The dumpster dives and fuzzy math of RFK Jr. and friends

Do you remember Robert F. Kennedy? I don’t. I was born way after his assassination in the 1960s. The only reason I know who he was is because I studied history and learned that he was the brother of President John F. Kennedy, serving as the US Attorney General in that and the subsequent administration, and then becoming a Senator. They also named a stadium in DC after him, and several games of the 1994 World Cup were played there. That’s it. That’s all I know.

Now, do you know who Robert F. Kennedy Jr. is?

He is the son of Robert F. Kennedy, and he has become the darling of the anti-vaccine movement as of late. See, Mr. Kennedy Jr. seems to be hung up on the idea that mercury in vaccines causes autism. He holds on to the idea against all scientific evidence and against the evidence that mercury was removed from childhood vaccines in the early part of this century but the prevalence of autism kept rising. (It kept rising for a myriad of reasons, none of which had anything to do with vaccines and/or mercury in vaccines.) Also, there is mercury in vaccines like there is chlorine in table salt. It’s a chemistry thing.

Oddly enough, when Seth Mnookin, a writer, decided to take on the anti-vaccine movement, the anti-vaccine movement quickly pointed to Mr. Mnookin’s past use/abuse of heroin. They wrote on blogs and on comment boards that Mr. Mnookin’s addiction disqualified him from writing about the benefits of vaccines. But, when it was pointed out to them that Mr. Kennedy Jr. (RFK Jr.) also had a problem with heroin, the anti-vaccine crowd called him “courageous” for working through his problems with heroin and, well, for being anti-vaccine. They lauded him with praise for his anti-vaccine views and for taking the time to air those views with his big last name.

RFK Jr. has taken advantage of this, and he has made some waves (not a lot) as of late in the anti-vaccine world. He’s done speaking engagements, released some documentary, and gone as far as saying that there is a “vaccine holocaust” going on. He would later apologize for his choice of words, but it is clear that he really seems to believe that vaccines are causing incredibly high levels of death and disability.

Just yesterday, in a Colorado News Site, RFK Jr. published an anti-vaccine rant so strange that it needs to be analyzed for more than scientific fallacies. It needs to be analyzed to see if RFK Jr. lives in the same dimension as the rest of us. In his rant, he wants the audience to “do the math” about the meningitis vaccine that is being recommended for college students. For him, meningitis is not a big deal:

“Meningococcal meningitis is exceedingly rare. There were only about 390 cases in the U.S. last year. In a population of 319 million, that adds up to one case in 817,949 people. There were only three meningococcal meningitis cases in Colorado last year — one resulting in death.”

Yes, to him one death is not a big deal. I wonder if he would say that to the face of the parents of the person who died? Of course not. Anti-vaccine loons are cowards, not necessarily stupid. Of course, to RFK Jr., even contrary to the evidence it’s all about the money and the mercury:

“With billions of dollars in annual revenue at stake, vaccine makers are pushing meningitis vaccine mandates across the country. Vaccine issues are always complex, but advocates of the meningitis mandate should consider some simple math.”

And,

“The CDC has approved three vaccines targeting the A, C, Y and W135 strains of meningitis: Menactra, Menveo and Menomune, which still contains significant mercury concentrations in multi-dose vials. These vaccines are effective in providing immunity to those strains of meningitis in only 85 percent of people who receive them.”

These statements are very telling. First, it is the Food and Drug Administration (not CDC) who approve vaccines to be used. CDC only recommends the vaccine, along with the ACIP, based on the best available evidence. And note that “only 85 percent” statement. It’s the Nirvana Fallacy that anti-vaccine people like to use a lot. To people like RFK Jr., if it’s not 100% safe and 100% effective, it is no better than the pus oozing out of a lanced cyst.

Never in his rant does RFK Jr. admit that meningococcal meningitis is rare because of the vaccine, because of what we have learned about it through some very horrible cases, and through the work of the very people he vilifies: public health workers.

Then RFK Jr. dives into full-on crazy when he talks about serogroup B meningococcus and the vaccine against it:

“Thirty percent of the meningitis cases are the B strain, which typically occur in college-aged kids and against which the three vaccines are completely ineffective.

The FDA recently approved two B strain meningococcal vaccines, Trumenba and Bexsero.Vaccine makers are pushing government officials to add them to the recommended schedule for the fall semester. Critics have faulted the government’s expedited safety and efficiency testing for the new B strain vaccines citing glaring lapses in safety protocols including the absence of inactive placebos. In addition, both new B vaccines are “pregnancy category B,” meaning that they should be administered to pregnant women only when necessary. Neither vaccine has been tested for carcinogenicity, mutagenicity or effects on male fertility.”

So vaccines that are effective in 85% of people and against 60% of cases of meningococcal meningitis are worthless? Not only that, but note that he states that “critics” are worried about the vaccine. Who are those critics? He and his anti-vaccine friends are the critics. Everyone else who lives in reality doesn’t “fault the government’s expedited safety and efficiency testing” because they were still good studies. Also, the vaccines don’t need to be tested for “carcinogenicity, mutagenicity, or effects on male fertility” because their predecessors already were tested for all those things. That, and we (epidemiologists) look at the post-market use of the vaccines and have not found them to be any kind of carcinogenic threat. (They don’t cut off testicles, either, because that’s about the only way a meningococcal vaccine could cause male infertility.)

These are just “scare words” used by RFK Jr. and others to try and put doubt into the minds of the uninitiated. If you are a parent, and you work two jobs to keep the household afloat, and you don’t have time to sit down and read the latest epidemiological data on vaccines, but you happen to read RFK Jr.’s rant, you might have some doubts. You might even go searching for more information with his name attached to it. And that is exactly what they want. They want the doubtful parent or person to join their cult. Because they are a cult. I have no doubts about that.

To further put doubts in people’s minds, RFK Jr. completely misrepresents the information contained in vaccine package inserts:

“According to their package inserts, Menactra and Menveo produce “serious adverse events” in 1 percent of recipients. Menomune, with its hefty mercury load, sickens 1.3 percent of those receiving it. According to the CDC Pink Book, 0.3 percent of those with “serious adverse events” from meningitis vaccines will die. So here is the math calculation that thoughtful student governments in Colorado must consider: If you inoculate Colorado’s 400,000 college students with the older vaccines, you can expect 4,000 serious adverse events and 12 dead. We do not yet know the effects of widespread vaccination of the hastily-expedited B vaccines, but according to their package inserts, about 2 percent of students who receive the B vaccine will be sickened or hospitalized with a serious adverse event. This could translate into an additional 8,000 sick students and 24 deaths, for a total of 12,000 sick and 36 dead in the attempt to possibly avert three meningitis cases.”

Package inserts are legal documents, not scientific ones. They are designed to tell us, the consumer, everything that happened with the vaccine before, during, and after testing it, including what happened after marketing the vaccine. Those deaths mentioned are many times the result of meningitis cases in people who were exposed, were offered the vaccine as a last line of protection, and still got sick because the vaccine didn’t take in time. Other cases are events that happened in the days, weeks, or even months after the vaccine was given. But, because lawyers are so litigious, they demand that the manufacturers include this information in the package inserts.

So what does the Pink Book really say about that 0.3% of serious adverse events who die? This:

Screen Shot 2015-06-10 at 4.02.54 PM

Scary, right? If all those kids get the vaccine, surely, as RFK Jr. states, we will see “36 dead in the attempt to possibly aver three meningitis cases.” But where did these numbers come from? Did they come from a trusted, unbiased source of information on vaccine reactions? In a word, no. They came from VAERS (my emphasis in bold):

“From licensure of MenACWY-D in January 14, 2005, through September 30, 2011, VAERS received 8,592 reports involving receipt of MenACWY-D in the United States; 89.0% reports involved persons aged 11 through 19 years. MenACWY-D was administered alone in 22.5% of case reports. The median time from vaccination to onset of an adverse event was 1 day. Males accounted for 40.6% of the reported events. The most frequently reported adverse events were fever 16.8%, headache 16.0%, injection site erythema 14.6%, and dizziness 13.4%. Syncope previously has been identified as an adverse event following any vaccination, with a higher proportion of syncope events reported to VAERS having occurred in adolescents compared with other age groups (89). Syncope was reported in 10.0% of reports involving MenACWY-D. Among all MenACWY-D reports, 563 (6.6%) were coded as serious (i.e., resulted in death, life-threatening illness, hospitalization, prolongation of hospitalization, or permanent disability).
Among those reports coded as serious, the most frequent adverse events reported included headache (37.5%), fever (32.5%), vomiting (23.6%), and nausea (22.2%). Cases of Guillain-Barré Syndrome (GBS) were recorded in 86 (15.3%) reports coded as serious, although the diagnosis has not been validated by medical records for all reports. A total of 24 (0.3%) deaths were reported, each of which was documented by autopsy report or other medical records and occurred in persons aged 10 through 23 years.
Among the 24 reports of death, 11 (45.8%) indicated that the cause of death was meningococcal infection (nine with a serogroup included in the vaccine and two with a nonvaccine serogroup). Among the other 13 (54.2%) reports of death, which occurred from the day of vaccination to 127 days following vaccination, stated causes of death were cardiac (five), neurologic (two), infectious (two), behavioral (i.e., suicide) (two), rheumatologic (one), and unexplained (one). There was no pattern among these reports. Except for the finding of GBS, which was further evaluated and is discussed below, no signals were identified in VAERS after MenACWY-D vaccination.”

Note the last part about “no signals”. This means that the proportion of deaths reported through VAERS — except for the death from Guillain-Barre — were not any higher than expected in a population of similar size and characteristics. That is, on average and in the long run, the same number of deaths would have occurred without the vaccination. Doing some “simple math,” yes, you could see a certain number of deaths occurring in the college population that would receive the meningococcal vaccine, but it would not be higher than expected for all causes. Like a good anti-vaccine loon, RFK Jr. just did some VAERS dumpster-diving without giving his audience the full picture of what he wrote.

So unless we are to believe that the vaccine — which has no living organisms because of the “mercury” in it — caused meningococcal infection in 11 of the deaths reported to VAERS, and that the vaccine causes suicides and cardiac arrests or infections, what then is the evidence that we’ll see “36 deaths” from vaccinating all of the students in Colorado? None. But the evidence, or lack thereof, has never stood in the way of anti-vaccine loons.

If you want to read the full, honest and scientific discussion on why we need students in close-contact with each other, in dorms and in schools, to get the meningococcal vaccine, please read the discussion and rationale from the Advisory Committee on Immunization Practices. To read and believe what RFK Jr. and his group are selling is dangerous. It’s dangerous because meningococcal outbreaks are much, much more expensive than vaccinating everyone will ever be, both in terms of money and lives. Finally, consult your healthcare providers for decisions on whether or not to vaccinate. Heck, don’t even listen to what I have to say/write… But please don’t listen to RFK Jr. and the other celebrity anti-vaccine loons.

Featured image courtesy of J Brew on Flickr, CC by-SA 2.0

I'm a doctoral candidate in the Doctor of Public Health program at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen

9 thoughts on “The dumpster dives and fuzzy math of RFK Jr. and friends

  1. It is mind bending that a lawyer, a self professed expert cannot understand a package insert, that he is saying things he knows or ought to know are false to prey on a vulnerable population. Yes, the FDA and Sanofi knew the risks — they put them right there on the package insert. Seriously?

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    • You forgot to mention RFK ran for president. The corporate shills are shadowing anything written or any appearance by RFK Jr. The science you believe in is all done directly or indirectly by the drug industry. The math here is right. Mercury and Aluminum and many other questionable ingredients in vaccines still and vaccines are unavoidable unsafe according to the Supreme court.

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      • Linda, Linda, Linda… Tell me of something that is not unavoidably unsafe, something that is 100% safe. Anything. Give it a shot. I’m sure you’ve done a lot of research into it. And since when is science settled in the courts, anyway? Again, you, Linda, will be dead and forgotten for many decades and vaccines will still be used. Your efforts are futile.

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  2. I have to echo James Lind. It’s shameful that someone with Robert F. Kennedy Jr.’s education and background cannot understand the legal document that is a package insert. He ought to read the post I wrote on them so he can learn what they actually are. (By way of credentials, part of my formal studies included the regulations around package inserts.)

    He should also know how to read VAERS, especially that disclaimer that you have to acknowledge you read and understand before entering the database.

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    • Many Dr’s refuse to report to VAers, many parents don’t even know it exists. Only about 10% ever reported so do your math OVER.

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      • Ah, Linda. Repeating the tired tropes that you’ve been feed by your “research” in anti-vaccine blogs is not going to work on this blog’s readers. You will not convince anyone that vaccines are dangerous, and we will continue supporting vaccines as an intervention against diseases. When you read this and for centuries to come, we will continue to vaccinate children. We might even get rid of some diseases for good, even with people like you standing in the way and lining the pockets of Big Pharma in the number of children you sent to the hospital. (Because antibiotics and respirators are so much cheaper than vaccines, right?) Think about it, Linda, you will be dead and forgotten and vaccines will continue to be used and work and save lives. Have a nice day.

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      • Linda,
        Mild reactions are not often reported. However, serious events are more likely to be reported to VAERS, whether actually caused by the vaccine or not. Though it’s nice to see you’re sticking to the anti-vaccine playbook with your 10% claim. Not that it actually addresses the problem I was pointing out: that VAERS cannot be used to make a conclusion that vaccine X caused event Y.

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