Dr. Jay Bhattacharya on COVID, Myocarditis, and Vaccines

Summary

The transcript discusses the complex issue of vaccine efficacy and safety, particularly focusing on COVID-19 vaccines. It emphasizes the importance of evaluating risks and benefits based on age groups, noting minimal benefits for children due to low COVID-19 mortality rates. The discussion also addresses concerns about vaccine side effects, such as myocarditis in young men, and the ethical challenges of conducting randomized vaccine trials. Furthermore, it touches on the broader topic of childhood vaccination schedules, the debunked autism-vaccine link, and the benefits of live attenuated vaccines beyond their intended targets.

Takeaways

• 🤔 The speaker discusses the complexity of assessing COVID-19 vaccines, particularly for younger individuals, due to the low mortality risk and potential side effects like myocarditis.
• 💉 The speaker and Martin Korf co-wrote an op-ed recommending against COVID-19 vaccination for younger people based on the small benefit-to-risk ratio.
• 🧬 There is evidence suggesting a higher risk of myocarditis in young men post-vaccination, which is a significant concern in the vaccine decision-making process.
• 👶 For older populations, the risk-benefit analysis leans more towards vaccination due to higher mortality risks associated with COVID-19.
• 📉 The effectiveness of COVID-19 vaccines in preventing symptomatic infection declines sharply after two to three months, indicating limited long-term protection.
• 🤒 COVID-19 itself can cause myocarditis, but the speaker suggests that the risk from the vaccine may be higher for young men than the risk from the virus.
• 🧬 The discussion moves to childhood vaccines and the speaker's personal journey of understanding vaccine skepticism, including the debunked claim that vaccines cause autism.
• 🏥 Large-scale epidemiological studies have found no correlation between the MMR vaccine and autism, contradicting earlier, smaller studies with flawed methodologies.
• 🛡 The speaker emphasizes the importance of vaccines in preventing serious diseases like measles, mumps, and rubella, and the ethical challenges of conducting randomized control trials for vaccines.
• 🌐 The concept of herd immunity is highlighted, where individual choices not to vaccinate can rely on the protection provided by the majority who do vaccinate.
• 🛡 Live attenuated vaccines, unlike non-live vaccines, have been shown to reduce overall child mortality from a variety of diseases, not just the targeted ones.

Q & A

What is the main concern raised about the COVID-19 vaccines for young people, especially children?

The main concern is that the benefit of the COVID-19 vaccine for young people, especially children, is very small due to their already low mortality risk from COVID-19. This makes the potential side effects of the vaccine a significant consideration, possibly outweighing the benefits.

What was the reasoning behind recommending against younger people taking the COVID-19 vaccine in an op-ed in The Hill?

The reasoning was based on the low mortality risk of COVID-19 in young people and the evidence of high rates of myocarditis, a heart inflammation, in young men who received the vaccine.

How does the risk of myocarditis from the COVID-19 vaccine compare to the risk from the actual virus for young men?

For young men, the risk of myocarditis from the COVID-19 vaccine is considered higher than the risk of myocarditis from the virus itself, especially since the benefit of vaccination for this group is minimal.

What is the general recommendation for older people regarding the COVID-19 vaccine?

The general recommendation for older people is to take the COVID-19 vaccine due to their higher risk of severe illness or death from the virus, which can be significantly reduced by vaccination, outweighing the potential risks.

What should one consider when evaluating the risk and benefits of a vaccine?

One should consider the individual's age, health status, the disease's mortality risk, the vaccine's efficacy in preventing the disease, and the potential side effects or risks associated with the vaccine.

What is the controversy surrounding the MMR vaccine and autism?

The controversy started with a small study published in The Lancet that suggested a correlation between the MMR vaccine and autism. However, subsequent large-scale epidemiological studies have found no such correlation.

Why is it considered unethical to conduct a randomized control trial for the MMR vaccine by intentionally not vaccinating some children?

It is considered unethical because it would expose children to the risk of measles, mumps, and rubella, diseases that can cause serious harm or death, especially when there is a widely accepted belief among medical professionals that the vaccine is effective and beneficial.

What is the concept of 'herd immunity' in the context of vaccination?

Herd immunity is the indirect protection from infectious diseases that occurs when a large percentage of a population has become immune to the disease, either through vaccination or previous infections, thereby reducing the likelihood of the disease spreading.

What is the difference between live attenuated vaccines and non-live vaccines?

Live attenuated vaccines contain a weakened form of the live virus that can still replicate inside the body, providing a mild form of the disease and immunity. Non-live vaccines, on the other hand, are made from inactivated or subunit parts of the pathogen that cannot replicate, stimulating the immune system to recognize the pathogen without causing the disease.

What additional benefits have been observed with live attenuated vaccines beyond the diseases they are intended to prevent?

Some studies have shown that live attenuated vaccines, such as the oral polio vaccine, can reduce the risk of mortality from other diseases not targeted by the vaccine, a phenomenon not observed with non-live vaccines.

What is the importance of considering the marginal benefit of vaccination in a largely vaccinated population?

The importance lies in understanding that the individual benefit of vaccination in a population with high vaccination rates may be small due to herd immunity, but the collective benefit in preventing outbreaks and protecting vulnerable individuals is significant.

Outlines

00:00

🤔 Vaccine Hesitancy and Risk Assessment

The speaker begins by addressing the complexity of the vaccine debate, particularly focusing on the COVID-19 vaccine. They emphasize the importance of evaluating the benefits and risks of vaccination, especially for different age groups. For young people and children, the mortality risk from COVID-19 is low, making the benefits of vaccination minimal and potentially outweighed by side effects like myocarditis. The speaker and Martin Korf had previously advised against vaccinating younger individuals based on this rationale. The discussion also touches on the importance of a balanced view, cautioning against alarmist or biased perspectives on vaccine risks.

05:02

🧬 Vaccines and Myocarditis Risks

This paragraph delves deeper into the myocarditis risk associated with COVID-19 vaccines, especially for young men. The speaker acknowledges that while COVID-19 can cause myocarditis, the risk from the vaccine may be higher for this demographic. They discuss the marginal impact of vaccination on the likelihood of contracting COVID-19 and developing myocarditis, noting that the vaccine's protection is temporary and may not significantly reduce the overall risk. The speaker also addresses broader concerns about vaccination, including the debunked claim that vaccines cause autism, and emphasizes the importance of large-scale epidemiological studies in understanding vaccine safety.

10:02

🛡 The Ethics of Vaccination and Herd Immunity

The final paragraph discusses the ethical considerations of conducting control trials for vaccines, highlighting the unwillingness of researchers to expose children to potential harm by not vaccinating them. The speaker explains the concept of herd immunity and the individual's decision not to vaccinate, which relies on the majority being vaccinated to reduce overall risk. They also mention the work of epidemiologist Christine Stabell Benn, who found that live attenuated vaccines may have broader health benefits beyond their intended targets, such as reducing mortality from other diseases. The speaker concludes by encouraging viewers to engage with the content and subscribe for more information.

Keywords

💡Vaccines

Vaccines are biological preparations that provide active acquired immunity to a particular infectious disease. In the video, the speaker discusses the efficacy and potential side effects of COVID-19 vaccines, emphasizing the importance of weighing the benefits against the risks, especially for different age groups.

💡Myocarditis

Myocarditis is an inflammation of the heart muscle that can be caused by a variety of factors, including viral infections. The script mentions a concern that COVID-19 vaccines, particularly in young men, may increase the risk of myocarditis, which is a significant consideration in the cost-benefit analysis of vaccination.

💡COVID-19

COVID-19 is the disease caused by the SARS-CoV-2 virus, which has been the subject of global health concern. The video script discusses the controversy surrounding the COVID-19 vaccines, their benefits, and the potential risks, especially in the context of different demographic groups.

💡Mortality Risk

Mortality risk refers to the likelihood of death from a particular cause. The speaker in the video uses the term to discuss the low mortality risk of COVID-19 in children and how this factors into the decision-making process regarding vaccination.

💡MMR Vaccine

The MMR vaccine is a combined vaccine that provides immunity against measles, mumps, and rubella. The script addresses concerns about the MMR vaccine potentially causing autism, referencing studies that have found no correlation.

💡Autism

Autism, or autism spectrum disorder, is a developmental disorder that affects communication and behavior. The video script discusses the myth that vaccines, specifically the MMR vaccine, cause autism, and cites epidemiological studies that refute this claim.

💡Epidemiological Studies

Epidemiological studies are research studies that examine patterns, causes, and effects of health and disease conditions in defined populations. The script refers to such studies as a method to investigate the relationship between vaccines and health outcomes, such as the link between MMR and autism.

💡Herd Immunity

Herd immunity occurs when a large percentage of a population has become immune to an infection, thereby providing a measure of protection for individuals who are not immune. The speaker discusses how individuals may choose not to vaccinate due to the perceived low risk, relying on the immunity of the larger community.

💡Live Attenuated Vaccines

Live attenuated vaccines are vaccines that contain a weakened form of the live pathogen. The script mentions that these types of vaccines, unlike the COVID-19 vaccines, can provide some protection against diseases other than the intended target due to their live nature.

💡Spike Protein

The spike protein is a protein found on the surface of the SARS-CoV-2 virus that the COVID-19 vaccines aim to mimic to stimulate an immune response. The script explains that the COVID-19 vaccines do not contain live virus but rather the genetic material to produce this protein.

💡Risk-Benefit Analysis

Risk-benefit analysis is the process of evaluating the potential benefits against the potential risks of a particular action or decision. The video script repeatedly emphasizes the importance of this analysis in the context of vaccination decisions, especially concerning COVID-19 vaccines.

Highlights

The discussion emphasizes the importance of evaluating vaccine benefits and risks on a case-by-case basis, particularly for COVID-19 vaccines in different age groups.

It is suggested that the COVID-19 vaccine's benefit for young people, especially children, is minimal due to their already low mortality risk from the virus.

The op-ed in The Hill co-authored by the speaker recommended against younger people taking the vaccine due to the minimal benefit and potential side effects.

Evidence of myocarditis, a heart inflammation, was noted as a concerning side effect, especially among young men who received the COVID-19 vaccine.

The speaker discusses the balance between vaccine benefits and risks, advocating for a nuanced approach based on individual health profiles.

For older populations, the vaccine's benefits in reducing severe illness and death from COVID-19 are considered more significant, justifying its use despite potential risks.

The speaker highlights the importance of critically evaluating the nature of risks presented by sources, especially when there is disagreement among experts.

The debate over vaccine-induced myocarditis versus COVID-19-induced myocarditis is explored, with the suggestion that the vaccine may pose a higher risk for young men.

The speaker shares personal experience of contracting COVID-19 despite being vaccinated, illustrating the vaccine's limited duration of protection.

The discussion moves to childhood vaccines, questioning the validity of claims that vaccines cause autism and the importance of distinguishing between different vaccines.

The MMR vaccine and its alleged link to autism are scrutinized, with large-scale epidemiological studies suggesting no correlation.

The ethical challenges of conducting randomized control trials for vaccines are discussed, highlighting the reluctance to withhold potentially beneficial interventions.

The concept of herd immunity is introduced, explaining its role in reducing the risk of disease spread and the implications for individual vaccine decisions.

The benefits of live attenuated vaccines, such as reduced mortality from non-target diseases, are presented as an additional advantage over non-live vaccines.

The speaker emphasizes the importance of considering the broader impact of vaccination decisions on public health and the potential for disease resurgence.

The transcript concludes with a call to action for viewers to engage with the content, subscribe to the channel, and stay informed on vaccination topics.

Transcripts

how should I think as an American about

vaccines and whether they are good or

not because there's crack pocks and

cranks everywhere including at the

heights of the medical establishment it

appears that's a tough question right so

just let's just stick for right now with

the covid

vaccines right so that uh that if there

had been an open discussion allowed

around it uh that it would have been

very clear I think to most doctors and

most parents that the benefit of the

vaccine for the covid vaccine for young

people especially especially children uh

was very very small why because the

mortality risk of dying from covid for

children was very very small so it's the

the the you reduce a small mortality

risk to an even smaller mortality risk

you're not getting very much benefit

that is enough to say that any

possibility of side effects in that

group would lead you to say don't use

that product in that group in fact

Martin korf and I wrote an oped in the

hill I think in April 2021 recommending

against younger people taking the

vaccine for that with exactly that

reasoning uh there were evidence coming

out already around then that young men

especially got high rates of myocarditis

in heart inflammation when they took the

vaccine with the covid vaccine and so

the question then is what what benefit

is there to the to to to my child from

taking it

uh that's the first question like if

it's if it's potentially large then you

want to consider it if it's not

potentially large uh then you want you

want to be more careful about it uh the

flip side of the old for the older

population there's a much higher risk of

dying and you're reducing the risk of D

of of getting sick with the the disease

you're probably going to you have a much

wider range of like how much benefit

that could be and you're going to be

willing to allow there to be I I should

speak for myself personally if I'm going

to G gain a lot of benefit and

expectation and I'm going to be willing

to take some risk I'm going to allow

there to be some har potential harms if

they're especially if they're low risk

um low

probability and I'll still take the

thing because I expect to have more

benefit than harm right so that's the

that's the base of the recommendation

for older people to take the vaccine uh

if somebody tells you that there's a

uniform risk and you know there's not a

uniform risk if somebody exaggerates to

you the nature of the risk on either

side you know the taking the vaccine or

not taking the vaccine and you can you

can get a sense of like are they

alarmist are they are they are they are

they reasonable are they balanced are

they are they accounting for uh other

people disagreeing with them what do

they have to say about the people that

disagree with

them then you should be very careful

about believing them about that the

nature of the risk that they're trying

to evaluate For

You Second I don't think that you as as

a parent

um I mean I do think that there's some

some there's it's very difficult right

so uh like the the let's just now let's

leave covid vaccines aside let's move to

the childhood vaccine schedule I do want

to I do want to ask one follow-up

question before we expand on the other

you know mmrs and all the rest so

there's

death but then there's other stuff right

that's not death but um is in the middle

so taking the vaccine appears to have

increased myoy iio carditis risk with

young men like my son was of age of that

age in that Target at the time when the

co magines were really getting

pushed but what did we know about what

if you got covid like so if my son got

covid survived just fine did did that

also Elevate myocarditis did it elevate

myocarditis risks higher than if he had

taken the vacine so the myocarditis is

is the the calculus around myocarditis

is really interesting uh so yes covid

can cause Mar carditis it had did cause

Mar carditis in in in in people

absolutely it did um the the uh the

question though isn't the relative risk

of Martis for covid versus the vaccine

the question is if I take the vaccine

what's the marginal impact on my

likelihood of getting covid and what's

the marginal impact of on the likelihood

of getting marz if I get

covid right so marginal meaning if I

take it versus if I don't what's the

change in the life likelihood of getting

covid it turns out that it prevents you

from getting infected symptomatic

infection for two months but it that

declines very sharply after just two or

three

months right so you it doesn't really

prevent you from getting covid you're

very likely to get covid afterwards I

got the shot the fiser shot I've I've

had covid twice since as an

example

personally yep I mean I got the I got

two fiser shot in April 2021 and in

August 2021 I got

Co I you know it's so the marginal

impact of on the likelihood of getting

covid and therefore the Mario carditis

associated with the covid is still

basically the

same the marginal impact of the vaccine

on because you still get so you take the

shot and then you still get covid anyway

so whatever Co was going to do to you

it's still going to do to you yeah it's

like two draws on the Mario carditis uh

you know slot slot

machine right so I mean Co isn't it's a

it's a terrible thing right it's not

like it's nice to have Co I wish we

didn't have it around but that doesn't

bias anything right right um okay so uh

the the the there's that I I have to say

I think for young men the risk of

myocarditis from the vaccine is higher

than the risk of mar marcitis from from

covid uh for older people it's less

really so it really was the case that if

you gave your if you gave your teenage

son the shot you were putting you were

perhaps putting them at higher risk of

myocarditis than just letting them go

play basketball and get covid from their

buddies sweating on each other yeah I

mean there's a lot of arguments in the

literature about this but somewhere

between 1 and 2,000 and one and 10,000

of young men who got the vaccine covid

vaccine got

Martis I mean that's too many especially

since the benefit from the vaccine for

them was minuscule there is this

question though about what to do more

broadly with with our kids and with

vaccination and I in general maybe it's

just because my dad's a doct traditional

MD I have usually been like I ask my dad

what should I get he says get the

standard kind of thing and I go do it

without much reservation when we had our

son my wife was more skeptical

and so I you know going all the way back

my son's 19 you know I looked into this

thing of well do do vaccines cause

autism which was a claim I was even in

my doctor's office because we had sort

of a crunch a little bit of a crunchy

granola doc which my wife picked and he

was telling a

patient vaccines cause

autism do vaccines cause autism

okay so first of all let me unpack that

question right so there's multiple

vaccines many of them uh

and the question is not do vaccines as a

class cause autism but the do the

particular vaccines that are

recommended to be given to Children

cause autism like measles monster

rebella and and such right you got to

you answer the question one at a time

now the allegation the idea that that

that the the VES cause autism actually

came out of uh the first time I heard of

it was a study in the Lancet uh which is

a very famous British medical journal a

small tiny study with I think inadequate

kind of uh kind of kind of methodology

that found that there was some

correlation it's a study that it's the

kind of study that would normally be

published in some like some Journal no

one's heard of and then there would be

there have to be much larger and larger

in investigations before he was studied

but it was published in a very top

medical journal and it caused a lot of

people to think that the MMR vaccine me

meel m rebella vaccine causes autism now

work that has been done subsequent to

that not randomized work but like large

scale population epidemiological studies

of the sort that I deem as credible in

the Netherlands by groups that are not

conflicted have found no correlation of

the MMR vaccine and subsequent autism in

using population scale data so I don't

believe the MMR vaccine causes autism

now it's not randomized so you know I've

tell I've tell my friends who who are

much more skeptical of vaccines than I

am that this and they're like well it's

not randomized and my answer is yeah

right I don't I know I yes you're right

it's not randomized I wish we had a

randomized study that concluded that but

it's hard to conclude a negative from a

randomized study sometimes and so it we

don't have that it's also hard to

convince doctors to run a study for a

intervention like the MMR vaccine that

almost every doctor believes is is

worthwhile to do and then say okay I'm

going to randomize some kid to not get

it right so so I understand this to

continue because the listener who's

skeptical who's made it to this point

and is like okay now we're getting into

the stuff I'm worried about for my

newborn um if most doctors believe MMR

will prevent measles and Ms and rebell

but measles is pretty like these not

good things they they they can be quite

harmful

not giving kids the the

shot feels like it might be almost child

abuse if you believe as a doctor that

this will prevent kids from getting

harmful diseases and it works and it's

well established so to to do the right

isn't that right so to do the control

trial you'd have

to intentionally follow kids that go

unvaccinated and see how many of them

get measel moms rebella versus the the

vaccinated said is that right that's

that's exactly right and no one very few

have been willing to do that or nobody's

has anybody been willing to do that I

mean what would happen is you'd go to a

if if you were if I were to propose such

a study I I wouldn't because i' work on

other things but like if I were to go to

a a try to propose such a study if I

could get funding for the study I would

have to show it to a human subjects

review board which whose job it is to

protect the subjects of the study and

they tell me that it's an unethical

control

arm that I'm not to run the study H um

okay so that's that but so the next best

thing are these large scale population

wide careful carefully controlled

epidemiological databases where you

match people that are very similar to

each other at similar

ages uh some I mean just in reality some

people don't get the vaccine and you

track

them retrospective persp perspectively

and see what happens to them I didn't

tell them not to get the vaccine they

just happen not get it I have they I

capture them in my database and I go go

forward and ask are the people the kids

that were vaccinated more likely to get

autism diagnoses later on than the kids

that are not and large scale studies in

like in Denmark found in like a 2000 in

the year 2000 no the answer is no

they're equally likely to get an Autism

diagnosis um there's some there more

complications here than this so uh let

me just tell you the couple the

complications uh so

one misil mumps and rebella are very bad

if kids get it it's bad for kids to get

it right it uh it can cause death in the

kids but it's very uncommon in part

because of the success of the

vaccination programs so the marginal

benefit in a population that's largely

vaccinated to any particular child

getting vaccinated is actually is

actually

small but if everyone were to choose to

do that then meel M reell would come

back and you would have the marginal

benefit get higher

so what you have is I can choose not to

get the

MMR and go and my my my risks are low

because I'm free riding on a herd

immunity that because most people get

it exactly the other aspect of it is

there's a very talented epidemiologist

in Denmark her name is Christine stable

Ben she has done some really interesting

work asking whether vaccines uh that are

live attenuated

vaccines what impact do they have on on

things that are not targeted by the

vaccine in terms of the health of the

child and it turns out that live attend

in her work live attended vaccines

reduce the risk of mortality from other

diseases not just related to the thing

that you're supposed to protect like so

for instance the oral polio vaccine

which is not the version that's given in

the US is given in Africa in her work in

Africa finds that it red reduces all CA

mortality for children in randomized

studies that get the oral polio vaccine

versus who don't other vaccines that are

not live attenuated vaccines do not have

that that do not have that result what

does that mean live you mean like the

virus is alive instead of dead yes right

the virus the virus uh replicates inside

of you uh so there's like two kinds of

vaccines one kind of vaccine you give

them you give a pathogen that's similar

to the thing you want to prevent that's

still alive you get a you know mild

version of the sickness and then you're

better uh and then you're now protected

against if you were to get you know if

you're if you're subject to polio then

you're not going to get it because

you've already had that that attenuated

version of it um the other version of

the vaccines are essentially dead parts

of it that's what Co the covid vaccine

is an example of this it's not supposed

to it's just producing the spike protein

it's not producing live virus that can

replicate inside of you and it TR your

body to react to that part that's it's

exposed not to the entire live virus

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