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Home » Debunking RFK Jr’s book “Vax-Unvax” – Part 7, flu vaccine

Debunking RFK Jr’s book “Vax-Unvax” – Part 7, flu vaccine

Last updated on May 2nd, 2024 at 11:14 am

This article, part 7, the flu vaccine, of a series of 7 debunkings of a new book, “Vax-Unvax: Let the Science Speak” is written by Frank Han, M.D., an academic board-certified pediatrician/ pediatric cardiologist. He splits his time between cardiac imaging (Nuclear, CT, MRI, and echocardiography), inpatient cardiology, and outpatient cardiology. He primarily cares for cardiology patients of all ages with congenital heart disease and is dedicated to educating pediatric residents and medical students.

While completing his pediatric residency at Connecticut Children’s Medical Center, Dr. Han became aware of and interested in the incursion of pseudoscience into his chosen profession and saw it explode during the COVID pandemic. He has since focused his efforts on spreading the joy of science literacy and teaching patients how to take charge of their health while navigating the tricky online world of medical information. Dr. Han has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @Han_francis. The comments expressed by Dr. Han are his own and do not necessarily represent the views or opinions of OSF Medical Center, or the University of Illinois College of Medicine.

As I did in Part 1Part 2Part 3, Part 4, Part 5, and Part 6 of this series, I will emphasize one chapter of the book “Vax-Unvax: Let the Science Speak,” by Robert F Kennedy Jr and Brian Hooker. In this chapter, the “Vax-Unvax” makes one mistake after another mistake in characterizing the flu vaccine.

Allegation 1 — “Vax-Unvax” and the flu vaccine

“Infant formulations of the same vaccines contain 12.5 micrograms of mercury in a two-shot series for a total inoculation of 25 micrograms of mercury.”

This is a false representation of the Afluria vaccine insert they desperately insist you read. I quote directly from their citation, specifically one of the many parts they glossed over:

Thimerosal, a mercury derivative, is not used in the manufacturing process for the single dose presentation. This presentation does not contain preservatives. The multi-dose presentation contains thimerosal added as a preservative; each 0.5 mL dose contains 24.5 mcg of mercury and each 0.25 mL dose contains 12.25 mcg of mercury.

The insert explicitly says the single-dose influenza vaccine contains no mercury. If you wish to select that kind of influenza vaccine, you most certainly can.

Allegation 2

“Miller and coauthors reported a causal association between the H1N1vaccine and narcolepsy in children and young people in England.”

This is a legitimate side effect of a specific influenza vaccine, Pandemrix, which was removed from the market for this exact reason. However, the book’s authors make no effort to thoughtfully think through known genetic risk factors for narcolepsy, nor the fact that influenza infection itself is also capable of generating narcolepsy.

The vaccine regulators did exactly what antivaxxers want, which is to pull vaccines that cause these types of significant side effects. Curiously, there is no effort on the part of the authors to thank the regulators or address the fact that the removal occurred.

In addition, the book authors make no effort to carefully describe how newer H1N1 vaccines do not carry a significant narcolepsy risk as their older counterparts. The US seasonal flu vaccines have been investigated many times for narcolepsy risk, and they do not have that risk. It’s almost as if – the book authors don’t sincerely want vaccines to get better, they just want to manufacture fear.

Allegation 3 — “Vax-Unvax” and the flu vaccine

“Using a self-controlled analysis where the control group consisted of vaccinated individuals followed starting 43 days from vaccination, Dr. Salmon also noted an associated increased risk of GBS (Guillain-Barré Syndrome) of 2.35, with a p-value of 0.0003 and a 95% confidence interval of 1.42 to 4.01, within 42 days of the H1N1 vaccine.”

For readers who have not encountered Guillaine-Barré Syndrome before, it is a neurological disease that consists of weakness, numbness, tingling, and difficulty doing daily activities. It is a result of the immune system mistakenly damaging the body’s normal nervous system.

The book authors intentionally cut off the very next few sentences of this journal article, which I quote: 

The modest risk of Guillain-Barré syndrome attributed to vaccination is consistent with previous estimates of the disorder after seasonal influenza vaccination. A risk of this small magnitude would be difficult to capture during routine seasonal influenza vaccine programmes, which have extensive, but comparatively less, safety monitoring.

Specifically, that was 1.6 additional cases of GBS per million doses of vaccination, which is an extremely small risk. When all the GBS literature is taken together as they relate to the influenza vaccine, one will realize that the risk remains small but is somewhat variable depending on the flu season.

The authors also neglect to tell their audience that the influenza virus itself causes GBS, at a higher rate than its vaccine, and that the annual incidence if all viral infection is taken into account, is 0.4–4.0 cases per 100 000 population among all ages. In other words, 80-160 cases occur per week regardless of vaccination status. While GBS, in certain cases, is rather serious, the book authors again use the age-old antivax tactic of overblowing the risks and omitting context.

vax-unvax flu vaccine

Allegation 4

“Vaccinated children four years old and younger showed a 4.8 times greater hazard of non-influenza acute respiratory infection compared to unvaccinated peers within a 14-day window following vaccination.”

This allegation stems from this article. At the most basic level, the problem with this allegation is that anti-vax leaders implore their followers not to worry about the common cold. This is considerable cognitive dissonance because this article being cited essentially says that you should now be worried about the common cold.

Which one is it? The study authors even specifically mention that the viruses that they searched for were the most common cold viruses, including RSV, coronaviruses, rhinoviruses, and enteroviruses.

Next, there is a biological principle that the book authors are getting at, known as viral interference. As is typical of many anti-vax principles, they are basing this allegation upon a tiny kernel of truth. That so-called truth is, that sometimes, more than one virus can infect a person, and the end result is that one virus can reduce or increase the risk of infection, by the second virus.

Next, the citation itself provides the tools on how to put the findings into context. Should the reader immediately drop all influenza vaccinations? Absolutely not.

While influenza vaccine efficacy is a known weakness given the ability of the influenza virus to change every season, it has been shown to decrease the risk of hospitalization and severe illness across all age groups and comorbidities. The book authors even fail to take into account the findings of other studies that conflict with the findings of the article they cite (meaning bigger studies did not find the risk of other viral illnesses to be higher after the influenza vaccine).

Lastly, the book authors commit another rookie statistical mistake which is to presume causation, when observational designs are explicitly not designed to measure causation.

Allegation 5 — “Vax-Unvax” and the flu vaccine

“The researchers found that the trivalent inactivated flu vaccine ironically increased the rate of influenza hospitalizations in children by 3.67 times, with a statistically significant 95% confidence interval of 1.6 to 8.4.”

The problem with drawing this conclusion from this study is that it is retrospective. This term means that the study looked into the past, and therefore, it is limited by several confounding variables, of which two big ones are recall bias and convenience samples.

These issues can be explained by some real-life examples. A convenience sample is just what it sounds like – if you look at the fruit section in the grocery store, and you only constrain yourself to the apples, you will not realize that there are other kinds of fruits in the store.

Recall bias is when subjects do not accurately remember a past event. While it is a legitimate question to ask if influenza vaccines set off asthma, as do the study authors, we fortunately have the answer to this from research from other centers.

Naturally, the book authors don’t care for any point of view other than the one they prefer to hear. A higher level of evidence, a meta-analysis, has found that asthma exacerbations and influenza infections are decreased with the usage of influenza vaccination.

woman lying on bed while blowing her nose
Photo by Andrea Piacquadio on

Allegation 6

“The investigators observed 28 individuals with type 2 diabetes inoculated with the adjuvanted influenza A vaccine. Before and after vaccination, researchers measured C-reactive protein (CRP), interleukin 6, and monocyte-platelet aggregates. After vaccination, the patients’ CRP level elevated from 2.6 to 7.1 milligrams per liter with a p-value less than 0.0001, interleukin 6 increased from 0.82 to 1.53 picograms per milliliter with a p-value less than 0.0001, and monocyte-platelet aggregation increased from 28.5% to 30.5%.”

If you ask your immune system to do work, don’t be surprised when inflammatory markers temporarily rise in response to that request to do work. Receiving a vaccination is asking your immune system to do work.

Reading that the book authors are surprised about this study is something akin to being surprised about a dog barking. On their comments about heart rate variability – when you dig into the study, you will find that the actual reported changes in heart rate variability (which is how they predicted the risk of future cardiovascular events) have only very tiny clinical significance.

In addition, the patients themselves reported no symptoms after influenza vaccination. Lastly, multiple studies such as this one, teach us that our highest-risk patients with heart disease benefit from a reduced risk of hospitalization for influenza when they get vaccinated.

Allegation 7 — “Vax-Unvax” and the flu vaccine

“Interestingly, there are 17,922 reported events of “cardiomyopathy” associated with influenza vaccines in the VAERS database.”

This finding is not at all interesting if you know what you are looking at. VAERS may not be used for the determination of causation (this is stated on the homepage of VAERS). Cardiomyopathies are mostly related to heart artery narrowings and genetic problems in most adults, and influenza vaccines cannot change your genes nor can they create heart artery blockages. Influenza vaccinations have been studied for a long time, and cardiomyopathies are not a safety signal associated with these vaccines. It is the COVID vaccine that has a rare association with vaccine myocarditis in certain age groups.

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