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we're seeing almost unprecedented decline in the trust of what has been coming out of what has historically been the public health sector that is having this impact of people wanting to know just what should we be doing and to and whom should we trust? Welcome

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to

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off the chart, a business of medicine podcast featuring lively and informative conversations with healthcare experts, opinion leaders and practicing physicians about the challenges facing doctors and medical practices. My name is Austin Luttrell. I'm the associate editor of medical economics. I'd like to thank you for joining us today. In today's episode medical economics, managing editor Todd schryock sat down with David Dodd, President and CEO of vaccine developer geoVax. They're talking about the state of vaccine confidence in the United States, and what's driving it in the wrong direction. Dodd shares his perspective on the AMA's vaccine integrity project. Why he pushes back on the idea that federal health leadership is wholesale anti vaccine and what the fragmentation of public health guidance is actually costing the industry. He also talks through the misinformation patterns doing the most damage, what the covid 19 messaging failures taught us about communicating efficacy honestly, and what he'd tell primary care physicians trying to counsel hesitant patients in this patients in this environment. David Dodd, thank you for joining us. Now let's get into

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the episode. I'm here with David Dodd, CEO of vaccine developer, geoVax, to talk about vaccine oversight and safety. David, thanks for joining me. Thank you. It's a pleasure. So David, for those who are not aware. Can you talk a little bit about the vaccine integrity project and why you see it as a necessary step?

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Well, I think it's an important step because it continues to underscore the importance of having different groups such as the AMA, involved in the process of decision making and guidance related to decisions parents have to make, people have to make on a daily basis, of the utilization of vaccines and what the guidelines should be for those so I think it's absolutely critical to have such a program or a project as the Integrity project.

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The organizers behind the initiative said that the CDC vaccine review process has, quote, effectively collapsed in quote, from your perspective as a vaccine developer, are there specific gaps or failures that you've observed in the CDCs current approach? I don't, I would not agree that it has effectively or that it has collapsed. I think certainly, as you see changes being made to the process, it's creating uncertainty. It's creating and it has resulted in confusion, and because of that, it ultimately has an impact on timelines of being able to progress and bring forward new vaccines or new uses of vaccines, and all of that creates uncertainty. It creates confusion, and on a practical matter. So the bottom line is that we're seeing almost unprecedented declines in acceptance of vaccines among the public, either people who are doing as an individual or their caregivers, their parents, their they may be caring for their elderly loved ones or relatives, etc, but for all of that, you have this uncertainty that is having this impact of people wanting to know just what should we be doing and to and whom should we trust? And so there's been a unprecedented I think most of us agree with the decline in the trust of what has been coming out of what has historically been the public health sector, where we had great faith and respect and regard in and just a lot of questioning of that from a development standpoint. I mean, it requires you to relook at how you make decisions? Do you invest in a particular area or not? What do you set as your priorities? We have multiple programs across different indications, covid 19 for immunocompromised patients, or a new vaccine that would be an additional to the supply for impacts and smallpox worldwide. And we have to make decisions which, which do we place as a priority? So we try to follow and monitor that. So the more, in my opinion, the more that we can have the involvement of entities such as the AMA. And at the same time, I think there'll be engagement with the CDC, and I know that the CDC is also having its own internal.

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Organizational challenges. We read about them on a continued basis, but all of this needs to be coming together. I'm an optimist. I think ultimately it, it'll it'll sort out, and not everybody will be pleased with how it sorts out, but I think we'll have a a defined process that is better than what we have as a somewhat of an ill defined process currently, but once we have a defined, accepted process that enables us to know how decisions are going to be made, how we interact with that process, things will go forward much more positively and successfully than what we may be experiencing right now. So you see that both of these systems can coexist effectively, and by both, I mean the federal government and the independent review I do. And in fact, I think there'll be a convergence at some point, when that'll be I don't know, I wish I did, because I'd probably be making a lot of money as a consultant, but I do think there will become a convergence. And the reason why I believe that is it's not the first time that you could see your different pathways being being pursued by by not only government entities, entities, either on a on a federal, state and local basis, but also, in this case, so different medical related organizations, patient advocacy group, organizations, even the industry associations such as bio. I think all of this is eventually going to go through a process of convergence, integration into a new process.

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The misinformation you talked about is a big problem that that's hurting everyday people. You know, what are some of the most damaging myths or pieces of misinformation that you've seen, particularly around the vaccines that this initiative will review, like flu, covid, 19 or RSV? I would say for me, at the top of the list is, is the the

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continuously repeated statement that Secretary Kennedy is totally anti vaccines. I think that's not true. I think there are perceptions that have come out of individualized statements, interpretations, no our own interactions with his office and related ones, and we're not set. We've been dodged by some of the programs for which we've been funded. So I'm not speaking this as a as a hard line supporter. I'm saying as someone who's tried to look at it and figure out, how do we figure out how to work together? And so from that standpoint, we we have seen statements made that we need more than mRNA as vaccine platforms. We completely agree with that, because we don't believe that any single platform for vaccines will do the job for every vaccine that's needed ever needed. Coming out of the pandemic, there was a very strong position coming out of decision makers that that if you weren't doing mRNA, you were using an outdated platform. That's not necessarily the case. We've heard the Secretary Kennedy express that, in his opinion, his preference and HHS preference for multi antigen vaccine platforms that would that is something which mRNA is not it's not a multi antigen. They can only work with one part of the virus at a time. We actually use a multi antigen platform. So from that standpoint, we were very pleased to hear that at the same time, we heard that as a statement of preference for how to approach vaccines, especially respiratory related type of vaccines. We also ended up being part of a program where we had received a major, major funding grant, $400 million and we're in the middle of that, getting ready to start vaccinating individuals in that program, when that program was Doge. So I have to say that we're not, you know, we're not satisfied by everything, but I'd say the thing of taking a blanket statement, how do you exist in an environment where the head of HHS is anti vaccine? Because, first of all, I don't accept that, that he is totally and undeniably anti vaccine. And so I think there is, there are ways, challenging ways, at times, to sort of be able to have a platform of common discussion and to progress and move things forward. If I didn't believe that, then we wouldn't be doing the vaccines that we have. And in one case, we have a vaccine for which we have been given an expedited development path by in this case, the European Medicines Agency, the EMA, which is the equivalent of the FDA, and we're proceeding in an expedited manner to having a product on the market within 18 months, perhaps, versus five to seven years. So I think there are ways to work through that. It's challenging and it's frustrating, because we'd all been told that the FDA had two.

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Turned down modernist path for going forward with their flu vaccine. And then today, we're reading that they have now come to some form of an agreement, I just read this earlier, that they're going to be able to proceed and go forward with reviewing their the flu vaccine, which I think is a great outcome. So so when I look at it, I say that there have been statements made. If people are asking me, well, you know, how can you be in the vaccine industry trying to raise money when the federal government is against all vaccines? And you see, I would say against, I don't agree with, in the word all, I don't agree with. I think there are a lot of questions being asked. Sometimes they may be questions that I find a little frustrating to have to address and deal with. But you know, I have to figure out how to work within this environment.

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So much in America is divided along political lines. Are you worried that with the fragmentation and public health guidance that we're going to end up with a set of guidelines for red states and a different set of guidelines for blue states,

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I certainly hope not. And again, I think we won't. I think we will. We'll see things sort out, not in an ideal manner, not not in a way that is quickly done. So here we are, you know, a year, you know, a year after an inauguration. And we all would have hoped that by now that we knew what the new normalcy was. And yet we're still sorting through some of these things. I think it would be totally impractical to see the difference between red states and blue straight states. And hey, by the way, let's not forget the purple states that are out there, also, they may have their own guideline. So I think we will sort things out, I think, quite frankly, that we're certain medical organizations have have stepped up to fill the void. I think that may be viewed negatively in some settings, that they're there. It's overreach on their part, but what they're trying to do is fill a vacuum, because the end of the day, you have parents, you have individuals, the non medical professionals have so many questions. And I speak to investor groups all the time, as you might imagine, because we're pre revenue company, always out there talking to a potentially interested parties, and they're asking me so so how do we make a decision about whether or not to get a vaccine or not to take a vaccine. I don't believe in any of these vaccine makers anymore. So you hear these things, the best I can do is try to listen, to be transparent, to communicate and answer what I what I can answer, and keeping in mind and underscoring that I'm not a scientist, I'm not a physician. You know, I'm someone who's a general manager that's been in this industry for 40 plus years, so I've picked up a lot of know how and learning, practical learning along the way. So I try to help people understand and then look at that. But there are a lot of different areas in which we have those you know, it's a it's a shame, because there's been a lot of energy expended dealing with issues that we could be working on more important issues and moving things forward at this point.

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Hey, there. Keith Reynolds here and welcome to the p2 management minute in just 60 seconds, we deliver proven, real world tactics you can plug into your practice today, whether that means speeding up check in, lifting staff morale or nudging patient satisfaction north, no theory, no fluff, just the kind of guidance that fits between appointments and moves the needle before lunch. But the best ideas don't all come from our newsroom. They come from you got a clever workflow, hack, an employee engagement win, or a lesson learned the hard way. I want to feature it. Shoot me an email at K Reynolds at mjh life sciences.com with your topic, quick outline or even a smartphone clip. We'll handle the rest and get your insights in front of your peers nationwide. Let's make every minute count together. Thanks for watching, and I'll see you in the next p2 management minute,

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so many people now get their information from social media. They're not listening to you. They're not listening to doctors who, some of whom have spent their entire lives studying these vaccines for safety,

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you know, how can we battle that? How can we

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how can truth win out over these very powerful social media messages that get out there and and people buy into even though there's very little evidence that shows that they're correct? Well, first of all, the challenge is that all of us, you know, we're human beings. We all have our own beliefs, prejudices, you know, whatever we believe in, and it's hard to always separate those, but we have to try and do that and and focus on, what do we know from the science, what do we not know? And I think there, there's a lot that we don't know. And so.

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Sometimes we focus on only what we think we know. So we have to listen and be guided by scientific clinical evidence, by the transparency of what we learn and what we know. You know, part of this has been bred, because when we heard about these vaccines in November of 2020, and we, we were told that there are these vaccines. They're 94 95% effective against this virus, covid 19, or this, you know, this, this illness, or from SARS cov two, that if you receive the vaccine, you wouldn't get the you wouldn't get the covid 19, and that they would last a year. And in reality, we've learned that they, you know, depending how you define efficacy, they're 40 to they're less than 50% efficacious. We see the virus continues to evolve, because that's what viruses like to do. And because of that, they we have to keep updating. For many of the technology, especially mRNA, you have to keep reconfiguring and coming up with a new one, which means more and more boosters. And we know that it they really don't totally prevent you from getting it. They hopefully and what their main reason is to reduce the severity so that we see true reductions as hospitalization and the risk of death. And so we were told and guided to say, and we were sort of almost, people will tell me all. I just spoke to a group last week. They said, Well, we were forced. We had no say. So we were told we had to be vaccinated and that it would be totally protected. It would last a year. And so people remember that, people don't like being pushed around, so we're dealing with that. And I think what we now are seeing in some instances, is that members of of various medical professional communities are stepping forward, and they, rightly so, are saying we need to do a better job communicating. Not just we in the medical center, but those such as people, journalists such as yourself, you know, people at medical economics and other one we need to communicate and be very transparent and show that we're listening. Because when you look at it, we take this idea and we think all vaccines are about the same. Well, all viruses are not the same. No, with measles, we've gone through this thing, and it's unfortunate, we've seen this tremendous decline. In fact, immunization of measles, because we know that a measles vaccine, you get vaccinated, you're pretty good for life. And so that's good. It's very important, because measles are highly contagious. You know, it you someone walk in the room with measles, they walk out of the room. If they have have it, they've left the virus. It's it's going to be still contagious for two hours. So, I mean, they don't leave the room when the host leaves the room. So in that instance, we were seeing an impact in an area that there's no need to be an impact. They're legitimate questions on others. We see certain viruses such as SARS, cov, two, HIV, mpox is a classic example where we continue to see new strains emerge. So we have to be ever vigilant about are those new strains such that we have to do something different for the existing vaccine, similar to what we've done historically with annual flu vaccines, because they're always a little bit different, no different strain and all. And we're used to that, but that's not true other vaccines. You get them once you're good, pretty much for life. So we need to be clear in how we educate and communicate to all particular interested parties, especially the public at large, and do a better job. Because I think we lost a lot of ground and saw a tremendous decrease in trust in the whole public health system. In fact, the United States had the envy of the world when it came to a public health system that we all trusted. We accepted their guidance, etc, and unfortunately, that has been pushed back. We saw unprecedented migration into the United States from regions of the world that did not have well established and well developed public health systems and policies or Immunization Practices, which has contributed to what we're seeing with measles, because so many people have come in from areas they didn't come in to bring in measles or to be exposed to it, but they have come from regions that did not have well established, as in the US practices and immunization policies and programs so and those were tremendous. Now I don't think that because they have fewer vaccines on a list in Denmark, that means they have a better program than we have. Maybe, maybe when we had 17, that was better than what people that only had seven. I mean, I don't know, because I've always felt and been very proud of the way the public health system has operated historically within the US. Do. I think there were times in which, and certainly during the whole pandemic, that we saw leadership doing a very poor job of communicating and providing guidance and transparency? It was, it was abysmal, quite frankly.

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But and so now the challenge is for all of us who are, those of us in industry, those of you who are who are journalists, you've got the talents and the capabilities of communicating and explaining things well, people in the medical community and policy makers, all, all of us have a role to sort of try and improve that, and that's what we should be trying to work together to achieve.

20:22
Our audience is primary care physicians. They see a lot of vaccine hesitancy day to day. They're dealing with the misinformation. Some are confused by the conflicting guidance. Do you have any advice for them on how to work through all of this?

20:39
Well, I think what many of them do. And I'm fortunate to have an i An excellent primary care physician, and it's one that we with whom we have worked. My wife and I since he hung up a shingle, literally when he when he started as a practicing physician. So we've been working with him. Have great trust him. Do not always agree with him. He knows I'm in the industry, so I'm going to be a smart aleck and challenge him back on things, and don't ever ask me if I want to be part of a clinical trial, because I don't want to be a guinea pig. But I need those people to accept it when they're when it's one of our products that are going through. But I think the most important thing is, is really that talent and capability of listening and communication and those skill sets. I can't think of a more important profession than than medicine, where you have to be outstanding on being able to listen to understand, in this case, your patient, to ask a little bit deeper in a probing question, because maybe you pick up on something. I mean that when you think about it, has to be a profession to be more skilled at that than you've ever seen. And again, we're fortunate that we have been working with someone through the last 20 plus years of our life, with someone that has that capability. And yet we've all encountered

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medical professionals, physicians in the past, nurses et cetera, pas et cetera, that were very curt and said, This is the way you do it. I had someone once that, and I changed the physician I was diagnosed with particular chronic condition. It was not life threatening, and the person didn't want to explain it to me, told me that all they want to do is put me in this clinical trial that they were running. And what I did the next day, because I of the profession I'm in, and we happen to that time, and that company we were developed, we had a product in the clinic for that same condition. I went to the clinical department and said, Can you tell me if there is a well with listening physician here in the Atlanta area, in this therapeutic area that we know of, that I might consider wanting to talk with. I've been working with that physician since 1997 once I was introduced to him, I dropped the one, I went to the other one. So I think that the your audience, you know these physicians who, I mean, there's no bigger challenge than a primary care physician, because you have to cover that breadth and being able to guide people to whatever specialist they need to have, and you've got to be such a great communicator. So I think that that is a critical aspect of what they need to be doing, and they should be seeking. And I would say, I know your time is short, but don't hesitate to seek out people in industry for input. And otherwise,

23:18
I heard you mentioned a couple of times, a key point public health officials and physicians, everyone in the industry just needs to do a better job listening to concerns and instead of dismissing them, or, you know, not addressing them, to do a better job of explaining to people, you know, why things work, how they work and really address their their concerns?

23:44
Yeah, exactly. I had someone recently that said, Well, I don't trust my physician. I really don't, don't, don't, don't like the input I get from them. I said, you know, it's up to you, but that would tell me you need to find another physician. I said, because if you if you don't feel that the person is working and communicating in your best interest, then you need to find someone else.

24:04
David, is there anything else that you would like to mention that we haven't talked about? No, I appreciate it. I you know, I've been following medical economics since I entered this industry many, many years ago. And I actually entered the industry as a healthcare economist. I was hired by a big pharma it was called Abbott Laboratories. Then there was no separation of Abbott and AbbVie. But that was the start end of this career. And I worked and I was an economist, and I did that, and I found that it was a wonderful industry, but I can always remember that medical economics was one of the journals you had to, you had to review every month. So thank you. It's a pleasure to be here. Great, fantastic. Thanks for your time. David, I really appreciate it. Thank you. Have a good day. You.

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Once

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again, that was David Dodd, President and CEO of geoVax, speaking with medical economics Managing Editor, Todd schryoc on behalf of the whole medical economics and physicist practice teams. I'd like to thank you for listening to the show and ask that you please subscribe so you don't miss the next episode. As always, be sure to check back on Monday and Thursday mornings for the latest conversations with experts, sharing strategies, stories and solutions for your practice. You can find us by searching off the chart wherever you get your podcasts, and if you'd like the best stories that medical economics and physicians practice published delivered straight to your email six days of the week, subscribe to our newsletters at medical economics.com and physicians practice.com off the chart, a business of medicine. Podcast is executive produced by Chris mazzolini and Keith Reynolds and produced by Austin Latrell. Medical economics and physicians practice are both members of the mjh Life Sciences family. Thank you.