WEBVTT 00:00:00.450 --> 00:00:07.436 - I think I know almost everybody here. I'm Michael Hamburger. I'm really pleased to welcome you guys. 00:00:07.436 --> 00:00:14.630 - Thank you so much for coming out on a beautiful afternoon. That may be part of the reason for our small 00:00:14.630 --> 00:00:21.755 - crowd here. I'm not sure. I've had a couple people today suggest that 5 p.m. is not the ideal time for 00:00:21.755 --> 00:00:27.358 - a public forum like this, but we also get comments about evening events as well. 00:00:27.618 --> 00:00:34.465 - Anyway, let me just say a word about our organization, Concerned Scientists at IU, and then turn it 00:00:34.465 --> 00:00:41.654 - over to our friend Tyler Morris, one of the leaders of our student advocacy group, Advocates for Science 00:00:41.654 --> 00:00:48.500 - at IU, who will be moderating the discussion today. So I'm a retired faculty member at IU and proud 00:00:48.500 --> 00:00:54.046 - to be one of the founders of Concerned Scientists at IU. We have been around for 00:00:54.210 --> 00:01:03.857 - Now almost 10 years since February of 2017, we are an informal, non-partisan, non-profit, non-affiliated, 00:01:03.857 --> 00:01:13.050 - non-funded group of faculty members, students, community members who are committed to supporting the 00:01:13.050 --> 00:01:21.150 - integrity of science, support for science, and kind of rational decision-making based on 00:01:21.378 --> 00:01:30.285 - the best we know about the world around us. Again, our group has a kind of loose connection with the 00:01:30.285 --> 00:01:38.046 - national organization, Union of Concerned Scientists, but we are formally unaffiliated. 00:01:38.146 --> 00:01:44.737 - Our student affiliate group has been around also for all that time and has really been the source of 00:01:44.737 --> 00:01:51.262 - a lot of energy and enthusiasm for the programs that we've been supporting over the past few years. 00:01:51.262 --> 00:01:57.852 - We've done a lot of public forums like this. We've hosted prominent speakers. We've done a number of 00:01:57.852 --> 00:02:04.443 - election-related forums. In fact, I'm still claiming, unless proven otherwise, that we did the first 00:02:04.443 --> 00:02:06.270 - ever national congressional 00:02:06.434 --> 00:02:15.896 - forum focused on science and technology policy issues, and we've tried to do that in every major election 00:02:15.896 --> 00:02:24.911 - year. We've also written commentaries on regulatory issues and met with legislators at the state and 00:02:24.911 --> 00:02:29.374 - federal level on important science policy issues. 00:02:29.922 --> 00:02:37.802 - I'm so excited for the event that we're doing today. It's one of these issues that move from the background 00:02:37.802 --> 00:02:45.098 - and as kind of accepted science and health policy now is in the foreground of political battles and 00:02:45.098 --> 00:02:52.394 - policy battles. And we have three experts here who we'll introduce in a moment. I wanted to be sure 00:02:52.394 --> 00:02:55.166 - to introduce our next forum, which is 00:02:55.490 --> 00:03:02.309 - We've just been set up in collaboration with Climate Week 2026, and we realize that Climate Week is 00:03:02.309 --> 00:03:09.470 - just a few days after the midterm elections and decide there's going to be a lot of interest, of course, 00:03:09.470 --> 00:03:16.425 - on the elections themselves, the results and the impacts of those elections. Of course, we don't know 00:03:16.425 --> 00:03:20.926 - what those results will be. I do, actually, but nobody else does. 00:03:21.122 --> 00:03:28.126 - And we may be still battling over certifying the results of those elections. But we've brought together 00:03:28.126 --> 00:03:35.468 - three experts, including David Watkins, who's the legislative director for the Union of Concerned Scientists 00:03:35.468 --> 00:03:42.607 - in Washington, David Koniski here at the School of Public and Environmental Affairs, and Marjorie Hershey 00:03:42.607 --> 00:03:49.342 - from the Political Sciences Department, who many of you know as three experts on political process. 00:03:49.538 --> 00:03:56.937 - environmental policy and at the national level. So I think that will be a lively discussion. That will 00:03:56.937 --> 00:04:04.551 - be virtual. We will be sharing information about how to sign up for that. You'll notice there's an absent 00:04:04.551 --> 00:04:11.734 - QR code. If you're not already on our mailing list, please do so. We've got a sign up sheet outside 00:04:11.734 --> 00:04:15.326 - and we will get you information about that forum. 00:04:15.426 --> 00:04:21.176 - Let me turn it over to Tyler Morris, who's going to say a few words about the structure for today's 00:04:21.176 --> 00:04:27.155 - event. And again, I just request, since we've got a small cozy group and some really exciting speakers, 00:04:27.155 --> 00:04:31.870 - that we keep this as lively and as interactive as we can. So take it away, Tyler. 00:04:36.994 --> 00:04:42.452 - Yeah, thank you, Michael. So as Michael mentioned, I'm Tyler Morris, a graduate student here in the 00:04:42.452 --> 00:04:48.184 - School of Public Health, and I'll be moderating this evening's discussion. So we're going to start first 00:04:48.184 --> 00:04:53.860 - actually with the presentation from Lisa on recent policy developments at the federal and state levels. 00:04:53.860 --> 00:04:59.537 - And then after that, we'll hear some introductions from our other two speakers, Jim and Katie, and then 00:04:59.537 --> 00:05:04.286 - we'll move into a panel discussion on some questions that we've come up with together. 00:05:04.770 --> 00:05:12.430 - Um, and then we'll have time for Q and a for the audience. So Lisa, I think I'll go ahead and hand it 00:05:12.430 --> 00:05:19.941 - over to you and you can introduce yourself and your work. Thank you. Okay. I'm really excited to be 00:05:19.941 --> 00:05:27.451 - here today. So thank you for the invitation. Uh, talking about vaccines is my favorite thing to do. 00:05:27.451 --> 00:05:33.534 - So when I had a Tyler reach out and ask about, um, coming today, I was ecstatic. 00:05:33.858 --> 00:05:40.300 - gets me out of my office. And I get to share some really interesting, if not troubling, information 00:05:40.300 --> 00:05:47.000 - with you all. So I'll apologize up front, because some of my slides are really text heavy. I understand 00:05:47.000 --> 00:05:53.507 - that. I know Katie is a health communications professor. She's going to be like, bad, bad, Lisa. But 00:05:53.507 --> 00:05:57.694 - you don't need to read it all. I want to have it for you to see. 00:05:57.922 --> 00:06:04.650 - all of the things that are happening. And I'm happy to share the slide deck afterwards. So if anybody 00:06:04.650 --> 00:06:11.576 - wants to take a closer look, you'll be able to actually read the text from there. So I'm Lisa Robertson. 00:06:11.576 --> 00:06:18.173 - I'm the executive director of the Indiana Immunization Coalition. The coalition has been around for 00:06:18.173 --> 00:06:24.241 - about 23 years. And I have been the director for the past 13 years. And things have changed 00:06:24.241 --> 00:06:26.814 - quite substantially in those 13 years. 00:06:26.978 --> 00:06:34.983 - Our mission is to reduce the spread of vaccine-preventable diseases, primarily in Indiana. So that's 00:06:34.983 --> 00:06:42.988 - all we think about is vaccines, barriers to access, language, anything that we can do to make access 00:06:42.988 --> 00:06:51.151 - and acceptance of vaccines easier and better in Indiana. And we do this through education, events like 00:06:51.151 --> 00:06:54.718 - this, advocacy, so we're at the State House. 00:06:54.978 --> 00:07:01.441 - at least every week during session. We do postcards every other month to all of our legislators. We 00:07:01.441 --> 00:07:08.099 - visit them when they're back in their home districts during the off session. So we spend a lot of time 00:07:08.099 --> 00:07:14.627 - thinking about policy. And then we do, we have a public citizens action group. So Hoosiers Vaccinate 00:07:14.627 --> 00:07:21.090 - is our advocacy arm and I will kind of share a little bit more about that when we're talking at the 00:07:21.090 --> 00:07:23.934 - end and there's stuff outside on the table. 00:07:24.066 --> 00:07:30.623 - And then during COVID, the big change that happened about six years ago, we used to do education advocacy 00:07:30.623 --> 00:07:36.871 - outreach. That's what we did. During COVID, we were watching our immunization rates drop. I mean, we 00:07:36.871 --> 00:07:43.180 - could see them going down, which we knew, right? Because our physicians were focused on first that to 00:07:43.180 --> 00:07:49.428 - and under, right? They were focused on COVID. They were looking at tracking disease, COVID vaccines, 00:07:49.428 --> 00:07:52.830 - our health departments. Everyone was focused on COVID. 00:07:53.794 --> 00:08:00.377 - Rightfully so. So what we decided as a coalition was we were going to focus on routine vaccines and 00:08:00.377 --> 00:08:06.960 - we entered the clinic space. So my board of directors, I'm not sure why, said yes and allowed me to 00:08:06.960 --> 00:08:13.542 - start a clinic. And over the years we have, I kept thinking like, oh, it'll start to decline, it'll 00:08:13.542 --> 00:08:20.125 - start to decline. That has not been the case. We run typically three to five mobile teams, at least 00:08:20.125 --> 00:08:21.310 - four days a week. 00:08:21.890 --> 00:08:28.610 - Last year we administered 55,000 vaccines, which is as Katie would want me to tell you about three and 00:08:28.610 --> 00:08:34.939 - a half vaccines per person that we saw. So we're always trying to make sure we don't have missed 00:08:34.939 --> 00:08:41.659 - opportunities. So we have been in this space. We are, we are really like, we're not just talking about 00:08:41.659 --> 00:08:48.183 - it. We are living and breathing this every day. I have no disclosures. So I always like to start my 00:08:48.183 --> 00:08:50.206 - presentations with pictures of 00:08:50.466 --> 00:08:57.121 - Usually it's just a picture of my kids, but I was thinking about like, I've been doing this for a while 00:08:57.121 --> 00:09:03.776 - now and they have been my models and I have their consent. There's no HIPAA issues here. They know that 00:09:03.776 --> 00:09:10.367 - I use their pictures. In fact, they're going to get their flu and COVID this week. So I was like, send 00:09:10.367 --> 00:09:16.830 - me your pictures. I'll pay you. I'll give you $25 if you send it to me. So, but this is them kind of 00:09:16.830 --> 00:09:19.326 - over the years getting their vaccines. 00:09:19.682 --> 00:09:25.430 - And I like to show this picture to remind people that, you know, there are a lot of really horrible 00:09:25.430 --> 00:09:31.408 - stories about vaccine preventable diseases, right? We know families who have lost children to influenza 00:09:31.408 --> 00:09:37.271 - or to Hib or to pertussis, but we all have our own story. And the most powerful thing that I can tell 00:09:37.271 --> 00:09:43.077 - my friends and my colleagues and families that I see in my clinic is that the two people that I love 00:09:43.077 --> 00:09:46.526 - more than anything else in this world are fully vaccinated. 00:09:46.946 --> 00:09:52.943 - They have their complete HPV series. They have both meningitis B vaccines. They get their flu and COVID 00:09:52.943 --> 00:09:58.766 - every single season. That's the most powerful thing I can say to another parent. And so I always, if 00:09:58.766 --> 00:10:04.763 - I'm talking to a parent, I'll say, oh, both my daughter and my son have all their HPV vaccines. Or yes, 00:10:04.763 --> 00:10:10.529 - they get their COVID vaccine every season. That's a really powerful statement. So we all have those 00:10:10.529 --> 00:10:14.334 - stories. It doesn't have to be this really terrible circumstance. 00:10:14.434 --> 00:10:20.974 - And there's even a picture of my husband up there because I love him too. And so that's his picture 00:10:20.974 --> 00:10:27.579 - about, you know, he's getting his pneumonia vaccine up there. So, so just thinking about how you can 00:10:27.579 --> 00:10:34.184 - share your story. If we are not using our social media spaces, if we are not using our voice to tell 00:10:34.184 --> 00:10:40.986 - positive vaccine stories, then we are letting the anti-vaccine rhetoric win. Because if we're not doing 00:10:40.986 --> 00:10:42.686 - it, who's going to do it? 00:10:44.418 --> 00:10:50.797 - So I just put this up here. This is the IDOH website. I hope everybody's familiar with it. But they 00:10:50.797 --> 00:10:57.558 - do amazing job tracking data. So if you want to know what your school system looks like, what your county 00:10:57.558 --> 00:11:04.001 - looks like, what the immunization rates are, they have dashboards that are phenomenal. So I hope you 00:11:04.001 --> 00:11:10.507 - use them. They do a really great job of sharing the data. So I'm going to talk about vaccine rhetoric 00:11:10.507 --> 00:11:14.334 - and anti-vaccine rhetoric and where we are now politically. 00:11:14.434 --> 00:11:20.971 - But I just wanted to remind people that this is nothing new. This is not a new phenomenon. This did 00:11:20.971 --> 00:11:27.573 - not start during COVID. This has been something that has been going on since our very first vaccine. 00:11:27.573 --> 00:11:34.175 - Now it has changed a little bit. But as you can see, this was 1879 when the Anti-Vaccination Society 00:11:34.175 --> 00:11:40.908 - of America was founded. And it was founded because of the smallpox vaccine. And it was founded because 00:11:40.908 --> 00:11:41.758 - of mandates. 00:11:41.890 --> 00:11:48.802 - because states were starting to impose mandates around getting smallpox vaccination. And you can see, 00:11:48.802 --> 00:11:55.578 - there was even, they were going to court. So the American waged court battles to repeal vaccination 00:11:55.578 --> 00:12:02.490 - laws. This was back in the 1800s. So what we are dealing with today is not a new phenomenon. This has 00:12:02.490 --> 00:12:07.166 - been going on for a really long time. This was some of the rhetoric, 00:12:07.522 --> 00:12:12.925 - in the papers, I put be a man on here because it actually says that in this article, which I thought 00:12:12.925 --> 00:12:18.435 - was really funny. But I was telling physicians who at that time were men not to vaccinate, to be a man 00:12:18.435 --> 00:12:23.891 - and to stand up and not vaccinate. But I thought this was really funny. It's in the slide deck so you 00:12:23.891 --> 00:12:27.422 - guys can read it when you get it. Hopefully you can email it out. 00:12:28.834 --> 00:12:35.921 - So we're not really going to talk about anti vaccine though, because that that is a space that is really 00:12:35.921 --> 00:12:42.873 - hard to move people out of. So we're really going to talk about today's vaccine hesitancy because that 00:12:42.873 --> 00:12:49.150 - is really what we're seeing. It is it is misinformation. It is the wrong information. It is. 00:12:49.378 --> 00:12:55.899 - not knowing who you can trust, who's giving you the right information. And so a lot of what we're seeing 00:12:55.899 --> 00:13:02.297 - today is hesitancy. And that is very, very different from anti-vaccine. These are people who maybe are 00:13:02.297 --> 00:13:08.694 - complacent, maybe it's a convenience or an access issue, maybe it's a confidence issue. And so knowing 00:13:08.694 --> 00:13:15.029 - why people aren't accessing vaccines or why they're saying no to some vaccines is really important to 00:13:15.029 --> 00:13:15.774 - understand. 00:13:18.274 --> 00:13:25.200 - So here's the AAP schedule, which we all know and love. And this is the current, the 2026 schedule. 00:13:25.200 --> 00:13:32.335 - And I just put this up here to remind you that this is gold. This is like the golden schedule. I would 00:13:32.335 --> 00:13:39.538 - call it gold science, but we don't want to use that terminology. That's what I would call gold science. 00:13:39.538 --> 00:13:43.486 - But this is where we start, right, because this is where 00:13:43.586 --> 00:13:51.770 - back in January with RFK and HHS, this is where the drama started. So here's the AAP schedule, which 00:13:51.770 --> 00:14:00.116 - we have followed for decades. On January 5th of this year, HHS released the new childhood immunization 00:14:00.116 --> 00:14:08.543 - schedule. And it was broken down into these three buckets, so recommended for all children, recommended 00:14:08.543 --> 00:14:10.974 - for certain high-risk groups, 00:14:11.234 --> 00:14:18.899 - and then recommended based on shared clinical decision making. And so this kind of just changed that 00:14:18.899 --> 00:14:26.943 - schedule into these three very kind of hard to grasp buckets, especially shared clinical decision making. 00:14:26.943 --> 00:14:34.531 - I always think this is a really horrible thing to call this bucket, because we have shared clinical 00:14:34.531 --> 00:14:40.830 - decision making for meningitis B, HPV over the age of 27, but I always think like, 00:14:40.962 --> 00:14:48.080 - What vaccine does anybody administer without shared clinical decision-making? It's not like I'm administering 00:14:48.080 --> 00:14:55.004 - anything to a patient or a child without having had a conversation with them about what they're receiving. 00:14:55.004 --> 00:15:01.669 - So I always feel like every vaccine we administer, we're doing shared clinical decision-making, right? 00:15:01.669 --> 00:15:06.846 - So this schedule was released on January 5th of 2026. It caused a lot of chaos. 00:15:07.010 --> 00:15:14.315 - kind of think about the general public, like if HHS says this is the childhood schedule, and you don't 00:15:14.315 --> 00:15:21.408 - understand how this childhood schedule is made in general, you have no idea that this is not a good 00:15:21.408 --> 00:15:28.713 - idea. You just know our HHS has said this is the schedule. So then what happened in this, like I said, 00:15:28.713 --> 00:15:35.806 - lots of text, please don't read it. So then what happened was fairly soon after that in March, AAP, 00:15:36.162 --> 00:15:43.219 - sued RFK, so AAP versus RFK happened. On March 16th, the federal district judge blocked that vaccine 00:15:43.219 --> 00:15:50.277 - schedule that we just looked at, paused all changes made by ACIP, which is the Advisory Committee on 00:15:50.277 --> 00:15:57.754 - Immunization Practices, reverted everything back to the 2025 schedule, said that ACIP had not been legally 00:15:57.754 --> 00:16:03.134 - formed under the RFK administration. The administration then filed an appeal 00:16:03.394 --> 00:16:08.749 - The case is still in trial. The appeal was heard at the district court in October, so just a couple 00:16:08.749 --> 00:16:14.158 - weeks ago, the first week of this month. And we're still waiting to hear what's going to happen from 00:16:14.158 --> 00:16:19.567 - that case. So that alone kind of throws everything into chaos, right? Like, here's one schedule that 00:16:19.567 --> 00:16:24.922 - everybody has followed. Oh wait, here's a new schedule. Oh wait, now that schedule's been repealed. 00:16:24.922 --> 00:16:25.886 - We're going back. 00:16:26.050 --> 00:16:33.276 - Not just to the last, we're going back to the 2025 schedule. Well, on that schedule, the flu and COVID 00:16:33.276 --> 00:16:40.362 - that was approved was not the current season schedule. So it has been a roller coaster. So in May of 00:16:40.362 --> 00:16:47.518 - 2027, or May 27th of 2026, the America Health Insurance Plan, so AHIP, tried to reassure everyone and 00:16:47.518 --> 00:16:54.814 - say, it's okay, insurance will continue to cover all vaccines regardless of what schedule is out there. 00:16:55.010 --> 00:17:02.405 - until at least the end of 2027. So that at least gave providers some reassurance that they were gonna 00:17:02.405 --> 00:17:09.801 - continue to get reimbursed for vaccines, trying to like calm some of these stormy waters. Then on May 00:17:09.801 --> 00:17:17.486 - 29th, the president issued an executive order directing the CDC and ACIP to realign our vaccine schedule, 00:17:17.486 --> 00:17:20.894 - reducing the number of recommended vaccines to 00:17:21.122 --> 00:17:27.549 - closely replicate what was done in our peer nations like Denmark, which I've never thought of Denmark 00:17:27.549 --> 00:17:34.038 - as a pure nation. They have, you know, universal health care. They have great access. They have a very 00:17:34.038 --> 00:17:40.465 - kind of homogenous population. But that was what this executive order said. The ACIP was still barred 00:17:40.465 --> 00:17:46.892 - from meeting per the federal judge's rule. So the ACIP couldn't do anything because they didn't exist 00:17:46.892 --> 00:17:47.774 - at this time. 00:17:48.130 --> 00:17:56.909 - In June, a new ACIP charter was posted. The version downplays the panel's role in recommending the use 00:17:56.909 --> 00:18:06.114 - of new vaccines. It says part of the ACIP's responsibility is to assess alternatives to disease prevention. 00:18:06.114 --> 00:18:14.637 - But then they didn't actually vote on this ACIP charter. So we still don't have an ACIP charter and 00:18:14.637 --> 00:18:18.046 - we don't have an acting ACIP. And then, 00:18:18.178 --> 00:18:24.804 - This is like just keeps going on. So even before that, all of the covid funding was repealed. So this 00:18:24.804 --> 00:18:31.299 - is like a never ending issue. So this happened on August 10th and this actually was concerning. The 00:18:31.299 --> 00:18:38.055 - last executive order was pretty like watered down. There wasn't a whole lot in it. This executive order 00:18:38.055 --> 00:18:41.822 - was different. So in this executive order on August 10th, 00:18:42.306 --> 00:18:49.004 - The President, one, recommended that combined MMR vaccines be administered as separate single antigen 00:18:49.004 --> 00:18:55.570 - vaccines when the product becomes available in the United States, while the product's not available 00:18:55.570 --> 00:19:02.136 - anywhere in the world as separate antigens, so that's a problem. And the manufacturers have said we 00:19:02.136 --> 00:19:08.768 - are not going to produce separate antigen MMR. Some very underdeveloped countries still have MR as a 00:19:08.768 --> 00:19:09.950 - separate vaccine. 00:19:10.210 --> 00:19:17.805 - but nobody has M and R, measles, mumps, and rubella, all as separate antigen vaccines. So not even possible. 00:19:17.805 --> 00:19:24.843 - Childhood vaccine should be administered at separate medical visits, which I don't know if you guys, 00:19:24.843 --> 00:19:31.253 - like my son is a needle-phobe, and so like if I said to him, every time you're going to see 00:19:31.253 --> 00:19:37.246 - your pediatrician, you're gonna get a vaccine, every single visit, it doesn't matter. 00:19:39.394 --> 00:19:45.854 - I don't know if he'd ever see the doctor again. He's 19 now, so I can only do so much. But I just think 00:19:45.854 --> 00:19:52.251 - about how much stress that puts on a parent, if you're trying to be like, but then I was thinking too, 00:19:52.251 --> 00:19:58.525 - like as a medical professional, if that means you have to come and see me more often, that means I'm 00:19:58.525 --> 00:20:04.736 - gonna get paid more, right? Because, so I mean, there's that would be a positive. HHS should assess 00:20:04.736 --> 00:20:09.022 - the timing and sequencing of childhood vaccines, which is what they, 00:20:09.154 --> 00:20:16.625 - AAP and ACIP have been doing for decades, should develop alternatives to aluminum containing adjuvants. 00:20:16.625 --> 00:20:24.096 - So this is kind of going back to the whole thimerosal and vaccine issue. Aluminum is the new, you know, 00:20:24.096 --> 00:20:31.710 - evil product in our vaccine. And there's lots of research on this, which I'm happy to share with you all. 00:20:31.842 --> 00:20:37.844 - And then this is the one that scared me the most, and I'm sorry, it's a little hard to see at the bottom. 00:20:37.844 --> 00:20:43.564 - But the executive order advises states to reconsider their school entry and attendance requirements. 00:20:43.564 --> 00:20:49.396 - It directs the attorney general to support legal challenges to state laws that allegedly conflict with 00:20:49.396 --> 00:20:55.625 - federal, constitutional, or statutory protections involving parental authority, religious freedom, disability 00:20:55.625 --> 00:21:00.382 - accommodations, equal protection, and medical and religious exemptions. And so that 00:21:00.514 --> 00:21:09.444 - Right there is what we are very concerned about. And I'll tell you why. After I tell you what just happened. 00:21:09.444 --> 00:21:18.292 - So HHS announced a package of actions centered around vaccine injury reporting and care. This just happened 00:21:18.292 --> 00:21:26.485 - like last week. Basically saying we should pay providers to report to VAERS, which is troubling all 00:21:26.485 --> 00:21:29.598 - by itself. VAERS is kind of a passive 00:21:29.794 --> 00:21:37.112 - Um, reporting system, anyone can submit a report to VAERS, how CMS would pay providers to report to 00:21:37.112 --> 00:21:44.722 - VAERS. We're not, I don't even know how that framework would work. Um, and, uh, it talks about EHR data 00:21:44.722 --> 00:21:52.113 - standards. So I won't read you all this. This just happened. We're just watching this in the systems 00:21:52.113 --> 00:21:59.358 - right now. Um, but this is what they're trying to do, right? This sows that kind of fear and that, 00:22:00.034 --> 00:22:07.313 - um, apprehension around vaccines and vaccine injury. And, you know, they're setting up a clinic to study 00:22:07.313 --> 00:22:14.453 - vaccine injuries. Um, so they're really kind of getting this rhetoric out there. And if you don't live 00:22:14.453 --> 00:22:21.732 - and breathe in this space, it's really, you don't know what's behind a lot of this policy. So what we're 00:22:21.732 --> 00:22:26.238 - watching in Indiana and what kind of keeps me up a lot at night, 00:22:26.722 --> 00:22:34.807 - is without an ACIP, so without the Advisory Committee on Immunization Practices, we actually don't have 00:22:34.807 --> 00:22:42.736 - ACIP. So all of our legislation in Indiana is based on ACIP. So if you read our pharmacy legislation, 00:22:42.736 --> 00:22:50.666 - it says pharmacists can administer based on ACIP recommendations. Our school requirements can be made 00:22:50.666 --> 00:22:56.030 - based on ACIP recommendations, things going into the state registry, 00:22:56.674 --> 00:23:04.187 - based on ACIP recommendations. It is in our legislation all over the place because we never in our wildest 00:23:04.187 --> 00:23:11.418 - dreams thought that that would not be who we wanted to be listening to when it came to vaccine policy. 00:23:11.418 --> 00:23:18.720 - So because there is no, so that last ACIP schedule and recommendation that exists is from 2025, there's 00:23:18.720 --> 00:23:26.654 - technically not a current recommendation from ACIP for flu or COVID because it's done every season based on the, 00:23:26.850 --> 00:23:35.022 - the vaccine itself. So pharmacies are in a really troubling spot because legally they're not sure that 00:23:35.022 --> 00:23:43.354 - they can administer COVID and flu because the language that gives them authorization to do so references 00:23:43.354 --> 00:23:46.686 - ACIP language that is outdated by a year. 00:23:47.874 --> 00:23:53.577 - So that's a concern. And for big pharmacies, not as big of a deal, but for those pharmacies that use 00:23:53.577 --> 00:23:59.393 - our state health commissioner for standing orders, like our smaller independent pharmacies, it's a big 00:23:59.393 --> 00:24:05.153 - issue. School mandates were released seven months late this year. So we had kids leaving school going 00:24:05.153 --> 00:24:10.912 - into the summer. The school nurses didn't know what was going to happen with school mandates, so they 00:24:10.912 --> 00:24:16.446 - didn't say anything. So we got back to school this year, and kids are so far behind because those 00:24:16.578 --> 00:24:22.809 - mandates were not released until the summer. And so now school nurses are playing catch up and it's 00:24:22.809 --> 00:24:29.415 - a mess. And the more concerning thing is our state health commissioner has the authority to change school 00:24:29.415 --> 00:24:35.833 - requirements at any time. So she could change our school requirements tomorrow. It is written into our 00:24:35.833 --> 00:24:42.189 - legislation that she has the authority to make that change without going through, there's a committee 00:24:42.189 --> 00:24:45.118 - on school immunizations that meets every year. 00:24:45.314 --> 00:24:52.716 - But she could make that change that the governor said to her we are making this change. I am demanding 00:24:52.716 --> 00:25:00.046 - that you make this change She has the authority to make that change without going back to legislation 00:25:00.046 --> 00:25:07.305 - to legislators. So that's We are watching it all very very closely so what else it means for Indiana 00:25:07.305 --> 00:25:13.054 - is Measles we currently have 50 measles cases in Indiana last Monday, we had 30 00:25:13.698 --> 00:25:21.532 - Uh, yesterday we had 50, so it is increasing rapidly. It's in 10 counties currently, um, primarily in 00:25:21.532 --> 00:25:29.443 - the Amish population. Uh, but it, I know they were testing two or three other counties, um, yesterday, 00:25:29.443 --> 00:25:37.201 - so we should know tomorrow if there are cases there. So we are, we are seeing the impact of what all 00:25:37.201 --> 00:25:43.422 - of this upheaval and misinformation and lack of clarity is doing to our systems. 00:25:44.578 --> 00:25:51.516 - And so just a reminder, this is what we're gonna talk about today, hesitancy. I won't read this to you, 00:25:51.516 --> 00:25:58.187 - because I wanna move on to our panel, but just remember that people that are hesitant, sometimes we 00:25:58.187 --> 00:26:04.859 - get into this like, oh, well, they just don't, like they're, I don't wanna say, I'm trying to use a 00:26:04.859 --> 00:26:11.863 - nice word, but sometimes we think that they're not paying attention, or they just will believe anything, 00:26:11.863 --> 00:26:13.598 - or, but it is really hard 00:26:13.954 --> 00:26:21.734 - to know what is true information, who is a good source. When our HHS is giving bad information, if our 00:26:21.734 --> 00:26:29.364 - CDC is not standing up and saying what's right, if our state health department can't talk, you know, 00:26:29.364 --> 00:26:37.068 - they're not allowed to say that measles is in the Amish population, we can't blame our population for 00:26:37.068 --> 00:26:41.374 - being concerned or not knowing what's real or, you know, 00:26:42.754 --> 00:26:48.575 - being hesitant about vaccines because they are hearing so many things that maybe aren't true. So we 00:26:48.575 --> 00:26:54.629 - have to give them grace. We have to be willing to take time to talk to them. And we have to have a good 00:26:54.629 --> 00:27:00.450 - understanding of vaccine science. And these are really great non-government resources, which again, 00:27:00.450 --> 00:27:03.710 - please check them out once you guys get the slide deck. 00:27:12.674 --> 00:27:19.269 - Yeah, so thank you, Lisa. I think that was very helpful for me personally because there's so much uncertainty 00:27:19.269 --> 00:27:25.444 - right now with where things are at with like childhood vaccine recommendations and school mandates and 00:27:25.444 --> 00:27:31.559 - obviously all the legal battles right now. Even being someone who is very interested in these things, 00:27:31.559 --> 00:27:37.554 - I struggle even trying to stay up to date with all of these. So that is very helpful. But before we 00:27:37.554 --> 00:27:42.590 - get into our panel discussion, I actually wanted to invite our other two members up 00:27:42.818 --> 00:27:46.398 - Jim and Katie, so you guys can introduce yourselves and your work. 00:28:20.514 --> 00:28:26.348 - I think Katie we can start with you if you want to introduce yourself and work any comments you would 00:28:26.348 --> 00:28:28.350 - like to add to Lisa's presentation 00:28:28.418 --> 00:28:35.009 - Yeah, hi, I'm Katie Head. I am a communication professor at IUPUI, which I will always call it, because 00:28:35.009 --> 00:28:41.410 - that's who hired me. People always wonder why a calm person speaks about vaccines, but I think as we 00:28:41.410 --> 00:28:47.747 - saw from Lisa's presentation, so much around health and medicine and decision making has to do with 00:28:47.747 --> 00:28:51.550 - communication. So that'll be the lens that I bring tonight. 00:28:51.778 --> 00:28:58.133 - I also am the Assistant Director of the Office of Community Outreach and Engagement at our IU Simon 00:28:58.133 --> 00:29:04.489 - Comprehensive Cancer Center at the School of Medicine in Indy. So I do a lot with cancer and cancer 00:29:04.489 --> 00:29:11.098 - screening as well. And if you know anything about cancer and vaccines, you probably are right to assume 00:29:11.098 --> 00:29:15.102 - that HPV is my main love. And I spend a lot of work with that. 00:29:15.650 --> 00:29:23.804 - I was lucky to run into this chick almost a decade ago. It's crazy. And we've worked really well together. 00:29:23.804 --> 00:29:31.425 - We work on a lot of community-engaged projects together, both funded and not funded. And I am lucky 00:29:31.425 --> 00:29:39.046 - to serve on the board of the Indian Immunization Coalition as well. So yeah. Thank you, Katie. Jim? 00:29:39.046 --> 00:29:41.790 - My name is Jim Laughlin, and as was 00:29:41.922 --> 00:29:48.693 - so eloquently displayed in the flyer you got, I am retired, which means I'm old, which also gives me 00:29:48.693 --> 00:29:55.397 - some credibility, I guess, because I've been here through the course of many of these vaccines that 00:29:55.397 --> 00:30:02.100 - weren't available when I first started in my practice, and I grew up in an age where a lot of these 00:30:02.100 --> 00:30:08.670 - vaccines weren't available, and now have lived through the vaccine era, which has been a godsend. 00:30:09.058 --> 00:30:16.786 - I came to Bloomington after graduating from IU School of Medicine and Riley residency at Indianapolis. 00:30:16.786 --> 00:30:24.589 - Did my pediatric residency there. Also did a pediatric pulmonary fellowship. So did dabble in academics 00:30:24.589 --> 00:30:32.692 - and the science of clinical studies during that time. Came to Bloomington in 1981 and set up solo practice. 00:30:32.692 --> 00:30:36.894 - I was in solo practice till 1995 and we saw the need to 00:30:37.090 --> 00:30:44.300 - have more access for pediatric care, and I set up a group called Southern Indiana Pediatrics, and it 00:30:44.300 --> 00:30:51.582 - rapidly grew from original three members to 20 providers of pediatricians and 14 nurse practitioners. 00:30:51.746 --> 00:31:00.422 - We had a lot of fun during that time period. And one of our main focuses was on access to care for kids 00:31:00.422 --> 00:31:08.931 - in our community and the surrounding 10 counties around here. We joined IU Health and were branded as 00:31:08.931 --> 00:31:17.606 - Riley Physicians in 2011. And we've been with Riley Hospital and Riley Physicians ever since that time. 00:31:17.606 --> 00:31:19.358 - And I think that's a 00:31:19.618 --> 00:31:28.414 - Oh, I did want to say that I have been very active in the past with the National Academy of Pediatrics 00:31:28.414 --> 00:31:37.210 - and actually served on a national committee called Ambulatory Practice in Medicine. That committee set 00:31:37.210 --> 00:31:42.334 - policies for office-based practice policies, which included 00:31:42.434 --> 00:31:49.220 - administration of vaccines and what vaccines we would endorse as an academy, along with the cooperation 00:31:49.220 --> 00:31:55.745 - of ACIP. Great. Thank you, Jim. So I think to get us started with our first panel question, I know, 00:31:55.745 --> 00:32:02.466 - Lisa, you discussed a lot of this, like what's going on at the federal level, especially, but I wanted 00:32:02.466 --> 00:32:08.926 - to get a better idea of what you guys are seeing here in Indiana. So Jim, being a pediatrician and 00:32:09.122 --> 00:32:15.307 - Katie and Lisa, I know you guys do a little bit more like work kind of out in the field, going around 00:32:15.307 --> 00:32:21.614 - places. So I guess my question is, through your work in Indiana, how have you seen, especially focusing 00:32:21.614 --> 00:32:27.860 - on something like vaccine hesitancy, how have you seen that change throughout, you know, the time that 00:32:27.860 --> 00:32:34.106 - you've been involved in your work here, especially these past couple of years and these past 12 months 00:32:34.106 --> 00:32:35.198 - maybe especially? 00:32:36.258 --> 00:32:45.403 - So Lisa, maybe we can start with you first. Sure. That's a big question. I think what we see, and again, 00:32:45.403 --> 00:32:54.113 - we're out in the community doing vaccines every day. And I think we're seeing more hesitancy around 00:32:54.113 --> 00:33:02.910 - particular vaccines. So a little bit around MMR, not as much as I would have thought. But of course, 00:33:02.910 --> 00:33:04.478 - still around HPV. 00:33:04.674 --> 00:33:11.639 - COVID, of course, and flu, lots of hesitancy. People that before would have kind of, you know, we could 00:33:11.639 --> 00:33:18.938 - make a recommendation and they would accept whatever was recommended, now tend to have a few more questions. 00:33:18.938 --> 00:33:25.768 - They tend to still be acceptors of vaccines, but they want a little clarity. They want us to reassure 00:33:25.768 --> 00:33:30.590 - them that they're making the right choice. They need to understand that 00:33:30.882 --> 00:33:37.191 - We're coming from the same spot where we want their child to be happy and healthy. We have the same 00:33:37.191 --> 00:33:43.626 - goals for them as their parents do. It does take, I think, a little bit more empathy and a little bit 00:33:43.626 --> 00:33:50.124 - more time, but I'm not seeing a huge. Now, we're a vaccine clinic, so they're not coming to me if they 00:33:50.124 --> 00:33:56.432 - don't want vaccines. It's not like the pediatrician who's getting those families as well. If we see 00:33:56.432 --> 00:33:57.694 - them, they at least 00:33:57.954 --> 00:34:04.597 - want their school-required vaccines, and we can talk to them about other things. So we're in a little 00:34:04.597 --> 00:34:11.304 - different space, because we know they're at least somewhat of a vaccine acceptor when they come to us. 00:34:11.304 --> 00:34:18.012 - But we've definitely seen we have to answer a few more questions and be a little more patient, provide 00:34:18.012 --> 00:34:24.590 - a little more guidance, and really understand the schedule. And then I think the other thing that we 00:34:24.590 --> 00:34:27.390 - see, and this is definitely way political, 00:34:27.490 --> 00:34:36.460 - is in areas where ICE is more active and we're having a clinic, we see far fewer people. And so one 00:34:36.460 --> 00:34:46.328 - of the populations that we serve the most is probably our families that are immigrating from other countries, 00:34:46.328 --> 00:34:51.710 - our refugees. We see a lot of migrant farm workers. And so, 00:34:53.186 --> 00:34:59.032 - you know, really thinking about where we can go that is a safe space for them is really important, where 00:34:59.032 --> 00:35:04.822 - they feel like they can come and not be at risk. And we can't always find that. So we were at a school, 00:35:04.822 --> 00:35:10.556 - we thought that would be a good place, but ICE had been active a couple days prior and we probably saw 00:35:10.556 --> 00:35:16.291 - a third of the families we normally would see. So there are a lot of other things going out, you know, 00:35:16.291 --> 00:35:22.526 - not just vaccine hesitancy, but there are other political things going on that are impacting people's access or 00:35:22.818 --> 00:35:29.866 - the ability to get vaccines. Yeah, and I'm kind of new to the policy space. It kind of scares me a little 00:35:29.866 --> 00:35:36.514 - bit. I just do mostly calm. But I've learned a lot working with this organization and others. And I 00:35:36.514 --> 00:35:43.429 - think what's been interesting, and to address your question over the past few years, policy in Indiana, 00:35:43.429 --> 00:35:50.078 - we, relatively speaking, maybe until recently, have had a really progressive state when it comes to 00:35:50.078 --> 00:35:50.942 - vaccination. 00:35:51.330 --> 00:35:58.275 - Pharmacists can vaccinate that's not true in every state We also have dentists that can vaccinate with 00:35:58.275 --> 00:36:05.287 - state policy that says dentists can vaccinate with flu and HPV Is that right those two? That's all they 00:36:05.287 --> 00:36:12.300 - want to do But then I think to dr. Laughlin's point like policy happens at the clinic level too, right? 00:36:12.300 --> 00:36:15.806 - so we think well pharmacists often have things like 00:36:16.386 --> 00:36:21.782 - the ability to store vaccines and the policies you have to have around vaccine storage that dentists 00:36:21.782 --> 00:36:27.446 - don't have. That's one of our big rollout problems around helping dental practices get to do vaccination. 00:36:27.446 --> 00:36:32.094 - And they're perfect for HPV because they're often, you know, doing a throat neck exam. 00:36:32.674 --> 00:36:38.759 - Um, there's also been some, some policies, uh, around workplace vaccination, you know, thinking about 00:36:38.759 --> 00:36:44.964 - our healthcare providers and their need to have flu and COVID vaccine, which Lisa's organization tracks 00:36:44.964 --> 00:36:51.229 - closely. Um, uh, there was a really great, uh, policy for college students as someone who's a professor, 00:36:51.229 --> 00:36:57.374 - uh, that they needed to get, have their, both of their MenB vaccines, um, public universities. We were 00:36:57.374 --> 00:37:00.894 - raring to go to get that going and unfortunately that was, 00:37:01.186 --> 00:37:06.698 - hard to implement, and then students couldn't register for the spring semester. So universities said, 00:37:06.698 --> 00:37:12.210 - oh, we don't really want to do that anymore, right? So to be able to opt out of policies. But I think 00:37:12.210 --> 00:37:17.777 - just one thing I want to point out and I talk to my students about, particularly when I'm working with 00:37:17.777 --> 00:37:22.046 - med students and school public health students, is policy is an evidence-based 00:37:22.306 --> 00:37:28.532 - practice and we need to remember that, right? Like when we think about the idea of recently we raised 00:37:28.532 --> 00:37:34.696 - the tobacco tax in Indiana finally, right? That's an evidence-based intervention. We know people, we 00:37:34.696 --> 00:37:40.922 - saw quit line calls go up, right? We know people will stop because they can't afford that. So I think 00:37:40.922 --> 00:37:42.814 - if we can think about policies 00:37:43.522 --> 00:37:49.317 - we can talk about policies and the rhetoric around policies as evidence-based interventions, right, 00:37:49.317 --> 00:37:55.285 - rather than mandates. And we're trying to make people do things. I think that's important to remember. 00:37:55.285 --> 00:38:01.196 - And these things work. As an HPV vaccine lover, I just want to point out that a few years ago, 25% of 00:38:01.196 --> 00:38:07.106 - HPV vaccines in the state of Indiana were given by pharmacists. And that would not have been possible 00:38:07.106 --> 00:38:11.742 - if we didn't have that policy in place. So policies can work, and they do work. 00:38:12.866 --> 00:38:20.688 - Thank you. Jim, anything you want to add? Just to reiterate, I think the shift in vaccine hesitancy 00:38:20.688 --> 00:38:28.510 - over time has been pretty dramatic in our experience. For many, many years, there were always going 00:38:28.510 --> 00:38:36.723 - to be certain parents that were worried. And I use the word worry rather than denying their kids getting 00:38:36.723 --> 00:38:40.478 - vaccines. They have questions, they worry about 00:38:40.610 --> 00:38:47.966 - the impact of vaccines, they don't understand them. And so we've always had that group of people that 00:38:47.966 --> 00:38:55.467 - we had to try to explain the risk benefit for vaccines and the safety of vaccines. Over the last, since 00:38:55.467 --> 00:39:02.967 - COVID particularly, that has become such a political issue that we have seen it go from those that were 00:39:02.967 --> 00:39:07.006 - just worried to those that don't want vaccines based on 00:39:07.522 --> 00:39:14.106 - new information that's coming out from the government, which is different than what we've always tried 00:39:14.106 --> 00:39:20.497 - to endorse and follow. And so it has become more of a political shift. And I always joke, and I can 00:39:20.497 --> 00:39:27.273 - say this in front of a number of you who I know are from the university, my biggest skeptics for vaccines 00:39:27.273 --> 00:39:33.665 - used to be my university professor parents, because they wanted to discuss it and make sure that it 00:39:33.665 --> 00:39:35.646 - was okay. And I relished that. 00:39:35.778 --> 00:39:43.152 - because you could have an interchange that was not a political argument. It was more of a science argument 00:39:43.152 --> 00:39:50.732 - and a safety argument. But now it's clearly more along political lines. And so I know that in the Bloomington 00:39:50.732 --> 00:39:57.692 - area, for instance, the vaccine hesitancy is less than it is in the surrounding counties of Indiana. 00:39:57.692 --> 00:40:02.654 - And that's largely due to political demographics. So it's a real thing. 00:40:03.938 --> 00:40:11.152 - Thank you. Actually, so just a brief follow up for you, Lisa, since Jim just brought up like the different 00:40:11.152 --> 00:40:18.028 - communities in Indiana. I know obviously what you do, you have a lot of people who trust vaccines and 00:40:18.028 --> 00:40:25.039 - understand the importance of them that are coming to you. But do you see differences in different areas 00:40:25.039 --> 00:40:32.051 - of the state, like say somewhere like Bloomington versus maybe more like rural Indiana? Yeah, for sure. 00:40:32.051 --> 00:40:33.534 - I think, you know, we 00:40:33.762 --> 00:40:40.560 - we're mobile. So our goal is to reduce barriers and by, you know, taking vaccines to where people are 00:40:40.560 --> 00:40:47.224 - already. And we definitely see some more hesitancy, primarily around COVID really in our more rural 00:40:47.224 --> 00:40:53.889 - communities. And a lot of times those are, you know, just conversations that, that we have to have. 00:40:53.889 --> 00:41:00.620 - But I will say that as we continue to keep showing up, so, you know, we were in Davies County, which 00:41:00.620 --> 00:41:02.686 - is a tiny County in the South, 00:41:03.458 --> 00:41:10.205 - We were there for the third time, so every six months we were going. The first time we were there, we 00:41:10.205 --> 00:41:17.150 - probably saw about 11 people, and then we were at like 20, and this last time we saw over 40. So I think 00:41:17.150 --> 00:41:23.963 - a lot of this, we talk about rural communities, a lot of it is trust, and it's building up that trust, 00:41:23.963 --> 00:41:27.998 - and part of being trusted is showing up time and time again. 00:41:28.290 --> 00:41:34.430 - And so we are trying to really live that and to continue showing up for these communities where access 00:41:34.430 --> 00:41:40.570 - is probably an issue. And we say, we still know that our providers, our physicians, our nurses are the 00:41:40.570 --> 00:41:46.650 - most trusted messengers when it comes to health. So people may not trust the government, they may not 00:41:46.650 --> 00:41:52.909 - trust our State Department of Health, but they still trust their provider. They sure as heck still trust 00:41:52.909 --> 00:41:57.022 - their nurse. And so working with the school nurses really important. 00:41:57.506 --> 00:42:03.457 - Because in a lot of these communities, we say, oh, trust your provider, talk to your provider. Well, 00:42:03.457 --> 00:42:09.526 - they don't have a provider, right? Their provider is the school nurse or maybe the local pharmacy. And 00:42:09.526 --> 00:42:15.889 - so we have to change our thought around this. We can't say, oh, they trust their provider. Well, especially 00:42:15.889 --> 00:42:21.781 - when we're looking at our uninsured population, they don't have a regular provider. So who are they 00:42:21.781 --> 00:42:25.022 - listening to? Who is showing up for these communities? 00:42:25.154 --> 00:42:31.710 - time and time again, because that's who they trust, and that's who we need to find in these communities 00:42:31.710 --> 00:42:38.266 - to partner with. Thank you. Yes, I think now we can move to our next question. I really wanted to touch 00:42:38.266 --> 00:42:44.633 - on this. This has been a question, too, that has been talked about a lot online. All of this is very 00:42:44.633 --> 00:42:51.000 - politically active right now, but with childhood vaccination schedules, I know, Lisa, you touched on 00:42:51.000 --> 00:42:54.782 - that right now in your presentation, but I was wondering if 00:42:55.170 --> 00:43:02.228 - at least I'll start with you, if you could discuss how families can navigate some of the uncertainties 00:43:02.228 --> 00:43:09.285 - going on right now with the childhood vaccination schedule and maybe a follow-up question that you can 00:43:09.285 --> 00:43:16.548 - think about is what role should those requirements play in protecting families and also local communities 00:43:16.548 --> 00:43:24.702 - because there's a lot of discussion there about families having their personal choices and getting vaccinated but then 00:43:25.090 --> 00:43:32.837 - how that can affect the community if we have low vaccination rates. So yeah, maybe you can just talk 00:43:32.837 --> 00:43:40.661 - more about like the vaccination schedule and things going on there. Let's see, that's a big question. 00:43:40.661 --> 00:43:48.485 - So I think with our childhood vaccine schedule hasn't changed really a whole lot in the past, besides 00:43:48.485 --> 00:43:54.238 - adding COVID and RSV, which was a huge addition to our pediatric schedule. 00:43:54.594 --> 00:44:01.954 - really reducing hospitalizations for our youngest babies. I don't I don't think people like I think 00:44:01.954 --> 00:44:09.314 - people are still looking at the AAP schedule. I think that they still in general like pediatricians 00:44:09.314 --> 00:44:16.673 - and local health departments and private practice everyone is still following that schedule because 00:44:16.673 --> 00:44:23.518 - the HHS schedule was pulled back so quickly. I mean it happened it happened relatively fast. 00:44:23.938 --> 00:44:30.521 - So we still get questions. We get questions about birth dose hepatitis B, like why are we giving hepatitis 00:44:30.521 --> 00:44:36.796 - B to infants or to babies day one? And there's a lot of research that goes into that. I'd be happy to 00:44:36.796 --> 00:44:43.501 - discuss afterwards. I think it's fascinating. But I think it's important that providers, medical assistants, 00:44:43.501 --> 00:44:49.899 - this is a huge goal for me this coming year, is helping educate our medical assistants. Because they're 00:44:49.899 --> 00:44:53.406 - the ones that are taking our patients back to the office 00:44:53.538 --> 00:45:00.581 - you know, back to the clinic, back to the office. And if their vaccine has a tent, they can really like 00:45:00.581 --> 00:45:08.031 - derail that conversation really quickly. And so making sure our medical assistants have the right information 00:45:08.031 --> 00:45:14.872 - when it comes to the childhood schedules, I think is really important. And then school requirements. 00:45:14.872 --> 00:45:21.983 - And I think this is hard because parents have the right to make this choice for themselves and for their 00:45:21.983 --> 00:45:23.134 - children, right? 00:45:23.970 --> 00:45:30.879 - I believe that, but I also believe in the common good and the public good and that for those families 00:45:30.879 --> 00:45:37.788 - who can't make that choice, right? So we have young children who are immunocompromised, who are going 00:45:37.788 --> 00:45:44.833 - through cancer treatments, who, you know, whose immune system, maybe they can get vaccinated, but their 00:45:44.833 --> 00:45:51.742 - immune system does not respond to vaccines at all. So we have an obligation to protect those children 00:45:51.742 --> 00:45:52.894 - as well. And so, 00:45:53.122 --> 00:45:59.153 - you know, that's why we have school mandates so that those children still can come to school because 00:45:59.153 --> 00:46:05.423 - if we were letting measles and chickenpox and whatever run rampant in our school systems, those children 00:46:05.423 --> 00:46:11.693 - who are most immunosuppressed would not be able to attend public schools. And we have a mother who talks 00:46:11.693 --> 00:46:17.783 - at a lot of our stuff who has a, you know, her child has some, you know, you would probably know what 00:46:17.783 --> 00:46:23.038 - it is, some deficiency in his immune system. So he doesn't respond to vaccines and she, 00:46:23.426 --> 00:46:28.979 - did some research on the preschool that he was in and found out that probably half of the kids were 00:46:28.979 --> 00:46:34.087 - not fully vaccinated. And she was terrified, you know, every day sending her kid to school. 00:46:34.087 --> 00:46:39.751 - She was like, he could come home with, you know, the flu or something that, that could kill him. But, 00:46:39.751 --> 00:46:45.692 - you know, most families, most children are going to be okay. And so I think we've gotten away from talking 00:46:45.692 --> 00:46:51.134 - about the public good and about community good. And I don't know how we get back to that, how we, 00:46:51.458 --> 00:46:57.579 - bring people back to feeling responsible for helping protect other people? Maybe there's a good answer, 00:46:57.579 --> 00:47:03.701 - I don't know, but. Yeah, I think, you know, one of the things we talk about at our vaccine conferences, 00:47:03.701 --> 00:47:09.998 - you know, and sitting around being nerdy, is vaccines are so interesting. It will never not be interesting 00:47:09.998 --> 00:47:15.943 - work. But it's one of the only things, and you can come up with other examples if you want, but it's 00:47:15.943 --> 00:47:19.710 - one of the only things where it's a public health intervention. 00:47:20.162 --> 00:47:25.922 - It only works at the public level, but it's a private decision, right? And so getting people to buy 00:47:25.922 --> 00:47:31.913 - into that. And to Lisa's point, a lot of the research I do in Indiana and around the country is looking 00:47:31.913 --> 00:47:37.674 - at predictors of vaccine decision making and things like that. And altruism is something we've also 00:47:37.674 --> 00:47:43.089 - added in political affiliation recently. We used to not have to add that in as a demographic, 00:47:43.089 --> 00:47:49.310 - and now we do, and it's one of the strongest predictors, Dr. Laughlin's right. But we've added in altruism. 00:47:49.442 --> 00:47:56.088 - And we never used to study that, but we've thrown in that measure to kind of see, and it is a very strong 00:47:56.088 --> 00:48:02.484 - predictor of people's willingness. It's just general altruism. Like, will you help someone take their 00:48:02.484 --> 00:48:08.441 - groceries to the car? You know, these questions are very general. And it is a strong predictor 00:48:08.441 --> 00:48:14.773 - of vaccination. So I do think some of our social and cultural leaders have a role to play in this. I 00:48:14.773 --> 00:48:15.902 - know some of the, 00:48:16.002 --> 00:48:22.793 - There's not a single large religious organization that is anti-vaccine, and some of the leading religious 00:48:22.793 --> 00:48:29.584 - organizations have actually come out and said it is your duty as a fellow human to protect others through 00:48:29.584 --> 00:48:36.247 - vaccination. And I don't know how we get those messages more out there, but I think it needs to be part 00:48:36.247 --> 00:48:42.782 - of it. Jim, anything you want to add? Oh, I did what's been said already. I think there are a couple. 00:48:42.914 --> 00:48:50.594 - things that came to mind as I was listening to this, though. I think we have become somewhat complacent 00:48:50.594 --> 00:48:58.127 - as the incidence of many of these contagious diseases has decreased because of the vaccine's success. 00:48:58.127 --> 00:49:05.585 - And so many parents think, oh, it's not necessary. It's not going to happen to us. Why should I risk 00:49:05.585 --> 00:49:12.158 - having that foreign substance injected into my child? And so from a parental standpoint, 00:49:12.482 --> 00:49:19.042 - standpoint, responsibility standpoint, that's one issue. That's a little separate from the public health, 00:49:19.042 --> 00:49:25.231 - for the good of the public health, because not too many of us would argue that we need to strap our 00:49:25.231 --> 00:49:31.544 - six month old into a car seat. And that's a public health issue, but it's also an individual decision 00:49:31.544 --> 00:49:37.733 - to protect your child. And I think as a parent, that's one of our duties, ultimately, is to do what 00:49:37.733 --> 00:49:40.766 - we can to protect our children and to think that 00:49:40.866 --> 00:49:49.627 - Well, I'm not going to get in a car wreck, so I don't need to put my kid in a car seat is kind of comparable 00:49:49.627 --> 00:49:58.146 - to saying I don't need to get an MMR because my child is not going to get one of the severe complications 00:49:58.146 --> 00:50:06.184 - of the measles. So there are all kinds of reasons parents are not having their kids vaccinated, but 00:50:06.184 --> 00:50:07.550 - I would say that 00:50:07.682 --> 00:50:13.699 - it's not gonna happen to me and that complacency argument is also one that we have to kind of keep in 00:50:13.699 --> 00:50:19.716 - mind. Yeah, I think that's an excellent point too. Cause I think one of the unfortunate ironic things 00:50:19.716 --> 00:50:25.615 - has been, you know, certain folks saying, well, you know, this disease isn't around anymore. So why 00:50:25.615 --> 00:50:31.632 - are we still vaccinating for it? Not understanding that that's, you know, that made a reason why it's 00:50:31.632 --> 00:50:35.230 - not around anymore. So yeah, that, that complacency and, um, 00:50:35.810 --> 00:50:43.522 - especially with, you know, I think even some younger folks nowadays when they've never heard of some 00:50:43.522 --> 00:50:51.617 - of these diseases, more like measles is coming back now. So, yeah, I think, yeah, it's just really tough, 00:50:51.617 --> 00:50:59.558 - you know, Katie, like you mentioned, how do we communicate this to different communities and, you know, 00:50:59.558 --> 00:51:05.438 - different people who respond differently to things. So, yeah, it's, I think, 00:51:05.762 --> 00:51:13.144 - I had a follow-up there, I was thinking of asking, but I think for now, just actually go ahead and move 00:51:13.144 --> 00:51:20.526 - into our next question. Katie, I actually think these two next questions will be very good to hear from 00:51:20.526 --> 00:51:27.908 - you first. So this is regarding this information, misinformation age we're living in where there's just 00:51:27.908 --> 00:51:35.006 - constant information and misinformation coming from right now the federal government, social media. 00:51:35.106 --> 00:51:42.448 - So I guess the question I have is when federal guidance, like right now, and these independent third-party 00:51:42.448 --> 00:51:49.378 - medical organizations like the American Academy of Pediatrics, when their recommendations and health 00:51:49.378 --> 00:51:56.515 - guidance is differing, how would you suggest, say, talking to parents about that? Because historically, 00:51:56.515 --> 00:52:03.102 - it was look at what the federal government is recommending, like the CDC or HHS, but right now, 00:52:03.234 --> 00:52:09.722 - We're more hesitant to say go look at the CDC website. Even recently they they've changed some of the 00:52:09.722 --> 00:52:16.464 - language about vaccines and autism. So I guess what would your suggestions be for helping people evaluate 00:52:16.464 --> 00:52:23.016 - you know things they hear online or when they hear different guidance from like the federal government 00:52:23.016 --> 00:52:24.606 - and other organizations. 00:52:25.826 --> 00:52:31.325 - I want to start with a story I work with a national organization that quarterly, we meet with a group, 00:52:31.325 --> 00:52:36.717 - a panel of moms who have adolescents to kind of talk through how they're thinking about vaccines and 00:52:36.717 --> 00:52:42.430 - vaccine information. And we were talking about the executive order that came out over the summer recently. 00:52:42.626 --> 00:52:48.218 - One of the moms, this woman named Janice, who's great, she lives in Wyoming, she has six kids, and she's 00:52:48.218 --> 00:52:53.650 - been with her pediatrician, you know, her oldest kid I think is like 21 and her youngest is 12. She's 00:52:53.650 --> 00:52:59.028 - been with the same pediatrician the whole time. And she said, we were talking about this very thing, 00:52:59.028 --> 00:52:59.774 - and she said, 00:52:59.906 --> 00:53:05.616 - I luckily can ask him, but if I was a mom of a newborn baby, I have no idea what I would do. I wouldn't 00:53:05.616 --> 00:53:11.106 - have had an established relationship with a trusted provider yet. I wouldn't have had a provider at 00:53:11.106 --> 00:53:16.706 - all. I would not have known how to make sense of these things. And all the other seasoned moms in the 00:53:16.706 --> 00:53:22.526 - group chimed in, and they were like, absolutely. I just say, what do you think I should do, and turned to 00:53:22.658 --> 00:53:29.747 - to that provider for guidance. So I do feel for new moms, right, especially first time moms trying to 00:53:29.747 --> 00:53:36.975 - really make that decision. We know moms are the major decision maker on vaccines. That's why I'm saying 00:53:36.975 --> 00:53:41.214 - that. But I think when it comes to making sense of guidance, 00:53:41.666 --> 00:53:48.036 - probably preaching to the choir a little bit that when it comes to science, consensus is important, 00:53:48.036 --> 00:53:54.660 - right? And so I think if we can help the public understand that this is the discordant, the errant sort 00:53:54.660 --> 00:54:01.029 - of group that's happening, and yet everybody else is saying, no, no, no, let's just keep doing what 00:54:01.029 --> 00:54:02.558 - we're doing. AAP, ACOG, 00:54:03.202 --> 00:54:08.751 - family physicians, AMA, they're saying, no, no, no, we're not changing. We're following the guidance. 00:54:08.751 --> 00:54:14.029 - We all are in consensus around, and AAP has really stepped up. I work with another pediatrician. 00:54:14.029 --> 00:54:19.578 - He said, it's never been more exciting to be a member of the AAP than it is right now, right? They're 00:54:19.578 --> 00:54:24.855 - just like, you know, you go to our meetings and there's like security outside the rooms because, 00:54:24.855 --> 00:54:27.902 - you know, and they're like, that never happened before. 00:54:28.418 --> 00:54:34.950 - I think if we can emphasize the consensus approach, that this is the one that's different and I know 00:54:34.950 --> 00:54:41.546 - we used to follow the federal, but really we're saying stick with the consensus here and that we feel 00:54:41.546 --> 00:54:48.336 - comfortable and we feel that this is the right guidance. I also wonder, and I know this started bubbling 00:54:48.336 --> 00:54:52.734 - probably before you retired, but I wonder how much parents actually 00:54:53.474 --> 00:55:00.625 - bring in knowledge of those different things or if they just kind of come into that clinical space, 00:55:00.625 --> 00:55:07.775 - just I'm confused, I don't know what the right guidance is? Is that kind of how they come into that 00:55:07.775 --> 00:55:15.212 - space? Both. Both. Some of they come into asking questions and not wanting a particular vaccine because 00:55:15.212 --> 00:55:23.006 - they read it on the internet or their spouse is concerned because not all parents are in alignment for sure. 00:55:23.394 --> 00:55:31.134 - And there are some who have done their research, and they bring files in. But when you look at the sources, 00:55:31.134 --> 00:55:38.587 - that's where the argument comes, because you've got good sources on the internet, and you've got plenty 00:55:38.587 --> 00:55:45.896 - of bad sources. And so that's where I have to kind of sort out and try to have them sort out the good 00:55:45.896 --> 00:55:51.486 - information from the bad information. And we've mentioned ACIP. I don't know. 00:55:52.226 --> 00:56:00.345 - Maybe I should just mention that in the past, to become a member of this committee, it took years of 00:56:00.345 --> 00:56:08.626 - vetting during the application process for a person to be chosen to be a member of this committee. And 00:56:08.626 --> 00:56:17.147 - all of these members have extensive academic experience and scientific experience and clinical experience 00:56:17.147 --> 00:56:21.086 - to help form a group that isn't willing to argue 00:56:21.282 --> 00:56:28.349 - about certain things, but is basically using science as the basis for their decision in the end. And 00:56:28.349 --> 00:56:35.625 - I think the credibility that they had was so outstanding that that's why all these organizations follow 00:56:35.625 --> 00:56:42.972 - them to a T, because that is the gold standard and was the gold standard, not now. Because the committee 00:56:42.972 --> 00:56:50.878 - now has been revamped to include vaccine anti-vaxxers and those who have actually been involved suing, you know, 00:56:51.202 --> 00:56:58.863 - monetary gain. So it's it's a completely different field right now. Yeah. And I'm really glad you brought 00:56:58.863 --> 00:57:06.235 - that up. One of my mentors, Greg Simmons, some of you probably know him always likes to remind people 00:57:06.235 --> 00:57:14.113 - it is an anti vaccine industry. Right. We're not spreading this and disinformation for the good of humanity. 00:57:14.113 --> 00:57:17.438 - Right. There's a don't get this vaccine. Take 00:57:17.858 --> 00:57:25.525 - Ivermectin instead. Don't follow this advice. Watch my YouTube video and like it and share it. 00:57:25.525 --> 00:57:33.837 - Buy my book. Try these supplements, right? The reason the anti-vaccine industry and the spread of this 00:57:33.837 --> 00:57:41.908 - misinformation exists is it is an industry. There is a monetary gain to it. And we've played around 00:57:41.908 --> 00:57:46.750 - with that messaging. And it doesn't quite land with groups. 00:57:46.914 --> 00:57:54.129 - Someone's trying to con me, right? I would like to know, but I think it's important to remind people 00:57:54.129 --> 00:58:01.345 - that, like, what is the motive behind this information coming out? Lisa, anything you'd like to add? 00:58:01.345 --> 00:58:08.560 - I think the only thing I would add is, you know, we talked about, we got a little complacent because 00:58:08.560 --> 00:58:13.918 - the vaccines, we're doing such a great job, we didn't really, but I think, 00:58:14.242 --> 00:58:20.445 - As providers, we also got complacent with it. And so we have to own some of that because even when I 00:58:20.445 --> 00:58:26.588 - started 13 years ago, we didn't even talk about the infant immunization schedule because it was so, 00:58:26.588 --> 00:58:32.730 - the acceptance rate was so high that we didn't have to talk about it. And so we focused on where we 00:58:32.730 --> 00:58:38.872 - could make the most impact, which was like at the adolescent schedule with HPV and meningitis B and 00:58:38.872 --> 00:58:43.294 - maybe a little bit in the adult space, especially with chronic disease. 00:58:43.778 --> 00:58:50.067 - And so my first probably six years, seven years, we didn't even talk about the infinite immunization 00:58:50.067 --> 00:58:56.294 - schedule. And that's on us for not reminding parents that this is why we're doing this. This is why 00:58:56.294 --> 00:59:02.209 - this is important. These are the diseases we're preventing. So I think not only did the public 00:59:02.209 --> 00:59:08.747 - get complacent, but as providers, I think we did as well. And so owning some of that space again I think 00:59:08.747 --> 00:59:12.670 - is really important. Yeah, I think that's a really good point. 00:59:12.994 --> 00:59:19.571 - And something you mentioned too, Katie, with like new mothers, that's such a vulnerable group. So when 00:59:19.571 --> 00:59:26.148 - they don't have care already established with the pediatrician, that's where I think those bad actors, 00:59:26.148 --> 00:59:32.916 - those anti-vaccine groups can come in and scare people away from getting vaccinated. So yeah, it's really 00:59:32.916 --> 00:59:39.301 - unfortunate. I think obviously that's what we're seeing a lot of right now, even within our federal 00:59:39.301 --> 00:59:42.366 - government somehow, we've gotten to this point. 00:59:42.562 --> 00:59:48.023 - And yeah, actually, Jim, I really liked your response because that was actually a question I was going 00:59:48.023 --> 00:59:53.591 - to ask you is how, you know, because I think it's interesting to hear the differences between your guys' 00:59:53.591 --> 00:59:59.158 - work and then, Jim, where you're seeing, you know, a broad range of people that are coming in that maybe 00:59:59.158 --> 01:00:04.461 - aren't coming to you for vaccines like they are for you. So I guess, Katie, another question I have 01:00:04.461 --> 01:00:07.006 - for you, though, to kind of just build on that. 01:00:07.266 --> 01:00:13.285 - communication side of things. I was wondering if you could share some approaches and I mean I think 01:00:13.285 --> 01:00:19.725 - all three of you probably have a lot of experience here just what approaches have you found most effective 01:00:19.725 --> 01:00:25.865 - when talking with worried parents or vaccine hesitant parents. Obviously if you have someone who's in 01:00:25.865 --> 01:00:27.550 - complete denial of vaccines 01:00:27.714 --> 01:00:33.904 - that may not be someone you could even have a conversation with. But when someone is actually concerned, 01:00:33.904 --> 01:00:39.918 - how do you go about addressing that? What things help, what things do not help? I think that could be 01:00:39.918 --> 01:00:46.226 - helpful for all of us here if someone has a concerned family member and wants to try and address something 01:00:46.226 --> 01:00:52.358 - like that in a productive way. So a lot of what I realized when I went into this area is the importance 01:00:52.358 --> 01:00:55.070 - of taking communication science and making it 01:00:55.266 --> 01:01:01.445 - easy for providers and public health professionals to be able to use, right? So I do a lot of training 01:01:01.445 --> 01:01:07.984 - and a lot of things like that, many through Lisa's organization. The first thing we like to remind providers 01:01:07.984 --> 01:01:14.223 - and people working in public health and people who will be sitting at the Thanksgiving table next month 01:01:14.223 --> 01:01:20.343 - with Uncle Steve, who listens to a few too many podcasts and news organizations that aren't truthful, 01:01:20.343 --> 01:01:24.542 - is just because somebody has questions doesn't mean they're hesitant. 01:01:24.930 --> 01:01:32.099 - Right? And we see that with anything. Is it okay to take this antibiotic? Is it okay for this vaccine? 01:01:32.099 --> 01:01:39.616 - So that's an important place to start. We want shared clinical decision making for any medical intervention 01:01:39.616 --> 01:01:46.715 - that we're providing. But something that I started instituting in my talks around the time that COVID 01:01:46.715 --> 01:01:51.518 - started is some communication science. So one of the things that we, 01:01:52.482 --> 01:01:58.249 - talk about is echo chambers. Have people heard of the idea of echo chambers? A few folks have. So it's 01:01:58.249 --> 01:02:04.128 - the idea that we live in communication environments, particularly in today's very targeted, minute media 01:02:04.128 --> 01:02:09.896 - spaces that we can all live in, right? And Lisa listens to podcasts and reads books I never even heard 01:02:09.896 --> 01:02:15.999 - of. We're close friends, so we talk a lot, right? It used to be we all watched the same three news channels. 01:02:15.999 --> 01:02:21.150 - We had the same radio stations. We all were exposed to the same media, but now we can pick. 01:02:22.178 --> 01:02:27.987 - So we live in these echo chambers where we hear the same messages over and over. And the people who 01:02:27.987 --> 01:02:33.797 - are close to us are listening and watching and reading the same messages close to us. And so if you 01:02:33.797 --> 01:02:39.780 - live in an echo chamber where you've been told that vaccines are dangerous, that they're going to hurt 01:02:39.780 --> 01:02:45.764 - your baby, they're going to cause long-term consequences, they're going to be infertile when they grow 01:02:45.764 --> 01:02:49.598 - up, it's going to kill them, would you get your child vaccinated? 01:02:50.114 --> 01:02:56.155 - You wouldn't, right? And so I like to remind providers that this is their reality that these people 01:02:56.155 --> 01:03:02.256 - are living in. And I think if you can start from that place, from a place of empathy, that we really 01:03:02.256 --> 01:03:08.297 - are coming from different worlds. There was that old book, men are from Mars, women are from Venus, 01:03:08.297 --> 01:03:14.218 - right? It's kind of the same thing, but it's thinking about the echo chambers and the information 01:03:14.218 --> 01:03:16.030 - environments that we live in. 01:03:16.194 --> 01:03:21.627 - bring in, it comes from my colleagues in psychology, is something called motivated reasoning. And this 01:03:21.627 --> 01:03:27.008 - is something that's really hard to break people out of, but trusted providers can do it. And it's the 01:03:27.008 --> 01:03:32.546 - idea that when I come across information, especially if I've been living in a really tight echo chamber, 01:03:32.546 --> 01:03:37.927 - when I come across information that supports what I already believe, I'm like, of course, yes. So I'm 01:03:37.927 --> 01:03:38.718 - a big Swiftie. 01:03:38.818 --> 01:03:44.261 - I have to draw, I have to bring that in as a certified Swiftie, I have to mention it at every point. 01:03:44.261 --> 01:03:49.919 - So if I see an article that says, oh, her new songs are great, I say, of course they are, they're great. 01:03:49.919 --> 01:03:55.416 - If I see an article though that says her new songs are horrible, I'm not even gonna listen to it, I'm 01:03:55.416 --> 01:04:01.075 - not gonna critically evaluate it, I'm not gonna read it. We do that with all kinds of information. We're 01:04:01.075 --> 01:04:07.326 - motivated to believe and pay attention to things that support our already held beliefs and to completely, you know, 01:04:07.810 --> 01:04:14.208 - not believe and not pay attention to things that disagree with what we believe. How do we break through 01:04:14.208 --> 01:04:20.361 - these echo chambers and this motivated reasoning process? It's very hard. And one of the ways we do 01:04:20.361 --> 01:04:26.513 - that is through evidence-based communication interventions. We do that through helping people learn 01:04:26.513 --> 01:04:32.542 - health literacy and critical thinking skills. We help them learn how to sort through information. 01:04:32.866 --> 01:04:39.356 - I also want to do a shout out to people like Dr. Laughlin that we put, I think this is on us, we've 01:04:39.356 --> 01:04:45.846 - put so much pressure on pediatricians and family practice and PCPs to address vaccine hesitancy and 01:04:45.846 --> 01:04:52.530 - they don't have time. They also don't often have the training or the ability to do that and nor should 01:04:52.530 --> 01:04:55.710 - they. Yes, they should work with their patients. 01:04:55.938 --> 01:05:02.135 - But Dr. Loughlin and his colleagues do not have time to look through Uncle Steve's printouts that he 01:05:02.135 --> 01:05:08.578 - brought to talk about, right, he's got to get through all of the other things. And so, you know, I think 01:05:08.578 --> 01:05:14.714 - it's so incredibly important for every single person in this room that when you see misinformation, 01:05:14.714 --> 01:05:20.359 - you are obligated to call it out in a thoughtful, evidence-based approach. But when you are 01:05:20.359 --> 01:05:24.286 - at the Thanksgiving table and someone brings up misinformation, 01:05:24.386 --> 01:05:30.039 - You jump on it. I want you to think of Dr. Laflon how tired he is. He had to retire because he was so 01:05:30.039 --> 01:05:35.747 - tired searching through all the Google printouts. We cannot put the onus of responsibility just on our 01:05:35.747 --> 01:05:41.399 - providers because they are not the only people who are part of this kind of vaccine ecosystem that we 01:05:41.399 --> 01:05:46.941 - live in. The most important place of course that that happens is the online space. And I'm sure Dr. 01:05:46.941 --> 01:05:50.654 - Laflon could speak to given that he's been in practice since 1981. 01:05:52.354 --> 01:05:58.353 - practiced way before the internet came around, right, and the crazy change that that created. We did 01:05:58.353 --> 01:06:04.472 - a study about five years ago when Twitter was still Twitter, and we pulled all of the posts around HPV 01:06:04.472 --> 01:06:10.233 - vaccination in a six-month period. And I'll finish up, Tyler. Sorry, I get talking about common, 01:06:10.233 --> 01:06:16.411 - I can't stop. What percent of all the vaccine, HPV vaccine posts on Twitter in a six-month period, what 01:06:16.411 --> 01:06:19.262 - percentage do you think contain misinformation? 01:06:24.930 --> 01:06:33.631 - I thought it was 25% is the only, but those were much more statistically significantly more likely to 01:06:33.631 --> 01:06:35.934 - be retweeted, to be liked. 01:06:36.290 --> 01:06:44.212 - right, compared to the boring ones from the Indian Immunization Coalition, right? So we have to think 01:06:44.212 --> 01:06:52.212 - about the power that these unethical actors are using to spread information and try to understand what 01:06:52.212 --> 01:07:00.134 - they're doing and how we can not use the same tactics, we should be ethical communicators, but how we 01:07:00.134 --> 01:07:05.182 - can battle that. I think that was great. One of the things that, 01:07:06.178 --> 01:07:13.525 - I thought about when you were talking is, how do I approach a patient when they are asking questions 01:07:13.525 --> 01:07:20.799 - or hesitant? And my approach has always been, I don't wanna be confrontational and I don't wanna be 01:07:20.799 --> 01:07:28.218 - considered a zealot because that just turns the patient off and makes us in a defensive position. And 01:07:28.218 --> 01:07:35.710 - pretty much I've always said, well, if they refuse a vaccine, I almost always start with the question, 01:07:35.874 --> 01:07:43.050 - Are there concerns you have that I can help with? Because then you start to open, you open the conversation 01:07:43.050 --> 01:07:49.695 - or keep the conversation open, because some of them will just say no, but that's rare. Most of them 01:07:49.695 --> 01:07:56.406 - will express a reason or some reasons, and that gives you a foothold of, well, how do I need to work 01:07:56.406 --> 01:08:01.854 - this conversation to provide the information that might make them think about it? 01:08:02.338 --> 01:08:08.993 - And I can't tell you, it's like when we talk to parents who smoke, I can ask them at every visit, would 01:08:08.993 --> 01:08:15.456 - you like information or help to quit smoking? And we were actually involved in a national study with 01:08:15.456 --> 01:08:22.175 - the AAP. And it takes the average parent who smokes sometimes up to nine times being asked that question 01:08:22.175 --> 01:08:28.702 - before they may say yes. And my experience with immunizations has been sort of similar, is that I may 01:08:28.702 --> 01:08:30.238 - ask them at each visit, 01:08:30.754 --> 01:08:38.163 - if they have changed their mind or if there are other questions they have. In a relatively high percentage 01:08:38.163 --> 01:08:45.226 - of patients, I can talk them into getting vaccines. There are some that are just going to say no, but 01:08:45.226 --> 01:08:52.428 - I think that trust factor and that willingness to engage in conversation without putting on a defensive 01:08:52.428 --> 01:08:54.782 - front is real important. I've had 01:08:55.138 --> 01:09:01.751 - I know of pediatricians who don't see patients in their practice who refuse immunizations. We've never 01:09:01.751 --> 01:09:08.363 - been that way. Because I know there are many, many reasons why parents would refuse those or make that 01:09:08.363 --> 01:09:15.105 - refusal. But I think it's important to kind of try to keep an open dialogue. And by doing that and being 01:09:15.105 --> 01:09:21.525 - non-confrontational, I found that that is the best way to approach vaccine hesitancy in most of our 01:09:21.525 --> 01:09:24.478 - patients. Yeah, I'll just add really quickly. 01:09:24.866 --> 01:09:31.952 - I think one of the hard things is you can scare people out of doing things, right? So the anti-vax movement 01:09:31.952 --> 01:09:39.169 - is really good at scaring people so they don't get vaccinated. You cannot scare someone into doing something. 01:09:39.169 --> 01:09:45.861 - And so we can share stories of kids with measles and the six deaths in Pennsylvania, but it is really 01:09:45.861 --> 01:09:53.406 - hard to scare people into doing something. And I think the other just two quick things is we can't dismiss people. 01:09:53.506 --> 01:09:59.745 - So if they bring in Dr. Google and they have all these things, you can't dismiss that and say, oh, this 01:09:59.745 --> 01:10:05.744 - is just all garbage or these are not good sources. The best thing to do is kind of look at them and 01:10:05.744 --> 01:10:11.863 - be like, oh, well, this part of this article is true. And I believe this. Here's where there might be 01:10:11.863 --> 01:10:17.982 - some issues. And here may be some other sources you could look at to see. But we can't be dismissive. 01:10:18.402 --> 01:10:23.694 - And we have to answer their questions with honesty. And I think sometimes that's harder when they ask 01:10:23.694 --> 01:10:29.090 - about side effects. And I think when someone asks about side effects, we would have nurses occasionally 01:10:29.090 --> 01:10:34.486 - be like, oh, there aren't really any side effects. It's going to be fine. That's not true. I mean, it's 01:10:34.486 --> 01:10:39.778 - probably going to be fine. But their arm is probably going to hurt. It might be red and swollen. They 01:10:39.778 --> 01:10:41.438 - might get a fever the next day. 01:10:41.538 --> 01:10:46.286 - They might be fatigued. And so if we can answer those questions honestly and say, here are the most 01:10:46.286 --> 01:10:51.509 - common side effects that will likely happen, and if they do, you can put an ice pack on it or take ibuprofen, 01:10:51.509 --> 01:10:56.257 - then they don't feel like they've been dismissed. They feel like you've heard them, you've answered 01:10:56.257 --> 01:11:01.100 - them. And so really thinking about how we are responding to these questions, because I know it's easy 01:11:01.100 --> 01:11:06.038 - sometimes to just be like, and sometimes I'm really, really good at this, and sometimes I'm really bad. 01:11:06.038 --> 01:11:11.166 - I walked away from one family one time and I heard the grandma say, well, she's a smart ass. And I thought, 01:11:11.842 --> 01:11:18.023 - Well that did not go as planned. So then we get we get busy and we get you know everything's hectic 01:11:18.023 --> 01:11:24.265 - and sometimes we're not as patient as we should be. And I will say looking back on that conversation 01:11:24.265 --> 01:11:30.693 - like I dismissed her concern. And so in that one interaction right there I broke that trust right. That 01:11:30.693 --> 01:11:36.874 - family will never come back and see me again. And so it is really really important that we are very 01:11:36.874 --> 01:11:40.830 - careful with how we are talking to and managing these families. 01:11:42.530 --> 01:11:48.006 - I just want to add, I wish Lisa would have talked about this when she was doing her slides. But for 01:11:48.006 --> 01:11:53.536 - those of you that don't know, the federal government has decided that vaccines are such an important 01:11:53.536 --> 01:11:59.176 - public health intervention that you cannot sue a pharmaceutical company or a doctor if you get injured 01:11:59.176 --> 01:12:04.980 - for a vaccine. There's a special, what's it called, the Vaccine Injury Court? Compensation. Compensation. 01:12:04.980 --> 01:12:10.456 - And Lisa's organization has had a really wonderful scholar who studies this and has been part of it 01:12:10.456 --> 01:12:11.934 - present. Is that recorded? 01:12:13.282 --> 01:12:19.568 - But it's incredibly interesting. There's no other medical intervention we have, right, that has this 01:12:19.568 --> 01:12:26.165 - special. So if you do get injured, there is a way to take care of you. Although what's really interesting 01:12:26.165 --> 01:12:32.451 - is her research showed that something like 75% of vaccine injuries, documented vaccine injuries, not 01:12:32.451 --> 01:12:34.878 - the fake ones that you see on Twitter. 01:12:34.978 --> 01:12:40.710 - are due to administration error, right? So it's not even the vaccines. It's really just, we have maybe 01:12:40.710 --> 01:12:46.553 - somebody who is giving it wrong. So anyway, read about that. It's incredibly interesting and the history 01:12:46.553 --> 01:12:52.118 - of that is interesting, but it's an interesting policy that was put in place in our country because 01:12:52.118 --> 01:12:57.683 - we believe vaccines are so important. Yeah, thank you all. That was very informative, very helpful. 01:12:57.683 --> 01:13:03.582 - I really appreciate everything that you guys have done in these areas and things you guys continue to do. 01:13:04.130 --> 01:13:09.788 - I think from here though we have about 15, 20 minutes so maybe we can open it up to audience questions 01:13:09.788 --> 01:13:11.710 - and looks like we already got one. 01:13:32.994 --> 01:13:40.368 - If you look here long enough, I think the one medical institution which most Hoosiers have almost complete 01:13:40.368 --> 01:13:47.535 - trust in is Riley Hospital. It has an extremely high reputation. If you don't know somebody, neighbors, 01:13:47.535 --> 01:13:54.495 - friends, all seem to have connections with Riley somewhere along the line. And in your last slide, I 01:13:54.495 --> 01:14:01.662 - looked for Riley. There were two .edu's among your resources, one in Philadelphia and one in Minnesota. 01:14:02.306 --> 01:14:10.366 - Does Riley not have? Let me ask you differently. If there is no such .edu from IU School of Medicine 01:14:10.366 --> 01:14:18.347 - and Pediatrics or Riley Hospital, why not? I mean, that's a source. I think Dr. Laughlin could hand 01:14:18.347 --> 01:14:26.248 - a pamphlet that said Riley Hospital or IU School of Medicine Department of Pediatrics. That would, 01:14:26.248 --> 01:14:30.398 - I think, dispel a lot of this mistrust immediately. 01:14:32.450 --> 01:14:41.644 - Yeah. No, I think that's like, I don't even know. I didn't think about it. I don't know what their resources 01:14:41.644 --> 01:14:50.163 - pages around immunization specifically look like, but they fund us every year. Quite, you know, they 01:14:50.163 --> 01:14:56.574 - fund quite a few of our clinics and so. Yeah. CHOP.edu doesn't mean diddle. 01:14:58.946 --> 01:15:07.752 - Yeah, that's Philadelphia Children's Hospital. It's an amazing resource. And they've done an amazing 01:15:07.752 --> 01:15:16.906 - job with outreach and public education. And I would, even though I was a Riley physician, Riley Hospital 01:15:16.906 --> 01:15:25.886 - does a very poor job of outreach, particularly into primary care. I'll be the first to criticize that. 01:15:26.018 --> 01:15:32.966 - as a frustration, but it's an opportunity for them, actually, to be aligned publicly to say, okay, we 01:15:32.966 --> 01:15:40.392 - endorse ACIP. We endorse the Academy of Pediatrics. We're in the same page because it is a trusted resource. 01:15:40.392 --> 01:15:47.476 - I think the Colts and the Riley Hospital are the two biggest names. Of course, the Colts are going down 01:15:47.476 --> 01:15:55.038 - the tube, so why can't Riley be number one now? As soon as IU Health acquired your practice, you founded, Jim, 01:15:55.202 --> 01:16:01.704 - What did they rename it? From Southern Indiana pediatrics, it became Riley Physicians. We were the first 01:16:01.704 --> 01:16:08.082 - primary care group in the state to be branded Riley pediatricians. As you would say now, it's a brand. 01:16:08.082 --> 01:16:14.460 - Yeah. But I do agree that there's an opportunity there to engender trust with that name in mind. Yeah, 01:16:14.460 --> 01:16:20.590 - I am going to take that opportunity and see what I can do, because we work with them all the time. 01:16:20.590 --> 01:16:23.934 - But yeah, they are not on my list. You're right. Tim? 01:16:24.770 --> 01:16:31.430 - I was impressed with Katie's statement about the necessity to combat misinformation. So I'd like to 01:16:31.430 --> 01:16:38.223 - ask the panelists specifically what they think is the most effective thing to do when two of the most 01:16:38.223 --> 01:16:45.150 - prominent purveyors of misinformation are our Secretary of Health and Human Services and our President. 01:16:47.906 --> 01:16:54.131 - fun times, isn't it? You know, I want to go back to just Dr. Laughlin's, you know, the interpersonal 01:16:54.131 --> 01:17:00.726 - open-mindedness of, you know, that when we encounter misinformation in our social networks that we address 01:17:00.726 --> 01:17:07.321 - it. I don't think it's always the best idea to address it online, although if that's where it's happening, 01:17:07.321 --> 01:17:12.190 - maybe try to find a way to do it. But if you can try to talk to that person in 01:17:12.418 --> 01:17:18.662 - person and see what's going on. But I think that interpersonal connection, we've got to start fighting 01:17:18.662 --> 01:17:24.845 - this battle on the home front. We can't just do it on Facebook and on TikTok and things like that. We 01:17:24.845 --> 01:17:31.089 - have to do it in our communities. So forums like this are important. A lot of the workshops and things 01:17:31.089 --> 01:17:37.151 - that Lisa's organization hosts are important. And there's a lot happening, but I think it has to be 01:17:37.151 --> 01:17:41.758 - more this in-person stuff. We're still kind of living in the Zoom age where 01:17:41.890 --> 01:17:48.791 - people are not engaging with information. Go ahead. I just want to say that what I'm going to take away 01:17:48.791 --> 01:17:55.559 - from this, the most important thing I've heard, is the story, which I could use as a metaphor, of the 01:17:55.559 --> 01:18:02.194 - daycare situation. Like, if you haven't been vaccinated and you're at a concert and someone next to 01:18:02.194 --> 01:18:08.896 - you can't be vaccinated and you're caught just starting around the tube, you've been responsible for 01:18:08.896 --> 01:18:11.550 - their death. And so that metaphor idea, 01:18:11.970 --> 01:18:17.364 - of that daycare situation. I think I'm going to use it with one person I know that I want to get this 01:18:17.364 --> 01:18:22.810 - point through to that it's just such an excellent story. And I want to encourage that story to be told 01:18:22.810 --> 01:18:28.309 - more. Yeah. And we've been talking about like altruism, doing it for the public good. I do want to talk 01:18:28.309 --> 01:18:33.967 - about a really effective intervention that happened. You can use this story too. One of the most effective 01:18:33.967 --> 01:18:39.308 - vaccine interventions we had was around whooping cough. Babies, new babies catch whooping cough from 01:18:39.308 --> 01:18:40.894 - grandparents, friends coming. 01:18:40.994 --> 01:18:47.011 - kissing that new baby. I mean, we all want to kiss that new baby smell, right? Gets whooping cough, 01:18:47.011 --> 01:18:53.148 - it's dangerous. And so the idea that we need to cocoon the baby and that you cannot come visit unless 01:18:53.148 --> 01:18:59.224 - you've gotten an updated vaccination was an incredibly effective intervention that came through AAP, 01:18:59.224 --> 01:19:05.662 - through pediatricians, and through other groups. And so we all care about babies. How can we start caring? 01:19:05.794 --> 01:19:11.408 - about the person who's beside us at the concert, for sure. But I really like that story. I think that's 01:19:11.408 --> 01:19:16.860 - a happy story. We do have successes. I mean, one of the things Lisa and I like to remind people, and 01:19:16.860 --> 01:19:22.312 - I'm sure Dr. Laughlin does, is most people still get vaccinated, right? We just need the rates to be 01:19:22.312 --> 01:19:27.872 - higher for us to get herd immunity. But most people are still getting vaccinated, and that's important 01:19:27.872 --> 01:19:28.574 - to remember. 01:19:29.154 --> 01:19:34.498 - I think one thing I wanted to add to what you just said, Katie, I was thinking earlier when you were 01:19:34.498 --> 01:19:39.789 - talking about like misinformation on social media too, I'm sure you're familiar with the term super 01:19:39.789 --> 01:19:45.133 - spreaders of misinformation. So someone actually like RFK Jr. And I know there is literature on this 01:19:45.133 --> 01:19:50.477 - that a lot of that misinformation comes from these concentrated areas, these echo chambers. So I try 01:19:50.477 --> 01:19:54.974 - to remind myself of that when I think about like vaccine rates and things like that. 01:19:55.074 --> 01:20:01.133 - that most people still are getting vaccinated. Most people still do trust their physicians. Although 01:20:01.133 --> 01:20:07.312 - you may see things on the news, like from our current health secretary and from the president, you may 01:20:07.312 --> 01:20:13.371 - see these things and you may think that, you know, like everyone is like super vaccine hesitant now. 01:20:13.371 --> 01:20:19.550 - But I try to remember that most people still do get vaccinated and trust their physicians. Absolutely. 01:20:19.778 --> 01:20:25.673 - So a few years ago, they did a study that found that 12 accounts on Instagram were responsible for the 01:20:25.673 --> 01:20:31.510 - majority of vaccine disinformation, which is information created with malicious intent. Guess who one 01:20:31.510 --> 01:20:37.291 - of those Instagram accounts was? It was RFK Jr. And then he became the Secretary of Health and Human 01:20:37.291 --> 01:20:43.071 - Sciences, right? But as I said earlier, disinformation, bad information, it's much more likely to go 01:20:43.071 --> 01:20:45.246 - viral than good information. Michael? 01:20:48.034 --> 01:20:55.997 - Other areas of science hesitancy, it seems to me one of the most pernicious things that's happened is 01:20:55.997 --> 01:21:04.351 - identification of a few experts, even going back to tobacco, the tobacco battles and certainly the climate 01:21:04.351 --> 01:21:12.314 - change, to find a few people with a prominent academic bio and so on who speak publicly in opposition 01:21:12.314 --> 01:21:14.110 - to the consensus view. 01:21:14.498 --> 01:21:23.415 - Do you find that that community of say physicians or public health practitioners is growing here in 01:21:23.415 --> 01:21:32.688 - Indiana or elsewhere who are kind of providing that lone but loud voice in opposition to the consensus? 01:21:32.688 --> 01:21:41.694 - I don't think in Indiana. I think I think we have had a couple of celebrity vaccine. I mean, I think 01:21:41.694 --> 01:21:42.942 - a paw off it. 01:21:43.234 --> 01:21:50.178 - I think of Peter Hotez, I think. Our own Greg Zimmet. Our own Greg Zimmet. I think, but I think we need, 01:21:50.178 --> 01:21:57.056 - like I said, I think we need people outside of medicine and science, like no offense to our scientists, 01:21:57.056 --> 01:22:03.868 - right? I think we need church leaders, I think we need political leaders, I think we need celebrities, 01:22:03.868 --> 01:22:05.918 - right? We need the cults, too. 01:22:06.530 --> 01:22:12.800 - win games, but we also need them to come out and do a flu vaccine campaign, right? It cannot just be 01:22:12.800 --> 01:22:19.009 - on scientists and medical professionals and the Dr. Laughlin's of the world. This is something that 01:22:19.009 --> 01:22:25.279 - affects all of us. We need more people. We need more celebrities to get involved. Well, Katie, maybe 01:22:25.279 --> 01:22:31.487 - you can talk to Taylor Swift. I'm working on it. She just doesn't take in my calls, but yeah. Yeah, 01:22:31.487 --> 01:22:33.598 - but I do think there is a growing 01:22:34.050 --> 01:22:41.829 - we are seeing a growing issue where the hesitancy is among providers. And I think that's, especially 01:22:41.829 --> 01:22:49.840 - when we have very young providers, my family physician is way younger than me and she's got young kids. 01:22:49.840 --> 01:22:57.542 - And if she was vaccine hesitant, that would influence me a lot. She's never seen these diseases. So 01:22:57.542 --> 01:23:01.470 - we are seeing this growing hesitancy in providers. 01:23:01.634 --> 01:23:07.974 - So not just our physicians, but also in some of our nurses, our MAs. And when we have that, it's really 01:23:07.974 --> 01:23:14.375 - hard to be like, oh, we have trust. Talk to your provider when they're actually, I will say pharmacists. 01:23:14.375 --> 01:23:20.533 - Sorry if any of you are pharmacists. Of all the groups that we educate, I find the most hesitancy in 01:23:20.533 --> 01:23:26.812 - that group. And a lot of it is just, they're like, oh, that's too many vaccines at one time. I'm like, 01:23:26.812 --> 01:23:31.262 - no, that's not what the science says. Let me share with you the science. 01:23:31.426 --> 01:23:39.538 - And so a lot of it a lot of it does come from our providers and some groups worse than others. But it 01:23:39.538 --> 01:23:48.446 - is it is a growing issue I think and especially with some of our younger providers. What would you say to those 01:23:53.090 --> 01:24:01.950 - Let me tell you a story about when I was a young doctor and saw. Can you tell me why? I'd approach it 01:24:01.950 --> 01:24:10.027 - the same way I would with a vaccine-hesitant parent. Then I could unload with statistics and 01:24:10.027 --> 01:24:18.713 - good information. I was thrilled when we came out with a single vaccine that provided six different 01:24:18.713 --> 01:24:21.406 - immunization components in it. 01:24:21.698 --> 01:24:30.013 - two, four, and six month old baby. Instead of getting six individual shots, they get one. What a win. 01:24:30.013 --> 01:24:38.165 - And to think Trump wants to divide the MMR into separate components, one of the myths I'm gonna say 01:24:38.165 --> 01:24:46.643 - right here is that pediatricians do not make money on vaccines. It's a tremendous overhead, it's a pain 01:24:46.643 --> 01:24:48.926 - in the ass to keep records, 01:24:49.090 --> 01:24:55.536 - To store them, you have to have special freezers and refrigerators. You have to check them two or three 01:24:55.536 --> 01:25:01.920 - times a day and document the temperature. And then you have to record the vaccines. You have to record 01:25:01.920 --> 01:25:08.242 - them in the registry. I mean, it's one process after another to go through the process of doing this. 01:25:08.242 --> 01:25:13.758 - And this is why many adult providers don't even stock vaccines in their offices anymore. 01:25:14.050 --> 01:25:20.650 - because it's too much trouble. They tell you to go to the pharmacist. Well, that's another barrier. 01:25:20.650 --> 01:25:27.381 - I can talk about barriers to vaccine access all evening long. But one of the things we've tried to do 01:25:27.381 --> 01:25:33.981 - in our practice is we don't discriminate based on your ability to pay. And vaccine compensation, if 01:25:33.981 --> 01:25:41.438 - you have insurance, you're required to have vaccine coverage. If you don't have insurance and you have Medicaid, 01:25:41.570 --> 01:25:48.179 - they cover it for free. And if you don't have any insurance, you can be part of the Vaccine for Children's 01:25:48.179 --> 01:25:54.602 - program. So there's financial considerations for families should not be the problem. It's really access 01:25:54.602 --> 01:26:00.778 - to getting the shots themselves. Steve, I know you had a question. Yeah, so in the presence of lots 01:26:00.778 --> 01:26:07.139 - of health misinformation from the federal government, there have been various consortia of states that 01:26:07.139 --> 01:26:09.054 - have gotten together to try to 01:26:09.698 --> 01:26:17.879 - basically replace CDC as the source of information. So I know of ones in the Northwest and the Northeast. 01:26:17.879 --> 01:26:26.138 - Do you know if there are any discussions in the Midwest, including Indiana? I mean, there are discussions, 01:26:26.138 --> 01:26:34.782 - but I mean, the likelihood of it happening are because our governor is trying to get back in the good graces of 01:26:34.882 --> 01:26:44.799 - our president after he couldn't get the redistricting passed. So vaccines seem to be a way for him to 01:26:44.799 --> 01:26:54.619 - get back into that space. So there are discussions about it, but our political leaders are not going 01:26:54.619 --> 01:27:02.494 - to approve anything like that. So we as coalitions and as public health agencies 01:27:02.594 --> 01:27:09.327 - are all talking. We have a Midwest consortium that we talk every month. But at the policy level, no. 01:27:09.327 --> 01:27:16.260 - What the Northeast and Northwest are doing is fantastic, and we're following them closely, but it seems 01:27:16.260 --> 01:27:23.260 - unlikely. Or if it does happen, it will not be good. We would be partnering with Florida, and that would 01:27:23.260 --> 01:27:30.393 - be a whole nother shit show. You know what? We should have mentioned about a good Indiana vaccine advocate 01:27:30.393 --> 01:27:31.326 - is Dr. Adams. 01:27:31.618 --> 01:27:38.685 - who was the Surgeon General under the first administration of Trump. And he's now affiliated with Purdue. 01:27:38.685 --> 01:27:45.419 - But he has been incredible. He speaks for us sometimes. And he is online addressing misinformation a 01:27:45.419 --> 01:27:52.086 - lot. So he is a great Indiana vaccine advocate. He's very active on Twitter. Yes, yes, yes, yes. We 01:27:52.086 --> 01:27:58.686 - had another question over here. Yep. Yeah. I was thinking about vaccine hesitant folks, what their 01:28:00.354 --> 01:28:07.237 - the benefits of having that perspective, right? There's emotional, social benefits of having 01:28:07.237 --> 01:28:14.787 - that perspective. They might have reallocated their trust from their doctor to moms or others, right? 01:28:14.787 --> 01:28:22.336 - To vaccine hesitant. And that made all these preemptive moves even in those posts about don't believe 01:28:22.336 --> 01:28:29.886 - the statistics or these facts, they're gonna distort them and so forth. Is the approach any different 01:28:30.274 --> 01:28:38.520 - or hesitant skeptics with that orientation? Whether there really is this emotional connection they have 01:28:38.520 --> 01:28:46.449 - with a social benefit, they're in a group of other moms. How do you help us think about that group, 01:28:46.449 --> 01:28:54.616 - which I think is wrong? Because they are, that trust is not disappearing, it's just being reallocated. 01:28:54.616 --> 01:28:57.470 - Are you speaking to some tribalism? 01:28:57.730 --> 01:29:04.602 - maybe happening around this issue or around that community. But there's real emotion. Like, I'm part 01:29:04.602 --> 01:29:11.542 - of that group. I'm getting benefits from this. That's why I have this belief. It's not just random or 01:29:11.542 --> 01:29:18.346 - just oppositional. It's like, I'm part of it. I feel energized. I feel part of a group. I feel like 01:29:18.346 --> 01:29:25.149 - I'm fighting something. Whatever those range of emotions that are very powerful. And statistics and 01:29:25.149 --> 01:29:26.238 - facts might not 01:29:26.434 --> 01:29:32.789 - do anything in that situation. Statistics and facts will do nothing in those situations. Did you have 01:29:32.789 --> 01:29:39.082 - a comment about it? I have a question that's, I'm starting to have a theory that's been building up. 01:29:39.082 --> 01:29:45.561 - And that is that people don't know what evidence is and people don't know what science is. And I'm even 01:29:45.561 --> 01:29:52.228 - wondering if in the professional realm that there's so much learning that doesn't have to do with hands-on 01:29:52.228 --> 01:29:55.966 - doing experiments and finding out what is actually involved 01:29:56.194 --> 01:30:03.028 - and proving something that people don't get it. I had a housekeeper for maybe 40 years, and we loved 01:30:03.028 --> 01:30:09.795 - each other. And she would not get vaccinated. And I tried to talk to her about science. And she was 01:30:09.795 --> 01:30:16.764 - from rural Michigan. Not a clue. I mean, there was no discussion at all. She had no understanding. But 01:30:16.764 --> 01:30:23.531 - I'm wondering if the big picture is we're not really teaching science. I think that's not uncommon, 01:30:23.531 --> 01:30:24.478 - to be honest. 01:30:25.058 --> 01:30:32.419 - I think there's so much mistrust based on a lot of mistakes made during COVID that that just reiterates 01:30:32.419 --> 01:30:39.780 - people's criticism of science. And I think it's a valid thing, just like if you have a cohort of people 01:30:39.780 --> 01:30:46.858 - that you're around that agree with you, you're going to continue to be around those people, because 01:30:46.858 --> 01:30:51.742 - that's the message you want to hear. I read a great phrase, and I'll 01:30:52.258 --> 01:31:01.106 - finish up with this that I thought was fabulous as it relates to this topic. Religion requires faith. 01:31:01.106 --> 01:31:09.867 - Science requires doubt. And that's why science is constantly changing. We accept that we're going to 01:31:09.867 --> 01:31:18.802 - continue to change because as we learn new things, we have to be willing to doubt our current premises 01:31:18.802 --> 01:31:20.190 - of what's true. 01:31:22.082 --> 01:31:28.868 - We're just trying to approximate. I have a bumper sticker that somebody gave me for my car that I'm 01:31:28.868 --> 01:31:35.722 - too shy to put in. Science doesn't give up what you believe. I actually have a shirt like that. Yes, 01:31:35.722 --> 01:31:42.779 - welcome here to the home. Yeah, no, I know. Well, I think we actually got to wrap things up. It's about 01:31:42.779 --> 01:31:49.701 - five minutes after, and I think close at seven, right? So I think maybe I think Jim, you have to take 01:31:49.701 --> 01:31:51.262 - off, but Lisa, I think 01:31:51.362 --> 01:31:59.123 - You were able to stick around for a few. I'm not sure about you, Katie, but maybe we can have some individual 01:31:59.123 --> 01:32:06.391 - questions if audience members want to come up and hang out for a few more minutes. And I brought a few 01:32:06.391 --> 01:32:13.447 - refreshments. So well, before we get kicked out of the library at 7, we have a few minutes to chat. 01:32:13.447 --> 01:32:20.926 - How about a big round of applause? Thank you. Any of you before, except Dr. Laughlin, whose reputation is 01:32:21.122 --> 01:32:28.523 - We've got the perfect people here. Tyler Morris, how about a round of applause for him? And a big thank 01:32:28.523 --> 01:32:35.710 - you to the library and the Class TV. I should have mentioned that we're going to have a high quality 01:32:35.710 --> 01:32:42.969 - recording of this that will be available in a few days. So thanks so much for making the time to come 01:32:42.969 --> 01:32:50.014 - here and hang around for a few minutes and chat. Bella as well, another ASIU member to livestream.