Dress Doctor Diaz might, in my
pronouncing your last name correctly.
Yes, that's fine. Steve Diaz.
OK, got it and what? What's
the appropriate title for you?
It is Doctor D as I go by. Steve is
what Steve is fine with me as well.
Oh sure, but chief medical officer right? I'm
sorry. Yes I'm the chief medical
officer for Maine General Health,
awesome. Well, doctor Diaz.
I guess you know.
Where I should start is just by we.
We do this verify segment to make sure
that we kind of calmed that all the
misinformation that's out there about
well in this case happens to be the
COVID-19 vaccines, but our verify, you know,
brand really applies to anything you know.
We had one the other day about his Social
Security going to run out in 12 years.
So anyway, but there's, but it's not.
But but there's a lot of stuff as as
I'm sure you've seen and probably heard
online and then just circulating from
people about you know misinformation
about the COVID-19 vaccine is there?
Is there one in particular that either
sticks out to you from either patients
or friends and family or or your
coworkers staff that that you hear a lot?
Yes, I know there's a few I.
I think the major thread is that
this is the first large scale
production of M RNA vaccines,
and so how do we know it's safe?
You know it's it's so new.
That's probably the number
one and I would say.
It's not as new as you think.
You know M RNA technology to get M RNA
into cells has been around since 1978.
And in the 21st century early 2000s they
started looking at it for other vaccines.
It had been used in mice in 1990s.
Then they start looking at humans
and they actually ran down the path
of Ebola and rabies vaccines with
M RNA and they never got very far.
Who knows the different reasons.
But then when the global pandemic hit,
they were well positioned to
take this technology,
which has been around for decades,
pivot and move the timeline for
production in two months rather than.
You know the typical four to seven years,
so in many ways we were very fortunate,
but it's not brand spanking new.
It's it's been well tested for
decades and it kind of then hinges.
The next thing I hear is that
is experimental. Uhm, yes.
Experiments were conducted to
get to where we are today,
but when the FDA issues
emergency use authorization,
it's gone through all the appropriate
steps to verify that it works.
That it has a safety profile
that is going to be continuously.
It's in all the things that other
medications or vaccines go through no
differently that we do not call experiment.
Also, no, it's not experimental.
It's not France spanking new.
The scale is,
and it's not experimental.
Those are probably the two biggest things.
That people throw into the conversation.
That makes it very difficult to then
talk about the value of vaccination.
Can you explain why that's so difficult
to have to have those discussions with
with people who have those beliefs?
I think the difficulty is that.
For the last 19 months, our national
communication has been fragmented.
I think there's been very smart people,
with perhaps good intentions,
whose message either didn't align
completely or **** align at all,
and I think that causes distrust.
And so when you look at who
people go to by and large,
it's largely been their primary
care physicians or other health
care professionals they trust.
And even amongst those factions,
sometimes there's not exact alignment.
But when it starts out that
the big message is muddled,
I think it's very hard then for people
to know that what we're saying is in
fact the science of the day and not
someone's opinion of which should be.
So that's why it's so hard.
We haven't had a consistent national message.
So the one on one discussions become much
more difficult as people can then say,
well, I read on this blog or I
saw on Facebook so so it's pulling
them back is very difficult.
Once that is set in.
One thing I wanted to make sure
that I understand before I do any
more reporting on this because
we've talked about the the the
technology of an M RNA vaccine has
been studied right by researchers.
Like the 70s, has it ever been
produced in a vaccine before to
combat like another respiratory virus?
So it so in the late 1990s,
I believe it was actually used
to create vaccines for mice.
They made some test mice
and they and so in the 70s.
What they developed was the ability
to use M RNA the way you wanted
and what they wanted to do was take
M RNA and deliver it into a cell,
overtly so that's what was discovered
in the 70s and 80s and the 90s.
They then were able to take
that mechanism and create.
A vaccine M RNA is different
than other vaccines.
Other vaccine vaccines have been
around for hundreds of years.
We take something that hurts us.
We take it either from ourselves
or from other animals like us.
We denature.
It is that we partly destroyed some way,
either with chemicals or heat,
and then once it's no longer really
active that these are early ones,
we give it to a lot of people,
so they get a partial immune
response so they don't get so sick
or die from whatever the diseases.
So your body is seeing parts of an
infection to create an immune response.
Myrna actually takes part of the
material of the infecting agent and
goes into your cells and creates
the proteins to help fight it.
They're not tricking the cells the
immune cells to work by showing
them the threat there.
Taking over the machinery to produce
the things that you need to fight the threat.
Very different concept and so.
When they did it in the mice
and then they started looking at
it for a Ebola and rabies.
I know some large companies spun up to do it.
I don't know where they went as far as
how far they were ready to go live.
Many of these, I think biochemical endeavors.
I don't think as well funded as things.
As as other things,
and so that's probably what happened.
They ran out of the capital to
pursue that for whatever reason.
But I think when something happens,
to which there's a large demand,
such as COVID-19,
they're able to take that same
mechanism and technology and then
find a way forward with a business
plan as well as they ethical
obligation to provide the material.
Got it, this is something also that that's
kind of come up before and I know our
public health leaders have addressed this,
but I wanted to ask you as well that
the concept of the emergency use
authorization means that the A vaccine
manufacturer was allowed to either
skip certain portions of research,
trials, clinical trials, or.
Skip the animal testing
or anything like that.
Can you just help me understand?
I mean, is that what an EUA allows for
it is? It is not?
In UA allows you to go forward with
authorization and it is full authorization.
It's not full approval,
it's full authorization that someone
has passed each step along the way.
You are not allowed to skip any steps
and that each step was successful
and that the committee that convenes
to make sure that the risk is.
Less than the benefit, UM,
meets all those tenants.
There is still ongoing data being recovered,
and there's a different level
for full approval where you have
to have data coming back to you
in certain population numbers.
Certain demographics,
although many more checkboxes
than getting to the emergency
use authorization area,
but emergency use authorization does not.
Allow any step to be skipped,
not fulfilled or any.
Uhm, you know any any.
Subjective discrimination to occur to say,
well it looks OK.
It is the same process as with anything else.
It's the step before the FDA is
ready to review for full approval.
It gives the companies a chance to to
complete the packet that they have
to complete anyway for the process.
Yet it allows us to use the medication or
vaccination in an appropriate fashion,
and in this case for this global pandemic,
it was exactly the right call.
There are a lot of people who have
actually before I move on so so it is.
It would be false to say that.
Anyway, authorization is authorizations.
Sorry, that's redundant,
but an EUA does not mean that
a vaccine is experimental.
That would be, it would be false
to say that anyway means they that
the vaccines experimental that
is a false statement, correct.
It is not experimental as an EUA.
OK and then the last thing I wanted
to ask you to is and I know this
is kind of comma block is concerns
about the long term side effects.
Other doctors that I've spoken
to have said generally.
With vaccines and with these ones,
we would have seen any type of long
term effects roughly around 6 to 8 weeks
following the administration of a dose.
Can you explain one?
Is that true and and and two how that works,
yes, so most vaccine related issues are
really in the immediate post vaccination
area of us reacting to something in
the vaccine and having an allergic
response or something like that.
The vaccine triggers your immune system
to do something that's readily apparent
and correct 6 to 8 weeks is usually the
longest that it takes to figure that out.
The long term effects of vaccination
is an interesting concept,
especially in COVID,
so people are concerned that there
are some COVID infections that
lead to chronic conditions which
may stay with you for a long time.
Kidney damage, lung damage, etc.
If you're weighing the scales
of risk and benefits.
Being vaccinated and having the minimal
number of events we've seen over the
hundreds of millions of doses given.
It's much less than people who
are unvaccinated, get kovid,
and have long COVID syndrome which
has been dubbed or other issues where
the COVID infection has accelerated
or in created new issues for you,
either in your neurological system,
your heart, your lungs,
your kidney,
so in many ways I know my answer
your question directly,
but the first step is that.
COVID infection creates lot many
more long term issues.
For those who have it than the vaccine has.
As we know today,
so even today we know those numbers are
completely in favor of vaccination to
mitigate long-term chronic health conditions.
As far as the vaccine on its own,
for long long term outcomes,
I think this again comes from misinformation.
Early on you by major remembered there's
some studies that were pulled back
after they were found to be false,
that some vaccines cause autism.
Those were founded completely false,
but putting the genie back in the bottle
and that discussion has been over the
last 50 years and it's still ongoing.
So once that gets out there,
people get concerned about long term
effects because of that one false study.
Planting that seed,
but over time we have not seen
that vaccinations of all comers,
meaning the long term chronic
conditions and there may be one
of the million one in 10 million.
It's hard to figure out the reason this
is hard is in the background of all of this.
Overtime.
Is these disease diseases occur anyway,
so if you get a chronic condition
from something in five years and
you say oh it's got the vaccine,
well it could have also been
busier five years older.
You can you have diabetes.
Keep blood pressure.
It's very confounding,
which is why you need large
data sets to figure that out.
But be that as it may,
we know right now that the risk
benefit profile for humans is
that being vaccinated is much
safer than being unvaccinated.
Understood I guess doctor Diaz really
my my last question for you here.
Is you know when you're dealing
with patients, how often are you
having to have the discussion with
somebody who is vaccine hesitant and
and what are you saying to them?
So the vaccine hasn't.
Si question comes up all the time,
like on a daily basis
pretty much.
And I would say that the best.
The best way to approach that
is to have an open discussion.
People need to be heard II.
I think that people have obviously the
right to their opinions and to be.
Dealt with in a professional
and compassionate fashion
so that we hear this out.
I also tell people depending
on what they tell me.
I know I'm not going to change your mind,
but here's what we know.
I hear what you're saying,
think about it and in primary care.
If someone is using tobacco products.
The time they come to us and say I'm ready
to quit it takes 7 visits with them.
Over time,
before that discussed that that
initial discussion of I'm ready to
do something becomes an action plan.
Just because the behavioral changes.
Take a long time and that's very akin
to the high vaccine hesitancy piece.
It's it's not about I think
people being polarized,
although it comes out that way
because of the way the discussions
going on nationally really is.
People's belief and you need to
understand it and support them
and maybe over time there will
be a different way to do it.
It really I'm going back to the
whole national communication problem
by not having a single message by
not being aligned by not agreeing
that this is the best way forward.
And doing it in a thoughtful way,
we've allowed fashion that people glom
on to things that resonate with them.
And we need to just be patient and
do the best we can to let them know
that the way forward we believe
from the medical community is to be
vaccinated and hopefully at some
point that might resonate with you.
Duck Diaz even incredibly generous
with your time and I got to
ask you a ton of questions.
Is there anything that I didn't
ask you that you think I should
have or anything you feel like
we've left out? At this point?
The only thing I would say on the
vaccination front is the COVID-19 host
is us humans and when the variance
emerged they emerged because they're
able to get into us and change
a bit before they get propagated
to elsewhere to other humans.
The vaccines help break that cycle,
so when you see the different
variants coming out of the UK,
now the new ones or variants that
have popped up all over the world.
One of the ways to mitigate that when
the best way to make mitigate that
is if we take away their ability to
come into us and have time to do that,
then the variant cycle gets broken and
the building for it to be more virulent
or really outside of what the alphavirus was.
The Alpha variant was.
It helps us really stop,
so I know that the vaccination is a
personal decision and it protects you,
but also.
The vaccination present protect
all of us because we're breaking
the cycle of the virus.
Being able to do its variant dance,
and so that's the last thing I would
say is that it really is both personal
and public health discussion, obviously.
And it's not just because if we
all get vaccinated,
we get less sick.
It also breaks the cycle of
the transforming itself,
causing these waves that we're
seeing that are ongoing.
Awesome doctor Diaz.
I I kind of hate to meet people for
the first time with a mask on so this
is what I look like without a mask.
I really appreciate you making the
time to talk to us about this,
and you know I'd love to stay
in touch if there's more stuff
that comes up that you feel like,
hey, I'm hearing this, you know,
claim a lot from my patients,
or I'm seeing this claim online.
I just I would love to stay in
touch to make sure that we're
helping you guys address those
claims as they come up 'cause.
Look, I I need social media for my job,
but if I if I didn't,
I don't think I would use
it 'cause it's so brutal.
Well, I want to thank you
for asking me to do this,
you know reached out to me in general.
It's important that we're all
trying to help communicate better.
Well, I hope I didn't talk too fast. I
thought you were great.
You're a Rockstar. You made my life easy.
Oh good. Uhm, happy to stay in touch.
Yeah, and and and come join
McKenna has all my info.
I'm happy if she shares up with you.
I'll let her know. OK, cool.
And keep up the great work
awesome. I'd love that. Hey I'm
gonna stop the recording for now.