A Not-So-Fond Farewell to Vinay Prasad

The Steve Urkel of COVID Twitter turned out to be incompetent at both drug regulation and being an authoritarian apparatchik

Note from Angie: I have no respect, as a scientist and an American patriot, for my colleagues who are willing to throw aside all professional and ethical standards to collaborate or be complicit with the undoing of American democracy. This is the first in a series of Never Forget posts intended to enshrine their deeds in the public memory and ensure that nobody ever forgets what they contributed to and participated in.

Credit: FDA

When hematologist and oncologist Vinay Prasad was installed at the Center for Biologics Evaluation and Research (CBER) by FDA Commissioner Marty Makary, I was alarmed. CBER is the division of FDA that approves vaccines, as well as blood products, probiotics, gene therapies, and immune globulins. Previously it was run by Peter Marks, the architect of Operation Warp Speed whose decades-long career as an experienced FDA regulator was cut short when HHS Secretary Robert F. Kennedy, Jr. forced him to resign on the grounds that he was too pro-vaccine. Marks’ departure provided an opportunity to install an anti-vax authoritarian lackey as the nation’s top regulator of new vaccines. Prasad eagerly stepped forward and prepared to live the contrarian podcaster dream.

I knew Prasad from social media, where we both became “COVID famous” for our perspectives on the pandemic. Those perspectives could not have been more different. While my approach was to provide information based on my experience as a virologist who has studied emerging coronaviruses since 2013, Prasad’s was basically to whine about COVID public health measures. Prasad never met a form of COVID risk mitigation that he didn’t complain about. Whether it was school closures, masks, or vaccines, Prasad didn’t like them and let everyone know via his many platforms.

Prasad was truly the Steve Urkel of COVID Twitter. Urkel was a deeply annoying nerdy neighbor to the Winslow family at the center of the ancient 90s sitcom Family Matters, who used to regularly invade their home and irritate the shit out of them with his chaotic, clueless, sometimes harmful antics.

So too with Prasad. I’d be minding my own business, tweeting facts about the alpha variant or mRNA vaccines or whatever, and then Prasad would pop up suggesting that vaccines and masks are oppressive, unneeded, cowardly, and possibly unsafe without any evidence. His signature move was to intrude into serious discussions uninvited and wag his finger at anyone with the slightest amount of expertise about vaccines, viruses, or public health, in the most annoying way imaginable. He would block any critics (I got blocked back in 2020), yet still carry on attacking them and promoting whatever contrarian idea was getting him engagement from behind the block.

“Did I do that?” Could be Urkel irritating Carl Winslow as usual or Prasad overriding FDA experts and regulatory procedure to reject another vaccine

In one particularly memorable incident from 2021, Prasad compared the US response to the pandemic to the rise of Nazi Germany. In this breathtaking display of insensitivity, inability to perform a valid comparison, and extreme thirst, Prasad argued that pandemic safety measures set a precedent that would allow a future aspiring autocrat to seize power by mobilizing emergency military powers in response to infectious disease outbreaks. He claimed that public health interventions were leftist tools of oppression that “provide the basis and preconditions for a potential usurping of democratic norms.” According to Prasad, we were one bad cold and flu season away from a Democratic strongman declaring martial law and destroying American democracy.

While Il Duce Joe Biden never materialized, Prasad was right about one thing. The US COVID response certainly was used to justify the subversion of democracy. The ongoing destruction of the entire HHS department—with particular attention towards eliminating anything pandemic-related—is fuelled and supported by the rage against public health that Prasad has cultivated. Ironic but on-brand that Prasad was so deeply concerned about health policy contributing to the rise of fascism that he decided to enthusiastically participate in it.

During his brief tenure at FDA, Prasad wasted no time carrying out his masters’ bidding. He teamed up with Makary to write this odious position piece on vaccines in the New England Journal of Medicine. This piece argues that US COVID vaccine policy is patronizing and aggressive, and that vaccines have undergone insufficient testing. Prasad and Makary argued that all vaccines in healthy people aged 6 months-64 years old would require a randomized clinical trial (RCT) for FDA approval. This effectively means no more COVID boosters for most people.

There is no reason to run RCTs for vaccines that have been in use for long enough to evaluate outcomes. We don’t do this for seasonal flu shots because we know that these vaccines provide benefits that greatly outweigh the risks. If we did RCTs for booster updates, we would never be able to use them during flu season, when they matter. The same is true for updated COVID boosters. This is a mechanism to limit or ban vaccines, despite Makary and Prasad’s claim that it is “gold standard science.”

Prasad wasted no time testing out his new powers as CBER Director. He overruled expert recommendations and rejected broader use of two COVID vaccines: Novavax and Moderna’s next-generation mRNA vaccine. Makary appointed him the FDA’s Chief Medical Officer and Chief Scientific Officer for his efforts in subverting established regulatory processes to limit vaccine access without evidence.

But Prasad evidently flew too close to the sun for the MAHA crowd to tolerate. He has been beefing with a company called Sarepta for months, after months of complaining that their gene therapy drug for Duchenne muscular dystrophy (DMD) “seems to be killing children and blowing their livers up.” DMD is a rare, but progressive and ultimately deadly condition and Sarepta’s drug is one of the only available treatments. This is why it was approved despite having death as a possible side effect. The FDA ordered Sarepta to pull the drug off the market. Then on Monday, the FDA suddenly reversed that decision and said that some people could still take it.

This may have been due to the fact that Prasad pissed off the “medical freedom” component of the base that wants to be liberated from regulating drugs to ensure they are safe and effective. He was attacked by MAGA superinfluencer Laura Loomer, former Senator Rick Santorum, and an opinion editor at the Wall Street Journal as a mole for liberal opponents of President Donald Trump based on old tweets supporting Democrats or progressive causes. He was accused of trying to surreptitiously undermine the MAHA agenda for supporting drug regulation in general.

Ouch. Not the review a sycophantic MAHA climber wants from the biggest cheerleader for drug deregulation in the legacy press.

There were some feeble attempts to defend Prasad from his allies, including the Daily Caller’s most useful idiot, “reporter”/propagandist Emily Kopp, attempting to blame this as Sarepta orchestrating a smear campaign. Makary declared to Politico’s Dasha Burns that “he doesn’t have a political bone in his body.” When I read that, I scoffed so loudly I startled one of my dogs and she started barking at me.

Alas, these weak defenses were not effective, leading to Prasad’s resignation yesterday. Presumably he’s already getting ready to return to the warm embrace of the medical contrarian social media cesspool that elevated him to this position in the first place. No doubt he will be celebrated as a hero by the anti-vaxxers who appreciated his efforts to withhold COVID vaccines from the market. But he also may return to his prior academic position at UCSF or another reputable institution. He may try his hand at doing media full-time. He may attempt to leverage his brief experience at FDA into consulting or entrepreneurial ventures.

When I was a kid and Family Matters was must-see TV, I wondered why the long-suffering Winslow family didn’t prevent Urkel from erratically shambling into their kitchen uninvited to wreak havoc upon their home by just locking the door. That’s precisely what credible scientists, physicians, and medical associations should do when Prasad comes calling looking for his next career opportunity.

Prasad may have been too incompetent at enabling fascism for the fascists, but we should not forget that he volunteered to be part of that. He chose to support people who are actively annihilating the American government and attempted to prevent people from accessing lifesaving vaccines and medications. He is not a colleague. His actions at FDA demonstrate that he is a traitor to our country and we should never forget that. We should never let him forget it, either.