Air Date: 9-2-2026

Today we look at how public health is being gutted by a system that took ordinary parental worry and organized, radicalized and monetized it into an anti-science "wellness" movement large enough to seize real political power.

Full Show Notes

Welcome to this episode of the award-winning Best of the Left podcast.

Today we look at how public health is being gutted by a system that took ordinary parental worry and organized, radicalized and monetized it into an anti-science "wellness" movement large enough to seize real political power.

For those looking for a quick overview, the sources providing our Top Takes in about 55 minutes today include

Takesâ„¢ by Jamelle Bouie

Zeteo

Radio Atlantic

The Daily Show

TED Talks Daily

Throughline

and Fondation Brocher

Then, in the additional, Deeper Dives half of the show, there'll be more in 4 sections;

Section A, THE CURRENT DAMAGE

Section B, HOW WE GOT HERE

Section C, WHY IT WORKS

And Section D, RESPONDING TO THE MOMENT

And now, on to the show.

This week, Donald Trump signed an executive order purporting to change the childhood vaccination schedule, a big sop to RFK Jr., notorious anti-vaxxer who sincerely believes that we'd be better off if disease just ripped through the human population, killing those who could not survive and leaving the healthy to be stronger and fitter.

If that sounds like eugenics, that's because it is. That's what MAHA is, a eugenics program The idea is that vaccines and public health and medical interventions prevent us from experiencing disease and thus getting stronger. And if you happen to be killed by the disease, in RFK's view, you just weren't gonna live anyway.

You were sick and destined to die. 

The average American who died from COVID had 3.8 chronic diseases. So what was really killing them? It was almost impossible for COVID to kill a healthy person. It was killing people who were already sick. there's, there's only three deaths from measles in 20 years, and they're all people with, with extreme complications.

And in fact- That's how you die from measles, because of the complications of it. 

Yeah. It, yeah, it's people who are already sick. 

But this isn't a video about RFK Jr.'s medical views or the way that Trump himself has indulged this kind of thinking his entire life with his obsession with genes and good breeding.

Don. He's a great guy, and his fiancee, Betina. Good, Betina, good. No, my son's got the greatest genes in history. I'm a big believer in genes, by the way, I will tell you. 

No, this video is about the fact that Trump was basically completely incoherent during this entire event. y- check it out for yourself.

I've seen proof of it, where they have a vaccination that looks like the size of a, a bottle of soda poured into a little child's, body, and bad things happen in many ca- in too many cases 'cause, this is an explosion. This is an epidemic. 

If he wasn't incoherent and babbling absolute nonsense, he was sleeping.

There's an interesting dichotomy in coverage of the Trump White House. On the one hand, if you read insider takes on the administration, deep reporting of the going-ons in the White House, you get the impression that Trump is some kind of savvy operator. He's constantly playing people against each other, who has plots among plots, who is clearly looking far ahead of everyone around him.

But then you just observe Trump in real life. You observe Trump in the White House. You observe Trump at events. You watch him stumble and fumble and slur. You watch him talk nonsense, barely able to communicate. You watch his inability to articulate really anything intelligent or even really describe what's happening in his own government.

You watch him blunder into disastrous wars and struggle to remove himself from them. You watch him make obvious mistakes, disastrous mistakes that threaten to undermine both the nation's interests and the wellbeing of ordinary people. I think the conventions of political journalism demand that the President of the United States, the person who holds the highest office in the land, it demands that person is savvy in some sense, is intelligent in some sense, does have some command of the world around him I think the conventions of political journalism make it difficult to see the truth of Donald Trump, which is that we elected an insane person to be president.

We elected someone who is barely capable of complex thought as we understand it. We elected someone who has no business running a lemonade stand, much less a large, complex bureaucracy on top of a powerful federal government. We elected someone who I wouldn't trust to check my mail, much less have his finger on the button that could destroy the world.

To think that the American people did that, to think that is the reality of the situation, raises difficult questions about the country, difficult questions about our capacity for self-government, difficult questions about the people who surround this guy, who feed his desires, who cater to his whims, who use his power for their own ends.

Better to not deal with any of that and just pretend that he is in some sort... Better to just not deal with any of that and pretend instead that he is in some sense a normal president. But he isn't, and we can all see it. I don't deny that Trump has some kind of animal instinct for people's weaknesses. I don't deny that he's in some sense a gifted politician.

He was able to leverage his celebrity to become President of the United States. But it's important not to read too much into the guy. He is the ultimate narcissist, a man of bottomless ego who only cares about receiving as much praise as possible and lining his pockets with as much money as he can steal from others.

There's no grand plan here or ideological vision. He has an insatiable will to power which drives his authoritarian impulses, but that's all about, again, his desire to satisfy his most base impulses. And there are surely ideologues around him who turn his resentments and bigotries into policies to harm people.

But as for the guy himself, he's not a savvy operator. He's not a political savant. He's an old man in decline, a mad king who might honestly take the rest of us with him. And while there are straightforward reasons to explain how and why he won, it is a stain on this country that he is where he is.

Mehdi, we wrote a lot of the book before- ... 2025, and we knew we were gonna be in for a rollercoaster ride. uh, I think Michael and I have been talking. I think in some aspects it's even, worse than they imagined in terms of the dismantling of our pandemic preparedness and vaccine eco-struc...

e- infrastructure. And of course, Michael can talk about, what's happening on the climate change front. 

Just generally, Mi- Mike, how long, how bad has it been? 

Yeah, thanks, Mehdi, it's good to be with you. And just to carry Peter's analogy forward, it's like the, the car at the end of the rollercoaster has broken free from the rest of the rollercoaster, and it's gone down a cliff.

That's how it feels right now. we had no idea that things could get as bad as quickly as they have gotten, whether it is the anti-science policies on COVID-19, on vaccination, which Peter can speak to, with RFK Jr. now the head of- Yeah ... the, Secretary of Health and Human Services, or the deconstruction essentially of all of the environmental progress, including climate progress, of the past several decades over the course of just a few months.

We are seeing the disintegration of all of the environmental progress that has been made through Republican and Democratic administrations in the past. W- 

why did you choose, Peter, to write this book now? you said you wrote it before 2025, before Donald Trump is in office. Even before he comes to office, you both clearly wanted to sound the alarm on the dangers of anti-science.

what made you wanna do that? 

we realized, that this was truly an existential threat. when Michael and I were comparing notes and it's pretty clear that the two major, threats to humanity right now are pandemic threats and climate change, and actually the two are related.

One of the reasons we're seeing the rise in, viruses transmitted from bats, like Ebola and coronavirus, is because of, shifting bat patterns and climate change, one of the reasons- 

Yeah ... 

we're seeing the rise in mosquito-borne illnesses, especially in Southern Europe, and Texas and the Gulf Coast, like dengue and others.

But it's clear now that there's a third leg to that tripod, and that third leg is, this whole anti-science disinformation ecosystem that's now blocking our ability to respond to it, and that becomes every bit as important as the two other ones. 

And Mike, in the book, you break down the five principle forces of anti-science.

You refer to them as the five, Ps, the plutocrats, the petrostates, the professionals, the propagandists, and the press. just briefly explain for those who haven't yet read the book what role those Ps play in promoting anti-science. 

Yeah, thanks. I'm on a, a sucker for alliteration. and, that's what we try to do here.

In enumerating, what we do see is the five, great threats, to, a sustainable existence on this planet. the plutocrats, of course, who are funding a lot of the disinformation infrastructure, right-wing, front groups, organizations that attack science, attack scientists. the petrostates, bad state actors like Russia and Saudi Arabia, we would've said in the past, that, have funded sort of climate change denialism.

But now, we have to include the United States as a petrostate because its policies are currently dictated by the fossil fuel industry, for whom Donald Trump and congressional Republicans are essentially now a rubber stamp. And then there are the propagandists and the pros. those are the folks out there who are spreading the misinformation, the disinformation, often on social media that has been weaponized by plutocrats like Elon Musk to promote that misinformation and disinformation.

And then the press, and of course we're talking about the right-wing press, the conservative press, Fox News, the Wall Street Journal editorial page, the sort of Murdoch media empire and other conservative media outlets. But- These days, every bit as problematic are many of the legacy media outlets- Yep

which we take to task, like the Washington Post and The New York Times, for what we call performative neutrality. This idea- Yes ... that the position- anti-science should be on the same footing as science as it's presented to the public. 

No, said. performative neutrality is a good phrase. Very accurate, sadly.

Peter, we've got to talk about the anti-vax elephant in the room.

RFK Jr. is the Health and Human Services Secretary of the United States government. Did you ever imagine that someone would say that statement out loud to you? 

not only, that he became Health and Human Services Secretary, which is an absolute tragedy for the country, but the fact that there's been none of the usual checks and balances- Yeah

to rein him in, either coming from the White House or from the Republican senators and House members. They, 

they voted to confirm him ... 

even after- Bill 

Cassidy ... 

but even after- Medical doctor ... but even after confirming him, there should be some- Yes ... reins put on him. look what he's done.

he's reopened this phony baloney vaccine and autism agenda, which is how I got involved in it, because I'd spoken to RFK Jr. for a full year, many years ago. Asked by the NIH, 'cause I have a, not only a vaccine scientist, but I have a daughter with autism and intellectual disabilities, and I actually wound up writing a book on that year of discussions- what we call Vaccines Did Not Cause Rachel's Autism. So he's reopened that. He's talked about creating autism registries, which have this very dark- 

you said you spoke to him for a year on and off. 

What's driving him? He, he, you could look at someone like Donald Trump and say, "Ignoramus," "Not the smart- not the sharpest tool in the box."

RFK Jr. is a smart man w- who had a good education, did some good things at one point in his career in different fields. What is driving him on this front to behave in this way? 

I can give you a, a sort of an, an example in my discussions with him. I went through all the genetics of autism and that accounts for most of, the, what, what causes autism.

These are genes operating in early fetal brain development. But I actually pointed out, I'd say, "Bobby, there are actually environmental exposures that interact with autism genes that we know about." an example is Depakote or valproic acid. So if you're pregnant and not aware of it, and on, on Depakote, that interacts with autism genes and increases the likelihood of your child to be born with an autism phenotype.

And I named four or five other ones just like that. Yeah. And he had no interest. Zero interest. and I was shocked. and I would say, "Bobby, you're an environmental attorney. This is your- Yeah ... this is your moment. This- 

So then what is driving him? You should be on- It's just being a conspiracy theorist

so, or suing vaccine companies. He seems very focused on, what he can win in terms of, legal cases. He, very prone to conspiracy- Yes ... thinking, and- Fair play ... and quickly goes down- Yeah ... that rabbit hole. So it was a, it was an exercise in frustration, probably for both of us. 

We actually have seen a measles outbreak, and there was interesting reporting in KFF Health News that showed confusion at the CDC did actually prevent the agency from correctly responding in Texas. What did you see playing out in the measles outbreak that already happened?

and I think this is a really good example to look at because those children were already unvaccinated before RFK took over. But I think what’s key to focus on is the response, or lack thereof, from HHS. I think under a different administration—and we have had other measles outbreaks in recent decades under different administrations. There should have been a really strong, concerted response led by CDC, led by the secretary of HHS, championing vaccination, sending resources, ensuring that people were well informed about what causes these sorts of outbreaks—again, lower vaccination rates—and having clear corrective action.

The response this time around was muted. It was not terribly focused on vaccines. It pushed unproven treatments that may have endangered some people’s lives. And in Kennedy’s recent op-ed that we were talking about, he honestly had the most bizarre description of the response to this outbreak. He praised it and said things that I fundamentally disagree with, like the outbreak âminated in this country about 25 years ago, and suddenly, we have this massive outbreak in which multiple people have died, and ne.

I have to say, I was surprised by how that played out, because I think, when he first took office, I had in my head, Okay, one child will die, or two children will die, and then it will end all this anti-vaccine sentiment. people will just wake up from this and realize, Oh no, vaccines keep children from dying, and that is not what happened.

I think, immediately, when you saw those children die, you saw people pointing to, Oh, they must have had underlying conditions. They must have been malnourished. Look, that’s support for this broader narrative about chronic diseases being the primary issue, nutrition being the primary issue. People see what they want to see, and I think that is a really powerful way for politicians to push their particular narrative.

I do think it was encouraging that a lot of people’s response to this outbreak was to ensure that their kids were vaccinated or even get their kids early vaccines if they were close to the outbreak region. That was a very smart move if that’s what they did. But that definitely was not universal, and measles outbreaks are a kind of a canary in the coal mine. We start here, but it is just a prelude for many more similar outbreaks to come.

Okay, so we’ve described a situation where the infrastructure is falling apart. It’s a little bit of a free fall. There are not people at the CDC who can stop it. In other actions that Trump and his administration have taken, we generally have relied on the courts, say, as a backstop against some of the more extreme policies. Is there a backstop when it comes to public health? Is there someone who can say no to the secretary of HHS or the CDC?

So there certainly have been legal challenges to some of what Kennedy has done at HHS. For example, the American Academy of Pediatrics and some other professional societies sued HHS. Individual researchers have sued HHS and Kennedy. It definitely has happened. But for the most part, I have actually not really seen as many successful legal challenges as I might have hoped to see, which, to me, tells me that the system of checks and balances is not really holding Kennedy to account.

And in particular, in the realm of public health, the secretary is extremely powerful. We have seen some moves at HHS overridden by the White House but not very many. It seems, for the most part, Trump has been pretty happy to let Kennedy do what he wants. He does not seem to be standing in the way of his anti-vaccine moves—including moves that have fundamentally undermined Operation Warp Speed, which was, if you remember, the Trump initiative in 2020 that got us COVID vaccines so quickly.

Okay, [Laughs.] that’s a no for the short term. Maybe my last question, then, is about the long term: Can you build back up a vaccine infrastructure? What does that take? And then the more difficult question: Can you build back up trust? a place where public health is actually meaningful, people trust that the government is looking out for the public health, and it’s not state by state, parent by parent.

Yes, but it will take a very, very long time, possibly longer than it took to build these systems up in the first place. I think in most cases, it’s fundamentally more difficult to rebuild something that has been destroyed than it is to build something from the ground up, because when you’re building something from the ground up, there isn’t necessarily as much resistance and broken trust to contend with. To build things back up, we will have to tell people to trust in entities that they have learned to distrust. We will have to tell experts to come back together. We basically have to ask people to get along in the wake of war, and I don’t see an easy path forward in that.

Wow, okay, so what do you do? Honestly, do you just do your own research and find a doctor you trust? How does an average person navigate in a place where the easily trusted institution—the vaccine list, the CDC—is no longer trustworthy? Is it just Live in a state that has good health policies [Laughs.] and find yourself a good doctor?

Yeah, I think, for the most part, doctors across the country are still pretty unified in following the evidence, following the recommendations of their professional society—which, as far as I can tell, are still [Laughs.] hewing very closely to the evidence and trying to step in where the CDC has not been able to. And so people should feel comfortable in trusting their doctors, for the most part. That is not something that I feel have any qualms about. I think the trick with that is not everyone has access to a doctor. Not everyone is going to be able to get those vaccines covered.

And I think now doctors and patients are being put in a bind where their government is telling them to do one thing and the science is telling them to do another. And when you factor in money and logistics and just all the challenges to getting adequate health care in this country, I think it’s going to get messy very quickly. I don’t know that advice will be the problem; it may truly be access and equity.

these diary entries didn't reveal any shocking revelations about Fauci's criminal negligence or intent. But that didn't stop Republicans from dragging Fauci into Congress yesterday and grandstanding on it. 

Somewhere along the line, it became all about you. You became a narcissist and a megalomaniac and a liar, and you've lied to the American people, and you've lied to this body.

Wow. Strong start, Senator Josh Hawley, and by the way, I love the hair.

Something about that hair, it just makes you look super cool, man. And smart. No notes. All you need to do now is bring it home. hit him with a, a closing line that makes everyone stand up and cheer. 

You've done more to harm science than anybody in my lifetime, and I hope you'll go home and write that in your diary Thank you, Mr.

Chairman. 

Is this thing on? Is this thing not on? Let's see. Let's see. anyone here been to Wuhan? Anybody? Anybody? Of course, Republicans weren't just there for political theater. They were hoping to get Fauci to say something on the record that they could use to incriminate him. Unfortunately for them, Fauci had an answer for everything.

Excuse me, one answer for everything. 

Are you disappointed in how you handled COVID? Do you have any regrets? 

On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. on the advice of counsel, I respectfully decline, decline to answer under the Fifth Amendment.

I respectfully decline to answer. 

What color tie are you wearing? 

On the advice of counsel- ... I respectfully decline to answer. Oh, wow.

Oh, you won't talk, huh? Don't worry, boys. I got a question for him. Dr. Fauci, what's your favorite Barbra Streisand song? 

I respectfully decline to answer. 

Damn it. He's good. He's very good. So Fauci answered every question by invoking his right to remain silent. nice try, doc, but your silence speaks volumes.

I'm no body language expert, but we're gonna have one in a few minutes. Let me show you this. I, I- you ever see Mr. Burns on The Simpsons? I still love The Simpsons, and he did this thing with the hands a lot. Yes. fingertips on fingertips. What do you make of that? It says something. 

It has to say something, right?

Otherwise, this whole segment would be stupid. I'd look like the, the biggest dipshit on TV. and while I have a body language expert here, the president going like this, that's normal, right? Right? Gotta be. It is. It has to be. This is weird. Normal. 

Weird, normal. 

I, I'm getting confused here. I'm getting confused.

what is it that Dr. Fauci did that is so heinous that you are still trying to get him six years afterwards? 

he did fund gain of function research at a sloppy lab, where a virus escaped and left a million Americans dead. 

Complicit in the deaths of millions of people. The guy killed or had something to do with killing nine million people.

Okay. that's right. Okay. he engineered the virus that killed milli- that killed millions and millions of people because it was so deadly, a threat to everyone. 

The COVID virus was simply not a threat to most people. My Spidey senses about him, about the entire scamdemic were accurate. 

The lot of us that 

COVID was a flu.

To tell kids they couldn't go to school- Ugh ... for years for no reason. Dr. Fauci lied about his own personal views. 

Shutting down the country for a virus he knew wasn't that deadly. 

Oh, yeah, yeah. See? It's deadly, and it didn't matter. And millions died, but it was fine. And God, my head, oh, hurts, okay? My ears are bleeding, and are those symptoms of the deadly virus that doesn't matter?

I just don't understand. Can someone try again to tell us what was in these diary entries? 

If you read the stories in the mainstream press about the Fauci Diaries- ... you will see an exact parallel to the Biden- 

I, I'm sor- I'm sorry. I'm sorry. I can't hear you over the pipe.

What's going on here? are you guys, are you guys trying to solve COVID or a murder on the Orient Express? But enough about Dr. Fauci. Shall we retire to the hot tub, my dear boys? Chomp, chomp. Listen, guys. Can we dial this back a bit? I'm not saying Anthony Fauci made no mistakes, but it's not like the man is Hitler.

Fauci's guilty of mass murder and crimes against humanity on a scale of a Hitler and a Josef Mengele. 

Okay. I stand corrected. Fun fact, Hitler also committed all his crimes to meet Barbra Streisand. Fun fact. By the way, if you think America's response to COVID was really that horrible, is there someone other than Fauci you might put some blame on?

maybe somebody Fauci worked for. Could even be somebody you may have met one, or two, or three, four, five times. Oh. Maybe a little turnaround the room might jog your memory, no? Donald Trump. He. He.

He was the guy who was president during the pandemic, and he also thought Fauci was sexier than Tyra Banks. 

He's a good man. I like, Dr. Fauci a lot. He's been doing a very good job. I'm very happy with Dr. Fauci. And I have a lot of respect for Dr. Fauci. 

And I have to pay tribute. We have, whether it's Dr.

Fauci, we have the best people on Earth. 

Normally when Trump praises something like that, that highly, he just had his broker buy a ton of stock in it. And look, this is not to say Donald Trump is the one big villain of COVID. There, there is no one big villain of COVID. except maybe COVID. He was a bad dude.

It was an unprecedented pandemic that we spent years stumbling through, trying to find some patchwork of solutions that would protect our health while keeping our society from total collapse. Did our leaders make mistakes? Of course, they did. Should we try to find out what we did wrong? Of course. But that was not what was happening with Republicans this week.

They were doing the only thing we do anymore, shove a, a complex issue through a performative partisan filter. But it's not gonna do anything for us to throw Anthony Fauci in prison. It's not even gonna do that much to Anthony Fauci. threatening an 85-year-old with life in prison, that's-

Kinda like putting a kid in time out 10 minutes before school is over. In fact, coding public health as a partisan issue is incredibly dangerous, because we've already seen what happens when a party comes in thinking that public health is the other party's issue. 

The Trump administration has started carrying out mass layoffs at the Department of Health and Human Services.

The cuts will impact roughly 3,500 workers at the FDA, 2,400 at the CDC, and 1,200 at the NIH. Canceling almost $500 million in funding for 22 projects focused on developing mRNA vaccines. 

An office established to prepare the nation for future pandemics is reportedly down to 

just one staffer. 

The 

source says it's not clear who that person reports to.

There's one guy left. This is why we are losing the diarrhea war to lettuce.

it seems like trust, and definitely in your space, but I think in so many areas we're seeing that with the rise of misinformation- Yeah

that there is this, this sort of fracture in the way people trust public figures, they trust voices that previously would've been trusted. How do you tackle rebuilding that and- and repairing what might have been damaged? 

Yeah. It's the, it's a long game, I think it takes a lot less time to break trust than it does to build it and to repair it.

I know the work of repair. As a mom, I'm constantly doing that and modeling it with my children. And I keep thinking about the bigger picture of, when there's something broken, ha- the time it takes to mend that. There's a lot that needs to be done to recognize the deep hurt and trauma of the last five years, and I think that's where we look at science as needing to be a lot more multidisciplinary.

It's not just the infectious disease people at the helm, right? It needs to be the social scientists and the psychologists and the therapists even, the politicians and the strategists all together thinking about what does this road to regaining trust look like. And what's- What keeps me up a little bit at night is knowing that myself and the scientific community is not the only one aware of that.

we're seeing like a tug of war over trust, and words are losing their meaning, including the word trust. Like what is trusted? What is evidence-based? What is gold standard? And so part of the work that I feel really compelled to do is on exposing, with deep transparency, all of the processes that go behind science.

exposing is maybe an intense word, but I say that because people have felt left out of the process and just expected to follow suit, to just obey. And I don't think that's the right way. I do think that there is a place for expertise, and experts should definitely be influencing a lot of these decisions and recommendations.

But when it comes to repair, a lot of it is gonna go back to the basics of saying, "I don't know. I don't know yet." And that makes a lot of scientists squirm. the lack of certainty is not a comfortable place. But if you think about it, the lack of certainty is why we all are scientists, right? It's me wanting to find an answer to an unknown or to something that I don't fully know is connected to something else So how do we go back to the basics of the scientific method of a hypothesis or of a process of getting to that conclusion and not coming in with so much certainty and binary thinking?

and I, I think when you think about young scientists who are coming up... and I think I- I'll even take a step back because so much of what you're saying is so relevant to others as well. But when you think about young people who are coming up and looking to communicate ideas, what is...

what makes you feel good about where things might be headed and the direction that they might be taking and how they approach these things? 

Yeah. the role of science communicator was not something that people were familiar with many years ago, and even the word infodemic or infodemiology was a word that was not in a lot of people's lexicon, and it now is, and that excites me.

Because I do think that what we need to do is train a generation of scientists who can communicate that science because their work is incomplete if it's just sitting behind closed doors at fancy institutions. It's not actually a tool in somebody's toolkit unless somebody can repeat that message to somebody sitting next to them at the dinner table.

And that's why I feel so passionate about the work that I do, that I somehow became a personal scientist to so many people who then could refer to me by first name and say, I heard this from Jessica, and she explained it this way." These repeatable messages, this generation, hopefully, of creating science communicators in the whole community.

And not everybody has to have the same training, but that they can repeat these messages so that everybody can understand. That to me makes me feel hopeful about the future despite the fraught information ecosystem that we're living in. 

The-- I think that's beautiful. And when you have these conversations, with people who maybe feel concerned about how they can break through and make a difference, what are some of the ways in which you encourage them and to keep going and to, to do this work?

Yeah. The good outweighs the bad. I have to keep reminding myself that. Yes, there's violence and death threats and antagonism and a lot of scary things. Oftentimes we're dealing with keyboard warriors and people who maybe are not as brave as they may sound on the internet. I'm not at all downplaying real threats, but I have to keep reminding myself that at the end of the day, we have evidence and data to back up the things that we say with that caveat.

That's different than what you're dealing with on the other side, and I think speaking that truth courageously, repeatedly, has shown to be beneficial because of what we see, right? What's interesting about public health is a lot of times what we see is what we don't see. The interventions are invisible in that sense, and they're a victim of their own success because when people are doing well, public health is working, and that's what we want.

We don't want people dying en masse and getting sick en masse. And so how do we make that invisible work visible? It's by this type of echoing and communicating and, and inviting more people into that process because if we just assume that it exists and we're not talking about it, that's when the defunding happens.

That's when the devaluation happens. That's when the deprioritization of it happens, and that's what got us into the terrible position we were in 2020. 

I'd love to know as we're s- winding down our conversation just how this... what this looks like for you. How does this show up in practice for you?

How do you find the courage to keep going and keep doing this work? 

Yeah. I think about all the hats that I wear. I think about the fact that I'm not just an epidemiologist and a science communicator. I am a mom. I am a first-generation American. I carry all these identities with me, and I think that's why I am trusted by some folks.

And I think a lot about The times that I've had to speak up when it has felt scary to speak up, whether it's in opposition to an administration or to a specific politician or to a specific person who is making very dangerous, harmful claims. My work requires me to see a lot of dark things, the dismantling of public health systems, really dangerous health misinformation, even what we're witnessing over the world.

I very much have spoken out a lot about what's been happening in Gaza as it is connected to public health, that is connected to children. I am a mom with kids, very young. All these things are connected, and I speak about these things in a connected way because I remember a few words that really ground me.

and this was really reinforced most recently. I was in Rwanda with UNICEF visiting a field site. Rwanda is just 30 years past the genocide. Something that I witnessed 20 years ago when I was there, 10 years after the genocide, and I remember thinking, "How can there be hope here? How can there be repair?"

And I saw it, and I remembered the question that I asked myself, "Why do I do what I do? What is the thing that I'm good at?" And I really genuinely think I'm good at sense-making. I'm good at making hard, complicated, uncomfortable things make sense to different types of people. And so because of that, it gives me my why.

And my why is that speaking up about science, about injustice, about the connection of those two things is always right. It's always worth it. And so that is how I keep reminding myself of the work that I do, the why that I do it, because it's really important to me, and I've seen the fruitfulness of it 

We were a country founded on libertarian values. Those values shaped the medical landscape of the 19th century, and really, the medical landscape up to today.

There's a tension between the authority of the parent and the authority of the state. And, this has implications for all different kinds of sectors and questions in society- Sure ... from, mandatory schooling down to, bike helmet laws and, other public health measures, and yes, vaccination.

And in 1982, that tension would come to a head around a vaccine against diphtheria, tetanus, and pertussis, known as the DPT vaccine. 

The diphtheria, tetanus, pertussis vaccine, had a difficult safety profile when it was first invented. 

The vaccine could cause rare but severe side effects, like prolonged crying and seizures in infants.

These symptoms were temporary, but claims began to circulate that the vaccine was doing permanent damage to children. 

So in the early 1980s, there is a reporter, Lea Thompson. 

A reporter at NBC affiliate WRC-TV in Washington, DC, who catches wind of these claims. 

And she embarks on this reporting project, and it ends up becoming the basis for a 1982 hour-long news broadcast titled Vaccine Roulette.

DPT Vaccine Roulette. 

Just a note here, the people call this vaccine both DTP and DPT. So you'll hear both in the episode, but they're referring to the same thing. 

And what Thompson reports is that scientists have known for some time that there are adverse events associated with this vaccine, but that they aren't disclosing them to parents and that parents are therefore, as she put it, playing a game of roulette with their children.

If we keep the Cutter incident in mind, we just marvel at the fact that parents at that moment in time knew that there was this horrible chance that something could go wrong, and yet people still got their kids vaccinated against polio anyway. But couple decades later, the early 1980s, that's not what the parent population of the US is ready to sign on for at that point.

Between the Cutter incident and DPT vaccine roulette, a lot had changed in the US. There was a string of government cover-ups, Watergate, the Pentagon Papers. These things had put the American people on edge. And there was a series of protest movements from civil rights to the anti-Vietnam War movement that changed the attitudes of the country towards their government.

Their attitude in the wake of the anti-authoritarian movements is, "Hold on. There were risks, and we weren't informed? Why weren't we informed?" 

After seeing the documentary, some parents began to allege publicly that their children had suffered permanent harm after getting the vaccine. 

They organized themselves into a group that they called Dissatisfied Parents Together.

DPT. They picked that acronym on purpose. 

And they were a pretty formidable group. 

Parents also began to sue pharmaceutical companies. 

The whole issue was, like, it was very complicated to determine with certainty whether it was the reaction that a kid had was coincidental with the vaccine, or was it some underlying condition that was triggered by the fever that they got as a result of this vaccine?

This is Arthur Allen. He's a senior correspondent for nonprofit KFF Health News and author of the book Vaccine: The Controversial Story of Medicine's Greatest Lifesaver. 

You wouldn't really blame the vaccine for that because maybe if they'd had a fever the next week from a regular viral illness, they would've, the same thing would've happened to them.

So there's the scientific, answer to that, and then there's the legal answer to that. 

The scientific answer became clear pretty quickly. 

Studies actually fairly quickly showed that wasn't, the vaccine that was doing it. If you looked at children who got the vaccine or didn't, there was no increased incidence of any permanent, defects associated with that vaccine.

The legal answer was a little murkier. 

vaccines are supposed to be really safe, and they should be, much safer than almost any medication you can think of. But that doesn't mean that they're completely safe. It doesn't mean that there's no harms. 

Parents were winning personal injury lawsuits against the vaccine makers, with the average claim rising to tens of millions of dollars by 1984.

It really drove vaccine makers from the market. 

But the activists powering dissatisfied parents together also wanted alternatives to lawsuits. They wanted a law on the books that would protect children from harm. 

They, over the course of the next four years, worked tirelessly in the capital To introduce new laws that said that the federal government would do even more to ensure that the vaccine supply was safe.

In 1986, they had a breakthrough, a new law called the National Childhood Vaccine Injury Act, which creates the Vaccine Injury Compensation Program, commonly known as the Vaccine Court. 

It was designed to compensate individuals or their families who were injured by certain vaccines. It was a no-fault court, and the compensation money came from a government trust fund, funded by a tax on vaccine manufacturers.

But the Vaccine Court also protected those vaccine manufacturers from lawsuits that threatened to hold up their production or even drive them out of business. 

So it's really important to pause here and look at this moment. The parents who came together were from across the political spectrum, and they did something that we've seen happen before.

They turned to Washington. They turned to the federal government and said, "Do more to ensure that vaccines are safe." This is really distinct in the history of anti-vaccination, and I hesitate to call it that because it does not seem accurate at all. This is a movement that's saying, some of our members actually have real reservations about vaccines, but we are the parents who got our kids vaccinated, and we want future parents to get vaccines for their children and feel absolutely confident in those vaccines.

Huh. Oh, see, that's a really important nuance. 

That it wasn't a, I don't want to vaccinate my child, then you shouldn't vaccinate your child. It's, we need to demand that we are continuing to improve these vaccines and make sure that they are as foolproof as possible. 

Exactly. Exactly. It's a lot easier to tell a story of simple anti-vaccinationism.

it, boils everything down to black and white.

This parent group 

Dissatisfied Parents Together 

fractured after a while. There were those who found themselves just absolutely devoted to the cause and stuck with it and kept pushing and pushing. And then there were parents who said, "Okay, we got what we wanted, and now I'm moving on."

Dissatisfied Parents Together would later morph into the National Vaccine Information Center, a group that today has been criticized for spreading misleading information about vaccine safety. The movement spawned by the documentary DPT: Vaccine Roulette lived on. 

Really, in many ways, that vaccine caused the birth of the modern American anti-vaccine movement.

Some parents began to draw connections between vaccines and any unexpected diagnoses. 

When Vaccine Roulette aired in 1982, it resonated with parents who feared that we were seeing, as a nation, more and more learning differences and developmental delays and disabilities in children, and they were really struggling to understand, like, why their kids had disabilities like this when they didn't and nobody in their family did, and vaccines started to suddenly seem like a possible explanation.

Concerns about the connection between vaccines and autism were circulating for close to two decades before they were published in The Lancet.

Anthony Fauci. He released a book, with his, reminiscences, of his whole career, but obviously a particular focus on COVID, and saying that he sees a crisis of trust, as being the greatest threat to public health. Not the public health emergencies, but the lack of trust in scientists to respond.

Now, maybe he's overreacting given his position and his sensitivity to, his partisan attacks, but he'd be in a position to really, experience the virulence o- of a lot of the pushback against science. Where does this come from? And I have a few of these graphs on the partisan divide. And we all are aware of this.

again, these are US-centric figures, but here is confidence in science, which I showed you in previous graphs is going down, and you can see how much more it's going down among Republicans than independents, and Democrats it's been going up.

how did we get here? So the, lawn sign on the left is one I see a lot in my neighborhood. The wrong side, the, the one side on the right is a response to it. I don't see that in my neighborhood, but I imagine there are neighborhoods where you see a lot of that. the one on the left kind of is what started out a whole set of beliefs and values.

bragging about values, turning trust in science into a belief, into a moral point. And then the other side, saying, "We believe all m- lives matter. Science is not, political," being a reaction to those who believe that the government should be driven by science to mandate vaccines and masks and so forth.

you see the importance of belief and, publicizing your beliefs as sort of a badge of honor so I showed the decline in trust for science, and we can see it here again starkly, in partisan, partisan, going down much more steeply among Republicans than among Democrats. Only slightly among Democrats and more or less plummeting from 70% to 47% among Republicans again, trust in scientists, taking the general skepticism of science and personalizing it, turning it into skepticism of individuals, an ad hominem approach.

Again, much more, among one political party than the other. generalizing it to the scientific community, to the individuals who are part of science. in essence, the other team , the, the them. And you can see it, the partisan difference, being accentuated around the time of COVID

One interesting study was looking at trust in science during COVID and before, and concluding that the Trump effect, which is widely credited with, promoting skepticism in science, according to this analysis, did not affect overall perceptions of science, but did increase polarization. So that is, again, my theme, that the polarization, for reasons I will describe, is really the driver here and not, so much the societal changes This is in the context of overall declining trust in authorities, including governments.

You can see a secular trend over a 60-year period, coming down steadily, not just, since COVID. being at the same low, level for, more than a decade now. And in line with the partisan aspect of this, trust in government, the blue line is Democrats, the red line is Republicans. And then you can see in small letters at top whether it's a Democratic or a Republican president.

And guess what? When a member of your party is the president, you tend to trust government or the electorate tends to trust government than, rather, more than, when it's a member of the other party And we see the partisan divide reflecting in demographics and in particular education. again, not too surprisingly, those with, the most education, post-graduate, baccalaureate, have the most positive view of science.

Of course, those are the people who probably studied science more and so are more likely to have faith in evidence and scholarly analysis and the elements of science. so my, point here is that trust in science, trust in authority, has a lot to do with belief rather than thinking, that rather than analysis, rather than conclusion.

Belief, as in those lawn signs, is a badge. It's telling the world, that you are on a specific team. And actually, the more you believe in the face of irrationality and contrary, contrary evidence, the more, the stronger that badge is. the more that you are saying, I'm not gonna let things like facts get in the way.

I'm sticking with my team." like a sports team in some ways. I, I don't care how bad the players are, they're gonna win the championship. there's a shared sense of grievance, of powerlessness, of unfairness, that you, share with other people and so you wanna show your solidarity. you then show that you're part of a community, that you share this faith, and that you believe rather than think, and I think that's an important distinction.

the New Yorker magazine had a story a few weeks ago, looking at the nature of belief and arguing that when you believe something, it's different than when you think something. Thinking is generally based on evidence. Believing is closer to faith, which by definition is not based on evidence what's the motivator for this?

Again, it's the team mentality. It's us versus them. don't like the, elites. Corporations are in it to make money. Them. they're patronizing us. It's paternalism. Them. I'm in solidarity with the community of skeptics. The scientists are on the other team. And then often it's attempting to find easy answers.

How am I gonna eliminate the risk of COVID? I'm gonna drink bleach, or I'm gonna, take ivermectin. it's much easier than they want me to believe again, tied to feelings of powerlessness, of unfairness, of grievance. So back to my lawn signs, advertising your belief. I'm on one team, I'm on the other team

Cognitive science has a lot to say about how this works. We have heuristics and biases that guide the way we understand evidence. For instance, the availability heuristic. If an image or concept is available to us easily, imagining a car crash, we will consider that a greater risk than if it's theoretical.

the abstract for a disease versus the actual, perception of the consequences of the disease, or, versus, the inconvenience of wearing a mask or getting a vaccine or the other mitigation factors. Recency of what we saw most recently, i.e., COVID and the COVID measures, is going to s- determine our context.

Confirmation bias, where we're likely to believe what confirms what we wanna believe, and then the powerful notion of cognitive dissonance, that we want to keep our thoughts consistent. And when one piece of the picture is inconsistent, we discount that one. So if our leader, who we want to respect says, "Don't use, a vaccine," or, "Don't wear a mask," evidence says, "Use a mask," we can't have all three points of the triangle, together in our minds.

We have to discount one of them. And so for many people, it's discounting the one that says evidence says, to wear a mask. How do we, rebuild trust? don't deny false claims. We know that. We know that the more scientists discount the link between autism and the MMR vaccine, the more entrenched people come in their beliefs because they're beliefs, they're not thoughts.

And the more resistant they can be to empirical data, the stronger the sense of community, the stronger the badge of honor. try to, address the cognitive biases directly, what's motivating people, the images that they see, how recently they've seen them, how clear, the risk is, and then speaking to underlying concerns.

is that easy? Absolutely not, which is I think why it hasn't happened. It's a lot easier to throw out more facts, but I don't think we're really gonna address, skepticism of science until we get to some of those underlying concerns, feelings of powerlessness, feelings of being taken advantage of. So my overall principle is, faith and belief are much more powerful than simply empirically based, uh, thinking.

the way to address skepticism of science, is not to directly contradict the disinformation, but the need to accept disinformation. And to come back to my original quote- Understand the rationalization, not the rational, because at our core, we're all humans. 

We've just heard clips starting with

Takesâ„¢ by Jamelle Bouie arguing that the RFK Jr.-driven MAHA agenda is a eugenics program, and that political journalism's conventions hide the plain reality that Trump is an incoherent old man in decline.

Zeteo broke down the five forces driving anti-science denial, the plutocrats, petrostates, professionals, propagandists, and press, warning that legacy outlets practice "performative neutrality."

Radio Atlantic examined how HHS under RFK Jr. failed to mount a strong pro-vaccine response to the largest measles outbreak in decades, which killed multiple people despite Kennedy praising the response.

The Daily Show skewered Senator Josh Hawley and other Republicans for their theatrical Fauci hearing, where lawmakers cracked open his diary and likened him to the Nazi Mengele.

TED Talks Daily explored how epidemiologist Jessica Rivera approaches rebuilding trust in science.

Throughline detailed how a 1982 news broadcast about rare DPT vaccine side effects launched lawsuits, the no-fault Vaccine Court, and the roots of modern vaccine skepticism.

And Fondation Brocher traced the collapse of Republican trust in science during COVID, arguing polarization, not societal change, drives the divide, since people display beliefs like team badges rather than reasoning from evidence.

And those were just the top takes, there's lots more in the deeper dives sections,

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As for today's topic,

As a society, we do an okay job of dedicating time and space to memorials so that we won't forget about great tragedies or injustices. We say, "Never forget" about the Holocaust and 9/11. Written right into the education system for aspiring medical professionals, we teach medical ethics in part by remembering failures of the past, such as the Tuskegee syphilis study, in which hundreds of Black men were deceived and denied treatment for decades. What we don't do a good job of is memorializing our successes so that we never forget how necessary and important those advances were, so that we don't fall into the trap of taking them for granted.

It was less than a hundred years ago when cases of polio were peaking, with thousands of children dying and tens of thousands paralyzed by the disease.

In 1955, when the first vaccine for polio was announced, it was headlined in newspapers using the same font size they'd use to announce a victory in a war. That's because it didn't just affect the tens of thousands of people who were directly harmed by the disease. It was also something to be very concretely feared by essentially everyone, and the vaccine represented not just a way to save lives but also to alleviate the fear of polio in the wider population.

It turns out that those newspaper headlines with the enormous font announcing the vaccine were quite justified. The last wild polio case in the U.S. was in 1979, and we now live in a world free from fear of polio thanks to that vaccine and those that followed. Just as it was the fear of polio that prompted the screaming headlines, the lack of fear of infectious disease just a few generations later is exactly the cultural environment that can breed complacency and allow skepticism to regain a foothold.

Vaccine skepticism has always been with us. In the 19th century, Americans were fighting compulsory vaccination while disease was rampant, and so they were able to hold both a fear of the disease and a fear of the vaccine at the same time. It's when vaccines are shown to be effective that the cultural consensus shifts in the direction of widespread vaccination policy. But that cultural shift appears to only last for about the length of a lifetime of a person who experienced the shift firsthand. Once they're gone, everyone left are those who grew up without the living memory of the diseases that the vaccines are helping to keep at bay.

Researchers looking at vaccine hesitancy at the World Health Organization call complacency one of the three Cs, along with eroded confidence in the systems developing the vaccines and the convenience factor of how easily accessible they are.

There is no equivalent to "Never Forget" for the victims of polio, measles or smallpox to keep their memories alive along with the triumph of the vaccines that helped push the fear of those diseases out of our lives.

Stories of failures are rightly kept alive. Events like the Tuskegee syphilis study are carried on into living memory by the victims' families, journalists, and ethicists who continually refer back to it as an important teachable lesson that we must never forget. But success, as with vaccines, doesn't generate an energized constituency to continually tell the story. Contracting polio before the vaccine was available was a tragedy, but it wasn't an injustice because there wasn't a way to fight it and injustices are what build enduring legacies and promises to never forget.

One of the other Cs in vaccine hesitancy is confidence in the science and distribution systems for vaccines. It's been said that the distrust of these systems has been earned, but what's also true is that the trust in those systems was initially earned as well. But that trust wasn't made to be enduring and begins to wane as generational memory of past diseases dies off on a biological schedule.

I think there's a decent argument to be made that the same basic process is playing out with fascism and authoritarianism more generally. The fact that it has sprung back to life all around the world at about the same time as those who lived through the 1930s and 40s were passing away may very well be evidence of the same pattern of complacency. When no one in living memory actually remembers what it looks like when fascism is on the rise, it makes it culturally difficult to recognize it for what it is, and so people dismiss the idea as hyperbole.

There's actually a whole book written on this theory of what happens when generational memory is lost. It was originally published in 1997 and is called "The Fourth Turning." I haven't read it and am not recommending it because there is some controversy among historians about the authors' methods and conclusions. What seems not to be in question is that the book turned out to be one of Steve Bannon's favorites. He made a documentary in 2010 called "Generation Zero" based on the theory and with help from the authors. The surviving author has said they never told Bannon what to say or think, but that they did perhaps provide him with an insight while working with him in 2010, that populism, nationalism, and state-run authoritarianism would soon be on the rise, not just in America but around the world.

Naturally, Bannon didn't take that as a warning, but as the opening of an opportunity for him to help bring that exact scenario to fruition in the U.S. Bannon seems to think that the current political crisis we're living through is a sort of necessary cleansing fire that will burn away much of the recent past and once again allow for what he would describe as traditional American values to re-emerge.

I also happen to see that we appear to be living through a crisis that is burning away much of the recent past but I tend to think that what's on the other side is a re-energized movement for democratic renewal. All you have to do is look at polling numbers to see how much people absolutely hate what we're being put through and the types of policies the people on the far right, like Steve Bannon, advocate for.

It may very well be that we are going through a similar fire with vaccines and public health in general. It will be painful. Lives will be lost, and there will be injustices because much of the harm being done is preventable.

We are going to give people within living memory the chance to see for themselves what happens when vaccination rates fall below the herd immunity threshold. It will be the harm caused that people can see with their own eyes that will turn the tide again, re-establishing in the cultural zeitgeist that vaccinations are necessary and far outweigh the small risks that the anti-vaxxers like to highlight and blow out of proportion.

So maybe we should take a lesson from memorials, holidays, museums, and the general sentiment of never forgetting. Use those tools directed at the positive progress that has been made in public health in general and vaccinations in particular.

We could have memorials and remembrance days for those who died before the advancements we now enjoy and should appreciate but, all too often, take for granted.

A lot of people had to die of cholera before people figured out that we need public sewage systems. A lot of people died from what are now preventable diseases to create the motivation necessary to design and develop treatments, vaccines, and other preventative measures.

Collective memory is like infrastructure that decays if you don't maintain it. We know this instinctually about wars and disasters, but it's just as true for the positive things like public health advancements. In both cases, we can only continue to reap the benefits if we remember the lessons learned, so let's never forget.

And now, we'll continue to dive deeper on 4 topics today. First up;

Section A, THE CURRENT DAMAGE

Followed by Section B, HOW WE GOT HERE

Section C, WHY IT WORKS

And Section D, RESPONDING TO THE MOMENT

the reason I asked you to come on, before Dr.

Fauci gave his testimony and before RFK Jr. was on CNN, really, I just, I wanted to talk to you about diarrhea lettuce. But, I think all of these things are connected. 

They are. 

So I use that to transition into Cyclospora. So w- what is it and where does it come from? 

Cyclospora is a parasite that can, it's very common, and it can cause a gastrointestinal illness or diarrhea, for simple terms, when ingested directly from a contaminated food source.

It's not spread from person to person. it is spread by eating contaminated food, and symptoms can last, unfortunately, for quite a long time, sometimes for several weeks. it is typically not a fatal infection, but it is a very disruptive and unpleasant one. And so- a lot of times it will require an antibiotic treatment, which sometimes folks get a little bit confused about how can a parasite be treated by antibiotics.

That's the amazing fact about science is that sometimes we look at drugs and see does it also work on other things. And so a very strong, antibiotic, Bactrim, can be used to treat cyclospora pretty effectively and safely. the concern, though, is if you have persistent diarrhea, you're at risk of dehydration.

So again, the experience is not equal for all people, especially if people are at risk of that type of complication. 

So why is this in the news now? Because I'd never heard about this before, and suddenly it pops up on our doorstep. and obviously, it's been around for a while. So w- what are the circumstances that have brought this to the forefront now?

Yeah. So cyclospora cases happen every year in the United States. They typically don't make huge headlines just because the outbreaks aren't typically that big. the parasite, again, it usually is spread in the summer because it grows more efficiently in warmer temperatures. but again, the numbers are usually low to not make headlines.

But from May to July of this year, we had an explosion of cases, for lack of better terms, and it was noteworthy. it made national news because there were over 15, 1,600 people that had confirmed case of cyclospora, s- with thousands more suspected, compared to less than 250 in the same time last year, according to data that we have from the CDC.

So it is a big jump from last year, which is why it's in the headlines. 

Yeah, I guess what I'm asking is why is this outbreak so big? if it's been around for a long time and we haven't seen an outbreak like this, before, has something broke down in our food system to make this outbreak bigger than what normally happens?

Yeah. A lot of things have happened that have been drivers of this outbreak. I'm being particular about my words here because it wasn't one thing that just caused it. cuts to food safety, make our food system more vulnerable to outbreaks like this, and you have seen what has happened in the last year and a half, which is taking a bulldozer to so many of our systems of data collection and data reporting and surveillance that have existed in places like FDA and CDC that help keep our systems safer and healthier for folks.

so what we did was essentially make cyclosporiasis, less visible in the data. and because of that, it makes it more difficult to respond to an outbreak. And you and I met in the context of there's not enough data, and that was during the COVID-19 pandemic- ... where we were saying it is impossible to have evidence-based recommendations that can help reduce harm in our population without knowing the big picture, and the big picture requires timely and transparent and reliable data systems to be r- available.

and instead, it was patchwork. Instead, it was an absolute communications failure when it came from the agencies and what they were saying. and then you're also dealing, honestly, Al, with some, companies doing shady things, and then their history of how they treat their employees gets revealed in the process.

I, I think this has been a big eye-opening expose on a large corporation that has been responsible for other outbreaks in the past, and people have been able to say, "This company is doing a lot of things that would make this m- more likely to happen again." 

So my understanding, though, is that the Outbreak was initially linked to Taylor Farms- but then the FDA came back and said that their tests of lettuce supplied to Taco Bell was a false positive. E- do we know exactly w- who the culprit is, where this came from? We- because it seems like it's just gone completely out of the news. we talked- Yeah ... about that for a while, and then it disappeared.

d- who is responsible for this? 

it's, it's so interesting that you mention that because I think that headline was very strategic, and I think that headline was in an effort to exonerate Taylor Farms, and they were not exonerated. A false positive does not say that they are not culpable or responsible for this outbreak by any means.

We know that cyclospora is a very difficult parasite to grow in the lab, and we also know that what they tested was not from the same batch that had been recalled. So a false positive in a lab is not a, "Oh, we made a mistake, mea culpa, it's not them, it's somebody else." it was just saying the sample that they had was not connected to the sample that may have been responsible for this, but it was Taco Bell as one of the companies that said, "Hey, we want to flag this to our shareholders that we have had- a source of lettuce that is causing potentially a, a problem, and this was our source," and as well as a bunch of other things that connected Taylor Farms, because Taylor Farms is not just one product. It's a ton of products under a bunch of different brands. it's not just them, but they are definitely not exonerated from this whole investigation.

How are you navigating what you eat and what you buy at the grocery store? Because- Yeah ... every time I'm at the grocery store, I used to buy those, salads that were packaged, ready to go. Yeah. I'd buy them all the time. Now I'm not buying them because I don't wanna get sick. and it's changed a lot of how I normally shop. So how do you shop? 

I'm no longer buying salad kits either. part of that is, I always felt guilty because of all the plastic that was involved in salad kits. That always made me feel uncomfortable. It was, but it's a really easy hack when you've got three kids and you're trying to make s- dinner really quickly.

I'm not buying salad kits. I'm also not buying lettuce from the grocery store. If I am gonna buy lettuce, I'm gonna get it from the farmers market. I'm trying to stick to fruits that are easier to clean, that would be less likely to be spreading, this parasite. small little berries like raspberries and blackberries are pretty difficult to clean.

We're eating a lot of stone fruit at our house and a lot of melons, which are much easier, smooth surfaces to clean. but again, it's, there's no way, and I s- I think I've said this to you, too, there's no way to eliminate risk. There's only ways to reduce risk, so these are just small measures that I'm taking to reduce our risk, knowing that I could never 100% eliminate it for me and my family.

You've written about how the politics around COVID's origin led to defunding of scientific research in the US. What does that mean in practice for things like disease surveillance and developing treatments? 

The people in the Department of Health and Human Services from RFK Jr. on down are clearly thinking that they're not going to have to deal with a disease emergency in the time of office, and if they are, that it's really not their responsibility.

I don't know if it is directly because they blame the NIH for giving a small grant to a laboratory in Wuhan for the pandemic. I don't know if they truly believe that, but that is an often used excuse for why NIH needs to be defunded, why CDC needs to be gutted, and, and also USAID. I don't know what's in their heads, but that is an excuse that they've given.

There is overwhelming, at this point, scientific evidence that COVID did not come from a laboratory, that it was a naturally occurring virus that spilled over from animals to people in a, in an animal market, live animal market in Wuhan, and the fact that they are choosing to c- reinforce this lab theory is disingenuous.

I can't tell if it's sincere, but it's, but it's still devastating. 

Wh- which areas of research are being hit hardest by the cuts? 

virology is being hit very hard, but so is everything else. grants to research, researchers in the US have fallen tremendously, and even though Congress has, intervened and said, "You can't, we're not allowing cuts to NIH and NSF," or National Science Foundation funding, it's not getting to the researchers.

so the money is being blocked by the Office of Management and Budget. It's probably illegal, but that doesn't mean that it isn't being done, and so by the time the legality all gets ironed out with different lawsuits, a lot of these scientists will have left or have to shut down their labs. 

There are a lot of people who are actively searching for scientific positions outside of the US, and a number of people have already left. So the brain drain is actively happening. 

when the US Health Secretary is promoting ideas like concerns about paracetamol in pregnancy or advocating drinking raw milk, how does that change what counts as credible public health advice?

So raw milk, a lot, just to make sure everybody knows what this is, so pasteurization is just a small heating step of milks. It kills the bacteria mostly th- that live in the milk. when you milk a cow, it's not just the milk that gets into the bucket, There's a lot of other stuff that the cow is in and does that ends up there, too.

And so when you have a small heating step of the milk, you kill a lot of the bacteria and viruses that might be in there. It is a risky idea to drink raw milk. Eventually, you will get a disease that will cause you to not be able to leave your bathroom for s- some days at a time, and possibly land you in the hospital.

I don't know why somebody would risk that by choice, but that is what will happen to you if you drink raw milk. The problem is that, for small children and babies, this could be a life-ending decision if they get s- very sick. yeah, it's not a good idea to drink raw milk.

It has never been a good idea to drink raw milk. Even before Pasteur came up with this, a lot of people would heat up their milk anyway. It was just a, a kind of thing that people did because it helped the milk stay stable for longer. So it's not... It's something even before people knew what germs were, it was something that, that people did.

So it's not a new thing, and it's, it's not even a big thing, and it doesn't change the nutritional content of milk. What does it mean when you have people from the highest, levels of government endorsing it? It just means that we have a lot of nonsense that we're having to deal with, that actually harms people's health.

I once, went on holiday to France when I was a, a teenager, and we were sta- staying on a dairy farm. And, a French farmer was milking his cow, and he offered me some milk straight from the cow. And I thought, "Oh, how charming. How charming." And I had a glass of it, and what followed was probably the nearest I've ever got to feeling biblical in my lifetime.

So I would just say never, ever drink milk straight from the cow. Never.

Now, the US officially left the World Health Organization earlier this year What does that mean for global disease surveillance and coordination? it just s- felt crazy to me. 

Yeah, it's bad for the US because we are not getting the kind of information that we need to be able to prepare for disease threats that might be arriving with, in, in sick people in the US and travelers to the US.

But it's really bad for the WHO because the US was funding a lot of it. it's a big financial hit, and that will mean that WHO is, was less able to, deal with the disease threats around the world than, and than it was. And it's not like they were rolling in cash before. so I think, it's not a good thing for the world i- in any way.

and what does this moment mean for epidemiology? how data is collected, how evidence is used, and whether it's actually acted on. And I'm wondering whether there are already examples where data is being ignored or sidelined in decision-making. 

Yeah, there are a few places. I guess the one that everyone will be dealing with is in the flu vaccine.

So when you don't collect data for which flu viruses people are experiencing, and then you don't know what to pick for the next flu vaccine. So every year the flu vaccine is different. It's, it, there are a few different strains that it protects against, and, the strains are picked based on what is circulating in the world at that time.

And so when you don't have good data of what's circulating in the world, you're not gonna pick it, the right flu vaccine, the right strains to put into the flu vaccine, to protect people against the flu. Now, people should always get the flu vaccine. Even when the picking is not as good as in some years as in others, it has demonstrated that it keeps people out of the hospital, and that's a good thing.

but, we want the flu vaccines to be as protective as possible, and that means have, having the right data that feeds into that decision. And another thing that, that the US did recently is they, there's been this anti-mRNA vaccine effort. So the US canceled a $500 million contract with Moderna to produce an mRNA vaccine against H5N1 avian influenza.

And also their, they interfered, it looks like it's in limbo right now, but interfered with a, an mRNA regular flu vac- vaccine and its application to the FDA. So these are all things that are really decreasing the availability of the best technology to pr- to give people flu vaccines. And flu is not a benign disease.

that, tens of thousands of people die of flu every year in the US and other countries, and it's not a fun experience, rec- Regardless. So we want the vaccine to be as protective as possible so people get it. we want people to get the vaccine, and people don't have a good perception of the vaccine as being useful, so the better it is, the more we hope that it will increase uptake.

And we want people to get their kids vaccinated against flu, not only to protect the kids, but to protect their grandparents. And it's a good thing overall that is being actively worked against by this administration. 

If this trajectory continues, what are you most worried about over the next few years?

So I am very confident that people are touching the stove right now. The, they are experiencing the risks. We're seeing measles cases. a fifth of those children that are getting measles end up in the hospital. They have their, they have immune amnesias, they have to get revaccinated against other diseases if they did have, get vaccinated prior.

And some small percentage of those kids are going to, years later, develop a fatal neurological disease that we can't do anything about. So touching the stove right now, maybe measles won't be the only thing that we're ha- we have to deal with. I know that people are going to see the value in public health and proven measures to prevent disease, but at what cost, and how long is it gonna take?

And what is going to be the precipitating event that will get people back on board?

The Secretary of Health and Human Services, RFK Jr.,

was recently on a program on CNN with Dana Bash. I wanna play you some of the audio and let's talk that through. 

Measles cases in the US just reached a 35-year high The second, record-breaking year in a row, 93% of these cases are among the unvaccinated. The outbreak is happening on your watch, and even be- before becoming HHS secretary, for years, you have been one of the leading voices questioning the ef- efficacy of vaccines.

Do you accept some responsibility for this measles outbreak? 

Absolutely not. First of all, this is an international outbreak. So w- and we're doing better at handling it than any country in the world. Mexico has 15 times the amount of measles per capita than we have. Canada has four times the amount of measles.

England has two times the amount of measles. Did I cause those measles outbreaks? 

You're the most 

famous- Did I cause- Maybe ... did I cause 137,000 cases of measles 

in Europe? You're the most famous vaccine skeptic on the planet. Do you want people to get the m- the MMR vaccine? 

Yeah, I said that already. 

Okay.

So Jessica, my friend, tell me what you thought of that clip. was the secretary... it seemed to me like he's making a lot of excuses for the measles outbreaks. Are his excuses factual? 

You're right that it seems like he's making excuses because that's what he, that's what he is doing, and that's what he has been doing.

He has an exceptional ability to play the whataboutism game and to play the blame game when asked very pointed questions about the consequences of his words and the consequences of a- of his actions. We have seen a massive increase in vaccine, refusal in the last two years, especially here in the United States. And to say that he is not directly responsible for that is categorically false.

He is a loud and very outspoken critic of vaccines, of particularly the measles, mumps, and rubella vaccine, which is the only vaccine we have that can actually reduce the incidence of measles, and it can actually prevent it in most cases, and he can't abide with that type of responsibility. he's forced and has been forced in the past to say what he said at the end of the interview, which is that the measles vaccine is recommended, that parents should get it.

But that's only because of his role as HHS secretary. If he didn't have that title, he would never say that sentence on live television. 

So there's another clip, with RFK Jr. and Dana Bash. Let's play that now 

So you are using, you are actually looking at, you're starting new studies to try to link autism, but you're also telling me- I'm not 

trying to link autism to anything.

I'm trying to find out why has autism gone from less than- Are 

you also trying- ... 

why has 

autism gone- Are you also trying to find out how it interacts with people's DNA, what's predisposed to, to have an autistic child? Are you doing both? 

Yeah, but, Dana, you probably don't understand this because you're not a scientist, but genes don't cause- you're 

not either

genes don't cause epidemics. 

I understand. Genes, epidemics. They can provide a vulnerability, but they, but 

you need- A g- 

a gene provides- ... 

environmental exposure ... 

environmental. That's what I'm asking. Are you studying the environmental trigger? You need, 

we're looking at all the different environmental exposures, but your statement, you have been fooled.

Your statement that this has been studied is not true. 

There's a lot to unpack in that statement. 

It's a lot. 

When you hear that, what do you think? 

It's deeply upsetting to me, Al, because That's not how you do science. You don't do science with a preconceived notion, a answer that you already believe in, and then create science to prove what you already believe.

And what he is attempting to claim is something that cannot be done in science, right? He is attempting to prove a negative, and that is not how the scientific method works. And he is saying that the ... And it's on the CDC website, which is absolutely horrifying, it's so embarrassing, that the claim that vaccines don't cause autism is not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism.

But we know that infant vaccines have been documented with decades and decades of safety h- data to show that if we have not seen it, it probably isn't the cause of it. it's also upsetting to me as a communicator when he uses the word epidemic. Epidemics refer to diseases, and autism is not a disease.

And he is trying to say that something that we have done or environmentally have given or exposed children to is causing this, and it is causing an outbreak or an epidemic of this type of condition. And it's so upsetting to the families who do have children with autism who are ex- who have thrived with autism or even who have severe autism to make it sound like it's something that the parents did or something that the parents exposed the kids to.

there's a lie on the CDC website. They say that studies have, have, studies supporting the link have been ignored by health authorities. The opposite is true. And later in that clip, he says something about there's never been any study to examine, what happens in the first six months of a child's life re- regarding this vaccine.

We don't give the MMR vaccine in the first six months of life, Al. We give it, the first dose is given between 12 to 15 months, and then the second dose is given right before kids go to kindergarten, and that's because it's not safe to do it before 12 to 15 months. Safety is the north star of vaccine trials, and it is the absolute standard when it comes to how we design the schedule for kids in this country, and in many other countries, too 

Why has measles surged again throughout the world?

Measles is on the rise around the world because of a decrease in vaccination. Now, historically, so we had eliminated measles in the United States up until 20- 2000. it had been a status that we'd had for a long time. And for the most part, when vaccination rates are at the herd immunity threshold, which means at least 95% of children are vaccinated for measles, you could mostly say we were measles free.

When measles outbreaks did happen in the past, it would usually be because a population, a school, a classroom would dip below that 95% threshold, and somebody would usually be importing the case, and a lot of times that was from international importation. So somebody who was visiting from a low vax country, who was unvaccinated, who has measles, came and then caused a little outbreak in a community.

That is increasing because we're both experiencing the importation of measles cases and low thresholds of vaccination in communities, where kindergarten classrooms across the United States are d- dipping well below 95%. And it's interesting too, because I was at a conference recently and somebody was saying something to the effect of, "95% is good, but, we should also accept things like 93%."

And you're like, no, no, we're not talking about what qualifies as an A grade here." The difference between 93% and 95% vaccination rates when it comes to measles is measles outbreaks. That's how precious we have to be about these rates, because as soon as we start dipping, we create vulnerabilities for even just one person with measles, which I've...

I think I've told you this in the past, one person with measles can infect 18 people. And think about that in exponential growth. If one person infects 18, those 18 can infect 18 each, and it's just absolutely like fire after that, the way it spreads. 

Next, Section B, HOW WE GOT HERE

For years, RFK Jr. had been concerned about mercury in the environment.

He'd pushed back on the coal industry to clean up rivers where the mercury in fish had been found to have a harmful impact on humans who ate them. So when he learned there was mercury in vaccines, he decided to investigate, and he called up Paul. 

It was a good conversation. We talked for about an hour.

At least, that's what he thought before he read the article. 

Although the vaccination industry insists that ethylmercury poses little danger because it breaks down rapidly and is removed by the body, several studies suggest that ethylmercury is actually more toxic than methylmercury. 

He just said that, mercury is in vaccines at a level that's toxic.

He had misstatement after misstatement in that article. 

Paul had developed a vaccine for an illness called rotavirus, and as he says he told RFK on that call, study after study had shown that a child would ingest more mercury from breast milk than from any vaccine. There was no evidence that such small quantities caused damage.

So back to the article. In it, RFK Jr. also repeated a claim from a scientific paper published in the late '90s by a doctor in England named Andrew Wakefield, the claim that vaccines are linked to autism.

He was arguing another thing, namely that the pharmaceutical industry was aware of something and was concealing it. 

This is Elena Conis. 

And that corporations like that actually needed more regulation and oversight than they were getting. 

The scientists and researchers, many of them sincere, even idealistic, who are participating in efforts to hide the science on thimerosal, claim that they are trying to advance the lofty goal of protecting children in developing nations from disease pandemics.

They're badly misguided. Their failure to come clean on thimerosal will come back horribly to haunt our country and the world's poorest populations. Deadly Immunity, Rolling Stone, June 2005. 

And coming from an environmental lawyer, that argument had a lot of traction. 

We reached out to both Andrew Wakefield and RFK Jr.

Wakefield did not respond. A statement from the Department of Health and Human Services in response to our questions read in part, quote, Secretary Kennedy is not anti-vaccine. He is pro-safety, pro-transparency, and pro-accountability. Okay, so back to 2005. RFK 

Jr.'s article reignited debates over vaccines, and Andrew Wakefield started to get noticed in the U.S.

Wakefield becomes this high-profile individual. He had been one in England. 

And he inspires other high-profile supporters. 

We do not need that many vaccines. 

A number of celebrities start talking about their own concerns about vaccines, going on nationally televised talk shows. 

Among the most vocal were- 

Jenny McCarthy and Jim Carrey.

Without a doubt in my mind, I believe vacci- vaccinations triggered Evan's autism. 

Actress Jenny McCarthy and comedian Jim Carrey were dating at the time, and Jenny's son had been diagnosed with autism. 

So I think they need to wake up and stop hurting our kids. 

Together, they organized a rally in the nation's capital called Green Our Vaccines.

I just wanna start by asking the CDC one question. How stupid do you think we are? 

RFK Jr. spoke at that rally. 

They've removed the thimerosal from the vaccines, and autism rates have not gone down. How many times have you read that repeated by these people from the press? That is an industry talking point that the industry knows is a lie.

Everybody knows 

it's a lie. National news outlets turned out story after story about vaccines. 

Local newsrooms were closing down, and there was increasing competition for news consumers, and the vaccine story was one of these stories that resonated broadly. 

And meanwhile... 

Social media is taking off. The public can actually weigh in, and so this thing really snowballs, and it's really creating a mass movement

So as this mass movement continued to make headlines in the 2000s, it also began to face more scrutiny. 

A lot of really critical media attention then starts to focus on the kind of characterization of vaccine skeptics as ignorant, selfish, uninformed, and worse. And it's become a moral position that many in media and politics have become comfortable taking.

Vaccines save lives. If you don't get vaccines, you don't care about people, and you don't believe in science, without including any of the vast context around the question. 

Yesterday, a respected British medical journal retracted a study that said the MMR vaccine may trigger autism. CBS News correspondent Richard Roth is in 

London with the latest step- With more eyes on the movement, the Wakefield paper came under more scrutiny.

The Lancet retracted it in 2010, and a British journalist named Brian Deer published an investigation revealing that it wasn't just flawed, but omitted key facts. Deer had already confirmed that Wakefield was paid to conduct his research by people with an interest in its outcome. His new work revealed that some children in the study had already exhibited signs of autism before getting vaccinated.

RFK Jr.'s article in Rolling Stone was also removed. 

you went through the sort of fallacies of the Wakefield paper. Do you remember when it was retracted and what your reaction to the retraction was, and what happens to Wakefield? 

My reaction was, it's too late. It should have never been published. You can't say anything about causality because there's no control group.

But were you surprised that even after the retraction, the, the narrative continued? 

I'm not even sure if they'd retracted it a, a month later, it would've mattered. 

I think the, the cage door got open and the devil came out. 

After the retraction, Wakefield lost his medical license in the UK, but he had already moved to the US and gotten involved in the anti-vaccine movement.

Eventually, he made a documentary, which controversially reiterated the claims in both his paper and RFK Jr.'s article. As for RFK Jr., he launched an organization called the World Mercury Project that was committed to, quote, "Exposing the government and corporate corruption that has led to increasing exposures to neurotoxic mercury in foods and medicines."

And in the meantime, vaccine-preventable diseases are starting to break out in really troubling numbers. 

Health officials fear thousands may have been exposed to the measles at Disneyland and Disney California Adventure last month. 

Then in 2014, there's this measles outbreak that starts at Disneyland. 

I think the original case may have come in from outside of this country because measles is still prevalent in the world.

Measles had been eliminated in the US by the year 2000, which meant enough people were vaccinated that even if someone came into the country with measles, it wouldn't be able to spread. Think of it as, a bunch of people holding up umbrellas in a group, so even if a few people don't have an umbrella, they're still shielded from the rain.

There was essentially a moat around them. 

But that protection wouldn't last forever. For decades, California had allowed some people to opt out of vaccines for non-medical reasons. The state actually created that exemption when it started mandating that kids get the polio vaccine before enrolling in school back in the 1960s.

California, had a philosophical exemption to vaccination. 

And vaccination rates had begun to fall. 

Once vaccination rates fray, that moat disappears. 

I'd been getting attacked for my views on vaccines for years, and, and that started a long time ago when the NIH asked me to speak to our good friend Robert F.

Kennedy Jr. I was in my office, and my assistant said, hey, Dr. Hotez, I have these two gentlemen on the phone." She's reading it. "One is named Dr. Anthony Fauci, and the other one is named Dr., Francis Collins. Can you speak to them?" And I was thinking, "Yeah, I think so." And, they said, "Peter, you have a, you have a daughter with autism.

You could explain to Bobby why vaccines don't cause autism." And I had a year of discussions with them, and that's what led to my writing an earlier book called Vaccines Did Not Cause Rachel's Autism, which wound up making me a big public target from anti-vaccine groups. But, it, I had to look up everything, and then, and I wound up becoming an expert not only on the vaccine science and making vaccines, but the vaccine anti-science.

But, there was a pretty sh- steady drumbeat of attacks, and it resurfaced when Mr. Kennedy was running for, president in 2023, and there was this big on social media from, Joe Rogan and Elon Musk and Kennedy for me to debate him in public on The Joe Rogan show, which I said I didn't wanna do because, I think it would send the wrong message of how we do science.

It's not done through public debate, especially with people who have no background in science. And also, I didn't wanna legitimize his presidency. and but, the, there was this massive, assault that came on from all of these tech bros and billionaires and even, New York Time columnist Ross Douthat that's, said, "Why aren't you debating him?"

and this kind of stuff. And it's like, where the heck is this coming from? and then I think that's when either Michael reached out to me or I reached out to Michael and said, "Hey, been there, done that," because he had ha- endured a similar attack as a climate scientist maybe a decade before. And we started comparing notes and realized that there was a, a lot of crossover between the attacks on climate science and biomedicine.

So if you think of them as two circles of the Venn diagram, they don't totally overlap, but there's significant overlap. And before we know it, we had a book, that, that could really show that this is a, an, a whole organized anti-science ecosystem that's not just some random junk out there on the internet.

It was organized, it was deliberate, it was politically motivated and financially motivated, a lot of it coming from the wellness influencer industry. and, and I thought, we had an important message to tell and to explain to people how this is organized. even though it is a dark book, the, our thinking was, if you can't even describe it, how can you hope to chip away at it?

and, and that's what this tries to do. 

If a young scientist came to you and said, how do I engage with bad faith criticized without amplifying it?" How do you manage that? What advice do, would you give to others as they think about "Yeah, I wanna get involved, but then this all it can do is escalate the, the platform."

I think, first of all, we clearly need more physicians and scientists and physician scientists out there in the public domain, because I think too often we're invisible. And I think, part of the problem there is the heads of the academic health centers don't necessarily like their docs and scientists out there because they're obsessed about controlling the brand of the institution.

and so it's become more, more perilous. And one of the things that I say is if you're, if you really want to do public engagement, really think about what your goals are. And, you don't wanna, as, as Churchill warned, if you stop to shy a stone at every dog who barks, you'll never get to the end of your journey.

And so you really want to be fairly strategic on how you do your public engagement. And when people ask me about public engagement, especially young people, they think I'm gonna start talking to them about social media. And one of the things that I explain to them, actually, no. social media is probably the least rewarding, for me, the least rewarding aspect of public engagement, especially on Twitter or X right now, which has become such a cesspool, so that if you're going to, wanna have a, a, a presence out there and aspire to talk to a wider audience, really think carefully about what you wanna do.

for instance, for me, the most mean... I don't do podcasts, but I could see that being a very rewarding and impactful thing to do. But in my case, I, I put my energy into, writ- writing books and, and opinion articles. And for me, that's the most meaningful part. the social media, I take-- think of La- Lady Gaga's immortal words, "Social media is the toilet of the internet," and I think she's probably right.

And I do it, I still do it because for legacy reasons, I have a lot of followers. I have 400,000 followers on Twitter or X and keep that going even though Elon is now, I understand, switching up algorithms to make me less, less visible or make other scientists less visible. but I think that- that's the message.

and think about how broad you wanna make your lane, become. I try to still stay pretty focused on the things that I'm passionate about, which are vaccines, infectious diseases, neglected diseases, climate health, things going on in Texas, and that's about it. What impresses, me about the two of you is how you've been able to, broaden your lane and really, are willing to engage on just about any health topic.

There are very few people who do that well, and unless, you really hone your craft, I recommend not trying to do that. um, you're, you two of you are among the s- exceptions that who do this exceedingly, in fact, I was just talking to John Lapook recently from CBS News, who's another person who does that well, or Sanjay Gupta.

But, and your dean of your School of Public Health is quite good at that, too. She's also, um, can talk about multiple different topics and do it, and yet in a, in an authoritative, yet, show humility as well, that she's not trying to be the expert on every topic. So it's a balancing act, so h- my hat's off to both of you, how you've been able to do that.

I'm gonna put that on a commercial. 

No, I think that, that's a key point, though. It's the humility. I do think that we know the narrow areas where we're actually experts, and we're willing to concede that other things we're always open to learning more. 

Let, let me just do a quick follow-up 'cause that, you mentioned that Churchill quote, so that's an interesting one, which is, what do you get distracted with?

What's worth your time? Where are you gonna engage? So recently, the CDC has changed their guidance because the Secretary of HHS has decided that there would be s- a statement that led to more ambiguity about the relationship between autism and vaccinations. Did you engage with that? 

That one I did because that one was right, right down the center of the lane, right?

that's how I got involved with public engagement is, having a year of discussions with Bobby Kennedy explaining to me vaccines don't cause autism, 'cause I have a daughter with autism. And what did you 

do? What did you do? 

what I did was, went back on, on TV first of all. I keep on hoping my TV career winds down, but, with, as the, as COVID begins to wane a bit.

But Mr. Kennedy seems determined to take me out of retirement. and I did multiple interviews, BBC and, and elsewhere, and then, went int- into the cesspool, X and, spelled out, why this is- 

And what was your central message? What did you say?

There's two parts to the central message. One is, other than this is total bullshit, the two parts of the central message were, one, a massive body of evidence showing that vaccines don't cause autism and reminding people that what the anti-vaccine playbook is to keep moving the goalpost, so you can't keep up with them.

first they said it was the measles, mumps, rubella vaccine, and that came out of the Wakefield paper in 1998. Then Mr. Kennedy came on the scene in 2005 and wrote in Rolling Stone magazine it was thimerosal preservative. That was also debunked through large cohort studies. Then it was spacing vaccines too close together, and it was aluminum vaccines, and this was yet another iteration of that.

And each time, the scientific community makes a good faith effort to show it's, the, the, to look into it, investigate it, and show it's not the case. 

Byron Donalds, the Republican nominee for governor in Florida, was recently asked about Florida's measles outbreak. Shouldn't you be pushing vaccination? Here was his response. 

So is your message to Florida parents, get your kids vaccinated against that one? 

No, actually my message to Floridians and quite frankly to Americans is the reason why we have seen a measles outbreak in certain parts of the country is because of rampant illegal immigration into the United States from the previous administration.

Margaret, before Joe Biden came to office, when our borders were basically secure. What evidence do you have of that? Margaret, we've seen the outbreaks in El Paso, Texas, in Southwest Florida where I live, and many other parts where you know that you have a situation. People have come into the country illegally, have not had that vaccination schedule, and not the ones today on young kids that parents do have concerns about.

Not only is this factually incorrect, but it's nonsense. It's again the kind of proud ignorance, and given the anti-immigrant sentiment, very reminiscent of the OG know-nothings, that characterizes so much of the modern Republican Party. Really, outside of a handful of Republican lawmakers, can you think of anyone of any national stature in this party who has any interest in solving an actual problem facing Americans?

Solving the high cost of living, solving the housing crisis, solving the lack of el- access to healthcare, solving the lack of ac- solving food insecurity. If anything, the policies, such as they have of these Republicans, would exacerbate these problems. The stance is this proud disregard of any kind of knowledge, this proud contempt for knowledge of any sort.

Now, I know I began this video tying this all up with Trump, and I do think that Trump has accelerated, supercharged all of it. But this is also a longstanding aspect of Republican governance at the national level. Arguably the most consequential Republican speaker over the past 40 years, Newt Gingrich, infamously destroyed Congress's capacity to make policy, both because it allowed him to centralize power in the speaker's office and out of a general disdain for institutionalized expertise.

Ronald Reagan also was defined by this disdain for institutionalized expertise. His economic and tax agenda rested on essentially fairy tales about the powerful ability of money for the rich to benefit everyone. As he often is, Trump is something of a break in that he is so distinctive, he takes something to such an extreme that it becomes qualitatively different, and he is in continuity with the past, in continuity with the Republican Party as it's been since the 1980s.

Yes, you can point to Republican officials, Republican lawmakers who were policy wonks during this period. But when it comes to Republican voters and to the energies and emotions that animate Republican politics, from Reagan onwards, from Nixon onwards, those animating energies, those animating emotions have been contempt for expertise, contempt for governance, hostility To the very notion of public goods.

And all of this tied in a host of racial, religious, ethnic, and gender-based resentments. Trump represents the extent to which those animating emotions and attitudes and feelings have superseded any kind of serious political activity within the Republican Party and become the dominant force behind both the politicians and the officials and the voters.

Or as the cliche goes, now the inmates are in charge of the asylum. There's that word again. So to extend that analogy perhaps a little more than it should be, is there a warden? And when will he come back in control? And I think the answer is that there is no warden, and this is just how the Republican Party is, and that's how...

and it's how it will be for the foreseeable future. And that does leave the country in a dilemma. You can't actually have a situation where one party is trying to govern, however unsuccessfully, and the other party is committed to destroying the capacity to govern. Doesn't really work out. And I don't have any answers for this one.

One of mine, potentially, is political reform. Changing the political system such that the incentives within the Republican Party are different. But if you believe, as I do, that some of this is an emergent property of the voters themselves, of the people who are committed to Republican candidates, and that those energies from the voters are what fueled Trump and gave him his prominence and are shaping the Republican Party across the board, then I'm really not sure what you do here.

It really may be that until there is some seismic change in the United States itself, the kind of seismic change that completely reconfigures a party system, it may be that until that point comes, we're all just hanging on for dear life as we attempt to navigate a situation where every once in a while, every so often, eh, fairly regularly, the mechanisms of state are captured by a bunch of people who want nothing more than to corrupt them, destroy them, and render them useless for the next people who happen to take the reins.

Now, Section C, WHY IT WORKS

my background in sociology and social psychology, I think a lot about identities and how identities guide us in our information processing. So to start out, big picture, we all have these identities that, thousands of identities, like parent, brother, friend, worker, sports fan.

All these types of identities, right? And they're gonna influence how we process things. And when it comes to things like, again, if we're a sports fan we might say, "Oh, that ref is biased and our team should win." that's a pretty benign type of, processing information in a biased way. But if we have a political identity- That can process our information in a biased way that might have more serious consequences.

Because ultimately, what our identities do is they provide us with meaning and a sense of structure in our social worlds, and they also can provide a really strong sense of self-esteem. So we have this motivation to maintain consistency between the values of our identities and the environments that we're in.

And so when we think big picture about why people believe misinformation, the perspective I often come from is a perspective of considering what identities are most important to that person And how those identities and set of identities are going to make them more vulnerable to certain types of misinformation.

And we're all vulnerable to different types of misinformation. So that's kinda like the first big picture, is thinking about our identities. But even beyond that, there are more specific components that can predict, a vulnerability to misinformation. the big ones are, education and media information literacy.

So when we think about just, aggregate studies of, okay, how do we... looking at this big population, what are the factors that predict higher susceptibility to misinformation? It's usually lower education, lower media literacy, and also, stronger partisan beliefs. So those are kinda like the, the main drivers of, specific individual factors that can predict misinformation susceptibility.

That's interesting. And also, you bring up this idea that we have, I think you said even thousands of different- ... identities. right? Sure. Yeah. And it's almost like at different points in time- ... different identities take precedence. Yeah. I know when I wear my scientist cap, I know, this is just, one random example, that red dye is, we don't have robust human data showing that red dye is going to cause a, whatever, a variety of health outcomes that some, some people say it does, right?

There's a lot of fear- ... mongering around dyes and additives and such. But then when I put on my mother cap, I think about my two kids, and I'm like, "Okay, I know the science is, there, th- these things are safe from a scientific perspective, and all the data are pointing to safe." But even still, my mama bear instinct, it's like, okay, but maybe I'll try to just minimize, just in case.

the, y- it's almost like I, I change the lens through which I'm seeing the world, right? And I'm placing a different emphasis on different things. So I just, I wonder, I'm sure that's a factor in some of the models that you're assessing and you're considering, is that those different identities can shift and change over time, even in short periods of time, right?

Yeah, absolutely. The technical term is identity salience. So that's why we talk about, what's more- ... salient in your mind on this, this hierarchy. And it's always moving, and there's this interaction between salience and importance. trying to think what's more salient in your mind versus what has overall more importance.

another important, factor as far as identities that I've been thinking about more- is this concept of, identity complexity. So basically what that means is how much do all of your identities overlap with each other? an example of really low social identity complexity is if you imagine all of your identities overlap on this perfect circle.

So your religious identity, your political identity, your friend identity, they all align, they all agree with each other, and you can see the world through a very narrow lens because it all fits in this identity Then you're very vulnerable to misinformation because everything is looking through that one lens.

And all of your self-esteem is derived through this one way of looking through the world. Whereas if you have a higher social identity complexity, and you have identities that don't overlap very much, then you're much more likely to see the world in a broader view and appreciate those shades of gray more, because you're not deriving so much self-esteem from a narrow set of overlapping identities.

So the, the broader we can be... And there's, there are studies that look at this, that when we have this higher, social identity complexity, when we have broader set of identities, we're, tend to be less likely to fall for these types of misinformation. 

and I'm sure, it's also influencing the way that we're seeking out information, and then you add in like social media algorithm and all that.

But, just recently I did a post on the way that we search for information, right? Yeah. Just even the search terms that we use and, confirmation bias, that's a whole other concept. But, if we're searching, does this cause cancer versus d- is this safe, for example- 

Absolutely

that's gonna spit out completely different information to us, and then also shape the, of course, the information that we're exposed to and consuming. So just something else for, for people to be mindful of. So Matthew, switching gears a little bit, so we're talking about susceptibility to misinformation, but what about the people who are putting out misinformation?

Why might someone do that? And then maybe you could just help distinguish between misinformation and disinformation in terms of intentionality, of deception. 

Yeah. So misinformation is the broad umbrella term of any sort of information that's false or misleading, regardless of intent. So if you just share something on social media, you're not trying to mislead anyone, but it just turns out to be not true, that's a, a form of misinformation.

disinformation is intentional. So you're intentionally trying to mislead or deceive someone because of some goal. And, some of the easiest examples of this are with political misinformation and propaganda, where someone has a clear political agenda to, elect a, a certain person or s- uh, a person from a particular political party, and that's why they want to share false information about their opponent, for example, because they want the other person to win.

So that's... Disinformation is intentionally trying to mislead someone. 

'cause I get the question, okay, what, why, what is the motivation? Why would a person lie about this? And to your point, sometimes they don't realize perhaps that what they're sharing is not in fact accurate information. But then of course there are unfortunately bad players who do, as you said, intentionally share disinformation And the motivations, the two that always come to my mind are fame and fortune, right?

So again, going back to how we kicked off the episode, we know that those very absolutist or extreme statements, those are the... That's gonna elicit a strong emotional response. It's likely to get people engaged with content, right? That's the stuff that makes a splash. It's clickbaity. and of course, large followings, although I have not cracked this code, they often translate to monetization, right?

a lot of times you can, if you grow a large following, you develop a platform, and you can make money from that. And then y- there's also just the fame aspect, the attention that, that people get, right? So any other thoughts or comments on why people might share misin- mis or disinformation?

Yeah, money and power are huge drivers. they, they drive so many different things, right? And we can think about the disinformation campaigns, ultimately they're driven by money and power. And when we think about people who have, public platforms, again, like you say, more sensationalist, misleading content is an easy way to get more attention.

So that's definitely some, some clear reasons why some people would share false or misleading content. And, I think about it as a, they might not, start off even, with a goal to mislead people, but maybe they see one post does really that was sensationalized, and they drift more into that direction.

And all of a sudden they're, spreading complete lies and complete nonsense and justifying it. One other thing I'll say about one- why people share misinformation is, it may be that they don't entirely believe it to be true, but they think by sharing it, it's better safe than sorry in some ways.

So if they think, for example, all this misinformation was spreading on WhatsApp in, in, in India a- among these certain villages. You might have heard these stories. That was, from a few years ago. And it was just rumors and lies about these people that were kidnapping children, and they were ultimately killed because of the misinformation, being spread about them in, in these villages.

And a lot of the misinformation spread on WhatsApp, just people just forwarding these, these rumors And some of the research looked at that as why did you re-share this? And some people said, I didn't know if it was true. I wasn't really sure, but I thought it was better to share this just in case there was a kidnapper in my village than to not share it."

So when we think about other types of misinformation, it's similar too. if we think that something's harmful, red dye or whatever, maybe you feel like that fear component of "I think it's better to protect people I care about and share this just in case," and you're not really considering like the whole information environment of what happens when you do that, and you're just having this fear response.

So sometimes it does come from a place of, of, protection and worry.

During the early 1950s, Polish American psychologist Solomon Asch expressed the power of conformity through a simple test. In this experiment, a volunteer is told that they're participating in a study on visual perception and is seated at a table with five other people. The experimenter shows the group a picture of a standard line and three comparison lines of various lengths, and then ask the people to say which of the three lines matches the comparison line.

It's clear to anyone with any kind of good vision that the second line is the right answer. But the thing is, most if not all of the other people in the group start choosing the wrong line. The participant doesn't know that those other people are all actors, a common deception used in social psychological research, and they're intentionally giving the wrong answer.

This causes the real participant to struggle with trusting their own eyes or going with the group. In the end, most subjects still gave what they knew was the correct answer, but more than a third were essentially just willing to give the wrong answer to mesh with the group. Asch and subsequent researchers found that people are more likely to conform to a group if they're made to feel incompetent or insecure and are in a group of three or more people, especially if all those people agree.

It also certainly doesn't hurt if the person admires the group because of maybe their status or their attractiveness and if they feel that others are watching their behavior. We also tend to conform more if we're from a culture that puts particular emphasis on respect for social standards. This might sound a little bit familiar, like It's all of high school, fraternities or sororities, the big company you work for, or any other group that you've ever been a part of.

The classic experiments of Milgram and Asch showed us that people conform for lots of different reasons, but they both underscored the power of situation in conformity, whether that situation elicits respect for authority, fear of being different, fear of rejection, or simply a desire for approval. This is known as normative social influence, the idea that we comply in order to fuel our need to be liked or belong.

But of course, groups influence our behavior in more ways than just conformity and obedience. For example, we may perform better or worse in front of a group. This is called social facilitation, and it's what might, say, help you sprint the last 100 meters of a race if people are cheering you on. But it's also what can make you nervous enough to forget the words to that poetry you were supposed to be slamming in front of a crowd.

But that's what can happen in front of a group. What happens when you're actually part of a group? Do you work harder or start slacking? One study found that if you blindfold students, hand them a rope, and tell them to pull as hard as they can in a game of tug of war, the subjects will put in less work if they think they're part of a team instead of pulling by themselves.

About 20% less, it turns out. This tendency to exert less effort when you're not individually accountable is called social loafing. That's pretty good. You can now add the word loafing to your scientific vocabulary. But a group's ability to either arouse or lessen our feelings of personal responsibility can make us do more dangerous things than just phone in some group homework assignment.

It can also lead to deindividuation, the loss of self-awareness and restraint that can occur in group situations. Being part of a crowd can create a powerful combination of arousal and anonymity. It's part of what fuels riots and lynch mobs and online trolling. The less individual we feel, the more we're at the mercy of the experience of our group, whether it's good or bad.

And it should come as no surprise that the attitudes and beliefs we bring to a group grow stronger when we talk with others who share them. This is a process psychologists know as group polarization, and it often translates into a nasty us versus them dynamic. And you know what is great at polarizing groups?

The internet. The internet has made it easier than ever to connect like-minded people and magnify their inclinations. This can of course breed haters, like racists may become more racist in the absence of conflicting viewpoints, but it can and often does work for good, promoting education, crowdsourcing things like fundraising, and organizing people to fight all kinds of world suck.

And group dynamics can not only affect our personal decisions, they can also influence really big decisions on a larger, even national scale. Groupthink is a term coined by social psychologist Irving Janis to describe what happens when a group makes bad decisions because they're too caught up in the unique internal logic of their group.

When a group gets wrapped up in itself and everyone agrees with each other, no one stops to think about other perspectives. As a result, you get some big and bad ideas, including some enormous historical fiascos, like the Watergate cover-up, and the Bay of Pigs invasion, and the Chernobyl nuclear reactor accident.

So while two heads may often be better than one, it's important to make sure those heads are still open to different opinions, or they can do some really dumb stuff. In the end, it's best to understand ourselves and our decisions as informed simultaneously by both individual and group factors, personality and situation.

it's frustrating to me that politics and health are now just such blatant entertainment that people don't... It doesn't matter if you're wrong because you just say, "I don't like the other guy," and your fans all clamor and applaud. It doesn't matter what you say. You just say, "I don't like that," and then that's what matters.

So that's something that is very frustrating to me. And, going back to health misinformation, it was actually interesting that, there was a recent meta-analysis that looked at, the impact of fact-checking across different domains, and it was found that health misinformation was actually most resistant to fact-checks.

like even more than some- That's terrifying. Yeah. Yeah. So like that's another reason. it's such a difficult problem too, and there's a lot of reasons for that. like a lot of it now is, like the politics, and we talked about how political identities can bias us and how if we want to believe something That, makes us feel like we have, are in control or makes us feel better about ourselves, and someone says, "No, that's wrong," it's really hard for them to change their mind.

So yeah, definitely things with health, but, all types of misinformation that has, really immediate consequences to harming people is very frustrating. 

There was another study, and I did not read it in its entirety to prepare for this at all. It just occurred to me. and tell me if you've heard of it, but it looked at the impact of political ideology on, VAERS, so the Vaccine Adverse Event Reporting System, and how in states that tend, that lean more conservative, the number of reports to VAERS was significantly higher than those in other states.

And I, I've talked about VAERS at, at length, and just in case folks are new to it, it's a, it's a passive public health surveillance system for vaccines where people can report, adverse events that they experienced after getting vaccinated. However, it's really used as a, as an early warning system for public health scientists.

if we see major trends, of a particular outcome, they're taken quite seriously, and they're rigorously investigated to see if they're true safety signals or not. but unfortunately, people, I think COVID shined a light on VAERS, and people don't really- Yeah ... understand that it is not, it cannot be used to signal causality.

Because just because something occurred after vaccination does not mean it was caused by vaccination. And also, some people do, unfortunately, intentionally put, file, false reports of adverse events after vaccination. So there's, it's a whole, it's a whole thing. But I thought that was really interesting, and I think, we're all aware of the role of political ideology in, in, in, in health and science information- consumption. Yeah. But we have not cracked that code and I feel like that's a real area, for future work. it just, it breaks my heart to see certain friends and family members who do lean, a, a certain way politically. They are, they're, they're much, they seem more likely to consume information specifically that paints, the government in a bad light, for example.

those who tend to have strong libertarian leanings automatically- ... distrust, vaccines, for example, because the FDA is all bad, or they're, quote, unquote, "in bed with industry." So those, I find that those people are quite difficult to reach- ... but I have not given up yet.

but I'm sure- I'm curious if you've, I'm sure you've seen that, and that's something that's, on your radar as well. 

Yeah. yeah, the- Interaction between politics and health misinformation is huge and definitely something I've studied. And, it's been unfortunate to see, the rise of anti-vaccine misinformation align itself with right-wing politics, and it wasn't always the case.

COVID really painted vaccination in a, a very partisan lens, unfortunately. 

And I know I find it challenging. obviously I'm unbiased science, right? But to, to- ... put out non-partisan information, again, this was something I talked about last week with, with Moshe, it's very difficult because science has been politicized, you know- Yeah

whether we like it or not. And so I feel like- ... no matter what I say, it's construed as taking a political stance. and that's something that I personally struggle with quite a bit. So Matthew, one more question and then I'm gonna leave you alone, but you posted something about the quantification of misinformation, and I believe it was Dr.

Karam Garimella's work in particular that you mentioned on Threads. a- as a data scientist, this is just something that I'm very curious about, how we quantify misinformation. Is there anything that you can share about that? 

Yeah. So misinformation, as I mentioned, is such a broad term, and how we study it- Can be challenging because to do a good study, you have to define your variables well and, and code them in a way that makes sense with your statistical analysis.

So sometimes you can't appreciate all of the nuance all of the time, and sometimes, things are changing and what used to be misinformation may no longer be misinformation in the future. like misinformation, it's based on the best available evidence we have. So that, that's the bigger picture, but also just like how it's defined.

Sometimes misinformation is defined as sharing links from non-reputable sources, so just any link from a source is kinda lumped in there. And that's done for, to make the experiment, like the statistical analysis possible. Because otherwise, if you try to go through each... if you're looking at millions of tweets, for example, you can't parse through each one individually and fact-check it, so you, you take a more generalized approach.

other research looks at specific statements of, if something has been fact-checked as true or false, so then you're defaulting to what fact-checkers say. and there's other research looking at, broad beliefs that people have. So we talk about anti-vaccine beliefs, like that's a, a big component of misinformation, and that's why we see a lot of these links between conservatism and, believing misinformation is when you just look at vaccine information, you see this very partisan slant.

So it's really challenging to, to quantify because you have to be very specific with how you came to those conclusions. And I think it's important for misinformation researchers to try to have as much humility as we can and not try to, come across as, as arbiters of truth. And I think, it's, it's tough because, there are some things that we can feel very passionate about that are very, there's a ton of science to support them, and we might just feel like this is clearly the way to go.

And then there's some other things that maybe are less certain, and I think it's important to try to be mindful of our own limitations and how we, perceive our worlds and try To navigate different spaces and try to study misinformation because ultimately the goal is to try to, have people, live lives that are based in evidence and make evidence-based decisions and r- have people recognize their own biases.

But as scientists, we have our own biases too. So I think it's really important to try to work together and determine consensus where we can call out each other's biases in order to all collectively become a little bit less biased.

And Finally, Section D, RESPONDING TO THE MOMENT

during that time, constantly visible online, constantly trying to translate scientific information as co- as is was coming out, what kind of personal drawbacks came from constantly being online, constantly being at the forefront, and not sharing, the most heartfelt news?

Yeah. I would be lying if I said it was all great. Yeah. It wasn't. it came at a big cost. being a public figure in general is costly, but being a public figure Related to public health during a time that was incredibly divided, a time that was highly politicized- a time where other racial tension were happening as well- Yeah

and political tension was happening, it, it created the perfect storm for a lot of vitriol. and I'm not unused to that or not used to that. it's... I'm familiar with the anti-science movement. I'm familiar with the anti-vaccine movement. Those were not new concepts. But to be the direct recipient of the attacks- as somebody who probably comes off as very thick-skinned, I'm very much not. I'm very sensitive. And it was very hard to receive death threats and very specific threats of violence towards me and my children. I remember there was a weekend where I got a call from a 703 number, which is Northern Virginia, and it was an FBI agent who had said that my name and my children's names had appeared on dark websites.

Perhaps I should leave town if I had the means. And I just remember thinking, "What if I didn't have the means?" Exactly. 

Yeah. 

and again, he did also say, a lot of times these are keyboard warriors who are a lot braver- Yeah ... on the computer than they are in real life, but I wasn't gonna take that risk- Oh, yeah

and wonder if anything would happen. 

yeah. 

so it was costly. I remember I was one of the co-authors of that letter to Spotify- 

in response to the episode with Robert Malone on Joe Rogan's 

podcast. yeah. 

Not asking for deplatforming or censorship. We were just literally asking for a basic warning that said, "This is not medical advice."

Yeah. 

The most basic warning. And what happened after that was truly horrific. I just was, dragged online, attacked, called every name in the book, to the point where I had to create creative spellings for, the N-word, to make it a hidden word- Oh ... that it wouldn't show up in my DMs- My God ... because I was being called that so often.

it was just using numbers and emojis and all kinds of things. It was just so awful. I say that, and I still wouldn't go back and change a thing because I know that when I look at the totality of that experience, the good far outweighs the bad. The bad was really bad, but the goodness of it and the benefits that I saw happen in people's lives and my, in our community was so much greater.

Wow. 

that's a 

lot. It's a lot. Oh, I'm so sorry 

you 

went 

through that. 

Yeah. 

can I just comment on, first of all, thank you for doing everything that you've done despite all of this crap that people had to put through you, or put at you. But this also is reflecting on the fact that a lot of the target and the harassment is very gendered, right?

Oh, 

absolutely. 

And can you speak a little bit more about... we teach science comms. we tell young people, including young women, "Get out there." Yep. We need more of us to speak up. We need more visibility, more representation in science, in public health- to be public figures so we can see ourselves represented- in the screens, and yet there is that dark side- Absolutely ... of doing public communications, especially in public health- Yep ... especially today, when so many words are just triggered- Totally ... just to say that. so how do you balance that? 

it was both the reason why I was so trusted, because I was a woman- Yeah

because I was a woman of color. I think it really opened, science up to a lot of people who were like, "Wow, she looks like me," or- Yeah ... "She sounds like me," or, "She's in a similar season of life as me." and then it was also the reason to attack me. Yeah. Yeah. "You're a woman. You must be dumb.

You're a woman of color. You must really be dumb." it was just the s- most Unoriginal and like- ... absurd- Yeah ... kind of critique. Yeah. and then predictable, deeply misogynistic kind of tropes that I would hear, telling me to shut up and cook dinner and like stupid stuff. 

Oh, gosh. 

Oh, yeah. Oh, yeah.

"You should be taking care of your kids and- Wow ... not talking about this. You don't know what you're talking about. This is a man's job." I a- any- anything you could imagine a misogynistic person saying to a woman like me, it was said. 

Quite un- Like- ... unoriginal, 

I think ... unoriginal. Yeah. Truly, deeply unoriginal.

Okay. 

but, I felt so strongly that for so many years science, capital S Science- Yeah ... was just so elitist and hidden behind prestigious institutions and often portrayed by and represented by white men. 

And the... I just wanted people to see, it could be so much more. There are...

There's so much diversity in this space, and you can look like me and be a scientist trained in very technical things. I'm not, obviously not the first at all, but I wanted to at least show people that you can also be a mom and do this, and you can also, work in this type of work and do this, and you can be a public figure and do this.

But I tried to also be very transparent that it wasn't just wonderful and- Yeah ... rainbows. 

Yeah. Can I ask you to reflect a little bit on how you coped with all of this? Yeah. Because receiving death threats, receiving, anger towards yourself, but also your kids- Yeah ... and your family, that's a lot.

How did you cope- 

Yeah ... 

with all of that? 

I scaled back a lot. I changed my relationship with... for a while it felt like a ball and chain a bit. You know- Yeah ... I ha- I was on a very short leash. It felt like I would do this weekly Q&A, which I loved doing, but then it became almost like an expectation, and this was all free labor.

Yeah. I was not charging for any of this. I'm like the worst kind of influencer in that sense. None of my work was sponsored or paid. I would just do this as a public service. And I stopped posting about my kids, and that was really sad because I think one of the most, compelling things that I did was I- Yeah

I shared my kids' journey through COVID and their vaccination journey- ... and even interviewed all of them about their post-vaccination experience. I remember some of that. It was so- And my- ... beautiful ... sweet toddler boy talking about, his T cells and his B cells- ... getting activated, it was like- Oh, my god

beautiful and so endearing, and it made so many people, feel that, oh, the vaccine's not scary. And- 

Yeah ... 

I wanted to lead by example, but I just, I thought, that privilege has been revoked, and I stopped posting about my kids. I started going to therapy for the first time in my life, honestly- and that was a really great reason to start. it was a traumatic experience- Yeah ... but it was a really great reason to, put that practice into my self-care. I took more breaks, Yeah. I think that I was... I'm still feeling like I'm chronically online, but I scaled back a bit, and my audience noticed.

they were saying, "You're not posting as much," and I just thought, "I can't." 

Yeah. 

this is a really intense job that I get nothing compensated for. Yeah. and I didn't resent that part, but I just thought, if the cost is so high-" Yeah ... "then I really need to think about the balancing of my, emotional budget here."

Yeah, for sure. Yeah. wanted to take a little bit of a step back, to Joe Rogan and other inf- influencers who are constantly speaking about scientific information that may not be the most reputable or, reaching to sources that maybe aren't sharing the best facts. speaking about that, specifically about the Meta community guidelines removal and how, social media used to be managed in terms of information that was put out, someone behind the scenes was looking at that, seeing if that was truthful.

What are your thoughts on kind of Meta stepping out of this equation? 

it was very disappointing to see a scaling back of any type of content moderation. Yeah. we've always known that the algorithms are optimized with clicks and eyeballs- Yeah ... and that the things that cause people to click and watch and forward and...

are things that elicit strong emo- emotional responses. 

And, my content wasn't salacious. My content wasn't creating people to have, big reactions. sometimes it was if I was having, a big reaction to some bad content perhaps. but, we got into this, very ridiculous debate about truth, and that's not even what we were asking them to do.

We were not asking them to be, like, final arbiters of truth. We were just asking them to recognize that when somebody is saying that it's something that is, demonstrably false, like the most basic science. Yeah. lying. 

Yeah. 

Literally lying in a provable way. 

Yeah. 

That even if they don't take it off, that it should be flagged.

And there was a whole section, there used to be for the f- the first couple years of COVID, where you can flag something as false information, then you could put it under the category of health, and you could even put it under the category of COVID-19 under health. 

And then all of that disappeared.

And I remember there was a time too where they were a little bit overzealous with the content ban- banners, and it would get in the way of our captions. Yeah. 

Yeah. 

Yeah. I remember seeing that. Yeah. It 

was like, And I 

remember They're like... And it would say things like, "For re- you know, for reliable information, go to the CDC or WHO."

The CDC, 

yeah. yeah, yeah. Yeah. 

which is crazy that we can't say go to the CDC anymore, at least not in the US, but- Yeah ... a full walk away from that was just shocking, especially because it wasn't just a walk away from that. Those of us who were content creators felt really supported by these- 

... these organizations, by these teams. And then those teams dissolved, and our emails started just to go unanswered. They stopped caring because they just deprioritized it as an organization so much. And I think that we are now in a very dangerous place when it comes to online content moderation or lack thereof.

Because you have other platforms who are almost boomeranging so much to the other side of like, if you really want free speech, because there's a different kind of suppression that's happening on platforms like Meta about political content, which public health was then downgraded to political- 

Yep

content, 

and therefore our, engagement dropped. but then you've got other platforms being like, you can say anything." 

Yeah. 

And it's completely the wild west. And that is also not what I'm asking for. Yeah. I don't think that is free speech. I don't think that you can- yell fire in a crowded space, right?

I don't think that you can yell that vaccines are killing people either. Both of those things are harmful lies and- ... and should have consequences. And so I worry about the future of digital ecosystems without any sort of checks and balances. 

I never raise my voice with patients, and I feel like these conversations are similar in that way, in that they should be kept very respectful. But at the same time, I thought it was valuable to show the level of passion that not only I feel, but my colleagues have been feeling for a very long time. In watching it back myself, I thought I did a pretty good job balancing being an active, empathetic, attentive listener with going to bat- For my colleagues, science researchers, science in general, and allowing people just to see the flip side of the conversation, but being a good person, meaning that the people who I was disagreeing with, I didn't want them to hate me.

Because I felt like if we created a hateful relationship right at the outset, no one's mind would be changed, no one would get any meaningful value out of these interactions. And it actually worked quite well. even walking in, I think I made a joke sitting down at the chair, which last time I didn't. I was so nervous.

This time I was a little more comfortable. Made a joke about the government shutdown. Everyone laughed. It put everyone in a better place. And then as feedback started coming in, I saw comments from some of my colleagues, and it, it got me a little bit upset. It pulled at the heartstring because right now in the healthcare community, especially those who are trying their best to put out evidence-based content, we're all on the same page.

We're all trying to do the best that we can. We all have different ways of doing this. I have the YouTube channel, the podcast. We do silly videos with meme reviews. More serious, hard-hitting interviews with people who've been impacted by MAHA. Other people make TikTok videos dancing with hula hoops.

Whatever it is, everyone has their own little strategy, and I think that's great. I think that's the power of social media. But then when our own group starts attacking each other, that's where I feel like we're setting ourselves back. Especially because the criticism that was, put forth here I think is similar to the criticism I heard starting my social media platforms.

The doctors that first heard about my wishes to put out evidence-based content on social media were saying, "It's not valuable. It's not professional. It's not gonna help anyone. You're not changing anyone's mind." When I see comments like this about the format being bad, I feel like it's in a similar vein.

It's judgmental in a way- That I don't believe is beneficial to the cause of evidence-based medicine. These Jubilee debates oftentimes devolve into shouting matches, disagreements where no one comes together. I see why people criticize that. But if you took a five-minute watch, a 10-minute watch, a 30-minute watch, if you were gracious enough to watch the entire episode, you'd see that this episode was far from that.

Humans saw other humans across from them. They heard one another out. We agreed, we disagreed, we had some commonalities. Ultimately, I think that's a win. Bringing people together to discuss issues is a huge win, and, what surprised me most is almost the ending of the debate. People came up to me that were debating me, thanking me for my time, for my honesty, saying that I'm different than most doctors.

And while I take this compliment, I have to remind them that the doctors that they have painted in their minds, or perhaps have had negative experiences with, do not represent the entirety of the healthcare profession. We wanna do better as a majority. We wanna be there for our patients. Sometimes the healthcare system gets in the way.

So at the end of the day, it's less about h- holding our noses up in the air and saying, "You shouldn't be on social media. You shouldn't be in these debates. You shouldn't be on Fox & Friends, Dr. Mike, 'cause they spread misinformation." Hold on a second. Bad actors are going on Fox & Friends and spreading misinformation.

Don't you want me on there to replace those people, get better ratings for Fox & Friends so that they can then get accurate information, the audience get accurate information? So that's my thoughts on that. I'm curious about your take. I asked about this in my Instagram stories, and I was actually pleasantly surprised to see the amount of, support that I got.

These days it's hard to find support on social media, given the fact that we don't do the whole parasocial thing on this channel, but cool to see nonetheless. The biggest value that I brought to this episode, I think, was highlighting blind spots that perhaps the panelists didn't even realize they had, whether it was highlighting the fact that RFK Jr.

is still getting legal fees, but they're just being sent to his son. He's getting money. How is that impacting his decisions?

He has 

gotten money in the past. He doesn't take payments anymore. He 

can't. 

And 

so- Do you know who's taking payments on his behalf? 

M- You're probably gonna say his wife. 

His son. And the participants didn't even know the MAHA report existed, and they didn't know that some of the data in it was completely fabricated.

The sources were fully made up, like AI hallucination level. 

Did you see the first MAHA report that he put out? 

I did not, no. 

Seven sources. Okay. Fully made up. About research that was never done. When I reach out to the authors that they listed their reasoning for why they were making certain recommendations.

There's no way to ask. And then finally, the point about they believe that our system sucks with transparency, a point of which I agree with. They then believe RFK Jr. is bringing back that level of transparency, when in reality, he just is ending a period of public comment like I pointed out to this gentleman.

Every time HHS enacts 

a new policy since 1946, they had a period of waiting for public comment. For people who are stakeholders to talk about how this policy will impact them. Guess what Secretary Kennedy ended this year for the first time since 1946? 

do, do you know why he did it? 

Yes. 

Why?

I can quote you word for word why he did it. 

Okay, so my understanding is that- 

no, I'm gonna read it to you It's not needed, and it's not very effective.

That's interesting, 'cause, uh, in some ways I agree with your statement. I 

agree. The prescription given by a doctor, and I think this is a major problem, and you guys have broken trust. 

I agree, and I think I agree with everyone here on that. You know what's wild? I agree with you. 

I think we agree on so much, 

man.

He's not making the reforms. 

Pause. 

Pause. Pause 

time. I think in general, the people who support RFK, perhaps even the MAHA movement, want the same things that doctors want. And once we realize we're on the same team, I prese- I was able to present a little bit of a different take from my perspective, because they're giving it from their patient perspective, and I'm giving it from the doctor perspective.

And I wanted them to reflect upon that, to see that I'm not the enemy. Just rattling off a couple things that we completely agreed upon during this debate. Chronic diseases are on the rise. Lifestyle changes are a big part of it. But as someone who's actually in the trenches and treating patients, it's not so easy to create sustainable behavior change.

So when someone says, "Just work out," on an individual level, that sounds great, but for a doctor who's trying to motivate a patient- That's very hard because patients come with all sorts of situations alongside them. The fact that the system sucks and has hurt some of them, I completely understand. I criticize the system probably more than anyone on YouTube because of how problematic it is in getting people affordable care, quality care, transparency, during their care, the administrative burden that comes with it.

The fact that conflicts of interest exist, that's true, and we need to call it out when it happens, especially when it's hidden, but we need to call out conflicts of interest when they happen on side A and side B. And the final one is the point that's probably most tired, is we messed up during COVID.

I get it. We could have done better. We, as a healthcare system, messed up. As a government, we messed up. This is a worldwide phenomenon where no one knew what the heck was going on, and as a result, we didn't handle it perfectly. We have videos on this channel covering what we did wrong, what we could do better, how do we learn from it, multiple podcast guests, and I think we'll continue to do that.

I think the participants were shocked that I was, someone who was willing to concede those points. But what doesn't make sense to me as a physician is that when we say, 'Make America healthy again,' is insinuating at some point we were healthier than we are now And I don't know what time period we wanna go back to, but I certainly don't wanna go back to the times before pharma, before antibiotics, before we knew how to perform surgeries and have medical devices and stenting and all this stuff.

So when we say healthy again, I don't know what timeframe we're looking at. And when we look at data, a lot of the participants would point out that chronic health diseases are on the rise. I agree. And I think this is a societal problem, not necessarily a medical problem. The disconnect was, in those scenarios, was people didn't see that we've actually made tremendous strides in helping people manage certain conditions, whereas in the past, they may have acutely died of those issues.

So that while chronic health diseases have gone up, we have to remember that when someone used to have a heart attack, and we had no treatments for them, they would die. So now we're allowing people to survive their first heart attack, they become chronic health patients. The, the fact that we've been able to better manage, chronically, these conditions, we're seeing better mortality numbers, but perhaps worse chronic health numbers.

And that's a very unique problem in healthcare, because for every condition you solve or cure you create, you actually end up creating a new problem. If you look at our relatives that only lived to age 20 or 30, perhaps they didn't have issues with skin cancer because they didn't live long enough to experience skin cancer.

If you think about those same individuals and their dental, health, they didn't live long enough to develop all the dental problems that living into your 70s, 80s, 90s can cause. I think we need to really understand, when we make an argument, why we're making the argument, what the flaws of our arguments are, and that's what science does, and I think that's what makes science beautiful.

Uncertainty is very disorienting. And I would argue that pandemics, public health emergencies, are probably the most disorienting thing that can happen. Yeah. And so when there's a lot of uncertainty, human brains like to make sense of things, right? There are dots, we wanna connect them, and that causes a lot of logical fallacies to emerge, and it's sometimes like the appeal to nature fallacy of like whatever is natural and organic and- from the earth might be better, or the correlation and causation fallacy, where people see two things and you assume that A caused B. and it's, it's trying to help people understand that- it's okay to feel disoriented and uns- and the uncertainty is disorienting itself. I want to, bring some human touch to the science communication and sh- and share the empathy that I have with, "This is scary.

This is really disorienting." But there are people who are literally out to cause more harm than the harm that is being caused by the thing that is causing the disruption, right? 

Since the beginning of time, misinformation has existed, and misinformation is this kind of byproduct, too, of a public health emergency, and there will always be snake oil.

There will always be conspiracies. There will always be alternative facts to the actual evidence, and I just want people to take a step back and recognize that. you might think those are lies, but why do you think that? Yeah. Is it because people who have your same religion think so? Is it because people- who have your same worldview and political view think so? Is it because that makes you feel more calm? And asking those questions can help them separate themselves from a little bit of the groupthink that happens. Because I don't think people who refuse vaccines want to harm anybody- No. ... or want to harm their own children.

I think they think those things because they've been led astray. 

Yeah. 

A lot of times, they're hesitant or confused and just have not been given the right information, or they've just been completely saturated with bad information. Yeah. And so it has to come in from, a judgment-free zone first to be like, "Look, information is not neutral, and you- You probably heard something that is causing you to believe these very binary things about what's going on.

How can I help you understand it more so that you're not assuming that something that you don't like is automatically bad or made up or fake, 

How do you filter or infiltrate or penetrate, those ecosystems? Because a lot of the times it's echo chambers, right? Yeah. It's communities that think like this.

how do you have those conversations? How do you have access to those conversations? 

I've done it in a multitude of different ways. I have had-- I've done focus groups with people who were all very politically conservative and done a lot of, listening and understanding, w- their perceptions of vaccines and vaccine policy.

Absolutely enlightening. Helped me as a science communicator to understand- what are the kind of sentiments that are happening in the community. I've asked my audience to tell me things that they've heard, frequently asked questions, circulating narratives, rumors, falsehoods, whatever.

I've done lots of one-on-one conversations. I had people who were like, "Look, my family member is an anti-vaxxer. My family member is, really obsessed with MAHA." I've done it on a one-on-one. I've done, group Zooms. I've done focus groups. I've done media. there's just so many ways.

and I think that not otherizing the groups- Yeah ... who disagree with you is a, a critical part of being an effective communicator, right? I want to be talking to people who are in MAHA so that I can help them understand, look, I want to make America healthy again too. I want to make everybody healthy again.

That's why I'm in, that's why I'm in public health. Yeah. 

Exactly. 

Even this concept of, like- Longevity, which is all over the news right now. Yeah. Yeah. you know that public health is, the whole goal- All about that ... is longevity, right? we're trying to- The 

quality 

of- Reduce... Exactly ... health. Yeah.

Reduce harm- Right ... increase your quality of life- 

Yeah ... 

give you healthier habits- ... promote health, regular screenings. that's all longevity science. Exercise. For sure. Exactly. Exercise, reduce alcohol, don't smoke. it's these things that are so, known, but they're just not sexy- Exactly

and they're not something that you can charge six figures for some, curated concierge experience. 

Vitamins. 

And supplements and other, smoke and mirrors. But I... Even saying that to folks can help them understand that it's not just, the system and big pharma and allopathic care against alternative, functional, natural solutions.

It's a very, like- ... mixed ecosystem in that sense, and I want to demystify what public health, capital P, capital H, actually means to people- ... because I think COVID really turned it into something that- 

Yeah ... 

it's not. 

Yeah. 

it's, it, people assume public health equals government. 

Yeah.

It doesn't all equal government. Or restriction. Or restrictions- Yeah ... or mandates and things that felt very oppressive. 

Yeah. 

I can empathize with that because it was a very difficult time. Yes. Yeah. And I think that goes a long way of telling people, "I get it. It sucked," or, "I get it. You did not enjoy that experience.

Let me tell you what public health is actually trying to do." 

Can I ask you, more on the information sources, back to Viaca's point earlier. A lot of folks are getting information from lots of different spaces. 

so what does that look like m- moving towards the future- Yeah ... for communicators or science communicators, who would like to do this type of work?

It's no longer sufficient just to go on traditional media- No ... and just speak to the same usual suspects. Yeah. What does that look like to communicate science and particularly during emergencies- Yeah ... and at this moment in time where people are getting information from all over? 

I, regardless of what people's opinions are on this, social media is a primary news source- Yeah

for many people, if not most people. It's why every newsroom has a channel- Yeah ... and has catered to the types of content that people like to consume, which is short videos with captions so they can watch it while they're not doing their work or in a meeting- Yeah ... or whatever. 

Yeah. 

Very memorable, eye-catchy content that's something that they can remember and also forward easily to other folks.

It's... And so it is the belly of the beast, but I'm, I have to be in the belly of the beast- Yeah ... because I have found it to be very powerful to be there, so that my content is also primary news to people. and I don't wanna just be there to be in a reactive response- Yep ... to the other sources, whether they be questionable or not.

I want it to just be part of the ecosystem so that people- ... can see it. if I was constantly reacting to bad news, I would never sleep. Yeah. It would just be a constant- Oh, for sure ... game of whack-a-mole, right? 

Very true. 

and so I wanna be front-loading that space with really good science, really evidence-based content.

but I do think that we have to diversify. I think it needs to be everything: video- ... images, infographics, long-form, short-form, traditional media at times, new media at times. it's... That's just the ecosystem that we are in right now, and I think the AI conversation- 

I was just going 

to that

is proving that- Yeah ... it's, we are... It can be a tool for good. It has already been a tool for bad. 

Yeah. 

we're not, it's not going anywhere. 

Yeah. 

And I think that if we are going to help people have discernment skills from the get on how to be good consumers and users of a digital information, now more than ever, we have to tell people, "This is how you should consume this- Yeah

and this is how you should treat it." you have to be extremely skeptical of everything online- ... because you need to ensure that it's real. 

But that's also exhausting. 

It's very exhausting. 

Yeah. 

It's very exhausting, and I th- that's why I really strongly believe, I'm a mom of three young kids.

I think that kind of training starts young. Yeah. I want my kids now- Yeah ... to start being very critical of whatever they hear. 

it seems like there, there really is no truer test of leadership than in moments where you're doing it in times of unfavorability, and we know right now that public health and science is being questioned, especially in the United States, but a- abroad. And so I'm interested to hear how you think about courageous leadership in times where your work, the very foundation of what you're doing, is unsupported and in some cases even under attack.

Yeah. A potentially unpopular opinion is I do think science is political- ... because we need good science to inform our politics. We need data to inform the policies that make decisions and make, systems available to our public. And what the difference is, though, is that it shouldn't be politicized.

And so what courageous leadership, what being bold in that space has looked like for me is saying that, and connecting with lawmakers and connecting with advocacy groups and even doing a lot of that work myself to make that connection more clear. the more siloed we are when it comes to science and policy, the more opportunity there is for really dangerous mistruths and false claims and conspiracies to fill that gap.

And so if we're not using the language of science and translating it so that people who are making these laws and policies understand them and the people who are using their votes and voices to elect them, then we're missing an opportunity to really make sure that everybody is represented in these science policies.

And I think to piggyback on what you're just saying here, you have s- stood at the, the center of sort of this tension of communicating these complex, unpopular truths in what can feel like a very emotionally charged environment. How do you practice care and courage in leading in moments where it feels like the political and personal stakes are really high For people in your audience 

Yeah.

It's not easy. I think that when I look back in the last several years, the good outweighs the bad. But speaking truth, uncomfortable truth for some people, has come at a great cost to myself, my safety, my family. 

I wouldn't go back and not do it, but it's... I'd be remiss if I didn't include the fact that we're living in some pretty dangerous times where we're re-litigating established truth.

And a way that I have Sought groundedness. A way that I have continued is to remind myself of that why, of the, the purpose that it is that my children who inspire me to do that work, and in finding solidarity with other scientists who are passionate about making science make sense, and informing people so that...

To me, it's tools in a toolkit. 

I don't want to dumb anything down for anybody. I want to elevate people's literacy in science and complex things. I'm not expecting people to remember all the things that I have to remember about biology and immunology. That's asking too much. But I do think that these are i- important tools for people to have to navigate really dangerous information ecosystems right now.

and I think there's a lesson there, not just how you can consume this information and think about it, but also as a leader. And I'd love to hear more about how you, you actually do this because, of course, you're doing this from the space of public health, but all of us are navigating what feels like a really divisive moment.

And so how do you decide, what is a, a, a great place for you to speak up? For you, when is it better for you to be quiet? When is it good for you to take a stand? How do you make those decisions? 

Yeah. I got into public health because at the core of public health is altruism. It is a desire to reduce harm, to prevent disease, to increase people's opportunity for long life and thriving in that long life.

And so my, my red line is when information, specifically harmful health information, challenges or jeopardizes those things. And I do think that, when we're experiencing public health emergencies, we're dealing with two outbreaks. We're dealing with an outbreak of a pathogen and an outbreak of information, and information today is not neutral.

And we need to recognize that lack of neutrality means that is probably an accelerating driver of that epidemic, and often is, and how do we address both? We sometimes get a little myopic with public health and just think about the one threat. And so I do think that having this big picture view of tandem outbreaks is the re- is the way we go forward with this.

It's the way for me to say, "I can't just think about all the interventions that we need to have." I think we need to talk about who doesn't understand this, and what are they feeling about these things? Are they scared? Are they feeling forgotten? Have they been hurt by the system in the past, so I'm gonna work a little bit extra hard to regain their trust?

I think a lot about the difference of trust and trustworthiness- Are, am I even worthy of the trust of the people I'm speaking to, to say these things? Instead of asking them, "Just trust me, I'm a scientist. Trust me, I'm an expert." We're now in a different world where trust and expertise is really subjective- And people are now choosing to aba- you know, abandon expertise for the sake of things that are more familiar- ... things that identify, that they identify with. And so I do a lot of that ground-level listening and hearing people to understand this is not a one-size-fits-all type of work. It really is hyper-tailored and hyper-focused on individuals.

And, I think this, this makes me think about the, the importance of s- of storytelling, and I have something that you've said before, that data alone doesn't change minds, stories do. And so how do you use storytelling as a tool for courage and, and leading when you're thinking about people might not having, potentially not having trust in some of the actual data or science behind some of- Yeah

what you're saying? 

I think about this so much because the, there's a phrase with plural of anecdote is not data. It's true, but anecdotes do have a significant influence on people's decision-making. And so we can't ignore the fact that an individual story can go a really long way in helping people connect science to science

decision-making.

That's going to be it for today.

As always, keep the comments coming in.

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The additional sections of the show included clips from;

Reveal

The Bunker

Throughline

Yale Insights

Takesâ„¢ by Jamelle Bouie

Unbiased Science

CrashCourse

Pandemic and Emergency Readiness Lab

Doctor Mike

and TED Talks Daily

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