Here’s what I’d need to see as a doctor if I’m going to be comfortable with a COVID-19 vaccine.
Hey everybody, it’s Dr. Z. Welcome to The ZDoggMD Show. We’re live it’s August, something, I don’t know, Monday. And we’re gonna talk about vaccines because it seems like everybody’s now talking about the COVID-19 vaccine, including Bloomberg Business that did a full spread about me, no stress. Talking about fighting anti vaccine misinformation prior to COVID and then during COVID.
The way that piece presented my views was very black and white, all vaccine all the time, no question, I think, and I think that’s a little confusing. Otherwise, it was very well done. And the reason it’s confusing is this, what would it take to get me to take a new coronavirus vaccine or give it to my family and kids? And this is a valid question you should be asking of your own experts, doctors and people that you trust, who understand the science and Immunology of it because, I had somebody I trust on the show, Dr. Paul Offit, who is a vaccine expert has developed his own, co-developed the rotavirus vaccine.
Kind of an expert in the space and he said that if he doesn’t see evidence that phase three trials are done correctly, he wouldn’t take the vaccine. And I think this is really important. When you look at what Americans are saying about this, with the exception of the one to 4% of people that were surveyed that say they would never take a Coronavirus vaccine under any circumstances. And you can think of them as kind of members of what I call the anti vaccine cult. So they have been so indoctrinated in this idea that all vaccines are bad, they’re harmful, that they inject foreign toxins into people and that big pharma and government is trynna control us with these things. Those people are almost beyond reach with a few exceptions that have messaged me and said, continually watching your show has changed my mind. But for the most part, those people are entrenched and delusional and you can’t reach them.
But most other people, 30, 40, 50% have expressed considerable skepticism that they would quickly take a vaccine if it was approved, just FDA approved. And to be honest, their skepticism is well founded. Because if a vaccine is approved in the next few months, say, you have to put that into the context of the fastest vaccine that has ever been developed and approved was Mumps, and that took a minimum of four years. So when you say oh, we have a brand new vaccine for a different class of virus for which we have never created a vaccine, using a technique, messenger RNA that Moderna and Pfizer are using in their big vaccine trials, that has never been done. Although it’s been studied for a long time, it has never been successfully done.
And you’re gonna do it in this record time, this operation Warp Speed that the government talks about. Skepticism is in order. And in fact, if you’re not skeptical, you are not doing what I’m asking you to do, which is critically think, review the data, listen to a series of experts who are real experts, not fake experts trumped up by conspiracy theorists, right? So you have to deeply look into it, and find people that you trust and listen, and that’s what I do as a doctor.
So I looked at the primary data. And then I talk to experts who I trust who have also reviewed that data to make sure I’m not missing anything. So in the case of let’s say Moderna’s vaccine, which is now undergoing phase three clinical trials. What does phase three clinical trials means? It means that they are now in human trials, looking in large number of people to see if is the vaccine safe? And is it effective, in this case compared to placebo. Now this is very, very important. Placebo means an inert substance that shouldn’t give any real immune response like salt water, but it’s injected in the same way.
So it creates the same set of circumstances in the mind of the patient as the real test vaccine would. So you would wanna randomly assign half the patients to the get the real vaccine side, and half the patients to the get the placebo side. And when you randomly assign those patients, you will eliminate a lot of what we call selection bias and other biases that can arise where, you’re cherry picking the patients that you think will do best with the vaccine or or vice versa. And that can introduce all kinds of bias, which we see in a lot of the trials for drugs that are observational trials. That aren’t actually looking at randomization into two groups, including a placebo, or at least another drug that you’re comparing it against.
Now, the randomization needs another thing, which is blinding. So what is blinding? When you hear people talk about a double blind placebo controlled trial, that means you’ve randomized the groups to one group or another one group gets an inert substance, the placebo. And the blinding occurs in two possibilities. The first is the patients are blind to which treatment they got. They don’t know if they got the vaccine or they got the placebo. Now the Moderna trials that are ongoing right now and the Pfizer trials, they are blinding the patients meaning, the patients don’t know which arm they’re in. And that’s important because once the patient gets a sense of what their treatment is, it can bias the results, especially if the patient is self reporting symptoms.
If they’re told you got a pretty strong vaccine, they’re more likely to report either positive or negative symptoms associated with that. So you want the patients to be in the dark. But then importantly, you don’t want the investigators to be biased. So the chief investigators that are actually crunching the data and actually making the interpretations, cannot know which groups the patients are in early on, or they will treat them potentially differently.
They will gather the data differently, there’s a million different biases that can destroy a trial now, so many times when you see people pitching some either treatment or diagnostic of whatever it is idea. They show you they’ll send you a link to something on PubMed or some other trial or something in some journal. If it’s not a well designed randomized control, double blinded, placebo controlled trial. You can go through it and find a ton of bias and often will, where you’re seeing correlations that don’t necessarily mean causation. And so many of these trials that people send me right now about coronavirus or that kind of nonsense garbage.
There are roles for those trials, but not they are not roles for that, when we’re moving forward on a brand new vaccine. That’s not, the style of which has not been tested with a class of viruses that we’ve never tested vaccines on. Randomized controlled double blinded, placebo trial is what’s happening with the Corona vaccine.
Now, so I would demand that and I think many experts would demand that moving forward. Now, again, for anti-vaxxers and the people in that sort of delusional cult of anti vaccine, that 1, 2% they’ll say, Oh, these placebo controlled trials have never been done with vaccines. That’s hogwash. They absolutely have and they’re undergoing them right now. Okay, so, and with HPV vaccine that everyone’s oh, it’s new and everyone’s scared of it, it was actually one of the most studied vaccines in history 30,000 trial participants in just one trial, the data is there and you should demand it.
So with a Corona vaccine as a doctor, what would I want? I’d want that trial. I want it to be sufficiently powered to detect efficacy and safety. Now, what do I mean by that? Power of a trial simply means are there enough subjects in the trial and I’m gonna simplify this, so are there enough subjects in the trial that you would detect real differences in both outcomes and side effects. And 30,000 participants across multiple trial sites, multiple ethnicities, both genders or both sexes, I should say, around the country and around the world. That is a good trial design and a good power trial designed to detect the differences you wanna see. Because what you’re looking for in this trial for the vaccine is the following.
You’re wanting to see, okay, compared to the placebo, what side effects are you seeing? And already in the early sort of phase two-ish type trials with same Moderna’s vaccine. Where they’re trying to decide what’s the dose and what’s the sort of safety and dosing at different doses. They found that a lot of people got big time, standard vaccine side effects like very sore arm, muscle aches, headaches, those sort of things that often will correspond to an immune response.
If you think about when you’re infected with the virus itself. Your immune response, actually is manifest by fevers and muscle aches and headaches and soreness. And if you have a vaccine do similar things, you could actually argue that, that’s actually the immune system responding with T cell response, interferon all the different sort of mini cytokine response that you would get with exposure to the real virus. So that’s actually not a bad sign, but you’re looking at other side effects that could be more serious. And so you wanna have enough people to detect that.
And then what you wanna do is, you wanna make sure that these people are actually at reasonable risk for getting the real coronavirus. So like frontline health care professionals, people who haven’t been exposed to Coronavirus before, particularly in more hotspot areas, or areas that haven’t peaked yet. Those are great populations because then when you move forward and follow them, that’s another term prospectively, meaning you’re doing this trial moving forward from scratch not looking back at data that’s already happened. You’re hoping that a lot of them actually will be in groups that get exposed because then you can determine the difference between your sugar water placebo injection and the vaccine, and if you find a significant difference that people who got the vaccine are less likely to get the disease or if they get disease, they’re less likely to get very sick, be hospitalized or die. That is a huge signal in that trial that says there’s efficacy. And then you’re looking at safety, you’re looking at efficacy, and you’re looking at it for long enough that you’re comfortable that you haven’t missed some signal that’s important. For example, a safety signal that only shows up in four months. Or efficacy that drops dramatically after four months say, well that would argue that this is not a very long lasting effect, and therefore either you need a booster or it’s not useful.
You wanna look at efficacy and goes at 50% of effective, is it 60% effective like flu shot can be. Or is it 90 to 95 to 99% effective like say an MMR can be, with the two injections and are the two injections of the vaccine, 28 days apart that they’re doing in the Moderna’s trial, say, is that the correct dosing? Are we seeing the right effect? So you would want to do all that in the phase three trial, with the 30,000 people they’re doing, in randomized prospective fashion double blinded.
And then you’ll wanna look at that data when it comes out and look at it carefully, and then have experts look at it carefully. And if that makes you say, hmm, this thing is safe in the population studied, it’s efficacious, meaning it’s high efficacy, it works. Then you make the personal decision. Okay, have I already had COVID? No, Okay. Am I at risk for COVID? Sure, everybody is and then you decide, okay, well, there’s always a small chance that post marketing surveillance meaning years down the line, they’ll find that this vaccine causes something odd that we didn’t predict. Are you willing to take that risk, versus the risk of getting COVID with whatever your personal risk is of actually getting very sick and dying. And that’s where you have to make a personal choice.
And then the other place you make a personal choice. And notice I’m saying choice here is when you decide, okay, but how much do I also care about infecting others. My family, people at risk around me, or I’m a health care provider or I’m a teacher, or I care for an elder, in which case that calculation changes. Well, even if there’s a very small risk, it’s worth it because I’m less likely to transmit in an asymptomatic way, because a lot of times we won’t even have symptoms will transmit it to someone and they’ll die. To someone that I care about or just as my moral fabric. I don’t wanna do that. Well, that affects your calculation.
Now, I said choice. At the time the phase three trials are done. Even if it’s in record time, but we’re comfortable with the data, then you should be able to make that choice. But your employer should be able to make a choice too, that they don’t wanna have you there if you haven’t gotten the vaccine, unless you have a medical reason not to get it. Immuno compromised some other contraindication to the vaccine. So you should be able to make that choice. The government should not mandate you. And I don’t think they will mandate you to get a vaccine. But private employers can say, I don’t want you if you haven’t gotten vaccinated, just like your health care system can tell you, hey, buzz off, if you don’t get a flu vaccine, you’re putting elders, patients and your colleagues at risk. And it’s true.
So, even with flu vaccine, which I get every year, I’m entirely up to date, my kids have gotten HPV and all the other vaccines on schedule on time, because I’ve reviewed that data. And there’s a lot of data there. And I’m absolutely comfortable giving that. What would I do with COVID-19 vaccine? What should you do? Wait till that data comes out, do not, do not take any vaccine that is improved, prior to the end of the year. And I’m saying that because there’s no physical way, that you could do the phase three trial with enough months of data and analysis to be comfortable. I wouldn’t be comfortable unless you’re the highest of risk.
Now, if you wanna participate in the trial, that’s great. But you’re willing to take the small risk that this thing has adverse events, right? In which case, you’re part of science. And that’s great. And also you might be protected if the vaccine works. So you’re actually doing that math in your head, you’re calculating risk for yourself and your loved ones, and you’re willing to do that. And 30,000 people will step up to the plate and do that at minimum. So it’s actually science in action here. You don’t rubber stamp it. If I see the data, and I talked to Paul and I talked to others and I’m not convinced that this is safe. I’ll tell you. And I won’t take it myself.
But if I think you know what, this is pretty good given risks and benefits. I’m gonna take it and I’ll be right up there doing it live. So stay tuned and see. Now the other thing you always have to look at, and this is good to question. The conspiracy theorists, their first thing out of their mouth is, who’s paying you excellent question, ask it. You’ve got to disclose, right? If you’re out there advocating, you have to disclose who’s paying you. And I’m telling you right now, no pharmaceutical company has ever given me a dime, to promote vaccines. And I’ve talked to them about it, because they are fans of some of the stuff I’ve done on vaccines, and there’s not fans of stuff I’ve done bashing Big Pharma. And I will not take money from them to promote vaccines, because I actually believe in the science around vaccines, and I don’t want that conflict.
And now others who work in the vaccine space should be paid for their work. But we should also listen to their expertise, but then weigh it and go, Okay, well, there is a bias there, right? But just as rubber stamp, assuming anyone who’s pro vaccine is in the pocket of Big Pharma is just poor imagination, poor critical thinking, poor empathy, because you don’t understand any theory of mind about how other people would behave. And you’re in your own thought bubble and then you need to get out of it.
And the same thing goes for people who would rubber stamp a vaccine, like, would you take Putin Vax? Hell, no, why? Why would I not take the Putin Vax? Even if there’s all these reports says that it works. Because I haven’t seen data one, from the Russians publicly released, peer reviewed, that this thing is safe and effective. Why would I ever take something like that without any public data or expert review? No, that’s where you put your foot down. So this is very, very important.
And people, I’m sure there’s tons of anti-vaxxers and all this garbage and I’m looking at the comments. That’s standard. We’re just used to that. What I’m telling you is everybody else who has a head on their shoulders, and isn’t absolutely, delusional, you know, especially if you’re concerned about vaccines, and you’re one of this high percentage of Americans that say they wouldn’t take it. Unless they saw really it was years down the line. Well, at that point, it’s not gonna be that helpful. So this is a bit of an urgent issue because 170,000 dead in eight months in America. So you have to weigh that.
Now, the other thing that you should do when you weigh vaccines is what’s happening when the vaccines approved. If our cases are naturally declined due to natural herd immunity that’s occurring at a lower rate than the 60, 70% that the experts currently predict. And I’ve done a show on this. There’s some that are contrarians that are saying it’s more like 20, 25%, then a vaccine may be less of an urgency, right? And what if we develop treatments for this disease that are very, very effective. Like so effective, that it’s no longer a fatal thing with a lot of morbidity and people having long term effects? Well, that changes the calculation, doesn’t it?
The way you should approach anything you do therapeutically for your body, or diagnostically we’re doing testing is like that. Weigh what are the pros, what are the cons, what are the experts say. You can listen to your intuition. What do I think about my own risk and my own family and my own moral values, and you go with that. And it should be your choice, it really should. But if your choice affects others, if you’re putting others at risk if you’re a teacher or a doctor or something like that. And there’s a safe and effective vaccine by the studies that we having, and a bunch of people take it and nobody’s having big side effects, I mean, big long term events. Your employer should have the right to say, you can’t come back to work, go get another job. If you don’t have a legitimate medical excuse, not take this vaccine. I think that’s absolutely as American has the right to say no to the vaccine.
So that’s what I think as a physician. And I think you should share this video. I think the people who support the show are awesome. I think that you can find us on zdoggmd.com on any podcast platform and all over the web, Facebook, everything. We’re live on Facebook, but this will be up on YouTube and Instagram and everywhere else. We try to get a captioned, we use our supporter funds to pay our team pay for captions pay for production. So thank you for everyone who supports the show.
Now we’ll read some comments, so anyone who wants to tune out can, because these are gonna be crazy. Let’s see a peel through these really quickly. Am I broadcasting the same time as the democratic national conventions, ZDogg he gives us something actually meaningful to watch. I agree. Either convention would be a garbage waste of time if you asked me. Okay, so this is one little thing I’m just gonna rant on a second. I have never seen, Of course it’s an election year such a politically charged scientific topic in the history. I mean, global warming comes close. But this has been so ridiculous that you can’t, you cannot talk about it without some a-hole, on one side of the aisle or the other, attacking you calling you either a communist or a, some kind of fascist, and that’s just dumb. Americans we should be citizens of the world. We should be better than that, right? Forget just Americans people do this around the world, politicizing this just shame on us for doing that really, really. And then people accuse me like because, for example, I did the press Bloomberg business. Well, I had no idea apparently Bloomberg is associated with, far left stuff according to many. So I was attacked by all these conservatives, and then I’m attacked by all the liberals. When I don’t stand up and say X, Y or Z, or whatever, you cannot win except to stay true to the truth, the science, your own critical thinking, your own moral matrix and forget the politics. Forget the tribal identity, forget the badges. And if we can do that in science. Oh, man, we’re actually gonna progress as a species beyond this muck that we’re in right now. Do they ever tell the phase three patients if they got the placebo or the real drug, after the trial is over? Craig Brock Miller. I believe in many trials, they’ll tell you after the trial. But one interesting thing with these trials, and this was there was a piece on this in the news actually where they were talking about Medford Oregon and how they’re enrolling a lot of patients, they’re at one of the testing facilities. And as you know, just average patients are getting enrolled. And they would get the injection and they would complain that they didn’t have any soreness or fevers, or muscle aches, and they were really sad they thought they got the placebo, right? So you can actually bias the patient just by this idea that Oh, did I get it and I get it? Without really any sense. I mean, you could get the actual vaccine and have no side effects. Who’s to say you got a placebo, you can get the placebo and have terrible side effects that are mind generated. And believe you got the actual vaccination. So that’s the beauty of randomized control trials. It’s a great equalizer. Doesn’t matter what you believe. We know the data at the end of it, when we unblind the investigators and take a look. Thanks to everyone who’s sending stars. There penny per star that we get for the show and we use it to support our music videos, waiting on the world changes coming out hopefully this week. We shot it this weekend. At San Mateo Medical Center here, they were wonderful the entire Respiratory Therapy Department showed up. And the San Mateo County Health Foundation that is responsible for providing care and helping to fund our county safety and hospital here in the Bay Area in San Mateo, where the 14th richest county in the nation and yet our poorest, most vulnerable patients have actually some of the best care in a publicly funded hospital, that is funded through donations from people like you. San Mateo County Health Foundation, and they were kind enough to let us shoot. The whole RT department showed up, they brought their PPE they showed it. It’s gonna be a great video and it’s because real frontline caregivers that we were celebrating in the video showed up on their day off to contribute. And that’s what’s just wonderful about this audience, right? Let’s see people attacking each other in the comments, nothing new. Cami Rochette says, who’s a supporter left or right sciences facts? And that’s the total truth. Well, we’re all trying to find truth. The truth is often skewed through our own moral matrix, which we’ve talked about on the show. So politics is a way for us to hash out competing interests based on interpretation of the same data. But the key thing is we can use critical thinking and reasoning to interpret that data, and then actually remove our political bias by recognizing it. That involves something called metacognition, where you’re able to think about your thinking. And if we did more of that, the world would be a vastly better place. Alright guys, I love you. Thanks for joining me tonight. Please share this video and we out. Now if I can just figure out how to stop this. There we go. Bye, guys.