Once I come to the final submit of a yr, I typically wish to look again on the yr that has handed after which maybe make some observations over what I feel may occur within the yr to come back. As an illustration, final yr right now I declared 2023 to be the yr that the evidence-based drugs mannequin, particularly the dogmatic model that dismisses any proof that doesn’t come from randomized managed trials as being principally crap, had been weaponized towards public well being interventions starting from masks to “lockdowns” to vaccines. Different examples embrace characterizing 2021 because the yr that “all the pieces [antivax and quackery] outdated is new once more” and 2020 because the yr of physicians behaving badly, due to a disturbing variety of physicians who had as much as that time been seemingly respectable taking a heel flip to COVID-19 minimization, assaults on public well being, and even outright quackery. Sadly, all of these issues that characterised these years continued in 2024—on steroids!—which led me to return to what I mentioned about one yr that I disregarded above, particularly 2022. That was the yr {that a} sure antivax activist characterised because the yr of “gaslighting” COVID-19.
Why return to that yr? As I wish to say, with regards to conspiracy theorists and science deniers, each accusation is a confession. Since Donald Trump received the 2024 Presidential election and has nominated a rogues’ gallery of quacks, antivaxxers, and grifters for key federal well being posts, all led by longtime antivax activist Robert F. Kennedy Jr., whom President-Elect Trump has nominated to be Secretary of Well being and Human Providers, I see gaslighting in every single place. Certainly, his allies and apologists are engaged in a propaganda program of deception, revisionist historical past, and outright misinformation to attempt to reduce or outright deny RFK Jr.’s antivax views, conspiracy theories, and the hurt that he had already achieved to public well being previous to 2024. Specifically, these days I’ve been seeing RFK Jr. apologists strive desperately to gaslight his private position in stoking antivaccine beliefs and undermining vaccination applications earlier than and through a lethal measles outbreak in Samoa in 2019. Specifically, two makes an attempt to do that have actually irked me. The primary comes from a predictable supply, the Brownstone Institute, within the type of an article by David Marks entitled RFK Jr. and the Samoan Measles Outbreak. The second exhibits simply how far a sure oncologist and EBM methodolatrist turned COVID-19 contrarian and public well being underminer has fallen. Clearly, I’m referring to Dr. Vinay Prasad, who not too long ago posted to his monetized Substack probably the most risibly traditionally ignorant makes an attempt at gaslighting RFK Jr.’s position within the 2019 Samoan measles outbreak that I’ve but seen, entitled The true story of the Samoa measles outbreak. (Trace: It ain’t.) Both that, or it was intentional fake ignorance. You be the decide after this submit. I’m additionally amused at how somebody like Dr. Prasad, who assaults any lack of sourcing, has barely sourced his little submit, having apparently relied on a single article from an obscure journal. No less than, that’s the one supply he cites.
As you will notice, these defenses of RFK Jr. are likely to rely closely on the truth that the low uptake of the measles-mumps-rubella (MMR) vaccine had occurred because of a tragic error that had led to the MMR-related deaths of two one-year-old kids. The central argument appears to boil right down to this: The low MMR uptake that predisposed the island to a measles outbreak wasn’t RFK Jr.’s fault (trivially true, however not related to what he did). The supposed implication is, in fact, that RFK Jr.’s opportunistic help of antivaxxers on the island in the midst of the outbreak, plus his use of the Kennedy identify to advertise antivax misinformation about MMR to the very best ranges of presidency in Samoa, had been no large deal as a result of they weren’t the first reason behind the outbreak.
Buckle up, that is going to be an extended one, even by my requirements.
The gaslighting begins: The origins of low MMR uptake on Samoa
The time period “gaslighting” comes from the title of the 1944 American movie Gaslight, which was based mostly on the 1938 British theatre play Gasoline Mild by Patrick Hamilton, though the time period didn’t turn out to be extensively used till the final decade or so. Within the movie, the husband, performed by Charles Boyer, emotionally manipulates his spouse (performed by Ingrid Bergman) to make her doubt her personal grasp of actuality—and even her sanity—in order that he might steal from her. He does this by isolating his spouse and utilizing numerous trickery and emotionally abusive strategies to make her query actuality. The title of the movie refers to at least one instance of the husband’s deceptions, the gaslight illumination of the couple’s home that appears to dim and flicker at any time when the husband leaves his spouse alone at dwelling. When she asks him, “Why do the lights hold flickering?” he responds that he doesn’t know what she’s speaking about and insists that the lights aren’t flickering, that it’s simply her creativeness. Since its wider adoption in more moderen years the which means of “gaslighting” has broadened past describing emotional abuse designed to make an individual query her reminiscence and actuality to seek advice from using misinformation and propaganda to supply a false narrative concerning the previous with the intention to manipulate a inhabitants. Given how horrible RFK Jr.’s conduct was stoking antivaccine fears in the midst of a lethal epidemic on Samoa, simply months earlier than the COVID-19 pandemic hit, you’ll be able to see why his apologists would wish to gaslight you about his position there, and so they have been furiously gaslighting ever since his nomination.
As I learn the 2 articles making an attempt to absolve RFK Jr. of any duty for his antivaccine proselytizing on Samoa from June 2019, three months earlier than the lethal measles outbreak started, via early 2020, after dozens of kids had died and over 5,000 had been sickened, I seen that Marks and Dr. Prasad take totally different tacks. I’ll begin with Dr. Prasad, whose central argument appears to be that it wasn’t RFK Jr.’s fault as a result of one of many fundamental explanation why MMR uptake had fallen so low proper earlier than measles was launched by an individual affected by the illness arriving in Samoa on a flight from New Zealand in August 2019, was a tragic medical error involving reconstituting MMR vaccine that had resulted within the deaths of two infants. That is, once more, true sufficient however irrelevant to the query of simply how terrible RFK Jr. behaved the next yr earlier than the outbreak. The general information and timeline aren’t in dispute, both. The story of the Samoan measles outbreak has additionally been extensively reported by many respected sources, not the least of which is Brian Deer, creator of The Physician Who Fooled the World and the investigative journalist who first reported on antivax gastroenterologist Andrew Wakefield‘s analysis fraud and conflicts of curiosity in his research linking MMR vaccination to “autistic enterocolitis.” Predictably, Dr. Prasad spends the overwhelming majority of his article harping on the tragic accident that fueled a downward spiral in MMR uptake the yr earlier than the outbreak and takes a “What, me fear”? angle in the direction of RFK Jr.’s actions on Samoa in 2019. Spoiler alert: Whereas there was loads of blame to go round for this lethal debacle, together with on the a part of the Samoan authorities, simply because there have been different causes of the epidemic on Samoa doesn’t absolve RFK Jr. from doing his damnedest to make issues worse and kill extra infants.
Earlier than I dig in, I can also’t assist however point out that I first famous Dr. Prasad changing into—let’s assume?—receptive to the type of antivax misinformation that RFK Jr. has spent the final twenty years utilizing the Kennedy identify to advertise when he expressed settlement with a few of RFK Jr.’s claims made throughout an look on Joe Rogan’s podcast in 2023, when he agreed with RFK Jr.’s misleading “criticism” of the delivery dose of the hepatitis B vaccine and steered that an unethical “multi-arm factorial RCT” (randomized managed scientific trial) of your complete childhood vaccination schedule could be a good suggestion. Principally, Dr. Prasad had swallowed complete RFK Jr. and his lawyer Aaron Siri’s misleading insinuation that, as a result of not each single final vaccine within the childhood vaccination schedule had been examined in an RCT with a saline placebo management, then your complete vaccine schedule was suspect. It’s a bogus argument based mostly on a half-truth for a lot of causes, not the least of that are that (1) it could be unethical to check new variations of current vaccines in a placebo-controlled RCT as a result of that would go away the management group unprotected towards the illness for which the vaccine was designed; (2) all the unique variations of the vaccines within the childhood schedule had been examined towards saline or an applicable management; and (3) saline isn’t at all times the proper management. On the time, I additionally famous {that a} “multi-arm factorial RCT” of the childhood vaccination schedule that might not be possible or moral however would require tons of of hundreds or thousands and thousands of individuals. In his EBM methodolatry, Dr. Prasad appeared…unconcerned.
In the end, Dr. Prasad’s viewers seize that led him to credulously parroting outdated antivax speaking factors as if they had been something however outdated antivax speaking factors bought worse, with him finally even embracing a really outdated antivax message of “don’t comply” with COVID-19 vaccine mandates. Extra not too long ago, he has been dashing to kiss RFK Jr.’s posterior and help his agenda, whereas making an attempt to fake that RFK Jr.’s “inconvenient” antivax stances didn’t exist or are simply minor forgivable peccadillos, nothing in comparison with the supposed righteousness about power illness, vitamin, and assaults on the pharmaceutical business. The one supply article that Dr. Prasad cites is entitled A Excellent Storm: The Social and Institutional Contexts of Samoa’s 2019-2020 Measles Epidemic and the Classes realized for the COVID-19 Pandemic. Revealed in October 2020 within the The Journal of Samoan Research, two of whose authors are students dwelling and dealing in Samoa, it states its objective and strategies thusly:
By way of a mixture of non-public commentary, evaluation of media articles, authorities stories and historic paperwork, we current an outline of the circumstances of the measles epidemic. We hint the circumstances of low vaccination protection, institutional weaknesses and an uninformed public leading to a delayed an efficient response. In conclusion we mirror on the teachings that historical past presents on public well being companies in Samoa.
Truthful sufficient, however it additionally crows about how, by October 2020, Samoa had realized its lesson and efficiently stored COVID-19 out:
Samoa stays one of many few nations on the earth with no confirmed circumstances of Covid 19, a pandemic which has affected thousands and thousands and killed hundreds the world over. Growing nations have been recognized as being extraordinarily weak to the impression of Covid 19 attributable to restricted testing capabilities and weak well being techniques. The vulnerability of Samoa to an outbreak was most evident after the devastating impression of the measles outbreak in 2019 and the teachings realized from it haven’t been forgotten. Samoa carried out a sweeping sequence of restrictions in journey, improved well being training about Covid 19 and a state of emergency swiftly. By these means, a rustic which nonetheless doesn’t have testing capabilities and which has restricted well being sources has been capable of stop Covid 19 reaching its shores.
Humorous how Dr. Prasad left that half out, which was sort of your complete level of the article. In any case, I can see why he likes this text. Though it does point out the issue of antivax disinformation, it mentions RFK Jr. under no circumstances. No marvel he wrote an article like The true story of the Samoa measles outbreak.
He begins:
Many commenters hyperlink RFK Jr to an outbreak of measles in Samoa that killed greater than 80 kids. What truly occurred? And who’s at fault?
I had an opportunity to temporary myself on the information of the case and that is my abstract.
Measles was not current on Samoa until introduced by guests within the Eighteen Eighties.
In July 2018, two nurses killed two children with the MMR shot after they drew it up with expired atacurium (a paralytic) moderately than saline. They took the vials dwelling and hid them, realizing their mistake. They might be convicted in 2019 for manslaughter.
The phrase “I had an opportunity to temporary myself on the information of the case” is doing a lot of heavy lifting right here. Apparently he learn one article that supported (considerably) his preexisting need to absolve RFK Jr. of any guilt for including gasoline to the hearth of the antivaccine views that had rendered Samoa weak to such a horrific measles outbreak. I used to be additionally questioning simply what the heck the relevance was of measles not having been current on Samoa till 140 years in the past. Apparently Dr. Prasad can learn Wikipedia too.
In any case, it’s true that the inciting occasion that sparked the fears that led to low MMR uptake and led to the Samoan authorities halting the distribution of MMR for ten months was the deaths of two infants attributable to a horrific, tragic mistake by two nurses, who later had been finally convicted of negligent manslaughter. An account of the trial in a Samoan newspaper will be discovered right here:
In response to police information tendered in courtroom, customary procedures for getting ready vaccines weren’t adopted on the Tuasivi Hospital on the morning of the incident, together with a requirement that registered nurses completely verify the labels on the parts used to combine vaccines.
Luse blended the M.M.R. vaccine powder with an expired anaesthetic, the Courtroom was instructed.
“Sadly Luse, with out checking the vial, blended the powder of vaccine with what she thought was a correct [substance for dilution],” the information state.
“It was not.”
Justice Vui discovered that the vial containing anaesthetic was clearly labelled however not checked.
“That motion would have averted the tragic occasions that had been then adopted,” he mentioned.
“[Luse] breached protocols and have become grossly negligent within the discharge of her duties.”
The deadly vaccination was carried out by a trainee nurse underneath Luse’s supervision with the syringe and ampule discarded in a garbage bin.
However the child’s mom, quickly after leaving the clinic together with her toddler daughter, started to note fast adjustments to her child whereas ready for a bus dwelling.
“Her child’s physique felt chilly; her eyes couldn’t open correctly and her legs had been [spasming] out; she rushed again to the Hospital for help and the nurses, together with the defendants, tried to revive the newborn however the younger child stood no probability,” Justice Vui mentioned.
“She handed away.”
I cite this primarily to display that, sure, it was undoubtedly a horrific negligent act that killed two kids that sparked the suspicion and worry of the MMR vaccine in Samoa—understandably so. And, sure, initially the reason for the deaths wasn’t recognized. (Dr. Prasad factors to a contemporaneous headline, “Two infants die in Samoa hospital minutes after receiving ‘MMR’ vaccinations; Investigation underway.”) And, sure, the medicine error wasn’t found for 2 weeks, which, based on Dr. Prasad’s supply, led to worry and suspicion of the MMR vaccine itself:
There was an instantaneous presumption that the vaccine itself was chargeable for the deaths, and it was introduced within the press that the vaccine was withdrawn. Two weeks handed earlier than well being authorities found that the infants had been poisoned; the 2 nurses concerned, realizing their error, had taken the vials dwelling and hidden them. Nonetheless this was not made public. Throughout the intervening interval, there was intense hypothesis within the media in Samoa and overseas about whether or not the vaccine itself had triggered the deaths.
Worse:
These and different stories planted the suspicion firmly within the minds of the general public that the MMR vaccine was the reason for the deaths. Though there was an instantaneous four-month suspension of the administration of the MMR vaccine and though ten months handed earlier than routine vaccinations resumed, with the general public nonetheless largely unaware that there had been a medical misadventure, there was widespread public worry of the MMR vaccine. A number of moms had been reported as saying that they had misplaced religion within the public well being system they most popular to deal with sicknesses through conventional means (Tautua- Fanene 2018). The suspicion that the vaccine was in charge enabled anti-vaccination activists in Samoa and abroad to grab public consideration.
I have to admit that I’m be aware totally shopping for the declare on this article that Samoans had been “largely unaware that there had been a medical misadventure.” It didn’t take a lot looking out to search out information tales earlier than that discussing the case, comparable to this one from November 2018 that reported that the inquest into the MMR vaccine as the reason for the infants’ deaths had been stayed pending the result of the trial of the 2 nurses accused of the lethal mixup. Certainly, the Samoan Ministry of Well being’s personal annual for 2018/2019 states:
In August 2018, Cupboard instructed a Fee of Inquiry to analyze the deaths of the 2 infants who handed away because of the Mumps, Measles & Rubella (MMR) Vaccinations carried out on the Safotu District Hospital. The Fee members had been Choose Tuiloma Neroni Slade as Chair, Leoo Dr John Adams and Lealaiauloto Liai Siitia as Fee members. Public hearings had been performed in September 2018 while the Felony proceedings for the alleged Nurses had been being held.
Even with this extra background, in equity, I’ve to conclude that it does seem like true that the Samoan authorities took approach too lengthy after it had found the issue that led to the infants’ deaths after vaccination to tell the general public. Australian doctor Prof. David Isaacs famous in a short communication to The Journal of Paediatrics and Little one Well being:
The Authorities suspended the MMR immunisation programme after the July administrative error. The reason for this vaccine tragedy was not made public for months, even after re-starting MMR vaccine in November 2018. In July 2019, two nurses had been sentenced to five years’ jail for inadvertently utilizing a curare-like muscle blocking agent as an alternative of water to dilute lyophilised (powder) MMR vaccine. This type of catastrophe shouldn’t be new: 15 infants died in northern Syria in 2014 when atracurium was used as a diluent as an alternative of water.6 It’s unclear why muscle relaxants had been stored in immunisation facili- ties in Syria or Samoa.
I really feel a necessity for a fast apart right here: WTF? No severely, WTF? How can one thing like this have occurred not as soon as, however twice? Apparently, in Syria, as an alternative of the common diluent for the vials, the MMR was blended it with atracurium, which has the identical coloration bottle and identical patch on it. “WTF?” certainly.
Transferring on, sure, in 2018 a tragic act of negligence triggered the deaths of two infants after receiving the MMR vaccine, and, sure, the Samoan authorities seems to have been approach too secretive about what it knew and when it knew it. As we all know, at any time when there’s a deficit in details about a tragedy involving a vaccine, antivaxxers and conspiracy theorists will at all times leap in to fill the void with rampant hypothesis and disinformation. That’s precisely what occurred and precisely what RFK Jr. and his minions did their finest to contribute to. Dr. Prasad blithely describes what occurred thusly:
Did some native activists seize upon the deaths to discourage vaccination? Probably, however that’s inevitable. After any tragedy some folks will discourage publicity. I do know somebody who advises towards transferring walkways as a result of they examine a lady whose leg bought caught. Chipotle famously had an enormous drop in enterprise after an E.coli outbreak. Usually these responses are disproportionate– greater than rational. Naturally, Samoans, who are sometimes poor with low well being literacy, can be fast to drop MMR vax after somebody died. However notably this was sanctioned by the federal government.
It is a Bizarro World description of what actually occurred. For one factor, there is no such thing as a “presumably” about it. Native antivaxxers did seize upon the incident to unfold antivax misinformation and disinformation. Certainly, the antivax group based by RFK Jr., Youngsters’s Well being Protection, lionized one such native antivax activist with whom it had labored, Edwin Tamasese, who had been arrested for advocating quackery (claiming that nutritional vitamins A and C alone might remedy measles) and spreading misinformation. RFK Jr. himself wrote an introduction to the article, wherein he lauded Tamasese as a “main Samoa medical freedom hero” and after which Tamasese was given quite a lot of digital to inform his facet of the story, which included touting a protocol that he had tailored from antivax doctor James Meehan and claiming that the mass vaccination marketing campaign undertaken in the course of the outbreak “statistically” had had no impact on the outbreak’s course. Make no mistake, CHD and RFK Jr. had been tight with native antivax leaders like Tamasese. Certainly, based on RFK Jr. himself:
Medical freedom advocates across the globe know Edwin Tamasese’s identify. In June 2019, I visited Samoa on the invitation of Prime Minister Tuilaepa Lupesoliai Neioti Aiono Sailele Malielegaoi who has served because the Prime Minister of Samoa and Chief of the Human Rights Safety Social gathering since 1998.
I went to Samoa to attend an independence celebration and talk about with the federal government the introduction of a medical informatics system that might enable Samoa’s well being officers to evaluate, in actual time, the efficacy and security of each medical intervention or drug on general well being.
Edwin Tamasese had organized the journey and Youngsters’s Well being Protection had supplied to finance the modern system. Samoa banned sure vaccinations after a number of kids had died following MMR vaccines the earlier yr.
I can’t resist quoting Marks at Brownstone once more, as a result of he himself cites Tamasese’s makes an attempt in charge the vaccine for folks getting sick:
Whereas the press condemned him as an anti-vaxxer, Tamasese’s interventions and observations are revelatory. In an interview after the outbreak subsided, he mentioned, “We had been very cautious to take statistics once we had been entering into to attempt to establish developments. Once we assessed our numbers, 98 % of those that had been getting in poor health had been vaccinated constantly six to seven days previous to sickness. The excuse was that the vaccine didn’t have time to turn out to be efficient. Nonetheless, based on an immunologist on the crew, the six to seven-day interval was additionally the size of time it could take an under-attenuated vaccine to make the recipient sick.”
I’m wondering if Dr. Prasad thinks that the MMR vaccine can do that. Actually, RFK Jr. appeared to agree that it might, as you will notice. Actually, these kids might have caught measles in the course of the window between vaccination and the event of ranges of protecting antibody ample to stop and attenuate illness, however, as is common, antivaxxers blamed the sickness on the vaccine. Once more, keep in mind that Tamasese invited RFK Jr. to Samoa and that CHD championed him after he had been arrested for spreading antivax propaganda and utilizing nutritional vitamins to deal with sufferers with measles. Nor was Tamasese alone in exulting over a go to to Samoa by his antivax hero. One other Samoan antivaxxer, Taylor Winterstein, posted rather a lot on Instagram:
Lest you doubt my assertion that Ms. Winterstein is antivaccine, right here is one other Instagram submit by her:
Word the widespread antivaccine trope that it’s “bullying” to criticize antivaxers for refusing to vaccinate or for spreading antivaccine misinformation. On this submit, she invokes Nuremberg, a favourite misapplication of the Nuremberg declaration beloved of antivaxers starting from Barbara Loe Fisher to, Rob Schneiderto, effectively, RFK Jr. himself, full with tropes about “knowledgeable consent” (which within the palms of antivaxers is de facto misinformed refusal, wherein a call is made based mostly on massively exaggerated or made up dangers, made up “toxins,” and an enormous understatement of advantages):
Elsewhere, Winterstein additionally referred to the federal government effort to vaccinate its inhabitants as “NaziSamoa.”
These are however a couple of of the various explanation why these occasions don’t absolve RFK Jr. and Samoan antivaxxers who regarded to him for steerage. They made the state of affairs a lot worse the next yr via their spreading of antivax propaganda. All of these items will be true on the identical time, and the truth that a tragically negligent error triggered two deaths that provoked worry amongst Samoan dad and mom and that the Samoan authorities was lower than forthright about what it knew doesn’t absolve RFK Jr. Furthermore, Dr. Prasad’s comparability of individuals being afraid of the MMR after the deaths of two kids to a lady afraid of escalators after getting her leg caught in a single or to the Chipotle E. coli outbreak is insultingly silly, clearly designed to downplay the tsunami of misinformation that arrived from exterior antivaxxers to bolster the native antivaxxers as no large deal.
The only worst a part of the passage above is the place Dr. Prasad cluelessly states:
What did RFK say in Samoa? I don’t know however the time course is senseless. He visited in 2019, however vax charges had been already low. The die had been forged.
Dr. Prasad’s argument right here appears to be: Issues had been already so dangerous that RFK Jr.’s actions didn’t matter. Nonetheless, we already know that they did matter. We all know, for example, that in 2018 CHD had been spreading antivax misinformation blaming the MMR vaccine for the 2 infants’ deaths and that it didn’t replace or change the social media posts after the story of the medicine error was made public. Furthermore, we all know what he mentioned. He bolstered and supported folks like Edwin Tamasese and Taylor Winterstein, and we all know native antivaxxers like them had been saying. We additionally know that RFK Jr. wrote a letter to Samoan Prime Minister Tuilaepa Aiono Sailele Malielegaoi concerning the MMR and measles in the midst of the outbreak.
RFK Jr. simply wrote me a letter
I have a duplicate of that letter to Samoan Prime Minister Prime Minister Tuilaepa Aiono Sailele Malielegaoi and wrote about it on the time, alas not on SBM. The letter was dated November 19, 2019, proper smack dab in the midst of the deadliest weeks of the epidemic. We all know what it mentioned. Its existence and content material had been reported pretty extensively within the mainstream press (e.g., The Washington Publish). None of that is in any respect troublesome to find for anybody who truly seems, however oddly sufficient, Dr. Prasad apparently seems to not have bothered his planet-sized mind to strive, as an alternative simply throwing up his palms and saying, in essence, “Who can know what RFK Jr. mentioned and did?” It’s such disingenuous bullshit, so simply debunked, that I used to be stunned that even somebody like Dr. Prasad might publish it. The contempt that Dr. Prasad exhibits for his viewers is palpable.
Simply to rub it into Dr. Prasad’s face, let’s check out RFK Jr.’s precise letter, which I conveniently determined to submit as photographs:
Curiously, David Marks at Brownstone approvingly cites this letter, even offering a hyperlink to it, in case antivax conspiracy theorists suppose that I cast the letter or one thing Marks truly fairly likes the letter and thinks that it displays effectively on RFK Jr. (it doesn’t):
In November 2019, whereas the deaths of Samoan kids had been quickly rising, Kennedy wrote a complete letter to the Samoan Prime Minister, presenting some attainable causes of the unprecedented, virulent outbreak of measles. His considerations concerning the epidemic in Samoa spotlight placing anomalies that had been obvious to some investigators on the time, though they continue to be unexplained.
Trace: As you haven’t any doubt guessed (and as I’ll clarify), these “anomalies” cited by RFK Jr. weren’t truly anomalies in any respect, nor do they “stay unexplained.” Since I do know that Dr. Prasad, planet-sized mind or not, grasp of EBM or not, won’t ever hassle to critically study RFK Jr.’s letter, I’ll. To take action, I’ve modified and condensed a dialogue of the letter that I wrote contemporaneously, when information of this letter first hit the media.
RFK Jr.’s letter begins:
I write with profound disappointment to supply my condolences for the measles outbreak that has not too long ago affected your nation and brought the lives of treasured Samoan kids. These deaths are a private tragedy for his or her bereaved households and for all of the folks of your tight-knit nation.
I used to be dismayed—however not stunned—to see media stories that linked the present measles outbreak to the so-called “anti-vaccine” motion. Whereas we are able to count on pundits to interact in uninformed finger-pointing, Samoa’s public well being officers should undertake the intense duties of containing the an infection and—equally importantly—to completely perceive its etiology. To safeguard public well being in the course of the present an infection in and sooner or later, it’s important that the Samoan Well being Ministry decide, scientifically, if the outbreak was brought on by insufficient vaccine protection or alternatively, by a faulty vaccine.
There was, in fact, no proof that the outbreak in Samoa had something in any way to do with a “faulty” vaccine. RFK Jr. was simply pulling this bit proper out of his nether areas. Furthermore, when you’ve vaccine uptake effectively south of fifty% (As you’ve seen, MMR uptake proper earlier than the outbreak began was estimated to have fallen to round 31%), measles outbreaks can occur. Within the background of low vaccine protection (significantly as little as it was in Samoa earlier than the outbreak), one case coming in from one other nation can quickly turn out to be tons of after which hundreds of circumstances.
After that inauspicious and disingenuous introduction, RFK Jr. requested three questions:
- What had been the ages of the victims?
- Have been Samoa’s deadly measles circumstances brought on by strains of measles not focused by Merck’s vaccine?
- Have been the deadly Samoan infections from a vaccine pressure?
Let’s tackle #1 first. What was RFK Jr. taking part in at? Nothing good:
Media stories from Samoa recommend that the an infection is focusing on younger infants who aren’t but of age to obtain the measles vaccine. If true, the offender is most definitely a vaccine that failed to supply antibodies within the vaccinated moms ample to supply the toddler with maternal immunity. Younger infants contracting measles is a comparatively new phenomena first acknowledged within the 1990’s. Previous to the event and widespread use of Merck’s measles, mumps and rubella (MMR) vaccine, moms handed safety to their infants through passive immunity derived from the placenta and breast milk. In distinction, moms vaccinated with a faulty Merck vaccine present insufficient passive immunity to their infants. Merck’s model of the MMR has created a disaster the place infants underneath the age of 1 are actually extremely weak to those infections. These younger infants undergo a a lot larger morbidity and mortality in comparison with populations traditionally impacted by wild measles later in childhood.
Initially, passive immunity to a illness like measles doesn’t come primarily from breast milk. It comes from the IgG antibodies handed to the toddler via the placenta into the blood. Thus is immunity to illnesses the mom has had handed on to the newborn for a time. At time period, depending on the immunological expertise of the mom, placental switch permits the new child to amass totally different specificities of IgG antibodies. This leads to an similar recognition sample of antigens between the mom and her offspring. After delivery, the newborn receives no additional IgG antibodies that can lead to measles immunity from the mom, and ranges of IgG antibodies within the toddler wane to zero by between 6-12 months of age. The antibodies within the breast milk consumed by the newborn are primarily secretory IgA, a category of antibody that’s tailored to withstand digestion by the GI tract and that serves primarily to guard the mucosal surfaces (e.g., mouth, nasal passages, and so forth.) from environmental pathogens. There are antibodies to measles in milk, however, opposite to the parable that breast feeding can defend towards measles, in a research of Nigerian girls and their infants the extent of measles-specific antibodies in milk dropped under the protecting degree inside two weeks of delivery.
However what about antibody ranges in infants born to moms who had pure immunity to measles versus these born to moms who had been vaccinated towards measles? A 2010 research sought to reply that query in 207 mother-infant pairs in Belgium, measuring serum IgG antibody degree over the primary twelve months of life in girls who had pure immunity to measles and evaluating these ranges to what was noticed in moms vaccinated towards the measles. These investigators reported the already recognized and accepted outcome that at delivery infants born to vaccinated moms have considerably decrease anti-measles antibody titers than infants born to moms with pure immunity. Nonetheless, right here’s the important thing sentence: “At 6 months of age, greater than 99% of infants of vaccinated girls and 95% of infants of naturally immune girls had misplaced maternal antibodies based on the mannequin.”
Principally, excessive vaccine uptake is one of the best ways to guard these infants, coupled with earlier vaccination throughout outbreaks. If herd immunity is excessive, quicker waning of immunity attributable to maternal antibodies is far much less of an issue. If herd immunity shouldn’t be excessive, then vaccinating earlier is a viable possibility to guard these infants. I additionally should repeat that there was (and is) no proof that the vaccine was faulty.
An earlier evaluate of the literature discovered that, sure, antibody degree does have a tendency to begin out decrease and wane to decrease than wanted for defense towards measles within the kids of vaccinated moms in comparison with kids of moms with pure immunity, though not all research confirmed a distinction. The entire situation is, as you may count on, far more difficult than RFK Jr. lets on. For instance, a part of the explanation that the primary dose of MMR isn’t beneficial earlier than age 12 months is as a result of the persistence of maternal antibodies can intervene with the era of an immune response to the vaccine. Nonetheless, in nations with excessive vaccination charges, ready till 12 months of age to manage the primary dose of MMR shouldn’t be an issue, attributable to herd immunity. Additionally, though it’d blunt an immune response to vaccine, persistence of maternal antibodies doesn’t stop an immune response. That’s why the CDC was recommending on the time that in an outbreak well being departments ought to contemplate vaccinating kids sooner than the beneficial age of first dose in a non-outbreak state of affairs and giving a further booster.
I have to admit that I laughed out loud at this passage:
When it first launched its measles vaccine in 1963, Merck promised {that a} single dose of its vaccine would supply lifetime immunity and maternal immunity equal to that offered by wild measles. Merck predicted that its vaccine would eradicate measles by 1967, as long as 55% of kids had been immunized. Main scientists together with the world’s preeminent bacteriologist, Sir Graham Wilson and Harvard Virologist John Enders, who first remoted measles, warned towards introducing a vaccine until it offered lasting life-long immunity, as Merck promised. Measles, they cautioned, would rebound with elevated virulence and mortality because the vaccine shifted outbreaks away from kids—biologically developed to deal with measles— to younger infants with insufficient maternal immunity and senior residents weak to measles-induced pneumonia. Sadly, we are actually seeing the worldwide emergence of the precise sample that scientists cautioned towards.
I do like how RFK Jr. pointed to just about 60-year-old predictions by scientists, who clearly vastly underestimated the extent of herd immunity essential to hold measles in verify in a inhabitants and certain didn’t envision how simply illnesses can now bounce borders, because of air journey, tourism, and folks touring to go to their households, over 55 years later. It’s a basic “science was fallacious earlier than” little bit of misdirection. I additionally counter by mentioning that lifelong immunity will be supplied with the assistance of booster vaccines.
Subsequent, RFK Jr. made this whopper of a declare:
Each Dr. Enders and Dr. Wilson and different main Virologists warned Merck that along with shifting the illness to weak infants and the aged, a faulty vaccine with excessive preliminary failure fee, or substantial long-term waning, would provoke the evolution of extra virulent measles strains.
American public well being officers have not too long ago admitted that, as an alternative of offering lifetime immunity, Merck’s vaccine failed in about 10% of vaccine people inside seven years. And, as scientists predicted, the measles virus has due to this fact mutated. Two new strains of measles that aren’t included within the present vaccine are actually spreading like wildfire amongst populations worldwide. World Public Well being Officers have not too long ago recognized these lethal new rogue strains as measles genotype D4.1 and D4.2. The vaccine genotype A within the present MMR vaccine can not adequately neutralize new strains. Merck can not declare that this growth is a shock. Virologists have lengthy recognized that viruses with a number of strains typically shift to evade a vaccine that targets only a few strains. That is the explanation that public well being officers develop new flu vaccines every year to focus on the rising viral strains.
I acknowledged this nonsense straight away as having come from Andrew Wakefield and his risible hypothesis about an impending “sixth extinction” because of the evolution of resistant measles mutants attributable to—you guessed it!—vaccines. Fortunately for functions of conserving this submit from ballooning to 10,000 phrases, I handled Wakefield’s incompetent tried prestidigitation with information and science three months in the past. You may learn the entire piece in order for you the gory particulars of this significantly unscientific and brain-dead little bit of antivaccine propaganda. Suffice to say that RFK Jr. was principally channeling some significantly deranged latter day Wakefield antivax propaganda within the passage above. I’m wondering if Dr. Prasad acknowledged that? In fact he didn’t. Bear in mind, earlier than the pandemic he thought that coping with antivax misinformation was so trivial as to be not value participating his large mind.
Let’s take a look at RFK Jr.’s closing query for Prime Minister Tuilaepa Sailele Malielegaoi:
There’s additionally the chance that kids who obtained the stay measles virus throughout Samoa’s latest vaccination drive might have shed the virus and inadvertently contaminated weak kids. It’s a regrettable risk that these kids are causalities of Merck’s vaccine. Alarmed CDC officers documented this rising phenomenon in the course of the measles outbreak in California in 2015. Federal epidemiological investigations discovered that at the very least 1/3 of Californian circumstances had been vaccine pressure. The truth is, CDC recognized 73 of the 194 measles virus sequences obtained throughout your complete United States in 2015 as vaccine pressure A sequences. Which means that these kids contracted measles from vaccination or from somebody who obtained the vaccine.
For apparent causes, it’s important for Samoa’s public well being officers to rapidly decide if the Samoan kids who not too long ago died suffered measles from the Merck vaccine or from a mutant pressure that developed to evade the Merck vaccine. In every of these circumstances, Samoa’s public well being officers would react with a really totally different technique than if the deadly measles genotype was a wild pressure that unfold attributable to insufficient vaccine protection.
RFK Jr. was both mendacity or simply misinforming Prime Minister Tuilaepa Sailele Malielegaoi There have been no vaccine pressure measles circumstances within the Disneyland outbreak. All measles circumstances in that outbreak had been brought on by wild-type measles. The declare that “vaccine shedding” could cause measles outbreaks shouldn’t be scientifically supported. It’s, in truth, utter nonsense. Once more, there are solely two prospects. Both RFK Jr. was completely clueless however didn’t care, or he knew and was mendacity. Once more, take your decide. That he would have the temerity to write down such a letter to Prime Minister Tuilaepa Sailele Malielegaoi, who’s struggling to guide a small, underdeveloped nation via a serious disaster, says rather a lot about RFK Jr.’s character, none of it good. So does his characterization of a measles outbreak that sickened over 5,000 and finally killed 83 kids as “delicate.” Come to think about it, Dr. Prasad claiming that he didn’t know what RFK Jr. mentioned and did earlier than and throughout the Samoan measles outbreak says rather a lot about his character, none of it good.
Principally, Dr. Prasad’s complete apologia falls for the believable deniability that RFK Jr. cultivated thusly:
The Samoa episode suits Kennedy’s M.O. As an anti-vax champion, he has decried vaccinations as unsafe and ineffective—repeating the debunked notion that vaccines trigger autism—and he has boosted makes an attempt all through the world to persuade folks to eschew vaccines. But when he has been questioned critically about these efforts, he has issued false denials and contended that he’s simply elevating questions and calling for extra analysis. In July 2023, on the invitation of Home Republicans, he appeared at a congressional listening to and declared, “I’ve by no means been anti-vax. I’ve by no means instructed the general public to keep away from vaccination.” But that very same month, throughout a podcast interview, he asserted, “There’s no vaccine that’s protected and efficient.”
Kennedy, as he claimed within the interview for Shot within the Arm, might not have publicly urged Samoans to refuse the measles vaccine. However he inspired those that did, and the group he led helped unfold misinformation to discredit vaccinations there. After the tragedy was over, he dismissed the outbreak as not severe and extolled the anti-vaxxers who helped carry it about.
That is what RFK Jr. does. it’s what he’s at all times achieved. It’s’ what he’s more likely to proceed to do whether or not he’s confirmed as HHS Secretary or not. There’s a cause why I periodically really feel obligated to remind everybody that RFK Jr. shouldn’t be a “vaccine skeptics” or “pro-safe vaccines,” however “antivaccine,” together with receipts. Sadly, Dr. Prasad is seemingly not glad with simply gaslighting RFK Jr.’s position in contributing to make this complete debacle a lot worse. Subsequent he has to
Brownstone does what Brownstone at all times does: promote antivax propaganda
Dr. Vinay Prasad’s article is sort of dangerous, however it’s of a bit with the Brownstone article by David Marks. One space the place they each strike the identical be aware is in disingenuously questioning why the mortality fee of measles was so excessive in the course of the Samoa outbreak. Dr. Prasad, for example, takes a really temporary paragraph to say:
And what concerning the excessive demise fee? In the end the case fatality fee for measles was very excessive. That looks like iatrogenic hurt (with inappropriate remedy) or there are severe limitations to the well being system. Each of those are true.
“Iatrogenic hurt”? I’m confused right here. The time period “iatrogenic hurt” implies that the hurt was brought on by docs, by typical drugs. Whereas it’s true that quacks like Edwin Tamasase had been peddling nutritional vitamins as therapy for measles and that quite a lot of Samoans had been turning to folks drugs and conventional healers to deal with measles, Dr. Prasad cites no proof to help this declare of iatrogenic hurt. It’s, nevertheless, true that the fatality fee for measles on this outbreak was unusually excessive. Usually, we cite an estimated mortality fee for measles of round 1 in 1,000 circumstances, whereas in Samoa by the Christmas vacation in 2019 there had been 79 deaths from 5,520 circumstances, with a mortality fee of roughly 14 per 1,000 circumstances, which was actually alarming. It’s actually true that poverty and lack of entry to correct medical care, plus mistrust of medical authorities, did certainly type the “excellent storm” (to cite the title of the article that appears to have been Dr. Prasad’s solely supply for his article) leading to many extra deaths than would have resulted from a comparable-sized outbreak in a developed nation.
On the bottom, public well being employees knew what was taking place:
And in growing nations, the affected by measles is at all times worse. Many rural Samoans had no transport, feared going to hospital, or tried conventional healers first. By the point folks did carry their infants in, they had been extraordinarily sick, mentioned Australian anaesthetist Dr Dan Holmes, who led the Australian emergency medical crew and was amongst greater than 100 medical personnel deployed to Samoa within the thick of the epidemic.
He spent two “relentless” weeks making an attempt to avoid wasting infants with issues from measles together with pneumonia, collapsed lungs, dehydration, and mind irritation.
“Your day may begin at 6am with a child who’s unconscious and never respiration, and also you may lose that child, then there’s one other one, day after day,” Holmes mentioned. “It’s impacted me greater than something I’ve achieved. It makes me really feel so indignant that it might have been prevented.”
Me, too, Dr. Holmes. Me, too. I’m significantly indignant and alarmed that the person who abused his household identify and fame to facilitate the unfold of antivaccine misinformation in the course of the pandemic is now poised to be put in command of the division chargeable for administering the non-military well being applications of the federal authorities.
In the meantime, Brownstone flack Marks does what Brownstone flacks do. He Gish gallops:
A renewed effort to vaccinate with this alternate provide started within the first week of December 2019; it was hailed as the explanation the outbreak subsided. Measles vaccines take at the very least 10 days earlier than creating an immune response. There was no rationalization for the info confirming that the onset of circumstances dropped dramatically two weeks earlier than this vaccination drive might have had any impact.
Subsequent up:
Any thought-about evaluation of the accessible information soundly contradicts the conjecture that the excessive demise rely was associated to low vaccination charges. Information protection continues to depend on a UNICEF report estimating the vaccination fee of one-year-olds was as little as 31% because the epidemic began. Nonetheless, the Samoan Authorities Well being Ministry reported (p. 9) in June 2019 — three months earlier than the measles outbreak started — that 80% of 12-month-old infants had obtained the MMR vaccine.
Even when the above is correct, I be aware that 80% uptake remains to be far under the mandatory 90-95% uptake required for herd immunity to measles in a inhabitants. Marks does notice that epidemics peak after which subside on their very own, doesn’t he? Furthermore, that the decline began earlier than the mass vaccination program doesn’t imply that the vaccination program had nothing to do with ending the outbreak. For instance, by early December the federal government had expanded its state of emergency to ban nonessential journey:
Colleges, outlets, and companies are shuttered. Youngsters are forbidden from public areas. And your complete inhabitants of 200,000 has been ordered to remain dwelling and to hang around pink materials if they need a cell vaccination crew to name.
May this have had an impact earlier than the vaccination marketing campaign might actually take maintain? I contemplate it possible. Marks additionally makes evidence-free claims that docs had been extensively reporting that the illness they noticed regarded totally different than measles ought to. Given the shortage of expertise most physicians have with measles today, because of mass vaccination and its near-elimination, I take these claims with a heaping grain of salt.
I’ll admit that I did snigger out loud—derisively, in fact, once I learn Marks’ evaluation:
The present criticism of Kennedy is an endeavor to make him look dangerously ignorant and irresponsible to sway members of the Senate. A lot to the chagrin of those that vilify him, his efforts to know and help within the Samoan measles outbreak exemplify his thoughtfulness and capabilities.
“Thoughtfulness” shouldn’t be a phrase that I’d ever affiliate with RFK Jr.
Conclusion
I’ve been writing about RFK Jr. for slightly below twenty years now, beginning with when he first “outed” himself as an antivaxxer, because of the co-publication of his misinformation-packed conspiracy-fest of an article, Lethal Immunity, which posited what I wish to name the Simpsonwood conspiracy concept. This specific conspiracy concept is, in fact, a subset of what I wish to name the Central Conspiracy Principle of the Antivaccine Motion, specifically that vaccines trigger autism, hurt, and demise (and don’t work), however “They” (e.g., the CDC, FDA, state well being departments, large pharma, the medical career, and provaccine advocates) “cowl up” the hurt, all within the identify of revenue, ideology, and…effectively, I’m unsure what else, aside from—if you happen to hearken to them—an obvious evil glee in harming and killing kids. Whereas I totally anticipated the standard suspects (just like the Brownstone Institute) to gaslight the general public about probably the most vile issues that RFK Jr. has ever achieved, contributing to the worry and uncertainty about MMR within the midst of an epidemic that was killing dozens of kids on an island with a inhabitants of solely round 200,000, I have to admit that even I didn’t suppose that Dr. Prasad would “go there” and conclude one thing like this:
In the end, I discover the narrative that RFK Jr is chargeable for the measles deaths in Samoa to be a stretch. The time course doesn’t match, and the foundation causes are systemic and multi-factoral, as is commonly the case in life.
It’s not stunning {that a} poor island nation with poor well being literacy, who 3 generations earlier than by no means had the illness in any respect, can be extremely skeptical of a medical intervention delivered to them by those that earlier introduced the illness.
I feel the MMR vaccine is protected and efficient. However the US general vaccine schedule is probably going extreme (in comparison with Europe) and we’d like cluster RCTs and higher security techniques.
As soon as once more, simply because the origins of the mistrust of the MMR vaccine in Samoa that led to plunging MMR uptake charges that made the nation vulnerable to a measles epidemic had been due largely to the deaths of two infants due to an tragic and negligent error made by two nurses doesn’t absolve RFK Jr. of his position in encouraging that mistrust of vaccination in collaboration with native antivax activists like Edwin Tamasese and Taylor Winterstein. Nor does it absolve RFK Jr. of utilizing his movie star to write down a letter to the Samoan Prime Minister wherein he tried in charge the epidemic not on low MMR uptake however on the MMR vaccine itself. That he did these items are effectively documented information that Dr. Prasad both knew however failed to say or didn’t hassle to search out out. I don’t know which is worse. Additionally be aware how he couldn’t resist signaling to his antivax viewers that he thinks the US vaccine schedule is “extreme” and to repeat his name for “cluster RCTs.”
Inform you what, Dr. Prasad. Why don’t you write some detailed posts that inform us how the US vaccine program is “extreme.” Which vaccines do you contemplate mandatory? Which of them would you drop from the schedule? Extra importantly, give us the small print of how one would conduct these “cluster RCTs” in an moral style, full with statistical justification to supply a minimal pattern dimension. (He received’t do it, as a result of his assertion that kids are getting too many vaccines and his proposal for “cluster RCTs” are deeply unserious, meant to sound profound to his antivaccine readers with out offering any precise scientific meat. Dr. Prasad might show me fallacious, and I’d admit it if he ever had been to show me fallacious by writing such detailed posts about his concepts on vaccines, however I think that I’m protected from having to do this, as he by no means will.
However, hey, as soon as once more, I may very well be fallacious. I simply doubt that I’m fallacious. I additionally be aware that one large distinction between Dr. Prasad and myself is that, at any time when I write one thing, I at all times entertain the chance that I could be mistaken and compelled to rethink what I wrote by somebody whom I’m criticizing exhibiting me why I’m mistaken utilizing proof and science, one thing that Dr. Prasad is at all times welcome to do, however in some way by no means appears to. I think that the chance that he’s in error is one thing that nearly by no means passes via Dr. Prasad’s planet-sized mind, which clearly views me as too trifling to hassle with. So the gaslighting will possible proceed, each by him and RFK Jr.’s many different apologists.