Should RFK Jr be confirmed?
Two writers debate a recent post
At Sensible Medicine, we invite debate and discussion. Recently we published a piece broadly supportive of RFK Jr, written by a Danish vaccine researcher, Dr. Schaltz-Buchholzer. In response, we feature a critical letter by Sensible Medicine writer and editor Adam Cifu. I also include a reply from Dr. Schaltz-Buchholzer.
Let us know if you enjoy this format.
Vinay Prasad MD MPH
My concerns with Dr. Schaltz-Buchholzer’s support of RFK Jr., by Adam Cifu
I recently read a recent post on this site by Dr. Schaltz-Buchholzer that was supportive of the nomination of Robert F Kennedy Jr. I found the piece too strident, felt it took too many liberties, and I have 8 points of disagreement.
Dr. Schaltz-Buchholzer refers to restrictions in the US as “ruthless lockdowns”. I agree that NPI recommendations aimed at curbing the COVID pandemic lasted too long, but calling them “ruthless” is hyperbole and lazy excess. These rules were often poorly enforced in the USA, if they were at all.
When describing the mortality differences between the US and Europe, Dr. Schaltz-Buchholzer writes:
“Yet it seems that US public health authorities have simply accepted this as the state of affairs, rather than trying to procure what can explain this absurd disparity in health outcomes.”
I disagree. Efforts aimed at discovering the causes of these differences and improving life expectancy in the US have been enormous. Many of my colleagues, at the University of Chicago and elsewhere, work diligently to investigate this precise disparity. Yes, we are faced with many challenges in this country, many self-inflicted, but the idea that we are OK with this is wrong.
Dr. Schaltz-Buchholzer lists possible causes of the Europe/US mortality difference. His list excludes obvious and important issues (gun violence), cites reasonable possibilities (ultra-processed foods), and includes some highly debatable ones (seed oil, glyphosate).
Dr. Schaltz-Buchholzer remarks that the difference in ultra-processed food, seed oils, pesticides, and food additives explain why Americans often lose weight on European vacations. This statement lacks robust evidence, and is made worse by the fact that he cites a FOX News article as a reference.
Dr. Schaltz-Buchholzer states:
“As an example, data has now appeared suggesting that NSAIDs ingested by pregnant women in the first trimester can affect the fertility of their female offspring, and that paracetamol (acetaminophen) disturbs the hormone balance in men.”
Even a cursory read of the linked articles demonstrate that these claims are preliminary, unproven, and their clinical importance unknown. Dr. Schaltz-Buchholzer is reaching to justify the conspiratorial claims and thinking of Mr. Kennedy.
I was most troubled by Dr. Schaltz-Buchholzer’s comparison of the US and Danish vaccination schedule. He argues that a Danish child would receive 11 shots while an American one would receive 72. This is not playing fair.
There are differences in American and European vaccine schedules. However, the differences are small. See this comparison between British, Italian, and US recommendations.
Second, to make his point, the author includes yearly COVID and Flu shots. Yes, these are recommended but far from being expected, enforced, or adhered to.
Third, Dr. Schaltz-Buchholzer argues that the hepatitis B vaccine is overtreatment using the fact that Denmark does not recommend this vaccine to all infants. Denmark is the outlier in NOT recommending population hepatitis B vaccination. The WHO reports that 83% of the world’s children get the hepatitis B vaccine. If there is less need now for the hep B vaccine compared to when it was introduced, that is thanks to the vaccine.
Vaccines and autism. The author writes on the subject, “On the other hand, we do not have data to say that vaccines do NOT cause autism, aside from MMR.” This is out of an antivax handbook. There is no link between vaccines and autism. PERIOD. FULL STOP. We should not spend our time disproving baseless hypotheses.
I chose not to address the author’s comparison of live and killed vaccines. This is the author's area of research. These decisions are complex, however, and have to take into account local realities.
In summary, I think Dr. Schaltz-Buchholzer was too strident and took too many liberties in making his argument, and I did not want it to stand on the site unchallenged.
Adam Cifu
Chicago, February 2, 2025
In reply to Dr. Cifu
I appreciate the input from Adam to my post about Robert F. Kennedy Jr’s nomination. In my post I sought to be engaging and spark debate, but did not attempt to engage in hyperbole or exaggeration.
I chose my words carefully in regard to the lockdowns having been ruthless, especially in the US. Trillions of dollars were spent, pandemic emergency plans were not followed, and in the US, toddlers in kindergartens and children in their first years of school were either home-schooled for extended periods or had to keep distance, they were masked and even 6-month old babies were subjected to vaccination with novel mRNA vaccines.
Neither masking nor pediatric mRNA vaccination was adequately tested before mass campaigns were performed. No RCTs of non-pharmacologic interventions were conducted by the CDC, so these measures were done with almost no evidence, and went on for months or even years in some states. Workers were fired for refusing to get a vaccine they did not need. The US was an extreme outlier in this and the response was, to me, ruthless.
Regarding the mortality differences between the US and Europe, it is true that there are many efforts being done in the US to address the large disparity. My comments were merely my impression, and it is also possible that the COVID-19 pandemic has derailed efforts. But whichever efforts that are in place should be much more outspoken, in my opinion.
US authorities could be outspoken about there being a mortality crisis (not just an opioid crisis). While it may exist, I have not seen evidence of such efforts or communication, and it amazes me that the low-hanging fruits are not being picked, such as those in the food product sector (e.g., products such as some food dyes that are unnecessary and were banned decades ago in other countries).
Someone on X noted that gun deaths are an important difference, and this is clearly correct, although I would not expect gun murders to cause the uniform excess mortality in all social classes and ages, which I described. More than half of the gun deaths are, by the way, suicides. Another important difference is fentanyl addiction, which is practically absent in Europe.
In regard to the comparison of the vaccine schedules, I wrote: ”I consider several of the vaccines (e.g. hepatitis B, COVID-19, influenza) in the US program to be completely unnecessary.”
For hep. B, I described how I find universal vaccination at birth to be massive overtreatment. Dr Cifu, responds with a comparison between the US, Italian and UK schedules up to 2 years.
First, I included the schedule up to 18 years, so responding with a comparison of the first 2 years is a different subject (but also important). I acknowledge that the overall difference is smaller when zooming in on this period, and note that none of those countries provide universal hep. B at birth nor COVID-19 and influenza vaccines, reenforcing my point that these vaccines are unnecessary.
A key aspect of maintaining confidence in a vaccination schedule is that the recipients believe that the vaccines are necessary and useful. This is how we can maintain a very high vaccine coverage in Denmark, and these fundamentals are a part of the reasoning when evaluating a vaccine candidate for the pediatric schedule (link in Danish).
A schedule with unnecessary hep. B, COVID-19 and influenza shots (we don’t even recommend that to adults <65 years of age) like in the US could provide a breeding-ground for vaccine skepticism, resulting in lower vaccination coverage and associated problems. Another thing to avoid is mandatory vaccination.
Dr. Cifu conflates mass universal hepatitis B vaccination at birth, in Europe only done in 4 former Eastern bloc countries and Portugal, with hepatitis B provided later in infancy in a combination vaccine (e.g., hexavalent ”6-in-1” vaccine), thus a completely different policy with fewer total shots that is irrelevant to my critique of the unnecessary policy of providing universal hep. B at birth.
In regard to vaccines and autism, I believe we do have to devote our time as researchers to disprove this hypothesis. When it comes to MMR vaccine, authorities and researchers have spent large amounts of time and money to disprove it. For this reason, I can safely inform worried parents that MMR does not cause autism, and I cited a high-quality study from Denmark to that end in my piece. If this work had not been done, chances are that MMR vaccination rates would have been lower, and we would have more outbreaks of measles, mumps and rubella. It has therefore been cost-effective to conduct the studies and this work should be commended.
Disproving hypotheses is the core of science, and if this hypothesis is not disproven, it would continue to fuel antivax sentiments. It seems that Robert F. Kennedy Jr. may have reformulated his postulate from MMR vaccine causes autism to vaccines causes autism. I consider that a victory for science, and an even larger victory would be if we scrutinize all of our vaccines, not just MMR, including effects of vaccine combinations and timing. This should be done to the point where we actually have the data to (hopefully) show that they 1) do not cause autism, and 2) do not have negative non-specific effects on overall health. The current framework for testing, approving and regulating vaccines is simply not good enough. So we have a lot of work ahead of us that needs to be done because until then, there will be no scientific basis for writing that the hypothesis is baseless. Writing this is as bad and incorrect as saying they do cause autism; we have evidence for neither and Dr. Cifu’s statement is as unproven as RFK Jr’s.
Frederik Schaltz-Buchholzer
Bissau, February 4, 2025
Vinay, Glad you do this. But as a many decades practitioner I have learned over the past few years how much "eyes closed" loyalty there continues to be in the profession to the "vaccines are good because I say so" mantra.
Most of them are understudied, and there are virtually no credible studies of the impacts of giving 90 shots during childhood including dozens the first few years. I have vaccinated my children, and recommended vaccines for many others. But as you have pointed out in your many evidence-based articles, there is almost no evidence on the safety of some vaccines, there is negative evidence on others (covid, which is NOT a vaccine, incidentally -- just a genetic product) in those under 65, and virtually none on the impacts (if any) of combinations.
I have come a long way in the past few years. I agree with Dr. Schaltz-Buchholzer.,..we do not know enough and RFK Jr. is the first in a long time to say "Shouldn't we find out"?
As usual, Cifu very wrong when it comes to COVID. Ruthless is an understatement. COVID lockdowns/mandates were criminal, draconian, cruel and spiteful and did enormous damage to our people, economy and society. We are still paying the price.