Robert F. Kennedy, Jr. and his World Mercury Project: Antivaccine, NOT “fiercely pro-vaccine”

Whenever I write about Robert F. Kennedy, Jr. and his World Mercury Project, it brings back memories of over 12 years ago, when I first became aware of him and deconstructed his highly deceptive and dishonest bit of conspiracy mongering published simultaneously in Rolling Stone and on Salon.com, Deadly Immunity. He quickly provided more blogging material, with conspiracy mongering and attacking critics of antivaccine pseudoscience as misogynists who hate mothers. More recently, RFK, Jr. met with Donald Trump during the Presidential transition to discuss vaccine safety or the “autism epidemic” or…something. It’s not exactly clear what. His claim was that the Trump Administration wanted him to chair a “vaccine safety commission,” but the Trump transition team quickly denied that version of events. None of this stopped RFK, Jr. from sending an e-mail to members of the Waterkeepers Alliance, which Kennedy leads, announcing that he would leave the environmental group if the commission actually comes to be. More recently, RFK, Jr. issued the most spectacularly dumb “vaccine challenge” since Jock Doubleday. Basically, like many antivaccine activists, RFK, Jr. dons the mantle of a “vaccine safety activist,” even though he’s anything but, his risible oft-repeated claim to be “fiercely pro-vaccine” notwithstanding.

Yes, RFK, Jr. is antivaccine to the core.

I was reminded of this when, for reasons that now elude me, I wandered over to his World Mercury Project. I wish I hadn’t. What I saw posted there was this video:

Basically, it’s an appeal for cash:

World Mercury Project is in the last 36 hours of our crowdfunding campaign for the Vaccine Safety Project. We know we’ve alerted you many times to give, but this project is so important… probably the most important issue of our lifetime because it involves the health and well-being of our children. With 54% of America’s children suffering from a chronic health condition, we don’t have a moment to waste. Donate now at igg.me/at/vaccinesafetyproject.

It’s a litany of antivaccine misinformation, as described over at the Indiegogo page for this fundraising campaign, which is introduced with this video:

In it, RFK Jr. touts how for over 30 years he’s been “successfully fighting the biggest bullies on the American political landscape,” such as the oil companies, coal companies, chemical companies, and big agriculture, all polluters. He then announces that he’s taking a hiatus from fighting these companies because he wants to take on what he considers a more important battle, to fight “criminal conduct” by another industry. What industry is this? Take a guess. Yes, it’s the vaccine industry and the pharmaceutical industry. Specifically, RFK, Jr. is cheesed that states are tightening vaccine mandates and views this as a plot by the “rapacious” pharmaceutical/vaccine industries. Apparently, it’s the last 36 hours of this fundraising campaign, which ends at midnight tonight. Unfortunately, as of this writing, RFK Jr. had raised $41,352 of the $50,000 goal. Yes, basically, RFK Jr. is raising $50,000 to go to war against states trying to protect their children by either eliminating nonmedical exemptions to school vaccine mandates or at least making such exemptions more difficult for parents to obtain.

He begins the video by presenting a study that was going around earlier this year suggesting that the DTP vaccine was associated with increased mortality in an urban African population in Guinea-Bissau in the early 1980s. To be honest, I don’t recall why I didn’t blog about this study when it was released and then later when it was being flogged by RFK Jr. and antivaxers, but I plead my case by citing the simple fact that there’s just too much antivaccine misinformation resulting from too many bad studies out there for me ever to cover them everything, even studies picked up by a lot of antivaxers. It was a very small retrospective study published by Scandinavian researchers in an obscure open-access journal that I had never heard of before, although oddly enough it’s a collaborative effort between Cell Press and The Lancet.

Let’s just put it this way. The study has many flaws, as was pointed out by our scaly friend Skeptical Raptor, and, having now read the study, I agree with him. Indeed, I was scratching my head as I read it. Basically, in Guinea-Bissau, the health authorities instituted a vaccine program in 1981 in which they would administer the DTP (diptheria-tetanus-pertussis) vaccine and the oral polio vaccine (OPV) at the quarterly weighing sessions for infants. As a result, because there were three monthly weighing intervals, children received their vaccines either early or late between 3 and 5 months of age. Reading the methods section of the paper, to be honest, left me scratching my head, as I had a hell of a time figuring out just what the heck the investigators had done, but basically they compared mortality between three groups of children, those vaccinated at a weighing session between 3-5 months of age, those who attended a weighing session but were not vaccinated, and those who did not attend a weighing session at that age. Through a convoluted analysis, they concluded that DTP is associated with a five-fold increased risk of mortality but that concurrent OPV vaccination might have reduced these negative effects.

The problems with this study were many. It was very small for an epidemiological study of vaccines (1,057 subjects); the whole cell version of the pertussis vaccine was in use at the time; the number of deaths observed was tiny, and the deaths were not categorized. Basically, the study is an outlier, and RFK Jr. cherry picked it. Big surprise. It’s even less of a surprise that he uses this one cherry picked study to ask whether the US has a surveillance system that would pick up a such an incident in the US, if a vaccine were causing increased mortality of such a magnitude. He claims the answer is no. He is, as usual, full of crap. There is the Vaccine Adverse Events Reporting System (VAERS) Database and also the Vaccine Safety Datalink. There are various post-licensing surveillance programs. Basically, RFK Jr. here is wrong or lying or deluded (I suspect he last of the three).

Once again, RFK Jr. promotes the nonsense that, because vaccines are biologics, the FDA can fast track them without rigorous science. He focuses on the “safety period” prior to review, which ranges from a few days to 30 days. As I described in detail a few months ago, this is a highly deceptive argument that cherry picks data and ignores longer, more rigorous testing. Although he doesn’t explicitly invoke it in this video, his argument has been recently that vaccines shouldn’t be licensed without testing long enough to verify that they don’t cause autism. This is, of course, a ridiculous standard, given that there is such copious evidence that vaccines are not associated with autism that it would unnecessarily prolong the evaluation process and add huge expense to wait the five or ten years RFK Jr. seems to think that pre-licensure trials of vaccines should take. In essence, RFK Jr. wants the FDA to require testing of each new vaccine, even vaccines for diseases for which other vaccines already exist, long enough to assure him that complications of vaccination that have never been demonstrated for any vaccine (autism, neurodevelopment disorders, autoimmune diseases, diabetes, other chronic diseases) do not occur. From a scientific, ethical, and financial standpoint, what RFK Jr. is advocating is an intentionally unreasonable standard.

Basically, RFK Jr. claims:

Here are the facts:

• One in every 2 American children (54%) are chronically ill
• One in every 6 American children (15%) has a developmental disorder
• One in every 8 American children (13%) require special education services
• One in every 10 American children (11%) have ADHD
• One in every 13 American children have eczema and food allergies including deadly peanut allergies
• One in every 68 American children have autism
• Infant mortality (SIDS, etc.) in America is much higher than in other high-income countries

I note that here is no good, credible scientific evidence that vaccines cause any of the above “facts.” Particularly despicable is the insinuation that vaccines cause infant mortality or sudden infant death syndrome (SIDS). They do not, and the arguments made to claim that they do are breathtakingly ignorant.

RFK Jr. also cites supposed conflict of interests in the CDC’s Advisory Committee on Immunization Practices (ACIP). As I’ve described before, it’s an antivaccine myth that ACIP is a tool of the pharmaceutical companies and riddled with serious conflicts of interest. RFK Jr. tries to get around that by citing a 2009 Inspector General Report that the “a systemic lack of oversight of the ethics program.” One can’t help but note that this report describes a situation 10 years ago, as the Inspector General examined reports from 2007. Presumably, if this situation hadn’t been rectified, RFK Jr. could have found more recent evidence. Basically, there was a problem with oversight, but no evidence that the ACIP was riddled with conflicts of interest, such that it was in the pocket of the pharmaceutical industry. As I like to point out, the two pharmaceutical company members of the committee are non-voting.

Another deceptive bit is where RFK Jr. points out that reporting to VAERS, which is a passive reporting database, might represent underreporting, with as few as one in ten adverse reactions being reported. Although this might be true, it doesn’t account for the types of adverse reactions that might be underreported or overreported. For instance, as I discussed so long ago, vaccine litigation distorts the VAERS database, with conditions thought by antivaccine activists and lawyers seeking to bring cases to the Vaccine Court being over- not underrepresented in the VAERS database, as lawyers encourage parents to report autism as an “adverse reaction” to a vaccine. It’s not for nothing that I often refer to examining the prevalence of autism using VAERS as dumpster diving.

What’s RFK Jr.’s answer? He has six actions he wants to see:

To this end, he plans on this:

WMP needs your help to meet our goals. The above-mentioned meeting was a start. There are many more to go. We plan to hand deliver this presentation and supporting materials to every member of Congress. And we will hold Congressional briefings for Congressmen and their staff to help them understand the gravity of the facts presented. We won’t stop until decisive action is taken to meaningfully address the serious health issues affecting over half of our country’s children!

Lovely. Just what we need. An antivaccine crank promoting his conspiracy theories to every member of Congress.

As for the specifics, #1 is nonsense. Vaccines already are subject to the same level of rigorous evaluation before licensing as other drugs. Mandatory reporting of vaccine adverse events is not as easy to achieve as RFK Jr. thinks it is. Besides, does he know what the Vaccine Safety Datalink is and how it works? Here’s how:

The Vaccine Safety Datalink (VSD) is a collaborative project between CDC’s Immunization Safety Office and eight health care organizations. The VSD started in 1990 and continues today in order to monitor safety of vaccines and conduct studies about rare and serious adverse events following immunization.

The VSD uses electronic health data from each participating site. This includes information on vaccines: the kind of vaccine given to each patient, date of vaccination, and other vaccinations given on the same day. The VSD also uses information on medical illnesses that have been diagnosed at doctors’ offices, urgent care visits, emergency department visits, and hospital stays. The VSD conducts vaccine safety studies based on questions or concerns raised from the medical literature and reports to the Vaccine Adverse Event Reporting System (VAERS). When there are new vaccines that have been recommended for use in the United States or if there are changes in how a vaccine is recommended, the VSD will monitor the safety of these vaccines.

That’s not all, though. There are active monitoring systems that cover vaccines, such as the Clinical Immunization Safety Assessment (CISA) project, in which the CDC partners with several large academic medical centers and Kaiser Permanente Northern California to study vaccines safety:

CISA addresses vaccine safety issues, conducts high quality clinical research, and assesses complex clinical adverse events following vaccination. CISA facilitates CDC’s collaboration with vaccine safety experts at leading academic medical centers and strengthens national capacity for vaccine safety monitoring. The CISA Project provides consultation to US clinicians who have vaccine safety questions about a specific patient residing in the US. In addition, CISA provides consultation to US healthcare providers and public health partners on vaccine safety issues, and reviews clinical adverse events following immunization ( AEFI) involving the US-licensed vaccines.

Then there’s the FDA’s Post-licensure Rapid Immunization Safety Monitoring System (PRISM):

The word “prism” might make you think of a triangular piece of glass that separates white light into a rainbow of colors.

But at FDA, it means a powerful, computer-based system that separates critical bits of information from vast streams of healthcare data in order to investigate adverse events and determine if there is a connection to a specific vaccine. And while the FDA prism–called Post-licensure Rapid Immunization Safety Monitoring System (PRISM)—might not have such a colorful name, it’s a bright light in the agency’s continual efforts to identify adverse effects in a timely manner.

PRISM is a cooperative effort between FDA’s Center for Biologics Evaluation and Research and its partners in the health care and medical insurance communities. It analyzes health insurance claims data from four national healthcare plans: Aetna, HealthCore (Wellpoint), Humana, and OptumInsight (United Healthcare).

And more:

PRISM is one component of FDA’s Sentinel Initiative, which monitors the safety of a variety of FDA-regulated medical products by examining information in electronic healthcare databases.

Sentinel performs what is called “active” surveillance, as opposed to “passive” surveillance. Passive FDA surveillance systems depend on industry, consumers, patients, and healthcare professionals to recognize and report suspected adverse events to an FDA web site, such as the Vaccine Adverse Event Reporting System (VAERS). This means that FDA might not become aware of potential problems related to a licensed product for months.

Unlike passive surveillance, Sentinel’s active surveillance lets FDA initiate its own studies using existing electronic healthcare data in a timely manner. Sentinel also lets FDA evaluate safety issues in targeted groups, such as children, or to evaluate specific conditions (e.g., heart attacks) that are not usually reported as possible adverse events of medical products through passive reporting systems.

In other words, systems exist to monitor vaccine safety, and they are just like the ones that RFK Jr. claims not to exist!

To say that there is no system in the US that would pick up a 5- or 10-fold increase in childhood mortality associated with vaccines is, to put it bluntly, bullshit. The VSD, for instance, uses real medical records, and if children started dying in higher numbers associated with a specific vaccine that association would certainly be picked up by VSD on the basis of medical records, and PRISM and CISA are active surveillance systems. RFK Jr. is intelligent enough to understand this, but he either chooses not to or is lying. Take your pick. I tend to favor the latter.

A lot of the other points on RFK Jr.’s list are standard antivaccine tropes, such as CDC conflicts of interest. Not surprisingly, there’s the “special snowflake” gambit, in which somehow, some way, various factors somehow make certain children more susceptible to “vaccine injury.” I like to point out that the only reason this gambit came about is because in populations no convincing scientific evidence supporting a correlation between autism and vaccination has yet been found; so antivaxers started saying that there must be certain genetic and environmental “triggers” that make children more susceptible to “vaccine-induced” chronic illness. Of course, they have yet to produce convincing evidence to support the existence of such “triggers.”

Then, of course, RFK Jr. goes full “health freedom” mixed with “misinformed consent.” The first trope ignores the rights of the child as an autonomous being who deserves protection from disease, while the second warps the concept of informed consent by downplaying vaccine benefits while exaggerating (or making up) risks of vaccination. So basically, RFK Jr. has laid down a veritable “greatest hits” of antivaccine tropes, lies, misinformation, cherry picking, and pseudoscience.

Tell me again how RFK Jr. is “fiercely pro-vaccine.” He’s not. He’s antivaccine to the core, and he’s either lying or self-deluded when he claims otherwise.