https://www.theatlantic.com/politics/archive/2010/09/when-bite-me-is-off-the-record/62534/ A day after Rolling Stone Magazine published an explosive profile of Gen. Stanley McChrystal, featuring raw comments and salty language, a sort of self-generated audit of Washington's journalistic conventions took off inside the Beltway. One phrase in the piece, written by freelancer Michael Hastings, captured its tone and triggered this rare self-examination: An unnamed McChrystal staffer referred to Vice President Joe Biden, the man a heartbeat away from being his commander-in-chief, as Joe "Bite Me." It was offensive to official Washington, not for its substance, but for its ham-handed execution.
It's an improvement enhancement. https://www.vice.com/en/article/7kzgg9/joe-biden-tongue-gif-twitter-deepfake
If you cannot tell it is a screenshot of a manipulated video, you are less than 40 YO. Maybe 50? Or just incoherently bad at perceiving reality?
Since Biden has a lot of physical/mental problems it would seem like this picture is real. And it probably is. He is a mess. People with Parkinson's do stick their tongue out while talking. They also like to lick their lips with strange tongue movements.