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Safi Bahcall
Foreign.
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Malcolm Gladwell
I recently called up my friend Safi Bahcall. I wanted to see if he could correctly guess the answer to a puzzle. First of all, before we start, I just wanted to briefly establish your bonafides for this conversation.
Unknown
You.
Malcolm Gladwell
You have a PhD from MIT, is that correct?
Safi Bahcall
Stanford.
Malcolm Gladwell
Stanford. Stanford. And you went on to be to work on the development of a number of different drugs? That's correct.
Safi Bahcall
I did.
Malcolm Gladwell
Safi ran a drug company for a long time that worked on some of the hardest problems in cancer treatment. In preparation for our call, I sent Safi the package insert for something called Rotatec. As I'm sure you've noticed, when you get a prescription drug, there's a leaflet inside the box all folded up, tiny print. That's the package insert. It tells you in great detail every benefit, every side effect, every clinical study associated with your medication. The Food and Drug Administration and drug companies spend years working out the exact wording of that leaflet. And I'm assuming you've never read this before?
Safi Bahcall
Never read it before, just saw it 20 minutes ago or whenever you sent it.
Malcolm Gladwell
Rotatec is a vaccine to protect babies against a very nasty intestinal bug called rotavirus. What Safi first noticed was how well it worked.
Safi Bahcall
Where I go to right away that's interesting is the efficacy data, which is post marketing Adverse events description, Drug interactions, clinical studies, section 14. Yeah. That's amazing. You look at table eight on page 10 or whatever.
Malcolm Gladwell
Yep.
Safi Bahcall
There was one incidence of any grade of diarrhea or gastroenteritis, which is what this virus is supposed to protect, and 51 on the placebo arm.
Malcolm Gladwell
Oh wow.
Safi Bahcall
So it's 50 times higher. 50 times higher. More kids will get some serious or moderate diarrhea or gastroenteritis compared to those who got the vaccine. That tells me, of course I want the vaccine for my kid.
Malcolm Gladwell
Yeah. If I told you you had a drug on development that had efficacy data where there was a 50x difference between treatment and control, what would you what word would come out of your mouth?
Safi Bahcall
That's absolutely astonishing. That's just jaw dropping. You almost never see that kind of efficacy in a therapeutic for treating active disease. Yeah, you see it once in a generation. You know, a 50x improvement is unbelievable, is incredible.
Malcolm Gladwell
And now that Safi knew what we were talking about, it was time to see if he could answer my little puzzle. A puzzle connected to the co inventor of Rotatech, a man named Paul Offit. I want to read to you now that we've done this. I want to read to you from a book. I'm going to have to tell you who wrote it, but it's someone in a position of real authority in the world. The best evidence indicates that Dr. Offit's rotavirus vaccine causes negative net public health impacts. In other words, Dr. Offit's vaccine almost certainly kills and injures more children in the United States than the rotavirus disease killed and injured prior to the vaccine's introduction.
Safi Bahcall
That's just complete bullshit. I don't know what else to say. That's just you look at this data. This is extremely robust, careful data. You look at the statistics are published on all of the numbers and tables here. It is just absolute nonsense.
Malcolm Gladwell
Do you want to guess who wrote that?
Safi Bahcall
Does it rhyme with Genadi?
Malcolm Gladwell
Oh, Safi, you win the prize. My name is Malcolm Gladwell. You're listening to Revisionist History, my podcast about things overlooked and misunderstood. This episode is the very strange story of Rotatec, a vaccine that every American infant is supposed to get three times in their first eight months of life. Or rather, the very strange campaign waged against Rotatec by Robert F. Kennedy Jr. The Secretary of Health and Human Services, the man in charge of every aspect of health, medicine and research in the United States. If you are the parent of small children in the developed world in the 21st century, diarrhea is not high on your list of things you worry about. But that was not true of your parents when you were a child, or your parents parents or anyone else for that matter. Going back as far as human beings go, particularly those living in the poorest parts of the world, this is what it used to be like.
Vishwajit Kumar
There's one vivid memory that I can actually think of is going into these pediatric wards and you had patients, these children, literally to the point that you would actually have a diarrhea ward, a separate diarrhea ward, because that was the quantum of cases that you would see in hospitals, without exception.
Malcolm Gladwell
This is Vishwajit Kumar, a pediatrician and public health researcher in Uttar Pradesh, one of the poorest states in India, remembering his days as an intern in the 1980s.
Vishwajit Kumar
You have babies who come in dehydrated, severely dehydrated, and the first thing you know, sunken eyes. You know, you could just pull their skin and you'll find that, you know, they just don't retract because there's no double pressure.
Malcolm Gladwell
A small child would get sick with the rotavirus. They would run a fever, they would start vomiting, they would develop severe diarrhea as the virus wreaked havoc in their stomach and intestines. That's three sources of dehydration suddenly and simultaneously. And if the child was far from a hospital and already malnourished, they were in trouble. The best estimates at the time were that children in developing countries had between four and eight episodes of severe diarrhea in their first five years of life, each lasting from two to 10 days. For Dr. Kumar, this meant a giant room full of shrunken infants, two and sometimes three to a bed.
Vishwajit Kumar
So you have these sweepers whose job is to just keep cleaning the mess or the parents would do it, or the parents would clean it, you know.
Unknown
And of the children in that ward, in that era, how many would you lose?
Vishwajit Kumar
Okay, so let's say there is a hundred of them who come in with severe and life threatening diarrhea. You'd lose 10% for sure.
Unknown
Oh, my goodness. I mean, to lose one, to be a doctor and lose one baby must is emotionally overwhelming. You're talking about over the course. So over the course of working in a ward, you would lose dozens of children over the course of months?
Vishwajit Kumar
Yes. To give you an example, we do these verbal autopsies because hospitals don't have good records, essentially reconstruct that event so that then experts can sit around and say this possibly could have led to the death. I have never been able to go through one verbal autopsy in one city.
Unknown
What do you mean?
Vishwajit Kumar
It's so heartbreaking because you're like, oh, you know, this is. This could have been. So this could have been prevented. You know, it's like you look at these cases and see every newborn dies. There is one mother who also, in some ways there is some part of it dies with her.
Malcolm Gladwell
The battle against rotavirus took years. First, the virus itself had to be identified, separated out from all the other pathogens that can cause diarrhea in young children. Then a vaccine had to be constructed from that newly identified virus, another time consuming task. One of the leading groups working on the problem was at the Children's Hospital of Philadelphia at a Lab run by Paul Offit. You helped develop the rotavirus vaccine in. In what year did that did that come out?
Paul Offit
2006.
Malcolm Gladwell
2006. How long did you work on that?
Paul Offit
26 years.
Malcolm Gladwell
Wow. Why was that a hard problem to solve?
Paul Offit
I don't think it was terribly hard to solve. It just takes a long time to solve these things. Although the veterinarians knew this to be a cause of disease in animals since the 40s, it wasn't really described as a human pathogen until the 70s. So there wasn't a lot of information about this. So we developed a small animal model for the disease in the early 80s. And then we figured out, and simply put, which part of the virus made you sick and which part of the virus induced immune response that was protective. And with that information, we then combined strains that were avirulent, benign, with virulent strains to knock out the virulent part but include the protective part. Thus summarizing 26 years of work in 40 seconds.
Malcolm Gladwell
Offit's group took their candidate vaccine to the drug company Merck, which spent well over a billion dollars to bring the candidate vaccine to market. The result was ROTEMEC.
Paul Offit
And with that, you know, the vaccine eliminate. Really eliminated hospitalizations from this country. We don't really. Most pediatric residents in our hospital have never seen an inpatient with rotavirus, which is amazing because it dominated my residency.
Malcolm Gladwell
It dominated your residency?
Paul Offit
Oh, yeah, no. You.
Malcolm Gladwell
You.
Paul Offit
Over the winter, you were just flooded with kids, both in the emergency department and coming into the hospital. Severe dehydration.
Malcolm Gladwell
Yeah. And now it's gone.
Paul Offit
And now the hospitalizations are gone.
Malcolm Gladwell
Other rotavirus vaccines followed. A group of scientists in India developed their own in 2016. Also around this time, many developing countries made huge strides in sanitation, which cut down on the spread of the virus. Oral rehydration therapy became widespread. And now the dedicated diarrhea wards that were such a big part of Kumar's training are all but gone. It's hard to find anyone who works with children and remembers the way things were who isn't in love with the rotavirus vaccine.
Unknown
And you sort of list the most important innovations that you've seen that have affected the lives of children. Where does this rank?
Zulfikar Butta
At the top?
Unknown
Amongst the top.
Malcolm Gladwell
This is Dr. Zulfikar Butta, co director for the center of Global Child Health at Sikh Kids Hospital in Toronto. He spent years as a pediatrician in his native Pakistan.
Unknown
We went down from 10 million child deaths under 5 in the year 2000 by 2015 to just under 6 million deaths today, they are down to around 3 million deaths in children under 5. It's the fastest rate of reduction in child deaths in the history of mankind. And it hasn't just happened by happenstance.
Malcolm Gladwell
And this is the vaccine that Robert F. Kennedy, Jr. Hates. I have to confess that I knew very little about Robert F. Kennedy Jr. Before he ran for president in 2024. But as he loomed larger and larger in the news, I realized I had his most recent book, the Real Anthony Bill Gates, Big Pharma and the Global War on Democracy and Public Health. His publicist must have sent me a review copy when it came out in 2021. I found it in a big pile of books on the porch. So I decided to read it all. 492 pages. And it was there in chapter three that I discovered the particular loathing that RFK Jr has for the rotavirus vaccines. I couldn't make head nor tails of it, which is why I had to call my friend Safi Bahcall up.
Unknown
We were going over the package insert, which you thought was clean as a whistle. Yeah, right. And so I was trying to figure out why, if it was as clean as a whistle, does Kennedy have such a problem with rotatech and rotavirus vaccines in general? And I want to read to you the key paragraph in his book which. And we're going to try and solve this puzzle together because I have a vague idea, but I think I'm.
Malcolm Gladwell
I can't.
Unknown
My idea is so. Reflects so poorly on him that I. Part of me thinks it can't be the right idea. This is the key paragraph. Reported adverse reactions from Dr. Offit's Rototek vaccine range from 953 to 1689 per year. These included fever, diarrhea, vomiting, irritability, intussusception, SIDS, severe combined immunodeficiency.
Malcolm Gladwell
Kennedy lists 20 different really bad things he thinks are associated with rotatec, ending with gastroenteritis, pneumonia and death. Then he writes the paragraph that I read to Safi at the beginning of this, that the list of adverse reactions is so long that rotatek quote almost certainly kills and injures more children in the United States than the rotavirus disease killed and injured prior to the vaccine's introduction. Now I have to say that at this point things get deeply confusing because I couldn't figure out where that number 953 to 1689 adverse reactions a year comes from. In the real Anthony Fauci, Kennedy lists as his source the package insert. But those numbers aren't in the package insert. We hired a fact Checker with a PhD in biology and she couldn't figure out where Kennedy's numbers come from either. Then we thought, oh, he got the numbers from vaers, the Vaccine Adverse Event Reporting System, which is the government run database where anyone can report a side effect that they think is associated with a vaccine. Keyword think. But VAERS isn't Kennedy's source either. We found the numbers. Vaers only has 344 reports of side effects over 15 years for all rotavirus vaccines, of which only 32 are serious, which is like miles and miles away from the massive number of problems that Kennedy's talking about. And even if he just made a typo and read the numbers wrong, it still doesn't prove his case. Because as the CDC says, quote, a report to VAERS does not mean a vaccine caused an adverse event. End quote. So just because a baby vomited after getting his rototech doesn't mean rotatec caused the vomiting. Babies vomit all the time. To prove the vaccine was the cause of the side effect, you really have to dig into the data, look for patterns, or better yet, go back to the original clinical trial and see if there were any clues when the vaccine was first tested for side effects. In the case of Rototec, the clinical trial was enormous. 12 countries, 34,000 infants were given the vaccine. 34,000 were given a placebo. The babies were followed for a full year, and absolutely every medical event that happened to them was recorded and analyzed. 68,000 babies. If in the course of a year, the babies who got the vaccine had more complications than the babies who got the placebo, then that would raise a red flag. It would suggest, wait, maybe the vomiting was the result of the vaccine. But if there was no difference in the experience of those two groups, it would suggest any associated problems were just the kind of health problems that you'd expect to see as a matter of course in a very large group of babies. All of this data is laid out.
Safi Bahcall
In the package insert, page five, the sae. Serious Adverse Events. And you would just look at that table and you would say, no difference.
Malcolm Gladwell
The table is a comparison of side effects in the kids who got the vaccine and the kids who didn't.
Safi Bahcall
Numerically, if anything, there were more SAEs on the placebo than the control arm, but it's insignificant. It's like the difference between eating a banana or an apple. Yeah, no difference.
Malcolm Gladwell
Together we went through every one of the medical problems listed on the chart. Gastro and I don't even know. Bronchiolitis, 0.6% fever. 0.1 for treatment. Treatment on. What's that? Placebo. Hematasthesia. Is that where we are now? We kept finding the same thing. No difference.
Safi Bahcall
No difference.
Malcolm Gladwell
And any difference?
Safi Bahcall
Let's see. 0.6. 0.6. No, no difference.
Malcolm Gladwell
And seizures.
Safi Bahcall
See?
Malcolm Gladwell
Where are you?
Safi Bahcall
Next page. Yeah, seizures.
Unknown
Yes.
Safi Bahcall
Numerically, maybe a little higher, but the SAEs were exactly the same.
Malcolm Gladwell
But somehow Kennedy reached the opposite conclusion. In his book, the Real Anthony Fauci, Kennedy writes, quote, since its approval, Dr. Offit's rotavirus vaccine has caused a wave of catastrophic illnesses and agonizing death.
Safi Bahcall
I mean that's just astonishingly. It's just astonishing. Yeah.
Unknown
So wait, what's he doing? He looked at the same thing you looked at and decided that the rotavirus vaccine was causing this enormous burden of adverse reactions.
Malcolm Gladwell
I have to say I got completely obsessed with this. Where is RFK Jr getting his information? And what about the data from the clinical trial? Did he not read it? Did he read it and not understand it? Or did he read it and understand it and just say, eh.
Unknown
You have a simple chart that has two columns. One column's called placebo, one column's called treatment. And he decided to completely ignore the column called placebo.
Safi Bahcall
Right, Exactly.
Unknown
He started to reach a conclusion about the vaccine by looking at. By com. By fundamentally not just misinterpreting, he's 180 degrees wrong in his interpretation of the data. And he had to place. It's as if he took his hand and placed it over the side of the chart that says placebo. There has to be some agency here that allows you to look at something that has two rows and only see one row.
Safi Bahcall
Well, firstly, I doubt that he actually looked at this source. I'm sure he's a pretty busy guy.
Unknown
But Safi, he writes half of an entire chapter denouncing the rotavirus vaccine. It's not like this is. This is not a. He's not making this observation in passing. He's going after at length one of the most significant public health advances of the last 25 years.
Malcolm Gladwell
Right.
Unknown
Something that's. That has saved millions of lives. This is not trivial stakes here.
Paul Offit
Right.
Unknown
He's big game hunting here.
Safi Bahcall
Yeah. Wasn't he trained as a lawyer? I don't know, I.
Unknown
He's a lawyer.
Malcolm Gladwell
Yeah, yeah, yeah.
Safi Bahcall
Because on the list, I guess I try to err on sort of generous explanations and maybe you are. You go on the other side. I don't know. But aren't lawyers trained to do that sort of thing? Dig deep into facts and make a case or prove or disprove a case? You would think that would be part of your legal training.
Unknown
But if you, if you was you a lawyer and made this argument in court, you would be humiliated by opposing counsel.
Safi Bahcall
Yeah, it would take five seconds.
Unknown
You just hold up the chart and say, oops.
Safi Bahcall
Yeah, I know.
Unknown
That's the other side.
Safi Bahcall
Yeah.
Unknown
One last question, but a very specific one, which is, if you're going to do this, why does he link to the source that refutes his argument so I can understand. I want to, I want to completely misinterpret the clinical data on ROTEMEC. I want to make this argument about vaccines and I'm going to cross my fingers and hope that 95% of my readers don't notice. But then he gives you the link to the very thing that shows you that he's absolutely wrong. Who does this? He's not even a good liar.
Safi Bahcall
What was that word that they used a few years ago? Truthiness. Yeah, right. There must be an equivalent word of scienciness. My book has scienciness because it has footnotes that are sciency done.
Malcolm Gladwell
By the way, this isn't even the half of it. If you spend any time at all immersed in the words and thoughts of RFK Jr. It's pretty clear that the person who he hates above all others is Anthony Fauci. Kennedy really, really doesn't like Anthony Fauci. He wrote a 492 page book about how much he hates Anthony Fauci. But do you know who's a close number two? Paul Offit, the inventor of rototech. In the real Anthony Fauci, Kennedy spends pages on Offutt. He writes Offutt, quote, represents himself as an authoritative source of reliable information, but he is actually a fond of wild industry ballyhoo, prevarication and outright fraud. End quote. Tune in to any of the countless podcast interviews Kennedy has given and you'll find the same thing. After he's gone after Fauci, he goes after Offutt to the point where after Kennedy goes on Joe Rogan and went on one of his usual Paul Offit rants, Offutt got death threats and hate mail.
Paul Offit
I mean, I don't know if you listen to the whole Rogan thing, but he attacks me all the time because I committed the unpardonable sin of being the co inventor of the rotavirus vaccine, which by the way, saves about 165,000 lives a year in the. In the world. I thought that was a good thing, but apparently, according to him, I'm just the farmer show.
Malcolm Gladwell
Yeah, I keep seeing him go after you, and I'm trying to sort of understand, but he's never to. To your. To your knowledge, has he ever kind of acknowledged what you. What you guys created was of value to mankind?
Vishwajit Kumar
Has he.
Malcolm Gladwell
He's never. Has he ever acknowledged that?
Paul Offit
No.
Malcolm Gladwell
165,000 people a year doesn't believe it. But did he. I mean, did he actually work through the logic of this, or did he just.
Paul Offit
Not publicly. I mean, I don't know. I don't know. What. How his brain works.
Malcolm Gladwell
Yeah, yeah, yeah.
Paul Offit
Maybe it was that worm. Maybe the worm was telling him to do it.
Malcolm Gladwell
I'm sorry to keep harping on this, but this is just bizarre. If I was someone who really didn't like vaccines and I was writing my massive opus on the subject, I'd pick a really marginal vaccine to go after. Something with dubious benefits, lots of side effects, something where the VAERS data was really alarming. I don't know, an inexplicable wave of strokes or seizures or something worrisome in people who got the vaccines. But what does Kennedy do? The opposite. He goes after maybe one of the most important public health triumphs of the last hundred years, a vaccine with a package insert that is so immaculate that he literally has to create an objection that is transparently false. It makes no sense. By the way, if you're wondering why we didn't just call up RFK Jr himself and ask him directly. Oh, we tried. Over and over again. Calls, emails, right up to the Department of Health and Human Services. Greetings. Thank you for calling the United States Department of Health and Human Total Runaround. Then to his lawyer and longtime confidant, Aaron Seri, who was all willing to be interviewed until I told him I wanted to talk about the rotavirus vaccine. At which point he put all kinds of stipulations and restrictions on how our interview would proceed, including the fact that we couldn't tape record it. And then when we finally did talk, Siri couldn't come up with any kind of plausible explanation for what his good friend and client was doing either. I thought, is there someone else I could call? Was I ever going to get to the bottom of this? And then I realized, maybe I'm overthinking things. Maybe I just need to keep reading Kennedy's book. And so I did. And sure enough, there it was. The answer in Chapter nine, entitled the White Man's Burden. One of the preeminent figures in modern Medicine was the 19th century French microbiologist Louis Pasteur. Pasteur is the pioneer of germ theory. Infectious diseases are the result of foreign microorganisms that invade the body. Every time you get a vaccine created specifically against a particular virus, or take an antibiotic optimized to fight a specific strain of bacteria, you are following Pasteur's logic. Germ theory is one of the foundational ideas of modern medicine. And in chapter nine of the Real Anthony Fauci, we learn that Robert F. Kennedy Jr. Doesn't believe in germ theory. He is instead a follower of pasteur's nemesis, another 19th century French microbiologist named Antoine Beach. Beam argued that Pasteur had it backwards. You don't get sick because you've been infected by a bug. The bug emerges in response to the fact that that your body was already sick. The bug is a symptom, not a cause. What matters is the terrain of the body, an individual's internal state of health. It's really hard to find people who believe in Antoine Bachamp's theories. I spent hours on the Internet looking before finally stumbling upon another disciple. Maybe you'll recognize his voice.
Woody Harrelson
And Pasteur believed the germ theory, Obviously, that's the theory that he pushed, right? And then be champ believed in the terrain theory. Now that's what I believe.
Malcolm Gladwell
This is the actor Woody Harrelson on.
Woody Harrelson
Joe Rogan, of course, the terrain theory, the germ theory, obviously a pathogen, a germ, a virus, whatever lands in your cornflakes or on your eyeball or whatever gets inside, right? And then in this blank, pristine, blank slate environment, it causes damage, maybe sickness and eventually death. To me, I don't believe this theory as much as I do the terrain theory, which is that your health is dependent upon your internal biological terrain and your internal filthiness or cleanliness. And so that's what I believe is where people's immune system gets messed up from what they're consuming. And in a nutshell, that's why I believe in Bechamp's theory as opposed to the germ theory.
Malcolm Gladwell
I should point out, guess who Woody Harrelson is good friends with? RFK Jr so maybe what we're looking at here is not two Bashampians who arrived at the same conclusion independently, but one Bishompian who infected another in defiance of everything. Bishompian. Of course, there is some truth to terrain theory. Diabetes and heart disease are the result in part of what Bachamp would call a disturbed terrain. A body that, because of obesity or smoking or bad nutrition or a lack of exercise, has become vulnerable to chronic disease. But Kennedy doesn't stop there. He's a radical Bishompian. He believes that if you're otherwise healthy, the cold virus is just not going to be an issue. HIV is probably not going to give you aids, not if you take care of yourself. There's a whole chapter on HIV and AIDS in his book making a version of this argument. Early in his time as Secretary of Health and Human Services, there was a major outbreak of measles in Texas. And Kennedy's response was so lackadaisical that his press secretary quit, it seems in disgust. Measles? It's only a problem if you're unhealthy. The virus is the symptom, not the cause. It took several months, two children dying and over 500 cases for him to finally give an interview where he said, okay, you should get the measles shot. Kennedy is unhappy to this day that in the 19th century battle between Louis Pasteur and Antoine Bishamp, Pasteur came out on top. Listen. This is from the audiobook version of the Real Anthony Fauci being read by what really, really seems like AI.
Zulfikar Butta
For better or worse, the champions of germ theory, Louis Pasteur and Robert Koch, proved victorious in their fierce decades long battle with their miasmist rival, Antoine Bechamp.
Malcolm Gladwell
Just so you're aware, if you're thinking of getting the audiobook, you're in for 27 hours and 20 minutes of this.
Zulfikar Butta
The ubiquity of pasteurization and vaccinations are only two of the many indicators of the domineering ascendancy of germ theory as the cornerstone of contemporary public health policy. A $1 trillion pharmaceutical industry pushing patented pills, powders, pricks, potions and poisons, and the powerful professions of virology and vaccinology led by little Napoleon himself, Anthony Fauci fortifies the century old predominance of germ theory.
Malcolm Gladwell
What doesn't RFK Jr like? Pills, powders, pricks and potions. The very things that the Department of Health and Human Services brings to the world. And of all the pills and powders and pricks within his domain, the one he hates the most is rototech. And why does he hate rototech? Because he's a Bishompian and a Bachompian has to hate rototech. Because if Kennedy admits that rotatech works, then the whole edifice of 19th century pseudoscience that he has committed himself to comes tumbling down. RFK Jr. Likes to pretend that he is alarmed by vaccines that do not work. No, he's alarmed by vaccines that do work. Heaven help us. Next time on Revisionist History. The plot thickens and the virus spreads from RFK Jr. To Joe Rogan.
Unknown
Then we run into each other in Aspen, just randomly.
Malcolm Gladwell
That was the weirdest moment because we.
Woody Harrelson
Were both staring at each other.
Unknown
Yeah.
Paul Offit
And then we almost did it, like a full 360.
Unknown
Yeah, yeah, yeah. I noticed you walking. I'm like, that's. Yeah, it is. So I said, hey, what's up?
Malcolm Gladwell
Revisionist History is produced by Lucy Sullivan, Nina Byrd Lawrence and Ben Nadaff Haffrey. Our editor is Karen Shakurji. Fact checking by Kate Furby. Original scoring by Luis Guerra. Engineering by Nina Byrd Lawrence. Mixing and mastering on this episode by Marcelo D'Oliveira. Production support from Luke Lamond. Our executive producer is Jacob Smith. Special thanks to Sarah Nix and El Jefe, Greta Cohn. I'm Malcolm Gladmo.
Revisionist History: The RFK Jr. Problem Release Date: April 17, 2025
Introduction
In the episode titled "The RFK Jr. Problem," Malcolm Gladwell delves into the controversial stance of Robert F. Kennedy Jr. (RFK Jr.) against the rotavirus vaccine, Rotatec. Through an engaging conversation with his friend Safi Bahcall, a former drug company executive with a PhD from Stanford, Gladwell unpacks the complexities and misconceptions surrounding vaccine efficacy and public health.
The Rotatec Vaccine: Unveiling the Data
Gladwell begins by introducing Safi Bahcall, emphasizing his credentials to establish credibility for their ensuing discussion. He presents the package insert for Rotatec, a vaccine designed to protect infants against rotavirus, a severe intestinal infection. Bahcall meticulously examines the efficacy data:
"There was one incidence of any grade of diarrhea or gastroenteritis... and 51 on the placebo arm." (02:12)
Bahcall highlights a striking 50-fold difference in adverse events between the treatment and placebo groups, underscoring the vaccine's effectiveness:
"That's 50 times higher. More kids will get some serious or moderate diarrhea... compared to those who got the vaccine." (02:48)
RFK Jr.'s Critique: A Misinterpretation of Data
Gladwell then shifts focus to RFK Jr.'s harsh criticism of Rotatec, as outlined in his book The Real Anthony Fauci. Bahcall expresses disbelief at Kennedy's assertions:
"That's just complete bullshit... It is just absolute nonsense." (04:43)
Kennedy claims that Rotatec "almost certainly kills and injures more children in the United States than the rotavirus disease killed and injured prior to the vaccine's introduction." (04:21) Gladwell and Bahcall scrutinize this claim, revealing discrepancies in the data sources and interpretations used by Kennedy.
Analyzing the Claims: The Evidence Against RFK Jr.'s Assertions
Gladwell and Bahcall embark on a detailed analysis of Kennedy's claims. They explore various data sources, including the Vaccine Adverse Event Reporting System (VAERS) and the original clinical trials for Rotatec. Bahcall points out the lack of significant differences in serious adverse events between the vaccine and placebo groups:
"In the package insert, page five, the sae. Serious Adverse Events... if anything, there were more SAEs on the placebo than the control arm." (17:30)
They conclude that Kennedy's interpretation is fundamentally flawed, suggesting a deliberate misrepresentation of data:
"By fundamentally not just misinterpreting, he's 180 degrees wrong in his interpretation of the data." (19:50)
The Impact of Rotatec: A Public Health Triumph
To contextualize the significance of Rotatec, Gladwell interviews Vishwajit Kumar, a pediatrician from Uttar Pradesh, India. Kumar recounts the dire consequences of rotavirus prior to vaccine introduction, highlighting the vaccine's life-saving impact:
"We went down from 10 million child deaths under 5 in the year 2000 by 2015 to just under 6 million deaths today... However, Rotatec has saved about 165,000 lives a year in the world." (12:14, 31:38)
Another expert, Dr. Zulfikar Butta from Toronto, reinforces the vaccine's importance, stating it ranks "at the top" of innovations affecting child health (12:00).
RFK Jr.'s Alternative Theories: Challenging Germ Theory
Gladwell explores the ideological underpinnings of RFK Jr.'s opposition to vaccines. He references the 19th-century debate between Louis Pasteur's germ theory and Antoine Bechamp's terrain theory. RFK Jr. aligns with Bechamp, rejecting the idea that pathogens are the primary cause of disease:
"Robert F. Kennedy Jr. Doesn't believe in germ theory... He is instead a follower of Pasteur's nemesis, Antoine Bechamp." (26:03)
Gladwell features an interview with actor Woody Harrelson, an ally of Kennedy, who advocates for terrain theory over germ theory:
"I don't believe this theory as much as I do the terrain theory... your health is dependent upon your internal biological terrain." (27:47)
Influence and Support: The Spread of Misinformation
The episode highlights the influence of RFK Jr. and his connections, such as Woody Harrelson, in propagating anti-vaccine sentiments. Gladwell critiques Kennedy's selective use of data and questionable rhetoric, noting the lack of acknowledgment from scientists like Paul Offit, co-inventor of Rotatec:
"You've got the same medical problems... So why does he link to the source that refutes his argument?" (22:11)
Offit expresses frustration over Kennedy's unfounded attacks:
"I've committed the unpardonable sin of being the co inventor of the rotavirus vaccine... I'm just the farmer show." (23:45)
Conclusion: Unraveling the RFK Jr. Problem
Malcolm Gladwell wraps up the discussion by emphasizing the gravity of RFK Jr.'s unfounded critiques against vaccine advancements. He underscores the importance of accurate data interpretation and the dangers of misinformation in public health:
"RFK Jr. Likes to pretend that he is alarmed by vaccines that do not work. No, he's alarmed by vaccines that do work." (31:38)
Gladwell invites listeners to critically assess the narratives presented by influential figures and to rely on robust scientific evidence in matters of public health.
Closing Thoughts
"The RFK Jr. Problem" serves as a compelling exploration of how misinformation can undermine significant public health achievements. Through meticulous analysis and expert interviews, Malcolm Gladwell illuminates the challenges posed by individuals who distort scientific data for personal agendas. This episode is a poignant reminder of the critical role accurate information plays in safeguarding public health.
Notable Quotes
Episode Credits
Revisionist History is produced by Lucy Sullivan, Nina Byrd Lawrence, and Ben Nadaff Haffrey. Editor: Karen Shakurji. Fact-checking by Kate Furby. Original scoring by Luis Guerra. Engineering by Nina Byrd Lawrence. Mixing and mastering by Marcelo D'Oliveira. Production support from Luke Lamond. Executive Producer: Jacob Smith. Special thanks to Sarah Nix and El Jefe, Greta Cohn.