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One consistent theme that I’ve been harping on since COVID-19 vaccines were granted emergency use authorization (EUA) by the FDA in December 2020, thus sparking a tsunami of antivaccine conspiracy mongering far beyond anything seen before the pandemic, it’s that everything old is new again in terms of the claims made by antivaxxers spreading misinformation. Basically, very old antivax tropes were rapidly repurposed to be wielded against the new COVID-19 vaccines, examples including:

I used to joke that the only reasons that antivaxxers weren’t claiming that COVID-19 vaccines caused autism—the dominant antivaccine claim since the 1990s—was because they hadn’t been approved for young children at the time. To be honest, I’m rather surprised that, now that COVID-19 vaccines are recommended for children as young as 6 months, this claim hasn’t become more of a thing, but maybe it’s just because there is so much other misinformation about COVID-19 vaccines. I anticipate that it will still eventually become a thing.

One other phenomenon that I soon started noticing was how “new school” antivaxxers, who had started out just anti-COVID-19 vaccination and justified their distrust of the mRNA vaccines because they were so new and had been “rushed” through development while expressing support for other, older, more established vaccines, were quickly becoming radicalized and increasingly indistinguishable from “old school” pre-COVID antivaxxers. In other words, “new school” antivaxxers were generalizing the “old school” antivax tropes repurposed to spread fear, uncertainty, and doubt about COVID-19 vaccines back to cover all vaccines. As I have said multiple times on Twitter, anti-COVID-19 vaccine antivaxxers were increasingly becoming just plain antivax.

This brings brings me to Steve Kirsch.

Steve Kirsch goes really old school antivax

What brought Steve Kirsch to my attention more recently have been a series of exchanges on Twitter, as well as a number of articles that he’s recently published on his Substack, including, but not limited to:

I could go on, as there are more such articles. Basically, you can tell from just the titles that Kirsch has gone all-in on “old school” antivax conspiracy theories about vaccines causing autism. He’s even latched onto the old “CDC whistleblower” conspiracy theory that formed the basis of Del Bigtree and Andrew Wakefield’s 2016 antivax propaganda film VAXXED and three weeks ago was really going to town with it on Twitter:

Truth be told, I hadn’t thought of the CDC whistleblower conspiracy theory for years, even though it was a conspiracy theory whose birth I watched in real time beginning in August 2014. The long version of an explanation of the conspiracy theory and why the CDC whistleblower does not demonstrate that Andrew Wakefield was right after all can be found here. The CliffsNote version follows.

In August 2014 Andrew Wakefield released a video claiming that earlier MMR vaccination is associated with an increased risk of autism in African-American boys and that the CDC had spent the last decade covering up this link that had been found in a 2003 study but not reported properly. These charges are based the result of a “reanalysis” by Brian Hooker published in 2014 in Translational Neurodegeneration entitled Measles-mumps-rubella vaccination timing and autism among young African American boys: a reanalysis of CDC data. The study that Hooker had “reanalyzed” was from a study by DeStefano et al (and of which the “CDC whistleblower” William W. Thomas was a co-author) published in Pediatrics in 2004 entitled Age at first measles-mumps-rubella vaccination in children with autism and school-matched control subjects: a population-based study in metropolitan Atlanta. Note that Hooker’s paper was retracted in October 2014. This “reanalysis” was undertaken as a result of a CDC scientist, William Thompson, having privately expressed concerns to Hooker about in a series of phone calls in which he basically ranted about the study’s principal investigator and CDC leadership for not having done the “proper” analysis. Hooker recorded these phone calls without Thompson’s knowledge, and Wakefield found out about them, leading to a release of a video which described the “coverup” as being akin to the Tuskegee syphilis experiment and the eventual unmasking of the “CDC whistleblower.” Again, none of this, either Thompson’s claims or Hooker’s “reanalysis” of the DeStefano study showed that the MMR vaccine was associated with autism in black boys, but it all became the basis of VAXXED.

As I like to say, antivax conspiracy theories never die. They merely disappear for a while, evolve, and then rise again. I also sometimes like to quote Yoda again with respect to antivax pseudoscience and conspiracy theories, once you start down the dark path (of antivax), forever will it dominate your destiny—consume you it will. I’m watching quite a few “only COVID-19 vaccine” antivaxxers becoming just antivaxxers and being consumed by antivax misinformation. Steve Kirsch is arguably the most rabid of the bunch thus far, which is why I decided to write this post, particularly after learning through a series of exchanges with Kirsch on Twitter and by email that Kirsch had teamed up with Brian Hooker and James Lyons-Weiler, both prominent “old school” prepandemic antivaxxers.

Yoda Antivax

Antivaxxers should listen to Yoda. Unfortunately, COVID-19 antivax is the gateway to the Dark Side of just antivax.

Regular readers might remember Steve Kirsch as the tech bro turned antivaxxers who loves challenging critics of COVID-19 quackery and antivax misinformation to live public debates, a common tactic of all manner of cranks ranging from antivaxxers to creationists to climate science deniers and more. Before the pandemic Kirsch was one of two independent inventors of the optical mouse in the 1980s. After that, he started several companies, examples including the search engine Infoseek in the 1990s as well as Frame Technology Corp. (which was purchased by Adobe in 1995) and a company making a spam filter (Abaca) in 2005, becoming quite wealthy over the years. Relevant to COVID-19, early in the pandemic Kirsch founded the COVID-19 Early Treatment Fund (CETF) in order to fund research into off-label treatments for COVID-19 using existing drugs already having FDA approval for other diseases. He donated $1 million himself and solicited donations from others. So far, not so bad, right? It actually wasn’t a bad idea. The problem, however, is that Kirsch didn’t seem to understand how clinical research works and what the failure rate is for testing repurposed drugs for pretty much anything, which made it unsurprising that things started going horribly wrong with Kirsch descending into COVID-19 misinformation and conspiracy theories, in the process becoming what the MIT Technology Review once called a “misinformation superspreader“:

With little government funding available for such work, Kirsch founded the Covid-19 Early Treatment Fund (CETF), putting in $1 million of his own money and bringing in donations from Silicon Valley luminaries: the CETF website lists the foundations of Marc Benioff and Elon Musk as donors. Over the last 18 months, the fund has granted at least $4.5 million to researchers testing the covid-fighting powers of drugs that are already FDA-approved for other diseases.

That work has yielded one promising candidate, the antidepressant fluvoxamine; other CETF-funded efforts have been less successful. But that’s not a surprise, according to researchers who conducted them: the vast majority of trials for any drug end in failure.

What has alarmed many of the scientists associated with CETF, though, are Kirsch’s reactions to the work he’s funded—both successes and failures. He’s refused to accept the results of a hydroxychloroquine trial that showed the drug had no value in treating covid, for instance, instead blaming investigators for poor study design and statistical errors.

He’s also publicly railed against what he claims is a campaign against drugs like fluvoxamine and ivermectin. And, according to three members of CETF’s scientific advisory board, he put pressure on them to promote fluvoxamine for clinical use without conclusive data that it worked for covid.

We can see right away from this account how Kirsch reacts to disconfirming data: He denies it and doubles down, a pattern that we see in him over and over again. Moreover, since then he has only grown increasingly radical. Indeed, this part of the story really resonates because it is a clear precursor of how Kirsch became increasingly antivax. Eventually, CETF’s entire advisory board resigned, no longer wanting to be associated with him and becoming very tired of harangues by Kirsch demanding that they promote fluvoxamine based on a preliminary study, as CETF advisory board member and vice chair of research at the West Virginia University School of Medicine Judith Feinberg described:

But even she was drained by Kirsch’s constant attempts to override the data. “After one or two conversations like that, I got tired of arguing, so I started avoiding his calls,” she said.

To scientists, giving fluvoxamine a chance means running a large trial—not giving it to individual patients in the clinic, off-label and outside the context of active data collection and analysis. The board members I spoke to say they refused to publicly promote any drugs for off-label use and tried to explain to Kirsch that it’s incredibly common for exciting results from small trials to disappear in larger ones.

Avoiding his calls? After just a few email exchanges with him, I can totally sympathize with Dr. Feinberg.

Eventually, in 2021 Kirsch was promoting ivermectin as a miracle cure (with fluvoxamine) for COVID-19. By May 2021 he was that COVID-19 vaccines impair female fertility (they don’t), and by September 2021 he was falsely claiming that the mRNA vaccines kill more people than they save—150,000 killed by the vaccines—!using some truly risible arguments to claim that grew by May 2022 to a claim that mRNA vaccines have killed over a half a million people while only saving ~25,000.

In retrospect, I suppose that it should have been expected that Kirsch would eventually expand his antivaccine messaging against mRNA-based COVID-19 vaccines to encompass all vaccines, but what surprised me somewhat were the enthusiasm with which he embraced them and how far down the rabbit hole he has gone to generate “evidence” to support his newfound total antivax stance. I mean, he’s even resurrected a variation of the Amish trope that was common in 2005, soon after I had first started my first Blogspot blog. It is a trope that I hadn’t thought of in a very long time, in which he claimed (falsely) that the Amish don’t vaccinated but that “only a handful” of them had died of COVID-19. (Regular readers might recall the false claim that there are “no autistic Amish” because they supposedly didn’t vaccinate.)

In which I am accused of “malicious manipulation” of data to support my agenda

In May, Steve Kirsch publicized what he called “the most important survey I’ve ever done.” It was a survey about vaccines and health problems suffered by children. He was soon touting its results on Twitter:

A number of Twitter users, including myself, tried very hard to explain that an Internet survey run from the Substack of an antivax activist would be, by its very nature, so hopelessly biased that one could predict with near 100% certainty that it would inevitably show that vaccines were associated with autism, autoimmune disease, and a number of other conditions. We also tried to explain to Kirsch that Anthony Mawson’s survey was horribly designed, not evidence that vaccines caused autism, and retracted once. Hooker’s study was no better. So where does the accusation that I somehow “maliciously manipulated” the data in Kirsch’s study come from?

It started with a Tweet in which Kirsch tried to deny that his survey was biased:

And:

So I obliged him:

I was even brutally honest about the effect that I thought my retweeting his poll would have:

Which led to:

And in his Substack Kirsch lamented:

The truth is now so bad for them that they have to stoop to malicious data manipulation techniques.

The truth is now so bad for them that they have to stoop to malicious data manipulation techniques.

I posted this poll and checked 51 minutes later on the votes and saw a 5:1 odds ratio that vaccines cause autism. This was nearly exactly as I predicted.

Then I suggested Gorski run his own poll.

I just checked on the poll 10 hours after I sent Gorski that message.

Which resulted in:

They flipped it from the vaccine causing autism to the vaccine being the magical cure for autism. This never happens in a poll unless it is being gamed.

Look at my poll now:

This is a stunning reversal from a 5:1 odds ratio (which later went to 6:1) to a 1:2 odds ratio. Basically, people who would normally have no child with autism lied and voted for the first choice so it showed the vaccines are now beneficial.

My polls weren’t gamed in the past.

Today, the opposition is now fielding armies of robot voters to manipulate the truth to support their narrative.

This shows you first hand how low these people will stoop in order to manipulate results that are counter narrative.

The only reaction that I could come up with besides a huge facepalm was: Be careful what you ask for. I also note that this is the one and only time that I’ve ever actually accepted a “challenge” from Mr. Kirsch, and it resulted in exactly what I knew would likely happen. After all, back in the day science advocates would routinely do the same thing to polls posted by creationists as a tactic to show how worthless Internet polls are as a source of actual evidence given how easily they can be influenced by where they are advertised. To be honest, even now, two weeks later, I have no idea if I had that much affect on Mr. Kirsch’s poll by myself. I was far from the only science advocate sharing it. Even so, instead of imbibing the correct lesson from this exercise, namely that his poll was biased and utterly worthless as a source of anything resembling reliable epidemiological data regarding vaccines, autism, and other health outcomes in children, Kirsch leapt to exactly the wrong explanation, namely that his poll had gotten the answer right the first time but had been corrupted by “malicious manipulation.” I’ll repeat again: If your Internet poll’s results can so easily be affected by where it is publicized, it is not a reliable source of objective information about the prevalence of a health condition or its relationship to any purported risk factors.

To top off this incident, Mr. Kirsch emailed me to ask me if I would look over his protocol in order to spot its flaws and improve it. My response was simple. I’d do it if it were a new protocol for which no data had yet been collected. However, if it was a protocol to “analyze” the “data” from his Internet survey above, then my answer would be no, because once data have been collected using a biased and scientifically worthless protocol there is no fixing it. Garbage in, garbage out. Mr. Kirsch never responded to my answer.

Steve Kirsch is now a font of old antivax misinformation

Over the last couple of months, Mr. Kirsch has become a veritable font of antivaccine misinformation of the old school “vaccines cause autism” variety. Skeptical Raptor and Dorit Reiss both addressed some of the most egregious misinformation that he’s been spewing (e.g., claims that vaccines aren’t tested against “true placebos,” a favorite old anti-HPV vaccine and even anti-MMR vaccine trope), but I’d like to conclude with one that he most recently published on his Substack, How can I be so sure that vaccines cause autism? I asked the ONE question that no autism researcher has EVER asked, with a blurb: I asked parents when they first noticed ASD behaviors in their child relative to the time of the NEAREST vaccination visit. The results were stunning.

Actually, they weren’t, but let’s quote Mr. Kirsch anyway:

If vaccines aren’t triggering autism, then the number of times a parent notices autistic behaviors BEFORE a wellness visit where a vaccine is given should be comparable to the number of times AFTER the visit.

I asked 642 parents who had previously reported having an autistic child in previous surveys to fill out my survey. I received 273 responses.

58 parents reported first seeing autistic behaviors within a month AFTER a vaccine appointment.

0 parents reported first seeing autistic behaviors within a month BEFORE a vaccine appointment.

This is stunning. It is highly unlikely you’ll get a disparity like this if vaccines aren’t triggering autism. It’s about the same as the chance of throwing a fair coin 58 times and getting all heads: 1 chance in 2.8e17 which is about as close to impossible as you will ever find in nature.

But the more stunning thing is that no autism researcher in the world has ever even thought to ask such a question. Ever.

Again, this is the same survey; so its results are, by its design, inherently hopelessly biased, unrepresentative of the general population, and scientifically worthless. Again, Kirsch’s audience clearly skews heavily antivax, perhaps with a smattering of science advocates like me who only read his drivel in order to stay informed about the latest antivaccine misinformation, and he is way too enamored of this single result. Why would this result be uninformative or even outright meaningless. The answer is simple: confirmation bias.

This is the problem with relying on anecdotes over data collected according to a protocol designed to be scientifically rigorous and thereby avoid bias as much as is humanly possible. Human memory is fallible, and, as was discussed on science and medicine blogs many times before back around 2007, parents tend to remember what conforms to their current beliefs and forget (or downplay in their memory) what does not. None of that stopped Kirsch from emailing me (and I had warned him that his emails were fair game for blogging after a certain date):

You look at the time the parent first noticed autistic behaviors relative to the most recent vaccination date.

It’s a 1:20 odds ratio for before:after! It’s really stunning.

Isn’t a shame NOBODY will do this???

It would expose the truth.

My response was simple and blunt:

Funny how you keep discovering antivax claims that were debunked a long time ago and then regurgitate them as though they were brand new.

Also, the vast majority of these claims of children “regressing” after vaccination are cases of confirmation bias. For a number of these cases, we have evidence that the child had been showing signs of ASD before the vaccines blamed by the parents for their regression. I recall one case where there was video evidence but can’t find the link right now, and Brian Hooker’s story is full of holes, as was discussed years and years ago by science communicators and advocates:

Double checking Brian Hooker’s story in VAXXED

Brian Hooker’s vaccine injury claim denied by NVICP

Sadly, truth be told, human memory is very fallible and malleable. It is quite common for parents to blame vaccines for their child’s regression or just autism even though the child had been showing signs of it before vaccination. Lest you think that it can’t be “coincidence,” it can, as was demonstrated in 2016, with an additional explanation why most anecdotes are worthless for proving causation:

Why are there so many reports of autism following vaccination? A mathematical assessment

5 reasons why anecdotes are totally worthless

Also, your “survey” is not a representative sample, as you yourself demonstrated when you challenged me to share it and my Twitter followers answers changed the results and eliminated the correlation. Dude, you are so bad at this it isn’t even funny anymore. It’s just pathetic.

If you think I’m too “nasty,” please remember that Kirsch has been intermittently emailing me for a while with his “challenges,” to the point where they have become tiresome and annoying.

How many times have we heard the story of a mother who is utterly convinced that her child’s regression started right after vaccines but then, when her story is more closely examined, that is found not to be the case? Another example came to mind after this email exchange. In the Autism Omnibus hearings, an expert examined videotapes of the child of one of the claimants (Michelle Cedillo) at ages 6-8 months submitted by the parents to prove that their child had been fine before vaccines. Sadly, the expert saw clear signs of autism in these videotapes, as well as signs of the parents adjusting their behavior to her. It is unsurprising that Kirsch was unaware of this background, as he is a newbie to the vaccine-autism conspiracy theory, but he really did embarrass himself acting as though he had discovered something new. No doubt he will react as other antivaxxers have reacted to such observations and accuse me of attacking parents as liars, when nothing could be further from the truth. Confirmation bias is a powerful force in human memory. We are all prone to it and all experience it. It takes active effort to counter it, which post of us do not do.

What happened to Steve Kirsch?

When I started this post, I had planned on going through a larger number of hoary antivax tropes from 15+ years ago that Kirsch has been digging out of the muck, wiping off, and selling them as new to the “new school” antivaxxers who make up most of his readership, but then I decided that it wasn’t necessary, particularly after Skeptical Raptor and Dorit Reiss had done it recently. Instead, relating this story led me to wonder: WTF happened to Steve Kirsch? Was he always like this and no one noticed, or did he somehow become this way?

The answer, I suspect, is a combination of both. Whenever asking why people fall so far down the rabbit hole of antivaccine misinformation, I often like to remind everyone that every human being is vulnerable to a similar tendency and to remind myself that it could happen to me, too, although it would likely be different conspiracy theories and pseudoscience given how long I have combatted antivax misinformation. Conspiracy theories appeal to us because they make us feel important and heroic; We are the chosen few with hidden knowledge facing “persecution” for spreading The Truth. It’s very much like religion that way.

In Kirsch’s case, although I can’t speak to what he was like before the pandemic, the indications were there very early on after COVID-19 hit and he started CETF. At the time, it was clear that he just wanted to help by encouraging research into repurposed drugs that might be useful against COVID-19, a not unreasonable strategy. What tripped him up, as is often the case, was a combination of ignorance and arrogance. His ignorance came from not knowing how often repurposed drugs fail rigorous clinical testing against a new disease even when it seems as though they should work, or, more pertinently, how often the ultimately fail after initial promising preliminary results (e.g., the case of fluvoxamine). His arrogance came in not listening to the actual experts who tried to caution him how often repurposed drugs fail validation in clinical trials and not to get to excited about initial promising results with fluvoxamine. That same arrogance led him not to accept negative clinical trials of hydroxychloroquine.

Indeed, even in 2021, when asked about his bucking the experts, Kirsch said:

“When you need to characterize me, you need to say that Steve Kirsch doesn’t go with majority votes on interpreting data,” he told me when I asked about his views on ivermectin, which he insists is a silver bullet against covid. “If you wanna find someone to debate me for ten thousand dollars, or a thousand dollars, I’m happy to do that, just for your benefit.”

These days, anyone who follows Kirsch on Twitter or reads his Substack knows that he’s been offering $5 million to or betting $5 million to challenge anyone who can prove to him that vaccines don’t cause autism, while challenging anyone who contradicts him to “debate” him and his antivax “experts.” It is a pathetic scene, really, but revealing. Kirsch appears to equate confidence in one’s views with correctness, which leads him to conclude that anyone who won’t debate him or accept his bets over evidence regarding vaccine safety must be wrong because they lack sufficient confidence in the science to accept his challenges.

Indeed, Richard Char, general counsel of M10, the latest company founded by Kirsch and one from which he ended up stepping down as CEO after his antivax advocacy had become a distraction, was quoted saying:

He is very smart, and knows that he is very smart, and sometimes he behaves like he thinks he’s the smartest guy in the room, whether he is or isn’t.

These days, I would say that Mr. Char is being too charitable. Mr. Kirsch is not coming across as very smart to me these days, even if he genuinely does believe he is saving the world. However, he clearly does believe he is the smartest guy in the room, which has apparently led him to think that he can master clinical trials, autism, vaccine science, epidemiology, and survey design by himself or with the help of a few crank scientists like Brian Hooker. Part of this might also be fueled by his experience as a cancer patient:

Saving the world has been a theme of Kirsch’s life for years. “There are two ways I’ve discovered that I may be able to save the world,” he told an IEEE Spectrum reporter in 2000. “One is to reduce the threat of nuclear war. Another is to identify an asteroid that is going to hit the planet.”

His efforts became more focused on medical research when, in 2007, he was diagnosed with a rare blood cancer. His foundation shifted focus to one goal—curing Steve Kirsch—by supporting one of the few scientists looking at the disease. After several failed attempts to stop the progression of his disease, he designed his own protocol for chemotherapy and doctor-shopped to find an oncologist who would give it to him. He’s now outlived his initial prognosis by several years.

Thus, a combination of wanting to save the world plus having apparently been right once—or, far more likely, just very lucky—about a medical issue appear to have led him to believe that he’s right now about early treatments for COVID-19 and mRNA-based vaccines, even though in this case he clearly is not. It’s a shame. Someone with his drive and apparent smarts could have done so much good. Instead, he’s contributing to fear and distrust of not just COVID-19 vaccines but now all vaccines, thus endangering the lives of everyone.

Indeed, just yesterday, he asked, Will you help me to redpill America? In the Substack post, he is asking:

Here’s something you can do right now that can really make a huge difference.

Call up your pediatrician and ask her to publish the 1 month autism before:after odds ratio for her practice on their Twitter feed like this: “Our 1 month AOR is 0:10.”

Nobody will know what that means except for us.

They can do it just for the most recent N patients that were diagnosed with autism where they choose N. So this can take as little as a few minutes of their time (e.g., N=5).

The one month before:after odds ratio is simply <# of families who noticed a dramatic overnight change in the behavior of their child consistent with ASD less than 1 month before the closest vaccine shot> : .

Once these numbers are published, it’s all over.

And they cannot be punished for publishing truthful information as long as they make no further comment about it. Leave that to me.

He truly doesn’t seem to realize that this would be hopelessly biased because the only physicians likely to be willing to respond to his challenge as relayed to them by patients who read Kirsch’s blog are likely to be overwhelmingly antivax. He just refuses to believe that uncontrolled Internet polls and reporting campaigns like this are not valid methods for determining the prevalence of any condition or whether any purported risk factor for that condition might actually be causative.

He is simply too arrogant and ignorant to learn, and as a result instead of being remembered for to find early treatments for COVID-19 his legacy will be to be remembered as one of the more prominent and wild spreaders of conspiracy theories and misinformation about COVID-19 and vaccines.

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Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.