与儿科医生一起应对疫苗错误信息

卫生与公众服务部长小罗伯特·F·肯尼迪长期批评疫苗，并多年来领导着一个反对疫苗的激进组织。

Health and human services secretary Robert f Kennedy junior has long been critical of vaccines and for years led an activist group opposing vaccines.

你知道的，根本不存在什么安全有效的疫苗。

There's no vaccine that is, you know, safe and effective.

尽管他对2023年在Lex Friedman播客中的言论有所收敛，但仍反复质疑疫苗安全性。

Although he's backtracked a bit on that comment he made at the Lex Friedman podcast in 2023, he repeatedly questions vaccine safety.

我来告诉你如何开始认真对待疫苗安全问题。

I'll tell you how to start taking vaccine safety seriously.

即使科学结论与既定范式相悖，也要参考最可靠的现有科学依据。

Consider the best science available even when the science contradicts established paradigms.

如今作为国家最高公共卫生官员，肯尼迪正在重塑联邦政府对疫苗的官方指导方针。

And now as the country's top public health official, Kennedy is reshaping the federal government's official guidance on vaccines.

小罗伯特·F·肯尼迪指示疾控中心更新其网站内容，声明不能排除疫苗与自闭症之间的关联。

RFK junior instructed the Centers for Disease Control and Prevention to update its websites to state that the link between vaccines and autism can't be ruled out.

尽管事实上疫苗与自闭症的关联早已被高质量科学研究证伪。

That's despite the fact that the connection between vaccines and autism has long been debunked by high quality scientific research.

肯尼迪告诉《纽约时报》说：'关于疫苗已经过测试并得出确定结论的说法完全是个谎言。'

Kennedy told The New York Times, quote, the whole thing about vaccines have been tested and there's been this determination made is just a lie.

这一举动令医生和健康专家们震惊不已。

The move has stunned doctors and health experts.

共和党参议员比尔·卡西迪——一位曾投票确认小罗伯特·肯尼迪任职的医生——在CNN周日节目中这样表示。

Republican senator Bill Cassidy, a physician who did vote to confirm RFK junior, had this to say on CNN Sunday.

任何破坏正确认知、违背科学依据的行为——即疫苗是安全的，不接种疫苗会使你的孩子或你自己面临更大危险——

Anything that undermines the understanding, the correct understanding, the absolute scientifically based understanding that vaccines are safe and that if you don't take them, you're you're putting your child or yourself in greater danger.

任何削弱这一信息的行为都是问题所在。

Anything that underlines that message is a problem.

一些公共卫生专家表示，曾经备受信任的CDC现在已不再可信。

Some public health experts say that the once trusted CDC is now no longer credible.

保罗·奥菲特博士负责费城儿童医院的疫苗教育中心。

Doctor Paul Offit directs the Vaccine Education Center at the Children's Hospital of Philadelphia.

我的意思是，小罗伯特·肯尼迪已经彻底改造了CDC，使其符合他的反科学、反疫苗形象。

I mean, Robert f Kennedy junior has shredded the CDC and made it in his image, which is to say an anti science, anti vaccine image.

令人担忧的是，依赖联邦政府获取真实信息的家庭会看到新指南，并选择不为孩子接种疫苗。

The worry is that families who rely on the federal government for factual information will see the new guidance and will choose to not vaccinate their children.

这简直疯狂。

This is madness.

这是美国儿科学会的肖恩·奥利里医生的观点。

That's doctor Sean O'Leary from the American Academy of Pediatrics.

我真的很抱歉，这实际上会对儿童健康造成影响。

I'm I'm so sorry that this is gonna have an impact on on, frankly, the health of children.

我担心这会导致接种疫苗的儿童减少，孩子们将遭受本可避免的疾病折磨。

I fear that it's gonna lead to fewer children being vaccinated, children suffering from diseases they didn't need to suffer

错误信息仍在传播，但区别在于现在它来自联邦政府。

misinformation, but the difference is that now it's coming from the federal government.

接下来，我们将与一位儿科医生探讨家庭应如何应对指南的变化。

Coming up, we speak with a pediatrician on how families should navigate the change in guidance.

这里是NPR，我是斯科特·德特罗。

From NPR, I'm Scott Detreau.

本条消息来自《金融时报》。

This message comes from the Financial Times.

铅中毒是英国一个隐蔽的流行病。

Lead poisoning is a hidden epidemic in The UK.

在Untold播客中，听听受影响者的亲身经历。

On the Untold podcast, hear from people who have been affected.

应对这一问题的国家战略在哪里？

Where is the national strategy to address this?

在您获取播客的任何平台收听《Untold：有毒遗产》。

Listen to Untold Toxic Legacy wherever you get your podcasts.

我是《美国生活》节目的艾拉·格拉斯。

This is Ira Glass of This American Life.

您知道我们的节目吗？

Do you know our show?

好的。

Okay.

无论如何，我都要告诉你这件事。

Well, either way, I'm gonna tell you about it.

我们制作的故事，希望能在一开始就用有趣的瞬间、情感和出人意料的情境吸引你，然后你会忍不住想了解接下来会发生什么，无法停止收听。

We make stories that hopefully pull you in at the beginning with funny moments and feelings and people in surprising situations, and then you just wanna find out what is gonna happen and cannot stop listening.

没错。

That's right.

我说的就是那些让你错过约会的故事。

I'm talking about stories that make you miss appointments.

这里是《美国生活》，在任意播客平台均可收听。

This is American Life, wherever you get your podcasts.

本周感恩节期间，NPR新闻的《Up First》将为您带来旅行、购物、黑色星期五、经济健康状况等各类晨间必备资讯。

This Thanksgiving week, up first from NPR News, is your companion with news of traveling and shopping and Black Friday and the health of the economy and all the other news you need to start your day each morning.

通过NPR应用或任意播客平台收听。

Listen on the NPR app or wherever you get your podcasts.

这里是NPR的《Consider This》。

It's consider this from NPR.

美国疾控中心(CDC)作为长期最受信赖的卫生权威机构之一，现在表示不能排除疫苗与自闭症之间的关联。

The CDC, long one of the country's top most trusted health authorities, now says a link between vaccines and autism cannot be ruled out.

这一指导方针也与美国儿科学会存在分歧，该学会负责发布《儿科指南红皮书》。

The guidance is also a break from the American Academy of Pediatrics, which publishes the Red Book on Pediatrics guidance.

詹姆斯·坎贝尔医生是参与编写该指南的执业儿科医生。

Doctor James Campbell is a practicing pediatrician who helped write that guidance.

他同时担任马里兰大学医学院教授，将与我们探讨这一变化对家长获取信息意味着什么。

He's also a professor at the University of Maryland School of Medicine and joins us now to talk about what this will all mean for the kind of information parents have access to.

您如何看待CDC的这一政策转变？您认为这会产生什么影响？

What do you make of this change from the CDC, and what do you think it means?

是的。

Yeah.

过去几个月我们看到的是，我们的公共卫生指导体系——疾控预防中心这个公共卫生机构正在被逐步瓦解。

So, I mean, over the last few months, what we've been seeing is essentially a a dismantling of our public health guidance of our public health agency, the Centers for Disease Control and Prevention.

众所周知，CDC是全球顶尖的公共卫生机构，其工作人员都是最优秀的公共卫生官员、流行病学家、统计学家，以及涉及传染病防控等各领域的权威专家。

As people probably know, it's the premier public health agency in the world, and the people that work there are the best public health officers, epidemiologists, statisticians, subject matter experts on everything having to do with my world, which is infectious diseases and prevention of those infections.

最近，他们实际上没有被给予继续提供循证指导这一出色工作的机会。

And recently, they've not really been given the opportunity to continue to do that stellar job of providing evidence based guidance.

本质上，网站页面和其他资源可以说被劫持了。

And essentially, website pages and others have been hijacked, if you will.

他们仍然声称代表CDC，但如果你与CDC这个领域的工作人员交谈，他们会告诉你，他们对这些指南的修改没有任何参与。

And they're still stating that they're representing the CDC, but I think if you talk to the people that work in this field in the CDC, they're gonna tell you, like, they had no part in changing those guide those guidelines.

所以我认为这让公众感到困惑。

So it's confusing, I think, the general public.

对于从业者和家长来说，看到不一致的指导方针确实令人困惑。

It's confusing for practitioners and for parents to see guidance that does not that is not aligned.

嗯。

Mhmm.

但我们相信，如果人们深入了解指导方针背后的原理，他们会看到美国儿科学会继续提供基于科学和数据的指导。

But, you know, we believe that people, if they look into what the rationale is behind the guidance, they'll be able to see that the American Academy of Pediatrics continues to do science based and and, you know, data based guidance.

鉴于我们过去一年在CDC看到的变化，这种对话现在会有什么不同吗？

Are there ways that that conversation is going to look different now given the the changes that we've seen at the CDC over the past year?

我认为这种情况将会改变，因为媒体和新闻所报道的，正是这些制定建议的不同团体之间存在争议。

I think the it's it is going to change because what makes it to the the media, to the news, is that there is controversy between the different groups that make recommendations.

过去，儿科医生在与家庭讨论疫苗建议时可能有时会遇到困难，但现在要解释不同推荐机构以及为何一个机构选择这样做而另一个机构选择那样做，我认为会让这些对话变得更加困难。

And so in the past, pediatricians, you know, had maybe a difficult job sometimes in discussing recommendations about vaccines with families, but now trying to explain the different recommending bodies and why one body would choose one thing and another, another thing I think is going to make those conversations even more difficult.

我的意思是，我们都希望父母能够获得最佳证据，以便他们能与医疗提供者一起做出最佳决策。

I mean, all of us want for parents to have the best evidence so that they can make the best decision with their providers.

我们都以儿童的最大利益为重。

And we all have the best interests of children.

这就是为什么我们花费大量时间审查这些数据，并努力制定出我们所能提供的最佳建议。

And that's why we spend so much time reviewing these data and trying to make the best recommendations that we can.

你已经看到了几十年来公众对疫苗看法的趋势线，我相信现在有很多听众可能以某种方式对疫苗持怀疑态度或担忧。

You've seen the trend lines on on public views of of of vaccines over the decades, and and, you know, I'm sure there's a lot of people listening right now who maybe in one way or another do have skepticism or worries about vaccines.

作为一名医生，你会对父母这种基本的担忧或焦虑说些什么，尤其是在当前这个时刻，当来自多个权威机构的信息纷至沓来时？

What would you, as a doctor, say to that just kind of baseline concern or anxiety in a parent, especially at this moment now when there is multiple, messages coming in from from multiple authorities?

是的。

Yeah.

首先我想说的是，我自己也是一位家长，而且我为所有孩子都接种了疫苗。

I mean, the first thing I would say is I'm a parent too, and I vaccinate and have vaccinated all of my children.

因为在审阅了所有数据后，我深知疫苗在安全性、耐受性和有效性方面投入了多少心血。

Because after reviewing all of those data, I know just how much goes into checking on their safety, on their tolerability, on their efficacy.

而且很不幸的是，作为一名传染病医生，我经常需要在医院照料那些因未接种疫苗而患上严重疾病的儿童。

And I am in the unfortunate position, if you will, of being an infectious disease doctor who spends his time in the hospital caring for children who have very severe disease because they were not vaccinated.

我见过因流感而需要使用呼吸机的孩子。

I see children with influenza who are on mechanical ventilators.

我见过因新冠肺炎而失去一侧肺部的孩子。

I've seen children with COVID lose a lung.

我见过在两次肝移植后仍死于乙肝的患者。

I've seen people die from hepatitis b after two liver transplants.

所有这些本都可以通过简单的疫苗接种来预防。

All of those were preventable problems, with simple vaccination.

你在谈话中多次提到，你认为CDC网站的最新变化是更广泛趋势中的一步，我想知道你对CDC未来几年可能做出的其他改变最担心什么。

You've said a few times in this conversation that you see this latest change to the CDC website as one step in a broader trend line, and I'm wondering what you're most worried about when it comes to possible other changes that the CDC can make over the next few years.

嗯，下一项议题已经排上日程了。

Well, the next thing's on the docket.

几周后有个会议，其中一天将专门讨论乙肝疫苗，另一天则全面讨论儿科疫苗接种计划。

There's a meeting in a few weeks, and one day will be spent talking about hepatitis B vaccine and the other day on the the pediatric schedule in general.

乙肝是个非常严重的问题。

Hepatitis B, is a very serious problem.

在我们对婴幼儿实施疫苗接种建议之前，美国每年约有1.8万至2万名婴幼儿感染乙肝病毒，他们几乎都会发展为慢性感染，其中许多人会发展成肝硬化——肝脏硬化，还有些需要肝移植的肝癌患者。

And before we had vaccination recommendations for babies and infants, about eighteen to twenty thousand babies and infants were infected with hepatitis B in The United States, and almost all of them go on to have chronic infection, and many of them go on to have cirrhosis, hardening of the liver, and some liver cancer requiring a transplant.

如今我们已把这个数字从1.8-2万例降低到每年仅几十例。

We now have reduced that number from the eighteen thousand to twenty thousand down to a few dozen every year.

能做到这一点是因为孕妇在孕期会接受乙肝检测，婴儿出生时及出生后第一年内会接种疫苗。

And the reason we've been able to do that is because moms get tested for hepatitis B during pregnancy and their babies get vaccinated at birth and then in the first year of life.

如果我们停止这样做，就会有更多儿童感染乙肝，这些孩子将承受巨大痛苦。

If we stop doing that, we will see more children with hepatitis B, and those children will suffer immensely.

就儿科疫苗接种计划本身而言，我们始终秉持的原则是：除非证实安全有效，否则绝不会将其纳入计划。

Looking at the pediatric schedule itself, the entire schedule, We have always looked at the schedule and we do not add things to the schedule unless we find them to be safe, and effective.

因此，在没有额外数据支持的情况下重新审视疫苗接种计划令我们担忧，除非能提供证明该计划需要修改的数据。

And so a a relooking at the schedule without any additional data is worrisome to us unless there are data that can be provided that would show that the schedule should be changed.

我认为疫苗领域有许多新问题，包括即将问世的新疫苗和需要ACIP及CDC审核的新版本疫苗，而不是回头去研究那些我们已经验证过或已纳入儿科建议的内容。

So I think there's many new issues in vaccines, new vaccines coming down the pike and new versions of vaccines that need to be reviewed by the ACIP and by the CDC rather than going backwards and looking at things that we've already proven or that are are already added to the to pediatric recommendations.

这位是马里兰大学医学院的詹姆斯·坎贝尔教授。

That is doctor James Campbell, a professor at the University of Maryland School of Medicine.

非常感谢。

Thanks so much.

谢谢。

Thank you.

本期节目由文森特·阿科维诺和卡伦·萨莫拉制作。

This episode was produced by Vincent Acovino and Karen Zamora.

由亚当·雷尼编辑。

It was edited by Adam Rainey.

我们的执行制片人是萨米·叶尼根。

Our executive producer is Sammy Yenigan.

在我们结束前，为NPR Plus支持者快速推荐我们最新的特别节目。

And before we go, a quick plug for our latest bonus episode for NPR Plus supporters.

玛丽·路易斯·凯莉与《华盛顿邮报》的调查记者卡罗尔·伦宁和亚伦·戴维斯进行了对话。

Mary Louise Kelly speaks with investigative reporters Carol Lenning and Aaron Davis of The Washington Post.

他们关于司法部的新书认为该机构已被政治和恐惧所'征服'。

Their new book about the justice department argues the agency has been, quote, vanquished by politics and fear.

作为NPR Plus支持者，您现在就可以收听这场对话，更多详情请访问plus.npr.org。

You can hear the conversation now you're an NPR Plus supporter and learn more at plus.npr.org.

这里是NPR的《考虑一下》节目。

It's consider this from NPR.

我是斯科特·德特罗。

I'm Scott Dettrow.

我想快速确认一下情况。

So I just wanna check-in really quick.

你还好吗？还是正遭受睡眠不足、账单堆积或政治宣传的困扰？

Are you okay, or are you suffering from sleep deprivation, a stack of bills, or political propaganda?

如果是这样，你可能陷入了父母陷阱。

If so, you may be stuck in the parent trap.

在《It's Been a Minute》播客中，我们将深入探讨现代育儿的焦虑，以及这种焦虑如何渗透到我们每个人身上——即使你没有孩子。

On the It's Been a Minute podcast, we're diving headfirst into the anxieties of modern parenting and how that trickles out to all of us even if you don't have children.

来寻找一些解脱吧。

Come find some relief.

请在NPR应用或你获取播客的任何平台收听《It's Been a Minute》播客。

Listen to the It's Been a Minute podcast on the NPR app or wherever you get your podcasts.

想听无广告插播版的这个播客吗？

Wanna hear this podcast without sponsor breaks?

亚马逊Prime会员可以通过Amazon Music收听无广告版的《Consider This》，或者你也可以支持NPR的重要新闻报道，并通过+.npr.org获取《Consider This Plus》。

Amazon Prime members can listen to consider this sponsor free through Amazon Music, or you can also support NPR's vital journalism and get consider this plus at +.npr.org.

网址是+.npr.org。

That's +.npr.org.