Dr. Paul Thomas: A rising star in the antivaccine movement

Of all the antivaccine activists out there, arguably the most damaging to public health are the antivaccine pediatricians. True, they pretty much all to a person deny that they are “antivaccine,” instead portraying themselves as “pro-vaccine safety” or “vaccine safety activists,” but inevitably spew misinformation that reveals them to be either lying or delusional in that portrayal. Of these doctors, perhaps the one I’ve written the most about is “Dr. Bob” Sears. Besides his recommendation in his book on vaccines for antivaccine parents not to advertise their children’s unvaccinated status in order to allow them to “hide in the herd,” He’s spent at least the last three years regularly letting loose his antivaccine dog whistles. I first noticed it after SB 277, a bill that ultimately became law in California and eliminated nonmedical exemptions to school vaccine mandates. That was when “Dr. Bob”” started really letting his antivaccine freak flag fly, invoking what have become the most commonly used antivaccine “dog whistles” with respect to school vaccine mandates ()”freedom” and “parental rights”) in his opposition to SB 277 but he started going full Godwin. Ultimately, he began selling medical exemptions to school vaccine mandates, to the point where the Medical Board of California took notice. Not surprisingly, antivaxers have rallied around him.

Of course, “Dr. Bob” Sears isn’t the only antivaccine pediatrician. There have been others before, including Dr. Jay Gordon and Dr. Mayer Eisenstein, and others. Well, there’s a new rising star among the ranks of antivaccine pediatricians, hell, among antivaccine physicians. I’ve been meaning to write about him for a while now, and his name is Dr. Paul Thomas. Basically, he’s continuing on down the path forged by “Dr. Bob” Sears by publishing a book for the vaccine-averse, in this case, The Vaccine-Friendly Plan: Dr. Paul’s Safe and Effective Approach to Immunity and Health-from Pregnancy Through Your Child’s Teen Years, which is advertised thusly:

The time has come to take our own health and that of our children into our own hands. Gone are the days when you can blindly follow your doctor’s recommendations, or count on your health plan or some government agency to have your best interests first.

Here I, Dr. Paul Thomas, bring you the best, and most important research, information, products, blogs and videos, vitamins and nutritional supplements, and provide links to information I feel you should not go without.

Lots of red flags there. Beware any “brave maverick doctor” who goes on about “blindly following your doctor’s recommendations” or “counting on some government agency to have your best interests first” as a prelude to selling you his book, his videos, and, above all, his nutritional supplements with blather like this:

It’s all there, starting with the favorite antivaccine claim that children today are not as healthy as they were in the past, how there he doesn’t remember any children with autism, asthma, ADHD, eczema, etc., while he was growing up. A physician should know better than to make an argument this blisteringly stupid, but apparently Dr. Thomas doesn’t. I’d be willing to bet that he knew kids with autism and ADHD when he was a kid. They just weren’t called that then because such the diagnostic criteria for these conditions were different then and even then they were underdiagnosed, with kids with ADHD simply being considered discipline problems and kids “on the spectrum” being viewed as just weird if their autism was mild and retarded if it was severe. I mean, seriously. Seeing a fellow physician make such idiotic arguments makes me want to get out my paper bag or Doctor Doom mask again. In the video, he asks, “Why?” And why is it? Well, he promises that his book will minimize the chance that your child will end up with any of these conditions. So that tells you right there that he must think it’s the vaccines that done it. He mentions all the “toxins” in the world as a prelude to mentioning that vaccines, although “very important,” also contain “toxins.” He even says, “This is not an antivaccine book. This is not a pro-vaccine book. This is a pro-kids, pro-healthy children book.”

He even offers a old discredited idea of “too many too soon,” with vaccines being spaced out or eliminated. Never mind that, like Dr. Sears, Dr. Thomas has no relevant expertise in immunology or infectious disease to be making such recommendations, and it shows. For instance, amazingly, he recommends no vaccines for pregnant women. That’s right, no Tdap and no flu vaccines. Why? They’re “toxic.” He doesn’t recommend HPV vaccines at all for anyone. Ditto the Rotavirus vaccine. Ditto hepatitis A (more on that later). He doesn’t recommend the MMR before three years of age. Why? Well, he lays down variants of the “toxins gambit” right in his it would be very impractical from a scientific, financial, and logistical standpoint. He invoked the need for a double-blind randomized study comparing vaccinated and unvaccinated children, which shows that he is utterly clueless with respect to basic ethics with respect to human subjects research! Such a study can never be done, because it would leave half the subjects unprotected against potentially deadly diseases, which violates the principle of clinical equipoise and is therefore completely unethical. He also threw the “toxins” gambit in there for good measure, which he also does with the polio vaccine:

The Injectable Polio Vaccine (Ipol) contains formaldehyde, along with a host of other ingredients you probably wouldn’t want to inject into an infant with an immature immune system, including: human albumin, calf serum, 2-phenoxyethanol and antibiotics. Since the last case of wild polio acquired in the USA was 1979 and it is essentially eliminated from the world, I recommend babies skip this vaccine unless you plan to travel to higher risk areas of the world.

I hate to inform Dr. Thomas (actually I don’t), but the human body makes formaldehyde as a normal byproduct of metabolism, and there is far more formaldehyde naturally occurring in the body than there is in any vaccine. As for the other ingredients, they’re all present at trace amounts. Dr. Thomas seems to have forgotten his medical school pharmacology class. I haven’t even mentioned all the problems with Dr. Thomas’ “approved” vaccine schedule (as if being approved by Dr. Thomas means anything at all), but Dr. Thomas assures us that he’s not antivaccine.

Of course, his own writings rather bely that claim, for instance this article profile of and interview with Dr. Thomas by Ashley James entitled Safe Vaccines. Let’s just say that Dr. Thomas lays down a lot of tropes that sure do sound antivaccine to this guy who very much knows antivaccine when he sees it.

First, we learn that Dr. Thomas grew up in a village in Africa. (His parents were missionaries.) You’d think that this sort of upbringing would make him appreciate all the more the benefits of vaccines, but you’d be wrong. Instead, he touts his upbringing as making him more “open-minded” and willing to entertain new ideas. Of course, you know what they say about not being “open-minded” that your brains fall out. Is that gray matter that I see on Dr. Thomas’ shirt?

For instance, I’ll start with one of the most blisteringly stupid things that Dr. Thomas says in the whole article:

Dr. Paul Thomas believes that Hepatitis A Vaccine is unnecessary. In fact, Dr. Paul Thomas has not encountered a Hepatitis A case in his entire medical career.

For children, in particular, Dr. Paul Thomas says Hepatitis A is a benign, mild, cold, flu-like illness. It is harmless and apparently, we develop a natural immunity to it. Hence, we do not need a vaccine for it.

That must be why we have a huge hepatitis A outbreak here in Michigan and why there is a smaller, but still large, outbreak ongoing in Kentucky. You see, what Dr. Thomas doesn’t seem to consider is that, even if hepatitis A is a milder illness in children, vaccinating is still a good policy because hepatitis A is not nearly so benign in adults, as we are discovering in Michigan, and immunity from the two-shot series can last two decades or more.

Of course, Dr. Thomas is not “antivaccine.” Oh, no, he’s “pro-safe vaccine,” just like Jenny McCarthy:

“You don’t have to dig far to know that vaccines have caused tremendous harm. Have they had benefits? Absolutely. Which is why I remain somewhat on the neutral side in saying that I am not anti-vaccine,” said Dr. Paul Thomas. “I’m pro-safe vaccines. I’ve progressed along to the point where I now don’t believe there is such a thing.”

In other words, Dr. Paul Thomas says it’s impossible to have 100% safe vaccines. This is because we are injecting things that stimulate the immune system. This alone poses some benefits and risks. Apart from that, Dr. Paul Thomas says we’re also injecting toxins and elements that overstimulate the immune system.

Let’s count the antivaccine tropes, shall we? There’s the “I’m not antivaccine, I’m pro-safe vaccine” trope, although Thomas goes further than that. He actually says he’s “neutral” and clearly on his way to being antivaccine even by his own estimation, given that he now says that he doesn’t believe there is such a thing as a safe vaccine. Then there’s the “toxins” gambit yet again. There’s also the “too many” trope implied, with his saying that vaccines “overstimulate” the immune system. Then there’s this:

Dr. Paul Thomas says that generally speaking, what people look for is really informed consent. This means people want to have the ability of choice, ability to have a doctor who listens to them and a doctor who’s educated and informed on what exactly are safe vaccines.

This is what I like to refer to as the “misinformed consent” gambit. Here, antivaxers claim they are for nothing more than “informed consent,” which is a basic fundamental principle of any medical intervention. The problem is that informed consent requires accurate information and an accurate estimate of the risks and benefits of any intervention. Antivaxers, as I’ve pointed out so many times, actively misinform patients, vastly exaggerating the potential harms from vaccines and vastly underestimating the potential benefits in such a way that, if you don’t know anything else about vaccines and hear this combination of information, it would actually be rational of you not to want to vaccinate. However, that decision would be based on gross misinformation, the “consent” not to be vaccinated would be a decision based on misinformation, hence my term “misinformed consent.”

Misinformation like this:

Dr. Paul Thomas’ book is about a safe and effective approach to immunity and health. It covers a vaccine-friendly plan from pregnancy to a child’s teenage years. The book is really for people who genuinely want to follow the CDC schedule.

The guiding principle of the book is to minimize toxins, minimize risks, and still get some protection. Dr. Paul Thomas also singles out that aluminum is toxic, yet if you postpone some of the childhood vaccines until they’re older, it will make sense for a lot of reasons.

“I wrote my book because after I started my practice, I instituted what I called the Vaccine-Friendly Plan. Don’t do vaccines during pregnancy,” advises Dr. Paul Thomas. “No Hepatitis vaccine until you’re at least pre-teen unless the birth mother has Hepatitis B. And there’s no need for polio because it’s not infectious.”

Polio isn’t infectious? WTF is Dr. Thomas talking about? Of course it’s infectious! I suspect I know what he means, but who can be sure. On the principle of charity, I’ll assume that he means that polio has been eliminated from the US and has been for a long time. This is true, but it ignores the rest of the world. Until polio is eradicated from the world, given how safe the polio vaccine is, it makes sense not to let up. As for aluminum, as I like to say, aluminum is the new mercury, the favorite ingredient in vaccines for antivaxers to demonize. It is not toxic at the doses used in vaccines.

It also turns out that Dr. Thomas fancies himself a clinical researcher now:

Under the plan, Dr. Paul Thomas has gathered data from over 1000 patients. From the batch, 894 patients were vaccinated, and 238 patients weren’t vaccinated.

From that data, Dr. Paul Thomas found out that all of the patients with autism was in the group that was most vaccinated. On the contrary, there was no autism in the unvaccinated group.

“But a little caveat. There were 3 cases in the Vaccine-Friendly Plan, of children who were starting to show autistic-like symptoms such as decreased eye contact and language delay,” shares Dr. Paul Thomas. “Anytime I would see any delay; I would immediately stop further vaccines. I wish doctors and family practitioners would follow that principle.”

Dr. Paul Thomas also reports that three kids in the Vaccine-Friendly Plan and five kids in the vaccinated group returned to normal. This was after Dr. Paul Thomas stopped administering the rest of the vaccines.

It’s hard to interpret what the heck is being described here, although it is disturbing that over 21% of Dr. Thomas’ patients apparently receive no vaccines at all and he’s OK with it. In any case, I can’t figure out what the heck he means here. He claims that all the cases of autism were in the the group that was “most vaccinated.” What the heck does that mean? He also claims that there were no cases in the group that was completely unvaccinated. Basically, these numbers are impossible to interpret without knowing the definitions, and, more importantly: (1) the number of children who were completely unvaccinated; (2) the number of children on the “vaccine-friendly” schedule; and (3) the number of children on the CDC schedule. He’d still also have to control for other risk factors for autism, not to mention for the fact that he openly admits that whenever he sees cases of children with early signs of autism he immediatley stops all vaccines.

But that’s not all. Apparently, Dr. Thomas thinks he’s going to run the “Framingham study of our time”:

So what is the Pediatric Health Outcomes Initiative? This is how it’s described:

The Pediatric Health Outcomes Initiative is a prospective registry that seeks to recruit 5,000 newborns (< 30 days old), and will follow them for 18 years. The goal is to determine if vaccination status or other factors play any role in the development of either acute or chronic diseases in children in the United States. Over the last 40 years, there has been an increase in the number of children diagnosed with both acute and chronic conditions, including asthma, eczema, allergies, attention deficit disorder (ADD), and autism. Some physicians and researchers have questioned if the increase in both the number of vaccines the pregnant mother receives, and the number of childhood vaccines, plays any role in the current state of our children’s health. In 1983, the Centers for Disease Control (CDC) vaccine schedule recommended children ages 0-18 receive a total of 11 vaccines, five of which were given during the first 13 months. In 2017, that number had increased to 55 vaccines, with 28 administered in the first 13 months. This registry seeks to collect prospective data to help answer this question.

Dr. Thomas claims that his study has been approved by an institutional review board (although he doesn’t say which one), and presumably it has, given that he started to recruit patients in October.

Personally, I would love to see the protocol for this registry study, because I would love to see if Dr. Thomas realizes just how easy it is for bias to be inadvertently and unintentionally introduced into such registries. For instance, there’s likely to be ascertainment bias, which is the systematic distortion in measuring the true frequency of a phenomenon due to the way in which the data are collected. In this case, bias is likely to be introduced into the estimated prevalence of autism in the registry population. How could this happen? Think about it. Dr. Thomas believes that vaccines cause autism. That right there introduces unconscious bias that could affect how likely he and his staff are to investigate subtle signs of autism and refer out to for evaluation based on vaccination status. One can easily imagine this bias leading to unvaccinated children to be less likely to be given an autism diagnosis than vaccinated children. Are there safeguards against this in the protocol? I’d be willing to bet that there are not.

Other biases that could creep into the registry suggest themselves. For instance, the parents who choose an “integrative pediatrics” practice are not like the general population, and hence their children are likely to differ in significant ways from the general population, hence decreasing the generalizability of any findings. There is also likely to be a form of bias known as consent bias, in which parents who believe vaccines cause autism would be more likely to agree to enroll their children in the registry. Such parents would be more likely to be prone to recall bias with respect to the diagnosis of their child’s autism.

The list goes on. The point is that putting together such registries is not a trivial task. In the database for the registry, what elements will be included as fields in the database? Who will enter the data? Who will assure the integrity of the data? I learned from my experience at a statewide breast cancer collaborative quality initiative just how complicated and vexing these problems are, and how easily the incidence of something (in the case of this database, complications) can be under- or overestimated. Let’s put it this way. Setting up and maintaining a registry like this is not a job for amateurs. Did Dr. Thomas recruit any professionals? I wonder.

I wondered whether his protocol had been approved by an institutional review board (IRB). Apparently it has been. I’d love to know which one and what reputation it has.

I like to say that my identification of antivaccine views is a lot like what Justice Potter Stewart said about pornography: I know it when I see it. Actually, I have written extensively on things to look for in recognizing antivaccine views that go beyond “knowing it when I see it,” and Dr. Thomas’ rhetoric qualifies as antivaccine.

Sadly, I know from other reports that Dr. Thomas has teamed up with other antivaxers, like James Lyons-Weiler and Brian Hooker, to try to write up studies for the peer-reviewed literature, but so far I’ve only seen rumblings and reports from other skeptics. My guess is that Dr. Paul Thomas is the new Dr. Sears. Dr. Sears is still a major voice in the antivaccine movement, but he’s yesterday, he’s dull, he’s too tied to SB 277, and besides he’s under investigation by the California Board of Medicine. Dr. Thomas is new, now, hip, and happening. I fear he’s poised to fill the void left by Dr. Sears. Certainly teaming up with cranks like Hooker and Lyons-Weiler, if indeed that is happening, is an indication of this.