"I Don't Have Time To Do Anything But Keep Fighting"

JEWS OF THE UNIVERSE: Introducing Dr. Paul Offit

“I knew from a very young age that I wanted to be a doctor. I was born with club feet – my feet sort of turned down and inward. By the time I was five, my father was distressed over the fact that my right heel couldn’t touch the ground. So he insisted that my foot be operated on. This was not a good idea but he couldn’t be dissuaded.”

“At first, my mother couldn’t get an appointment with the Club Foot Clinic at Johns Hopkins. So she called my grandfather’s brother — her uncle — who was the biggest bookie in Baltimore and maybe even the country. His name was Buckley Offit.

He was like the Jewish Godfather, a real macher, the patriarch of the family. And all his transactions were paid for in cash. A memoir was written about him by my mother’s cousin, actually, titled Memoir Of The Bookie’s Son, and there was also a fictional account of his life, The Other Side Of The Street.

In any event, he called the clinic and, lo and behold, suddenly an appointment was available.

And so my foot was operated on. Badly. There was no real operation to correct a club foot at the time. Ultimately the procedure was perfected in the mid-90s, but this was 40 years earlier. In any case, it was a failed surgery and it landed me in the Kernan Hospital For Crippled Children. I grew up in an era where you could use words like “crippled” and “feeble-minded” in the names of children’s hospitals.”

“I was there for around 6 weeks. If you’re in a chronic care facility in 1956, you’re going to be in a place with a polio ward. And there was a polio ward there, complete with those rows of iron lungs. And I remember witnessing those children getting the so-called “Sister Kenny Hot Pack Treatments,” in which these excruciatingly hot packs were placed on withered arms and legs as a way of trying to relieve muscle spasms and increase function in the affected limbs. I remember listening to those kids screaming. It was literally hell, like something out of a Dickens novel.

And these wards allowed visits for just one hour a week, on Sundays from 2 to 3 pm. My father, who was a traveling salesman, was always on the road, so he didn’t come. My mother was on bed rest from complications with her current pregnancy, so she never came.

So I just remember: nobody came. I was just abandoned in this awful place. I remember that my bed was on a balcony overlooking the front door of the hospital and I just kept watching that door, waiting for someone to walk through it and save me. But it didn’t happen.”

“So I had the most visceral awareness of the children on that ward as being vulnerable and helpless and alone. It was a scarring event, and I believe the passions of our adulthood are often tied to the scars of our childhood. So that was mine, and I think it drove me into pediatric infectious diseases — as did your mother [Dr. Ellen Wald], because she was a real inspiration to me both at Maryland and in Pittsburgh.

Ellen was the first mentor I encountered who was able to tell a story well – about the patients, and about the treatments. She was so clear and easy to understand, and so compelling, and I have no doubt that she was the reason I went into pediatric infectious diseases. She had everything to do with that decision. She was the first person to sit me down when I was a resident and give me a detailed lecture about vaccines. And I thought: this makes so much sense, it’s so clear. And so compelling.”

Portrait of the Doctor as a Young Man

“I also think that formative experience drove me to write my first book, which was about the polio vaccine. And I think it drives my passion now. I have reporters calling me up, asking me how I’m doing given all the death threats against me, but the reason this moment is so hard for me is the reason I went into pediatrics, which is: I see those children – and myself at some level – in those beds. I see myself as having been among those vulnerable children who were helpless and alone and needed protection.

And I feel like I’ve failed, at some level. And so I just keep fighting and fighting. That’s why I ignore the death threats. I’m ignoring a trial that’s going on right now in California, even though I was asked to testify about the defendants, who threatened my life.

Because the hell with it. I don’t have time to do anything but keep fighting as hard as I can. Right now it’s the middle of summer and I’m in a house about a block and a half from the beach, but I pretty much never go there. I just work all the time.”

“Finally, my drive to serve and save children also comes from my patients – from my awareness of how precious each life is. Judaism holds that to save a single life is to save the whole world. That imperative is always with me.

I once took care of a girl who had cystic fibrosis and she eventually died. Her name was Mary Kay McFarland. This was back in the day when I’d be on call for 36 straight hours, and she and I used to play backgammon. I would even visit her home occasionally, when she was able to go home. But she was clearly critically ill and this was before we were able to do successful lung transplants on people like her.

And I got very attached to her. I did. And she to me. We really became friends. And I paid a price for that at some level, which is why doctors learn to maintain a certain emotional distance.

But she was a writer – a really good writer. She was very smart and intuitive and I remember her saying something about the poster kids we chose for our fundraising pamphlets and brochures.

It upset her that the children we chose for that kind of material were always the kids with a broken arm or leg. She said: They would never show someone like me. By that she meant someone drawn, emaciated, as she was from her illness. She felt they wouldn’t show the ravages of terrible diseases like hers, because it was too real. And that bothered her.”

Drifting by John Worthington

“I grew up in Baltimore, MD in a conservative Jewish home. My bar mitzvah and confirmation happened at Beth El Synagogue there. My Jewish education was formative in terms of the way I’ve lived my life.

I remember as a young child – maybe 6 or 7 years old – reading a story about Hillel, who wanted to study Torah but could not afford the tuition required by the local beit midrash. So he climbed up onto the roof of the building and pressed himself against what was essentially a skylight, so he could listen to the scholars discussing the Torah. But then, as it got colder and colder, he was covered with the falling snow and nearly froze to death. And the message I took away from that story as a child was that learning was that important.”

“Another takeaway from my Jewish upbringing was the importance of standing up for what was right. Whether it was Abraham or Moses having the chutzpah to argue even with God, or whether we’re talking about the Jewish firebrands on the forefront of the civil rights movement, the heroes in Judaism are the ones who stood up and fought for their principles. So someone like Mark Elias, the lawyer – I’m sure he’s Jewish, and he’s a very inspirational figure to me.

And certainly I’ve carried that into my life since I get threats all the time. And the goal of these death threats is to shut me up, to make me stop talking, but that’s not going to happen, because the people I’m opposing are putting children into harm’s way.

RFK Jr.’s decision to back away unilaterally from the Global Alliance Vaccine Initiative (GAVI) which has probably provided a billion children with vaccines and saved an estimated 20,000,000 lives – I mean, what could be crueler? And he holds up this bogus paper from decades ago claiming that this one particular vaccine killed some little girls, which is completely wrong, and he’s using that as an excuse to do something which is not even his place to do – as that decision should be coming from the State Department, not the Department of Health and Human Services. But such is the nature of this administration – you have madmen in positions of power.”

“One problem is that RFK Jr. hit on something that nearly everyone can endorse, within his Make America Healthy Again movement. The idea that America is deeply unhealthy draws bipartisan consensus: Democrats, Republicans, people from all over the political spectrum can agree with that. He’s right about certain things: that we don’t get any bang for our buck given what we spend on healthcare; that we have a high level of obesity as well as the maladies that come with it, like diabetes and hypertension. All true. It’s true that highly processed foods don’t necessarily do us any good.

But he’s not the guy to do this. Because he’s a science denialist. Just look at his stance on fluoride, on seed oil – I mean, these aren’t scientifically supportable stances and he’s been an anti-science activist for 20 years. So who could possibly believe he’s going to get this right? He continues to support the notion that the MMR vaccine causes autism when 24 studies have proven that it doesn’t. He still believes it because he’s got these fixed, immutable, science-resistant beliefs.

So of course we all want to be healthier. But being anti-vaccine is no way to accomplish that.

My problem is that I’m pretty intolerant of anti-vaccine activists. I really am. They’re just doing way too much harm — they’re highly uninformed, and at the same time, they’re absolutely sure of themselves, which is just maddening.

RFK Jr. also pretends he’s not anti-vaccine when he is absolutely anti-vaccine. He says things like: “I also want to get mercury out of fish. That’s doesn’t make me anti-fish.” But it’s a disingenuous statement, and his issue with mercury is a perfect example of how little he understands.”

“What just happened this past week at the Advisory Committee on Immunization Practices (ACIP) was very dangerous and I don’t think people realize how dangerous it was. First of all, he fired all 17 members of the Committee because of this bogus notion that they were in the pocket of the pharmaceutical industry, when independent groups have looked at this advisory board and found absolutely no conflicts of interest. He replaces them with eight, and now seven, people – several of whom are self-proclaimed anti-vaccine activists. Then he holds a vote on whether or not to recommend a thimerosal-preserved influenza vaccine.

So thimerosal is an ethyl mercury-containing preservative that’s been in vaccines since the 1930s. It is utterly harmless. It is a trivial and frankly undetectable contribution to the mercury you already have in your bloodstream because we live on the planet Earth and ethyl mercury is part of our lives; it’s in everything we drink, including infant formula and breast milk. You can’t even tell you’ve gotten a vaccine that contains thimerosal because it adds a negligible amount to the level you’re already living with.

So it was a bogus vote. But what he did was: he had an anti-vaccine activist lecture on that topic before the vote. Now, normally they have something called “evidence to a recommendation framework” where you have to have your presentation reviewed by subject experts — which hers was not. So she presents this false information and all but one person voted to basically eliminate this vaccine.

And that was just round one. Now he’s shown what he can do. He can have an anti-vaccine activist present without subject matter oversight; he can hold a vote to eliminate a vaccine – and this was fairly trivial because it’s only 4-5% of the influenza vaccines out there. But what’s next?”

“Here’s my prediction: I think he’s going to make aluminum adjuvants – aluminum salts – his next campaign. Now, he can’t take those out of vaccines; in order to have an adequate immune response, you need these adjuvants in vaccines. But I think he’s going to make them part of the vaccine injury compensation program. He’s going to say that anybody who’s gotten these vaccines is in increased risk of developing asthma, or autism, or diabetes, or whatever false paper he holds up next, and he will break that program.

It will end up sending the issue into civil courts, which is where we were in the 80s, when we had eighteen companies that made vaccines at the beginning of the decade, and by the end, we had four.

Because this will enable him and his personal injury lawyer friends to get rich, or richer, and he’ll be on his way to eliminating vaccines in this country. We know he’ll have no qualms about doing this, because what he just did with GAVI eliminated millions of vaccines to vulnerable children around the globe. Believe me, he’s as cruel as the rest of them.”

“In the 80s, there was lawsuit after lawsuit after lawsuit over the pertussis / whooping cough vaccine. Which brought us from eight pertussis vaccine providers to one, and that one remaining company lost a lawsuit for more money than they even made from the vaccine, so they said: we’re out.

We would not have had pertussis / whooping cough vaccines for the citizens of this country if the Reagan administration hadn’t stepped in and created the National Childhood Vaccine Injury Act in 1986, which had the vaccine injury compensation program, and that stopped the bleed. But look at all the companies that left. The point is they can leave, because the manufacture of vaccines represents less than 10% of what they do.

Specific vaccines are something people usually get only once or twice in a lifetime, so they’re never going to be able to compete with, say, lipid-lowering agents or other blockbuster drugs that people need to administer continually. So make vaccines onerous enough, and these companies will abandon them.

I have children and very young grandchildren and I worry about their ability to protect their health in this climate.”

“Three people have died of measles this year in the U.S., including two healthy children. One of them was six years old; the other was eight. Before that, no child had died of measles in this country since 2003 – more than 2 decades. Those three deaths equal the total number of deaths from measles over the previous 25 years. This current outbreak is bigger than any we’ve seen in the U.S. since 1992.

And meanwhile, 250 children have also died of the flu this year. That is a number we haven’t seen since the swine flu pandemic in 2009. And people are dying of pertussis and whooping cough in states that also haven’t seen such deaths for many years. So across the board, bad things are happening.

Something we’re up against is a knee-jerk tendency of parents to deny having done anything to harm their children. The worst thing you can experience as a parent is the death of your child. The only thing worse is feeling in any way responsible for that death.

So for instance, in 2009, I treated a child who was around five years old. He was the youngest of four children. And the mother vaccinated her other three children, but she saw this child as more vulnerable so she didn’t have him receive the swine flu vaccine. As counterintuitive as that might sound to us, that was her logic around that decision.

So that child contracted the swine flu, and they brought him in with an oxygen mask on, and that turned into a CPAP machine, and then a ventilator, and finally a heart and lung machine, which he was on for a long time. And because he experienced intermittent stretches of hypoxemia – which is a low level of oxygen in the bloodstream -- he ended up with brain damage.

So when it was all said and done, I asked his mother what her thoughts were about all that had transpired. And she said, “Well, I’m glad I didn’t vaccinate him. Because I think the damage would have been much worse if I’d vaccinated.”

Now, when you hear something like this — in one way, it makes no sense at all. But then you realize that if she were to see it otherwise, she would have to face the fact that she bore some responsibility for her child’s now-permanent disabilities, and for many people, that’s just too hard to accept.

We saw a very similar response from the parents of those previously healthy children in West Texas who died of measles. The MAHA people had gotten to those parents. And despite the fact that their children had died of a preventable disease, they still say they’re glad they didn’t vaccinate their kids, because they believe the vaccine would have brought about a fate worse than death.

They were told the measles vaccine made kids blind and deaf, and that it also kills children outright, because that’s what they heard from RFK Jr. on national television. He also said that measles – the disease itself -- prevents cancer and heart disease later in life.

He’s crazy: that’s his problem. He does not believe in vaccines, period, even though they represent the single greatest advance in public health in the history of the world. He’s even against the polio vaccine; he tells people that it killed many more people than it saved.”

“No, I don’t live in fear, no matter how many death threats I get. I don’t really think about it. Because to hell with them. They’re trying to get me stop, and that’s not going to happen, so there’s nothing to think about.

The only time a threat really gave me any pause was when someone told me they knew where my children went to school. That’s the only time I went to my wife and said, “Tell me to stop, and I’ll stop.” But she’s a woman of valor. She’s tough. And she said: to hell with them.

Just the other day, I got a notice from the Department of Justice, letting me know that one of the defendants in this trial, who’d threatened my life, was out on bail. And they cautioned me to be careful – whatever the hell that means. I mean, this is the same administration that revoked Dr. Fauci’s security detail.

You know, I talk to Tony [Dr. Fauci] periodically and he was recently asked to give a talk in suburban Philadelphia. He agreed on the condition that they would pay for his security detail, but that would have cost them $150,000. That’s a little more than the symposium wanted to spend.”

“I myself haven’t made any efforts around security. I mean, what’s the point? People have successfully been able to shoot at the president of the United States so they’d certainly be able to get me. So forget it. Forget it. The minute I become preoccupied with that kind of thing is the moment they win.

The CDC had a meeting once, and the anti-vaccine people were out in force, including one of the people who just presented at that ACIP meeting last week. So there they are with their banners and there’s helicopters overhead and police cars, but nonetheless, as a voting member, you still have to walk through that crowd, right?

So a guy grabs my arm. Hard. And he’s not letting go. And see, now you’re stuck. Because you can’t push him back. You can’t hit him in any way, because then he sues you. So you just have to stand there and say, over and over again, ‘Please let go of my arm. Please let go of my arm.’ Hoping that at some point, he’ll do that.

I’ve given talks where people will come up to me afterward and put their camera right in my face, like an inch from my face, because they want me to push them away. And you can’t do that.

There was a time at the Presbyterian Church at Bryn Mawr, I think, where I gave a talk to a few hundred people. And I asked the people staffing the Q & A, you know, not to give the microphone to any audience members. I said: hold it for them while they ask their question, but then pull it back. Keep it in your possession. Or just have people write their questions on index cards.

But one guy failed to do that and someone grabbed the mike and just started filibustering. And I said, ‘Sir, you’re going to have to ask your question at some point.’ But he just kept ranting, and finally the crowd started to scream at him. Someone eventually called the police, and three cop cars pulled up and they physically had to pull that guy out of there.”

“I started working on the rotavirus vaccine with my two collaborators in the late 1980s. Rotavirus is a virus that affects the small intestine. It causes fever, vomiting and diarrhea primarily in children 6-24 months of age. In this country, it hospitalizes about 70,000 children a year because it causes severe dehydration.

And it dominated my residency. We would admit 400 children over any given winter when the virus was at its peak. In the U.S., it would kill several dozen children a year. But around the world, it was the single biggest killer of infants and young children. Around half a million children would die of the virus each year – as many as 2,000 a day.

And I saw a child die of it when I was working in Pittsburgh. The mother was salt of the earth; she did every single thing the doctors told her to do. She gave frequent sips of water around the clock, but it’s a vomiting illness, so no matter how many sips of fluid a child takes, there’s no way to retain it if they keep vomiting. So we tried to put an IV in when her mother brought her to the hospital, but she was so dehydrated, we couldn’t get an IV in either arm or leg.

So we called in a surgeon to come place an IV in her neck, and we even attempted something called a clysis, which is a technique of putting fluid into the subcutaneous tissue instead of a vein, hoping the body will be able to absorb it that way. But by the time the surgeon came down, she had coded. And then we tried to revive her and couldn’t.

So then I remember having to walk out to the waiting room to tell this mother – whose 9-month-old baby girl had been perfectly healthy just two days before – that her child had died. And this is the most traumatic experience. Because nothing is worse than losing your child and you know you’re about to tell this parent the worst possible thing has happened and it’s going to change her life forever. You know, I cried telling her, and that was before I even had kids, which would have made it even harder still.

That evening, I remember getting the key to the library – this was in the 70s – because I wanted to research the virus. And I remember seeing an article in the Journal of the American Medical Association titled Fatal Rotavirus Gastroenteritis. And there had been 10 or so cases where the same thing had happened. Until then, I didn’t think children could die of rotavirus in this country.”

“So the way our research worked was: we developed a small animal model to study the disease in mice. Our goal was to figure out which parts of the virus made you sick and which parts of the virus induced an immune response that was protective, and then create these combination strains. And ideally these strains would have genes containing the code for the formation of proteins that would protect us, but not the ones that would make us sick. That’s summarizing around 26 years of work in about 40 seconds, but that was essentially what we did.

So Merck was the company that did the research and development, and in 2006, that became the vaccine that was routinely recommended by the CDC for all children in this country, and for all children in the world by WHO at the same time. And that vaccine has probably saved 165,000 lives a year ever since, which means that by now it’s saved more than 3,000,000 lives. I feel very fortunate to have developed it with Fred Clark and Stanley Plotkin.”

Dr. Offit with a co-inventor of the Rotavirus vaccine, Dr. Fred Clark.

“And RFK Jr. has vilified me ever since. All the time. To Joe Rogan, to Tucker Carlson… he was just on the Martha McCallum Show on Fox. He always says the same thing. He refers to my time on the Advisory Committee of Immunization Practices which was from 1998-2003. So he always says that I was on that committee when our vaccine came up for a vote, and he says that I voted myself rich.”

“First of all, I’d been off that committee for 3 years by the time my vaccine came up for a vote. Second, he claims I made $186,000,000 from the creation of that vaccine. Well, that’s very good news to me. I wish someone would tell me where those millions of mine are.

Because I did that work as an employee of the Children’s Hospital of Philadelphia. So it’s their intellectual property and they own that patent, not me.

I have reporters calling me up and asking me to comment on the fact that RFK Jr. is saying I should be in prison. And I’ve said, ‘You know, Jonas Salk [inventor of the polio vaccine] got a ticker tape parade, but I should be in prison? Shouldn’t there be something between those two poles?’”

“I’ve written eleven books. The most recent was about Covid, titled Tell Me When It’s Over. It’s about Covid myths and misinformation.

How do I do it all? You’re not the first person to ask me that, but I never really know how to answer the question. Well, I do get up early. I’m usually up by 4:30 am.

My wife’s a pediatrician and our system was that she’d go to work first and I’d get the kids up for school and give them breakfast. But I’d get a few hours of my own work done before that. And because I started my day so early, I could often get home in time to make dinner as well.

And that was fun. It’s all been fun. It’s not really work if you enjoy it. And I love the sciences – it’s this quest where you’re trying to figure out how to do this or that.

And by the way, you never believe you’re working on a new innoculation. You’re just trying to understand the virus. You’re trying to get your next paper published. You’re trying to get your next grant funded.

You’re not thinking: I want to invent a vaccine. Because that would be ridiculous.”

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To learn more about — and from — Dr. Paul Offit, you can visit his own Substack page, Beyond The Noise.