SPEAKER_02 0:00

This episode of Why didn't Become a Doctor is brought to you in partnership with Medical Brief, South Africa's leading daily healthcare news service.

SPEAKER_03 0:09

Stay informed with trusted reporting, expert insights, and analysis that matters to healthcare professionals. Subscribe free at medicalbrief.co.za forward slash subscribe. I read them myself every week diligently, yik. And you should subscribe if you've not. Gonna do it right now. Cheers. Mr. Daniel Kapalas, son of David, son of who's the son of Manley. Yeah. You come from a long line of legendary lawyers, Daniel. Yeah, yeah.

SPEAKER_00 0:40

Very, very legal family. So Why don't you become a lawyer? I think when you are exposed to something from a very young age, um it either makes you insanely passionate or it puts you off immediately. And uh I mean my dad is, as you say, my dad's a, you know, he's an attorney, my mom is an advocate, so all the small talk around the table for my whole childhood was always legal stuff. And I just realized pretty quickly I couldn't do this, man. I saw the size of the files that they bring home and have to read in the nights or whatever. Not for me. Did you ever even pitch it to them? Like I'm thinking of it or not? Every now and then if I want to because I mean I I ended up going into science. So if I ever want to kind of get to my parents a little bit, I'll tell them I'm gonna go do patent law.

SPEAKER_03 1:21

Yeah.

SPEAKER_00 1:22

That I'm I'm gonna still go do an LLB. That's fine.

SPEAKER_03 1:25

Yeah, didn't you want to do that? Yeah, I thought I was gonna do patent law after I left dentistry. No, and I'll tell you why I asked the thing about pitching it to your parents, because I pitched it to my dad when I was in Matrix, 79 Matrix. Yeah. And he's also an attorney. Uh probably just as long, maybe even longer than your your dad has been. Because my dad's 78 at the moment. And he said to me, Don't do it.

SPEAKER_00 1:44

So Yeah, I think my my parents both were pretty I mean, obviously we spoke about it, but you know, and they were both pretty unanimous in I don't they don't think I'd be a good attorney, and I don't think I would be a good attorney, because um the I think it it requires a very specific personality type to to be able to collate, you know, all of that evidence together, but also keep track of so many open cases and you know, be very formulaic. Um but what I think I would be good at and what my parents do agree with is that I would probably be good at being an advocate and being, you know, an orator and arguing and that kind of thing, which which I'm much more inclined to do. And I did a lot of debating and that kind of stuff at school and public speaking. And um if I had to, I would definitely be keen on being an advocate. Yeah.

SPEAKER_03 2:35

You know, you can immerse yourself in one or two matters and know everything, the in and out of it. Your parents didn't want you to do it.

SPEAKER_00 2:41

No, they discouraged me pretty actively. Um the law thing. Yeah, but you know, I think that there's a there's this like human phenomenon where we we benchmark intelligence based on characteristics that we don't have. So for example, I'm not musical or artistic at all. So when I see someone who can play grade eight piano and you know, have a picture in their mind and then draw it, I'm like, wow, that person is incredible. So my parents weren't um, and I don't think they'll mind me saying this publicly, they weren't great at maths and science. So when they saw that as a child I was good at maths and science, they were like, wow, this kid is so, so much cleverer, you know, and they really pushed me to harness that. So they discouraged me from doing um anything that was more, I suppose, humanities-facing, just purely because of the maths and science ability. Well, I'll say it.

SPEAKER_03 3:26

They probably were thinking, don't waste your brain on law, right? You've got a good brain, don't waste it. I I deliberately called you Mr. Daniel Capalist, but in a few months' time, you're gonna be Dr. Daniel Kapalist, right?

SPEAKER_00 3:37

Yes, hopefully. I am I'm right at the tail end of my PhD in vaccinology. Yeah. So you I mean, can I call you a vaccinologist? Is that what you're doing? Yes, yeah, that is what I am. And you're the expert in vaccines. So Yeah. So vaccinology is a really cool field because all of the sort of constituent parts of vaccinology have existed for a really long time. And we've had vaccines for a really long time. So if you look at vaccinology, you've got the virology and microbiology of the actual pathogen, and then you've got the immunology of how it all works, and you've got the production side and the regulatory side. And I mean, there are so many things. And then relatively recently, the idea came to sort of how can we create an umbrella that all of these things will fall under with a vaccine focus? So we create these vaccinologists who then get exposure to that whole pipeline, and then you then sort of niche yourself into a specialty. So in my master's degree in vaccinology, I got uh exposure to all of that stuff from vaccine design and discovery through to production, testing, regulatory stuff, all the immunology, all the microbiology, et cetera. But also um with the opportunity to sort of say, well, what part of it do you really love? And I really love the immunology of it. So, so I've my PhD is in the the immunology around vaccines. Okay. Um, so I specialize in sort of long-term vaccine response, looking at if we tinker with the doses and the timing of doses and whatever, could we be eliciting longer lasting protection and could we be using what we've got better while we wait for new vaccines to be made?

SPEAKER_03 5:13

So so if I see something on like TikTok or Instagram where somebody, some doctor or whoever, medical doctor or even whatever, is talking about vaccines and saying this or that. And if I'm not sure, could I come to you and say, hey Daniel, I mean, does this check out? Yeah. Would you be able to like talk some sense into me or tell me if it's right or wrong? Or because you never know who to go to, right? I mean, yeah Especially with social media, it people are very convincing.

SPEAKER_00 5:39

For sure. For sure. And and it's very easy to to talk a good game. Yeah. And um there's this there's this like societal phenomenon now where people just don't like to admit they don't know something. Yes. And I think the hallmark of a good scientist, especially, is that we're very prepared to say we don't know something. Because science isn't about certainty, it's about, you know, the highest likelihood that this is how things work.

SPEAKER_03 6:04

You put helping your case. No, you put it nicely. You put it nicely, uh but but I'll put it even differently. You said there's a societal thing about not being able to say I don't know. Yeah. That's one of my pet peeves about lawyers. Like you'll ne a lawyer you'll never hear a lawyer saying I don't know. Yeah. I I mean I've spoken to many. It'll be they'll they'll default to it depends, yes, or they'll talk about they'll you know redirect the conversation to something that they know about, and then you'll just be sitting there nodding and okay, okay, yeah. They must know what they're talking about. Exactly.

SPEAKER_02 6:31

But if I can ask like what he's saying about the likelihood of the possibility of the correctness, but then aren't we just arguing with someone else who could be a little bit more correct or less correct? So up until the science proves otherwise.

SPEAKER_00 6:46

Yeah, absolutely. So so but before I answer that, I mean, and it's a great question because it's something that I I love discussing. But I mean, if you see something online that's about vaccines, then I'm in a good position to be able to answer it. And if I if I can't, I will say to you, I'm not really sure on this, or this isn't my area of specialty, I can check up on it for you, or I can refer you to someone who might know better. But um, with my with my training and with the exposure I've had to general vaccinology as well as my specializations, um, if it's vaccine related, there's a good chance that I'm in a good position to answer it. But when it comes to that scientific process, you know, I think the difference between good science and like uh, you know, like conspiracy theorists or that kind of thing is is good scientists will never speak in in absolutes, right? So when we you can you formulate a hypothesis about how something works and then you set up an experiment to test it, and it's better to think about it as like a falsification attempt rather than a proving attempt. So then you test what you think is happening and you rigorously look for uh statistical proof that it that it's not really the case, per potentially, you know. So when you set your significance level for your stats and that kind of thing, what you're saying is like if I'm testing two different vaccines and I want to see if one produces a better antibody level than the other, I'm looking for a difference in the antibody levels. And then if I look at my data and I've set my significance at 5% and I see that there is genuinely a difference, that is saying that I would only see this in the data 5% of the time or less if there wasn't real, really a difference. And then what we do with science over time is we accumulate evidence that converges on what is pointing towards the most likely outcome that's happening. And that's why science is so strong, is because we don't just say this is the truth. We say this is what our current consensus on all the evidence is pointing to, and we invite you to falsify it and we invite you to stress test it. And that's why when, even if it's your own theorem that gets disproven, when science evolves and changes, it's the most amazing thing because it means we're we're getting more evidence to converge on a closer consensus to what is actually the truth. But we can't ever say with absolute certainty that this is the truth, if that makes sense.

SPEAKER_03 9:19

So I mean I've had a dig at the lawyers, but I must also mention that similarly, I mean, I I've consulted with a numbers, a number of doctors and clinicians over the years, and there's only a handful of cases where a clinician has told me, look, I need to read up on this or I need to consult with a senior colleague and come back to you. I I wonder if there's, you know, there's probably some pressure on the clinician who's patient-facing to not come across as I don't know what's going on here, you know, and then put in their mind thinking the patient's not going to trust me because I'm I'm saying I don't know, right? That's the one thing. But then my gripe with scientists, because I mean I think scientists are brilliant. Engineers and scientists, I always have this this there's this debate we have in my family, because my family has a lot of healthcare workers in there. Yeah. And I always tell them, yeah, you guys think you're all very clever, doctors and everything. But the sharpest among us are the engineers. That's my perception. Having also consulted with engineers in my capacity as a lawyer, right? But my gripe with engineers and scientists and all those like really analytical, super buffin types, is that they're not good at storytelling. Yes. And storytelling is what gets people informed or misinformed.

SPEAKER_00 10:24

Absolutely. The PR of the profession. Exactly. And that's actually uh um the biggest gripe that I also have with my peers. And and um, you know, COVID really exposed this because if you uh if you are privileged enough to have access to this really niche technical information that just not a lot of people um have the opportunity to learn, I feel that part of the responsibility of holding that knowledge, especially when it is something that has as big a public interest as vaccinology, part of your responsibility is to try and communicate it and make it more accessible. And you get a lot of people, especially with something as scary as COVID, you know, where a lot of people just don't understand what's going on. You know, there's the scary new virus going around. We've produced a vaccine in, you know, way less time than we've been told it usually takes. Like people don't understand why we managed to do it so fast. They think maybe the corners cut, et cetera, et cetera, where it it was a really rigorous process. But most of the time I found that when you just sit down and you engage with someone and you you communicate effectively and you you're storytelling and that and you're listening, that's when you win people over and show them how things really work. My colleagues who would listen to someone say, I'm a little hesitant about the COVID vaccine, and they would just be like, oh, you know, don't be silly. You know, just that dismissive attitude and lack of communication pushes people away from the science and pushes people away from what we want to achieve in public health. So I agree with you completely. That that storytelling aspect and communication is so vital to actually making us have the impact that we want to have.

SPEAKER_03 12:08

I mean, the point about dismissive colleagues and stuff, I I see that a lot in clinical practice where, and you'll notice Yak, we always have this joke to say, don't come here with your Dr. Google stuff, right? We dismiss the patient because they've researched it. I mean, to the best of their ability, right? Yeah. But as you say, that doesn't help because you you're dismissing them, but you're not correcting them, right? That's the first thing. And the second thing is that I feel like people they go online. They're not going online looking to be misinformed or misled. They're they're looking for all the information that's accessible to them, and they're deciding, okay, I'm gonna trust this because that guy he speaks with conviction and he looks like he's intelligent and he wears glasses and whatever it is, right? Whereas this the scientist is not connecting with me. You know, they're just telling me, no, do this and do that because we know better. We're the scientists, yeah.

SPEAKER_00 12:57

We're the experts. There's a there's a whole, I mean, like the the psychology behind effective communication is really fascinating. Um, and I mean, I went down a whole rabbit hole during COVID with because I try to do a lot of um public-facing stuff to try and put good information out. And and I wanted to really learn how to communicate effectively with different kinds of people, you know. So I would like uh do podcasts or that kind of thing, or I would just go to my friends of mine who were restaurant managers or whatever, would ask me to come and speak to their staff. And so I had the opportunity to speak to a very wide range of people about the same topic. And it gave me a lot of exposure into how, like, what are the common threads that you can use to communicate with people? And that was really interesting. But one of the things that I noticed with people who were um trying to uh push a different narrative, should I say, I want to be, I want to be diplomatic about this. Um the the usage of sort of like um um uh like false logic and like logical fallacies and certain things where you you put in just enough information that people know is correct that you hook them and then you can start slipping in some stuff. And but also like, you know, there's a lot of these like set logical fallacies that people use. Like, for example, the appeal to nature, where like people say, well, anything that's natural is better than anything synthetic. And then they talk about chemicals. And you're like, cool, but everything is a chemical. You know, like I saw this interview where this guy goes around to people and it's like, how do you feel about the fact that there's dihydrogen monoxide in our water supply? And they're like, this is terrible, the company needs to do something about it, you know, and it's like, cool, so we should remove the water from the water supply. Yeah, you know, and like if you list the the chemical structure of an apple, you know, like you could you can make that scary. Um, but then you can also say, well, okay, um, like puff out of venom is natural. So is it good for you? You know? But but I've what I find really interesting when it comes to the communication stuff is how people really weave in these logical sort of fallacies really intelligently to win, to make their narrative win. Manipulation, I think. Yeah, it's so interesting. And I just like I think one of the challenges is when you're trying to, when you're trying to communicate um like scientific evidence, um, we always want to do it in the most objective way possible. So we try and use the most like level, bland language, we try and use the most neutral tone, we try and make it like unemotional. So when you have someone who uh is a lay person and they're watching a debate between a scientist and a non-scientist or anti-scientist, for example, um the the difference in like that emotional level of delivery or whatever, or like someone will bombard a scientist with 20 questions, but one question can take five minutes to answer. So then people will walk away thinking, okay, well, they only answered one of the 20 questions. So they didn't know the other answers of, you know, that kind of thing. So it it it is a fascinating thing to deal with. You know, how do we how do we make science more accessible to people?

SPEAKER_02 16:13

So what Yash was saying earlier on, I don't know if you've seen this meme, don't confuse your Google search with my medical or dental degree. Yeah. So sometimes I tell my patients, don't confuse your Google search with my Google search intentionally. But it's probably not the best way to deal with that sort of stuff. But just to head back, you I mean, you said your specific uh focus is immunology. All right. Um I correct in assuming that that is basically sort of an acquired process within the human body intrinsically to be more preventative so that vaccinology is not needed or vaccines aren't needed. So so You need to dumb it down for us.

SPEAKER_00 16:57

Okay, so there are two primary wings of the human immune system, right? You've got innate immunity, which is not pathogen-specific, and it's your body's first line of defenses, um, and it's a broad response to um whatever, whenever your body detects that there is something that is not you inside of you, it will unleash the innate immune system. And then the subsequent process is the adaptive immune system, and that is this whole pathogen-specific memory-associated targeted acquired immunity. Exactly. Right. So with vaccines, what we what we're doing is we're trying to give you that acquired immunity and that immune memory and train your body so that if it ever does recognize or encounter that pathogen in the wild, it um it knows what to do really, really quickly. And hopefully it can prevent you from getting sick at all. But what we really want to do, what the first line of uh importance with vaccines are is to try and prevent you getting seriously ill. So that, like the COVID vaccines, for example, were not good at preventing infection, but they were very good at preventing severe disease care. The point about it getting to a point where vaccines are no longer necessary only becomes a reality when we have eradicated a disease. So there are three layers to it. You get diseases that are endemic and like they're uncontrolled. They're like raging through your population. The first layer is to control that disease. So it's still going around, but you've kind of got the impact of it under control. The second layer is elimination. So that means in a certain geographical region, you have eliminated transmission of that disease. So you're no longer encountering it. And then eradication is it no longer occurs on planet Earth. So smallpox is the only disease that we've ever eradicated, which is why we no longer have smallpox vaccines, because there's literally no chance that you can ever encounter smallpox again.

SPEAKER_03 19:03

So smallpox is smallpox is the only disease that has gone through those three stages of the process that you just mentioned. Exactly.

SPEAKER_02 19:09

Yeah. But if I can ask, how do we know that? What if we don't know what the origins of smallpox are, or do we?

SPEAKER_00 19:15

So what we do. Um, but also viruses are what we call obligate parasites, right? They cannot survive outside of a host. So a bacteria, for example, can be completely self-sufficient. So bacteria can exist in uh outside of a reservoir, whereas a virus needs to be within what a reservoir somewhere in the world for it to keep happening, whether that's humans or animals or that kind of thing.

SPEAKER_02 19:44

So that's sorry, so that's my point. I mean, what if if what if smallpox cross the species barrier and it exists in, I don't know, mice or some other.

SPEAKER_00 19:56

So I mean, like there are other species of there are other there are other relatives of smallpox like cowpox and monkeypox that exist. But we've seen that they have very like limited ability to uh consistently infect humans, that kind of thing. But but we have incredibly sophisticated surveillance systems out there where we are constantly looking for what is around us. And when you can go through a number of years not seeing a va a virus anywhere in the world and you are actively looking for it, there's a good chance that it's because it's no longer there. I'm glad you said good chance because you were not being absolute.

SPEAKER_02 20:35

So it's still a possibility.

SPEAKER_00 20:36

I mean, we haven't there there has not been an identification of a a wild-type smallpox virus in nature um in like over half a century. Yeah um so uh I mean, I you know, maybe there's like some tiny population. I don't know, it's it we can we can with confidence say that smallpox has been eradicated from the planet. But until you reach that eradication, you still need to be using the vaccines. Measles is a really good example, right? A lot of countries in the world had eliminated measles, like a lot of countries in the global north, like high-income countries. Um, and they got to a point where they had they effectively did not have measles in their populations. But measles still exists in the world, and it is also the most infectious disease known to man, right? So measles will exploit any gap in your population immunity that that starts dropping. And now we've seen it in the UK, in Canada, in the Netherlands, in um, you know, all over Europe, North America, countries that have lost their measles elimination status because vaccination rates have dropped and they've reintroduced those susceptibility gaps. So even if you have eliminated a disease, you still need to maintain your high vaccine coverage to make sure that you you keep that going.

SPEAKER_03 21:57

Daniel, I mean, I want to get into the nitty-gritty of All this stuff later, but I want to take us back a step first. When you were growing up as a little boy, right, did you ever think you were going to be doing this kind of work? Or w what's what did you want to be when you were growing up?

SPEAKER_00 22:10

I I I'm going to tell you when at the beginning of 2019, when I started my honors degree, I had literally never even heard the word vaccinology. Okay. I did not know it was a thing. Um and now, you know, seven years later I'm I'm getting a PhD in it, you know. Um when I was growing up. Where are you from? I mean, what did you do? Uh so I'm Joe Berg, born and raised. Um and uh I went I went to uh Red Hill School from all the way from kindergarten to Matric. Very good school. Yeah. Um and um there were a bunch of like my core group of guy friends. Like all of us had this idea that we wanted to be engineers, all of us. Um Red Hill's co-head, co-head, right?

SPEAKER_03 22:50

So yeah, that's why you mentioned guy friends. Yeah, like we were.

SPEAKER_00 22:53

We we were also like uh we were a bit nerdy. We used to spend our weekends, you know, landing at one guy's house and bringing all our computers and playing. Oh, yeah, yeah.

SPEAKER_03 23:01

What land games did you guys play? Counter-strike.

SPEAKER_00 23:02

Oh, like Counter-Strike, Call of Duty, you know, all like all of those classic ones.

SPEAKER_03 23:06

Jack used to play land games at his university and he got people kicked up.

SPEAKER_00 23:11

Yeah, suspended. Oh, amazing. Nice. Yeah, go on. That's kind of an achievement. But uh so yeah, so so we we all were like, you know, we want to be engineers and we want to make cool stuff and we want to solve cool problems and whatever. And I I realized um uh that a lot of school uh a lot of school kids have a very romanticized idea of what some professions are because all of us started engineering degrees, one of us finished it and is still an engineer. Um and I I did I started by medical engineering. What did you think was so fascinating about engineering? Like Yeah, honestly, like do you know you remember Makano? Those Makano. It was like those toys. Yeah, like the Well, just explain it for the other. I used to like you know it's it's like it's almost like mechanical Lego. Right. You know, and it's like you you you build really cool stuff and like there's motors and like you build functional things, and it is so interesting. And I like the Sorry, what is what is that?

SPEAKER_02 24:05

Is like a is that like an advanced Kinder Droid?

SPEAKER_00 24:08

Yeah, it's like Lego, yeah. It's it's it's really fun. And like I the idea of making stuff seemed really cool to me. I I loved tearing things apart and very often not being able to put them, actually, I would say always not being able to put them back together. But like seeing how things worked was super interesting to me. And I always understood that that is what engineers do. They like understand how something works and then they make it better and they build a cool new thing. And like that's why we have supercars and smartphones and all that kind of stuff. Um so I wanted to be one of those guys who like to do that. They shape the world. They shape the world, don't they? Yeah, exactly. Yeah, but I um I didn't realize how much, you know, that like that is that is a very small part of what some engineers do. And that engineering as a as a as a discipline is not all about that. Yeah.

SPEAKER_03 24:55

Um don't they all just become consultants and work at these companies? I don't know what an engineer does.

SPEAKER_00 25:00

I just work for a bank.

SPEAKER_03 25:02

Yeah, it's maintenance. Okay, so and then obviously the folks are cool with this because now you're using it. Yeah, exactly.

SPEAKER_00 25:07

And the other thing the other thing is like um it's a profession. Yeah, you know, and I I don't know if I mean like with my with my parents, um, with them both being lawyers, um they and like coming from professional families, like my grandfather on my mom's side was an engineer, my grandfather, my dad's side was a lawyer, you know. And um I think for a long time the convention was you had to become a thing. Like, you know, and uh you're from a Jewish family, right?

SPEAKER_03 25:32

Yes, yeah. So uh what I've noticed interacting with Jewish c community is that they're very much similar to the Indian community in that like being a becoming a professional is a thing, right? I I don't know if it was like that in your family. Yeah, yeah, absolutely. It's like you must become a professional. It's an achievement. Yeah. Yeah, you know, it's really it's so funny.

SPEAKER_00 25:49

Like my my uncle, my dad's younger brother, uh was the only person in the family who just like followed this completely arbitrary path. He became a social anthropologist, right? And my dad recounts the story of when his his his brother was six years younger than him, and he tells the story of when he was at university and he went off to like start, he did a he did a BA and did anthropology. And then my dad kind of said, Okay, well, after his BA, I'm sure he'll you know, he'll go and get a professional degree. And then he said, No, I'm gonna do my master's degree in social anthropology. My dad was like, Okay, this is a bit weird, but I'm sure after that he'll go and get a job, you know. And he just never joined that like conventional fold. Um so when I wanted to be an engineer, it kind of fit in that fold and it was all good. And then when I left engineering and I like eventually plucked up the courage to say to my parents, I really am hating this degree and I don't think I'm good at it. Was that why you left? When did you do it? At VIT, yeah. And I I said, I, and they said, Well, what do you want to do? And I said, Well, I really love biology and I want to do a BSc in biology. I want to become a I want to do science. How did you know this? Uh so part of the biomedical, I I I mean, I did biology for my trick and I loved it. And um part of the biomedical engineering that I did was heavily, you know, uh introductory sort of medical stuff and very heavy um uh biology stuff. Um and that's the part of the degree that I excelled in. And then all of the electrical engineering components I, you know, I just flunked out of basically. And like I never had an interest in being an electrical engineer, and I didn't understand that biomedical engineering is just electrical engineering with a medical application, really. So there was a there was a point which I was sitting in it in a lecture on like um electric and magnetic systems on high voltage power grid lines. And I remember thinking, like, what am I doing? And how long did you s suffer through this? So I did first year twice, but that was because I did really well in my trick and then was real cocky and at first year and thought I could You know what they say, right?

SPEAKER_03 27:49

First year is the best two years of your life.

SPEAKER_00 27:51

Yeah, exactly. I agree. My first first year was amazing. My second first year, I did some good stuff. Yeah. Um and then I did second year, and then after the second year courses, I uh I said to my parents, I I just can't do this. And how did they react? Um I think they they could see that I was really unhappy. So they they supported me in changing to something that could make me happier and improve my quality of life. But they were initially very nervous about this idea of my entering a degree that doesn't result in a job.

SPEAKER_03 28:20

Biomedical engineering.

SPEAKER_00 28:21

Yeah. So the yeah, but then I mean my BSC was in genetics and physiology.

SPEAKER_03 28:25

Okay, yeah.

SPEAKER_00 28:26

So like you have to then get into honors and you have to then do a master's or something, because you know, if you just have a BSC, it kind of you're like, cool, I know some cool stuff. But like Did they not tell you just do medicine, do it, just become a But my mom, yeah. My mom was like, that's the next. If you don't want to be an engineer, be a doctor. Yeah. She really pushed me for it. Why didn't you do it? Because I do I've never felt that pull towards being in a clinical environment. Like I've always loved biology, I've always loved physiology. I like, I like the idea of medicine and I like the theory of medicine. But I I think that when people talk about it being a calling, I think that is very true. And the best doctors that I've ever been treated by or interacted with in my exposure to you as a medical scientist, are the doctors who you can see live and breathe for being in that clinical environment. And they love being patient-facing, and they love the idea of working with patient and making that patient better. And, you know, and and you can tell when someone is in a clinical role where they would rather be anywhere else. Um, and I felt that considering that I never felt the pull to that, I would be doing a disservice to myself and my patients if I didn't want to be there. And I was also really scared of going from one degree that I hated to another degree that I hated. Like part of my changing core changing directions was to find what I loved. And I knew that science was a safe space for that because I knew I would enjoy it at a base level. But this is a very like mature thought process.

SPEAKER_03 29:55

How old were you at this time, the Quran?

SPEAKER_00 29:57

I uh was uh 21 when I changed when I moved degrees. 20, 21, yeah.

SPEAKER_03 30:03

But you I mean you you gave it good thought and like you actually applied your mind and said, okay. So then what do you apply for once you leave the engineering? What do you apply for?

SPEAKER_00 30:11

So I went to the science faculty and I said, um yeah, it vits and uh and I said I'd like to change degrees. And they said, what are you changing from? And I said, I medical engineering. And they said, Did you pass all your first year courses? I said, yeah. Then they said, I said, can I, is it possible to get transfer credits for first year, like first year BSC mathematics, physics, and chemistry and biology? And they said, but you've got engineering physics and mathematics and chemistry. I was like, yeah, they were like, you can have whatever transfer credits you like. So uh so I I went I moved into second year of the BSC in genetics and physiology. Um, and immediately like my marks picked up like 40%, and you know, my enjoyment went up. And and I I loved um I loved that I enjoyed learning again. You know, that was an amazing feeling for me. And then I But did you have a plan?

SPEAKER_03 31:04

Like I'm getting into this thing.

SPEAKER_00 31:05

Right. No, I was like, cool, I'm interested in this right now. I my career has been shaped by um saying yes to a lot of things that I had no idea where they would lead, and just following curiosity and passion. And I firmly believe if you decide on a career and try and find passion within it, you will almost always fail. But if you follow passion and find a career in it, you will almost always succeed.

SPEAKER_03 31:34

This this is fascinating because you've got two lawyer parents, right? Yes. So surely they would have asked you these questions. Yes, they did. Daniel, we have many objects. What's the plan? And and oh, I don't think I mentioned this, but your dad was my boss at Norton Rose. These are all Dine's rates, Norton Rose, now Dine's, yeah. Um and I know him. He would have asked you these questions, right? Like, what's the plan? So how did you answer that? And what did you how do you navigate that? I'm asking this because it's important for people that come from families that are maybe not as liberal or as like supportive or whatever.

SPEAKER_00 32:06

No, look, I mean, you know, and I mean my parents are now, my parents are extremely proud of me and they are so supportive of my career, and they so believe in what I do, and you know, they they they are my number one supporters. But when I was making this transition from engineering to science, there was a lot of friction about it. And we had pretty explosive arguments about it. And and my, you know, you're exactly right. I mean, my dad would say, you know, like, but like what is the plan? You know, what are you gonna be? You know, how you like what's your career? How are you gonna earn money? And that's it. And I and I kind of say, I don't know, but I'll figure it out. You know, like something will come of this because the the you the reality is that if you're involved with uh medical science and biology and you know, applied applied biology, there will always be something to do. I just didn't know what that was yet. So, like the first thing I fell in love with was genetics. I was like, cool, I'm gonna be a geneticist. Yeah. So my honors was in genetics. And then my honors research was looking at the relationship between certain mutation, like genetic mutations and the responses to rotavirus vaccines. Okay. Because there was this documented thing where the rotavirus vaccine product that we were using in a lot of countries in sub-Saharan Africa is the same one that they use in a lot of countries in Europe. And they, it it would have like a 95% efficacy in Denmark, but then like a 65% efficacy in sub-Saharan Africa. And um and I became fascinated with why, how could a vaccine respond differently in different populations? And then I started saying, well, how do vaccines work? And like, what is a vaccine? And you know, all this kind of stuff. Yeah, no, but hold on, then hold on.

SPEAKER_03 33:52

You're sucking us away from the function. But I want to take us back to this thing of how do you ask you a question? How do you convince David Kephalis to say, okay, I'm gonna support you at that time when he asked you all these questions. Yeah. But before you answer it. Wait, no, no, but you know why? Because I want to say this is the beauty of having white parents. Yeah, like they will support. I don't always have to be this joke, but like white parents will support you with anything. Like, oh, you want to go do arts, go do it. I don't know if Jewish parents can't. Yeah, I was not gonna say that. I didn't want to go with that.

SPEAKER_00 34:18

I don't, I don't, yeah, I don't I don't know if I would love Jewish parents and with just generic white parent in that regard. The classic Jewish answer is you can do whatever you like as long as you become a doctor first.

SPEAKER_03 34:29

So how did you how did you convince him? So you gave him this whole spiel and then he said, okay, fine, go ask.

SPEAKER_02 34:34

But wait, before you answer that, can I ask you? Was he was he's you're he's damn passionate about about law. I don't know, I haven't interviewed him yet. Yeah, well you is you working on it. Get him on the show, right? I don't know what a lawyer specialist is. I I can't I can't imagine like you as a as a young kid that just quit something trying to convince your dad that you're following your passion and you'll make a career out of your passion. Kind of passion fruit like tea.

SPEAKER_00 34:55

So so I think the fact that I had a decent track record with the the biology subject in the engineering degree was kind of like a little bit of hard evidence that like this is stuff that I that I can do at the end of the day. Well, a little bit. I mean, you fail first year, but then you mentioned. Well, I never failed biology at first. I failed engineering, maths, and physics in first year. I know, I know. Um but um but I um I think um the other thing that that strongly coincided with this process was I've always had I was diagnosed with ADHD as a child and like eight or nine years old. And it's something that I always struggled with. And at this time, I uh got a new treating psychiatrist who at that stage said, I think it's really important that we have a discussion with your parents about what ADHD actually is and how ADHD actually works, because everyone associates it with just attention deficit and hyperactivity. But it's a whole executive functioning disorder. You know, you really struggle with prioritizing and scheduling and consistency and you know, all of these kind of things. So it's, I mean, it's a it's a physiological condition. Um and my parents kind of understood that one of the characteristics with an ADHD person is they've we fully embody that you can take a horse to water but can't make a drink, sort of thing. And like if I, if if something doesn't give me dopamine, I cannot and will not do it. You know what I mean? And like I as I've gotten older and now I've reached a point of like, and it's taken years to develop this control where now I can push through tasks that I don't enjoy. But at that stage, I really like engineering was giving me no dopamine and I didn't want to do it. And I think the fact that I was so insistent on transferring to the BSC, coupled with my my parents' growing understanding of how ADHD worked, coupled with my uncle's unconventional path, you know, and my uncle did an amazing uh an amazing amount of of um, he gave me an amazing amount of support because he understood, you know what I mean, not following this like structured career path and like you know, looking, it's almost like you get to the edge of a map in a game and it hasn't rendered yet, and you're like, you know, just looking into that fog. And he had been there and he had forged a career and and he spoke to my dad a lot, I think, about it. And um and eventually my dad kind of said, you know, like um eventually I I actually I had an I had a conversation with him about Manly, about my grandfather. Because my grandfather was the senior partner of Danae's raids for a long time, and I mean he was a formidable person in terms of his, you know, in a professional capacity. And and at one point, and I I I was I you know, my wanting to change degrees, it's not a pleasant thing because you feel like a failure, because you feel like you're failing at what you set out to do. And I said to my dad, Do you think Manley would still be proud of me? Because he had passed away by this point. And my dad said to me, Manly wouldn't care if you wanted to become a bricklayer, just as long as you are trying to be the best bricklayer you could ever be. And I said to my dad, I don't know what kind of scientist I want to become, but I will become the best scientist that I can be. And I will find what I'm gonna do.

SPEAKER_03 38:25

And I did.

SPEAKER_01 38:26

Wow.

SPEAKER_03 38:27

I've got goosebumps hearing that story. And thank you for sharing that because it's important context, the whole ADHD thing and how to get, you know, your parents also they needed to understand their kid, you know? For sure. Yeah.

SPEAKER_00 38:37

Okay, so then take us to how what what happens then next. Yeah. So then I I got it, this exposure to vaccines in my otter's research. Um, so it was still very genetics orientated. It was, you know, all the coursework was genetics stuff, but but the application of the research was around vaccine response. And I said to my supervisor, um, I really want to learn more about vaccines. Like, I want to understand this properly. Because that's the other thing with me, is you know, like going back to pulling everything apart as a child. Like, if I'm intrigued by something, I want to understand it to its tiniest nut and bolt. I want to really interrogate it. And this was in 2019, I was doing my honors. And at the same time, Vitz had just launched their master's degree, which was a Master of Science in Medicine in vaccinology. And vaccinology, as I said, as a as a recognized sort of term, is quite new. And at that point, there were extremely few places in the world where you could become a bona fide vaccinologist. Um and Witz started this consortium called Alive, which stands for the African Leadership in Vaccinology Expertise. And I always thought it was quite a clever acronym that a vaccinology consortium was alive. Yeah. Um, and they uh so and my supervisor happened to be part of this consortium. And she said, well, go and do this master's degree. So I she put me in touch with the the um program director, who's an amazing, amazing professor. And um she interviewed me and and I got in to start in 2020. Wow. Um, and it was completely fortuitous. You know, as I said, at the beginning of that honors year, I had literally never heard the word vaccinology. And it ended up being my true passion in life.

SPEAKER_02 40:25

And the biggest buzzword of the year.

SPEAKER_03 40:27

You were at a time when now vaccines are a thing. Yes. Wow. Yeah. You couldn't have planned it, eh?

SPEAKER_00 40:31

Absolutely. I mean, it was uh the the to say we got thrown in the deep end is an understatement. Yeah. But it was incredible uh to see um you know, starting to go into this career path to see firsthand just how vital it is to the world.

SPEAKER_03 40:51

So t tell us about that deep end. What what what were you swimming against all?

SPEAKER_00 40:55

So we started uh the the program is a two-year master's program. First year is coursework, second year is your research. So we were starting our coursework year in um in 2020. There were, I think, seven of us in our class.

SPEAKER_02 41:09

Um January 2020.

SPEAKER_00 41:11

Yeah. And then, you know, December 2019, COVID, the SARS-CoV-2 virus had been detected. There were cases in China. By January, it was pretty recognized that this was now starting to spread. And we, the 5th of March was when South Africa went into our oh, I think it was the 5th or 20th, it was late, was it late March? Somewhere in March, right? Somewhere in March.

SPEAKER_03 41:32

But in but by Jan, people were still making jokes about COVID.

SPEAKER_00 41:35

Yeah, yeah. By Jan, like we like in public health circles and medical circles, they were like, okay, cool, there, there is something going on here. But I think publicly it wasn't being taken very seriously yet. I don't know. I think as far as I, my experience was. But but um what started happening was like all of like in the coursework we were doing, um our lecturers were starting to like reference this new, this new thing. And like kind of when we were talking about the importance of vaccines, for example, and like how do we like emerging pathogens and that kind of thing, because especially in in like tropical areas, like emerging diseases are is a huge thing. So, what better example to use than the currently emerging disease that is, you know, and um and when it started really accelerating and we went into lockdowns and everything, then you know, the the vaccine production went into overdrive, the whole world realized what a significant problem this was. And um, you know, it was one of the only times I think that we've had the world's resources concentrated on solving the same problem. And it was amazing to see what we could do. But then uh, you know, all resources were stretched thin. So they needed all hands on deck in the clinical trials that we were running, in responses in clinics, that kind of thing. So they very quickly said to us, um, we're rotating you through clinical trial teams, we're exposing you to real-world clinical trials. We are, if you if you have the ability to volunteer in a clinic and help out, then please do, you know, that sort of thing. So we were getting all the same coursework we would have gotten, but with this super intense, like real-world exposure to what it was all actually about. Um, and and I think that just made it such a powerful experience. Sure. And what do you do in those trials? And so at that stage as students, we rotated through every different part of it. So we had some exposure to the clinical side, the lab side, the data handling side, all that kind of thing. But um the the the clinical trial process is really interesting. So typically what would happen is um in a when you are not in an emergency situation and you can l at leisure develop your vaccine, you would have the idea for your vaccine and kind of start developing it. And then you would have this extensive pre clinical testing phase where you do like anal. Models and cell culture models and that kind of thing. And you kind of just want to see if there's any like viability to this idea, you know. But I mean, if your animal model fails, then that is definitive. It doesn't work. Okay. And then once you get your pre-clinical data and you say, okay, well, I have enough of I have enough data to suggest that we could be onto something here, then you would do your phase one trial, which is a really small trial, like tens of people, and it's rare, and it's mostly in very healthy people, and it's all about safety. It's like, I don't know what this product does really yet. So I need to give it to healthy people in a super controlled environment and just make sure that it's safe. It's not like causing anything. And then if it passes that, you then go into your phase two, which is now a few hundred people or up to maybe a couple of thousand people in exceptional stances. You know, your phase two is a hundred, a few hundred. And that's all about, like in a vaccine, it's all about immunogenicity. So that's the ability of a vaccine to elicit an immune response. So I've now looked at, okay, I've I know it's fundamentally safe. I now need to see like, does it actually stimulate the immune system the way we want it to? And once we say, okay, it checks those two boxes, now we can see about how does it actually work in trying to prevent disease and you know what's the what's the long-term effect and that kind of thing. So then you have your phase three, and that's now thousands of people. Um and there, like there was there's always a lens where you're like assessing safety, because if you have a side effect that occurs in one in 10 people, you're very likely to see it if you have 50 people in your trial. If you have a you know one in a hundred, then you're very likely to see it if you've got a thousand. But if you now you know have a one in a thousand chance of something happening, you know, you so the bigger you scale, the more chance you have of seeing rarer side effects. So there's always a safety lens. But then that phase three is all about um what's the efficacy of this thing? You know, so like in our group that gets the new vaccine versus the old vaccine, or if there is no old vaccine, then the new vaccine versus a placebo. Um, do kids get the disease less in this group than in that group? You know, like does it work fundamentally? And then it would get licensed. Right. So it's this linear process where there are like valleys of death. And still long, right? Hugely long.

SPEAKER_02 46:22

Because you're talking like an under normal circumstance. Yeah, yeah.

SPEAKER_00 46:26

So like that's classic vaccine development. And like after each phase, there's a chance that your that your data shows that this is not a good vaccine and it and it dies. You know what I mean? Um, so usually what happens is companies and like pharmaceuticals, whatever, don't want to invest everything into it. You know, you don't want to fund a phase three if it's gonna fail at phase one. So you would typically fund the phases very independently of one another. You would like do the phase, do all the data analysis, like make sure it works, take your time, then do your funding for the next phase, then recruit. And you know, so there's all this administrative stuff between the phases. So with the COVID vaccine trials, what it happened was bets were hedged. So instead of running um uh consecutive phases, they were run concurrently with the caveat that if like the phase one group or phase two group fails, then the phase three group automatically fails. Chop it out. So you run all of them at once. So we actually gathered the same amount of data that we would do in a normal clinical trial in a much shorter time, hoping that the preceding phases would pass, um, and that then the work you were currently, you were c you were concurrently doing on the later phases would then be, you know, not thrown out. Um, but also, in fact, because so many countries in the world were conducting these vaccine trials on the same products with all with the same goal, we actually got an astounding amount of clinical trial data. Because very rarely would you have a vaccine candidate being tested at the same time in so many different parts of the world, right? So the amount of like people think, people ask me, you know, in COVID vaccine development, did we cut corners? Like, no, we we actually expanded the amount of data that we would usually get. The only thing that we couldn't have was that like two years of follower or three years of follower. But because of the the platform that was being used, especially with the mRNA technology, like there's a lot of also it's not new. I mean, mRNA technology has been around for 20 years. It's just that it was brought to popularity as a platform for the COVID-19 vaccines. But um What's a platform? What do you mean? So a vaccine platform is a is a different, like different kinds of vaccines. Um but I'll get into that now. Yeah.

SPEAKER_02 48:49

But but um And also you said mRNA.

SPEAKER_00 48:52

Is that like it affects the DNA of the So mRNA, so the the virus, the central, like all of molecular biology works on this like central dogma. And the central dogma of molecular biology is that you have DNA, and your DNA is the blueprint of everything that makes you you, and it encodes for all the proteins that make up your body, right? Because proteins are what gives your body structure and what enables all processes to run, right? Your carbohydrates and fats and you know, all other kinds of structural molecules, whatever, are, you know, all of everything that is not a protein in you is is precipitated by a process that is run by a protein. So, like without proteins, we are nothing, right? So that DNA uh is like um the blueprint of you. It then gets transcribed and it sits inside a nucleus inside your cell, and nothing can get into that nucleus, right? So your DNA is really protected. But in order for the builders to build that protein, they need to be given building plans. So your DNA gets transcribed into messenger RNA, mRNA, and that then gets given to the other proteins in your cell that are that are that are structural proteins, and they build that protein according to that building plan that they've been given. So with an mRNA vaccine, what we did is we took the blueprint for the spike protein of the SARS-CoV-2 virus, and we basically, instead of giving your body the spike protein, we give your body the building instruction to make it. And then your cells will take up that mRNA and they'll treat it the same as they treat every other mRNA, which is, hey, we got building plans, let's build this protein. It just so happened that the protein they were building wasn't a protein for you, it was a protein that is the SARS-CoV-2 spike protein that then gets released from the cell because the cellular machinery says, I've done my job, I've built the protein, here you go. And then your immune system says, hey, that's not part of me. Let me let me respond to it. And then you get the whole immune cascade where you develop immunity against that target. Because if we were to use, for example, a subunit vaccine, which is where I take a piece of my virus or bacteria and I physically like I culture it and I grow it and I put it in a syringe and I give it to you. I can only give you so much, right? Whereas if I give you the building material, the instructions, and let your body make it, you can produce a whole lot more than what I could give you. You've got a much better chance of having a good, strong immune response to that target. Right. Also, it makes production super easy because if we want to change the target, we just change the instruction we put inside the vaccine, right? So you have a plug-and-play vaccine platform that you can use for different targets. And then after three or four days, all of that mRNA is cleared. It doesn't stay in your body, it doesn't ever interact with your DNA, and that spike protein that's produced has been uh worked out and attacked by your immune system and studied. And after about a week, there is literally nothing left inside of you except that immune memory about what it was that you encountered.

SPEAKER_03 52:11

I mean, the way you described how vaccines are developed and how it was tweaked for the COVID vir for COVID, it like made so much sense to me. So clearly that research you did into communicating things has helped. You know what the sad thing about that story is? Where you said you had to go and research it yourself? Yeah. Like how to communicate? I feel like that should be like one of the core cause. Prerequisites in any of the scientific. So what do you think was causing like so much vaccine skepticism at the time? Was it because it came so fast?

SPEAKER_00 52:42

Or I think it's I think the speed of the speed of production was definitely a factor because like it's like people really held on to this idea that like it takes five to ten years to make a vaccine and test a vaccine, whatever. Um and that is very true when you're working in a resource-constrained setting and like potentially no one else really, you know, is interested in the product. And like, you know, you've maybe got one pharmaceutical company who's interested in developing it, and like it may be very specific to a certain region. You know, so you, you know, in that case where you've got limited resources, then you know, the less you can put in, the the longer it's going to take you to achieve that process. Um but um I think the other thing is just that like um people were people are inherently afraid of what is unknown. And there's there's also like a like a risk perception bias where people are very happy to accept like severe risks that we choose to take. So for example, I know that when I get in my car and drive home, I know that there are, I know the motor vehicle accident rates in this country, I know that I am taking a risk in driving home, I am choosing to take that risk, I accept taking that risk. People are a lot less comfortable with the same or even a much lesser risk that they feel they are not choosing. So if I say to you, you've got a, I mean, I I I I'm pulling a number up. Let's say I say you've got a one in ten chance of um falling on your way out of this building, right? And you could get hurt. You say, well, I'll take that because I'll just make sure I don't fall. Yeah. But if I say you've got a one in a million chance of having an allergic reaction to a vaccine that I'm gonna give you, you're like, whoa, that's yeah, that's a that's pretty that's unacceptable. You know, so there's that risk bias that scares people and that gets And it's also the unknown, right?

SPEAKER_02 54:46

Like they don't understand it.

SPEAKER_00 54:47

Yeah. So I mean, people were already scared of of the virus because that was an unknown. And then you add this new vaccine, and like no one's ever, like people have heard of like your flu shots and your MMR and that kind of thing, but like no one had ever heard of an MMR vaccine. Yes. Uh I'm sorry, of an mRNA vaccine. Um, you know, they like it was new technology to the public, and like why is it so quick? And you know, how do we know it's gonna be safe? And like, so there were there were unknowns from all sides, which I think just compounded the fear. And then you also had a lot of fear mongering, you know, like antivaxism. Yeah, but not even that. Like you had fear mongering around the disease and the virus, and you had fear mongering around like we're gonna, if the lockdowns continue, we're not gonna, we're we're gonna run out of resources. And like they were all, there were so many things to be scared of that I think the like for a lot of people, um, it was easy to then direct that fear into something. And often that thing was the vaccine. Um, but we know like COVID vaccinations and the rollout of COVID vaccines averted an estimated 54 million deaths. You know, like they they were highly effective at what they did. And the risks associated with COVID vaccination, like for example, with the AstraZeneca and Johnson ⁇ Johnson viral vector vaccines, that you had a you had about a um like a one to two and a hundred thousand risk of the blood clotting um that's uh vaccine-induced thrombotic thrombocytopenia. Um we like now we understand why that happened. Um, but also it's a it's a very low risk. Um and uh with the mRNA vaccines, like the Pfizer Madonna vaccines, there were there was that risk of myocarditis in young men that was about a 10 in a hundred thousand risk. Um both of those things, blood clotting and myocarditis, you had about a 20-fold higher risk of that happening with natural SARS-CoV-2 infection. So, like every single pharmaceutical product in the world, like if you've ever read the package insert on a Pinado, like they list some pretty severe adverse events that can happen. And there will always be someone who will react adversely to a pharmaceutical intervention, right? We have an acceptable risk rate in medicine. You know, if if the the risk is low and the benefit is so huge, it's acceptable. And and as long as like you are aware of it and like you can manage it, which we always do, and because of our surveillance systems and our pharmacovigilance, like we we detect these adverse events so quickly, no matter how rare they may be.

SPEAKER_03 57:30

Um But the funny thing is it's it's not only in medicine, like it's in day-to-day life. Like as you said, you get in the car, there is a risk that you'll die, but you you drive there anyway.

SPEAKER_00 57:37

Yeah, but like there's a risk that your brakes could have a mechanical failure and you you won't be able to stop. Or like, you know, there's a you know, there's a risk that we there may be a natural disaster, or there's a, you know what I mean? Like everything, there's all there's inherent risk in being alive. Yes, every every day. Yeah. And and I it's it's it's just that perception of like whether we feel in control of that risk or not. And like a lot of people are scared that with pharmaceutical interventions we are not in control of that risk, but we actually really are, because we understand the risk, uh, you know, the relative risk. We understand um how to identify it, we understand how to treat it. Um, and the the relatively speaking, the chances of that risk actually being a concern is super low. You know what I mean? So we are actually in control over that situation a lot more than people think we are.

SPEAKER_02 58:31

So speaking of surveillance, I'm sure you've heard of this NEPA virus thing that's coming out of NGO. Is that NEPA virus?

SPEAKER_00 58:38

Um I will preface not my era of specialty specialty.

SPEAKER_02 58:42

So all right. Well, we we asked uh Prof. Glinda Gray about it. You you know of her, right? Yes, of course. And my legend. Yeah. My straight up question to her was like, shouldn't we be concerned about this? And she was like, Yes. Um my question here is if you have heard about it, like you guys have to stay abreast of whatever it that it is that's coming out in the world, being through your surveillance programs, to identify that some if something could be a pandemic or not. What what's your response to it? Like, do you have um you know people that instruct you now to like redirect resources?

SPEAKER_00 59:19

So I think this like this is variable depending on what like where in the whole vaccinology world you sit. So I am I'm not involved in vaccine development at all. So um I keep abreast of these kind of things out of interest, but there are people who keep abreast of these things because they they are vaccine developers, you know, they are they need to understand firstly with vaccines that we already have, could we make could we be making them better? Or with all of these emerging diseases, does it get to a point where it warrants a vaccine, or do we need to start thinking about a vaccine, that kind of thing? So there are there are a lot of factors that go into it. The first is um how like I mean when you hear of a new a new pathogen, like you ask a couple of questions that that are not in any order of significance, they're all significant, but like how infectious is it? How clinically severe is it? Um, you know, is it something like um swine flu that's got a pretty high case fatality ratio, or is it something that's like pretty benign, you know, that you may get sick, but you unlikely mortality rates. Um is it like what's the basic reproductive number? So how infectious is it? Like is is is one person going to pass it on to three people, five people, ten people, you know? Um, how quickly could it spread? And then where is it? Who is it happening? What is it happening in a very specific population? Um is it uh is it like was it a a zoonotic virus or was it an animal virus that's crossed barriers? Could that happen anywhere else? Is that animal a carrier somewhere else? Um if it is, then are we seeing it there as well, for example? Um and all of these come into play about whether or not there is a level of urgency and severity that like you need to start vaccine development. But after COVID, there is this, there is a um a new kind of approach to it where we have we have the idea of like a hundred-day mission, right? And the idea is that we proved how quickly we can respond to things with COVID when we unite. So now with 100 day missions, we want to have um within 100 days of new pathogen detection, we want to try to have uh a therapeutic, a diagnostic, and a preventative measure.

SPEAKER_02 1:01:52

Is this an organization?

SPEAKER_00 1:01:53

No, this is like an approach to public health systems thinking. Um it's like spearheaded by, I mean, like, for example, like big big yeah, and like big um um public health institutions and like research centers that do this kind of work. But I mean it's it's it's an approach to these problems. Um and you know, it's a highly ambitious thing to say, well, within 100 days I want to I want to have a diagnostic, a therapeutic and a preventative measure. Um but that that that thinking is like drives you to really pursue these questions with intensity.

SPEAKER_03 1:02:30

Don't just sit on your laurels.

SPEAKER_00 1:02:31

Yeah, because the problem is, is like it it you know, there there are unfortunately, I mean, we want to ideally like think about public health issues as just public health issues, you know, like the primary driver of vaccine development should be burden of disease. But there are other things that factor in, you know, for example, like if it is a super, super rare disease that is happening in a very small population in a very isolated part of the world, uh, it may not be financially or economically viable. All about money, right? Yeah, at the end of the day, you know. So, like, you know, I mean, if you look at um, there are some infectious diseases that were neglected for a long time, but then when they started threatening certain populations of certain countries, and suddenly there was interest in developing uh um pharmaceutical interventions.

SPEAKER_03 1:03:24

Um like when it affects your workforce, then suddenly the company Yeah, exactly.

SPEAKER_00 1:03:28

You know, and like we have this whole category of what we call orphaned diseases, and they're diseases that are just so rare, it's not like it's not worth it for pharmaceuticals to develop interventions for them. Um Tropical neglected diseases. Yeah, exactly. Another big one, you know. Like right now in Ethiopia, there's a there's an outbreak of Marburg virus, which is a terrible hemorrhagic fever with a super high mortality rate. Um, but the you're not caring about that in the news. Yeah.

SPEAKER_01 1:03:56

Yeah.

SPEAKER_00 1:03:56

You know.

SPEAKER_03 1:03:57

So so tell us. So the masters was two years. Any any other interesting stories there? Or what happens after a master's?

SPEAKER_00 1:04:02

Like scientists were the the idea with that vaccinology masters is to produce people who are then going to go and work in the field of vaccinology in some capacity. So a lot of the people who come into that master's are people who have public health experience or who or who are medical doctors or whatever who want to expand into this field. So you were there were medical doctors in your group seven. Of the seven of us, I think four, four or four of us were medical doctors, I think. Yeah. Um and then there were three, I think three of us were scientists. Okay. Um and um and it's really cool because I now teach uh a genetics component of that vaccinology degree. So I get to then see every year I see the new class of vaccinology master's students, which is, you know, it's always interesting to see the proportions of like medical doctors. But the other, the other, I think last year or the year before, we had someone who was a like a bioethics regulatory person, like from a pretty legal background coming in to specialize in this kind of thing, which is awesome. But the idea is that then you would you would go from there into industry or into some sort of working capacity around vaccinology. So either vaccine development or testing or implementation, rollouts, regulatory, that kind of thing. I knew that I wanted to do a PhD because I I I loved the process of like this process of diving into something and researching it and learning it. And and the idea, I think there's a bit of there, if I'm being entirely honest, there was a bit of an ego involved because when you have a PhD, you know, you're contributing novel research to something. So like you are regarded as a global expert in that field, and like you know that you've answered a question that hasn't been answered before. Um Ego is so important. And like, yeah, you know, I I think I think it's got a bad reputation. It does, but like, yeah. So it it it definitely drove me to like want that prestige of a PhD.

SPEAKER_02 1:05:58

And being the best scientist that you could have been.

SPEAKER_00 1:06:00

Exactly, you know, like being the best preclair I could be, right? You know, yeah.

SPEAKER_03 1:06:02

Um ego needs a good PR person. Yeah.

SPEAKER_00 1:06:06

Yeah. I think uh I think when it clouds your judgment of what you can or can't do or what you do or don't know, that's when it becomes an issue. But like you you need to you need to have ambition. Yeah. You know. Um so I I, after my master's pretty heavily pursued PhD opportunities, I uh was really interested in uh my master's research was similar to my honours, it was vaccine response related to genetic mutations, but for measles vaccines this time. Um and I I really became interested with measles. And measles is, you know, people kind of neglect it a little bit because they're like, ugh, it's like it's nothing. It's it's an incredibly severe uh um pathogen. Like it's really, it's got huge public health significance. And because of the dropping in in the vaccine coverage uh globally, you know, we're seeing measles making a comeback. Like I said, you know, all those countries had lost their measles elimination status. So I really wanted to have a measles research component uh in my PhD. And I approached um, there's a very, very closely working with Alive is a research unit called WitzBita, which is the WITS Vaccines and Infectious Diseases Analytics Research Unit, which is uh run by Professor Shabir Madi, who's the dean of the health science faculty at WITS, and also um the co-director of Alive. Um so we had exposure to Prof. Madi during our masters, and I I I mean I and he is a legend in vaccinology. Um he became a household name, right, during the COVID period. Yeah, but even like I mean, like his his work in in like pneumococcal conjugate vaccines and like well that's saying, I'm saying, but like it it there's no question that you know uh uh he is a an amazingly prominent vaccinologist. Um and with Alive and Vita being so closely related, I then kind of really I I like targeted wanting to get into Vita to to pursue my PhD. Um so I managed to get introduced to some people and and then it turned out that there was uh there was this clinical trial that had been run where they needed immunology work done and all the samples had been collected, but that they they were there, but the the the work hadn't been done. So I took that on as like the backbone of my PhD. Um, and then I kind of added some measles work and then added a rubella component. And um I my PhD is now looking at three different pathogens. So I got Streptococcus pneumonia and looking at at um how we can optimize the the way that we use pneumococcal conjugate vaccines, which I mean, streptococcus pneumonia is the leading cause of vaccine preventable death in children under five years old in the world. It's it's you know, incredibly it's the most common cause of bacteria-induced pneumonia. Um, and then I've got this really cool measles thing where I'm also looking at measles vaccine schedule optimization in terms of timing of doses and long-term immune effect and you know, whether or not how we're using measles vaccines is is uh is developing long-term protection as well as it could be. And then my last sort of research objective is looking at rubella, because South Africa's only just introduced a rubella vaccine in our public program. We never had it before. Okay. And um, rubella can be really, really significant if pregnant women get it, because it can infect the fetus and lead to really severe congenital deformities, uh, this thing called congenital rubella syndrome. Um so I wanted to see prior to our introduction of a rubella vaccine, what are our natural rubella immunity uh rates looking like uh in different parts of our populations? So I kind of combined all of this into a PhD that is all centered on using immunological evidence and and antibody data to optimize vaccine schedules and how we use them. But that sounds like a lot. It is a lot.

SPEAKER_03 1:10:10

Isn't like a you know, PhDs, it's like very like focused and niche and like a really tiny thing. You seem to have gotten a whole lot of stuff involved.

SPEAKER_00 1:10:16

So it's the the questions themselves are niche, okay, but their applications are broad, which is really cool. And and I think what I'm really passionate about in the long run is vaccine policy and strategy. And uh and I think that there are, you know, there are I I um I think that there is a at the interface between evidence and policy, you can see that sometimes there's a breakdown where policy decisions are made that may not reflect what is actually being shown in the evidence or in the literature and I mean what's happening around the world right now in in certain countries is reflective of public health uh policy not not following the trend of evidence. It's just dumb sucking or whatever. Yeah, and uh uh or like you know, for whatever ideological reason or whatever. But but I I'm really passionate about using evidence, generating evidence like I've done my PhD that has a direct policy implication, you know, where we can say, like, look, this is how, this is what we're seeing, this is how this is working, this is a recommendation about how we could maybe use this vaccine better, or this is how we could do something better. And I really want to, over my career, I want to add a strong voice to that evidence-to-policy pipeline and help decision makers be guided by evidence.

SPEAKER_03 1:11:37

Yes, and the decision makers need people who can explain it to them so they understand it, right? Exactly. Because I made that throwaway comment about thumbsacking and you said, well, ideologies, and I think you're right, but it all depends on who's passing on that information to the decision makers. Yeah, exactly. So how are you gonna make money?

SPEAKER_00 1:11:54

Like serious. Are you making like do you do you uh uh do they pay you for that? I I get a uh so I I won a I won a scholarship from the South African Medical Research Council, yeah. So I get a stipend. Um I think it's no it's no secret that um being a PhD student is not gonna, you know, it's not the most lucrative endeavor. Um I I see it a lot with like people who've worked and then come back to study struggle with that like financial sacrifice that it is. Whereas I've never worked. You know, I've I just did degree after degree after degree. I've been in I've been at university for 13 years.

SPEAKER_03 1:12:33

Yeah, I feel like I'm asking this question on behalf of David Capitalists. Yeah, so he's gonna be.

SPEAKER_00 1:12:38

So I'm I'm kind of I'm like, I'm used to not making a lot of money because I've never made money. But um in the long run, there are you you can go into like pure public health where you're working like with government sort of entities, um, or you can go the sort of NGO route where you're working with like sort of things like the Gates Foundation, or um like the, you know, there's a bunch of these kind of like the Welcome Trust or like these kind of funding organizations that are really interested in like steering research to into a a way that it's going to be useful in in real-world interventions, that kind of thing. Or you can go the like the the kind of um like big global like WHO UN pathway. Um, or you can go into consulting. Um so like uh you work for consulting firms where you then um you uh assist with like uh evidence uh grading and um uh you with implementation strategy or with um market access work or that kind of thing. You know, like a lot of it is also about you know, how do we ensure like equitable vaccine access, that kind of thing. So you get these boutique specialized consulting firms that are private entities, private corporations, um, but that their work is focused on a public health interest, and they then then work with things like the WHO or governments or ministries of health or that kind of thing. So like, or you can go into pharmaceuticals. I was an art, big pharma. So so you can work directly for a pharmaceutical in in research or vaccine development or um being uh like a market access person or you know that kind of thing. Which one pays the most out of all those options? I think it's I think probably being in pharma pays the most. I I again I'm I'm guessing here because you know I've I mean You haven't really looked into it then. So I I I have, um, but I mean I've also like um the other option that's available to me that also makes a lot of sense is to do it postdoc, where I kind of stay and research. But but but uh but um you know so so there there are a lot of options that are available.

SPEAKER_02 1:15:03

So that's gonna happen probably.

SPEAKER_00 1:15:05

Well I don't I I I'm keeping my options very odd for the moment.

SPEAKER_02 1:15:07

I'm I mean how there's what there's like three months left. Don't you have to do that?

SPEAKER_00 1:15:10

Yeah, so so I'm gonna submit my PhD thesis in like end of April, beginning. Like we're aiming for by the end of May it's it's submitted.

SPEAKER_03 1:15:18

We're recording on the first of March for people watching because we release later.

SPEAKER_00 1:15:21

Yeah, yeah. So today, yeah, today's the first of March. We're hoping that by the end of May it's sealed, submitted, sent off. That's when you start applying. So I'm starting to think about my options now because I need, you know, I don't want to, I don't want to sit with a big gap between finishing the PhD and therefore like not having funding, you know, and getting a job because you know, I I want to live and, you know, like a I've got you know my own ambitions about you know family stuff and all, you know, that kind of thing. So I would really I I want to make sure that I'm starting my career. Also, I'm 30 years old now. I've been studying for a long time. Like I want to have a you know a big person job and earn big person money and you know this thing, expendable income. Like that's a totally foreign concept to me right now. So I'd like to submit to it or the lighties will learn. So uh so I'm putting out feelers now about options and things to do, and then hopefully the idea is that it'll line up such that I submit the PhD and then can start whatever I want to start. But I'm I've right now I'm not I'm not putting all my my I'm putting my fingers in as many pies as possible to see what what is gonna be the best thing for me. So what are your hobbies like? Um my hobbies, so in the limited free time that I have, I uh do Brazilian jujitsu and judo. Um and um And what got you into that? I so it was it's it's quite funny. I um um I was always uh like a bit of a a bigger kid. Um and I have always been like active, but I was never fit and I was never in good shape. Um and I think with that, you know, comes you know, confidence issues and all that kind of thing. So like I wanted, I I've always like I've wanted to get in good shape. Um and I um at one stage I got like really into like powerlifting and gym, and then I kind of like justified my size because I was like, well, weight moves weight, and you know, it doesn't matter that I'm 115 kilos because I like I it means I can bench heavy, which I was just you know, make I was you know cutting myself a little bit. And then uh in in 2020, I uh it was the the the end of 2020 when we were out of our lockdowns and everything like that. And um I had moved out of home into an apartment building, and there was a guy who lived in the apartment building as well. And it turns out that he had gone to the same high school as me, and his younger sister was my matrix when I was in grade eight. So like I, you know, I knew of him and and I was a big MMA fan, so I knew it, like I knew what grappling was. Um, and we, our parking bays in the garage were right next to each other, and we got home at the same time one day, and I saw he was wearing his jujitsu gui, and I recognized the the logo on his pants because it was like a big a big international franchise of these jujitsu gyms. So I said, Oh, do you do jujitsu? And he said, Not only do I do jujitsu, I own a gym down the road, like literally down the road, because the flat was at the top of Corlet Drive and the gym's at the bottom of Corlet Drive. Um, and he said, Come try it out, you know. And at this stage, I was I was 116 kilos. Um, I couldn't tie my shoes without you know having to hold my breath. I couldn't walk upstairs, you know, I was and I was not feeling great about it. And this offered a new way to be active. It was also really like it offered some social interaction after a year of a lot of social, you know, um isolation. And I'm a very extroverted person, so I was craving something. Um and um it's also jujitsu is an amazing uh martial art because it's like very cerebral. Like people we call it human chess because it's like it's not about violence and hurting someone, whatever. It's it's it's it's like it's puzzles and it's problem solving, and it's how do I implement what I want to do and how do I present problems to my opponent faster than they can present problems to me? How do I solve their problems faster than they can solve my problems? You know, and um and I went for my trial week and I just fell in love with it. And uh, and it kind of started this whole martial arts journey for me. Like I started boxing, um, I uh I started judo. Um, and I mean now, almost six years later, uh or five and a half years later, I'm now 82 kilos, I'm in great shape, I can go and do a 15 kilometer run. Yeah, man.

SPEAKER_03 1:20:03

I mean, look, I follow you on social media. Yeah. And when you were telling the story about that you couldn't tie your shoeless and that you were out of breath climbing whatever, yeah, I'm surprised because I I've only followed you know recently. And yes, you're the opposite of that. You know, you strike me as like a fitness freak type.

SPEAKER_00 1:20:18

Well, I mean, now I am, and you know, it's also like such an important thing for my mental health. You know, if I if I'm injured or I can't be active, um, I really suffer with, you know, not having an outlet for stress and that like extra energy and that kind of thing. Um, and also the thing that's beautiful about like in the gym, um, it's very like I've learned how to train really hard in the gym. So I've learned how to train myself in a gym to the point that it becomes a singular activity that my mind can't drift. But a lot of people find that like they say, oh, gym is like too boring or repetitive and my mind drifts. And like I kind of always say, well, you're not training hard enough. Yeah. But the nice thing about something like I also like a rock climb and that kind of thing. And the nice thing about those activities is like if you're on a wall or if you're in a fight, you can't afford to be thinking about anything else because then you will lose. Like if I'm in a boxing ring and I'm not focusing, I'm going to get punched in the face. Yeah, but just avoid walls and avoid avoid fights. Yeah, exactly.

SPEAKER_02 1:21:14

So I like I like how you explain what jiu-jitsu is like the scientific version. You're trying to disprove someone else's problem that they're presenting. Yeah, exactly.

SPEAKER_00 1:21:23

Yeah. And it's and it and it's it's you know, when you've got like a PhD is so all-consuming, you know, like I'm always thinking about my work. And like I'm, I'm like, I I mean, I keep a notebook next to my bed so that if I wake up at three in the morning, I can write an idea down or something. So having an activity that can be so single-minded, it becomes meditative, you know, and it's it's genuinely an escape from everything else. Like when you're on that jujitsu mat, nothing else off that mat exists. And like that mat becomes whatever you need it to be. It's your therapy space, it's your social space, it can be church, it can be whatever you need it to be. And the group of like the camaraderie that you make with people, and like it's, you know, we have men, women, boys, girls, we've got every culture, every religion, every, you know, every kind of person comes together and we've and we do jujitsu or judo, whatever, and you are united by this camaraderie. And like the friendship you form with someone when you have, when you like have physically fought them, it's it's like a very special kind of bond, you know.

SPEAKER_03 1:22:29

It's so you reckon I should keep um keep my daughter at it because she's she's she's telling me I don't want to do judo. And I'm like, no, we need to carry on. We need to carry on.

SPEAKER_00 1:22:38

You know, it's it is the most incredible thing. And there are actually like there are actual studies that have shown that kids who do particularly judo jujitsu or wrestling, um, develop much higher levels of emotional regulation, uh, discipline, um, social interactions. They do, they do better at school, you know, and but also like fundamentally um they can defend themselves, they can, you know, like that's an important skill.

SPEAKER_03 1:23:04

But the first part that you mentioned is is the part that attracts me to it for my for my daughter. Uh and the person who recommended that she do judo is my colleague from the UK who's a psychiatrist, and he said he said all these things that you're telling me.

SPEAKER_00 1:23:15

So I'll just keep her at it. The other thing that's amazing about it is um neurodivergent people, like especially people who are on the autism spectrum, respond amazingly well. In it, like this is a generalization, obviously, but like we've seen it at our gym where like people who uh really struggle um start grappling, and the way that it builds identity and confidence and like brings people out of their shells and like overcomes obstacles of like social anxiety and that kind of thing, like it's such a powerful tool. And it and jujitsu is like there's a big joke in the jujitsu community. Like we joke that we're all a bit autistic to like want to do jujitsu, and it's something that you can become so obsessive over. Like my Instagram feed is literally like science feeds and like grappling highlights. You know, like my algorithm has got me like to a T. It's just like, hey, if he has a meme about how much PhD is or soul destroying, but also look at this guy get choked out, you know? Um, so it's so it's it's it's it's really attractive for neurodivergent people in in channeling that like you know, that intensive focus of or or obsession about something into something that's productive. Yeah. I mean, you mentioned you you're an extrovert. Were you were you always that way or income lighty? When I was when I was um three years old, right? I mean, like this, this is like sums me up in a in a in a nutshell. We have a we have a very good, but there's an Italian restaurant called Mastro Antonio in Ilovo, and we're very good friends with the the restaurant here who who owns it. Um and we would it's about as old as I am. So I mean like I've literally been going there my entire life. And I would see Paolo, the, the, the, the owner, going around all the tables and talking to people, right? So I just like assumed that this was something that one did in a restaurant. So I was like three years old, and I would we would go to Mount Antonio and I would say to my dad, I want a pear juice or whatever, and then I would hop off my chair and literally go to everyone in the restaurant and go, Is everything to your liking? How is your food? You know, and it's like out of interest, how did your parents react to that?

SPEAKER_03 1:25:26

Do they let you do it? Yeah, I think also because it was a different time and no, but I feel like I feel like parents are important in either like bringing out the extra butt in you or like shaping it.

SPEAKER_00 1:25:36

Yeah, I know my parents were very and you've got your mom's Italian, isn't she?

SPEAKER_03 1:25:40

Yes, yeah, yeah, yeah.

SPEAKER_02 1:25:41

Well, until you get kidnapped, I think they were like, oh, really?

SPEAKER_00 1:25:43

Like I said, I mean I think it was a different time in the 90s, you know.

SPEAKER_03 1:25:47

And you went to Tokyo, right? And you said three-year-old is walking around the streets there in town. It's different.

SPEAKER_00 1:25:52

It's an amazing thing.

SPEAKER_03 1:25:53

Is there anything we didn't touch on that you want to like put, you know, put out there? Um please do.

SPEAKER_00 1:25:58

I think I think the the there are there are two really important parts of vaccines that I I would really like two points I'd really like to make. Um and they're very topical and everything, you know, because there's so much hype about vaccines right now. You know, we see what's going on in in the states and that kind of thing. And and I think we like I could spend hours, like the first thing is I could spend hours going into the core biology and the science of like fundamentally why vaccines are some of the safest pharmaceutical products that exist and why these uh these scary, severe adverse events that people attribute to vaccines are just not uh happening uh at the rate that people claim they're happening, and like these whole vaccines cause autism stuff and all that kind of thing. And we could go super mechanistic, but uh let's just boil it down to a game of numbers, right? So globally in routine immunization, like the the doses you give your, you know, you would give routinely. So your infants, your children, flu shots, whatever, we conservatively give one and a half to two billion vaccine doses around the world every year, routinely. And then when you add outbreak response and catch-up campaigns and supplementary immunization activities and row extra rollouts and you know, all these things, those add a good few billion more doses every year. I mean, like COVID, for example, we it gave out over 14 billion doses of COVID vaccine over like a three-year period, right? Like, and that's in addition to all your routine vaccines that were happening anyway. So let's like absolutely conservatively low ball it at we give four billion doses of vaccines every year around the world, right? Yeah. If there was a genuinely high risk rate of an Adverse event happening. You wouldn't even need surveillance systems. It would be so apparent. Our like hospitals would be overwhelmed. Like we would have like consistent, constant public health crises of people suffering. You know, even if it's a like even if it's a one in 10,000 incidence rate, if you if you're giving four billion doses, that's 400,000 adverse events. You know, you can't hide that. Right. So the fact that we're not seeing that and the fact that we can give so many billions of vaccine doses with almost nothing happening, kind of just from a logic perspective shows the safety profile of these products. I mean, when like the number, for example, um the the um myocarditis incidence of like 10 per 100,000 is super low. But if I immunize 4 billion people in a very short space of time, then those like 40,000 cases are gonna look like a lot happening right now. But in terms of relative risk, it's still it's still 10 and 100,000 or you know, whatever it is. Um so the other numbers that are really involved with vaccines that are so important to understand is the return of investment on vaccines, right?

SPEAKER_02 1:29:21

So if you sorry, wait, before you carry on there, if I can play devil's advocate and ask like what's the point? The point I I think for for vaccinations and what is it that you do is like to ensure the continuity of mankind. Yeah, I'm assuming, right? But how do we know you are you are saying what you are, but it's it's based on like short-term studies. How do we know what the long-term studies are going to show?

SPEAKER_00 1:29:50

I mean, it's also like for for something like a COVID vaccine, for example, right? We now have five years of data to go on, right? But with other vaccines like MMR, for example.

SPEAKER_02 1:30:03

Is that long?

SPEAKER_00 1:30:04

Yeah, we I mean, that's been around since the 60s. You know, like there are vaccines that we've got. There are, there are, there may be new products, but they're there are improvements on older on older vaccines, you know. So we've been vaccinating with what we recognize as vaccines for over a hundred years, right? We have an extremely long data period to show that the mechanisms through which vaccines work do not ordinarily lend themselves to long-term adverse events, right? So we when you look at something like we when we we look at the biological plausibility of this product causing a long-term effect, vaccines really don't fit into that unless you've got immune dysregulation, autoimmunity, or something like allergy to a vaccine ingredient, that kind of thing, whatever. But but in all in healthy people with functioning immune systems, which almost all of us are, um vaccines just don't work in a way that lends itself to this long-term effect. Um, also, there's nothing in the vaccine that stays in your body for a long time. You know what I mean? Whereas, like if you're taking chronic, high-schedule medication that you're taking daily for years or whatever, like that's way more likely to give you a long-term effect, uh side effect than a vaccine is. But but we we have a an overwhelming amount of data to go on. Like, for example, like the link between vaccines and autism, right? The claimed link. There are a handful of studies that are like methodologically flawed and statistically flawed and use very small sample sizes that have claimed that there is a possible link between vaccines and autism. We also know that autism, we now know that autism is a multi-factorial problem with it's incredibly complex. It's a very um wide spectrum of symptoms and severity, and there's no single cause that can precipitate all like autism happening. But we have decades, two decades of evidence, right? Since the first claim that MMR was linked to autism was made, scientists have been actively, because an important part of science is replication, right? If I can't replicate what you've done, then and if no one can replicate what you've done, then maybe you didn't do it right, right? Or maybe what you what you're saying is not true. And we also know that in that first study that that person has admitted to think it was fraudulent, you know. But there have been two decades of studies cumulatively covering over a million children over many years that have shown that there is no correlation between exposure to vaccines, timing of vaccines, number of vaccines, and incidence of autism. Right. So when we link back to what we were saying at the beginning, where the whole point of the scientific method is to say, well, beyond a reasonable doubt, all the converging evidence points to this being the case, we have an overwhelming amount of converging evidence that shows no association between vaccines and autism. Right. And the numbers back it up. Right. So I I I find when you boil it down to a numbers game, like it it it helps people understand it when you because we I find when you try and like like explain from a biological perspective why it's not a thing, you lose people. You know what I mean? Yeah.

SPEAKER_02 1:33:41

Like Yesh is 100% right. I feel like you guys need a whole PR team because the fact that you are you are trying to explain this to us, it's so bizarre. I mean, you're a scientist. This is this is all facts. Like the only other person that should be arguing with you is another scientist. Guys, storytelling is so underrated. Yeah. It's so underrated.

SPEAKER_00 1:34:01

But the other thing that I was gonna say is the return of investment on on vaccines is amazing, right? So there's two ways we can look at it. The most basic way is is savings in terms of cost of care. So if I, if you don't get a vaccine and then you get sick and then we have to care for you, that in that incurs costs, right? So for every one dollar that you invest into vaccinations, you get about $20 saving in terms of cost of care, right? Because you're preventing incidence of disease. But then if you take into effect, if you take into account like total like statistical value of life, so that's like now you like, because the majority of vaccine preventable diseases were causing mortality in children under the age of five, right? So you're having huge mortality rates in children that then obviously are never getting to grow up, join the workforce, contribute to the economy, et cetera, et cetera. And through vaccinations, right, between 1974 and 1920 and uh 2024, so over that 50-year span, it's estimated that routine immunization averted 154 million deaths in children under the age of five. That's 154 million kids who grew up to get jobs, to spend money, to make money. And then you get an ROI of about one to 54. So every billion dollar that your country wants to invest into vaccines, you're gonna get $54 billion of economic stimulus from that. So the the like they are an incredibly powerful economic tool, um, which is why like cutting vaccine resources or funding towards vaccines makes no sense economically because like you get this short-term stimulus of diverting funding, but you lose all of this long-term growth from having kids grow up and be healthy and being able to like join your workforce. Um and it kind of also like feeds into the other point that I want to make, which is why different countries have different vaccination schedules. Because like now there's all this talk about like the US wants to adopt Denmark's vaccination schedule. And like there are a couple of reasons why this is not feasible. The the first one, which is the biological stuff, is different countries have got different burdens of disease. And that can mean that different countries have completely different diseases. Like, for example, yellow fever is not endemic in South Africa. We don't need routine yellow fever vaccination, right? TB is not really a big problem in Europe. So they don't give uh the BCG vaccine at birth, which is used for TB, whereas we all do in sub-Saharan Africa and in a lot of low and middle income countries, right? And then it could also be that, okay, yeah, the disease happens in both countries, but to very different severities. Okay. So it may be a huge problem here that we need to vaccinate against that. It may be like very low incidence, very low burden, very easy to control somewhere else they don't need to vaccinate. And then you get all the economic stuff. Like, what is like maybe that country has got such strong healthcare infrastructure that they've decided that this disease is something that they can easily treat. Okay. Whereas another country maybe can't. And therefore, vaccination is a much better way of them preventing it. So, or, you know, uh one country may have more sophisticated infrastructure and can handle more vaccines because they've got better cold chain management, whereas another country may struggle, so they need to really prioritize the the most important vaccines, you know, that sort of thing. So it's such a it's such a delicate balance. But that means that over decades and decades of stringent epidemiological data and immunological data and pharmaceutical data, your country's vaccine schedule has been fine-tuned to be specific to your population, right? Makes so much sense. So when you try and swap it out for another country that has that is so like epidemiologically different to yours. I just copy-paste. Exactly. You you then may be risking opening yourself up to massive incidences of disease that you had controlled because now you're cutting those vaccines out, right? So it's just really important to like understand that that vaccines all over the world are working towards the same goal of preserving life, you know, preserving health and making sure that children don't have to suffer, right? Um, from a health perspective with infectious disease. But that um goal looks different in different parts of the world. So you can't just blanket approach vaccinology. It's got to be tailored.

SPEAKER_03 1:38:33

You've you man, you've really you've dumbed it down so well that even I get this. So I'm I'm glad. And it's just got me thinking, as you're telling that, I mean, are you not play do you not have plans to maybe one day like spread the word on social media or something, like different platforms type of thing?

SPEAKER_00 1:38:50

I I would love to, and I've actually been like for a long time I've been thinking about maybe starting a YouTube channel, you know. Um, because there's a lot of amazing scientists who have become um like influencers who put out amazing material, who try and educate people and communicate in a really effective way. And uh and I would love to, it's just a it's really just a matter of time. And I'm hoping that after the PhD, which which is you know, I'll have a bit more time to play with the play with TikTok. I haven't you must you must I've resisted the scared of TikTok, right?

SPEAKER_03 1:39:19

Yeah, I only started TikTok because of the podcast. And being on TikTok for the podcast, obviously I'm gonna be doom scrolling every now and then, right? I get sucked in. And I'm have you heard of Charlie Pooth, the musician? He's like a nerd when it comes to music. Yes, he's amazing. And he's brilliant. And I just I find myself like following him because and now I'm like into music. Yeah.

SPEAKER_00 1:39:40

So I'm telling you, yeah, I would, I mean, I would love to be the reason that if I can inspire one person out of a thousand to pursue this, to pursue medical science, pursue vaccinology, it would be incredible. But more importantly, if I can if I can help someone, an individual, a parent who may be sitting on the fence about whether to vaccinate themselves or their child, if if I can just be a constructive voice that helps them make an informed decision, whatever that decision may be, but an informed one, then I would be really proud. Yeah. So thank you for this opportunity, guys. I followed you now.

SPEAKER_03 1:40:22

Yeah, you'll be doing you know, everyone a service. So I think think about it carefully and do it, man. But thank you so much, dude. It's been fascinating. Thank you. This has been awesome. Thanks, Dan. We'll hope this is will go viral. This is going to be probably published in in like maybe all the way up to like mar uh May now. So by the time it's published, you might we might have to change the title to you know Dr. Danny. Sweet, Matt.

SPEAKER_00 1:40:42

You can add a little uh a little uh postscript.

SPEAKER_03 1:40:45

No, it's not gonna add too much effort. Thanks a lot, Matt. That was an awesome conversation. Yeah, thanks, man. Cheers. Let me press stop here.