This clinical update, recorded on Thanksgiving, decries the continued assault on public health and science, starting with the controversial appointment of anti-vaccine advocate Ralph Abraham as Deputy CDC Director. The hosts present overwhelming evidence supporting critical public health tools, detailing the dire consequences of vaccine hesitancy through current outbreaks: seven pertussis-related infant deaths this year and surging measles cases. Data from large studies confirm the HPV vaccine's safety and immense effectiveness (80% cervical cancer risk reduction) and show that current JN.1-adapted COVID-19 mRNA vaccines provide substantial, sustained protection (70-95% efficacy against severe disease/death) even against mismatched variants (KP.3.1.1, XEC). Critiques are levied against the development of novel oral polio vaccines (nOPV1/3) due to ethical concerns regarding non-zero paralysis risk when a safer alternative exists (IPV). The discussion also addresses the rising RSV season, analyzes the superior efficacy of cell-based and mRNA flu vaccines, finds no link between COVID vaccination and myositis, and notes the lack of efficacy for current cognitive interventions for long COVID.
Clinical Update Summary: Vaccines, Outbreaks, and the Attack on Science
0:31 Public Health Under Attack: Daniel Griffin critiques the appointment of Ralph Abraham (MD, former Louisiana SG, long-time advocate for ivermectin/HCQ) as Deputy Director of the CDC, citing his history of undermining public health, including advising against Hepatitis B birth doses and ignoring pertussis outbreaks. As far as I can tell, this is a clear indication that political expediency now outweighs scientific necessity.
5:24 Pertussis Deaths: The national whooping cough outbreak has resulted in seven infant deaths this year (three in KY, two in TX, two in LA). This is the highest activity level since 2012 in Kentucky. The hosts emphasize that while the vaccine has dramatically reduced historical deaths (9,000 annually pre-vaccine), anti-vaccination efforts are eroding community protection, risking vulnerable infants.
7:43 HPV Vaccine Efficacy: A massive Cochrane review (225 studies, 132 million people) confirms the HPV vaccine reduces cervical cancer risk by 80% when administered at or before age 16. It also significantly reduces pre-cancerous lesions (CIN3+) and anogenital warts (47–53%). The data shows no association with specific adverse events frequently discussed in social media (POTS, chronic fatigue, paralysis, GBS, infertility). The premise that the vaccine is dangerous is demonstrably false.
13:00 Marburg Virus: Ethiopia reported its first Marburg virus outbreak (Nov 14, 2025). As of late November 2025, there are 12 confirmed cases and 7 deaths, but the outbreak remains localized, as far as I can tell.
17:01 Polio Vaccine Ethics (Crucial Takeaway): Phase 1 data for novel oral polio vaccines (nOPV1/3) shows they are safe and immunogenic in adults, intended to be less paralytogenic than Sabin strains. However, Vincent Racaniello rejects the premise of their use, stating that utilizing any OPV that risks paralysis (even reduced risk) is unethical when the Inactivated Polio Vaccine (IPV) provides zero risk of paralytic disease.
19:45 Measles Resurgence: The US confirmed measles case count (1,798 as of Nov 25, 2025) is nearing the 2000 case threshold, highlighting the catastrophic failure of vaccination coverage post-pandemic.
21:48 Flu Vaccine Technology: Cell-based influenza vaccines showed 19.8% relative superior effectiveness over egg-based vaccines in preventing symptomatic illness during the 2023-2024 season, translating to over 2 million preventable symptomatic illnesses.
26:22 mRNA Flu Vaccine: A phase 3 trial showed a modified mRNA flu vaccine (Moderna) had 34.5% relative efficacy improvement over standard inactivated vaccines against lab-confirmed flu-like illness. Both speakers agree that focusing solely on efficacy against mild illness misses the point; effectiveness against moderate/severe disease is the key metric. There is concern that political opposition might block access to a potentially better vaccine platform.
29:26 RSV Season & Risk Calculation: RSV season is growing everywhere. The risk of Guillain-Barré Syndrome (GBS) is estimated to be 2 to 4 times higher after RSV infection than the established (rare) GBS risk associated with RSV vaccination (estimated at 10 excess cases per 1 million vaccinated adults $\ge$ 60). The math clearly suggests that vaccination remains the safer option.
31:50 Math Matters: Dr. Griffin uses Dr. Mehmet Oz’s inability to calculate a simple drug price reduction percentage (from $242 to $10, which is a 96% discount) as evidence of the damaging idiocy undermining healthcare leadership.
34:50 COVID-19 Vaccine Effectiveness (Mismatch): Danish data (older adults, Oct 2024 - Jan 2025) on JN.1-adapted vaccines (BNT162b2, mRNA-1273) showed high sustained protection against severe outcomes despite circulating variants (KP.3.1.1 and XEC). BNT162b2 efficacy: 70.2% vs. hospitalization, 76.2% vs. death. This suggests cellular immunity provides robust defense against severe disease regardless of minor antigenic drift, raising the question of whether annual variant-chasing boosters are necessary.
39:55 COVID Vaccine Safety (Myositis): A large Scandinavian cohort study ($>13.6$ million person-years) found no increased risk of myositis following SARS-CoV-2 mRNA or adenoviral vector vaccination compared to unvaccinated periods (Adjusted IRR for mRNA: 0.84, $95%\text{ CI: } 0.63\text{-}1.11$). The data is unambiguous on this safety issue.
41:25 Long COVID Biology and Treatment: Long COVID symptoms are associated with clear biological markers, including decreased mitochondrial function in NK and CD4+ T cells and impaired cytokine production. However, a large, randomized clinical trial (RCT) found no benefit for remote cognitive training interventions targeting cognitive symptoms (45:53).
49:00 Clinical Q&A: HPV Therapeutic Use: The Cochrane review supports that HPV vaccination may be beneficial even for older adults with prior HPV exposure (48:03, 51:11). Dr. Griffin recommends the $600$ cost for a male partner of a woman with recurrent lesions is a worthwhile investment to prevent re-exposure and potential cancer development, since vaccines are the most cost-effective intervention (52:04).
54:38 Clinical Q&A: COVID Testing Myth: The myth that rapid COVID antigen tests do not work on current strains is false. The antigen being tested remains stable. For maximum sensitivity, testing should be done first thing in the morning (54:44).
55:33 Clinical Q&A: RSV Monoclonal Use: While Nirsevimab/Closerivimab are prophylactic, an Emergency Medicine doctor asks about their therapeutic use in the ED. Dr. Griffin suggests administering the monoclonal to unvaccinated children during the season makes sense, even if past the 48-72 hour window, to protect them from future severe disease (56:22). I don't care about the name, but this seems like a rational application of a prophylactic agent in a high-risk setting.