EVERY SPOKEN WORD
150 min read · 30,080 words- 0:07 – 1:41
Why Hotez is back: tropical-disease vaccine maker pulled into the autism/vaccine fight
- JRJoe Rogan
And we're live. How are you, sir?
- PHPeter Hotez
How are you?
- JRJoe Rogan
Good to see you again.
- PHPeter Hotez
I'm thrilled to be here. Thanks for-
- JRJoe Rogan
Thanks for doing this, man.
- PHPeter Hotez
... thanks for having me.
- JRJoe Rogan
I... No, I should tell people before we get started, I did not know when I asked you to come back on that you were heavily involved in this whole vaccine debate. What I wanted to have you on to talk about is tropical diseases, because, uh, I remember when we did that sci-fi show, um, you explained to me that some ungodly percentage of people that live in tropical climates are infected by parasites.
- PHPeter Hotez
That's right. Well, my day job is developing vaccines for tropical diseases. We develop the vaccines no one else will make because, uh, they're for the world's poorest people. So we call them tropical diseases, but they really are diseases of poverty. The vaccine issue, the ad- the advocacy issue around vaccines and autism is kind of a new thing that I got drawn into just because I'm a, a parent of an adult daughter with autism and I make vaccines, so it was a natural that I'd get drawn into it.
- JRJoe Rogan
Yeah, so when I said that you were gonna come on, then I got inundated by people that are... You know, the- the vaccine thing is such a polarizing issue.
- PHPeter Hotez
Yeah, it's awful. Yeah.
- JRJoe Rogan
And, uh, so many people seem to think they absolutely know what causes what, especially when it comes to something like autism, which is a, it's a huge issue in this country, it's a huge issue around the world, and it doesn't, didn't used to seem to be. The question is, was that because it was undiagnosed? Was that because i- it just, there's m- it's more prevalent today?
- PHPeter Hotez
Yeah.
- JRJoe Rogan
What do you think? What is your take on this?
- 1:41 – 6:19
Autism definitions, diagnosis limits, and the neurodiversity tension
- PHPeter Hotez
Well, I don't think we really know. Um, one thing's for sure, we're diagnosing people with autism who we diagnose wi- as something else in the past, you know, whether it was, you know, really horrible diagnoses, we'd use pejorative terms like mental retardation-
- JRJoe Rogan
What's the matter, Jamie? Sorry. I, my bad. Just telling you the clock was off. Oh, okay. Sorry. Sorry.
- PHPeter Hotez
Should we start again?
- JRJoe Rogan
No, no, no, it's okay. He was just saying-
- PHPeter Hotez
(laughs)
- JRJoe Rogan
... he was just telling me that the, our clock is screwed up because of the daylight savings time thing.
- PHPeter Hotez
Oh, right, right.
- JRJoe Rogan
Sorry. And totally unrelated to what you were saying.
- PHPeter Hotez
The whole country's clock is screwed up because of daylight savings time.
- JRJoe Rogan
Yeah, yeah.
- PHPeter Hotez
Right.
- JRJoe Rogan
Um, so, so we don't know. We don't-
- PHPeter Hotez
Well, you know, o- one thing's clear, that the number of diagnoses is going up, but part of that is because what we used to call pejorative things like mental retardation now get thrown into the autism category. The other thing now-
- JRJoe Rogan
They do?
- PHPeter Hotez
... absolutely. You know what I mean?
- JRJoe Rogan
How so?
- PHPeter Hotez
Well, you know, now we call it as part of the autism spectrum. Um, we also, because autism often has a lot of associated intellectual disabilities, not always, but sometimes. Uh, the other is that, um-
- JRJoe Rogan
Can I pause there for a second?
- PHPeter Hotez
Yeah, sure.
- JRJoe Rogan
Is that based on, uh, apt- aptitude tests? Like, how do you, how do they decide?
- PHPeter Hotez
How do they decide what's autism?
- JRJoe Rogan
Yes.
- PHPeter Hotez
They, they have a list of diagnostic, uh, categories, criteria.
- JRJoe Rogan
But it's not based... It's not like you could test someone if they test positive for a disease?
- PHPeter Hotez
That's right. That's right. Well, although it... You know, one of the interesting side pieces to this is, you know, w- the, there's a group of, in people out there who self-identify themselves as the autistics and they get very resentful or hurt when they're called a disease or a disorder. The, and, because they say, "Well, we're not an epidemic, we're, we're a person," and they, it's part of this whole neurodiversity movement, which is quite interesting.
- JRJoe Rogan
Neurodiversity movement.
- PHPeter Hotez
Right. They say they're neurodiverse, that they, you know, maybe think differently from others and they respond differently than others, but they're not, quote, "abnormal" and, and I think they have a good argument.
- JRJoe Rogan
Hmm. Um, I heard a crazy argument once with someone that was-
- PHPeter Hotez
So, so the, so the point is that it's, you know, the, the impairment, like Rachel, my daughter, it's not so much her autism that, uh, uh, thwarts her, you know, ability to have partners or to, uh, have a meaningful career. It's the fact that she has profound, in, in her case, profound intellectual disability that goes along with it.
- JRJoe Rogan
Um... I forget what I was gonna say. The, so when, when they say that people have a s- there, there's a spectrum, right? And some people who are autistic have in- incredible abilities.
- 6:19 – 7:24
Genetics and early brain development: why vaccines don’t fit autism timing
- JRJoe Rogan
Right. Now, if we don't know what causes autism, how-
- PHPeter Hotez
Well, we do.
- JRJoe Rogan
We do?
- PHPeter Hotez
Well, we're getting there very closely. So we've now ... There was a very important paper produced by, uh, written by a group at the Broad Institute at Harvard and MIT, which is one of the premier genetics genomics organizations in the country, and they've now identified 99 genes. It's a, it's a huge team of scientists, not only at the Broad, including p- scientists at Baylor College of Medicine. 99 genes involved in autism, uh, all involved in early fetal development, uh, early brain development, uh, in the first and second trimester of pregnancy. So now, we're starting to really get our arms around what autism is. And that's one of the things I talk about in the book. I mean, we, we have learned so much in the last couple of years about autism, how it begins early fetal development, well before kids ever see vaccines, and that's one of the reasons I say vaccines did not cause Rachel's autism. Vaccines don't cause autism, because autism was already underway in early, uh, early brain development.
- 7:24 – 9:40
MRI prediction, whole-exome sequencing, and separating coincidence from causation
- JRJoe Rogan
Is it possible that some people have this tendency towards autism and it's exacerbated by vaccines?
- PHPeter Hotez
I don't think so. Um, I think what, what happens is the sequence of events happens, uh, during pregnancy, but the full clinical expression of autism often doesn't happen until 18 or 19 months of age. Like Rachel, for instance, wasn't actually diagnosed till 19 months of age. And there's some fe- fabulous studies now showing that that clinical expression of autism actually coincides with a big increase in the ex- in the volume of the brain. You can actually show on serial magnet- magnetic resonance imaging, serial MRI, how the brain starts to, the brain volume starts to increase. And that's very important, because parents, uh, will often remember, "Oh, my kid got vaccinated around 18 months of age or, or 15 months of age," and want to link the two. But now you can go back to six months of age, and this is studies done at the University of North Carolina Chapel Hill showing so that you can do an MRI at six months of age and they can predict now with, they say, with 90% accuracy which of the kids will go on to develop autism. And then you can take it-
- JRJoe Rogan
What are they seeing?
- PHPeter Hotez
What?
- JRJoe Rogan
What are they seeing?
- PHPeter Hotez
Um, y- y- they can see s- Uh, I have, you have to go... We can go into detail in the paper, but they can see certain things on signatures on MRI that tell them that this kid is gonna go on to, uh, develop autism.
- JRJoe Rogan
Okay, so in fact there is a way to test positive for autism then-
- PHPeter Hotez
Mm-hmm.
- JRJoe Rogan
... with this serial MRI?
- PHPeter Hotez
That's what they think, right.
- JRJoe Rogan
That's what they think?
- PHPeter Hotez
And, and now we have the 99 genes, so we can even take it back further by doing what's called whole exome sequencing, sequencing all the DNA, all the expressed DNA, uh, of an individual. And in Rachel's case, we did that, and we actually found a mutation in, in a gene controlling, uh, neuronal connections, which makes a lot of sense if you think about what autism is.
- JRJoe Rogan
Mm-hmm. Yeah, of course. So, so there is a way to, to show whether children will be more likely to develop autism, and there's a... either... there is a way to s- to look at their brain through fMRI at a very early age?
- PHPeter Hotez
And, and also do the g- and also do genetic sequencing.
- JRJoe Rogan
So it's not simply a matter of how they perform on cognitive tests?
- PHPeter Hotez
That's right. That's right. We're getting much better at getting our arms around the diagnosis.
- 9:40 – 14:22
MMR stories vs population data: epidemiology, risk, and what “severe adverse event” means
- JRJoe Rogan
Why do you think there's so many people that have these anecdotal stories of their child getting vaccinated, especially large doses of vaccines when they hit them with like 10 in a row, and then all of a sudden... or measles, measles, mumps, and rubella is the one that gets repeated over and over again. "That's the one that made my child have autism." I've heard that so many times, and I've heard it from friends, from friends that have children that have autism. They had a child. Their child got the measles, mumps, and rubella shot, and then immediately there was a very distinct change in the child's behavior.
- PHPeter Hotez
Well, no question when you get the measles, mumps, rubella vaccine, many times kids cry and, and things like that. And then autism will then begin sometime between the first and second year of life. So it's logical to want to connect the two, but now we know it's not even plausible, because we know that if you go back to that MRI at six months of age, or go back prenatally, we can even, uh, determine which kids are gonna go on to develop autism.
- JRJoe Rogan
So even though this vaccine-
- PHPeter Hotez
And, and, and, and then, and then complementing it, complementing it are massive epidemiologic studies done on over one million kids that... In fact, a new paper was just released this week showing that, um, kids who get the MR- get the MMR vaccine are no more likely to get autism than kids who don't, who don't get the MMR vaccine. And the con- converse is also true. Kids on the autism spectrum are no more li- likely to have gotten the MMR vaccine than kids not on the autism spectrum.
- JRJoe Rogan
Okay. So-
- PHPeter Hotez
So, so it's the combination of that, those big studies of over one million kids, together with knowing what autism is, that completely rules out the possibility.
- JRJoe Rogan
Right, so these genes... (clears throat) Excuse me. And the, and the issue with these genes, and then the ability to scan the brain with the serial MRI, and the... so you can tell which children have the propensity. Is it possible that children have all these issues and then do not get autism, or do 100% of those children with those issues get autism?
- PHPeter Hotez
That's a good question. Uh, I don't know. I'm a vaccine scientist, so I'm, you know, the, the-
- JRJoe Rogan
You're not a biologist?
- PHPeter Hotez
... the re- well, well, I'm a biologist, but I'm a vaccine scientist who, who's really tried to do a deep dive in autism doing research on the book.
- JRJoe Rogan
Versus human development?
- PHPeter Hotez
Right, right.
- JRJoe Rogan
Right. Okay, so, uh, so what you're saying, though, is that if a child does not have these mutations and does not have these issues that are present in, uh, during serial MRI, that they will not go on to develop autism, is that true?
- PHPeter Hotez
As far as we can tell, yeah.
- JRJoe Rogan
As far as we can tell.
- PHPeter Hotez
Yeah.
- JRJoe Rogan
So children without those issues who get vaccinated have z- have no problems, which most children have no problems.
- PHPeter Hotez
Right. Yeah, I mean the, you know, we've learned a lot about the, the risk of vaccines and, um, them numbers are extraordinary. I mean, the risk of a severe adverse event happening after getting a vaccine is roughly on the order of one in a million between- between one in a million and one in 10 million. Um, so and I found an internet report once that the li- likelihood of getting struck by lightning is one in 700,000 so it's, you know, the likelihood-
- JRJoe Rogan
Right.
- PHPeter Hotez
... of having a severe event after a vaccine is your bet- odds are better, uh, of getting struck by lightning than-
- JRJoe Rogan
And when you say severe event, what do you mean by severe event though?
- PHPeter Hotez
Oh well, the, there's actually a table that's put out, uh, by the National Vaccine, uh, Compensation Act, um, that includes, um, uh, shoulder injury, uh, that's one, uh, encephalitis, encephalomyelitis-
- JRJoe Rogan
Shoulder injury?
- PHPeter Hotez
Yeah, that's actually on the list.
- JRJoe Rogan
From the actual injection point?
- PHPeter Hotez
Yeah, put getting injecting it in the wrong place.
- JRJoe Rogan
Oh. So it goes into the joint or something like that?
- PHPeter Hotez
Yeah, yeah.
- JRJoe Rogan
Yeah. Is that common?
- PHPeter Hotez
No.
- 14:22 – 19:41
The ‘vaccine whack-a-mole’ cycle and how online misinformation dominates
- PHPeter Hotez
We know, um, studies in over one million children that there's no link between vaccines and autism. That's number one. And, and so let me parse this-
- JRJoe Rogan
How do they do that?
- PHPeter Hotez
Let me, let me parse this out-
- JRJoe Rogan
Okay.
- PHPeter Hotez
... in two, in two bits.
- JRJoe Rogan
(coughs)
- PHPeter Hotez
So there's, there's the studies in over one million children showing that vaccines do not cause autism. That's part one. The second part-
- JRJoe Rogan
Is it an epidemiology study?
- PHPeter Hotez
And then I'll, and then I'll do, and then I'll do a deeper dive on each of them. The second part shows not only is there massive evidence that there's no link between vaccines and autism, there's no plausibility because we know so much about autism, how it begins in pregnancy.
- JRJoe Rogan
Okay.
- PHPeter Hotez
So let's go back to the first part. The first part is studies in over one million children. One of the things that the anti-vaccine lobby does is they play this game of what I ... well, it's not really a game, but what, what they ca- what they do is play this kind of, uh, thing of vaccine whack-a-mole because at first they alleged it was the MMR vaccine and that came out, out of the study that was published in The Lancet in 1998. Then another group came along and said, "No, no, no, we didn't mean the MMR vaccine, we meant the thimerosal preservative that used to be in vaccine." And the scientific community not only demo- debunked the MMR link, they debunked the thimerosal link. Then the anti-vaccine lobby came along and said, "No, no, we didn't mean that. We're spacing vaccines too close together." Then they changed it around again-
- JRJoe Rogan
Mm-hmm.
- PHPeter Hotez
... uh, saying now it's the alum or aluminum in vaccines. So the, and then each time the scientific community responds with massive epidemiologic studies showing just absolutely none of those things are true.
- JRJoe Rogan
And do you think that it's just when you look at, say, if there's one in a million that has an issue with this and there's-
- PHPeter Hotez
And it's not autism, by the way.
- JRJoe Rogan
So whatev- whatever those i- issues are, that they hear these stories and these stories do accumulate because there's 300-plus million people in this country and over 10, 20 years of one in a million you develop a significant history of cases where children did have issues with vaccines. So these people hear about these stories and people are terrified. Obviously you're ... I have children. You become very overprotective of your children. You worry a lot.
- PHPeter Hotez
Right, right.
- JRJoe Rogan
And then you also don't know, like why do they get so many shots all in a row like that? Why does a baby get 10 shots in a day? That seems crazy.
- PHPeter Hotez
Well, they don't get 10 shots in a day. Most of the vac-
- JRJoe Rogan
Ever?
- PHPeter Hotez
Most of the vaccines are now combined. So for instance, in one vaccine, we can vaccinate against diphtheria, pertussis, tetanus, um, polio, uh, haemophilus influenza type B, which is a terrible cause of, of meningitis and in some cases now even hepatitis. So one shot is protecting-
- JRJoe Rogan
So they just give like soup of all these things?
- PHPeter Hotez
Well, it's combined.
- JRJoe Rogan
Right.
- PHPeter Hotez
And there's all sorts of studies showing that it's safe to combine them and, and it's fantastic. Now you can vaccinate with one shot against six diseases. And these-
- JRJoe Rogan
So-
- PHPeter Hotez
... are life-threatening diseases.
- JRJoe Rogan
Right. So the only concern is the child's immune system when they're bombarded with this one ... So a lot of times it causes them-
- PHPeter Hotez
Does-
- JRJoe Rogan
... to be tired or they get sick or they don't feel very good.
- 19:41 – 24:52
Motivations behind anti-vaccine activism: money, bots, and harmful ‘autism cures’
- JRJoe Rogan
Why do you think that exists? Why do you think there is this major media empire that's against vaccines?
- PHPeter Hotez
That's a great question. What's the motiv- ... What's the motivation-
- JRJoe Rogan
Yes.
- PHPeter Hotez
... number one? And number two, where's the money coming from?
- JRJoe Rogan
Right.
- PHPeter Hotez
Right? There's real money behind this, millions of dollars behind this to put out phony documentaries and phony books.
- JRJoe Rogan
What's a good phony documentary to point to?
- PHPeter Hotez
Well, I'm a little reluctant to do it, say it because they're so litigious.
- JRJoe Rogan
Okay.
- PHPeter Hotez
And, and, uh, and, you know, I, I don't have the means to defend the lawsuit and things-
- JRJoe Rogan
Right.
- PHPeter Hotez
... like that. So ... But-
- JRJoe Rogan
So-
- PHPeter Hotez
... but they're out there.
- JRJoe Rogan
... these, um, documentaries-
- PHPeter Hotez
That's why I, I usually don't name specific names-
- JRJoe Rogan
Sure.
- PHPeter Hotez
... or-
- JRJoe Rogan
I understand.
- PHPeter Hotez
Yeah.
- JRJoe Rogan
These documentaries, what do you think their motivation is? Did, do, do you think they, they earnestly believe that vaccines do cause harm or vaccines do cause-
- PHPeter Hotez
I, I, I don't, I don't-
- JRJoe Rogan
... diseases or, excuse me, uh, autism?
- PHPeter Hotez
I don't know. I mean, is there some kind of other agenda that they have? I mean, we do know in some cases that, um, the, uh, some elements of the anti-vaccine lobby are promoting phony autism therapies, right? They're doing terrible things like this thing called MMS, which are bleach enemas.
- JRJoe Rogan
What?
- PHPeter Hotez
Yeah, bleach, giving bleach enemas to kids. You can Google it.
- JRJoe Rogan
To children?
- PHPeter Hotez
To children.
- JRJoe Rogan
Bleach? Why bleach?
- PHPeter Hotez
Uh, because they're cleansing the immune system.
- 24:52 – 42:32
Policy, free speech, and the debate question—plus measles’ real-world costs
- JRJoe Rogan
So what do you think should be done? Should there be a- a- a- a pro-vaccine documentary that makes sense?
- PHPeter Hotez
I- I- thank- thanks for that question. I think there's three things that need to be done. I think, first of all, some of this anti-vaccine media empire needs to be dismantled.
- JRJoe Rogan
Dismantled?
- PHPeter Hotez
Dismantled. And- and then again, I- and-
- JRJoe Rogan
But who's to say whether they're wrong or right? Like shouldn't ... I mean, it seems like there should be some sort of a debate, right? Like if there's someone who's saying that there's some evidence of vaccines cause debates, you're saying there's no evidence of vaccines cause debate ... uh, uh, b- no, excuse me, that vaccines cause autism, and you're saying there's no evidence that vaccines cause autism. There should be a debate where there's some sort of a- a- a- a- like some sort of a monitored conversation where you can have you versus someone else and break this down.
- PHPeter Hotez
Yeah, but that- that has ... That's a two-edged sword too, because, you know, then it gives some false legitimacy to the anti-vaccine side. It's like debating, "Does smoking cause cancer?"
- JRJoe Rogan
Yeah, but doesn't-
- PHPeter Hotez
Right. I mean, I- I mean, uh-
- JRJoe Rogan
Isn't there already a problem? I mean, it seems like if there's this many ... If you do a Google search and you're just overwhelmed-
- PHPeter Hotez
Right.
- JRJoe Rogan
... with anti-vac ... It seems like the- the fight has already been lost, if that's the case.
- PHPeter Hotez
That's right. Yeah.
- JRJoe Rogan
So giving them legitimacy ... It's like, it's not necessarily giving them a legitimacy, it's giving them, e- you g- you rather, a forum to dismiss their legitimacy.
- PHPeter Hotez
Yeah, I mean, I think, you know, part of what has to be done is ... I mean, it's ... And- and this gets into all sorts of First Amendment issues, and I'm not a lawyer-
- JRJoe Rogan
Mm-hmm.
- PHPeter Hotez
... uh, but, you know, the- the idea that Amazon now is putting out all of these phony books and- and phony documentaries, that could, that-
- JRJoe Rogan
Well, they're just a distributor, right?
- PHPeter Hotez
Yeah.
- JRJoe Rogan
I mean, they- they don't have to go over every book that they sell with a fine-tooth comb.
- PHPeter Hotez
Well, but maybe they should. I mean, not-
- JRJoe Rogan
I-
- PHPeter Hotez
... a fine-tooth comb, but maybe there should be some screening. Maybe Amazon, maybe Facebook should all be hiring chief scientific officers to, you know, putting some stops on the dissemination of- of information, because it's harming children.
- JRJoe Rogan
Right. I understand.
- PHPeter Hotez
I mean- I mean this is ... The reason I get passionate about it, um, the reason I actually wrote the book is- is kind of interesting. I ... It actually happened before all of these big measles outbreaks that we've been having.
- JRJoe Rogan
Yeah.
- PHPeter Hotez
Um, I noticed that in Texas there was ... Where I ... Uh, my laboratory is at Texas Children's Hospital in Baylor College of Medicine. We noticed that there was this steep increase in the number of kids whose parents were opting them out of getting vaccinated, to the point where, in Texas, we have over six- almost 60,000 kids not getting their vaccines in the state of Texas, and those are the ones we know about. We don't know anything about the 325,000 homeschooled kids. So we probably have over 100,000 kids not getting vaccinated, all because of this misinformation campaign.
- JRJoe Rogan
Hmm.
- PHPeter Hotez
And I was really troubled by the fact that there was no response to it, and that was- drove me to write the book. So the point is now Texas is very vulnerable to measles outbreaks. And I say measles more than the others 'cause that's the most highly contagious disease, uh, that we know.
- JRJoe Rogan
What are the ... What's the danger of a child getting measles?
- PHPeter Hotez
So we-
- 42:32 – 59:13
Flu shots, shingles vaccine, and a detour into health habits (diet, exercise, vitamins)
- JRJoe Rogan
Ta- I mean, th- besides measles, uh, what other diseases are more prevalent now because of people not vaccinating their kids?
- PHPeter Hotez
The ones that ... There's three diseases that I worry about the most. Actually four. Well, whooping cough is another one, so that, that's one.
- JRJoe Rogan
Mm-hmm.
- PHPeter Hotez
But the other one I worried about is the flu vaccine. Kids aren't getting their flu vaccine. Last year in the 2018 flu epidemic, 150 unvaccinated kids died of influenza despite the recommendation of vaccinating against flu.
- JRJoe Rogan
Can you enlighten me on this? Because what I've been told is that sometimes they get the flu vaccine wrong, so you can get vaccinated but it doesn't ... it doesn't protect you for the strain of flu that everybody's getting.
- PHPeter Hotez
Well, so that's again something that was heavil- an idea that was heavily pushed by the anti-vaccine lobby. Here's the story. Uh, l- you're right. Last ... partially right. Last year, the, there was not a p-... perfect match between the, between the v- the virus and the vaccine, the killed virus in the vaccine and the wild type flu strain that was out there. But it was good enough to prevent you from dying, and it was good enough t- to, would likely prevent you from being hospitalized. So-
- JRJoe Rogan
So it would have an effect even if you did get the flu?
- PHPeter Hotez
That's right, 'cause there was enough cross-protection so that it would, it would mitigate the symptoms. And-
- JRJoe Rogan
That's confusing to people because if they have the flu, they say, "Oh, well, then it didn't work."
- PHPeter Hotez
That's right, but it did, because it prevented you from getting sick and dying. And, and again, that was, that was a message that never really got out in 2018.
- JRJoe Rogan
Okay, but let's talk about someone like me-
- PHPeter Hotez
Mm-hmm.
- JRJoe Rogan
... who's a healthy person. I've had the flu before, um, but I don't usually get a flu shot.
- PHPeter Hotez
That's crazy. You should.
- JRJoe Rogan
Why is that? Why is that crazy?
- PHPeter Hotez
Especially now, es- especially now as you're getting older.
- JRJoe Rogan
Why is that?
- PHPeter Hotez
Um, because flu is, uh, one of the leading, is probably the single leading infectious disease killer of, of, of adults in the United States. It-
- JRJoe Rogan
But every time I've had it, it's really been like, just a couple of days out, I rest, I-
- PHPeter Hotez
Well, you got, y- you-
- JRJoe Rogan
... I drink a lot of fluids.
- PHPeter Hotez
... you got lucky, my friend. So, yeah, yeah-
- JRJoe Rogan
Is that what it is? Is it luck or-
- PHPeter Hotez
Yeah.
- JRJoe Rogan
... is it health?
- PHPeter Hotez
Well, you know-
- JRJoe Rogan
Taking care of yourself?
- PHPeter Hotez
Eh, well sure, taking care-
- JRJoe Rogan
Maintaining your immune system?
- PHPeter Hotez
I mean, let's, so if you look at the, uh, 80,000 adults who died in the influenza epidemic of 2018 in the United States, you're right, a lot of them had underlying, um, uh, things like diabetes or, or, or non-communicable, you know, cardiovascular disease or underlying respiratory disease.
- 59:13 – 1:13:49
Back to Rogan’s original interest: parasites as the hidden mass burden of the tropics
- JRJoe Rogan
So this brings me to the thing that, uh, I wanted to talk to you about in the first place, 'cause this is what you brought up to me, um, when we were doing this, uh, sci-fi show. And, uh, you, you said something to me that has been haunting me ever since, that the vast majority of people that live in tropical climates have parasites.
- PHPeter Hotez
Mm-hmm.
- JRJoe Rogan
Vast majority.
- PHPeter Hotez
That's the ... Yeah. That's right.
- JRJoe Rogan
That-
- PHPeter Hotez
That's right.
- JRJoe Rogan
There's things like Toxoplasma gondii and-
- PHPeter Hotez
So let's look at the, let's look at the hit parade, right? The top one is one called ascariasis, intestinal roundworm. Uh, the estimates are around 800 million people have ascaris roundworms in their bellies.
- JRJoe Rogan
Whoa!
- PHPeter Hotez
So-
- JRJoe Rogan
800 million.
- PHPeter Hotez
So, so more than one in 10 people on the planet, mostly people who live in extreme poverty. Um, 400 million have hookworm infection, 400 million have whipworms. And a lot of these are wormy diseases. 200 million people with scabies, which is an ectoparasite on, on the skin that causes terrible itching and, and secondary bacterial infections. Schistosomiasis is another one. The point is, every ... Almost every single person who is in extreme poverty has one of these, what I call, neglected tropical diseases. And one of the interesting features about them is they're very debilitating. They not ... So they not only occur in the setting of poverty, but I think they reinforce poverty 'cause they make people too sick to go to work.
- JRJoe Rogan
Yes.
- PHPeter Hotez
They make, uh ... They actually sha- We can show they shave IQ points off of kids when they have them, uh-
- JRJoe Rogan
Well, this is the hookworm connection to-
- PHPeter Hotez
Right.
- JRJoe Rogan
... the idea of the slack-jawed, dumb southerner, right?
- PHPeter Hotez
Right, right, right.
- JRJoe Rogan
In the United States of America.
- PHPeter Hotez
Right, right. And now one of the things that we have found ... So Rogelio Mejia on my faculty, uh, working with an environmental activist named Catherine Coleman Flowers in Alabama found that hookworm is still present in Alabama.
- JRJoe Rogan
Mm-hmm.
- PHPeter Hotez
It's among the poor, among the poor.
- JRJoe Rogan
Explain that to people so they, they understand what we're talking about because for the longest time, there was this stereotype about people that lived in the South, that they were dull minded-
- PHPeter Hotez
Right.
- JRJoe Rogan
... and that this could be di- directly connected-... to hookworm infection, which had run rampant.
- PHPeter Hotez
Right. There was even the term given called, they called it the germ of laziness-
- JRJoe Rogan
Mm.
- PHPeter Hotez
That, that hookworm infection, because it causes severe anemia. So if you're walking around with terrible anemia, of course, you're, you're too... You're not feeling up to working a full day and, and all that sort of stuff.
- JRJoe Rogan
Right.
- PHPeter Hotez
So hookworm was widely president- present in the Southeastern United States at the turn of the 20th century. And then as malaria went down with economic development, so, so did hookworm infection as well. But we still have pockets in this country.
- 1:12:39 – 1:47:19
Why vaccines for these diseases lag: market failures, CEPI limits, and a public-funding model
- JRJoe Rogan
So, um, there's no, no, no, um, vaccine for toxoplasmosis. Is there anything on the horizon? Is there anything being worked on? Because that's a big one, right?
- PHPeter Hotez
It, it's a real big problem among people with HIV AIDS, for instance. That's, uh, because it reactivates your toxoplasmosis and we even see it in, I even see it in kids sometimes, but the thinking is it-
- JRJoe Rogan
Reac- reactivates it? How so?
- PHPeter Hotez
Well, what happens is, um, uh, it's ... In some countries, up to 30% of people are actually infected with toxoplasma.And the parasite has the ability to undergo a dormancy state in the body until your immune system gets compromised, either because of AIDS or because if you get some kind of, uh, medicine that suppresses your immune system, and then it can reactivate it and cause what's called cerebral toxoplasmosis, which is quite serious. So most people handle their toxoplasmosis very well. You know, you, you, you die with it and don't even know you have it, but in some cases it gets reactivated. Right now, um, there doesn't seem to be a lot of incentive for developing a toxoplasmosis vaccine, although I'd be very interested to, to work on something like that.
Episode duration: 1:51:11
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Transcript of episode dodsGp37M50
