From the desk of Dr. Gupta

In today's highly segmented media world, most of the people who watch and listen to me every day on CNN have already received and accepted the message about the utility of vaccines, the importance of masks and how we can all work together to put an end to this pandemic. So I realized that if I was serious about trying to communicate public health, I needed to go to a less comfortable place. I needed to go into the lion's den and accept an invitation to sit down with Joe Rogan, a popular and controversial podcast host, for more than three hours.     Many friends cautioned me against accepting Joe's invitation. "There is little room for reasonable conversations anymore," one person told me. But Joe Rogan is the one guy in the country I wanted to exchange views with in a real dialogue -- one that could potentially be among the most important conversations of this entire pandemic.    So, it turns out that Joe Rogan says he nearly got vaccinated. That was a headline. It was a few months ago when he was in Las Vegas. He had an appointment scheduled but had logistical hurdles and couldn't make it. He offered up this story as proof he is not necessarily "anti-vaccine," even if he does consistently raise issues questioning their legitimacy.    Despite a downplaying of Covid risks often heard on Joe's podcast, his private studio prioritizes safety. A nurse was present to perform a rapid Covid test before we began. We were even checked for the presence of antibodies with a finger prick blood test.    Both of us carried antibodies -- his from natural immunity, mine from the vaccine. I was vaccinated in December of last year and Rogan contracted Covid at the end of August. Even though this antibody test could only detect the presence of antibodies and not their strength, Joe took great pride in his test, insisting the thickness of his lines must mean stronger immunity. I am fairly certain he was joking. And, I didn't have the heart to tell him that my antibody line was significantly thicker than his anyway.    It bears repeating that no one should choose infection over vaccination. That is the concern many public health officials have had since the earliest days of the pandemic. If nothing else comes out of my conversation with Joe Rogan, I hope at least this point does. Far too many people have become severely ill and died, even after the effective vaccines became available. Just in the last three months, there have been more than 90,000 preventable Covid-19 deaths in the US among unvaccinated adults, according to a new analysis by the Kaiser Family Foundation.    At the same time, an Israeli study garnered a lot of attention after it appeared to show that natural immunity offered significant protection -- even stronger than two doses of the Pfizer/BioNTech vaccine in people who had never been infected.     So the question Joe raises, as do many others: Why should those who have previously had Covid still get the vaccine? It's a fair question, and one that I raised myself with Dr. Anthony Fauci back in early September.     One issue with natural immunity is that it can vary substantially based on the age of the individual and just how sick they got in the first place. Milder illness in older people often resulted in fewer antibodies being produced.    Some studies have shown between 30 and 40% of people who have recovered from Covid did not have detectable neutralizing antibodies at all. That probably explains why a recent study showed that unvaccinated people who already had Covid were more than twice as likely to get reinfected as those who had also been vaccinated.    I told Joe that even in the study from Israel, the authors concluded with the recommendation that people who had recovered from Covid still get a vaccine. It showed, as did several others, that people who got naturally infected and then vaccinated, too, had the strongest immunity.    And when Joe pushed hard on the risk of myocarditis in kids who receive the vaccine, especially young boys, I countered back equally hard that the risk of myocarditis has been shown to be much higher for infected children under 16 years old compared to their uninfected peers. Those numbers dwarf the risk of myocarditis in kids who receive the vaccine (and, to be sure, most cases of myocarditis can be treated without hospitalization). For me, the risk-benefit analysis is clear: Vaccination is safer than infection.    I guess a small part of me thought I might change Joe Rogan's mind about vaccines. After this last exchange, I realized it was probably futile. His mind was made up, and there would always be plenty of misinformation out there neatly packaged to support his convictions. Truth is though, I am still glad I did it. My three-hour-long conversation wasn't just with Rogan. If just a few of his listeners were convinced, it will have been well worth it.