Part the First: As Giants Still Walk the Earth. Stanley Plotkin began practicing medicine in the 1950s. When he was an intern, outcomes for patients such as this little boy were frightening and devastating:
Stanley Plotkin recalls a night in 1957, during his pediatrics internship, when a father brought a gravely ill toddler into the Cleveland Metropolitan General Hospital on his shift. The 3-year-old was struggling to breathe. Before Plotkin could even examine the little boy, he died.
The child had contracted Haemophilus influenzae type b, a nasty bacterial illness that can cause mild symptoms in some children, but triggers dangerous, more systemic disease in others — things like meningitis, pneumonia, and sepsis. In the case of the boy Plotkin saw, it induced swelling of the epiglottis, the flap at the base of the tongue that prevents food from entering the airways.
When the epiglottis swells, a kid can’t breathe.
“That was a terrible disease which caused a lot of mortality and hospitalizations, and which disappeared after the vaccination,” said Plotkin.
Disappeared with vaccination…How many other childhood (and adult) killer diseases also disappeared as vaccines were developed for them? We can consider HiB that killed the little boy in Cleveland nearly seventy years ago:
Before vaccines were introduced in the latter half of the 1980s, about 20,000 children a year in the U.S. developed the more serious forms of Hib, where the infection moves into other organ systems. (Mild cases typically manifest as ear infections or infections of the airways.) Somewhere between 3% to 6% of those children didn’t survive. A number of the survivors carried scars of the infection for the rest of their lives — deafness, blindness, and developmental delays among them.
Widespread use of Hib vaccine has brought cases of invasive disease in this country down to levels so low that single cases are actually newsworthy. (This study, published last March, reports on the only two cases a New York City hospital saw over a 10-year period.)
It wasn’t so very long ago that a case of measles was a newsworthy event due to its rarity. Not so much now. Dr. Plotkin was inspired by the novel Arrowsmith when he was a boy, and he was not the only one. Sinclair Lewis told the story of an American archetype in his novel. It was a different time. And in ours, Dr. Plotkin, the original author of the standard text in the field of Vaccinology, now in its eighth edition, predicted exactly what would happen if the current Secretary of Health and Human Services was confirmed in that role:
Plotkin knew what would happen if Kennedy became health secretary. “Oh, I expected it,” he said of the myriad changes that Kennedy has overseen. “I did everything I could when Kennedy was up for confirmation, to convince people like Senator [Bill] Cassidy to vote against him — and failed.”
Beyond Covid and Kennedy, he attributes the declining confidence in vaccines to memory — more precisely, the fact that today’s younger generations have no recall of what used to be — as well as the dissemination of anti-vaccine propaganda on social media and the shortcomings of science education in schools.
“So, people can be reading lies and not recognizing it. I don’t know how to deal with that,” he said.
That about covers it, Senator Cassidy. And now one of the pioneers who saved countless lives and even more heartache, near the end of his long and productive life, says this, “All I can say is that I’m beginning to regret having lived so long — because we’re going downhill.” Dr. Stanley Plotkin does not deserve this. Nor do those who will sicken and die because “reasons.” No, not reasons…actually unreason of a sort that has been rare for a very long time.
Part the Second: The Torment Continues. As noted in STAT again, RFK Jr has wide discretion to choose evidence to support vaccine decisions, DOJ argues. What is the keyword in that sentence? “Choose.” Those who argue that RFKJR is out of place as Secretary of Health and Human Services because he is a lawyer and erstwhile politician forget that cabinet secretaries are generally one or the other or both. That is the way of the world. But it goes without saying that few of his predecessors would have ever considered “choosing” evidence to support vaccines, or not. Or “choosing” anything else related to the basic and clinical science of medicine. Yet here we are:
How far can health secretary Robert F. Kennedy Jr. go in remaking public health policy in his image?
Could he, say, call on Americans to maximize their exposure to measles in a bid to reach herd immunity?
The Department of Justice seems to think so. In defending the health secretary’s changes to the childhood vaccine schedule and to the federal vaccine advisory committee in federal court on Wednesday, government lawyers said that Kennedy and other health officials have broad discretion to issue such guidance — and to choose the kinds of evidence to consider and the experts to consult.
The hypothetical, presented by federal District Judge Brian Murphy of Massachusetts in a suit between the American Academy of Pediatrics and Kennedy, shows how the administration thinks about its power to make unprecedented changes to the country’s vaccine policy.
“The case as a whole is really a test of ‘Is there any mechanism to ensure that actual scientific basis are being followed in any policy area,’” said Brian Dean Abramson, a vaccine law professor at the University of Houston Law Center and Florida International University.
Does the American Academy of Pediatrics have a point of view? Yes. Is it based on sound principles of clinical medicine? Also, yes. Has the AAP at times been influenced by Big Pharma and Big Medicine. Yes, again, but unfortunately that is the nature of American medicine. I asked one of my former students who has been practicing pediatrics in a small rural town since completing her residency about this nonsense regarding vaccines. She replied that it has only made her rewarding life in service to her community more difficult than it should be. As she put it, trying to get the mother out of the room so she can talk candidly with a 12-year-old girl or boy used to be her most difficult daily task. Now, that can be persuading the mother, and sometimes the father, that Gardasil will prevent their daughter from getting cervical cancer and prevent their son from spreading the virus that causes it, and sometimes also getting cancer himself. These outcomes would be through no fault of their own, except engaging in perfectly normal human behavior, without the vaccine.
As they say, this will not end well. But I do want to stick around long enough to see what happens. In the meantime, we should all remember that maybe God sent us scientists like Stanley Plotkin and pediatricians like my former student so that our children and grandchildren won’t have to risk death or serious illness with permanent sequelae like we did. Just a thought.
Part the Third: Libraries Are One of the Great Wonders of the World. I have mentioned before that I realized my calling as a nerd from the moment I walked into my university library at the age of seventeen, a building that at the time held several million volumes. The Science Library was smaller but just as astonishing. It also had Country Life on the New Journals Table, and I still look at the “aspirational” real estate to this day as a minor guilty pleasure. And yes, I also checked out from behind the circulation desk the volume of Annalen Der Physik that contained Einstein’s relativity paper. This was done under the watchful eye of a librarian, no ink anywhere nearby. So, imagine this, Galileo’s handwritten notes found in ancient astronomy text:
On a cloudy day in January, historian Ivan Malara sat in Italy’s National Central Library of Florence poring over seven 16th century printings of the ancient world’s most influential astronomy text. The pages belonged to The Almagest, in which second century polymath Claudius Ptolemy described his vision of an Earth-centered cosmos. As Malara flipped through the pages, he spotted something out of place. Someone had transcribed Psalm 145 on an otherwise blank page—in handwriting reminiscent of a very, very famous Tuscan astronomer.
That book, Malara came to realize, had been extensively annotated by none other than Galileo Galilei. Malara’s discovery, described in a paper now under review at the Journal for the History of Astronomy, promises new insights into one of the most famous ideological transitions in the history of science: the moment when Earth was thrust from the center of our universe.
The general view of Galileo seems to be that he was the great man who showed up Claudius Ptolemy as someone who was simply wrong. Well, he was mistaken, but Galileo was not just a scientific politician looking to make a name for himself, however carefully he must tread:
Galileo’s notes, perhaps written around 1590, or roughly 2 decades before his groundbreaking telescope observations of the Moon and Jupiter, reveal someone who both revered and critically dissected Ptolemy’s work. And they imply, Malara argues, that Galileo ultimately broke with Ptolemy’s cosmos because his mastery of the traditional paradigm’s reasoning convinced him that a heliocentric system would better fulfill Ptolemy’s own mathematical logic. That interpretation contrasts with many historians’ typical portrayal of Galileo as being motivated by philosophy or even political savvy, not careful math. “He has been presented as a big-picture sort of guy—not interested in the nitty-gritty technical details of astronomy,” says James Evans, a historian of astronomy at the University of Puget Sound.
So, Galileo mastered Ptolemy’s math and then showed how the heliocentric system fit the data better? Good science done by a master of his discipline, who could see farther by standing on the shoulders of giants. Sounds about right. For those who want to get a personal view of the life of Galileo, Dava Sobel’s Galileo’s Daughter is the place to begin.
And God bless libraries and the historians who use them to explain our world to us.
Part the Fourth: Diet and Health. Does eating well and exercising lead to good health? Yes, for the most part. But contrary to the New Eugenicists such as RFKJr, sometimes people get sick through no fault of their own, no matter what they eat (even if they don’t get sick from snorting cocaine off toilet seats in public restrooms). This has been demonstrated once again in a short article at the BBC, Vegetarian diet lowers the risk of cancer, study finds:
A vegetarian diet can slash the risk of five types of cancer by as much as 30%, a new study has found.
Researchers from the University of Oxford found that vegetarians had lower risks of pancreatic, breast, kidney and prostate cancer, as well as multiple myeloma – when compared to meat eaters.
However, the study also found that vegetarians have nearly double the risk of cancer of the oesophagus compared with meat eaters.
The team behind the study said more research would be needed to uncover whether it was meat consumption that was problematic, or if something specific in vegetarian diets lowers the risk.
The underlying scientific paper was published in the British Journal of Cancer (open access). It is impressive, with more than 1.8 million women and men from nine prospective studies included. Why are vegetarians more likely to get cancer of the esophagus than meat eaters? Who knows? From the Conclusion:
This consortium includes the great majority of prospective data currently available worldwide on vegetarian diets and cancer risk. Among the people studied, most of whom lived in the UK or USA, poultry eaters had a lower risk of prostate cancer, pescatarian diets were associated with lower risks of colorectal, breast and kidney cancer, vegetarian diets were associated with lower risks of cancers of the pancreas, breast, prostate, kidney and multiple myeloma but a higher risk of squamous cell carcinoma of the oesophagus, and vegan diets were associated with a higher risk of colorectal cancer although the number of cases among vegans was small. Future research should examine the possible mediating roles of both metabolic factors and nutritional deficiencies, and collect more data particularly in vegans and in populations outside Western Europe and North America. The generalisability of the findings should be considered cautiously, because the diets and nutritional intakes of both vegetarians and non-vegetarians can vary substantially within and between populations.
Which brings us back to what we have known from time immemorial: Eat a balanced diet of real food, exercise, don’t smoke, and drink distilled spirits and fermented beverages in moderation. The risks of the occasional shot of Blanton’s over a large round or square ice cube are more than covered by the stress relief gained. Oh, and it would help if you refused to expose yourself to stress at home and at work and on the streets. Never breathe air containing chemicals or soot or go anywhere near polluted water. It remains true that the best way to live your best, healthy life is to choose your parents wisely.
See you next week!
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It seems that a cycle postulated for financial regulation also occurs in public health: hazards –> precautions –> safety –> complacency –> risk taking –> hazards
Hopefully there are lots of people working at local level to make their localities less fragile.
Oh my! R. Kennedy Jr. somehow symbolizes the decadence of the US which seems to be going steeper every passing year. Also that of his family and humans in general. Somebody published an opinion piece at the NYT last year saying that Every 100 Years America Produces a Robert Kennedy Jr. Was this headline’s objective to spread some comfort among the liberals? Don’t worry this will be cleared, it only happens once in a century. I disagree. Kennedy is symptomatic of the many things going wrong in the US. It is indeed problematic when the punditry do not realise what’s going on.
Interesting about Galileo, who has always struck me as not theoretical. To me, it seems typical of him to study Ptolemy’s math and make observations. Hence the later importance of the telescope.
Also, I know Galileo as a hands-on publisher. In his course on display of information, Edward Tufte showed us a copy of The Starry Messenger. Galileo oversaw design and layout — the book is excellent, timeless. Again, Galileo as practical minded.
He liked his wines:
https://winenews.it/it/galileo-galilei-ed-il-vino-scienza-arte-convivialita-ingegno-e-filosofia-in-un-calice_552488/
This article mentions his daughter Suor Maria Celeste, who is the protagonist of the touching book you recommend.
As a naive student of Italian literature (my major, why didn’t I stick with it?) I was completely blown away by the beauty of Galileo’s vernacular prose. The dialogues he wrote are practically modern. I don’t think many people today know that he was also a major intellectual of his era, a scholar and philosopher, as well as a scientist and inventor. Da Vinci as well was a good writer, if a bit dry.
Thanks KLG for keeping us on track with your Friday column.
Thank you, Bugs! Somewhere I have a copy of Stillman Drake’s translation of A Dialog Concerning Two World Systems. You remind me to finally go through those boxes in the basement archive!
Given the huge amount of corporate investment in skewing so much scientific research to fit their preferences, it seems obvious that a leader needs to “choose” which evidence to believe and base policy on. “Choosing” which scientific evidence to believe and act on is what any responsible person must do in this world.
And when so much contradictory or fraudulent supposedly-scientific evidence exists, especially related to vaccines, what else is a leader supposed to do but “choose” which evidence is valuable and which is not?
You may disagree with Kennedy’s choices, but to suggest that he shouldn’t even show judgment and choose which evidence to prioritize seems bizarre.
The point is that it is impossible to imagine previous Secretaries Joseph Califano or Kathleen Sibelius or Tommy Thompson choosing to make a medical judgment about vaccines. Tom Price or Louis Sullivan, both physicians in the position, perhaps, but only at the margin and after long and serious consultation with physician-scientists such as Stanley Plotkin and Paul Offit.
You get no argument here that “special interests” have tainted what is called evidence-based medicine. This has been covered often. The Search function is over there on the right. Yes, we would all be better off if we had listened to Aneurin Bevan, Welsh coal miner and Labour leader who founded the British National Health Service after World War II: “The field in which the claims of individual commercialism come into most immediate conflict with reputable notions of social values is that of health.” Alas, we are far away from Bevan’s vision, and that includes the United Kingdom.
You imply that RFKJr is an honest broker who is only looking for the truth. Nothing could be further from the truth. He is an anti-vaccine proselyte of the first magnitude and he is only making performative noise regarding diet and health. One example of many suffices. Several years ago, a batch of the MMR vaccine was mishandled (the vaccine was mistakenly diluted with a muscle relaxant instead of sterile water) in Samoa and two babies died. Their deaths had absolutely nothing to do with the vaccine and everything to do with this horrible mistake. Nevertheless, RFKJr pounced and at least 83 Samoans subsequently died of measles, most of them under the age of five, because vaccination was halted. The latest news of RFKJr’s involvement is here: Newly obtained emails undermine RFK Jr.’s testimony about 2019 Samoa trip before measles outbreak. Just more evidence that he lied to the United States Senate during his confirmation hearing? A case could be made.
RFKJr is also a father who took his young children swimming in Rock Creek Park in Washington DC, where coliform bacteria levels are not safe. These bacteria are a marker for raw sewage, no matter how “clear” the water is. He seems to think that if one is strong and healthy and therefore one of the chosen, disease keeps its distance. Not so. This is nothing but the latest excrescence of a eugenics that will not die. So, no. No one should trust his judgment about much of anything.
KLG, I am sorry, but I am astonished that you are astonished that people are hesitant about Gardasil. I am neither a Doctor nor an antivaxxer. But I have some common sense. Here please my thoughts why I wouldn´t let my teenager have Gardasil. I am sure lot’s of people have come to similar conclusions.
– The producer is Merck. Is the very same company that gave us Vioxx. Despite clear danger signals it took years and tens if not hundreds of thousands of death before it was withdrawn. A far as I know nobody ever went to jail and the fine was less than the profit Merck made.
– Cervical cancer isn´t exactly the plague. There were 4600 death in 2023 vs. 134 000 for lung cancer.
– The average age of death for cervical cancer is 50 years. As the vaccine was introduced in 2007 it will be the late 2030s before we will know for sure whether it is effective or not.
– As nobody knows what is 30 years down the road the vaccines efficacy is based on modelling by Universities that get sponsored by Big Pharma and then published by Lancet et al that also get huge $$$ by Big Pharma.
– The rate of cervical cancer has been going down ever since the introduction of the pap smear. The trajectory has not changed since the introduction of Gardasil.
– CDC and FDA approved it. That there’s a revolving door between these agencies and Big Pharma is common knowledge.
There were reports in VAERS regarding Gardasil and various autoimmune diseases. These were dismissed as self reported and not confirmed. If you read IM Doc’s reports here about Vaers and the Covid vax you will most definitely not be convinced.
Basically the choice of parents boils down to either believing FDA, CDC and Merck when they say “Trust me” or using common sense.
https://www.cdc.gov/hpv/hcp/vaccination-considerations/safety-and-effectiveness-data.html
With more than 135 million doses of HPV vaccines distributed in the United States, there are robust data showing that HPV vaccines are safe.
The most common side effects reported through CDC’s Vaccine Adverse Event Reporting System (VAERS) are pain, redness, or swelling in the arm where the vaccine was given, dizziness, syncope (fainting), nausea, and headache.
With the exception of syncope, which is more common among adolescents after receiving any vaccine, there have been no confirmed adverse events occurring at higher than expected rates following HPV vaccination.
On very rare occasions, a person may have a serious allergic reaction (anaphylaxis) to any vaccine, including HPV vaccines. In the United States, anaphylaxis following vaccination has a reported rate of 3 cases per 1 million doses administered. People with severe allergies to any component of a vaccine should not receive that vaccine.
HPV infections
Monitoring HPV vaccine prevalence is ongoing in the United States. As early as 4 years after Gardasil licensure, vaccine-type HPV infections had decreased 56% among 14–19-year-old females.1
Within 12 years of vaccine introduction, infections with the four HPV types prevented by Gardasil decreased 88% among 14–19-year-old females and 81% among 20–24-year-old females in the United States.2
I would also point out that the pap smear has been effective because it identifies precancerous cervical lesions that are removed surgically or ablated in outpatient procedures before they progress to cervical cancer. This is why cervical cancer rates went down after Dr. Papanicolaou’s intervention was widely used. The combination of Gardasil and pap smears as part of regular checkups will eventually reduce cervical cancer rates by 99%. Gardasil will also prevent genital warts and oropharyngeal squamous cell carcinoma caused by HPV. The latter has an 85% cure rate with radiation and chemotherapy, but that still means that 15% of cases are not cured, probably because they are not identified soon enough.
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First, your attack on Gardasil. is effectively an ad hom. The fact that Merck made Vioxx, with by the way is not a vaccine, does not prove it manipulated data with Gardasil.. You fail to produce one iota of evidence.
You also abjectly misrepresent IM Doc on VAERS.
He was a critic of how it was managed under Covid because it was a radical departure from how it had always operated before. There is zero evidence of suppression of negative outcomes for the use of Gardasil. The onus is on you to prove it.
If you keep Making Shit Up as part of your anti-vax agenda, you will not longer be welcome.
Thanks KLG, my bandwidth is about fried, regarding vegetarian and vegan diets, there is so much over processed foods that fall into these categories, such as “impossible burgers” and cool ranch Doritos, both “vegan”.
I’m not sure what you’re trying to say here. Of course eating too much, like, potato chips is bad for your health. But most junk foods have animal products! Fats are addictive! A better critique would be that people who don’t eat animals are often more health conscious etc. But I for one am not a health or fitness person, and I’ve never in my life eaten an “impossible burger”
However red meat is a carcinogen. So many diseases are created and spread via the animal killing industry. Think mad cow and “wet markets.”
Sorry, not trying to stoke a debate on the merits. Mine is a poorly framed comment.
There is a lot of over processed food aimed at the vegan market. Clearly there is demand.
How come damn near every librarian back in the day before this contraption came along was considered a know-it-all, polymath-a-magician?
If PE is now in a feeding frenzy in the MAHA psyops…then medical science is regrettably wagging the dog
As a child I had whooping cough, measles, mumps, chicken pox and polio. I was vaccinated for small pox, a requirement by law before attending school in the 1940s, and I had a later small pox vaccination or perhaps it was two. I was born in the mid 1930s the DPT shot came along later. My sisters and I had most of the childhood diseases. We survived and there were no obvious after effects. I remember my son, then 8-years old, staring wistfully out a window at the biggest snowfall he had ever seen and he confined by a bad case of chicken pox, a small tragedy for a young boy in 1969. There were many worse.
My grandchildren have had none of these diseases. They were vaccinated. I suppose there can be reasoned arguments about the timing of the vaccine schedule, but there is no argument I can conceive that vaccination is anything other than a boon, the few individual bad outcomes notwithstanding.