In case anyone was wondering why I haven’t written any blog posts since Monday, the answer is simple. I had a grant deadline. The grant has been submitted, which leads me to wonder what I should write about before the week is out. Unfortunately, when I’m frantically trying to finish a grant I tend to spend a lot of time on Twitter because it’s the sort of thing I can do at for a minute or two between bouts of writing and editing, which is bad because I’m usually in a bad mood while editing my grants. My bad habits aside, anyone who follows me on Twitter will be aware that the kerfuffle stirred up by my post a week ago criticizing Dr. Hooman Noorchashm’s #ScreenB4Vaccine campaign. Dr. Noorchashm’s idea and concern were that a mass vaccination campaign against COVID-19 could be dangerous in people with preexisting antibodies to SARS-CoV-2, the coronavirus that causes the disease, because the virus infects the endothelial cells that line the inside of blood vessels and vaccination could therefore cause an autoimmune reaction that results in vascular clotting events. His idea was, therefore, that we should “screen” before vaccinating against COVID-19 (hence the #ScreenB4Vaccine hashtag), so that we don’t vaccinate people who either have or have had COVID-19 and have pre-existing antibodies.
At the time, I was more disturbed by how unconcerned the good doctor was that his idea had been co-opted by a leader in the antivaccine movement—namely Robert F. Kennedy, Jr. himself! Worse, Dr. Noorchashm used anecdotes to support his concern in much the same way that antivaxxers have weaponized anecdotes of deaths after COVID-19 vaccination:
As regular readers know, I’ve been warning about an expected veritable tsunami of reports of death and adverse events after COVID-19 vaccination that will result from antivaxxers weaponizing them and taking advantage of the human tendency not to understand baseline rates and coincidence. In brief, if you vaccinate hundreds of millions of people, there will be bad things that happen to some of them as a result of random chance alone. You have to understand the baseline rate of such events to judge if the reports we’re hearing might represent an actual signal indicating that the vaccine is associated with (and might cause) the adverse events reported. A good example is the report of deaths in elderly nursing home patients in Norway after vaccination, which ended up almost certainly being due to coincidence and the high baseline rate of mortality among very elderly, very frail nursing home patients with multiple comorbidities.
That’s why I thought that I should post an update to this sad saga. The reason is simple. A week ago, before I wrote my post, I had considered Dr. Noorchashm’s concern at least “not entirely unreasonable.” However, I’ve since read more recent scientific literature that has led me to believe that Dr. Noorchashm’s concern is actually not particularly plausible from a basic science standpoint.
First, in the spirit of Dr. Noorchashm’s repeated exhortation “Always polite!” I’ll point out that the good doctor finally did call out RFK Jr. for having stolen his idea to use for antivaccine propaganda. It took a lot of prodding over the course of four days by me and a number of pro-vaccine advocates, but he did eventually do it. That’s good:
Dr. Noorchashm’s request of RFK Jr. is fairly weak sauce, and, as far as I know, Dr. Noorchashm hasn’t directly written to RFK Jr., even though he knows RFK Jr.’s email address. (How do I know this? He cc’d RFK Jr. in some of his emails to me, along with my department chair.) But, hey, it’s a start. It’s something. It’s definitely better than nothing. True, I’d like him to do more, but, quite honestly, I don’t expect him to, although I’d love for him to surprise me.
Unfortunately, Dr. Noorchashm has continued to do the same thing that he did with Hank Aaron, which is even more unfortunately exactly the same thing that antivaxxers do with reports of death anywhere soon (or even not-so-soon) after any vaccine dose:
One notes in particular that, in the case cited above by Dr. Noorchashm, an investigation had specifically ruled out the COVID-19 vaccine as a contributing factor for the death. Dr. Noorchashm apparently didn’t care and hasn’t stopped doing the same thing:
Unfortunately, I feel obligated to point out that elsewhere Dr. Noorchashm has most definitely not lived up to his “Always polite!” motto. I’ll discuss that at the end of this post, in particular my concerns about how the good doctor has been (unknowingly, I assume) spewing familiar antivaccine talking points. First, however, let’s do science. Let’s look at his #ScreenB4Vaccine idea and why I now think it’s not even very plausible from a scientific standpoint.
Why Dr. Noorchashm is wrong about #ScreenB4Vaccine
I’ll start my discussion by reviewing the concept that I discussed a week ago, Dr. Noorchashm’s #ScreenB4Vaccine. Dr. Noorchashm’s main concern seems to be that those who have previously been exposed to COVID-19 (and have pre-existing antibodies), who’ve had COVID-19, or who might have asymptomatic COVID-19 at the time of vaccination will have particularly severe reactions to COVID-19 vaccination. At the time, I characterized #ScreenB4Vaccine as a “not entirely unreasonable fear, but also as a fear for which even the good doctor admits there is no evidence:
I want to be clear to be clear that my warning here is based on a near definitive scientific Immunological prognostication. It is a “prognostication” in that I have put it forth in the absence of clear “evidence” of it being a material risk.This is because we are dealing with an evolving 11-month old national health emergency with many unknowns, and a vaccine that is only several weeks old — and was approved for massive scale use on the Emergency basis. And, in a setting where it is critical to quickly vaccinate as many citizens as possible to achieve herd immunity against SARS-CoV-2.
As you also know it appears that the ACE-2 receptor on endothelium is the portal for viral entry into endothelial cells — and it seems that endothelial injury from the virus or from the inflammatory reaction it incites is the reason why many COVID-19 patients experience thromboembolic complications.
So it is a matter of certainty that viral antigens are present in the endothelial lining of blood vessels in all persons with active or recent SARS-CoV-2 infection — irrespective of whether they are symptomatic or convalescent.
I am writing to warn that it is an almost certain immunological prognotication that if viral antigens are present in the tissues of subjects who undergo vaccination, the antigen specific immune response triggered by the vaccine will target those tissues and cause tissue inflammation and damage.
Most pertinently, when viral antigens are present in the vascular endothelium, and especially in elderly and frail with cardiovascular disease, the antigen specific immune response incited by the vaccine is almost certain to do damage to the vascular endothelium. Such vaccine directed endothelial inflammation is certain to cause blood clot formation with the potential for major thromboembolic complications, at least in a subset of such patients. If a majority of younger more robust patients might tolerate such vascular injury from a vaccine immune response, many elderly and frail patients with cardiovascular disease will not.
Basically, Dr. Noorchashm expressed concern based on a simple observation. The SARS-CoV-2 viral spike protein is the protein used in the Moderna and Pfizer/BioNTech vaccines as the antigen to provoke an immune response. This protein is also the same protein that binds to the ACE-2 receptor on cells to allow the virus to gain entry to those cells. The ACE-2 receptor is a very important protein that is located on the surface of a number of cell types and has a major role in regulating blood pressure, among other things, which is why blood pressure drugs target it.
Here’s the problem. This concern was based on an early understanding of SARS-CoV-2 infection. Early in the pandemic, it was observed that COVID-19 patients with severe disease often developed (among other serious problems) life-threatening dysfunction in their clotting system. One potential explanation proposed was that, given how SARS-CoV-2 gets into into cells by binding to the ACE-2 receptor, perhaps the immune reaction to the presence of coronavirus proteins being produced caused inflammation of the endothelial cells that line blood vessels resulting in clotting, because injury to vascular endothelial cells is one of the early events in clotting. After all, the function of clotting is to stop the bleeding that results when blood vessels are injured.
As Ed Nirenberg explained:
I’ll get to the “except” in a minute. First, note that this paper was originally published in April, when our understanding of the serious disease caused by SARS-CoV-2 was still in its infancy. The question at the time was whether the hypercoagulability (excessive activation of the clotting system leading to clots that can result in strokes, organ damage, and more) was due to direct infection of the endothelial cells lining the blood vessels by the coronavirus or whether it was a byproduct of a more general systemic inflammatory response to infection. At this point, I’ll simply note that hypercoagulability is not an uncommon phenomenon observed in systemic inflammation, regardless of the underlying cause (sepsis, trauma, etc.). So, back then, either mechanism (or both) could explain the hypercoagulability observed in patients with severe COVID-19. (As an aside, the former trauma surgeon in me can’t help but note that hypercoagulability often, paradoxically, leads to bleeding. The explanation is that the excess clotting uses up clotting factors faster than the body can produce them. You’re welcome.)
Basically, if this observation were accurate, it wouldn’t be unreasonable to be concerned that vaccinating a patient concomitantly infected with SARS-CoV-2 might lead to the immune system attacking endothelial cells harboring the virus. That being said, it is a bit unreasonable to claim that previous infection with coronavirus, as evidenced only by the presence of antibodies to SARS-CoV-2 in the blood, would be dangerous based on this mechanism. After all, someone who has cleared the infection would not be expected to be still harboring viral proteins in their endothelial cells, particularly if the infection had occurred weeks or months ago. Again, though, the concern that someone with an asymptomatic infection or a recent infection might develop inflammation of the endothelium if vaccinated was a theoretical concern.
It turns out that this concern was very likely not correct:
So the second paper that led to the hypothesis that SARS-CoV-2 directly infects endothelial cells never made that claim and used rat heart ventricle cells, not vascular endothelial cells. Second, it’s been called into question whether what was observed in the original Lancet paper were even viral inclusions in vascular endothelial cells in the first place! And the above wasn’t the only paper calling into question whether what had been observed really were virus particles in endothelial cells. The authors of one paper warned:
We read with interest the Correspondence by Zsuzsanna Varga and colleagues1 on the possible infection of endothelial cells by SARS-CoV-2 using electron microscopic (EM) images as evidence. However, we believe the EM images in the Correspondence do not show coronavirus particles but instead show cross-sections of the rough endoplasmic reticulum (RER). These spherical structures are surrounded by dark dots, which might have been interpreted as spikes on coronavirus particles but are instead ribosomes. The purported particles are free within the cytoplasm, whereas within a coronavirus-infected cell, accumulations of virus particles would be found in membrane-bound areas in the cisternae of the RER–Golgi area, where the spikes would be located on the inside of the cisternal space.2 In addition, cross-sections through the viral nucleocapsid are not seen in the interior of these structures as would be found with coronavirus particles (figure).
Just recently, there have been two additional reports3, 4 in which structures that can normally be found in the cytoplasm of a cell have been misinterpreted as viral particles.5 EM can be a powerful tool to show evidence of infection by a virus, but care must be taken when interpreting cytoplasmic structures to correctly identify virus particles.
Of course, one could simply point to this as a difference in interpretation of electron micrographs among scientists and thus still claim that Dr. Noorchashm might have a point. Unfortunately for his idea, this paper is not all the evidence calling his hypothesis into question. Perhaps the most damning evidence disconfirming the hypothesis that SARS-CoV-2 directly infects vascular endothelial cells comes from this paper:
Here’s what the investigators did. First, they noted with respect to endothelial cells (ECs):
In retrospect, there are minimal data supporting SARS-CoV-2 infection of ECs and no immunohistochemical studies demonstrating the colocalization of SARS-CoV-2 antigens with EC markers in pulmonary or renal tissues, which express ACE2 on adjacent epithelial cells. Nearly all studies reference electron microscopy data displaying two potential SARS-CoV-2 particles (3, 15), which instead of virus have been implicated as being endoplasmic reticulum (ER) vesicles (16).
To address the question of whether SARS-CoV-2 can infect vascular endothelial cells, the authors isolated primary cultures of human endothelial cells from lung, heart, kidney, brain, and umbilical veins and tried to infect them with SARS-CoV-2 in cell culture. They failed. The coronavirus would not infect these cells. Asking why SARS-CoV-2 couldn’t infect vascular endothelial cells, the authors looked for ACE-2 protein and RNA in these cells and didn’t find any. So next they used a lentivirus vector that drives the expression (production) of the ACE-2 protein in the cells it infects and infected endothelial cells with it. The result? Lo and behold, driving the artificial expression of ACE-2 made endothelial cells susceptible to infection with SARS-CoV-2!
The authors concluded:
Our findings indicate that the absence of ACE2 prevents SARS-CoV-2 infection of human ECs and suggests that ECs are not primary targets of SARS-CoV-2 infection in COVID-19 patients. Consistent with this, COVID-19 does not result in Ebola-like hemorrhagic disease that would likely result from lytic SARS-CoV-2 infection of ACE2-expressing ECs. The inability of SARS-CoV-2 to infect human ECs is supported by low ACE2 expression in the highly vascularized lower respiratory tract (22), CDC and primary human EC infection findings (1, 14, 22), and the presence of ACE2 in vascular smooth muscle and heart muscle cells (11, 18, 23, 24) but not the EC lining of vessels (12–14, 23). These findings support a secondary role of the endothelium, perhaps in response to epithelial cell damage and cross talk, alveolar tissue factor/basement membrane exposure, or inflammatory EC activation, that directs a coagulative, endotheliitic state (1, 3, 17, 25).
Translation: SARS-CoV-2 doesn’t infect vascular endothelial cells because they don’t express ACE-2. The authors do concede that there might be a small percentage of endothelial cells that could be infected by SARS-CoV-2 through a mechanism that doesn’t depend on ACE-2, perhaps as a result of secondary inflammation that “activates” endothelial cells, but I agree with Ed here that the current evidence does not support Dr. Noorchashm’s hypothesis:
Again, there is a tiny bit of wiggle room, but Dr. Noorchashm’s hypothesis does not look promising at all. This is particularly true in light of the fact that, so far, no safety signal that would support his hypothesis has yet been observed after tens of millions of people vaccinated:
In other words, there really isn’t any good evidence to support Dr. Noorchashm’s hypothesis, and, even as a theoretical concern, there is no good reason to use his hypothesis as a reason, even based on the most generous interpretation of the precautionary principle, to test everyone for COVID-19 virus and antibodies before vaccinating them. CDC guidelines already say that someone with an active infection should defer vaccination for a while anyway, specifically:
Data from clinical trials indicate that mRNA COVID-19 vaccines can safely be given to persons with evidence of a prior SARS-CoV-2 infection. Vaccination should be offered to persons regardless of history of prior symptomatic or asymptomatic SARS-CoV-2 infection. Viral testing to assess for acute SARS-CoV-2 infection or serologic testing to assess for prior infection for the purposes of vaccine decision-making is not recommended.
Vaccination of persons with known current SARS-CoV-2 infection should be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue isolation. This recommendation applies to persons who develop SARS-CoV-2 infection before receiving any vaccine doses as well as those who develop SARS-CoV-2 infection after the first dose but before receipt of the second dose.
While there is no recommended minimum interval between infection and vaccination, current evidence suggests that the risk of SARS-CoV-2 reinfection is low in the months after initial infection but may increase with time due to waning immunity. Thus, while vaccine supply remains limited, persons with recent documented acute SARS-CoV-2 infection may choose to temporarily delay vaccination, if desired, recognizing that the risk of reinfection, and therefore the need for vaccination, may increase with time following initial infection.
None of this has stopped Dr. Noorchashm from claiming that vaccinating people who’ve already had COVID-10 is a “breach in the standard of care.” It is not:
The bottom line is that Dr. Noorchashm’s #ScreenB4Vaccine is not supported by evidence; the mechanism he proposes is not plausible from a basic science standpoint; and real world evidence after tens of millions of vaccine doses has not turned up any of the safety signals predicted by Dr. Noorchashm’s concept. Worse, #ScreenB4Vaccine is not only unnecessary but would add considerable cost and logistical difficulties to the mission of getting as many people vaccinated against COVID-19 as possible as quickly as possible and thus might even contribute to letting the newer more infectious SARS-CoV-2 variants, for which current vaccines appear to be less effective, to spread faster, thus costing lives.
Dr. Noorchasm’s “polite” reaction to criticism
I debated about including this last section to my post, but I think that it really is important to see how, his grudging appeal to RFK Jr. to stop using his #ScreenB4Vaccine campaign as antivaccine propaganda notwithstanding, Dr. Noorchasm is, whether he knows it or not and whether he can admit it or not, promoting a form of antivaccine messaging. I’ve already mentioned the first example of how he is doing this by including some examples of Tweets in which he pointed to deaths after COVID-19 vaccination, even one for which the vaccine had been explicitly ruled out as a cause, as reasons to adopt his proposed “solution” to what is almost certainly a non-problem with COVID-19 vaccines. Unfortunately, Dr. Noorchashm also appears to have a bit of a double standard when it comes to “civility” and “politeness.” If you’re not interested in reading a number of Twitter exchanges in which Dr. Noorchashm becomes increasingly nasty, feel free to skip this last section. I’ll understand.
After a whole week of this kerfuffle, there are many examples of what I’m talking about; so I’ll simply highlight a few to make my point, particularly ones that demonstrate that Dr. Noorchashm has a worrisome affinity for antivaccine talking points and language as abusive as any that he decries, whether he realizes it or not and, again, whether he will admit it or not.
I’ll start with, believe it or not, one of the less offensive examples of Dr. Noorchashm’s stylings:
You saw that Tweet right. Dr. Noorchashm characterized calling out antivaxxers like RFK Jr. for spreading antivaccine disinformation and conspiracy theories as “character assassination” for political purposes and referring to RFK Jr.’s critics as “clueless.” Not very polite at all.
I couldn’t help but respond:
Here I also respond thusly: RFK Jr. is out there spreading fear and loathing for COVID-19 vaccines after at least 16 years of having spread fear and loathing for all vaccines, and Dr. Noorchashm is more upset that I (and others) criticize RFK Jr. harshly for doing that than he is at RFK Jr. for stealing his article for antivaccine propaganda purposes. That’s pretty disturbing to me.
As was this:
Which is why I responded:
In case one wonders what I’m talking about, here’s a primer. Apparently, Dr. Noorchashm labors under the delusion that “live debates” decide anything in science or are good for anything other than persuasion based on rhetoric instead of evidence. He also seems to labor under the delusion that countering antivax disinformation is so easy, that the “dunking on a 7′ hoop” analogy came to my mind:
Somehow, I’m reminded of someone else who made a similarly misguided and ignorant argument, but I won’t dwell on that. Let’s move on. Next up, Dr. Noorchashm notes:
Oh, goody. Dr. Noorchashm is not-so-subtly implying that I am “unethical”! Whatever. I counter that I do not “detest” vaccine-hesitant parents. Quite the contrary! I view them as victims who need to be given the tools to recognize antivaccine disinformation and conspiracy theories when they see them. I do, however, detest antivaxxers like RFK Jr. who spread the antivaccine disinformation and conspiracy theories that create vaccine-hesitant people, and I make no apologies for that. Apparently, he also thinks I’m an “availability entrepreneur”:
For those who don’t know what an “availability entrepreneur” is (prior to Dr. Noorchashm’s accusing me of being one”), here’s a description:
Availability entrepreneurs are individuals or groups that understand the dynamics of availability cascades, and use this knowledge in order to promote availability cascades with the goal of supporting a certain agenda.
Accordingly, availability entrepreneurs often utilize various tactics in order to increase the likelihood that an availability cascade will occur. Such tactics include actively promoting a certain stance in the media, making a certain idea more appealing to people, and ensuring that a certain concept is easy for people to repeat to others.
For example, availability entrepreneurs often make sure to craft simplified, rhetorical statements that are easy for people to understand, even if those statements are misleading in some way. The advantage of such statements is that people are prone to accepting and promoting them over statements that are complex and difficult to understand, even when the latter type of statement reflects the situation at hand more accurately. There are various ways to craft such statements, and one technique that availability entrepreneurs frequently use it to focus on using dramatic anecdotes, while ignoring empirical data that is more meaningful, but also more difficult to understand.
In other words, Dr. Noorchashm accused me of being opportunistic and deceptive in the service of promoting pro-vaccine science. Again, that’s not very polite. It’s also not accurate. Indeed, ironically, one can almost see how such a definition might be applied to Dr. Noorchashm himself, who is clearly intentionally glomming on to something being publicly discussed in order to promote his idea. It’s just that he isn’t doing it very well and hasn’t much succeeded in promoting his #ScreenB4Vaccine concept.
It gets more interesting:
Here, Dr. Noorchashm is pulling the “elitism” gambit and characterizing pro-vaccine advocates as oh-so-nasty. Where have we heard that before? Maybe when RFK Jr. himself characterized us as “hating mothers“? Or perhaps it was when Alice Dreger basically described us as frenzied, self-righteous zealots? What Dr. Noorchasm did here is a common trope used by antivaxxers, whether he understands that or not, whether he could ever admit that or not.
This brought Dorit Reiss into the conversation:
It’s odd that Dr. Noorchashm was confused by Dorit’s having mentioned vaccines and autism. The claim that vaccines cause autism is arguably the central claim of the antivaccine movement. It’s the claim that Andrew Wakefield glommed on to with his horrible Lancet paper and remains, even in 2021, the zombie lie that just won’t die. It had to be explained to Dr. Noorchashm:
To which I responded:
Dr. Noorchashm never provided any citations showing that “stacked” vaccine schedules can cause “inflammatory or autoimmune complications.” One wonders if he’s been reading too much of Yehuda Shoenfeld‘s writings.
Even worse, Dr. Noorchashm then invoked one of the most frequently used antivaccine tropes:
This is a statement that could easily have been made by Robert F. Kennedy, Jr., Del Bigtree, Andrew Wakefield, Barbara Loe Fisher, or any number of antivaccine activists, prominent or in the trenches. How do I know this? I’ve lost count of the number of times I’ve seen antivaxxers express variations of this particular claim, that you “can’t question vaccine safety” or “They” (translation: big pharma, the medical profession, the CDC, the government, and, of course, the “rabid” pro-vaccine advocates) will make your life very uncomfortable or even destroy you.
These exchanges really disturbed me, particularly Dr. Noorchashm’s parroting almost word-for-word familiar antivaccine tropes. After first taking claims of parents of “vaccine injury” at face value, even though the evidence overwhelmingly does not support such claims, Dr. Noorchashm has, whether he realizes it or not, parroted a second major claim of the antivaccine movement, namely that, as far as vaccinations go, we’re giving “too many too soon.” Worse, it appears that he and his wife themselves used an “alternative vaccine schedule” à la Dr. Bob Sears to vaccinate their own children. Seeing Dr. Noorchashm Tweet vitriol about “character assassination” at people criticizing RFK Jr.’s antivaccine propaganda, uncritical acceptance of claims of “vaccine injury,” and support for major talking points used by the antivaccine movement, such as “too many too soon” and the admission that he himself vaccinated his children according to an alternative vaccination schedule made me wonder if I had been too quick to bend over backwards to assume that Dr. Noorchashm isn’t at least antivaccine-sympathetic.
The—shall we say?—problematic Tweets did not end there, though. Dr. Noorchashm is very much enamored of false balance, labeling “both sides,” pro- and anti-vaccine, as so very extreme, while characterizing pro-vaccine advocates as “arrogant,” in much the same way that antivaxxers do:
I never accused Mr. Schultz of lying.
Note the false equivalence, though. Note also that it’s not very “polite” to incorrectly characterize the pro-vaccine position as strictly utilitarian while calling it “mindless” and pro-vaccine advocates “intellectually lazy and ethically misguided.” Truly, when it comes to the antivaccine movement and pro-vaccine advocates trying to combat antivaccine pseudoscience and conspiracy theories, “bad people on both sides” and “extremism on both sides” are the new “very fine people on both sides.” (Yes, I’ll go there. Dr. Noorchashm did, after all, liken pro-vaccine advocates to Trump supporters.)
That’s not all. Dr. Noorchashm also used another favorite antivaccine trope, namely accusing me (and other pro-vaccine advocates”) of being “unconcerned” about vaccine safety—not just “unconcerned,” but “moronically unconcerned”:
It gets worse:
Dr. Noorchashm posted several Tweets in the same vein, in which he more or less accused me and other pro-vaccine advocates who combat antivaccine disinformation of wanting to “round up” the vaccine hesitant, hold them down, and forcibly vaccinate them—or even put them in internment camps! He also accused me and other pro-vaccine advocates of wanting to “round up” doctors who question vaccines and put them in internment camps. Apparently, he soon realized that he had gone too far, as he does appear to have deleted those Tweets.
Although perhaps not all of the Tweets:
I’m half-surprised that Dr. Noorchashm didn’t invoke the Tuskegee syphilils experiment, even as I note that it’s not necessary for the majority of the population to refuse COVID-19 vaccines to be a problem. (Also, oops! And oops again! And double oops! Over half of some very critical groups say they would refuse the vaccine! Oh, dear. Antivaccine misinformation has a most deleterious effect!)
To summarize, Dr. Noorchashm is very, very concerned that vaccinating those with silent COVID-19 or who are recovering from COVID-19 or who have had COVID-19 before and have pre-existing antibodies is very, very dangerous and can lead to death, particularly of the elderly. He uses the same technique that people like RFK Jr. like to use to cultivate fear of vaccines, specifically pointing to anecdotes of people who died after receiving the COVID-19 vaccine, even though there is no evidence of causation and, in one case, strong evidence against causation. Meanwhile, he repeats, probably unknowingly, antivaccine talking points, such as taking parents’ attribution of their children’s health issues to vaccines at face value even though there is no evidence that such health issues are caused by vaccines and repeating the “too many too soon” trope long beloved of the antivaccine movement. All the while, he keeps doubling down on his idea.
Finally, his previous frequent exhortation of “Always polite!” notwithstanding, Dr. Noorchashm likes to call provaccine advocates to Trump supportersl “mindless” and liken us to”pro-life nutjobs”:
And call us fools:
I take Dr. Noorchashm at his word when he states so emphatically that he considers himself pro-vaccine. However, the disconnect between his behavior on Twitter during the last week and his exhortation of “Always polite!” is impossible for me to ignore, as are his rather nasty attacks on pro-vaccine advocates up to and including his not-so-subtle insinuation that we have fascist tendencies when it comes to vaccines and want to round up antivaxxers and put them in internment camps. His having deleted the most extreme of his Tweets doesn’t make him look any better, at far as I’m concerned. It also disturbs me that he uses a technique favored by antivaxxers (anecdotes) to advance his idea and, whether he realizes it or not, has been Tweeting the same sorts of talking points used by antivaxxers. I find that disturbing.
I hope that when Dr. Noorchashm sees this post he will manage to suppress his anger at me for a moment and seriously consider the points that I make. Assuming that he truly is provaccine and just has an idée fixe so powerful that it has overwhelmed his better judgment and led him, in this instance, to ignore his “Always polite!” mantra, I continue to hope that he will see reason again. He’s not entirely wrong when he proclaims, “Divided we fall!” However, he does seem rather blind to the the fact that people like him are far more source of the division than pro-vaccine advocates.