#vaccineswork Aseem Malhotra, a British adult cardiologist and TV personality, has come out with an article railing against COVID vaccinations. It has multiple logical errors, conflicts of interest, and citations of dubious quality. Lets discuss. 🧵
(1/11) as someone who has previously published, we generally do not write articles for journals with a completely different main theme. He wrote an immuno-cardio-epi crossover article and put it in a diabetes journal. He doesn't acknowledge that he is on the board of editors.
(2/11) it is extremely rare to collaborate with anonymous co-authors unless that co-authors' life is on the line should their identity be revealed (or some other extremely extenuating circumstance). As an academic you should be able to stand by your work and respond to critique.
(3/11) an association with Norm Fenton, Stephanie Seneff, and Clare Craig is dubious at baseline. These people have been pushing antivax rhetoric for ages now (reference sciencebasedmedicine.org).
(4/11) it takes years for coronary atherosclerosis to happen. In someone with severe stenoses of the coronary arteries - their morbidity/ mortality is already going to be quite bad. We need at least some effort to derive a mechanism of ischemia/ infarction, and there is none.
(5/11) the core of his argument revolves around the controversial "Circulation" abstract, which really terribly overstates its conclusions without the evidence to back them up sciencebasedmedicine.org/the-puls-test-…
(6/11) ARR vs RRR: this is an antivax trope that has been in use well before COVID vaccinations came online. ARR is used to intentionally make effectiveness look smaller, but ARR suffers from dependence on transmission. ARR for classical vaccines are also small, but...
this by itself is not a reason to protest the MMR, DTaP, and other classical childhood vaccines. A door is not too small only because you looked at it side-on.
(7/11) significant reduction in deaths: While the original COVID vax phase 3 trials did not prominently feature calculations on reductions in deaths, it is really intellectually dishonest to ignore the shelves of data now written on this exact outcome. med.stanford.edu/news/all-news/…
(8/11) Immunobridging is not a new technique; it has been used in prior vaccinations in the same way it has been used in COVID vaccinations pubmed.ncbi.nlm.nih.gov/25943067/ .
(9/11) Of the cardiac risk factors for more severe COVID19, significant coronary artery disease CAD) is one of those risk factors! While I am happy overall deaths are less than in the beginning of the pandemic, people with CAD are not out of the woods ncbi.nlm.nih.gov/pmc/articles/P…
(10/11) Blood clot risk/ MI remains elevated even one year after COVID19: (and that doesn't even go into other organ system issues) heart.org/en/news/2022/0… + nature.com/articles/d4158…
(11/11) And we don't even try to come up with any sort of lab experiment to support his primary conclusion that people are getting MIs. At the very least, try to systematically study the Kounis syndrome that he is likely getting at.
So - take the Malhotra article with lots of grains of salt.
He has a part 2 - that is more a discussion on the regulatory aspects of vaccine safety. I freely support fighting pharma company misconduct and don't mind criticizing pharma indemnity clauses/ drug trial shenanigans. (1/6)
(2/6) Optimal metabolic/ social determinants of health - can you name a healthcare worker that asked you not to optimize these things? This is much harder to deliver in practice. You should always be optimizing these determinants whether you see a HCW or not.
As a cardiologist he should be acutely aware of how difficult it is to guide a patient to stop smoking or consistently eat more healthy food. He is intentionally misrepresenting the difficulty of this task to push his distorted conclusions. (3/6)
(4/6) if peds cardiologists really didn't care about pediatric vax myocarditis we wouldn't be spending time, and effort to do multi-center studies to sort out the long term outcomes. He intentionally omits this, knowing that we are uniquely well suited to study myocarditis.
(5/6) releasing raw data - it is very, very conceited to state that only he and his colleagues are capable of analyzing data correctly, and that all the shelves worth of vaccine safety data aren't right because the conclusions don't sit well with him.
(6/6) if he genuinely thinks legions of people are getting coronary vasospasm, he owes the cardiology community at the very least, an animal study, to show this, followed hopefully by a human study. Cardiologists don't get to make guidance based upon their hunches.
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