By Alex Morozov
Dr Morozov is CEO and founder of Eviva Partners, a nonprofit promoting better understanding of evidence. He is working on a book called The Language of Evidence: Getting Well in a World Without Proof, from which parts of this essay are adopted. He is an oncologist and previously spent 14 years in the pharmaceutical industry overseeing over 200 clinical trials of novel oncology therapies, as well as leading digital innovation teams.
On Wednesday morning this week, I drove from New Orleans to Jackson, Mississippi to have lunch with Dr. Anthony Mawson, the lead researcher of the latest scientific study attempting to show that vaccines cause autism. The study (I will call it Mawson 2025) was published two weeks ago in an obscure journal with an impressive title, “Science, Public Health Policy and the Law” (I will abbreviate it as SPHPL).
As I was driving, my mind kept drifting to one exchange near the end of Robert F. Kennedy Jr.’s confirmation hearings last week. Senator Bill Cassidy, the Committee Chair and a gastroenterologist, commends Kennedy. “I have been impressed that on many things you are familiar with recent medical data,” he says. “But on other things, you haven’t been.” He puts on his glasses and looks at his tablet, describing a large study from 2014 titled “Vaccines Do Not Cause Autism.” He takes off his glasses and looks at Mr. Kennedy. “I’m a doc trying to understand. Convince me that you will become the public health advocate but not just churn old information …”
Kennedy responds, “There are other studies as well, and I’d love to show those to you. There’s a study that came out last week of 47,000 9-year-olds in the Medicaid system in Florida, by I think a Louisiana scientist called Mawson, that shows the opposite,” he retorts, effectively ending Senator Cassidy’s line of questioning.
Note the wording – “I think a Louisiana Scientist” – giving an impression that Kennedy barely knows this work or the scientist. More on this later.
On Tuesday, the Finance Committee voted to advance Mr. Kennedy’s confirmation to the full Senate. Senator Cassidy cast his decisive vote.
That evening, I sat down to do a “string board” exercise for the first time in my life, inspired by the show “Only Murders in the Building” – our family’s favorite. Instead of strings I googled the names of lead characters, two at a time.
I quickly discovered that James Lyons-Weiler, the Editor-in-Chief of SPHPL, who is also the owner of its publisher, IPAK-EDU and the author of most of its editorials, calls himself a friend of Kennedy. “Honored to call him my friend; I would love to call him “Mr. President,” he tweeted in June 2024, above a photo of them walking together.
The Mawson paper lists National Vaccine Information Center (NVIC) as the sponsor. Google led me to its Chief Marketing Officer, Susan Sweetin, who, according to a friend, asked Kennedy if he wanted supporters in the Senate building during the hearings. “Yes. A Tsunami,” he replied. OK, they know each other well, I concluded. Another string.
I then looked at SPHPL’s editorial board. Every journal has them – a group of scientists responsible for the quality of publications. They are bound by a strict Code of Conduct developed by the Committee on Publication Ethics. SPHPL has 34 editors – a lot.
My first thought was, is this a predatory journal? This scourge has plagued the research community for years.
The term was coined in 2010 by Jeffrey Beall at the University of Colorado, Denver. Beall obtained a Master of Science in Library Science in 1990 and became a prominent researcher, published a series of papers on cataloguing and indexing of scientific literature. This was the time when libraries paid subscription fees for hundreds of journals that filled miles of dusty brown folios of “issues” bound into “volumes.” Soon this became unsustainable, and a new concept was born – an open access online journal, where the authors paid, rather than the readers. What happened next changed Beall’s life. “And then predatory journals, those using the author-pays model just for their own profit, started to appear. I first noticed them in 2008 and 2009, when I received spam emails soliciting me to submit to broad-scoped, newly-launched library science journals I had never heard of before,” he recalls.
Spotting predatory journals can be difficult, Beall warns. “They aim to dupe researchers, especially those inexperienced in scholarly communication. They set up websites that closely resemble those of legitimate online publishers, and publish journals of questionable and downright low quality.”
Beall started to keep a list of predatory journals to warn researchers that soon became known around the world as “Beall’s list.” Then the threats from predatory publishers came. Ultimately, in 2017, Beall was forced to shut down his list – at the time it had over 1000 publishers. Another volunteer took over anonymously, and only recently revealed himself.
According to the latest count, there are more than 15,000 predatory journals. Last months’ joined statement by leaders of the NLM, ICMJE, and top international journals in the UK, France, Korea, India and Germany called for increased awareness. Experts in Korea and Australia call for government intervention.
As an aside, I pictured Kennedy as Secretary of Health and Human Services. The National Library of Medicine (NLM), “the world’s largest biomedical library and a national resource for health professionals, scientists, and the public,” is part of the National Institutes of Health (NIH) and would be fully under his control. Is he qualified to address the issue of predatory journals, given that he calls all medical journals “part of a “Medical Cartel”’ and “utterly corrupted instruments of pharma”?
I looked closely at the SPHPL editorial board, and specifically at the 18 editors in the section called “Clinical.” Maybe some of them don’t know they are even listed there, I thought – a tell-tale sign of a predatory journal. But I quickly realized that this was no ordinary predatory journal.
Of the 18 members of the Clinical Editorial Board, 15 profess extreme anti-vaccine views. Peter McCullough, Pierre Kory and Paul Marik are on it, all frequently cited by Mr Kennedy in his 2023 book Vax-Unvax. Peter McCullough was a guest on Kennedy’s podcast twice. Paul Marik and Pierre Kory are prominently featured on the website of Children’s Health Defense (CHD) that Kennedy founded. All three had their American Board of Internal Medicine certifications revoked recently. Another, Harald Walach, had his university affiliation terminated. Yet another, Aseem Malhotra, was named in a General Medical Council judicial review in the UK. And so on.
I got in touch with one of the three who had no obvious association with anti-vaccine views based on my online search, Rainer J Klement, asking whether he knew he was on it. He told me “of course,” and that he and the other editors are fully aware of their anti-vaccine bias and consider the journal to be a “safe haven” for papers that are rejected elsewhere.
An “anti-vaccine journal” – that’s a new concept, I thought: A journal stacked with editors who espouse one specific scientific view. Its bias is well-hidden behind a generic title and not obvious on a cursory look. It’s driven not by profit, as a predatory journal would be, but by a political agenda.
Another such journal recently popped up – The Journal of the Academy of Public Health (JAPH). Its Founding Editor-in-Chief, Martin Kulldorff, is famous for being an author of the “Great Barrington Declaration” which I describe as Go-get-sick-with-COVID-and-whoever-survives-will-be-immune strategy. The Declaration authors were labelled as “fringe epidemiologists” by Francis Collins, head of NIH at the time, who demanded in a rash email a “quick and devastating published takedown” of their approach, as he describes in his recent book. Kulldroff was fired from Harvard, removed from the CDC COVID-019 vaccine safety commission and censored on social media.
Other editorial members of JAPH are Jay Bhattacharya, the mastermind behind the Great Barrington Declaration nominated to serve as the Head of NIH (including its National Library of Medicine), and Marty Makary, nominated to be the head of the FDA. In his recent book, Blind Spots, Makary calls the medical establishment “a broken system.”
Another JAPH editorial board member, Peter Gøtzsche, a professor of clinical research at the University of Copenhagen, is an author of a book called “Vaccines: Truth, Lies, and Controversy” which “explains when and why we should not have confidence in the science and official recommendations,” according to its publisher’s description. Incidentally, it’s the same publisher that published Kennedy’s books – Skyhorse Publishing, which “has built a reputation for taking on books other houses consider too controversial to publish.”
Gøtzsche was recently quoted as saying, “This is exactly the type of journal we need to replace traditional medical journals where there is far too much censorship and vested interest among peer reviewers, editors, and owners. Some of us regard traditional journals as more or less dead.”
So now, in addition to checking whether a journal is predatory, we also need to check whether it’s “traditional/dead” or “a new type.” Who will start this list?
I went back to the string board focused on the Mawson paper. All key players were now individually connected to Kennedy: the journal publisher, James Lyons-Weiler, the editors such as Peter McCullough, the sponsor – Susan Sweetin’s NVIC. But do they know each other? Yes, it turns out – they all attended a conference called Covidcon in 2021 and their photos are all on the collage.
One question remained – how is Mawson connected to them? How did he get NVIC support for this study, how did he decide to submit his paper to SPHPL, and why was it published just a week before Kennedy’s hearings, leading to speculation that the publication was planned to help Kennedy?
***
The drive from New Orleans to Jackson, MS is about three hours. I started playing “RFK Jr. and The Rise of the Anti-Vaxx Movement,” one of my favorite episodes of the podcast called Maintenance Phase.
“There is a whole big swirling panic about vaccines in the 1990s in the UK,” narrates Michael Hobbes, the co-host and a HuffPost correspondent. His speech is addictive – fast, clear and light (I condensed it a bit below).
“And there is this woman named Jackie Fletcher. She has a son who she says was totally normal, one year old, and he gets an MMR shot, and almost immediately starts having seizures. She then gathers other mothers, and this becomes an organized political movement called Justice Awareness and Basic Support (JABS). In 1995 they hire a lawyer named Richard Barr. The problem he has is that there is no actual proof of this. He has to gin up some actual evidence that these people were harmed by the vaccines. So, he finds a researcher named Andrew Wakefield, a bowel surgeon interested in Crohn’s disease. In the early 1990s, Wakefield has this ‘Eureka moment.’ He is in the library reading old books. He finds that the measles virus can in rare cases cause ulcers in people’s bowels. He then becomes convinced that the measles vaccine is linked to Crohn’s disease. He’s like, where are kids getting exposed to the measles virus at this point – Aha! It’s in the vaccines. In 1993 he publishes a ‘very junky’ study ‘proving’ this link.
Even though this study is not seen as particularly credible by researchers, he starts becoming a ‘media darling,’ interviewed in the right-wing scare stories. ‘I’m in the medical establishment, but I am pushing back’ – he has this ‘forbidden knowledge’ kind of story about himself.’ In 1995, this lawyer for the moms, Richard Barr, finds him in one of these articles, and he’s like, Aha! This guy might be my ticket to ginning up some proof that vaccines are causing developmental delays. So Richard Barr hires Andrew Wakefield. Wakefield will eventually be paid, adjusted for inflation, more than 1 million dollars over the next decade. They then start putting out calls to parents. In the JABS newsletter, Richard Barr places ads, ‘If you think your kid may be harmed by the vaccine, get in touch with this Andrew Wakefield guy, he is putting together a study.’
In 1998, he publishes the study. What this study purports to be is like, ‘we are in a hospital in London, and over the course of the last couple of months, we’ve had 12 kids come in with autism.’ Eight of them got tummy trouble which they call ‘nonspecific colitis,’ and very rapid disintegration of developmental markers. They become nonverbal.
The paper is published in the Lancet, one of the most prestigious journals. Lancet also published a critique: this is based on only 12 kids, only memories of the parents, etc. But you know which perspective is going to end up in the tabloids.
I was looking at statistics of the various countries and vaccination rates over time. You can see a dip in 1998 in the UK. It craters. Even zooming out to century level you can see the ‘Wakefield divet.’ It’s wild. In the years after this, people go back and find every single kid in the UK who has autism – there is no link with vaccination. There are whole-country studies. People have looked for this for years and found nothing.
Six years later, in 2004, a journalist named Brian Deer tracks down the parents of all 12 kids who participated in the study. When he reads the case descriptions from the paper to them, the parents say, ‘this is not true.’ Many kids had symptoms of autism before being vaccinated. He discovers the newsletters, and that the kids were brought specifically for the study. One kid was flown in from the Bay Area. There was no ethics board. There is eventually a trial of the Medical Licensing Board that goes on for more than two years. Eventually Wakefield is stripped of his medical license.
“The story of Andrew Wakefield is not a story of the scientific establishment being too mean to somebody,” concludes Hobbes. “This is a story of the scientific establishment being too nice. Deer mentions numerous times in his book how long it took him to get other scientists to admit that Wakefield was acting in bad faith and this was a fraudulent paper. Everyone was like, No, No, No, he really believes this. And Deer is like, ‘He is lying to you about his finances. He is lying about the basic chronology of these kids. He is lying about where they are based.’ It takes 6 years after Deer’s discovery for the Lancet to retract this paper.”
***
Mawson has practically no online presence, but he does have a LinkedIn profile where he calls himself President at Chalfont Research Institute and Chalfont LLC, Jackson, Mississippi. In fact Chalfont is the affiliation listed on the paper for him and his co-author, a statistician and his former student. Its address is on a residential cul-de-sac. Probably his house, I thought.
Under “About”, the LinkedIn profile says “Seeking funding.” “What type of funding,” I inquired. After a brief exchange, we arranged a lunch.
I pulled up to the restaurant and took a quick look at his paper again before stepping out of the car. I should ask about DEVEXI too, I reminded myself.
The paper says, “The data used in the study were obtained from DEVEXI, an integrated health and medical research platform for generating epidemiological studies (24).”
This DEVEXI peaked my interest, and not only because of the mysterious name (to which I still don’t have an explanation – it’s a Latin word that means “I carried away” or “I transported down/away.”)
Several other things were puzzling. Reference (24) in the back of the paper says,
DEVEXI. Conveying advanced health information. 2022
http://devexi.s3-website-us-east-1.amazonaws.com/
(Last accessed February 9, 2022. The company is no longer in existence.)
Clicking on the link gives “Error 404.”
Strange, I thought. A paper that just came out 2 weeks ago, and the links are already broken. And if the data company is no longer in existence, how can anyone reproduce the analyses?
Searching for “DEVEXI” online yields surprisingly little. Even when it was started is fuzzy. Crunchbase says 2015. Someone named Reuben Firmin says on LinkedIn that he was the Virtual Chief Technology Officer of DEVEXI from January 2014 to October 2016. I spoke to him, and he told me that indeed he was DEVEXI’s first CTO. Another person on LinkedIn, Mitch Parver, claims to be the President and Co-founder from December 2012 to January 2020.
A company that has been in existence for over 7 years, and then disappears without a trace. The website www.devexi.com is blank. A full-text scientific article search on ScienceDirect yields only a paper called “Checklist of the Grasses of India.”
OK, I thought, time to turn to the Wayback machine, a service of the Internet Archive. Indeed, replicas of devexi.com were captured 33 times over the years. But they are all blank. This had to have required a request submitted to Internet Archive. Why would someone do that?
A few online clues to DEVEXI’s origins were pieced together by a blogger, Christopher Hickie. He discovered that it was started by Claire and Albert Dwoskin, prominent anti-vaccine activists, whose foundation funded a nonprofit which in turn funded Mawson’s 2017 work. Another string. The same people fund his work and create a data source for him to use.
Hickie discovered another connection of DEVEXI to anti-vaccine activism. He found a recent video on CHD.TV (Kennedy’s CHD apparently has its own TV channel.) In the video, Brian Hooker, the Chief Scientific Officer for CHD and a co-author along with Kennedy of Vax/Unvax, makes a curious comment:
… we did get this really kinda in a sort of a wink wink sideways way um it was actually obtained from a politician in Florida and then it became the heart of a software package called DEVEXI.
When I spoke to Reuben Firmin, I asked him about this “politician in Florida.” He said he knows the story but is “not at liberty to discuss.” He said it was done through “some kind of settlement, legally.” What was done? I was left confused.
One thing was clear: DEVEXI was started by anti-vaccine activists. And someone erased its every trace once it shut down.
***
Last but not least, I found DEVEXI puzzling because from my digital health experience, I knew essentially all the commercial sources of data for epidemiological studies such as Mawson’s, referred to as “real-world data,” or RWD, i.e. data not from clinical trials, but from regular patients who usually don’t even know that their data is used for research (to avoid the need for informed consent, the data is anonymized to the point that it cannot be traced to the individual person). But I had never heard of DEVEXI. I also knew that when it comes to RWD, data quality is key.
In June 2012, the same year as apparently DEVEXI was started, Nat Turner and Zach Weinberg, both 26, started a company they called Flatiron Health, after the New York City neighborhood where their offices were located, which in turn is named after the landmark flatiron-shaped building squeezed into the sharp corner of Broadway and Fifth avenue. Flatiron became and remains to this day a gold standard for RWD quality.
At the time, medical records were barely usable – fragmented and full of errors. Nat’s and Zach’s initial goal was to make them better – to help cancer patients and oncology care teams by pulling all relevant information together in one place to enable better care, and in the process setting up a master database of all these cancer patients to be used for research.
The idea was so elegant, so simple – thousands of cancer patients are being treated every day. Their successes and failures, the treatments they are receiving, the side effects they are experiencing – are being recorded sloppily and inconsistently into their medical records – some as indecipherable scribbles on paper, some as copy-paste notes in Electronic Medical Record (EMR) of dubious reliability – and disappearing forever. What if they were to preserve this ocean of data and learn from it?
For that to happen, the data from individual patients, scattered around multiple clinics, had to be captured and brought over to one common database. Being technology experts, Nat and Zach had the idea that they would write software to automatically capture all relevant data from EMR into the Flatiron database. But there was a challenge: “unstructured data,” data that is written by a human in a free-flowing form and is therefore difficult for a computer to find and read.
The Flatiron approach was “brute force” – hiring human “extractors” to manually review EMR data and enter it into the Flatiron database, similar to how it’s done in clinical trials. They required up to 1000 extractors, all with healthcare backgrounds to be able to navigate through the morass of medical records and understand technical shorthand. They were aided to the extent possible by customized prompts contained in the Flatiron database.
The result was incredible – for the first time, from the messiness of medical records, emerged a clear, high-quality collective picture of thousands of cancer patients’ experiences.
We don’t know how DEVEXI handled data as it matured alongside Flatiron, and what its quality was. One clue comes from the Mawson 2025 study which states in the appendix that only 429 (1% ) of total vaccines administered in this cohort of 47,000 9-year-old children were MMR vaccines. I asked another editor of SPHPL, Dr Andreas Sönnichsen, what he thought of this given that MMR is a required vaccine starting at 12 months, and 90% of children in the study were vaccinated with at least some vaccines. The database is “probably missing quite a few vaccinations. This is certainly a weakness of the study,” Sönnichsen admitted.
Besides invalidating the conclusions of the study, this answer made me wonder – why use such a poor-quality database when there are others such as Flatiron available?
***
I knew what Mawson looked like from a video of his talk at the 2017 AutismOne conference – tall, with neatly combed white hair. I noticed his British accent and that he was hard of hearing, barely able to hear the questions from the audience. Kennedy also spoke at that conference but on a different day – the only online clue that they may have known each other. I watched both talks, trying to see if I might spot them together, but to no avail.
I arrived first and easily recognized Mawson when he walked in. Not surprisingly, he looked a bit more frail than in 2017. He was dressed in a white collared shirt and a black sportcoat. Under the shirt I noticed a worn-out round-neck T shirt. He emanated an almost coquettish British charm – listening intently and smiling as he absorbed what I said. His hearing must have gotten worse – he could not hear the waiter at all. I spoke slowly and loudly, and could see him reading my lips.
He wanted to go to medical school, he told me, but his father discouraged him – “your chemistry and physics skills are not good enough,” he said. His father was clearly wrong, as Mawson spoke in great detail about his work on detecting retinoic acid metabolites in human blood. “I ended up getting a PhD – ‘Poor hungry Doctor’ – as opposed to the MD – ‘Money Doctor,’” he lamented. I thought of his funding request on LinkedIn and his torn T-shirt.
His younger sister is a homeopathic doctor in the UK, he said. “She was the one who got me to be suspicious of vaccines,” he told me. “I did not believe her at first, especially because my wife was a nurse anesthetist and a proponent of mainstream medicine, including vaccines.”
But then tragedy struck. His son died in 2010 at age 30 of a brain tumor. Mawson thought back to his son’s early childhood and recalled an incident when his son came home lethargic after getting vaccinated. “He was not the same after that, developed ADHD and other behavioral issues,” Mawson told me. “I started to suspect that his brain tumor was due to his childhood vaccination.”
In 2017, Mawson published two studies that he called “Vax/Unvax” – comparing vaccinated vs unvaccinated children and finding higher rates of autism in those who were vaccinated. There were only about 660 children in these studies, but they became a source of great excitement at the AutismOne conference where he presented the results. And Mawson informed me with great pride that these two studies are the first ones Kennedy sites in his 2023 book with the same title, Vax/Unvax. Kennedy calls them “Mawson study 1” and “Mawson study 2”
“Have you met Mr Kennedy,” I asked. “Yes of course. We met at the 2017 AutismOne conference, took a picture together” – he gestured with his right hand, hugging an imaginary Kennedy. (I was on the right track, I thought). “And we met last year when he was running for President and came to Jackson.” (Curious that Kennedy said “A Louisiana doctor, I think,” I thought. Did he really not remember where Mawson lives, having just met him in Jackson, Missisipi a few months prior? Was this meeting not arranged in advance? Was he not excited about “Mawson Study 3” finally being published – the first “Vax/Unvax” study since 2017 – with almost 10 times as many patients, on the topic that he wrote the whole book about in 2023? If he remembered all of this, his pretense is striking to watch. He fooled us all.)
“Was your latest paper a continuation of the 2017 studies,” I asked. He then told me the story.
“In 2019, Claire Dwoskin, the founder of DEVEXI, invited me to Washington, DC, to meet Barbara Loe Fisher, the President of NVIC. We stayed at the Trump Hotel. The blueberries there were enormous,” he said, showing a circle with his fingers. “They asked me to continue the research,” he said.
Fisher offered $150,000 of financial support, and Dwoskin offered access to DEVEXI. (This confirms some of Hickie’s account).
“We also met with Betsy DeVos, the Secretary of Education, to see if she would fund this project from the Department of Education budget, but she ultimately did not.”
“Interesting,” I said, “I didn’t realize that the Department of Education funds medical research.”
“Well, these children do require support in school,” he said.
He then proceeded to do the research. His co-author and former student “familiarized herself with the DEVEXI database and performed the work over about 2 years.”
Then suddenly their access to DEVEXI was cutoff in 2022 when the company went out of business. “This was because Albert Dwoskin started to believe in vaccines and stopped paying for DEVEXI,” he said. “And then the lawsuit.” He was perhaps referring to the divorce between Claire and Albert.
So the research stopped. (Why not find another data source? Perhaps it would have required a budget they did not have. Good quality RWD is expensive.) Mawson listed to me other analyses they wanted to perform, but could not. So they proceeded to publish what they had.
In the end, he said the results were “identical to the 2017 studies.” He was disappointed to see multiple criticisms of the study in the days since it was published, such as Dr Morris quoted by Factcheck.org. To Mawson, the results are clear. “How would Dr Morris explain the different rates of autism and other neurodevelopmental disorders (NDD) in two groups of children that are otherwise identical?”
He was referring to the 90% of the 47,000 children that received at least some vaccines, and were considered “vaccinated,” and about 10% for whom no vaccines were recorded in DEVEXI and were thus considered “unvaccinated” (although given the glaringly low 1% rate of MMR vaccines, data quality was so poor as Sönnichsen admitted, with so much data missing, that there is high likelihood that many of the “unvaccinated” children in fact received vaccines.)
But his comment also revealed to me a lack of understanding of basic medical statistics. The major limitation of non-randomized studies is that the groups are never “identical.” In this case, a key factor that could account for the difference is healthcare utilization, as noted by critics of the paper. Perhaps children who generally are more in contact with the healthcare system get more vaccines, and also are more likely to be diagnosed with NDD, since they have closer follow-up. Or vice versa, the children with NDD see doctors more often and have more opportunities to get vaccinated. Healthcare utilization could have been easily estimated in the study as the total number of visits, but this was not done.
Then it came time to publish the paper. They first submitted to Nature Medicine, Mawson said. The journal rejected without even reviewing the paper, he said. (I was not surprised – the defunct data source giving Error 404 would be enough reason to reject). They submitted to 2-3 other journals, with the same result, Mawson said.
“How did you decide to submit to SPHPL,” I asked.
“I’ll tell you a secret,” he replied. “Andrew Wakefield told me to submit it there.”
“You know Andrew Wakefield,” I asked, shocked. I had not heard his name associated with SPHPL, CHD or any other recent anti-vaccine efforts. I assumed he was no longer active in this field.
“Yes, of course, I have known him for years. He is an excellent doctor,” Mawson said. “I met him in Iowa when I was working at a University there and he came to give a talk. He is a brilliant speaker and a brilliant doctor. He lives in Texas now and is a filmmaker. Back when he was unfairly attacked and punished following his 1998 Lancet paper, I wrote a letter to British Medical Journal supporting him.”
I imagined Mawson as one of the doctors that Deer had a hard time convincing to stop believing in Wakefield.
“I hope Kennedy gets confirmed, and maybe he can appoint Dr Wakefield to a government position, perhaps in the NIH,” Mawson reflected with a smile.
“Andrew Wakefield introduced me to James Lyons-Weiler,” he said.
The paper indicates that it was submitted to the journal on October 16, 2024, two months after Kennedy endorsed Trump and the possibility of having to go through confirmation hearings emerged. It was accepted for publication on December 16, 2024.
“Did it undergo peer review,” I asked. “Yes of course, anonymously,” said Mawson. “I didn’t know who the reviewers were – they were selected by Lyons-Weiler. “The reviews were very favorable.”
Mawson claimed that the timing of publication just prior to Kennedy’s hearings was “lucky.” But he also said “the paper was fine tuned, fine tuned, fine tuned – I knew every word would be scrutinized.”
He said he is working on a response to the criticisms and when done, will send a copy to Kennedy, in the next 1-2 days. “I hope it helps him. But he will probably be already confirmed by then,” he said, unwittingly confirming the suspicion that this was the goal of the paper.
***
After we said goodbye, I sat in the car and reflected on what I heard.
Many of my questions were answered. Wakefield’s story repeats itself – with his help behind the scenes.
A party benefits from demonstrating that vaccines cause harm – maybe a lawyer representing patients who are suing the manufacturers, such as Richard Barr, or maybe someone who gets fees for referring such patients, such as Kennedy. Kennedy also relies on energizing his MAHA base with anti-vaccine rhetoric.
Reaping these benefits requires evidence of vaccine harm. What if such evidence doesn’t materialize? Then it needs to be manufactured. Funding for such projects comes from donations and is limited. DELEXI will have to do, made available through generosity of one family, and shuttered as soon as that support ends. Nobody could afford modern RWD sources like Flatiron. Of course, unless the NIH coffers can be made available.
Mawson is called to Washington, DC in 2019 and asked to do this project by two anti-vaccine activists who are so well-connected that they have access to DeVos, a member of Trump’s cabinet. By giving this project to a trusted anti-vaccine researcher, the desired outcome is assured.
In 2020, a journal, SPHPL, is set up as a “safe haven” for anti-vaccine papers, since mainstream journals simply would not accept such poor quality research (regardless of what the results show).
Trying mainstream journals doesn’t hurt – submit 3-4 times, and then it’s time for SPHPL. Mawson doesn’t know this plan. He told me he was reluctant to submit initially to SPHPL – “it’s an unknown journal that is not even registered on Pubmed,” he said, referring to a National Library of Medicine journal repository. He needs a nudge, and who better to deliver it than Wakefield. Time is of the essence. The paper is needed before Kennedy’s hearings, not after.
The goal is to create an appearance of a “peer-reviewed” journal. Each one of the few research articles published there is marked clearly as “peer-reviewed,” the phrase used repeatedly by Kennedy in his books as though it automatically guarantees reliability of a scientific study. Well, for the 15,000 predatory journals it does not. And neither for SPHPL, where the Editor-in-Chief who assigns peer reviewers is a friend – thus favorable reviews and quick turnaround (typically additional analyses are required by peer reviewers, so a 2-month window from submission to acceptance is unusually short).
Clearly all of this represents conflicts of interest and should have been disclosed by Kennedy at the hearings when he brought up this paper, as Hickie noted.
Discussions of flaws, debunking, retractions miss the real problem, and so does the discourse between pro- and anti-vaccine voices about who has the “correct” science. “These papers are flawed,” declare the pro-vaccine scientists. “No they are not,” declare anti-vaccine scientists. To an outside observer, it’s a scientific debate. With this lens, Kennedy can parry any line of questioning. We saw this play out during the six hours of Senate hearings.
But after my conversation with Mawson, I understood that we are witnessing something much more sinister – a systematic effort to manufacture evidence so that the anti-vaccine story, from which so many people benefit, continues in perpetuity.
And vaccines are not the only area where this happened. Case in point: ivermectin. Kennedy ignores a large body of evidence from well-conducted randomized trials demonstrating no benefit of ivermectin as treatment of COVID-19, and declares it to have “staggering efficacy.” But a paper he cites in support of this claim was sponsored by a pro-ivermectin group called The Frontline COVID-19 Critical Care Alliance (FLCCC, now Independent Medical Alliance). Paul Marik, whom we saw earlier on the SPHPL editorial board is the Chief Scientific Officer. Authors of the paper are: Juan Chamie, a “freelance data analyst at the FLCCC”; Jennifer A. Hibberd, a Canadian dentist and the co-founder with Peter McCullough’s help of a Canadian anti-vaccine group; and David Scheim, a self-employed researcher.
The “manufacture of evidence” cycle works like this:
- Find researchers that share your agenda;
- Sponsor their work;
- Publish their work. If needed, create new journals such as SPHPL with friendly editors, or attack the “establishment journals.”
- Cite their work as though it was independently done.
With this machine in place, no amount of arguing, debating science, exposing “flaws,” etc. will be effective. People in charge cannot afford (literally) to be proven wrong. So they will continue to manufacture more evidence.
Political influence on scientific literature unfortunately is not new. But to my knowledge there is no precedent for a paper being published in a scientific journal to help a politician pass confirmation hearings (if that’s what we see here). And not just any political appointee, but someone who is entrusted with preserving the scientific integrity of the largest biomedical research organization and medical library in the world.
Kennedy himself talks of the “Medical Cartel:” “pharmaceutical companies, hospital systems, HMOs and insurers, the medical journals, and public health regulators.” Yes, medical journals get industry advertising money – open any medical journal, and you will see full-page pharmaceutical or medical device ads. Yes, the FDA gets about 75% of its budget from pharmaceutical companies in the form of prespecified fees codified in the 1992 Prescription Drug User Fee Act (PDUFA), which also specifies review timelines familiar to drug developers. But I have never seen the FDA impacted by those fees, in my 14 years of working with them on multiple drug approvals. In fact, if the FDA were driven by the fees, it might incentivize them to decline approvals to force pharma companies to keep resubmitting applications and pay more fees.
Similarly, I have not seen advertising money impact decisions made by medical journals in terms of what to publish and what the publications should say. Big pharmaceutical companies have ads in all journals, and yet their studies get declined all the time.
Yes, there are historical examples of the tobacco, oil and pharmaceutical industries shaping scientific discourse, as Naomi Oreskes famously exposed in her 2010 book, Merchants of Doubt.
The “manufactured evidence” machine follows the same paradigm.
There are still many things we don’t know. Why did Wakefield ask Mawson to submit to SPHPL? Did Wakefield know about the upcoming hearings? Did Kennedy truly forget that Mawson was not in Louisiana, or was he putting on a show to give an aura of independence to the study? Did Kennedy know about this study and have a role in making sure it gets published before his nomination hearings, to have in his back pocket? Having talked at length about “Mawson study 1” and “Mawson study 2,” the original “Vax/Unvax” studies, in his 2023 book with the same title, was he anticipating the Maswon study 3? Is Kennedy spearheading this manufacture of evidence, as Richard Barr did, or simply benefitting from it? One thing that is clear – he cannot be unaware of it, given his friendships with all involved.
And what exactly was DEVEXI, who was the Florida politician who started it through a “wink-wink” process as described by Kennedy’s co-author, and why was its entire online trail erased?
Media outlets surely will fill in the gaps.
But with what we do know, what does all of this say about Kennedy’s qualifications to serve as Secretary of Health and Human Services?
I reached out to several US experts in medical evidence – they either didn’t respond or were unwilling to go on record.
Then I contacted Gordon Guyatt, Distinguished Professor in the Department of Health Evidence and Impact at McMaster University in Canada. He coined the term “evidence-based medicine” (EBM) in 1991, and since then has been a leading advocate of evidence-based approaches to clinical decision-making. His over 1,800 publications have been cited over 225,000 times, making him one of the most cited living scientists.
Here is what he said: “Mr. Kennedy is either unaware of the scientific standards for assessing the effect of medical interventions or is unscrupulously willing to ignore those standards to promulgate his misguided and destructive views. His behavior unequivocally demonstrates that he will not act with either integrity or with acquiescence to scientific principles underlying optimal health care.
He will not, as a result, provide what this country and the world needs: a role model for safeguarding the integrity of science.”
Author Bio
Alex Morozov is a physician, scientist and drug developer with a passion for improving health outcomes and reducing care gaps in every community around the world. He is the CEO and founder of Eviva Partners, a nonprofit promoting better understanding of evidence through education and behavioral science approaches for both patients and providers, while characterizing and monitoring improvement in care gaps (defined as both underuse and overuse).
Alex obtained his undergraduate degree from MIT, followed by combined MD-PhD training at the Albert Einstein College of Medicine in New York. After internal medicine residency at Columbia-Presbyterian and medical oncology fellowship at Memorial Sloan-Kettering Cancer Center in New York, Alex was recruited by a friend to join the pharmaceutical industry. Over his 14-year drug development career, Alex has designed, conducted and overseen hundreds of clinical trials, leading to regulatory approval of several new cancer therapies by the FDA and other health authorities around the world. Following his interest in data and digital innovation, he led teams developing and implementing new technologies to accelerate clinical trials, address health equity, and improve outcomes for patients in clinical practice.
He is working on a book called “The Language of Evidence: Getting Well in a World Without Proof,” from which portions of this essay are adopted.