On Breakthrough, a new series from the Prognosis podcast, we explore how the pandemic is changing our understanding of healthcare and medicine. We start with an examination of long Covid, a mysterious new illness that has stumped doctors attempting to treat symptoms that last for months and potentially years. It has changed the way hospitals work and forced healthcare officials to prepare for the next pandemic. Covid has also opened the door to revolutionary technology: messenger RNA vaccines. It’s a technology that never could have been proven so quickly outside the crucible of that first pandemic year, 2020, and it holds big implications for the future of medicine. Breakthrough launches on Oct. 19. Subscribe today on Apple Podcasts, Spotify or wherever you get your podcasts.

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Demographics alone would suggest Bradley County, Arkansas, should be struggling fiercely with local resistance against vaccines, just as many other counties are all across the southern U.S.

Yet in July, Governor Asa Hutchinson announced that Bradley was the first county in Arkansas to inoculate at least half of its eligible population. At the time, that was more than twice the rate of several other Arkansas counties.

In this bonus episode we head to Bradley County to find out what’s going on. The answer provides a case study on how to combat pockets of vaccine skepticism.

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In our final episode of the season, we look at where vaccine hesitancy stands in America today. More Americans are getting vaccinated every day, but the numbers of skeptics are still high enough to seriously threaten efforts to achieve widespread immunity and end the pandemic. The answer to solving that problem, though, may be an attitude adjustment from public health.

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We meet Dr. Timothy Sloan, a pastor of a black church in Texas, who is torn over how to talk to his congregants about the Covid-19 vaccines. He is skeptical about getting one, and knows the rest of his church is, too. But, the vaccines could also be a lifeline. Black Americans have died at about twice the rate of white Americans from the virus. So while there may be trust issues with the vaccines in communities of color, they’re also the communities that need vaccines the most. Dr. Sloan goes on a journey to find out who can help him learn more about the vaccines, and how the medical establishment can win back some of the trust it has lost over generations of mistreatment.

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In October 2020, anti-vaccine elite gathered for a conference to discuss, among other things, how to use the pandemic to grow their movement. In this episode, we travel inside the world of anti-vaccine extremists to show how they weaponize uncertainty and mistrust to spread rumors about vaccines — rumors that threaten to prolong the global pandemic.

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The 2015 Disneyland measles outbreak was a pivotal moment in explaining the vaccine hesitation we see today. The outbreak made clear that number of people opting out of vaccination was significant. But it also changed the people protesting vaccines. Before that, activists speaking out about vaccines had mainly been parents concerned about the safety of their kids. California's push to get rid of vaccine exemptions in the wake of the outbreak changed the conversation. It became political. It became about choice and freedom and democracy.

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Meet the man behind all the myths: Andrew Wakefield. Wakefield’s retracted 1998 study linking autism to vaccines helped kickstart the modern vaccine hesitancy movement. We’ll explore the forces that helped propel Wakefield into the spotlight and show how groundwork Wakefield laid decades ago helped seed the mistrust we’re seeing in the age of the coronavirus.

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In the series premiere of "Doubt," we meet Jon, a New York City paramedic struggling to decide whether he should get vaccinated. Bloomberg health reporter Kristen V. Brown shows how the pandemic has led many people like him to question vaccines for the first time — and how this distrust threatens to prolong the pandemic.

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This month marks the one-year anniversary in the U.S. of nationwide school closures. The public health measure was designed to help stem the spread of Covid-19. But in doing so, it’s had a profound effect on children. That’s in contrast to the disease itself, which rarely makes young people seriously ill. Jason Gale talked to experts about kids and Covid, and why keeping children out of the classroom may leave a lasting legacy.

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Fast-moving variants of the coronavirus seen in England, South Africa and Brazil have sparked concern around the world. Researchers worry some may diminish the potency of existing vaccines and complicate efforts to escape the pandemic. As COVID-19 cases started to climb in early 2020, British scientists decided to track the evolution of the pathogen. James Paton reports that this project gives the country and others the chance to respond quickly if alarming changes arise.

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