Part the First. Convergence and Consensus in Science, or and how to interpret scientific results in context. From Holden Thorp, the Editor-in-Chief of Science:
Kathleen Hall Jamieson believes that scientists need to talk…about convergent evidence. “Unlike declarations that a consensus exists, a claim that convergent evidence exists honors science’s norms of critique and correction by inviting discussion of the extent of existing knowledge and the multiple ways in which it was developed rather than on what a lay audience is likely to hear as a ‘case closed’ appeal to authority.” When a scientific consensus is overturned, it requires not only introducing new evidence that counters the accepted understanding but also explaining why all the evidence, new and old, is now pointing in a different direction.
This is true. But we must remember that science is not the pursuit of truth, something scientists often fail to understand. Rather, the goal of science is to produce useful knowledge about the natural world, including the social part of our human world. It is difficult to imagine useful knowledge that is not also largely true, but “truth” is more properly the province of theologians and philosophers of a certain sort. And of course, mainstream Neoliberal economists in either wing of the Uniparty, to hear them prattle.
The question of whether vaccines cause autism is a perfect example of this notion (that scientific consensus includes all the evidence available). There is a massive amount of convergent evidence that refutes the idea that the measles, mumps, and rubella (MMR) vaccine causes autism. This has been discredited in one study after another. Nevertheless, US Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. announced that the Centers for Disease Control and Prevention (CDC) will carry out yet another study on this claim, and that “exposures” that cause autism would be known by September, despite the discouragement of many scientists and physicians, including Senator Bill Cassidy who chairs the Senate committee that oversees HHS. Even a report released by the CDC last week describes multiple ways in which better identification has led to higher rates of autism diagnoses. With any subject, one can always do another study but at the cost of diminishing returns. It is certainly the position of many scientists that this issue is settled, including Jay Bhattacharya, director of the US National Institutes of Health, not because of an opinion poll of scientists, but because of evidence converging from numerous directions that has debunked the idea. If another study seems to suggest some kind of correlation between vaccines and autism, it would not suddenly erase all of the solid research that came before it. The outlier would need to be considered along with the overall picture, which would likely still converge on the lack of a meaningful connection unless the large number of previous studies were somehow shown to be flawed.
I would add here that Jay Bhattacharya is not a scientist or a physician. He is an economist associated with one of our most effective merchants of doubt. He earned an MD from Stanford to go along with his undergraduate degree from same, but he went straight from his MD to a PhD from Stanford in economics, where it was most recently a faculty member in economics This makes him a triple tree, but it does not give him the right to call himself a physician or a scientist. Jay Bhattacharya may be the first Director of NIH who was never a practicing physician and/or scientist. One does not need to die to learn how to write an obituary, but the Director of the National Institutes of Health should have relevant experience. Senator Bill Cassidy of Louisiana has been a practicing physician and ensured the confirmation of RFKJr as Secretary of HHS. I would like to ask him how he feels now about the attack of the berserkers on NIH, NSF, CDC, plus NOAA and NWS – who needs adequate warning of the path of a coming hurricane or to be warned that a tornado is likely in the next few hours?
Part the Second. Speaking of autism, about which RFKJr seems to have some monomania, Holden Thorpe was recently diagnosed in his mid-50s as being on the spectrum, which gives the lie to RFKJr’s pronouncements on the subject. How about that! RFKJr also says he will soon know (September is closer than we think) the cause of autism (vaccines and/or environmental toxins undoubtedly) accounting for the imagined tsunami of autism. Well, no he won’t. Science does not work that way or we would have the “cure for cancer” more than fifty years after the war on cancer was declared by Richard Nixon at the urging of Mary Lasker. But Dr. Thorpe explains the obvious anyway, not that anyone in the Administration is listening:
As a scientist with autism, I believe the rise in diagnoses is the result of greater awareness, better identification (especially among women and girls) and a broader definition that now includes a range of neurodevelopmental conditions under the umbrella of autism spectrum disorder.
As a child, I often stared into space, missed social cues and delivered long monologues about my specific interests. But it was not until I was 53 that I suspected I had autism spectrum disorder. The idea arose during a professional review for which my employer had brought in a psychologist. After interviewing my co-workers and me, the psychologist suggested that I might have autism, which subsequent evaluations confirmed.
It’s hard to grasp how a seventyfold increase in autism cases could mostly reflect changes in diagnosis or heightened awareness, but my experience helps make sense of it. When I was growing up in the late 1960s, autism was mostly diagnosed among children who had huge difficulties in daily functioning and needed extensive support. I wasn’t flagged for evaluation or diagnosis, but that might be different today.
Studies show that the increase in autism spectrum diagnoses among people like me who do not have intellectual disability…has steeply increased since 2000. If I had been diagnosed as a child, it probably would have been with Asperger’s syndrome, a label that was often given to children who struggled socially but didn’t have the language delays present in many cases of autism. But in 2013, the American Psychiatric Association folded Asperger’s syndrome into the broader category of autism spectrum disorder.
In contrast to RFKJr’s skewed disunderstanding (a term coined by a former colleague) of autism, Holden Thorp is a highly accomplished individual, not unlike many if not most of those “on the spectrum,” which includes more than a few scientists. In any case, Dr. Holden Thorp, professor, administrator, editor of the leading American scientific journal has a job and is a productive member of society…
Part the Third. The destruction American scientific institutions continues with another lament:
In just the first three months of his second term, US President Donald Trump has destabilized eight decades of government support for science. His administration has fired thousands of government scientists, bringing large swathes of the country’s research to a standstill and halting many clinical trials. It has threatened to slash billions in funding from US research universities and has terminated more than 1,000 grants in areas such as climate change, cancer, Alzheimer’s disease and HIV prevention.
The White House is expected to propose a budget for 2026 that would slash investments in science across the federal government; for example, the Trump administration is considering cutting the science budget for NASA nearly in half and spending at the National Institutes of Health (NIH) by 40%. The administration has also begun implementing strict immigration measures that have left some students and researchers in detention centres, and many academics fear that these and future measures could spur researchers to look for opportunities outside the United States.
Those researchers who can, they will leave. Those who cannot, they will die on the vine if the worst comes to pass. That seems the way to bet. And all the while I hear from my MAGA friends that industry should be funding basic research anyway. No. This is not how it is done. Industry will not take up the slack. Industry uses publicly funded research as their crucial building blocks, especially in biomedical research.
Here we should distinguish between the development of chemistry as a discipline and development of biology. Modern chemistry came straight out of the chemical industry and has flourished because of that (neglecting forever chemicals, for now). This is also true of much of physics, with the example of Bell Labs. But that lasted only so long as ATT was protected as an erstwhile benevolent monopoly and Bell Labs could afford to let Arno Penzias and Robert Wilson discover background radiation leftover from the Big Bang. The Solvay Conferences funded by the Belgian industrialist Ernest Solvay that began in 1911 (jpg) also contributed to the development of modern theoretical physics. Biology had essentially no similar support in the beginning.
Biology, including the biomedical sciences of physiology, biochemistry, and cell biology, was different. These disciplines developed on their own in university and hospital laboratories or in dedicated biology laboratories such as the Institut Pasteur, the Marine Biological Laboratory at Woods Hole, the Plymouth Marine Laboratory, and the Stazione Zoologica Napoli. There was money in early chemistry and physics, not so much in biology. The Roche Institute of Molecular Biology (RIMB) on the Nutley, New Jersey, campus of Hoffman-LaRoche was for a time the one “Bell Laboratories” of biomedical science. I was fortunate to work there nearly forty years ago, learning how to construct gene cloning libraries long before complete genes could be bought off the shelf or custom ordered and ready to be expressed in any cell type. A task that took me at least two years in the late-1980s can now be completed in two days, one day if the order is placed before 2:00 pm.
RIMB was an astonishing place. The scientists there could concentrate on their research instead of massaging their current grant application. But now it is gone with the wind. As is the adjacent research and manufacturing campus of Hoffman-LaRoche, which was also an astonishing combination of pharmaceutical research and production. Tariffs, even if that is the most beautiful word in the world, will not bring back the buildings, laboratories, and above all the several thousand people who worked hard and did well for themselves and all of us, only twelve miles from Times Square, instead of the other side of the world. It is hard to imagine right now, but this was not so very long ago.
Part the Fourth. In a modern Profile in Senatorial Courage, a Republican US Senator in the form of Susan Collins of Maine has spoken up against the Trump v2.0 devastation of American science. GOP Senator Collins says Trump’s layoffs of scientists, cuts to biomedical research ‘must be reversed’.
Sen. Susan Collins (Maine), the Republican chair of the Senate Appropriations Committee, rebuked (a sternly worded letter comes next, no doubt) the Trump administration for cutting federal biomedical research funding, cancelling grants, and laying off federal health department employees, and said the changes must be reversed.
“Proposed funding cuts, the firing of essential federal scientists, and policy uncertainties threaten to undermine the foundation for our nation’s global leadership,” she said Wednesday at a hearing titled Biomedical Research: Keeping America’s Edge in Innovation.
No Trump administration officials are appearing at the hearing, but Collins said it’s a precursor for a hearing on the same topic at which administration witnesses will testify. No date has been announced for that hearing (imagine that; I predict it will go the way of Amazon’s trial balloon about explicitly adding the “tariff increment” to their prices).
Collins said that China is catching up with has effectively passed the U.S. in biomedical research, and that the U.S. should not take its hard-earned position as the “world leader in scientific research” for granted. And she noted the consequences of falling behind in biomedical innovation could be dire.
“If clinical trials are halted, research is stopped, and laboratories are closed, effective treatments and cures for diseases like Alzheimer’s, Type 1 diabetes, childhood cancers and Duchenne’s Muscular Dystrophy will be delayed or not discovered at all,” she said.
Sometimes late is not better than never. But where are other Republican US Senators and Representatives and governors as their constituents who have been doing essential work at CDC (Georgia), NOAA/National Hurricane Center (Florida), and other federal agencies are thrown without a second thought on the scrapheap of Neoliberalism? Democrats are still playing possum, despite the boffo reviews of AOC-Bernie Show, as directed to by the Cajun whiz kid who got Bill Clinton elected in 1992 in spite himself. Nothing can be expected from that half of the Uniparty.
Part the Fifth. The current trope about “outrageous indirect costs” (overhead) comes up in the previous article from STAT News. I have covered this before, but the short version can be repeated here. This is a serious battle to be fought. Yes, it is true that private funding agencies allow only 10-15% overhead on their research grants. But, and this is the key, these awards go only to laboratories that already have funding in place to support the research, and that funding comes primarily from NIH (indirect costs ~45-60%) or institutional resources such as a “startup” budget for a new faculty member. I have received support from the American Heart Association (AHA) and the American Cancer Society (ACS) at three institutions. The first was a postdoctoral fellowship from AHA that would not have been awarded unless I was doing my work in a well-funded laboratory in the medical school of one of the best research universities in the world. The source of that other funding? The National Institutes of Health, of course.
Later my independent laboratory received similar funding, but a requirement for those awards was that my lab budget (from NIH and the institution) was adequate to support our work and the contributions of my graduate students, who all received graduate fellowships from the AHA. Funding from AHA, ACS, Alzheimer’s Foundation, Hereditary Disease Foundation and the like is a very thin layer of icing between the layers and on top of a very thick cake that was baked by NIH, NSF, USDA (Agriculture), DOD (Defense) funding and an institutional infrastructure that is maintained by indirect support. Without the buildings, the infrastructure, the animal care facilities, the compliance and accounting staffs, electricity, water, and other support, absolutely no research gets done. Period. Once again, the nonpartisan vision of Vannevar Bush is the missed key. From the NSF website:
In 1945, Bush presented his report, ‘Science: The Endless Frontier’ to President Harry S. Truman (also available from Princeton University Press at 50% off now; their sales are difficult to resist). The report envisioned a new agency whose mission would promote the progress of science by supporting basic research at colleges and universities.
In 1950, following a series of bill revisions, Congress passed and President Truman signed Public Law 81-507, establishing the National Science Foundation and the National Science Board. NSF’s place in history was cemented.
For the first time since 1950, maybe the place of NSF (and NIH and CDC) in history is wobbling. If Vannevar Bush’s concrete vision does not survive the current jackhammers and wrecking balls, American science as we have known it for nearly eighty years will die. I am not saying the administrative mechanics, sometimes smothered by administrivia, by which we fund public scientific research in the United States cannot be improved. As someone who has seen the best and the worst of, there is clearly room for improvement. But only if done thoughtfully and incrementally, as all good science progresses. If American science is demolished because of current “Administration priorities,” it will remain so for the duration. But good science will continue to be done, elsewhere, with China leading the way.
Digression: The most effective way to improve American science would be to increase funding by 25%, which might be ~$25 billion in round numbers. Not pocket change, but eminently doable when a $1000 billion dollar defense (sic) budget is no longer only a gleam in the eye of the current Secretary of Defense. And if we did come up with the money, those unknowable advances would make our world a better place. Beats all-war-all-the-time. But repeat myself, again.
Part the Sixth: To finish with very good news for science and public health, the National Cancer Institute has shown that the multivalent HPV vaccine works exceedingly well with only one course instead of two. And according to STAT News, this could:
(T)ransform efforts to reach the three-quarters of children globally who should receive the vaccines but don’t. The shots prevent cervical cancer and also anal, penile, and some head-and-neck cancers. Worldwide, 350,000 women die from cervical cancer, the most common HPV cancer.
In developed countries, including the U.S., two doses of the vaccines are currently recommended. But in the clinical trial, whether one dose or two doses were used, the results were equivalent, according to the study of 20,000 girls between ages 12 and 16 in Costa Rica who were followed for 4 1/2 years. In all cases, the estimated efficacy of the vaccines was upwards of 97%.
This would lead to a signal success in cancer prevention. The vaccine, Gardasil (Merck) protects against nine (9) variants of human papilloma virus (HPV), including those that cause cancer. Without going into too much personal detail, three years ago I was diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) in my right palatine tonsil. A long course of recently developed, focused high-power radiation and chemotherapy using an ancient anti-cancer drug completely “resolved” the tumor and one involved lymph node (so far). My cancer was caused by HPV, which made it easier to treat. The primary, possibly only, mutation was the expression of a viral protein in my tumor cells. Still, it would have been better to get the vaccine when I was 9-10 years old than to meet with radiation therapists at 6:15 am every morning for seven weeks and spend all day Thursday during that time in the infusion center hooked up to a pump through a port.
But naturally, there is a catch in the form politics:
Robert F. Kennedy Jr., the secretary of the Department of Health and Human Services, has long criticized HPV vaccines, particularly Gardasil…which is the HPV vaccine used in the U.S. Kennedy has asserted on social media that Gardasil may increase the risk of cervical cancer, a claim contradicted by many studies. During his Senate confirmation hearing, he refused to disavow previous comments he had made questioning the safety of the vaccine.
At Children’s Health Defense, the nonprofit group where he served as founder and chairman for years, Kennedy filed more than two dozen lawsuits over the vaccine. During the nomination process, he promised to give any fees he earned from the Gardasil litigation to his son.
Well, gifting any proceeds from this litigation to the fourth generation of the quintessential American political dynasty certainly removes any conflict of interest in my book. But the question is this: Does the HPV vaccine, for which initial research was conducted at NCI with public money, work at preventing HPV infection and subsequent disease? Why, yes. Yes, it does.
In developed countries, the HPV vaccines have had a dramatic impact. In the U.S….they have decreased the incidence of precancerous cervical lesions by 80% – particularly impressive because only 77% of people in the U.S. who should receive the vaccine have been administered at least one dose. In the U.S. and other developed countries, effective screening against these lesions means that other types of HPV cancer, in particular head-and-neck cancer, are as common as cervical cancer. This is one reason vaccination is recommended for boys as well as girls.
Studies across the world have affirmed that HPV vaccination does prevent cancer. In one stunning recent example, Scotland said in 2024 that, of girls in the country who were born between 1988-1996 and had been vaccinated in time, none had been diagnosed with cervical cancer. Australia has said that it believes it can eliminate cervical cancer through vaccination and screening.
There was also a time when measles, mumps, and rubella (MMR) were on the elimination list. The only thing necessary for the elimination of these diseases is the resolve shown with smallpox. The road will be rough, but this can be done. Suggestions welcome, however. More to come on how to proceed in future, especially on the matter of vaccine hesitancy – where it comes from and how to overcome it.
Happy May Day plus one! See you next week.
After a very successful start Russia now has mRNA cancer vax in phase 2 trials. Tailored and administered after the diagnosis. Apparently it’s brought people back from the brink of death.
Expected to become public next year, released for free use.
Being confronted with chemo, vax or death, I think most people will come around and thank their lucky stars that a vax exists.
https://blackdoctor.org/russias-breakthrough-mrna-cancer-vaccine-heres-what-you-need-to-know/
This is exactly what this technology should have been used for. The possibilities are endless. As a vaccination for a respiratory virus – not a good idea. First of all, there has never been a successful vaccination campaign for coronaviruses in history – not because of not trying. Could it be that this is just not an appropriate use for a humoral vaccine?
But secondly, the risk benefit ratio is much more favorable for something like cancer. Injecting these agents into young health people by the millions was absolutely going to generate lots of side effect problems in otherwise healthy people. Please remember – injecting things into otherwise healthy people is much much different ethically than injecting things into cancer patients. The incidence of all kinds of very severe reactions has been known in mRNA technology for much longer than COVID.
It was a fateful decision to role it out for COVID – and the gamble has failed miserably. There is a huge chunk of the population that will have nothing to do with these vaccines no matter what they are for. And along with the COVID vaccine, there is now vaccine hesitancy all over the entire field. A completely predictable and a completely tragic outcome. But the billions were great for the companies for a little while.
“It was a fateful decision to role it out for COVID – and the gamble has failed miserably…”
I get from what follows the above that you see the failures as having been down to bad public relations and poor policy rather than in the efficacy or or lack thereof of the vaccine. Is that the case?
From IM Doc: “First of all, there has never been a successful vaccination campaign for coronaviruses in history – not because of not trying.”
This is the problem! The first coronavirus identified was probably what became known as IBV, infectious bronchitis virus, in chickens. The literature is a bit difficult for me to parse since I no longer have immediate access to a large research library with practically every journal ever published in the stacks, but I think the first report of this disease is from the 1930s, even if the animal biologists didn’t really understand what they had. As chicken husbandry became progressively more industrialized after WWII, IBV became a big problem. No vaccines for IBV ever really worked well or for very long. This has been covered here previously.
This is a given in veterinary medicine, and my close friend and veterinarian colleague who died of Long Covid last November told me from the beginning of the pandemic that a COVID-19 vaccine would never work. That started my reading on coronaviruses. The failure of vaccines against SARS-CoV-2 are unsurprising. Now, it is true the vaccines did lessen the course of disease in many of the vaccinated. But a vaccine that stops neither the spread or course of the disease is a failure in the public mind, by definition. Especially when the President of the United States that if you get vaccinated you will not get sick. It should not be forgotten that Operation Warp Speed was an amazing technical feat, under Trump v1.0. There was no way for a politician to know that durable immunity, either through vaccination or infection, to coronaviruses is a unicorn. The leaders of NIH and CDC and Pfizer and Moderna have absolutely no excuses.
I have been working on a piece about how our collective (non)-scientific, illiterate response to COVID-19 turbocharged vaccine hesitancy. That Fauci et al. went all-in on vaccines that were never going to work constituted a series of acts of hubris and dollar grabbing that boggle the mind. We are still waiting for the HIV vaccine more than 40 years later, but within a year behavioral and clinical methods for halting the spread of HIV were well understood. Pharmaceutical interventions followed relatively soon after. Imagine what could have been accomplished 40 years after the beginning the AIDS epidemic…
The cul de sac of COVID-19 vaccines has contributed much to the current attack on American science. The damage being done will reverberate for a very long time. But China has passed the US in high-level biomedical research, so we have that going for us. Which is nice.
What makes you think that it will be allowed to be used in the west? No, I’m not being snarky here. About four or five years ago both the Russians and the Chinese developed their own vaccines but western countries refused to recognize them. If you flew into a country after having the Russian vaccine, you were treated as if you were unvaxxed. However great that vaccine really is, can you see it being made available to the plebs here. Or will it be made illegal like some countries did for the earlier Russian vaccine. They use to say that science knows no borders but that was then and this is now.
Some unmentionables from 30s and 40s did talk about German science and Jewish science. If the shoe fits…
Part the sixth is an elegant rebuke to some simpleton in the comments to one of your pieces recently who was JAQing off about HPV vaccines. I dug up the Scotland study but couldn’t be bothered to post, as it feels like there’s no point trying to reach these people. Credit to you for making the effort.
Thanks for the point on Bell Labs. People I’ve argued point to it as industry-funded research that could be re-created, but they don’t like to consider the fact that it was being funded indirectly by the government (by being allowed to be a monopoly and collect excess rent from all).
Why would we want to add a middleman, unless our aim is to provide more economic rent and allow CEOs to skim?
Here’s a thing that I often wonder about: how rich were executives at GE, Ma Bell, or other big corporations that did basic research? I think the answer is “not that much.” No doubt they were very well compensated, but the revolution in executive compensation, esp the CEOs (via stock options and such) is a fairly recent development. Plus, high income tax rates for top brackets probably drove down the value of the excess compensation, too. So there was a decent pile of money left that could be put into other things, like badic research, I wonder.
Exactly! Engine Charlie Wilson and Electric Charlie Wilson, of GM and GE respectively, were wealthy men by any reasonable measure, except that of today. Neither particularly loved unions but they were proud of what their companies made and how they made a real middle class. It is true that the benefits were not universal, but that was a political problem, with a solution begun but permanently interrupted. Then came Jack Welch and his ilk.
Ah, Jack Welch and the destruction of GE.
Funny thing about neoliberalists; they know the price of everything and the value of nothing. But the customers know the utilitarian value of what they are buying. / ;)
If only, darest I suggest it, that science or “science ™” had not been bought by the highest bidders. Yes, yes, no one wants to think that science itself could be compromised by funding sources or monetary considerations. ( I do not want to think so having spent a lifetime in a science discipline. It truly grieves to think this might be true.)
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