year's
44:19
Speaker 4: curve has been like kind of flattened the curve like
44:21
Speaker 4: they talked about, and the BAYFDAS has slowed it down.
44:25
Speaker 4: So we started getting like a hint of cases all
44:28
Speaker 4: the way back in November, which is sometimes when it starts,
44:32
Speaker 4: and usually it'll bell curve really fast and you know
44:34
Speaker 4: within eight weeks it's over. But we actually are getting
44:38
Speaker 4: the peak right now that we've we're having a lot
44:42
Speaker 4: more cases right now this week, and they started all
44:45
Speaker 4: the way back in November, so it's kind of been
44:46
Speaker 4: like slower and steadier this year. I think Bayfordas is
44:50
Speaker 4: having quite an impact. If you have a baby, please
44:54
Speaker 4: get them. They're RSV know Glabyn. I'm not a big
44:57
Speaker 4: fan of the mom vaccine, just with all of what
45:01
Speaker 4: I know about the immune system cascade in brain development
45:04
Speaker 4: and infancy, I just don't think we should ever be purposely.
45:08
Speaker 5: Stimulating a mom's immune system.
45:10
Speaker 4: I mean, obviously they can get sick and you know whatever,
45:12
Speaker 4: But the idea that I would vaccinate a mom against
45:16
Speaker 4: something to protect their baby.
45:17
Speaker 5: Later, I think I'd have to.
45:19
Speaker 4: Have a lot more data of like what that looks
45:22
Speaker 4: like neurodevelopmentally at age five, which nobody's done. So I'm
45:28
Speaker 4: uncomfortable with maternal vaccines. So but the bayfort is is amazing.
45:33
Speaker 2: That's amazing. The other thing that I found that they
45:36
Speaker 2: did not adequately message was the changes to HPV.
45:41
Speaker 6: Yeah.
45:42
Speaker 2: I had to really really go digging to find what
45:45
Speaker 2: their recommendations were with HPV.
45:47
Speaker 6: What has changed?
45:49
Speaker 2: They changed it from tudosis to one Okay, I thought
45:52
Speaker 2: was very interesting.
45:54
Speaker 4: Most vaccines don't work well with windows, so I don't
45:57
Speaker 4: understand what they're basing that on.
45:59
Speaker 2: I didn't find it. The only thing that I found
46:02
Speaker 2: that had HPV on it was they had a graph
46:05
Speaker 2: of every other country. We'll take the human paplova virus.
46:09
Speaker 5: It's like typical cancer genital words.
46:13
Speaker 6: Is that why you have like a papsmith for ye?
46:15
Speaker 5: I see? And interestingly also had and net cancers in
46:19
Speaker 5: men from oral sets.
46:21
Speaker 2: Yeah, and so you get it in your early preteen
46:24
Speaker 2: and you're not early there's no such thing in preteen
46:27
Speaker 2: like eleven twelve, and I'm at you know, we have
46:31
Speaker 2: kids that are of that age, so it's top of
46:34
Speaker 2: mind for me right now because I've already made every
46:35
Speaker 2: other decision. And so they only the only place that
46:39
Speaker 2: I saw it was on a graph of every other
46:42
Speaker 2: country's dosage schedule, and and they changed the American dosage
46:48
Speaker 2: schedule from two to one, and there was no explanation.
46:51
Speaker 2: I looked, I just.
46:54
Speaker 5: Know the way. So this is a complicated thing.
46:57
Speaker 4: But you saw it, and COVID at first they thought
46:59
Speaker 4: maybe they could just give you two doses, like two
47:01
Speaker 4: weeks apart. But it was a complicated immunological discussion about
47:05
Speaker 4: it at the time, and they were saying that, you know,
47:08
Speaker 4: you have to process the antigen through your macrifages. Then
47:11
Speaker 4: you have to do it and you have to present
47:12
Speaker 4: it to the B sales and the B cells. Anyway,
47:14
Speaker 4: it really takes a second exposure to solidify long term immunity.
47:21
Speaker 4: So that's why almost everything we give takes at least
47:25
Speaker 4: two doses, usually six months apart, sometimes three, but you
47:29
Speaker 4: have to have some spacing and the body has to
47:33
Speaker 4: be exposed to it twice to really get great immunity.
47:36
Speaker 5: So I haven't talked to a amnologist about it. I'm
47:39
Speaker 5: just very suspect of a one dose anything.
47:43
Speaker 2: Yeah, there was an interesting conversation that Megan Kelly had
47:48
Speaker 2: when I back when I listened to Megan Kelly, which
47:51
Speaker 2: is no longer, but she had a pediatrician on and
47:56
Speaker 2: then kind of a skeptic. A pediatrician and a skeptic,
48:00
Speaker 2: and it was a very interesting conversation and I was
48:03
Speaker 2: glad to listen to it. And I still haven't decided
48:05
Speaker 2: what I'm going to do.
48:06
Speaker 5: It's a it's tricky.
48:09
Speaker 4: So even someone who worked on the development of the
48:11
Speaker 4: vaccine was pretty vocal at saying I didn't picture this
48:15
Speaker 4: for American children really, Yeah, and shet HPV and so
48:23
Speaker 4: she made a lot of news in the anti vax circles.
48:26
Speaker 4: I saw her interviewed several times, like she wasn't quiet
48:29
Speaker 4: about it.
48:29
Speaker 5: She kind of got repeated. I don't remember her name.
48:34
Speaker 4: And her argument was that when she developed it, she
48:37
Speaker 4: felt like this was for third world countries, for women
48:39
Speaker 4: who didn't have access to good medical care, but that
48:43
Speaker 4: women in America don't die of cervical cancer because they
48:46
Speaker 4: get pap smears, and that you're inducing risk of a
48:50
Speaker 4: vaccine to a population who has zero risk of dying
48:55
Speaker 4: or having bad outcomes at age twelve for something that
48:59
Speaker 4: they might developed by the time they're thirty or forty,
49:01
Speaker 4: and that is totally treatable. That was a very interesting argument.
49:06
Speaker 4: The thing that I wouldn't agree with her about is
49:08
Speaker 4: general words are not to be you know, simplified. I mean,
49:13
Speaker 4: they're awful. And yes, you can treat it and get
49:19
Speaker 4: you know, cryotherapy to your cervix. That's if you keep
49:22
Speaker 4: your pap smears again, will your daughter be compliant? You know,
49:27
Speaker 4: when you are making a decision for your daughter. Everyone
49:29
Speaker 4: thinks their kid's going to be a virgin forever and
49:31
Speaker 4: always be great with their medical care. But let's just
49:34
Speaker 4: be honest, neither of those things are true most of
49:36
Speaker 4: the time. And even if your daughter's amazing, and even
49:39
Speaker 4: if I have a good friend who are in ministry,
49:43
Speaker 4: like super amazing people, but he talks about how like
49:48
Speaker 4: before he became a Christian, he you know, was a
49:52
Speaker 4: sailor with all the things that came with it, you know,
49:54
Speaker 4: and so like, you know, you could be marrying an
49:57
Speaker 4: amazing person who has a storied background, so yeah, or
50:01
Speaker 4: you just get raped or you get raped, yes, But
50:04
Speaker 4: I mean, like even under the most ideal situations, it
50:07
Speaker 4: may not go like you think it's going to. So
50:09
Speaker 4: you're making a decision that relies on a lot of ifs.
50:13
Speaker 4: If you don't get one, and even if you do
50:15
Speaker 4: get treated with cryotherapy for HPV, it can weaken your
50:19
Speaker 4: cervix and put you at risk for preterm labor and
50:21
Speaker 4: incompetent cervix. So, you know, it's a hard one in
50:26
Speaker 4: that if you assume vaccines have zero risk all the time,
50:30
Speaker 4: then of course you would get it. But there have
50:33
Speaker 4: been some vaccine injuries from HPV, and you know that's
50:36
Speaker 4: pretty tragic. And so the woman who you know had
50:39
Speaker 4: been vocal about it, was like, why would I do that?
50:42
Speaker 4: Why would I put risk into a twelve year old
50:44
Speaker 4: girl that doesn't have any risk?
50:46
Speaker 2: Yeah? Yeah, and that's where I am right now.
50:48
Speaker 5: Yeah, it's tricky, It's really tricky. I don't know. I
50:51
Speaker 5: struggle with it myself. I've got two daughters. The boys
50:54
Speaker 5: are even more hard for me.
50:56
Speaker 2: Yeah, that's a hard note for me.
50:58
Speaker 5: Yeah.
50:58
Speaker 4: The E and T doctors are like, yeah, but I
51:00
Speaker 4: have to do these headed neck surgeries on people who
51:03
Speaker 4: have you know, cancer and their head neck and their
51:05
Speaker 4: men and and I'm like, okay, but I mean how
51:08
Speaker 4: many of those I don't know.
51:09
Speaker 5: But it's actually interesting.
51:10
Speaker 4: I have some anti vaccine and tees I know, and
51:12
Speaker 4: they're like, yeah, but my kids getting HBV And I'm like, oh, interesting.
51:15
Speaker 2: Yeah, that is weird. I mean with boys, the risk
51:18
Speaker 2: is just so low because you have to get general
51:22
Speaker 2: wartz from giving oral sex, and then it has to
51:25
Speaker 2: go down and then it has to become cancerous, like
51:28
Speaker 2: the steps. There's a lot more risk for a girl
51:31
Speaker 2: than there is for a boy.
51:33
Speaker 6: I get that if there's if there's any.
51:36
Speaker 2: Risk, whad wouldn't you just because there's risk to the shot, right,
51:42
Speaker 2: A very small amount of risk to the shots.
51:44
Speaker 4: But yeah, but and and circumcision makes a big difference too.
51:47
Speaker 4: So circumcised boys have very very low risk, but circum
51:51
Speaker 4: uncircumcised boys still carry risk of penal cancer.
51:54
Speaker 2: Yeah, and I can I think I can share that
51:58
Speaker 2: my Jewish sons are at low or risk. I don't
52:02
Speaker 2: think they would mind me sharing that. But yeah, no,
52:05
Speaker 2: I mean my boys, it's up. It's like a very
52:08
Speaker 2: easy No. My oldest daughter, she's twelve. I haven't done it,
52:13
Speaker 2: and that I don't know. I mean, we had we
52:17
Speaker 2: had her eleven year old appointment and I got really
52:20
Speaker 2: pressured to do it, and I was like, no, not
52:22
Speaker 2: this year and twelve year old appointment. I did not
52:25
Speaker 2: get pressured at all. And let me tell you, I'm
52:27
Speaker 2: going back to that doctor now because I want a
52:31
Speaker 2: collaborative relationship. I don't want to I don't want a
52:33
Speaker 2: hostile relationship, right, And I did not think that she
52:37
Speaker 2: needed to put the screws in at eleven years old
52:39
Speaker 2: about the HPV shot, and it made it for a
52:42
Speaker 2: very contentious visit. It was unnecessary. And so now the
52:47
Speaker 2: one who did not put the screws into me has
52:49
Speaker 2: more of my trust, and I.
52:51
Speaker 5: Will go to our trust Tyranny, and I will go.
52:53
Speaker 2: Back to her for her thirteen year appointment. But it's
52:58
Speaker 2: just like every like these lots years, I've just kind
53:00
Speaker 2: of been like, well, I don't need to make a
53:02
Speaker 2: decision this year, so I'm not going to.
53:05
Speaker 5: I think it creeps up on you. My kid is
53:07
Speaker 5: so far from having sex at eleven, you know, and
53:10
Speaker 5: you're like, I got.
53:11
Speaker 4: Time to think about it, And the next thing you know,
53:13
Speaker 4: you're like, wait a second, they're sixteen, you know.
53:18
Speaker 2: Anyway, you start to like, you know, I think my
53:21
Speaker 2: daughter it's going to be the first Jewish nun. Actually,
53:25
Speaker 2: she's going to start an order of the Jewish Nuns.
53:28
Speaker 5: There you go, that might happen.
53:29
Speaker 4: Yeah, yeah, but you know, I do think that it's tricky.
53:34
Speaker 4: But this also goes back to like there's like, I
53:37
Speaker 4: don't you guys don't remember this. I'm sure, but Texas
53:41
Speaker 4: at the time was the first state to require HPV.
53:45
Speaker 5: For school admission. I do remember that, yes, And it
53:48
Speaker 5: was quite a.
53:48
Speaker 4: To do because they said it was you know, connections
53:51
Speaker 4: with Bush and everything in the vaccine and whatever.
53:54
Speaker 5: I don't really know.
53:55
Speaker 4: It was a whole political scandal about like who had
53:57
Speaker 4: paid off the Texas people to do this. And it
54:02
Speaker 4: was kind of a hard argument for me in that
54:07
Speaker 4: the argument that you have to be vaccinated to go
54:09
Speaker 4: to school because you might spread it to someone else,
54:12
Speaker 4: you know, having sexist school, and then the patricians would
54:15
Speaker 4: get but you meet your boyfriend at school.
54:17
Speaker 5: I'm like, that's a really hard argument.
54:19
Speaker 4: To me.
54:20
Speaker 5: It's a really hard one.
54:22
Speaker 4: And so that was the beginning of the arguments about
54:25
Speaker 4: school mandates, and then they kind of went away for
54:28
Speaker 4: a while, and like quietly got pasted in all these states.
54:31
Speaker 4: There was really uptick after that with them aligning the
54:34
Speaker 4: states with the ACIP. So if HPV was on ACIP,
54:38
Speaker 4: then it was on the state.
54:39
Speaker 5: See.
54:39
Speaker 1: So let's finish because we're all exhausted. But I just
54:44
Speaker 1: want to end on one thing, which is kids are
54:47
Speaker 1: having sax in school. Kids are having sacs in my school.
54:52
Speaker 1: Kids are having tacts in my school with teachers.
54:55
Speaker 2: Oh not in the word I'm homeschooling forever.
54:58
Speaker 4: I think there's probably some truth to that, Kara, but
55:03
Speaker 4: I still have a hard time with the idea that
55:04
Speaker 4: you're just sitting in class and spreading it to everybody.
55:07
Speaker 6: But it is.
55:10
Speaker 2: And on that note, thank you so much for joining us.
55:15
Speaker 2: This was a delightful conversation. And where can people find you?
55:22
Speaker 4: Our office website is www dot doctor Karean dot com,
55:27
Speaker 4: d R C A R I n E dot com.
55:29
Speaker 4: And I do keep a Twitter or x account, although
55:33
Speaker 4: I don't talk about it that much, and also on
55:37
Speaker 4: Facebook of course, and YouTube. I do a lot of
55:40
Speaker 4: videos on YouTube, so I'm trying to keep people updated
55:43
Speaker 4: on things I might do some more here. Now that
55:46
Speaker 4: the dust has settled, we are doing lots of things here.
55:49
Speaker 4: I have hired some more nps and I'm going to
55:51
Speaker 4: be moving my office and we joined a larger group
55:56
Speaker 4: that helps us with our payment, which is a whole
55:58
Speaker 4: nother discussion about the mess that is American healthcare.
56:01
Speaker 2: So where can people find you? Not on your website
56:04
Speaker 2: because this is twenty twenty six.
56:06
Speaker 5: What do you mean?
56:07
Speaker 2: So what is what is your Twitter? Come on?
56:10
Speaker 5: Yes?
56:10
Speaker 4: Yes, oh my name Ali Kreen Dio. Okay, I just
56:13
Speaker 4: keep it is my name Ali Korean Dio. So so yeah,
56:17
Speaker 4: I'm there and probably the most contents on YouTube.
56:20
Speaker 2: Amazing. Yeah, thank you so much for joining us. You
56:24
Speaker 2: know who knows what Secretarity Kennedy is going to do
56:26
Speaker 2: next that we're going to have to have you come
56:27
Speaker 2: back on?
56:28
Speaker 4: If I told everyone this week, I feel like I'm
56:31
Speaker 4: in the Hunger Games and the game master just keeps changing.
56:34
Speaker 5: The rules, and they say.
56:36
Speaker 4: Today the rule is going to be this, But you
56:41
Speaker 4: just have to like scramble around and figure out what
56:44
Speaker 4: to do and what that means. We have all this
56:46
Speaker 4: paperwork around our vaccine policy and I have to change
56:48
Speaker 4: it all.
56:50
Speaker 2: Well, it's rfk's world and we're all just living.
56:52
Speaker 5: It, just like you know, responding to the chaos every day.
56:57
Speaker 2: So anyway, well until next week everyone, don't forget to
57:01
Speaker 2: subscribe and leave your reviews and we will. We'll chat
57:05
Speaker 2: with you soon. Thanks for coming on, Hi, everybody
57:16
Speaker 5: Ricochet Join the conversation.