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Episode 155
The Doctor's Farmacy

The Real Story About COVID Vaccines: What We Know, What We Don’t

Open the Podcasts app and search for The Doctor’s Farmacy. If you’re viewing this site on your phone, you can just tap on the

Tap the subscribe button and new shows will be added to your library.

If you’re using a different device, our show is available on the following platforms.

View all Platforms

There’s no way around it, we’re being bombarded by an insane amount of information when it comes to COVID-19, and not all of it makes sense. As vaccines make their way across the country, the questions are only increasing and it can feel overwhelming to find answers from expert sources.

While we don’t have all the answers, we are learning more every day. We’ve seen that for people 15 and older, COVID-19 can double our risk of dying this year. And while we know chronic disease puts us at an increased risk for severity and death, we don’t know why some perfectly healthy people still can’t fight this virus off. We’re seeing that vaccines will be a dramatic help for this virus, helping to reduce the risk of severe symptoms and death, but that they won’t stop transmission.

I really wanted to talk to someone in-depth about where we are with COVID-19, what we can count on with the vaccines, and what we still don’t know. I knew Dale Harrison would be the perfect scientist to help me break down this topic.

We kick things off with a clear explanation of how mRNA vaccines work, why they’re safe, and why they are more protective than catching the actual virus. Looking at the latest available vaccine studies, Dale walks us through the most intriguing points from the AstraZeneca trial which he feels is the most thorough so far.

Achieving herd immunity is something we keep hearing about, but how realistic is it really? We discuss the four key components of herd immunity and why Dale does not think it’s something we’ll be able to reach.

While many are hopeful the vaccine will mean a complete return to “normal” life, Dale and I talk about why this won’t likely be the case if we want to stay safe and keep others safe. While the vaccine will help reduce the risk and severity of the disease, it doesn’t prevent us from becoming infected and passing it along to others. Spreading in this way could actually lead to accelerated growth if we don’t keep the virus in check. We discuss why now is not the time to stop all safety measures like mask wearing and hand-washing, which are actually important complements to the vaccines.

We also discuss what vaccine mandates might look like, vaccine boosters, why we still need to focus on diet and lifestyle interventions to stay resilient, and so much more.

This is an in-depth and extremely informative episode. I hope you’ll tune in.

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I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

In this episode, you will learn:

  1. How COVID-19 vaccines are different from traditional vaccines
    (9:07)
  2. COVID risk considerations for young and healthy individuals
    (17:22)
  3. Unique elements of the AstraZeneca vaccine study, what vaccine effectiveness means, and why you can still spread the virus even if you are vaccinated
    (32:17)
  4. How the COVID vaccine is different from the measles and polio vaccines
    (38:10)
  5. What we do and do not know about potential short-term and long-term reactions to the vaccine
    (45:39)
  6. What the COVID vaccine does and does not protect against
    (58:30)
  7. The four things needed to achieve herd immunity and why Dale does not think it is realistic to think we will reach it
    (1:02:23)
  8. Weighing the effectiveness of wearing masks and social distancing
    (1:10:32)
  9. Vaccine mandates
    (1:27:25)
  10. How regularly will vaccination be needed to maintain immune protection?
    (1:33:59)
  11. Vaccine supply concerns and considerations
    (1:37:07)
  12. Protecting yourself from COVID-19 through diet, sleep, stress reduction, and other therapies
    (1:50:33)

Guest

 
Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

 
Dale Harrison

Dale is a senior executive with more than 20 years of experience in the biotech industry. He has held multiple VP and C-level positions with companies in the research tools and molecular diagnostics sectors. Dale currently works as a consultant with companies that are developing new clinical diagnostic platforms, including a company developing a CRISPR-based COVID test for the OTC market, and a metagenomics-based NGS platform for infectious disease testing in the human transplant market.

Show Notes

  1. Subscribe to Dale’s Covid Updates Newsletter
  2. Results from the AstraZeneca/Oxford Vaccine Trials
  3. Pfizer Vaccine Report to FDA
  4. Covid Vaccines Confer No Sterilizing Immunity
  5. New UK Coronavirus Variant
  6. Covid – YEAR 1
  7. Covid Testing & Autoimmune Disease
  8. Masks – Choosing Masks & Eye Protection for Covid-19

Transcript

Dale Harrison:
So the vaccine isn’t a bulletproof vest. The virus can still colonize. You can still pass it on. And you still have, albeit a greatly reduced risk of disease, you still have some risk of producing disease.

Dr. Mark Hyman:
Welcome to Doctor’s Farmacy. I’m Dr. Mark Hyman. That’s Farmacy with an F. F-A-R-M-A-C-Y, a place for conversations that matter. And if you’re concerned about COVID and you’re confused about vaccines, this conversation is one you want to listen to very carefully. It’s with an incredible scientist who I’ve gotten to know lately through some of his writings around COVID and vaccines and immunity, Dale Harrison. He’s a senior executive with more than 20 years of experience in the biotech industry. He’s held multiple C-suite positions in many companies using research tools and molecular diagnostics, particularly around viruses. And he’s really been thoughtful in analyzing and analysis of the overwhelming, confusing, and often misleading research that we get to hear in the headlines.

Dr. Mark Hyman:
So we’re going to go way below the headlines today to talk about vaccines, what we know, what we don’t know, and how we navigate this next period of COVID-19 in our culture. So welcome to The Doctor’s Farmacy, Dale.

Dale Harrison:
Thank you.

Dr. Mark Hyman:
All right. So here we are, it’s early January. And we are seeing record numbers of cases a day, over 300,00, record numbers of deaths, over 4000. We’d expect by now that we are going to see a decline, or an improvement, or that’ll it get better, but it’s actually getting worse, which is very concerning to me as a physician. The hospitals are being overloaded. We’re seeing incredible burdens on society. All the measures that we seem to have taken around mitigation have not really worked that well, although when we were really locked down, the cases did go down. But as people started to be a little bit lax, and we can see over the holidays, that Thanksgiving there was a spike after that. Christmas, there was a big spike how in January after that. So we’re seeing that this is not going away, and we have to figure out how to navigate this next period of COVID and humanity.

Dr. Mark Hyman:
So I want to invite you to talk about some of the stories about vaccines because vaccines are a very hot topic. They’re highly polarizing. I think there’s a few topics out there in science and medicine that are just so volatile that often we get focused on ideology rather than facts. We focus on vaccines good, vaccines bad, I mean the pro vaxers or anti-vaxers. Obviously, I’m not pro or anti vaccine, I’m for safe vaccines, effective vaccines. And I think just like I’m for safe flying and safe planes, it doesn’t mean I’m anti flying. It just means I want the thing to be safe.

Dr. Mark Hyman:
And I think vaccines historically have been something that’s really made a huge difference in public health, whether it’s tetanus vaccines, measles vaccines, polio vaccines. I mean, I think we forget how much our society was ravaged by these really horrible infectious diseases. And vaccines have been a huge advance in public health. The problem over the last decades is a couple things. I’m just going to set the stage before we get into the conversation, is that we’ve had a situation where the government, in order to get vaccine makers to make vaccines, which often is a low profit business for pharmaceutical companies, they’ve indemnified the vaccine makers against liability.

Dr. Mark Hyman:
What that means is if there’s a problem with the vaccine, the government takes the hit. The government has a vaccine court, and it’s paid out about $4 billion or $5 billion in vaccine injury cases. It doesn’t mean vaccines are all bad. It just means that it’s complicated. And I think the other issue is that there’s been a plethora of vaccines on the market now for everything. And the question is: Do we need all of them? And does everybody need all of them when we’re supposed to get them? And I think that’s sort of a separate topic, and it’s why this is such a confusing issue.

Dr. Mark Hyman:
However, today we’re going to talk about COVID vaccines. Now we need to think about how we solve this problem holistically, have COVID in our society. We can’t just simply hope it’s going to go away. We have to be thoughtful. And I do believe, and probably some people will be taking much dissatisfaction at my position here, but I do believe that COVID vaccines are important and will play a role, however, they are not a panacea, they are not perfect. And there’s a lot we don’t know about them. So today, we’re going to talk with Dale about the vaccines that we have, what we know, what we don’t know, and what we need to find out still about the vaccine. So Dale, let’s start with just a general overview of the COVID vaccines. How are they different from traditional vaccines? And how do they work?

Dale Harrison:
So these are in some ways, quite a bit different than a traditional vaccine, and in many ways, far simpler than a traditional vaccine. The traditional vaccine, you basically take either an attenuated virus, meaning a virus that is weakened to the point that it won’t cause a disease, or you take fragments of a virus, and you inject that into a person. And the immune system responds to the virus, produces antibodies, and now you’ve got some protection when the more lethal variant of that virus comes.

Dale Harrison:
The way these work are quite different. The vaccine is basically a delivery vehicle to take what’s called messenger RNA to cells, mostly cells in the liver. So mRNA is basically a blueprint, a molecular blueprint, for fabricating a protein. And so all the proteins in our bodies all start out as an mRNA blueprint that the cells then use to fabricate the protein with. So in this case, the mRNA that the vaccine is delivering to the cell in the recipient is basically a blueprint to fabricate a portion of the spike protein from the SARS-CoV-2 virus. So the spike protein is the, if you’ve seen the pictures of the virus, the spikes that are coming out with a sort of a mushroom head on top.

Dale Harrison:
And so what these vaccines are doing, they’re actually fabricating what’s called the S2 unit of the spike protein, which is essentially the mushroom head of the protein, the S1 unit is the stalk that attaches it to the surface of the virus. So you’re taking just a fraction of the spike protein and you’re manufacturing it. So what happens is the vaccine basically delivers the mRNA to cells, cells will then use that to make these proteins. Your immune system will recognize that this is a foreign protein, will then respond by producing antibodies to this foreign protein. And once you’ve got the antibodies produced, they’re now there ready for the potential of becoming infected with a real SARS-CoV-2 virus, so now you’ve got immune protection.

Dr. Mark Hyman:
So essentially, basically, you’re taking an RNA that is being given to the body, which then uses it to produce this little protein that’s on the SARS-CoV-2. And then our immune system then responds to that foreign protein by creating antibodies, which makes us hopefully immune. Right?

Dale Harrison:
Right. Well, and the other advantage too is that it’s highly targeted. So there’s a virologist in Berlin named Drosten, who’s considered one of the leading experts in corona viruses. And he has this phrase when he talks about immune response to corona viruses, which is a sloppy immune response, that people tend to have a very poorly formed immune response to corona viruses. And part of the problem is these viruses are enormous in size in terms of the size of their genome. And as a result, they’re producing a very large number of proteins, many of which have no use directly in the production of new viruses. And so all of these proteins are being dumped into your system when you’re infected. And your immune system is targeting everything.

Dale Harrison:
But the problem is that almost all of these are worthless in terms of protecting you from severe disease. And one of the things that you’re seeing is, this is a very recent paper that came out, where patients in the ICU with very severe disease, very severe COVID, but that have very high antibody titers, meaning very high levels of antibodies in their bloodstream, when they analyze the antibodies, what they’re finding is that their immune system targeted the wrong proteins, that instead of targeting the spike protein, it targeted a nucleocapsid protein or some random nonstructural protein. So these are various other proteins the virus produces.

Dale Harrison:
And so even though they have a strong immune response, their antibodies are of no help in protecting them from the virus. And so the great thing about these vaccines is that they will give you a dramatically superior immune protection from the virus than natural disease will give you, so this is a much better way to be protected than to actually catch the virus.

Dr. Mark Hyman:
That’s incredible. Just to back up a little bit, give people context, this is a coronavirus, which is a common virus that’s causing the common cold in many people, but a very kind of unique one. It seems to be extremely contagious, far more contagious than the flu, for example. It’s also more lethal than the common cold. So it’s not just like getting a cold, even though it’s a coronavirus, which is one that often causes colds. And it spreads very easily, and it spreads asymptomatically. So we kind of have a perfect storm of a virus that doesn’t kill everybody, that spreads really easily, that can whip through a population very quickly, and that causes a lot of havoc in the body.

Dr. Mark Hyman:
So it’s kind of a very unique virus. And it sort of worries me because it’s got all these characteristics that makes it particularly dangerous, that it infects not just the respiratory tract, but it infects all the organs in the body, all the lining of your blood vessels, your lungs, your heart, your brain. I mean, it’s quite a nasty virus, so this is not something we’ve really seen before, anything like this, where you’ve got such a powerful virus that doesn’t kill everybody, that spreads so rapidly. It becomes sort of everywhere, and it’s kind of terrifying to people. How do you help people understand the context of what this virus is and how it’s different.

Dale Harrison:
Well, I mean, if you think about viruses in general, they’re really going to be characterized by two things, the rate at which they infect people and the rate at which they kill people. And so right now, we’ve got a virus that is significantly more contagious than the cold, I mean, just dramatically more contagious than flu. And potentially, we’ve got this new variant out of the UK that is where you’re seeing as much as a 70% increase in infectiousness. And the data’s still not fully gathered on that, but if the early studies pan out, it means that this new variant is on par with smallpox in terms of the level of infectiousness. And again, no one alive today has living memory of smallpox. But if you read historically about how smallpox could just tear through an entire city in a matter of weeks, that’s a concern.

Dale Harrison:
But then couple that with the fact that it’s reasonably deadly, now again, it’s nothing compared to smallpox, it’s nothing compared to a lot of the historical viruses. But you’ve got something that in the absence of a vaccine and the absence of an effective therapeutic, you’re seeing a death rate that’s roughly 10 times greater than the death rate of catching the flu. And so again, you’ve got something that is more contagious than a cold and 10 times deadlier than the flu. And that’s a very dangerous combination, and it’s really sort of the multiplication of both of those two factors that’s resulting in hospitals and the ICUs being full of patients right now.

Dr. Mark Hyman:
[inaudible 00:13:09] say, “It just affects the old, or the sick, or the overweight,” but most people who are relatively young and healthy don’t have to worry about it in terms of causing severe issues. Is that true?

Dale Harrison:
Well, I mean, it’s true and it’s not true. So most of the people who are dying are older. Well, and it turns out that pretty much any infectious disease, that’s the case. Most of the people who are dying are older, simply because they’ve got less ability to amount an immune response. They often have comorbidities, other issues that they’ve spent a lifetime developing, where younger people are healthier.

Dale Harrison:
But here’s the thing that’s interesting with this virus. If you ask the question: What’s the increase in likelihood that I will die this year if I catch the virus, compared to the chance of me dying this year if I didn’t? It roughly doubles your risk of same year death, irrespective of age, above the age of 15. Now under age of 15, there seems to be much less impact. But if you’re 15 or older, if you catch this virus, you’re going to double your chance of having died this year.

Dale Harrison:
Now the fact is, if you have a roomful of 90 years olds and a roomful of 20 year olds, you’re going to expect more of those 90 year olds to die this year than those 20 year olds to die. And so if you double the chance of death of each group, you’re going to have a lot more 95 year olds dying. But the fact is that for each one of us, whatever our age is, that if we catch this thing, we have essentially doubled our risk of dying this year.

Dr. Mark Hyman:
Yeah. We had that 41 year old Republican congressman who just got elected, who was healthy, and just is now dead. So we think it mostly doesn’t kill the young and the healthy, but it can, and it’s unpredictable. And that’s the thing that scares me about it. It’s unpredictable. You don’t know what everybody’s underlying risks are, underlying immune function is, genetic variations. There’s a lot of unknowns, so you really want to be careful about getting this.

Dale Harrison:
Well, and there’s a-

Dr. Mark Hyman:
It’s not just like getting the flu and you get better and you’re fine two weeks later.

Dale Harrison:
But there’s also, there’s an interesting paper that came out about two months ago out of the Scripps Institute, looking, doing a very detailed study of immune response over time. It was featured in the New York Times. It’s gotten a lot of publicity. A lot of the publicity I think doesn’t accurately reflect what the paper says. But if you actually read the paper, one of the things they talk about is this idea of a highly heterogenous immune response, meaning that irrespective of age, underlying health conditions, that what you see is a very, very large range of immune responses, where some people have a very effective immune response, some people have a very ineffective immune response, and it doesn’t really seem to be tied to age.

Dale Harrison:
Now again, as you’re older, you’re more vulnerable, and so you’re going to be more likely to die. But it’s really spinning the roulette wheel. And the problem is that, and this was one of the other outcomes of the study, was that they were unable to find any predictors for the variants in immune response, meaning that you couldn’t look at a comorbidity, or a measurable parameter on a blood test, for instance, that would let them predict who’s going to have an ineffective response versus an effective response. And so what you see are people where it’s literally nothing but a cold. And then you see other people where in three weeks time, they’re dead. And the problem is that no one understands why you have this heterogeneity in the immune response. And no one knows how to predict it. And so the only way to know whether you’re going it’s going to be a cold or a trip to the ICU is to catch it, and so that’s not-

Dr. Mark Hyman:
That’s not good. [crosstalk 00:17:22]. That’s not good. Well, here’s the other thing that worries me about this. And this is a pattern we’ve been seeing. It’s well documented in the science, which is what they’re calling long hauler or post COVID syndrome, and this can happen to anybody. And I’ve seen it happen in young, healthy people who get COVID, and they just don’t get better. And I’ve talked about this in the podcast, but in one study that was sort of looking at people who’ve been hospitalized at 60 days, 87% were still sick. They still had symptoms of fatigue, muscle aches, cognitive issues, headaches, and they weren’t well. And there’s a whole group of people who are not even hospitalized, who do also get this long hauler syndrome, where they just don’t get better after months and months. And this can be young, healthy people.

Dr. Mark Hyman:
And that’s what concerns me even more than COVID because if you got it, and your risk of death is 1%, and you’re kind of in the category where maybe it’s not a big issue as it is if you’re chronically ill, or obese, or elderly, you could still get this long hauler syndrome. If you’re talking about 50 million, 100 million Americans getting COVID, and maybe 5%, 10%, I don’t know how many are going to get this long hauler syndrome, we’re talking about millions and millions and millions of people who are going to be chronically ill, like chronic fatigue syndrome for years after they get COVID.

Dr. Mark Hyman:
So this is what really concerns me and why I think this conversation about vaccines is so important. And the question is: What do the vaccines do? What do they not do? What do we know about them? So I want to sort of start to dig into a little bit of that. Based on these studies from Pfizer, Moderna, Astra-Zeneca, I think there’s a lot of things that are not being talked about in the news. In fact, I did watch an Axios segment with the chief medical officer for Moderna, and I was sort of struck by what he said, was that it doesn’t prevent transmission. It doesn’t prevent you necessarily from getting sick.

Dr. Mark Hyman:
So we think if you get this big infection, you get sick, and we know what happens. You get the vaccine, you think you don’t get sick, and you’re protected. That’s what happens when you get the measles vaccine. It’s a very different kind of vaccine here we’re talking about. It’s not like what we call sterilizing immunity. So can you just break down for people the difference between, we’ll call it disease immunity and sterilizing immunity, what the studies showed, and why they didn’t show, so that people can have a real sort of comprehensive context of how to understand these vaccines and their risks and their benefits?

Dale Harrison:
So we’ve got a growing body of scientific literature now, so we’ve got preliminary data from Moderna, the Pfizer, and the Astra-Zeneca vaccine trials on humans. But there are also quite a number of animal trials that have been done on all three of those, plus the Johnson and Johnson vaccine, on both what are called transgenic mice, so these are genetically engineered mice to mimic, to make the mouse look like a human being to the virus. In rhesus monkeys, which is important because the rhesus monkeys is a good model for immune response in humans, and ferrets, which is another laboratory animal that is particularly easy to infect with this virus.

Dale Harrison:
And so what they’ve done in these trials, so the animal trials and some of the human trials, we have placebo groups and you have … Except in the placebo group, they just don’t give them anything. In the vaccine group, they vaccinate them. And but with the animals, one of the advantages is that you can do things like kill the animal and autopsy it at the end. You tend to do this with the mice studies, not the monkey studies. But you’re able to get much more information, and you’re also able to do what are called challenge trials, meaning that you directly expose the animal to the virus.

Dale Harrison:
So in the human trials, like the Pfizer or the Moderna trial, you basically vaccinate a lot of people, and then you just wait to see which ones of them naturally get the virus from the environment. The animal studies are a lot more effective in the sense that you can directly infect the animals with the virus and see how effective the vaccines are. So if we look at these studies overall, one of the things that comes out of it is that all of these vaccines are showing highly effective what’s called disease immunity, meaning at kind of a mechanical level, it means that they’re very effective at producing antibodies in the bloodstream, and they’re very effective at preventing the virus from jumping from the upper respiratory region to the bloodstream.

Dale Harrison:
And so a lot of the severe disease that puts people in ICUs and kills people is once the virus has jumped to the bloodstream. If you can constrain the virus to just the upper respiratory region, you’ve essentially turned it into a bad case of a bad cold or a mild case of the flu. And one of the other important considerations here, you were talking about the long haulers, so there’s a growing body of evidence to support a theory behind what’s causing the long hauler syndrome because one of the things that’s known is that these people have no evidence of any sort of low level viral infection, so these are people that six months, eight months after their initial infection. There’s no evidence that there’s some low level of ongoing viral infection. They seem to be entirely clear of virus. They often have very strong antibody responses.

Dale Harrison:
So the theory is that because this virus produces such a large number of proteins, all of these proteins are seen as foreign. And so your immune system is going to attempt to build antibodies against a very wide range of proteins. They’re going to build antibodies to anything that looks foreign. When you start to produce very large numbers of antibodies, you run the risk that some fraction of those are going to also attack native tissue, so essentially produce autoimmune responses. You see this in things like lupus and multiple sclerosis and psoriatic arthritis, some types of rheumatoid arthritis, where it’s your own immune system that’s attacking particular tissue types.

Dale Harrison:
And so the current thinking is that these long haulers are essentially experiencing new categories of autoimmune diseases that have not been previously seen, which again is more of a reason to avoid having infection. And one of the great benefits of the vaccines is that if you can keep the virus out of the bloodstream, you’re going to minimize that sort of risk of developing an autoimmune response. But so the first thing definitely is the vaccines are quite good at keeping the virus out of the bloodstream, which means that you’re not going to see all of the internal organ damage that you’re seeing in people. And you’re not going to see a lot of the really severe disease that you’re seeing in people, a lot of the-

Dr. Mark Hyman:
So the good news about the vaccine is one, it will prevent it from getting into your bloodstream, so you won’t get the long-term consequences, hopefully, of these-

Dale Harrison:
Hopefully.

Dr. Mark Hyman:
Immune related diseases, we don’t know for sure. And two, they prevent you from getting really sick and ending up in the hospital in the ICU, which right now, our medical system is buckling under the weight of COVID-19. And so this is sort of a good thing in the long-term, even though it doesn’t necessarily prevent infection. And reading your article on the Astra-Zeneca vaccine and some of the other issues, it was pretty striking that it doesn’t really prevent you from getting infected.

Dale Harrison:
Right.

Dr. Mark Hyman:
That about 40% of people will still get infected. It doesn’t prevent you from getting reinfected. If you already had it, the vaccine won’t prevent you from getting another infection. So it really only prevents more severe disease and death is what we’re saying.

Dale Harrison:
Right.

Dale Harrison:
Hi everyone. Hope you’re enjoying the episode. Before we continue, we have a quick message from Dr. Mark Hyman about his new company, Farmacy, and their first product, The 10 Day Reset.

Dr. Mark Hyman:
Hey, it’s Dr. Hyman. Do you have FLC? What’s FLC? It’s when you feel like crap. It’s a problem that so many people suffer from, and often have no idea that it’s not normal, or that you can fix it. I mean, you know the feeling. It’s when you’re super sluggish, your digestion’s off, you can’t think clearly, or you have brain fog, or you just feel run down. Can you relate? I know most people can.

Dr. Mark Hyman:
But the real question is: What the heck do we do about it? Well, I hate to break the news, but there’s no magic bullet. FLC isn’t caused by one single thing, so there’s not one single solution. However, there is a systems based approach, a way to tackle the multiple root factors that contribute to FLC. And I call that system The 10 Day Reset. The 10 Day Reset combines food, key lifestyle habits, and targeted supplements to address FLC straight on. It’s a protocol that I’ve used with thousands of my community members to help them get their health back on track. It’s not a magic bullet. It’s not a quick fix. It’s a system that works. If you want to learn more and get your health back on track, click on the button below or visit getfarmacy.com. That’s get farmacy, with an F, F-A-R-M-A-C-Y.com.

Dale Harrison:
Now back to this week’s episode.

Dale Harrison:
So the Astra-Zeneca study is probably the most thorough of all of the vaccine studies that have been done so far. It’s really an extraordinarily well designed protocol. And …
PART 1 OF 4 ENDS [00:27:04]

Dale Harrison:
So it’s really an extraordinarily well-designed protocol. And so, one of the things that AstraZeneca did that none of the other vaccine studies have done is that every participant in the study was tested once a week through the entire duration of the study to look for infection. This was entirely separate from their looking for symptoms because the basic way that the study worked was people had to report whether or not they had experienced one or more of a specific list of symptoms. And these are fairly basic symptoms, shortness of breath, cough, fever, fatigue. And so, what the vaccine was targeting was to reduce that specific list of mild to moderate symptoms. And when they say the vaccine is 90% effective or 94% effective what that means is it’s 94% effective at reducing or eliminating that list of specific symptoms.

Dale Harrison:
Now what they didn’t look at was the death rate or the rate of severe illness but the assumption is, is that you would probably see both of those go down significantly if the vaccine is able to reduce mild to moderate symptomatic disease. But here’s where the study gets interesting. So in the AstraZeneca study, every single patient in both the placebo and the vaccine arm of the trial was given a laboratory run PCR test each week to look for infection. The other thing that was interesting in the study was that unlike the other studies the AstraZeneca study permitted what are called seropositives into the study meaning people that already had antibodies in their bloodstream from an infection. And so everyone that entered the study got an antibody test, and these were very high quality laboratory run antibody tests, as well as a medical history.

Dale Harrison:
And so in there, you had people who had already been infected that got vaccinated as well as people who had not been infected And then they were tested for infection weekly during the study. So here were a couple of interesting things that come out of it, that you were seeing about 40 to 45% of the participants were testing positive but asymptomatic. So, and this was the people in the vaccine arm. You actually had another block of people who were positive with symptoms but symptoms that were below the level of what would be triggered to declare you having gotten disease. So, what you’re seeing was really about 50% or more of those who had been vaccinated ended up getting infected compared to the placebo group. Now again the absolute numbers, it’s not 50% of everyone in the study but it’s your rate of infection was about 50% the rate of people who had gotten no vaccine at all. Here’s the other interesting…

Dr. Mark Hyman:
So, that’s asymptomatic infections?

Dale Harrison:
Or mildly symptomatic.

Dr. Mark Hyman:
So you’re saying about half the people almost who got the vaccine still got infected. [crosstalk 00:30:48]

Dale Harrison:
But the idea was your risk of getting infected with the vaccine was about half of the risk of having gotten infected during the same time period if you had not gotten the vaccine.

Dr. Mark Hyman:
Yes.

Dale Harrison:
So, it’s a relative risk

Dr. Mark Hyman:
So, it’s better but it’s not zero, right?

Dale Harrison:
Right.

Dr. Mark Hyman:
It’s better than getting nothing but it actually does not prevent you from getting the vaccine. And it also doesn’t prevent you from spreading it which is another striking thing. Because people think, “I’m going to get the vaccine. I’m going to be fine. I’m going to be immune. I can run around. I don’t need to wear a mask. I don’t need to socially distance.” I’m like, “Great.” Well, you might not die or get really sick but you could become a super spreader because you could be spreading this asymptomatically if you’re not careful. And I think that’s a really important factor that people are not hearing about in the news and this is what the difference is between a sterilizing immunity which means you get the measles vaccine you’re never going to get infected with measles versus a coronavirus vaccine where you may not get really sick and die but you still can get the infection and you can still spread it, right?

Dale Harrison:
Right. Right. And it’s even more striking in the animal trials because in the animal trials what you were seeing was only about 20% of protective immunity, protective sterilizing immunity from the vaccine. Meaning that if you compare the group of animals who were vaccinated versus the group that were not vaccinated you still had about 80% chance of catching the virus even if you didn’t develop the disease. And the retransmission rate was identical. Once you had picked up the infection, you’re passing it, at least again in the animal studies, you’re passing it to other animals at exactly the same rate that the animals who had not been vaccinated were.

Dale Harrison:
And to drop back to what’s the machinery of this, so when you’re injected the vaccine goes into the bloodstream, it basically deposits the MRNA mostly in the liver, it produces these S1 subunit or S2 subunit of the spike protein and you get an immune response and now you have antibodies in your bloodstream. This is why the vaccine is highly effective at preventing the virus from jumping from the lungs into the bloodstream because you’ve got a very effective ability to produce a lot of antibodies that’s in the bloodstream. But the problem is, is that antibodies in the bloodstream doesn’t help in mucosal tissue so that’s an entirely different sort of immune response. And you see a lot of RNA viruses and especially a lot of RNA upper respiratory viruses that never produce an effective what’s called humeral mucosal immune response meaning that you end up with B cells in the mucus membranes in the nose and throat that are able to then produce antibodies directly in those areas. So that as soon as you breathe the virus in it’s immediately attacked and destroyed.

Dale Harrison:
And so what that means is, is that even if the virus stays out of the lower lungs and out of the bloodstream, it can still colonize the nose, throat, upper lungs. And the way that this virus is, because this is an airborne virus, so the way that we infect other people is by breathing out and what we’re breathing out isn’t stuff deep in our lungs, what we’re breathing out is the virus that’s in mostly the throat and the upper lungs. And so, without effective sterilize and immunity you’re still going to be able to both acquire an infection, it may be very mild or it may be completely asymptomatic, but you’re going to still be able to infect others. Which means that the virus remains in circulation within the population and that’s a very difficult thing.

Dale Harrison:
This is a quite different than the measles virus where if you get vaccinated for measles you develop a very strong mucosal immune response which means you can walk into a room full of people with measles and you’re not going to catch anything. And so a lot of people’s naive intuition about vaccines is really informed by the childhood vaccines that people are familiar with. Most of these are sterilizing. The ones that are not sterilizing, the lack of sterilizing immunity turns out not to be an issue. And so, a very famous one of these is the polio vaccine. So, the polio vaccine is non sterilizing and you see these hidden polio outbreaks in different places. It was an interesting one a few years ago in Iceland where nobody had developed any symptoms but you clearly had an outbreak where people were getting infected and they were reinfecting others.

Dale Harrison:
And now again, with polio part of the problem there isn’t the nose and throat, polio is primarily transmitted through fecal transmission. And so, the other place that you can have a lack of sterilizing immunity is in the gut. And that’s the deal with the polio vaccine is that it doesn’t produce sterilizing immunity in the gut. The virus is able to colonize the gut and then pass through feces into the environment and then infect others. But if you’re vaccinated, it’s not going to get into the bloodstream and it tends not to develop any symptomatic disease and so you get these silent outbreaks.

Dale Harrison:
The other one is the seasonal influenza vaccine. So, it produces only partial sterilizing immunity which means that a lot of people who get that vaccine can still get infected and still can infect others. And in fact, influenza has a significant fraction of asymptomatic carriers and transmitters as well that’s not understood popularly. But one of the reasons that the influenza, people talk about the seasonal flu vaccine is 10 to 40% effective, some of that is because they may not have had exactly the right strain because they have to begin the work on the vaccine so many months ahead and the vaccine is a fast mutator.

Dale Harrison:
But the big part of why the flu vaccine isn’t effective is it doesn’t keep people from being infected even if they’re asymptomatic and it doesn’t keep the virus from spreading through the population. And you still have some fraction of people, and again you hear these stories, “I got the flu vaccine and I still got the flu.” Well, what happens is if you pick it up because you don’t have sterilizing immunity, some fraction of the people that pick it up will still develop disease. And again, you’re seeing this in these vaccine trials because you’ve still got 10 to 30% of the people with the vaccine that once infected are still developing disease. And so the vaccine isn’t a bulletproof vest. The virus can still colonize, you can still pass it on and you’ve still, have albeit a greatly reduced risk of disease, you still have some risk of producing disease. And so, people have to understand that this is not a perfect bulletproof response to the virus.

Dr. Mark Hyman:
Yeah. I think most of the media is like, “Vaccines are coming. They’re going to save us. We can go back normal. Everything’s going to be great.” And yes vaccines have a role, but they’re not a panacea as you said. And the kind of viruses we’re dealing with are different than other things like measles virus where we’re not getting the same type of protection. So just to recap what you said, it does reduce the incidents of moderate to severe disease. It doesn’t necessarily prevent you from getting it, in fact about 40% of the people compared to the placebo group got the virus. You can still spread it asymptomatically. Hopefully, and I don’t know if this is the case with all the cases that were found, it does prevent it from getting into the bloodstream although I’m not sure that’s 100%.

Dale Harrison:
No. Because again, people were still getting, they were still getting disease, they were still getting asymptomatic disease after vaccination. So again, things like the measles vaccine is such a miracle vaccine because it has strong sterilizing immunity and very strong disease immunity. Once you’ve got that vaccine you really are nearly perfectly protected but the measles vaccine is the outlier. Lots and lots of vaccines are simply not entirely effective.

Dr. Mark Hyman:
Now the other thing just to track for a minute, the other thing we don’t really know is one what are the long-term side effects if any. We’ve just had a few months into this. What if we wait six months or a year and what if instead of 30,000 people, we have 30 million people vaccinated and the 30,000 people were a very specific select group. When you take the heterogeneous population, young, old, thin, overweight, sick, not sick, auto-immune, not auto-immune, you’re going to see a whole different range of different effects. And so, we don’t really know what those are.

Dr. Mark Hyman:
We also don’t know how long the antibodies last. So does the protection last two months, six months, a year, five years? We don’t know. Do you need the vaccine every year? Do you need it every two years? Do you need it every six months? I mean, these are the kinds of questions that I think are coming up. So yes, this is an incredible scientific advance. Yes, we’ve rapidly created a number of vaccines which seem to be effective in reducing the severity of the disease. But there’s a lot of still questions out there. So can you address some of these concerns because I think people are wondering about this and we’re not hearing a lot about it in the media.

Dale Harrison:
Right. So, and I have to say early on, because I’m very familiar with the history of vaccine development, and early on I was very skeptical that we were going to see an effective vaccine before probably 2024, 2025. And I was also very skeptical in terms of the ability to produce not only an effective vaccine but a safe vaccine. And as time has gone along and I’ve seen more and more data and more and more good research papers have come out now I’m becoming increasingly comfortable with the safety of the vaccine. And so, you have to think about risk less in terms of what might happen to you if you’re unlucky versus what’s your chances of being unlucky. These are two different things. So, what’s the chance that that next airplane ride I take will crash is quite different than if that next airplane crashes will I die.

Dale Harrison:
And so, a lot of the fear mongering quite frankly is about how horrible it is when the airplane you’re on crashes which is really not the important question. The important question is what’s the risk that airplane is going to crash. And so, the way to think about that is the incident rate per 10,000, per 100,000, per million, per 10 million people getting vaccinated. And the studies very heavily focused on the safety aspect but because of the size and the duration of the study what they were able to do was to basically look for adverse reactions… And again, there’s two types of adverse reactions. There’s a short-term reaction and then a long-term reaction.

Dale Harrison:
And so they’re looking mostly for short to midterm adverse reactions at the rate of about one per 10,000 participants. And what you saw out of the studies was that you had one to three day relatively manageable mild to moderate adverse reactions like soreness in the arm, getting a fever, maybe getting chills for a day, but nothing that represented a medically significant issue. And they were able to show that there were no adverse reactions up to about the rate of one in 10,000.

Dale Harrison:
Now, we’ve now embarked on very massive vaccination programs and so we’re seeing rare versions of this, of reactions. So what’s in the news are these allergic reactions and but they’re occurring at about the rate of one in 100,000 which is why they didn’t show up in the original vaccine studies. So one of 100,000 is roughly your risk of dying from a lightning strike. It’s pretty rare.

Dale Harrison:
And the other thing is, is that the nice thing about the allergic reaction is that it’s extremely manageable and it tends to occur almost immediately. And so, if you haven’t started to have that reaction within 15 to 30 minutes after vaccination you probably aren’t going to have the reaction. The other thing here is that there’s a reasonably good understanding, again going back to the scientific literature because there’s been a lot of focus on this on the scientific side in the last couple of months, the consensus that’s building right now is that those are allergic reactions or from a single particular lipid, a fat molecule that’s used to create the envelope that carries the RNA. That this same lipid has been used for about 15 years in certain chemotherapy drugs to be able to carry a highly targeted chemotherapy drug that will only attach to a malignant cell but not to nonmalignant cells.

Dale Harrison:
And so it’s a very similar technology to this except it’s carrying a drug instead of carrying MRNA. And what they’ve seen is about a one in 100,000 allergic reaction rate to this particular lipid. And so, the thinking is is that that’s what’s behind the current rate. In the first 2.3 million vaccinations in the U.S. you had 21 cases. So a very, very low incident and very manageable. Because the different vaccines from the different manufacturers are fabricated in different ways, this is probably only going to be a problem with the Modern and the Pfizer vaccine because they use lipid, the synthetic what are called viral…

Dr. Mark Hyman:
That’s the allergic reaction but there are going to be other longer-term things.

Dale Harrison:
There are going to be other ones.

Dr. Mark Hyman:
No I mean, there’s a joke that I read in the New England Journal of Medicine once which was make sure you use the new drugs as soon as they come out before the side effects develop. It’s different when you study a drug and you look at 15,000 people they’re all identical and then you put it in 15 million or 150 or 300 million people, all of a sudden you’re changing the conversation. And I think we don’t know but what you’re saying basically is this seems to be a very safe vaccine and the short term there’s just common reactions that are probably one in 10,000 such as local inflammation or feeling sick.

Dr. Mark Hyman:
A friend of mine just got the vaccine and she felt like she had the flu for a few days. Those are common, those are probably one in 10,000 which showing 300 million people would be like 30,000 people getting sick. But in terms of the real severe reactions that’s one in 100,000 which is far less. But then long-term, we don’t know does this trigger auto-immunity? Does it have other effects? Can you give it in pregnant women? What about kids and what about people with autoimmune disease? We just don’t know the answers to these questions yet, right?

Dale Harrison:
Yeah and it’s just too early. But again, the studies did a fairly good job of pulling in a pretty wide range of people. And again, going back to the AstraZeneca study, the AstraZeneca study was just so well-designed. And one of the things that they did was they pulled in immunocompromised patients into the study. So they had a much wider range of people and what you saw to the AstraZeneca data was nothing that hadn’t been seen in all of the other data, that these people did quite well but the vaccine. So, just personally looking at the literature and looking at the data I think that any really significant reaction is probably going to be on the order of one in a million to one in 10 million. We’ve seen a single interesting reaction that’s been in the news, a doctor in Miami who recently died, and he they understand that what happened is an extraordinarily rare type of immune response that basically caused his platelet count to go to zero and it couldn’t be reversed. But again, just looking at the numbers that looks like about a one in 10 million or less reaction.

Dr. Mark Hyman:
To put it in perspective, if you get COVID your risk of dying is one in 100.

Dale Harrison:
Right. Yeah.

Dr. Mark Hyman:
Like one in a million, right?

Dale Harrison:
Right. But or one in 10 million but we’re definitely embarking on an experiment here where we’re going to be vaccinating an unprecedented number of people. So if you look at most of the vaccines on the market, the typical number of doses administered in a year in the U.S. is around four to five million for any given vaccine which is roughly equal to the number of people that are born each year, which makes sense because most of these are one-time vaccinations. The exception is the flu vaccine and to some extent of the pneumococcal vaccine. But the flu vaccine, we’re doing about 150, 160 million people a year. We’re going to need to do 250, 300 million people with this so this is going to be unprecedented but we’re also facing a pretty unprecedented situation where the disease rate and the fatality rate if you have no protection is very high as well as the long-term morbidity rate. All of these potential long-term effects that people are going to have, there’s going to be a huge weight on the healthcare system for potentially decades if we don’t get out ahead of this.

Dale Harrison:
And so, the evidence is the vaccine is really, really effective at preventing these severe disease responses. It’s got a reasonably low side effect rate. And quite frankly, most of the side effects that I’m hearing from people taking it right now is soreness, fever, chills, they may end up in bed for a day. Well, in September I got the seasonal influenza and the pneumococcal dual vaccine and I ended up in bed for two days with fever and chills. And it doesn’t happen often, it’ll happen about every maybe 10 years when I take those, but it’s a risk with even a pretty well understood and a fairly simple vaccine like the influenza vaccine. So, but the other thing that I always say is no one’s allergic reaction has ever caused them to end up in the ICU on a ventilator.

Dr. Mark Hyman:
Yeah. That’s true.

Dale Harrison:
But COVID is doing that thousands of times a day.

Dr. Mark Hyman:
Yeah. Serious.

Dale Harrison:
So again, it goes back to what’s the risk of the plane crashing and then what’s your risk when the plane crashes. And the alternative here is if you are not protected your risk are not only much higher… The risk of the plane crashing is much higher and then what happens when the plane crashes is a lot worse if you don’t have any kind of protection. And so, the other analogy I always use is if I know I’m going into a gunfight and all I have access to is a mediocre bulletproof vest I’ll take that bulletproof vest over going into that gunfight wearing nothing but a snarky t-shirt. So, you can’t think in terms of absolute risk and absolute protection, you have to think in terms of what are my relative options to be able to basically optimize the odds in my favor in this current environment. And so that’s a more nuanced thing than saying, “This is the perfect vaccine with no side effects.” Well, that doesn’t exist.

Dr. Mark Hyman:
So, let’s talk about some of the other things you bring up in your writings. So it seems like we have a pretty balanced view now of what the vaccines do and what they don’t do. As a review, they do create antibodies that prevent you hopefully from getting severe or moderate disease and ending up dead or in the ICU. They don’t prevent you from getting the infection at all and they don’t prevent you from spreading it. They don’t prevent you from getting it again if you’ve already had it. So the reinfection rates are still there.

Dale Harrison:
Yeah and let me throw one other thing in there on that, very interesting bit of data buried deep inside the AstraZeneca study. Because they brought seropositives into the study, meaning people who already had COVID previously and because they were testing for infection weekly and there was no other dataset in existence that looked at this, you had this chance to look at a pretty significant population of people that had already had the disease and follow them for a period of time.
PART 2 OF 4 ENDS [00:54:04]

Dale Harrison:
The disease and follow them for a period of time, a period of several months. So if we look at just the placebo group, that the people in the placebo group during the duration of the study, you had 1.7% of those people became infected during that period. If you look at the serapositives in the placebo group, 2.1% became infected, that the people who had already had COVID. They were getting reinfected at exactly the same rate as the people who had never had COVID.

Dr. Mark Hyman:
That’s right. [crosstalk 00:54:40]

Dale Harrison:
That’s a remarkable piece of data that really says that reinfection is a real thing, and that you probably have relatively little durable immunity against re-infection after having initially had COVID.

Dr. Mark Hyman:
That’s concerning. Okay, so we know all those facts. We also know that the common, mild reactions are about one in 10,000, and that serious reactions are one in a million to one in 10 million, which is far less than the risk of 1% of getting dead from COVID, or 20% of ending up in the hospital, which is quite high. We also know that the vaccine will not necessarily allow society to open up again, that it won’t create a possibility of herd immunity, that it won’t prevent the spread of the virus for the population, and then actually may not even reduce the death rate overall, that the number of people dying might reduce the percentage of people dying, but the overall number of people dying might go up as we increase vaccination, because people will be lax about protective measures, such as wearing masks, or socially distancing, or washing their hands, or not going to large gatherings.

Dr. Mark Hyman:
So this is sort of the sort of sense overall of the vaccine. Can you talk more about what does the future look like with the vaccine? Let’s assume that we get over the fact that half of the population doesn’t want to get the vaccine. Let’s say we get up to 70, 80, 90%. Are we home free or not? Are we going to be able to sort of open up and go to sports games and concerts and everything just back to normal, or what’s going to be the future of the 2020s with COVID?

Dale Harrison:
Well, I mean, I think anything anyone says is speculation simply because the data doesn’t exist yet, and we’ve got to run that experiment with 300 million people and we’re going to do that this year. But my look at the data and my understanding of the underlying virology and how infectious disease works, what I see is probably no possibility of herd immunity. If you think about herd immunity, you really need four things for that to occur, so you need an effective vaccine that’s going to offer durable lifetime immune protection.

Dr. Mark Hyman:
What is herd immunity? Just so people can-

Dale Harrison:
So herd immunity is what we have with measles and polio and smallpox, meaning that you have enough people vaccinated that you have fewer and fewer cases until the virus finally essentially burns out of the population. You may have very tiny isolated outbreaks, especially among non-vaccinated people. You see that with measles. You see that you see that in the third world with polio. But generally, polio, measles, rubella, smallpox, all of these things that they’ve developed effective vaccines for just don’t exist other than in rare small pockets of outbreaks. They’re just not a part of our life anymore the way they were 60, 70 years ago. So the idea of herd immunity is you get enough immunity, enough people in the population that’s immune, that even if you don’t have everybody immune, the virus doesn’t have enough chances to spread, that it eventually burns out.

Dale Harrison:
You see a version of this with flu in the springtime, because the deal with influenza is that the warmer the weather is, the less contagious it is, and by typically around sometime in April, the weather, at least in the northern hemisphere, the weather has gotten warm enough that each person that catches the flu ends up giving the flu to fewer than one other people on average. So basically you get, within about a two week period, you see flu just drop off the cliff and go to zero. Then during the warm months, it largely isn’t around, and then in September, it starts to pick back up as the weather cools down because the infectiousness of the flu virus is tied to temperature.

Dr. Mark Hyman:
Coronavirus is not like that.

Dale Harrison:
I’m sorry? Yeah, well-

Dr. Mark Hyman:
But the COVID virus is not like that.

Dale Harrison:
Actually, the COVID virus appears to also have a similar seasonality, but the problem is so there’s an R-nought number that probably everyone has heard by now, and the idea is that if a disease has an R-nought below one, then it’s going to burn out of the population. If the R-nought’s above one, it’ll continue to spread.

Dr. Mark Hyman:
And that makes how many people will one person infect? If one person will affect more than one person, then it continues. If one person infects less than one person, it burns out.

Dale Harrison:
Right. So flu has an R-nought of about 1.1 to 1.2. Colds have an R-nought of around two. What you tend to see is these upper respiratory viruses, their R-nought will drop in the summer by about a factor of a third. So what that means is, is that both the R-nought of flu and of colds drop below one by sometime in late spring. That’s why you don’t have everybody catching a cold in the middle of the summer and you don’t hear about people catching the flu. It’s possible to catch the flu in this in the summer but it’s very rare.

Dale Harrison:
With COVID, COVID is somewhere between 3.5 and five R-nought, which means that even if you lobbed off a third of its infectiousness in the warm months, you still have something that is significantly more infectious than a cold. I think that’s why you saw over the summer, you tended to see, even though we had the big summer surge, part of that was because you had sort of virgin populations that had not had significant exposure previously, but there’s no reason to think that COVID is going to go away in the summer, but it likely will reduce its rate of infection compared to how it is in the winter. Again, massive spike we’re in right now-

Dr. Mark Hyman:
So talk more about the herd immunity, because what you were saying is it will never get herd immunity with coronavirus, which is what everybody’s talking about as a way out of this, and you’re saying this isn’t happening. Why?

Dale Harrison:
So herd immunity requires four things, so you need an effective vaccine that offers a durable lifetime immune protection. You need a critical percentage of the population to be vaccinated, and the more infectious the disease, the higher that percentage is. The actual formula is one minus one over R-nought, which means that with COVID, we need about 70 or 80% of the population vaccinated. Now the problem there is that we now have a new significantly more infectious variant that is starting to take over. It’s completely taken over in the U.K. It’s already in the U.S. and it’s already in Europe.

Dr. Mark Hyman:
This on top of being already one of the most infectious viruses out there. So this is like a more infectious than the most infectious already.

Dale Harrison:
Right. So based on the estimates of the R-nought of this new variant, we’re going to need north of 90% of the population vaccinated. This is why, again, measles burned out when we were able to achieve above 90% vaccination rates and why we’re starting to get outbreaks, because there are blocks of people who won’t get vaccinated, and we’re starting to get close to that 90% line.

Dr. Mark Hyman:
So given the resistance to vaccines for COVID and the conspiracy theories and the-

Dale Harrison:
Oh, I know.

Dr. Mark Hyman:
Confusion, we’re never going to get to 90%. Maybe we’ll get to 50 or 60.

Dale Harrison:
But the third condition for herd immunity is the vaccine has to confer sterilize and immunity because you need to be able to stop the transmission. So again, if you look at measles, measles is very effective at blocking the transmission of the virus, and so measles vaccines are effective at producing herd immunity. Again, even if the vaccine is partially sterilizing, let’s say half of the people are protected from infection, you still have a large amount of population that can still potentially get infected and then retransmit that to others even if it’s largely asymptomatic. Becomes less of an issue if you have 90% vaccination rate. Becomes a huge issue if you’ve got 50% vaccination rate.

Dale Harrison:
Then the fourth thing that isn’t talked about as much is that the virus needs to not have an animal reservoir. So one of the reasons that we’ve been so effective eliminating smallpox is that smallpox never had an effective animal reservoir, and you had extremely high vaccination rates, and you had a vaccine that was very effective at producing both sterilize and immunity and a strong, durable lifetime disease immunity. So the smallpox vaccine had all four of those and as a result, nobody’s even getting the smallpox vaccine anymore because smallpox simply doesn’t exist anymore. By the late 1970s, we had achieved global herd immunity on smallpox. The problem is, with COVID, it seems unlikely that we’re going to hit any one of those four key components that are required for herd immunity. Again, you know, the thing that you hear in the news is really only about we only need a certain percentage of the population protected. But it’s more than that. It’s how you’re protected. It’s things like the animal reservoirs and it’s things like the rate at which you can get a large enough fraction of the population to be willing to be protected.

Dale Harrison:
So, in the absence of that, there are two potential paths going forward in 2021 and beyond which is we maintain the current level of mitigation, so masking, distancing, reduced social density, closures, this sort of thing, because those have actually been extraordinarily effective. What you’ve done is you’ve taken a virus with an R-nought of about 3.5 to five, and you’ve reduced it to an R-nought of between 0.9 to about 1.2. So in other words, all of this masking, this sort of historically unprecedented amount of mitigation, has basically reduced the effective infectiousness of COVID to about the flu.

Dr. Mark Hyman:
So basically you’re saying as the average person would have infected over three people if they had COVID and now it’s like about one.

Dale Harrison:
Right. So as a comparison-

Dr. Mark Hyman:
What evidence do we have that the mitigation measures like masks are doing that? Because I think a lot of people are dubious about masks and their effectiveness, and you hear just tremendous amount of controversy about this. So what’s your perspective on that?

Dale Harrison:
I’m pretty sure I wouldn’t want to have open heart surgery with the surgical team unmasked. I mean, masks are very effective and most of the non-

Dr. Mark Hyman:
So where did it come from that masks may not be effective, or that they don’t really reduce it, or there’s no evidence, or there’s no trials, or they’re all rigged? I mean, where does it all come from?

Dale Harrison:
I mean, it’s the deniers and the conspiracy theorists and the fact is is there’s enormous evidence that they’re effective and-

Dr. Mark Hyman:
Not perfect, but they do reduce the spread.

Dale Harrison:
But again, it goes back to the analogy I use with masks, as the analogy I use with a bulletproof vest. If I’m going into a gunfight, I’ll take a 70% effective bulletproof vest over going in with a snarky t-shirt because I’m not an idiot. The masks are probably somewhere in the 50 to 70% effective range depending on which mask you get and how you wear the mask, so there’s huge variability there, but so are bulletproof vests. If you don’t cinch down a bulletproof vest and you get shot, you’ll still get killed. So if you wear it wrong, it doesn’t work. That shouldn’t be a surprise and a lot of people wear it wrong. So-

Dr. Mark Hyman:
You mean the mask down over their nose or cloth masks which aren’t as effective.

Dale Harrison:
But overall if you look at our mitigation rates, we’ve pushed the R effective of the virus down to something comparable with the flu. To give you a comparison, in a typical flu season, so we look back over the last 25 years of flu seasons, during flu season, we’re seeing about four to five million flu cases a week in the U.S. Right now, we’re seeing about six to seven million COVID cases in the U.S., so about 30 to 50% above the number of flu cases, with an extraordinarily contagious virus, which means our mitigation efforts have pushed this down to where COVID is as roughly as contagious as the flu. What happens is if people start to push, and I think there’s going to be an enormous amount of political pressure once vaccinations are widely available for, well, everybody who’s wanted the vaccine has now got it, so it’s time to open everything back up and drop all the requirements. If we do that, we’re going to push the effective infectiousness of the virus up to its R-nought, which is quite high.

Dr. Mark Hyman:
You mean three people will be infected for every [crosstalk 01:09:15] three to five. Yeah.

Dale Harrison:
Which is the range, and maybe something more like five to seven with this new, more infectious variant. So-

Dr. Mark Hyman:
So in other words, you’ve got a lot of people running around who’ve been vaccinated who think they’re great. The society wants to open back up. Everything opens back up. So the people who got the vaccine maybe are protected. The rest of the people who aren’t getting vaccinated are at much higher risk.

Dale Harrison:
Right. So the best estimates are that this vaccine will likely reduce mortality by a factor of 10. So instead of having a 1% chance of dying, you’ve got a 0.1% chance, which now pushes the fatality rate down comparable to catching the flu, which I think a lot of people are fairly comfortable with the idea of catching the flu. I certainly am although I still get a flu vaccine every year because I want to tilt the odds in my favor. So if we make two assumptions, we assume that the vaccine will be effective in pushing the fatality rate down by a factor of 10, and we assume that you don’t have effective sterilize and immunity, and then we assume that there’s a political push to fully reopen the economy and to drop mitigation.

Dale Harrison:
What will happen is the virus will go endemic, meaning it will start to look more like a cold, a common cold, in terms of the rate at which it spreads through the population. So the thing in the U.S., is every year 93% of the population catches at least one cold a year. We have a billion colds a year in the U.S., and the average person catches three colds a year. On average, you’ve got roughly two months, about eight to 10 weeks, of immune protection for most people. Now again, some people will have as little as two weeks, and some people will actually will have as much as a year of immune protection after catching a cold. So again, these upper respiratory RNA viruses and coronaviruses tend to have a very heterogeneous immune response. But on average across 330 million people, we’re getting a billion colds a year.

Dale Harrison:
The average person catches three a year in the roughly eight month cold season. That’s what an endemic virus looks like, which means that instead of getting five to seven million cases a week, we could see 20 or 25 million cases a week if we drop all mitigation. So now got-

Dr. Mark Hyman:
Even with the vaccine.

Dale Harrison:
Well, right. Yeah. But again, part of it depends on how effective the partial sterilize and immunity is. Assuming you had a hundred percent vaccination rate, will half the population still be susceptible to infection and retransmission? That’s an entirely unknown at this point. We’re not going to know until we run that experiment on 200 million people. But here’s the risk. Even with a hundred percent vaccination and no mitigation efforts, if the virus goes endemic, meaning we see 20 plus million cases a week, but most of those cases look like the common cold or even asymptomatic, you’d still are going to have roughly 10% of those cases develop disease, some sort of significant disease symptoms.

Dale Harrison:
Even if you can push the fatality rate down by a factor of 10, if you have two to three times as many people a week catching it, but I’m sorry, I mean, if you [crosstalk 00:19:10]. Yeah. I mean, if you have 10 times as many people catching it, but you have one 10th of vitality rate, you’re going to end up with the same absolute number of people dying.

Dr. Mark Hyman:
So the percent of people dying will be less, but the number of people will be [crosstalk 00:19:26], which means our hospitals will still be overwhelmed and flooded even if we are all vaccinated, if we don’t continue to also do mitigation measures.

Dale Harrison:
Some level of mitigation, right.

Dr. Mark Hyman:
Okay. So how long are we talking here, Dale? Are we talking a year? Are we talking five years? Are we talking 10 years? Forever? Are we all wearing masks for the rest of our lives? What does the future look like?

Dale Harrison:
Yeah. I mean, again, I don’t think anybody knows at this point. Now there is one interesting, there’s actually a couple of these, but there’s one particularly interesting historical data point. So right now, there are about a third of all colds are caused by one of four coronaviruses that are split into two families, called alpha corona and beta coronaviruses. So there is pretty solid evidence that the beta corona family originated about sometime around 1880 out of China where it jumped from bat population to human population, and then spread across Russia into Europe, and then into the U.S., and then South America. So in the 1880s up into the early 1890s, you had this massive global epidemic and they referred to it as the Russian Flu. But again, there’s pretty solid evidence now that in it wasn’t the flu, it was a coronavirus. In fact, it was the coronavirus that causes a significant fraction of colds today.

Dale Harrison:
What you saw is between from the time it jumped, which the estimates are about 1880 until about 1900, about 20 years, the virus gradually mutated and attenuated until it literally just went from something that was roughly 10 times deadlier than the flu to something that literally is now just the common cold. So coronavirus is a very, very slow mutators. Part of this is because, so they’re quite different than HIV or influenza which are fast mutators, part of this is because they carry what’s called a proofreading enzyme, meaning that they have a molecule that actually proofreads when they’re translating from the RNA and the virus to a protein, and will actually make corrections if their errors occur.

Dale Harrison:
So you end up getting a very, very slow mutation rate with a coronavirus, which is why the current vaccines are going to be good for a long time, because the virus is probably not going to significantly mutate away from the vaccine. But the downside is it takes a long time for the virus to mutate to an attenuated form. The one data point we’ve got with the beta coronaviruses is something on the order of 10 to 20 years to reach a fully mutated form. Now-

Dr. Mark Hyman:
So what you’re saying is basically we’re stuck with masks for 10 to 20 years and no sports games, and concerts, and big gatherings and-

Dale Harrison:
But if everybody gets vaccinated and the vaccine basically turns a fairly deadly vascular disease into a fairly manageable upper respiratory disease, it’s going to be a lot easier to start to reactivate large portions of people’s lives, but it doesn’t mean you get to go back to 2019. So I think there’s something between how hard we had to lock down in 2020 versus the free for all of 2019, and the future is going to be somewhere in between. So I’ll tell you just in terms of my own kind of personal risk calculus, so I fully intended to get the vaccine basically as soon as it’s available for my age group, so I’m guessing I’m probably going to get it sometime in the March or April timeframe.

Dale Harrison:
Once that happens, I’m going to be relatively comfortable flying again. So I normally do a fair amount of travel. I’ve done no travel whatsoever in 2020. So I’m going to be comfortable flying again. I’ll be comfortable going to certain public venues. I will not be comfortable dispensing with mask. I’m still going to be very cautious about who I socialize with if I think that they’re being irresponsible in terms of protecting themselves. Because I’ll know that even with the vaccine, I’m still at the risk of catching it and passing it to others, and I’m still going to be at risk of catching it and developing disease, just much, much lower risk of developing severe disease or developing a fatal disease. So what I’m expecting in my own personal life is once I get vaccinated, I’m going to be able to start to open up the range of activities, but I’m not going to be able to go back to how it was in 2019.

Dale Harrison:
I’m still going to wear a mask. I’m still going to practice distancing. Because the deal is, in the winter time, I don’t like catching the flu. I wash my hands and I stay away from people coughing on me. Not because I’m living in fear, but because I just don’t want the hassle of catching the flu, and I can do a few simple things to tilt the odds in my favor, and every winter I get a flu vaccine. So I still go out and do lots of things, knowing that I could get the flu, but I’m going to do a few basic things that’s going to tilt the table in my favor. It’s the same thing here. It’s just that we now have a much more contagious virus which means that the risk of simple things that you need to do to tilt the odds in your favor are going to be more extensive.

Dale Harrison:
So I’m probably never going back to shopping the way I did in stores. I’m probably going to continue to use Instacart for reasons even beyond the virus, simply because it’s such a massive convenience in my life to not have to go to the grocery store. I’m probably going to continue to rely far more heavily on ordering goods online. Some of this is because it’s going to minimize the number of sort of meaningless contacts I make, which is going to minimize my chance of catching this even with the vaccine, and these are very simple things to do. So, I also-

Dr. Mark Hyman:
Which had been hard to convince the population to do.

Dale Harrison:
Yeah, I know, I know. So once I get vaccinated, I’m going to be comfortable flying, but with a mask. I’m going to wash my hands year round the way I do during flu season. I’m going to avoid coughing on me. Quite frankly, I’m going to avoid people who I think are acting like idiots because I don’t want these people breathing on me, because I still don’t want to get it even if I know that I’m largely protected. But I’m going to be comfortable going back to things like restaurants, and probably some music venues, and things like inviting people over. I’m going to be a more comfortable with that, again, depending on especially if they’re all vaccinated as well, then I know that we’re all fairly protected. I think the real danger here, and the greatest danger point from a societal standpoint, is when we have 50% of the population vaccinated coupled with a growing pressure to-
PART 3 OF 4 ENDS [01:21:04]

Dale Harrison:
… And coupled with a growing pressure to drop mitigation. And I think that’s going to be an absolute danger zone because if you’ve got half of the population just butt naked, and you start to drop the mitigation measures, and you have a non sterilizing vaccine, that’s a lethal combination where you’re going to end up really starting to push the virus through the unvaccinated population at a really accelerated rate. And so, we could easily see, with the expected maybe 40 to 60% vaccination rate in a year, which seems to be the consensus among a lot of public health people, that I think next November, next December, we could see both case rates and death rates significantly above what we’re seeing right now [crosstalk 00:00:59].

Dr. Mark Hyman:
So what do you think of the conversation about vaccine mandates? Because I think there’s this whole view that we should maintain our civil liberties, that we should have medical freedom, that we should have choice. And yet we’re in a situation where we’ve got so much misinformation, disinformation, confusion, even about the real science, even when we talk about vaccines, we’re not having these detailed conversations like you and I just had about the nuances of what it does and what it doesn’t do. And if we’re really facing an acceleration of COVID, an increase in the number of deaths, and increased destabilization of society and the economy, if we all don’t get vaccinated, how do you have a conversation with someone who is so convinced that these vaccines are harmful and don’t want to take them?

Dale Harrison:
Well, and I think that’s going to be tough and I’m not sure, personally, I think I’d be shocked to see universal mandates, partly because it’s going to be difficult to get compliance, but partly because I don’t think they’re going to be necessary. And the reason why is I think that there are other things that are going to nudge people toward getting vaccinated. And the real mandate is going to come from Delta Air Lines, Carnival Cruise Lines, passport control in Paris, because they’re not going to let you in the fricking country if you don’t have a vaccination [crosstalk 01:23:29].

Dr. Mark Hyman:
Yeah. Yeah.

Dale Harrison:
The local [crosstalk 00:02:33].

Dr. Mark Hyman:
So governments aren’t going to be mandating it, but businesses can [crosstalk 01:23:35].

Dale Harrison:
I think businesses [crosstalk 01:23:36].

Dr. Mark Hyman:
… you can’t walk into a store without a mask, even if you don’t believe in masks, right?

Dale Harrison:
Right.

Dr. Mark Hyman:
You can’t get on a plane unless you get a vaccination, even if you don’t believe in vaccinations.

Dale Harrison:
Right.

Dr. Mark Hyman:
That’s going to change everything.

Dale Harrison:
I think it’s going to be non-governmental entities largely that are going to end up driving it. And part of that is because people are not going to want to get sick. And so, you look at the airlines, which I thought were extraordinarily irresponsible in the spring, where they resisted any attempt at a mandate to wear, now they’re pretty rigorously enforcing masking, and they’re now openly talking about requiring vaccination cards. So, they’ve really progressed, and they’ve progressed because they felt market pressure. And you look at the cruise lines, every single attempt in the last six months to restart cruising has ended in just complete total disaster, because these things are like giant floating Petri dishes.

Dr. Mark Hyman:
Yeah. Yeah. Yeah.

Dale Harrison:
And with buffet lines, and the cruise industry has got maybe 12 to 18 months of cash max before they’re permanently dead. And so they’re going to be under enormous amount of pressure to restart cruising, and I don’t see how they’re going to do that without vaccination cards. And the other thing is, a lot of countries are already smart enough to not let Americans in, it’s damn hard to get into South Korea, or get into Singapore, or get into New Zealand right now, if you’re an American. And I think you’re going to see this universal that if you want to travel and expect to clear passport control, you better have a vaccination card.

Dr. Mark Hyman:
Yeah. Yeah.

Dale Harrison:
And then I think you’re going to see it come down to businesses as well, because business continuity issues around, so assume that the vaccine, that you’ve got an effective vaccine but you’re still going to have an increased number of people with cold or flu like symptoms that’s going to cause them to lose work even with the vaccine, because you have this [inaudible 01:25:55] virus, you’re already going to have a business continuity issue. If you then stir into that mix, half of your employees who refuse to take a vaccine, you’re going to come down to a point to where the vaccination is going to be a requirement for employment in a lot of businesses.

Dr. Mark Hyman:
Yeah. Well, it is now. So as a doctor, when I work in the hospitals, I have to get the hepatitis vaccines, I have to get the flu vaccine. There’s mandated vaccines if you want to work in certain environments today, that exists in businesses, and businesses have the ability to make those choices.

Dale Harrison:
And I could also see the same thing happening with certain types of stores, where you got to show a card to get in the store, because right now you got to be wearing a mask to get in the store. And the vaccine is going to be dramatically more effective than wearing a mask.

Dr. Mark Hyman:
So why did Redfield, the CDC director, say that he thought that masks are more effective than vaccines?

Dale Harrison:
It was interesting when he said that, so he says that in late August, early September. The initial data from Pfizer and from Moderna had started to become available. And at that point, we started to see a lot of the animal studies, the transgenic mice and the rhesus monkey studies. And what was clear was that already by July, it was quite clear that none of these vaccines were producing effective sterilizing immunity, and that you’re going to have to keep wearing a mask to avoid transmission. And so around late August, you started to see Hahn at FDA, you started to see Fauci and you started to see Redfield at CDC, all began to lay down hints that masks were not going to be going away, and that the vaccine was not going to be able to eliminate the need for that. And I think that they were doing it because they were all looking at the same data that all the rest of us were looking at, that we’re following the scientific literature.

Dale Harrison:
The early animal studies, this was back in early June when the first of these transgenic mice studies on the Pfizer and the Johnson & Johnson vaccines hit the preprint servers. And it was pretty damn clear when you saw those papers that, this vaccine was going to work a lot like the flu vaccine in terms of reasonably effective at reducing disease severity, fairly ineffective at producing sterilizing immunity, you’re still going to catch it and retransmit it, even if you didn’t develop full disease.

Dr. Mark Hyman:
So do you think we’re going to need an annual coronavirus vaccine, COVID vaccine [crosstalk 01:28:42].

Dale Harrison:
Or every six months.

Dr. Mark Hyman:
Or every six months, right?

Dale Harrison:
Here’s my prediction on this. So if you go back to the Scripps Institute study, so this is a really, really good study where basically the people at Scripps, their Institute for immunology, they’re tracking people who had, had COVID, and so they’re following the, both antibody levels and B cell, and T cell production. Now, again, measuring [crosstalk 00:01:29:12].

Dr. Mark Hyman:
And B cell and T cells are the cells that are part of your immune system. The B cells make antibodies, the T cells basically have a different way of fighting infection.

Dale Harrison:
Right. Yeah. And one way to think about it is, B cells keep you from getting infected, T cells keep you from dying once you’re infected. It’s a very rough way of thinking about it. They each have a job, but they’re slightly different. They focus on a different phase of the infection and disease. But so out of that study, you saw really significant heterogeneity in the immune response. So you had patients that had almost no antibody levels in their bloodstream within two weeks of recovery. You had other people six months after, because they were only able to look six months, that although their antibody levels were clearly declining, there were still at a reasonably high level, and at least at that rate of decline, they could see them having effective levels out to probably at least a year, maybe for some small fraction of the population, maybe after two years.

Dale Harrison:
Again, this precisely matches what’s been known for a long time about coronavirus infections causing the common cold, that most people lose immune protection typically within two to four months, there are some people that have immune protection up to 18 to 24 months. The average is around six months, which is why you just keep getting colds over and over again. So, given that, what I’m predicting is that what you’re going to see is people are going to end up needing to take weekly or monthly home antibody test. So probably a cheap lateral flow strip, pin-prick antibody tests that they’d be able to buy at CVS and take it at home.

Dale Harrison:
And those tests are going to basically going to look for, what’s your current antibody levels? And once the antibody level drops below a certain level, based on the test, you then go in and get a booster. So for some people that might be every three months, other people it might be every two years, because I think there’s going to be so much range in the level of durable immunity that you’re not going to be able to come up with a standard, everyone has to get vaccinated once every six months, once every 12 months, it’s going to be different for different people.

Dr. Mark Hyman:
This is really striking, Dale, because what you’re saying is that on average vaccine produces about 4 million doses a year. We’re talking about the need for billions of doses. So that brings up a whole nother question of what is our capacity to produce and manufacture the vaccines, and can we actually, if everybody wanted to get vaccinated, vaccinate everybody on that schedule?

Dale Harrison:
This is what’s great, especially about the Pfizer and Moderna vaccines that use these, what we call viral like particles, these synthetically produced viral envelopes that carry the RNA, that those can be produced at massive scale. So you really have the ability to manufacture these things at absolutely a mass industrial scale. We’re not there yet, but there’s no real inhibition. And the turnaround round, right? The length of time it takes to produce a dose is relatively short compared to a traditional vaccine. So you look at something like the flu vaccine, they start manufacturing usually in March or April, the first doses aren’t available until late August, or early September. So, it takes months of manufacturing to be able to start to produce doses. So, this newer generation of vaccines, I think have the potential to really allow you to produce a billion doses or 10 billion doses a year, which in fact is what we’re going to need. We’re going to need something more on the order of probably 10 billion doses a year globally. And it’s going to be unprecedented, nothing like [crosstalk 01:33:19].

Dr. Mark Hyman:
Yeah. Nothing, no.

Dale Harrison:
Flu vaccine is produced in the largest quantities of any vaccine, and it’s only about 165 million doses a year in the US.

Dr. Mark Hyman:
Yeah.

Dale Harrison:
So this is really [crosstalk 01:33:32].

Dr. Mark Hyman:
Yeah. It’s staggering. It’s staggering. Okay. Last question is, we’re hearing talk of getting the first vaccination of two vaccinations that are required out of the population as quickly as possible, which would mean that we’re potentially going to have a delay with the second vaccine, because if we use up all the first doses and don’t reserve the second dose for each person, we’re going to run into vaccines, is that realistic? Is that a problem? [crosstalk 00:12:58].

Dale Harrison:
No.

Dr. Mark Hyman:
… not worry about it?

Dale Harrison:
So I think it’s a problem, I’m not sure it’s something we should worry about, and here’s why. The calculus, I think that people are making is that sometime late this month, we’ll probably we’ll see the AstraZeneca vaccine be approved, I think by late February to early March, we’ll see an EUA approval for the Johnson & Johnson vaccine. These things are already been in manufacturing for months now. And so there are already preexisting stockpiles, they simply can’t be released. And so I think part of the calculus is that if we can get these additional stockpiles released, approved and released, we’re going to be able within a couple of months start to have significantly more doses, and so the idea is, is that the supply side of the problem will largely take care of itself. Plus the other thing is that even the Pfizer and the Moderna, they’re still significantly ramping up their scale of production.

Dale Harrison:
And so every month, I think we should expect to see larger and larger quantities of vaccine being manufactured by those companies. So, I think that the supply side of the problem will take care of itself within a few months. The bigger problem seems to be the last mile logistics, how do you get people lined up to get poked in the arm? And I think the other issue is going to be getting people to come back for the second dose. Now, each of the vaccines has a different timeline based on what was designed into the original study. So we have no data on what it looks like to go two months before you get the second dose versus one month. But again, from people that I have talked to and from things I’ve read in the scientific literature, nobody seems to be particularly concerned about whether the second dose is three weeks, four weeks, six weeks, or eight weeks later, probably can’t be six months later, but the exact timing is probably not important. What’s going to be more important [crosstalk 01:36:15].

Dr. Mark Hyman:
But you’re not necessarily protected after the first dose, right?

Dale Harrison:
Right. This is the much bigger concern about a single dose regime is that if you’ve got partial immunity, you’ve now set up the condition to start to foster large numbers of variants, large numbers of mutational variants. And because what happens is, is that you’re getting these mutational variants all the time. You get sick with a virus, you’re producing all kinds of variants, but most of those are in very, very small numbers. And your immune system is ramping up, even without the vaccine, your immune system will ultimately clear the virus from your body. And so, most of those mutants never get a chance to get passed on to other people, so they die inside you.

Dale Harrison:
If you now have a partial level of immunity, what happens is that if you develop a single mutant variant, single mutated variant, that is antibody resistant, the partial antibody protection you’ve got will basically kill off everything that is easy to kill off and will leave behind that one rare mutation that is antibody resistant, but now that mutation has the ability to recolonize and fully grow, and so now that becomes the dominant variant of the virus in you, and you’re now breathing this out [crosstalk 01:37:47].

Dr. Mark Hyman:
What you’re saying is if you get both vaccinations that is less likely to happen and they’re likely to cover the mutated viruses. So we’re hearing about these mutated viruses, will the vaccines work on those as well? What you’re saying is yes.

Dale Harrison:
Yeah, yeah.

Dr. Mark Hyman:
Okay.

Dale Harrison:
And the reason why there is that, the virus is a very, very slow mutator. So, there’s now been tens of thousands of sequencing studies done since the original, what was called the Wuhan isolate was sequenced back in mid January. And what you’re seeing is that most variants differ from the Wuhan isolate by an average of between one and two, what are called single nucleotide variants per month, meaning out of a 30,000 nucleotide genome, most of these viruses are different from the original one by only about one or two variants per month. So you’re slowly getting more mutation, but it’s at extraordinarily slow rate. And most of these will have no impact whatsoever. And even the ones that affect, like the UK mutant, UK variant, it doesn’t look like it’s going to have any impact on the vaccine, and partly because the protein that the vaccines are producing is several hundred amino acids, so somewhere around two, 300 amino acids in length.

Dale Harrison:
And these mutations only represent one or two or three isolated variants within that protein. And so the basic shape of the protein doesn’t really change. And so as a result, the vaccine basically won’t even notice that there are these pinprick changes randomly scattered through the protein. It’ll still be able to bind to the bulk of that protein without any issues whatsoever.

Dr. Mark Hyman:
So that’s pretty good news. That’s pretty [crosstalk 01:39:43].

Dale Harrison:
Yeah. So that’s quite good. So I think most of these variants we’re seeing are likely to have no impact for a long time on any of the vaccines.

Dr. Mark Hyman:
All right. Well, this has been an incredible conversation, Dale. I just want to try to summarize because we’ve covered a lot of ground. And I think people are maybe still a little bit confused. So first of all, vaccines seem to be quite safe, two, they don’t protect you necessarily from getting COVID-19, but they prevent you from getting seriously ill and dying, hopefully, three, you can still spread it significantly if you get it, which is a concern because it means if you don’t practice mitigation, if you don’t practice mask wearing, washing your hands, social distancing, et cetera, you’re going to be a vector for disease and spread it in your family and community, and it can be an accelerated growth in the population if we’re not careful.

Dale Harrison:
Right.

Dr. Mark Hyman:
That we still have a lot to learn, and then to track and update the story maybe in a couple of months with you about what we’re learning about, the effects of vaccines, the reaction rates, the how long immunity lasts, there’s still a lot of unknowns whether they’re safe in auto-immune patients, pregnant patients and so forth, but at the end of the day, vaccines are not going to save us, they’re going to help dramatically. They’re going to reduce the lethality of it. And if we practice it along with the mitigation measures, we’ll be in a position where we’ll start to be able to open up a little bit, but we’re not looking at full back to normal from what I hear you saying, for potentially five, 10, even 20 years, where people can just go party their hearts out. Is that what you’re saying?

Dale Harrison:
Yeah. Basically, yes.

Dr. Mark Hyman:
Okay.

Dale Harrison:
The one subtle distinction is I think it’s important too because a lot of bad news articles come from not understanding this distinction. So COVID is the symptomatic disease you get from a SARS-CoV-2 infection. And so the vaccine is quite good at protecting against COVID, meaning symptomatic disease. It’s not as good at protecting against SARS-CoV-2 infection. And so there’s a subtlety in language there, but it’s important because a lot of the research papers will talk about essentially COVID protection, or COVID immunity, which is protection against symptomatic disease, which is not exactly the same thing as protection against viral infection.

Dr. Mark Hyman:
Right.

Dale Harrison:
And so [crosstalk 01:42:12].

Dr. Mark Hyman:
… 94% effective, it’s a little misleading.

Dale Harrison:
Right. Well, and the last thing I would say there too is that, historically, so within, in the vaccine world, there are two important terms. There is efficacy, and then there is effectiveness. And so efficacy is what you measure in a highly controlled trial. Effectiveness is what happens when that vaccine is then introduced into the broad general population. And what you typically see is a significant drop between efficacy to effectiveness as you deploy a vaccine. So that 90, 95% efficacy, this is a small, highly controlled study group where that number is coming from. The general population is not going to entirely look like that study group, and they’re not going to entirely respond. And most of the response differences are going to translate into less effective, not more effective.

Dr. Mark Hyman:
Yeah.

Dale Harrison:
And I’ll throw one other interesting bit of data buried deep down inside the AstraZeneca study that I find a bit fascinating. So if you look at, again, you look at the placebo arm of the AstraZeneca trial. So they’re testing people weekly for infection, for the duration of that trial, the people in that study were getting infected at 30%, the rate of the general population. And so these were the people who had no vaccine, no protection whatsoever, and they were getting infected at only 30% of the rate. And this is 30% of the rate after adjusting for age, gender, race, geography, and nationality, and comorbidities. So if you adjust for all of those factors, they’re still getting infected at only 30% of the rate, and what that implies is this was a highly unusual, the people who volunteered for those studies were highly unusual compared to the general population and were likely already engaging in really significant mitigation measures.

Dr. Mark Hyman:
Yeah.

Dale Harrison:
And which means that some fraction of that study is the vaccine combined with extensive mitigation measures, as opposed to just the vaccine.

Dr. Mark Hyman:
Yes. That’s important to understand. So we still got to take care of each other, and this is a long process [crosstalk 00:01:44:43].

Dale Harrison:
It’s a long haul.

Dr. Mark Hyman:
… but hopefully the vaccine will mitigate the long-term side effects of COVID, which I’m most worried about, this long hauler post COVID syndrome, them SARS-CoV-1, the original SARS virus, 40% of people had chronic fatigue at three months who survive. If that’s the case with this one, we’re in big trouble if we don’t get smart about either getting vaccinated or getting really smart about not getting the virus through mitigation. We’ve had other podcasts looking at other therapies like ozone, and diet, and nutritional supplements and other things, which I believe are also extremely important in protecting yourself from getting sick. So we’ve covered that a lot, but don’t forget if you’re listening to this, that it’s not just a vaccine or masks, it’s how you take care of your overall health.

Dr. Mark Hyman:
It’s your diet, it’s sleep, it’s exercise, it’s stress reduction, it’s making sure your nutritional levels are at a good amount. For example, vitamin D is critical, zinc, vitamin C and so forth. There are a lot of things we can do. And of course, there’s other therapies out there that are being explored around the world like ozone therapy and peptides and so forth, which seem to be helpful and may even be more effective than some of the medications that are being studied. So therapeutics is another topic we didn’t really cover, and we’re doing a little bit better on that front, but not that much better because we’re still seeing 4,000 deaths a day, and if we had a good therapeutic, we wouldn’t see that.

Dr. Mark Hyman:
So I’m really grateful, Dale, that you came on to the Doctor’s Farmacy podcast, so you help navigate this extremely controversial, very difficult subject. I know we’re going to need a lot of flack about this podcast, but I felt it was really important to bring in a scientist who really understands these issues, who’s read the studies as I have, and really go into the nuances, because what you’re hearing is the headlines and not between the lines. For those listening there’s going to be, in the show notes of the podcast on my website, there is going to be links to a number of articles that discuss these issues in great detail, and you can get into the nuances even more if you want.

Dr. Mark Hyman:
If you love this podcast and you want to share with your friends and family, and I bet you do, because this one’s going to be a keeper, just share it with everybody on social media, leave a comment we’d love to hear from you, even if they’re not nice comments, we want to hear what you’re really thinking and what your questions are, and we’ll try to answer those as well, be nice, but you can ask hard questions, and of course, subscribe wherever you get your podcasts and we’ll see you next time on the Doctor’s Farmacy.
PART 4 OF 4 ENDS [01:47:13]

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

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