Antivaccine nonsense Medicine Politics

A “not antivax” COVID-19 contrarian: “RFK Jr. makes ‘reasonable’ points”

Podcaster Joe Rogan conveyed a “debate” challenge by antivax conspiracy theorist RFK Jr. to Dr. Peter Hotez. COVID-19 contrarian Dr. Vinay Prasad, wanting to be on Rogan’s podcast, sucked up to both, saying RFK Jr. made many “reasonable” points. What gives? And should scientists ever agree to debate cranks?

Having just recounted yet again Robert F. Kennedy, Jr.’s 18+ year history of being not just rabidly antivaccine, but a leader in the antivaccine movement, all for the benefit of those who still labor under the delusion that his claims that he is “not antivaccine” but rather “for safe vaccines” are not a product of delusion or deception, I had not expected to discuss him again so soon. Unfortunately, since announcing his candidacy for the Democratic nomination for President, RFK Jr. has been riding the tide of antivax activism spawned by the pandemic, and wealthy tech bros have been promoting his antivax views. Thanks to his candidacy, he is also getting way more press than he has ever gotten before in his entire life. Unfortunately, much of it is overly favorable—the Kennedy mystique isn’t dead, I guess—and glosses over his long history of antivaccine activism, first in the hypothesis that mercury in vaccines was responsible for an “epidemic” of autism but then, when that hypothesis failed, in the service of general antivaccine conspiracy theories, which has led some of us to express frustration like:

This particular pseudonymous Twitter user nailed it.

Fortunately, not all stories have glossed over RFK Jr.’s undeniable history as an increasingly bonkers antivax conspiracy theorist, with one even calling him the “conspiracy candidate,” while others note how he has been cozying up to white supremacists.

So what brings me back to RFK Jr. again so soon after recounting his long and inglorious history? First, let me mention that the main COVID-19 contrarian in this story is Dr. Vinay Prasad, whose methodolatry and willingness to spread dubious misinformation about COVID-19 and preach against vaccinating children I’ve written about a number of times before. On Monday Dr. Prasad wrote an article on his Substack entitled Take RFK Jr seriously: what RFK Jr. gets right and wrong. I couldn’t resist responding, because it’s basically a paean to RFK Jr. as “reasonable” (other than, you know, a couple of those pesky antivax views about the childhood vaccine schedule, which Dr. Prasad blithely dismisses merely as not having any evidence to support). It’s as close as I’ve ever seen to Dr. Prasad just letting his antivax freak flag fly high as I’ve ever seen. Before I explain, let’s first go over a bit more background.

RFK Jr., Joe Rogan, and Elon Musk challenge Dr. Peter Hotez to a “debate” with RFK Jr., thus siccing their followers on him

Last week, RFK Jr. made an appearance on Joe Rogan’s podcast, where, as he is wont to do, he spewed his usual misinformation, pseudoscience, quackery, and conspiracy theories about vaccines and autism, COVID-19 and vaccines, ivermectin and hydroxychloroquine, 5G (which, he thinks falsely, causes cancer), and the like. He even called back to his 2005 antivax “coming out” article Deadly Immunity, in which he popularized what I like to call the Simpsonwood conspiracy theory, which claims that in 2000 the CDC had met at the Simpsonwood Conference Center in suburban Atlanta in order to suppress data that supposedly demonstrated that mercury in childhood vaccines had been responsible for a surge in autism. (Because everything old is new again in antivax land and the Simpsonwood conspiracy theory had been resurrected by antivax tech bro Steve Kirsch, conveniently enough I just mentioned it and why it’s nonsense recently and discussed it in more depth in December.) It was so bad that Anna Merlan aptly described the interview as an “an orgy of unchecked vaccine misinformation, some conspiracy-mongering about 5G technology and wifi, and, of course, Rogan once again praising ivermectin.” Her article plays a big role in what happened next.

Here’s what I mean. On Saturday, friend of the blog Dr. Peter Hotez Tweeted a link to Merlan’s article:

By Saturday afternoon, Joe Rogan was conveying a challenge by RFK Jr.:

To which Dr. Hotez responded:

“This is the way.” Do not agree to debate cranks in a venue moderated by someone who has proven himself to be either a credulous fool or a cynical showman who doesn’t care about the truth of what he’s presenting, take your pick. (Actually, he’s both.)

Rogan, as you might imagine, was not mollified. He did, however, reveal something important about these “debates” and debate challenges by “debate me bros,” even as he received tactical air support from the billionaire tech bro who purchased Twitter last year:

And there you have it, the message that cranks always try to push with respect to their “Debate me, bro!“ challenges. That Musk amplified the message shows that he’s all-in with this sort of performative nonsense.

Meanwhile, other wealthy players tried to ratchet up the pressure:

Just say no. This is the equivalent of me offering $250. It’s not a large sum to these people, who are deeply unserious and acting in bad faith.

And other antivax grifters saw an opening:

Seriously, these new school antivax grifters can’t wait to get some of that old school antivax energy.

Here’s what I mean by “revealing something important.” Rogan issued the challenge publicly because these challenges to “debate” are not about science, medicine, or getting at any sort of accurate information or truths. They are theater, nothing more. Real scientists debate all the time in the academic literature, at conferences, and among themselves as they work. Staged “debates” like this are not really debates. They are opportunities for cranks to appear on the same stage as a respected scientist like Dr. Hotez and then firehose, Gish gallop, make shit up, misrepresent and cherry pick studies, and basically flood the zone with bullshit to their heart’s content and then declare victory. I’ve explained more times than I can remember now why agreeing to staged debates like this with a crank like RFK Jr.—especially one moderated by a credulous twit like Joe Rogan—is a very bad idea for scientists, physicians, and skeptics. Even debaters very knowledgeable and knowledgeable about the relevant conspiracy theories and misinformation likely to be featured can be hard pressed to deal with a pseudoscience-pushing crank. We, after all, are bound by science and the truth. Cranks like RFK Jr. are not.

This challenge led to Twitter basically blowing up on Sunday, with hordes of purchased Blue Check Elon Musk and RFK Jr. fans swarming Dr. Hotez and any science communicators who defended him or pointed out how ridiculous and pointless it would be for a respected physician and scientist to engage in a debate with a slick antivax politician moderated by a host who’s demonstrated his love for pseudoscience that brings in viewers.

There were real consequences to this pile-on too. The social media swarming went beyond social media, with one antivax crank showing up at Dr. Hotez’s house with his smartphone:

Everyone should block this fool.

Mr. Rosen went on to mock all the stories about his harassment of Dr. Hotez on the basis of Dr. Hotez’s having been civil with him. Personally, had Mr. Rosen accosted me on my own property I would have calmly but in no uncertain terms told him to leave or I would call the local police, but instead Mr. Rosen posted this on Saturday evening:

Dr. Hotez, however is a class act:

I wish Dr. Hotez well on his mission. It will not be easy.

Unfortunately, that did not stop the threats:

Here we go with the old antivax fantasy of “Nuremberg”-like tribunals to punish provaccine advocates.

Into this social media frenzy on Twitter boldly stepped Dr. Prasad, who has been angling to get on the Joe Rogan Podcast since at least two years ago:

“Probe the parts I disagree with”? Like what, the bit about wifi causing cancer? About there being microchips in the COVID-19 vaccines? About vaccines causing autism? Do tell, Dr. Prasad: What is it that RFK Jr. says that you actually disagree with and why?

I suspect that RFK Jr. wouldn’t “destroy” Dr. Prasad, because, as you will see, Dr. Prasad seems to agree with him on almost everything, which brings us back to his article, in which, apparently inspired by the Twitter exchange above, he basically says as much, brushing aside RFK Jr.’s Alex Jones-level beliefs as though they represent just minor disagreements that a few randomized controlled clinical trials (RCTs) and some reasoned debate would disabuse him of. Either he’s being incredibly naïve—after all, when do dyed-in-the-wool conspiracy theorists ever change their minds?—or calculatingly disingenuous. You be the judge!

Dr. Prasad sucks up to Joe Rogan and RFK Jr. and repeats at least one favorite antivax trope in the process

So let’s circle back to Dr. Prasad’s article, Take RFK Jr seriously: what RFK Jr. gets right and wrong, which massively sucks up to both Joe Rogan and RFK Jr., in which he blames the media thusly: “Because the media screwed up Covid19 policy & because of how they choose to cover him, RFK Jr’s influence is destined to grow.”

In fairness, he’s not wrong that RFK Jr.’s influence is likely to grow,. That’s mainly because of how the press chooses to cover him, which is as an interesting candidate who injects something to write about in the race for the Democratic nomination, which, given that President Biden is running for reelection and expected to win his party’s nomination handily, was very, very boring indeed to political reporters, who like a horserace. Too many stories gloss over the sheer bonkers nature of RFK Jr.’s antivax, COVID-19, and other conspiracy theories, emphasizing the few seemingly reasonable things he says—e.g., about regulatory capture and the like—while blithely handwaving away the Alex Jones-level conspiracies. Of note, even RFK Jr. himself did not mention vaccines when he announced his candidacy and does seem to try to deemphasize his past antivax utterances likening “vaccine-induced autism” to death camps during the Holocaust, statements that seem to trouble Dr. Prasad not at all. Indeed, the strongest criticisms that Dr. Prasad can seem to muster about RFK Jr.’s antivaccine views seem to consist of mentioning “RFK Jr’s more troublesome points of view” and writing things like:

Yet, while he gets some things right, he gets other things wrong.

Orac ask: What, pray tell, does RFK Jr. get “wrong”? Oh, those pesky things he believes about wifi causing cancer, 5G contributing to COVID-19, vaccines causing autism, and those microchips in vaccines?

Early in the piece, Dr. Prasad writes:

RFK Jr holds views I disagree with. Mostly because I think he has not made a strong or sufficient case. Yet, I’m am willing to compromise on some of these issues, and I can devise a study that we will both agree upon that will adjudicate the question. If I were to speak with him, I would suggest that we agree to run these proposed studies, and let’s let that result settle the question. I strongly suspect he’s going to be incorrect about several things he believes. But I do think the best way to disarm his concerns is to sit down and agree upon the study that will settle the question. I think insulting him is very unlikely to be fruitful, yet that is the preferred media tactic.

“Views I disagree with”? “Because he has not made a strong or sufficient case”? How about views that are utterly bonkers, based as they are in pseudoscience, bad antivax science, and conspiracy theories? Views for which there is no reasonable science-based case, like vaccines causing autism? There, fixed it for ya.

The energy expended tap dancing around RFK Jr.’s conspiracist views is amazing, as is the oh-so-reasonable seeming suggestion that one can “disarm his concerns” by agreeing upon a study that will “settle the question.” (Hint: It’s been tried before. Many times. Yet here we are.) Moreover, it is not “insulting” RFK Jr. to call him a conspiracy theorist or an antivaxxer or a crank. He is inarguably all of these things, Dr. Prasad’s studiously twisting himself in a pretzel to downplay the bonkers notwithstanding. Indeed, it is primarily the cranks who misrepresent being called “cranks” as “insults,” all in order to defang and downplay such observations. Of course, I have to wonder if even Dr. Prasad truly believes the line of BS that he just laid down. After all, he wants to be on Joe Rogan’s show so bad that it hurts, and accurately characterizing RFK Jr.’s views would not serve that purpose. So instead he flatters RFK Jr.:

Acknowledging that one can agree and disagree with someone, and before I get to the specific, let’s be honest about his appeal. RFK Jr is an incredibly powerful speaker. He’s hyper-articulate. Although he suffers from vocal cord dysfunction, that may even enhance his perception rather than diminish it. It may even be a feature and not a bug. I think many are underestimating how persuasive he is. He is poised to be one of the most influential figures of the next decade. Dismissing him outright will only backfire. When have we made that mistake? I wonder.

I’ve never “underestimated” how persuasive RFK Jr. is, his spasmodic dysphonia notwithstanding (which, it’s been revealed, RFK Jr. blames on a flu vaccine he took before he turned antivax. Indeed, it is his very slickness as a lawyer (and not a scientist) that makes me think RFK Jr. would be very skilled at firehosing and Gish galloping in any debate, particularly one hosted by someone like Joe Rogan. Of course, if his “opponent” were Dr. Prasad, RFK Jr. wouldn’t need to do much of either, because Dr. Prasad, apparently, agrees with most of what he says. That is, in fact, one reason why I think Dr. Prasad’s thirsty gambit to be on Rogan’s show will fail. The “debate” isn’t about getting at the truth about vaccines. To RFK Jr., it’s about humiliating a critical scientist, asserting power, and rallying the antivax faithful. To Joe Rogan, it’s about entertainment, and having two guys mostly agree with each other without any real conflict would not make for particularly compelling video.

Next up, Dr. Prasad does a whole lot of “both sides” rationalization:

On Covid-19 policy, RFK Jr is absolutely correct that lockdowns were a colossal failure and abandonment of the poor. He’s absolutely correct about many of the issues with the Covid vaccine program. I think the vaccine lowered death rates in older, un-immune people, but pushing COVID vaccines on people who already had covid was insane. Pushing repeat mRNA COVID vaccines on young men at high risk of myocarditis and college mandates resulted in net harm. RFK Jr is correct about many of Tony Fauci’s lies. One has to give RFK Jr a lot of credit for speaking openly about these topics. Obviously he’s completely wrong about ivermectin and hydroxychloroquine. The burden is on those products to show benefit in randomized studies and they have never met that burden. You can always fault the available randomized trials (as he does for dosing), but if you believe something is helpful, you must show how it will help. Mask zealots fault mask RCTs, but the burden is on them to prove how they might help. Mask supporters and ivermectin supporters are actually more similar than they know.

Notice the false equivalence likening RFK Jr.’s promotion of the disproven repurposed drugs ivermectin and hydroxychloroquine to treat COVID-19 to those who have argued for mask mandates to slow the spread of COVID-19. It’s a clever rhetorical pivot to portray RFK Jr. as no “worse” than those “mask zealots” that Dr. Prasad rants about so frequently while portraying them as being like RFK Jr. Although Dr. Prasad is correct that believers in ivermectin and hydroxychloroquine always find a reason to discount the RCTs that show they don’t work against COVID-19 (just as RFK Jr. and antivaxxers always find reasons to dismiss large, well-designed studies that show that vaccines are not associated with autism), this is not the same thing as pointing out the problems with the mask RCTs that limited their applicability, particularly given the biological and scientific plausibility.

Dr. Prasad also shows his ignorance of history and the National Vaccine Injury Compensation Program (NVICP) when he rants:

When it comes to the structural issues in medicine, I think RFK Jr has some good points. The US FDA is working too closely with Pharma. In fact, it appears that they are doing their bidding. I totally agree with him that vaccine manufacturers should not have indemnification. They should be able to be sued. When it comes to covid-19 vaccines, they should have their asses sued. Every young man who had vaccine myocarditis it should be filing a class action lawsuit against them, and the school that mandated it. The laws that shield them from litigation are unjust in a democratic society. He is correct.

This is nothing more than a regurgitation of a standard antivax talking point about the NVICP and the Vaccine Court that it produced that I just debunked yesterday. In brief, in the wake of claims that the DPT vaccine had caused neurologic injury to children, there were so many lawsuits against vaccine manufacturers that pharmaceutical companies were strongly considering leaving the US market due to increasing difficulties obtaining liability insurance, with only one manufacturer still making pertussis vaccine in 1985. The solution agreed upon by Congress and President Ronald Reagan and codified in the National Childhood Vaccine Injury Act (NCVIA) of 1986 was to set up a special “no fault” compensation program for those injured by vaccines, the National Vaccine Injury Compensation Program (NVICP). The law also set up a special court with special expertise, commonly called the Vaccine Court, all funded by a tax on each vial of vaccine sold. Complainants denied compensation through the Vaccine Court still have access to federal courts and can still sue vaccine manufacturers this way. What the law does require is that complainants seek compensation through the Vaccine Court first. I also like to point out that, not only does the Vaccine Court bend over backwards to be fair to complainants by allowing them to posit “theories of injury” that don’t pass the Daubert standard for expert testimony, but it is a civil court, in which the preponderance of evidence—sometimes referred to as “50% and a feather”—wins. But that’s not all! The Vaccine Court pays the complainants’ attorney fees and reasonable expenses, too, win or lose!

Basically, Dr. Prasad is parroting an antivaccine caricature of the NCVIA of 1986, the NVICP, and Vaccine Court that antivaxxers will recognize as more than just a dog whistle.

This part drives home Dr. Prasad’s double standards when it comes to public health, nonpharmaceutical interventions for COVID-19, and, yes, vaccines:

I think it’s important to think about the fact that an environmental lawyer and an epidemiologist have different standards of evidence to conclude an intervention is net harmful. A lawyer is happy to use observational data, with persistent residual confounding, to build the courtroom case that something is a problem. But an epidemiologist will demand very pure data to believe something is harmful, especially when we think it offers alternative benefits. This is the crux of the issue with childhood immunization, and largely the root of my disagreement. 

At the same time, things get messy very quickly when you talk about toxic exposures in drinking water. What should the level of evidence be to restrict the use of pesticides if trace levels are found in drinking water? Obviously corporate interest would favor permissive standards. RFK Jr would be critical of that. Demanding very stringent evidence might be counterproductive.

Wait, what? Why isn’t Dr. Prasad demanding RCTs to guide setting acceptable levels of exposure to toxic substances in drinking water, the way he does for basically every public health intervention, be it masking, vaccines, or anything else? His justification is very weak:

I think there’s a philosophical difference between the evidence to prevent someone from engaging in pollution versus the evidence required to sell a product that you claim make someone better off. I have long been interested in this question, and we have published many papers on the topic. I suspect I am close to RFK Jr about regulating industrial pollutants.

Funny, though, how Dr. Prasad doesn’t see that in the middle of a new pandemic we might not have time to subject every intervention to RCTs before adopting it on a widespread basis. He seems not to recognize that some RCTs are not feasible or ethical. He does, however, seem to understand that the best evidence we can get for environmental toxins is likely to be physical and epidemiological, at least when it comes to environmental pollutants. I could get into the weeds and have a lot of fun playing with Dr. Prasad’s double standard here, but let’s move on.

No wait, just one other thing in Dr. Prasad’s suck-up to Rogan and RFK Jr.:

Yet on hepatitis B vaccination, RFK Jr makes a fair point that we could target higher risk populations. At least that could be the central question of a randomized control trial. He’s also fair to ask if the particular timing of doses is optimized, or if it could be given it a later date. That could also be a randomized trial. I think this century will see the pediatric childhood immunization schedule the subject to a multi-arm, factorial RCT. It is better to launch that effort now before public distrust gets too out of control.

It is a longstanding antivax trope to call for RCTs of the childhood vaccination schedule, despite the expense and the impracticality of such an effort. Indeed, I challenge Dr. Prasad to design such a “multi-arm factorial RCT” of the childhood vaccination schedule that would be (1) feasible; (2) not require hundreds of thousands or millions of participants; and (3) ethical. Remember, any placebo-controlled RCT would require leaving one group unprotected against potentially deadly infectious diseases. Even comparing spacing out vaccines versus not spacing them out would leave one group potentially more at risk of harm. As for hepatitis B vaccination shortly after birth, antivaxxers like RFK Jr. love to demand why we are vaccinating newborn babies against a disease that is primarily transmitted sexually, needle sticks, or sharing needles. It’s primarily a moral argument, much as objections to HPV vaccines given to preadolescent girls based on claims that such vaccination will encourage promiscuity are moral, not scientific, arguments. The idea is that my baby or child isn’t at risk because my child doesn’t have premarital sex, share needles, or engage in what I consider morally dubious high risk behavior. The subtext, of course, is that those “dirty vaccines” should be reserved for people who need them because they are dirty too.

In fact, there are sound scientific and epidemiological rationales for vaccination against hepatitis B shortly after birth, including maternal transmission to the newborn and the observation of hepatitis B transmission in school and daycare settings. Seriously, if Dr. Prasad had done the least bit of research or engaged in the slightest bit of intellectual honesty, he would have acknowledged the reasons why the CDC recommends a birth dose of hepatitis B vaccine. Not all countries have chosen that path, but we have, and there are very defensible scientific reasons to adopt such a strategy.

Yet Dr. Prasad continues:

In order to deal with RFK Jr’s more troublesome points of view, I think the only solution is to agree that the current surveillance system— and the current epidemiologic evidence is limited in many ways. We need to improve the current surveillance system on vaccine safety, so that we can adjudicate whether or not even some of his claims are true. I personally believe that most will not hold up, but I think one must acknowledge that the current surveillance system is flawed, and some may hold up. Why do I think this compromise is worth it.

He then goes on to claim that the “safety issues of vaccine induced thrombocytopenia and thrombosis and myocarditis were not detected in the United States” and that “learned about this from other countries.” That must be why two years ago the CDC Advisory Committee on Immunization Practices (ACIP) carefully considered early signals of myocarditis only seven months after the vaccines rolled out, three months before Dr. Prasad’s buddies dumpster-dived into the Vaccine Adverse Events Reporting System (VAERS) database to try to fear monger about myocarditis and COVID-19 vaccines in children. Interestingly, the story he cites notes that the Department of Defense had reported 14 cases of myocarditis that it thought might be associated with COVID-19 vaccines and that apparently at that point only Israel had seen such cases and started looking into a possible connection but were still unsure. Basically, the CDC was only marginally slower than a country like Israel, which is a much smaller country with universal health care and an integrated health system very different from that of the US.

Having parroted a favorite antivax talking point and proposed getting RFK Jr. on board with science by just doing a few impractical and unethical RCTs, Dr. Prasad assures us that he does understand “why many doctors are critical” of RFK Jr.’s statements on MMR and DTaP vaccines:

The news media keeps labeling RFK Jr as a conspiracy theorist and a charlatan, but that is a colossal mistake. He is somebody who on many issues is saying something deeply true. On other issues, I think he is off the mark. One of those is his views on wifi. Another is his views on early childhood immunization with MMR and DTAP. He has not made a strong enough case that the harms of these programs outweigh the massive benefits. I understand why many doctors are critical of his statements on these topics.

RFK Jr. “has not made a strong enough case that the harms of these programs outweigh the massive benefits?” There is only one appropriate reaction to such a monumentally silly statement:

Godzilla facepalm
Godzilla just can’t anymore with fools like Dr. Prasad.

More like he hasn’t made any credible scientific case that the harms of these programs outweigh the massive benefits. I mean, seriously. I’ve been discussing his massive output of antivaccine fear mongering going back almost exactly 18 years, when he first published Deadly Immunity in 2005. At least Dr. Prasad “understands why many doctors are critical of his statements,” such as likening vaccination to the Holocaust, trying to persuade Samoan officials that the MMR vaccine was dangerous in the middle of a deadly measles outbreak, claiming that today’s generation of children is the “sickest generation” (due to vaccines, of course!), or toadying up to President-Elect Donald Trump during the transition period to be chair of a “vaccine safety commission.” His “criticism” of RFK Jr. is weaker than the Kennedy family’s was when they called him out for his antivaccine activism before the pandemic.

Why do cranks demand “debates”?

Leaving aside just how thirsty Dr. Prasad is to get on Joe Rogan’s show with RFK Jr. and thus expose himself to his millions of viewers and listeners (something that is clearly motivating his brown nosing RFK Jr. and Joe Rogan), I will conclude with a couple of observations. The first observation is that Dr. Prasad’s pretzelizing himself to stick his nose so far up RFK Jr.’s anus that he can see RFK Jr.’s uvula from the inside, this is yet another example of how what I like to call methodolatry—a.k.a. the obscene worship of the RCT as the only valid method of clinical investigation and devalue to an inappropriate degree any evidence that does not come from an RCT—predisposes to COVID-19 contrarianism and even to denial and antivax views. It’s something I’ve been discussing since at least 2009.

The second observation is a question. Ask yourself this: Why is it that cranks like RFK Jr. and their enablers like Joe Rogan and Elon Musk love to issue these sort of “debate me, bro” challenges? It’s almost always the cranks like RFK Jr. challenging scientists and science communicators and only rarely the other way around, with a legitimate scientist or science communicator challenging a crank to a “live debate.” Worse, famous science communicators sometimes fall for it, as Neil deGrasse Tyson did recently when he accepted an invitation from antivax activist Del Bigtree for a “discussion” about vaccines.

The main reason that cranks love “live public debates” with legitimate scientists and physicians so much is because the most common formats favor science deniers because they are not bound by science or even the truth, particularly without a moderator bound to enforce rules. In such debates, cranks like RFK Jr. are usually free to Gish gallop to their heart’s content; that is, to “baffle them with a torrent of bullshit” that includes obscure studies, bad studies, studies that don’t support their points, and even irrelevant information that superficially to nonexperts appears to support their arguments. Unless a scientist or science communicator is not only very skilled at dealing with this technique but also very familiar with the deep well of studies ranging from the highly dubious to the good studies misrepresented by the science denier, it is easy to fall into the trap of trying to swat down each gallop in turn and have no time left to make an argument for science. Worse, most science communicators who don’t know the background behind a claim made by someone like RFK will generally just let the claim slide uncontested, giving the impression that it is being accepted it as accurate. What else can one do?

Another trap in these debates is the expected “civility,” the expectation that the scientist treat the crank as a learned colleague (or at least not as a crank but rather a reasonable person who disagrees). Cranks really, really, really hate being labeled as cranks, as Dr. Prasad clearly knows given how much he harped on how “insulting” RFK Jr. was a bad idea. He also knows that most people like to think of themselves as fair and open-minded, even if they are so open-minded that their brains sometimes fall out when it comes to people like RFK Jr. Thus, appealing to their sense of fair play by portraying someone like Dr. Hotez as unreasonably hostile to Dr. Prasad’s “truth teller” (except about those pesky Alex Jones-like conspiracy theories) and letting personal animus drive him rather than a drive to sit down with a horrible crank and sing Kumbaya while reasonably discussing whether Pfizer and Moderna are intentionally poisoning people or Bill Gates is putting microchips in vaccines as part of his quest for world domination is a tactic guaranteed to appeal to a certain type of person, particularly if that person is a fan of Joe Rogan and/or RFK Jr.

Besides serving as “bread and circuses” entertainment that promotes conspiracy theories and science denying propaganda in the absence of any evidence that will sway true scientific experts, the purposes behind these “debate” challenges include (1) for the conspiracy theorist to appear reasonable and not at all a science-denying conspiracy crank in front of a large audience; (2) to embarrass a hated scientific critic; and, failing that, (3) to portray that critic as a coward for having declined such a “politely” offered invitation. (Of course, public challenges of the sort that Rogan made are anything but polite.) That last one is no doubt why Rogan offered to the charity of Dr. Hotez’s what is a large sum of money to most people but a mere pittance to him and Ackerman upped that ante. It’s the reason why Rogan’s minions swarmed and harassed Dr. Hotez and one of them even showed up at his house, always an intimidation tactic. The idea was to make him look even more cowardly for having refused even when accepting would benefit a cause he champions.

Of course, Dr. Prasad didn’t see it that way, although his second Tweet destroyed my irony meter, given how desperately he wants to be on Rogan’s podcast and cable news shows:

I don’t know what scientific conferences Dr. Prasad goes to, but certainly we do debate in science. Of course, Dr. Prasad exemplifies wanting to be on media with large audiences. He was practically begging—no “practically” about it, actually—to be on Joe Rogan’s show with RFK Jr.

One argument that I’ve seen for scientists to accept such a challenge is the parade of opportunistic fools and ideological grifters like Dr. Prasad who rush in and say that they’ll take up the challenge where Dr. Hotez in their false assessment had “chickened out.” If you don’t accept, they say, then a lesser science advocate will and will lose embarrassingly. My response? So what? The message after the debate will be the same regardless of who represents the provaccine or prescience side—although in the case of Dr. Prasad there wouldn’t be much for RFK Jr. to “win” given that Dr. Prasad has already publicly conceded most of his arguments. It’s the old quote about the pigeon again. Debating cranks is like playing chess with a pigeon. No matter what happens, the pigeon will knock over pieces, shit on the board, and then strut around as though it’s won. If cranks want to find a much less famous and less knowledgeable patsy to do that to, let them. It’s far less damaging than if a prominent scientist is tricked or trapped into being the patsy.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

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81 replies on “A “not antivax” COVID-19 contrarian: “RFK Jr. makes ‘reasonable’ points””

“But I do think the best way to disarm his concerns is to sit down and agree upon the study that will settle the question. I think insulting him is very unlikely to be fruitful, yet that is the preferred media tactic.” – Vinay Prasad.

This just shows how ignorant VP is. This has been done, people tried to mollify RFK Jr. with studies and explanations in the past, and it ALWAYS fails. VP is just an attention whore. He’s not competent, in my opinion. He has no credibility.

Good to see this. I had seen the video version pop up on my YouTube feed and thought about giving it a look but you saved me the trouble.

I think anyone interviewing or “debating” RFK, Jr should start by asking him if he has decided that thimerosol really does NOT cause autism. If he had any intellectual integrity he would have conceded that long ago, about the time he changed the name of his World Mercury Project. But they need to confront him head-on about all the cray-cray, not dismiss it as trivial.

Someone like Dr Dan Wilson or Mehdi Hasan could debate Junior effectively. But Rogan’s podcast would not be a good forum for that. And as you said, Prasad is far to cozy with most of Junior’s views even to make it interesting. It would be a bit like Damania telling Prasad and Makary that he thinks we should give Covid-19 vaccines to some people.

And when the political season really kicks in around September they should also give him hard questions about the rest of his political agenda. For instance, he has called for a “free market energy policy” which he claims would lead to cleaner, safer energy. For instance, how would he deal with Mercury Pollution from Coal Plants? And of course the “little things” like voting rights, abortion rights, LGBT rights, fighting against racism, providing a quality education for all Americans, improving the standard of living for the ordinary working people, etc., etc.

Kennedy only changed the name of his World Mercury Project a few years ago. When Kennedy launched it in 2016, there was much eye-rolling, because thiomersal had been removed from childhood vaccines in the US for a decade and a half.

I suspect Kennedy’s answer will be that thiomersal does cause autism, as do aluminium adjuvants, and too many vaccines all at once. This is because it is always the vaccines, no matter how much evidence is provided. The goalposts are just moved every time.

Which metal was replaced with which metal?

I think it is safe to say that labarge has no clue what roles mercury compounds and aluminum compounds have played in vaccines.

Or it may not. Thiomersal was not replaced just removed (it is a presertativnot needed in one shot vials). And again, “they”. Who are thry ?

Mehdi had a segment on RFKj on his weekend MSNBC show: he’s an advocate of debate generally, of course, but explained why he thinks ‘debating’ RFKj on Rogan would be nuts, covering many of the points Orac has made.

The wider point I’d make from a communication theory standpoint is that the utility of any form if debate is ENTIRELY dependent on the rules/terms (including e. g. the venue etc.). It’s totally bogus to insist an opponent accept your rules. Debates only occur when opponents agree on the terms, and stick to them. The reason live Presidential debates suck is the parties will only agree on rules that grossly limit their probative value.

In contrast, right now Orac and Prasad are engaged in a relatively no-holds-barred debate on the subject of Rogan’s challenge. This is no less a public debate for being contested in posts here and Substack (and elsewhere) over time, or there being a variety of other folks writing about it. In this case the form of publication determines the rules (for better or worse) and both participants show acceptance of those rules by choosing to participate in writing about the subject.

IOW: Rogan, Musk, Prasad are ignoring that there already is an open public debate between RFKj and pro-vaxers, and just trying to win points in that contest by accusing Hotez (absolutely falsely) of cowardice. This is the sort of dubious tactic that broad public political debate in dueling columns allows, though of course it also allows the opponent to try to flip the script by calling out the strategy, as Orac has done here.

It could indeed be entertaining, and maybe even enlightening, to have Mehdi Hasan engage RFKj in a live moderated debate on politics and policy (not ‘science’). Since I doubt RFKj (or his Bannon and Bro chorus) would accept truly fair terms, Hasan could maybe have some fun with a challenge of his own.

But yeah, Rogan’s not going to book Prasad to debate RFKj. You know who should offer to accept a debate with RFKj on Rogan? Marianne Williamson.

“.. there is already an open public debate between RFKj and pro-vaxxers..” which isn’t subject to conditions that enable liars, fakers.

Mehdi Hasan debating RFKj on politics? Agreed. It might be easy to do because Hasan has his own show. Who might avoid a debate then?

–Insulting people who advocate that vaccines cause autism and who dismiss general hiv/ aids science is perhaps the right response.

–Now that Dr Fauci is less visible, working for an EU based company I believe,
Prof Hotez is anti-vaxxers’/ PH denialists’ biggest target.

–Even hucksters like Gary Null target Hotez’s “failure” as a scientist: what has he ever done?
Nothing this loony critic could understand.
Similar, Sharyl Atkisson. RFK jr’s various followers.

“–Now that Dr Fauci is less visible, working for an EU based company I believe,”

I do hope that he wasn’t literally driven out of the US by all the complete f$ckwits, and this was just his next natural step?

” Why is he now so attractive to COVID-19 contrarian doctors?”

as to this, are you sure you have never heard of the Trojan Horse?

that’s what junior is. he is being paid to be a monkey wrench to the dems. I have never seen such outright nasty politics as the GoP have created for themselves over the last 10 years, but this strategy is far from uncommon.

I don’t know.
He took an advisory position to the director at Siena Biotechnopolo.

Burly which ones are the cranks? In the age of COVID? Masks,wet markets and negative efficacy – 🤔 Btw is the Wall Street journal now taken over by conspiracy theorists because they too conclude Covid came from the lab? Maybe it’s a conspiracy of antivaxxer grifters taking over the UK times, Wall Street journal and NY post. Goodness me they’re everywhere!

Three publications owned by Murdoch’s News Corps. For someone that prides himself on his ability to follow the money, John has some remarkably large blind spots.

Conspiracy? From the Dominion case, I gather that Murdoch will platform whatever views he thinks are profitable, even if he personally knows them to be false. Follow the money, John!

I’ll edit my second sentence to avoid unsupportable generalizations: “From the Dominion case, I gather that Murdoch is not above platforming views that he knows to be false if it is profitable to do.”

I’m not even claiming that the lab leak stories are false. My impression is that Dr. Harrison is correct and that much of the evidence for a leak is a combination of the circumstantial and the speculative. Various outlets may nevertheless be writing these kinds of stories knowing that they will appeal to a particular kind of audience. That you on the one hand suppose that the entire medical profession has been compromised by big pharma while on the other hand seeming to preclude the possibility that the way that your preferred media outlets cover certain stories isn’t corrupted by the profit motive indicates just how incoherent your thought process is.

Murdoch encouraged the “election was stolen” conspiracy, even though he knew it was untrue. So I don’t see why not.

I have lived my whole life with the disruptions caused by the lies the Murdoch press published, so I have no illusions about him.

Murdoch certainly. Shellenberger too i guess. Although he may be just a believer..
To me in effect they both seem to be common zone-flooders. Zoneflooding has aims…

For people that are supposed to be able above avarage to weigh information and it’s quality, it’s very strange that such people reject the (at least according to ‘my own research’ and conclusions) by far most plausible story about the source of the pandemic (namely that it just happened again in the way it always happened. Not only as a common sense assumption, but in this case also underpinned with comprehensive (just not final) evidentiality and logic, hardly needing any assumptions left) in favor of a far less plausible story, needing a lot more assumptions (that for a part in the meantime have even be found to be probably untrue (if we can believe e.g. the (also quite comprehensive) EcohealthAlliance-letter. Allthough not that EcoA lying would render the natural origin story much less far more plausible).

I at least think that’s very strange! (But maybe they were just lazy
that day..)

(Oh , more EcoA letters even! A lot of extra work. (Also a zone-flooding aim!))

For this imo ‘most plausible story’ i would like to link this imo really great! groupblog/publication:

Writer The Gift of Fire wrote a whole range of very thorough articles about the subject. I’d suggest reading them all.
(And the rest too. Very relaxing, reading some sanity now and then…)

(Elsewhere this story may be found too, i guess. I just found it here..)

We’ve been over this. Stop conflating the lab leak with the other batshit insane stuff you believe.

The lab leak is at least possible. The other nonsense you believe absolutely is not as has been proven to you ad nauseum.

The answer, of course, is that it depends.

I know you think you’re clever with these kinds of quips. I only wish you could see how pathetic and foolish you sound to any rational adult.

You remind me of this old Army buddy of mine. He’s a bitter, angry, sarcastic guy ever since his wife had enough and left him over his crazy-ass Trump/Qanon bs. I’m one of the few people who still talks to him.

Now all he goes on about is men’s rights, vaccine/lockdown nonsense, aliens will be revealed any day, etc, etc. He does nothing to better himself or the world and takes no responsibility for his lot in life.

He makes stupid, self-pleasuring, pseudo intellectual quips like yours all the time. He spends most days and every night alone. He thinks he is “winning” just like you do.

But which is it? 6 or 10? Droplets or aerosols? Seems like a question we should have known the answer to wrt coronavirus from the start, no?

@Labarge: I think the current consensus is farther is better and wear a quality disposable mask if in a crowd or if you’ve been around someone sick, because it’s both droplets and aerosols. But early on, there was optimism, based on primarily droplet-spread SARS being the closest relative (plus incentive toward white lies to not leave doctors without masks for those who suspected aerosols early on), that 6 feet and cloth masking if sick or around sick people was enough.

See, to conspiracy theorists and extremists, there are just lies and Truth, and you can tell which is which by who says it, and done. But to Skeptics, there is a large gray scale from well-tested knowledge, to honest ignorance, to situations actually changing, to white lies, to whoppers, to egregious whoppers. Pure Truth is unattainable, but we aspire to the pale side of the gray scale and both keep an eye out for the whoppers (and yes, the white lies too) and seek to correct the honest ignorance and adapt to the changing situations.

“But which is it? 6 or 10? Droplets or aerosols?”

It shouldn’t really need explaining to an adult of average intelligence but the safest distance possible is about 12,400 miles and the most dangerous distance is zero with a snog. Naturally there’s a scale of danger between these two points with the level dropping to effective zero in the first few yards……

……depending on weather conditions, dickheads, local politics, mask quality, variant, level of sickness, how passionate was the snog…..

About 5 feet (1.5 metres to be precise) apart was recommended in Australia. It varied between jurisdictions, because there’s no magic cutoff distance.

Right. I’ve seen demonstrations on the news illustrating how far material can travel from coughing etc. 5 or 6 feet was very useful.

This reminds me of how deniers laugh at masking rules for restaurants- Bill Maher even made a routine about it-
People wear masks walking in the restaurant and sit down and then take them off! WTF! does the virus avoid tables?

OBVIOUSLY he wasn’t thinking because:
–you want to reduce the total time you are unmasked
–you can’t be masked and eat
–when you enter/ leave/ pay, you are interacting with people you hardly know whereas when you sit, you’re with people you have already interacted with/ live with
— being masked when you enter/ leave/ speak to a waitperson reduces the amount of time THEY are exposed to strangers/ unknown viral status.

Risks are cumulative.

just following up on this:

“The lab leak is at least possible”

not really. if you look at the papers published on the genetics of the virus, there are NO matching markers with any currently studied strain. none. Those genetics labs in Wuhan are not isolated; they are part of a large global chain of labs designed to study viruses. they keep public records. There is literally zero chance this came from one of those labs.

The Wall St. Journal has “concluded” no such thing, either in its news or editorial sections.

“because they too conclude Covid came from the lab?”

So… believe the media when it says what you believe but disbelieve the media when it says what you dont? You accuse the media of being the mouthpiece of the oppressor when you disagree but, apparently, uninfluenced when the same mouthpiece says something you agree with?


“vast antivax conspiracy…”

Well it’s more like a bunch of cats heading in the same general direction because someone is rattling the food bowl.

The world depopulation conspiracy is much better organised.

Interesting is that you MSM when it agrees with you. Evidence is still lacking, both lab leak ad masks. Give it to us.

Sorry. Mis-spelled the tecno part

But, according to La Voce di NY, Dr Fauci was recognised for his work by the University of Siena but was greeted by about 500 protestors with signs saying ” Fuck you, Tony” and other lovely sentiments. My translation.

Reading over this again, I’ve decided I’m more disgusted with Vinay Prasad than with RFK Jr. RFK Jr. is infinitely more honest than Vinay Prasad. He’s also not as smart and conniving.

Prasad’s desperate longing for attention, demonstrated by inserting himself into the Hotez kerfuffle, is truly sad. He’d love to get invited onto Rogan’s show, but that would be a dullbore and ratings flop, compared with the drama Rogan was hoping for with a Hotez-RFK Jr. “debate”.

If Prasad kisses antivax butt any further he’ll need to do an RCT for which brand of TP cleans his nose the best.

VP has that figured out. On the way up the GI toward the uvula, the stomach acid cleans the feces off his face.

The combo of stuff getting into his cranium via the ear canal is another matter all together, however,

I appreciate you calling Prasad out and agree with your criticism. I do want to say that we need to do better on compensating covid-19 vaccines harms. They’re not under the reasonably easy and reasonably generous VICP but under the counter measures injury compensation program (CICP) which is very ungenerous and hard to win in, even for people with valid claims.

That’s not okay.

But as you point out, the problem is not with the limits on manufacturers liability; in spite of what Prasad thinks, there isn’t likely to be a valid claim in civil courts for these vaccines, anyway. The problem is that the government compensation mechanism we provide is not good enough.

Vaccines serve a public benefit in addition to a private one, so the rare cases of vaccine harm should be borne by the public and compensated fast and generously, including in cases of doubt, and even if there’s no good claim of a product defect or negligence (which is what you would have to show in court, and is not easy – something Dr. Prasad appears not to appreciate).

But that’s tangential to your well taken criticism of his acceptance of antivaccine talking point and fawning over an extreme conspiracy theorist.

compensated fast and generously

Increasing the statutory number of VICP special masters from eight should have been done already.

I looked for Rogan’s demographics although I could guess
Morning Consult, March 2022, Eli Yokley:

–4400 Ss, 10% avid fans, 20% casual fans, 70% non-fans
–70% avid fans male
–lean heavily Republican, more conservative, half not Trump
–7 in 10 under 45
–fans and non-fans not big SES differences
–25% Hispanic, 64% white
–55% vaccinated
–more live in suburbs
–7 in 10 no college

They note Rogan’s derogatory comments about Black and Trans people and feature Tim Miller’s comments about moderates/ liberals on shows like this.

So RFK jr is not talking to an audience unlike his usual one.
I’ve noticed anti-vax’s more obvious recent appeals to conservatives although it’s always been there: of late, alties sound more at home with rightie luminaries than with lefty ones. The only common ground is possibly their love for Nature and rejection of meds etc. Of courses, religious themes seep through strongly:
love Nature or love g-d who created Nature.

Interestingly, Kennedy leans upon his more famous relatives – father and uncles- who strongly supported vaccines.

I listen to Rogan sometimes. Depends who he is talking to. I definitely fit that demo before I went to medical school.

I frequently find myself shaking my head or audibly disagreeing but I don’t ever feel like he says some of the thing he says or fails to correct certain things because he’s malicious.

His central theme seems to be that information should flow freely and that bad ideas or lies will be exposed in this way. I think Orac has covered the naïve nature of this belief.

I’m disturbed by the fact that he, Bari Weiss, and others are giving RFKj oxygen. He really believes some repugnant stuff. He praised Hugo Chavez for crying out loud. He’s on that loony WiFi CT kick.

Well, unlike Maduro, Chavez at least had some good points. What did RFKj praise him for? When was it? It seems out of step with RFKj’s recent embrace of the Right.

“I don’t ever feel like he says some of the thing he says or fails to correct certain things because he’s malicious”

so, it’s clearly because he’s an idiot then. As I always thought.

Sure. Maybe. He has a huge following. A very large number of people trust him more than they trust the media or government, for better or for worse. Calling him an idiot just makes them like him more. I hope you and others understand this.

Just because someone says the government is lying does not mean they are telling the truth.

I didn’t say that did I? I’m not defending Rogan. It’s a big world. A large portion of it doesn’t think like we do.

did you need me to refer you to the many papers that have been published on the value of ridicule in public discourse? no?
I thought not.

@ johnlabarge

Guess you missed the following: NPR (2023 Feb 27). Energy Dept. says with ‘low confidence’ that lab leak may be origin of COVID-19 AND Sony Salzman et al. (2023 Feb 27). COVID’s origins ‘most likely’ lab leak, agency reportedly says: The Energy Department’s assessment came with “low confidence,” per the WSJ. ABC News.

I found a dozen articles, all stated Energy Department’s assessment came with “LOW CONFIDENCE.”

Do you understand what “low confidence” means?

And, as I’ve written in previous comments, I don’t completely rule out a lab leak; but what is more important is the high death rate in US because of our underfunded public health system and mainly Republican dominated areas where lowest vaccination rates and lowest mask usage, etc., so, whether from nature or lab, it was stupid unscientific Republicans who think, I mean don’t think like you, responsible for far more deaths that could have been avoided.

So, you jumped on a report based on “low confidence.” Typical of you and others like you who don’t really understand many aspects of our world and don’t try to learn the basics, just post comments based on your paranoid conspiratorial mentality.

What is frustrating is that Junior is just above running through the standard laundry list of anti-vax P.R.A.T.T.’s.

Any reasonably competent interviewer could be prepared to counter and ask probing questions. But Rogan just listens and plays dumb.

Dr Yeti said, ” A very large number of people trust him more than they trust the media or government ..”

This is very true amongst the people I survey ( alt med/ anti vax. etc):
I imagine it’s because they identify strongly with anti-intellectual, less educated types who have axes to grind and attack experts and institutions even if it might ultimately harm them.

There are three types:
guys ( and it’s usually men) like Rogan, Bigtree who have no relevant education and are proud that they have figured things out on their own. They won’t be talked down to or be “educated” by the libs/ pharma whores/ Nazis/ Commies/ whatever.
AND those who are SBM educated like anti-vax doctors/ scientists who sound like the above but use bigger words and SBM terms. They rebelled against the Power. Denialists fall into this category- Malone, McCollough, Kory, Mercola, Tenpenny** etc.
FINALLY, there are pretenders who cosplay expertise with trumped up resumes, degrees, “published research” and “exposes”- Null, Adams, Sayer Ji

Followers enjoy big mouths taking down authority figures: that is much of their appeal. Of the last group, I’ve often ventured that they might have started out wanting to become a scientist/ medical professional but were not accepted by universities. A few claim poverty but as anyone who has been to university knows, brilliant but poor students receive aid, get loans, scholarships. Yet they also claim great athletic prowess. To be honest, their poor language skill gives their general ability away.

I’m unsure where to place RFKjr, Naomi Wolf and other educated people ( in diverse fields) who simultaneously pretend expertise in areas outside their studies and also appeal to the anti-expert sentiments of their audience.

These groups enable each other.

** now in trouble in Ohio

“I imagine it’s because they identify strongly with anti-intellectual, less educated types who have axes to grind and attack experts and institutions even if it might ultimately harm them.”

might? i would argue it HAS harmed people, including people close to them. Hell, how many times did you see a die-hard (literally) antivaxxer dying of Covid? I saw dozens. there must be tens of thousands by now.

disinformation kills, full stop.

Some RL Know-it-all BS…
my SO’s relative gives unsolicited medical advice despite lacking education:
she told him he needed to get scans for osteoporosis: it was a devastating condition that she had.
OBVIOUSLY, he’s a guy, at least 6′ tall, has big bones, has been very active since childhood and- wait for it- had imaging several times because he had surgery where the surgeon directly worked on his bones! No scans ordered.

[…] The first data about the adolescent vaccine emerged on March 31, 2021, when Pfizer announced their vaccine was 100% effective in stopping COVID infections in a randomized-controlled trial. (The study was later published in the NEJM). By this time however, the campaign against the vaccine was already well underway, and few doctors worked harder to ensure unvaccinated children contracted COVID than adult oncologist Dr. Vinay Prasad. […]

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