CDC Reviewed Study on VAERS Data Finds 133 Times Increased Risk of Myocarditis following COVID 19 Vaccination
A study by US FDA and CDC scientists titled Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021 published on JAMA Jan 25 2022. Using official CDC VAERS data, researchers found real-world evidence that the Pfizer COVID-19 vaccine significantly increases myocarditis risk; hardest hit 12-14 year-old males, who sustain a whopping increased myocarditis risk of up to 133x. In other words the Pfizer COVID 19 Vaccine myocarditis risk is 13,000% higher than normal.
“Based on passive surveillance reporting in the US, the risk of myocarditis after receiving mRNA-based COVID-19 vaccines was increased across multiple age and sex strata and was highest after the second vaccination dose in adolescent males and young men.”Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021
Not only did the study utilize official (real world) CDC VAERS data of 192.4 Million verified COVID-19 vaccine injuries, but the just under 2000 Myocarditis cases were also cross-checked to ensure they fully complied with CDCs clinical definition of myocarditis. In other words each of the vaccine injury reports, fit all the symptoms and conditions to be classified or diagnosed as Myocarditis. This is important because there is very strict criteria for diagnosing a case of myocarditis, and the fact that all cases in this study were verified to meet that definition, ensures the studies accuracy and validity.
You may be thinking 2000 myocarditis reports on over 194.2M people really isn’t too alarming. However multiple studies have shown injuries are grossly under-reported on VAERS, with estimates that roughly only 1%-5% of COVID-19 vaccine injuries are actually reported in the database. This is due to multiple factors including: a) VAERS has a small department to process tens of millions of vaccine injury reports from across america b) reports have to get bounced back and forth (takes sometimes 6+ months to complete a report before it is submitted to the VAERS database) c) many doctors don’t know how to fill out a VAERS report (they are very difficult to fill out, and are often rejected; filling out a report does not guarantee it will be accepted into the database.) d) Many individuals may ignore minor symptoms, or may out of fear of diagnosis, dismiss minor symptoms until they become more severe e) doctors fear ridicule or loss of job, funding or license if they report vaccine injuries; due to media and corporate pressure from big-pharma controlled hospital administration (including CDC, FDA, etc pressure).
It’s also important to point out that there are no mild cases of myocarditis…those diagnosed with this condition have on average 5 or less years to live before some form of cardiac failure. Therefore unless these individuals get a heart transplant, they are essentially living on borrowed time via medications.
Please Note: Although this analysis of the study is lengthy and comprehensive…it may only select particular excerpts from the study, and some data / information may be omitted or altered to make this article more concise. Please view the original study for a full and complete transcript of the study.
- Supplemental Data
- What is Myocarditis?
- Why is Myocarditis a Severe Disease?
- Dr. John Campbell on Israel Study on Increased Risk of Myocarditis Post COVID-19 Vaccine | Video
- Military Dr Explains Myocarditis from COVID-19 Vaccines (Unrelated to this study) | Video
Please Note: The abstract is sort of a synopsis of the study including: methods, outcomes /end-points, results, etc. If you are strapped for time or not into lengthy reading of medical literature, you can pretty much get the rundown of the study in under 1 page, simply by reading the abstract. Checking the original study abstract also let’s you as an individual, verify if an article is accurate on what it says about a study, or if it’s being too generous on the conclusions it’s drawn. You should always check the original study abstract, because a) many journalists do not have a medical education, and b) may also have a bias in writing an article covering a study, therefore they may push a narrative that is not a true reflection of the actual study data.
Question / Objective: The study aimed to analyze the rates of myocarditis, post mRNA-based COVID-19 vaccination in the US.
Design, Setting, and participants: “Descriptive study of reports of myocarditis to the Vaccine Adverse Event Reporting System (VAERS) that occurred after mRNA-based COVID-19 vaccine administration between December 2020 and August 2021 in 192 405 448 individuals older than 12 years of age in the US; data were processed by VAERS as of September 30, 2021.”
Exposures: “Vaccination with BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna).”
Main Outcomes and Measures: “Reports of myocarditis to VAERS were adjudicated and summarized for all age groups. Crude reporting rates were calculated across age and sex strata. Expected rates of myocarditis by age and sex were calculated using 2017-2019 claims data. For persons younger than 30 years of age, medical record reviews and clinician interviews were conducted to describe clinical presentation, diagnostic test results, treatment, and early outcomes.”
Results: “Among 192 405 448 persons receiving a total of 354 100 845 mRNA-based COVID-19 vaccines during the study period, there were 1991 reports of myocarditis to VAERS and 1626 of these reports met the case definition of myocarditis. Of those with myocarditis, the median age was 21 years (IQR, 16-31 years) and the median time to symptom onset was 2 days (IQR, 1-3 days). Males comprised 82% of the myocarditis cases for whom sex was reported. The crude reporting rates for cases of myocarditis within 7 days after COVID-19 vaccination exceeded the expected rates of myocarditis across multiple age and sex strata. The rates of myocarditis were highest after the second vaccination dose in adolescent males aged 12 to 15 years (70.7 per million doses of the BNT162b2 vaccine), in adolescent males aged 16 to 17 years (105.9 per million doses of the BNT162b2 vaccine), and in young men aged 18 to 24 years (52.4 and 56.3 per million doses of the BNT162b2 vaccine and the mRNA-1273 vaccine, respectively). There were 826 cases of myocarditis among those younger than 30 years of age who had detailed clinical information available; of these cases, 792 of 809 (98%) had elevated troponin levels, 569 of 794 (72%) had abnormal electrocardiogram results, and 223 of 312 (72%) had abnormal cardiac magnetic resonance imaging results. Approximately 96% of persons (784/813) were hospitalized and 87% (577/661) of these had resolution of presenting symptoms by hospital discharge. The most common treatment was nonsteroidal anti-inflammatory drugs (589/676; 87%).”
Conclusions and Relevance: “Based on passive surveillance reporting in the US, the risk of myocarditis after receiving mRNA-based COVID-19 vaccines was increased across multiple age and sex strata and was highest after the second vaccination dose in adolescent males and young men. This risk should be considered in the context of the benefits of COVID-19 vaccination.”
In the study introduction it basically just explains the association between COVID-19 vaccines and reports of acute myocarditis and the purpose of the study to investigate those myocarditis vaccine injuries on VAERS, in order to calculate the risk of myocarditis post COVID-19 vaccine.
“Myocarditis is an inflammatory condition of the heart muscle that has a bimodal peak incidence during infancy and adolescence or young adulthood.1-4 The clinical presentation and course of myocarditis is variable, with some patients not requiring treatment and others experiencing severe heart failure that requires subsequent heart transplantation or leads to death.5 Onset of myocarditis typically follows an inciting process, often a viral illness; however, no antecedent cause is identified in many cases.6 It has been hypothesized that vaccination can serve as a trigger for myocarditis; however, only the smallpox vaccine has previously been causally associated with myocarditis based on reports among US military personnel, with cases typically occurring 7 to 12 days after vaccination.7
With the implementation of a large-scale, national COVID-19 vaccination program starting in December 2020, the US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration began monitoring for a number of adverse events of special interest, including myocarditis and pericarditis, in the Vaccine Adverse Event Reporting System (VAERS), a long-standing national spontaneous reporting (passive surveillance) system.8 As the reports of myocarditis after COVID-19 vaccination were reported to VAERS, the Clinical Immunization Safety Assessment Project,9 a collaboration between the CDC and medical research centers, which includes physicians treating infectious diseases and other specialists (eg, cardiologists), consulted on several of the cases. In addition, reports from several countries raised concerns that mRNA-based COVID-19 vaccines may be associated with acute myocarditis.10-15
Given this concern, the aims were to describe reports and confirmed cases of myocarditis initially reported to VAERS after mRNA-based COVID-19 vaccination and to provide estimates of the risk of myocarditis after mRNA-based COVID-19 vaccination based on age, sex, and vaccine type.”
The methods really goes into detail in how the study was carried out, how the data was obtained, what the endpoints or outcomes were, what formulas or calculations were preformed etc. Most of this section I’ll skip, as it’s beyond the scope of the non medically trained reader, and unless you are verifying the study data, it’s unnecessary for most. You can find all the information on the study methods here (clickable link).
Data Sources | COVID 19 Vaccine Myocarditis
This section is important because it shows the data used for this study was valid and ethically obtained. Essentially the data was obtained from VAERS, reviewed by the CDC and in-line with federal laws and CDC policy.
“This activity was reviewed by the CDC and was conducted to be consistent with applicable federal law and CDC policy.”Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021
Exposure | COVID 19 Vaccine Myocarditis
Essentially exposure was those who received either the Pfizer or Moderna vaccine 1yrs and older who were eligible; the number of COVID-19 vaccine doses administered was obtained through the CDC’s COVID-19 Data Tracker.
“The exposure of concern was vaccination with one of the mRNA-based COVID-19 vaccines: the BNT162b2 vaccine (Pfizer-BioNTech) or the mRNA-1273 vaccine (Moderna). During the analytic period, persons aged 12 years or older were eligible for the BNT162b2 vaccine and persons aged 18 years or older were eligible for the mRNA-1273 vaccine. The number of COVID-19 vaccine doses administered during the analytic period was obtained through the CDC’s COVID-19 Data Tracker.17”
Outcomes | COVID 19 Vaccine Myocarditis
Essentially this section is regarding what diagnosis or end-point was the study analyzing and how that endpoint diagnosis was reached; in this case primary outcome was myocarditis, and secondary was pericarditis. Each individual case met the symptoms for the aformentioned condition, according to the Medical Dictionary for Regulatory Activities, a review of patient medical records (when available) and reviewed by CDC physicians and public health professionals, as well as verified by MRI or evidenced in microscopid tissue analysis. Part of meeting CDC criteria means “no other identifiable cause of the symptoms” can exist…in other words there can be no other probable cause of the myocarditis diagnosis, aside from the COVID-19 vaccination.
“The primary outcome was the occurrence of myocarditis and the secondary outcome was pericarditis. Reports to VAERS with these outcomes were initially characterized using the Medical Dictionary for Regulatory Activities preferred terms of myocarditis or pericarditis (specific terms are listed in the eMethods in the Supplement). After initial review of reports of myocarditis to VAERS and review of the patient’s medical records (when available), the reports were further reviewed by CDC physicians and public health professionals to verify that they met the CDC’s case definition for probable or confirmed myocarditis (descriptions previously published and included in the eMethods in the Supplement).18 The CDC’s case definition of probable myocarditis requires the presence of new concerning symptoms, abnormal cardiac test results, and no other identifiable cause of the symptoms and findings. Confirmed cases of myocarditis further require histopathological (presence of microscopic tissue changes) confirmation of myocarditis or cardiac magnetic resonance imaging (MRI) findings consistent with myocarditis.
Deaths were included only if the individual had met the case definition for confirmed myocarditis and there was no other identifiable cause of death. Individual cases not involving death were included only if the person had met the case definition for probable myocarditis or confirmed myocarditis”
Statistical Analysis | COVID 19 Vaccine Myocarditis
This section really goes into even more comprehensive detail on how and where the data was obtained, specific calculations and tools utilized to obtain and organize the data.
“Crude reporting rates for myocarditis during a 7-day risk interval were calculated using the number of reports of myocarditis to VAERS per million doses of COVID-19 vaccine administered during the analytic period and stratified by age, sex, vaccination dose (first, second, or unknown), and vaccine type. Expected rates of myocarditis by age and sex were calculated using 2017-2019 data from the IBM MarketScan Commercial Research Database”
Not only were the reports from a reliable source; VAERS, and verified for their diagnosis according to CDC guidelines…for those under 30 years of age it also verified diagnosis based on a medical review and clinician interviews, with testing and symptom analysis.
“In cases of probable or confirmed myocarditis among those younger than 30 years of age, their clinical course was then summarized to the extent possible based on medical review and clinician interviews. This clinical course included presenting symptoms, diagnostic test results, treatment, and early outcomes (abstraction form appears in the eMethods in the Supplement).23“
Case Characteristics | | COVID 19 Vaccine Myocarditis
“Between December 14, 2020, and August 31, 2021, 192 405 448 individuals older than 12 years of age received a total of 354 100 845 mRNA-based COVID-19 vaccines. VAERS received 1991 reports of myocarditis (391 of which also included pericarditis) after receipt of at least 1 dose of mRNA-based COVID-19 vaccine (eTable 1 in the Supplement) and 684 reports of pericarditis without the presence of myocarditis (eTable 2 in the Supplement).
Of the 1991 reports of myocarditis, 1626 met the CDC’s case definition for probable or confirmed myocarditis (Table 1). There were 208 reports that did not meet the CDC’s case definition for myocarditis and 157 reports that required more information to perform adjudication (eTable 3 in the Supplement). Of the 1626 reports that met the CDC’s case definition for myocarditis, 1195 (73%) were younger than 30 years of age, 543 (33%) were younger than 18 years of age, and the median age was 21 years (IQR, 16-31 years) (Figure 1). Of the reports of myocarditis with dose information, 82% (1265/1538) occurred after the second vaccination dose. Of those with a reported dose and time to symptom onset, the median time from vaccination to symptom onset was 3 days (IQR, 1-8 days) after the first vaccination dose and 74% (187/254) of myocarditis events occurred within 7 days. After the second vaccination dose, the median time to symptom onset was 2 days (IQR, 1-3 days) and 90% (1081/1199) of myocarditis events occurred within 7 days (Figure 2).
Males comprised 82% (1334/1625) of the cases of myocarditis for whom sex was reported. The largest proportions of cases of myocarditis were among White persons (non-Hispanic or ethnicity not reported; 69% [914/1330]) and Hispanic persons (of all races; 17% [228/1330])...”
To summarize…1626 VAERS reports met the clinical definition to be diagnosed as myocarditis, with 82% occurring post 2nd dose within <7 days and comprised mainly males at 82% (white males 69%); 73% under 30yrs old and 33% under 18 years old.
Reporting Rates of Myocarditis Within 7 Days After COVID-19 Vaccination
“Symptom onset of myocarditis was within 7 days after vaccination for 947 reports of individuals who received the BNT162b2 vaccine and for 382 reports of individuals who received the mRNA-1273 vaccine. The rates of myocarditis varied by vaccine type, sex, age, and first or second vaccination dose (Table 2). The reporting rates of myocarditis were highest after the second vaccination dose in adolescent males aged 12 to 15 years (70.73 [95% CI, 61.68-81.11] per million doses of the BNT162b2 vaccine), in adolescent males aged 16 to 17 years (105.86 [95% CI, 91.65-122.27] per million doses of the BNT162b2 vaccine), and in young men aged 18 to 24 years (52.43 [95% CI, 45.56-60.33] per million doses of the BNT162b2 vaccine and 56.31 [95% CI, 47.08-67.34] per million doses of the mRNA-1273 vaccine). The lower estimate of the 95% CI for reporting rates of myocarditis in adolescent males and young men exceeded the upper bound of the expected rates after the first vaccination dose with the BNT162b2 vaccine in those aged 12 to 24 years, after the second vaccination dose with the BNT162b2 vaccine in those aged 12 to 49 years, after the first vaccination dose with the mRNA-1273 vaccine in those aged 18 to 39 years, and after the second vaccination dose with the mRNA-1273 vaccine in those aged 18 to 49 years.”
This essentially just details that symptom onset was usually <7 days for both vaccines. Rates varied by age, sex and 1st or 2nd vaccine dose. With the majority of cases in young teens 12-17years old and young men 18-24, in that order.
In both vaccines: BNT162B2 12-25yrs, 12-49yrs and for mRNA-1273 18-39yrs and 18-49yrs (essentially all age ranges), they exceeded the the expected maximum rates of myocarditis. In other words they broke records in myocarditis rates, reaching numbers far beyond what could have been expected.
The second part of this section I’ll summarize rather then paste into this article…essentially it says females had lower myocarditis rates across all age ranges <50years old. However myocarditis rates in females still exceeded expected maximum rates for BNT162b2 12-29yrs and mRNA-1273 18-29yrs.
Clinical Course of Myocarditis After COVID-19 Vaccination in Persons Younger Than 30 Years of Age
Please note: this is a direct quote as denoted by the “quotes”, but the sections with (*brackets) are notes or commentary by me.
“Among the 1372 reports of myocarditis in persons younger than 30 years of age, 1305 were able to be adjudicated (verified by an authority), with 92% (1195/1305) meeting the CDC’s case definition. Of these, chart abstractions or medical interviews were completed for 69% (826/1195) (Table 3). The symptoms commonly reported in the verified cases of myocarditis in persons younger than 30 years of age included chest pain, pressure, or discomfort (727/817; 89%) and dyspnea or shortness of breath (242/817; 30%). Troponin (*protein found in the muscles of your heart) levels were elevated in 98% (792/809) of the cases of myocarditis. The electrocardiogram result was abnormal in 72% (569/794) of cases of myocarditis. Of the patients who had received a cardiac MRI, 72% (223/312) had abnormal findings consistent with myocarditis. The echocardiogram results were available for 721 cases of myocarditis; of these, 84 (12%) demonstrated a notable decreased left ventricular ejection fraction (<50%). Among the 676 cases for whom treatment data were available, 589 (87%) received nonsteroidal anti-inflammatory drugs. Intravenous immunoglobulin and glucocorticoids were each used in 12% of the cases of myocarditis (78/676 and 81/676, respectively). Intensive therapies such as vasoactive medications (12 cases of myocarditis) and intubation or mechanical ventilation (2 cases) were rare. There were no verified cases of myocarditis requiring a heart transplant, extracorporeal membrane oxygenation, or a ventricular assist device. Of the 96% (784/813) of cases of myocarditis who were hospitalized, 98% (747/762) were discharged from the hospital at time of review. In 87% (577/661) of discharged cases of myocarditis, there was resolution of the presenting symptoms by hospital discharge.”
I’ve said this before but I feel the need to repeat it, in order to clarify any confusion some readers may have regarding this section specifically “98% (747/762) were discharged from the hospital at time of review“…the heart does not regenerate cells like the rest of the body, damage to the heart is permanent. If these patients were discharged using drugs, it is likely they will be on those drugs for the rest of their lives. There is also the risk of cardiac issues anywhere down the road, especially when they get older and during physical exertion including sports and exercise. This section makes it sound (to the untrained reader), that these patients symptoms are permanently gone and they will be fine for the rest of their lives…that is simply not the case.
Discussion is essentially a section for commentary related to the study, that is not directly part of the study. It helps to provide some background on the study, and to add additional details to put the study and it’s data in a clearer context. I’ll extract relevant excerpts from this section (but omitting some sections).
“Compared with cases of non–vaccine-associated myocarditis, the reports of myocarditis to VAERS after mRNA-based COVID-19 vaccination were similar in demographic characteristics but different in their acute clinical course. First, the greater frequency noted among vaccine recipients aged 12 to 29 years vs those aged 30 years or older was similar to the age distribution seen in typical cases of myocarditis.2,4 This pattern may explain why cases of myocarditis were not discovered until months after initial Emergency Use Authorization of the vaccines in the US (ie, until the vaccines were widely available to younger persons). Second, the sex distribution in cases of myocarditis after COVID-19 vaccination was similar to that seen in typical cases of myocarditis; there is a strong male predominance for both conditions.2,4“
This paragraph is stating that because vaccines weren’t available to younger age ranges who are at higher risk of a myocarditis adverse event, until months after the initial Emergency Use Authorization (EUA), this is likely the reason why myocarditis was reported as rare. Once vaccines were made available to adolescents and young teens, and VAERS reports started rolling in, myocarditis rates shot up exponentially.
“However, the onset of myocarditis symptoms after exposure to a potential immunological trigger was shorter for COVID-19 vaccine–associated cases of myocarditis than is typical for myocarditis cases diagnosed after a viral illness.24–26 Cases of myocarditis reported after COVID-19 vaccination were typically diagnosed within days of vaccination, whereas cases of typical viral myocarditis can often have indolent courses with symptoms sometimes present for weeks to months after a trigger if the cause is ever identified.“
Essentially onset of myocarditis symptoms was shorter in COVID-19 vaccine induced myocarditis than from other causes. They also state that symptoms from COVID-19 vaccine induced myocarditis were resolved much faster than normal; most with only pain management. Again I want to point out that myocarditis is permanent, once you have it, it’s there for life. You can alleviate the symptoms, but you still have the condition.
“In the current study, the initial evaluation and treatment of COVID-19 vaccine–associated myocarditis cases was similar to that of typical myocarditis cases.28–31 Initial evaluation usually included measurement of troponin level, electrocardiography, and echocardiography.1 Cardiac MRI was often used for diagnostic purposes and also for possible prognostic purposes.32,33 Supportive care was a mainstay of treatment, with specific cardiac or intensive care therapies as indicated by the patient’s clinical status.”
Basically majority of cases were thoroughly vetted with evaluation of troponin levels, electrocardiography (electro = electrical = electrodes taped to chest record heart electrical signals / beats), echocardiography (echo = sound = monitor of heart and its pulses, using sound waves) and in some cases Cardiac MRI (MRI = magnetic resonance imaging = radio waves and magnets are used to image heart – shows chambers, valves and muscles).
Every study has to denote it’s weak points…In this section they denote them.
“although clinicians are required to report serious adverse events after COVID-19 vaccination, including all events leading to hospitalization, VAERS is a passive reporting system. As such, the reports of myocarditis to VAERS may be incomplete, and the quality of the information reported is variable. Missing data for sex, vaccination dose number, and race and ethnicity were not uncommon in the reports received; history of prior SARS-CoV-2 infection also was not known. Furthermore, as a passive system, VAERS data are subject to reporting biases in that both underreporting and overreporting are possible.38 Given the high verification rate of reports of myocarditis to VAERS after mRNA-based COVID-19 vaccination, underreporting is more likely. Therefore, the actual rates of myocarditis per million doses of vaccine are likely higher than estimated.“
Essentially they are saying that VAERS is a passive reporting system, reports sometimes were missing additional useful data, and it is likely due to the strict requirements for a myocarditis diagnosis and its acceptance into VAERS, that they are under reported; actual myocarditis rates are likely far higher than estimated.
“efforts by CDC investigators to obtain medical records or interview physicians were not always successful despite the special allowance for sharing information with the CDC under the Health Insurance Portability and Accountability Act of 1996.“
In other words some detail medical records, and interviews of physicians simply couldn’t be preformed by CDC researchers, to verify some VAERS reports of myocarditis adverse events following COVID-19 vaccination.
“the data from vaccination administration were limited to what is reported to the CDC and thus may be incomplete, particularly with regard to demographics.”
Basically some demographic data may be missing, which would provide better stratification of things like ethnicity.
“calculation of expected rates from the IBM MarketScan Commercial Research Database relied on administrative data via the use of ICD-10 codes and there was no opportunity for clinical review. Furthermore, these data had limited information regarding the Medicare population; thus expected rates for those older than 65 years of age were not calculated. However, it is expected that the rates in those older than 65 years of age would not be higher than the rates in those aged 50 to 64 years.4“
Essentially some reports couldn’t be verified by clinical review, and senior data wasn’t available (over 65yrs).
“Based on passive surveillance reporting in the US, the risk of myocarditis after receiving mRNA-based COVID-19 vaccines was increased across multiple age and sex strata and was highest after the second vaccination dose in adolescent males and young men. This risk should be considered in the context of the benefits of COVID-19 vaccination.”
Rates of myocarditis was highest in young males after their second dose. This study calls into question weather the benefits of COVID-19 vaccination; considering you can still become infected with and spread COVID-19 after receiving the jab, outweigh the cons such as myocarditis (or blood clots).
References are available on JAMA.
What is Myocarditis?
According to the Mayo Clinic “myocarditis is an inflammation of the heart muscle (myocardium). The inflammation can reduce the heart’s ability to pump and cause rapid or irregular heart rhythms (arrhythmias).”
Why is Myocarditis a Severe Disease?
Unlike the vast majority of cells in the body, heart cells to not regenerate like others…That means that once the heart muscle is damaged, that damage is permanent, and there is no rewinding the clock.
There is no mild version of myocarditis, it’s a one size fits all disease (so to speak). Over time myocarditis weakens the heart so the rest of the body doesn’t get enough blood, which leads to clots forming in the heart, and death from a stroke or heart attack.
Dr. John Campbell on Israel Study on Increased Risk of Myocarditis Post COVID-19 Vaccine | Video
I recommend you subscribe to Dr. Campbell on YouTube (I have), as he keeps you up to date on important COVID-19 studies, and his reviews are very ‘fact based’, without inserting a bunch of opinion and speculation which many other Doctors often do in other videos.