A Breakdown of Vaccines - Understanding the Building Blocks with Dr. Ryan Hassan
Meet Boost Oregon's medical director, Ryan Hassan, M.D. Dr. Hassan is a pediatrician in Happy Valley, and he will appear frequently to answer your questions.
In this episode, Dr. Hassan talks about vaccination and the COVID Vaccine. If you have any questions for Dr. Hassan, email or send a voice message to boostingourvoices@gmail.com. Your question may be answered on a future episode!
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Our Host
Ari O'Donovan
Our Guest
Medical Director Ryan Hassan, M.D., M.P.H
Ryan Hassan, M.D., M.P.H., is a board-certified pediatrician working at Oregon Pediatrics in Happy Valley, where he lives with his wife, Christen, daughter, Olivia, and chihuahua, Luna Joe. His professional work centers around improving the lives of children by promoting preventive healthcare and healthy lifestyle choices at the individual and community levels and by empowering physicians to become better advocates for their patients. Dr. Hassan is an avid outdoors enthusiast and enjoys running, biking, swimming, hiking, backpacking, climbing, snowboarding, and kite surfing.
Transcript:
Ari O’Donovan (00:00):
Thank you so much for listening to boosting our Voices. This program has been brought to you by Boost Oregon. You can find them online@boostoregon.org.
Ryan Hassan (00:13):
We figured out ways to more precisely figure out the antigen. We need the protein that stimulates immune response that we need in order to become immune to a disease and we found better and better ways to isolate that antigen and deliver it to the human body safely.
Ari O’Donovan (00:31):
Welcome back everyone. This is another episode from the Boosting Our Voices podcast. As always, we are here to amplify Bipo voices and bring topics to the community that Bipo people wanna know about. I have Dr. Ryan Hassan here and he is part of Boost Oregon. As our medical director, Ryan can introduce yourself and tell us a little bit about what you do and what you do for Boost Oregon.
Ryan Hassan (01:02):
Sure. Hi everyone. My name's Ryan. I am a pediatrician. I work at a private practice clinic in Happy Valley where I live with my wife, our 16 month old baby Olivia and my Chihuahua Luna. And I've been volunteering with Boost since I moved to Oregon back in 2017 because one of my passions is public health and helping people translate the science of medicine and public health information into information that's usable and useful. So vaccine advocacy is always been a big part of what I do in my clinic and it was great to be able to expand on that work with Boost. And as of January of this year, I was able to become the medical director for Boost Oregon, which has been a fantastic opportunity. So now I take a much larger role in helping create design and edit content for the workshops and presentations we provide for community members and the trainings we provide for health professionals and community workers. So it's been a really fun opportunity so far and I've been really enjoying it.
Ari O’Donovan (02:13):
We are so happy to have you Ryan, and it's really been amazing working with you so far. I know we have a lot of new projects and everything coming up, so I'm excited for all of that. Now I'd like to get into a question that I know a lot of listeners have. A lot of people who are listening may have been mistreated or neglected by a medical professional in the past. I know I've had that experience going to the hospital at least once or twice and it, it's never a very fun experience. It's never, it leaves you really questioning what's going on in the medical industry to have this happen. And though we can't entirely change the medical industry right now, how can we best advocate for ourselves and our kids at medical appointments?
Ryan Hassan (03:01):
Well, that's a really good question. So I think there's a lot of things that I think are important to keep in mind when we're talking about equity in healthcare and how to get the best outcomes for ourselves and for our loved ones. You know, I've been on both sides of this. I've been treated differently because of my race and I've also inadvertently provided differential care to people based on race. And it was without meaning to or knowing that I was doing it because there are a lot of structures in our institutions that we rely on and systems that we rely on that are inherently prejudicial against people based on their backgrounds and their race that we aren't always even aware of. So I think it's important to keep in mind that all of us can be potentially guilty of treating people differently based on their background, based on their, their race or ethnicity, even when we have the best intentions.
Ryan Hassan (03:59):
And it's not to say that this is something we need to carry with us as a means of feeling guilty, but rather just that there's always room to learn where we can improve and where we can make better care or provide better care for the people we care about. And that's true for me as a healthcare provider as much it is, is for anyone in any other field or in the community at large. I think the best way to advocate for yourself is to keep that same idea in mind that all of us, or in general, I think the approach I take is that assuming that everyone is working with the best intentions and is trying to do their best to create a better world for all of us and that when things aren't really going as we'd like them to, that it might not be because of malice or because of mal intent, but maybe because someone just doesn't have the information that they need.
Ryan Hassan (04:53):
So trying to keep an open mind and work with people where possible, it's definitely important to approach a medical a visit as a collaborative experience where you know, a patient and a healthcare provider are able to discuss their shared health goals and how to achieve those. That's how the approach I try to take with my patients. I think it's much more effective to and much easier to achieve the health outcomes we all want if we are working together. Rather than having say me as the expert telling you as the patient, these are the things you need to do to be healthy. Instead saying, okay, what are your health goals? What would you like to achieve and how can I help provide guidance to get you there? So it's much more of a dynamic collaborative process and a recognition that, you know, I have a certain expertise in medicine as a provider, but each of my patients has their own expertise in their own interests, their own values, their own life. And so really harnessing the knowledge that everyone brings to the table in those decisions. And I would encourage people to find healthcare providers that adopt that or a similar type of, uh, of view in patient care.
Ari O’Donovan (06:08):
I think that's really important to keep in mind. You are definitely an expert in your field and other medical professionals and doctors out there are too. But when it's a collaborative effort between you and your patient, that person can have way more of a say so about their own health, more agency, all of that. And that's the kind of thing that people really wanna have and they wanna hope that they'll come across a physician or a medical professional that's gonna treat them with respect and listen to them and realize that they know a lot about their own experience.
Ryan Hassan (06:44):
I think that's exactly right and that's often where the disconnect comes in my experience in the stories I've heard from people who felt they've had poor experiences in healthcare setting, it's this sense that they're not being listened to. And this can happen even when the providers have the best intentions, they are trying to listen to their patients If they're not taking this collaborative approach, it doesn't matter how good of a job you do of listening if your patient doesn't feel like they've been heard and if you're not actually able to understand their perspective and their own values, um, because they're not necessarily the same as the provider's values.
Ari O’Donovan (07:23):
Yes, being a medical professional is more than just diagnosing patients, especially when bipo community members come into an appointment or interact with the medical field in some kind of way. Many of them already have knowledge about past public health failures, medical failures, governmental failures. One of the biggest examples is the Tuskegee study and people come in knowing that. So they already have some of these walls put up and it's really important that you can just make them feel like you have really good information, they can trust you, you can trust them, and it's a collaborative effort and their health matters to you.
Ryan Hassan (08:06):
And I think, you know, you mentioned like the Tuskegee trials, I think there's a lot of families who are gonna be, you know, especially black families who are gonna be more knowledgeable about that and have more direct experience with those types of injustices than a lot of providers will. And I think, you know, it highlights the fact that there is a lot that we can benefit from as healthcare providers when we listen to our patients. We can really learn a lot from the lived experience of the people we care for. And I know, you know, some of the things that are most important to me in the way I practice in medicine now are things that I've learned from other patients I've, I've worked with over the years. And so I think it really is a key to not only providing better care, but to improving the way that we provide care in the future.
Ari O’Donovan (08:57):
I agree. I'd love to see a greater and greater shift in making it more of a collaborative effort between medical professional and patient. I think that would improve things greatly because any given patient is always going to be an expert on their own lived experience. And when I go out and do diversity outreach for my job at Boost Oregon, I always go out with the understanding that I know a lot about what I do, but I don't know anything about anyone until they give me a little bit of their time to share some of their life with me. And I wanna learn as much as I can. You're always able to learn something new from someone, an individual about their specific lived experience in any case.
Ryan Hassan (09:44):
Yeah, I totally agree. Yeah, I think that's perfectly said.
Ari O’Donovan (09:48):
Thank you Ryan. Now I'm gonna make a slight shift and it's kind of a larger question, but maybe you can truncate it for us just a little bit. Can you give listeners a brief history of vaccines?
Ryan Hassan (10:01):
Sure. So a vaccine is basically a way that we are able to safely expose ourselves or our loved ones to a antigen that allows our bodies to become immune to that antigen and thereby become immune to a disease that has that antigen on it. So the simplest vaccines weren't really vaccines rather inoculations were back in early, you know, first century BC or so or AD or so and in in China and and India and Africa where people would take the pules of patients with smallpox and either rub them into their skin or inhale them through their nose to get some exposure to a small amount of this disease and it would allow them become immune to the disease. And that actually worked really well to reduce the burden of that disease. It wasn't very safe. A lot of people still got sick and died from that, but it did save a lot of lives by reducing the severity of the disease and how much it spread.
Ryan Hassan (11:03):
But then the first actual vaccine developed centuries later, this was the smallpox vaccine when we discovered we could use the cowpox virus to inoculate us and make us immune to the smallpox virus that affects humans. So that was kind of the first real vaccine. And then after that we kind of just through gradual step by step iterative processes, we figured out ways to more precisely figure out the antigen. We need the protein that stimulates immune response that we need in order to become immune to a disease. And we found better and better ways to isolate that antigen and deliver it to the human body safely. So we're still achieving the same goal of giving you an antigen that your body can recognize and attack and create an immune response to so that you can later defend against the disease with that antigen on it. But now we can do that with more modern vaccines that have either completely inactivated and dead germ or a only a part of the germ that we need, just the protein rather than the whole virus or a weakened version of it. Or now with mRNA vaccines with just the code for the antigen that we can make ourselves and then create an immune response to. So that's essentially how vaccines have evolved from where we started, where we are now. The bottom line is over the last several decades and especially they become much more safe and much more reliable. We become a lot better at being able to make vaccines that don't require us to expose ourselves to people who are sick or snort some s smallpox scab up our nose.
Ari O’Donovan (12:46):
That's really amazing. Vaccines have come such a long way and there are so many vaccine preventable diseases that some of which are like almost nonexistent because of vaccines.
Ryan Hassan (13:00):
Yeah, I mean and smallpox, I mean is a, this is a great example cuz that is nonexistent. It doesn't exist in the wild at all anymore because we've been able to eradicate through vaccination and yeah, many others are much closer to eradicated and hopefully one day we might be able to get rid of many more. They've really done more than anything else to allow us to actually reduce the burden of these diseases that used to be, you know, the most common causes of morbidity in, in especially our children.
Ari O’Donovan (13:29):
I really look forward to seeing more diseases eradicated over time due to more advancements in vaccine development, more people getting vaccinated. I think that's really important as you mentioned for kids, for families, for everyone, for the elderly, for everyone. So I really look forward to seeing that. You shared a little bit of information about this, but maybe you can go into just a little bit more detail. How do more modern vaccines work?
Ryan Hassan (14:00):
Yeah, so there's a few kind of main categories of vaccines that I like to think of. And this is well summarized on the um, vaccine education center from the Children's Hospital Philadelphia. They've got a great website, just chop.edu/vaccines. I love referring there to helpful information. But the ways that I like to think about vaccines is there's what's called the live attenuated vaccines. These are things like MMR and varicella, just the chicken pox vaccine. These are vaccines made by taking the vaccine and growing it in different media, usually different animal media to grow it over multiple generations. So it becomes better at infecting other types of animal cells, which in turn makes it not as good as infecting human cells. And so what we've done with this process has created the, for example, MMR vaccine that is now, it's the same viruses of measles mums and rubella, but they've been grown and selectively bred, you could say, to forms that are not able to replicate more than maybe 20 times in the human body.
Ryan Hassan (15:07):
So they cannot cause any kind of serious infection, but they still look the same on the outside. So they still create the same immune response. So I think that one is easiest to understand with the analogy that I learned from Dr. Joel sson, which is that it's kind of like what we've done with wolves breeding them over many generations to create puppies which we can keep in our homes. It's the same species but we just gave 'em all the love and attention they needed and selected for the ones with the traits that we wanted. And now you know, you can keep the same species that you know is the gray wolf that you wouldn't want anywhere near your baby. You could keep the pet dogs that we have in our homes all the time. The other way of making a vaccine or one other way of making a vaccine is to inactivate a virus and have a, what's called a killed virus vaccine where you just take the virus, you kill it and then you can inject it into someone where it doesn't cause infection but it can still lead to an immune response.
Ryan Hassan (16:02):
The third way of making a vaccine is by inactivating a toxin or taking part of the virus or bacteria. So a protein or a sugar from the germ itself and only using that part. So that's for example, how the HPV vaccine works. We just use the protein from the virus rather than the whole virus. And then the fourth and most newest way of making a vaccine are the mRNA vaccines. And that's where you create the genetic code you need to create just the antigen that you need to make. And then the body is able to make that antigen, that protein without making any of the rest of the virus that has the advantage of not requiring you to have any kind of part of virus or bacteria. You don't have to have any yeast or anything that you need to grow, you just create the mRNA and then you inject it in the body and the body does the whole job itself, which is much more convenient in many ways.
Ari O’Donovan (16:55):
That's really amazing and I think it's something worth noting that whatever the form of vaccine, they're very safe, they are made with a lot of care, they're monitored and they're not just distributed to the public without being tested without a lot of information gathered before they're released. When they're released and after for safety regulation.
Ryan Hassan (17:24):
Right. They're more well studied than any other medicine that we use. The FDA has to vet and approve them before they can be on the market. So you know, if you trust that the foods in your supermarket are safe to eat, which I hope you do because that's where I get most of my food. You know, vaccines are regulated by the same body except that they have more stringent regulations than our foods do. They're more strictly regulated than medicines that we take and especially more regulated than alternative medicines. And the health supplements which have very few restrictions by comparison, so very closely monitored, deliberately created with only the ingredients necessary to create the immune response. And of course all the ingredients in vaccines are deliberately chosen to be things that our bodies are able to handle easily. And in fact generally other than the antigen itself, most of the other components of the vaccine are things that are found in foods and and drinks that we consume every single day.
Ari O’Donovan (18:27):
Thank you for sharing that information Ryan. I think that's really informative for people that may still be hesitant about vaccines. I know that when you've shared that information in presentations, when I've shared some of that in presentations I've given, a lot of people don't know that and especially with the supplements too because you think, oh I'll just take some vitamin C, that's fine. Nobody thinks that it's not very heavily regulated by the FDA at all, not like vaccines are
Ryan Hassan (18:56):
Right. I would trust a vaccine to have what it's supposed to have far more than I would ever trust anything I find in a, you know, health supplement aisle or in a vied shop because they are um, you know, notoriously under-regulated Now not to say that they're, you know, generally unsafe, but they certainly don't have the same level of scrutiny, you know, where the FDA is continuously monitoring and going and doing site visits at vaccine manufacturing plants to make sure that safety and safe processes are monitored in continuing as long as the vaccine's on the market.
Ari O’Donovan (19:32):
Exactly. And I feel like that's become even more important ever since the covid 19 pandemic began and vaccines became available to the public. I remember the days of being told, wear a mask everywhere, don't gather in large groups at all. It got to a point where they were encouraging people not even to walk in small groups in public parks or anything like that. So we've come a long way. It's due to covid 19 vaccines. So can you tell us what makes the COVID 19 vaccines different from the others you mentioned?
Ryan Hassan (20:09):
Sure. I think the biggest thing for most people is the fact it's an mRNA vaccine. So the Pfizer and Moderna vaccines the most commonly administered ones, they're the first mRNA vaccines licensed for use in humans. But this is a technology that's been in use and studied since the nineties and so it, it's very well understood and the way it works is really not very different from other vaccines. The most crucial parts are the same. Your body sees an antigen, it makes an immune response to that antigen and then gets rid of it and then you have immunity to the disease. The difference is instead of giving the antigen directly, like injecting for example an inactivated tetanus toxoid into your body, we give you the mRNA that would be on the virus so that your body sees that and makes the protein itself and then gets rid of the protein the same way it normally would.
Ryan Hassan (21:07):
So this is what would happen if you got infected with the virus. Your body would see the virus, see the viral mRNA use it to create a bunch more viruses and that's how you get an infection. The difference is this mRNA only codes for the protein we need. So you can't make the whole virus so you can't get sick. Your body's able to translate countless strands of mRNA every day. It does so regularly from our own DNA and from genetic material from other viruses and bacteria that we're routinely encountering just, I mean right now as I'm speaking. And we're able to handle that, eliminate them from the body without any issues. So it's a process our bodies are intimately familiar with. I think the other main kind of difference with the covid vaccine is the fact that it was made in a pandemic. So it was expedited very much more than you would expect for a vaccine that for something like malaria, which you know, we're working on in a much longer timeframe with the pandemic that required that we get this done as quickly as possible.
Ryan Hassan (22:07):
And so a lot of people I've talked to have expressed concerns that well maybe this means that were some corners cut or was this a rushed job? And of course that's not true. All of the same steps that are required for any vaccine to be licensed in the US were followed with the Covid vaccines. The difference is that we had billions of dollars uh, funneled toward this project that allowed us to get it done quickly. And there are some other factors but I think that's the biggest one is that we had the money and the public willpower to say we want this vaccine, we need to save people's lives now so we need to create this as quickly as possible. And that allowed the pharmaceutical companies developing it to go through all the phases of research and trials and manufacturing much more quickly without having to do a cost benefit analysis at each stage cuz we had the money to get it done. So I think the biggest lesson there for me is the fact that if we had the level of public and political willpower as we did with Covid, if we had that level of commitment to cure and treat other infectious diseases and other health melodies of all kinds, I think we could make a lot more medical marvels much more quickly.
Ari O’Donovan (23:21):
Man that makes me think of so many diseases that don't have cures, don't have vaccines or anything like that. If we just have the same amount of resources we could develop vaccines and perhaps cures for so many diseases.
Ryan Hassan (23:36):
Yeah, it's a nice thought to think about and maybe we'll learn a lesson from, you know, what we've seen with Covid and one day shift our priorities a bit. But yeah, I think there is a lot of possibility. There's a lot of things we could do, especially now that we have, you know, the ability to make MR and a vaccines, there's you know, so many new diseases I think we could eradicate and not have to deal with anymore with the use of this and other technologies that we just need some money to fund.
Ari O’Donovan (24:06):
Absolutely. I know the HPV vaccine is a cancer prevention vaccine, so like the foundation is there, we just need more resources, more people and more time invested.
Ryan Hassan (24:19):
That's a great point too. I mean you can get two shots and you are protected from cancer. That's revolutionary. It's better than a cure for cancer, it's a prevention of cancer. It's one of the most understated achievements of modern medicine that we have now found a way to keep people from getting certain kinds of cancer. Like that's incredible And I think there's a lot of room to build on those types of successes.
Ari O’Donovan (24:46):
There really is. There absolutely is. And we've seen so much of that with the covid 19 vaccines and it's different from the vaccines that you mentioned earlier, but not so much. It's really just building off of foundational research that was already there.
Ryan Hassan (25:04):
I mean the, the key component is the same. You know, you just, you get a shot so your body learns how to protect itself from this deadly virus and then you don't have to worry about it as much anymore.
Ari O’Donovan (25:15):
Absolutely. I know when I do community outreach I hear from a lot of people that the Covid 19 vaccines were rushed and so I don't want something injected into my body that was rushed and nobody knows how it's going to affect you and it's new technology and and then I try to give some information after I make a connection with these people, whoever I'm speaking to that it's not really new, it's just technology that's building off of already widely used, regulated and safe technology.
Ryan Hassan (25:49):
Exactly. So I think, you know, it's normal to be a little more concerned and not really, you know, confident about something we're not as familiar with. But I think you know, the information, the data, it's all there and you know it's freely available for people who want to take the time and labor to try and sift through it all. But I will say, you know, I have spent a great deal of time looking through, you know, how this all works and understanding how it works and I have no concerns about, you know, the covid vaccine more so than for any other vaccine. We have more than enough data to know that they are very safe and they work very well and that's why they continue to be available and it's why we've managed to curb the levels of K cases so much since the vaccine became available.
Ari O’Donovan (26:34):
Absolutely right And that's why Boost Oregon exists in part to get this information out there with care and understanding of people's hesitancies. That's why we're here. Can you tell me now, are Covid 19 vaccines available for younger kids and how young if so?
Ryan Hassan (26:54):
Yeah, so earlier this summer that the vaccine finally became available for our youngest age groups kids six months and up, which was really exciting to me because my baby Olivia is now 16 months old so she was in the six month to five year age group so we were eagerly waiting for that approval. So now she's gotten her first two doses of the Pfizer vaccine and we'll get her third in October. So that was really nice. So yeah, I think this is really great news now. Really pretty much any parent, if your child is over six months, they are eligible for the vaccine and would benefit from it. And so yes, everyone can get it now over six months and I would recommend it to everyone. It's a great way to just add an extra layer of protection for your children as well as for the people there around.
Ryan Hassan (27:44):
So really good news. You know the thing that worried me the most about Covid before the vaccine was, you know, I know that my baby's not at high risk for serious complications cuz it does, Covid tends to be worse in older kiddos and adults. But I mean for one, I don't really care how low the risk is. If it's an unnecessary risk, I don't want to take it. I don't think I'm gonna get in a car crash the next time I go for a drive, but I'm gonna make sure my baby's seatbelt and car seat are appropriately buckled. It's something where you're much better off taking the precaution than not. But the other thing is, you know, I worried more about things like long covid, which is much more common and can be quite annoying. I've seen that a lot in many of my patients and that was something I wanted to really try to protect my baby against. And then of course the added benefit of having her more immune so we can more safely visit some of my family who are more at risk. My grandmother who is 84 now, who I hope to be able to see over the holidays again, it'll be nice to do so with all of us having had an extra layer of protection so that we're minimizing as much as we can. Her risk of you know, a potentially varied what could be for her, a very dangerous infection.
Ari O’Donovan (28:56):
Isn't that amazing? I'm so happy to hear that you will be gathering with your family. I plan to do the same with my mom. She's 72 and we were all afraid to do that prior to covid 19 vaccines because we didn't want to introduce a disease that could be potentially lethal or at least cause very serious complications being admitted into the hospital. All kinds of things that you would never wanna see with a loved one that is an older person especially.
Ryan Hassan (29:28):
It is a gift I think to be able to be in this position where we have the ability to more safely protect people and and not have to worry so much about, you know, getting it together and spending time, time together. So I'm definitely very grateful to all the people who worked so hard over, you know, those first 10, 11 months especially. But even since then in developing this technology, testing it and to the thousands of people, tens of thousands of people who signed up to volunteer for the trials that were required to get these vaccines tested and licensed, it was really a huge collaborative effort by the parts of so many hundreds of professionals and experts and tens of thousands of everyday people who just decided to contribute to this project. So I'm always, I think, very grateful to the work that has been done by so many people worth this one collective goal of trying to help get us as a global society through what has been the worst pandemic in a hundred years.
Ari O’Donovan (30:34):
Yeah, so many people played such an important role in getting us to where we are now, kind of seeing the pandemic improve and be at the best state that we've seen it since it happened. Congratulations on your daughter being vaccinated. She's cute as can be as well. Yeah,
Ryan Hassan (30:54):
She is quite adorable. She handled her shots very well, No side effects. So that was nice. I was hoping she might be a little fatigued the next day so we could have a longer nap, but um, but she wasn't, we still had a very rambunctious day. But that's fun too.
Ari O’Donovan (31:09):
These moments are so special. Thank you for sharing with us, Ryan. A little bit about yourself, all this great information you gave us about vaccines, Covid 19 vaccines, the availability of Covid 19 vaccines for Kids. It's always great to have you as a guest and I look forward to talking to you more on boosting our voices.
Ryan Hassan (31:31):
Yeah, thanks for having me. It was a lot of fun.
Ari O’Donovan (31:37):
Don't be a stranger. Email us or send us a voice memo at boosting our voices@gmail.com with your health related questions. Your questions may even be featured on an upcoming podcast episode. Follow Boost Oregon on Instagram, Facebook, Twitter, and TikTok. You can find all of our social media and our website information in the show description below. Until next time, thank you for listening and be well.