Editor’s note: This post responds to a Feb. 13 article in The Atlantic, “The Scientific Literature Can’t Save Us Now,” written by Retraction Watch cofounders Adam Marcus and Ivan Oransky.
The contentious issue of what — and more importantly who — to believe, when it comes to medical science, is at a critical moment. Watchdog organizations such as Retraction Watch provide a great service to science and the public, by exposing junk scientists and their products, helping to disinfect the field with their sunlight. I commend Mr. Marcus and Dr. Oransky for their sustained efforts in this meta-discipline.
However, policing the scientific literature is a tricky business. In particular, one must be careful to apply the same standards one demands of others to one’s own work. Agreeable as many of their points are, Marcus and Oransky’s article discrediting Mawson and Jacob’s study (which Robert F. Kennedy Jr. cited during his confirmation hearings) falls woefully short of meeting even basic scientific editorial standards. This failure imbues their article with the same yellow hue that they decry in others’ journalism.
Resorting to a combination of circumstantial evidence and ad hominem characterizations, Marcus and Oransky insinuate that the study, which purports to show a link between current childhood vaccinations and neurodevelopmental disorders (NDDs), is scientifically flawed and thus not to be trusted. Yet nowhere do they provide any substantive critique of the study itself. Indeed, it is unclear from their article whether Marcus and Oransky even read the study they seek to discredit.
Rather, their argument runs as follows: The study’s first author is no longer an academic. The journal that published it was not indexed by an organization with scientific credibility. Several editorial board members seem shady. The journal can’t even be bothered to spell an editor’s name correctly. And, by the way, the hypothesis Mawson and Jacob investigate has already been “thoroughly debunked” and is therefore pointless to question.
Really? So henceforth, no investigator shalt ever study whether vaccines are associated with, not just autism, but the spectrum of NDDs (as Mawson and Jacob do)? Which vaccines are Marcus and Oransky specifically referring to? All vaccines? Or only the MMR? As they must know, it is nigh impossible to prove scientifically that a hypothesized association doesn’t exist, let alone for all vaccines, and a roster of disorders. Would they extend this inference then to every new vaccine that enters the market? What if someone’s findings don’t align with what is already “known”? Should they be tossed out? Buried?
It is not clear what relevance Mawson’s employment status has to the validity of his and his co-author’s study. Many scientists work at private research institutes, or for corporations, outside of academia. That two editorial board members have, according to the claim, tainted scientific reputations, is circumstantial. The lower scientific stature of Science, Public Health Policy & the Law might seem damning, were it not for the fact that, as Marcus and Oransky’s own work has shown, publication in a venerated journal is no guarantee of a study’s reproducibility, or even veracity. Conversely, publication in low-tier journals may be the terminal fate not only of shoddy research, but unpopular ideas. The former deserves no defense; the latter does.
Worse, Marcus and Oransky sandbag their own article with unsubstantiated, dubious claims, meant to advance their argument but ultimately leaving it naively exposed to Hitchens’s razor (“What can be asserted without evidence can also be dismissed without evidence”). How could they possibly know that “far more papers should be retracted than are retracted”? Not every publication with errors discovered post hoc need beget a retraction. Scientific journals commonly publish errata. Further, on what grounds can they plausibly claim that “most” published papers “serve no purpose whatsoever”? I allege they do not have exclusive insight into what purpose a given paper serves, especially considering posterity. Short-run citations are not the same as purpose.
On my read of Mawson and Jacob’s paper, it appears to be a straightforward analysis of 47,155 Florida Medicaid claims records from 1999 to 2011. Nothing immediately screams “junk.” The authors use methods common for other claims-based case-control studies, and control for confounding effects of age, gender, and congenital anomalies in their analysis. Their paper describes a relatively balanced assessment of the study’s strengths and weaknesses.
Since the study was rejected without review from other journals, it is unclear what the basis for rejection was, but this editorial action is common and not necessarily an indication of study quality. Publication bias, which refers to how a study’s results affect its publication status, could easily be a factor influencing preceding editorial decisions. In any case, the records are publicly available, and the methods appear duly described, enough to make the study reproducible, should anyone want to analyze it independently.
My prior research in vaccine safety, infectious diseases and neurologic disorders, treatment of vaccine-preventable cancers, and quality of medical scientific literature have made me no champion of the vaccine-autism theory. As for disclosures, I have consulting agreements and research funding from pharmaceutical companies, including Johnson & Johnson and Merck, makers of vaccines. I love vaccines, but I will defend scientists who want to study their safety, and report what they find, where they are able to find a receptive outlet, irrespective of how well their findings comply with other studies.
We all should defend studies against sloppy attempts to discredit them. Because in the current tumult of distrust in experts, it has never been more crucial that Marcus and Oransky, and influential media that provide them a platform, retain their scientific high ground. Status and slick innuendo do not confer the right to skirt rigorous discourse when it comes to critiquing science. Weak arguments from strong voices also do our field a disservice. “Settled science” claims are lazy and readily backfire when thrust upon a distrusting public. They also betray a humanistic disconnect, which I suspect lies at the root of this distrust.
Every month I see patients who refuse to consent for the best known cancer treatment, despite my recommendation, for various personal reasons. Often these reasons are irrational. Many are rooted in misunderstandings courtesy of junk science. My job isn’t to castigate patients for their irrationality. It is first to establish their goals of care. Within that, I can convey my interpretation of the present state of the pertinent medical science. Then, it’s up to them. Among my most important ethical obligations, described in the Declaration of Geneva, is to respect patients’ autonomy, even if it conflicts with what I believe to be in their best interest. Policing junk science can slow, but won’t eliminate irrational beliefs. Nor will policies that threaten individual autonomy, such as making vaccines coerced or compulsory. This merely fuels distrust.
With respect to vaccines and autism, based on work from DeStefano et al., Jain et al., and others, I would conclude that the balance of scientific evidence to date does not support the hypothesized association. This can be stated without having to malign studies that cut against the grain. Yet such mouthfuls are insufficiently sensational, and do not lend themselves to pithy soundbites in mainstream media — which is the point here. Scientific discourse and mainstream journalism operate by different standards. The conventional forum to raise concerns about an article is within the journal’s pages, as a Letter to the Editor, typically alongside a rebuttal from the author(s). Since The Atlantic has chosen to dedicate its pages to scientific discourse, I trust it will provide space for rigorous dissent.
Loren K. Mell, M.D., is a physician-scientist and clinical trialist at the University of California San Diego specializing in head and neck cancer. He previously studied vaccine safety at the Center for Health Studies in Seattle and his current research areas include treatment of vaccine-preventable malignancies and quality of scientific literature.
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I agree. We should, every second of every day of our lives, entertain every crackpot hypothesis that anyone ever brings up because to do otherwise is unscientific. Expect my next paper on whether the sun will rise tomorrow, and if you don’t spend at least two hours reading it, you hate science
Kevin, I feel this is a disingenuous and intentionally obtuse reply. If you read the article it is quite clear that this is not what Loren is proposing. This attitude will only continue to fuel mistrust in the scientific establishment.
I read it, Zach. Loren’s article is filled with emotional hyperbole, unsupported rejections of some remarkably reasonable statements (yes, there is a fraud crisis in scientific literature, and many articles that should be retracted aren’t—which we know after watching articles with clear data fabrication remain unretracted for decades), and ironically, ad hominem attacks against the authors he himself is accusing of ad hominem.
I have no doubt he is a scientist in good standing, but it does not sound as though this article was written by a serious academic, and most of the issues he covers are ultimately irrelevant to his argument.
Oddly enough, I agree with the point that (I assume) Loren is trying to make: the effort to discredit pseudoscience should not discourage us from research that overlaps with conclusions idiots leap to without evidence. It’s difficult to speak up in a domain where your words will be mistaken for political advocacy. For one example, if signs of a serious side effect of COVID vaccines were to appear in the data, scientists may face a reluctance to examine the possibility with sufficient rigor knowing that tinfoil-hats and foreign psyops will use any data they highlight to encourage vaccine skepticism, which will almost certainly lead to more people unnecessarily dying. This is also an issue in research in transgender youth: while the rates of regret from medical intervention for trans youth are remarkably low, it is difficult to do research on some of the risks involved because we know in advance that disingenuous and bigoted actors will use whatever credible science they can find as ammunition against hospitals and children in need of treatment. And so on. It’s hard to do science when you constantly have to worry about the ethical effect of the optics. See also Rand et. al. (as an example of political “truth by fiat”, not as an example of scientific rigor).
Instead of making his point clearly and unambiguously, Loren complains about minor things like word choices and cherry-picks elements of a magazine article aimed at the general public. Far worse, he directly, vigorously defends an indefensible study which concluded with strong and unsupported emphasis that vaccine schedules contribute to NDD and ASD. I choose for now to assume he does this in good faith and is simply trying to reinforce the idea that one must be willing to critique in a measured, factual, and neutral manner.
But this is precisely the opposite of what he does in his argument here.
(Also, who uses the word “shalt” in 2025? Yikes.)
When I got to your statement “the rates of regret from medical intervention for trans youth are remarkably low” I understood you are ready to embrace “evidence” that is as tenuous (or worse) as the one about vaccines and NDDs.
A typical example of double standard attitude.
Yikes.
Agreed.
Brandolini’s law (bullshit asymmetry principle):
The amount of energy needed to refute bullshit is an order of magnitude bigger than that needed to produce it.
But I respect RW’s willingness to publish this.
You are the exact kind of “scientific” mind ths article is intended for.
Your analogy isn’t apt because of inherent uncertainties in human subjects data and the way knowledge about drug safety is acquired, as opposed to astronomy. Studies examining vaccine safety might be valid or flawed based on the data quality and study design, but should be critiqued on their flaws, not results that disagree with your predetermined position or personal characteristics that aren’t relevant. Not every study invites critique. People can let your sunrise article speak for itself and your methods, but if one opts to critique it then I hope they would do so on your study’s demerits rather than yours as a person.
Do we really need to prove that poop tastes bad now?
and smells !!!
Thank you for publishing this critique of your article. It is important to know that Retraction Watch is willing to subject itself to criticism. Dr. Mell makes some valid points that I hope you will take seriously.
One important point is that journals reject articles without review for many reasons, most of which have nothing to do with quality of the paper. Often they won’t even have looked at the paper closely enough to judge quality – it’s often a matter of not finding the topic of interest to them, especially in high impact journals with many more submissions than they can publish or for papers with null/negative results (the file drawer problem).
People who think anything in medicine like a putative link between vaccines and autism can ever be debunked with the same amount of certainty with which you can debunk e.g., flat earthism, just don’t appreciate how complex and high-dimensional biology is. The comments section is filled with dangerous ideologues that are doing science a great disservice (while thinking they’re championing it which is what makes it dangerous).
Let’s see – study’s author is no longer doing academic research – this IS a warning flag – did he stop because he couldn’t get published, and was let go for failing to publish?
Journal does not have scientific credibility – in other words, it is either a very new journal OR a fake journal that doesn’t actually do real peer review, but just publishes for pay. Another warning flag.
Shady editorial board – really starting to look like a pay-to-publish journal or a journal trying to push an unscientific goal. Warning flag.
Journal misspells editor’s name. What the? This should never happen – this isn’t something that is manually typed in every time. Warning flag.
Publishing a hypothesis that has been debunked (falsified) already. Once a hypothesis is falsified, there is no point in publishing about it unless you have solid enough evidence that you can easily get published in the most prestigious journal in your field. Big warning sign.
Article uses specific unusual years of one state’s (Florida) Medicaid records – why those years (199-2011)? Why go 2 years beyond a decade mark? Why Florida? Did the authors analyze a much broader set of data, find out a set of parameters that would support their desired conclusion, and use only that data? BIG WARNING SIGN.
These are exactly the things I look at when figuring out if a paper is even worth reading.
I have used public records in epidemiological research, and often data sets are available for only certain years with a significant time lag between the record date and the publication date. 2011 could very well have been the latest relevant data set available to the authors. States, not federal government, administer Medicaid programs, and not all states publish the kind of data used in this study. The state I live in does not. Florida has a large population and its records may have provided statistically significant results by itself. I am not saying that this study was legitimate, but I am saying that claiming the data sets are a “BIG WARNING SIGN” is unfair without knowing anything about the subject. Would you have had the same concerns about the data sets if the paper were not linking vaccines to NDD?
A causal link between vaccines and NDD has not been “debunked” and never will be. In empirical science it is impossible to prove a universal negative. Particular studied purporting a causal link HAVE been shown to be dishonest and/or flawed. The same objective standards need to be applied to research with authors, hypotheses, or conclusions we mistrust, as the research we are inclined to have faith in. Otherwise we lose all credibility.
“Let’s see – study’s author is no longer doing academic research – this IS a warning flag – did he stop because he couldn’t get published, and was let go for failing to publish?”
This is a complicated issue, but I would very much disagree with this being a default warning flag. People stop doing academic research for an exceptionally large number of reasons. Even just taking your example here, not being published could also result from a number of reasons beyond “bad science” which you seem to imply here.
Super! On point, and also very useful to me as a not-sophisticated-about-statistics-study-design person. Please weigh in early and often!
Jennifer Scott
Psychiatry
The fact that the Mawson paper doesn’t even appear to acknowledge some extremely obvious potential confounders to their analysis is a huge red flag. I’ll pick on one of them:
The authors state: “Children of parents with lower education levels, income, and access to health services, in addition to those with medical contraindications, tend to receive fewer vaccines”, but (conveniently) fail to mention that a diagnosis of ASD is also less likely to occur along those exact same lines.
This isn’t some hidden bit of knowledge, either; it’s widely reported that ASD diagnosis rate is higher, and age at diagnosis is younger, in higher-income / more educated families with greater access to healthcare. These households are simply better equipped to detect ASD, so their children end up with higher diagnosis rates. Yet, for some reason, this well-known phenomenon that could undermine their entire analysis is suspiciously absent from the manuscript. I wonder why…
That the authors fail to even acknowledge such a basic, and widely known, potential confounding factor supported by numerous studies is ignorance / sloppiness at best and dishonesty / maliciousness at worst.
Then, consider that the authors, in their conclusions, claim that “the evidence accumulated to date suggests that vaccination can precipitate unintended adverse outcomes”, which is an absolutely wild leap of logic to make after this extremely superficial bit of data mining. They go a step further and actually recommend that any new vaccines being considered for the federal vaccine recommendation schedule be paused, pending “urgent” further research. At this point, the paper is fear-mongering instead of promoting rational scientific discussion.
Dr. Mell, doing get me wrong: I appreciate the point you’re trying to make, and I agree in principle with most of what you wrote, but I think you are off-base when you state that the authors provide “a relatively balanced assessment of the study’s strengths and weaknesses.” They are blatantly ignoring well-known confounders which should be glaringly obvious to anyone publishing in this field.
This is a good point about ascertainment bias in claims data, and whether that would primarily drive observed associations with ASD in retrospective claims data. The authors did cite claims data as a limitation but could have elaborated on this potential source of bias. Note that the reported odds ratios were higher for the other NDDs in this study, and I’m not sure this same correlation with income/education holds true for epilepsy/seizures, encephalopathy, etc. Clearly a prospective cohort study where one can better define and control diagnosis ascertainment would be preferable from a study design standpoint. It is not far-fetched to want to study vaccine safety with respect to children’s neurologic health. The live oral polio vaccine (OPV), for example, causes (rare) cases of vaccine-associated paralytic polio. The reputable Cochrane Review (doi: 10.1002/14651858.CD004407.pub4) also reported associations between certain MMR/MMRV vaccines and febrile seizures and aseptic meningitis (and, notably, *not* ASD or encephalopathy). So the broad claim that vaccines do not cause neurologic disease is demonstrably false. That of course does not imply that even these vaccines aren’t a good public health policy recommendation, but the question is still consistent with rational scientific inquiry, especially as applied to new vaccines or specific subpopulations.
Yes, I picked on ASD specifically in this paper for a reason. It’s so well-studied and the relationship between income/education/healthcare access and ASD at this point is not only widely reported, but very logical, which makes it shocking that these clear potential confounding factors are completely absent in this paper. In my opinion, if you are going to perform data-mining like this, you have an obligation to account for common confounders.
Correcting for known confounders is just like including a standard in a Western blot, or including a control group in an efficacy study. Sure, nobody is stopping you from doing the experiment without these, and you can even go ahead and write up a manuscript describing your findings, but at the end of the day you have to be ready to get eviscerated by your peers (and rejected from any reputable journal) because the lack of controls undermines your results. And this paper deserves to be judged similarly harshly because of these glaring omissions. I do not know if the authors didn’t have access to the socioeconomic data or what their reason is for excluding it, but either way, the results are undermined.
I don’t think anyone (who is being honest) is trying to claim that vaccines do not or cannot cause neurologic disease – as you mention, there are plenty of historical examples. In fact, if I read a paper claiming that vaccines are perfectly safe and cause no side effects and cannot cause neurologic disease, I would conclude that the authors are either A) ignorant, or B) dishonest, given how well-known and well-studied these side effects are. Which is why I find it odd that anyone would want to give these authors get a “pass” for doing the exact same thing (not pointing at you, just generalizing here).
I encourage any and all follow-up research to figure out if vaccines are *causing* any of these NDDs, but I find it alarming that this particular paper is being used to prop up anti-vaccine sentiment at the federal level even though its methodology is fundamentally flawed.
No clinician of any stripe who paid attention in medical school, unless blinded by enrollment in post-graduation group think or too exhausted/busy to think of how to answer a patient’s anti-Vax remarks on the fly, is likely to opine that vaccines never cause neurological damage. No-one with pretensions to being a clinician or a scientist can say in good faith that any research question is disallowed, no matter how “settled the science.” However, the amount of damage harm done to patients, families and the members of the medical profession by the publication of shoddy science in the service right-wing propaganda on this topic has become deeply enraging to many of us taking care of patients during the Covid-19 public health emergency in the US. At one point during the public health emergency period, about 1 in 5 of the doctors and nurses polled were planning to leave clinical medicine once the pandemic was over. And certainly psychiatrists and pediatricians and family physicians are fed-up to the teeth with having to clean the messes left when families believe the right-wing talking points about childhood vaccines. I was taught that in a measles outbreak there’s about one death for every 2,500 kids who catch measles. And here we go — the first death yesterday from the outbreak in Texas and New Mexico. RFK said that measles outbreaks are “normal” yesterday. No, they are a failure of society. This back ground may be part of the reason that the Marcus and Oransky did not expend the energy to review the flaws in the Mawson and Jacob’s study with the scientific rigor you might have wished. Sure, it is unscientific to believe that if it quacks like a duck and walks like a duck, it must be a duck — but it is going to require much better science than the Mawson and Jacob’s study to convince most people in medicine that any study on vaccines, vaccine schedules, or vaccine injury that gets the approval of RFK is worth the intellectual effort to read, much less spend the time to refute to scientific standards. It does the right-wing propagandists too much honor to wade in their duck shit yet again. We are very tired and the fact that their ignorance is vincible is quite clear. Your turn to start doing it, kid. You’ve got the chops given your university connections and past experience. I’m thrilled you have the mojo for it. Go to it.
Dear Jennifer Scott,
the history of the anti-vax movement in the US is complicated and not a “right wing” exclusive trademark as you appear to imply.
Historically, political and ideological affiliations have shifted significantly over time.
In the 1970s and 1980s, the anti-vaccine movement took on associations with “natural living” and environmentalism—ideals that tended to lean left politically. During this era, skepticism about vaccines intersected with broader movements that questioned corporate power, chemical industry/big pharma, and mainstream medicine. These concerns were reflected in parenting circles and women’s health movements, particularly among those advocating for “holistic health” and “alternative medicine”. The damage done was substantial.
Only in the 2010s and accelerating during the COVID-19 pandemic, the movement has shifted politically to align more closely with the political right, I believe mainly because of vaccine mandates.
Conservative-leaning groups broadened the base of the movement by incorporating it into other priorities, such as skepticism of public health agencies, distrust of elites, and resistance to democratic-led policies.
Dear PF,
Yep, yep, yep, great points about the obvious lack of speaking to the cofounding by socio-economic class issue and the (appearance?) of mendacity about the recommendation that the vaccine schedule be paused. In the phrase “relatively balanced assessment” the word “relatively” is carrying an awful lot of freight.
Jennifer Scott
The title implies that the latest emission from Mawson & Jacob is in fact ‘science’, despite their established track-record.
The population of this study was born in 1999-2002. Thimerosal (contains mercury) was removed from childhood single-dose vaccine manufacture in the US in 2001. I don’t know how long it took to clear inventory. If I were composing such a study I would try for a population born in 2003 or later.
It would be great of Marcus and Oransky made their Atlantic article available to non-subscribers somehow. It would make this easier to assess this critique.
I would second that. Thanks!
There are site like archive[dot]is that may help.
Indeed, https://archive.ph/kiHJw
Reader of this site tend to be familiar with the facts mentioned in that little essay, in general terms, and also with the sort of bluster that comes out when someone’s ox is gored, but in any case there it is.
It’s amusing to see that the same inane bickering occurs in the comments of academic forums, as does in the comments of my local news webpage. Dissent is a critical aspect of the scientific process, but nitpicking in the comments section hardly seems like productive discourse. Just throwing that out there. To those embracing the spirit of scientific discovery (and not just arguing), thank you for your contribution.
Maybe I’m too stupid, or maybe my brain is fried from reading all day, but was there any substantive scientific critique here? Not trying to be combative, honestly. The closest it gets from what I can tell is the 8th paragraph here. Maybe I’m approaching this incorrectly from jump because based on the title “If you’re going to critique science, be scientific about it”, I thought it might be a more scientific critique of the paper in question.
A better look at the paper in question can be found here: https://news.immunologic.org/p/a-recent-study-did-not-show-vaccines
There is no association between MMR and autism, no doubt, and I am inclined to think that is true for other vaccines. However, kids receive up to 72 shots in the US before age 18, and we do not have evidence for vaccines other than MMR. Therefore, any general, apodictic statement about the negative correlation of “vaccines” with anything (including NDDs) is only misleading.
Gene X environment interactions exist, though they may affect a susceptible subset of the population. Vaccines may have non-specific effects beyond their intended purpose of protecting against specific diseases.
Some may be beneficial: e.g. BCG and the measles vaccine have been associated with reduced mortality from causes unrelated to the target diseases. Studies in Guinea-Bissau by Aaby et al. found that children who received early BCG and/or measles vaccinations experienced improved survival rates, suggesting that such live vaccines might boost overall immunity through mechanisms not yet fully understood.
Some appear to be harmful: e.g. studies on non-live vaccines like the diphtheria-tetanus-pertussis have shown a tendency for increased mortality in children who received these vaccines. Specifically, in meta-analyses of studies in Guinea-Bissau and elsewhere, DTP-vaccinated children were found to have higher mortality rates compared to unvaccinated children, with these findings being particularly significant among girls.
We do not know why.
“However, kids receive up to 72 shots in the US before age 18”
You made that claim here and elsewhere: https://pauloffit.substack.com/p/rfk-jrs-misdirection-gambit/comment/96144293
Do you have a source?
The CDC. It varies by State but can reach that number.
The CDC does not say so. Either you need to count vaccines like MMR as three shots, or you are just counting all available vaccine formulations.
Yes, it does. You should be able to go to the CDC website and count. In any case, here the CDC table, https://www.cdc.gov/vaccines/hcp/imz-schedules/downloads/child/0-18yrs-child-combined-schedule.pdf
I counted, it’s not 72. Here’s a link for you to learn about that shot inflation:
https://vaxopedia.org/2024/05/22/the-race-to-give-kids-more-shots/
Just “the CDC” is unhelpfully unspecific. I was hoping for an actual web link, or some other definable source.
1) I said “up to 72” and “varies by State”.
2) I am not at all antivax but I like to get the data straight. I have no idea of what “vaxopedia” is but it looks like a mess.
2) Here is a Vaccine-by-Vaccine Dose Explanation (after which I will stop replying, I have work to do).
1. Hepatitis B (HepB)
3-dose series typically given at birth, 1–2 months, and 6–18 months. Total doses: 3
2. Rotavirus (RV)
RV1: 2-dose series or RV5: 3-dose series.
Total doses: 2–3
3. Diphtheria, Tetanus, & Acellular Pertussis (DTaP)
5 doses at ages 2, 4, 6, 15–18 months, and 4–6 years.
Total doses: 5
4. Haemophilus Influenzae Type b (Hib)
4 doses (3-dose series with a booster at 12–15 months), though PedvaxHIB may require only 3 doses.
Total doses: 3–4
5. Pneumococcal Conjugate (PCV)
4 doses at ages 2, 4, 6, and 12–15 months.
Total doses: 4
6. Inactivated Poliovirus (IPV)
4 doses at ages 2, 4, 6–18 months, and 4–6 years.
Total doses: 4
7. COVID-19 Vaccine
Varies by manufacturer and number of boosters necessitated; for initial series, 2–3 doses are typical, with additional boosters.
Approximate doses: 2–4 for estimation
8. Influenza (Yearly)
1 dose annually starting at 6 months, or 2 doses in the first year of vaccination (total up to 16 doses by age 18).
Total doses: Up to 16
9. Measles, Mumps, & Rubella (MMR)
2 doses at ages 12–15 months and 4–6 years.
Total doses: 2
10. Varicella (Chickenpox)
2 doses at ages 12–15 months and 4–6 years.
Total doses: 2
11. Hepatitis A (HepA)
2-dose series at ages 12–23 months.
Total doses: 2
12. Tetanus, Diphtheria, & Acellular Pertussis (Tdap)
1 dose at age 11–12 years.
Total doses: 1
13. Human Papillomavirus (HPV)
2-dose series if started before age 15 or 3 doses if started later.
Approximate doses: 2–3
14. Meningococcal (MenACWY)
2 doses at ages 11–12 years and 16 years.
Total doses: 2
15. Meningococcal B (MenB)
2 doses for certain high-risk groups during adolescence.
Approximate doses: 2
16. Dengue Vaccine (DEN4CYD)
3 doses for children 9–16 years in endemic areas.
Total doses: 3 if applicable
Additional Considerations
RSV (Respiratory Syncytial Virus) may add 1–2 doses depending on risk factors
Certain vaccines or doses may vary based on medical conditions, such as immunocompromised states, catch-up schedules, or travel requirements.
Therefore: approximation to 72 Doses, based on the above breakdown:
Core vaccines (HepB, RV, DTaP, Hib, PCV, IPV, MMR, Varicella, HepA, Tdap, HPV, MenACWY): ~35–40 doses.
Influenza vaccine (administered yearly): ~16 doses.
COVID-19 vaccine: ~2–4 doses (conservatively).
Special vaccines (RSV, MenB, Dengue): ~5 doses (varies).
Adding these together provides a total close to 72 doses, particularly depending on annual flu vaccinations and individual risk factors.
Perhaps ‘Cheshire’s’ comment strikes to the root of the dilema. Those of us with the training, and inclination, to review research are few in number compared to the number of papers needing examination. A possible solution might be a standardized Large Lanuage Model with training in statistics. To do publicly accessible flagging of all pre-prints.
There is a parallel universe where the only cures that work are based on, say, Ayurveda, and conventional vaccines cause not only autism, but also persistent diarrhea since birth and self-immolation at the age of 35.
Just a “standardized Large Lan[g]uage Model with training in statistics” cannot discriminate between our consensual reality and that parallel universe, which limits its use to cases where authors are sloppy enough to leave giveaways. If you want to go beyond that, your LLM has to have A WHOLE LOT of real-world knowledge. And I don’t see that anywhere near.
Mell makes a good case for scientific inquiry based exclusively on science. While I agree, it appears to be a quaint notion. The very idea seems to be a source of great discomfort for many. According to several of the comments here, the public can’t be trusted with an unvarnished revelation of scientific study results, including the skeptical back-and-forth of critics that has historically propelled science, lest those results be twisted in service to some “right-wing” goal. This “hide the decline” argument is a treatment worse than the disease it attempts to treat.
It’s reasonable to ask why those clinging to “settled science” as the basis for their viewpoint shrink from laying out that settled science and responding to critics methodically and unrelentingly. Seems like it would be an easy and rewarding endeavor, and vastly more convincing than claiming the moral high ground. Should we simply have a list of scientific questions that can’t be asked? Perhaps supplemented by a (long) list of settled science “facts” that have been overturned by heretical critics? Can a scientific community intent of conformity and uncomfortable taking on critics purely on the merits of the science be trusted by the population at large? I think not. And is that the fault of some right-wing propogandist? No, sorry.
To make any critical assessment of mainstream science a manifestation of “right wing” politics is quite childish and frankly unhelpful.
You might want to re-read my comment. That was exactly my point.
ACCORDING TO SEVERAL OF THE COMMENTS HERE, the public can’t be trusted with an unvarnished revelation of scientific study results, including the skeptical back-and-forth of critics that has historically propelled science, lest those results be twisted in service to some “right-wing” goal.
I wasn’t suggesting that any critical assessment of mainstream science is a manifestation of “right-wing” politics. I was merely pointing out that that is in fact an argument that is frequently made in defense of the obfuscation of inconvenient results, such as Mann’s “hide the decline.”
Can you explain how YOU think Mike Mann supposedly obfuscated inconvenient results?
I doubt you can, since the infamous “hide the decline” is related to cover art of a study that did not involve Mike Mann.
Does this help?
“I know there is pressure to present a nice tidy story as regards ‘apparent unprecedented warming in a thousand years or more in the proxy data’ but in reality the situation is not quite so simple.”
—Dr. Keith Briffa, Climatic Research Unit, disclosed Climategate e-mail, Sep. 22, 1999.
“Keith’s [Briffa] series…differs in large part in exactly the opposite direction that Phil’s [Jones] does from ours. This is the problem we all picked up on (everyone in the room at IPCC was in agreement that this was a problem and a potential distraction/detraction from the reasonably consensus viewpoint we’d like to show w/ the Jones et al and Mann et al series).”
—Dr. Michael Mann, IPCC Lead Author, disclosed Climategate e-mail, Sep. 22, 1999.
“…it would be nice to try to ‘contain’ the putative ‘MWP’ [Medieval Warm Period]…”
—Dr. Michael Mann, IPCC Lead Author, disclosed Climategate e-mail, June 4, 2003
“By the way, when is Tom C [Crowley] going to formally publish his roughly 1500 year reconstruction??? It would help the cause to be able to refer to that reconstruction as confirming Mann and Jones, etc.”
—Dr. Michael Mann, IPCC Lead Author, disclosed Climategate e-mail, Aug. 3, 2004.
“I gave up on Judith Curry a while ago. I don’t know what she thinks she’s doing, but it’s not helping the cause, or her professional credibility.”
—Dr. Michael Mann, IPCC Lead Author, disclosed Climategate e-mail, May 30, 2008
“Well, I have my own article on where the heck is global warming… The fact is that we can’t account for the lack of warming at the moment and it is a travesty that we can’t.”
—Dr. Kevin Trenberth, IPCC Lead Author, disclosed Climategate e-mail, Oct. 12, 2009.
Manipulating Temperature Data
“I’ve just completed Mike’s [Mann] Nature trick of adding in the real temps to each series for the last 20 years (i.e. from 1981 onwards) and from 1961 for Keith’s [Briffa] to hide the decline.
—Dr. Phil Jones, Director of the Climatic Research Unit, disclosed Climategate e-mail, Nov. 16, 1999
“Also we have applied a completely artificial adjustment to the data after 1960, so they look closer to observed temperatures than the tree-ring data actually were….
—Dr. Tim Osborn, Climatic Research Unit, disclosed Climategate e-mail, Dec. 20, 2006.
I was just reinforcing your argument. I agree with you.
Interesting commentary, but I cannot take anyone with affiliations with large pharmaceutical companies seriously (at least, as an academic). You honestly expect a reader to believe you have no conflicts of interest when you are receiving consulting fees from J&J? Even if you are ‘arguing’ for the side you (and the pharma companies) are ostensibly against – objective opinions don’t have room for nebulous affiliations. Not that this is necessarily your fault – I am sure 99% of academics offered consulting fees would jump at them. But it is a wider problem that (in my opinion) casts doubt on much of the discussion.
Out of curiosity – is this comment directed at anyone in particular?
Anon – I suggest read Retraction Watch more frequently. If you did, you’ll see that it is very very rare that studies from large pharmaceutical companies are retracted as fraudulent.
I will add for clarity that for vaccines that are mixed antigens (e.g. MMR, DTaP), even though it is one shot each of the antigenic challenges act independently (=like injecting those separately). That is how one gets to up to 72 and more.