Ep. 36: Fighting the Flu, Green Burials, and Teen Vaccinations

Join journalist, author, and the director of MIT’s Graduate Program in Science Writing Seth Mnookin as he chats with Undark’s deputy editor Jane Roberts about teenagers pushing to get vaccinated against their parents’ wishes. Also in this episode: Kasha Patel talks with researchers working to develop a universal flu vaccine that would provide protection across the seasons; and Randy Scott Carroll reports on the trend of green burials, both for environmental reasons, but also as way to take back control over our bodies.

Below are the individual segments and a full transcript of the podcast, lightly edited for clarity. You can also subscribe to the Undark podcast at iTunes or listen on Spotify.

 

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Kasha Patel: Hey, Undark listeners. Happy February! I’m your host, Kasha Patel. In today’s episode, we’re talking about how people are reducing their carbon footprint after death. Plus, a new kind of teenage rebellion: kids who go against their parents to vaccinate themselves. But first, I want to talk about a nasty three-letter word that is very popular this time of the year: the flu. Last year, 80,000 people in the U.S. died from the flu – that’s higher than the number of soldiers who died in the Vietnam War. And while the flu is worse for the very young and the very old, last year’s season was the first to be labeled high severity across all age groups. Thankfully, this year is considered “mild” but what does mild really mean?

Nancy Messonnier: Mild still means so far, in February, we have had 19,000 deaths due to flu, so in most settings, people wouldn’t think that’s mild.

Kasha Patel: That’s Dr. Nancy Messonnier from the CDC. She’s the Director of the National Center for Immunization and Respiratory Diseases. Now, it seemed strange to me that we still have kind of large numbers for flu outbreaks nowadays. We can keep diseases like measles and polio at bay with a couple childhood shots of a universal vaccine. Why haven’t we figured that out with the flu? Why do I have to go in every year for a different flu vaccine? Well, here’s the short answer: it’s an especially tricky kind of bug.

Nancy Messonnier: It’s actually the flu virus that’s the problem. So the flu virus is a new virus every year, and we basically have a new season every year. So finding a vaccine is much more difficult because of how frequently the virus changes and the potential to have dramatic changes, which is what can lead to a pandemic.

Kasha Patel: The flu virus, unlike the ones that cause measles or polio, comes in several different varieties. Scientists use two proteins on the shell of a flu virus to classify it: hemagglutinin and neuraminidase. These two proteins have several different subtypes. Then those subtypes can be broken down even more into different strains and the exact kind of virus going around changes every single year.

Earlier this month at the American Association for the Advancement of Science conference, Dr. Messonnier sat down with several other flu researchers and discussed the challenges of creating a flu vaccine.

I talked to John Shiver, the senior vice president of global vaccine research and development at the pharmaceutical company Sanofi Pasteur, who also participated in the press conference.

John Shiver: Flu is kind of a paradox, it changes, it is a moving target from year to year, which of course the vaccines need to keep up with that. On the other hand, it is kind of a simple virus because there’s only really 10 components, or proteins, that comprise the virus. Only one of these is the primary vaccine target that we build vaccines around, the so-called hemagglutinin protein.

Kasha Patel: Shiver said starting in 2009, researchers gained some valuable insight into the structure of the hemagglutinin protein. The protein has two components — a head and a stem. Vaccines prime our immune system by giving it a target to remember — for the flu vaccine, that target is on the head of the hemagglutinin. But the heads change every year and, as a result, so do our flu vaccines.

But Shiver and other researchers are also interested in the second component of the hemagglutinin protein — the stem — because it might just be the key to a universal vaccine. Unlike the protein head, the stem remains pretty much the same for each type of virus. If scientists can figure out how to create a vaccine that targets the stem or another stable structure that all flu viruses share, they may be able to create a single universal vaccine. A universal vaccine would be a holy grail. You take it once at childhood and it covers you for several seasons or maybe forever. Developing a universal vaccine, though, is still in the very early stages.

John Shiver: A universal flu vaccine is an important goal. It is possibly achievable, and certainly [there is] a lot of work going towards that. But even short of that goal, a more broadly protective vaccine, that might protect across multiple seasons would have tremendous impact and value and would be a big step forward I think for flu vaccines overall. And I think that there is also value in perhaps having improved seasonal vaccines. There are certainly things to explore to have a potentially improved seasonal as well as a more broadly protective vaccine. And time will tell which of these might emerge and which will emerge first.

Kasha Patel: Companies are already finding ways to make current seasonal vaccines better, especially in populations aged 65 and older, which are the most vulnerable to the flu. Sanofi has produced a high-dose flu vaccine for older populations. Compared to a regular dose flu shot, it has four times more antigens, which is the part of the vaccine that helps build up immunity against the virus in your body. The vaccine was 24 percent more effective in preventing the flu in that age group than the standard vaccine. Another company called Seqirus created a vaccine that protects against flu but also includes some ingredients to help boost the immune systems for those 65 and older. In an observational study, it was 63 percent more effective than regular-dose run-of-the-mill flu shots.

So maybe right now, we don’t have a universal vaccine. Probably not even in five years, but Shiver and Messonnier do believe that we will see major improvements for seasonal vaccines.

Nancy Messonnier: Five years is probably a good estimate for a major step forward, but we’re not going to have the one single vaccine all taken care of in five years, that’s a much longer endeavor. Incremental progress is still great. Even small improvements in the effectiveness of the vaccine can prevent countless deaths, hospitalizations and occurrence of disease every year. So we shouldn’t just shoot for the stars, we should be happy with those small improvements too.

 

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Kasha Patel: Now, until we find that universal cure, remember to keep taking your seasonal flu vaccines. Yes, getting a vaccine every year is a pain, but it is also the most effective way to fight illnesses associated with the flu. It reduces your chances of getting the flu by 40 to 60 percent and it also makes it less likely that people around you will catch it. And that’s persuasive enough for me.

Have you ever thought about how big your carbon footprint will be after you die? More and more Americans are looking into green burials, which is a part of a fast-growing natural burial industry. Today we’re going to find out what exactly is a green burial and why so many people are choosing them. Here’s Randy Scott Carroll, reporting for Undark.

Jackie Wilson: It’s dust to dust…what’s happening to me. I’ll be buried back into stardust.

Randy Scott Carroll: I’m with Jackie Wilson in her living room in Silverlake, New Jersey.

Jackie Wilson: I don’t like the end. Yeah. You know I’m resistant to the end. I don’t want to leave it.

Randy Scott Carroll: Jackie is on hospice here. The lights are off, but the big window lets in a soft glow and she can see the lake from her hospital bed. As she nears the end of her life, she says she’s chosen to do things a little differently.

Jackie Wilson: I’ll be having a green burial in the forest…with the little stone that comes from my field…That I can have carved with a little name…

Randy Scott Carroll: Green burials like the one Jackie just mentioned are on the rise in the U.S., with cemeteries reporting a big increase in demand. So I wanted to find out what is a green burial, exactly? And why are we choosing them?

Ed Bixby: This really is a movement, it’s a cultural change.

Randy Scott Carroll: It’s a dreary day in southern New Jersey as Ed Bixby gives me a tour of the grounds where Jackie will be buried. He’s the owner of Steelmantown Cemetery, where natural deer trails lead to one grave site after another, some graves with no identification at all.

Randy Scott Carroll, on tape: What’s the decision behind having no marker?

Ed Bixby: You know, it’s just, just a personal decision. I just have people who say, you know, I don’t want a marker.

Randy Scott Carroll: Green burials, or natural burials, cover a wide range of options, from planting seed-impregnated biodegradable urns to having your remains turned into artificial reefs to help restore aquatic habitats. To set itself apart, Steelmantown has chosen a simple yet traditional approach to their burials. Using modest pine caskets or burial shrouds, there’s no embalming fluids, no concrete vaults, and the grave site is dug by hand, often with the family’s help. Ed says, it’s very healing for the families to be so hands on.

Ed Bixby: We’re going back and we’re allowing the family to be a major part of the process. I mean, we’re allowing them to care for their loved one in a way that…has been kind of lost in the last hundred years…You know, it really, really changes the whole game.

Randy Scott Carroll: Eventually, Ed shows me a fresh grave site. There’s a mound of dirt covered with leaves and twigs from around the forest. I’ll admit, a sense of peace comes over me in a way I didn’t expect. And then, as Ed begins telling me all the ways he hopes to grow his cemetery in the future, I’m hooked.

Ed Bixby: Why not make that into a beautiful butterfly garden? Why not put in a trail system? Allow it to grow up with native grasses and flowers, bring in a natural educator, bringing school groups or different groups to appreciate the history…

Randy Scott Carroll: Like a lot of folks, I try to be a pretty environmentally conscious person and so yeah, I’ve wondered how that could continue even after my death. And in fact, a survey by the by the National Funeral Directors Association found that over half of Americans are also looking to reduce their environmental impact when it comes to their own funeral.

Antonius Robben: It’s almost like a reciprocal relationship between culture and nature we now return to nature what we took from nature…It’s a sacrifice kind of, you know, paying a debt with nature.

Randy Scott Carroll: This is Antonius Robben. He’s an anthropologist at Utrecht University in the Netherlands, and the editor of “Death, Mourning and Burial,” an anthology on how cultures have viewed and processed death throughout history. Robben says natural burials are really nothing new. He mentions the Zoroastrians in India.

Antonius Robben: So you have these towers in India and you have hundreds of vultures sitting around them and then they leave your body there and then these vultures come you know…that is a natural burial, see, but it would be forbidden in this country or in the United States. So both cases have natural burials, but they’re always natural burials under very specific conditions.

Randy Scott Carroll: With modern environmental concerns today, he says it makes sense that green burials would start to have their own movement, but that it doesn’t tell the whole story.

Antonius Robben: Because of this movement of natural burial, in a way, if you take the long… if you take centuries of development of what’s being done with the body, people taking the power back over their own bodies and the bodies of their loved ones.

Randy Scott Carroll: Sovereignty over the body, he thinks, is the biggest factor for this growing trend towards more natural burials. In fact, that same survey by the National Funeral Directors Association found that for Americans, desire for religion to be a part of the rituals in death is at an all-time low, below 40 percent. And, according to PEW Research center, our confidence in the government is at a historic low as well, around 18 percent. It’s with this in mind that Robben says, people are beginning to question the way things have been.

Antonius Robben: So this could be also, you know, start of a kind of a rebellion of taking back control over ourselves.

Randy Scott Carroll: Through this conversation, it becomes clear that this movement towards places like Steelmantown feels more like a political and cultural statement of who we are and about who we want to be — about finding new meaning in a world full of growing uncertainty in our long-held institutions. So, whether it’s as a cultural rebellion, a tower in India, an extension of your environmental passion, or just a new and helpful way for families to mourn the loss of their loved one, he says we can’t escape the fact that how we choose to bury our dead says as much about who we are and our current values than anything else.

Antonius Robben: Burials are always cultural. Burials always have meaning for people and culture is about meaning.

Jackie Wilson: Everybody has to die of something. Some time. Some place. And the way I’m directing is my own personal way…

Randy Scott Carroll: Back in Jackie’s home, she begins to tell me stories from her life, of what it was like as a doctor trying to make it in the 60s, and as a lesbian too, something she had to hide for a long time. Her partner is now with her in these last few days. She tells me, as a doctor, she would have patients that would come to her with anxieties, often about death. She would tell them that sometimes the best way to ease those anxieties is to focus on the meaning we make for ourselves and with our loved ones here in this life.

Jackie Wilson: Enjoy a piece of fruit together. It could be an organic peach that you took out of a brown bag after two days and it was really good and juicy. You know, share something like that with each other.

 

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Kasha Patel: We’re heading back to talk about vaccines again. Jane Roberts wrote a piece for Undark Magazine on teens who go against their parents’ wishes and vaccinate themselves. The piece went viral, no pun intended, so we brought Jane in to learn more. Interviewing her is Seth Mnookin. Seth is a journalist, author, and director of MIT’s graduate program in science writing. Take it away Seth.

Seth Mnookin: It is my absolute pleasure to welcome to the podcast Jane Roberts, the deputy editor of Undark, who, earlier this month, wrote a really phenomenal article called “Coming of Age Unvaccinated” that looked at the issue of vaccines in a really original and new light. She examined it from the perspective of teenagers whose parents decided not to vaccinate them who now are reconsidering that and, in some cases, going ahead and choosing to get vaccinated. This is a topic that is near and dear to my heart. My last book, “The Panic Virus,” was about the anti-vaccine movement and how the misinformation about vaccines has spread over the years and why it has remained so persistent in spite of all the evidence showing that not only are vaccines safe, but they’re incredibly important to protect against infectious diseases. Jane, welcome to the podcast.

Jane Roberts: Thanks so much, Seth.

Seth Mnookin: So, my first question is what brought you to this story? It’s a unique angle, and it’s one that you really don’t see, so I’m curious about how you came up with this.

Jane Roberts: I came across a … I think it was a tweet where somebody had said, “Apparently teenagers on Reddit are asking how to get vaccinated.” So, I talked to a couple of the teenagers and then decided to actually look into what the laws were to see, can somebody under 18 get vaccinated?

Seth Mnookin: So, Jane, you got into some really fascinating issues in your piece, including exactly what the legal issues are for teenagers who might wanna get vaccinated. Can you talk a little bit about that?

Jane Roberts: What I found was that there’s no federal laws that relate to vaccines. It’s all done by state, and there are some states that allow teens to get vaccinated in specific circumstances and for specific vaccines. So, for instance, I pointed out in the piece that Minnesota allows minors to get vaccinated for Hepatitis B and California allows minors, from the age of 12, to get vaccinated for Hepatitis B and HPV. In some other states, there are laws that refer to general medical care. In Alabama, a minor could consent to this at age 14, and in Oregon, they could consent at age 15. But these are all very specific cases. In general, minors can consent to medical care if they are emancipated. One really interesting thing is if a minor has a child of their own, in most cases, they can consent for themselves to be vaccinated and that child. So, you could have a 16-year-old who has a child who can consent to get vaccinated, but a 16-year-old who doesn’t have a child can’t make that decision.

Seth Mnookin: Right.

Jane Roberts: There’s also this idea of what we call a mature minor where a doctor can make a call on if they determine that a minor is mature enough to make a decision for what they say is low-risk care. Normally, that’s used in cases of reproductive health, but when I spoke to Allison Winnike, the president and CEO of the Immunization Partnership, which is a nonprofit that is focused on eradicating vaccine-preventable diseases, she told me that mature minor is like a code for emancipation, not in a legal sense, but when a doctor’s making that decision, they’re gonna look at is a minor living on their own, are they financially independent, and those sorts of things.

Seth Mnookin: Right. Right. Just from a reporting perspective, was it difficult to get teenagers to open up to you? Almost by definition, this is something that they’re doing at odds with what their parents want them to do.

Jane Roberts: So, I reached out to three teenagers, and Ethan Lindenberger, who everybody knows now from the story, he was really open about talking with me. At first, he didn’t really want his mom to find out about this story, which didn’t work out that way. I did talk to another teenager, who is still under 18, who requested to remain anonymous. So, yeah, I think most teenagers probably wouldn’t wanna speak out about it, but I’m really glad that Ethan was willing to share with me.

Seth Mnookin: And so in this story, you talk to Ethan, who is 18, from Ohio, his mom and, it sounds like, his dad, to a lesser extent, didn’t want to have him vaccinated, and he’s decided on his own, when he was 18, to go ahead and do that. In the article, you talk about his decision-making process. So, Jane, I know no matter how prepared someone might be for being the subject of a news article, it’s different once the piece is actually published. What was Ethan’s reaction to this coming out?

Jane Roberts: Yeah. I actually asked him about this, so I’ll let him speak for himself.

Hey, Ethan. How’s it going?

Ethan Lindenberger: Hey. It’s going all right. How are you doing?

Jane Roberts: Good. So, it’s been a few weeks since we first connected to talk about your decision to get vaccinated and since we first published the story in Undark. It’s really taken on a life of its own. With all of the follow-up interviews from the Washington Post to Fox to CNN and even the Today show Good Morning America, how do you feel about the way that the story has grown and changed compared to the way that it was first reported?

Ethan Lindenberger: Yeah. Even by the title of the original ways that the news and the media was presenting the story drastically shaped depending on who had their hands it. I know when Undark first reported the story and the article was titled “Coming of Age Unvaccinated” and talked about the issues with going against the parental figure’s authority to pursue vaccinations was a lot more tame. Some of the other articles are saying stuff like, “Oh, teenage attacks … Teen attacks mom,” or, “Teenager defies mother and gets vaccinated,” or, “Get all of his shots for his 18th birthday,” and so a lot of it was very exaggerated for sure.

Seth Mnookin: That’s fascinating. That’s a fascinating look at the science news ecosystem and how you take a piece like yours that was very judicious and fair-minded and presented everything in a way that certainly was not sensationalistic and then how quickly that can change once other people start re-reporting it. What were some of the ways that your story was then taken and disseminated by other news sources?

Jane Roberts: My piece was focused on the legal aspect and it was really the dynamic of Ethan and his mom and some of the quotes that I got from her that people really latched on to. So, once my story ran, I think then it got picked up by NPR, the Washington Post, and then Ethan got asked to be on TV news, and so it got condensed a lot more to really just focusing on the differences in opinion between he and his mom and framing it in a way as him going against his family’s wishes or defying them. Really, he just saw it as he is making an educated decision backed by fact and he was doing something that was not only in his own best interest, but in the best interest of others as well. So, yeah, I don’t think that he saw it as being as big of a deal as some of the other news outlets framed it to be.

Seth Mnookin: Right. In shrinking it down, you got some of that on the one hand. On the other hand, which is one of the ways that, I think, people end up believing things for which there’s no evidence. Also, his mom is pretty direct and upfront about how she feels like this is really a slap in the face to her. What was it like talking to Ethan’s mom?

Jane Roberts: It was interesting. She did have her oldest daughter vaccinated, and then she started vaccinations with her oldest son, and then found out from someone that she could opt out. And so she told me she started researching on her own, she read a lot of things. She read books that were both for vaccines and against vaccines and in the middle, and she talked to friends as well … And she actually told me that she had a friend who believed that their two children had been injured by vaccines and had developed autism.

Seth Mnookin: Yeah. That’s been one of the more persistent claims, and we know that there is actually no evidence of that. There’ve been huge omnibus court cases that have looked at that, and the rulings have been overwhelming that there’s absolutely no evidence that the MMR vaccine causes autism or any autism-like conditions.

Jane Roberts: Yeah. So, she told me that she had come to the conclusion, as she put it, that it was not a black and white issue and that, for her family, that it was the best decision not have them vaccinated. She said that, really, what hurt her was that she had put in all of this time and effort into researching over the years and that when Ethan decided to get himself vaccinated, he didn’t come and talk to her about why she had made that decision for them. He just went to talk to his doctor and made the decision on his own, and she really felt like that was disrespectful to her.

Seth Mnookin: But I do just want to emphasize that when Ethan’s mom says that there are two sides to this, there really aren’t respected medical authorities who share that view. They’re the single most tested medical intervention that we have, and now because they’ve been used for decades and decades, they’ve been tested literally on tens of millions of people, that not only are they incredibly safe, but obviously, they protect against a range of infectious diseases, some of which can be deadly.

If someone with measles is in a room and then leaves the room, 30 minutes later, and sometimes even more than that, if someone without immunity comes into the room, there’s a 90 percent chance that that person will get infected. We’ve really learned and seen how contagious measles is over the past couple of years. There have been outbreaks around the country of hundreds and hundreds of cases, all in areas where there are pockets of unvaccinated people. It really highlights how not getting vaccinated is a decision that carries with it real risks and real public health costs. There have been analysis that containing a single case of measles costs over $10,000.

Jane Roberts: Yeah and just something I wanted to bring up on a more personal note here, is that the mumps component of the vaccine is less effective, at about 88 percent. So we actually had an outbreak at the University of Wisconsin-Madison when I was a student there and I got infected. And as much as people say that these diseases are just part of childhood and that they’re mild, that was a really horrible experience for me. I couldn’t eat or really even lift my head for days and the swelling was really painful. And the cases at my school were in vaccinated students, but I think it’s important to remember that the majority of people were protected. Before vaccination started in the 60s, according to the CDC, 186,000 cases reported each year. Now, annual cases max out at a few thousand per year. I don’t really want to think about how bad things could have been if we had a large population of unvaccinated students living in close quarters at the university like we were.

But going back to measles; the MMR vaccine is 97 percent effective for that. Before we had the vaccine, there were 3 to 4 million cases per year. I don’t think that’s something we really want to go back to..

Seth Mnookin: In some ways, vaccines have been a victim of their own success because they have succeeded in countries like the United States, making these diseases, like polio and measles, and Rubella, almost distant memories.

Something that has changed since my book came out is that when I was researching my book, and then even in the couple years after that, for the most part, the anti-vaccine community was really focused, overwhelmingly, in communities that have been affected by autism, either families who knew someone or had a family member who was affected by autism, and it sounds like Ethan’s family and a lot of the families that you’re referencing in the piece have come of age in a different environment where the anti-vaccine sentiments have spread through social media or other means, and so now even if they have no connection with someone who they think has been harmed by vaccines, they’re deciding not to vaccinate. Is that accurate? Is that what you found in talking to people?

Jane Roberts: Yeah, I think some of it does come from personal stories, but also, there’s a lot that comes from social media. There’s a lot of Facebook groups that push this anti-vaccine message or more self-report it to be an issue of medical freedom. They don’t want vaccines to be mandated, and they wanna be able to still have those philosophical or religious exemptions, and so I think a lot of that really reinforces their view, and when you’re in these Facebook groups and you’re just speaking to other people who have the same views, I think it really creates that insular community.

Seth Mnookin: Yeah. I had one pediatrician once say to me that getting vaccinated is a purely personal decision the way that drunk driving is a purely personal decision. Obviously, it’s not something that just affects you if you end up with one of these diseases. By far, the most difficult and painful conversations I had were with parents whose children had been infected and, in some cases, died, and they were too young to get vaccinated, so these were not parents who decided not to vaccinate their kids, but parents whose children, in all likelihood, were infected with a vaccine-preventable disease in the pediatrician’s office and then, in several cases, died.

Two other questions. One … You obviously know this is a very emotional topic, a hot button topic. Just as a journalist, as a reporter going into this, did you have any hesitation? Did you think about, “Maybe this is not something I wanna weigh into. My life is busy enough without needing to deal with all of the anger and invective that comes with covering this type of story?”

Jane Roberts: No, I didn’t have any hesitation. I knew that I might get some backlash and negative comments, but I thought it was a really important thing to talk about, and I think it’s been a really important story, and with how widespread it’s gotten, it’s really created a lot of discussion among other teens and their parents about whether they can actually get vaccinated and just empower them, I think, to take that into their own hands a little bit more.

Seth Mnookin: Have you learned all of the new ways that you are being funded by Big Pharma?

Jane Roberts: Yeah. I did see one Twitter post that was trying to link the Knight Foundation, which funds Undark, to the CDC and the Gates Foundation and creating all of these links. Yeah. So, I thought that that was sort of interesting. But overall, I haven’t received a ton of comments aimed directly at me. I think most … Ethan has really taken most of the heat…

Seth Mnookin: Right. Right.

Jane Roberts: … from what I’ve seen.

Seth Mnookin: Yeah. It was certainly … It was courageous of him to speak out like this. Has he talked at all about a positive effect this may have had on other teens or creating a space where teens who have not been vaccinated can start to have those conversations?

Jane Roberts: Yeah, definitely. He’s told me he’s gotten a lot of people reaching out on Reddit and through other channels, thanking him for speaking out, either people who have … also grew up unvaccinated, even people over the age of 18, I think people in their 20s who were still afraid to get vaccinated. One important point that he makes is … There’s a lot of comments saying, “Why is this a story? He’s 18,” but he’s pointed out that just because somebody’s 18 doesn’t mean that they’re financially independent, doesn’t mean that there’s no repercussions from their family for making this sort of decision, and so even people who are older than him are finding if they still live with their parents, they might not be able to make that decision to get vaccinated for fear of actually being kicked out of the house or other things like that. But yeah, he’s definitely noticed some positive impacts and he’s actually gotten asked to be on a panel in September from the American Academy of Pediatrics to talk about this.

Seth Mnookin: That’s great. Yeah, the fact that he’s over 18, first of all, it, obviously, doesn’t change the emotional component of needing to do something that’s against your parents’ wishes, but also, it’s a way to talk about these issues for people who are under 18. I thought you did a really … you and he did a really valuable service in that regard. That, actually, leads me into another question. Did you talk with Ethan at all … Do you know whether this piece and the reaction to it affected his mom at all? Did she reexamine any of her assumptions?

Jane Roberts: Yeah. I also asked him about this. I have another clip to play for you.

And from dealing with this on a daily basis at home, has talking about this helped you come to any conclusions about how to better reach people who hold these sorts of views about vaccination?

Ethan Lindenberger: Yeah. Part of it’s pessimistic and part of it’s very realistic in a way for me where it’s like … People don’t necessarily always wanna change their mind, and some people are just set in their ways when it comes stuff like this, and I think, at this point, I’ve concluded that my mom is like that. Even publicly, she’s continued to share the same information I’ve tried to beg her to analyze because it’s just so questionable on an ethical level, on a journalistic level. The information she’s getting is just so bogus. Part of it is … I’ve gotten to the point now where for years now, I’ve tried to explain things to her, and nothing’s gotten through, nothing’s resonated.

Seth Mnookin: Yeah, that’s so fascinating. My book came out in 2011, and within a year of when it was published, Andrew Wakefield, the person who really started the modern-day vaccine scares. He lost his medical license because of some really heinous experiments he was conducting on children, including at his son’s birthday party, and the original paper that posited that there was some connection between the MMR vaccine and vaccine injuries and autism was withdrawn and there was evidence of fraud there, and I thought at the time, “Well, okay. I guess my book will be this nice historical document,” but now, this will end this debate. I think what Ethan just said is a really fascinating illustration of how when people, and there have been a lot of studies on this, when people believe in a conspiracy, evidence, factual evidence to the contrary, most of the time, only ends up leaving them more convinced that the conspiracy is actually happening, that their original opinion is correct, and it sounds like that’s definitely what happened with Ethan’s mom here.

Jane Roberts: Yeah. So, even after the story came out and with all the different coverage, I know she definitely felt like it wasn’t presenting her side of things in an accurate light, and she … Yeah, it was clear that she had doubled down in her views. She’d even said to me that this whole process with Ethan getting vaccinated has made it all the more important that she talk to her younger children before they come of age so that she can make sure they understand why she didn’t get them vaccinated and make sure that, as she says it, make sure they’re educated before they make the decision on their own.

Seth Mnookin: Right. Yeah. Well, Jane, thank you so much, both for writing this piece … I think it’s a really important piece, and on a subject like this that has gotten a lot of coverage over the last five or 10 years. It’s pretty unusual that you see a piece that really comes at it in an entirely new way, and your piece definitely did that. I think it did a great service, so thank you for that and thank you for coming on the podcast.

Jane Roberts: Yeah, thank you so much. I really hope that it continues to generate discussion.

Kasha Patel: Thank you for listening Undark fans, that’s all for this month. We’re produced by Lydia Chain, music is by the Undark team. Music in Randy Scott Carroll’s piece was by himself and Thomas Cleary. I’m your host, Kasha Patel. Talk to you next month.