The Advisory Committee for Immunization Propaganda

Anti-vax ACIP wants to build trust in vaccines by lying about the evidence

Yesterday one of the most striking things about the most recent meeting of the Advisory Committee on Immunization Practices (ACIP) was how many of the members cited “trust” as the reason for reevaluating long-established vaccine recommendations for the MMRV vaccine. A spectacular moment was when, after examining the data on the hepatitis B virus (HBV) vaccine that overwhelmingly shows massive benefits with no risks and one of the most reliable safety profiles of any vaccine on the market, ACIP resident turbocancer garden gnome Robert Malone weighed in on why the panel should not recommend universal HBV vaccination at birth. Ultimately, ACIP tabled this vote because there had supposedly been insufficient discussion of safety risks.

According to Malone, there are lots of vaccine skeptics out there who don’t trust public health professionals. He would know, since he’s converted many of them himself through his paid speeches at anti-vax rallies, media interviews, and his 6-figure Substack vaccine disinformation empire. Malone, like ACIP Grand Wizard Martin Kulldorff and his anti-vax comrades-in-arms Retsef Levi, Vicky Pebsworth, Evelyn Griffin, and Kirk Milhoan, has profited handsomely from sowing distrust in public health and convincing his marks to open their wallets to pay for the privilege of being lied to. So it is unsurprising that he would use the trust he has relentlessly diminshed as a substitute for evidence to justify stripping vaccine access of safe, effective vaccines for children.

To assist in further eroding public trust in CDC, the CDC itself is helpfully assisting the disinformation purveyors on the ACIP. CDC’s official X/Twitter account live-tweeted choice quotes from yesterday’s meeting. This included a clip of Kulldorff praising the CDC for “detecting” a well-known adverse event that has been studied for 20 years since the ACIP reviewed the evidence for the MMRV vaccine in 2005, in 2008, and in 2010. I’m not sure what his idea of “detecting” is, besides reading the published ACIP recommendations in the Morbidity and Mortality Weekly Report when fishing for excuses to restrict the MMRV vaccine’s use and availability.

I do owe ACIP members Cody Meissner and Joseph Hibbeln an apology for characterizing them as anti-vaxxers in the past, when it is clear from yesterday’s meeting that they are not. While both have been anti-vax curious in the past, both asked very important questions during the discussion of HBV vaccines and pushed back against the absurd statement that trust should take precedence over evidence, which is clear for HBV: the universal birth dose of the vaccine has almost eliminated HBV from the US and 40 years of safety data shows that the rate of severe adverse effects is almost infinitesimally low. Meissner also provided critically important clinical context about the actual long-term risk of febrile seizures as well as key facts about pediatric HBV infection to completely destroy the notion that transmission is only sexual. Meissner also expressed his opinions about the process, specifically his disapproval of the American Academy of Pediatric’s declining to participate in the process after HHS Secretary Robert F. Kennedy, Jr. attacked them for being pharma shills and developing their own recommendations. While I disagree with this opinion, it’s notable that the CDC’s social media team chose to share this rather than highlighting Meissner’s expertise as a pediatrician and vaccinologist and his comments that directly addressed the need for evidence-based decision-making.

Rather than inform, the CDC chose to instead promote the current ACIP and highlight ACIP opinions that support the political talking points coming from Kennedy and HHS. This is a major deviation from the CDC’s prior practice, in which the ACIP was convened as an independent expert panel that would not be influenced by governmental or institutional priorities. Now, the CDC appears to be trying to convince the public that stocking the ACIP with anti-vaxxers who are pretending to carry out evidence-based business as usual. In reality, they are manufacturing evidence to support recommendations predetermined by Kennedy that will block vaccine access for millions of Americans.

Wake up babe, new hep B transmission risk just dropped

As an editor at Vaccine, I keep up on the vaccine literature by handling and reviewing manuscripts on vaccines. However, given my expertise is in experimental virology and preclinical testing, I don’t get assigned a lot of papers on HBV vaccination because the vaccine has been around for more than forty years and almost all of the HBV papers submitted to the journal are post-licensure clinical studies of vaccine effectiveness. This is outside my specific expertise, so these studies go to one of my colleagues with more experience with clinical and statistical review.

I am fortunate, however, that viral hepatitis is kind of the family business (even though I got out of the game after my postdoc on hepatitis C virus). My uncle, Brian McMahon, is a hepatologist who is a retired officer in the Public Health Service, the former Medical and Research Director for the CDC’s Liver Disease and Hepatitis Program at the Alaska Native Health Consortium, and although he is semi-retired, he continues to treat patients and conduct research at the Alaska Native Medical Center. He has been studying the HBV vaccine for the last 40 years. So I called him up last night to talk about the data and the ACIP.

McMahon told me that he’s working on an updated to a long-term study he has been doing to look at HBV vaccine effectiveness since he began vaccination in remote Alaska Native communities in the early 1980s. In 2022, he published a study in Hepatology that showed that the HBV vaccine is so effective that the vast majority of participants in his study had evidence of protective immunity 35 years after being vaccinated. This is even more impressive, considering HBV is endemic in Alaska Native communities, so exposure risk is much higher. McMahon is working on a follow-up study with similar results after 41 years, but unfortunately has to end the study four decades in because too many participants have died of old age. These participants would have died much earlier from either liver failure or liver cancer, had they not been protected by this vaccine. The HBV vaccine is incredibly effective and has prolonged life and improved health for those in endemic areas who are repeatedly exposed to the virus.

McMahon also told me that he sent a large data package to ACIP for consideration and has not received a response. This is consistent with the refusal of the current ACIP to assess vaccine safety and effectiveness using an evidence-based framework. Hibbeln seemed incredulous yesterday that the evidence for the HBV vaccine was being ignored, since anyone viewing the evidence in good faith cannot argue that the vaccine isn’t safe or effective. However, the CDC tweeted this out, presumably to imply that the process is actually evidence-based.

In reality, Hibbeln’s entirely correct comments about how scientific processes should be carried out were ignored by most of the ACIP. Kulldorff sourly thanked him for his opinion and moved on, much as he did when expert liaisons repeatedly demanded that ACIP return to using its evidence-based framework for analyzing data and making recommendations. The CDC’s choice to share this quote outside of that context only serves to create the illusion that ACIP is using a scientifically-driven process rather than one motivated and serving ideological goals.

But this seems par for the course. CDC also featured a quote from ACIP member and anti-vax ivermectin grifter Kirk Milhoan rephrasing an overtly anti-vax position (no HBV vaccine birth dose) as a question about risk reduction that falsely exaggerates the risk of immunization.

Sure, every vaccine and drug has risks. In the case of the HBV vaccine, that risk is extraordinarily low. The only way to reduce risk from vaccination entirely is to not vaccinate, which puts people at a much, much higher risk of HBV infection. So the ACIP wants to consider whether they can reduce risk by only vaccinating babies who are at high risk of perinatal infection from mothers who are infected with HBV. Theoretically, this could be done by testing mothers, which CDC implies here by quoting long-time anti-vaxxer and ACIP member Vicky Pebsworth demanding that mothers be tested as a condition of vaccination at birth.

Except there is one BIG problem with this. Only about 70% of mothers have access to prenatal care, including HBV testing. Testing can give false negatives in some cases, as well. And the biggest flaw in this is that HBV is not only transmitted perinatally to children.

McMahon told me that many of his patients in endemic areas were infected as children before they could be vaccinated. They get infected by household exposure: breast-feeding, having their diapers changed, having their hair trimmed, teeth brushed, or nails clipped with contaminated equipment, playing with other kids, contact sports, or any of the many casual interactions that can lead to blood exposure. He told me that before infant vaccination, he had patients who died of liver cancer when they were in high school. Vaccination of both mothers and babies completely stopped this wave of carnage. By 1992, there were no new cases of HBV in Alaska Native children living in communities with endemic transmission. That was only due to vaccination as early in life as possible. McMahon’s dogged efforts to bring HBV vaccines to thousands of children at risk paid off. It also built a great deal of trust with the communities he served.

But don’t tell that to Milhoan, who said that there is no evidence of trust unless we ask patients in general if they felt they were able to make informed consent for vaccination. This is absolutely untrue. Vaccines are given with forms that contain full information about risks and benefits. Milhoan is actually making a claim phrased in the form of a suggestion: that vaccination is unethical and trust is diminished because patients are not providing informed consent. And the CDC’s official account is amplifying this false claim.

Trust the supply chain guy’s opinion on immunology

Today was the big day for supply chain management specialist Retsef “mRNA vaccines kill people” Levi to tie down his mane with his best ponytail holder, cloak up in his best armchair immunologist disguise, and summon his vaccine workgroup from the depths of hell, where they have been busily compiling entries from the Vaccine Adverse Events Reporting System (VAERS) to make false claims about safety. VAERS is a database of self-reported vaccine injuries, which means much of the data is not actually a vaccine injury. In the before times, when ACIP functioned as an actual panel of experts, VAERS was used to identify safety signals for further investigation. The idea is that if enough reports of a particular adverse event are linked to a particular vaccine, it warrants detailed investigation by an ACIP workgroup. Safety signal investigations were carried out by experts in these workgroups using the CDC’s established framework for evidence-based review. Then these results would be presented to ACIP and discussed, with new recommendations proposed for a vote if warranted by the evidence.

Levi presided over a simulacrum of the normal ACIP workgroup process. He assembled a workgroup stacked with mostly people who are highly skeptical of mRNA vaccines, if not outright opposed to them. Levi and his first string workgroup presenters shared slide after slide of bullshit about myocarditis: falsely claiming with cherry-picked VAERS reports that myocarditis is much more common and dangerous than it is, presenting underpowered studies linking genetic variants to myocarditis, and eliding the fact that the myocarditis risk from mRNA vaccines is very small relative to the risk from having actual COVID-19.

Despite having no background in immunology or biology whatsoever, Levi, Malone, and his selected batch of workgroup anti-mRNA “experts” (none of whom are virologists, vaccinologists, or infectious disease researchers) made numerous unsupported statements about immune function and how vaccines are evaluated for safety, efficacy (how well they work in a clinical trial), and effectiveness (how well they work in the real world). When challenged on anything, he defaulted to “gold standard science.” He continued to claim that vaccines are not valid without randomized, placebo-controlled trials (this is not true at all). Oncologist Wafik El-Deiry presented on “uncertainties” and, in addition to making unsupported statements about vaccine mechanisms of action and uncritically presenting studies on supposed DNA contamination in mRNA vaccines, he was unable to correctly pronounce the word “pathogenic.”

The various discussion periods could be characterized as clownish chaos. Malone couldn’t keep his beardhole shut and kept pompously bragging about his own embellished achievements in delivering pathology lectures to first year medical students and failing to conceal his rage that the expert liaisons and all of social media wasn’t impressed by his indefatigable bullshitting. He decided to pronounce that there is no such thing as a correlate of protection for COVID vaccines because T cells. Correlates of protection are essentially markers, like neutralizing antibody titers, that can be measured to assess whether a vaccine is protective or not.

I grabbed the popcorn when Meissner immediately went camera on and demanded Kulldorff allow him to respond. Meissner proceeded to eat Malone’s entire lunch in front of God and everyone, noting that while he agreed with Malone that correlates of protection are complex, some have been defined and cited this New England Journal of Medicine paper from 3 years ago. Embarrassing that the self-proclaimed inventor of mRNA vaccine technology (not true) didn’t bother to PubMed “correlates of protection COVID” while he was cashing in on his supposed vaccine expertise on the medical freedom influencer circuit! That didn’t stop him from also demanding that, in order to declare COVID vaccines truly safe, they’d have to prove a negative.

This is something that non-scientists (and many actual scientists) don’t fully appreciate. It is impossible to prove a negative hypothesis. If you claim there’s “absent data” needed to show that vaccines don’t kill people, you can scour the earth without ever being sure you’ve captured all the potential data that might prove the hypothesis one way or the other. It is an unattainable demand. Either Malone is incompetent in fundamental principles of the scientific method or he is intentionally demanding an evidentiary standard that he knows can never be met. Both are valid hypotheses, in my opinion. Actual scientists develop falsifiable hypotheses and design experiments to test them with proper experimental controls, not declare that a question cannot be answered because it is asked in a way that fails to demonstrate a basic grasp of standard scientific practices. Malone should spend less time stroking his beard in imitation of greater thinkers and actually familiarize himself with the data concerning the safety of COVID vaccines, although he has many incentive$ for not actually exploring this too thoroughly. It speaks volumes that the CDC’s official social media account is highlighting what is otherwise a shameful display of either woeful ineptitude or chicanery.

Levi was undeterred. CDC helpfully highlighted his wildly exaggerated statement that COVID vaccines cause death from subclinical (asymptomatic or very mild) myocarditis, claiming “it’s not questionable.” Uh oh…Died Suddenly is a thing!

Except it’s not. Levi is referring to a study in which 21 out of of 44 million people died from “sudden cardiac death” (their heart stopped) that was later linked to myocarditis. I’m not sure how much math supply chain operations PhDs study, so I thought I’d use my hard science training (multiplication and division) to help Levi out by calculating the mortality rate. In the interest of radical transparency, I like to show my methods, so here you go: (21/44,000,000) x 100, calculated on an iPhone Calculator app. I determined the mortality rate in this study to be 0.000048%. 21 out of 44 million is a risk that I’ll take, considering the mortality rate for COVID is much higher.

Ultimately, the feared destruction of COVID vaccines did not occur. The ACIP failed to require a prescription for COVID vaccines, which would have severely limited access despite Levi’s pathetic claims that they would not. Levi claimed that he has been unable to find a single pharmacist in Boston willing to discuss his concerns about the vaccines he claims he is getting there. His anecdotal basis for his demand failed to persuade some of his more evidence-focused colleagues that this necessitated “nuanced” discussions before COVID vaccines could be administered. Meissner hilariously quipped, “Retsef, I think you need to find a new pharmacy.” I laughed out loud like a complete weirdo in the banh mi restaurant where I was listening in while grabbing a sandwich.

The ACIP did not recommend a requirement for a prescription, since ACIP isn’t even empowered to regulate that. They did vote to recommend discussion about risks and uncertainties with the health care provider administering the vaccine, that vaccine recipients do a risk-benefit analysis with their health care provider, and that the vaccine be based on individual decision-making for people aged 6 months-64 years old. Also individual decision-making about age 65, which is more or less what people do now anyway.

While I’m relieved COVID vaccines will remain available and the idiotic decision to revisit HBV vaccination has been tabled indefinitely, the CDC’s participation in trying to hype up and paper over the sheer unscientific amateurishness and quackery of these proceedings is yet another indicator of how degraded our national public health institution has become. This could have been much worse in terms of vaccine access, but this is a battle, not the war. There is another ACIP meeting in late October. Expect Kulldorff to come back from this setback like the decaying revenant that he is, with even more bad faith and more refined lies to push the anti-vax agenda forward. And despite the heroic efforts of career CDC scientists, expect the agency itself to promote Kulldorff and crew’s amateur hour deliberation over the actual processes that previously made the ACIP process the “gold standard” for the entire world. The CDC used to be objective and valued scientific evidence above all else. Now they have been reduced to a propaganda mill hyping the absolute least qualified, least credible people in the world who are conspiring to put millions of Americans at risk. Bring the real CDC back. Get these people out of there before they start killing us all.