SELECT * FROM videos WHERE NOT EXISTS (SELECT 1 FROM votes WHERE video_id = videos.id AND user_id = $user_id) AND NOT EXISTS (SELECT 1 FROM not_interested WHERE video_id = videos.id AND user_id = $user_id);
Aka don't recommend anything I've already voted on or already explicitly told you I'm not interested in. That would remove at least 98% of my recommendations.
Even without that improvement, though, YouTube is an amazing service, and the reliability is first class. I can't remember the last time it was actually down. Personally I suspect the YouTube team is just tasked with keeping things ticking over, and that they're too busy putting out fires and coping with tech debt to actually develop useful features.