Jan Jekielek is a senior editor with The Epoch Times, host of the show “American Thought Leaders” and co-host of “FALLOUT” with Dr. Robert Malone and “Kash’s Corner” with Kash Patel. Jan’s career has spanned academia, international human rights work, and now for almost two decades, media. He has interviewed nearly a thousand thought leaders on camera, and specializes in long-form discussions challenging the grand narratives of our time. He’s also an award-winning documentary filmmaker, producing “The Unseen Crisis: Vaccine Stories You Were Never Told,” “DeSantis: Florida vs. Lockdowns,” and “Finding Manny.”

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[RUSH TRANSCRIPT BELOW] Recently, the CDC’s Advisory Committee on Immunization Practices (ACIP) met for the first time after Health Secretary Robert F. Kennedy Jr. replaced its entire membership with new picks.

In this episode, I’m sitting down with two new ACIP members, Dr. Robert Malone and MIT professor Retsef Levi, for a deep dive into all things ACIP.

“They basically impact billions of dollars of revenue for the pharmaceutical industry. So there’s big money at stake here. There’s big policy at stake,” says Malone.

“One of the problems that we had in the context of vaccines, and more broadly maybe pharmaceutical products, is that debate was considered confusing to patients and something that we should avoid,” says Levi.

We take a look at some key discussions during the recent meeting, from thimerosal in certain flu vaccines to RSV shots for children, and what may happen with this committee moving forward.

“What you’re seeing here is a firm commitment on the part of these two volunteers, and I think the committee as a whole, in trying to be open and transparent to the general public,” Malone says.

Views expressed in this video are opinions of the host and the guest and do not necessarily reflect the views of NTD.       

RUSH TRANSCRIPT
Jan Jekielek:

Dr. Robert Malone, Professor Retsef Levi, such a pleasure to have you on American Thought Leaders.

Thank you, Jan. It’s a pleasure to be here.

Thanks, Jan. It’s a pleasure to be here again. And I’m so pleased with how American Thought Leaders has been growing and to be part of this yet again.

It’s wonderful. Of course, you have both been on the show before. This is the first time that you’re together. And huge congratulations on completing the first meeting of this new ACIP panel that’s been put together, two of eight. Why don’t we actually start with this? This is a committee that actually has quite a bit of influence in decision-making, but most people haven’t actually heard of it until very recently. So bottom line, what is ACIP in the end?

ACIP is an acronym that stands for the Advisory Committee on Immunization Practices. This is a federal advisory committee. It’s the product of the Federal Advisory Committee Act [FACA]. Another FACA committee that matters in this space is the Vaccines and Related Biologicals Advisory Committee [VRBAC], and that’s the one that advises the FDA [U.S Food & Drug Administration]. So there are these two key federal advisory committees.

Both of them are voluntary, by the way. So we’re not getting paid big money to advise the CDC [Centers for Disease Control and Prevention] and the director of the CDC specifically through the Advisory Committee on Immunization Practices. We’re basically volunteering and getting a very minimal stipend of $250 a day. So we’re not in this for the money.

What is this thing, the Advisory Committee on Immunization Practices? It’s set up historically, and it goes back decades, to provide advice to the director of the CDC and, by extension, the director or the secretary of Health and Human Services, currently Robert F. Kennedy Jr. So the way that ACIP is supposed to work, as just another federal advisory committee, is that it, through its subcommittees, investigates issues relating to basically infectious disease countermeasures. So it’s not just vaccines. It’s antibodies, and technically it could also cover early treatment for an infectious disease, although that’s rarely, if ever, considered.

What it’s supposed to do is convene these subcommittees, and by the way, the rules are that the subcommittees have to be chaired by one of the formally appointed ACIP members. But the subcommittees can include people from all kinds of places, including comments from industry. So that’s where the real work gets done. They analyze issues, particularly relating to newly licensed products from the FDA. The charter is that the ACIP is supposed to take up the issue of whether or not the CDC will recommend the use of recently authorized FDA interventions for infectious disease, particularly biologics and vaccines.

The flow of work is that the VRBAC advises the FDA, the FDA makes decisions on whether or not to authorize the marketing of a new product. And then at the next following meeting, the ACIP is supposed to take that up and make it advice to the director of the CDC about whether or not the CDC would recommend and under what conditions it would recommend the use of that product.

Now, the wrinkle in this comes in that Congress has authorized a program called the Vaccines for Children Program [VFC]. The VFC has basically appropriations authority granted to the ACIP. So if ACIP votes and the CDC director agrees that a product should be made available through the Vaccines for Children program, which is basically a subsidy to ensure the availability of the products to underserved populations.

If the ACIP votes and the CDC director approves, then those products are automatically purchased by the CDC and the federal government and distributed to the tribal nations, to underserved communities all across the United States. That gives the ACIP unusual responsibility and authority relative to other FACA committees.

But what has happened over time is that the various professional societies, the medical professional societies, have aligned themselves with the ACIP. They actually serve as an unofficial advisory component. And they typically align their recommendations with the CDC/ACIP recommendations. The consequence of that is that, functionally over time, the ACIP has developed into the body that establishes the standard of care for medical practice as it relates to vaccines, antibody preparations, and other biologics in particular for the whole of the United States.

Now, the wrinkle in this is that the federal government doesn’t actually have the authority to regulate the practice of medicine in the Constitution. And so what you end up with is this kind of strange soft power, whereas we’re in ACIP and the CDC functionally establish the standard of care, that triggers the insurance industry to decide whether or not these products are going to be covered. Basically, they follow the ACIP recommendations.

Once a product is established as standard of care and the use of it in the way that the ACIP with its partner professional societies agree upon, then that becomes basically legally the situation in which physicians can’t functionally go against that. Or if they do, they put themselves at risk for liability, basically for medical malpractice lawsuits. By the way, the recommendations that the ACIP made, and by extension, the director of the CDC, who’s the one that actually makes the recommendations, we just advise directly, but they basically impact billions of dollars of revenue for the pharmaceutical industry.

So there’s big money at stake here. There’s a big policy at stake. And as many people have come to recognize, particularly during the COVID crisis, all of this feeds into a kind of a strange functional mandate that flows from the federal government all the way down to local school boards. And that is at the heart of a lot of the controversy that is happening right now with the changes that have happened in the composition of the ACIP.

I’m absolutely going to dive into some of that controversy. I’d love to talk about that. But before we go there, Retsef, you know, you were very, very important for me in terms of my understanding of all sorts of policies around the pandemic. Through speaking with you quite a bit, I understood that I should look at everything from the concept of risk-benefit analysis, whether that’s specific policies, whether that’s products that are being used as interventions because of disease. And frankly, I’ve actually expanded it quite a bit further than that now. But tell me, why do you think that you were invited to join ACIP, of all things, and how does your particular acumen fit into working on this committee?

Thank you, Jan. Just to build on what Robert said, I think that in my mind, the ACIP role is to translate a generic approval by the FDA to a set of more detailed recommendations that take into consideration risk-benefit aspects that could be different for different subgroups of patients and recommend both public policy as well as standard of care. It’s a great honor and very humbling to be part of the ACIP, but I cannot speak to why people selected me. That’s something you have to ask those who selected me, but I can speak about my background. And I’ve been in academia since 2006, and I have a PhD in operations research from Cornell University.

This is a discipline that is focused on trying to use data and models to inform complex decisions that involve risk-benefit trade-offs. And that’s kind of the purpose of this discipline. So it’s using a lot of statistics, a lot of artificial intelligence, a lot of machine learning, a lot of data, and a range of methodologies to essentially develop decision support tools in different contexts to inform complex decisions that involve nuanced trade-offs of risk and benefits.

Specifically, I’ve been working thousands of hours with clinicians on the ground in healthcare systems on thinking about various issues related to the design of care, design of operational processes, design of healthcare systems, and how to optimize those to provide the best care for patients. I also did research on epidemiological models, on manufacturing biologic drugs, and how you can use data to improve their safety and quality.

I did work on post-marketing safety surveillance, but also on other areas related to human health, like food, water, agriculture, access to healthy food, and food safety. Beyond my academic experience, it’s fair to say that I’ve been thinking about risk since the age of 18, when I became a part of the Israeli Defense Forces and spent almost 12 years as an intelligence officer.

I have a strong belief that there is no one discipline that can capture the complexity of these decisions. So this is why it’s very important that a committee like ACIP will have people from different backgrounds, from different perspectives, and from different experiences. And I’m a strong believer that the collective wisdom of a team is far stronger than the wisdom of an individual. And I also hope and believe that that’s the plan, that this team will also expand and have even more people and more members, because I think that we really want to ensure a diverse set of opinions and backgrounds.

You know, looking at—I didn’t watch the entirety of the many hours of the ACIP meetings that happened just recently. But what I did see was some, you know, constructive discussion. Of course, there were also, you know, people making quite different decisions, and some of those things I’d like to actually dive into a little bit later in the episode. At this point, I’d just like to give Robert an opportunity to talk a little bit about his particular background and how that fits into being part of ACIP and perhaps why he was picked.

First, I want to address the issue of the modest Dr. Levi. What he didn’t mention is that he’s bloody brilliant. He is a full professor at the Massachusetts Institute of Technology in data science and data evaluation. That’s no small achievement. Furthermore, he was quite brave and bold throughout the coronavirus crisis. In speaking his truth, he has revealed himself to be an independent thinker and not swayed by proven narratives or conventional thought. I think that the nation is really blessed by having such a mind with these capabilities serving in this way. I don’t know that there has been this level of capability in data analysis before.

It’s complemented by the other members, but in particular, Dr. Martin Kulldorff, former professor of epidemiology at Harvard and arguably one of the top epidemiologists in the world, who was dismissed from Harvard because he refused to accept the COVID vaccine product, which is a major travesty. So the narrative that’s been promoted by corporate media that this is a committee composed of anti-vaxxers that are completely unqualified is clearly a gross misrepresentation.

In my own case, of course, there’s been a focus on this history of what I did when I was 28 and the origins of the mRNA vaccine technology, the patents that are behind me, etc. But that was only early on in my career. I’ve been working in infectious disease, virology, and immunology literally since I was an undergraduate working in the laboratory at UC Davis that did a lot of the pioneering work having to do with what we now call HIV and the related virus, simian immunodeficiency virus.

There are few people that I know of that have worked deeply in government positions, non-governmental organization positions, such as the Aeras Global TB Vaccine Foundation, funded by the Bill and Melinda Gates Foundation, in industry for Solvay vaccines, in the contract support industry, both in a vaccine-focused clinical research organization, and in a regulatory submissions shop located close to the FDA. I’ve kind of done it all in terms of working closely with the government on the HHS side and on the DOD side in relation to infectious disease, biodefense pathogens, biodefense countermeasures, influenza.

I was the clinical director responsible for over $300 million in BARDA [Biomedical Advanced Research and Development Authority] contract funding for the building of a cell-based influenza vaccine under Solvay. I’ve been doing this for 30 years. For some reason, the media only focuses on what happened in the last couple, but I’m very facile with modern immunology, modern vaccinology, and modern vaccine technology.

Of course, I also am very familiar with the current secretary of HHS. I consider him a friend and a colleague. I will never forget the day that he called me in my home and asked me some questions and then asked me to assist in editing the book, The Real Anthony Fauci. It’s been my privilege to build a working relationship with him since then. I’m grateful for the selection. I didn’t anticipate it. I absolutely did not want to join the administration in a functional role of having significant responsibility for a sub-agency. But I’m very grateful for the opportunity to serve my country in this volunteer role at the ACIP.

Jan, if I may just inject another thought. You know, disciplines are important, but I think that equally important is the culture of team dynamics. More broadly, I think that one of the problems that we had in the context of vaccines and, more broadly, maybe pharmaceutical products, is that debate was considered confusing to patients, as something that we should avoid, which in many ways goes counter to science. It goes counter to, I think, the complex nuances that exist when you consider risk-benefit considerations with respect to a patient and how a patient has to think about the trade-off of whether to take a pharmaceutical intervention or not.

Beyond the expertise, my hope is, and I think that hopefully we already illustrated that as a team in the last meeting, that we should not only shy away from debate; the discussion is equally important beyond the decision that was made. If anything, I hope that this committee will change that, not only in the narrow context of the ACIP discussions but maybe more broadly on how we think as a society, as scientists, as public policy, public health policy people, about the process and the principles of the process that should guide us in making decisions.

This interview is basically another demonstration of our personal commitment. Remember that Retsef and I are speaking in our personal capacity right now. I just want to note that we are not representing the U.S. government, and we’re not representing the ACIP. We’re representing only ourselves. What you’re seeing here is a firm commitment on the part of these two volunteers, and I think the committee as a whole, in trying to be open and transparent to the general public so that they can better understand why these decisions are being made, what the debates are behind them. Hopefully, that will help build back the confidence that has been lost by this kind of insular, one might almost say authoritarian approach that is characteristic of the federal public health enterprise during the COVID crisis.

I think one of the things that this committee, at least so far from what I’m hearing, is accomplishing is turning committee meetings into a kind of spectator sport. I think one of the themes, Retsef, that you mentioned here, I think you were suggesting, is that having the patients or having people play a much more active role in their own health care and also being given the correct information to be able to make these decisions themselves. There seems to have been this kind of strange culture that has developed, almost where that information isn’t presented very effectively, presumably, you know, kind of to protect the patient in a way from having to deal with too difficult decisions.

Yes. So to me, the core interaction of healthcare should always be kept to be the intimate interaction of a patient with their consulting physician and/or clinical professionals and medical professionals. My view is, I guess that’s kind of my personal view that being a member of the ACIP committee, the main role that I will try to help with is to communicate to patients and medical professionals what is the best knowledge that we have, what we know and what we don’t know.

The second principle that I would like to highlight is personalization. The one thing that I think is a staggering contrast is that, in most areas of healthcare and health management, we are emphasizing personalization. In fact, we are talking now about therapeutics that are going to be tailored to the individual DNA of a person, right? However, when it comes to vaccines, we more often than not tend to think about them as one size fits all, both on a single vaccine as well as, even worse, on all vaccines, right?

To me, the interplay between these personalized considerations and the intimate interaction between the patient and the medical professional to allow them to make the best personalized decisions for themselves, considering the risks and benefits that they have to face, is the single most important thing that we need to enable as a committee.

A lot of the decision-making at the CDC and in American Public Health, as follows those with three of the masters in public health [MPH], please understand that the MPH degree is a two-year degree that is granted to individuals who have any undergraduate major. They don’t have to be biology majors. They certainly don’t have to be co-doctors or medical practitioners or have any experience in that. The essence of the MPH degree has to do with statistical analysis, based on the thesis of promoting, it’s a utilitarian argument, promoting the greatest good for the greatest number.

That is at the core of the framework, not only of the MPH but of modern public health in the United States. This utilitarian greatest good for the greatest number approach is fundamentally socialist, in my opinion. I believe that we need to swing back to the practice of medicine to what was a prior generation in which the focus was on the patient and the physician-patient relationship. We are moving into a new era of personalized medicine increasingly driven by artificial intelligence.

It’s an open question what the role of the physician and the medical care provider is in that environment. Do we really want to have our medical care determined by algorithmic, artificial intelligence, utilitarian decision-making implemented through insurance agencies and very large health maintenance organizations? Or do we want to have a situation in which individuals have sovereignty over their own bodies and those of their children to make informed decisions?

The challenge there is that they’re not medical professionals. How do you communicate complex medical decisions to a layperson? But it’s achievable. It can be done. It takes a little more effort, and it is very threatening to many medical care providers.professionals and public health officials, including CDC staff, to have their opinions questioned.

Now, Retsef and I have lived for most of our careers in the academic world, being subjected to peer review. Retsef, bless his heart, still does. And it can be a challenging environment, but it is very healthy to have outside independent oversight to ensure that we’re not missing something. We’re not generating an artifact to the best of our ability. And this kind of large data analysis is super susceptible to strange quirks in data oversight, overlooking confounding variables. The only way that I know of to effectively immunize yourself from that is to subject your work to peer review.

I’m sorry to say, historically, the CDC and those who are doing the analyses for the ACIP have not had their work subjected to peer review. The Morbidity and Mortality Weekly Report [MMWR], the monthly report put out by the CDC, is not a peer-reviewed journal. The MMWR is not peer-reviewed. It represents the opinions of a group of people often strongly biased by CDC personnel. Why shouldn’t the work product of the federal government’s epidemiologists and data analysis, also be subjected to rigorous outside scrutiny? I think it will improve public health. I think it will improve public trust. I think it will make for better science and better medicine.

One of the exciting aspects of becoming a member of ACIP is the opportunity to work with the CDC staff and other academics to really pursue together the truth based on the data. And I think the CDC, my impression from the first meeting, has very passionate staff members who are very hardworking. So I personally look forward to building those professional relationships and really engaging with them and others to pursue the truth.

One of the things that I really liked about Martin Kulldorff’s opening statement is that he really mentioned the analogy of airline safety, especially when you are considering giving medical intervention to healthy individuals, let alone healthy children and babies. I think that your approach to both safety and efficacy should be guided by the caution that you would have when you think about sending an airplane on a flight carrying hundreds of passengers.

The analogy is that when you recommend something to be used broadly, you are launching a flight with potentially billions of children or millions of children, right? I think that adopting the safety paradigm or the safety approach of airlines is going to be very, very important going forward. And I thought that it was very inspiring to hear Martin speaking about this at the opening of the meetings.

Let’s talk about one of the decisions that was made. The vaccines related to influenza were mentioned, actually a very prominent decision, one that’s been given a lot of play in the media: this removal of thimerosal from these multi-vial influenza vaccine decisions. But let me ask a few questions right off the bat, even when it comes to the basic data. I mean, I’ve heard that influenza vaccines just aren’t effective at all or have negative efficacy. I’ve seen some papers that suggest that for some years that they’ve been applied, they have that.

I’ve seen people say, thimerosal has been removed mostly from these vaccines in the first place. Why is this such a big deal? And of course, thimerosal is mercury. And so for some people, it’s even shocking to discover that there was mercury in the first place. So why don’t we just start off? Can you kind of unpack influenza vaccines for us? Which, by the way, ACIP approved the use of in general or recommended the approval of. So a lot of different pieces here.

We were presented with language without really an opportunity to debate that language, endorsing universal influenza vaccination, as well as the nuance of which specific influenza virus sequences would be included in the recommended upcoming vaccine year for the vaccine. And to provide a little bit of context for that, historically, those decisions have been made at the level of the World Health Organization and then propagated down. There tends to be one recommendation for the Northern Hemisphere and one recommendation for the Southern Hemisphere, because the flu strains circulate in contrary seasons, having to do with the fact that when it’s winter here, it’s summer there.

This is the first time, to the best of my knowledge, since the United States government has withdrawn under the direction of President Trump from the World Health Organization that the CDC has had to act unilaterally in its recommendations for what strains to be included in the following year’s influenza vaccine. And by the way, those influenza vaccine campaigns will kick off in August, depending on the vaccine platform, and continue through the winter. So we were basically presented with a fait accompli in terms of the language recommended to us regarding influenza vaccination as the first resolution, and then a series of second, third, and fourth resolutions having to do with this really nuanced quirk of removing thimerosal from the influenza vaccine multi-dose vial.

Jan, you have raised a key issue, and you’ve used that forbidden term, negative efficacy. This is, just for context, I personally lost two jobs in the past working in the influenza vaccine industry for even raising the issue of negative effectiveness of immune imprinting and original antigenic sin. The last two being, really all three of those being very technical terms that have to do with the issue of whether or not taking this type of product year after year after year makes good sense, even the logic, or whether doing this year after year after year is somehow imprinting one’s immune system in ways that are, just to simplify it, counterproductive or mounting an effective immune response against a new strain your body may not have encountered in the past.

Basically, it’s as if we’re training the army. You know, you can build a strategy based on the last war. And functionally, what happens with influenza vaccines is it’s teaching your immune system to fight the last war, largely. And there is data, and it’s been a hot subject of debate in the vaccine community now for decades. Annual boosting, or in the case of the COVID product, much more frequent than annual, is actually counterproductive. It’s driving the immune system towards categories of responses that are counterproductive. We’ll just leave it at that and recommend that people Google immune imprinting and original antigenic sin if they want to get more information.

But this is a topic that has been anathema in the influenza community, including at the ACIP and the CDC. The subcommittees are where the business gets done at ACIP. Subcommittees are where the hard decisions have to happen. The public committee is basically a forum for presenting the data that has come out of the subcommittees and then debating that data among ourselves, including people who weren’t part of those subcommittees, and making decisions about whether or not to endorse those recommendations for consideration by the director of the CDC.

Retsef is going to chair the COVID subcommittee. So this is super important because it means he’s going to be in charge of setting the agenda for what gets discussed about COVID and the various COVID products and how they’ve been evaluated going forward. He hasn’t had that opportunity in the past, but now he does have that. And I find myself having been positioned as chair of the influenza vaccine. I mentioned in the meeting that it’s my intention that these issues of immune imprinting, original antigenic sin, etc., will be discussed and strongly considered in upcoming meetings.

But in terms of the decision that we were faced with, we were presented with essentially language that was already approved and had to make a decision about whether or not to endorse both those specific virus strains that had been vetted thoroughly and to endorse a universal influenza vaccine recommendation, as has been the case for decades. And the decision was that this was not the time to fight on that hill about the universal influenza vaccine recommendation.

Now, the other recommendations that were passed also had to do with, as you point out, this nuance of multi-dose vials containing mercury of the standard influenza vaccine, mercury in the form of a preservative called thimerosal. And just to calibrate this, because this is something the press has latched onto and has made a big deal about, what we’re talking about is that 97% of all influenza vaccines currently administered in the United States are administered either using single-dose vials.

That means that it comes in a little vial, and it’s got the rubber nib at the top, and the physician puts the syringe and the needle into that, draws out that one dose, hopefully changes the needle; otherwise, the needle’s a little dull and it hurts more, and then administers it to the child or the adult. What that does is minimize the chance of introducing contamination by going through that rubber stopper, that nib, again and again and again, which is what you do with a multi-dose vial.

Multi-dose vials are a little bit cheaper, but they are considerably more risky in terms of introducing contaminants into the jar that then get drawn out and injected into another patient. That could be a virus like hepatitis B. It could be bacterial contamination, etc. It could be a fungal contaminant. That’s why in a multi-dose vial, you have to put in some sort of preservative. And there are other approved preservatives other than thimerosal.

In the interest of doing our best at this stage to take another move forward in eliminating the added dose of mercury to patients that receive an influenza vaccine.  Remember that they’re going to get a vaccine every year. And the people that get it from a multi-dose vial today are likely to be the same ones that get it from a multi-dose vial next year. So the mercury doesn’t get excreted very well, and there is a cumulative effect.

The committee, I think wisely, voted to just say no to thimerosal-containing multi-dose vials. Now, for some reason, the pharmaceutical industry and corporate media see this as some sort of existential threat that eliminating 3% of the influenza doses that contain thimerosal is a crisis for the entire vaccine industry and their academic and media supporters. I don’t get it, but that seems to be the meme.

The strange thing is that it’s Left-media and pharma arguing in favor of injecting mercury into Americans. It is just horrible optics. It’s not the right decision. And I think I applaud the committee for having the temerity to just say no at this point in time.  And by the way, unfortunately, influenza vaccines are not the only products that contain thimerosal. There are other vaccine products that are still on the schedule that contain thimerosal.

I suspect the industry sees the writing on the wall. Since the committee said no, just said no to thimerosal-containing flu vaccines, one might speculate that in the future there might be a tendency to say no to other thimerosal-containing vaccines, but that’s forward-looking, and we don’t know that to be the case yet. So maybe that explains their existential crisis over this, what I call a tempest in the teep.

Retsef, I want to get you to comment here as well, but just before, can you just explain why it’s a problem to be injecting even tiny, tiny amounts of mercury into people?

First, I just want to acknowledge that Robert and I are expressing our own opinions about that. There was actually a different opinion in the committee. And I think if I want to kind of represent that, I think that some people were concerned more about other areas outside the U.S., more maybe developing countries where the current state is not that 97% of the vaccines that are being administered are free of mercury. So this is nuanced.

I think that this is actually a great question because it’s really kind of a point where I think we need, when we consider risks, we need to really go beyond a single vaccine or a single episode of administering a vaccine. Because if you just think about a one-time vaccine, you could argue that the amount of mercury in a single dose of a single vaccine is probably small and you could argue potentially that it poses no significant risks.

The problem is that you don’t take one shot, you actually take a shot every year and moreover you are actually being exposed to mercury from other sources in your life, from food, from fish, from other sources. So when you want to consider risk here, you need to adopt a system-level kind of thinking and really think about not only this isolated episode, but rather than what is the overall contribution to the overall risk, to the overall exposure. And if you do that, I think it’s going to be sensible that given the fact that mercury is a highly toxic compound, nobody debates that, and it accumulates in the body. I think it’s going to be sensible, at least in my mind, to say that if we can control and eliminate some controllable sources of mercury, we should do that.

Speaking more broadly, and because you also asked about the efficacy of flu vaccines, I think it’s again an area where I think current evidence that we have is rather low quality. And again, we are thinking about this question only year by year. Like every year we’re trying to assess the efficacy of the vaccine in that year, which is important, but I don’t think it’s sufficient. And the issues that Robert alluded to of what is the long-term impact of using multiple doses every year are super important because at the end of the day, we are not managing one year, we are managing a horizon of years.

We really want to think about essentially the immune profile of the population. And to some extent, that immune profile is the shield for the most vulnerable people in our population, right? To some extent, the more resilient the immune profile of the population is, the less chance there is for the virus to hit the most vulnerable people. And it might be tempting to think that vaccinating everybody with the same vaccine every year is the best strategy, but I think there is actually quite a lot of evidence that suggests that that might not be the case. And I’m not sure that we have been thinking deeply enough about this to know or to figure out what the right answer is.

Now, the other thing that I would like to say, I think that in order to answer this question, like many other safety and efficacy questions, we cannot just look at observational data from the field. We also need to look at research that is conducted to understand the biological mechanisms that take place once we vaccinate people. I know that there are great concerns about potential radical changes that this committee would recommend to or would cause. And on the other hand, there is maybe an impatience by others that radical changes have to happen immediately.

My philosophy in life, and actually, I teach that when I teach in courses that I teach I usually tell people that if you want to change something the first thing that you need to do is to fully and very deeply understand why it’s set up the way it is so you have to take the time to understand before you make changes. We are going to be very, very thoughtful and thorough in first understanding why people make decisions the way they are now before we are going to recommend changes if and what changes we are going to recommend. I think it’s a very important aspect that may not make us popular, but I think we are all determined to be thorough and take the time to study and not to make rash decisions.

Can I pick up one of the threads that Retsef just introduced? We could call it immunotoxicity or immunotoxicology or fundamentals of immune responses to introduced antigen. One of the, so part of what happened during this recent ACIP meeting was we had an opportunity to gently query, and we were very diplomatic about it across the board. Even the Atlantic Monthly and their attacks on me acknowledged that I was very polite in my questions to the CDC staff. But we were able to directly query in a way that really has not been done in the past by the senior staff of the CDC that were presenting these data.

One of the questions I happened to have put forth, but Retsef could have, or anybody, was whether or not the CDC has metrics and processes in this. Track whether or not there are toxicities of the immune response or system. In other words, are they looking at the big picture of how people’s immune system is functioning and whether it’s being altered in a larger or broader way by these interventions?

What we learned was, no, they do not have that. That has not been part of their thinking. That is not part of their assessment or their analyses. So these issues that are being raised in the context of COVID, whether they’re true or false, having to do with immunoglobulin class switching, which sounds like a big mouthful of immunobabble, but it’s pretty important in terms of how healthy you are and how you’re able to resist new pathogens and whether or not you’re more likely to develop allergic responses, for example.

I’m going to introduce a controversial topic that we didn’t talk about during the ACIP, but there are some that suggest that the COVID products are causing various types of damage to the immune response that’s leading to a susceptibility to one of the most common immunologically controlled diseases that we’re all familiar with, which is cancer. And so the question came up, and I asked it very gently, whether the ACIP is tracking these issues, whether they have the data to support or refute these hypotheses. And the answer is no, they don’t.

I hope that we, as the ACIP going forward, you know, frankly, my impression is that a lot of the thinking at the CDC in terms of these monitoring and analyses routines that they get into are a bit antiquated. They’re kind of old school, to start incorporating in their analyses newer frontline concepts about immune response. Now, this leads to another core topic that I think we encountered in our patient questioning and to issues concerning the CDC, public health, FDA, and the NIA.

Important topics get lost in that chasm. If I had a general recommendation to give at this point to the secretary of HHS, it’s that it would be in the interest of the American public to find ways to bridge these gaps between these different HHS agencies so that key issues don’t fall into the cracks in between agencies, because I suspect that’s happening.

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Behind the Curtain of the New CDC Panel on Vaccines: Dr. Robert Malone and Retsef Levi