Sawbones: A Marital Tour of Misguided Medicine - COVID Variants and Guns for Vaccines

Episode Date: June 8, 2021

You might have heard about the COVID variants that have some people worried, and how effective the current vaccine will be against them. But not to worry, we’ve got the sweet sweet data from the Lancet, and some good news regarding the (specifically Pfizer) vaccine. And if you haven’t gotten a vaccine yet, maybe a car or lotto ticket will motivate you. Or a gun?Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, Tommy is about to books. One, two, one, two, a day for our family. Hello everybody and welcome to Salbo. It's a marital tour of Miscited Medicine.

I'm your co-host, Justin McRoy. And I'm Sydney McRoy. The voice is sounding good today, said, I don't know, have it, did you sense it? You sense it, right? It was kind of deep today. The instrument, the gravelly. It's in it and ready to, ready to go.

You know what, I think it's just excitement because we're finally going to do it. We're finally going to talk about coronavirus. Oh, yeah. Well, now don't say that because as soon as you say that, there's a section of our audience who's going to go, no, but I. No, it's good. It's very, it's, it's, it's a good time. I just got my, my weekly after vaccination check-in reminder, literally as we were just talking. Well, there were a couple things that we got a lot of emails requesting, you know, some questions answered, a little bit of clarification on. And I thought it would be worth, I mean, I don't want to do an update.

There's places you can go look at the numbers of cases and stuff and for a lot of people you're living that. But specifically addressing two things, one, the variants. Because I think especially very recently there was an article that came out about the variants and vaccine efficacy. And I noticed there was a large gap between what the article and the data actually set about that and what the headlines set about that. Yeah, I've been bothering you with some questions about that. So that's one of the things I prompted us to want to talk about this today.

That was definitely part of it. And then the other thing I've been receiving very recently, a lot of tweets and messages and emails about is the question of vaccine incentives. And we'll get into the West Virginia specific ones because they're spicy. Oh boy, baby dogs on the prowl. They're spicy. And part of those questions are, is West Virginia really doing this? I'll, you know, spoilers, the answer, yes. And- For sure, for Gevergyar.

Secondly, it's an interesting question, the idea of incentivizing vaccines in this way. Is there a history for that? Is there evidence for that? Is that something that would work? So there is some history to this show, this episode. Okay. Because I do want to talk about like,

why would somebody think that was a good idea? It's not that wild. But let's start with the variance because I think that's the thing that is on a lot of people's minds. Is my vaccine still working? If I got it, hopefully you did. I did.

You know I did actually personal. Well, I know you did. That illicit, non-street legal legal after Santa Cumpan to my veins government says it's too powerful Straight from Oxford to us with no FDA infringement. No need the man getting in my way So we have incredibly effective vaccines against COVID-19 That is the appreciate it like headline that should trump all other headlines that keep going out there. We have it credibly. It's the greatest word choice but...

Go on. You know what I mean? Woo, that should... You serve all other headlines. Worse somehow! Worse! It's more obvious by the effort. At the time of this recording, and you can follow this, if you go to CDC.gov, you can watch

their like coronavirus tracker, which not only keeps track of all the cases in your area and in the country and all that kind of stuff, but keeps track of all the variants and what proportions are various places, keeps track of vaccination rates down to the county level. All these things are being tracked. So you can go, this is all open information. You can go check it out. At the time of this recording, 41.6% of the US population is fully vaccinated. That's of the entire US population.

So not just those eligible, but I think that that's an important number to track because while it is nice like morale wise to see that if you just go to the people who are actually eligible, that number goes up. And if you go to specific high risk groups, like people over 65, that number goes up even higher. That's all good news. When we talk about things like herd immunity, when we talk about the idea of enough of us being vaccinated to protect those who aren't 41.6% is not there yet, which, you know,

I mean, we're getting there. That's, it's not bad news, but it's a reminder that we still got work to do, right? Yes. Part of that work is approving the vaccine for, you know, everybody, but we're getting there. We're getting there. And I think I should preface,

I am gonna mainly focus on the situation in the United States. That's where I have most of my data. And that's where I understand as a medical professional working here what the situation is on the ground. Obviously, we saw a huge global issue in terms of vaccine availability. The vaccine distribution has been incredibly inequitable. And we have some countries like ours, which are super saturated with vaccines, and other countries where it is still rare

to come by outside of those in specific like healthcare professionals, high risk fields and things like that. So, I think it's always important to remind our listeners of that that we are so privileged to be having a conversation about incentivization for vaccines in this country and not a conversation about how the heck do we get vaccines. But what other issues are there?

Well first, the variants are causing concern as we're trying to get everybody vaccinated for a couple of reasons. One is that many of these seem to spread more easily, right? That's what we keep hearing about these new variants. And that headline, if you see it as true, these tend to be more contagious. They spread more easily than the original recipe, I guess, if you wild-type. It's a new extra crispy variance. Technically wild type is what we would call the first virus. The one that was originally isolated. And so it's kind of a race, right? If these spread

more quickly, but are not necessarily more deadly, we don't necessarily have that data to prove that they're more dangerous, just that you're more likely to give them other people to other people if you get them. So now the, you know, rush to get people vaccinated becomes more urgent. But the other concern is that will the vaccines that currently exist cover these new variants? Will they still be effective? And that's probably the scarier of the two, right? One is just a matter of moving quickly. The other is, will moving quickly even work? So the first variant that you may have heard of, and I don't remember hearing it called this a lot,

the alpha variant. They just, I read a story about this, they just decided to like start rebranding these to make them easier to like, I think probably to avoid the old Spanish flu thing of like, call it naming them by a region, you know, they're, I think you're exactly right. That's exactly why I'm going to, I'm going to regionalize two of the variants we talk about only to give you the new names so that you understand what I'm talking about.

Because I noticed that too, the, some of the older names are being replaced with these alpha beta gamma delta delta these new names. Which I approve of that idea, they are going to be I think harder to remember now because we learned them one way, but it's a good idea. I think we should be doing that. So the alpha variant has replaced the wild type virus in many places, if not most places, that has taken over. So like if you think about what is spreading wildlife in the US for instance right now, we're talking about the alpha variant.

We're not talking about the wild type virus that was first detected in Wuhan. What seems like a million years ago, but it wasn't. The good news is that the vaccine still appear very effective against that one. That's why you haven't, I think, heard as much about how it overtook everything is because we kind of thought it was still working well against the alpha variant. But like the bad news, like many of what are called VOC's variants of concern. There are variants of concern and variants of interest. So like, and there's qualifications for each of those.

Those are like, are there some maybe chill variants where they're not very bad? And it's like, oh, this is a good variant. Variants of no concern. Yeah, variants of zero concern. Very good. Chill, chill variants. I'm sure, but they don't maybe track those quite as closely.

Once they find them, they forget about them and pay more attention to the others. But again, you can look all this up on the CDC website where they list what are the US-specific variants of interest, variants of concern, and what the criteria are for those different categories. But like many of them, the alpha is more contagious, which is the theme. You're going to hear that repeated again and again. They're more contagious. The other variant that's causing concern globally,

although not circulating widely in the US yet, which I mean, you just have to assume it's just a matter of time with all of these. If one is out competing the other strengths, so to speak, in the sense that it's more contagious to your scene, rise in those cases while you see a fall in the alpha cases, it's just a matter of time before it gets everywhere.

Yeah, don't trick yourself into the thing we all did in January of 2020, we're like, I don't think it's actually going to be. I don't think it'll get here. It's going to take a weird problem right here. The Delta variant. This variant originally isolated in India is now taking over the alpha variant in many places.

Like the UK just recently, I think they have, it has come into the lead. It is more prevalent than the alpha variant, new cases, so the incidence, I should say, is higher, because it is even more contagious than the alpha, than the original, then, you know, like we've said, most new outbreaks are associated with this delta variant. And while the jury is still out at this point, honestly, as to whether this one might be slightly more dangerous, so not just more contagious, but is it more likely to make you sick? Is it deadlier?

We don't think so, but we don't know for sure, right? Because that piece is going to follow. Like you're going to see if you're monitoring the genomic situation, like you're monitoring new strains and testing periodically to see what are not strain but variant. What variant is out there? If you're monitoring and monitoring and you start to see a higher proportion of these delta variants, you wouldn't see the increased rates of hospitalization and then increased fatality until later. So we don't think it's necessarily more deadly, but that's kind of still a question mark. Is it theoretically more dangerous?

We fear reinfection with it. That's been one thought or we've seen new cases because people who had alpha and recovered are now getting delta or people who had wild type and recovered are now getting delta, the data has not supported that as of yet, that that's not really the case. And we know that it has at least four specific mutations that make it spread more easily. That's the level, if that science brings me comfort, if that level of detail might bring you comfort, we are understanding how this thing is changing down to like, like I said, there are four tiny mutations

of this mutation. And it's genetic code where we know exactly why it is what it is. They're mutations, oh, you're saying that there's four little things that are different about. Four little differences that make it more contagious. And we understand each one of them and why that is happening. Scientists are following all of this so closely.

And again, this data is all widely available too. You can look at all this online. I think it is a little denser. It's a little harder to parse. I mean, even for me, like as a medical professional, I understand it conceptually, but I'm not, you know, viral genetics or not my specialty.

Yeah. But it's still, you can look it all up. The big question is- You should ask me for help, baby, if you're struggling with it, I'd absolutely would have just waited in there and I'm a white guy, so I probably- Sure. I've kind of explained it to me. A little bit, yeah.

As a man. You've done so much for me over the years of science Communication, I feel like if you were if you're if you've been like, ah, shucks. This was just too tough I would be like what's going on? Maybe I could help that kind of yeah, yeah, I can yeah, I can hear you saying that Don't need to get frustrated those do this together Yeah, it's like when you're woodworking and I come in and say, well, I don't know anything about tools or woodworking, but maybe I could figure it out for you. Yeah, and I'm always very gracious

in accepting that help. Oh, wait, I've never done that. That's so weird. I wonder what the difference is. Well, the difference is I didn't do it either. It was just a joke for the podcast. I'll move on. The big question with this Delta variant,

and with all the other variants we've heard about, there's the beta variant, which initially they were calling the South African variant. And now that one was earlier, right? I'm going to figure out a lot about a little bit of that. So now we're calling it the beta variant. And the gamma, which is, I don't feel like it was called the Brazilian variant, but maybe they talked about one out of Brazil anyway. The gamma. So the beta and the gamma and the delta are the ones that we're all kind of more worried about than the alpha at this point. They are all more transmissible again. The question is are the vaccines as effective against them?

So there was a recent study that was published in the Lancet and it specifically looked at the Pfizer vaccine. So that's the only one we have a good amount of data for. There's some scattered data for some of these things from the Oxford or AstraZeneca vaccine and the Johnson & Johnson or Johnson vaccine. There's nothing so far that I've seen published yet from the Moderna. And this is the thing that got all the media coverage. This study that came out in the Lancet just this past week

and then you saw all the headlines, this is where it came from. So they looked at the Pfizer vaccine against the Delta Alpha and Beta variants. Okay. And what it found, like I said, has been widely reported but not necessarily well reported. First of all, I would say, again, the takeaway point is that the vaccine still seemed to be very effective against all variants of concern so far. That's the main takeaway, I would say. It did show a couple of things, though, that we do need to know and monitor and be concerned about. I think it's important to be very clear about that.

It wasn't all rosy, like, yep, works just as well against all the variants. No, it didn't show that. It wasn't all Rosie like, yep, works just as well against all the variants. No, it didn't show that. But the idea that it showed this catastrophic deficit in the vaccines, which I think is what was sort of hinted at in some of the headlines, is not true. Yeah, we actually was looking at this right before because I had seen some of these headlines pop up. I feel like the media needs to get their act together the way that they're reporting, like take a beat and say, like, do actually know what I'm doing. Cause they are, there's some fear mongering

going on that they need to be. You saw it a lot, I think when there would be incidents of side effects for the vaccines, like the Yahoo news story about this exact topic is the Delta variant of COVID-19 just got even scarier. Like can we do better, please? Can we be adults about it? Thank you.

Okay. Well, I think you're exactly right because it's not, I mean, it's not scary. It's overall good news. But if you don't acknowledge the places where you can do better, then why are you even, I don't know, in science? Yeah. You're not seeing problems and trying to perfect the thing you're working on to work even better and address things, which obviously scientists are.

I mean, that's why they do these things. So they can look and go, how can we address this? Moving forward, is there something we're missing? Not so that we can be scared, because being scared doesn't seem to help us very much. Yeah, yeah. No. So, like I said, it showed a couple of things we needed to know.

First of all, one Pfizer shot was found to be pretty good against the original wild type strain, right? Like we learned that as things went on. Like I know it's a two-shot regimen, but you get pretty decent protection even after the first one. So that's good news, because while you're in the midst of your vaccine series, you already are quite not fully, but quite protected. So that was something we all really like.

This is not, and it's only slightly less robust against the alpha variant. However, the reduction of efficacy of one shot of the Pfizer against the Delta and Beta was much more significant. So the idea that we could get away with just one shot, maybe of the Pfizer, seems to have dissipated with this. Like, well, maybe against the old, the old variants, but against these new ones, that second one is going to become really important because after two shots that gap was bridged considerably.

It wasn't found to be as effective against the Delta and Beta as it was against the original wild-type virus, but the difference was pretty marginal. And it was still an incredibly effective vaccine. If the numbers that came out, which are in the 80% tile, in the 86% I think percentile range effectiveness against these new strains, if that was the original number that came out with the vaccine,

we would have all celebrated, right? I mean, because some of the vaccines that are in use are in the 70% range. Yeah. Why? So why is a reduction to the mid 80s, why is that bad? Why are we focusing on it at all? I mean, here's the thing, this is my opinion after hearing you talk. We shouldn't be sparing our thought for these variants currently when vaccine one,

hesitancy, and two, supply line issues and production, Those are what we should be focused on. Like it, not these, not the variance, right? Like if you're wondering you're worried about something is what I'm saying. Not like the government shouldn't be, but like if you personally as a human being wanna be worried about something, be worried about like those things.

I, yes. Yes, no, I think, okay, yes, I'm going to get there. I have the takeaway points. What I do think is important that we could all as just, you know, people, not necessarily the scientists involved in making this stuff, but just people living through this. I think there are some takeaway points from this that are helpful, but I agree with you generally that this is not where our focus should be right now is like People trying to make it through it. I want to talk just briefly about how this study was done to understand what we can learn from it

But before I do that we got to go to the bill in department. Ah, well, let's go The medicines that ask you let my God for the mouth. From the internationally acclaimed creators of Who Shacha comes the movie podcast Maximum Film. Star and producer and film festival programmer Dreaklark as a woman bound by passion. I saw this eight months ago on the festival circuit and I loved it. Film critic Alonzo D'Araide as a man corrupted by passion. I saw this eight months ago on the festival circuit, and I loved it. Film critic Alonzo D'Auraldé as a man corrupted by greed. Why watch one homework, Chris's movie when I can watch seven? And comedian Ify Wadiway as a man protecting a love that society simply won't accept. I think Pacific Rim is a perfect movie, and if you can't accept that, then I want you out of my life.

From the makers of the movie podcast, Hushacha comes Maximum Film. That's right, we changed the name of our show to Maximum Film. But don't worry, we're still a movie review show that isn't just a bunch of straight white dudes. So tune in to Maximum Film at MaximumFund.org, or wherever you get your podcasts. The back of my seat is all cold because I've only needed the edge of my seat. I didn't be here about how this vaccine study was conducted for the Lanson. They're doing this big. I'm going to be I'm going to be brief.

I'm not going to get in. I read all the details so that I could summarize it for you and you wouldn't have to read all the boring stuff. Oh, thank you. They're doing a big study in the UK called the Legacy Study and they're taking basically like antibody levels, they're taking serum from people who got the vaccine,

healthcare workers largely and periodically testing them. And there's this big giant study to collect lots of data so that we hopefully in the future can understand better why do some people get so sick? What are the risk factors to get so, getting so sick from COVID-19, and then what treatments might work better in the future?

So there's this big giant study and it's part of the serum that they've collected, you know, from all these individuals in this study. They were able to do this, this other research. So basically what they did is they took serum from somebody who's vaccinated. So like, let's say you're a healthcare worker and you got one vaccine. Then they would take some of your, you know, vaccinated serum and they would add it to some infected cells in a petri dish. And there would be a petri dish with some wild type infected

cells, some with the alpha variant, some with the delta variant, and basically look to see how effective it was at stopping replication and entry into the cells and infection, as a model of stopping infection. Right? And then they would dilute that and put it in again and dilute it and put it in again. And from each of those dilutions, they could calculate how many neutralizing antibodies were in there. Okay. This is how they come up with these concepts of how effective it is. This is like the stuff that's actually being done

when they then publish that percentage. Does that make sense? Yeah, because you can't just, I mean, it's hard to do that in the human body. I would imagine to run those tests on actual people. Yes, well, yeah, I mean, that would be, they would be very difficult to say, hey, we have this new highly contagious strain that may or may not be more deadly. And we would like to do is give you one vaccine

and then give it to you and see what happens. Did we mention the Starbucks gift cards? Because that is more of an equation. I don't know. Okay, you're walking away. All right. Basically, what they found is that it was harder to, that you didn't have as many neutralizing antibodies to the Delta and Beta variants as you did to the alpha and wild type.

There was like a slight reduction to the alpha and then a more, and then a statistically significant reduction for the Delta and beta. After one dose, the number was much lower after two. There was a 17% reduction as the number they came up with. What does that mean? Contextualize that for me. That the vaccine is 17% less effective against the Delta variant than it is. Right, but what is the practical, practically speaking, what's it mean? Like will you still get sick? I don't know. Theoretically, they're going to be more breakthrough infections with the

doctor. But I don't know what I mean. 70% what I, the question for me as a layman is, does that mean there's an 83% chance I won't get it. And there's a 70% chance I'll get it just as bad as everybody else. Or there's an 83% chance that I will like, are we talking about reduction in power or reduction in like binary? Yes, no, you are defended or not defended against COVID. We're not sure yet. We don't know if that's a reduction in like asymptomatic infections, symptomatic infections, hospitalizations,

serious infections, deaths. What we know is that you don't have as many neutralizing antibodies to these new variants as you do to the original. 17% less, you might say. Yes. Got it. Got it. That's what it means. All right.

So theoretically, I mean, what, and you can look, there are charts where people have taken this data and sort of extrapolated it to what that means. And again, that's where you, that's where you get that, like, I think 86% based on this data, we would extrapolate it that it is 86% effective in preventing serious disease, hospitalization, death, blah, blah, blah. And like, I think, I believe the chart said 82% effective in preventing all infection. Yeah. Which are still great numbers, but obviously less than the original, what 94% I think for the

Pfizer. So, and there's problems with comparing all these numbers and we're extrapolating things based on models. And so like, there's a lot, there's a lot of variant in there. It's not so easy as saying, so these numbers are hard, like it's not hard, Matt, you know what I mean? Like that we're still trying to piece some things together. So what does all this mean? First of all, they found that an older age made you more at risk for having a low number

of circulating neutralizing antibodies, right? Which are what the vaccine is supposed to make you have. We know that's true anyway. We know that's true for vaccines. Generally speaking, the older you are, your body is not as good at generating that immune response. We know that. Second, as time since vaccine increases, your number of neutralizing antibodies decrease. We knew this already. We already

were seeing this that like in these studies that many of us are in as they take our blood and measure our numbers of neutralizing antibodies as time goes on, the further we get from that second dose, the lower those numbers get. We don't know exactly what that always means for immunity because as we've talked about before, there's that memory, that humoral, that memory immunity that youral, that memory immunity that your body has, or even if you don't find the antibodies, your body still remembers and T cell mediated immunity. All these things that are sort of immeasurable in this study.

They're measurable, but not we're just not like that. So we don't know what that means, but we do know that those numbers go down. Third, the vaccine still works extremely well against these new variants, the Pfizer at least. And fourth, we still don't know what any of this, as I've already kind of alluded to, we don't know what this means in terms of actual disease.

They're doing all this in cells in a petri dish because it's what they have to do. But we don't know what the Delta variant is gonna look like when it plays out like in real life. If a vaccinated person gets exposed to the Delta variant, does this just mean that it provides them less protection from infection at all? And they're more likely to carry it asymptomatically, more does it mean they're more likely to get a severe case of COVID.

We can extrapolate numbers that we think are true, but we don't know for sure yet. This is still something we need to know. What it did indicate though is that since the UK, like most places, this is where a lot of this was focused initially, since they vaccinated older people first, which we did too. That means it was a while ago. They've had their vaccines, some of them the longest. I'll also front line workers and all that. But I mean, if you're over 65, you got your vaccine quite a while ago.

If you're over 80, maybe even longer. And because they are older, they generate less of an immune response possibly. So maybe they're getting to be at higher risk. That is one concern that was generated by this. The further out we get from them being vaccinated, we start to worry. It also called into question, if you remember in the UK, they initiated a policy of let's get everybody one shot and will increase. Remember, they increased the interval between the first and second dose in order just to get everybody vaccinated as quickly

as possible. And if one shot provides you a really good level of immunity, that strategy makes a ton of sense. But if one shot doesn't, that strategy starts to make less and less sense. This is, I think this is part of why this got so much sort of like a alarming traction is that that specific idea that maybe we

could just get everybody one shot as fast as possible and then get the second one whenever our supply catches up. That idea kind of crumbles in the face of this Delta variant. Sure. Yeah. There's a lot of math to figure out exactly, you know, well, how long can we wait and how much effectiveness does it still have and all this. But I think that is part of why this got so much more press. The AstraZeneca and the Johnson have also indicated less efficacy against these other

variants, but we're not really sure what that means yet for the Delta. They haven't done this. This that the Lancet published was the first really good piece of chunk of data we have just on the Pfizer. Yes, and it's just on the Pfizer. The Moderna we don't know a lot of people have said like we should probably extrapolate whatever Pfizer has to Moderna because they're very similar. They're both in RNA vaccines, but we can't say that for sure. We just don't know. So what do you do with this information? I would say one, if you're not vaccinated, I would start that process as soon as possible.

Yeah, I as well go get one. She can. And two, if for some reason you were considering not getting your second shot, and you've already had the first one, I would reconsider and get the second shot. Because while the old variants, maybe you were OK with that one shot, the new variants, it is less likely that the one shot's gonna get you there.

It still could, it's just less likely. Yeah. So I think that that's like, there's not a lot of other takeaway that the average person can do with this information. The vaccine still works super well. Nothing changed. It just stresses more that we need everybody to get vaccinated and everybody to get fully vaccinated.

Pay attention, there may be a booster at some point. That's the other thing that a lot of people are talking about is well from this data, are we thinking like we're going to need to not just get a booster of the same thing, but a booster that has been, you know, tinkered with just a little. Yeah, yeah, yeah. Like, you know, especially with these mRNA. Just to broaden your coverage a little bit. Yes, or maybe our booster, you know, there are a lot of like the flu vaccine, for instance. The flu vaccine doesn't just have one flu strain in it, right? We know this.

It usually is made up of four different strains, three A's and a B. Well, maybe the future COVID vaccines will have more than one in them. Maybe they'll have this wild type alpha, all this stuff that it covers really well. And we'll throw in something that's a little bit changed to better cover these delta and gamma and beta variants. That's why this information is important. It doesn't mean that you at home should be scared of anything.

It means that the scientists who make the vaccines are figuring this stuff out. It's information for them, but then it gets published in the lay media and all these words like scarier. That just shouldn't even apply. Yeah, it's pretty irresponsible. So if you're still not convinced with all this, but let's say somebody isn't. I just told you why all this information means is more than ever get the vaccines that are available because they are still incredibly effective and safe and you should get them.

Everyone who is eligible should get them. If you're still not convinced, how about a truck? Yeah. Or maybe a lottery ticket? Do you want to get entered into a million dollar lottery? Yeah. Or would you like a hundred dollar gift card? Or a saving spot? Which would you prefer if you're a young person? I'm just going to keep getting vaccines until I hit it bigger, guys. You want a free ride to college? Oh, yeah. Or a free beer. It depends on which state you're in, which one you're getting off of. Or, or, or, how about a gun? Oh.

Hmm. That'll be the one I win. You watch. I'm just going to open up boxes for a GLA. Only outside, there'll be my gun from West Virginia. Thanks for your participation in vaccination either gun. These are all, in fact, incentives being used to encourage people to get the vaccines.

These are all true depending on where you are in the country. And while our state, West Virginia, has become the butt of a whole slew of new jokes. Just we knew them. That I don't appreciate because of this. I will tell you that, let me separate this out. First of all, I'm just going to say I'm going to qualify this with I do not believe we should be giving guns away for vaccines. Yeah, or period really? No, we have a gun violence problem you might say in the United States of America.

Yeah, just about a gun violence we have. Right, with all the gun violence and shooting and shooting deaths. But other than those. Yeah, but so like I don't I don't support that incentive. So let me just put that out there. Yeah. Now that being said, the idea of vaccine incentives is evidence-based. We do have studies and data that say this isn't like a wild idea. We've largely studied this in the past in families, like looking at childhood vaccination rates. So like, how can you incentivize families to get their kids vaccinated?

We've also done some studies in people experiencing homelessness. How can you encourage people experiencing homelessness to come get different vaccines as they've been offered through the years? I think one was on like hepatitis B. We've been doing this since 1980 and so we have like big meta analyses which are we take a bunch of studies and then analyze all the data from those altogether. And we have those from different countries to the US has done it Australia's done it Germany's done it different places all over the world have done this for a long time to try to get people vaccinated. And they've done things like money, gift cards, food vouchers, a lot of stuff

aimed at families. So like, here's a gift card for various baby products that you might need, lottery tickets, government vouchers for childcare assistance, all these things have been used to increase vaccine uptake. And we know that even modest incentives do work, like it's true. If you have a fixed incentive, if you get the vaccine, then you will get this. We have plenty of data that shows that there is definitely a subset of the population

that is vaccine hesitant, but not vaccine, you know, not anti-vaccine. And those vaccine hesitant people, for some of them, it's just a matter of, they're a little anxious about it and they're busy, and it's one more thing to have to do. And they just, they haven't gotten around to it, and there's probably a part of like fear there too.

And that if you can just give them sort of the right motivational thing, it will overcome that hesitancy and go do it. Now, I am not going to suggest that this is the only way to do that. But this definitely works for some people. They've also found, you know, if you care about such things that it's cost effective to provide money to people to go get vaccines. Because of all the money you saved, taking care care about such things that it's cost effective to provide money to people to go get vaccines. Because of all the money you saved, taking care of very sick people from the diseases that the vaccines prevent.

Right. They have also found that a benefit is that it provides this increased contact between healthcare workers and patients who are like, hey, come get your kid vaccinated. And then when you bring them in there, they ask you about other things and you build your relationship and you take better care of people. And then when you bring them in there, they ask you about other things and you build your relationship

and you take better care of people. And so like there are other reasons why this is good. That being said, because you're going to talk about something like this, you need to talk about the concerns and the possible harms. Obviously, the appearance of coercion isn't great. Right. And I think what we're seeing that play out is that one, and it's a very small percentage of the population

I think one study estimated it like 14% who have said like absolutely no, no way no pro the COVID-19 isn't a problem for me And so I would never even consider the vaccine That percentage of the population sees this as More evidence as to why they shouldn't get the vaccine right. Yeah, well Why would the government give me money? What are you trying to do to me? What's the conspiracy? This, this, these past months have been an absolute test of my,

but we weren't going to reach those people anyway. I know. I know, but there's still human beings. It's like so. I know. And the human is, it's like a very, a very challenging time. I try to look at this from a public health standpoint. And if somebody is never going to get vaccinated no matter what I say,

but there are 10 other people who, if I can talk to them about the right concern, answer the right question, help them traverse the right barrier. They will get vaccinated. The better use of my time as a science communicator is those 10 people. Because that one person who believes that Bill Gates and microchips and 5G and government conspiracy. Do you know how I'm never gonna convince you? Do you know how expensive microchips are right now? Do you know how bad of a microchip short?

There are a truck sitting in four plants that they can't put out the door because they don't have enough microchips but know they're just like giving, they're just putting them in your arm. It's so stupid. When you say that, you know that there's going to be somebody out thereips, but no, they're just like giving, they're just putting them in your arm. It's so stupid. When you say that, you know that there's gonna be somebody out there saying, but why do you think there's a shortage of microchips? Because they're raw materials.

Because they're in the vaccines. I can't. They're obviously not in the vaccines. I was being just anxious. There's no microchips in the vaccines, just, you know, vaccine. Anyway, you have to be especially careful though, not just because of this sort of like

fringe conspiracy stuff, but also we're dealing with vulnerable populations in a lot of these studies where they've done this, like children or people experiencing homelessness, who you could use financial incentives as a form of coercion. And you don't want that to be, you're motivating people, you're helping people,

make good choices by giving them something that makes their life a little easier, which is why like for all these programs for childhood vaccination, they found things that were very focused on families like a food voucher was helpful. Because it does help to address, so some people have been asked,

like, why are you not getting the vaccine? And there are a lot of places in the US where there are communities of people who are still concerned about cost, because we haven't communicated effectively that the vaccine is free to everybody. And I know, through my personal experience, helping someone else get a vaccine,

like navigate that process, help you get them signed up for a vaccine appointment, that when you sign up at certain locations, they tell you to bring your insurance card. If you are uninsured, you might see that and think, oh, well, I can't get it. I don't have insurance, and I don't know how much it's going to cost, so I'm not going to go. And it doesn't say on those forms, also, you get the vaccine for free, whether you have insurance or not. Right. We're just going to. We're just going to.

We're just going to. We're just going to. We're just going to. We're just going to. We're just going to. We're just going to. We're just going to. We're just going to.

We're just going to. We're just going to. We're just going to. We're just going to. We're just going to. We're just going to. We're just going to. We're just going to., it doesn't matter. You still get the vaccine. We haven't communicated that well and we could do that. There are other people who have heard about these accounts of people saying, like, well,

I took the day off of work after I got my second shot because I had so many side effects and so I wanted to make sure I could recover. There are a lot of people who can't afford to take a day off of work just to recover from vaccine side effects. And so they're really hesitant to get the vaccine because can't afford to take a day off of work just to recover from vaccine side effects. And so they're really hesitant to get the vaccine because they're trying to find a time in their schedule where they can be sick for a day. So I don't think we've communicated effectively that majority of people won't need to do that.

You know, most people won't need to do that. We also haven't said like, how about this? How about we'll give you your vaccine and we'll pay you to take a day off work if you need to recover from it Like that's a thing a country could do you talking about a functional country that I mean Yeah, if you want to live in a functional country or I mean like the bigger systemic issues Which is like you should be able to take sick leave when you're sick and you shouldn't have to lose your job or lose your pay You know there's a functional society would have I that I want to live in a functional country.

But instead, we have people go to work sick to their own detriment and the detriment of everyone around them and then you get a pandemic. You have an adversarial relationship between the medical establishment and patients anyway right now. And so it just seems like another brick in the wall. The trust there is very is very low here in our country. There's more we could do. We could be taking more vaccines out to the people. Centralizing them isn't always the most effective. There are a lot more things we could do than just giving incentives, but there is a demographic of people for whom this will work.

And it's so generally speaking, studies have found it to be a low risk, low harm intervention, and cost effective. So if that is the case, even if it's only a low risk, low harm intervention and cost effective. So if that is the case, even if it's only a chunk that we're getting of the unvaccinated, that's a chunk that wasn't getting vaccinated that will now. It might be working. Ohio claimed that, you know, they announced a lottery. Right. They're governor who's doing a few different things and one of them was a lottery.

And in the days after he announced that lottery, they stated the Department of Health in Ohio said that they had a 28% jump in vaccines given in the days following that announcement. When they had been sort of like lagging in their numbers, they did studies of this ahead of time. People have been asking this question for a while. Like for months now, people have been out there trying to figure out what works, like secretly doing studies been out there trying to figure out what

works. Like secretly doing studies on us to try to figure out how we would respond and what would get us vaccinated. They asked like if we gave you money, would you get vaccinated? And what they found is like two thirds of those surveyed had a price. There was a number and for a third of them, it was a hundred dollars or less. So for a third of them, it was $100 or less. Nice. So for a third of people, $100 will get you vaccinated. Right to check. I mean, I don't, I don't, I think the coercion thing is silly. Who cares?

Well, you know, you always need to, I think, I think, I think. Coercion, okay, now hold on, we, we use coercion in every facet of society. We coerce people by giving them tax incentives for behaviors that we approve of as a society. We have celebrities who are telling people to go out and I mean, it's coercion. Like it's all coercion. You have to think about things like,

so the US Equal Employment Opportunity Commission had to issue guidance on this in terms of like employers. Right. What can they to avoid them coercing their employees into receiving vaccines? They've had to issue guidance because of this kind of thing because if you're an employer and you're like, hey, I'll give you a day off if you get the vaccine and where the one's giving you the vaccine, then it starts to, it gets icky.

Why? It gets dangerous. What they've said is that if it's a third party, if you just bring us proof that you got vaccinated, it's fine. But we don't want to set the precedent that the employer can start giving you medications and they can fire you if you won't take them. I understand this, this vaccine is different. I understand that, but like, do you trust big business to have that power

or do you want somebody independently saying, okay, look, these vaccines are great. Yes, you should encourage your workers to get them, but like, let's be careful how we do it. Let's just make sure we're doing it in an ethical way. Yeah, I know. I mean, that's a fair point. I mean, really? It's a fair. I mean, it's not, yes, that's a fair point. Because if they can save money by cutting out bathroom breaks and having their employees pee in bottles, you know, maybe for example, just a wild example, I came up with all the top of my head, they'll do that. So what else?

Yeah, no, it's fair. There's always limits. But the point is, we have an established track record that in various programs throughout the world, they have given people cash, cash is usually pretty effective to get a vaccine and they've gone and gotten the vaccine. And a lot of those people were going to get it anyway, right? Like, we're not dealing with people who were absolutely against the vaccine and then said, well, okay, but for $100, I'll do it. Right. Those people have probably made up their minds,

but there are a lot of people for whom getting the vaccine is a perceived burden. And if there is something given to them to offset the burden of getting the vaccine, they're more likely to get it. There's, and I know that there are a portion of the population that is like vaccine hesitant in the literal sense where they're like, I will go get it just like, I need to, I'm procrastinating, vaccine procrastinators.

Either it's, I want to see how it goes with everybody else. That's a big one. Which, by the way, chill impulse, very cool of you. I want to see how it goes with everybody else. That's a big one. By the way, chill impulse. Very cool of you. I'm gonna see how it goes with you guys. And then, you know, I'll maybe dip my toe in if you guys haven't grown a third nipple or something. Like it's a wack thing to do. But it's also like, I don't know,

I just haven't had time to do it. I know I need to do it, but like I just haven't had time. Because there's, because we have people who are like, barely getting by. So like, yeah, it's not that, you know, look at the voting rate. You know, that's a hugely important thing

that would be great if everybody did. And we don't make it easy for anybody. No, no, I would say that as challenging it, as it may have been at some times during this process to get a vaccine, it is way easier right now to get a COVID vaccine than it is to vote for many, many Americans. If you can believe that in our, in our what shining hill of democracy, whatever the heck we say we are. Anyway, the only

other thing is I thought it was really interesting as I was reading about the history of these incentives and like the idea is this helpful, which again, it seems it will be. It seems it, or at least it could be. It's a good, it's a good effort. They have been trying to figure out how to get us to take this vaccine this whole time. One of the things they did a study on, they did surveys and found was that there were a proportion, especially of people who identified as Republicans, who were more likely to get vaccinated if it meant that they didn't have to wear a mask anymore. Democrats said they were two, but Republicans even more so. And you got to wonder when you saw like the CDC issue, the guidance that if you're vaccinated, you no longer have to wear a mask. You got to wonder how much of that didn't come from this idea that we have all these people, we really need to get vaccinated and

they're just not. And maybe if we incentivize them this way, they'll get vaccinated. I mean, I would argue it a smarter way of doing that would have been like, if we can get to this number as a society, then we can walk it back. So there's like peer pressure to get people. Well, I would, I would agree with that. I know. Because it's like, I'm sorry, you walk around now anymore. And I don't know how it is across the country, but you walk around indoors.

One's for you anymore. There is zero mask adherence, which like, I know the vaccination rates here, and they ain't 100% like absolutely not. No, I mean, I think it was a risky play. I'm not saying I necessarily endorse it. I think it was a very risky play. I think, and this is a whole other subject, so I'm not going to get to it. I think especially children have been completely left out of the thought process for the rest of this. My kids still have to wear masks, which we have told people from the beginning are to protect you from other people. So to protect other people from you.

Yes. Excuse me. So like they have to wear the mask even though we've been told that like that's not what it's designed for. Yet all these other adults, unvaccinated adults can just hang around no problem. Like sucks. It's really, it's been very upsetting to me. Not just as apparent, but like I'm a human and kids are humans

and I care about them just like I care about other human adults to see how much they've been left out of the conversation as we move forward because the thing is like I Agree that like kids benefit from being able to be around people and other kids and I agree that we needed to move in a direction Where we could get kids in school and safely in places and all that but then kids don't mind where the masks anybody who's out there saying like these masks are harmful to kids Have you been around kids wearing masks? They don't care. They are better at it than adults They are they just wear them and they don't really think about it because they're getting to you know go places again And so if they have to wear a mask, they'll do it The masks weren't harming them the masks weren't harming us

but But that's a whole other issue anyway. All of this being said, I would like to apologize on behalf of our country that we are having this conversation about how can we pay people to get vaccinated when there are so many places in the world where people would pay to get vaccinated or walk miles or whatever to get a vaccine. And they just don't have them. We have like, I think one one statistic said we have like more vaccines than people right now. And we can't pay people to get vaccinated. I know. I know. I know. I know. I know. I know. I know.

I know. I know. Like, from a moral standpoint, there's a part of, when I hear people cry for like, if the, if these people in the US don't want them to send them somewhere else where they'll take them, I mean, I understand that. I understand that feeling. I do think like it's a systemic failure. It's not the fault of every individual who's vaccine hesitant.

It's the fault of our institutions that have failed us educationally on all levels, but But anyway, sign up in West Virginia and hey, if nothing else, I told mom I said mom I don't know what I would do if I won a gun. I don't want a gun I don't have guns and I wouldn't own guns. So what would I do with a gun? And she said well, maybe you can like dispose of it somehow and rid the planet of one more gun. That's sure. That's how I don't know how one disposes of a gun. I just throw it in the woods. I don't think that's it. I have to look that up. Like, what do you do if you just want to get a gun out of circulation? What do I do? As far as you can,

10, 20 feet in the city. But that's my plan. If I were to be the recipient. Don't email us about how to get rid of a gun. Well, if it becomes an issue, we'll let you know. Thank you so much. We won't be getting guns. Thank you so much for listening to our program. We wanted to let you know, I have a quick plug.

I was in the narrator for a horror anthology series called Bad Vibes. I play a character called Mr. Boogie. He's like a kind of a scary gentleman. Yeah, and he's the host of the show and he narrates it. Got a lot of great writers and a lot of great stories. It's made by a company called QCode and I am the narrator of it.

And a lot of people said good stuff about it. It's cool, it's coming in 3D audio, so if you listen with headphones, which I would recommend, it kind of like sounds like, you know, stuff to the right, you know, kind of stuff. It's cool, it's called Bad Vibes. So please check it out if you get a chance.

And please get vaccinated, please. Well, Sid, we should have led with that. Now I look like a real heel. I'm just saying, please. Sheesh, Sid. Ask your friends and neighbors and family like encourage people, talk it up, help people find dispel myths. There is no cost.

There is no microchip. Just by the word, say free and effective. Thank you so much for listening. Thanks to taxpayers for these, of their song Medicines is the intro and outro program. Thanks to you. It's been a do it for this week, so much for listening. Thanks to taxpayers for these of their song medicines is the intro and outro program. Thanks to you. It's gonna do it for this week.

So until next time, my name is Justin McRoy. I'm Sydney McRoy. As always, don't drill a hole in your head. Alright!