Dr. Edward Fogarty’s antivaccine rant: Where’s my paper bag again?

In May, I will have been a physician for 31 years, and in July I will have been practicing my particular specialty of surgery for 20 years straight. The difference between those times comes from my doing a residency, getting my PhD, and doing a fellowship, which together combined took 11 years. (Yes, I was a glutton for punishment and don’t know whether, if I had it to do over again, I’d go the same way, except that a different path could easily have resulted in my never having met my wife, which is unimaginable and unacceptable). Basically, what I’m getting at is that I was a doctor a long time before I started combatting Holocaust denial on USENET (1998) and before I started the first version of this blog (2004). Since I started combatting medical pseudoscience and antivaccine misinformation, I’ve learned something about my fellow physicians. Far too many of them are prone to believe in medical pseudoscience. Indeed, back in the early days of this blog, I used to joke about wanting to put a paper bag over my head (or even a Doctor Doom mask to cover my face) because I was so ashamed of a fellow physician making a fool of himself supporting creationism, quackery, or antivaccine misinformation. It’s not a schtick that I do any more—and haven’t for a number of years—but I recently saw something written by a physician that wanted me to do more than resurrect an old blog schtick and instead actually put a paper bag over my head in shame. Meet Edward Fogarty, MD, Chairman of Radiology at the University of North Dakota School of Medicine. (Yes, he is a fellow academic physician, believe it or not after you read his post.) Now behold his post on the website of the antivaccine group Informed Choice Washington, Philosophical Exemptions as Behavioral Economic Signals of Fraud: An Open Letter. Here’s yet another example that most doctors are not scientists.

Before I start, let me just remind you that Washington is a state that is currently experiencing a major outbreak of measles, thanks to low uptake of the MMR vaccine. According to the Washington State Department of Health, the outbreak is up to 71 cases as of yesterday, 70 in Clark County and one in King County. I’ve written about this outbreak before. Washington County is across the Columbia River from Portland, Oregon, and as a result of the outbreak there have been efforts in the state legislature to eliminate so-called philosophical or personal belief exemptions to school vaccine mandates. (Unfortunately, no one is trying to remove religious exemptions.) In any event, Informed Choice Washington is an antivaccine group doing its best to prevent the elimination of personal belief exemptions. (If you don’t believe it’s an antivaccine3 group, just peruse its website for a while; you’ll recognize all the familiar antivaccine tropes.)

So it’s not surprising that Dr. Fogarty is completely down with antivaccine nonsense and lays down a heaping helping of it. However, he does it in a way that I don’t quite recall having seen before. Before I begin, remember that Dr. Fogarty is a radiologist. Radiologists are primarily diagnosticians, and many don’t have a lot of interaction with patients other than through images. True, interventional radiologists do procedures on patients, and many mammographers perform core needle biopsies on women suspected of having breast cancer, but that’s not the same as evaluating and treating a patient from the get-go. Radiologists are invaluable for patient care, without a doubt, but sometimes, like all too many doctors (particularly surgeons), they seem not to know their own limitations, as was the case with Gordie Howe’s son.

So let’s see what Dr. Fogarty has to say. First, he brags about his background:

I am a practicing physician with multiple state licenses who has had the privilege of being the Chairman of Radiology at the University of North Dakota School of Medicine for the last 12 years. My pathways of understanding many issues in medicine and law have dovetailed over understandings of fraud in science and medicine. I am associated with a large network of attorneys and physicians who have the best intentions of employing whistleblower statutes and legal leverage where possible to alert our fellow citizens of Federal and State Fraud, Waste and Abuse practices.

Translation, as Dr. Fogarty admits later: He’s an expert witness for parents bringing action for “vaccine injury.” Why does he do it? Apparently because he has an autistic son whose autism he blames on vaccines. Indeed, he claims that his son “has an epigenetic risk of neuroimmunologic and neurodevelopmental problems related to metals handling in his body due to Methylene Tetrahydrofolate Reductase genes.” Yes, indeed. He buys into MTHFR pseudoscience, which involves dubious conclusions from testing for MTHFR mutations with respect to predisposition to “vaccine injury” that are not based in evidence that’s been called out by genetics experts.

Next, Dr. Fogerty abuses the concept of “As Low As Reasonably Achievable” (ALARA):

From an overview perspective of medicine by way of interacting with every specialty in multiple states, my profession of medical imaging has a unique observational role and its practitioners a unique voice in medical ethics and public health. The profession of radiology relies on a primary principle of ALARA in the protection of public health. This is especially relevant on a developmental continuum in pediatric radiology. This acronym stands for As Low As Reasonably Achievable.

At its core, the ALARA concept imparts the understanding that we should strive to reduce the dose of toxins in our practice of medicine to achieve the therapeutic goals of Interventional Radiology or the goals of Diagnostic Imaging for our colleagues tracking disease via the most advanced machines of modern physics in medicine.

Whether those toxins are purely waveforms, or a mix of waveforms from injected metals (radioisotopes), or a non-radioactive metal such as gadolinium, we must always strive to protect our patients from this genetic and immunologically harmful substances under our Hippocratic Oath.

“Immunologically harmful substances”? You and I both know where this is going. He’s about to discuss vaccines as harmful. I know he’s about to lay down a whole heaping helping of antivaccine pseudoscience, which is exactly what he proceeds to do. But first he has to claim that there are parallels between pediatricians and radiologists when it comes to ALARA, and, yes, the parallel to him is between radiologists minimizing exposure to radiation and contrast agents used in imaging studies. Hilariously, he brags about the role of radiologists in diagnosing “vaccine injury,” as if that were something to be proud of when the “injuries” attributed to vaccines by antivaxers like Dr. Fogarty are not caused by vaccines. Let’s put it this way. Blaming autism, sudden infant death syndrome (SIDS), asthma, autoimmune disease, and other conditions that aren’t caused by vaccines is nothing to be proud of. Dr. Fogarty opines:

Increasingly, vaccine injuries are being diagnosed by the world’s radiology community. The well characterized Autoimmune Syndrome Induced by Adjuvants (ASIA) is often documented in MRI images as Shoulder Injury Related to Vaccine Administration (SIRVA). This has resulted in the occupational disability of many healthcare workers around the nation in recent years with the push for 100% compliance in healthcare for the use of influenza vaccines.

I must be behind on my antivaccine pseudoscience. Of course, I’m well familiar with ASIA, the bogus autoimmune syndrome supposedly caused by aluminum adjuvants that was invented by Israeli antivaxer Yehuda Shoenfeld. Also, SIRVA is a real syndrome, basically long-lasting shoulder pain after vaccination that’s associated with inadverent injection into the deltoid bursa or joint space and thought to be due to an immune reaction. It has nothing to do with ASIA which is a nonexistent syndrome that’s so vaguely defined as to be useless as a diagnosis.

Next up, some fear mongering about influenza vaccines. Yes, according to Dr. Fogarty, we should be worried about covert biological warfare. I must admit that I laughed out loud when I read this:

This is not only a costly loss of worker productivity, influenza vaccines are a yearly unethical experiment because of the lack of any safety studies on these medical products. Influenza vaccines are distributed within weeks of their development and have repeatedly been found contaminated aftermarket release in the last 20 years. Our national healthcare security through the workforce of physicians, nurses, laboratory and radiology technologists is placed at risk for political espionage even as more vaccines are manufactured in jurisdictions that could use these products as Trojan horses for slow viruses or prions. Epidemiologically, my colleagues in public health, Neurology or Infectious Disease will need years and many exposures to identify a signal if such covert biological warfare is occurring even now.

Yes, you read that right. Dr. Fogarty thinks our vaccine program is being infiltrated and vaccines might be used as Trojan horses for slow viruses or prions. As for inadequate testing of influenza vaccines, the components of the vaccine remain the same every year except for the proteins used to provoke an immune response, which vary depending on the predicted dominant flu strains. This is not unethical experimentation; it is public health.

I must admit that Dr. Fogarty is talented at the Gish gallop. He invokes bioinformatics in an impressive-sounding but scientifically vapid manner. He tries to paint traumatic brain injury (TBI) as being really due to aluminum from—you guessed it!—vaccines. It’s the same sort of vile gambit that antivaxers have used by trying to claim that shaken baby syndrome (SBS, now known as abusive head trauma) is a misdiagnosis for “vaccine injury.” He also claims to have “published several neuroimaging statistical analyses of brain injury from metals linked through TBI and dementia.” So I went to PubMed and looked for his publications. Dr. Fogarty has six publications listed, which is not very impressive for the chairman of a department. One advantage, though, is that this small number allowed me to peruse the abstracts of all of them. All I can conclude is that Dr. Fogarty likes to study MRI and/or SPECT images of the brain before and after hyperbaric oxygen therapy for head trauma, drowning, and Alzheimer’s dementia. There’s nothing there that I can see that has anything to do with aluminum.

None of this stops him from claiming:

Mild recurrent encephalitis from trauma with iron is being defined as CTE in our athletes and on MRIs with specific sequences (SWI), capturing the virtual history of this recurrent chronic encephalitis by medical imaging techniques recoding iron/hemosiderin deposits. It is no stretch to suggest that autism in some children may be a complex metals detoxification impairment syndrome from stepwise recurrent encephalitis. This relates to a myriad of environmental toxins such as lead, mercury and aluminum as well as cytokine stimulus from viral illnesses, some being proprietary live infections from a corporation named Merck. Basic immunology and periodic table politics aside, would you as a legislator mandate YOUR OWN participation in a marketplace that has no liability for its products? There is no liability for these products and thus the best real economic mechanism we have left to discern fraud is consumer choice.

I’ll give Dr. Fogarty more credit. Not only is he very good at the Gish gallop. He knows how to weave a bunch of unrelated findings together in a superficially convincing-sounding way. Scientists with any actual knowledge of the relevant sciences know it as biobabble. Remember technobabble from Star Trek:The Next Generation? Techobabble was scientific-sounding nonsense that the writers of the show were fond of to describe and resolve plot problems. Think of biobabble as the same thing, only with biology. Or maybe I should call it immunobabble instead. Either way, it’s nonsense dressed up in science-y sounding gibberish.

Oh, and Dr. Fogarty believes that the useful idiot to the antivaccine movement, Dr. Andrew Zimmerman, is actually on to something, rather than being part of a silly conspiracy theory cooked up by Robert F. Kennedy, Jr. and antivaccine journalist Sharyl Attkisson.

He then finishes with a hyperbolic flourish, addressing the Washington legislature:

If removing philosophical exemptions to participation in fraudulent unregulated markets are what your collective actions bring to bear in your state, you may find liabilities that you did not anticipate. I can say this without reservation, the most pervasive molecular crime against humanity in the last 20 years has been the use of aluminum injections on day one of life which have no medical indication. Diagnostic medicine has long ago marked the crime of medical assault on American babies whose mothers’ obstetric laboratory panels have shown millions of times over that they are delivering antibodies against the Hep B vaccine itself to their fetuses. There is no medical indication for a vaccine on day one of life outside of active infection of the mother. The rest of my colleagues in medicine would be sued or lose their license for serial billing of the state or insurance companies on completely worthless un-indicated interventions like Hep B on day one, or for that matter, at 2 months of life.

Aluminum in vaccines are the “most pervasive molecular crime against humanity in the last 20 years”? (One wonders what the other “molecular crimes against humanity in the last 20 years” were.) But don’t call Dr. Fogarty antivaccine. Don’t you dare call him that! As for the hepatitis B vaccine on day one after birth? Actually, there are a number of very good, scientifically justifiable reasons to administer it.

Then:

I believe you can all see now that the only check and balance in the system against fraud in vaccine science is a public consumer (parents) becoming aware within our nation discourse regarding these issues. Please hold the line on the philosophical exceptions for the greater good of Washington’s political well-being. Forcing your youngest citizens to participate in a fraud and racketeering scheme is a violation of basic human rights. We first need ethical corporate leadership in the vaccine industry before we can trust our genetically-disabled to the gross negligence of entire generations of humans being treated like cattle. Thank you for your time and attention, may the wisdom of the great decision makers of history help you discern the best for your state regarding philosophical exemptions.

Now that’s some seriously over-the-top antivaccine ranting! I particularly salute Dr. Fogarty for his use of the term “cattle” and his self-restraint in not using the term “sheeple.”

Now where was that paper bag again? No, this one’s bad enough that I need the steel Doctor Doom mask. My embarrassment over my profession elicited by Dr. Fogarty’s ignorant, immunobabble-packed rant demands nothing less, as antivaccine doctors, particularly ones who lay down such pseudoscience on an epic scale, are among the worst of our profession.