In this episode of A Moment in Health, Dr. Ashish Jha explains how 99% of new hepatitis B infections can be prevented with a universal newborn vaccine and critiques the recent ACIP decision to step away from that recommendation. He reviews a new New England Journal of Medicine study showing that one dose of the HPV vaccine is non-inferior to the traditional two-dose schedule, reducing barriers to protection. Dr. Jha is joined by Cate Ryan, Brown Class of 2021 and current Harvard public health student, who reflects on how reporting on science during the pandemic shaped her path in public health and how issues like housing stability continue to drive her work today.
Cate Ryan is an MPH candidate at the Harvard T.H. Chan School of Public Health, focusing on the intersection of health and housing. She graduated from Brown in 2021 with a cell and molecular biology major and was the former senior science and research editor for the Brown Daily Herald, as well as the producer of the COVID Pod with Dr. Ashish Jha.
About the Host
Dr. Ashish K. Jha is the dean of the Brown University School of Public Health.
Music by Katherine Beggs, additional music by Lulu West and Maya Polsky
Transcripts
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Ashish Jha
ild born in America since the:
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Cate Ryan
Thank you so much for having me. It's so fun to be back on the podcasting screen with you.
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Ashish Jha
Yes, but now we're flipping the screen here. I'm going to ask you the question, which is super exciting. Um, so here's my question and and it's a broad question, but you know, you were a student and senior during partly a junior, but then in your senior year in the middle of the pandemic. And obviously, as the person who was sort of the science and research editor at the at the Herald and then running the Covid Pod, you were immersed in thinking about the evidence and data and how it was all changing. I'd love if you could just talk a little bit about how your experience as a student and as a person deeply involved in this shaped your interest in public health and how it continues to influence the way you're studying public health and how you're thinking about practicing public health later.
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Cate Ryan
o my senior year, the fall of:
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Ashish Jha
That's super helpful and it's a it's a reminder. Look, there is something very powerful about studying cellular biology or or being a physician, like there's a direct impact that you can see, you can feel. Public health often is about doing things where the people who benefit will never know your name, never know what you did. And not only do you have to be comfortable with that, you have to actually rejoice in that. So that I think is a feature that most people don't understand. Let me maybe just follow up to say you'll be graduating soon, uh not that soon, but in like six months. How do you think about your future in public health now given all the kind of tumultuousness of of the field? How do you how do you think you're going to navigate that?
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Cate Ryan
e I was graduating college in:
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Ashish Jha
Yeah, well, thank you for for reminding me of that and and thank you for being on. It is a great reminder that, you know, at moments of crisis, you need people to step up and that can come in all sorts of different forms. And it is easy at this moment to feel disheartened by what is happening in public health, but listening to you and listening to your commitment to making sure people get housing and that we have a a housing policy that is not only good for the direct benefits of of housing, but all the public health benefits of housing, it's awesome. Kate, thank you for coming back to the to my podcast this time and enjoy the rest of your time at HSPH and and thanks for everything you're doing.
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Cate Ryan
Thank you. Thanks so much for having me on. It's such an honor.
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Ashish Jha
And there you have it. Another episode of a moment in health where we talked about one data point, 99%. That's the reduction from a universal hep B vaccine at the time of birth. We talked about one study, the non-inferiority of the one dose HPV vaccine and finding that one dose is as good as two or certainly not inferior. And then we heard from Cate Ryan. Cate was a senior during the the time when I arrived at Brown and was head of the science desk at the Brown Daily Herald and we did a pretty regular podcast. Now she's a master student at the Harvard School Public Health. And we heard from her about public health interventions and how they benefit people and the miracle of working in public health, the benefit, the beauty of working in public health is you do things that nobody will know they benefited from your work and yet that is the most satisfying part of all of this. And that gets me to a broader point across all three of the things we talked about today, the hep B vaccine, the HPV vaccine and Kate's comments, which is the heart of public health is about letting people live healthier lives without asking them to make changes in their decision making. That when you turn on the tap water, the water is clean and safe to drink, you're not asking people, hey, do you want clean water or dirty water, you default to clean water. That when you can make a two-dose vaccine, a one-dose vaccine, that's great. You just make it easier for people to do the right thing. One dose and they're done. Can't always get that. Some vaccines are multiple doses, but the goal of public health is to let people live their lives, do the things they care about and not have to worry about illness whenever you can accomplish that. That's what I found so important about the universal uh hep B vaccine at the time of birth. I have three kids, all of them got that. The point of giving it at birth is the mom and the baby are in the hospital usually and it's a great place and a great time to just give the vaccine. It's extraordinarily safe. There is no reason to delay it. And the only reason I believe that the ACIP at CDC did this was they just want to make it harder for people. It's sort of the ultimate anti-public health move to say, we have an opportunity to just do this, it's safe and effective, it'll work, but let's actually have you come back in two months. That means it won't be as effective because if there was perinatal transmission, those kids will not be protected and it's an extra visit. This was the most anti-public health in its spirit move that I have seen. Not catastrophic. I think most kids will continue to get the happy vaccine. A lot of them will continue to get it at birth, but to take away that recommendation makes zero sense. There's no scientific logic. All you're doing is creating friction in the system and making people's lives harder, the opposite of what we're trying to do in public health. Thanks so much for joining everybody. Uh stay healthy, stay well. I will see you back next week with another episode of a moment in health where we will cover a data point, discuss a study, answer a question. Thanks so much.
