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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There's nobody who wants a child to get sick. Right. And I think that, you know, for me, that's the grounding point. You know, that's the place where I think that I or any other pediatrician can come together with a family. And then we can talk about the details.
And we can talk about balancing risks and benefits, which is something that we all do all the time and often with not enough information available. for people to feel entirely comfortable. Some of it is talking about the diseases that we're trying to prevent, which can get minimized in anti-vaccine rhetoric, but can be really serious.
I'm old enough that I'm able to use my personal experience often in those conversations. I've seen a lot of the diseases, although not all of them, that we vaccinate against. And I think building that trust and building on the fact that we're all pulling for the same thing is the most important piece of the conversation. But it's hard, and it's usually not one conversation.
Variably. So I'm not a primary pediatrician. Like I am an infectious disease specialist and I see kids in the hospital. So I see families at kind of a different time than their primary pediatricians do. And the primary pediatricians are really the heroes in pediatricians. this piece of things.
Like, I think they're the ones who have repeated conversations with families who develop trust over time and who can help families take in good science-based messaging and help bring them around to vaccination. I see parents at a different time. There is no family who wants to be where I work, which is a children's hospital.
Yes. And so I sometimes have families, I sometimes have conversations with families who are in the hospital because their child has a vaccine-preventable disease. And that's a different conversation. And it's one that can very easily go south in the sense that People can often feel like they're being blamed, which is never my intention.
And people can feel like it's not an appropriate conversation to have at the time. And I think it's a conversation that needs to be had, but it needs to be done carefully. Like you need to choose your words carefully. It needs to be done with empathy because when I'm seeing children, it's usually because they have a child who's sick enough to be in the hospital.
But it needs to be done clearly because the story that this family is going to tell themselves and tell their relatives and their friends about what happened may hinge on how you talk about vaccines in that moment.
That came as a surprise to me, and it is unbelievable to me now that you know, five years after the start of the pandemic, that we are in the situation that we're in. I thought that we would be in a place where vaccine skepticism was rare and where people had gotten to see firsthand the incredible beneficial effects of vaccination on the population. And, you know, the COVID vaccines...
saved millions and millions of lives, and they are an incredible success story. Amazingly, that's not the story that is generally being told, and it's not the story that most people believe.
So I think that there are a couple of things to be concerned about here. And I think that first and foremost, what we know about the avian flu and how it has spread and the situation that we're in right now is because there is a robust surveillance system. And it points to the importance of funding for CDC and for state and local health departments to do that crucial work.
That is the only reason that we know what's going on. I think that avian flu has the potential to affect humans and has made some humans sick already in the current outbreak. I think that we need ongoing surveillance and we need to understand the extent of the problem and to be able to do things like rapidly type the flu strains that people have when they go to their hospitals or go to doctors.
It is something that is done sometimes now, but a lot of our diagnostics don't tell us exactly what sort of someone has, and that's important to understanding the scope of the problem. But really, what needs to happen is strengthening and keeping them strong of public health systems in order to keep this under control.
A fundamental issue in how we think about measles is memory. In the same way that the measles virus kills the cells that are the keepers of immune memories, our temporary successes and competing priorities distract us from the toll that it continues to exact every day of every year.
When we forget, measles thrives, both within the body of an individual and in a society making decisions about whether to prioritize vaccination. Both kinds of amnesia leave us vulnerable to a host of conditions beyond measles. Measles is a master at infiltrating and revealing the cracks in our human systems.
When we forget to use the tools that we have, when we allow anti-scientific voices to influence policy, when we ignore the places that it is difficult to deliver care, there it is. For all these reasons, you can think of measles cases as a probe for whether we are paying attention.
As outbreaks pop up, we should ask ourselves what we could have done better and what other warning signs we are ignoring. While measles is often first, it is a harbinger of problems to come.
This is... the prime problem of modern public health communication. It is a different world than it was in the stories that I told about the measles vaccine development and vaccines for children and things like that, where there were limited news sources. There was often collaboration between public health entities and news outlets.
And now we're in a very different situation where there is unlimited information. Much of it is bad. Some of it is malicious. And I don't have a simple answer to this question. I will go back to what I said about pediatricians being trusted sources and about personal family-to-family type discussions that are difficult to scale but that are effective. And I think that's it.
I mean, I think there certainly does need to be direct countering of misinformation and disinformation that are put out there by anti-vaccine groups. And that is something that CDC and public health departments should be doing. But there's also the direct outreach to individual families and to communities and
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