Wellness Unmasked: Rethinking Vaccine Policies: Public Trust, Mandates, and Health Risks

Summary

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Podcast Summary

Podcast: The Clay Travis and Buck Sexton Show — Wellness Unmasked: Rethinking Vaccine Policies

Host: Dr. Nicole Saphier (iHeartPodcasts)
Guest: Dr. Monique Johannon, Senior Fellow at Independent Women, author of "Rethinking Vaccine Policy"
Date: September 16, 2025

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Brief Overview

This episode of "Wellness Unmasked" features a thoughtful and evidence-based dialogue between Dr. Nicole Saphire and Dr. Monique Johannon. The conversation centers on the current U.S. childhood vaccine schedule, declining public trust in public health mandates, and ways to restore credibility and rational decision making to vaccine policy. Recent political and societal shifts—including Florida’s move to drop vaccine requirements for students—are discussed alongside concerns about health risks, community responsibility, and parental choice.

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Key Discussion Points & Insights

1. Declining Childhood Vaccine Rates & Public Trust

• Dr. Saphire highlights slipping national child vaccination rates—MMR vaccination down from over 95% to 93%—and a record high in vaccination exemptions (03:20).
  • “That 2% difference, it's tens of hundreds of thousands of children and it's enough to fuel localized outbreaks.” (03:34)
• Factors behind this include COVID-19 mandate fallout, online misinformation, and a rising movement questioning mandates in schools.
• Florida’s announcement of intent to remove all vaccine requirements for students has sparked a heated national debate.

2. Personal Experience: Real-World Vaccine Effectiveness

• Dr. Saphire shares her son’s whooping cough episode despite up-to-date vaccination, prompting her to “look more critically” at the durability and real-world effectiveness of some vaccines (05:25).
  • “He got whooping cough. I mean, it was kind of shocking to us, but he got whooping cough.” (04:29)

3. Is It All or Nothing? Reevaluating the Vaccine Schedule

• Guest Dr. Monique Johannon brings her background writing evidence-based medical guidelines and outlines her drive to apply technology and “fresh eyes” to vaccine policy (13:59).
• Both Dr. Saphire and Dr. Johannon emphasize the polarization in vaccine debates—either “all-in” or “none at all”—and advocate for a nuanced middle ground (15:01).
  • “Questioning the vaccine schedule…doesn't mean you’re anti-vax. In fact, you’re pro vaccine.” (08:44)

4. Which Vaccines Should Be Mandatory?

• Dr. Johannon distinguishes between “community obligation” vaccines (measles, mumps, rubella, diphtheria, pertussis) vs. those for individual protection (e.g., hepatitis B), suggesting only the former are justified as mandates (16:06).
  • “For diseases for individual protection...I think that's a parent's decision.” (16:54)
• Dr. Saphire questions why hepatitis B, which isn’t highly contagious in classroom settings, is mandated for schoolchildren (17:36).

5. Historical and Legal Foundations of Mandates

• Discussion covers Supreme Court precedents (Jacobson v. Massachusetts, Zucht v. King) on vaccine mandates—originally tied to smallpox and often linked to fines or school attendance rather than blanket exclusions (19:08–21:19).
• Noted exponential vaccine schedule expansion post-1986, when manufacturers gained liability shields (21:19).

6. Vaccine Safety, Aluminum Exposure, and Schedule Comparisons

• Dr. Johannon discusses U.S. children receiving nearly double the aluminum from vaccines compared to Europe, raising concerns about asthma and neurodevelopmental risks substantiated in CDC and Danish studies (21:52).
  • “We have about double the amount of most of Europe...and a CDC report found a 26% increase in risk of asthma when you had the US dose of aluminum.” (22:45)
• Both agree that dosing timing and volume may need overhaul, referencing Denmark’s less intensive schedule leading to fewer shots and similar or better immunity (24:18).

7. Do Mandates Still Work for Herd Immunity?

• Dr. Johannon argues: The math behind school-based mandates for measles no longer works, as a significant share of children now opt for homeschool or alternatives post-COVID (29:08).
  • “Literally, the math for mandates does not work for measles...even if you get rid of all exemptions.” (29:51)
• Removing mandates entirely, as in Florida, risks further drops in coverage without a plan for replacement strategies (31:00).

8. Restoring Public Trust & Policy Recommendations

• Dr. Saphire expresses concern at “an all-time low” in public trust, worsened by COVID messaging and hasty mandates (32:37).
• Dr. Johannon credits the current HHS secretary (RFK Jr.) for putting important topics—including over-medicalization and overreliance on vaccines—back on the table, but cautions against over-corrections (33:16).
• Recommendation: Refocus on vaccines that confer clear community benefit (especially measles). Use technology and better communication for outreach and allow for more individualized, risk-based decisions on other vaccines (35:55, 35:45).

9. Polio Revisited

• The effectiveness and necessity of current U.S. polio vaccination is questioned, as transmission risk is minuscule—on par with daily risks like driving (36:26–37:42).
  • “I think kids should get the inactivated polio vaccine. But I think any case that… the polio vaccine we give now is protecting other kids, I disagree.” (37:42)

10. Moral & Societal Responsibility

• Both agree on the catastrophic risk of endemic measles returning, especially for infants too young to be vaccinated (40:08–41:13).
  • “While I am a libertarian at heart, there are things that we have moral obligations to each other as members of society...We cannot get back to a disease that will affect 4 million kids.” (41:13)

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Selected Notable Quotes & Moments

• Declining coverage and urgency
  • “Vaccination exemptions for kindergarteners have reached the highest levels ever recorded in the United States.”
    — Dr. Nicole Saphire (04:03)
• Vaccine schedule and mandates
  • “I cannot make the same case for hepatitis B.”
    — Dr. Monique Johannon (16:54)
  • “Depriving school [attendance] for a disease that isn’t actually communicable...frankly, I don’t think the math for mandates works anymore.”
    — Dr. Monique Johannon (16:44)
• Aluminum risks
  • “When you get to the kinds of higher doses that you have in the US, that's when you start to see harms.”
    — Dr. Monique Johannon (23:52)
• Mandate logic breakdown
  • “We don't even have 95% of kids in school. So literally, the math for mandates does not work for measles.”
    — Dr. Monique Johannon (29:51)
• Restoring trust
  • “Each one has a different level of effectiveness, durability and just overall impact on community health…every recommendation should be rooted in maximum demonstratable benefit.”
    — Dr. Nicole Saphire (46:25)
• Societal obligation
  • “There are things that we have moral obligations to each other as members of society. We cannot get back to a disease that will affect 4 million kids [with measles].”
    — Dr. Monique Johannon (41:13)

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Timestamps for Important Segments

• Introduction and context: 03:20–09:29
• Personal story (whooping cough in vaccinated child): 04:29–07:30
• Mandate polarization and nuanced approach: 13:59–16:06
• Which vaccines justify mandates / hepatitis B debate: 16:06–17:36
• Legal/historical background (Jacobson v. Mass.): 19:08–21:19
• Aluminum in vaccines and comparative schedules: 21:52–25:26
• Danish vs US studies and lack of further research: 25:26–28:07
• Mandate effectiveness in modern era: 29:08–31:00
• Restoring trust, political notes: 32:37–35:45
• Community focus and nuanced recommendations: 35:55–41:13

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Overall Tone

The episode is measured, deeply informed, and refreshingly devoid of hyperbole. Dr. Saphire and Dr. Johannon openly question but do not dismiss established vaccine policy, advocating for prudent, evidence-based reforms. Both stress the need for humility, parental partnership, and renewed honesty from public health authorities to repair trust and improve child health.

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This summary captures the fundamental debates and recommendations in the episode and provides timestamps and attributed highlights to guide deeper listening or reference for those who weren’t able to tune in.

Transcript

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[Dr. Nicole Safire]

And shop [e-mail] welcome to Wellness en Masse. I'm Dr. Nicole Safire. Today we are going to take a closer look at the childhood vaccine schedule. It's a topic that's becoming increasingly complex in recent years. When I was in medical school, you know, it's not really something we talk about. We knew it existed and that was it kind of settled science you don't really talk much about. It just is what it is. I have learned more about the childhood vaccine schedule over the last five years than I think I even spent for the preceding 15, 20 years of my career. But here's the situation. Nationally, vaccination rates among children are absolutely slipping. CDC data shows that kindergarten coverage for measles, mumps and rubella that MMR vaccine has fallen to about 93%. That's down from over 95%, which is our target just a few years ago. Now, I know 2% doesn't really sound like that big of a deal, but I can tell you that 2% difference, it's tens of hundreds of thousands of children and it's enough to fuel localized outbreaks. And that's a problem. At the same time, also, vaccination exemptions for kindergarteners have reached the highest levels ever recorded in the United States. Now, there are many reasons behind this. The lingering fallout of the COVID 19 mandates, which is, we all know, are a complete disaster and uncalled for, increased online misinformation and just the growing political movement. And maybe it's not even political, just the growing movement questioning whether mandates belong in schools at all. Florida recently announced its intent to remove all vaccine requirements for students. This, you know, fueling and sparking the national debate about the balance between individual choice and community safety. I'll share something personal here because I am an open book. I've always tried to be that way as I entered the public space, my own, one of my own kiddos. I have three sons, you Know, one of my own kids in middle school, when it came to whooping cough, was fully vaccinated and even had been recently boosted. Well, he got whooping cough. I mean, it was kind of shocking to us, but he got whooping cough. We only knew it because he had this characteristic cough that I read about, I heard about all throughout my career, but I had actually never heard the cough myself. But as soon as I heard it in him, my husband and also a doctor and I, we looked at each other. We're like, no. Could it be? Sure was took him to the pediatrician and it was. But that's when it had me thinking that night, you know, I was a little bit panicked because when you hear about whooping cough, you're concerned about it. I mean, we get vaccinated, we don't talk much about whooping cough anymore. So. So I found myself going into a deep literature dive all about pertussis, which is what causes whooping cough. And is it dangerous? In my middle school son, why did he get this right after he had just been boosted for whooping cough? And it really kind of pushed me to look just more critically at how effective some of the vaccines still recommended for children really are. Especially, as we know, immunity from these vaccines and boosters can wane over time. When it comes to whooping cough. The CDC surveillance data shows about 1% of reported cases in adolescents like those 11 to 18 years old, actually required hospitalization. Now, in contrast, 50% of infants less than six months were hospitalized. So 1% of teens, adolescents being hospitalized with whooping cough. 50%. Half of the kiddos, the little ones who are infected, are in the hospital. Obviously, there's different risks with these populations. So whooping cough, also nicknamed the 100 day cough. It's certainly accurate. Let me tell you. My son coughed for a very long time. This cough can last like six to 10 weeks, but really without any long term, long lasting effects. Just this annoying cough, which by the way, is not contagious. It's just an annoying cough. And in the US death in adolescents are extremely rare, with CDC data showing no deaths in adolescents. And it's really all in just these young kiddos too young to be vaccinated. So I was able to sleep soundly that night because I'm like, oh, okay, well, my son has whooping cough, but he's going to be just fine. That was a really good thing for me to feel. I didn't have to be like, oh my gosh, thankfully my son is vaccinated. He's going to be fine. Just my son with this infection is going to be fine. That certainly gives comfort to a parent, but my research really underscores kind of an important truth. Obviously, vaccines are not one size fits all, because when you look at some of the other illnesses that we vaccinate for, like measles or even chickenpox or flu, there's a much higher rate of hospitalization in teens than say, whooping cough. So I wanted to have a conversation with someone who, like me, questions a vaccine schedule. And by the way, questioning the vaccine schedule, that doesn't mean you're anti vax. In fact, you're pro vaccine. You can recognize the importance of vaccines, but you can also look at them critically, especially as we're facing a crisis within our country of declining vaccine rate. Have to figure out what's causing this and what can we do to move forward so that people can actually trust the public health process all over again. So to unpack all of this, I sat down with Dr. Monique Johannon, senior Fellow at Independent Women and author of the newly published Rethinking Vaccine Policy, A case for Humility, Precision and Parental Partnerships.

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[Dr. Nicole Safire]

[e-mail] Dr. Johannon I have to admit I went through your entire Rethinking Vaccine Policy report and I'll be honest, I thought it was very well written. I work in academics myself, so obviously I really appreciate when people bring forth the data they link to all of their references instead of speaking in hyperbole. And that is exactly what you did with this report. Can you kind of just talk a little bit about why you felt compelled to put this together?

[Dr. Monique Johannon]

Sure. First of all, Nicole, thank you so much for having me here today. My background really is I've spent 20 years writing evidence based medicine guidelines for a variety of organizations. And the last place I did that was Change Healthcare, where I wrote the guidelines for Covid in 2020. And I really saw a disconnect that in the literature versus what I was hearing public health authorities saying at that time. That's what led to my initial specific interest in that. But the other piece is that I'm currently the CMO for an AI health care company. And when I look at our health care system and vaccines in particular, I don't think we're optimizing technology. And I do think that a lot of the challenges we have with vaccines and the vaccine schedule could be addressed with technology. So it's a combination of my background, that experience, and frankly, an administration with a will that I thought was actually going to be willing to consider looking at this with fresh eye right now.

[Dr. Nicole Safire]

A lot of the conversation I like to talk about the pendulum swinging from one side to the other side. Some people are all in, meaning you have to get every single vaccine. And if you say anything about any the recommended vaccines on the CDC childhood schedule, then that makes you a charlatan, that makes you a conspiracy, anti, vax, whatever, whatever word they're using that day, you have to be all in. But on the other side, you have to be all in. There it's all or nothing, it seems. And so you're coming at this with a very thoughtful approach, one that, you know, you hear Senator Rand Paul talk about, I've talked about myself, whether it's on TV or the podcast saying we have to reevaluate the vaccine schedule. So what we're seeing in Florida, with the Florida Surgeon General taking away all vaccine mandates, I mean, that's a whole different conversation. But again, it kind of gives us that whole all or nothing mantra, that mindset. And so. But what you are talking about in your report is not necessarily the all or nothing, but maybe we need to have conversations about the individual vaccines.

[Dr. Monique Johannon]

Absolutely, Nicole. So when I look at vaccines, I think there are about five of them that I feel like are what I would consider community obligation vaccines. And of those five, maybe one that I would consider most important. So measles and then mumps, rubella, diphtheria, Pertussis, that's it. In terms of vaccines for diseases that are really easy to spread, that if most people don't get them, it's hard for people who are at risk to be protected. So for example, with measles, if we don't get to herd immunity for measles, a six month old can't be protected. They're too young to get the vaccine and they really depend on herd immunity. I cannot make the same case for hepatitis B. When you look at the Florida mandates as they had been, yes, they required measles vaccination, but they also required hepatitis B vaccination. To your point about the all or nothing depriving school for a disease that isn't actually communicable, not in any way questioning the effectiveness of the vaccine. I am saying that basically for the community, protective vaccines, to this extent that we consider them, I frankly don't think the math for mandates works anymore. That's sort of another issue that I have with them. But to the extent that we even think about, they need to be for the diseases what that really depend on community protection, for diseases, for individual protection. And I would put hepatitis B in that. I think that's a parent's decision.

[Dr. Nicole Safire]

Well, and you know, the hepatitis B vaccine, that to me is the most glaringly obvious one that we certainly should have a conversation about and why it is on any sort of school mandates for kids going to school, especially school aged children. That's hard for me to wrap my head around. As you said, it's not like a respiratory transmitted virus. It's not highly contagious as like a measles or even a chickenpox. It's really risk based. And so that doesn't make sense other than, you know, the knee jerk reflexes. When we have an available vaccine, all of a sudden it gets put on the CDC recommendation and those recommendations, the CDC loves to say we're not making the mandates, we're not saying they're required, but they very well know that when they put that on their recommended schedule, that then turns into mandates and requirements and so on and so forth. And obviously this became the most glaringly obvious during COVID You brought up something which I found very interesting in your vaccine report. You talked about like the whole constitutional foundation of vaccine mandates. And it was really interesting. It was a really interesting read in the sense that it was from I think 1905 where they compared vaccination to the whole military giraffe saying that, well, you send individuals into harm's way for the collective Good. Acknowledging that some will be injured or killed in the process. And so the fact that they quoted that in, you know, legal paperwork when it comes to vaccines, I mean, that. That's really hard, you know, a hard pill to swallow.

[Dr. Monique Johannon]

And I think that's a history that we lose. So the case that you're talking about is Jacobson versus Massachusetts. That vaccine was for an adult mandate, and the penalty was a fine. So it didn't keep you out of public life.

[Dr. Nicole Safire]

Was that for smallpox?

[Dr. Monique Johannon]

It was for smallpox, Exactly. And there was a minister, actually there had been harm to one of his children from the smallpox vaccine. He had some chronic conditions he didn't want to get. I went to the Supreme Court and they said, yes, you know, the reality is we have some obligations such that you might be hurt, you might even be killed by getting a vaccine, but there are vaccines that we can use the police power of the state to take away your rights to bodily integrity in the name of protecting the community. And so, again, that was a fine. It wasn't until about almost 30 years later, there was a case called Zuck vs King in 1922 that said kids can't go to school if they don't get a smallpox vaccine. There wasn't an outbreak or anything at that time, but the Supreme Court linked it to school. So we've had about 100 years in which even not having an outbreak, the Supreme Court had said it's fine to keep kids out of school if a community wants to have a mandate for particular diseases. So that is something that we haven't really completely revisited. There were cases that the Supreme Court danced around during COVID but I do think that was also at a time with very different in terms of the number of vaccines. And as you pointed out, until 1986, we had very few vaccines. We just see this progressive increase after we have a shield law that manufacturers. Manufacturers can't be sued. Every year or two, we get one or two vaccines added to the schedule. So at this point, we've got about 17 diseases that kids are getting vaccinated against by age 18. So that sort of volume. And to your point, once it's on the schedule, it just gets added. So you brought up hepatitis B. 46 states mandate it. So from a practical sense, getting on the schedule is an excellent way to make sure it's a way to keep kids out of school if they don't get it.

[Announcer]

Yeah.

[Dr. Nicole Safire]

You know what I find interesting, as you pointed out, and you had great charts on it showing that the United States. Well, most Other countries don't have mandates for vaccines, but we recommend vaccines and ultimately mandate them more than any other country. I mean, the amount of boosters and so much and so forth. And you talk about the concern of the aluminum exposure that's in it, the aluminum salts. I suppose it is. And so, you know, talk me a little bit about that, what you've found in that.

[Dr. Monique Johannon]

Sure. So aluminum just in case other people don't have that background. A lot of vaccines don't work particularly well unless they have a kickstart. And they also kind of need to be doled out over time. And aluminum does those two things. It acts as a kickstarter for a vaccine that acts sort of as a train depot station, that it gradually will dull the dose of vaccine individual shot over time. It is a toxin. And originally when we had the old schedule, we had diphtheria, tetanus and pertussis that had aluminum. We keep adding more and more vaccines that have aluminum in them, such that when you look at our schedule compared to Europe, it's basically that we have about double the amount of most of Europe. And then England and Canada are somewhere in the middle. We have a report from CDC that was done a few years ago that found a 26% increase in the risk of asthma when you had the US dose of aluminum. And they said, oh, that's interesting. But even though the CDC had designed this study themselves and it was a huge study, they decided that they were just going to keep things exactly the same. The issue with aluminum is that for neurodevelopmental disease and for asthma and allergies, that is sort of the canary in the coal mine for aluminum. When you get to aluminum doses that are on the higher end, that's when you really worry about those diseases. And I do want to mention that there was a study that got done in July of this year from Denmark and they looked at aluminum and they said, oh, we didn't find any problems and we didn't find any threshold responses. Now, I'm kind of a geek about this stuff, but I will tell you that they also made a claim that there's no dose response. That's the equivalent scientifically of saying we found in our study that the sun rises in the west and it sets in the east. It's the thing that something only somebody who did not understand aluminum toxicology would say that basically with aluminum, when you get to the kinds of higher doses that you have in the US that's when you start to see harms.

[Dr. Nicole Safire]

Aluminum is kind of like fluoride.

[Dr. Monique Johannon]

That way, like a certain amount of.

[Dr. Nicole Safire]

Fluoride is fine, but it's actually, it's helpful. But as soon as you get up on that curve, it can be, you know, deleterious for you.

[Dr. Monique Johannon]

Exactly. Why that the doses that we see when Denmark doesn't see arm, well, duh, they give half the dose that we do. They don't give it for essential vaccines. You could still get, you can still get the vaccines for diphtheria, for tetanus, for pestis. You could get it for the pneumonia vaccine and still be well within what is probably a safe threshold. It's when you start adding hepatitis B, hepatitis A. And if I could just mention one other thing, part of why we give extra doses is we don't time our. We don't time our vaccines for immunity. So we start the diphtheria pertussis vaccine before the kids immune systems actually can tolerate them. Part of why Denmark gives less is they wait a little longer to give their vaccines and therefore they're able to give three shots and we give five. So when we look at it, if our schedule not just had fewer shots and fewer diseases, but if we actually looked at the immunity, the level of development that kids have, we have fewer shots, but we have better immunity from the shots we get.

[Dr. Nicole Safire]

You know, that Denmark study, you know, I looked at it and obviously a lot of people said, oh, it was reassuring. I agree with what you're saying that they do have a lesser amount. I mean, they even talk about the doses of aluminum that the kids they absorb dose essentially, that they, you know, were able to estimate. There were some on the far extremes that had that higher amount that would probably equate to the US but it was the minority of the kids in their study, not the majority. But what you touched on earlier was that I think it was 2022 study put out by people funded by the CDC or the NIH, which essentially said that there was a correlation of these, the Illumina doses of vaccination, specifically in kids who already had eczema, meaning that they're hypersensitive as is. And as you're saying, I think it was like 24. There was a range even more of these kids had chronic asthma, and they likened it to the aluminum. And then that's a big. That study was a big deal, yet nothing came of it. And their, their concluding lines were, well, we need to do more research. And by the way, the people who say we need to do more research, that's them saying, well, this is what we found. But people aren't going to like it. So we'll just say we need to do more research just to buy us more time. But what happened was in the United States, they didn't do any more research. And the. I think it was the lead author on that paper was part of the ACIP committee of the CDC recommending the vaccines, Covid vaccines, flu and all the other ones. So of course he doesn't want the fact that his data shows that there may be harm to this vaccine schedule. He's the one who's creating the vaccine schedule.

[Dr. Monique Johannon]

Absolutely. You know, again, this is a big study. There were almost 327,000 kids. CDC designed it. It's a well done study. No research is ever going to be perfect when people say, well, it's not replicated. Well, if you don't do any more research on this, I would say I not only look when I, when you're looking at the evidence, it sort of tells you a story and part of it is the story of what's in the literature. But when you see absent literature, when you see people stop doing studies, when you get findings that are inconvenient and that's the way I would describe aluminum, there have been a lot of inconvenience, things that people just don't want to realize. And so there's unfortunately far too little literature. The other part that bugs me about this Danish study is it was published in an American medical journal and it was absolutely intended to reassure an American audience. The core aluminum studies, the core aluminum toxicology literature, they don't even cite.

[Dr. Nicole Safire]

Well, that same author, I think the author of the US study from the CDC on the ACEP committee, he commented, commented on it. I saw it in a interview or something somewhere. He's like, oh, it's, it's great to see this study. It's so reassuring. I'm like, so are you admitting that your data was flawed? Because your data actually seemed pretty on point for someone who loves to criticize data. So it was it that it's hard to not feel that people's personal opinions and the push for the mandates, which by the way, listen, you know, I guess I can ask you this question, but when it comes to vaccine mandates, you know, do you think that these mandates serve an effective tool in achieving herd immunity or do they actually they more risk infringing on personal freedoms? Like, what is your take on these mandates? Especially like measles like we're talking about. We've already kind of agreed we need to revisit the vaccine schedule because we think we're overdoing it for many reasons. But what about the school mandates and some of the other things? I mean the fact that Florida is trying to eradicate them entirely?

[Dr. Monique Johannon]

Sure. To me the best case you can make for mandates is they give us an infrastructure. There are some logistics to my kids going to school and I have to have my vaccine. So I'm going to set up my well child visit. I'm going to get this shot. There are logistics. Most parents who do not get vaccinated, for example, who homeschool, are not homeschooling because they're anti vax. They are homeschooling because they want more control over their kids schooling. But the reality is if you look after Covid at the number of kids who left formal in person school, you have basically about 9% of kids, you know, kind of depending on the numbers are in home schools or micro schools or umbrella schools or online charter, basically you need 95% of all kids. But right now we don't even have 95% of kids in school. So literally the math for mandates does not work for measles. It is impossible even if you get rid of all exemptions to actually get to a national measles herd immunity based on the number of kids who left school. Because public health authorities thought it was fine to shut down schools for more than a year, those kids didn't go back to school. And that's a reality that I think our public health infrastructure and for example aap, I don't think they've really caught up with the math of this. When you only have 93 to 94% or so of kids who are in in person school depending on the state, you cannot get to herd immunity with permezels with a mandate, the math just doesn't work anymore. So I do recommend just doing away.

[Dr. Nicole Safire]

With them because I would say, I would argue that, I guess that they have herd immunity at least in the classroom, which is a place for measles to spread very quickly.

[Dr. Monique Johannon]

Yeah. So the problem I have and the challenge I think with what happened in Florida is they do serve a purpose. So if we're going to take something away, we have to offer something else in its stead. So Florida for example, could have changed their ability to tech outreach. They could have changed the ability to opt, you know, that texting could be better. They could offer other different strategies. They could have a more liberal strategy in terms of allowing kids to get vaccinated later. There are a variety of other Strategies that have been tried internationally to increase uptake of measles vaccination. So the problem I have with what Florida did is not that, you know, I can conceptually understand what they're getting at, but I think to do it for everything without something to substitute, it was a mistake from my perspective. I do think, for example, pulling them for prostatitis B would have made a lot of sense. And then working to what can we do to fill the gap? We're talking about measles. That's me. Or even allowing more liberal exemption policies. Because the reality is even with exemption policies, kids will actually stay in school. When California made their exemptions so, so tight and they got rid of all exemptions, it's true, the vaccinations did go up among the kids who stayed in school. The number of kids who left formal school doubled. So the reality is every single state has tightened up exemptions and basically made it harder because I have an increase in medical exemptions and an increase in kids who've already gone to school.

[Dr. Nicole Safire]

Do you think? I mean this place, I feel like we are in such a faith, you know, a place where public trust is. I felt it was an all time low in Covid, but I didn't realize that we could even get lower than that. And I think RFK Jr. The HHS Secretary is doing a lot of great things in the sense that he's looking and talking about things that no one has in decades and they're very important things. But my concern is that it's affecting public trust even more. What are your thoughts? Pendulum, we were over here, now we've gone this way. Like where's the center?

[Dr. Monique Johannon]

Right? So I do think RFP junior Really there's a lot of important revisiting. You know, I read through the MAHA report on kids that came out this week. So talking about food, talking about exercise and stress for kids, looking at over medicalization for kids, I think all of these are really important topics. I also think his advisor on vaccines is Martin Krampolz, who is somebody who's publicly talked about being in favor of measles vaccination. So whatever people are saying about his opinions about vaccines, I do think he has people around him who are not a no vaccine. And frankly when I listen to him and I've read his books, he's not all out against every single vaccine. He just, I think more than anything he has a discussion that says probably there are some things we are crediting to vaccines that when you look at the big star sanitation we've played a role that there's some other. So I do think that there's a lot more nuance. But I also think some of this is frankly anti administration. I think that there are very logical things. Yeah, I think that when you look at the evidence or the lack of evidence for Covid vaccination people, including kids who are healthy, that evidence is at best weak. And I do actually from a scientific standpoint, from an evidentiary standpoint, I agree with the decisions that the FDA took. I think that they are evidence based decisions. But I think that, let me just say this, some of this is definitional. So during the Biden administration, the definition of what a vaccine was, was changed. So anything that causes an immune response is a vaccine. Now that's not the way it used to be. You used to actually have to show that it was something that showed a benefit in preventing disease or preventing harm. That's not the case anymore. So when these agencies say these are evidence based, all the COVID vaccine does is it increases an immune response for people who are healthy. That is what the evidence shows. So I do think, unfortunately there's a lot of, of things maybe stylistically in terms of hhs, you know, that people are latching onto, but I think in terms of the evidence just going to say for vaccines consistently, I think in agreement with what he's been saying.

[Dr. Nicole Safire]

So your take home. If they could just do, what could they do to try and get us on the right step from a public health standpoint, but also a public perception standpoint.

[Dr. Monique Johannon]

Sure. So for vaccines I think we need to step. I think we need to focus on the vaccines that are for community protection. And again, if I'm going to pick one, it's measles. I think the potential risk of really getting to endemic measles, it's a disaster. If we would ever get back there. We have a lot of outbreaks now. This is something that I think is really important.

[Dr. Nicole Safire]

Polio in that too, seeing as polio has been found in more water in like Europe. And what do you think?

[Dr. Monique Johannon]

Polio is an interesting one. So it is interesting because the vaccine we have given for polio for the last 25 years does nothing to stop an individual from getting polio. It does nothing to stop transmission neurological effects. It absolutely does.

[Dr. Nicole Safire]

It's a big deal.

[Dr. Monique Johannon]

Well, it is. So Nicole, but here's the question I would ask you. And again, I'm not being cavalier about polio. If you look at the exposure rates that we have in the United States, when people come in because we only see it when there's some strains that can be imported. Literally the risk of getting polio, neurolytic polio in the United States if you're exposed is 1 in 10 million, which is actually, that's the math for the risk of the vaccine. I'm going to make the case that you're probably putting your kid at greater risk if you're driving your kid to school of having a neurologic problem than you are by not getting the polio vaccine. And let me just say this, my.

[Dr. Nicole Safire]

Kids, that's a great analogy because I use that all the time. Speaking about the COVID vaccine. I'm like, if you're able to drive your kid to school and you're not worried about that, they're probably going to be okay if they get Covid and they're healthy, whereas the vaccine has a higher risk.

[Dr. Monique Johannon]

I just think that parents make and should make frankly a lot of decisions about their kids. And while I understand, I have an mph, I understand the instinct to want to be protective and paternalistic about the way we protect our kids. But the reality is this is not a disease that kids are at high risk of having complications for. I'm not saying that kids shouldn't get it. Let me just be very much on record. I think kids should get the inactivated polio vaccine. But I think any case that you are going to make, not you but a person might make, that the polio vaccine we give now is protecting other kids. I disagree with it in terms of the kinds of risks that we let parents make in the way they raise their kids. I think we let them have trampolines, we let them drive their kids to school. There are certain risks that I think taking away parents rights to make medical decisions for their kids if there's not a community benefit, I chafe at that.

[Dr. Nicole Safire]

I think you make very strong, valid arguments. And like I said, I read through your whole report and it's very fact based and which I appreciate you don't. You're not hyperbolic in your, what you say at all. I just, I wish that we could put it together so something like for me to read it. I mean I actually you wrote it in a way that anyone could read it. Like you don't have to be a physician or an academic. But I wish that we could all kind of come together and at HHS they could really put something concise out and that could be, you know, the start instead of we keep having these conversations back and forth and these little things keep happening and all it's doing is creating a sense of chaos and it's just not helping us move forward as a nation. And so I wish that they could kind of like what you did, but then just take that and say, these are our recommendations, these are the risks. Give it to the parents, give it to the pediatricians and say, you all need to work together and let's figure it out. I guess that's. But I also think it's dangerous to let like measles go completely unchecked.

[Dr. Monique Johannon]

I think the part of where we are is it's so polarized right now. I actually don't think it's an if. I do think we're going to, we're headed towards getting regional endemic disease. I do worry that in the Southeast we're going to have a situation in which measles becomes a reality for some kids in some parts of the country.

[Dr. Nicole Safire]

As a reminder, 10 to 20 years to clog.

[Dr. Monique Johannon]

Before, before the vaccine, almost 4 million kids got measles every year and hundreds of them died. And the kids who died were babies who really, they cannot get vaccinated. So when we think about this, I am very much for parents rights to make medical decisions about their kids. But the kids who are going to suffer if we get back to endemic measles are going to be kids who cannot get vaccinated. This is something that, again, while I am a libertarian at heart, there are things that we have moral obligations to each other as members of society. We cannot get back to a disease that will affect 4 million kids. And frankly, measles parties, 5 to 9 year olds, that worked because it's not usually a severe disease. And the kids who were old enough to go to a party, the kids who died, the kids who had complications were babies who depended on older siblings actually getting vaccinated. That's the reality that I feel like we're missing with this.

[Dr. Nicole Safire]

Well, I truly appreciate you coming on Wellness Unmasked talking about this. It's an important conversation and, and you know, voices like yours who've really done research know what they're talking about. Not one size fits all. That's exactly the voices we need in the room right now. So thank you. I loved your report and I'm going to tell people about it.

[Dr. Monique Johannon]

Thank you so much, Nicole. Thanks for having me on.

[Dr. Nicole Safire]

You're listening to Wellness Unmass. We'll be right back with more.

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[Dr. Nicole Safire]

Well, that was a jam packed conversation. A lot of information. Honestly, to have a real conversation about the vaccine schedule, it would go on for days. Not just a short podcast episode. But you kind of understand the gist of what we're talking about. Vaccines have been one of medicine's greatest success stories, nearly eradicating diseases like polio and measles specifically here in the United States. Yet the reality today, it's obviously more complicated. CDC data showing the exemptions are on the rise, vaccination rates are on the decline. And so we're also starting to see resurgence of illnesses once considered under control. We're seeing a lot of outbreaks of measles, obviously, we are seeing some flu. We're seeing a lot more whooping cough as well, my son being one of them. So when we look closely at the data, one of the biggest questions that comes up is if certain vaccines aren't actually preventing transmission, do they really need to be routinely given in lower risk populations like whooping cough vaccine and healthy adolescents? By continuing to recommend every vaccine across every age group, regardless of the risk level, we may be actually undermining public trust. We saw this with COVID What happened with COVID They kept pushing Covid vaccines in every age group, including healthy adolescents, even when they were about the lowest risk population. And on top of that, they were one of the more higher risk populations for side effects. Well, what happened? Well, all of a sudden you have parents saying, forget it, I'm not giving my kids the COVID vaccine. And you know what they also stopped doing? They stopped giving them flu shots too. Now maybe in teens, flu shots aren't as necessary as school age kids, but I can tell you school age kids have about a three times hospitalization rate from flu than they do Covid. But because they pushed Covid just like it was as good and as beneficial as like measles and flu, all of a sudden parents are like, forget it, you're pushing. You push that COVID vaccine on us. Now the data is showing they probably didn't even need it. Now I'm just going to stop doing the vaccines in total. So if we just could narrow the schedule to prioritize vaccines with maximum proven benefits like decreasing transmission and focusing on the high risk groups, we could restore confidence in the system and help people take the most critical vaccines more seriously. Each one has a different level of effectiveness, durability and just overall impact on community health. And in an era of growing skepticism and declining uptake, we have to be especially careful because every recommendation should be rooted in maximum demonstratable benefit. Otherwise we risk further eroding the trust my conversation with Dr. Monique Yonahan was a reminder that while we can debate policies like Florida's decision to remove mandates, what matters most is that families receive clear, honest information to make decisions that balance both individual health and public safety. That's what I'm trying to do in my own household and so I want to make sure that everyone has the information to make the best choices for their own family. Thanks for listening to Wellness unmass on America's number one podcast network. I heart follow Wellness on Mass with Dr. Nicole Safire and start listening on the free iHeartRadio app or wherever you get your podcasts and we will see you next time.

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[Dr. Monique Johannon]

You.

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[Dr. Monique Johannon]

Com.