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Peter Hotez, M.D., Ph.D. is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine where he is also the Director of the Texas Children’s Center for Vaccine Development (CVD) and Texas Children’s Hospital Endowed Chair of Tropical Pediatrics.
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And we're alive. How are you sir? How are you? Good to see you again. I'm thrilled to be here. Thanks for doing this man. Thanks for having me. I should tell people before we get started, I did not know when I asked you to come back on that you were heavily involved in this whole vaccine debate. What I wanted to have you on to talk about is tropical diseases because I remember when we did that Sci-Fi show, you explained to me that some ungodly percentage of people that live in tropical climates are infected by parasites. That's right. Well, my day job is developing vaccines for tropical diseases. We develop the vaccines no one else will make because they're for the world's poorest people. So we call them tropical diseases, but there really are diseases of poverty. The vaccine issue, the advocacy issue around vaccines and autism is kind of a new thing that I got drawn into just because I'm a parent of an adult daughter with autism and I make vaccines. So it was a natural that I'd get drawn into it. Yeah. So when I said that you were going to come on, then I got inundated by people that are, you know, the vaccine thing is such a polarizing issue. Yeah, it's awful. And so many people seem to think they absolutely know what causes what, especially when it comes to something like autism, which is a huge issue in this country. It's a huge issue around the world. And it didn't used to seem to be. The question is, was that because it was undiagnosed? Was that because it just, there's, it's more prevalent today? What do you think? What is your take on this? Well, I don't think we really know. One thing's for sure. We're diagnosing people with autism who we diagnosed as something else in the past, you know, whether it was, you know, really horrible diagnosis. We'd use pejorative terms like mental retardation. What's the matter, Jamie? Sorry. My bad. Just telling you the clock was off. Oh, okay. Sorry. Sorry. Should we start again? No, no, no. It's okay. He was just saying, he was just telling me that our clock is screwed up because of the daylight savings time. Oh, right. Sorry. Totally unrelated to what you were saying. The whole country's clock is screwed up because of the daylight savings time. Yeah. Right. So, so we don't know. We don't. Well, you know, one thing's clear, the number of diagnoses is going up, but part of that is because what we used to call pejorative things like mental retardation now get thrown into the autism category. They do. The other thing now, absolutely. How so? Well, you know, now we call it as part of the autism spectrum. We also, because autism often has a lot of associated intellectual disabilities. Not always, but sometimes. The other is that- Can I pause for a second? Yep. Is that based on aptitude tests? Like how do they decide? How do they decide what's autism? Yes. They have a list of diagnostic categories. But it's not like you could test someone if they test positive for a disease. That's right. That's right. Well, although, you know, one of the interesting side pieces to this is, you know, the, there's a group of people out there who self-identify themselves as the autistics. And they get very resentful or hurt when they're called a disease or a disorder. Because they say, well, we're not an epidemic. We're a person. And it's part of this whole neurodiversity movement, which is quite interesting. Neurodiversity movement. Right. They say they're neurodiverse, that they, you know, maybe think differently from others and they respond differently than others, but they're not, quote, abnormal. And I think they have a good argument. I heard a crazy argument once with someone that was- So the point is that it's, you know, the impairment, like Rachel, my daughter, it's not so much her autism that thwarts her, you know, ability to have partners or to have a meaningful career. It's the fact that she has profound, in her case, profound intellectual disability that goes along with it. I forget what I was going to say. So when they say that people have a, there's a spectrum, right? And some people who are autistic have incredible abilities. That's right. They have incredible mathematical abilities, musical abilities, language abilities. And then some people do not. And some people have legitimate issues. Yeah. With Rachel's case, my daughter, it's, she has a pretty good verbal IQ, 80, 90, but she has a very low performance IQ in 40. She can't do simple math. She can't count money. Fortunately, Goodwill Industries came to her rescue and our rescue, and now she works there two hours a day sorting clothes. And that's been really meaningful for her to get a paycheck. Oh, that's great. Even if it's due to some wage. Yeah. Right. Just to do something and feel. Yeah. Right. And feel part of the mix. Yeah. That's huge. That's huge for everyone, right? Absolutely. Yeah. Absolutely. But so there's no, there's, it's not like you could test positive for syphilis or you can test positive for the flu. Right. Although now, you know, as I say, you know, so that's why I don't like using those terms because it puts people on the autism spectrum as though they have a disease or a disorder, which I don't like to do. But if it is a disorder, no? Well, you know, now we know there are 99 genes that are linked to autism. But why is it a bad thing to say that you have a disorder if it's just a disorder? You know, people have disorders. Right. It's a fact. A lot of the individuals in that, that self-identify themselves as the autistics don't like to think of themselves as a disorder. They like to think of themselves as different, different, but not necessarily as a disorder. Right. But that doesn't help us when we're trying to discuss it, does it? Yeah. It gets very, it's hard, it gets hard to talk about. Well, it also, they're trying to stop you from talking about it in a certain fashion, which is actually accurate. Right. Oh. When they have an issue. There is an issue. To say there's no issue is kind of ridiculous. It's, I mean, there's a reason why so many people are so concerned about autism and vaccines and just autism in general. Right. Whether it's an environmental pollution factor. Right. But what they like to do is they like to make the distinction between autism, that neurodiversity thing, and actually having intellectual disabilities that go along with it. Okay. And maybe it's a bit of semantics also, but they feel strongly about it. Right. Now, if we don't know what causes autism. Well, we do. We do. We're getting there very closely. So we've now, there was a very important paper produced by, written by a group at the Broad Institute at Harvard at MIT, which is one of the premier genetics, genomics organizations in the country. And they've now identified 99 genes. It's a huge team of scientists, not only at the Broad, including P.S.I., does it Baylor College of Medicine? 99 genes involved in autism, all involved in early fetal development, early brain development in the first and second trimester of pregnancy. So now we're starting to really get our arms around what autism is. And that's one of the things I talk about in the book. I mean, we have learned so much in the last couple of years about autism, how it begins early fetal development well before kids ever see vaccines. And that's one of the reasons I say vaccines did not cause racial autism. Vaccines don't cause autism because autism is already underway in early brain development. Is it possible that some people have this tendency towards autism and it's exacerbated by vaccines? I don't think so. I think what happens is the sequence of events happens during pregnancy. But the full clinical expression of autism often doesn't happen until 18 or 19 months of age. Like Rachel, for instance, wasn't actually diagnosed until 19 months of age. And there's some fabulous studies now showing that that clinical expression of autism actually coincides with a big increase in the volume of the brain. You can actually show on serial magnetic resonance imaging, serial MRI, how the brain volume starts to increase. And that's very important because parents will often remember, oh, my kid got vaccinated around 18 months of age or 15 months of age. I want to link the two. But now you can go back to six months of age. And this is studies done at the University of North Carolina Chapel Hill showing so that you can do an MRI at six months of age. And they can predict now, they say with 90 percent accuracy, which of the kids will go on to develop autism. And then you can take it to the other end. What are they seeing? They can see – we can go into detail in the paper, but they can see certain things on signatures on MRI that tell them that this kid is going to go on to develop autism. Okay. So in fact, there is a way to test positive for autism then with this serial MRI. That's what they think, right. And now we have the 99 genes. So we can even take it back further by doing what's called whole exome sequencing. Sequencing all the DNA, all the expressed DNA of an individual. And in Rachel's case, we did that and we actually found a mutation in a gene controlling neuronal connections, which makes a lot of sense if you think about what autism is. Yeah, of course. So there is a way to show whether children will be more likely to develop autism and there is a way to look at their brain through fMRI at a very early age. And also do genetic sequencing. So it's not simply a matter of how they perform on cognitive tests. That's right. That's right. We're getting much better at getting arms around the diagnosis. Why do you think there's so many people that have these anecdotal stories of their child getting vaccinated, especially large doses of vaccines when they hit them with like 10 in a row and then all of a sudden or measles, mumps and rebellious, the one that gets repeated over and over again. That's the one that made my child have autism. I've heard that so many times and I've heard it from friends, from friends that have children that have autism. They had a child, their child got the measles, mumps and rebellious shot. And then immediately there was a very distinct change in the child's behavior. Well, no question when you get the measles, mumps, rubella vaccine, many times kids cry and things like that. And then autism will then begin sometime between the first and second year of life. So it's logical to want to connect the two. But now we know it's not even plausible because we know that if you go back to that MRI at six months of age or go back prenatally, we can even determine which kids are going to go on to develop autism. And then complementing it, complementing it are massive epidemiologic studies done on over one million kids. In fact, a new paper was just released this week showing that kids who get the MMR vaccine are no more likely to get autism than kids who don't get the MMR vaccine. And the converse is also true. Kids on the autism spectrum are no more likely to have gotten the MMR vaccine than kids not on the autism spectrum. So it's a combination of those big studies of over one million kids together with knowing what autism is that completely rules out the possibility. So these genes, and the issue with these genes, and then the ability to scan the brain with the serial MRI so you can tell which children have the propensity. Is it possible that children have all these issues and then do not get autism or do 100% of those children with those issues get autism? That's a good question. I don't know. I'm a vaccine scientist. Well, I'm a biologist, but I'm a vaccine scientist who's really tried to do a deep dive in autism doing research on the book. Versus human development. Right. So what you're saying, though, is that if a child does not have these mutations and does not have these issues that are present during serial MRI, that they will not go on to develop autism. Is that true? As far as we can tell. As far as we can tell. So children without those issues who get vaccinated have no problems, which most children have no problems. Right? Yeah. I mean, we've learned a lot about the risk of vaccines and the numbers are extraordinary. I mean, the risk of a severe adverse event happening after getting a vaccine is roughly on the order of one in a million between between one in a million and one in 10 million. So and I found an Internet report once said the likelihood of getting struck by lightning is one in 700,000. So it's, you know, the likelihood of having a severe event after a vaccine is your odds are better of getting struck by lightning than. And when you say severe event, what do you mean by severe event, though? Well, there's actually a table that's put out by the National Vaccine Compensation Act that includes shoulder injury. That's one encephalitis and shoulder injury. Yeah, that's actually on the list. From the actual injection point? Yeah, put injecting it in the wrong place. Oh, so it goes into the joint or something like that? Yeah. Yeah. Is that common? No. So there have been issues where children have adverse effects and reactions to vaccines. What do you attribute those to? But one in a million. I think, you know, in some cases- Biological variability? I think in some cases inadvertently, if it's a live virus vaccine like the measles, mumps, rubella vaccine, and you have an underlying immune deficiency that wasn't picked up before, then that virus can replicate better, but very rare things like that. Right. So as far as you know, children who are healthy, who get a vaccine, it's not biologically possible for them to develop these traits, these mutations in the genes, and these issues that you see present- As best we can tell right now, that seems to be the case, right? As best you can tell right now, it's a great thing to say. But for people that are like, hmm, on the outside, like, what does that mean? I'm not a doctor. I'm not smart enough to understand what Dr. Hotez is saying here. Right. What is he saying as best as we can tell? How much can we tell? So here's what we can tell. We know studies of one million children, that there's no link between vaccines and autism. That's number one. And so let me parse this- How do they do that? Let me parse this out in two bits. So there's the studies on of one million children showing that vaccines do not cause autism. That's part one. The second part- Is there epidemiology study? And then I'll do a deeper dive on each of them. The second part shows not only is there massive evidence that there's no link between vaccines and autism, there's no plausibility because we know so much about autism and how it begins in pregnancy. Okay. So let's go back to the first part. The first part is studies on over one million children. One of the things that the anti-vaccine lobby does is they play this game of what I- well, it's not really a game. But what they do is play this kind of thing of vaccine whack-a-mole because at first they alleged it was the MMR vaccine and that came out of the study that was published in the Lancet in 1998. Then another group came along and said, no, no, no, we didn't mean the MMR vaccine. We meant the thimerosal preservative that used to be in vaccine. And the scientific community not only debunked the MMR link, they debunked the thimerosal link. Then the anti-vaccine lobby came along and said, no, no, we didn't mean that. We're spacing vaccines too close together. Then they changed it around again, saying now it's the alum or aluminum in vaccines. And then each time the scientific community responds with massive epidemiologic studies showing there's absolutely none of those things are true. And do you think that it's just- when you look at- say if there's one in a million that has an issue with this and there's- And it's not autism, by the way. So whatever those issues are, that they hear these stories and these stories do accumulate because there's 300 plus million people in this country and over 10, 20 years of one in a million, you develop a significant history of cases where children did have issues with vaccines. So these people hear about these stories and people are terrified. Obviously you're- I have children, you become very overprotective of your children, you worry a lot. And then you also don't know like why do they get so many shots all in a row like that? Why does a baby get 10 shots in a day? That seems crazy. Well, they don't get 10 shots in a day. Ever? Most of the vaccines are now combined. So for instance, in one vaccine, we can vaccinate against diphtheria, pertussis, tetanus, polio, homophilus influenza type B, which is a terrible cause of meningitis, and in some cases now even hepatitis. So one shot is protecting- So you get a soup of all these things? Well, it's combined. And there's all sorts of studies showing that it's safe to combine them and it's fantastic. Now you can vaccinate with one shot against six diseases. And these are life-threatening diseases. Right. So the only concern is the child's immune system when they're bombarded with this one. So a lot of times it causes them to be tired or they get sick or they don't feel very good. But the point is the immune system is not bombarded. I think that's another kind of a misnomer that- or a misunderstanding that's put out by the anti-vaccine lobby. Remember, the child's gut, the intestines, and the respiratory tree is this- are organs of antigen presentation. A baby on average is exposed to hundreds of new antigens every day. So the idea that you're going to, quote, overwhelm the immune system with a vaccine against six diseases just doesn't make any sense either. Again, this is all phony baloney stuff put out by the anti-vaccine lobby.