RFK Jr. is not a serious person. Don't take him seriously.

Well, president-elect Trump has announced that he will nominate Robert F. Kennedy Jr. to be the Secretary of Health and Human Services (HHS), putting him in charge of most of the nation's public health and medical research.

I can't say strongly enough how unqualified RFK Jr. is for this job. He isn't qualified to come anywhere within a thousand miles of any medical or science-related issue, much less to be in charge of health policy for the whole country. Virtually everything RFK says about science is wrong–actually, it's worse than that, because he speaks with such absolutely certainty, despite being wrong, that he convinces people to take actions that end up hurting themselves. To a normal person, someone not accustomed to lying so boldly, these claims can be convincing.

Since Trump's announcement of the nomination, I've been seeing columns in major media outlets (I'm looking at you, New York Times and Washington Post) saying things like "hey, some of RFK's ideas aren't entirely wrong." 

Just. Stop. Even a broken clock is right twice a day. Don't take RFK Jr., or his nomination, seriously.

I don't want to try to list all of RFK's mistaken views, which would require a book-length column, but here are a few. Just last year he said, on the Lix Fridman podcast, that "there’s no vaccine that is safe and effective," and that the polio vaccine did more harm than good. (Both of those statements are wildly wrong.) In 2005, he wrote a long essay for Rolling Stone and Salon which claimed that thimerosal-containing vaccines cause autism (they don't), and that the government knew about it and had been covering it up:

“The story of how government health agencies colluded with Big Pharma to hide the risks of thimerosal from the public is a chilling case study of institutional arrogance, power and greed.” [quote from RFK Jr.]

The article was full of dramatic claims like this one. The only problem was, all of them were false. Rolling Stone and Salon eventually retracted the article and deleted it from their websites. 

In 2019, Kennedy visited the island nation of Samoa to spread his anti-vaccine message, sponsored in part by his anti-vaccine organization, Children's Health Defense. (The name is highly misleading.) Vaccination rates plummeted, and just a few months later a tragic measles outbreak began, causing 83 deaths and 1,867 hospitalizations. Kennedy published an article afterwards calling it a "mild measles outbreak," and in the same article claims (falsely) that vaccines themselves, rather than measles, caused the deaths.

RFK Jr. is someone who never admits he was wrong, even (or especially) when his mistakes cause the deaths of innocent children. Instead, his conspiracy-addled brain blames someone else.

And that's only a tiny sample of RFK's misinformation. He also loves raw milk, which I wrote about in 2014 and again in 2023. Raw milk sometimes contains nasty bacteria and viruses, but fortunately Louis Pasteur solved this problem in the 1860s, when he invented what we now call pasteurization. As I pointed out in my 2023 piece, bacteria just love raw milk. And you know what else is in raw milk but not pasteurized milk? Cow poop. Just don't tell this to RFK Jr. 

By writing columns saying "RFK Jr. has some good ideas" (which I won't link to, since that's just feeding the beast), media organizations are falling into a trap: they're taking RFK seriously. I'd like to ask these journalists: if Trump nominated a first-grader instead, would you write similar stories? Maybe something like "hey, this nominee has some good ideas about nutrition!" 

Don't do it. This nomination deserves ridicule and scorn, nothing more.

I've written multiple columns (both on this site and at Forbes, my former site) warning about RFK Jr. and his dangerous anti-vaccine craziness, starting with this 2014 piece where I called him out for his efforts to lobby Congress against vaccines. His primary obsession then–and he still has this obsession–was the mistaken notion that thimerosal, a harmless preservative that isn't even used in vaccines today, causes autism. This claim has been thoroughly debunked in multiple studies. 

In 2017, I wrote about "Trump's lovefest with anti-vaxxer RFK Jr." – a lovefest that apparently still continues, seven years later. That column was about Trump's promise to put RFK in charge of a commission on vaccines. Fortunately, that vaccine commission never happened, but today we face a much more dangerous threat, if RFK Jr. is confirmed as Secretary of HHS.

I've also pointed out that Kennedy is one of the "Disinformation Dozen," a group of twelve people who, as reported by the Center for Countering Digital Hate, was responsible for 65% of all the anti-vaccine disinformation online. And earlier this year I asked how he could possibly be so arrogant as to think he's qualified to be President, given that his only claims to fame are his name, which he inherited, and his anti-vaccine notoriety.

My problem with RFK Jr. is not just that he is wrong about vaccines, although that is the most immediate threat to public health. But he's also an idealogue, someone who holds onto his mistaken ideas despite mountains of contradictory evidence, and someone who simply makes up things to "prove" his points. 

And in that quote from him above, where he uses the phrase "institutional arrogance," highlights another danger: RFK Jr. is the one who is arrogant. He believes that he can substitute his own unsubstantiated beliefs for the knowledge of genuine experts, and why? Because he's a Kennedy, a man who has lived a life of great privilege, getting into Harvard as a "legacy" despite being expelled from prep school over his drug use, all the while pretending to be fighting against the system. He is too arrogant to listen to others, or to admit his mistakes.  

So no, I cannot take this nomination seriously. Children will die if RFK Jr. is put in charge of HHS. There are tens of thousands of people who are far, far more qualified than Kennedy, and I hope the Senate will refuse to confirm him. I'm not optimistic, but I hope a few Senators will look at the man's record and treat him with the scorn he deserves.

RFK Jr. is a famous anti-vaxxer. How does this make him qualified for President?

I’ve written about the anti-vaccine movement and its many proponents more times than I can count. So why write about it again? Because one of them is running for President of the United States.

Robert Kennedy Jr. is famous for two things: first, he’s famous because he’s the son of a former Senator and the nephew of a former president. His father, Robert Kennedy Sr., served as Attorney General under President John Kennedy and then as a US Senator. Tragically, both JFK and RFK were assassinated in the 1960s, and RFK might very well have been elected president in 1968, as he was leading the Democratic field when he was killed.

Having a politician as one’s father does not qualify anyone for office, although many children of politicians use their famous name to win elections. That’s clearly what RFK Jr. is now hoping for.

But what RFK Jr. is really famous for now, and for the past 20 years, is something entirely different. As I wrote nearly a decade ago, Kennedy is obsessed with the notion that vaccines cause autism. He’s particularly obsessed with the thoroughly discredited idea that thimerosal, a preservative used in some vaccines, causes autism.

His efforts to convince people of the harms of vaccines landed Kennedy in the number two position on the infamous list of “The Disinformation Dozen,” This list, created by the Center for Countering Digital Hate, contains “the twelve anti-vaxxers who are responsible for almost two-thirds of anti‑vaccine content circulating on social media platforms.” Yes, this is what RFK Jr. has been focusing his energy on, at least until he decided to run for President.

Ten years ago, Kennedy published an entire book on this topic, called “Thimerosal: Let the Science Speak,” and he promoted it both in the press and in the halls of Congress. He had personal meetings with then-U.S. Senator Barbara Mikulski and Sen. Bernie Sanders to try to convince them to take action based on his claims. Why is it that a scientifically unqualified anti-vaccine advocate got a private audience with two U.S. Senators? Because he’s a Kennedy.

RFK Jr. gives hundreds of speeches a year, and up until the early 2000s, he spoke mostly on environmental issues. I heard one or two of his interviews during that era, and he was quite convincing. His usual argument was that large corporations were engaged in some kind of conspiracy to damage the environment so that they could increase their profits. That made sense to me!

But then he found the thimerosal issue and went completely off the rails. One example was a Salon.com and Rolling Stone article (jointly published in both magazines) that he wrote in 2005, which claimed not only that thimerosal-containing vaccines cause autism, but that “the government” knew about it and had been covering it up. Kennedy wrote that

“The story of how government health agencies colluded with Big Pharma to hide the risks of thimerosal from the public is a chilling case study of institutional arrogance, power and greed.” [quote from RFK Jr.]

Alarming-sounding stuff. The article was full of dramatic claims like this one. The only problem was, all of them were false.

To explain, let’s review what thimerosal is and why it has probably saved many lives. There was never a conspiracy because there was nothing to hide.

Thimerosal is a preservative that was used in many vaccines for decades. Why? Well, as I’ve explained before, early vaccines (back in the pre-WWII era) were administered from multi-dose bottles, in which bacteria would sometimes grow. In one particularly disastrous incident in 1928, 12 children in Australia died from staph infections after receiving the diptheria vaccine from the same multi-dose bottle. After the introduction of thimerosal, bacterial infections caused by vaccination virtually disappeared.

Why the panic from RFK Jr. and others about thimerosal? Well, it’s a mercury-based preservative, and RFK assumed (wrongly) that the tiny amounts of ethylmercury in vaccines caused autism or other neurological problems. One problem with this idea is that ethylmercury is very different from environmental mercury, which is called methylmercury and which can indeed be toxic. Ethylmercury is cleared from the body far more quickly–and the minuscule amounts in vaccines have never been shown to cause any harm.

But many anti-vaxxers, especially RFK Jr., have continued to spread alarming stories about vaccines (particularly through Children’s Health Defense, an organization founded by Kennedy), and a disturbing number of parents have withheld vaccines from their children because they didn’t know who to believe.

In the late 2000's, in an effort to address the concerns of anti-vaccine alarmists, a special U.S. vaccine court conducted three lengthy hearings in which the anti-vax advocates were asked to present their best cases. One of the cases focused specifically on the question: does thimerosal in vaccines cause autism? In that case, the judge concluded:

“The numerous medical studies concerning the issue of whether thimerosal causes autism, performed by medical scientists worldwide, have come down strongly against the petitioners’ contentions. Considering all of the evidence, I find that the petitioners have failed to demonstrate that thimerosal-containing vaccines can contribute to the causation of autism.”

As a lawyer, Kennedy should have been able to understand this. The science agrees with the court: in study after study, scientists found no link between thimerosal and autism or any other kind of neurological disorder. That should have been the end of the matter, but of course it wasn’t.

Furthermore, as RFK Jr knows, thimerosal was removed from childhood vaccines in the U.S. over 20 years ago, and the rate of autism diagnosis continued to rise after that. This fact alone contradicts his major claim: if thimerosal was fueling an autism epidemic, then cases should have declined after vaccines stopped including it.

What was shocking to me, the first time I heard Kennedy talk about thimerosal in vaccines, was how absolutely certain he was. He came across as a man who remained utterly convinced that vaccines cause autism, despite the mountain of evidence against him.

After RFK Jr.'s Salon article appeared, scientists responded quickly and convincingly, pointing out its numerous flaws and distortions. Salon tried to fix the problem, issuing five corrections before throwing up their hands and removing the article entirely from their website. Rolling Stone also took down the article. Salon’s editor-in-chief wrote an apology, saying

“I regret we didn’t move on this more quickly, as evidence continued to emerge debunking the vaccines and autism link. But continued revelations of the flaws and even fraud tainting the science behind the connection make taking down the story the right thing to do .”

Kennedy has steadfastly refused to admit any errors, ever. When I wrote about him in the past, his website still displayed the original Salon article, without even the small corrections that Salon.com had made. (That website, robertfkennedyjr.com, no longer exists now that he’s running for President.)

Kennedy also published another anti-vaccine book just last year, titled “Vax-Unvax: Let the Science Speak.” (In case you didn’t notice, Kennedy has zero credentials to write a book about vaccine science, but that has never slowed him down.) And in case there’s any doubt about his leanings, early in 2024 Kennedy hired Del Bigtree, a “top anti-vaccine activist,” as his campaign communications director.

By ignoring the scientific evidence that shows that thimerosal and vaccines have no link to autism, Robert Kennedy placed himself firmly in the camp of conspiracy theorists and cranks. He’s also demonstrated breathtaking arrogance. He believes that despite his lack of scientific training, he knows the truth that every scientist who’s studied this issue has missed.

Even worse, Kennedy has used his fame to spread anti-vaccine misinformation, which grew far worse during COVID. Though I doubt he will listen to me (he’s ignored everyone else), Kennedy needs to take a hard look at the harm he’s causing to defenseless children, the elderly, and cancer patients, and anyone else with a weak or compromised immune system.

When I heard Kennedy talk about environmental topics, where I agreed with him, I was impressed by his passion and his seeming command of the issues. But having heard him speak about thimerosal and vaccines, I now realize that he’s a dangerous ideologue, willing to distort the truth so thoroughly that he can’t be trusted on any topic, even ones where I agree with him. His campaign for President, although certainly doomed to fail, is likely to increase the spread of his harmful anti-vaccine tropes.

Finally, I couldn’t help but notice that the bio on RFK Jr’s campaign’s website makes no mention of his anti-vaccine activism, even though it’s been his top priority for the past 20 years, and it’s the main reason he has the visibility he has today. It does mention “his nonprofit, Children’s Health Defense” but doesn’t say that the primary work of that nonprofit is to spread scary misinformation about vaccines. I’m just guessing here, but it appears that some of his campaign advisers have decided that being a famous anti-vaxxer might not be the best qualification for President.

Update, May 28, 2024: Since this story was published on May 27, RFK Jr. has been contacted for comment.  

Vaccines Show Surprising Link To Reduced Risk Of Alzheimer’s

Well, the anti-vaccine community is not going to like this one.

A growing body of evidence, buttressed by a new report out last month, shows that people who are vaccinated have a significantly lower risk of Alzheimer’s disease.

Yes, that’s right: in addition to the obvious benefit of protecting you from infections, multiple different vaccines have now been shown, in two large studies, to be associated with fewer cases of Alzheimer’s.

How big is the effect? Well, the earlier study, published about a year ago, looked at the flu vaccine. Scientists from the University of Texas Health Science Center, led by neurologist Paul Schulz, collected data on more than 1.8 million older patients from around the U.S., of whom half had received the flu vaccine and half had not. Their average age was 74 years, and the scientists examined health records for four subsequent years to see how many developed signs of Alzheimer’s in that time.

In the vaccinated group, nearly 48,000 patients (out of 936,000) developed Alzheimer’s during the four-year follow-up period, about 5.1% of all patients. That might sound like a lot, but in the unvaccinated patients, nearly 80,000 developed Alzheimer’s. To put it another way, patients who got the flu vaccine had a 40% lower risk of Alzheimer’s, 5.1% versus 8.5%.

It appears this benefit isn’t specific to the flu vaccine, though. In the newer study published this September, the same group from the University of Texas looked at three more vaccines: the Tdap vaccine (tetanus, diphtheria, and pertussis), the shingles vaccine and the pneumococcus vaccine. They were able to collect records on 1.65 million people, among whom more than 500,000 had received one or more of the vaccines. All of the patients were over 65 years old.

Remarkably, all three of the vaccines showed similar and quite significant benefits against Alzheimer’s disease. In an eight-year follow-up period, the risk of Alzheimer’s was 30% lower (7.2% versus 10.2%) in patients who had the Tdap vaccine versus those who hadn’t. For the shingles vaccine, the reduction in risk was 25%, 8.1% versus 10.7%. And for the pneumococcal vaccine, the risk was 27% lower, 7.9% versus 10.9%.

(Note that this study looked at the older shingles vaccine. The newer one, Shingrix, has only been widely available since 2017. The scientists hypothesize that the newer vaccine, because it’s more effective against shingles, may provide even greater protection against Alzheimer’s.)

So how might this work? Is Alzheimer’s caused by an infection, and the vaccines prevent Alzheimer’s by preventing the infection? Well, the short answer is no, probably not. Although we don’t know the cause of Alzheimer’s, we don’t have any strong evidence that it’s the direct result of an infection.

Furthermore, with data showing that at least four different vaccines offer similar levels of protection against Alzheimer’s, the evidence indicates that the effect cannot be specific to the flu vaccine, or the Tdap vaccine, or with any of the other vaccines or their ingredients.

The University of Texas group that published the study speculated that vaccines might work to protect against Alzheimer’s by “long-term reprogramming of innate immune cells,” also called “trained immunity.” This hypothesis is far too complex to try to explain here–and it involves immunology, which I don’t really understand myself and which is “absurdly intricate” as science writer Ed Yong put it. So let’s just say that this is an intriguing idea that needs more research.

And for anyone who thinks that getting an infection and recovering (instead of getting vaccinated) might offer the same benefit, that doesn’t seem to work: another study looked at precisely this question and found no connection between the number of influenza infections and the risk of Alzheimer’s. So the vaccine seems to confer a benefit that the disease itself does not. (I mention this because a popular–but wrong–claim of anti-vaccine activists is that you get better immunity from infection by catching the disease and then recovering. Not a good idea.)

Also, I have to add that these studies report correlation, not causation. So even though the effects are large and significant, we don’t know for certain that vaccines do something to directly prevent Alzheimer’s. Maybe people who get vaccinated also have other behaviors that help them avoid Alzheimer’s–although the study design tried to minimize this possibility.

Vaccines have enormous, extensively documented benefits: they prevent suffering and disease, and they’ve saved countless millions of lives. And now it appears that they offer something else: a lower risk of Alzheimer’s. So if you haven’t received your boosters, now you have one more reason to get them.

Are there two sides in the vaccine debate?

Headline from a debate about vaccine hesitancy,

from December 2020.

I keep getting into debates with people about the safety and efficacy of vaccines. I’m not talking about anti-vaxxers (though I’ve encountered plenty of them), but level-headed, rational people who genuinely have doubts.

Usually their doubts about vaccines come from dubious sources, but there’s so much misinformation out there, often coming from people with the letters M.D. or Ph.D. after their names, that I can understand why it’s confusing.

So let me engage in what is sometimes called “both-sides-ism” (a disparaging term, of course) and consider, briefly, the pluses and minuses of vaccines. While I’m at it, I’ll include some points specific to the Covid-19 vaccines.

Let’s start with the pluses, shall we?

1. Vaccines are the single greatest public health innovation in the history of medicine. They’ve saved millions of lives.
2. Vaccines completely eliminated smallpox from the planet. They have nearly (but not quite, due to anti-vax resistance) eliminated polio.
3. The new mRNA vaccines for Covid-19 are remarkably effective, have very few side effects, and are easy to modify as the virus itself mutates over time.
4. Vaccines protect us so thoroughly against childhood infections that many formerly common infections–including measles, mumps, and Haemophilus influenza–have almost disappeared.
5. Child mortality from infectious has plummeted in countries with robust early childhood vaccine programs.
6. The vaccine against human papillomavirus (HPV) will prevent many thousands of cases of cervical cancer, throat cancer, and other cancers, saving lives for decades to come.
7. Vaccines train our immune system to recognize and fight off infections, in many cases stopping the infection before we even have symptoms.

I could go on, but the bottom line is that vaccines continue to save millions of lives every year. They also dramatically reduce non-fatal illnesses, sparing people a great deal of suffering as well as long-term harms caused by some infections. (For example, mumps can cause permanent hearing loss.)

Given all of these benefits, you might wonder why everyone doesn’t get every vaccine available. Well, some people do, and part of the answer is simply that we don’t have enough vaccines for everyone, and many countries lack the public health infrastructure to deliver vaccines. But there are a few very small minuses, so let’s consider the downsides of vaccines:

1. The shot (or “jab”) hurts a little bit, and your arm might be sore for a day.
2. In very rare cases with some vaccines, some people might have allergic reactions. One example is that some flu vaccines are manufactured in chicken eggs, and people with egg allergies might react to those.
3. In a few rare cases, the live polio virus vaccine has caused some people to get polio. This vaccine was discontinued in the U.S. decades ago.
4. In rare cases, some people might have an immune response to a vaccine that causes ongoing inflammation. This includes the Covid-19 vaccine. However, the risk is much smaller than the risks associated with an actual infection.

That’s pretty much it. I hope it’s clear that the pluses far outweigh the minuses, but I imagine that some people looking at this list are wondering why I didn’t include a host of other supposed harms of vaccines, such as an increased risk of autism.

That’s because vaccines don’t cause autism or any other neurological disorder, as I’ve written before. Studies involving hundreds of thousands of people have been done to investigate this possibility, starting in the early 2000s, and all of the science points the same way: vaccines do not cause autism.

This supposed risk, and others like it, are inventions of the modern anti-vaccine movement. I won’t go into the history of the anti-vax movement here (I’ve done that before, many times), except to point out that many people promoting anti-vax misinformation are making lots of money selling “cures” for problems that don’t exist in the first place.

Anti-vaxxers continue to invent new harms caused by vaccines, and spread these claims on social media. Even with no evidence whatsoever, some of these claims catch on, because - well, the Internet.

Now back to the title of this column: are there really two sides to the vaccine debate?

Well, no.

Among doctors, scientists, and public health professionals, virtually everyone agrees with my first point in the “pluses” list above. However, we all recognize that when a foreign substance (a vaccine) is injected into one’s body, it’s possible that something unexpected might happen, and we must continually monitor vaccines so that we’ll know if something goes awry.

Let me end with an analogy. Seat belts in cars have been around for decades, and they’ve prevented millions of injuries and deaths. And yet people have argued (and probably still do) that it’s possible that wearing a seat belt might cause harm, for example if the belt jams and one cannot escape a burning car after an accident. (This seems to happen all too often in movies.) Thus you can’t argue that wearing a seat belt is 100% risk-free. Even so, wearing a seat belt is a really good idea, because the benefits are so much greater than the risks.

The same is true of vaccines. There might be some very, very small risks, but the benefits vastly outweigh them. And modern vaccines are safer than ever. There’s no serious debate about that.

We may get a universal flu vaccine, thanks to mRNA technology

The mRNA vaccines for Covid-19 are an amazing story: a new vaccine developed in a matter of weeks for a brand-new virus, SARS-CoV-2, at the beginning of the pandemic in early 2020. Clinical trials moved forward at record speed, and by December of that year we had an approved vaccine that was safe and over 90% effective against Covid-19.

Why not use this mRNA technology for other vaccines, especially for the flu? When I asked this question last year, I didn’t realize that a group of scientists at the University of Pennsylvania were already hard at work making this idea a reality. They’ve just published their first results, and the news is very encouraging.

But first, some background. Messenger RNA (mRNA) vaccine technology was the big breakthrough behind the Covid-19 vaccines. Invented by Katalin Karikó and Drew Weissman at the University of Pennsylvania, the idea is, at its core, very simple: take the genetic code for a protein from the virus (any protein can be used, and for Covid-19 this protein is called Spike), and inject it into someone’s arm. (The genetic code I’m referring to here is the mRNA that encodes the protein.) From there, the cells of the human host manufacture the protein–not too much, though, because mRNA quickly degrades once it’s in your body.

What’s kind of amazing is that the human immune system will then recognize the Spike protein as an invader, and generate antibodies against it. From that point on, the person who received the vaccine will be prepared to fight off a real infection by Covid-19. In other words, they’ll be immunized.

The actual development of this technology was much more complicated than I’m describing here. First, you can’t just inject mRNA without causing a lot of inflammation, which can be dangerous. Weissman and Karikó solved that problem by using chemically modified mRNA. Second, you need to package the mRNA in something; the scientists discovered that they could use little packages of fat molecules called liposomes to make an effective container. Eventually, they got it to work, and the rest is (recent) history. Both the Moderna and Pfizer/BioNTech vaccines use mRNA technology.

Now about this new “universal” flu vaccine, and why it’s so much better than what we currently use. The annual flu shot contains pieces of one protein from 4 different influenza strains. Each year, as the flu itself evolves, the 4 strains used in the flu vaccine are fine-tuned in an effort to keep up. In some years, this effort fails and the vaccine just doesn’t work very well, for reasons I explained here.

One huge problem is that the current flu vaccine process grows the flu virus in chicken eggs, and sometimes the darned thing just won’t grow! So in those years, the vaccine manufacturers must switch to another flu strain, one not as well-matched to what’s circulating. The result is a vaccine that sort of sucks, although it’s usually better than nothing.

With mRNA, you don’t have to grow anything in chicken eggs, and you aren’t limited to just 4 strains. As the new research shows, you can put ALL 20 known influenza strains in the same vaccine, and it protects subjects against all of them. It even protects against other flu strains that weren’t in the vaccine. To create the vaccine, scientists simply synthesized the mRNA that encodes the surface protein of the flu, hemagglutinin, from 20 different flu strains. The synthesis process is already being done on an industrial scale for the Covid-19 vaccines, and the same process will work for any mRNA, from any virus.

In the new research, scientists at UPenn led by Scott Hensley and Drew Weissman (the co-inventor of the mRNA vaccine) inserted all 20 flu strains in a single vaccine. They found “that the vaccine dramatically reduced signs of illness and protected from death, even when the animals were exposed to flu strains different from those used in making the vaccine.”

Did I mention that the subjects in the new study were mice and ferrets, not people? Well, this experiment is just the beginning: we’ll need further trials to test the safety and efficacy of this vaccine in people. Those are much, much more costly, though, and it’s not clear when or even if those trials will happen.

If we had a universal flu vaccine, we might no longer need the annual flu shots that we beg everyone to get each year. So when can we expect to see this new 20-strain vaccine?

Well, there’s the rub. Even if this new flu vaccine works perfectly in human testing, we might never get it. At the moment, we are completely dependent on private companies to develop vaccines. At the beginning of the Covid-19 pandemic, the U.S. created incentives for vaccine manufacturers by promising to buy millions of doses, and–fortunately–that worked. We’ve never tried anything like that with the flu vaccine.

We need to re-think our dependence on private, for-profit companies for this critically important public health technology. Perhaps it’s time for the government to step in and make sure we get this vaccine, whether through incentives like the ones used to create the Covid-19 vaccine, or through a direct effort by the government itself (as other countries have done) to create a universal flu vaccine. A universal flu vaccine will save tens of thousands of lives every year. Let’s hope we get there.

Why the new COVID vaccine boosters are safe and likely very effective

In case you haven’t heard, there’s now a new set of vaccine booster shots that protect against the latest variant of Covid-19, BA.5. This new variant is highly infectious, and the original vaccine doesn’t protect people against it as well as it protected against earlier variants.

Now, before someone takes that last sentence out of context, let me emphasize that the original Covid-19 vaccines are still highly effective at preventing severe disease and hospitalization. Anyone who isn’t vaccinated would be well-advised to get one of those, if that’s their only option.

But the new vaccines protect against two different strains of Covid-19: the original strand and the latest Omicron variant, BA.5. BA.5 just emerged in August, and it’s spreading extremely fast–it now accounts for 88% of the cases in the U.S. The FDA authorized these “bivalent” boosters on August 31.

My main point today is to explain how this happened so quickly, and why it didn’t involve many months of clinical trials the way that the original vaccines did. Some people have expressed suspicion about the speed with which these boosters appeared, but those suspicions are entirely unfounded.

First of all, we do have data showing that the new vaccine boosters are safe: a study showing these data for the Moderna booster just appeared in the New England Journal of Medicine. That study also showed that people generated robust antibodies against the BA.1, BA.4, and BA.5 Omicron variants after getting the new booster.

Second, to explain why that’s all the data we need, let me explain something about the flu vaccine. Many people are well aware that we have a new influenza vaccine every year–but what they might not know is that each year’s vaccine contains a different strain of the flu virus from the previous year. (Actually, it has up to four different strains, and any or all of them could be new.)

And yet we don’t run large, months-long clinical trials of the flu vaccine each year to measure it’s efficacy. Why not? Well, the basic designs of the flu vaccines (there’s more than one) have been tested in large clinical trials, and we know they’re safe. Replacing the vaccine strain with a new one doesn’t affect the safety of the vaccine, as decades of experience with the flu vaccine have now demonstrated. And because flu mutates quickly, we need to change the vaccine strain every year if we want the vaccine to work.

So that’s what we do: we change the flu vaccine strain to match whatever seems to be circulating, but everything else about the vaccine design remains the same.

This is exactly what scientists have done with the new Covid-19 booster shots from Pfizer/BioNTech and Moderna: they simply added a new strain, in this case to match the latest Omicron variant.

Both of the new boosters are mRNA vaccines, which means the vaccine contains a tiny bit of genetic code (mRNA) with instructions on how to make the “spike” protein from SARS-CoV-2, the Covid-19 virus. When you get the vaccine, your own cells follow those instructions to make a limited number of copies of the spike protein–but nothing else. The virus itself can’t be created without many other genes, and the spike protein alone can’t form a virus.

But your immune system recognizes that an invader is present–that spike protein–and it generates antibodies against it. After that, your immune system is primed to recognize and defeat Covid-19, if it ever infects you.

So the new boosters contain mRNA from the BA.5 spike protein as well as the original spike protein, and now you get protection from both old and new strains. Other than that, it’s the same vaccine as before.

The vaccine makers have produced safety data showing that the booster is just as safe as the original vaccine (see that NEJM article I mentioned above). But the FDA didn’t require them to prove that the booster really works better against BA.5, because that would require months of trials, and by that time the virus could mutate again. So while it’s possible that the boosters won’t help against BA.5, it’s very, very likely that they will.

One of the big advantages of mRNA vaccines is precisely this: we can swap out the mRNA easily, allowing us to respond quickly to mutations in circulating viruses. That’s a good thing, and it might be our only path to controlling Covid-19.

The bottom line is that the new boosters should be very safe, and they will likely provide much better protection against the current strains of the Covid virus. I’ve already gotten my booster, and I hope everyone else will too.

Europe's pause on the AstraZeneca COVID vaccine plays right into anti-vaxxers' hands

Last week, more than a dozen European countries suspended the AstraZeneca Covid-19 vaccine. They claimed it was out of an excess of caution, but instead they played right into the hands of those who continue to spread anti-vaccine misinformation.

On Thursday, the European Medicines Agency announced that there was nothing to worry about, that the AstraZeneca vaccine was safe, and that all countries should resume using it.

Too late, I fear. The harm has already been done.

I’ve been fighting the anti-vax movement for years, as have many other scientists, doctors, and science bloggers. We’ve seen their strategies, and they don’t play fair. They don’t care about facts, and they love to scare people. This latest incident gives them plenty of fodder.

First let’s talk about the “fear” part. A very, very small number of cases were reported in which people had blood clots soon after getting the vaccine. This sounds scary.

But wait a minute. We are giving the vaccine to millions of people. If you look at a group that large, how many of them will have blood clots in a given week? The answer, not surprisingly, is greater than zero.

So the first thing that public health authorities should have asked is, obviously, are we seeing more blood clots than expected? But no, they didn’t do that. Instead, out of an excess of caution (so they claimed), they halted the AstraZeneca vaccine while they investigated. This meant that literally millions of vaccine doses were not administered.

Fortunately the investigation took only a few days. What did they find? Well, here’s the answer, directly from the European Medicines Agency itself:

“the number of thromboembolic events reported after vaccination ... was lower than that expected in the general population.”

In other words, the vaccine clearly doesn’t cause blood clots. If anything, it might even prevent blood clots, because the number observed was lower than expected. (No one is claiming that it actually prevents blood clots; I’m just pointing out how wrong the decision to halt the vaccine was.)

Now the unfounded fear of vaccine-induced blood clots has spread through Europe and beyond. You can’t “unsay” something like this, and anti-vax websites and social media groups are already using it to scare more people. (I won’t link to any of them because I don’t want to give them the traffic.) Indeed, several northern European countries still haven’t resumed use of the vaccine, and Germany, France, and Italy are including a warning (an incorrect one) that the vaccine might cause blood clots. This is just wrong.

Halting the AstraZeneca vaccine without doing some very basic number-checking was a huge blunder. Let’s just hope this decision doesn’t cost too many lives.