Dr. Lawrence Palevsky: An antivaccine pediatrician who’s an endless font of misinformation

Dr. Lawrence Palevsky is a pediatrician. He is also one of the things I detest the most, an antivaccine physician, having appeared in the antivaccine propaganda film disguised as a documentary, The Greater Good; actively spread antivaccine misinformation among the orthodox Jewish communities in Brooklyn and Rockland County in New York; and has become an active promoter of antivaccine pseudoscience and conspiracy theories to the point where I advocate taking his license to practice medicine away. Recently, I was made aware of a video of him providing “expert” (if you can call it that) testimony before a legislative informational forum in Connecticut, which has been considering removing the religious exemption to the state school vaccine mandate, and it had so much misinformation that it set my teeth to grinding, and when my teeth start grinding my blogging hands get itchy for a keyboard to type out a rebuttal on, particularly given that his testimony is being touted by quack websites.

It also occurred to me that a rebuttal to the antivaccine pseudoscience, disinformation, and bad science is a useful exercise, because, make no mistake, Dr. Palevsky is a major asset to antivaxxers. Why? First, he’s a physician and, even better and more relevant for their purposes, a pediatrician who’s gone completely over to the Dark Side on vaccines. Second, being a later middle-aged white guy (it turns out that he started medical school one year before I did), he looks authoritative, just like the traditional cliche of what a physician should look like. Worse, he sounds authoritative when giving testimony, even when that testimony consists mainly of easily refuted antivaccine tropes and denial that there is data on certain aspects of vaccine safety when in fact there are a lot of data. As you will see, in a little over 18 minutes, Dr. Palevsky lays down a veritable barrage, a Gish gallop, of antivaccine tropes and claims that sound plausible if you don’t know a lot about the issue. This makes him a menace to public health:

Please allow me to introduce myself; I’m a man of antivaccine taste

Dr. Palevsky started his testimony by introducing himself, recounting his history working in emergency rooms, intensive care units, and later private practice. Of course, what he neglected to tell the legislators was that his private practice is an “integrative pediatrics” practice that offers rank quackery such as acupuncture and Chinese Medicine, chiropractic, osteopathy, cranial-sacral therapy, environmental medicine, homeopathy, and essential oils, along with natural healing modalities such as aromatherapy, yoga, Reiki, meditation, reflexology, and mindfulness. Worse, his philosophy towards treating children is truly horrific. No wonder since he entered the public eye, he’s “cleaned up” his website, purging it of most of its quackier elements. Unfortunately for him, though, the almighty Wayback Machine at Archive.org knows all, remembers all, and tells all:

Acute symptoms, such as fever, vomiting, diarrhea, rash, cough, runny nose, mucus production and wheezing, are all important ways in which children discharge stored accumulations of wastes or toxins from their bodies. These toxins enter and are stored in their bodies from repeated exposures to in utero, air, food, water, skin, nervous system stress, and injected materials, that for whatever reason, don’t easily exit their bodies through the normal means of detoxification. These toxins are too irritating to children’s bodies and must be removed. Eventually, a critical level of the toxins is reached, and children get sick with symptoms to purge them. Children, therefore, must be allowed to be sick, in order for them to get well.

In his practice, Dr. Palevsky encourages parents to allow children to express their symptoms when they’re sick. No one wants children to “feel” sick. Parents can learn to use remedies, however, that help children feel better and heal more effectively, without altering the important physiology which is helping them cleanse their systems. Letting children have their symptoms, without suppressing them, can be a challenging process both for parents and health care practitioners. We often come face-to-face with our own discomfort when children experience discomfort from their illnesses. It’s hard for us to watch them “suffer”, so we reflexively give them something to bring immediate relief. This reflexive response to suppress their symptoms, however, weakens them and delays their healing process.

I will continue to quote that passage every single time I write about Dr. Palevsky’s promotion of antivaccine pseudoscience. Indeed, if I were at that legislative session, I’d quote Dr. Palevsky’s words back to him and ask him if he really believes in not vaccinating because vaccines prevent children from “expressing their symptoms” and fully experiencing the gloriousness of measles, mumps, chickenpox, Haemophilus influenza type b, etc. Personally, as I said the last time I discussed Dr. Palevsky, come to the belief that Dr. Palevsky is a monster. He seems to have believed (and almost certainly still does believe) that children should suffer, that their suffering shouldn’t be relieved, that children should be “allowed to be sick” because to do otherwise would be unnatural and prevent them from “cleansing” and “healing” their systems properly. I also can’t help but note, as others have, that there is a distinct strain of germ theory denialism here. You see, it’s not so much the bacteria and viruses causing fever and disease. It’s the toxins. He’s even explicitly said it, as others have documented. Dr. Palevsky definitely deserves his entry in the Encyclopedia of American Loons.

Dr. Palevsky continued his testimony with the sort of story we commonly hear from antivaccine quacks like himself, namely that all he was taught about vaccines in medical school was that “they were safe; they were effective; and give them,” saying that he wasn’t taught the science of vaccine safety. The reason this particular narrative is effective, regardless of whether it’s true or not, relies on something that the lay person doesn’t usually know, namely that medical school is where students go to learn the basics of medicine, the common base upon which residency training builds to produce the finished product, the fully trained doctor. When we graduate medical school, we are not qualified to practice. When we finish internship, although most states will allow us to be licensed, we are not really qualified to practice, which is why someone with only one year of postgraduate training, while technically able to practice, won’t be able to get hospital privileges and won’t be able to be signed up on any insurance plans. No, the real learning how to be a physician, for instance a pediatrician, happens in residency, and I’d bet that Dr. Palevsky learned all the potential side effects of every vaccine that was on the schedule at the time. Why? Because he was being trained to administer vaccines, and if you administer vaccines you need to know how to deal with the minor side effects (e.g., fever, sore arm, etc.) and to recognize potential serious side effects..

The whole purpose of this narrative is to deceive lay people into thinking that doctors have no training in vaccines at all. It’s a profoundly dishonest narrative. Of course, it wouldn’t surprise me if, through the wonders of confirmation bias and selective memory, Dr. Palevsky has convinced himself that he didn’t get any such training in residency, either.

The next part of his testimony reveals Dr. Palevsky to be profoundly ignorant. In it, he told the story of a mother coming up to him in 1998 and asking him if he knew there was mercury in vaccines. Seriously? He didn’t know? Did he not know what thimerosal is? Didn’t he ever read the package inserts? I know I rip on how antivaxxers misuse package inserts, but package inserts do at least list vaccine ingredients, and back then thimerosal was used as a preservative in saline solutions for contact lenses as well. In any event, here is the first instance where Dr. Palevsky goes nauseatingly out of his way to convince legislators that he’s a Man of Science, saying, “As a medical student, I was trained to critically think. If you see an observation, you go after it and see if there’s a question to ask.” Given the quality of Dr. Palevsky’s testimony, I would very much dispute whether he was ever taught to be a critical thinker, in medical school or anywhere else. If he was, his medical school clearly failed.

The next part of the video shows just how ignorant Dr. Palevsky is. He related how he had started looking into vaccine ingredients and found “many animal studies” showing that these ingredients were “very dangerous to animals” and said, “I didn’t understand why these ingredients were in vaccines.” Dude, just ask. What you were doing in that testimony was nothing other than parroting the “toxins gambit.” There are people who can tell you why various ingredients are in vaccines. Thimerosal, when it was in vaccines, was used as a preservative for multidose vials. Formaldehyde is used to inactivate virus, and traces are left behind, traces too small to cause any harm given that formaldehyde is a normal product of metabolism and an infant’s body has far more of it than any vaccine. I realize that the Children’s Hospital of Pennsylvania Vaccine Education Center website probably wasn’t around, but even at this late date Dr. Palevsky could, if he so chooses, to easily educate himself about exactly why each vaccine ingredient is in vaccines and how none of them are dangerous at the concentrations/doses present.

Naturally, Dr. Palevsky is very much into confusing correlation with causation and demonstrated it by relating stories of “thousands” of parents who thought vaccines had injured their children, indignantly telling how “every one of these parents” was told that vaccines “had nothing to do with” their children’s health problems, autoimmune disease, regression into autism, and the like. He listed a bunch of statistics, straight out of the “sickest generation” myth promulgated by Robert F. Kennedy, Jr. Full of false confidence, Dr. Palevsky said that, looking at vaccine ingredients, he had The Science to explain what had happened to these children. (Spoiler: He didn’t and doesn’t.) In fact, he went on to claim that vaccine ingredients can “be seen to be responsible for every single one of these cases.”

Nanoparticles, emulsifiers, and vaccines, oh, my!

Here’s where things get bizarre. Dr. Palevsky went on an expanded riff about the blood-brain barrier, as structural feature of blood vessels in the brain and central nervous system that keeps certain compounds and drugs from getting into the brain tissue. Having exercised his vast Dunning-Kruger skills reading the animal literature, he pontificated about how, if you want to get a drug into the brain, you can attach it to a nanoparticle and, if you want to get even more of a drug into the brain, you combine the drug attached to a nanoparticle with an emulsifier. (Emulsifiers are compounds, like detergents, that can dissolve in both water and fat, stabilizing something that’s fat soluble in an emulsion in water.) I bet the chemists can see where this is going.

According to Dr. Palevsky, guess what? That’s exactly how vaccines are made! The nanoparticle is the aluminum salt in the vaccine, and the emulsifier is something like polysorbate 80, which is in some vaccines. Naturally, this leads Dr. Palevsky to ask if that means that the nanoparticles and emulsifiers in vaccines can bypass the blood-brain barrier and get the antigens used in the vaccines into the brain and explain why so many children allegedly deteriorate after vaccines, even though the doctors, the media, the government, etc., say that it’s not the vaccine. Those of you familiar with Yehuda Shoefeld’s autoimmunity pseudoscience will now see where this is going.

At this point, Dr. Palevsky made the first of multiple annoying “no study” assertions, “You cannot find a single study in the literature that addresses whether the injection of aluminum into the body penetrates the brain, whether any vaccine ingredients enters the brain, and whether polysorbate 80 enhances the delivery of any of those ingredients into the brain.” Of course, he then claimed that these vaccine antigens get into the brain and cause inflammation.

At this point I can only say that Dr. Palevsky must not have looked very hard, and I can’t help but note that good blog bud Skeptical Raptor recently published a discussion of this very topic, complete with listing studies, of the pharmacokinetic distribution of aluminum, as did an actual blood brain barrier scientist and yours truly. He also wrote a very good deconstruction of the claim that polysorbate 80 breaks down the blood-brain barrier, complete with a list of many studies. As for studies, I like what he said here:

Keep in mind that polysorbate 80 is good at dissolving lipid in water solutions but it is not good to let charged molecules across the BBB, just in case someone comes with the claims that it conjugates with aluminum. Thats some high-school chemistry level.

Precisely. When a claim contradicts chemistry 101 (at best) knowledge, all it does is to show that the person making the claim is a clueless twit about the science behind the claim. Another error made by Dr. Palevsky, the aluminum particles used as an adjuvant in vaccines are not nanoparticles. As Blood Brain Scientists pointed out in her post, they range between 2-10 μM in diameter, with a median diameter of around 3 μM. (That’s micrometers, not nanometers.) True, there have been efforts to reformulate the aluminum salt particles as nanoparticles in order to increase the immunogenicity of vaccines, but they are still experimental. Right now, aluminum nanoparticles are not used in commercially available vaccines. Even more importantly, being microparticles, aluminum salt particles in vaccines tend to remain localized at the site of injection. Polysorbate 80 can form nanoparticles, but not in the way that Dr. Palevsky claims and not with aluminum, which is present at much larger particle sizes, and, again, we already know that it doesn’t “break down” the blood-brain barrier to allow vaccine antigens to get into the brain.

I could go on and on and on and on. It’s not as though the distribution of formaldehyde after injection or after its production by normal metabolism isn’t known. Seriously, Dr. Palevsky needs to go back to school to learn some chemistry, biochemistry, and pharmacology, in particular pharmacokinetics and pharmacodynamics. If he did, he might also figure out that we already know the pharmacodynamics of polysorbate 80 and aluminum, and that the doses present in vaccines are way too small to do what antivaxxers like him claim.

Oh, no! No saline placebo!

The less said on this issue, the better, but damn if Dr. Palevsky didn’t next pivot to the most brain dead, ignorant, easily refuted antivaccine trope of all, the “no randomized studies of vaccines versus saline placebo” gambit. It’s a trope so divorced from reality, a trope that just takes a quick perusal of PubMed to refute, that I really don’t want to waste a lot of time on it other than to refer you, my readers, to previous discussions by Dr. Vincent Ianelli (also here); Helen Petousis Harris; and Skeptical Raptor. I’ll also point out that, contrary to antivaccine myths, from a scientific standpoint a saline placebo is not always the most appropriate placebo, as anyone who designs clinical trials of vaccines (i.e., not Dr. Palevsky) knows.

Oh, no! No safety studies!

Dr. Palevsky is a veritable font of antivaccine claims, and he kept going, next diving into the claim that there are no good vaccine safety studies. This is, of course, utterly untrue. Safety testing of vaccines is, in actuality, very rigorous. None of that stopped Dr. Palevsky from claiming that human subjects in vaccine trials are only followed for four or five days (although he “conceded” that it’s now up to ten days). Wrong, wrong, wrong, wrong! That’s another antivaccine myth. There are lots of long term studies on vaccine safety. Dr. Ianelli has even listed quite a few of them for Dr. Palevsky’s convenience. He should read this post. (No, really, he should.) There’s even one study that followed children out for 20 years. So when Dr. Palevsky made the claim that if your child has a seizure 5 months after a vaccine, there are “no studies” (that idiotic trope again!) to show one way or the other if vaccines could have caused his seizure, he’s revealing nothing more than his profound ignorance. No, we have lots and lots of studies that tell us if an event years later is likely to have been caused by vaccines.

One bizarre claim made by Dr. Palevsky was that the pharmaceutical companies determine what will and will not be considered adverse reactions for purposes of reporting in the clinical trials. This claim reveals a profound lack of understanding how clinical trials are regulated and run in the US. While it is true that preapproval studies are funded and run by the pharmaceutical company seeking to license their vaccine—who else would fund them?—they are overseen by the FDA, which, thanks to regulations regarding the protection of human research subjects, requires that the trial be approved and overseen by an institutional review board (IRB). IRBs are tasked not only with making sure that the study design is ethical, but with reviewing all reports of adverse reactions in the trial, whatever they might be. The law requires reporting all adverse reactions. True, there is an assessment of whether a given observed adverse event is due to the vaccine or not, but it’s not just the investigators or the pharmaceutical company that gets to make that determination. The FDA is involved, as is the IRB overseeing the clinical trial. Dr. Palevsky made it sound as though the pharmaceutical company could just decide however it wants which adverse events are and are not due to a given vaccine in a clinical trial.

Also, doesn’t he know that many vaccine safety studies done postlicensure aren’t carried out by pharmaceutical companies? They’re carried out by governments, independent researchers, and the like.

Dr. Palevsky deserves a Godzilla facepalm.

Oh, no! Unvaccinated children can’t cause outbreaks!

I’m sorry, but this claim deserves a mega-facepalm. Dr. Palevsky actually said in his testimony that there are no studies that show that the unvaccinated can start an epidemic. First, I wish I could have stopped Dr. Palevsky right there and told him that the word he was looking for was “outbreak,” not “epidemic.” In epidemiology and infectious disease, the word “epidemic,” although often used interchangeably with the word “outbreak,” does not connote the same thing. “Outbreak” connotes a rapid increase in the number of cases of infectious disease (as does “epidemic) but over a smaller geographic area than “epidemic.” Still, I’ll let it slide.

In any event, here we see Dr. Palevsky using the “just show me one paper” fallacy. It’s also profoundly deceptive, as often we come to scientific conclusions based on the confluence of data and studies from different sources and disciplines. It’s also silly. We know the attack rate of a pathogen during an epidemic is much higher among the unvaccinated than the vaccinated. For instance, during a pertussis outbreak, the risk of being infected with pertussis is 23-fold higher among the unvaccinated than among the vaccinated. For measles, the increased risk is between 22- and 35-fold higher. I’ve seen even seen one study that estimates that the unvaccinated are as high as 200-fold more likely to catch the measles during an outbreak.

As for “no studies,” it’s often difficult to determine with certainty who “patient zero” is in any given outbreak, and the scientific literature can only identify the most likely candidates for “patient zero.” What we do know is that when vaccine coverage for a given pathogen falls below a certain level in a population, outbreaks become much more likely, and the pathogen can spread much faster because there are so many more susceptible individuals. We do know that in the most recent measles outbreaks in the US the vast majority of those who came down with the measles were unvaccinated. We know that in the most recent measles outbreak among orthodox Jews in Brooklyn, because so many were unvaccinated, one student infected at least 21 other people because parents ignored warnings not to send their unvaccinated children to school during the outbreak.

Time and time and time again, when measles outbreaks (and outbreaks of other infectious diseases) are studied, it’s found that the attack rate in the unvaccinated is much higher and that usually most of those who become ill are unvaccinated. Time and time and time again, these outbreaks are found to have started with an unvaccinated individual, often returning after traveling to an area where there are ongoing outbreaks, bringing the disease back and spreading it to other unvaccinated people.

Of course, Dr. Palevsky then claimed that vaccines don’t eliminate the pathogen from the body, that the vaccinated can still be carriers. First of all, that’s not true of most pathogens; Dr. Palevsky appears to be referring mainly to pertussis, where it’s controversial whether vaccinated children can still be asymptomatic carriers, because certainly there aren’t other examples that I’m aware of. What we do know is that the vaccine against pertussis does prevent disease and interrupt the spread of pertussis; so vaccinating is the safe thing to do. (Yes, I do know about waning immunity due to the vaccine, but that’s taken care of with appropriately timed boosters.) In other words, this is not a reason not to vaccinate and not a reason to conclude that the unvaccinated don’t cause and perpetuate outbreaks.

If you want to get an idea of how ignorant Dr. Palevsky is, near the end of his testimonay he even made the claim that 38% of the measles cases in the Disneyland measles outbreak were due to vaccine strain measles. Nope. This is an antivaccine talking point that, like many others, has been refuted thousands of times but just won’t die.

No vaxxed/unvaxxed studies!

Dr. Palevsky does love to play the “confuse correlation with causation” card when he once again trotted out the “sickest generation” trope, repeated his disinformation claiming that there are no saline placebo-controlled studies of individual vaccines, and then claimed that there are no health outcome studies comparing the health of vaccinated children with those of unvaccinated children. Again, that last claim is a myth. There are several such studies. No, really, there are. Seriously, can Dr. Palevsky stop repeating the lie that there are no studies comparing health outcomes in vaccinated and unvaccinated children when there are? Of course, what these studies show is not what Dr. Palevsky wants you to think. Contrary to showing that unvaccinated children are healthier than vaccinated children, at minimum, they show that vaccinated children are just as healthy as unvaccinated children, with some studies suggesting them to be in general healthier. Of course, we know they’re healthier in one area, namely being at a much lower risk of acquiring a serious vaccine-preventable disease.

Dr. Palevsky is clearly unaware of the phenomenon of confirmation bias. It’s a bias to which all humans are prone in which we remember things that support our beliefs and biases. Skeptics and scientists try to account for it when examining evidence. Most people, like Dr. Palevsky, do not, which explains why he said things like this about unvaccinated children during his testimony:

They are the healthiest children I have ever seen.

No, Dr. Palevsky only thinks his unvaccinated patients are the healthiest children he’s ever seen because he primarily remembers the healthy ones and most of the children in his practice are unvaccinated or undervaccinated anyway.

Hubris, thy name is Dr. Larry Palevsky.

The last five minutes or so of Dr. Palevsky’s testimony is truly something to behold, and I don’t mean that in a good way. The display of hubris demonstrated by Dr. Palevsky in his assertions beggars the imagination. For instance, he pointed out that vaccines don’t always produce an antibody response and—shock of shocks—that sometimes antibody titers don’t correlate with immunity as though this were some great discovery that scientists have been hiding from the public. Seriously, the only people shocked to learn that there are people who don’t develop an antibody response to vaccines and even those who are not immune despite an antibody response are people who know nothing about the immune system but what they’re fed by antivaccine cranks. It’s not as though immunologists haven’t been discussing and studying this phenomenon for…oh…forever, looking for better correlates of immunity and how to make vaccines more immunogenic. Seriously, if, like Dr. Palevsky did, you’re going to lay down nonsense like claiming that vaccinating stops the spread of disease is an assumption that’s never been “solidified in science,” get thee to an introductory course in immunology forthwith and shut up until you’ve passed the course!

Dr. Palevsky also engaged in some amazing projection, characterizing the current faith in vaccines is based on “belief” and “opinion” instead of “actual science,” adding, “and beliefs go a long way.” Having listened to Dr. Palevsky’s misbegotten and deceptive testimony, I can only conclude that he wouldn’t recognize “actual science” if it were a bear biting him on his gluteus maximus. As for “beliefs going a long way,” no kidding. That explains how Dr. Palevsky can spew such utter nonsense divorced from science and cite without naming the investigators animal experiments carried out by the likes of Christopher Shaw that accomplish nothing other than the unnecessary torture of mice with such utter certainty that he knows what he’s talking about when anyone who actually knows the subject recognizes what an ignoramus he is. (If he’s not an ignoramus, he’s a lying propagandist. There is no third option.)

He even made the ridiculous assertion that, in order to provide herd immunity we have to be able to prove that the children vaccinated are immune. What? I know what he was trying to say. He was trying to claim that because antibody titers don’t always correlate with immunity you can never demonstrate herd immunity. (At least I think that’s what he was driving at.) Guess what? We can demonstrate herd immunity by the observation that when greater than a certain percentage of the population is vaccinated against a pathogen outbreaks of the disease caused by that pathogen become much less likely. We can demonstrate it with examples such as the measles outbreak in Samoa, which didn’t start to subside until MMR uptake passed 90%. Dr. Palevsky even parroted Andrew Wakefield’s lie that measles virus is mutating in response to the vaccine to become more virulent. It’s not.

Dr. Palevsky is ignorant. He is spreading antivaccine misinformation. He is also dangerous because of his status as a pediatrician and also because he knows how to look and sound authoritative and convincing. Unsurprisingly, as I mentioned before, he is also an “integrative pediatrics” practitioner, which, sadly, goes along with pseudoscience, bad science, and antivaccine nonsense. Once again, I will say that any doctor who not only uses quackery like homeopathy but actively endangers public health should not be a doctor. It’s a travesty that doctors like Dr. Palevsky continue to hold medical licenses and treat patients.