we are in the front of the kurt vonnegut library in the gallery room. we have kurt vonnegut's typewriter that leaves used in the 1970s. this was donated to us by his daughter, nanny. he wrote many of his more familiar books during the 1970s and we are happy to have this typewriter. he was not a fan of high technology and he did not use a computer. he preferred to use a typewriter to his dying day. he liked to work in his home. on an office chair and a coffee table. he would slump over his typewriter. vonnegut would go out into the world every day.

he talks about how he had learned that you can buy postage stamps over the internet, and he just thought that was horrible because then you know, if he chose that route he would not have the everyday experience of going to the post office. and those everyday experiences and the people he encountered during his daily walks were the basis for some of his stories. ..

>> i thain his work is timeless. >> i was a resident in

pediatrics and at children's hospital in pittsburgh the late 1970's. at that time every week as interns thomas c. children who would come to the hospital who would come to influence the type b in incredibly comment cause of meningitis whining of the brain and the spinal cord and a bloodstream infection ankara -- common cause when the epiglottis that sits on top of the windpipe would swell to cause suffocation. we saw that every week. that was our life as an intern president. wrote by the late 1980's a vaccine was developed to fight hiv b effected 25,000 children every year and killing many and living-- leading others with permanent brain damage or

kidney damage. hot after that was introduced we went from 2,425,000 to fewer than 10 cases up until recently. to put it into perspective, one year ago we had a child admitted to our hospital with bacterial meningitis and every money we have our weekly infectious diseases conference where the people come to listen to our presentation. when we presented that case we ask them to go through the differential diagnosis of what bacteria or virus could have caused that. none of them licit -- listed hiv b they have never seen that before even of that is what the child had and was one of several new and the philadelphia area that died of hiv b because the parents

are more frightened of the vaccine and the disease that it prevented. it is a testament to how successful we happen that these fellows, that bacteria did not even come to mind. but the outbreak of hiv b and not only in the philadelphia area of minnesota and a couple other states with the outbreak it is not unique because there has been other outbreaks. we had a measles epidemic 2008 better -- piven anything in a decade. mum's epidemic of new york and new jersey involving 1500 levying several people dead. protests this outbreak in california we have one now causing 10 young babies to die. of the biggest outbreak in california since 1947. why is it we have come to fear vaccines to the level

that we now have outbreaks? that we come to see the life-saving medical products to be feared rather than praised? i argue in the book i think the burden of the anti-vaccine movement occurred on one specific day, april 19, 1982. on that day there was a one hour television documentary airing in washington d.c. which was the nbc affiliate called dpt vaccine roulette that stance for diphtheria purchases and tetanus. it was dramatic. frederick wiseman was the documentary filmmaker. but it had that to quality one and of parents all of the same. the parents told the story my child was fine, they got

the vaccine now look what has happened. you have seen up close these children who have mental retardation and permit seizure disorder and a poet -- epilepsy wearing bicycle helmets and reducing and look vacantly up into space. it was dramatic almost like a film and you were far too intimately involved with the pictures of those children they and you could stand. it was very emotional and had an effect. there were a few people in the northern virginia washington d.c. area that day including kathy williams and jeff shorts who got together through the local of soviet -- of elliott and they very quickly within a couple weeks for a group called the satisfied parents together called the pt they

had to enter new to the national vaccine information center that barbara fisher was the head. this was powerful and connected enough early on that within one month of the hearing there was congressional hearings headed by a paula hawkins from a republican senator from florida who was looking into whether or not vaccines were doing more harm than good. the result was predictable with a flood of litigation claiming they not only because the epilepsy or mental retardation, a comas, sudden infant death syndrome and there were hundreds of millions of dollars in its settlements and awards and companies were abandoning the business. we went from six measles vaccine work -- makers down to one and eight whooping cough makers down at one.

we were on the verge of losing vaccines. what happened is the government stepped in to create the national childhood injury act and decorated a compensation program to put up a wall between the parent and the pharmaceutical company you had to go through the federal claims court before you could sue a pharmaceutical company in open court. we went from 27 vaccine makers in 1955 down at 18 in 1980 to basically five makers today. the national childhood vaccine hot line that was a tremendous hit. what is interesting is at the time and john stossel remembers we did not have the science to go up against the contention. of the fear was the purchases vaccine caused

brain damage but there was not the epidemiological studies of the children who did receive it to see what the instance was greater. it took 10 years for the science to mature and by the time that it did we now know that it never cause permanent brain damage. but it took another 15 years to figure what was happening that in 2006, almost 25 years later, and now you have the genetic probes to allow you to look at those children to see what was the cause of epilepsy and retardation and that was done from one professor looking at those children to see what was going on and almost all of them had a mutation to say a genetic mutation and all of the children will develop mental

retardation rorer epilepsy independent whether or not they had vaccine. that work was published in 2006 and got absolutely no media attention. if you think 50 pt reflect magazines, newspapers, telev ision shows, "today show" show", 2020 now s lowered to where you have that answer and no one single journalists cover the story. remarkable. but the national vaccine information center became the one-stop shop to scare parents about vaccinating. every time a new one was introduced, the vaccine center was there and when it was first introduced, there was barbara fisher on world news tonight claiming the

vaccine causes diabetes but it does not. when hepatitis b was first introduced, as there again again, world news tonight call at -- gas multiples girlicious lower since and that was on the 20/20 peace giving advice making the claim that the vaccine cause permanent harm but these were very emotional shows. hepatitis b9 20/20 showing a mother who had given her child the second dose and within one day from sudden infant death syndrome and the vaccine killed her then to show the tombstone with the inscription our little angel and anybody he was two men will be moved by this

although they clearly know that does not cause sudden infant death syndrome and hepatitis b vaccine only is to prevent and one pathogen come a hepatitis b not everything in the first few years of life. and those that are temporarily associated, i think that a greatest hits is the human papilloma virus that prevents the only known cause of several cancer. there are a group of girls going from state to state supported by anti-vaccine groups claim there were fined and they develop chronic fatigue syndrome or blood clots and strokes and heart attacks. the data shows clearly that the vaccine does not do that. but they have powerful stories and people choose not to get that vaccine and then put themselves at risk

paying cervical cancer 25 years from now. the biggest hit good to embrace that it costs on to isn't going from one hypothesis to the next may's o moms rubella vaccine that morph to into merck a bit -- mercury and now has more to a general vague fear that too many vaccines given too soon causes autism may be reaches separate them more space the mouse we do not put children at risk but by doing fact we increase appeared a time during which children are susceptible that no clear they it has no benefits. >> so you have parents that have the vague notion say

may be doing harm. and now you start to see the outbreaks. and the best example is the polio vaccine restarted to see that from the early '60s to the late nineties. that was a rare cause of polio, the only live the vaccine that has the capacity to revert to and cause polio that is in distinguishable from clinical polio. that is rear. kerger we would see six or eight causes every year and one of those children who suffered polio was a child

named john working with the anti-american foundation and made this a cause. i was on the polio working group in the late 1990's and he was asked to be on the group and his voice was important. when we moved from the oral polio vaccine to the inactivated vaccine and thus of the native the rear cause, john had everything to do with that. vaccine activism is important but it has to be signed and space-bar you cannot just make stuff up and say you want them to be safer so they don't cause autism when they don't cause that any way. you can make it safer if it does not cause it anyway. i do think the pendulum is swinging back.

jon should do this but i think the media has gotten a little more suspicious about the entire vaccine rhetoric. it is no longer carried by mainstream media as a scientific controversy. and they have gotten much better. "new york times" have articles and the "l.a. times", i think that has changed. that is good. you're also starting to see hospitals take stronger stands. i worked at the children's hospital of philadelphia and we decide to mandate the vaccine. since the early 2000 we had pushed to educate our health workers to get the influence of vaccine. 9400 employees at children's hospital and anybody could

potentially walk on the floor with a vulnerable child. there was a lot of conditioning in the mid 30% range that i would argue that puts us is one of the best outcomes in the united states we did that with raffles and giveaways like the eagles tickets. [laughter] when they were good not like the sixers tickets that you cannot give away. but still, that meant several hundred people were choosing not to be vaccinated. we mandated the flu vaccine and basically said if you do not want to get one in 2009 you had two weeks of unpaid leave if you still not want to get one you were fired. we fired nine people, they took us to arbitration the decision was made september 2009 on behalf of

the hospital. the reason greed did it since 2003 we had to the broker also came to a hospital with cancer, not vaccinated her because it would not matter. it was immunosuppressed said it would not have four. they depended on those around them to be infected. they caught influenza and the hospital despite the heroic measures on our part. who is responsible for them? is our responsibility to make sure we put them in a position that they are least likely to get influenza? it is not your inalienable right to catch and transmit a potentially fatal infection. you could make the same argument for the protests this outbreak in california. batted balls 9,000 people and 10 children have died. all children were less than three months, they depended

on those of the home to protect them. what is the immunization rates in the home? all adolescence are recommended to get it only 40% do. those that are recommended to received the dtap vaccine 6% get it. one child came into the hospital of a two month old who got whooping cough and died from it. she caught it from her mother. everybody else was well the mother got sick with the upper when the local mother delivered the vendors came in within 24 hours and said you are recommended to receive the dtap vaccine and she said would rather not get it. that was the chance to save the child's life. at that moment house to me far more passionate from the clinician size you could

argue parents deliver a child into the home that it be mandated the father and mother received 35 facts scene. there are some exemptions but you could argue it is the only way to protect the young child. who dies from purchases? less than six months old of their brand pipe is more narrow so when it is clogged with a guy. if it is in the home, you feel enormous sympathy for anybody who watches a child sufferer it is the worst loss. you never want to come down on the parent, but it is that balance between the

sovereign right of a parent and the right of society to protect its children. that to balance far too much goes on the side of the parent percolation on the the parents' rate to transmit a fatal infection and to the child. what changes all of this? we hear rhetoric about tighten religious exemptions. i don't think force will change. what hast to change is the way we see ourselves as part of the comment that is true. we're all in this together. of their 500,000 americans who cannot be vaccinated because they are too young, because they get chemotherapy for their cancer or their transplants or their asthma. they depend on those around

them because if not, they are most likely to suffer to be hospitalized and die. we have to find no way to appeal to the instinct. when 9/11 have been to come toby applauded the societal instinct of the police department to go save those who were at risk for those who ran toward the gunshots in tucson arizona to protect their fellow man. i do think we have to find them better way to appeal. thank you for your attention. [applause] costs >> with of whooping cough

being an epidemic? >> endemic. >> should you get a shot adjusting case you are exposed? >> that is when you are recommended to receive dtap vaccine if it has been more than 10 years you are recommended by my guess is within the next few years you will be recommended to receive one every 10 years. , so they should get one. >> they go to their in turn? >> but i think we think back seemed generally is a kid in thing to do not the adult thing to do. they are terrible particular to the objections disease group what percentage had the dtap vaccine it will be less than 100%. you are right. >> i have been having annual

checkups as long as i remember i cannot remember ever being vaccinated cents a was a child. i cannot remember a position recommending inoculation. as an adult, which ones should they have? >> dtap a booster 410 s-- for a tetanus shot and also recommended to have the chicken pox vaccine if you have never had a few are over 60 are more likely to get the shingles which will protect one of the more painful and debilitating diseases of man. and also hepatitis b if you

have never had that. you are right. of the internist are not great at this neither are obstetricians'. >> also the flu shot is recommended. that is a good point* and do not -- pneumococcal vaccine for those at risk. [inaudible] >> i am a medical oncologist year and congratulations to the wonderful work you have done. [applause] but the problem may not be with the stars but with us. physicians have done a terrible job with

public-relations and did you bear with me i will give you an example. first we both read about breast cancer drugs. the day the fda says it should not be given one of the most prestigious breast cancer conference in the world said given to women before surgery having 40% increase is the triple negative that involves 30% of people and there was no reaction to this at all. saying we cannot use the medicis and that will help 25% of the women? that is outrageous. now everybody is running around which company is good but they don't want to cover that. number two. i remember walking down to children's hospital while training, this is one of the

great heroes of modern day america as it approving women need the lumpectomy also did a wonderful drug and when he did the trial 40 or 50,000 cases were found typical french the account had to be 150,000 at 145 they say it is okay. he said let me finish the trial. jon also went after david baltimore who won the nobel prize and did research over 10 years. it was outrageous the american society of clinical oncologist bernie fisher walks in. he gets a standing ovation.

there is no word of this and we should have been screaming and yelling into the modern hero of modern-day medicine. he was exonerated and had to raise $3 billion. long story. when obama passed a wonderful health care law, there is john dingell standing next to the president and how wonderful. this man probably cause the death of women with breast cancer because the trial was delayed two or three years but then with the health care bill, did anybody question to the doctors were lowered there expertise when betsy macquarie had a forum. >> i am sorry. >> there was a forum here so my question is, what do we

do to get trained physicians in public relations to go about it? we do work that nobody knows about. >> i completely agree that the clinicians and scientists are terrible at interacting with the media. i will tell you why and how we can get better part of the reason it is true as a pediatrician, we are nice people. we're not good at confrontation and even bad. a scientist like a -- you're not trained to work with the media you are taught to be critical of your day and circumspect and it is hard to make a definitive statement like mmr causes autism although you can never say never but then you have people like jennifer mccarthy who are perfectly willing to say that is what you are up against.

but the of the scientists who has been backed by the national institute of health that is public money it is your responsibility to try to educate the public that pays you. but we have been terrible at it and we are not trained to do that. we do the opposite and we need to get into the game. it is not an easy game to enter. on national television when you are asked to take a complex issue and reduced to a sound bite. it is wrong and intellectually dishonest but you have to get in the game because the anti-science side is perfectly willing to do it. >> sought -- are there other motivations with the anti-vaccine camp less than what we heard about?

>> those who passionately believe vaccines can hurt their children believe it. their child was fine they got the vaccine and now they are not fighting it. they don't want other children to be heard. although the funding his little concerning and upsetting with personal injury lawyers say an anti-vaccine activists are connected but most truly believe what they are doing. mrs. fisher urged genuinely believes her child was hurt by the protests this vaccine but the fact is it did not cause permanent brain damage as she is advocating for something that is not science based. she has a powerful voice and politically connected and could do a lot of good and there are issues. the flu vaccine is made in aid so those who are severely allergic to eggs

have a problem with that vaccine. who there are some vaccines that are stabilized like the of flu vaccine angeles and can be a significant allergen. if you have advocates for that you would see changes. but it is so painful to watch these people who are so good at what they do advocate. >> talk about this in the book there is a cottage industry of experts who make a very lucrative living testifying in these cases. >> yes the vaccine injury compensation program has $2 billion days dollars it is a large and tempting pool for those personal injury lawyers and those to testify on their behalf. >> let's look at the science

based concern's and its value because very often it is not short-term it and may require long-term so if you have a vaccine today, than what? not that it will prevent you from getting aids really. maybe now 10 years later, 15 years later, but they did not know about. it is not just fear of vaccine of science based anxiety because we are a society that believes in liberty and the autonomy of the individual.

what circumstances h1n1 from subways and places like that , what would require people to have vaccines to make it mandatory first is now those who volunteer? >> i think the question, it is not when you know, everything but win do know enough? if you use the h1n1 example that is mine. here is a vaccine made with technology that has been used to make implements of since the mid 1940's. this is technology 60 years old. we know the influence of vaccine has the immune response but would that induce the same level of

protection to what we now know? we had asians come into the nine states causing 37,000 to suffer causing 250,002 sufferer and 1100 were children 10 times more than died typically and five children died in our hospital. none had been vaccinated. the odds are they suffered at the odds are they would not have died if they received. i am not dismissing the point* but could there be a long-term effects is reasonable but as an example, that has been around the last 200 years we have a lot of data on that the longest and best tested and i guess i do not share that fear although i and

understand it. when you choose not to get a flu vaccine, that you take a risk for the choice is not a risky choice but to what does that look like? >> at what age should you take the shingles vaccine? >> 60. >> also this man the the said he did not have any vaccines that but it was mandatory to go to school in this country. >> yes. but there are many pop off house that states have the religious exemptions 27 states have say it is a fallout of philosophical

exemption i am not sure where the wisdom is but i don't understand the religious exemption either. in 1796 the new testament was written around 180 and the karan around 689 of them never mention the word vaccine program not sure where that comes from. [laughter] christian science 100 years later specifically says don't get vaccines said only that is a christian scientist. >> everything we have discussed has been about the united states. could you provide the international perspective on whether the same issues are controversies to which the

populations are vaccinated and other countries or which the vaccine industry is encouraged or discouraged around the world? >> to put this into perspective, the united states is great vaccinating our children. yaks day shia's them to prevent 14 different diseases that is 16 different diseases and our rates are in the high 80 range that is great but we have certain communities that are under vaccinated where you see the outbreak. so to put it into perspective, if you look at those that are never mandated, measles is endemic. month since endemic. that outbreak from new york and new jersey came from england. it was a camp counselor

there. of the fears are exported. we it anti-aids the vaccine movement that the originated in england in 1973 publishing a paper and they have 35 deaths because their rates dropped and dozens of hospitalizations. also with the notion hepatitis because multiple sclerosis day shutdown of school based program because of that bought which was wrong. single-engine knows a source that and them our cause autism. that was the late 1990's. first it is this the tax and now this. the problem is england. [laughter] but if you look at the measles outbreak 2,008, the epicenter was southern california where a mother

takes our indoctrinated child to switzerland ketches measles comes back and then those children who come in contact in a pediatrician's office and the whole foods store, if you look at the outbreaks, both food store. [laughter] that is ironic. [laughter] that was in switzerland where it was more common. israel has not been a great our country is doing well but we're just now starting to see fit of rage at the edges does this represents something bigger? did you hear something at some point*? are we hearing something now? >> dr. estimated 10 or 15 million illegal aliens

presumably many if not most have not been vaccinated. is that a problem with that many people walking among us? >> that is part of the story in california not only they did not choose to do that which is part of the california story but also those medical care is less and less able to give the vaccine. it to look into chooses not to, almost the opposite of what happens in england and mid-1800s when they were dealing with smallpox. look at the anti-vaccine movement it were those who were not as well educated who feared vaccines because they did not understand the biology. it is the opposite the upper-middle-class person who has a responsible position who makes the choice. in philadelphia of the hispanic population which

generally is closer serve and somewhat less educated, they get vaccines and believe in the expertise of the doctors that serve them and think they may know more about that. but it is ironic. >> is the general climate that makes vaccines unpopular cause us to miss opportunities in the malaria or aids or others that are powerful weapons? >> i don't think so. there is a tremendous push ample to make a and malaria vaccine. the gates foundation those that have made significant commitments and the hiv vaccine spends over

$1 million with their program that failed but they were willing to spend money. i don't think money is the problem with hiv or malaria. i don't think so. the good news is that is not true. they're not that many companies that do it. that is describing some level of the litigation in the early '80s. >> to what extent is the unholy alliance between the litigation industry and the vaccine? >> win a national vaccine act was created, the program is the exceptionally good fire wall between the litigants and as a jury trial. the way it works you have special masters, judges who are lawyers who at least

look through the data to make a recommendation. the autism proceeding is the best example. you have parents of 5,000 children come the more than 5,000 who believe the vaccines cause of autism that was a trial that went 2002 through 2010 that was a long time and a lot of money spent and the judges were very clear and strong. vaccines do not cause autism. if that had gone to civil court or state court i cannot imagine what would have happened. there is some judicial hellholes with philadelphia as one of them, mississippi where jury trials i think they would have gotten murdered. there is a critical supreme court case heard in october which would be adjudicated february 22nd in its heart has the capacity to overturn the compensation program

that puts us back to the early '80s. i don't think that will happen and i am confident the supreme court will rule in favor of wyeth because they can to there is too much at stake if they made that decision. [applause] its >> in addition to a questionnaire that covered a wide variety of background items, the members were

asked to imagine the nation's history 1966 through the end of the century. the year 2000. they were looking ahead 34 years what they perceive or what they were viewing as to what would happen to our country with the remainder of our century. the graduate student doing the study, richard, was surprised by what he described as the belief of the yaf members of the drift to moral decay and socialism would be reversed in the near future by the weakening of the american people resulting in moving the train of events back to common sense. sift he also surveyed

members of students for a democratic society the new levying left organization of the '60s and the young democrats and college republicans reported on his results in an article that he co-wrote and published in an academic journal and it is interesting to view some of the projections of the yaf members in 1966 when predicted there be direction towards freedom and conservative principles. remember he is right dr. offit 66. here is what he said. united states led by hypocritical and a principal leaders becomes very democratic and increasingly socialistic. the united states generally loses the battle of foreign affairs because it does not present its philosophy of

free enterprise, a libertarian believes, , etc. as well as it should. animal sounds familiar to the current data. finally coming in 1980's or thereabout, the american people realized economic security is not necessarily free down. they realize the freedom is a bridge to and they realize the economy is becoming too regimented and the government to bureaucratic. those who will change the trend of events back with conservative principles of government and remember the prediction was 1980. recalling from history, it turns out that is when the american people voted for a conservative president, ronald reagan. who did.

[applause] -- who did indeed change defense back to common sense conservative principles. he was and having another student predict defense in the future 1966 through 2000 prepare his prediction were as follows, republican victory, 1972 you -- re negative elected president pro 76, reelected. 78 the fall of soviet russia. 80, fall of red china. the end of welfare and social security and medicare 2000 end of the union. as the co-author noted compared to the counterparts on the left they seem to have a mountain of my youth face propellants look back

nearly 45 years later and we can see then i youth eighth days 90th faith is inaccurate. change of view of the dates and those yaf members who were then only high school and college students laid a political history of the 20th century because consider nixon's victory in 1968 brought both day realignment of politics and the disgrace of watergate, impeachment and resignation. reagan's victory came eight years after the student had predicted but was followed by a landslide and realizing it took years for the berlin

wall to fall closely by the soviet union and then it is 1993 state of the union message the new democratic president promises to 10 1/2 and welfare as we know it. and enacted one time later in 1994. two years after that the original "state of the union" message, the same president declared "the error of big stage the era of big government is over in the "state of the union" message. >>

>> the reason i felt it was important to do a book s.a., that is what it is on the obama administration, that is because it is extremely important for the progress of people not to create too many illusions because they don't help. and to see if and a hard-headed way what the new administration is and what it represents in terms of foreign policy and what it represents at home. it is important to do that to understand what extent it is different and what it continues the policies of the previous three administrations. but clinton and bush senior.

from that point* of view the balance sheet i have prepared, the obama's syndrome or abroad and the surrender at home is not very optimistic account or pleasing account of the administration that because when you see what is going on and read a lot of material that is for domestic policies, it is striking how conservative the administration has been. i know all of the constraints. i know that we live in a new liberal period if that to despite 2,008 come of this system and its political leaders have not attempted any theory of structural

reform that was necessary after the crash. the crash has not gone away but merely plastered over and it goes to the worried people and from the progressive the economist for those who say it will not work. so for the opportunity for a newly elected president who was not responsible or could not be held responsible for this economic crash, who had come unlike previous presidents come immobilized hundreds of thousands of young people in this country have brought them out into the streets to help them get to elected and created the illusion they would do something.

yes we can is not a concrete slogan. [laughter] but it offers some hope or creates the impression and young people were mobilized and some thought they would take change abroad. the balance sheet was made and let's discuss foreign policy. continuing the foreign policy was symbolized by the pentagon buy essentially accepting video that had solved the problem by state game to bush's plan, without bringing about any change at

all but the shame of plans through which assembles with combat units and build a huge military bases sticky between 50 and 70,000 troops permanently. that is what the withdrawal is it is the same plan but imploded with the revolution in iraq 1958. and they threw the british out to. it is very likely not been the fifties but a similar thing would happen if they stay there. once again seated frustration is carried on with the policies with the israelis being appeased by

iran. both from the nuclear question and generally comes from the israelis who are prepared to do anything to preserve their own nuclear monopoly. that is what that particular issue is about. and the failure of this illustration that to break with those policies is not all that surprising. the teaching four weeks and it champagne and i saw a young fresh face man running for the senate called barack obama. i was at one house and they said he is the great hope of the democrats. i said let's watch him because i am always interested in the great