If you are already tired of hearing about RFK Jr. being the Secretary of Health and Human Services (HHS), buckle in. I get it – it can be exhausting. Don’t we already know everything we need to about what a medical crank he is? While SBM will not neglect the many topics that we cover, we certainly consider it a high priority to be a watchdog on someone who is at least in the running for the worst cabinet appointment in American history. As David Gorski correctly observed, this is an “extinction level event” for Federal health policy.
And he is turning out to be every bit as awful as we predicted, from downplaying a measles outbreak on his watch, to touting an ineffective treatment, all while remaining silent while his boss unravels a regulatory system meant to protect the public from actual toxins and poisons. Whatever environmentalist cred RFK had from his earlier career is now completely obliterated.
During his confirmation hearing, Senator Bill Cassidy, a Republican and a physician, generally considered the last hope of blocking RFKs confirmation, asked RFK if he thought vaccines cause autism. RFK responded that if he see scientific evidence showing that vaccine are safe he will accept it.
This was a transparent lie. RFK has had decades to review the ongoing research, and he has, and he has already cherry picked and distorted his way to his desired conclusion. More evidence will not change a flawed process. He relies on fatally flawed or even fraudulent studies, nit picks legitimate research, mischaracterizes what the evidence says, and essentially engages in extreme motivated reasoning to get to the conclusion that supports his narrative.
lt is therefore no surprise that RFK has made it an early priority of his time as HHS secretary to relitigate the question of a link between vaccines and autism. First – there is no scientific or medical reason to do another such study. There is extensive high-quality scientific research showing a lack of any link between any vaccine or vaccine ingredient and autism.
Having said that, as a general rule I am not opposed to doing more research to establish safety (whether for a medical intervention, food ingredient, or environmental substance). More information is generally better, and proving a negative (and therefore what is “necessary”) is always a relative thing. For example, here is a study from 2019, a national cohort study in Denmark, which concluded: “The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination.”
But context here is important. Is an additional study feasible, cost effective, ethical, and useful? The Danish study opportunistically used a large national registry. Why not look at data we already have to bolster reassurance for the safety of vaccines?
This is very different from the context of RFK Jr. proposing that the CDC conduct yet another study of a potential link between vaccines and autism. RFK has not demonstrated the need for such a study. Antivaxxers generally cite “public skepticism” as a reason – but of course, they are the ones generating that public skepticism by distorting and lying about the existing evidence.
Also, how would the study be done? As we have pointed out numerous times, a placebo-controlled study is not practical or ethical. You cannot withhold proven treatments from study subjects. Any such study would have to be observational, which is subject to potential confounding factors. It is reasonable to do observational studies (like the Danish study), because they can still be useful and have certain advantages, such as the ability to capture large amounts of data.
But what database of information would the CDC use to perform an observational study in the US? One potential candidate is VAERS – the vaccine adverse event reporting system. Unfortunately, this is a voluntary reporting system that is not systematic or filtered and is an extremely noisy database. As David likes to say, antivaxxers have been “dumpster diving” in the VAERS database for years, producing terrible studies with pre-determined conclusions.
Any study using VAERS or a similar source of observational data would have to be extremely rigorous, as bulletproof as possible, and as objective as possible so as not to put any thumbs on the scale to determine the outcome. Who can RFK Jr find to head such a study? Well, just as Trump found the worst possible person to head HHS, RFK Jr has apparently found the worst possible person to head such a study – David Geier.
David Geier is not a doctor or a scientist (and in fact was charged with practicing medicine without a license). He often works with his father Mark Geier, who is a doctor. The pair have a history of publishing horrible fatally flawed studies of vaccines. They are the kings of the “dumpster divers”. They have also promoted dubious treatments for their fake causation.
The choice of Geier to analyze the data in a new study looking for a link between vaccines and autism makes it perfectly clear what RFK Jr. goal is in pushing for such a study. It is not to build or shore up the consensus (which doesn’t need shoring up). It is not to gather data that is higher quality or more reliable than existing data. If that were the goal then you would tap someone who has extreme qualifications, who could assemble a team of the best and brightest, and whose objectivity is beyond question.
Tapping David Geier tells us everything we need to know – this is a hit job. In my opinion, Geier has zero credibility in the scientific community due to his long history of crankery in this area. He is not qualified as is evidenced by a long history of shoddy science and discredited conclusions.
As a result there is no possible outcome here that would be helpful. The scientific and medical communities will not take the results of Geier’s analysis seriously, as it is almost certain to be riddled with errors and poor methodology. The antivax community does not base their beliefs on scientific facts, so any such study will either reinforce their existing beliefs or will be summarily dismissed.
It seems pretty clear that the study itself and whatever outcome it produces will simply become more anti-vaccine fodder. It will be used to undermine public confidence in vaccines and be used to worsen the health and safety of Americans. With RFK Jr and David Geier in charge there is no other plausible outcome.
