Episode Transcript
Speaker 2 00:00:12 And greetings. This is Disability and Progress, where we bring you insights into ideas about, and discussions on disability topics. We wanna remind you that if you wanna be a part of the Disability and Progress Listener Club, you can just email us at Disability and progress, sam jasmine.com. State your name and where you're from, and we will announce your name and where you're from as part of the Listener club starting in January. Each week we'll pick a couple names and we'll read them out, so we always appreciate your listening. And my name is Sam, I'm the host of the show. Thanks for tuning in. Charlene Doll, who is my research person, is on vacation. Uh, this week we have Dr. Jill Foster, who is with us to talk about polio. Hi, Dr. Foster. Oops. Are you with me? Hold on. There you go. Good.
Speaker 3 00:01:08 Yes. Oh, here. Yes, I can hear you.
Speaker 2 00:01:10 All right. Well, thank you so much for coming on again, <laugh>.
Speaker 3 00:01:15 I'm so glad you invited me,
Speaker 2 00:01:17 <laugh>. Um, well, so I wanted to talk about polio. That's our discussion for tonight. So I'm gonna ask you a myriad of questions, but first of all, can you give me some history, uh, for all those listeners who don't know you and, um, what you do in your specialties?
Speaker 3 00:01:37 Okay. So I'm a pediatric infectious disease doctor, and I work at Masonic Children's Hospital and in part of the University of Minnesota Medical School. And so I see children and teens, um, that have in different sorts of infectious diseases.
Speaker 2 00:01:56 Excellent. So you've got a whole myriad of experience with different diseases. Yes.
Speaker 3 00:02:03 Yes, I do.
Speaker 2 00:02:04 <laugh>. So we're here today to talk a little bit about polio and, um, not probably a real common topic, but give us an idea. I think they're, like, if I was doing my research, write three types. Can you talk about them and, uh, what they are?
Speaker 3 00:02:23 So, there's polio is, is sort of the, a generic sort of term for a paralytic illness that can occur from a variety of different viruses that are all kind of cousins of each other. Um, the, there it's a family called enro viruses, meaning they kind of live on the inside of you, enro. Um, so there's different kinds of polio. Um, paralytic polio, there's one, there's one form of polio that it's just, it's like a, like a flu type of thing. There's another one that's a paralytic polio. Um, and then the third one is a more severe form of the paralytic polio that leaves disability, um, from it. Mm-hmm. <affirmative>, um, that, that's long lasting.
Speaker 2 00:03:07 And this is the one that's more, most commonly seen. Is that correct?
Speaker 3 00:03:12 Well, it's the one that's most commonly diagnosed because it's so severe. The one that's actually most commonly sort of seen but not seen is the asymptomatic kind that, you know, that looks more like a cold. Um, somebody might have a little bit of fever, um, maybe a little bit of a rash for a couple of days, and then it just passes on. And they never re uh, even know that they had the polio virus. Huh. Um, I think the, the one that's more that we think of as polio though. But I think that's the one that, you know, we wanna talk about tonight.
Speaker 2 00:03:45 Sure. So you sounded like it kind of lives around in you. What are the causes of polio?
Speaker 3 00:03:53 It's a, it's a virus. Um, and it's a virus that, you know, different viruses sort of have, you know, different sort of, I, I kind of view 'em like, they almost have like different personalities in different places. You know, like the covid, you know, lives in your nose and your lungs. This is a virus that you take in usually through your mouth. So this is something that lives in the GI tract, but it, and that's, you take it in through your mouth and it comes out in your poop <laugh>. And that's the problem is that it gets, it, it contaminates water. And, you know, back in the, like the 1930s, forties, fifties, it was something that people got from, you know, going to a swimming pool cuz you go to a swimming pool and unfortunately swallowed a little bit of the water and then ended up going into your GI tract. But then that's where, you know, the, the, there was the cases that just, you know, become the, the really asymptomatic cases. Mm. And then there's the cases that in some people it actually then travels into the nervous system, specifically into the spinal cord. And then that's when people get polio. Is that when it travels into the spinal cord,
Speaker 2 00:04:59 That's when they care about it. <laugh>? Yes. Yes, exactly. Because it leaves damaging stuff. So, yes. Can you give us a little bit of history? Like how did they first discover polio? Like when was it really dis discovered as a, as a disease?
Speaker 3 00:05:17 Well, polio has been around forever. Um, and in the beginning, you know, it was just, you know, people would, you know, again, the, the kind that, you know, no one even knew it was associated with polio. But, you know, children, mostly children, young adults, it was unusual that it would happen to somebody really more than 20 years of age, um, would, you know, have an illness, have a high fever, and then they would become paralyzed. And sometimes the paralysis was in their limbs and sometimes the paralysis was actually in the muscles that we used to breathe. And that was, you know, I don't know if you've ever heard of the, you know, the iron lungs or pictures of Right. People in an iron lung. Yeah. It actually actually paralyzes the diaphragm, which is, which is a muscle that you need to breathe.
Speaker 2 00:06:01 Huh. Can we talk about like, the vaccine for polio? Cause I think that's changed throughout time. What was it originally and how did it change?
Speaker 3 00:06:12 So it was originally a vaccine that was a shot. Um, and the way we make some vaccines, at least the polio vaccines, is you get the organism and then you kill the organism or you weaken the organism and then you give it to someone so that their body thinks that they had the illness and the body starts making immunity to it. So the first one was a totally killed virus that was given to people as a shot. Um, worked incredibly well, but it was hard to, you know, you have to store it in the refrigerator and you need needles and it was hard to really get it to everybody that needed it. Mm-hmm. The second one that came out was the sugar cube one. It was a oral form of the vaccine. Mm-hmm. <affirmative> that this one is. We just kind of knocked the vaccine down and made it weak. And this was one, I remember when I was a kid going to the firehouse and there was a whole line of people going a block long, uh, lining up at the firehouse. And we all went in and got the sugar cube that had the backseat.
Speaker 2 00:07:10 And so, and how many did you get? Like how is it a, was it a series or was it just a one thing
Speaker 3 00:07:19 Back then? We was just given as one. Um, now we give a series of, of three, three vaccines early in life in infancy and then a booster vaccine given around, um, between four and six years of age.
Speaker 2 00:07:32 How effective is the vaccine?
Speaker 3 00:07:35 Oh, vaccines incredibly effective. Um, it's, it's, it's sort of, you know, old school vaccine as vaccines go and it works incredibly well.
Speaker 2 00:07:46 So then how common is it to have an adverse, um, reaction to that?
Speaker 3 00:07:52 Well, the, so there's two different issues. One is, you know, with like with any vaccine, you might get a little soreness at the site. The problem is with that oral vaccine, the sugar cube vaccine, because I, I remember I said that it was, it was the vaccine was the, um, virus was kind of knocked down and made weaker. Well, occasionally that va the virus in it, it easier is given to somebody who has a weakened immune system and their immune system can't even fight off the immune, the, the weakened virus and they get polio or the virus learns to become strong again. And then you're giving the vaccine to somebody who can actually get polio from the vaccine. Ugh. Yeah.
Speaker 2 00:08:34 Yeah. Not good. Um, if you receive the polio vaccine in another country, could it be different than ours?
Speaker 3 00:08:48 Well, in the United States, we stopped giving that oral vaccine cuz we decided here that the risk that was there was so little polio and it was so easy to have clean needles and refrigerators to store it in. Hmm. That we were just gonna not give that weekend one anymore. We were just gonna give the one that was totally dead virus. And even though it's a shot and it's another shot to give, we decided to give that here. But when you go to places that don't have all the resources that we do, especially in places like Africa and Asia and places like that, it, it was really hard to have those conditions. And so in those countries, it's much more likely that you're gonna get the oral vaccine because you can, you know, send a couple people into a village and within a couple hours you can immunize everybody in that village by just having 'em line up and give 'em that little bit of the, uh, the, a couple drops of the vaccine.
Speaker 2 00:09:40 Ah, gotcha. Is there anything else that makes up the vaccine? Like what would be a reason that somebody would react to it or why wouldn't somebody get one besides no education? Possibly
Speaker 3 00:09:56 The, I mean, all vaccines have, I mean, you want the vaccine to have some chemicals in it to keep it from spoiling mm-hmm. <affirmative>. Um, because you know, you don't want to inject somebody with something that has, you know, had bacterial contamination or something like that. So all the vaccines have, um, a little bit of a preservative in 'em. Um, and then also to make vaccines really work, we put something in, it's called an adjuvant, which is really something that, it's sort of something that stimulates the immune system a little bit. It used to be mercury, well, we
Speaker 2 00:10:27 Don't use mercury anymore. Yeah. Not a good idea.
Speaker 3 00:10:29 It used to be something called, um, uh, that had a mercury in
Speaker 2 00:10:32 It by solid something. Right? Yeah.
Speaker 3 00:10:35 The little tiny bit of mercury healthy immune system respond to it. But we, we stopped doing that also. That was another thing that we said, you know, the danger of the mercury one, it, it's not good, and two, it really sounds bad, <laugh>. Um, and it's gonna get people keep people from getting the vaccine.
Speaker 2 00:10:52 So recently, not too long ago, polio was in the news and primarily I heard about it with New York and probably various other places. Can you talk a little bit about what that was all about?
Speaker 3 00:11:05 Well, what happened is that there was somebody in New York who had not been vaccinated, um, who came into contact with a, a contamination of, of something water, something else could have been an, or, you know, a restaurant, somebody not washing their hands with somebody that was carrying that weekend virus. Um, and because this person did well, it was a weekend virus that had woken up a little bit. Mm-hmm. Um, and because this person had never been immunized, they got actually contracted polio.
Speaker 2 00:11:37 So it's interesting because I would think this would be more common than like, I was surprised to hear about it. And then I, I thought, well, why should I be? Because we have people coming in all the time to this country and it would be foolish to think that they had the same vaccination protocol that we do. And so how is it not more common, I guess is my question?
Speaker 3 00:12:06 Well, it's, it's a couple things and that the majority of people who are adults in this country have had vaccine and have good immunity. And this, you know, again, this polio vaccine is so good that, you know, you and I, we got this vaccine when we were little mm-hmm. <affirmative> and we still got good immunity all these years later. Right. So what happens is that even if you bring somebody into the country that is excreting this poliovirus and huge amounts, we have such good immunity that it doesn't spread any further than us. Ah. Uh, cuz we can't carry it. Um, because our immune system has, has fought it off. But then the more people you put into the environment who haven't had the vaccine, ah, then they're gonna be septi susceptible. And it's kind of a game of Russian roulette that, you know, you imagine a Russian roulette machine with, you know, a hundred, you know, a hundred things loaded, but there's only one, you know, one, only one bullet in it. You know, odds are you're gonna be pretty good. Um, but right now there's so many people increasingly, especially in the younger folks, this vaccine hesitancy, we call it Mm. Only started happening back in like the late nineties. So most of us who were kids before the late nineties have had our full series of vaccines.
Speaker 2 00:13:24 So that kind of brings me into the next question. That was, how has the vaccine rate changed? And I think about, especially with this, you know, virus that we are unfortunately still fighting. Um, do you see a lessening of people in general doing fewer vaccines, fewer immunizations for children, things like that?
Speaker 3 00:13:48 Oh, absolutely. Absolutely. We were already in a place before Covid that people were becoming more scared of the vaccine than they were of the illness. And, and you know, like if you talk to peoples, you know, sort of older than I am, more of my mother's age, they're terrified of measles, they're terrified of right, of polio
Speaker 2 00:14:10 Because they've seen the after effects
Speaker 3 00:14:12 Because they, they have seen it. They knew somebody. They remember being, you know, in school and having somebody, you know, who they were in school with who either died of polio or ended up with paralysis from polio. So it made a big impression on them and they made sure that their kids got vaccinated. And right now, between people just not seeing it and then all the crazy stuff that shows up on the internet that isn't even true about the vaccines. People got really scared of the vaccines. So we were sort of already there then there's already been, there's been all the craziness about the covid vaccine that's just made people even more scared. And then on top of it, you know, who wants to go into a healthcare place if you're feeling well right now mm-hmm. <affirmative>. And so the number of people just going in for their routine visits when they would be getting those shots has really decreased. Cuz people are trying to stay out of healthcare because they're worried about being exposed to something.
Speaker 2 00:15:04 Right. So the, the spread of polio, um, we, we, I have heard very little now I presume whatever's happened, it's kind of under control or what do you know about it?
Speaker 3 00:15:18 Yeah, it seems to have passed. Um, for, um, one of the things that places have started doing now is public health departments are monitoring, uh, wastewater, right? They're going to those big sewage treatment plants and pulling out a bottle of the, the, the water that's coming out of the sewage treatment plant and then they're testing it for various viruses. We've used that, um, in, in Minnesota, in fact, it was really pioneered here in, in Minnesota at the University of Minnesota of being able to do this. And in New York they were tracking the polio and it, there was a temporary blip that went up for a little while. And, you know, it's like loading the Russian roulette machine with lots more bullets. And then it seems to have, it seems to have gone back down again.
Speaker 2 00:16:01 Did we get any fallout here? Was there anybody we were worried about as far as with wastewater? Did we find any here
Speaker 3 00:16:09 We were watching for it here, and I, I know we had no cases here and I don't, I haven't seen the data on, uh, the polio from our wastewater here, but we had no cases here.
Speaker 2 00:16:20 What happens if, I know a while back you were, you would talk about when somebody used to get polio, it was kind of a, especially if it, certainly if it was symptomatic polio, um, it was possible paralysis or death is if they got polio, if it was asymptomatic and they were pregnant, could that affect their child?
Speaker 3 00:16:46 Unlikely that, that one, you know, again, these viruses all have kind of their own particular, um, places that they lived and travel in the body and, uh, unlikely it would pass to, uh, to the fetus.
Speaker 2 00:17:00 So is polio contagious as you know, how if, if we had an outbreak, how contagious would it be?
Speaker 3 00:17:10 Well, it's contagious in that the first place it goes is into the back of your throat. So, you know, the same thing that protects us from all the other respiratory viruses is, you know, wearing a mask, not staying, you know, close to somebody. So it's in respiratory droplets so close that's probably gonna take like, you know, like you and I sitting close together for an hour or household contacts is, is really what it's gonna take for that unlikely that you're gonna get, you know, you're gonna get it just by walking by somebody in the mall. Um, but the other place that you know it is, is that it, it's, it's it's on people's dirty hands. People that, you know, that, uh,
Speaker 2 00:17:46 Touching things.
Speaker 3 00:17:47 I, I won't go into, there's probably probably people trying to eat dinner so I won't go and someone detail them that.
Speaker 2 00:17:53 Um, so like so many viruses that we are seeing now, especially like the coronavirus and you see that it, it has many mutations, can polio, mutate,
Speaker 3 00:18:06 It doesn't really seem to have big mutations to it. Not like covid has where you have almost an entirely new form. Mm-hmm. Um, it, it is already sort of a, a cluster of kind of some close cousins, but now it, it's unlikely that it's, it's going to, I mean, there's the one like we weaken it and then it gets stronger again, but it's unlikely that it's gonna turn into, you know, a super virus.
Speaker 2 00:18:31 So you talked about the after effects of what you saw, you know, what people saw back before, um, people were immunizing or at being good at immunizing. Um, what else besides paralyzation did you see from polio? Anything else?
Speaker 3 00:18:52 It, it's, it's mostly the paralysis from it. Um, and some people have paralysis and they get better and it, it's called a flacid paralysis. So think of it as a paralysis that like, you know, you just, you can't move any of your limbs. Everything becomes sort of just limp. Um, and then in some people it goes on and becomes complicated by a a, a hypertonic, meaning it's then it's a stiff and a spastic paralysis. And that can be very, very painful for people. So the flacid one is just, you know, it's, it's just sort of a floppy person. Um, but the fla the, the hypertonic paralysis is the one that is the one that is more sort of long lasting. Um, which is one where the, and it can be very painful cuz you get spasms of the muscles.
Speaker 2 00:19:42 So is, is French polio a, a relative of polio then?
Speaker 3 00:19:49 Well, which kind? I'm
Speaker 2 00:19:50 Sorry? French polio. Like gure that
Speaker 3 00:19:53 Yeah. Yeah. The, it's it, you know, it's very interesting you brought up Ian Beret because I, I don't know if, you know, it's sort of a quiz for your audience. Here is who's the most famous person who had polio
Speaker 2 00:20:06 <laugh>
Speaker 3 00:20:07 Was, uh, Franklin Roosevelt. You know, Franklin Roosevelt was, you know, in a wheelchair and Right. You know, back then, you know, but people have actually looked back at medical records and just sort of the case of him. And most people think that he actually probably had Guillen beret and not polio really. Um, cuz his, his story was much more, uh, consistent with that. But no, Guillen beret is one where you are, right? It's that flacid paralysis, the lib paralysis and it starts, you know, it, it starts and then just moves, you know, moves up your body, it starts, it's just sort of weakness that's just one part and then slowly spreads through your whole body. And most of the people that have Guan beret though, recover from it.
Speaker 2 00:20:50 Mm-hmm. <affirmative>. Yes. That's, I knew I, I've only known one person, but, uh, she talked about it afterwards. She said it was just the most horrifying experience that she had had. Yeah. And, uh, she was a coworker and she called me and she said, I don't think I'm coming into work. I'm starting not to be able to move. I'm like, what <laugh>? So it was, uh, it was quite an experience for her and she, it was literally horrifying. So,
Speaker 3 00:21:16 Um, yeah. Yeah. It just sort of feels like somebody has taken over your body. Mm. It's just this sucking all of your energy out.
Speaker 2 00:21:24 Are there, I mean, we're pretty good about it I think, as far as not having this problem, but are there other countries that do have polio as a problem?
Speaker 3 00:21:37 You know, that's interesting because po so there was these big public health efforts mm-hmm. <affirmative>, uh, when you have a vaccine like this that is so effective, um, we, public health organizations, including the World Health Organization, proceeded to go onto this campaign of let's eliminate polio in the world. Right. Um, and have been able to, except for a couple little tiny hotspots, oh, have been able to totally eliminate that natural virus polio in the world. It's this incredible PO health. So I don't think people even know about. So that now, other than I think it's Pakistan is the only country that actually still has a little bit of the sort of what we call wild type polio. So now if you hear a polio, it's one of those rare cases when the vaccine, uh, virus got stronger again. Or whether the vaccine virus got given to somebody who didn't have an immune system that could even fight off that, that weakened one. Oh. And so it's vaccine, it's vaccine associated polio, we call it B
Speaker 2 00:22:39 But it then it still doesn't, you'd think it would jump more to some because there are other people who are not vaccinated.
Speaker 3 00:22:46 Well, when you think of it though, if you're forgiving fresh vaccine, the way we give it in the, the area where there's resources aren't quite as good, you're gonna give it to like a whole village at the same time. Mm-hmm. <affirmative>. So the cook news is, is even though one or two people might get, you know, say you have a thousand villagers and only one or two people get the breakthrough kind, you know, the other 999 just got the vaccine and are gonna be immune. And so it's not gonna spread
Speaker 2 00:23:17 If someone had polio, which is, I realize much more rare now. But I think you could probably still find somebody who has had it, um, as a child, do they still need to get the vaccine?
Speaker 3 00:23:30 Yes, they should. Um, because we d we don't know how long the immunity lasts, um, from having the natural disease. And so just to be safe, it's better to get the vaccine as well.
Speaker 2 00:23:44 Ah, gotcha. I am curious to, if, so, if, if the, um, vaccine is weak in your body, can you, do you have to have a booster later? Like how do you know, um, if the vaccine is weakened? You know, we, I think, I guess where I'll, I'll start over. I think we, we kind of assume when we get our, our vaccinations as children that they last forever, um mm-hmm. <affirmative>. However, I do know some people who have gone into the healthcare, they maybe work in, um, places where they're are vulnerable adults with compromised immunities and they have been sent back to get tested to make sure that their vaccines are at a, at, at a great, a good level. Um, so there's no nothing catching or or spreading <laugh>. So what I'm wondering is how do we know that the polio vaccine has stayed good at a good level, um, in our bodies?
Speaker 3 00:24:54 That's a great question. And you know, we te what you can do is you can actually test somebody's level of antibody. And when we're in the place that we are now where there's very little polio around and people aren't even going to be, there's very little chance of somebody getting exposed to polio. Mm-hmm. <affirmative>, we don't bother to check those, we call 'em titers. We don't bother to check the antibody levels because we assume that people probably have pretty good levels. Um, and even that's a little bit tricky cuz you have different parts of your immune system and there's the one that makes antibodies and that's really easy to test with a blood test. But then there's other parts of your immune system that have, that are a part of sort of a long-term memory system mm-hmm. <affirmative> and those are hard to test so that even though somebody might have a low antibody level, they still are gonna probably be able to make an immune response. It's just they need their immune cells to get, you know, assuming that they don't have any problem with their immune system, they're going to, you know, the, the memory from their immune system is gonna kick in.
Speaker 2 00:25:58 Ah, okay. So unless you have to have a test, um, you, you're probably okay, especially for things that are not readily contagious right now and, and that you don't have any, you know, that we're not getting any signs that, that they're out there really for the United States.
Speaker 3 00:26:22 Right. So what I would do, for instance, if we had, if we had polio in Minnesota and patients were to come to me, I would probably check their antibody levels and recommend that they get a booster shot if they had low immunity levels or I might even just say get a booster shot anyway, um, I'd talk about the health department cuz our health department here is incredibly good and gives us really good advice on it. But that's the kind of thinking I would go through is like, now we've got a threat mm-hmm. <affirmative>, so what do, what do we have at our armamentarium to, you know, to make sure that we neutralize that threat? Cuz the more people that have a good immune system, the better off we're gonna be.
Speaker 2 00:26:58 So is there a reason why, why an adult might need a booster besides, I guess if you're going to Pakistan
Speaker 3 00:27:07 <laugh>? Yes. That, that would basically be it. We sometimes do give boosters to people that are gonna travel, especially like somebody who's gonna work for the Peace Corps, who's gonna go into, you know, remote areas where, you know, there's gonna be, you know, part of it is, you know, they, they might get polio, which we certainly don't want them to get, but then also they're gonna get polio in a place that is not gonna be close to having good medical care to be able to take care of 'em if they do. So there's a whole group of vaccines we give people if they're traveling,
Speaker 2 00:27:35 Talk about what it means to have post polio syndrome,
Speaker 3 00:27:40 Um, with what syndrome? So
Speaker 2 00:27:42 Post polio syndrome.
Speaker 3 00:27:43 Oh, the postpone. So the post polio syndrome is what I was talking about with the, um, that after that flacid stage go, um, you know, again, some people it resolves and then in other people it doesn't resolve. And they end up with this post polio syndrome where they have these very painful spasms and contractions of their limbs. Um, and, you know, it can be made better with really good physical therapy and, you know, some point, you know, bracing and things like that. But that's really the post polio syndrome of that instead of the paralysis just getting better, it goes to that second stage with the second stage being that, you know, spasms and, and, and contractions.
Speaker 2 00:28:22 I'm guessing if one gets polio, there's really nothing you can give them that it just needs to run its course.
Speaker 3 00:28:29 Right. We don't ex you know, I, you know, medical research is usually around illnesses that we have a lot of. Um, so we, we eliminated polio with the vaccine and so people aren't really spending time looking at, you know, what would be a good treatment for polio. Back before we had the vaccine, there was no treatment. Um, a lot of different things were tried, you know, it was a also a different era. We have so much better, um, antiviral medicines now. Um, but there really is nothing to to, to treat polio.
Speaker 2 00:29:03 What do you feel it would take to eradicate this disease?
Speaker 3 00:29:08 It takes, you know, it takes near a hundred percent immunization. Um, you know, I really worry that we're gonna get it back here with the rates. You know, we're already seeing, we had, you know, in Minnesota, we and beyond Minnesota also, we had an outbreak, have had an outbreaks of measles. Mm. You know, which, you know, that's, that's coming from having, you know, a, a very low rate of, of, well, an insufficient rate of measles immunization that people, there was a, a rumor on the internet that it result, that measles immunization caused, um, autism, which was totally not true, has been extensively investigated and found not to be true, but people were so afraid of the autism that they didn't get measles vaccine for their children.
Speaker 2 00:29:54 And this is something truly that is so easily controlled. Um,
Speaker 3 00:29:59 Yeah,
Speaker 2 00:30:00 It should just be exactly an easy thing. And I I what will it take in your opinion? You, I mean, you're a doctor, you, you talk to so many people and parents and, and I'm sure you hear a lot of stuff in and out of your office every day. What do you feel will be the, the breaking thing that will help people like get on the stick and get vaccinated? What will it take?
Speaker 3 00:30:32 You know, for most people it usually takes something close to them. Um, someone they know getting sick, um, or, you know, with some people it's, you know, having somebody famous get sick, um, because then it has to become personal. So, you know, back, you know, what I talked about of, you know, my mother's stories of, you know, losing a classmate to polio. It, it's, it's, you know, became more scared of the polio then. So, you know, it's, I would, I would love to say, I mean, the biggest thing we need is people to care more about each other. Um, it's a tiny, tiny risk of getting a vaccine, but we know that if everybody gets vaccine then everybody's protected. Um, but I think, you know, one of the things that has happened with C O V is we've all kind of, you know, gone back into ourselves and our families and our, our our own little corner and are thinking about, well, what do I need rather than what's gonna help
Speaker 2 00:31:35 The good of the whole
Speaker 3 00:31:36 Need in general.
Speaker 2 00:31:37 Yeah. Plus if you get the vaccine you help, there are probably very small. Right. But some subs, some amount of people out there that cannot have the vaccine. Is this correct?
Speaker 3 00:31:51 Um, not for polio vaccine.
Speaker 2 00:31:53 Not for polio. Okay. I've always heard that in, in regards to certain vaccines. Yes. Maybe that was mumps, measles, rubella type thing. Yes. Where they,
Speaker 3 00:32:02 Because it's, um, it's made on eggs. Right. So if you're allergic to eggs or if you're allergic to one of those preservatives in it, you, um, you can't take it. But, uh, it's a, it's a would be an incredibly rare circumstance for somebody. I have never had somebody allergic to, um, uh, polio vaccine. All right. Never. I never have heard of anybody.
Speaker 2 00:32:22 No excuses. Right. Um, right. What I'm guessing, I guess I, this would be a question for you. How do you, you must have parents that, or, or know a doctor that has parents that have come in and said, we don't believe in in vaccinations, we're not doing it. What's the protocol there and what do you do?
Speaker 3 00:32:46 Uh, yeah, I, I have had patients that have said that they're, they're rare. I mean, I have a lot of people that come and tell me that they're worried about the vaccines and they want more information. And so, you know, I love when that happens because, you know, I don't want patients to just come in and blindly do whatever I say I want, I want people to be making informed decisions and to feel good about what they're doing. Mm-hmm. <affirmative>. So the folks that come in that are just like, eh, I'm kind of worried about this. Um, you know, I I I absolutely welcome that. Um, then there's kind of another group of people who just kind of wanna customize things. They feel like it's more in their control when they can, they can, you know, they'll say, oh, I only want one shot today cuz I, I'm afraid of three, but, you know, one shot today and then when another month we'll do another one.
Speaker 3 00:33:35 You know, fine, I'll, you know, I'll work with 'em. Um, I don't think that's the best way to do it and it's not my recommendation to do it, but, you know, fine, fine. We'll, you know, we'll come to something that everybody feels comfortable with. It's really hard group of people who just absolutely refuse vaccines though. And many of my colleagues will tell those patients that they can't come to their office anymore and they need to find a different pediatrician. Um, because by allowing those folks to come to your office, they're potentially putting everybody in your waiting room at risk then. Right. And you have to think about the effect for all of your patients rather than just that one patient.
Speaker 2 00:34:16 Why do schools not demand that children get vaccinated?
Speaker 3 00:34:24 Well, some schools it, it, it all depends from, you know, state to state what the laws are and, and, and how much you're going to go by. What science tells us is the answer versus what public opinion votes to be the answer. And you know, this is a constant struggle of, you know, of, you know, I mean we have really, really good data on vaccines now and, you know, and that people make decisions and they make policy and, and rules around it. But then people that are in legislatures and, and otherwise governing have a choice then are they gonna go with the science and the really well thought out policy? Or are they gonna go by sort of a popular vote and not even a popular vote? Are they gonna listen to the people that are shouting the loudest? And the reality is will
Speaker 2 00:35:20 Concept.
Speaker 3 00:35:22 Yeah. The people that are shouting the loudest. Yeah. In my experience through covid are actually a fairly small minority of people, um, who are against mass or against vaccines or, you know, whatever the of the day you're against. But they're the ones they can listen to.
Speaker 2 00:35:39 Huh. You talked a little bit, I, I want you to revisit, you said you definitely will work with the person who wants to kind of trim the or or um, schedule the shots a little differently, only a couple at a time or or whatnot. Why do you not recommend that?
Speaker 3 00:36:04 Well, the vaccines were tested under very, very specific circumstances. And then we, you know, we gave vaccines and we drew blood tests and we measured immune responses. And so they were tested in a place where they were all given together. And so we know that when we give them all together that they work really well and that they may be using parts of the immune system that, you know, the thing that's helping against one thing in the shot is maybe helping you also build an immune response to another thing in the shot. And so that we know, we know they work that way. We don't have any tests that look at like, this month we'll give you polio and next month we'll give you your whooping cough one. And then, you know, three months from now we'll give you your, your chickenpox shot. We don't know that that will necessarily work as well cuz we don't, we don't have an, we don't have any data on it.
Speaker 2 00:36:59 Are parents informed of that? If they choose to, you know,
Speaker 3 00:37:06 Yes. Well at least go off
Speaker 2 00:37:07 The grid
Speaker 3 00:37:08 And at least I do. And the people that I know do we, we talk about it.
Speaker 2 00:37:14 And does that, you know, go ahead.
Speaker 3 00:37:16 You know, one thing in this that I absolutely totally understand is, especially in new mothers, is that you have this precious little baby that you are entrusted with keeping safe. Mm-hmm. <affirmative>. Okay. And many times you're going to a doctor that, especially if you're going to a pediatrician with your first baby, the first time of this person that you've just met. Right. Uh, doctor or nurse practitioner or physician assistant. And you've gotta then trust this person to take out a sharp object and inject your baby with things that you not even sure exactly what it is for an illness that you've never heard of. That's hard. It really is hard. And so, you know, it's, it's on the part of those moms, part of it is they have to trust a little bit that, that we know what we're doing. And the other part is on, on the provider's side is we have to make sure that we're trustworthy and that we're treating people right and we're doing things to show that, that they can trust us.
Speaker 2 00:38:19 And I will say too, coming from a parent's perspective is there's also, I think this concept of, here I have this brand new baby with this clean slate so to speak. It's, it's got this pure, you know, this pure slate and then I'm going to inject all these things like all at once, like mm-hmm <affirmative> and it's not used to that can it handle having all this stuff thrown at it. Um, and then I'm sure they get the whole, if something goes wrong, okay, what made it go wrong? Um mm-hmm <affirmative> that may not have anything to do with the vaccines, but for some reason, you know, the stuff happened then or during that time of a vaccine. So I would say that coming from a parent's perspective, I'm sure that's just that whole, how much do I expose my child to How much is too much? And you know, where's that? I, I feel like that's not talked about a lot and I, I don't know if it's because it's not known or if it's just that, as you said, this has been tested so well altogether that it hasn't had another, you know, hasn't had another type of testing.
Speaker 3 00:39:39 Well, in a lot of ways we are victims of our own success because if you think about it, a hundred years ago, um, we didn't have clean water. Um, our air was not as clean. We had a lot more people, you know, multi-generations all living one on top of each other. And so we constantly had, these babies were being exposed to a lot of really bad things. Um, they, you know, in with the water, people breathing on 'em that had, you know, hooping cough. Right.
Speaker 2 00:40:11 And
Speaker 3 00:40:12 So babies developed their immunity kind of that way and their immune systems, all of our immune systems are built to be able to handle all of these pathogens. But now because we have clean water and we don't have houses with quite as many people living in them and we don't have a lot of people walking around with scarlet fever and pertussis and measles, you know, people aren't getting the exposed to 'em from the natural disease. And so we're needing to do this to protect the babies.
Speaker 2 00:40:44 Gotcha. Is there anything you'd like to leave people with as far as discussing diseases and vaccines and um, things like that?
Speaker 3 00:40:56 Yeah, they should just, you know, people should really be free to ask questions. Um, you know, you know, even you have to shop around, find, find a, a healthcare provider who you're gonna trust and then don't be afraid to ask 'em questions cuz if they're not, if they're not answering your questions, then you need to find somebody else.
Speaker 2 00:41:18 I guess, um, for me I would wanna throw in, um, to talk about where people get their information. Right. Because the internet is such a open space and anybody can put out information anywhere, so it seems Yeah. And it doesn't mean it's accurate by any means. Uh, so yeah,
Speaker 3 00:41:41 People and people need to be honest with themselves in this of that. If you're s scared of a vaccine, then you're gonna go look for a reason not to vaccinate. Rather than keeping an open mind of, you know, I'm gonna go look for that scary story cuz then that's gonna justify why I don't have to do this thing. It's legitimately scary. Um, so they should go to the American Academy of Pediatrics, the American Associa Family Medicine. There's a great group right outta St. Paul that people all over the whole country uses called immunized.org that has incredible information on it. And people, you know, before they make a decision, they need to go to a trusted source and not just look at, you know, the cra the crazy person who lives someplace else.
Speaker 2 00:42:26 Mm, thank you. I I really did wanna touch that because besides having political, uh, duress under what was happened with the coronavirus, I feel like the internet has been just as irresponsible with putting out false information. And it is so hard sometimes for the person who doesn't have the time, doesn't have the patience, doesn't know what really to do, um, to sort through where to go. So the idea that there are trusted resources, look for a medical trusted resource, presumably, and Yeah,
Speaker 3 00:43:07 Yeah, yeah. Something There are pedia, pediatricians, family medicine people, again, immunize.org is, it's, it's again national, but it's right here in St. Paul. Great organization.
Speaker 2 00:43:20 Excellent. How can people, is there a place people can go to find out more about polio and infectious diseases, childhood diseases like that,
Speaker 3 00:43:27 That immunized.org.
Speaker 2 00:43:29 Excellent. Dr. Foster, thank you so much for being on. I really appreciate it. And, uh, it's been very informative and I, uh, I'm sure I'll come up with something to drag you on again later on. <laugh> <laugh>.
Speaker 3 00:43:43 I'll look forward to it and hopefully I can be there in person. Cause not
Speaker 2 00:43:47 Good bad weather again. I know. So thank you. We love having you on. It's, it's always a great conversation and you're very knowledgeable, so appreciate it. Thank you.
Speaker 3 00:43:57 Thank you. Have a great holiday.
Speaker 2 00:43:58 Thank you. You too.
Speaker 3 00:43:59 All right, bye.
Speaker 2 00:44:01 And thank you for listening to tonight's show. We were speaking with Dr. Foster, Dr. Jill Foster, and she was talking about polio and vaccines and all things polio. My name is Sam, I'm the producer of this show. I will be back, we're gonna come back with music, but I just wanted remind you that if you'd like to listen to our podcasts, of which we have many up now, thanks to Erin Westendorp. Thank you Erin, our wonderful podcaster. Um, you can ask your smart speaker to play Disability and Progress podcast. Join us every week. I will be, um, gone for the next, maybe if I can the next couple weeks, but I will find something interesting for you to listen to for the holidays. And I hope you have great holidays,
Speaker 0 00:44:50 KPIs.
