Dr. Adam Ratner
speaker
62 appearances
1 recordings
1 series
first heard Feb 2025
last heard Feb 2025
Dr. Adam Ratner’s voice in public audio — every appearance, attributed to the second.
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Appearances
Thanks so much. Delighted to be here.
When I first started writing the book, the question that I got most often was, why measles? Because I think a lot of people I talked to thought of measles as a solved problem. And really, so did I. And that's... kind of the encapsulation of the measles story put very simply in the sense that measles thrives on being underestimated.
So all throughout my training, I learned to take care of children with all sorts of diseases. And then as I focused on infectious diseases, I learned to take care of kids with complicated infections and sometimes with unusual infections. And Measles was something that in my mind had been filed under solved problems.
It was a thing that we had had a vaccine for since the mid-1960s and that we very, very rarely saw. I saw a handful of cases in my training. And then in 2018 and 2019, we had a huge measles outbreak in New York City with about 650 cases and some kids who were very, very sick. I took care of children in intensive care units due to complications of measles. And
That was the point at which I dug deeper into the measles story and I realized that there was so much here that people don't think about and that when we start to see measles, it's evidence of faltering of our public health systems and of fomenting of distrust of vaccines and that measles outbreaks and measles cases are so much more than just the rash that you see.
Absolutely. I mean, I think the the pandemic, we all experienced together, but we each experienced in kind of a different way. The way that I experienced it was in the hospital, taking care of children with COVID and some children who were very sick from it. And also, of course, in my home life, worried about my wife, worried about my daughter, worried about my parents. And
I think we all got to see the evolution of a pandemic, which is something I had never seen before. We also got to see an incredible scientific triumph, which was the development of the mRNA COVID-19 vaccines. And I think back to how I felt when, you know, those first trials of the mRNA vaccines came out and they were enormously effective against hospitalization and disease. And they still are.
And they were highly effective against catching COVID-19. Although that effect is limited in time, which we didn't know then, and we didn't know then that boosters would be necessary. But there was such a feeling of relief when I saw those data. And I remember the moment I got my first dose of the mRNA vaccine. I remember the day my wife got hers. I cried.
I cried when my daughter got hers because... I felt like we had won. Like I felt like science had saved us. Vaccine science had saved us. And in the back of my mind, I thought, this is the end of the anti-vaccine movement. Like how do they possibly recover from everyone in the world seeing what we can do?
And, of course, looking back now, five years after the start of the pandemic, I was naive and I was wrong at that time about how the anti-vaccine movement would respond to the COVID-19 vaccines and where we would be just a few years later.
To start, I want to be clear that my comments about RFK and about everything that we talk about today are my personal opinion and aren't meant to represent the institutions I work for or anyone else I'm affiliated with. The It's very disconcerting.
It's very disturbing that someone who has spent so much of his career trying to undermine confidence in vaccines, trying to tear down the infrastructure that approves and recommends vaccines, has the potential to be in a position of power over the infrastructure that has— those goals.
I worry about vaccine availability in the United States, but more than that, I worry about vaccine confidence, which many of us have worked for years and years and years to build. And as mentors of mine have said many times over the years, it is much easier to scare people than to unscare them.
And I think that just by elevating anti-vaccine views in the guise of RFK, I think that we risk a crisis in vaccine confidence in the U.S.,
That is the crux of what I was trying to get at in the book. I trained in pediatrics and then in infectious diseases at this incredible inflection point where the generation before mine had seen their diseases that – I was not seeing as a resident. There were things that vaccines just made disappear between that generation and my generation.
So there was a horrible disease called Hib, which is a bacterium that can cause sepsis and pneumonia and meningitis and death in children. There were a couple hundred thousand cases of this in the United States every year. And pediatricians worried about Hib all the time.
When my mother trained, so my mother is also a pediatrician, a generation before me, she had tons of patients with Hib, and she lost patients with this disease. And then in the late 1980s, a Hib vaccine came out, it was widely adopted, and I did not see a single case over the course of my training. And so there was this – it was like a switch.
There was this incredible power of vaccines that was visible right in front of me in real time. But if you look at people who are parents today and people who may have questions about vaccines and are weighing risks and benefits, which is a fully reasonable thing for parents to do – They may say, I've never seen someone with polio. I've never seen someone with whooping cough.
One person says that there are side effects of the vaccine. The other person says that there aren't. Why would I take a chance by giving the vaccine for something I've barely heard of? And the answer to that, of course, is that you've never seen these things. You've never heard of these things because of vaccines. But that's a hard thing to communicate.
And it's sort of the difference between—I found this during the measles outbreak in 2018, 2019. Talking to the parents of the children with measles and talking to the grandparents of those children was entirely different. The grandparents had seen tons of children with measles. They had probably had measles themselves. Their kids had had measles.
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