- What's up guys?
Today I have an amazing video for you
where we're going to be talking about
all of your most frequently asked questions
on the COVID-19 vaccination.
I brought an amazing guest, Dr. Seema Yasmin.
Who's not only a doctor,
she's an epidemiologist, a journalist.
She's the director of research and education
at the Stanford Health Communication Initiative.
Dr. Yasmin, thank you so much for being here.
We're really excited to have you.
- I'm really excited.
Thanks so much Dr. Mike for having me on today.
- Everyone is hearing about the vaccine.
When do you think
that we can actually start giving this vaccine
to everybody outside of frontline healthcare workers
and those who are over the age specified by the CDC?
- As of mid to late December
we got two different COVID-19 vaccines
with an emergency use authorization in the U.S.
But more coming I think in the next few weeks.
The point at which you can start to extend vaccination
to many more people,
the tens of millions that we need vaccinated,
could be a few months away.
There are strong projections
that it could be around April time.
I think saying spring to summer is fair because bear in mind
that at least for the two vaccines
we have currently available,
it's not just a one and done shot.
You're having to go back three or four weeks later
depending on which one you got.
And even then it's only one to two weeks
after your second shot
that your body's actually develop that kind of immunity,
that's going to protect you from getting sick.
- Should there be a preference
to which ones our countries should be buying?
Are you allowed to mix the vaccines?
- Some people may get a choice
like, "Hey we have this a buffet of vaccine."
I think for some realistically that won't be so much choice.
But now I think when you are told
you are eligible for a particular vaccine,
I would roll up your sleeve and go for what's available.
We don't have any data on mixing and matching.
So that means if your first shot
is the Pfizer BioNTech shot,
you should get that as your second shot three weeks later.
If your first shot was the Moderna one,
that should be your second shot four weeks later.
- We're still humans.
Errors are going to be made.
I just read a press article of a pharmacist I believe
that was given multiple doses of the vaccine accidentally
because they didn't know it came in a multi-dose vial.
And things like that are part of real-world applications.
These things are gonna happen.
Yeah, we shouldn't be set back by one piece of bad news.
And I know the press a lot of times will do that
and make it seem like something is horrible.
- I want people to know
that some people don't feel very well.
Some have to take a day off work the next day.
If you know that,
it's less scary going in should it happen to you.
However, the flip side of that
is that every single time
someone on the planet has had an allergic reaction
to one of these COVID-19 vaccines,
it's become a big headline.
And I know people that are like,
"Oh, I'm just really scared."
And I'm like, "Hold on."
A few million people
at this point have received these vaccines
and about eight I think at my last count,
you know, less than a dozen
have developed an allergic reaction.
You are totally allowed to be scared of that.
Allergic reactions are scary, but all of them were fine.
They got treated.
And this is the very reason that,
after you get any vaccine for the most part
you're not allowed to go home straight away
even though you want to get back to work or whatever.
You're told, "No.
Please sit in the waiting room for the next 15, 30 minutes
in case you have a reaction."
Because this vaccine was produced rather quickly,
we haven't had the longterm side effect research available
on it, simply because the time hasn't been there.
Is there anything in your mind that would suggest
that there are serious long-term side effects?
- If you look at the history of vaccines
and reactions to vaccines,
the vast majority if not nearly all of them
occur within the days after you get vaccinated
or at most about four to five weeks after vaccination.
So we put safety data beyond that amount of time, right?
We've got at least eight weeks of safety data,
but the other thing to bear in mind
is that we haven't just dropped the ball
now that we have emergency use authorization
of these vaccines.
We are continuing to monitor people for years out.
And also another thing is, remember, we're prioritizing
especially in the UK older people to get vaccinated.
And so we're going to be hearing stories
and I want to give everyone a heads up of this,
of folks saying, "Well, my granddad was 85.
He got the COVID 19 vaccine
and then he died the next month."
The thing is, if you are in your eighties,
you have a 1 in 10, 1 in 12 roughly chance
of dying in the next year.
And so just because you're in that high priority group
to get the vaccine,
it might look like increased deaths occurring
in that population.
- How does this vaccine work
and why is it different than the flu vaccine
or other vaccinations that we've heard so much about?
- So all vaccines are trying to do the same thing.
They're trying to give your immune system a heads up
to be prepared should you ever be exposed
to the actual virus.
With these two mRNA vaccine,
so there's one made by Pfizer BioNTech one made by Moderna,
they are new technology.
They're doing something really amazing
where they're giving your body a little piece of RNA
which is the genetic code that your body needs
for your own cells to start making little tiny fragments
of this new Coronavirus.
So your body's not making the whole virus.
You can't get any infections from the vaccine,
but your body gets the code to make just the spike protein.
And then by making that protein,
your immune system sees it, takes note.
It's like, "Okay going to get ready
should we ever get exposed to this."
In the meantime,
that RNA that got injected into you from the vaccine,
it disappears quite quickly.
It's very fragile.
- Re-iterating what you said 'cause it's so important.
You're not making the full virus.
So you cannot get COVID-19 by getting the vaccine.
- The incredible thing about these newer vaccines,
is that they don't contain any portion of live,
weakened or dead virus,
which is how some other vaccines work.
- What are the ingredients of the vaccine?
And are they trustworthy?
- Some of the questions I get asked the most are,
is there anything toxic in there?
And is there aluminium
or aluminum as you would say in the U.S.
The list actually of ingredients in these vaccines
it's publicly available.
You can go online and see it.
It's quite a short list
and there is no mercury and no aluminum in them.
- And the important part is,
just because there's a chemical name to a substance,
it doesn't make it automatically bad or dangerous.
And on the flip side,
if something has claimed to be all natural
doesn't mean that it's all safe.
How effective do we think this vaccine is going to be?
Let's not talk real-world,
let's talk based on the evidence we have thus far.
- In the clinical trials,
in those phase three clinical trials
which was 44,000 people for the Pfizer BioNTech trial
and about 30,400 for the Moderna trial,
these vaccines were found to be very efficacious.
And I'll say efficacious, not effective
'cause they're talking about in a clinical trial.
But around 94 to 95% efficacious,
that was way more than we expected.
And specifically
when we're talking about those numbers of efficacy,
we're talking about the reduced likelihood of a person
becoming sick with COVID-19.
Were not talking about a reduced chance
of getting the infection and therefore a reduced chance
of spreading it to other people.
That transmissibility part that question about
if I get this vaccine, am I less contagious?
Unfortunately, the clinical trials we have so far
did not seek to answer that question.
That's something we're going to learn from the real world.
- How soon after we're vaccinated, both doses
are we considered protected to this 90, 95%.
- It takes one to two weeks
for your body to build up that immunity against the virus.
- How many people need to get this vaccine
in order for it to be considered like eradicated?
- We think about 70, maybe 75% or so
of Americans would need to be vaccinated
in order for us to achieve
that herd immunity that we talk about.
But it's still a big chunk.
We are talking about three out of four people.
- How much will it cost?
Do I need health insurance in order to be vaccinated?
- No cost to individuals
whether you are insured or you are not insured.
The vaccines themselves can be quite expensive,
but remember the billions it's cost to get us here,
that's largely taxpayer money.
So we paid for these.
Now it's the government's job to distribute them fairly
and to make sure everyone who needs a vaccine can get one.
- What's the official recommendations
for who should get this vaccine?
Are there groups that we recommend shouldn't take it?
- So right now I'm not seeing too many recommendations
about who should be excluded from vaccination.
There's some kind of gray areas,
for example around pregnant women,
because unfortunately and I think this is not great
but they weren't included in the clinical trials.
And so it means pregnant women are kind of told
you can if you want, to talk to your doctor,
weigh the risk of infection
versus potential risk of vaccination
and then make up your mind.
That's not clear cut guidance.
The other question that comes up is should groups
who are immunocompromised not receive these vaccines?
And actually we're saying you can receive these vaccines
because they don't contain the virus
like from other different kinds of vaccines do.
- And then what about children?
You know, generally they have fared better with this virus.
They are still vectors for it,
and potentially can be spreading.
- When you don't have that clinical trial data
from children it makes it really hard to say
what you should do for children at large.
The good news is Moderna is now recruiting
for a clinical trial for its vaccine
among 12 to 17 year olds.
So I hope in the next few months, that gives us that data
about how should children be involved.
- This is so important to state here,
that the reason this vaccine is being recommended
for groups 16 and older, is not because we have evidence
that it's harmful for those who are under 16,
it's because simply we do not have full efficacy
and we haven't tested it in groups under the age of 16.
And I think now is a really good time to talk about
the difference between
those who are truly anti-vax activists
or anti-vaccine activists
and those who are vaccine hesitant,
because they've heard something, they've read something
that's potentially misinformation or disinformation.
- I'm so glad you worded it that way as well Mike
because I think I try actually not to use
the term anti-vaccine very much.
The vast majority of people who are kind of
a bit worried about these vaccines,
they're not what you people might call anti-vaxers
they're vaccine hesitant.
They're the kinds of folks who are like,
"Yeah my kids got all their childhood vaccines.
Normally get my flu shot.
I'm just not too sure about these new ones.
They seem to have been developed a bit quickly."
Those are the people we really need to be reaching out to.
And actually specifically that question about,
"Wait, you told me,
normally it takes about 10 years on average
to develop a vaccine,
then how could it happen in 10 months?"
The question should be
why does it normally take us 10 years to develop a vaccine?
That's way too long.
What's happened in the last 10 months
is proof of what can get done,
how amazing science can be done
and what achievements you get
when you have international collaboration
and literally tens of billions of dollars
thrown at the problem.
But the other piece of context is,
I know this virus is brand new,
but the researchers who brought us these vaccines
have been working on this kind of scenario for years.
So that university of Oxford group for example,
have been working on a vaccine for pandemic X,
a virus potentially that comes along.
That is brand new.
What they've been working on for a few years,
is how do we get 10 steps ahead of that?
So that when this nali infection arises,
we have to do very little work to make a vaccine.
- This is an international effort
where everyone is on the same page.
We're cutting out a lot of bureaucratic red tape
to put it simply, right.
Like in getting the funding.
Why?
Because our economy was threatened.
Anytime you threatened the economy or money,
the problem usually gets solved a lot quicker
in a more efficacious way.
I think this antibody conversation
has been really confusing to the general public.
Because A, we can test for the antibodies.
We don't know what the cutoff is to know that you're immune.
We don't know how long it lasts.
We kind of have this arbitrary three month cutoff.
- The kind of immunity that you get
from some vaccines can be stronger
and longer lasting than what you get from natural infection.
We also don't have amazing antibody test.
Some of them and not the most specific
and the most sensitive.
So there's been a lot of confusion around,
who's been exposed?
- I've actually had some debates
with fellow physician friends of mine
who I've basically taken a firmer stance in saying
that I don't see a value for an individual
to go get tested for antibodies.
Do you agree with that? - I agree.
Whenever you order a test,
it's your responsibility to follow up on their result,
med school 101,
and also think about what's actionable.
We don't have a full understanding yet
of what level of antibodies truly confer resistance,
truly confer protection against this virus.
So to me, there are still many unknowns.
It's interesting from like a
theoretical research perspective to gather that data now,
but in terms of telling a patient what to do or not to do,
I don't think antibodies change that conversation.
- If you questions about the vaccine,
drop your questions down below.
If you have any hesitations drop them down below.
I'm going to be trying to be more active
in this common section versus others,
'cause I know a lot of folks do have questions.
Dr. Yasmin, thank you so much for being here
for all the work that you've done.
Not only with COVID-19,
but all the diseases you've investigated.
Where can people follow you?
Where can they stay up to date?
- Well, thank you so much for having me on today.
Folks can follow me on Twitter @DoctorYasmin
and on Instagram at @DrSeemaYasmin.
- Thank you for being here
and as always stay happy and healthy.
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