 I'd like to just play you some of the montage of clips of the CDC director, Rachelle Walensky, talking about vaccines over time and get your reaction. You are protected against severe COVID hospitalization and death and are even protected against the known variants, including the Delta variant circulating in this country. We have seen now evidence that we've been looking at just over the last week or so that has demonstrated that the vaccine is starting to wane in its effectiveness against infection. Just last month, the CDC and the FDA both said we would not need booster shots. What specifically has changed in the data that has changed your guidance? Right, several things. So first, in the last six weeks, we have seen Delta in this country. I don't want to say never, but we are not necessarily anticipating that you will need this annually. A new vaccine with a new approach for most Americans, that means one COVID-19 shot once a year each fall. We are simplifying our message. The message is you need to get your fall booster vaccine. So go ahead and get it. What do you think of the job that the CDC and Rachelle Walensky have done as it pertains to the vaccine rollout? I think it's been very poor and deeply troubled. It's the characteristics of a speaker who's decided what she wants the public to do and then reasons back to the sort of messaging that she should deliver rather than somebody looking at the scientific facts and just telling you what we know and what we don't know and what we still uncertain. We can go back to the beginning, the first six months of 2021 as vaccine rollout started to take place. You know, in the first four months we were supply constrained, meaning not everyone who wanted one could get one right away. We made a number of mistakes around who should be prioritized. We prioritized a lot of young, healthy people, over older people. We made mistakes about dose two, the United Kingdom stretch dose two out, which actually provides more durable antibody levels and has better safety than putting the two doses together. Those doses were arbitrarily picked very close together because we needed the trial to result quickly in 2021. By the summer of 2021, it was apparent from Provincetown, Massachusetts and other instances that you would get people who were vaccinated were still able to catch the virus and transmit the virus. That means all the mandates that happened in the fall, which was when Biden pushed the mandates were medically unethical because you cannot compel an intervention on a third party if it provides, sorry, you cannot compel a medical intervention on somebody unless there is a benefit to third parties. But by the fall of 2021, we knew that that wasn't the case. Now I wanna point out, we could have made Pfizer answer the question. In the randomized trial Pfizer ran in 2020, we could have asked them to swab people randomly and their households randomly and we would have had an estimate of transmission. But over and over again, you'll see that to some degree, both administrations give the companies the benefit of the doubt the easiest path forward. Now let's talk about boosters. This country is unique that we have a singular focus on boosting everybody from 12 year olds to six month olds to 86 year olds. Whereas in Europe, a number of nations have focused primarily on older vulnerable people. That makes a lot of sense, the European strategy. Our strategy does not make sense, not supported by evidence. She's being criticized by people like Paul Offit who he himself makes vaccines. And her rhetoric throughout all this is always too certain and states things that she does not know to be true. I mean, there are video clips of her saying, we know you can't spread the virus. She didn't know that to be true when she said it and it turned out not to be true. I wanna contrast what the official line or advice is about the vaccines with what you are saying because what it more or less is, and I'm gonna play the clip of Rachelle Walensky in a second talking about myocarditis and display some of the CDC's messages about this. But it's basically like, okay, this is a, there's a mild risk, but in the big picture, you can get myocarditis from the infection itself. There's lots of other bad things that can happen from the infection itself. So we need to just simplify the message and say you're better off getting the booster than not. So let me play this clip from Rachelle Walensky and then have you respond to that line of argumentation? It's of this rare but mild myocarditis come in and we heard about this yesterday at the advisory committee on immunization practices yesterday. But what we do when we do this is we look at the risks and we look at the benefits. And to just put this in perspective, if we have a group of 12 to 17 year olds who are working to vaccinate over the next four months and we can vaccinate a million of them, which would be great strides. Over the next four months, we could expect 30 to 40 of these mild, self-limited cases of myocarditis. And for that, if we were to vaccinate all one million, we would avert 8,000 cases of COVID, 200 hospitalizations, 50 ICU stays and one death. And so we raise the risks as well as the benefits, these extraordinary benefits of vaccines as we make these recommendations. And it is why we at CDC have made the recommendations to vaccinate and had co-signers from so many other medical organizations, including the American Heart Association. So that on its face, that argument makes sense. Is there something wrong with her math? Yes, that's exactly right. So I mean, her premise is correct that every time you take any medical product, you gotta weigh the potential upside against the potential downside. And even if there's downside, if there's more upside, it's still in your best interest to take it. So we all agree on that premise. But the problem is there are errors in her math. All of their math is nothing but errors. A few things they conceptually get wrong. One is that you don't have to give, in their modeling, a lot of the times it's all or nothing. It's either four boosters or no shots at all. I personally think that the vast majority of adults benefit from dose one. Dose two is when I start to struggle with from 20 year old men. And dose three and dose four, I have different cut points. So it can vary by dose, depending on your modeling. Number two, we only really know with sort of good precision the reduction in severe disease in the first two doses. That's what we tested in a randomized fashion. For boosters and for the fourth, the bivalent booster, we're doing sort of retrospective looks. In other words, we don't actually run an experiment to see what the efficacy is. We just let people get it and we go after the fact and say, hey, let's compare people who got it to people who didn't get it and see how they do. Okay, let me bring up like this slide real quick. Because I know that you analyze this. This is a CDC slide. And it's to the point that you're talking about there, saying that per million doses of the, this is of the bivalent booster in 12 to 17 year olds over six months, there's the numbers of hospitalizations. ICU admissions prevented zero to one death prevented. And then in red at the bottom, zero myocarditis cases. So that's the message coming from the CDC, but you're saying that these studies are just, they're garbage, they're not designed properly. Yeah, so I mean, this is a model. It's based on like all the models we've had in the pandemic that you know, wildly inaccurate. Oftentimes it's based on your assumptions. And so what they're assuming is rate hospitalization from the past that are gonna go forward into the future unchanged. But of course that's gonna be different because more people have had and recovered from COVID. So that's gonna be lower. What they assume is a vaccine effectiveness so that this bivalent booster will lower your risk of severe disease that they're actually getting from an older age group and extrapolating to any younger age group. They're getting it from this sort of backwards looking kind of study that has a bias in it. And that bias, of course, you know, Zach and Nick, the bias is that people who choose to get the booster are different than those who don't in other ways than the booster. I mean, they're usually more precautious people. They're people who may have higher socioeconomic status. They may more likely to be liberals who live in certain cities, you know, for instance. And those other differences might play the role, not the bivalent booster itself. So you have a sort of dubious estimate of hospitalization, dubious estimate of vaccine efficacy, extrapolating to a younger age group. And then let's talk about the harm side of the ledger. She says zero harms out of the 48,000 doses, but they can't actually believe the harm will really be zero. It will be something when you give it to more people and allow more time for follow-up. My best guess as to what that something will be is one in 10,000 because that's a very nice estimate from the third dose in roughly this age group from the Kaiser Permanente group. So again, you know, these types of exercises modeling in science, it's the most malleable science. You can bend and flex it. And I can make my own analysis that would probably reach a different tipping point than hers. The problem is that the person doing this modeling has already decided on the policy. They've already decided that these vaccines have to be given to this age group and then they do the modeling. And that's very problematic because if we know where we wanna go, we can get the model to give us the result. Is there any world where this, you know, in an alternate universe, how would this have been accomplished? How would quality studies have been accomplished? Because you do understand, like I can understand from their perspective, we're in an emergency situation. It's a pandemic, people are dying, getting hospitalized all the time. So we don't have time to do these high quality randomized control trials might be the argument. Is there anything to that? And you just kind of have to deal with the uncertainty. Yeah, so I think it's a potential argument. And there's always two things. They say, we don't have the money and we don't have the time. The money, I think we'll all concede they have because Pfizer and Moderna have 100 billion reasons they can make this happen. The time is the question, how long do these studies take? And my answer is the following, simple thing. They debuted this bivalent booster in the fall, I believe in September, and we still have 14% uptake nationally in age groups. So what's the point of rushing something that nobody wants anyway? The next thing I'd say is that randomized studies actually don't take as much time as you think. Just think about the initial vaccine trial which was launched sort of in the summer of 2020 and yielded a result by the fall. If you increase the number of people you give it to, you'll get a result even faster. I think it's inexcusable that they don't make the company do those studies. The company is going to make money for year after year, billions of dollars. They can afford to do it. We can have the infrastructure to do it. And by doing those studies, I think you will learn the reality. And my guess is the reality is that the benefit of these products year after year after year is gonna be smaller than what they think it is. Hey, thanks for watching that excerpt from our conversation with Vinaya Prasad about US public health, mRNA vaccines and future threats that the precedent set by COVID emergency measures might pose to our civil liberties. You can check out the full conversation by clicking on the link in the description and catch these conversations streamed live to Reason TV every Thursday at 1 p.m. Eastern. See you next time.