LEVI: Hi. This is Levi (ph) in Hangzhou, China. I just finally bought tickets for “Ne Zha 2,” the new record holder for the highest-grossing movie of all time in China. This podcast was recorded at…
SUSAN DAVIS, HOST:
12:23 p.m. on Monday, March 10.
LEVI: Things may have changed by the time you hear it, but I will probably still be searching all the Chinese I didn’t understand in this two-hour, 20-minute movie everyone in China is talking about. OK, here’s the show.
(SOUNDBITE OF THE BIGTOP ORCHESTRA’S “TEETER BOARD: FOLIES BERGERE (MARCH AND TWO-STEP)”)
DAVIS: Well, now I know what I’m Googling after this podcast is over.
DOMENICO MONTANARO, BYLINE: My son was telling me about this movie and the push, actually, in China to make it the most seen movie of all time. There’s a whole PR thing behind that, too. It’s really interesting.
DAVIS: No, that’s fascinating.
Hey there. It’s the NPR POLITICS PODCAST. I’m Susan Davis. I cover politics.
MONTANARO: I’m Domenico Montanaro, senior political editor and correspondent.
DAVIS: And NPR’s health correspondent Maria Godoy joins us today. Hi, Maria.
MARIA GODOY, BYLINE: Hi. How are you?
DAVIS: I’m good. And this is, we should note, your very first time on the POLITICS PODCAST, and we are so happy to have you today…
MONTANARO: Woo.
DAVIS: …Because today we’re going to talk about measles and how the nation is responding to an ongoing outbreak in West Texas as new cases pop up across the country. Maria, you are health and science expert. Let’s start with a little bit of 101. Can you just explain what exactly measles is and how infectious it is?
GODOY: Yeah. So measles is probably one of the most contagious diseases known to mankind. It’s more contagious than Ebola, polio, chicken pox, you know, just about anything you can think of. The way I’d like to explain it is, like, when you think of how contagious a disease is, like, in a vacuum where nobody is vaccinated, for every person who’s sick with measles, they would go, on average, to infect 18 other people.
DAVIS: Wow.
GODOY: And for context, the original strain of the coronavirus, you know, circa 2020 – for every person that was infected with that, roughly they went on to infect roughly three others, and we all saw how that went. So that gives you a, like, perspective on how, you know, in the wild, measles – when I say in the wild, I mean in an unvaccinated universe – how infectious it can be.
DAVIS: And how exactly does measles spread?
GODOY: So it’s an airborne virus, and basically, you know, coughing or droplets, etc. When you emit those infectious particles, they can hang in the air for up to two hours. And that means, like, if someone is infected with measles, they cough, they leave the room. You come in two hours later and you’re not vaccinated, you could catch measles. And the other thing is that you can actually be infectious with measles for four days before you get that telltale red rash from measles – and up to four days after. So you could be going around spreading measles without knowing that you’re infected.
DAVIS: OK. So there has been this outbreak in West Texas. How many people have been impacted in this community?
GODOY: Well, so all told, in West Texas, you know, it’s in several counties – the epicenter is Gaines County – yeah, it’s, like, around 130 cases. But in Texas total, there’s about 198 cases. And, you know, right over the border in New Mexico, we just had a death in an unvaccinated adult last week. That’s the second death in this outbreak. The first one was an unvaccinated child in Texas.
DAVIS: I guess one thing I’m curious about here is perspective because it’s not the first time there has been a measles outbreak in the country. Put this in that context. Why is it happening now? Is it typical, cyclical, or is something really deviating from the norm?
GODOY: We shouldn’t be seeing this. The last big outbreak we had in the U.S. was in, like, 2018, 2019, in New York, and that was in an Orthodox Jewish community that was targeted by anti-vaccine messaging for years. We saw about 649 cases in that outbreak. But to put it in perspective, in this outbreak, we’ve seen the first two deaths in the U.S. since 2015. That was the last reported death from measles in the U.S. In the early 2000s, the U.S. declared measles eliminated, which doesn’t mean eradicated. It means we’re not seeing ongoing transmission for a year. So that was a big win. To be seeing, you know, sizable outbreaks, what’s really changed is that we’re seeing vaccination rates drop, and that’s been happening for years, but it’s a trend that accelerated during the COVID pandemic.
DAVIS: Yeah. I mean, Domenico, books can be written about the ways in which the pandemic has left a lasting effect on American culture and society and politics, but it certainly seems like heightened vaccine hesitation is one of those problems.
MONTANARO: It absolutely is. And, you know, NIH kind of looked into this – National Institutes of Health – a little bit on the public opinion side on this. And, you know, Maria mentioned in one of the religious communities. In some religious communities, it’s as low as 12% of people who are vaccinated. And you could go higher than 90% among medical center employees or health care workers. Hesitancy, they found, was worse among younger adults, those with lower education, lower income. You know, so financial insecurity, they said, and limited access to reliable health information, and those who believe in alternative forms of immunity or different kinds of treatments were also less likely to want to be vaccinated. And there’s always been vaccine hesitancy, but it really spread during the pandemic, and we’re seeing the effects of this now with all kinds of vaccines. And it’s really troubling when you have something like measles, which can spread so quickly.
GODOY: You know, I cover children’s health – is one of the topics I cover, and I’ve been talking to pediatricians for, you know, the last year who’ve been worried about these trends you’re seeing. And it really was something that’s been happening for years, but it accelerated during COVID because the – we saw how much the COVID vaccine was politicized. It was almost like a political litmus test – right? – if you got the vaccine or not, for a lot of people. And that sort of hesitancy about the COVID vaccine, pediatricians say, has, like, spilled over into general vaccine hesitancy among, like, the regularly scheduled immunizations the kids have. And so we’ve seen, nationally, vaccination rates dropping slowly, and in some places, they’re really low.
MONTANARO: And it can be really dangerous when you have public officials then giving mixed messages about this.
DAVIS: Yeah. Maria, I wanted to ask you about that because, obviously, this is now happening at a time when President Trump is in office, Health and Human Services Secretary Robert F. Kennedy Jr. These are two men that have, I would say, at a minimum been tolerant of vaccine-skeptical views. RFK Jr. has a well-documented history of sort of giving credence to some of those views. So how is the administration responding in real time to this latest public health crisis?
GODOY: RFK Jr. made headlines last week because he published an editorial in Fox News that was later posted on the Health and Human Services website in which he was addressing this measles outbreak. And he did say that vaccines were an important tool. You know, he said that people who are unvaccinated are more vulnerable to measles. But he didn’t outright say, go get vaccinated. He called vaccination a personal choice, and he said people should be given all the facts on vaccines. And he did say that the best defense against chronic disease and infectious disease is good nutrition, which is interesting because the public health message, historically, when you’re talking about measles specifically is the best defense against measles is vaccination.
The other thing that was interesting is in comments both in that editorial and later in an interview with Fox News, Kennedy basically spent a lot of time talking about the role of things like vitamin A to treat measles. And vitamin A does have a role in measles prevention. There are studies done in lower- and middle-income countries that show when you have kids who have vitamin deficiencies and vitamin A deficiencies and you give them vitamin A, it does help reduce the risk of death and severe disease. There is some evidence that even in the absence of vitamin A deficiency, measles seems to deplete your vitamin A stores. So the World Health Organization and the American Academy of Pediatrics both, you know, do recommend vitamin A supplementation for kids with measles. But that’s not the same as preventing measles, and it’s very important to say that vitamin A can absolutely not prevent measles. And the concern is that some parents may be giving their kids vitamin A routinely, long-term, to help, you know, protect against measles, which, of course, it can’t. But that could actually do damage because vitamin A builds up in the body, and it can be toxic to the liver.
DAVIS: OK. We need to take a quick break, but more on this when we get back.
And we’re back. And, Maria, can you talk more about the measles vaccine? It’s obviously been around for a very long time, and it’s pretty effective.
GODOY: It’s highly effective. One dose of the measles vaccine is 93% effective, and that means that 93% of people who get it will have an immune response after that first dose. Two doses is 97% effective. It’s very safe. It’s been tested again and again. It’s your best defense against getting the measles.
DAVIS: And, like, right now, ’cause I imagine that there might be some parents or individuals who don’t know if they’re vaccinated, are like, oh, man, I should go get a measles vaccine – it’s pretty easy to get and effective pretty quickly?
GODOY: Yes. OK, so most of us will have gotten a measles vaccine because it’s required for, like, you know, kindergarten enrollment. There are ways to get exemptions. But if you’re not sure about your vaccination status, you can look up your records, talk to your doctor. But if you really are not sure if you’ve been immunized, yeah, there’s no harm in getting another measles shot. You know, at worst, it won’t do anything, and at best, it’ll protect you if you weren’t protected previously.
One of the things I should note is that people who got vaccinated before 1968 may have gotten a weaker version of the vaccine, so they should get revaccinated if they haven’t been already – they probably have been. And people in – who were vaccinated before 1989 – routinely, the recommendation back then was one dose, which is pretty effective. But certainly, if you work in health care or you’re heading to a place that has a measles outbreak or you live there, you want a second dose, then, if you haven’t gotten one already.
DAVIS: Domenico, the politics of this, ’cause this is a politics podcast, but it’s also, as I sit here thinking about it, it’s not lost on me that a very large and maybe the singularly most important contributing factor to Donald Trump’s loss in 2020 was the public confidence in his ability to handle the COVID pandemic.
MONTANARO: Yeah.
DAVIS: And this, of course, is not that, but I do think that so much has changed, both politically about what the public is willing to tolerate in these public health crises and also a bit of forgiveness towards Trump in the electorate this time around.
MONTANARO: And I have to say, one of the interesting things I kept finding when I talked to undecided voters – I heard from, you know, several people who were, you know, certainly in that category of potentially wanting to vote for Trump but didn’t like that he was pro-vaccine, they said. And, you know, there’s really seemingly no convincing folks like that, and we saw that sort of bubble up even this, you know, this past week with the Trump’s NIH nominee…
DAVIS: Yeah.
MONTANARO: …Who then was testifying and got into this back-and-forth with Senator Bill Cassidy from Louisiana, who’s a doctor. And they were talking about whether the MMR vaccine – the measles, mumps and rubella vaccine – can cause autism.
DAVIS: So here’s a bit of that exchange between Senator Cassidy and the Trump administration’s nominee to run the National Institutes of Health, Jay Bhattacharya.
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JAY BHATTACHARYA: Yeah. I mean, I think as I said, Senator, I don’t think that there’s a link between, you know, the MMR vaccine and autism. I’m convinced based on that literature. The only reason I’m not wholeheartedly saying yes to your question, which I – you know, I – every instinct of mine is to do that, is that there are people who might disagree with me. I want to make – it’s (ph)…
BILL CASSIDY: But that’s life.
BHATTACHARYA: Yeah.
CASSIDY: I mean, there’s people who disagree that the world is round.
BHATTACHARYA: That’s true.
CASSIDY: And I say that not to minimize these concerns. But people still think Elvis is alive. And so if you just say someone disagrees with me, so, therefore, I’m going to put precious, limited taxpayer dollars to this and not to addressing the issues of obesity, heart disease, cancer.
MONTANARO: I mean, this is what’s happened with misinformation and disinformation that really sprung up during the pandemic. It certainly hurt Trump during the pandemic and into 2020 about his competence in dealing with this. But then the entire sort of blogosphere, internet, you know, strain of people who are the do-your-own-research crowd and saying that these are things that could be problems are a big portion of the people who voted for Donald Trump.
DAVIS: Yeah. Maria, I hesitate to put the big burden on you, but I do think you’re the one watching this closely. What are you watching for next? I mean, is the concern that this could spread? What’s the response to it? Sort of what’s the next turn here?
GODOY: So here’s the thing. You want to have a really robust response, right? Like, the way you contain a measles outbreak is you vaccinate people who are unvaccinated. In terms of how big this could get, the infectious disease modelers I’ve spoken to say, you know, given that the nation as a whole has high vaccination rates, we wouldn’t expect to see this go into the, like, you know, thousands of cases like we saw measles outbreaks in the past. Like, in the 1990s, I think it was, like, 1,400 cases or so in Philadelphia. But that said, if vaccination rates continue to decline like they have been, we could see that again in five to 10 years.
DAVIS: Well, Maria, thank you so much for coming on the podcast for the first time and for sharing all of your reporting with us. We really appreciate it.
GODOY: Oh, it’s my pleasure.
DAVIS: That is it for us today. I’m Susan Davis. I cover politics.
MONTANARO: I’m Domenico Montanaro, senior political editor and correspondent.
DAVIS: And thanks for listening to the NPR POLITICS PODCAST.
(SOUNDBITE OF THE BIGTOP ORCHESTRA’S “TEETER BOARD: FOLIES BERGERE (MARCH AND TWO-STEP)”)
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