You can’t debate RFKjr live. No matter how smart you are, you will lose — badly. He’s far more prepared with the crazy than you are with the science. An example is this exchange on Bill Maher’s show, where he spews lies and mischaracterizations faster than a fact checker can keep up, but no amount of debate can ever prove him wrong.
In this exchange, RFKjr claimed that vaccines don’t undergo placebo-control trials like other drugs. This is obviously false. For example, Pfizer’s mRNA covid vaccine clearly underwent a placebo-controlled trial before getting authorization. Most every vaccine you’ve ever taken has had some sort of placebo-controlled trials.
But this truth won’t help you. It’s more complicated than that. RFKjr has been claiming this for years in the face of smart criticis proving him wrong. He has far more experience defending this than you have debunking it.
Below, I show how this works. I start by taking his side a little bit.
Where he’s right
To start with, he’s actually right in some fashion.
For one thing, he can list a number of vaccines that haven’t gone through such trials. Even if I can list the ton of vaccines that have had placebo-controlled trials, he can list important ones that haven’t.
For example, consider the Pediarix vaccine, which combines the DTP vaccine with a well-known hepatitis-B and polio vaccine. The “control arm” of this trial is another DTP vaccine called Infanrix. There is no placebo arm of the trial.
This Infanrix DTP vaccine is combination vaccine where the Pertussis vaccine was replaced with a better one, making it a DTaP vaccine. The control was the olderDTP vaccine.
The original DTP combination vaccines against Diphtheria, Tetanus, and Pertussis (aka whooping cough). It was developed back in the 1930s, being the first childhood vaccine. The combination of the vaccines weren’t tested against a placebo.
Thus, he’s got some technical points here about placebos.
His argument is more than that. He also argues that the trials aren’t as long as normal drugs. A vaccine trial is often for less than a year (Pfizer’s was 4 months before authorization), while the average length for other drugs is around 4 years.
Why this is crazy
He’s misrepresenting how the science works.
His underlying assumption is that placebo-controlled trials are about safety.
This isn’t really true. The primary focus of such trails has been on efficacy. Read the Wikipedia page on placebo-controlled trials. It largely doesn’t mention safety. Instead, it focuses on the historic battle in medicine proving the efficacy of a treatment.
This is the fundamental problem with debating crazy. They twist things into a new truth that’s hard to debunk. The Wikipedia page doesn’t explicitly refute their point of view, but it clearly also doesn’t support it.
Just because there’s a placebo-controlled trial doesn’t mean safety is adequately tested. The statistics are different.
The Pfizer trial showed 95% effective against placebo with 43,000 participants in the study. This proves conclusively that the vaccine worked over the ~6 months of the trial. However, it appears that myocarditis appears in 1 in 100,000 recipients of the vaccine. The trial was underpowered, unable to detect such a small rate of side effects.
The same is true of most drug trials. They find common things like nausea and dry mouth, but they won’t detect rare side effects that may be important. The average drug trial, even after 4 years, won’t detect a 1 in 100,000 incident of myocarditis.
Scientists have been agonizing over this forever. Sufficiently large trials looking for all possible side effects of every single drug are impractical. They look for other ways to practical assess the safety. For vaccines, VAERS is an important part of this.
Typical drugs have long lasting trials simply because most drugs are taking for long periods of time. The typical blood pressure drug is typically taken for life, or until a better drug comes along.
But drugs given over a short period of time have shorter trails. For example, this drug taken before surgery was studied for only 90 days.
Vaccines are studied for a short period of time just like all drugs that aren’t taken over long periods. Trials don’t continue much longer than after you take the vaccines.
It’s highlighting how they twist this thing, that somehow vaccines don’t meet the standard of typical drugs that are tested for years. In reality, they do meet the standard of not testing a drug for years after the point the person stops taking it. It’s just a question of which comparison better applies.
Lots of drugs aren’t tested against placebos. For example, if you are developing a new (hopefully better) cancer treatment, the control arm is going to be against the old treatment instead of placebo. If developing a new type of insulin, the control arm is the old type of insulin. You don’t test against a placebo, because those taking the placebo die.
The same is true of vaccines. They are trying to find vaccines that are better. You don’t want to leave the kids unvaccinated in the control arm. There have been a lot of papers written on the ethics of given people placebos, when the placebos hurt the patient.
But it’s even more sophisticated than that. Take the DTaP vaccines like Infanrix. The entire point isn’t a more effective vaccine, but a safer one. The entire point is proving the new vaccine is safer than the old DTP vaccine. Thus, the control arm is supposed to be that of the alternative. Maybe there should be a third, placebo arm of the trial, but it seems unnecessary, since the entire point is to prove the new drug safer than the old one.
The always right position
Once you get past the lies and misrepresentations of RFKjr, he’s still right. Do we need to do more to guarantee the safety of vaccines? Nobody really can claim “no”. Think of the children! Nobody can prove that we don’t need to do more.
I work in cybersecurity where we have the same problem. There are always those arguing that we need more cybersecurity. They misrepresent cybersecurity to the same extent as antivaxxers misrepresent science. For example, people are obsessed with 0days and unpatched vulnerabilities, even though they are responsible for only a tiny amount of hacking.
No matter how much RFKjr loses the factual debate, he always wins the moral debate.
Conclusion
RFKjr’s discussions on Bill Maher, Joe Rogan, and other podcasts are full of easily disproven rhetoric. But you won’t catch him on it, because he’s pivot to a more complex defense, where he’s very practiced and nuanced.
Here, he’s created a different sort of science, one that pretends vaccines don’t follow the same placebo-controlled trials as normal drugs. This is just plausible enough that his followers will absolutely believe it, even though scientists don’t agree with the description.
Even if you get past all the lies and misrepresentations, he’s still taking the emotional “think of the children” side of the argument. All he has to do is introduce enough confusion in the debate to convince people that more safety is needed. No amount of careful explanation will stop the befuddled masses from believing this.