GERM
00:00:10.560 – 00:00:11.680
Yu stap Gut? My name is Germ.

WORM
00:00:12.000 – 00:00:12.880
I’m Worm.

GERM
00:00:13.280 – 00:00:15.640
Welcome to episode 88 of the Germ and Worm Travel Health podcast, Endurance on Foot. How to go the distance. It’s a big planet. See it in Good Health.I’m Dr. Paul Pottinger, also known as Germ. I’m a professor of Infectious diseases at the University of Washington in Seattle.

WORM
00:00:30.170 – 00:00:38.650
I’m Dr. Chris Sanford, also known as Worm, associate Professor in the Departments of Family Medicine and Global Health, also at the University of Washington.

GERM
00:00:41.130 – 00:00:44.250
We are so excited to answer a number of great questions about travel health and travel safety. Today’s topics include what injuries are common in international travelers traveling for a long distance walking or running event, how to go the distance, air quality in Thailand, where is it better? Where is it worse? And what will be the effect on tourists? And what are medical professionals doing about. New CDC pediatric vaccine recommendations? These questions come to us from you, our listeners. Please contact us with stories, questions or tips for success.

If you have a request for a clarification on something you’ve heard here on the podcast, just let us know at germandworm.com or send us an email. Germandworm@gmail.com. Before we jump in, here are our medical disclaimers. This podcast is designed to inform, inspire, and entertain.

However, you should not use this podcast as clinical care before you travel. Please see a qualified healthcare professional for recommendations specific to you and your itinerary. Chris, this question comes to you from me.

You’ve been very savvy and very clear. Over the entire podcast experience about the importance of preventing injuries. Infections are a concern, but injuries are a bigger risk, statistically speaking, for international travel.

And now I think we have a recent scientific article that really backs you up on this. Would you comment on that article, please?

WORM
00:02:02.830 – 00:04:04.300
Yeah. One of my favorite journals is the Journal of Travel Medicine and this nice systematic review came out published by Benjamin Weiler and colleagues.

And actually this was published three years ago and they were looking at the risk of death due to injury in travelers.

And first off, I would not interpret this as that it’s dangerous to travel because actually the absolute number of people who die abroad is very small, maybe one in. However, some do. And this was an analysis of those unfortunate people.

And indeed it found the same thing that the other studies have found, that the most common causes of injuries, number one, was motor vehicle accidents. So cars, buses, motorcycles, and then a couple others that were very high on the list were drowning and then homicide.

And so when people think about going to places like East Africa or Latin America or Asia, most people first think about infectious diseases, which are important and you should get your vaccines. But the first thing I want to talk about is things like seat belts. One other question that came up and I think was answered in this paper.

Is it more dangerous to travel or is it more dangerous to stay at home? And it depends really more on where you’re going and what you do.

But the overall average for the planet, unfortunately is it’s probably a little more dangerous to travel.

So especially if you’re going to a low income country, especially if you’re engaging in some unhealthy behaviors, there is a higher rate of death abroad. But in my opinion, most of the risk is not determined by where you go. Most of the risk is determined by your behavior.

So you’re not going to die of a motorcycle accident if you don’t get on a motorcycle. You’re not going to die from falling off the roof of a bus if you don’t get on the roof of a bus, and so on. So it’s a nice paper.

It does suggest that motor vehicle accidents should be a very high priority, especially in low income countries. But it was nice to have this quantified.

GERM
00:04:13.500 – 00:04:20.940
Yeah, I agree. And you know, every time I travel, I think of you as we go through this process. I’m always trying to stay safe.

And I keep thinking, my God, if I get injured when I’m overseas, Chris is going to have an unholy cow and I’ll just be busted. So thanks for your diligence and your clarity and persistence on this important topic.

WORM
00:04:29.740 – 00:04:35.860
Hey, next question for you, Paul. Can I be vaccinated for chikungunya here in the United States?

GERM
00:04:36.660 – 00:05:20.640
Yes. Yes you can. There’s a beautiful vaccine called Vimcunia that works very well indeed.

And in fact, in anticipation of a trip that I’m planning to take to Singapore and Sri Lanka, I’m going to get my Vimkunya vaccine a week after next. So I’m excited about that. However, that is indeed the only licensed vaccine currently available in the United States.

We recently lost one that’s a different vaccine called Ixchiq, which I still think would be a great name for a rock band. But anyway, all female rock band.

Anyway, Ixchiq was a different vaccine and that was a live attenuated vaccine that was related in a way to the yellow fever vaccine that’s been around for a long time. Ixchiq was a good vaccine, but not good enough. It was a safe vaccine, but not safe enough.

And we have investigation, as we’ve talked about here on German worm by the US Food and Drug Administration looking for side effects and adverse events related to Icschick related to neurological problems.

People had certain neurological side effects which were rare but were, we think potentially happening in response to being immunized with the Ixchiq vaccine.

Although the full story remains somewhat unsettled, it’s clear enough to Food and Drug Administration that this was a concern that they let the manufacturer called Valneva know about this. And Valneva has voluntarily pulled its product from the market, meaning Ixchiq is no longer licensed here in the United States.

It’s the end of this vaccine. It will never come back. That’s the bad news. The good news is twofold. Number one, we have an alternative which is a completely different technology.

That’s a virus like particle, that’s the Vimcunia and that’s what I’m going to get myself week after next. Number two, it’s also a good sign that food and drugs still has somebody awake in the office. They’re still doing some kind of surveillance.

Remember, after a vaccine or a biologic or a drug is licensed, it goes into something called phase four surveillance. And that’s where we look for any issues that didn’t show up in clinical trials.

That’s exactly what happened here with these rare neurologic side effects became known to fda. This was going on and they did the investigation and now we’re protected from that potentially harmful vaccine.

I still think the vaccine did more benefit than harm to people of all ages. But in older people it did seem to have this potential risk and so that issue has now been resolved.

So yeah, if you’re headed to an area where there is chikungunya, it’s a bad infection, I’ve seen it before. You don’t want to get chikungunya and so please get immunized, but not with IC check.

WORM
00:07:20.140 – 00:07:42.350
Yeah, I was actually reassured by this being withdrawn.

This shows that there’s still some vigilance from the FDA with they’re doing, as you say, this phase four testing and this is done with every vaccine.

And I was just glad to see that they were so vigilant that they were able to take this thing really with a fairly low but significant level of side effects just off the market.

GERM
00:07:47.070 – 00:08:02.160
Chris, this question comes to you from Abe of Vancouver, bc. I’m traveling to Thailand on holiday next month visiting Bangkok, Chiang Mai and Pattaya.

I have asthma and I’m worried about air pollution in Thailand. Should I worry?

WORM
00:08:02.320 – 00:09:46.450
Thank you for the question. I think the question, if I can paraphrase your question, I might change it to should I go? And if I go, what should I do?

Because just worrying alone doesn’t really achieve anything. Short answer. Yeah, you can go, but there’s a couple precautions you should take.

There was a nice article that came out again in the Journal of Travel Medicine recently, and it looked at travelers to a couple different cities in Thailand, specifically Bangkok, huge city, the capital, and Chiang Mai way up north. And actually I learned something.

I had assumed that Bangkok was more polluted because it’s a much bigger city, but in fact, Chiang Mai, this smaller town up in the north, is significantly more polluted.

And this study found that a lot more people who visited Chiang Mai ended up with respiratory side effects from the air pollution than did the people go into Bangkok. And this was things such as irritated eyes, sore throat, and cough.

They also found that people who avoided the heat of the day, who avoided exercising outdoors, had a lower rate of respiratory symptoms. Now, unfortunately, some people with asthma can get worse in smog, although most don’t.

Most people just even with asthma, have standard reaction to air pollution. If you’ve exacerbated with smog in the past, and certainly take all your inhalers, but also check the AQI air quality index of where you’re going to.

And in places with heavy pollution, like Chiang Mai up north in Thailand, avoid exercising in the heat of the day. Maybe have more at getting a mask, and not just a loose surgical mask, but actually a fitted N95 respirator.

If you get an exacerbation on your asthma, you might consider seeking local medical care.

GERM
00:09:46.930 – 00:10:34.010
Yes, agree. And I think it’s just a reminder that, look, fossil fuels, they have fueled our modern society and they just suck.

It’s time for us to make societal changes, not only in the US but globally.

And my hope is that countries including Thailand, India, Nepal, all of our beautiful, exciting places to go visit, they really do struggle with this, don’t they, Chris? So my hope is that we could actually come together, make change that makes the pollution less.

It’s usually related to industry and transportation both. And I think there’s opportunities to make both of those things better if only we get our shit together and make it happen.

Next station, Victory Monument.

WORM
00:10:34.570 – 00:11:54.690
One interesting aspect of infectious disease I wanted to touch on, and this is one of the things that makes infectious disease so complex and interesting, is that a given infectious disease is not simply contagious or not, but there’s a huge range of how transmissible a given disease is. So at one extreme, in the most infectious direction would be something like measles.

And Paul, correct me if I’m wrong, but I remember a statistic something like, suppose you have 21 people in a room, in a closed room and one of them has measles, but none of the other 20 has been vaccinated or has ever had measles. That actually, if sitting there for a few minutes, 19 of the 20 people will develop measles from that one person. So that’s extremely infectious.

At the other extreme, you have something like tuberculosis, which indeed is infectious, and it can be spread by coughing or breathing or secretions, but usually takes a fairly long term exposure. So if you’re just a tourist, you have a short term exposure with somebody.

Even with active tb, you’re unlikely to get tb, but if you live with somebody who has tb, then you’re more likely to get it.

That also ties into inoculum, which is how many of the infectious organism, the virus or the bacteria or what have you, you need to swallow or breathe in to get a given disease.

GERM
00:11:54.850 – 00:16:11.810
Yeah, I’m glad you raised this question. It’s part of the joy and challenge of my profession, which is infectious diseases medicine. Right.

I’m an ID doctor, so I have dedicated my career to the prevention, diagnosis and treatment of these infections. And this is part of the process, understanding how these germs get into our body. Some infections are very contagious person to person.

Measles is the classic that you mentioned. Some are not at all transmissible person to person. Anthrax we get from the environment, but we don’t spread it human to human.

You need to know that for infection control purposes and for public health response, ID has all these things wrapped up together. You need to know the cast of characters, all these different bugs, where they live, what they do, and how they are transmitted from person to person.

I think you put your finger right on it too. You don’t have to be ultra transmissible person to person in order to be ultra important.

Tuberculosis is the classic, the most common infection on the planet, far as I know. And yet it’s tough to catch unless you have intense prolonged contact with someone who is sick. At least that’s the general paradigm.

But because so many people have it and because so many people at risk are indeed crowded together, it persists through the world.

And so that, you know, the response to tuberculosis would be different from the response to measles, aside from the fact that we do have a very effective, although not perfect, measles vaccine and we do not have that for tuberculosis, by the way, your 20 person thing, I thought that was pretty good. What if those other 19 people were immunized?

There’s a chance that one of those 19 would get measles as well because it’s just not a perfect vaccine, although damn close. So yeah, that’s really interesting. And the amount of germ that it takes to make somebody sick, it varies from bug to bug.

Not disease to disease, but bug to bug. Think about diarrhea caused by enterotoxigenic E. Coli. Good old etec. Here I am in Mexico.

I guess I’m at risk of E. TEC as people are all around the world. Well, it takes quite a number of E. Coli to get into your system.

The inoculum is high, much higher, at least than it is with a germ like shigella, which is genetically very close to E. Coli. But it takes just a few Shigella bugs to get in and cause misery. I know that because I got a terrible case of shigellosis back in 1984 in Kathmandu.

I put the doo doo in Kathmandu. It was a big deal. And it just took just a handful of those Shigella organisms to make me sick at that time.

So I think you put your finger right on it and I thought that was quite fascinating. There’s a related aspect of our field as well, which is the fact that even a given infection when you get may manifest in different ways.

Right, Chris? That’s another thing that makes ID interesting.

If you’re someone who lives in an area where an infection is endemic, you may present differently from someone who’s a traveler. The classic example would be malaria. We have partial immunity to malaria if we are immunized by constant exposure.

The bite of an infected female anopheleen mosquito. When we first get malaria, we can be quite sick.

But then if we survive and 95% of people do, then we can end up with a relatively mild case moving forward. That’s different.

If you’re a traveler and it’s the first time you get sick, you’re going to have a big bad case of malaria, maybe not fatal, but that does happen. Likewise with schistosomiasis. Right? Katayama syndrome, Katayama fever. That’s your first exposure to those egg antigens.

And so the first time you get schisto, it’s horrible. After that there are long term effects, but you don’t get that Katayama again.

So all of this is to say whatever we talk about here on germ and worm around Infectious diseases and prevention. Remember the context for you as a traveler may be different from the context of the person you’re going to visit.

If you’re visiting friends and relatives, they may already have partial or complete immunity to the things that could make you very sick. And so that’s what makes ID interesting. That’s what makes travel medicine complicated.

And that’s why we’re glad to have our listeners here with us on this amazing journey.

WORM
00:16:12.130 – 00:16:24.200
Yeah, it’s almost like as a tropical medicine doc, you have to learn about two diseases for every disease, how it presents in the traveler, and then how it presents in a person who’s in the environment where it’s a common illness.

GERM
00:16:30.680 – 00:16:44.200
Well, Chris, I have a question for you. This comes to us from an anonymous listener, which is totally fine. It’s very simple, and yet the answer is complicated.

Can you perform CPR in the wilderness?

WORM
00:16:44.980 – 00:18:02.950
Thank you for the question. The answer is yes, but it’s complicated, and it’s different than doing it in a controlled environment, such as a medical facility.

The first thing you want to do in the wilderness when there’s a situation to do CPR is not to do CPR instantly, wherever you are, but to do something we call seeing awareness or seen safety, which basically means, is it a reasonable place to do cpr. So, for example, if you’re in the middle of a road and somebody needs cpr, well, that’s not a good place to do cpr.

So a higher priority than doing CPR is getting the person off the road to a safe place. Another thing to consider even before you do cpr, is your own safety. If the person is bleeding, do you want to put on latex gloves, for example?

And so another thing to think about is, are there other victims of whatever happened? So if it was an event such as a tumble of rocks and you start doing CPR on one person, maybe first think, wait, should you tell someone to call 911?

Or look for other possible victims? So it’s very different than, as I say, a controlled environment in terms of the more technical aspects of doing the cpr.

Paul, I’ll let you weigh in on that.

GERM
00:18:03.480 – 00:18:29.830
Thanks for asking about that, Chris.

You know, before medical school, actually during college, I got trained as a wilderness EMT at Solo Stone Hearth Open Learning Opportunities up in Conway, New Hampshire. The best. They are excellent.

And I remember during wilderness EMT training, this was front and center, because as an emergency medical technician, as a physician, as a caring human being, we should all know cpr. I mean, CPR can save lives. That’s the point. And yet it has limitations, and I think especially in the wilderness, there are these specific concerns.

Knowles, the National Outdoor Leadership School, they have an approach that I like a lot, and these are the things that they train people to think about before they jump in and start doing compressions. I’m number one. I’m the responder. Can I do this safely? In other words, take care of yourself before you take care of others.

Am I safe to do this if there was an injury to someone in the wilderness? Am I also injured if there was a lightning strike, was I also struck, etc. Next, don’t get an infectious disease.

Try to be thoughtful about the risk that you’re willing to take with mouth to mouth resuscitation. Is it one person or are there many people? And if there are many, how many can you possibly try to save?

And then the idea that we should really assess this person who has fallen, the person who is down, are they dead or are they dead? And that’s the medical term I would use. Is this a survivable situation?

If it’s related, for example, to electrical injury or hypothermia, being cold, those patients can do very well. If the person is visibly dismembered and it’s been a terrible, catastrophic injury, you may not do them or yourself a service by trying.

So this is something that we deal with in emergency medicine. It’s something that people who are in the field are trained to do.

For our friends who are listening to this podcast, if you are a traveler, number one, please do get certified in cpr. Number two, please go through those simple checklist guidelines. And I would ask you to look at the Wilderness Medicine Society CPR guidance.

It’s a beautiful document. It’s longer than I think it should be, but anyway, it’s there.

And you can actually get familiar with this, certainly if you’re doing backcountry work, if you’re going to be in the wilderness, getting formal training as a wilderness first responder, wilderness first aid, etc. This can make a big deal.

You should not be put in a position where you’re asked to do things that could make you unsafe and things that would be futile for the person that you’re helping with that general preamble. To answer your question, Chris Boy, it just depends. It just depends on all of these factors. And these can be heartbreaking situations.

Getting that return of spontaneous circulation, bringing somebody back, it can be done. But I have to say, in the wilderness, in many cases, it’s very, very difficult to do.

WORM
00:21:07.460 – 00:21:25.060
Paul, this is for you. Suppose somebody is traveling for a long distance event.

This could either be a walking event like the Camino de Santiago in Spain, or it could be for a marathon or an ultramarathon. What are some tips to remain safe so they can finish their event?

GERM
00:21:25.540 – 00:23:44.770
What a great question. I love this and I have friends who’ve competed in the Marathon de Sables, which is ultramarathon in the Sahara desert.

In fact, Dr. Brian Krayback is one of the doctors who serves that group of incredible athletes. I was so interested recently to meet Dale Simonson, who is a friend from Antarctica.

I was recently on his Carpe Diem podcast and I was talking about Mount Everest. He was talking about an ultramarathon he’s about to do in Minnesota in the dead of winter. In fact, I’ll put a link to that podcast in the show Notes.

It’s called. Very fascinating discussion. I hope the point is, boy, it just depends.

There are so many ways that people can do this in the extreme, and it doesn’t even have to be an extreme run. What about the Camino? Whatever it’s going to be where you’re making these long pilgrimages, it’s walking day after day for many days in a row.

That can also be a joy and a great experience. And it can also lead to injury.

So there’s many different things that go into this, Chris, in terms of injuries, boy, it happens whether you’re running or walking. We do know that some of the top five are patellofemoral syndrome.

If you don’t have strong enough quads, you can get terrible knee pain when you walk, shin splints, Achilles tendon, plantar fascia, iliotibial band. Musculoskeletal overuse injuries are common in both contexts of walking and running. And the best way to prevent that, of course, is to train.

You don’t want to roll off the couch and onto the Camino. So you want to make sure that you’re doing your proper training ahead of time. That can make a huge difference.

And please do not over train at the last minute. You should be limber. You should have your stretching program and your strength program lined up.

In terms of medical issues, you know, in the context of a marathon, it’s usually around heat exhaustion and heat emergencies. You know, we talked about issues of heat exhaustion and cold cold injury, both with Dr. Eric Weiss on a previous episode.

Check that out if you want to learn more.

But that’s one of the things that I think we should figure out, how to make sure you don’t overheat what to do if you do and how to stay warm and avoid wind burn and frostbite as well. Those environmental exposures are important.

Chris, do you want to give us a quick summary of that particular topic of heat and cold injury and response?

WORM
00:23:44.770 – 00:24:54.050
You bet. So there’s a number of different things that can happen and I’ll address heat. Some are more minor. You can treat yourself, some are life threatening.

And you want to involve the emergency medical services. So heat cramps sometimes is from a lack of salt. So you want to consider salt tablets or a saline solution.

Heat syncope, where you pass out or you’re dizzy. Ice packs help elevate the legs. Make sure you’re drinking enough water. There’s a thing called post exertional orthostatic syncope.

Syncope means fainting. And again, this can usually be treated without calling 911 with oral hydration and cool yourself down.

But if you get a thing called heat stroke, exertional heat stroke, that’s life threatening for that, you definitely want to involve the emergency services. The treatment on the spot is isomersion or cooling down and IV hydration. Hydration. So some of this stuff is minor, some is life threatening.

Unfortunately, as you get some of these, your judgment gets worse. So you want to hope that you’re around some people who have some good judgment.

GERM
00:24:54.130 – 00:25:21.300
Yeah, totally agree. And again, I just cannot emphasize enough the importance of preparation.

Knowing your body, knowing how to hydrate, knowing how to take care of your feet. My gosh, we had that beautiful discussion with Kyle Allred explained extreme feet in the extreme heat.

If you are going to make any of these efforts, please do go back. Listen to that episode of German Worm.

There is so much that’s wonderful there about just foot health, aside from these other issues of how to stay euthermic.

WORM
00:25:21.300 – 00:26:05.280
And just to expand on something you said, Paul, the best thing you can do is long term training. And recall that training is not an event, it’s a lifestyle. And go many, many months in advance.

And actually when I talk about people who go on these events, sometimes that’s the favorite part of the whole event is maybe the one year leading up to it because it gives them an incentive to train, to eat right, to sleep right for a long duration of time. But you can’t go from being a couch potato to being an endurance athlete, whether you’re mountain climbing or walking or what have you.

So it’s okay to have a somewhat increase in your level of activity when you do this event, but any abrupt increase is just a recipe to hurt yourself.

GERM
00:26:09.680 – 00:26:25.880
Chris Speaking of extreme events, here’s a question from someone who is going to the Olympic Games in Milan, Italy. They’re curious to know whether there’s anything that they might do to protect themselves at the 2026 Winter Olympics in Milan.

WORM
00:26:25.880 – 00:27:16.100
Yeah, yeah, that sounds super fun. And actually I read that over 2 million people are expected to attend that.

And this is the same as we’ve talked about with other mass events like in Rio de Janeiro. Few things. One, concerning health, when 2 million people get together, they tend to cough on one another.

And so you want to be up to speed on immunizations, including influenza and COVID 19.

And as age appropriate for the pneumococcal disease, frequent handwashing will bring down the risk of things like everything from influenza to the common cold to diarrhea. Also, think about security risks. If you’re mashed with a lot of other people, it’s a good way to lose your wallet or other.

So I would consider leaving things in your safety deposit box at your hotel or in a zippered security money belt under your clothing.

GERM
00:27:16.420 – 00:28:05.480
Yeah, totally agree. I think it could. I actually went to the Winter Olympics at Lake Placid many years ago when I was a kid. It was incredible.

It is such a fascinating, joyous, inspiring thing. So I’m glad that this listener is going to go.

We now know much more about respiratory infections and so please take those simple steps to keep yourself safe. Those immunizations still matter. They’re still helpful. This is a bad global flu season.

There is still plenty of COVID 19 out there and it can in some cases still not only ruin your Olympics experience, but it could lay you low and can have possible long term effects. So immunizations are a big part of that success.

If you make this trip and come back, please let us know what you think and we hope you are safe and healthy, whether or not you were. Please drop us a line.

WORM
00:28:05.480 – 00:28:13.360
We’d love to hear from you and Paul, personal question. Suppose you were going to Milan, when would you wear a mask and when would you not?

GERM
00:28:18.860 – 00:29:20.200
Yeah, thanks to me, the trip to I love Milan, by the way. It was so, so beautiful. I’ve been there a couple times, including just last year.

I am worried about the airports where there’s just so many people from so many places.

So my own personal approach, especially in wintertime, in this winter, would be to wear a comfortable mask, Ideally something the N95 or KN95 rating. And I would do that in the airport or train stations when I’m around gobs of other people in close quarters with poor air circulation.

For example, when you get on the plane, I’m wearing a mask. Once we get to cruise, the mask comes off and that way, you know, we have good bleed air from the environment. I think that’s much lower risk.

The reason I do this in transit especially is because I want to enjoy my time at the Olympics and I’m just, I don’t have time for Covid or the flu, so that would be my biggest time. If you’re outdoors at one of these venues, watching skiing, for example, you know, there’s such an endless supply of fresh air that it’s lower risk.

My friends, please understand you can still Get a respiratory infection outside. It does happen, especially at the Olympics where they really cram you in. It could be a thing. So if you’re at high risk of complications, you might choose to mask up outside. Generally speaking, I do not.

Chris as we wrap up this episode, I just wanted to share with our listeners. I think we mentioned this in a previous episode. You and I co authored an op ed piece in The Seattle Times, January 14, 2026 edition Talking about our sadness and anger and frustration with RFK and our Health and Human Services Department and the way in which it’s just doing all everything wrong, as far as I can tell around immunization practices.

I will put a link to that particular op ed, which I think people can read for free right down in the show Notes But I also wanted to emphasize that we’re not alone. I mean every doctor I know is doing this.

And in fact there was a recent article in JAMA News about the hundreds of medical groups that are currently challenging the US Childhood Immunization schedule. What’s your thought about that article and any last parting thoughts on this ever enraging topic?

WORM
00:30:36.800 – 00:31:28.980
Yeah, I was glad to see that so many docs around the country are being activist on this and as you say, literally hundreds of medical professional societies are going to the courts and trying to protest against these new changes with the pediatric vaccine vaccine recommended schedule.

For some reason, RFK Jr wants to imitate the Danish vaccination schedule, which recommends fewer scheduled vaccines than we give in the US there’s no reason for this. It’s apples and oranges. Denmark is a small country with 6 million people. They have more well to do people.

They’re more homogeneous than the US and they have a much lower poverty rate than the U.S. and so I think every country needs to develop its own ideal vaccine schedule and to pick one country that’s very different in the US and imitate their schedule as a justification for these changes, I think is not so.

GERM
00:31:29.220 – 00:33:15.160
If I’m not mistaken, Denmark also has a unified electronic medical record. In other words, screening and medical information is easier to gather in Denmark. Here in the United States, it’s crazy.

We have 50 different states, each with its own regulations, and there are many different records as well.

And so, you know, we talked about hepatitis B, didn’t we, that if you don’t know your hepatitis B status, you could, as an expecting mother, undergo a hepatitis B blood test and then see whether you need to be immunized, whether your newborn needs to be immunized. Theoretically, scientifically, that’s true. We tried that in the United States for decades. Didn’t work. A lot of people got hepatitis B and died.

So that’s why we went in our country, in our context, to the universal newborn schedule, that everyone born in America should get their hepatitis B shot. That hadn’t changed. What has changed is the makeup of this corrupt and inept advisory committee on Immunization practices.

The ACIP has always been the vanguard, the gold standard for information worldwide on vaccine practices. Now it’s a bunch of corrupt fuck nuts. And it’s just a real problem and it’s a tragedy and it’s frustrating for us.

So thank you to our friends here on German Worm Nation for listening to us, for trusting us, and we’ll continue to keep you apprised of our efforts along these lines. And thanks to all of you for what you’re doing in your own lives as well. Everyone, that’s a wrap for episode 88 of Germ and Worm.

As always, we would welcome your questions on travel Health Just send us questions, tips for travel success, or suggested corrections. We would welcome it.Just send us an email germandwormmail@gmail.com or Visit our website germandworm.com if you’ve enjoyed this episode, please subscribe. Give us a thumbs up and spread the word with friends, family and on the socials. I’m Germ.

WORM
00:33:32.810 – 00:33:35.570
I’m Worm. It’s a big planet. See it in good health.

GERM
00:33:35.810 – 00:33:42.450
We look forward to seeing you next time. This podcast is designed to inform, inspire and entertain. However, it does not establish a doctor. Patient relationship and so it should not replace your conversation with a qualified healthcare professional. Please see one before your next adventure. The opinions in this podcast are Dr. Sanford’s and Dr. Pottinger’s alone and do not necessarily represent the opinions of the University of Washington or UW Medicine.