Vaccine rumors keep going viral…but which ones actually hold up when you look at the evidence?
In this episode, pharmacists Don Weinberger and Steve Small take on the vaccine claims patients bring to the counter, with insight from infectious disease expert Dr. William Schaffner of Vanderbilt University School of Medicine.
- 📜 Have some past vaccines really had safety issues…and what changed?
- 🧪 Is the aluminum in vaccines toxic?
- 👶 Do HPV vaccines affect fertility?
· 💉 Does giving multiple vaccines at once overload the immune system?
Plus, Fast Facts on egg allergies and flu shots, the truth about thimerosal, and where to find our take on whether mRNA vaccines change your DNA.
Roll up your sleeves…we’re following the evidence wherever it leads.
Key claims explored in this episode include:
- Some PAST vaccines had notable safety issues
- Aluminum ingredients in vaccines are toxic
- HPV vaccines cause infertility
- Giving multiple vaccines overwhelms the immune system
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TRC Healthcare Editor Hosts:
- Stephen Small, PharmD, BCPS, BCPPS, BCCCP, CNSC
- Don Weinberger, PharmD, PMSP
Guest:
- William Schaffner, MD, Vanderbilt University School of Medicine
CE Information:
For the purposes of disclosure, Dr. William Schaffner reports a relevant financial relationship [honorarium: RSV infections in adults CME] with Abbott Diagnostics. The other speakers have nothing to disclose. All relevant financial relationships have been mitigated.
TRC Healthcare offers CE credit for this podcast for subscribers at our platinum level or higher. Log in to your Pharmacist’s Letter, Pharmacy Technician’s Letter, or Prescriber Insights account and look for the title of this podcast in the list of available CE courses.
The clinical resources related to this podcast are part of a subscription to Pharmacist’s Letter, Pharmacy Technician’s Letter, and Prescriber Insights:
- Algorithm: Vaccine Adherence: Addressing Myths and Hesitancy
- FAQ: HPV Vaccination
- Chart: Flu Vaccines for 2026-27 (United States)
- FAQ: Communicating About Flu Vaccination
- Article: Address Vaccine Concerns That Keep Going Viral
- Toolbox: Resources for Discussing Medical Misinformation
Want to report a possible vaccine reaction? Healthcare professionals and patients can submit reports to the Vaccine Adverse Event Reporting System (VAERS).
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Transcript:
This transcript is automatically generated.
00:00:05 Narrator
Welcome to Rumor vs Truth, your trusted source for facts, where we dissect the evidence behind risky rumors and reveal clinical truths.
00:00:12 Narrator
Today, we’ll take a shot at claims about vaccines.
00:00:21 Don Weinberger
You know, Steve, between disease outbreaks in the news and, you know, cold and flu season kicking off, vaccine questions are coming at us pretty much from every direction.
00:00:31 Steve Small
That’s for sure.
00:00:32 Steve Small
And the rumors feel like they’re spreading faster than the infections themselves.
00:00:36 Steve Small
And with that, I’m Steve the pharmacist.
00:00:39 Don Weinberger
And I’m Don the pharmacist.
00:00:40 Don Weinberger
And as we promised last time, this episode is a little more serious.
00:00:46 Don Weinberger
Same evidence, fewer puns.
00:00:49 Steve Small
Fewer, but not zero, Don.
00:00:51 Steve Small
Let’s be realistic here.
00:00:53 Steve Small
And should we give everyone the lineup for today?
00:00:55 Don Weinberger
Sure.
00:00:56 Don Weinberger
So today we’ll look at whether some past vaccines had safety issues.
00:01:01 Don Weinberger
See if aluminum in vaccines is truly toxic.
00:01:05 Don Weinberger
Check if HPV vaccines cause infertility with the help from an expert guest.
00:01:10 Don Weinberger
And unpack if getting multiple vaccines overwhelms the immune system.
00:01:15 Steve Small
Those are four big claims, Don.
00:01:17 Steve Small
Talk about overwhelming.
00:01:19 Steve Small
And we’ve got our work cut out for us.
00:01:20 Steve Small
So let’s roll up our sleeves and get to work.
00:01:23 Steve Small
But first, as a reminder here, this podcast offers continuing education credit for pharmacists, pharmacy technicians, prescribers, and nurses.
00:01:32 Don Weinberger
Yep, just log into your Pharmacist’s Letter, Pharmacy Technician’s Letter, or Prescriber Insights account and look for the title of this podcast in the list of available CE courses.
00:01:42 Steve Small
And for the purposes of disclosure today, Don and I have nothing to disclose.
00:01:46 Steve Small
And our guest, Dr. William Schaffner, reports a relevant financial relationship with Abbott Diagnostics for an honorarium regarding RSV vaccines.
00:01:54 Steve Small
That’s his own relationship, not TRC’s.
00:01:57 Steve Small
And we’ve mitigated it by having his segment independently reviewed for evidence and balance.
00:02:02 Don Weinberger
Right.
00:02:03 Don Weinberger
So thanks for bringing that up.
00:02:04 Don Weinberger
And that actually brings up, you know, maybe a mini elephant in the room.
00:02:08 Don Weinberger
So we do, before we start, every time you write about vaccines or drugs, we do get some questions asking whether we take money from manufacturers, specifically in this case, vaccine manufacturers.
00:02:20 Don Weinberger
And I’ll say that we do not.
00:02:23 Don Weinberger
TRC does not accept money from the pharmaceutical industry at all.
00:02:27 Don Weinberger
We’re funded by our subscribers.
00:02:29 Don Weinberger
So at the end of the day, our agenda here is the evidence.
00:02:34 Don Weinberger
And with that, let’s jump right into it.
00:02:36 Don Weinberger
So vaccines are one of the biggest public health wins in history.
00:02:44 Don Weinberger
For instance, they gave us the ability to eradicate smallpox.
00:02:47 Don Weinberger
Who wants that roaming around still, right?
00:02:50 Don Weinberger
But people still have real, sincere questions about them.
00:02:55 Don Weinberger
And they are one of the most charged healthcare debates in current times.
00:02:59 Steve Small
And patient trust is key to providing effective healthcare here.
00:03:03 Steve Small
Vaccines have been a sticking point for decades, and we all know the heat on this topic just continues to climb.
00:03:11 Don Weinberger
So today isn’t about winning arguments, unlike my home life.
00:03:15 Don Weinberger
It’s about approaching concerns with empathy, understanding, and evidence to help build and maintain trust in immunizations.
00:03:23 Steve Small
And with cold and flu season here, Don, like you said, those questions are about to spike, whether it’s at the pharmacy counter, prescriber’s office, or all over social media.
00:03:33 Don Weinberger
Which is why our approach matters.
00:03:35 Don Weinberger
So we’ll separate three things today.
00:03:37 Don Weinberger
What went wrong in the past, what the evidence says about specific ingredients and technologies now, and how to talk to patients who are still unsure.
00:03:46 Steve Small
Let’s get into it.
00:03:48 Steve Small
So for our first claim, we’ll start somewhere that might surprise people by admitting that vaccine safety hasn’t always been perfect.
00:03:54 Steve Small
So the claim is some past vaccines had notable safety issues.
00:03:59 Don Weinberger
All right, so I do appreciate that we’re opening here.
00:04:02 Don Weinberger
Pretending there’s never been a problem doesn’t really build trust.
00:04:07 Steve Small
Exactly.
00:04:08 Steve Small
And the most famous example that I found is the Cutter incident all the way back in 1955.
00:04:15 Steve Small
Right after the polio vaccine was licensed and available to the public, one manufacturer released batches that still contained live poliovirus.
00:04:25 Don Weinberger
So how bad was it?
00:04:26 Steve Small
Well, we’re talking about 120,000 contaminated doses here.
00:04:31 Steve Small
And counting children and their contacts, about 164 people were severely paralyzed and 10 died.
00:04:39 Don Weinberger
That’s heartbreaking.
00:04:40 Don Weinberger
I can’t imagine.
00:04:41 Don Weinberger
So, you know, what’s different now?
00:04:44 Steve Small
Thankfully, a lot’s different now.
00:04:46 Steve Small
Since the Cutter incident over 70 years ago, we now have better and more reliable technology for manufacturing vaccines.
00:04:53 Steve Small
Plus, think of all the safety systems we have in place now to detect issues in case one occurs.
00:04:59 Don Weinberger
Right.
00:05:00 Don Weinberger
So for example, we now have the Vaccine Adverse Event Reporting System, or VAERS.
00:05:06 Don Weinberger
We have V-safe, the Vaccine Safety Datalink, and the Clinical Immunization Safety Assessment, or CISA, to help detect possible adverse effects and study them to see if they’re actually related to the vaccine.
00:05:21 Steve Small
Yes, and a good example of where the system worked is the old rotavirus vaccine, RotaShield, which was introduced in 1998 when I was still a kid.
00:05:29 Steve Small
The next year after that, VAERS detected an increase in intestinal intussusception in babies who got the vaccine.
00:05:37 Don Weinberger
Okay, so I’m going to need you to break down intussusception for us.
00:05:41 Steve Small
Right.
00:05:42 Steve Small
So intussusception is where the intestine gets blocked due to one part of the intestine sliding to the next part, similar to how sections of a telescope collapse into each other.
00:05:51 Steve Small
And this is something we look out for in pediatrics.
00:05:54 Steve Small
And the detection of this with RotaShield led to further studies that confirmed a link and the manufacturer then removed the vaccine from the market by fall of 1999.
00:06:03 Steve Small
And nowadays, we have a different vaccine, RotaTeq.
00:06:08 Don Weinberger
So that’s a relatively quick turnaround in the pharmaceutical world.
00:06:13 Don Weinberger
So past safety issues are actually proof the system can catch problems.
00:06:18 Don Weinberger
And another recent example was myocarditis or heart inflammation, seen with COVID-19 vaccines.
00:06:25 Don Weinberger
Monitoring picked up myocarditis signals after mRNA COVID-19 vaccines.
00:06:32 Don Weinberger
Myocarditis was mostly seen in young males and was usually short-lived, around a few days.
00:06:40 Don Weinberger
And keep in mind that this is rare, at a frequency of 27 cases per million doses in men ages 12 to 24 years old.
00:06:50 Don Weinberger
That led to label warnings and updated guidance.
00:06:53 Steve Small
And the system isn’t perfect and no therapy is 100% safe either.
00:06:59 Steve Small
But the system is built to find and fix these rare issues that are unlikely to be caught in relatively smaller clinical trials before vaccines are licensed and then available to the public.
00:07:09 Steve Small
So when it comes to this claim that some past vaccines had notable safety issues, the verdict is true.
00:07:22 Steve Small
And the nugget here for practitioners is to not gloss over or deny past problems.
00:07:28 Steve Small
Those problems were rare, they were caught, and they’re the reason today’s safety monitoring exists, right?
00:07:34 Steve Small
So approach these issues honestly, but explain how those lessons shaped today’s vaccine manufacturing standards and safety monitoring.
00:07:43 Don Weinberger
All right, and that brings up a related truth here.
00:07:46 Don Weinberger
Specify that vaccine adverse event reports can’t really prove a cause and effect.
00:07:52 Don Weinberger
A report to VAERS does not automatically mean the vaccine caused the event, but don’t dismiss it either.
00:07:58 Don Weinberger
VAERS is what flagged RotaShield and the myocarditis finding with mRNA COVID-19 vaccines.
00:08:05 Steve Small
That is a really important point, Don.
00:08:07 Steve Small
And anyone can submit a report, so keep that in mind.
00:08:10 Steve Small
And reports can contain errors and media attention can drive reporting up.
00:08:15 Steve Small
And I think of VAERS really like a smoke detector.
00:08:18 Steve Small
It tells you where to look, not what started the fire per se, right?
00:08:23 Don Weinberger
I like that.
00:08:25 Don Weinberger
And those signals can then get further studied in systems like the Vaccine Safety Datalink to confirm it.
00:08:31 Steve Small
And for pharmacists who vaccinate, you’re required to report certain adverse events and give a Vaccine Information Statement, or VIS, before vaccination.
00:08:41 Steve Small
So make sure those key steps happen.
00:08:44 Don Weinberger
And prescribers, nurses, and technicians who vaccinate share these same responsibilities.
00:08:49 Don Weinberger
So every team member can help make sure the VIS handouts are ready and documentation is complete.
00:08:56 Steve Small
And remember that the same 1986 law behind those requirements created a no-fault compensation program for people injured by vaccines.
00:09:04 Don Weinberger
Right, so acknowledging rare harms and having a system to address them is part of earning that trust.
00:09:11 Steve Small
And we, including patients, should report issues ASAP to VAERS at vaers.hhs.gov.
00:09:17 Steve Small
I’ve had to do that myself as a pharmacist, and it really is our duty.
00:09:21 Steve Small
So we’ve linked to the VAERS website in the show notes.
00:09:24 Don Weinberger
Great.
00:09:25 Don Weinberger
Okay, so let’s shuffle on to our next claim here.
00:09:28 Don Weinberger
So safety concerns often zero in on a specific ingredient, and aluminum is increasingly getting singled out a lot.
00:09:36 Don Weinberger
So the next claim is aluminum ingredients in vaccines are toxic.
00:09:42 Steve Small
Okay, first question, Don.
00:09:43 Steve Small
What does aluminum toxicity actually look like here?
00:09:47 Don Weinberger
Yep, so that is a great place to start.
00:09:49 Don Weinberger
So actual aluminum toxicity is mainly seen in people who just can’t clear it well, like patients with kidney dysfunction on dialysis with large sustained exposures, and it can cause bone pain and fractures,
00:10:04 Don Weinberger
and a condition sometimes called dialysis encephalopathy, with speech problems, tremors, seizures, and confusion.
00:10:12 Steve Small
And now that you mention that, Don, in pediatrics, we sometimes worry about this with preterm infants on long-term IV nutrition, since some ingredients do contain trace amounts of aluminum.
00:10:21 Steve Small
And we know that preterm babies have kidney issues where they don’t filter things as well.
00:10:26 Don Weinberger
All right, so now aluminum salts like aluminum hydroxide are adjuvants, ingredients that boost immunity you get from vaccines, making them more effective.
00:10:37 Don Weinberger
And aluminum has been used in vaccines since the 1930s.
00:10:40 Don Weinberger
Aluminum basically helps the immune system notice the vaccine, helps immune cells pick up the antigen and send a local “hey, pay attention to me” signal so you get a stronger antibody response with fewer doses.
00:10:53 Don Weinberger
You’ll find these adjuvants in vaccines like DTaP, pneumococcal conjugates, HPV, and hepatitis B.
00:11:01 Steve Small
But how much aluminum are we talking about in vaccines, Don?
00:11:04 Don Weinberger
Yep, that’s the other golden question, right?
00:11:06 Don Weinberger
So here’s the perspective.
00:11:08 Don Weinberger
Across 18 years, kids get about 4 to 7 milligrams of aluminum from vaccines.
00:11:14 Don Weinberger
Now compare that to other sources.
00:11:16 Don Weinberger
So versus 70 to 400 milligrams absorbed in the body from their diet.
00:11:22 Steve Small
Oh, okay.
00:11:23 Steve Small
So food is the bigger source by a mile over time.
00:11:27 Don Weinberger
By a country mile, right?
00:11:30 Don Weinberger
And the body clears it.
00:11:32 Don Weinberger
The adjuvant is absorbed slowly from the injection site over time.
00:11:36 Don Weinberger
And once it’s in the bloodstream, the kidneys clear most of it within a day.
00:11:40 Steve Small
And is there a cap then to how much aluminum you can put in a vaccine vial, for instance?
00:11:46 Don Weinberger
You’re asking all the right questions, Steve.
00:11:49 Don Weinberger
So yes, US vaccines are generally limited to 0.85 milligrams of aluminum per dose.
00:11:56 Don Weinberger
Now, that’s not the true cap.
00:11:58 Don Weinberger
It can actually go up to 1.25 milligrams per dose, but the manufacturer must show data that the increased amount of aluminum is safe and necessary to produce the intended effect.
00:12:10 Steve Small
And I’m thinking about this, Don, too, on the hospital side.
00:12:13 Steve Small
I think about those dialysis patients you mentioned.
00:12:15 Steve Small
They clear aluminum poorly and they get hepatitis B doses, right?
00:12:20 Steve Small
And we don’t worry about that per se.
00:12:22 Steve Small
So there are no credible reports of aluminum toxicity from vaccines in them.
00:12:27 Don Weinberger
Yeah, that’s a powerful point.
00:12:30 Steve Small
And what about claims that say that aluminum has other toxic effects, things like causing conditions like autoimmune diseases or asthma or even autism?
00:12:39 Steve Small
You know, with rising rates of autism diagnoses, many folks are pointing at vaccines claiming they’re the cause and potentially aluminum here.
00:12:48 Don Weinberger
Yep, you’re really testing the metal today, Steve, but that’s where the big data comes in.
00:12:52 Don Weinberger
So a 2025 Danish observational study followed about 1.2 million children.
00:12:59 Don Weinberger
So aluminum from vaccines in the first two years of life wasn’t linked to higher rates of autoimmune, allergic, or neurodevelopmental disorders, and that includes autism.
00:13:09 Don Weinberger
But one caveat here, Danish kids get somewhat less aluminum than US kids because the immunization schedules differ.
00:13:18 Don Weinberger
But the study still found no dose-related increase in risk.
00:13:22 Steve Small
Okay, interesting.
00:13:23 Steve Small
Glad you caught that caveat there.
00:13:24 Steve Small
And what other caveat should we think about?
00:13:27 Don Weinberger
Yeah, so one smaller US study found an asthma signal, but it likely reflects confounding.
00:13:34 Don Weinberger
What’s that?
00:13:36 Don Weinberger
Where another difference between the groups may explain the result, so not the aluminum itself.
00:13:41 Don Weinberger
And larger studies haven’t backed it up.
00:13:44 Don Weinberger
Okay, so going back to that claim that aluminum ingredients in vaccines are toxic.
00:13:51 Don Weinberger
And the verdict is…
00:13:58 Don Weinberger
Rumor.
00:13:59 Don Weinberger
Aluminum can be toxic in certain settings, but not in the very small amounts we see in vaccines.
00:14:05 Steve Small
And like you said, Don, kids get much more aluminum over time from their diet, not vaccines.
00:14:11 Don Weinberger
Yeah.
00:14:11 Don Weinberger
So plus, reassure patients that aluminum vaccines aren’t linked to serious health problems or acute aluminum toxicity.
00:14:18 Steve Small
And for more strategies to talk through these concerns, check out our Vaccine Adherence: Addressing Myths and Hesitancy resource.
00:14:26 Steve Small
Now, speaking of trust here, concerns about vaccine safety can feel especially personal when they involve reproductive health.
00:14:33 Steve Small
And the charged claim that continues to come up is HPV vaccines cause infertility.
00:14:40 Don Weinberger
So this one is heard a lot with parents of preteens, and it is an emotional one.
00:14:47 Steve Small
It is, and it helps to know where it came from.
00:14:51 Steve Small
And it traces back to a small number of case reports and press stories suggesting a link to primary ovarian insufficiency, sometimes called premature ovarian failure.
00:15:01 Don Weinberger
So the question is, why do you think this claim still sticks around?
00:15:08 Steve Small
Well, it lands on something people care deeply about, and infertility is common enough that people look for a cause, right?
00:15:15 Steve Small
So to help us unpack the data here, I reached out to Dr. William Schaffner, MD.
00:15:20 Steve Small
He’s a professor of Preventive Medicine in the Department of Health Policy, as well as the Division of Infectious Diseases at the Vanderbilt University School of Medicine.
00:15:28 Steve Small
And he’s also a former medical director and past president of the National Foundation for Infectious Diseases.
00:15:35 Don Weinberger
Excited to hear his thoughts.
00:15:42 Steve Small
Welcome, Dr. Schaffner.
00:15:43 Steve Small
It’s a privilege to have you on our program today and we value your immunization expertise here.
00:15:47 Steve Small
So really to start off, what are your thoughts on this claim about the HPV vaccine causing infertility?
00:15:53 Steve Small
Where does this claim come from and what does the evidence actually say?
00:15:57 William Schaffner
Well, Steve, first it’s good to be with you, of course.
00:16:00 William Schaffner
And yes, we hear all kinds of questions that have come up about so many vaccines.
00:16:06 William Schaffner
And one of the questions that we hear with some frequency is whether the vaccine that’s designed to prevent a whole variety of cancers, particularly cancers of the genital tract, both in women and men, could in some way influence a woman’s fertility, right?
00:16:28 William Schaffner
That’s a real question.
00:16:30 William Schaffner
And it’s a question that many of us have looked into particularly.
00:16:34 William Schaffner
And fortunately, we can say that there’s no basis for this.
00:16:40 William Schaffner
It seems to have been brought up by someone who kind of fell into the trap.
00:16:47 William Schaffner
I’d like to say that just because A comes before B, B must have been caused by A.
00:16:57 William Schaffner
And so just because things are linked in time, for example, let’s just take this particular example.
00:17:05 William Schaffner
A person, a woman gets HPV vaccine and then at some later date discovers that they are infertile or are having difficulty conceiving.
00:17:19 William Schaffner
Well, just because they got the vaccine does not mean that it caused that.
00:17:24 William Schaffner
As we tell our medical students when we discuss this, is a little bit facetious.
00:17:30 William Schaffner
But we all know that the rooster crows before the dawn.
00:17:35 William Schaffner
But there are not many of us who think that the rooster makes the sun come up.
00:17:39 William Schaffner
Those were things that were in temporal, linked in time, but not causally related.
00:17:47 William Schaffner
And so you can fall into that trap.
00:17:50 William Schaffner
If you got a vaccine on Monday, and on Thursday you had a heart attack and you can’t think of anything else in your life that was different, you have a tendency, all of us humans do, to attribute the heart attack to the vaccine.
00:18:06 William Schaffner
Although there was no association between the two, you would have gotten the heart attack anyway, even if you hadn’t received the vaccine.
00:18:14 William Schaffner
So it’s that kind of an issue that has come up.
00:18:18 William Schaffner
And of course, it’s an important issue for young people, particularly young women who are getting the vaccine or contemplating it.
00:18:29 Steve Small
Absolutely.
00:18:30 Steve Small
And I love that we’re talking about those temporal associations here and putting that in perspective.
00:18:35 Steve Small
In weighing benefits and risks here, what are the risks if patients don’t get the HPV vaccine?
00:18:40 Steve Small
You mentioned cancers before.
00:18:41 Steve Small
Is there anything specific to that?
00:18:42 Steve Small
Is there anything else our learners should know?
00:18:44 William Schaffner
Well, we should remember HPV vaccine, human papillomavirus vaccine was the first vaccine explicitly developed to prevent cancer.
00:18:56 William Schaffner
And the first cancer that was on the list was cancer of the cervix in women.
00:19:01 William Schaffner
But then we discovered this virus, this human papillomavirus predisposes to a number of other cancers in women, vaginal and vulval cancer, in both sexes, anal cancer, and increasingly, head and neck cancers, particularly cancers that involve the back of the throat.
00:19:26 William Schaffner
And that’s a kind of cancer that’s actually increasing in the United States.
00:19:31 William Schaffner
So we would want every child, female, male, and female to be vaccinated with HPV vaccine explicitly to limit these cancers.
00:19:45 William Schaffner
In particular, since this vaccine is so spectacularly effective, it’s 95 to 100% effective.
00:19:55 William Schaffner
It’s dynamite.
00:19:56 William Schaffner
And at the moment, there are no recommendations to even get boosters.
00:20:01 William Schaffner
So it looks as though if we can get vaccinated during early adolescence, that protection will protect us essentially lifelong.
00:20:12 William Schaffner
That’s our concept at the present time.
00:20:15 Steve Small
Yeah, those are key benefits and a key time, like you pointed out.
00:20:18 Steve Small
Are there still side effects or precautions listeners should still consider with the HPV vaccine?
00:20:24 William Schaffner
Absolutely, Steve.
00:20:25 William Schaffner
And it’s interesting that these are relatively minor, but notable.
00:20:30 William Schaffner
It’s an ouchie vaccine.
00:20:32 William Schaffner
When you get it, it kind of hits your arm.
00:20:35 William Schaffner
It’s a little like when I got tetanus vaccine.
00:20:38 William Schaffner
That hurts your arm.
00:20:39 William Schaffner
Your arm is a little sore.
00:20:42 William Schaffner
About 3 to 4% of people get a degree of fever.
00:20:46 William Schaffner
And then there’s one other thing.
00:20:48 William Schaffner
We give a lot of these vaccines to young adolescents, and they’re kind of a little psychologically fragile.
00:20:56 William Schaffner
So we always say, sit down when you get the vaccine and stay seated for 15 minutes because there’s been some evidence that both young men and young women can faint.
00:21:13 William Schaffner
They get feeling a little woozy after they get this vaccine.
00:21:17 William Schaffner
So sit down while you get it, stay seated for 15 minutes, have a drink of water, and you’ll be fine.
00:21:25 Steve Small
Great.
00:21:25 Steve Small
And I did want to take some time to ask you a really key question here that I think is on everyone’s minds.
00:21:30 Steve Small
We all know that we live in this moment where vaccines are a very heated topic in healthcare.
00:21:35 Steve Small
And these conversations can feel deeply personal for many people.
00:21:38 Steve Small
In general, I’m curious what are tips or your own approaches you use when patients are hesitant to get immunizations?
00:21:45 Steve Small
Any advice we can give our listeners?
00:21:47 William Schaffner
When I speak to healthcare providers, I say, acknowledge that vaccine questions are common.
00:21:55 William Schaffner
Tell the patient, you know, I get a lot of questions.
00:21:59 William Schaffner
I’m happy to respond to yours.
00:22:01 William Schaffner
What concerns you?
00:22:03 William Schaffner
And then quickly answer the question.
00:22:06 William Schaffner
Don’t give the medical school lecture that goes on for half an hour.
00:22:10 William Schaffner
Talk quickly about that and then transition to reassurance and comfort because information is what the patients are asking about, but what they’re really looking for is reassurance and comfort and what they’re doing is good for themselves, their families, and their communities.
00:22:32 Steve Small
I think that’s great advice.
00:22:33 Steve Small
I think we can all walk away with some good tidbits there.
00:22:36 Steve Small
And thank you so much for being on the program.
00:22:37 Steve Small
I’m excited to share this with my co-host Don, and we’ll see what he has to say.
00:22:42 William Schaffner
My great pleasure.
00:22:47 Don Weinberger
Yeah, so really great to have Dr. Schaffner’s expertise on this topic.
00:22:51 Don Weinberger
And he had really thoughtful points on how to approach vaccines in general with patients.
00:22:57 Steve Small
Yes, he really touched on the human element here and how we should effectively connect the facts with patients, not just regurgitate talking points, right?
00:23:06 Steve Small
And the data back him up regarding HPV.
00:23:08 Steve Small
So large studies, including one following over 900,000 young women, found no increased risk of primary ovarian insufficiency after getting HPV vaccines.
00:23:19 Steve Small
And a US survey also found no link between HPV vaccine and infertility.
00:23:25 Don Weinberger
Yeah, and I also did like his rooster analogy, which goes back to our smoke detector point earlier.
00:23:32 Don Weinberger
And what really threatens fertility is HPV disease and its treatment.
00:23:37 Don Weinberger
Treating cervical pre-cancer and cancer can affect the ability to have children and a hysterectomy ends it.
00:23:44 Steve Small
And that’s really serious.
00:23:46 Steve Small
And going back to Dr. Schaffner’s point, the vaccine does produce close to 100% protection against infection and cervical cancer in clinical trials for those targeted HPV strains in the vaccine.
00:23:58 Steve Small
And when grouping many studies together, HPV vaccination at 16 years or younger cuts real world cervical cancer risk by about 80% overall.
00:24:07 Steve Small
And that’s still substantial.
00:24:09 Don Weinberger
Yeah, agreed.
00:24:10 Don Weinberger
And preventing HPV disease also means preventing some of those fertility harming procedures.
00:24:17 Don Weinberger
Plus HPV infection itself has been linked to infertility in women and to sperm problems in men in observational studies.
00:24:25 Steve Small
Right.
00:24:25 Steve Small
So when it comes to this claim that HPV vaccines cause infertility, the verdict is rumor.
00:24:37 Don Weinberger
So it’s a good idea to acknowledge the fertility fear and then help reframe.
00:24:42 Don Weinberger
The evidence doesn’t show that HPV vaccination harms fertility, and preventing HPV disease helps patients avoid treatments that we know can lead to fertility issues.
00:24:53 Steve Small
And it’s key to vaccinate early before exposure when the benefit is greatest, and that includes boys too.
00:24:58 Steve Small
And if a patient has a concern, a calm “I hear you, here’s what we know” can go a long way.
00:25:06 Steve Small
And technicians can help by flagging patients who are due for their HPV vaccination so the pharmacist can start the conversation.
00:25:13 Steve Small
And keep in mind, recommendations have been changing, so check the current schedule.
00:25:18 Don Weinberger
Yep, I love that phrase, having patients feel heard about it, right?
00:25:22 Don Weinberger
So, and check out our HPV vaccination resource for help with dosing, ages, and catch-up questions.
00:25:30 Steve Small
And now for everyone’s favorite segment, fast facts.
00:25:34 Don Weinberger
So this is where we jump into some common bite-sized claims about vaccines and give them a seal of approval or debunk them quickly.
00:25:47 Steve Small
First up, patients can get the flu vaccine if they have an egg allergy.
00:25:50 Steve Small
And the verdict here is?
00:25:52 Don Weinberger
True.
00:25:53 Don Weinberger
Yep.
00:25:53 Don Weinberger
So let’s unscramble that one quickly.
00:25:56 Don Weinberger
People with egg allergy can get any flu vaccine that’s appropriate for their age and health, egg-based or not.
00:26:01 Steve Small
And since the 2023-2024 season, no extra precautions are recommended beyond what’s used for any vaccine, regardless of how severe the egg reaction was.
00:26:10 Steve Small
And severe allergic reactions to flu vaccines are rare.
00:26:14 Steve Small
We’re talking about one per every million doses. And our Communicating About Flu Vaccination FAQ covers that and more.
00:26:22 Don Weinberger
So next claim is thimerosal preservatives in vaccines cause autism.
00:26:26 Don Weinberger
Verdict is rumor.
00:26:28 Steve Small
Many large studies do not show any link between mercury containing thimerosal preservative in vaccines and autism.
00:26:35 Don Weinberger
And thimerosal was eliminated from US childhood vaccines in 2001 as a precautionary measure.
00:26:41 Don Weinberger
Keep in mind that measles, mumps, and rubella, or MMR, varicella, which is chickenpox, inactivated polio, and pneumococcal conjugate vaccines never contained thimerosal.
00:26:58 Steve Small
Nice.
00:26:58 Steve Small
We really injected some truth into the conversation there.
00:27:01 Don Weinberger
So let’s inject the next claim here.
00:27:04 Don Weinberger
Sorry to reuse your joke.
00:27:06 Don Weinberger
But even when patients are comfortable with each individual vaccine, they may still worry about getting several vaccines at once.
00:27:13 Don Weinberger
And one claim we are hearing more and more is, giving multiple vaccines overwhelms the immune system.
00:27:21 Steve Small
I agree, Don.
00:27:21 Steve Small
Pharmacists hear this at the counter all the time, questions like, can we just do one today and come back for the rest later?
00:27:28 Don Weinberger
Yeah, and to be fair, that instinct makes sense.
00:27:32 Don Weinberger
But let’s put it in perspective.
00:27:34 Don Weinberger
Babies and young children are exposed to thousands of antigens every day, but the entire vaccine schedule contains about 165 antigens, and that’s per American Academy of Pediatrics, or AAP.
00:27:46 Steve Small
So I guess a trip to the playground is a bigger immune workout than the whole schedule.
00:27:51 Don Weinberger
Yeah, pretty much.
00:27:52 Don Weinberger
And you might hear that kids get 80 or more vaccines.
00:27:56 Don Weinberger
In reality, AAP says it’s about 30 shots, protecting against about 20 diseases by age 18, not counting yearly flu shots.
00:28:07 Steve Small
Yeah, that’s a lot less than people think or assume.
00:28:11 Don Weinberger
And a study in JAMA looked at whether kids with more vaccine antigen exposure in the first two years had more infections later, and they didn’t.
00:28:20 Steve Small
Okay, so maybe it doesn’t overwhelm the immune system there.
00:28:23 Steve Small
And so over time, those 30 shots aren’t overkill then.
00:28:27 Steve Small
But back to that parent at the counter asking to do just one today.
00:28:31 Steve Small
What about several shots at the same visit?
00:28:34 Don Weinberger
Yeah, so CDC says vaccines are as effective in combination as they are individually.
00:28:39 Don Weinberger
Some combinations can cause a fever, but it’s temporary.
00:28:44 Don Weinberger
And there are concerns about giving the combination MMR-varicella, or MMRV, in some kids due to a small increase in risk of febrile seizures.
00:28:54 Steve Small
Okay.
00:28:54 Steve Small
And then what about the autoimmune worries here?
00:28:58 Don Weinberger
So data show most vaccines aren’t associated with autoimmune reactions, but with specific rare exceptions, such as Guillain-Barré syndrome with flu vaccine, where the immune system mistakenly attacks the nerves.
00:29:11 Don Weinberger
They can cause tingling and muscle weakness, usually starting in the legs and moving upward.
00:29:16 Don Weinberger
But rarity there, this happens one or two out of every 1,000,000 doses.
00:29:22 Steve Small
Wow.
00:29:22 Steve Small
And another one I think of is low platelets from MMR vaccine, which can happen in about one out of every 30,000 doses.
00:29:30 Steve Small
And we need to point out here that delay immunizations comes with its own risk.
00:29:35 Don Weinberger
Yeah, big ones.
00:29:36 Don Weinberger
So spreading out shots may mean doses are given late and sometimes not at all.
00:29:44 Steve Small
And young kids are the most vulnerable here since protection from mom’s antibodies only lasts a few months after birth.
00:29:50 Don Weinberger
Yeah, true.
00:29:51 Don Weinberger
So going back to that claim:
00:29:53 Don Weinberger
Giving multiple vaccines overwhelms the immune system.
00:29:57 Don Weinberger
The verdict is rumor.
00:30:05 Don Weinberger
Reassure patients that multiple vaccines don’t overwhelm the immune system, while delaying doses may leave them unprotected, plus fewer visits means less time, cost and stress.
00:30:18 Steve Small
Good point.
00:30:19 Steve Small
Definitely more cost and stress there.
00:30:21 Steve Small
But what do you do, Don, if a patient still wants to space things out?
00:30:27 Don Weinberger
Okay, so acknowledge they still want the vaccines they’re supposed to get, right?
00:30:30 Don Weinberger
They just want them spaced out.
00:30:32 Don Weinberger
Then in this case, I take steps so that a modified schedule doesn’t become an abandoned one.
00:30:38 Don Weinberger
I try to make sure we decide on the next visit before they leave and set up a reminder or two or three or five.
00:30:46 Steve Small
And technicians can be a huge help there, scheduling follow-up visits and setting up reminder calls or texts, for example.
00:30:52 Don Weinberger
And remind families that young children are at the highest risk from these diseases.
00:30:57 Don Weinberger
That’s exactly why the schedule starts early.
00:30:59 Steve Small
And keep in mind, the goal isn’t to win the conversation here, it’s to keep the patient engaged and protected.
00:31:07 Steve Small
And I think that moves nicely into our bottom line truth today, that vaccine safety isn’t about blind trust.
00:31:13 Steve Small
It’s based on evidence, monitoring and honest conversations here.
00:31:18 Don Weinberger
Couldn’t agree more.
00:31:20 Don Weinberger
And today’s claims had one big thing in common.
00:31:24 Don Weinberger
Real concerns deserve real answers and not dismissal.
00:31:28 Steve Small
I agree.
00:31:29 Steve Small
Patients should have questions about their medications and we want our patients to be engaged with their therapy.
00:31:35 Steve Small
So vaccine safety has learned a lot from its past as we talked about.
00:31:40 Steve Small
And today’s evidence doesn’t support fears about things like aluminum, fertility, or immune overload.
00:31:46 Don Weinberger
So those questions, meet patients with empathy and give the evidence a shot.
00:31:52 Don Weinberger
When patients still have doubts, keep that door open.
00:31:56 Don Weinberger
A patient who comes back is a patient we can still protect.
00:32:00 Steve Small
That’s great.
00:32:00 Steve Small
And now that we’ve given you a booster of evidence, claim CE credit and access evidence-based resources from Pharmacist’s Letter, Pharmacy Technician’s Letter, or Prescriber Insights.
00:32:11 Don Weinberger
If you’re not yet a subscriber or want to upgrade, you can save 10% with our exclusive listener code, RVT1026 at checkout.
00:32:20 Don Weinberger
Easy link in the show notes.
00:32:22 Steve Small
And if you’re already a subscriber, tap the claim credit link in the show notes or search your CE organizer for this episode.
00:32:29 Don Weinberger
Okay.
00:32:30 Don Weinberger
You have a vaccine question or a story about a tough conversation at the counter, send us a message.
00:32:36 Steve Small
E-mail us at [email protected] or click the send us a fan mail link right at the podcast show notes.
00:32:44 Don Weinberger
We also use your suggestions, feedback, and questions to plan future episodes.
00:32:49 Steve Small
For example, you’ve probably gotten questions about whether mRNA vaccines change your genome.
00:32:54 Steve Small
We address this in a Rumor vs Truth article about vaccines in our October 2026 issues of Pharmacist’s Letter, Pharmacy Technician’s Letter, and Prescriber Insights.
00:33:03 Steve Small
So check it out.
00:33:04 Steve Small
And join us for our next episode where we’ll look into burning claims behind meds for gastroesophageal reflux disease or GERD.
00:33:12 Don Weinberger
Yep, just in time for those big holiday meals.
00:33:16 Don Weinberger
And warning folks, some of those claims might get spicy.
00:33:19 Don Weinberger
Thank you for joining us today on Rumor vs Truth, your trusted source for facts where we dissect the evidence behind risky rumors and reveal those clinical truths.
00:33:28 Steve Small
We’ll see you next time.
Rumor vs Truth
