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Last week, a reader of my not-so-secret other blog alerted me to the social media activities of a physician in my area. Oddly enough, this particular physician is one whom I couldn’t recall ever having written about, even though, like Dr. David Brownstein, who also practices in the northern suburbs of Detroit, this particular physician is an “integrative doctor” with a rather large following. Unfortunately, as I soon discovered, this local physician is also amplifying antivaccine disinformation and COVID-19 conspiracy theories, just as Dr. Brownstein has been doing. This doctor is Dr. Joel Kahn, and he is a somewhat famous “integrative cardiologist” who runs a clinic called the Kahn Center for Cardiac Longevity. The only mention I could find of him on this blog was that he had provided a promotional blurb for Vani Hari’s (a.k.a. The Food Babe‘s) first book back in 2015. Not a good sign, to be sure, but I was unprepared for the level (and sheer vehemence) of Dr. Kahn’s antivax conspiracy mongering in the form of misinterpreting reports about COVID-19 vaccines to the Vaccine Adverse Events Reporting System (VAERS) database.

On paper and websites, Dr. Kahn, who has become somewhat famous as an almost celebrity “holistic cardiologist,” looks like a brilliant guy, albeit clearly an arrogant one. He received his medical degree from the same medical school where I received mine (the University of Michigan) and, as you will see, likes to brag on social media about having completed U. of M.’s six year Inteflex combined bachelor’s/MD program and graduated summa cum laude. At the same time, as you will also see, Dr. Kahn exhibits extreme arrogance and condescension towards those whom he views as inferiors in education and/or brilliance of intellect, while at the same time actively resisting engaging with (or even reading) any material that counters his narrative that VAERS reports indicate that COVID-19 vaccines are causing mass death and destruction, all while responding to quite reasonable accusations of amplifying antivaccine disinformation with incredible righteous indignation that he is “not antivaccine”.

Before I go on, I’ll note a couple of things. First, although this post is based on a post from Friday on my not-so-secret other blog and there will be some overlap, it is (mostly) a new post. I decided to write about the same topic here mainly because Dr. Kahn’s reaction to criticism in the wake of his antivaccine social media activity is very telling, but, more importantly, because he is spreading the same misinformation about VAERS that I’ve countered multiple times before and, given that, I felt that it was time anyway for an updated post on how antivaxxers weaponize VAERS against COVID-19 vaccines. I also wanted to do it in more detail. (I didn’t really go much into why Dr. Kahn is so wrong when I first took note of him.) That was a mistake, one that I mean to use SBM to rectify. As a result, the social media posts from Dr. Kahn that I feature will be (mostly) from over the weekend, after my original pseudonymous post, although I will repeat a few because, well, damn they’re bad. Also, I don’t want you to have to keep clicking on a link to see what I’m talking about, even if it would boost traffic to my not-so-secret personal blog.

Kahn, not Khan...

No, not this Khan…

Joel Kahn, MD

It’s this Joel Kahn, MD, actually.

And in case you’re wondering why I included the above photos, I present a Twitter exchange from over the weekend:

Let’s just say that I couldn’t resist that little bit of snark before I move on to the meat of the post.

Dr. Joel Kahn, holistic, “integrative,” vegan cardiologist

As I mentioned above, Dr. Kahn is an “integrative” (or, as he likes to put it, “holistic”) cardiologist who practices in the suburbs of Detroit at what appears to be a concierge practice. Of note, Dr. Kahn DOES NOT ACCEPT INSURANCE PAYMENTS FOR OFFICE VISITS (the all caps are not mine, but straight from the page on his website that informs patients of this fact).

As noted by one Twitter user:

Also, Dr. Kahn charges $500 for a one-hour consultation and $250 for half-hour follow-up visits. (Nice work if you can get it.) Dr. Khan calls his clinic the Kahn Center for Cardiac Longevity and advertises thusly:

The Kahn Center for Cardiac Longevity in Bingham Farms, Michigan, is one of the world’s premier cardiac clinics. Joel Kahn, MD, and his team offer advanced care using a direct patient model — you have exclusive access to Dr. Kahn, longer and more thorough consultations, and access to the most advanced preventive screenings.

One of the clinic’s sought-after services is a one-on-one thorough evaluation with Dr. Kahn. It’s called the Ultimate Heart Check Up. Additional services at the clinic include Carotid Intimal Medial Thickness (CIMT) ultrasounds, EndoPat artery health screenings, advanced labs, calcium scores, genetic testing, and nutrition counseling.

I note that these tests are in addition to the consultation, with the CIMT ultrasound costing an additional $250; the EndoPat $225; and more, including the unproven “GAINSwave low-intensity shock wave therapy of erectile dysfunction, whose sales pitch describes it as a “turnkey, direct-pay brand that has been successful in helping our network of providers easily add an additional revenue stream to their practices”, a “particularly powerful tool for edifying a solo practitioner’s or small practice’s independence”, and whose deployment “can augment existing services for virtually any medical practice”. Generously, Dr. Kahn notes that “patients must carry insurance to cover other medical services” and that his fees are for “the personalized services and enhanced access offered in the program in his office” while they will need insurance for “other medical visits and hospital services”.

I can’t help but wonder how many of these “specialized tests” are covered by most health insurance plans, but I do know that health insurance won’t pay for most, if not all, of the numerous supplements that Dr. Kahn sells on his website. Be that as it may, Dr. Kahn is fairly famous. His website includes a bunch of logos of television shows and other media in which he has appeared, including—of course!—Dr. Oz and the incredibly popular The Joe Rogan Experience podcast. Amusingly, there, as a “vegan cardiologist”, Dr. Kahn “debated” an acupuncturist and “functional medicine” advocate named Chris Kresser who is also a well-known proponent of the so-called “paleo diet.” In any event, Dr. Kahn’s whole brand appears to be to recommend a plant-based diet as, more or less, the be-all and end-all of heart health, having written books with titles like The Plant-Based Solution: America’s Healthy Heart Doc’s Plan to Power Your Health. While there’s nothing intrinsically horrible about such a position, given that there is decent evidence that a more plant-based diet can be associated with better heart health (although a lot less evidence that it can miraculously reverse heart disease), Dr. Kahn has, from my observation, gone a bit beyond that and appears to attribute near-miraculous powers to such a diet, much the way Dr. Dean Ornish does.

Dr. Kahn didn’t use to bother me that much, given that he seemed to be a run-of-the-mill vegan-promoting cardiologist most of whose other medical advice appeared to be fairly sound, if you could leave aside his overly enthusiastic cheerleading for vegan diets. However, as time has gone on Dr. Kahn appears to have drifted further and further from science-based medicine. For instance, he’s now quite credulous about touting unproven health benefits of CBD and hemp oil, as well as “heavy metal detox” quackery.

Just a few days ago on his Facebook page:

Then there’s Dr. Kahn’s conspiracy mongering about how Big Pharma is supposedly “suppressing” plant-based miracle cures and preventatives for cardiovascular disease:

Then, as I described above, last week a reader of my not-so-secret personal blog directed me to Dr. Kahn’s Twitter feed. This led me to peruse his Instagram and Facebook feeds as well. The results were…disturbing. Then, after I had written about how much antivaccine disinformation Dr. Kahn was amplifying on his social media feeds (although, tellingly, not on either of the websites for his personal brand or cardiology practice), Dr. Kahn doubled down, leading to what can most kindly be referred to as a Twitter kerfuffle. It was that Twitter storm that led me to decide that, no matter how many times I’ve described why the weaponization of VAERS reports of adverse reactions by antivaxxers is deceptive, apparently I need to revisit the topic, given that it’s been a at least a couple of months since I have. And, wow. As you will see, Dr. Kahn amplifies some real COVID-19 quacks and cranks.

A few examples of COVID-19 antivaccine misinformation amplified by Dr. Kahn before the kerfuffle

So here were the very first posts I found on Dr. Kahn’s feeds last week. First, Instagram:

Then on Twitter:

You will note that the Facebook and Instagram posts recycle a common antivaccine meme about “informed consent.” I’m just amazed that Dr. Kahn restrained himself from adding a rape analogy, given that antivaxxers frequently love to compare “forced vaccination” to rape. In any event, as I’ve discussed many times before, the version of “informed consent” that antivaxxers tout is in reality “misinformed refusal“, in which misinformation is used to drive a decision to refuse vaccines based on a distorted version of “informed consent” in which risks are hugely inflated and benefits as badly downplayed, if not denied altogether. Now he’s bragging on Twitter about having been put in “Facebook jail” for promoting misinformation. (I know, I know, Dr. Kahn doesn’t view it as misinformation, but it is, as I’ll explain yet again.)

There was such copious misinformation on Dr. Kahn’s social media feeds that last week I had a hard time deciding which examples to feature in this post. However, there was one that I definitely had to repeat for the SBM update, namely this Instagram post:

That’s right. Dr. Kahn is likening vaccination during pregnancy to smoking during pregnancy. I assume that he’s referring to the COVID-19 vaccine, but he doesn’t actually specifically say that he is. What tells me that he is are the hashtags “#experimental” and “#EUA”, the latter of which clearly refers to the emergency use authorization used to distribute the current COVID-19 vaccines and the former referring to a favorite antivaccine trope about COVID-19 vaccines, that they are still “experimental.” This latter trope is based more on a legal, rather than scientific definition, of “experimental” or “investigational”, a legal definition that antivaxxers like Del Bigtree have exploited for propaganda purposes. Basically, drugs or vaccines that have not yet received full FDA approval must still be referred to as “investigational”. However, from a scientific standpoint these vaccines are clearly not “investigational” any more. They’ve all undergone phase 1, 2, and 3 testing, with phase 3 clinical trials involving tens of thousands of subjects. Moreover, they’ve been administered to hundreds of millions of people now, with an overall excellent record of safety and efficacy, efforts of antivaxxers to use fear mongering to claim otherwise notwithstanding, including memes like this one shared by Dr. Kahn:

Meanwhile, in response to criticism, Dr. Kahn tried to claim this:

Of course, even as he Tweeted about how he’s “never posted once not to get vaccinated”, Dr. Kahn couldn’t resist including an antivaccine meme deceptively using VAERS data to imply that the COVID-19 vaccines are deadly. I could go on and on (and did elsewhere), but I want this post to be far more new material than old. So I’ll move on to what got this whole ball rolling, specifically Dr. Kahn’s promotion of a favorite antivaccine bit of disinformation, the misrepresentation of reports to the VAERS database.

Before I do that, though, let’s look at a few examples in Dr. Kahn’s social media feeds, in which he posted anecdotes and references to VAERS straight from the antivax playbook:

He also promotes Tweets from the notorious antivaccine and COVID-19 conspiracy website TrialSiteNews.com:

Dr. Kahn even went beyond the above claim that vaccine mandates somehow violate the Nuremberg Code, when he posted this to Instagram:

Yikes! Argumentum ad Nazium!

Contrary to his claim that he is “pro-vaccine,” Dr. Kahn is no more “pro-vaccine” than Robert F. Kennedy, Jr., who likes to portray himself as “fiercely pro-vaccine” while likening vaccine mandates to the Holocaust, which, I’ve argued elsewhere, is a form of Holocaust denial. The claim that vaccines, be they COVID-19 vaccines or vaccines against other diseases, violate the Nuremberg Code is complete and utter nonsense that I’ve discussed more times than I can remember, both here and on my not-so-super-secret personal blog (for example, here). It’s a favorite lie used by antivaxxers that allows them to portray vaccine advocates as Nazis and pro-vaccine physicians as akin to the Nazi doctors who carried out such horrific experiments in Hitler’s concentration camps. Basically, claims that COVID-19 vaccines (or vaccines in general) somehow violate the Nuremberg Code are just a short step from this:

To which the Auschwitz Museum replied over the weekend:

I also note that the website Tweeted by Dr. Kahn features Dr. Peter McCullough on its advisory board. Dr. McCullough, as you might recall, is peddling the lie that COVID-19 vaccines are killing huge numbers of people. He also promotes an unproven drug and supplement cocktail for COVID-19, because, where there are COVID-19 conspiracy theories, there is grift. It’s a near-universal rule.

Then I saw these:

“I’m not antivaccine. I’m a pro-safe vaccines!”

“I’m not antivaccine. I’m a vaccine safety advocate!

“I’m fiercely pro-vaccine!”

Remember those quotes? They came from Jenny McCarthy 13 years ago and other antivaxxers echoing her, with the last one being the one I mentioned above by Robert F. Kennedy, Jr., who, again, is most definitely not pro-vaccine. Also, Before COVID-19 vaccines even received their emergency use approvals (EUAs) from the FDA, I was warning that antivaxxers would weaponize VAERS reports this way. Since then, I’ve written about many such instances, which makes this a perfect segue to revisiting the topic of VAERS reports about adverse reactions after COVID-19 vaccination.

The weaponization of COVID-19 vaccine VAERS reports: An update

Months before EUAs were granted by the FDA for vaccines against COVID-19, starting with the Pfizer/BioNTech vaccine and then continuing with the Moderna and Johnson & Johnson (J&J) vaccines, those of us who’ve long followed and countered the antivaccine movement—particularly the disinformation it spreads—were predicting that, as soon as there were COVID-19 vaccines, antivaxxers would publicize and weaponize reports of death and adverse events to give the impression that the vaccines are horrifically dangerous and deadly. By the end of January, our predictions had come true even more blatantly than I had expected, as I discussed this technique and why it is deceptive. In fact, first time I noted this particular antivaccine line of misinformation was actually in December. Like clockwork, it occurred within days of the first doses of the Pfizer vaccine being administered under the FDA’s EUA, when antivaxxers immediately started publicizing reports of Bell’s palsy and syncope. It’s a technique that continued with claims based on VAERS that COVID-19 vaccines cause heart attacks and sudden cardiac deaths, with these sorts of claims being central to messaging by antivaccine activist Del Bigtree.

None of these reports demonstrated causation (and some were pretty weak even in the correlation department), but that didn’t stop antivaxxers from publicizing them. Then, when the FDA issued a pause for the J&J vaccine based on (at the time) one-in-a-million reports to VAERS of a rare type of blood clot, reports that the FDA and CDC took very seriously, antivaxxers predictably went wild over it, even though the risk-benefit ratio of the vaccine was still deemed to be favorable.

This weaponization of VAERS became only more blatant and more hysterical as time went on. At the extreme end of the antivax hysteria, as one might expect, Mike Adams at NaturalNews.com was proclaiming, “VACCINE HOLOCAUST now accelerating: VAERS data show nearly 4,000% increase in vaccine deaths in 2021 (so far) vs. the entire year of 2020“. Another example of this particular antivaccine messaging comes from a recent article in The Liberty Sentinel, “COVID vaccines killing huge numbers, warns leading doctor“. The doctor is Dr. Peter McCullough, someone whom Dr. Kahn cited yesterday:

As I’ve written in detail before, Dr. McCullough’s conspiracy theory and misinterpretation of VAERS for the purposes of fear mongering are epic. One can see, however, where Dr. Kahn has likely gotten his talking points from. Whenever I want to know what the latest antivaccine talking points about VAERS and COVID-19 vaccines are, I go to antivaccine activist Robert F. Kennedy Jr.’s Children’s Health Defense website. The reason is simple. Every week, when the CDC releases the latest VAERS data, CHD uses it to fear monger about COVID-19 vaccines. It’s a practice RFK Jr. has been engaging in for several months now, and, like clockwork almost every Friday, CHD posts the latest VAERS numbers using basically the same template to try to paint them as evidence of horrific harm from COVID-19 vaccines. Sure enough, last Friday he posted an article by his freelance antivaccine propagandist Megan Redshaw, entitled “Number of Deaths Reported After COVID Vaccines Jumps by More Than 2,000 in 1 Week, According to VAERS“.

Here’s the gist of it:

Data released today show that between Dec. 14, 2020 and July 2, 2021, a total of 438,441 total adverse events were reported to VAERS, including 9,048 deaths — an increase of 2,063 over the previous week. There were 41,015 serious injury reported during the same time period — up 6,950 compared with last week.

In the U.S, 328.9 million COVID vaccine doses had been administered as of July 2. This includes: 134 million doses of Moderna’s vaccine, 182 million doses of Pfizer and 13 million doses of the Johnson & Johnson (J&J) COVID vaccine.

Of the 9,048 deaths reported as of July 2, 22% occurred within 48 hours of vaccination, 15% occurred within 24 hours and 37% occurred in people who became ill within 48 hours of being vaccinated.

The first thing to realize is that these sorts of analyses totally ignore what we in the biz call the baseline rate. In other words, absent a vaccine program, what is the baseline rate of these events, starting with death? This is an issue that has been touched upon with respect to VAERS data multiple times on this very blog, starting back in February, which brings me back to this Tweet from late January:

And, from my former ScienceBlogs compadre Mark Hoofnagle:

So, back in February, the number of deaths reported to VAERS compared to the number of deaths expected among the population thus far vaccinated was actually very small. The same has been true every time I did similar back-of-the-envelope calculations, but I haven’t revisited this question in a couple of months at least. So it’s fair to ask: Is the same true now? To do that estimation, we need to know how many people were vaccinated in the US between December 14, 2020 and July 2, 2021. Unfortunately, although RFK Jr.’s drone tells us that 328.9 million doses of COVID-19 vaccines were administered during that period, she did not say how many people were vaccinated. However, Our World In Data told me yesterday that 332 million doses have been administered, with 158 million Americans being fully vaccinated, or 48.2% if the population. NPR’s vaccine tracker roughly agrees. So we’ll use 158 million people as our population.

Now, let’s go back to that estimate of baseline death rate, roughly 2.4/100,000 per day. That means that, for a population of 158 million vaccinated, we would expect to see ~3,792 deaths per day by random chance alone. How many days are encompassed in the VAERS data thus far? The handy-dandy time and date calculator let me get the answer without manually going through the months and figuring it out, and that number is 201 days. We would therefore expect to see 762,192 deaths by random chance alone in that period. Remember, too, that I’m using pre-pandemic numbers, which means before the increase in excess mortality due to COVID-19 hit. Also remember that children, for whom daily mortality is much lower, are not included and that the vaccinated population generally skews older, even since the Pfizer vaccine was issued an EUA for the 12-15 year old age group. Moreover, the data presented by RFK Jr. shows that the average age of death was 74.7 years, with 71% of the deaths in persons 65 and older.

Of course, I know as well as anyone else that this is a very crude calculation, as it could include someone who was vaccinated in December but died in June as well as someone who died within a day or two after the vaccination, thus diluting the numbers with mortalities for which causation would be more likely (those who die soon after the vaccine) with mortalities in which causation would be less likely (those who die months after the vaccine). So let’s go back to that baseline death rate. By random chance alone, we’d expect 2.4/100,000 people to die within a day after vaccination, 4.8/100,000 within two days, 16.8/100,000 within a week, 72/100,0000 within 30 days. Again, this is a rough calculation, but I suspect that you get the idea. Now, if you look at the graph for the US for doses of vaccine per day, you’ll see that the high end of the number of people vaccinated per day is around 1:100 (although one news report says that the number of doses hit four million on April 2, which is a bit more than 1:100 people receiving a dose in a day, given that the US population is approximately 332 million). Using that number, though, we can see that, after that date, by random chance alone we’d expect to see 96 deaths within 24 hours, 672 within a week, and 2,880 within 30 days. That’s the highest. Towards the end of the most recent VAERS reporting period, the rate per day is more like 0.33:100. So, on the surface, you’d think that the addition of 2,000 more cases in one week would look horrible. However, there are also vagaries of how reports are made to VAERS. Again, it’s a passive reporting system.

There’s also another issue. One thing about VAERS is that anyone can search it. So I decided to see if I could replicate (or at least come close) to finding 9,000+ deaths due to COVID-19 vaccines in VAERS. You can do it yourself, too, right here, which provides links to search the VAERS database or to download the raw data for yourself. So I did a search, and I used the most generous criteria I could think of to maximize the number of deaths found in VAERS after COVID-19 vaccination. I did restrict my search to vaccinations administered from December 2020 to July 2021, but left most of the other criteria at the default, which was all dates going back to 1990, even though COVID-19 vaccination didn’t start until December 2020. This table is what I came up with:

You will note that it is very different from the table linked to in the CHD article. I get only 4,004 deaths, while somehow CHD got 9,048.

I played around with the search criteria, loosening things up as much as I could, such as including reports where the dates of vaccination and death were unknown. That got me to this table, and 4,242 deaths:

Still nowhere close to the number of deaths reported by CHD. So, finally, I eliminated all qualifiers other than death as the outcome and restricted to all COVID-19 vaccines. This got me this table:

That’s up to 4,255 deaths. Still nowhere near as many deaths as on the CHD website. So I tried one last thing. I clicked every “death” option, including neonatal deaths (even though COVID-19 vaccines are not given to infants), death of family member, and even death of pet. (Why that one is there, I have no idea, unless VAERS covers veterinary vaccinations, which it might, although I didn’t see any animal vaccines listed in the vaccine field.) There was no change. 4,255 deaths was as large a number of deaths reported after COVID-19 vaccines as I could find.

Quite frankly, I’m stumped. While I have to concede that it is possible that I’m doing something wrong, knowing RFK Jr. the way I do I strongly suspect that there’s something about the search parameters used that exaggerates the number of deaths. The problem is that RFK Jr. doesn’t list the search parameters used. In any case, unlike Dr. Kahn, I know my limitations and would be happy if someone could show me how RFK Jr. got those numbers. (Maybe I’ll email him, as I’ve been inadvertently included on emails to him and have an email address, although I don’t know if it’s the email address; i.e., one that goes to him rather than one of his employees monitoring social media.) The difference between antivaxxers and me is that I will admit when I’ve hit a discrepancy I can’t figure out. Antivaxxers, on the other hand, will just run with it.

[Note added after publication: A reader told me how to get to the CHD figure. I’ll add it to the post later. Apparently, I was being more complex than necessary. But, hey, it’s me.]

[Second note added after publication: I tried what the reader recommended. I can’t get it to work and produce the same number. I’ll keep trying every now and then.]

So what’s going on here? First, whether the figure is 4,255 or 9,048 deaths, that’s actually a very low number, well below the baseline rate of mortality for a population as large as the number of people in the US who have thus far been vaccinated against COVID-19. As I like to say, the baseline death rate of 2.4/100,000 deaths per day, each and every day, plus hundreds of millions of people will equal thousands of deaths just from the population baseline mortality rate. The same is true for adverse events reported after vaccination. Let’s just put it this way, in the US, just under 8,000 people die each and every day, day in, day out, for a total of around 2.9 million deaths a year, and that’s still under 1% of the population dying every year. Unless you take baseline rates into consideration, VAERS numbers are meaningless and easily used to frighten. Indeed, none of this is anything new. Antivaxxers were doing this for deaths after HPV vaccination and for sudden infant death syndrome after infant vaccines long before SARS-CoV-2 showed up in China and spread to the world.

The problem with VAERS

As I said earlier, even before there were safe and effective COVID-19 vaccines, my fellow science advocates and I who have paid attention to the antivaccine movement were warning that antivaxxers would weaponize VAERS reports to frighten people. We warned that, by random chance alone, coupled with the unprecedented vaccine safety monitoring system set up as the COVID-19 vaccines rolled out that solicited VAERS reports using a smart phone text messaging system (V-Safe), there would be a lot of reports of deaths and many other adverse events by random chance alone and that antivaxxers would widely report any news report of a death after vaccination as though it implied causation. Similarly, antivaccine propagandists like RFK Jr. have basically taken advantage of the openness of VAERS to set up a regular reporting infrastructure that leaps on each new week’s VAERS update to use it to spread fear of vaccines. You’d think that such supposedly brilliant physicians like Joel Kahn would understand baseline rates and that correlation does not necessarily equal causation, especially in VAERS reports, but unfortunately you’d be wrong, because yesterday he was Tweeting this:

Clearly, he is innumerate in many ways and, as I pointed out to him multiple times, does not understand VAERS.

So what is VAERS? Basically, VAERS was intended as an early-warning system. Anyone can report to it, not just doctors, nurses, and other health care professionals. Thus, even the VAERS website states:

VAERS is a passive reporting system, meaning it relies on individuals to send in reports of their experiences to CDC and FDA. VAERS is not designed to determine if a vaccine caused a health problem, but is especially useful for detecting unusual or unexpected patterns of adverse event reporting that might indicate a possible safety problem with a vaccine. This way, VAERS can provide CDC and FDA with valuable information that additional work and evaluation is necessary to further assess a possible safety concern.

Or, as a blog friend of mine put it:

VAERS is a feel-good system for those who think that there’s a link between vaccines and something terrible, but without an active investigation, the data is just above the level of totally meaningless. Most epidemiologists know it is valueless. Even the VAERS system itself says that the data cannot be used to ascertain the difference between coincidence and true causality.

For example, there is a background rate for mortality, across all causes, irrespective of whether an individual is vaccinated or not, and unless you understand the background rate, the vaccine “mortality” rate has no scientific meaning. In fact, we could provide a Starbucks coffee drinking in the car “mortality rate”, which may or may not have any causality whatsoever.

However, and many vaccine supporters miss this point, the VAERS system can be used to provide observational data that could be used to form a testable hypothesis, the hallmark of real science. Using VAERS as evidence to support a hypothesis, for example, “vaccines cause people to die”, is pseudoscience, pure and simple.

I’m not as hard on VAERS. I understand the value of having a system that anyone can report to, even if it sometimes accepts reports that the flu vaccine turned a man into The Incredible Hulk (this is not the first time I’ve mentioned this) and even if antivaccine lawyers looking to sue for “vaccine-induced autism” game VAERS by encouraging reporting of autism as an adverse reaction to vaccines. That being said, VAERS was always intended as a “canary in the coalmine” system, never as the be-all and end-all of vaccine safety monitoring. Antivaxxers love to misrepresent it as such because VAERS by its very design cannot infer causation from correlation, and often there isn’t even convincing correlation in its reports. All it can do is this, according to the CDC:

VAERS accepts reports of adverse events and reactions that occur following vaccination. Healthcare providers, vaccine manufacturers, and the public can submit reports to the system. While very important in monitoring vaccine safety, VAERS reports alone cannot be used to determine if a vaccine caused or contributed to an adverse event or illness. The reports may contain information that is incomplete, inaccurate, coincidental, or unverifiable. In large part, reports to VAERS are voluntary, which means they are subject to biases. This creates specific limitations on how the data can be used scientifically. Data from VAERS reports should always be interpreted with these limitations in mind.

The strengths of VAERS are that it is national in scope and can quickly provide an early warning of a safety problem with a vaccine. As part of CDC and FDA’s multi-system approach to post-licensure vaccine safety monitoring, VAERS is designed to rapidly detect unusual or unexpected patterns of adverse events, also known as “safety signals.” If a safety signal is found in VAERS, further studies can be done in safety systems such as the CDC’s Vaccine Safety Datalink (VSD) or the Clinical Immunization Safety Assessment (CISA) project. These systems do not have the same scientific limitations as VAERS, and can better assess health risks and possible connections between adverse events and a vaccine.

The CDC also notes that:

  • Reports may include incomplete, inaccurate, coincidental and unverified information.
  • The number of reports alone cannot be interpreted or used to reach conclusions about the existence, severity, frequency, or rates of problems associated with vaccines.

The VSD and CISA are much better systems in that they are not passive reporting systems and therefore aren’t subject to the same biases as VAERS. Funny how antivaxxers rarely mention them.

The problem with Dr. Kahn

Dr. Kahn has been a fixture in the Detroit area for quite some time. Unfortunately, he even practiced at one of the hospitals I used to practice at, holding the title of Director of Preventive Cardiology. He still apparently holds an appointment as clinical professor of cardiology at my medical school and another local medical school. In years past, I used to think of him as one of those “integrative cardiologists” who is too enamored of vegan diets as a cure-all for heart disease, but not someone into serious medical pseudoscience or conspiracy theories. Clearly, either I was wrong then, or something has changed. Now, Dr. Kahn is all-in on misinterpreting VAERS in order to fear monger about vaccines.

Worse, since Friday, I (and others) have tried to educate him about VAERS and why it doesn’t show what he claims the data show. This is a sampling of some of his reactions:

x

And, most obnoxiously:

Leading me to say this:

You get the idea.

The bottom line is that, for whatever reason, Dr. Kahn has—shall we say—expanded his brand beyond vegan “holistic” cardiology into all-out COVID-19 conspiracy theories and antivaccine pseudoscience, including ivermectin:

There are many more such Tweets. Let’s just say that I’ve discussed how ivermectin almost certainly doesn’t work on three different occasions now.

Unfortunately, for whatever reason, Dr. Kahn has decided that antivaccine and COVID-19 quackery are for him. But why? Basically, more and more, I’m coming to believe that “integrative medicine”, in which one “integrates” quackery with real, science-based medicine, all too often serves as a “gateway” to antivaccine pseudoscience. Sure, there are a lot of integrative medicine doctors who swear up and down that they are very much pro-vaccine, and most of them probably are. However, once you embrace one form of pseudoscience alongside science-based medicine, it becomes more likely that you will embrace others. Given how closely the rhetoric from antivaxxers about “natural immunity”, “toxins”, and distrust of big pharma aligns with similar beliefs among “integrative medicine” doctors, it shouldn’t be too surprising that a significant subset of such doctors goes down the rabbit hole of antivaccine conspiracy theories, particularly during a pandemic, when the sheer volume of conspiracy theories and disinformation is probably unprecedented.

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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.

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