Making Sense with Sam Harris - #256 — A Contagion of Bad Ideas

Episode Date: July 23, 2021

Sam Harris speaks with Eric Topol about vaccine hesitancy and related misinformation. They discuss the problem of political and social siloing, concerns about mRNA vaccines, the Emergency Use Authorization by the FDA, the effectiveness of the COVID vaccines, vaccine efficacy vs effectiveness, the Delta variant, the misuse of the Vaccine Adverse Event Reporting System (VAERS), concerns about long-term side effects from vaccines, bad incentives in medicine, ivermectin, government and corporate censorship, vaccine mandates, and other topics. If the Making Sense podcast logo in your player is BLACK, you can SUBSCRIBE to gain access to all full-length episodes at samharris.org/subscribe.   Learning how to train your mind is the single greatest investment you can make in life. That’s why Sam Harris created the Waking Up app. From rational mindfulness practice to lessons on some of life’s most important topics, join Sam as he demystifies the practice of meditation and explores the theory behind it.

Welcome to the Making Sense Podcast. This is Sam Harris. Okay, well, today's podcast is yet another PSA. There have been many of them of late. Needless to say, if you want to support what I'm doing here, the way to do that is to subscribe to the podcast at SamHarris.org. way to do that is to subscribe to the podcast at samharris.org. It's really the subscribers that make all of this possible. But given the kinds of topics I touch here, it's with some regularity that I feel the need to put out a podcast in a form where the most people will hear every word of it. And today the topic that could not suffer a paywall is what is now universally described as vaccine hesitancy and the general condition of misinformation and disinformation

that surrounds vaccines in general, but the COVID mRNA vaccines in particular. I think anyone who has listened to the podcast in the last year or so will have no doubt about where I stand on the topic of the COVID vaccines, but I haven't focused on it because it seems like there really has not been all that much to say, and it's just a general air of futility around persuading anyone who has decided, for one reason or another, that they're really worried about the COVID vaccines and not all that worried about COVID. That's the bifurcation here. We have a very large cohort in our society society who think that COVID is not an especially big deal. At minimum, the dangers of it have been exaggerated. Of course, there are many millions of people who think it's a hoax and that there is,

in fact, no problem at all. In any case, there's a spectrum of opinion on this side, spectrum of opinion on this side, wherein people are really not at all concerned about getting COVID, but they're quite concerned about the dangers or imagined dangers associated with the vaccines for COVID. And then there are the rest of us who have the valence on those terms flipped, and were quite concerned about COVID, and not especially concerned about the risk of vaccines. Rather, we were incredibly eager to get vaccinated, and to get our kids vaccinated, and we are fairly aghast at and increasingly troubled by the thinking and unjustified certainties coming from the other camp. If people agree about anything on this topic, it's that you can't shame the other side into compliance, right? And to talk down to them, to cast the vaccine hesitant as stupid or uneducated, is generally deemed counterproductive.

And it's also, in many cases, just not true, because there are many smart people who fall into this camp, as will become obvious. Anyway, the fact that this is possible, the fact that one can be smart and aggressively misinformed and misinforming of others, attests to just how bad the problem of misinformation has grown in our society. Anyway, I was avoiding this topic because, again, I don't think there's that much to say on it, but it's pretty obvious now as the pace of vaccination

has slowed to a crawl in the United States and the need for vaccination globally is fairly excruciating. And the Delta variant has tipped us into a condition where even those of us who are vaccinated can no longer enjoy the light at the end of the tunnel, because we have been pushed back into that tunnel by, frankly, the confusion of our neighbors. The tipping point for me the other day was I was eating at a restaurant and noticed that about half of the waiters were wearing masks and half

weren't. And I asked one of them, well, what's the policy here? Are we wearing masks or not wearing masks? And he said, well, the policy of the restaurant was that if you're vaccinated, you don't have to wear a mask. And if you're not vaccinated, you do. I chewed on that for a few minutes after he walked away, and then I looked at all of these young men, they were all men, with kind of a fresh set of eyes, and realized that there is no reason these guys aren't vaccinated, but for the fact that they have some spurious memes and bad ideas bouncing around their brains. And they were very likely put there by some of my friends, some of my fellow podcasters who have either gone down this rabbit hole themselves or just platformed people who

spread misinformation about vaccines and about COVID and not known enough to push back in real time against these ideas. And in sitting in this restaurant looking looking at these waiters, who are all podcast listeners, I just know it, I've spoken to a few of them about it, and they're advertising their dangerous confusion on their faces by wearing masks that would otherwise be unnecessary for them. This was before the explosion of the Delta variant in my city. I just figure I have to say something. So, the goal of today's podcast is to present a very simple case, which hopefully stands a chance of persuading some number of the vaccine hesitant.

And the punchline is this. Even if you accept the worst claims about the risks of the mRNA vaccines, which are almost guaranteed to be false, but even accepting them, the case for getting vaccinated, is absolutely clear-cut, given what else we know about the effects of the vaccines in preventing disease and about the effects of COVID itself. It's a very simple argument, but it requires that we get into some of the details here about what's being claimed and about what we know thus far from what is really one of the largest medical experiments ever performed.

We now have over 100 million people in the U.S. alone who are fully vaccinated. We have an extraordinary amount of information about the dangers here, or lack thereof. So anyway, I wanted to produce a document that could be spread around to the people in your life who may still be hesitating to get vaccinated. And to help me do this, I decided to speak with Dr. Eric Topol. Eric is a truly world-renowned cardiologist. He's also the executive vice president of Scripps Research and one of the top 10 most cited medical researchers. He's the author of several books, The Patient Will See You Now, The Creative Destruction of Medicine,

and Deep Medicine, how artificial intelligence can make healthcare human again. And even more relevantly, for our purposes, he's been very active on Twitter for the last year and a half or so, countering some of the crazy ideas that have been spread around COVID and around vaccines. And you can follow him on Twitter at Eric Topol, E-R-I-C-T-O-P-O-L, and I recommend you do that. He's continually surfacing useful articles. But I thought Eric was one of the best people I could find

to walk me through what we currently know or have every reason to believe about vaccines and about the state of our response to COVID. We discuss the general problem of misinformation, the political and social siloing that people experience in our society. We cover concerns about mRNA vaccines, the emergency use authorization by the FDA, what that means and what it doesn't mean, and the false claims made about it. We talk about the effectiveness

of the vaccines and differentiate vaccine efficacy from effectiveness. We discuss the Delta variant, the misuse of the Vaccine Adverse Event Reporting System, the VAERS database. We discuss concerns about the long-term side effects of the COVID vaccines, bad incentives in medicine, ivermectin, government and corporate censorship, and touch upon vaccine mandates and other topics. Anyway, as you'll hear in the discussion, neither I nor Eric have any conceivable conflict of interest here. In fact, Eric has distinguished himself in the past for going after big pharma.

He had his career fairly derailed at one point in his battle against Merck over Vioxx, and he was very much on the heroic side of the good in that battle. Neither of us have an idealized picture of the pharmaceutical industry or the incentives that might drive any specific decision there. or the incentives that might drive any specific decision there. The only reason for this podcast is I'm growing increasingly concerned about misinformation leading to needless illness, disability, and even death in our society and the world over. So, with that said, I hope you find this podcast useful. And now I bring you Eric Topol. I am here with Dr. Eric Topol. Eric,

thanks for joining me again. Great to be with you, Sam. So let's say you've been on the podcast. I forget when that was. It was a while back. But let's briefly introduce you properly. How do you describe your background and current perch in medicine? Well, I'm an old dog. I've been around for a while now. In the early years, well, I was a cardiologist, but research was more in clinical

trials. And then in the mid-90s, it switched to genomics and digital medicine. And so I'm at Scripps Research. I'm a professor of molecular medicine here and also executive vice president of the Scripps Research Institution. Nice, nice. So I'm talking to you today just because, you know, I know you're a wonderful communicator of science and medicine,

and you just help people think about what is rational on this topic. And also, you've been very active on Twitter throughout the pandemic, just forwarding articles articles which you helpfully highlight for people and just cutting through what has become truly a deluge of misinformation and disinformation and conspiracy thinking, malignant fantasies. It was just that we're now dealing with an information space that is so contaminated by, you know, the digital entrepreneurship of people with, you know, various convictions that it's just very difficult to get to anything like ground truth around around truth, around COVID and vaccines and sound public health advice. And this is coupled to a pervasive distrust in institutions now.

People distrust the government. They distrust the media. They distrust science and scientists. Our medical journals have lost standing. Certainly organizations like the CDC and the WHO have fairly immolated their reputations over the last 18 months or so. And some of this is understandable. I mean, there really has been some terrible failures of public health messaging and instances of hypocrisy and doublethink. But, you know, rather than perform an autopsy on all of that, I want us to see if we can have a

conversation about vaccines and vaccine hesitancy, and starting pretty much from first principles and from what we can be reasonably sure about in the current environment. So, you know, I have a few other things I want to say by way of getting us started here, but is there anything you want to say just to kick this off? Well, your points in the intro here are spot on, Sam. The vaccine progression from the sequence of the SARS-CoV-2 in January, January 10th, to the clinical trial executed, completed in November, and rolling out vaccines all in a matter of months is of historic significance. There's never been a vaccine that's been short of eight years as the average, and many fail. So what we have here is one of the greatest triumphs in biomedicine

in history, and it's very sad to see that being compromised by mis- and disinformation. Okay, so let's just talk about a few background facts here. So first, despite that triumph of rolling out these vaccines at record pace, the vaccination rates in the U.S. have now plummeted. We're around 250,000 shots, first shots given a day now, which is like first shots given a day now, which is something like one-tenth of where we were at our highest rate. And we'll focus on the US here, but anything we say will apply to other countries where vaccines are available and where a significant percentage of people don't want to get them. But I think we have to recognize that everyone is very likely to be in a bubble of sorts here. So I think, I mean, I honestly think I only know a few people out of the hundreds of people I know

personally. I think I'm only aware of knowing one or two who aren't vaccinated. And I'm sure that anyone who isn't vaccinated is very likely surrounded by people who are not vaccinated, right? So this is analogous to what happens with smokers, right? I think I only know one or two people who still smoke cigarettes, whereas if you smoke cigarettes, I imagine many of your friends are smokers. So we're impressively siloed here, and this is all making it very difficult to talk about what is rational and responsible because the siloing is not just socialist

with respect to information and sources of information that one deems credible. There's one difference, though, about that, Sam. I think you're making an apt comparison to the smoker circle orbit versus the non-smokers. But the difference is that the smoker circuit isn't directly trying to hurt the non-smokers. Whereas here, we have a harm that's serious, unfortunately. Yeah, it's worse than secondhand smoke coming from the unvaccinated here. It's a flip of the model. The way it was supposed to work, Sam, was that there was this famous herd immunity, which a lot of people had never heard of until they heard of herd immunity.

And then that idea was, if we could just get 70% of people vaccinated, then the other 30% would benefit because the virus wouldn't be able to find hosts. So that there, the majority, the one bubble would help the smaller one. But what's happened, unfortunately, is that we have a much more transmissible, contagious version of the virus with Delta. So we've seen a flip of that model where the unvaccinated, because it's a substantial minority, are now leading to infections in the vaccinated. And that's not the way it was supposed to work. Right, right. Yeah, so this is a bit of a stretch psychologically to build a bridge between where we are and where the unvaccinated, the resolutely unvaccinated are, right? I and all of my friends were profoundly impatient to get vaccinated.

And many of us were going to vaccine centers early on and lining up for hours, you know, even whole days, hoping to get some overflow vaccine, right? This is now months ago. And now vaccines are ubiquitously available. And we have people who don't want them. Right. And, um,

right. Right. So, but I do think, you know, rather than stigmatize the unvaccinated or put the onus on them in, um, very judgmental terms,

I just, I just want to see if we can, I mean, this is a pointless exercise. If we can't say something that stands a chance of being persuasive for these people. So, I mean, first, I think to understand who these people are, there's been a fair amount of polling on this. I'm drawing these comments from the Kaiser Family Foundation vaccine monitoring website. So there are a few ways in which our society is segmented here.

The first is obviously political, right? So there's a left-right divide politically that accounts for a lot of this difference. So 2% of Democrats say they definitely will not get the vaccine, whereas 23% of Republicans say that. So there's a very significant effect. And no surprise, there's about a 30 percent difference in vaccination rates among Democrats and Republicans. Eighty-six percent of Democrats have received at least one dose, and only 52 percent of Republicans have. And there have been exceptions to this with respect to public messaging. I mean, some Republicans and right-wing

media figures have said, you know, what I would consider the reasonable thing, but many have tended to amplify the message that COVID itself is not really bad. It's, you know, just a flu or maybe even a hoax, but these newfangled COVID vaccines are dangerous. And then you have people like Trump slinking off to get vaccinated in secret without using it as an opportunity to actually send a helpful public health message. So politics are definitely part of it, but it's not the whole story. Age is also a major variable. So people over 65 are much more likely to be vaccinated than the young. This is actually fairly rational So people over 65 are much more likely to be vaccinated than the young. This is actually fairly rational because people over 65 understand their much greater risk for serious illness or death from COVID. And there's also a rural-urban divide, which is again

somewhat, if not rational, understandable because the people living in crowded cities are more likely to get exposed to COVID, and they're more likely to be vaccinated as well. And there are other cuts you can make at this. Education is a variable. College graduates are more likely to be vaccinated than those who haven't finished college or never went. And there's some stratification by race. finished college or never went. And there's some stratification by race. Whites are more likely to be vaccinated than blacks or Hispanics, but the effect is not that great. And then there are weird pockets where there's a very strong anti-vax sentiment, like the yoga community apparently is very wary of getting vaccinated for COVID. And the reasons, when you poll people in these various groups, the reasons they give for not being vaccinated tend to focus on concerns about the

newness of the vaccines, right, and fear of side effects. You know, these are new vaccines, they could not have been fully tested because they were produced so quickly, and therefore they're likely to be dangerous, right? And then you add to this distrust of the government and also just a belief that they don't actually need a vaccine because the risk of COVID has been greatly exaggerated. This is basically the picture you get of why people are not getting vaccinated. So I think- I think there's two prominent things that you've mentioned that deserve emphasis, Sam. So first, you did cite the Kaiser Family Foundation survey, a large survey of Americans.

And in that, one of the most important reasons that people gave, and you can understand it, is that the FDA didn't give full approval yet, and it's still being categorized as an emergency use. And so that, you know, you can understand people being skeptical without this final blessing by the FDA. Then the other thing I think you've alluded to, but can't be emphasized enough, it isn't so much the problem with the unvaccinated, it's the problem of the information being fed to them, which they actually believe these things, because a lot of this is purposeful. A lot of this is

intentionally trying to prevent the benefit from being actualized. So I think those are factors that I consider pretty high on the list for where we are right now. What do you mean intentionally trying to get the benefit from keeping the benefit from being actualized? Well, in the political specter, as you've mentioned, there's such a remarkable dichotomy between the Republicans and the Democrats. And there was a great cartoon by one of my favorite cartoonists, Bill Bramhall, who said, well, Biden, he's out there in sunglasses, and he says on the cartoon, vaccines are bad. And that's how you get Republicans to go get vaccinated. But there is clearly a movement among many Republican leaders in Congress and states to not be

supportive of the vaccine front. And only in recent days, interestingly, have they started to come out with a message that this is important and that we're facing a very serious Delta wave right now. So this is, of course, very late in the game where we're now highly dominant with this very formidable version of the virus. And so the messaging from politicians to Buck, a lot of things have been blocked politically, and it's not an area that I want to even get into as far as politicization of the vaccines, but unfortunately, it has happened. And the data you cited, I mean, there are other surveys that suggest it's even worse

than that. So never before has vaccination in this country been so highly political. And I remember, you know, as a kid, I know I'm older than you, I think, Sam, but when I was a kid and getting polio vaccine, everybody got the polio vaccine. There was no politics. And, you know, if you go back in time, we've never had anything like this. And the sad part is the people who are not getting the benefit of the vaccine, a lot of it is because they're just, you know, they're on social media, they're getting fed misinformation. And by the way, we also know the Russians are involved. This is part of this, you know, mission of their divisiveness.

And we haven't had a counteroffensive in this country to all this misinformation. And in fact, I pleaded with Vivek Murthy, our Surgeon General back in May to do that. And I think you saw just last week, he did make that announcement, but it hasn't really been aggressive. It isn't calling out the sources of this. So what we have is a problem of lots of misinformation, some of it quite deliberate, and lack of a counter. Yeah. The reason why this is so upside down is you have many, many millions of people who believe some combination of the following, that the risk of COVID, the disease, has been vastly exaggerated, right? COVID is a hoax, or it's just a flu, or it's just not a factor, but the vaccines are scary and dangerous, right? So we just have literally tens of millions of people who are totally sanguine about the prospect of catching COVID, but really averse to the idea of getting vaccinated for COVID.

And obviously, from our point of view, that's totally upside down. But this is the balance that has to be, you know, the results of which have to be fairly judged. On the one side, you have the risk of COVID plus the effectiveness of the vaccines weighed against the risks of vaccination. Because, I mean, this is really a forced choice for all of us. Unless you're going to be perfectly in hiding, you're going to be exposed to the novel coronavirus, and it's some variant or many variants thereof. And you can either be exposed having been fully vaccinated or not having been fully vaccinated. And this should be simple to talk about, and the comparative risks should be simple to assess now, because we have many, many millions of people who have

run this experiment. We've got millions of people who have caught COVID without the benefit of a vaccine. We've got millions of people who've been vaccinated, and we can assess the negative side effects of getting these vaccines. All of this can be assessed, but again, this is happening in a context where many, many millions of people believe that, for instance, everything that has been going on here has been part of a vast totalitarian conspiracy. I mean, there are people who think that the lockdowns and the masking has been not for the purpose of mitigating real illness.

The whole point has been to acclimatize otherwise free societies to regimes of extreme social control, right? And then you add to that paranoia the belief that any emphasis on vaccination rather than treatment of COVID with existing compounds like ivermectin, that's based on a pure profit motive coming from big pharma and the mercenary manipulation of government, right? We're all doing the bidding somehow of Pfizer and Moderna. I mean, so I can say, for instance, someone's going to think that of us in this conversation. I mean, I should go without saying that I have absolutely no entanglement with big pharma. And there's no pressure on me to do a podcast about the benefits of vaccines. So this is just a pure PSA from my point of view.

But that's the environment in which we're having this conversation. Yeah, I would add, I have no connections, conflicts with pharma. But even every day, people on Twitter say, you're a tool, you're a shill for pharma. When in fact, I've been attacking them throughout. In fact, before the vaccines were approved, I was attacking them for not posting their protocols during Pfizer and all the rest of them. And also, more recently for a premature pronouncement of need for boosters. more recently for a premature pronouncement of need for boosters. And no, this is all, as you say, just part of that kind of multi-dimensional conspiracy, accusal and theory. And it's really,

it's saddening to watch and in a way be part of that. Yeah. Okay. So what do we know about the effectiveness of the vaccines at this point? Right. So the vaccines, when we had the first trials that came out in November, December was a formal review, we learned that they were 95% effective, both Pfizer and then subsequently shortly after Moderna. That was against any infection or, as it turned out, which wasn't the primary endpoint of the trials, the same was at least against any severe illness like death or hospitalization. or hospitalization. So the trials were just designed, 75,000 participants, multi-country,

which is the largest trials ever performed in vaccines. And they showed this remarkable, you may recall, Sam, that at the time when the trials were done, the FDA had set the bar for 50%. If 50% with narrow enough confidence intervals, that would qualify as approval. Here we had 95% striking. There's only one other vaccine in history that's been at this level of efficacy. That's efficacy. So then you have, of course, the different world, which is effectiveness, when you put the vaccines in the real world. And what's striking, wherever you look, whether it's Israel or the UK or the various centers that are reported in the US, we see the same effectiveness as efficacy. Now, that's unusual too, because what's happened there is the real world isn't like that ideal situation of the inclusion criteria, the exclusion criteria, exactly the right way that the vaccines were given, and they're frozen into the moment, and all the perfect things.

Usually, you see a drop-off in effectiveness. And in fact, it's held up. Now, that was with the original strain. And of course, there's been some evolution. First, from what is called the ancestral or Wuhan strain to the D614G, which had a little bit more transmission. And then we went through this alpha, beta, gamma, and finally now to delta. Now, delta, there is a small drop-off in effectiveness. We don't have an efficacy trial. We have now effectiveness in the real world. And what we're seeing now is like a five or six point drop. So instead of 95%, it's like 88, 90% effectiveness. That's exceptionally good against any symptomatic infection. And 96%

against death or hospitalization, which is extraordinary. So here we have what most would consider the best vaccine and data sets in history. And it's ironic that we have such a substantial number of people, or as you position it, bubble, that just are still not believing this. And of course, the safety has gone along with that. Yeah, so there are many natural experiments happening here. So one thing you can do is compare the rates of hospitalization and death for the vaxxed and unvaxxed. I mean, granted, there are contexts in which this can be misleading. So, I mean, obviously, in a society where 100% of people are fully vaccinated, well, then 100% of people who are hospitalized or dead from COVID will also be fully vaccinated, right? So, I mean,

but presumably there'll be very few of them if the vaccines actually work. But we have many who are hospitalized or dead from COVID will also be fully vaccinated, right? But presumably, there'll be very few of them if the vaccines actually work. But we have many situations where around 50% of people are fully vaccinated and 50% aren't. And we can compare what's happening at the hospitals and in the morgues. And you take a place like Virginia, where about just under 54% of the population is fully vaccinated. If you look at the hospitalization data, over 98% of the people hospitalized are not fully vaccinated. And over 99% of the deaths are for people who are not fully vaccinated. So it's just that our hospitals are not filling with the vaccinated in places where there's comparable cohorts of vaccinated and unvaccinated

people. So what we have is, what we appear to have now, is a raging pandemic among the unvaccinated. And of course, some number of vaccinated people will experience breakthrough illness and even severe illness and death, but the numbers are minuscule by comparison. Is there any way in which this doesn't speak to the effectiveness of the vaccines? I mean, is this a... Well, yeah. I mean, I think you're bringing up what has been used, again, by the same people who are the anti-vaxxers, anti-science. But what is being used

is the increasing number of breakthrough infections with Delta. So in prior, Delta, we know, has a viral load or the number of copies of replicant virus that is a capable replication, a thousand fold or more compared with the ancestral strain. So we know it's a more challenging virus, much more contagious, transmissible. Now with that, the breakthrough infections of people winding up in the hospital with the prior variant versions of the virus was less than 1%, and even less than a fraction of 1%,

and something like 0.1% for death. Now, it has gone up some for Delta. That is, you know, now it's a couple of percent, you know, few percent hospitalizations. And, you know, perhaps it will approach 1% in death. But the point here is that this is a formidable now version of the virus. And what we have is a problem with mathematics. Because people who don't understand that, like, for example, let's say in Israel where you have more than half of the current breakthrough infections, people are in the hospital and say, oh, well, look, the vaccines aren't working. Well, that's just because in Israel, among these people that are being looked at, you

know, 89% of adults have been vaccinated. There's no one else. There's no one left to get sick. Yeah. Right. Right. It's that whole point. If 100% of the people are vaccinated, then everybody's having, you know, and anybody who's in the hospital, obviously that defined a breakthrough illness. So people are missing the point about denominators and fractions, but if you calculate the vaccine efficacy, as has been done in the UK and in Israel, effectiveness, I should say, it stays at the 90% level. It has never changed with Delta. So here, I think, is, again, whenever there's just a sleight of hand with statistics, it's being used in a way by anti-vaxxers, what I consider to be deliberate.

A lot of these people are intelligent, they know better, but this feeds their narrative. Yeah, there's another comparison here, which should be pretty straightforward. We have something like 159 million people now who have been fully vaccinated in the U.S., right? And we have probably a similar number of people who have been exposed to the coronavirus. I mean, there's only 34 million confirmed cases, according to the CDC, but we know it's got to be higher than that. So we can compare, and we have tens of millions of people in each cohort, people who've been vaccinated and people who have gotten COVID. Now, if the people have gotten COVID, we have around 600,000 who have

died. For the people who've gotten vaccinated, when we ask how many people have died as a result of getting vaccinated, this is just a comparison of just how dangerous is COVID compared to the danger of getting vaccinated. These data are kind of hard to get your hands around because it seems like there's just, there are reports of people dying after getting vaccinated without there being any real assessment of whether the vaccine was causally responsible for their death. I mean, there's just people who happen to drop dead from something after being vaccinated. And the highest number I've seen there is 12,000. Yeah, but that is probably 12. Right. probably how many, if it's that many. But I think

this is the problem you're bringing up, is this is this unfortunate situation. We all like open science, open data, but the CDC, when they set up the VAERS, this is the Adverse Event Reporting System, they didn't recognize that this was going to be used by anti-vaxxers. Because these cases are not adjudicated. They've not, as you say, not been reviewed. They have no idea whether the death has any linkage because because we know, you know, people, when you have 162 million Americans, which we have as of today, who are fully vaccinated, you know, some people are going to die naturally with vaccination. And so these are people, part of the VAERS reporting system.

Now, what is extraordinary here is that this is used on a daily basis. The likes of Fox News, Tucker Carlson, Laura Ingraham, mainstream television stations and lots of other entities are using this data and it's obvious misuse because unlike the clinical trials where no one died of a vaccination, the safety was, I mean, it was just extraordinary. No one died of the vaccine in either Moderna or Pfizer, you know, when the 75,000 patient trials,

because every case, every potential side effect is reviewed by an events committee. Now, you know, we have one of the ways you could die of a vaccine would be if you had anaphylaxis, this profound allergic reaction. But there's been multiple reports of the people who had anaphylaxis with the, specifically with the mRNA vaccines, and they haven't died. I mean, they got treated and a few, you know, a small number had to get hospitalized, but that would be the one thing you could link with death. Now, there are these exceptionally rare, rare side effects like with the J&J and AstraZeneca, this blood clotting issue, which is called vaccine-induced thrombocytopenic

thrombosis, or what we have seen, very rare myocarditis in young people, particularly men, with mRNA vaccines. These are exceptionally rare. Guillain-Barre with Johnson & Johnson, 100 cases among 12 million people vaccinated. So if you just look at these rare things, first of all, they don't die. Most of these people don't die. They recover. Myocarditis,

almost all recover, and it's very mild. With the blood clotting issue, well, if it does occur where there's a cerebral sinus thrombosis, yes, that has a high fatality, but it's incredibly rare. One in hundreds of thousands of people with AstraZeneca or with J&J not seeing with mRNA. So just to review the composite here, the safety is overwhelming, but the VAERS open data registry of unadjudicated data is what's causing the problem because it's being basically used by people who either don't know or unknowingly are using it to spread false information. Right. Yeah. So I take all those points and undoubtedly that's the correct way to look at it. But even if we took the VAERS numbers at face value, even if we acknowledge that 12,000 people have been killed outright by these vaccines, it still makes COVID look a hell of a lot more dangerous than the vaccine for COVID, right? I mean, it's like,

you're still talking about when you have on the order of 160 million people who have been fully vaccinated, 12,000 people dying, that's less than 1 in 10,000 people dying based on this intervention. It would be a depressing number, but it's so much better than the number for getting COVID without having the benefit of the vaccine that people still have this upside down, even taking those numbers at face value, which of course we can't do. I couldn't agree with you more. In fact, you're looking at it overall. With respect to the exceptionally rare side effects that I've mentioned, the chance of you having any of those from COVID is considerably higher, orders of magnitude higher. So yes, across the board,

higher. So yes, across the board, the relationship between getting COVID risk versus any risk of the vaccine, it is overwhelming that the vaccines are providing an exceptional net benefit. And that can't be questioned. That's real data. That's the most solid evidence data set that I've known in my 35 years in academics. And it's important to realize that when you're talking about numbers this large, when you're talking about 160 million people being exposed to any intervention, there will always be some number of bad reactions that if you focus on those without understanding the background statistics, you know, could make, you know, a rational person, an otherwise rational person, nervous about that intervention. But, I mean, the truth is, if we were giving people peanut butter as a prophylactic against COVID,

if peanut butter were 100% effective against COVID, some number of people would die outright from peanut butter. That's right. I mean, that's just the nature of human biology. But, you know, obviously we would consider it an absolute gift beyond words if peanut butter could prevent this disease. Well, one other thing I just want to mention, because what you're saying is so spot on, but the issue about the concerns of long-term effects of the vaccine.

I do want to address that because a lot of people say, well, you know, I think the data look good, but what about, could something happen later? You know, and the answer there is, I think, pretty astounding in that in the history of vaccines, there has never been something that showed up beyond two months after the vaccines were in common use. Okay. We're now, you know, beyond seven months. reason to think that these vaccines are going to be different than vaccines that have been going on for, you know, many, many decades and so many different diseases and platforms. So the long term, people should have confidence in vaccines because we're not going to, there's no more surprises. You know, the surprises have been unveiled either in the clinical trials or the

first two months when they get into, you know, you have 190 million Americans who've been exposed to at least one dose. We have hundreds of more millions around the world. We know what these vaccines do. There's no long-term surprises that we could see at this point. Right. But even if we were going to give a hostage to paranoia here and grant that we don't understand the long-term implications of the vaccines, you still have this head-to-head comparison with

the actual disease of COVID, which makes the vaccines look comparatively benign, right? So if you're worried about the long-term possibilities of vaccines, you should be doubly worried about the long-term possibilities of having caught COVID without the benefit of having been vaccinated. If you're worried about people circulating an article that suggests that the spike protein born of the mRNA vaccines could be bad for the blood-brain barrier, right? But what does COVID do to the blood-brain barrier, right? Well, yeah. I mean, firstly, that is absurd. You know, I saw this through commentary that Brett Weinstein put out that people who get a headache as a side effect of a COVID vaccine, which is not uncommon to get a headache, that that could be a brain fog from the mRNA getting into the brain. This is totally unsubstantiated, totally. And to try to make a parallel where the true brain fog, that is the cognitive effect, a hit to people who do get COVID,

so-called long COVID or long haulers, which is happening in at least 10% of the people with confirmed infections. And I know many people, colleagues, people I work with who are affected by long COVID, who have a brain fog and have profound fatigue, have difficulty breathing, can't even go on a long walk that they used to be, you know, healthy and athletic. So for anyone to posit

that people who get a headache is having mRNA going into the brain, that is totally irresponsible. It's reckless, it's sick, and it casts unnecessary doubts to these people, the innocent. You know, in a way, Sam, I have to say it's predatory. It's taking people who want to believe in a conspiracy or don't know what to believe and making vaccines look like they're intended to harm with no evidence whatsoever. It's really sad. Yeah, well, so there's a conspiratorial frame of mind here, which is given just enough Pavlovian reinforcement to be almost impossible for people to break out of, because there are occasional conspiracies. there are certainly bad incentives that can be detected where it's easy to allege

a profit motive on the part of Pfizer. You referenced the fact that Pfizer was prematurely recommending booster shots, right? Well, the cynical reason for that is fairly obvious to see, because this would mean literally billions of dollars falling to their bottom line if that were our health policy. And so there's this background concern about a profit motive in medicine that is deranging people's thinking here. And I mean, so Brett Weinstein is an example of this. I know that he's very concerned that the emergency use authorization for these vaccines required that to be judged that there was nothing in the armamentarium of medical science that could treat COVID in principle in order to fast-track these vaccines. And therefore, we overlooked the near panacea of ivermectin, an old compound that is generically available and from which no pharmaceutical company stands a chance of profiting. And so there, in Brett's mind, you have the perfect storm of bad incentives

and greedy pharmaceutical executives driving policy toward a, you know, windfall profits and disregarding the life-saving opportunity of handing out ivermectin to one and all, and driving us toward some kind of abyss of novel risk, right? because on his account, these mRNA vaccines are new and therefore have to be assumed to be dangerous because they, by definition, are untested or we're testing them on ourselves now on his account. So this is where we have to deal with the claim about ivermectin and why it's not a rational alternative to these vaccines. Yeah, well, I do want to go over this because the notion about the emergency use authorization is incorrect. Firstly, that is the definition in the setting of a pandemic or a crisis for the FDA is may be effective. That's all it takes.

May be effective. It doesn't have to be that there's no other treatment. As long as it's something may be effective in an emergency situation, the FDA has the ability to push forward. As they did, you may recall, they gave an EUA for hydroxychloroquine. They gave an EUA for convalescent plasma. There already were other things, like for example, when the convalescent plasma was granted, which was wrong and had to be withdrawn, as was a hydroxychloroquine, both of those were, there were other things out there for treatment. That is, when the plasma, they were

already... So, you know, we've been through this, where there were all sorts of scents, whether it was then president or other people following the president, that hydroxychloroquine was, you know, some magical drug. And it proved not only to not have an effect, but to also have some dangers. The convalescent plasma, where over 600,000 Americans got convalescent plasma because of a tortured data analysis without a randomized trial. That was given an emergency use authorization, which promoted hundreds of thousands to get the treatment. It may have actually helped to spur on these variants because they were getting these polyclonal antibodies that certainly wasn't helping the situation, helping them.

So then comes ivermectin. Now, I've reviewed that data carefully because on Twitter, if I put anything on Twitter, I usually get at least some comments about, did they get ivermectin, or if only they had ivermectin. If they all had ivermectin, no one needs a vaccine, this kind of stuff, right? And so I tell, where did this come from? So it turns out, you know, there are a bunch of small studies, right? And they've been meta-analyzed multiple times by different parties. multiple times by different parties. And I think the best raking over of the data was by this fellow Gideon Meyerowitz-Katz, who put together, is ivermectin for COVID-19 based on fraudulent research? And that was just earlier this month on a medium. Now, in it, he takes an unbiased view and very careful view of ivermectin, which is an anti-parasitic medicine, as you mentioned. It has been used for river blindness. It is used

for lice. It is used for various parasitic diseases. And it's relatively safe. I mean, there are some serious side effects, but they're uncommon. Now, the point here is that what about these trials? Do we have any large trials? The trials like, you know, I did one of the largest clinical trials in medicine with 41,000 patients in 18 countries around the world for heart attack. And, you know, I know what a large trial is when I see it, mega trials, over 10,000, which is what you want and what the UK has done in the recovery trials. We haven't had one large trial in the whole COVID-19 pandemic done in the United States. But these trials, these trials of ivermectin are exceptionally small. And the largest one was this one from

Egypt, which Gideon Meyerowitz-Katz shows was highly irregular. One-third of the people who died from COVID in the trial were already dead when the researchers started to recruit them. I mean, you just don't see this kind of stuff. You need a time machine to run that trial. You have, quote, if this is an outright fraud, the ethical concerns of randomizing people into a clinical trial before the ethical approval comes through is enormous. And his piece takes this apart in terms of the fact that this trial from Egypt, the largest, which isn't large at all, I mean, just a few hundred people in

either arm of ivermectin. This is not what you would call any evidence for making ivermectin a standard drug. Now, I see a signal there that ivermectin could be beneficial. I don't know why. I don't know the mechanism. And I would also hasten to add that, you know, our place and many others have raked through every drug known to mankind for repurposing. That is, most molecules, drugs have been characterized. We know their structure and we can match up whether it would work against this virus. And ivermectin has never shown up, despite hundreds of others that have, for having an antiviral specific qualities. But putting the biology aside, it looks like there's a signal. But for anyone to say that this should be given universally, and as Brett Weinstein

has said, and others, that it's 99% effective, there is no drug that's 99% effective known to man. And then to say it reduces mortality or improves survival by 70, 80, 90%, these are impossible. They have never occurred. This is just not acceptable. Yeah, well, what's conspicuous here is what I am not saying in Brett's defense. I mean, Brett is somebody who I consider a friend. He's definitely a colleague. He's moderated some of my debates. I know his brother, Eric, very well. He's a fellow podcaster. We've been on each other's podcasts. I guess I would say that I haven't heard everything he has said on this topic, and he's gone on for many,

many hours, I know. But I've heard enough to be very uncomfortable with what he has said on this topic, and he's gone on for many, many hours, I know, but I've heard enough to be very uncomfortable with what he has put out there, and I do consider it dangerous. What strikes me as just frank misinformation getting pushed out there to millions and millions of people. But it is, in Brett's case, born of almost a characterological bias against institutions at this point, some of which I do understand. For instance, one thing that's really animating him is the response to what he's doing from the big tech companies, right? So the fact that YouTube will demonetize the episodes of his podcast where he discusses ivermectin, I'm torn even here. I don't know what YouTube and Facebook and all of these companies should be doing. I mean, there's certainly a straightforward argument that they should be censoring what is obviously misinformation.

But the problem here is that, you know, many things that were wrong yesterday are considered good information today, right? And it's like, they're very unlikely to get censorship right. You know, what is outlier thinking and can be deemed dangerous or irresponsible can, in the fullness of time, prove to be the only correct view. So it's just a difficult problem that they show no sign of being able to solve. And, you know, Brett and everyone who's listening to him are incredibly animated by their clumsy efforts at censorship, because they can always point to the instance where what they censored was, you know, actually is now CDC policy, right? You know, at one point CDC was against mask wearing, right? And you're going to censor the people who said we should have been wearing masks a year ago? It was just obvious we should have been wearing masks. It's a hard problem to solve

in terms of a response, and it's easy to see how people get freaked out by the authoritarian implications of having these virtually monopolistic companies close down conversation on specific topics. But it's a nightmare what's happening in terms of how friction-free the spread of misinformation has become. So I don't know what your thoughts are on the front of what we should be doing. And also just to close the loop on Brett's concern here, it's not just that the big tech companies are doing it, but there really is a conspiracy that's happening out in the open where you have the government asking the big tech companies to do this. It's not that no one ever conspires. Even in this case,

they even admit that they're conspiring. But certainly viewed from one side, it seems counterproductive, as bad as the misinformation and disinformation problem has become. Yeah, no, I am sympathetic to the point that everyone should be heard and things shouldn't be censored. That I think is clear. However, when it has come to a point where it leads to harm of people, then you have to say, well, is this crossing the line when you're harming a lot of people? Now, I think the conspiracy theories and theorists get tremendous amount of fuel when this happens. So for example, if we go back to the lab leak origin versus the natural zoonotic

origin of the virus from zoonotic to human, there were a lot of people who initially in the science community advanced that this had to be a natural, not a leak at the Wuhan Virology Institute. And then as time went on, you know, there were more and more irregularities, still no definitive evidence either way. And we may never get that definitive evidence. the people's voices who were not being heard regarding the Wuhan Institute lab leak, you know, assuming an accidental lab leak, they got more, they got more concerning substance. And then the conspiracy theorists would say, huh, there you go, right? And they were saying that at the beginning. And so now you have another parallel where, you know, whether it's ivermectin or, you know, vaccines, you have people who are pushing these agendas. And you know what? I

don't have a problem with pushing ivermectin as advancing it as a candidate drug that we need. Totally. There's 2,200 people in randomized trials. Most of the randomized trials are 20, 40, 60 people. 2,000 people to say it should be given universally and has 99% effective, that's not, you can't make that assertion. And I listened to Brett, a couple of his podcasts, interview with Tess Laurie, one of the UK scientists who he has been aligned with. And I can tell he's an intelligent fellow. I mean, he's a bright fellow, but he doesn't know how to do clinical trials and he shouldn't be passing himself off as an expert to interpret that data. These are not what we would consider definitive trials. Now,

it should be pursued. Ivermectin is a very inexpensive and relatively safe drug, and it may indeed have, you know, very positive effects. But you shouldn't be, you know, having emergency podcasts. And then the people that he brings together, like, for example, the Dr. Kirsch, who said the COVID vaccines have caused more deaths than have all other vaccines combined over the last 30 years. This is somebody he brought on as a guest. And then you have him also lined up with the frontline COVID-19 critical care alliance for an emergency podcast with Joe Rogan, making these claims. There's something serious afoot. The public is largely unaware. They have been placed in kind of danger, 99% effective ivermectin.

The pandemic would end in a month. That is complete balderdash, okay? The pandemic will not end in a month, and there is no drug or no vaccine that's 99% effective. So the problem here, there is no drug or no vaccine that's 99% effective. So the problem here, Sam, I see, is that he is overstepped. That is, he's aligned himself or had guests who are saying things that he then has a large following. And instead of taking a critical view, I'm sure he's upset with these censoring. I would be too. But it doesn't mean it should go across the line as to advancing things or people who have, and saying things like, for example, the headache, which is the mRNA crossing into the brain. These are unfounded things, and they're dangerous things. And that's where I have a concern. What do you make

of the fact that some of these people who he's brought on his show and at least one i think he was on with rogan with at least one other person these people are mds with seemingly relevant credentials in caring for people with covid and i mean these are not mds who've been sidelined from malpractice years ago, and they should be credible sources of information here. And it is... Should be. It's genuinely bewildering, even to very smart people, to see an MD who purports to be close to the data, and in one case, one of these people who even claimed to be the originator of mRNA

vaccine technology. I don't know how specious that claim was. And in one case, one of these people even claimed to be the originator of mRNA vaccine technology. I don't know how specious that claim was. This is actually one of the chief offenders. I'm glad you mentioned it, Sam. This Dr. Malone. Dr. Malone, who puts out that he was the inventor of the mRNA vaccines. Well, guess what?

He wasn't the inventor. And what he does is he's now a person who is leading the charge against the vaccines. And people unknowingly, because he identifies himself as the inventor, this is the perfect fuel for the conspiracy. I mean, it's incredible. You couldn't make this stuff up that a person who positions himself as the inventor, having worked decades ago on a path, but he is not the inventor of either of the mRNA vaccines. And then also, the frontline doctors, the frontline doctors, one of whom I should say was part of this, they are the ones who are suing the government right now that the vaccine should

be taken off the market. Okay, so we have a problem here, you know. This is a group of people who are either unwittingly or knowingly harming people who don't know better, who I have to say, you know, their channel of disinformation is, I consider, predatory, because it's not based on the right evidence data. And I don't want to see it censored, but I also want to see it toned down and stick with the facts. Don't make stuff up. Yeah. So again, people are going to find this hard to adjudicate, because on the one hand, going to find this hard to adjudicate because on the one hand, it's you and me talking about this, and you're an MD with a seemingly relevant background, and we're up against Brett Weinstein and his MDs, and it's a, he said, she said, situation where you sort of have to pick the

authority who you trust. But that, I mean, there's more information than that. That's a standoff. But we're living in the presence of the largest vaccine and disease experiment ever run, right? We're talking about tens of millions, even hundreds of millions of people getting the disease under conditions of being vaccinated or not. And the disparity in the results is so clear at this point. And again, even if you take the worst numbers from the most vaccine avoidant as the ground truth for what these vaccines do to you, it's still an easy decision to get vaccinated to mitigate your risk. Yeah. I mean, when you have vaccine trials done around the world, you know, the first two, the mRNAs and 75,000 people, and then, you know, since that time, hundreds of thousands more participants in randomized double-blind trials. I mean,

these are the real deal. Then you have, you know, 2,200 people in all of the ivermectin trials total, you know, around the world. I mean, there's a little bit difference in the weight of evidence, the totality of evidence, also with the safety. And I think that should drive people, if they truly are data-driven, evidence-based, even if you're not with a medical or science background, you want to see totality of evidence. And you don't want to see things that are just either made up or fueled by these, I would say, a good example of somebody who I know, known from the past, is Alex Berenson. OK, he's a formerly an excellent New York Times journalist.

He then wrote a bunch of novels that were highly successful and spy thrillers. And now he's a regular on Fox News talking badly about vaccines and making stuff up and using data, manipulating data. And of course, he's a hit with this group, right? But he has no background. He has no clinical trials background, no science background, but he is a darling of those who want to be fed with this kind of information. But how do you explain, Eric, the people who do have the relevant background going this far down the wrong rabbit hole? I mean, just the MDs who Brett has in his stable. What are they up to?

I mean, what has happened? I mean, one way to explain it, it's a fairly invidious thing to say, but there's some percentage of MDs and PhDs and people who have all the right credentials on paper who snap for one reason or another. I mean, they're going through some inordinate stress in their life, or they're actually delusional. We basically have a background level of schizophrenia in any human population of 1%, right? So you will occasionally find crazy MDs and PhDs who will testify about anything. Now, I'm not making a specific allegation with respect to

the people we've named, but you have to expect that you can always find a crackpot PhD or MD for any... I mean, you can find them to defend big tobacco. There are people who will either cynically or based on some derangement will back any cause and put their credentials to that purpose. But do you have any other sense of what's going on with these guys? Yeah, you're making a really valid point here. And that is we have seen people who have a medical degree who are not supporting the body of data that's so overwhelming regarding safety of vaccines or the lack of adequate proof, for example, in the case of ivermectin. And, you know, the answer for that is difficult to come up with a why.

But I think the thing that hasn't been done, And the answer for that is difficult to come up with a why. But I think the thing that hasn't been done, I'll go back to something we discussed early in our conversation. If we had a counteroffensive for the facts, that is, if we had said, remember when Trump was very frequently lying and there was a fellow on CNN that was the official fact checker and he would take them on one by one and get the facts. And he did an exceptional job of that. He was pretty busy, you have to say, throughout the time of the- Like 20,000 documented lies or something. Right, right. Well, anyway, we don't have that in the pandemic. If the people were called out for lying or for fact-free, they may back off. But when they have a license to just make stuff up or twist things, to not acknowledge that the VAERS registry, none of it has been adjudicated.

None of it we know of any events, or we know that they actually happened in what was the potentially known root cause of these events. But they don't do that. That's a data set that's abused in the highest way. But there's something about being a contrarian, too. I mean, you're a minority. You're in a different circle. The people in this group are very, you know, seem to be close-knit and, you know, kind of spurring each other on. You know, perhaps the fellowship of being in this group is alluring.

I just don't know. the fellowship of being in this group is alluring. I just don't know. It's sad to see, though, because I know these people are intelligent, and they must recognize the lapses in what they're pushing. Yeah, what I don't think people recognize, I mean, people who have a conspiratorial style of explaining anomalies don't tend to recognize that their explanations don't actually run through. I mean, there's no plausible background set of incentives that could explain a given conspiracy coming together. I mean, so you take, you know, like the 9-11 truth conspiracy as an analogy. You talk to conspiracy-minded people on that topic, and they'll just toss off one claim after another without acknowledging the truly insurmountable obstacles around getting

people whose incentives are not perfectly aligned to collaborate in such an awful project, right? Who rigged the Twin Towers to explode, right? Like, just how many hours does it take to go into those buildings unobserved and rig them to explode, right? And, you know, how do you get hundreds or thousands of people to collaborate in that project of murdering their neighbors on a bright fall morning and then never breathe a word of it afterwards? I mean, no one feels guilty, no one divorced their husband and then spilled the beans. I mean, it's just perfect silence, perfect collaboration. And so it is with many conspiracies that get alleged in this context,

just like the influence of Big Pharma. The truth is, there is absolutely no conspiratorial explanation for what you and I are doing on this podcast. Right? There's no connect... Like, I've got no connection to Big Pharma. I will criticize Big Pharma in the next podcast on another topic. Right. With absolute freedom.

I've got no fear of YouTube demonetizing me. I mean, it's just, I'm completely free and this is, I'm doing exactly what I want and you're the person I wanted to do it with. And this is what we're doing. And as you know, Sam, I almost, my career almost ended back in 2004, 2005, because I took on Merck about my ox. You know, I am the least person in the world that's pro pharma. Okay. And I've taken big risks about takingioxx. I am the least person in the world that's pro-pharma, and I've taken big risk about taking them on, and I still am during the pandemic. So no, we're trying to play this thing straight. We're trying to go with what is the body of evidence that is extraordinary.

We are in a momentous time in life science where we learned how to, you know, develop vaccines at scale in a time velocity that no one could ever have imagined. And to basically end the pandemic, we could have, had we been able to get vaccines widely distributed throughout the world, potent vaccines throughout the world early on, the pandemic would essentially be over now, okay? We wouldn't have a Delta variant. We wouldn't even have beta and gamma, right? We probably would have just been able to arrest it largely and contain it at the alpha stage. The problem is, though, we aren't able to make the vaccines for seven plus billion people, right? Not fast enough.

But the other problem is in the United States, which is far worse than any other place that I know of in the world, we have a very significant proportion of these anti-vaxxers, conspiracy theorists, anti-science. I mean, this started, of course, before the pandemic, but it's been, you know, gone much higher levels. So we are not reaping the advantages and the protection here that we could. And, you know, I have to say,

I was really looking forward to the summer, this time of year, because I thought, you know what, we could get right back to pre-COVID life. I could stop having to put my attention on COVID and get it back to the things that I much more enjoy. And basically, it's been screwed up because of Delta. It's now going to last a lot longer. We'll get through Delta. It'll take a couple of months. We'll get over this wave. But the toll it will take on the deaths, on the hospitalizations, and particularly the large number of cases we're going to see with long COVID. That was unnecessary had we not had so

much resistance and hesitancy and anti-vaxxing for the people who would be part of the protection instead of part of the liability and vulnerability group. Right. All right. Okay. so let's conclude on some recommendations or confessions of uncertainty about what we should do going forward. Before we talk about vaccine mandates and related matters, what's taking so long with the full FDA authorization of the vaccines? Why is that not already accomplished? Yeah, well, I've been pushing hard on that. And as you saw, I had a New York Times op-ed a few weeks ago. And prior to that, trying to get Dr. Woodcock, who's the acting commissioner, to come out and talk to us, tell us what is going on. So I know the former FDA commissioners well,

some of them, a few of them I've spoken to at some length about this. And as you know, I've been on several FDA advisory committees over the years. So I know the workings and I understand what's happened here is that the usual so-called biologic licensing application, that's the full approval, that is 100,000 plus pages of documents. It requires plant inspections. It's not just the clinical trials. It's emergency authorization, the company started submitting packet by packet to get FDA review. And so we've had seven months since that time for the FDA to have completed their review. And indeed, in speaking to FDA commissioners, they believe it should have been done by now. In fact, it should have been done in June at the latest. And we now have heard just last week from Dr. Woodcock that this could

take till January. Well, we can't wait till January. This should have been done. Now, there is no excuse except that this is not the number one priority. And as you saw, there was an Alzheimer's drug that was approved, highly irregular, concurrent with this. And so it's really unfortunate. We do not have an FDA that's functioning at the level it needs to in the midst of this pandemic, especially as the U.S. is confronting this very formidable version of the virus. Yeah, and in defense of the people who are worried about the quality of our information, the truth is we need institutions we can rely on, and it's pretty clear we don't quite have them.

I mean, the FDA, the WHO, the CDC, all of them have at various moments covered themselves in embarrassment in the last 18 months. So, you know, that's, again, there's a rational way to understand that, and then there's the paranoid way to exaggerate the nature of that problem. But it's, yeah, I mean, we do need a rebooting of our institutions here, and there's no question. What do you think we should do around requiring vaccination in the public or private sector in various contexts? So, you know, mandates in schools or hospitals or businesses or for travel. I mean, what are your thoughts about that?

businesses or for travel? I mean, what are your thoughts about that? Yeah, it's really tied in, Sam, to the question you just asked about the full approval, because general counsel of our health system, and if you talk to private large companies, municipalities, even though there have been some that have said, like, for example, at the University of California, you have to be vaccinated or you can't come on campus. You can't be a student. You can't be on the faculty. But that's the rarity right now. The day that we get full approval, which should have happened by now, all these things open up and there will be a requirement for vaccination, or there'll be accommodations for those who don't want to get vaccinated. You have to wear a mask at all times at work, and you have to get tested on a frequent

basis. And I would submit to you that the people that opt for the non-vaccination after a couple of weeks, they're not going to want to go through all that, and they'll go ahead and get vaccinated. So I actually think tens of millions of Americans soon after full approval will be required to be vaccinated or will be given an option that is unpalatable. Yeah, we should acknowledge that there are some people who actually can't get vaccinated. I mean, there are people in various stages of cancer treatment, I believe, and there are people who just have weird immune systems who go into anaphylaxis over vaccines that are as benign as possible. And so, you know, herd immunity is the only way to protect those people because they can't get vaccinated. And under any regime where vaccines are required, there would still be a medical exemption for certain people, right?

Yes, yes. But, you. But those same people want to have protection with masks. They want to have protection from, like, for example, if they did get infected from testing, they'd want to get monoclonal antibodies to the virus as soon as possible because they don't have an intact immune system. So yes, you're absolutely right. Some people can't get vaccinated. It's very rare, but for them, that same option of masks and frequent testing is part of their defense. If we didn't have the anti-force, we would have passports, right? We would know that you had an option. Either you had your vaccination digital proof or you had a rapid antigen test very soon around that time. You had proof that you're good to go, whether it's to a restaurant or to work or on a plane, whatever. We are against passports in this country, just like we've had the anti-force against masks and vaccines and stay at home when things were really rough. So that's unfortunate,

but several countries, as you know, are adopting the passport system and it's working well. I mean, there are countries like in Denmark, they rely heavily on rapid antigen tests. And while they're getting their vaccinations up to the highest level, it's working extremely, extremely well for suppressing infections and many other places as well. So we aren't taking advantage of the rapid testing side, which we should. I mean, a lot of these companies are U.S. companies. But that's another misfire. I wish we could do that. It would help the situation we're in right now.

Well, Eric, to my ear, I feel like we've covered it. I'm sure not to the satisfaction of the people who are unpersuadable. But is there anything else left to be said in your view on this topic? Is there anything else left to be said in your view on this topic? Well, you know, I just think when we go forward years from now, well after this pandemic is over, and hopefully we'll be at a time when we can really be reflective, we'll think about this momentous science advance, science and medical advance of vaccines, and the extraordinary proof track record of potent efficacy safety. And we'll wonder, what happened? Why did the U.S., who failed as a country in the early part of the pandemic, with, as you said, 600,000 and more deaths still, 600,000 and more deaths still. Why did they not become the world model for blocking the virus's harm? And I think a lot of things we discussed today, Sam, will be written about for years to

come because we had the potential to just show the world that we could build the delta wall of immunity, whether it be from the vaccines or, as you mentioned, the 100 million plus people who had prior COVID had had some natural immunity. How did we botch it up? How did we become as vulnerable as we are right now and in the weeks to come? It's really unfortunate. And maybe, maybe after all this, we'll have a movement back to being data-driven, evidence-based, and not allow for the misinformation to propagate, which is something that should be emphasized. We know that the misinformation gets spread far better than truth, right? That's been documented.

So maybe, maybe out of all this, it won't happen now, but in the years ahead, we can get back to where we were. Where we were in the old days when the polio vaccine was being rolled out and all the other ones since then. Yeah. As always, Eric, thank you for your wise counsel and your time. I look forward to the next occasion. We'll talk about a happier topic. We'll talk about human health somehow, rather than our needless misadventures and own goals around disease.

But until then, thank you so much. Thank you, Sam. Real pleasure. I look forward to the next chance that we get to talk.