Human Genetics Features Archives - Genetic Literacy Project: Recent Episodes
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From tampons to tap water, from cereal boxes to vaccines, nearly every modern health scare rests on the same myth: chemicals are killing us. This fear—chemophobia—has become one of the most powerful engines of misinformation worldwide.The World Health Organization (WHO) lists vaccine hesitancy as a top global health threat, but I’d argue that chemophobia is even more pervasive. It’s the common thread that links all forms of science rejection; it fuels fear around vaccines, food, medicine, agriculture, and cosmetics.
Chemophobia, the irrational fear or aversion to chemicals, is everywhere—whispered in parenting Facebook groups, shouted by influencers, amplified by media outlets that should know better, and weaponized by politicians.
Chemophobia is the hidden language of health misinformation.
You’ve seen it:
- Headlines about “heavy metals in tampons”
- Myths about vaccines containing “toxic” ingredients
- Legislative bans on synthetic food dyes
- Public outcry against fluoride in drinking water
- The Environmental Working Group’s annual Dirty Dozen list, warning about “toxic pesticides” in produce
- “Paraben-free” or “preservative-free” marketing slapped on cosmetics, sunscreens, and even foods
If you didn’t know better, you might think you and your family are in constant danger. You’re not. Instead of protecting people, chemophobia increases costs, reduces safety, harms public health, and stalls lifesaving science.
What Is Chemophobia?Chemophobia claims that synthetic chemicals are inherently harmful, while “natural” chemicals are safe—a textbook example of the appeal to nature fallacy.
Chemophobia gained traction in the mid-twentieth century, following real industrial disasters such as Love Canal, Three Mile Island, and the Bhopal gas leak. Those events, which led to justifiable concern, were used to demonize all “synthetic” chemicals.
Rachel Carson’s Silent Spring (1962) fueled the flame:
“The chemicals to which life is asked to make its adjustment are no longer merely the calcium and silica and copper … they are the synthetic creations of man’s inventive mind … Such ingenious manipulations have produced a battery of poisons of truly extraordinary power.”
The origins of chemophobiaCarson was a gifted writer and a marine biologist. Her work contributed to the EPA’s creation and the restriction of DDT use, which previously helped eliminate endemic malaria in the United States during World War II.
While DDT saved lives from mosquito-borne disease, it caused ecological damage in birds, where exposure thinned bald eagle eggshells, leading to fragile eggs and high chick mortality. Once malaria was controlled and the off-target effects were understood, the ecological risks outweighed the benefits, though the danger was not to humans.**
Carson contributed to important scientific efforts in her field, but she wasn’t a chemist or toxicologist.
Yet, when she framed all “synthetic creations” as a “battery of poisons,” Carson unintentionally left a legacy of exaggerated distrust toward synthetic chemicals.
That distrust metastasized into today’s chemophobia, where people are terrified of anything artificial, even while scientific principles tell us that the source of a chemical has no bearing on its potential harm or safety.
Many of the most toxic chemicals are all-natural, including Botulinum toxin, abrin, ricin, arsenic, and cyanide.On the flip side, countless synthetic chemicals are lifesaving.Chemistry enables scientists to harness our knowledge, nature, and chemical synthesis to expand our health-improving resources.
Aspirin (acetylsalicylic acid) exists because chemists improved upon the natural compound salicin found in willow bark to make a safer and more effective pain reliever. Many lifesaving chemotherapies are synthetic derivatives of natural chemicals altered to improve effectiveness and safety (read more on that, below)
Chemophobia paints synthetic chemicals as universal villains. You’ve heard the commonly repeated claims:
- “I only want natural ingredients.”
- “If you can’t pronounce it, don’t eat it.”
- “Vaccines are filled with harmful chemicals.”
- “GMOs aren’t natural, so they must be bad.”
Fear in a soundbite beats nuance, especially when leveraged as a marketing ploy by the wellness industry.
Their tactic: if synthetic is “bad,” then the “natural” alternatives they promote must be safer, healthier, more beneficial, and even more eco-friendly—because they are trying to convince you that modern science and tools developed by it are evil.
But your body doesn’t care if a molecule was isolated from a plant or synthesized in a lab.
Vitamin C is vitamin C (scientifically, it’s actually (5R)-5-[(1S)-1,2-Dihydroxyethyl]-3,4-dihydroxy-5H-furan-2-one), whether it’s extracted from a lime or fully synthesized in a laboratory.
Formaldehyde is formaldehyde (and yes, your body makes much higher levels of formaldehyde every day than you would ever encounter in a vaccine).
What matters is dose, not origin. All-natural botulinum toxin is a million times more toxic than synthetic sarin—yet people willingly inject that into their faces while fearing preservatives in bread.
This context is almost always omitted from public discourse, where media outlets, influencers, and even policymakers repeat false claims about chemicals without scientific evidence.
Even among individuals who vocally proclaim to support science, you see anti-science actions rooted in chemophobia. That’s why Democratic governors ban artificial food colorings without considering that they’ll be replaced with naturally derived coloring chemicals that are less studied, less safe, and more ecologically damaging (yes, I am talking to you, Gavin Newsom).
That’s why Democratic legislators move to restrict the use of glyphosate, one of the safest herbicides, while conveniently ignoring that this would force farmers to use weed control measures that are more toxic, less effective, and have broader ecological impacts. That’s also why European governments restrict genetic technologies in farming, even while they embrace the same science for cancer therapies.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPChemophobia Thrives on Low Chemistry LiteracyOnly 28 percent of Americans are civically scientifically literate, meaning they can find, understand, and apply science to policy decisions.
So, when voters are told fluoride is “toxic,” they predictably vote to remove it. When they’ve heard for decades that glyphosate causes cancer, despite data showing otherwise, they support bans.
And when new parents are bombarded with disinformation from Moms across America or the Environmental Working Group (EWG), they make choices that don’t actually protect their families but do drive profits for those very people spreading the fear. While many believe these organizations have their best interests in mind, they are major contributors to disinformation.
Moms Across America is an activist organization founded in 2013 that spreads pseudoscience and chemophobia about GMOs, pesticides, vaccines, and food additives.
EWG is a nonprofit and lobbying organization best known for its annual “Dirty Dozen” list and alarmist rankings of consumer products and foods. Most people don’t know that they also spread objective lies about vaccines—something they have attempted to scrub from their history. EWG is one of the biggest propagators of chemophobia, routinely exaggerating risks of chemicals for their financial benefit.
This isn’t just an American problem, either.
In Europe, 40 percent of adults say they’d prefer to “live in a world without chemicals,” and nearly a third openly fear them. Ninety-one percent don’t grasp that toxicity depends on dose, and 82 percent don’t realize that table salt is always sodium chloride (NaCl), whether isolated from nature or synthesized in a laboratory.
Too many people forget that chemistry shapes their existence—food, medicine, clean water, even their smartphones and homes—until it is used to stoke fear. Combine that with a “do your own research” culture where Google and TikTok pass for toxicology training, and chemophobia spreads unchecked.
Chemophobia Shapes Policy—and Not in a Good WayChemophobia doesn’t just distort individual choices; it influences lawmaking across political ideologies and harms public health as a result.
Chemophobia hinders the development of crops using genetic engineering that can withstand more extreme climates, grow in places that were previously inhospitable, and produce higher yields with fewer pesticides. Chemophobia drives anti-vaccine opposition, slows development of novel therapeutics, fuels unfounded fears about medicine ingredients, and erodes trust in evidence-based science and medicine.
Chemophobia leads to banning safe food ingredients and demonization of healthy fruits and vegetables, causing people to avoid nutritious food, which, unlike the pesticide residues they fear, actually does pose a health risk. Chemophobia forces consumer product companies to kowtow to public outcry and remove safe and effective ingredients (such as preservatives like parabens), increasing costs, reducing safety, damaging the environment, and legitimizing misinformation.
The most dangerous expression of chemophobia right now is RFK Jr.’s “Make America Healthy Again” agenda.Now that he has co-opted the Department of Health and Human Services, he is wreaking havoc on public health, trust in science, and our safety guardrails. MAHA gains appeal because it’s marketed as a bipartisan “health” platform: rhetoric around healthy foods, chronic health issues, and environmental contaminants.
But peel back the façade?
MAHA is a full-blown chemophobia manifesto, the magnum opus of RFK Jr.’s forty-year anti-science career. None of it will make Americans healthier.MAHA appeals to anti-GMO and anti-pesticide sentiment among left-leaning people who, ironically, have been misled by decades of anti-science rhetoric by RFK Jr. and his allies. Organic purity narratives blend with “ban preservatives” rhetoric, while building on distrust of corporations and “Big Food.” This same tactic fueled the original anti-vaccine activists, many of them left-leaning individuals concerned about toxic vaccine ingredients.
MAHA appeals to the right by branding chemophobia as government overreach: the FDA and EPA are “poisoning” citizens with vaccines, fluoridated water, and processed foods. It feeds broader anti-regulation, anti-institution ideology that led to the 1994 Dietary Supplement Health and Education Act (DSHEA), which removed FDA oversight of dietary supplements and drove exponential growth of the wellness industry.
Chemophobia is uniquely dangerous because it transcends political lines. RFK Jr. doesn’t need to persuade people on policy specifics; he only needs to stoke distrust in “chemicals” or legitimate qualified experts who try to educate people, and fear does the rest.
MAHA positions have already seeped into legislation.* The Department of Health and Human Services adopted a federal policy legitimizing falsehoods about thimerosal, used globally to prevent contamination in multi-dose vaccines. * They have halted $500 million in funding for mRNA vaccine research, claiming it is a “risky” technology. * Multiple states around the country are pursuing bans on “genetic medicines” based on the same reasoning. * This year Utah and Florida banned fluoridation of public water, even while nearly eighty years demonstrate its benefit for dental and overall health. * Legal challenges that block cultivation of golden rice, a lifesaving farming technology, have drawn support from environmental activists and conservative conspiracy platforms alike. * California food dye bans were cheered by left- and right-leaning wellness influencers similarly touting it as the path to healthy food. It isn’t; it instead legitimizes false claims that these colorings are harmful while global experts have asserted their safety.
Chemophobia is the common theme.Chemophobia thrives on the risk perception gap between real and perceived risks. People fixate on Red Dye 40 in snacks while ignoring real systemic factors that impact health, such as healthcare inequities, income inequality, and food deserts.. They avoid nutritious foods because of unfounded pesticide fears but freely consume unregulated supplements full of untested compounds. This double standard distorts personal decisions and public policy and harms society.
Chemophobia has staying power because it is applicable to every single topic in science and health. Today it’s food dyes, tomorrow it’s pesticides, next week it’s vaccines. The narrative doesn’t require data—only fear of the chemical boogeyman.
We All Must Recognize Chemophobia as a Global Health ThreatIf we want better health and smarter policy, we must confront chemophobia. That starts with science literacy—basic chemistry, toxicology, biology, and, yes, media literacy. Education matters, but so does accountability.
Stop confusing notoriety with expertise. A podcaster saying “trust me” is not a credential. Journalists need to quit amplifying clickbait and start quoting real experts, not wellness influencers. And elected officials must write laws based on evidence, not vibes, polls, or lobbyists’ checks. Scientists can contribute by meeting the public where they are, using plain language, acknowledging fears, and fact-checking loudly and often. If we don’t, misinformation gets a free pass.
Chemistry underpins everything—medicine, food, clean water, sustainability, climate science. Yet public fear of “chemicals” stalls progress, raises costs, and undermines safety. Chemophobia thrives because fear is profitable, politically useful, and amplified by powerful networks. Scientists fighting it do so on our own time, without the money or infrastructure backing the fear machine. Until society treats chemophobia as the public health crisis it is, we’ll keep losing ground.
Chemophobia isn’t a nuisance; it’s a global health threat. If you consider yourself a skeptic, this is your call to action: challenge chemical fearmongering wherever you see it—even in yourself. Our health, our safety, and our future depend on it.
Dr. Andrea Love, a microbiologist and immunologist, provides the facts (and the data!) on science and health topics. Follow Andrea on X @dr_andrealove
A version of this article was originally posted at Immunologic and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article.
The human body is a machine whose many parts – from the microscopic details of our cells to our limbs, eyes, liver and brain – have been assembled in fits and starts over the 4 billion years of our history.But scientists are still puzzling over why we evolved into this particular form. Why do humans uniquely have a chin, for example? And why, relative to body weight, is a human testicle triple the size of a gorilla’s but a fifth of that of a chimpanzee? As I show in my new book, The Tree of Life, we are still searching for the answers to many of these “why” questions. But we are starting to find answers to some of them.
The story of evolution tells us how, starting from simple beginnings, each species was built – when each of the components that make a living creature was added to its blueprint. If we climb the evolutionary tree of life, we can follow a twisting path that visits the increasingly specialised branches that a species belongs to. We humans, for example, were animals before we became vertebrates; mammals before evolving into primates and so on.
The groups of species we share each of these branches with reveal the order our body parts appeared in. A body and a gut (inventions of the animal branch) must have come before backbone and limbs (vertebrate branch); milk and hair (mammals) came before fingernails (primates).
There is a way we can study the separate problem of just why we evolved each of these body parts, but it only works if the feature in question has evolved more than once on separate branches of the tree of life. This repeated evolution is called convergence. It can be a source of frustration for biologists because it confuses us as to how species are related. Swallows and swifts, for example, were once classified as sister species. We now know from both DNA and comparisons of their skeletons that swallows are really closer relatives of owls than swifts.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPSize matters when it comes to evolutionBut convergent evolution becomes something useful when we think of it as a kind of natural experiment. The size of primate testicles gives us a classic example. Abyssinian black and white colobus monkey and bonnet macaque adult males are roughly the same size. But, like chimps, humans and gorillas, these similar monkeys have vastly dissimilar testicles. Colobus testicles weigh just three grams. The testicles of the macaques, in contrast, are a whopping 48 grams.
Bonnet macaques are no monogamists. SHAJI C/ShutterstockYou could come up with several believable explanations for their different testicle sizes. Large testicles might be the equivalent of the peacock’s tail, not useful per se but attractive to females. But perhaps the most plausible explanation relates to the way they mate. A male colobus monkey competes ferociously for access to a harem of females who will mate exclusively with him. Macaques, on the other hand live in peaceful mixed troops of about 30 monkeys and have a different approach to love where everyone mates with everyone else: males with multiple females (polygamy) and females with multiple males (polyandry).
The colobus with his harem can get away with producing a bare minimum of sperm – if a droplet is enough to produce a baby, then why make more? For a male macaque the competition to reproduce happens in a battle between his sperm and the sperm of other males who mated before or after. A male macaque with large testicles should make more sperm, giving him a higher chance of passing on his genes. It’s a sensible explanation for their different testicle sizes, but is it true? This is where convergent evolution helps.
If we look across the whole of the mammal branch of the tree of life we find there are many groups of mammals that have evolved testicles of all different sizes. In almost all these separate cases, larger testicles are consistently found in promiscuous species and smaller in monogamous.
A small-testicled, silverback male gorilla has sole access to a harem. Big-testicled chimps and bonobos are indeed highly promiscuous. Dolphins, meanwhile, may have the biggest mammalian testicles of all, making up as much as 4% of their body weight (equivalent to human testicles weighing roughly 3 kilos). Although wild dolphin sex lives are naturally hard to study, spinner dolphins at least fit our expectations, engaging in mass mating events called wuzzles.
It was thanks to the multiple observations provided by convergent evolution that we were able to discover this consistent correlation between testicle size and sex life right across the mammals. And as for humans, we have testicle size somewhere in the middle, you can make of this what you want!
But what of the human chin?
The human chin has been fertile ground for arguments between scientists over its purpose. As with testicles, there are half a dozen plausible ideas to explain the evolution of the human chin. It could have evolved to strengthen the jaw of a battling caveman. Maybe the chin evolved to exaggerate the magnificence of a manly beard. It might even be a by-product of the invention of cooking and the softer food it produced – a functionless facial promontory left behind by the receding tide of a weakening jaw.
Intriguingly, however, a chin can be found in no other mammal, not even our closest cousins the Neanderthals. Thanks to the uniqueness of the Homo sapiens chin, while we have a rich set of possible explanations for its evolutionary purpose, in the absence of convergent evolution, we have no sensible way of testing them.
Some parts of human nature may be destined to remain a mystery.
Max Telford is Jodrell Professor of Zoology and Comparative Anatomy at University College London. Follow Max on Blue Sky.
A version of this article was originally posted at Conversation and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find Conversation on X @Conversation_US
After trying unsuccessfully to treat his depression with medication over several decades, Noel Farris, a 43-year-old web developer based in Philadelphia, found a ketamine clinic through a friend’s recommendation. He’d heard that the drug helped people mentally dissociate from the disease. So last year, he met with the clinic’s doctor, who recommended three intravenous infusions per week for a month, at $400 a session. He never saw or talked to the doctor again.
Instead, he said, a nurse took his blood pressure, placed the IV, then left the room each session. He was told to avoid driving for a few hours but was allowed to return to work. After several months and several thousand dollars, he stopped, saying he felt temporarily lighter, but didn’t see any long-term difference.
But Farris’ experience was specific to that one Philadelphia clinic. If he’d gone to a different site, even in the same city, he likely would have received a different treatment plan: a different dose, a different number of infusions, and different after-care instructions. And he might have experienced a different result.
In Jacksonville, Florida, Kevin Beaugrand, a 33-year-old restaurant server, received IV ketamine infusions while connected to a pulse oximeter, a blood pressure cuff, and an electrocardiogram. A medical professional stayed with him for most of the hour-long session, and his mother drove him home. After six treatments in two weeks — combined with outside counseling sessions — he started to feel better and purchased about 20 sessions over three years, at a total cost of about $10,000.
Across the country in Spokane, Washington, Jake Reinert, a 26-year-old insurance adjuster, said they started taking Spravato, a ketamine-derived nasal spray also known as esketamine, in April 2024. The first clinic Reinert tried required them to come in twice a week for a month and monitored their blood pressure from another room. Reinert then switched to a private psychiatrist and now pays $50 a month for a ketamine nasal spray made at a local pharmacy. At one point, Reinert was taking ketamine every day, and now uses the spray four times a week.
For more than five decades, ketamine has been used as an inexpensive anesthetic in operating and emergency rooms. But in recent years, the drug has emerged as a last-chance treatment for depression. The market really took off after 2019, when the U.S. Food and Drug Administration approved Spravato, which is chemically related to ketamine, for treatment-resistant depression.
Ketamine itself, though, isn’t approved to treat any mental health condition, meaning it must be prescribed off-label. It’s now available across the U.S. through mail order and private IV infusion clinics, and in the form of nasal spray and medicated lozenges. And the drug has recently come into the national spotlight since billionaire tech mogul Elon Musk discussed his ketamine use in an interview, and suggested it could be an alternative to traditional antidepressants.
Evidence on the efficacy and safety of ketamine as a depression treatment is still evolving. But some patients who have tried other medications without success call the drug life changing. And it’s popular: More than 1,000 private IV ketamine clinics have reportedly cropped up in recent years. One 2023 market research report estimated the private ketamine market would double from $3.41 billion in 2023 to $6.9 billion in 2030.
Yet despite that popularity, there are few state regulations and little federal oversight about who can administer the drug, at what dose, and how many times. In fact, one state has pulled back on requirements to gather data about adverse events despite concerns of underreporting.
Experts say that lack of regulation and oversight is concerning and could be dangerous. While ketamine is unlikely to be fatal unless combined at high doses with other drugs, it’s regulated as a Schedule III controlled substance, meaning it has potential for addiction and abuse, like Tylenol with codeine. Repeated use has also been associated with damage to the bladder and kidneys, and studies on the effects of long-term use are limited. Safety concerns led the United Kingdom to consider putting ketamine in the same restricted class as cocaine and heroin after “Special K,” as ketamine is also known, became widely used as a party drug.
In the U.S, much of the challenge with using ketamine as a depression treatment is related to its off-label use. When a drug that can have serious side effects, like Spravato, is prescribed, doctors follow a safety program set by the FDA, called a Risk Evaluation and Mitigation Strategy. But such a program does not exist for ketamine.
In more than 30 interviews with private clinic owners, current and former federal sources and state government officials, researchers, and patients, Undark found that dosing, safety protocols, and administration methods varied significantly from provider to provider. One clinic director was unclear if they should be reporting serious adverse events like breathing problems and manic episodes to their state or to the FDA, which collects medical reactions in its national database. (An email to Undark that Emily Hilliard, deputy press secretary at the Department of Health and Human Services, requested be attributed to an FDA spokesperson, noted that distributors of the drug are required to submit reports of adverse events “that are both serious and unexpected.”)
Several experts Undark interviewed could not point to a state-by-state list of regulations, and independent searches revealed limited information.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPAlthough medical providers at clinics must register with the Drug Enforcement Administration for approval to administer a controlled substance, that’s about the limit as far as regulations. Seth Mehr, who started his own ketamine clinic, Cascade Psychedelic Medicine, in Portland, Oregon in 2021, said he is frustrated by the lack of state and federal guidelines about how a ketamine clinic should operate, calling the system “a sea of non-answers.”
“You don’t have to register with anybody to open a ketamine clinic,” said Mehr, a former emergency room physician. “There’s not a gold standard set of rules as far as who needs to be there, how many people need to be there, what kind of safety equipment you can use, what dosing ranges you’re allowed to use. Really, none of that exists.”
For-profit clinics do have to adhere to general safety regulations and may face varying restrictions on how they can operate, depending on the state. But because treatments at such clinics are usually not covered by insurance, clinic directors can set their own prices and the number of sessions recommended — with little science to guide any standard.
Some in the field have tried to collect data on ketamine use for years, as the number of private clinics and telehealth businesses continued to grow.
Gerard Sanacora, a professor of psychiatry and director of the Yale Depression Research Program, who has long studied the impact of ketamine on depression, is among those who have called for a “ketamine registry,” to track dosage, treatment frequency, and adverse events.
But that, too, has its challenges, he said. “While it seems like such a simple thing — that we should be having some way of tracking this and registering it and everything else,” Sanacora said, adding that “it’s really hard to set up a regulatory control over it without dramatically limiting access to people that will need it to have their wisdom teeth extracted,” among other applications. He said that he has spoken to many regulatory agencies, including the FDA and National Institute of Mental Health, as well as professional societies, about increasing ketamine oversight and data collection.
“It really is one of these unique things that just seems to fall through the cracks,” Sanacora said.
Ketamine was first developed in 1962, and soon began to be used as a battlefield anesthetic in the Vietnam War. Army doctors had previously relied on a related compound, phencyclidine, otherwise known as PCP, but some patients experienced hallucinations and convulsions after use. Ketamine seemed to induce similar dissociative effects but was shorter-acting and safer.
It wasn’t until the 1990s that researchers became increasingly interested in its potential as an antidepressant. Studies began to find that subanesthetic doses of ketamine — meaning below the threshold dose for anesthesia — relieved symptoms of major depression and reduced suicidal thoughts.
Researchers and psychiatrists were excited about ketamine because it acts quickly and dissipates from the body within a few hours, compared to SSRIs — selective serotonin reuptake inhibitors — which can take weeks or months to have an impact and often have side effects like changes in appetite.
Although there are few studies addressing the long-term impact of ketamine efficacy, some small trials have shown that ketamine could have an impact in just a few hours where others failed, particularly for suicidal patients. One 2024 study of 75 people who received three ketamine IV infusion treatments over 11 days found that two-thirds of the participants experienced at least a 50 percent reduction in suicidality as measured by a self-reported questionnaire. And meta-analyses have found the drug to be a promising antidepressant.
Patients characterized the impact of ketamine treatments in different ways. Just one patient interviewed for this story described the ketamine experience as a high. Some said that ketamine allowed them to separate their thoughts from their emotions, or that they felt the weight of their depression lift.
Although everyone’s experience with IV infusion was slightly different, most people interviewed said their sessions lasted about 45 minutes to an hour. Some wore eye masks, some did not. And some listened to music. And while ketamine isn’t generally considered to be a classic psychedelic like LSD or psilocybin, it can induce a psychedelic effect at high doses.
“It sort of takes you out of your body into what feels like another realm or bubble or plane of existence,” said Beaugrand, the Florida restaurant server. He said he frequently listened to a reggae-version of Pink Floyd’s “The Dark Side of the Moon,” and would, at times, experience “visual hallucinations that make you leave your body when your eyes closed, are very vivid in real life, and it can be kind of disconcerting.”
Despite its promise as an antidepressant, doctors warn that ketamine is not a good choice for everyone. It raises blood pressure and heart rate, so isn’t recommended for people with uncontrolled heart disease. Several guidelines advise those with a history of mania or psychosis to avoid the drug. And there is concern about long-term use causing cognitive impairment and what’s known as “ketamine bladder,” which can cause the bladder to shrink and become irreversibly damaged.
Kimberly Juroviesky is a nurse practitioner and a captain in the Air Force who was disabled during active duty and started receiving ketamine treatments for chronic pain. She also is president of The Ketamine Taskforce, a volunteer organization aimed at improving education, access, and insurance coverage for ketamine.
“You watch any drug commercial on television and what are they going to say, ‘may cause kidney issues, may cause this, may cause that, may cause death,’” she said, noting that she now limits her ketamine treatments to once every four to six weeks. “That’s why you have to have guidelines, that’s why you have to use it appropriately.”
When the FDA approved the nasal spray Spravato — otherwise known as esketamine — it came with strict treatment guidelines: Clients had to have tried and failed at least two oral antidepressants first. Treatment also required a two-hour monitoring period in which a health care provider watched for serious side effects such as vomiting or dizziness.
Psychiatrists started using ketamine off-label in the late 2000s, after a study found that 71 percent of participants who received intravenous ketamine reported feeling better. But the number of clinics expanded significantly after Spravato was approved. And those clinics didn’t have to follow the strict guidelines required for Spravato.
When the Covid-19 pandemic hit a year later, the FDA allowed providers to prescribe controlled substances virtually. That’s when telehealth companies like Mindbloom became popular; they created online consults and sent medicated ketamine lozenges, called troches, through the mail. The lozenges release the drug more slowly than through an IV. Trapped in their homes, people reached out, looking for relief from their depression and fear.
While state boards of medicine oversee the medical practitioners administering the ketamine, and the Drug Enforcement Administration issues licenses to those prescribing controlled substances, it’s up to states to decide who can administer the treatments, what data to collect, if any, and what safety standards to impose, said Seth Mailhot, a former FDA investigator and compliance officer who specializes in FDA regulations for Husch Blackwell legal firm in Washington D.C.
This January, Mindbloom announced an injectable program, allowing patients to draw a dose from a vial of ketamine at home. Concerns about safety abounded, but Mailhot said it’s unclear if, in general, telehealth companies legally fall under the state where they send the product, or where the company is based.
Meanwhile, the landscape could change dramatically in the next couple years. During Covid-19, regulations passed to allow practitioners to prescribe controlled substances to patients after telehealth appointments. But those regulations are set to expire on Dec. 31, 2025.
Credit: WikimediaIn untangling the patchwork policies, Undark examined three states with contrasting ketamine approaches: Pennsylvania, Utah, and Oregon. Pennsylvania, recognizing the growth of private ketamine clinics, created a task force to develop general guidelines in 2020, early in the ketamine boom. Utah, at one point, appeared to have very strict rules for ketamine clinics. And Oregon’s guidelines for its ketamine clinics differ from its psilocybin centers, which were legalized in 2020.
Most states have guidelines — voluntary rules for ketamine clinics, not regulations. Regulations would take a legal process, and states would need the money and manpower to enforce those laws, whether it be through regular inspections or data collection, said Mailhot.
In Pennsylvania, the challenge was that when those guidelines were developed, it was unclear what potential issues might arise.
“We were aware that there were a lot of clinics opening up, but probably not with the appropriate providers or equipment, and we realized that this was a space that really wasn’t governed or regulated in Pennsylvania,” said Jessica Poole, a nurse anesthetist who served on the state’s task force and helped develop state guidelines for best dosing practices.
The current guidelines recommend strict monitoring, including blood pressure, cardiac, and neurological checks, and the availability of emergency equipment. But Poole said there are a lot of gray areas for clinics operating outside of hospitals and ambulatory surgical facilities (ASFs), which specialize in outpatient procedures. The guidelines do not require clinic directors to report adverse events to state or federal agencies.
“There are not any strict black and whites on it when we’re talking about clinics outside of a hospital or an ASF unfortunately,” she said.
Although private ketamine clinics in Pennsylvania do not have to register with the state department of health, practitioners do need to have a DEA license and to follow the same license rules as any other business, according to Barry Ciccocioppo, communications director for the Pennsylvania Department of Health.
The current guidelines also recommend that a physician or a certified registered nurse anesthetist who has adequate training and experience supervise any ketamine administration. But again, Poole said, those are only guidelines, not requirements.
In 2023, Evan Husted, an emergency room physician, opened Mindstream Medicine, a private ketamine clinic in Philadelphia, after, he said, he had a positive experience with ketamine himself. But he said the state guidelines were often unclear about safety protocol. For example, he was unsure if he was supposed to be reporting adverse events and to whom. (Pennsylvania guidelines call for monitoring for adverse events, but do not require adverse event reporting.)
As an emergency physician, Husted said he’s comfortable handling physical issues that may come up — for example, increased blood pressure and heart rate. But because he doesn’t have a psychiatric background, he chose not to accept bipolar patients or those with a history of psychosis, as some evidence suggests ketamine treatments can trigger rare manic episodes. The Pennsylvania guidelines, however, don’t stipulate which medical or psychiatric conditions should exclude patients from treatment. They simply caution that patients with high-risk coronary artery disease and poorly controlled psychosis are at increased risk for adverse events following ketamine infusion.
Husted said more guidelines are needed, both for patients and for the medical practitioners trying to provide a uniform treatment.
“You can go to 10 different clinics — not even in other parts of the state, but just other parts of the city of Philadelphia and the suburbs — and find people using ketamine in 10 different ways,” he said.
Among those major differences is dosing, which is largely left up to providers.
Some experts, like Sandhya Prashad, a practicing psychiatrist near Houston and president of the American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3), caution against using high doses due to safety concerns.
But Husted, for one, said he believes patients get more out of a level of what he called “therapeutic intoxication,” though he said that dose differs dramatically from person to person.
“There’s no telling how much ketamine someone’s going to need to get to the level you’re trying to get them to,” Husted said, “and so I would be wary of regulations that tell me I can only give so many milligrams per kilogram [of body weight] and still be operating in good practice as a ketamine clinic.”
In contrast to Pennsylvania’s minimal oversight, Utah started out as a strict outlier. In 2017, the state passed a law requiring clinics to track adverse events related to outpatient anesthesia. However, the monitoring ended in 2023 despite a Utah Department of Health and Human Services task force recommendation that it continue until 2025, amid concerns of underreporting. Of the 14 adverse events reported during that time, eight of them involved dental procedures. It was unclear if any involved ketamine infusion clinics.
It was also unclear why the monitoring ended. Melanie Hall, communications director for the state Department of Commerce, which oversees the Division of Professional Licensing, said there was a “sunset” date of 2023 on the monitoring law: “We do not monitor the use of ketamine or any adverse events associated with it,” she wrote in an email.
Some clinic directors said the Utah oversight was helpful, particularly when Covid shut many of the clinics down and providers switched to providing ketamine via mail. When the pandemic shut down services, William Beesley, founder of Restorative Health — a clinic that offers ketamine treatments as well as weight management and hair loss therapies in Sandy, Utah — said he was able to call the state and see what they could provide, and under what circumstances.
Beesley also noted that the state keeps a controlled substances database so providers can confirm that patients are not getting ketamine from other clinics. According to Patrick Fitzgibbon, a spokesman from Utah’s Division of Professional Licensing, telemedicine prescriptions would be in the database if reported by the pharmacy.
“Utah’s systems seem to work better to me,” he said. “It’s a very, very, very complicated situation but the state is handling it better than the national government.”
Meanwhile, in Oregon, clinics face an additional challenge, as many of them provide both ketamine and psilocybin treatments. But the state takes a much stricter approach with the latter: Oregon requires providers at its psilocybin centers to take a verified training course, register with the state, and collect data on any events requiring emergency medical attention. Tim Heider, a spokesperson with the state’s health authority, noted in an email that the agency does not regulate ketamine.
It’s confusing for the clinic directors and the patients, said Mehr, the emergency room doctor who founded Cascade Psychedelic Medicine. The private clinic offers both ketamine and psilocybin treatments. Mehr said he remains with patients throughout the experience and asks them to seek additional mental health support as part of the treatment process.
Like Husted in Philadelphia, Mehr uses doses of ketamine high enough to induce a psychedelic state. He said he turns down about 10 to 15 percent of patients who apply for treatment due to mental health concerns or physical health issues. Patients typically start with sessions twice a week for a few weeks, and then taper from there. They generally move to sessions every other week for a few months, Mehr said, and then once a month after that. An individual session is $685, although a sliding scale is available. About 50 percent of the treatments are now partially covered by insurance, he said.
He said part of the problem is that there are so many organizations developing their own versions of guidelines. All of them are voluntary. The reality, he said, is that ketamine practitioners are held accountable by two entities: the legal system and the state medical boards, the latter of which will investigate if there is a complaint.
“Being accountable to a lawsuit and being able to demonstrate that you are practicing within community standards, that’s how a malpractice suit is defined,” he said. “Then there’s the boards themselves that regulate their providers the same way they do everything else.”
Eric Hermes, the national director of psychopharmacology and somatic treatments at the Veterans Health Administration Office of Mental Health and Suicide Prevention, said the VA has two national programs to train personnel about ketamine, from clinical needs to developing ketamine programs at facilities. He said because IV ketamine is unregulated, providers tend to use higher doses because some feel that the length of dissociation is linked to overall effectiveness in treating depression long term, but that has not been proven in the research or in his experience.
Another challenge with ketamine, he added, is ending treatment: “What we’ve found in clinical treatment is that some patients, sometimes a large proportion of patients, don’t do well when you try to taper off ketamine.”
That results in some VA patients receiving what he called “long term serial treatments,” even though there is not a lot of data about the benefits and risks of long-term use.
In a 2023 article looking at legislative reform for psychedelic drugs including MDMA and psilocybin, Joshua Siegel, a psychiatrist then at Washington University, wrote that “legislative reform for psychedelic drugs has been proceeding in a rapid, patchwork fashion in the U.S.” For ketamine, he said, the legal situation is even more challenging, since it’s already an approved drug but is being prescribed off-label.
The lack of regulations could have serious consequences, said Siegel, now an assistant professor at New York University’s Center for Psychedelic Medicine, because while overdoses with ketamine are uncommon, they do happen, particularly when combined with other drugs.
“You can overdose on ketamine and stop breathing,” he said. “But that’s not the case with LSD and psilocybin, where you don’t really see overdoses like you do with ketamine.”
Siegel pointed out that at least in a clinic, there is some medical oversight and someone is physically in the clinic in case something goes wrong. That’s not the case with mail-order services, leading to a higher-risk situation, he said.
Prashad, president of ASKP3, echoed safety concerns, particularly regarding dosing.
Patients have come to see her, “and they’ve seen someone else in the past that administered IV ketamine, and they gave them such high doses they were practically anesthetized,” she said. “There’s no data that suggests that that’s what you should be doing. In fact, there’s data that shows that that’s neurotoxic.”
ASKP3 is working to develop updated guidelines for drug type, dose, and frequency, though it would be voluntary for practitioners to follow them.
L. Alison McInnes, a psychiatrist and former medical director for Kaiser Permanente Northern California’s ketamine infusion therapy program, agreed with Mehr that enforcing those guidelines will likely only happen through patient lawsuits.
“If you have standard of care out there,” she said, “then malpractice courts have something to deal with.”
But Mailhot said it’s up to the states to create legislation — like Utah did requiring adverse event reporting. But most states haven’t issued more regulations because state legislators aren’t comfortable weighing in on the practice of medicine for fear of unintended consequences, he said.
He pointed to the effort it took to shut down opioid “pill mills,” noting that the government was able to track the biggest offenders through the number of prescriptions, but that’s harder to do with ketamine because it is not being tracked, and it is not being used in the same volume.
“When there’s enough of an outcry to the safety issues, they’ll crack down,” he said, noting that the country is currently in a “deregulation environment.” “But for now, you can’t stop everything from happening.”
While states and professional organizations are struggling to address the increasing number of private ketamine avenues, experts like McInnes are trying to work with clinics through an entirely different path: She’s the vice president of scientific affairs for Osmind, an electronic health record system specifically for clinicians administering psychiatric medications and treatments like ketamine.
As of late May, she said at least 200 clinics had signed up, including more than 250,000 patients. The record template includes vital signs, doses, any medication the patient is on, and any side effects. And there’s a new record for each infusion, she said.
The clinics and patients consent to use the data — without identifying factors — for research. Right now, McInnes is working on a paper in consultation with a researcher at Yale University comparing esketamine results with those from ketamine infusion therapy.
She said it would be helpful if there was a nationally recognized ketamine certification program for providers and those working in the field. Instead, she said, there are some “charismatic figures” offering training courses for thousands of dollars, but there’s no standardization.
McInnes said that, from her data, most people don’t need more than six ketamine infusions to treat their depression. But for many clinics, there is no end point for its use.
“It’s just really quite egregious,” she said.
For patients who work with ketamine, part of the challenge is figuring out how to use the drug as a tool and not a crutch.
Reinert, the insurance adjuster from Spokane, has been regularly taking ketamine since October 2024, increasing the dose to where they are now taking 140 mg several times a week. The treatment has been life changing, Reinert said. At one point, Reinert had taken a medical leave to deal with their depression but is now working full time and taking a full load of college courses, aiming for a degree in sociology.
“I’ve tried other antidepressants but this is the first that has launched me towards life goals,” they wrote in an email.
The challenge is that Reinert plans to move to Australia in a year, where ketamine treatments are much, much harder to find. They are working with their psychiatrist to come up with a plan to drastically reduce their use of the medication.
The longest Reinert has been off the drug was three weeks, and they said their mood plummeted. They were a little worried about life without ketamine.
“They say it’ll be six sessions, but from my experience it does seem to be a long-term thing,” Reinert said. “And once you stop, the benefits also stop.”
Dawn Fallik is a medical and science reporter specializing in data analysis. She worked as a staff writer for The Associated Press, St. Louis Post-Dispatch, and The Philadelphia Inquirer, and has won awards for investigative reporting, feature writing, and column writing. She is now a professor at the University of Delaware. Find Dawn on X @dfallik
A version of this article was originally posted at Undark and is reposted here with permission. Any reposting should credit both the GLP and original article. Find Undark on X @undarkmag
For years, Donald Trump’s distinctive, large and bold signature has captured the public’s attention. Not only did it recently come to light that his signature appeared in a book that Jeffrey Epstein received for his 50th birthday, but it fits neatly alongside Trump’s long history of brash self-adulation. “I love my signature, I really do,” he said in a Sept. 30, 2025, speech to military leaders. “Everyone loves my signature.”His signature also happens to be of particular interest to me, given my decades-long fascination with, and occasional academic research on, the connection between signature size and personal attributes.
A long-time social psychologist who has studied America’s elite, I made an unintentional empirical discovery as an undergraduate more than 50 years ago. The link that I found then – and that numerous studies have since echoed – is that signature size is related to status and one’s sense of self.
Signature size and self-esteemBack in 1967, during my senior year of college, I was a work-study student in Wesleyan University’s psychology library. My task, four nights a week, was to check out books and to reshelve books that had been returned.
When students or faculty took books out, they were asked to sign their names on an orange, unlined card found in each book.
At some point, I noticed a pattern: When faculty signed the books out, they used a lot of space to sign their names. When students checked them out, they used very little space, leaving a lot of space for future readers.
So I decided to study my observation systematically.
I gathered at least 10 signatures for each faculty member and comparison samples of student signatures with the same number of letters in their names. After measuring by multiplying the height versus the width of the amount of space used, I found that eight of the nine faculty members used significantly more space to sign their names.
In order to test for age as well as status, I did another study in which I compared the signatures of blue-collar workers such as custodians and groundskeepers who worked at the school with a sample of professors and a sample of students – again matched for the number of letters, this time on blank 3-by-5-inch cards. The blue-collar workers used more space than the students but less than the faculty. I concluded that age was at play, but so was status.
When I told psychologist Karl Scheibe, my favorite teacher, about my findings, he said I could measure the signatures in his books, which he had been signing for more than a decade since his freshman year in college.
As can be seen in the graph, his book signatures mostly got bigger. They took a major leap in size from his junior year to his senior year, dipped a bit when he entered graduate school and then increased in size as he completed his Ph.D. and joined the Wesleyan faculty.
I did a few more studies, and published a few articles, concluding that signature size was related to self-esteem and a measure of what I termed “status awareness.” I found that the pattern held in a number of different environments, including in Iran – where people write from right to left.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPThe narcissism connectionAlthough my subsequent research included a book about the CEOs of Fortune 500 companies, it never crossed my mind to look at the signatures of these CEOs.
However, it did cross the minds of some researchers, 40 years later. In May 2013, I received a call from the editor of the Harvard Business Review because of the work I had done on signature size. They planned to run an interview with Nick Seybert, an associate professor of accounting at the University of Maryland, about the potential link between signature size and narcissism in CEOs.
While Seybert told me his research had not found direct evidence for a positive relationship between the two, the possibility of the connection he inferred nonetheless intrigued me.
So I decided to test this using a sample of my students. I asked them to sign a blank 3-by-5 card as if they were writing a check, and then I gave them a widely used 16-item narcissism scale.
Lo and behold, Seybert was right to deduce a link: There was a significant positive correlation between signature size and narcissism. Although my sample size was small, the link subsequently led Seybert to test two different samples of his students. And he found the same significant, positive correlation.
Others soon began to use signature size to assess narcissism in CEOs. By 2020, growing interest in the topic saw the Journal of Management publish an article that included signature size as one of five ways to measure narcissism in CEOs.
A growing fieldNow, almost six years later, researchers have used signature size to explore narcissism in CEOs and other senior corporate positions such as chief financial officers. The link has been found not only in the U.S. but in countries including the United Kingdom, Germany, Uruguay, Iran, South Africa and China.
In addition, some researchers have studied the effect of larger versus smaller signatures on the viewers. For example, in a recent article in the Journal of Philanthropy, Canadian researchers reported on three studies that systematically varied the signature size of someone soliciting funds in order to see whether it affected the size of donations. It did. In one of their studies, they found that increasing the size of the sender’s signature generated more than twice as much revenue.
The surprising resurgence of research using signature size to assess narcissism leads me to a few conclusions.
For one, signature size as a measure of certain aspects of personality has turned out to be much more robust than I imagined as an observant undergraduate working in a college library back in 1967.
Indeed, signature size is not only an indicator of status and self-esteem, as I once concluded. It is also, as recent studies suggest, an indicator of narcissistic tendencies – the kind that many argue are exhibited by Trump’s big, bold signature.
Where this research is taken next is anyone’s guess, least of all for the person who noticed something intriguing about signature size so many years ago.
Richie Zweigenhaft is an Emeritus Professor of Psychology at Guilford College. His primary academic focus has been on the United States’ power elite.
A version of this article was originally posted at Conversation and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find Conversation on X @Conversation_US
For nearly four decades, Americans who believe they have been harmed by a vaccine have had access to a little-known legal process called the Vaccine Injury Compensation Program (VICP) — often referred to simply as the vaccine court.Now, Health and Human Services Secretary Robert F. Kennedy Jr. — a longtime critic of the system — has vowed to “revolutionize” or “fix” it, calling the program “biased,” unfair and punitive toward claimants. But transforming it wholesale would be far more complex — and potentially far more damaging to public health — than he seems to appreciate. Or perhaps he simply wants to open the door to the kind of vaccine-causes-injury suits and large settlements that were his forte as a tort lawyer.
The four-decade-old legal fix for a public health crisisThe vaccine court was created by Congress in 1986 amid a crisis in the nation’s vaccine supply. At the time, lawsuits over side effects from whooping cough (whole-cell pertussis) vaccine had driven several manufacturers out of the market, threatening shortages and risking the resurgence of deadly diseases.
To stabilize the situation, Congress passed the National Childhood Vaccine Injury Act, which shielded vaccine makers from most lawsuits and established a specific process within the U.S. Court of Federal Claims to handle vaccine injury claims. Instead of suing manufacturers directly, petitioners could bring cases before legal officials known as special masters.
The law also created a dedicated trust fund, financed by a 75-cent excise tax on every vaccine dose sold — to pay both compensation and attorneys’ fees. Some injuries with well-established causal links, such as certain allergic reactions or shoulder injuries from injection, qualify for automatic compensation. Others, where the science is disputed, go through evidentiary hearings involving physicians, attorneys, and medical experts.
This system has long been praised as an ingenious compromise — a humane and science-based way to deliver justice for the small number of people genuinely harmed by vaccines, while maintaining confidence in the nation’s immunization program.
A system in need of modernization. But by Kennedy?Still, much about the vaccine court reflects 1980s realities, not 21st-century ones. The number of special masters remains capped at eight, even as the caseload has surged with the inclusion of new vaccines. The $250,000 cap on damages for pain and suffering — set nearly forty years ago — has never been adjusted for inflation. And the three-year statute of limitations has proved too short for many petitioners who fail to file in time.
The program’s scope also remains uneven and seems arbitrary. Originally limited to childhood vaccines, it was only recently expanded to include shots given during pregnancy. Adult vaccines, such as shingles, are still excluded. Claims related to COVID-19 vaccines are routed through a separate emergency countermeasures system that has been widely criticized as opaque and inefficient.
Many experts across party lines support modest, bipartisan reforms to address these issues. Kennedy himself has mentioned several of these ideas.
What remains unclear is what Kennedy actually intends to do. His broad promise to “revolutionize” the vaccine court could mean anything from modest modernization to total dismantling.
The first path — pursuing incremental, congressionally approved reforms — would be the least disruptive and most achievable. But Kennedy’s rhetoric sometimes suggests more radical ambitions. Some of his statements imply a desire to overturn past vaccine-court rulings or even reopen long-settled questions about vaccines and autism.
Kennedy’s involvement in this system is uniquely perilous because he is not merely a critic of bureaucratic inefficiency but an activist who has built his career on sowing distrust in vaccines themselves. Unlike most reformers who seek to strengthen public-health infrastructure, Kennedy approaches the issue from the conviction that the system is fundamentally corrupt — a worldview that casts regulators, scientists, and courts as co-conspirators in a vast cover-up of vaccine manufacturers’ misdeeds. From his years leading anti-vaccine organizations to his amplification of scientifically debunked claims linking vaccines to autism and chronic illness, he has consistently blurred the line between policy skepticism and medical disinformation. He now has the power to reshape the very mechanism that guards vaccine confidence. That could legitimize pseudoscience under the guise of reform.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPThe autism precedentFrom 2002 to 2010, the vaccine court oversaw one of its largest and most complex legal proceedings: the Omnibus Autism Proceedings, which examined whether vaccines could cause autism. After eight years, 50 expert reports, 939 medical articles, and testimony from 28 scientific experts, the court concluded decisively that autism is not a vaccine injury.
These findings were and remain consistent with the global scientific consensus. Yet Kennedy has continued to challenge them, asserting that the special masters “prioritize the solvency” of the system over justice for claimants.
He has no direct authority to remove or replace the special masters, who are appointed for four-year terms by judges serving 15-year terms on the Court of Federal Claims. But he could, in theory, try to revise the official list of recognized vaccine injuries to include autism or other conditions — a complex administrative process requiring public comment, scientific justification, and credible evidence. Doing so without credible evidence would trigger legal challenges and near-universal opposition from medical and public health organizations.
Return to the civil courts?Kennedy could also undermine the vaccine court indirectly — for instance, by reshaping the Advisory Committee on Immunization Practices (ACIP), which determines which vaccines are covered — and which he has already reconstituted with a sorry assortment of anti-vaccine ideologues. Removing a vaccine from that list would again expose manufacturers to direct lawsuits, potentially making vaccine production unprofitable.
Kennedy has also supported legislation allowing claimants to bypass the vaccine court entirely and sue manufacturers in civil court — precisely the scenario Congress sought to avoid in 1986. That would potentially turn vaccine-injury claims into high-stakes jury trials, requiring plaintiffs to meet stricter standards of evidence and to face formidable corporate defendants.
Such a shift could vastly increase litigation, destabilize vaccine manufacturing, raise prices, discourage innovation, and undermine public trust — returning us to the crisis that prompted Congress to create the vaccine court in the first place.
The danger lies not only in the content of Kennedy’s proposals but in his ability to undermine public confidence in scientific evidence. As a cabinet-level official, his statements carry the imprimatur of federal authority; misinformation that once circulated on the fringe now emanates from the top of the nation’s health apparatus. This institutionalization of nescience and conspiracy thinking could erode trust in vaccines, embolden litigation built on junk science, and weaken the fragile social contract that keeps herd immunity intact. Thereby, Kennedy represents a greater threat than a single misguided reform effort; he embodies the convergence of populist politics and medical denialism, a combination that history shows can undo decades of progress in a single news cycle.
The stakes for public healthThe Vaccine Injury Compensation Program is an ingenious hybrid of science, law, and social policy that has compensated thousands of people while sustaining confidence in vaccines as a collective good. Reform is needed — more special masters, higher caps on compensation, broader coverage, and simpler filing rules — but radical, unjustifiable changes could undo decades of stability and progress.
As Kennedy proceeds with his review, he will face resistance not only from pharmaceutical companies but also from physicians, patient advocates, and public health professionals who understand how much is at stake.
Reforming the vaccine court requires careful evolution, not revolution. If its critics succeed in tearing it down rather than improving it, the result could be a return to the chaotic, litigious landscape that once threatened America’s vaccine supply — and, with it, the health of millions.
Henry I. Miller, a physician and molecular biologist, is the Glenn Swogger Distinguished Fellow at the Science Literacy Project. He was the founding director of the FDA’s Office of Biotechnology. Find him on his website: henrymillermd.org
People are still debating whether the mRNA from COVID-19 vaccines remains in the body longer than it should. Some say it lingers and causes harm, others say that idea just doesn’t hold up. A new article in Stat brings the issue back into the spotlight. Chemistry explains what’s going on.The latest controversy regarding messenger RNA persisting in the body, potentially causing harm from COVID-19 vaccines, should be settled. Or is it?
Matt Herper’s new piece in Stat tackles the issue head-on with an interview with one of the co-inventors of the mRNA vaccines for COVID.
The Controversy
Discounting those who are simply anti-vaccine, some credible-sounding individuals still argue there’s an inherent safety issue with the Moderna and Pfizer vaccines because the mRNA supposedly persists. One of the most prominent is Dr. Retsef Levi, who now chairs ACIP’s working group on COVID-19 vaccines. As he put it:
“The initial safety paradigm was that the vaccine contents would only stay in the arm and be cleared after a short duration. Now we know that’s not true – so we need to understand the biodistribution and persistence of the mRNA, the spike protein, and the lipid nanoparticles, and what their respective risks are.”
— Retsef Levi, Brownstone.org
A Nobel Prize Winner Disagrees
Herper’s article contrasts these claims with the views of Dr. Drew Weissman, Professor of Medicine at the Perelman School of Medicine, University of Pennsylvania, and co-laureate of the 2023 Nobel Prize in Physiology or Medicine for developing mRNA vaccines.
Asked whether vaccine mRNA could persist for months in a rare patient, Weissman was unequivocal:
“It is absolutely impossible. mRNA is degraded incredibly rapidly. When you modify it, it’s a little slower. It’ll last 24 hours. It never, ever lasts six months. That’s just impossible.”
Why Chemistry Sides With Weissman
RNA is, by its very nature, a short-lived messenger, while DNA is built for stability and long-term storage. This isn’t speculation—it’s basic biology and chemistry. RNA’s fragility is exactly why cells use it for temporary instructions and DNA for the permanent archive. That simple fact, reinforced by both chemistry and biology, is why claims of vaccine mRNA persisting for months or years don’t hold up.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPThe Chemistry Behind RNA Instability
Behind all the noise is a fundamental, well-known chemical reaction called ester hydrolysis – the breaking of an ester bond by water, producing a carboxylic acid and an alcohol. (Figure 1) While this may seem irrelevant to vaccines, it is anything but.
Figure 1. Hydrolysis of an ester involves the addition of water, followed by the breaking of the ester bond (red hatched line), which forms its components – an alcohol and a carboxylic acid.
Phosphate esters, the backbone of DNA and RNA, can also be hydrolyzed. The process (Figure 2) is conceptually identical to that of esters.
Figure 2. Hydrolysis of phosphate esters is conceptually identical to that of “traditional” esters. Note that instead of a carboxylic acid, one molecule of phosphoric acid and two molecules of methanol are formed.
What does any of this have to do with the instability of RNA? Time to roll out the chemistry.
It’s All About Ring Size
Without getting into the details of organic chemistry, it’s useful to know that compounds, natural or synthetic, can exist in a linear (straight-chain) form, while others exist in a cyclic (ring) form. Linear molecules are flexible chains of atoms, whereas cyclic molecules are built around closed rings. Both types are common in nature, each suited to different biological roles (Figure 3).
Figure 3. (Top) Geraniol (acyclic) and menthol (cyclic), two common natural scents. (Bottom) Leucine (acyclic) and proline (cyclic) are both amino acids.
Messenger RNA Instability
This may sound obscure as it relates to COVID vaccines, but it is anything but. The propensity of acyclic molecules to form cyclic versions depends significantly upon the size of the ring that forms.
Figure 4. The ease of ring formation depends on size.
Open chains of three or four carbons (Left) rarely cyclize because their ends can only meet by forcing the atoms into highly strained angles, resulting in rings with severe ring strain. Chains of seven or more carbons (Right) are so flexible that their ends seldom align properly, making ring closure entropically unfavorable. By contrast, five- and six-carbon chains (Center) have just the right length and geometry for their ends to meet, form bonds with minimal ring strain, and react efficiently — which is why the vast majority of natural products contain rings of this size.
What does this have to do with the instability of RNA?
A lot. In Figure 5, we see a segment of RNA (Left). Note that a hydroxyl group (called 2′-hydroxy) is five atoms (double arrow) from the phosphorous atom of the phosphate ester. This makes RNA ideally suited to form a 5-membered cyclic phosphate (Right, red oval). Once this happens, the phosphate bond (red hatched line) breaks and the remaining RNA (blue oval) falls apart. In other words, RNA is built to break itself down.
Figure 5. Autocleavage of RNA.
By contrast, DNA contains a non-reactive hydrogen atom (green circle) instead of the hydroxyl group in the 2′ position (Figure 6). While this may seem like a small change in a huge molecule, the opposite is true. In the absence of the 2′-hydroxyl group, the same phosphate bond is exceptionally stable.
Figure 6. DNA, which lacks the 2′-hydroxyl group of RNA, is exceptionally stable.
Bottom Line (Science Only)
So, it really just comes down to this:
DNA differs from RNA by one oxygen atom, a seemingly trivial change in a huge molecule. But that’s all it takes to make RNA less stable than DNA. While RNA decomposes in minutes or hours, DNA can survive for centuries under favorable conditions.
People may argue about the safety of mRNA vaccines, but there is no argument about the difference between RNA and DNA. They have evolved for specific purposes, which are governed by the underlying organic chemistry – a science that has long been established and is independent of political considerations.
Josh Bloom is ACSH’s Director of Chemical and Pharmaceutical Science. Josh earned his Ph.D. in organic chemistry at the University of Virginia, followed by postdoctoral training at the University of Pennsylvania. Find Josh on X @JoshBloomACSH
A version of this article was originally posted at American Council on Science and Health and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find American Council on Science and Health on X @ACSHorg
The recent death of James Watson, co-discoverer with Francis Crick of the three-dimensional structure of the genetic material DNA, brought back memories. Although a leader and groundbreaking scientist, he was also known for the occasional insensitive comment and controversial views that reawakened the hushed field of eugenics. Watson and Crick shared the Nobel Prize in 1962. Watson went on to launch the Human Genome Project at the National Institutes of Health, and then to become Chancellor Emeritus of the Cold Spring Harbor Laboratory on Long Island.
I had two curious encounters with the man.
Futile journeyWatson earned his doctorate at Indiana University in 1950; I did the same 30 years later. I heard him speak when he visited the campus, in Bloomington, when I was a grad student in genetics, but I was too sleep-deprived to remember anything. Shortly after Francis Crick died in 2004, I decided to interview Dr. Watson while he was still around. He’d agreed to sit down for a chat, perhaps because we had some things in common. I was writing for The Scientist at the time, working on a book about gene therapy, and was also the author of several textbooks. Watson wrote genetics textbooks, too, such as The Molecular Biology of the Gene, as well as books on his observations on life, such as Avoid Boring People, and of course, The Double Helix.
Dr. Francis Crick (left) and Professor James Watson with a model of the DNA molecule whose structure they discovered in 1953So, I journeyed 14 hours on Amtrak during a single day, going from Schenectady, New York to Cold Spring Harbor Laboratory, arriving early afternoon. Watson was prompt, polite, very well dressed, and charming. And then I asked my first question.
“Dr. Watson, which do you think was more significant, deducing the structure of DNA, or sequencing the human genome?”
He sat back, smiled, and stroked his chin, seemingly deep in thought. It wasn’t a bad question to start. A pause, then …
“Ricki, do you consider yourself a girl or a woman?”
I came prepared with a list of questions about science in general and genetics in particular, but never could get him to answer me seriously. I didn’t even get enough material to publish my intended article, nor add anything to my human genetics textbook. At least I was reimbursed for the train fare. Perhaps I’d get another chance, if Dr. Watson spoke at a conference I was attending.
Genome pioneerSeven years later, Watson was the first speaker at the opening session of the 12th International Congress of Human Genetics in Montreal in October, 2011. He was on a panel of “genome pioneers” who were among the first to have their genomes sequenced — which was then a very big deal. Watson’s sequence was second, following that of Craig Venter, who led the private effort to sequence the first genome.
The session was led by Kevin Davies, who wrote “The $1,000 Genome” (2010), Editing Humanity: The CRISPR Revolution and the New Era of Genome Editing (2021), and is writing a book on sickle cell disease due out next year. Science journalists attend these meetings, and we were told we could freely quote from lectures, so Watson’s comments were widely circulated (mostly minus the more offensive ones).
I quoted from the session in Why I Don’t Want to Know My Genome Sequence, an article published on the USC Annenberg Center for Health Journalism website. A useful roundup of Dr. Watson’s greatest hits can be found at Goodreads. Watson’s quotable quotes ranged from the blunt — “No one may have the guts to say this, but if we could make better human beings by knowing how to add genes, why shouldn’t we?” — and profound — “Our goal should be to understand our differences” — to “There is no firm reason to anticipate that the intellectual capacities of peoples geographically separated in their evolution should prove to have evolved identically. Our wanting to reserve equal powers of reason as some universal heritage of humanity will not be enough to make it so.”
He was sexist and racist and spoke as if he would say anything that popped into his head — something that these days very few people can get away with.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPHere is a dialogue from when I heard Watson speak about genome pioneers. Select audience questions are in CAPS, Watson’s responses in italics, and my commentary and explanation follow.
*WHY DID YOU HAVE YOUR GENOME SEQUENCED?*
I thought, why not? I had no objection, with the exception of not wanting to know ApoE4. My grandmother had Alzheimer’s in her 90s, and the fact that I was in my 70s and didn’t have it didn’t reassure me I wouldn’t in my 90s.
At Watson’s request, the gene ApoE4 and the surrounding DNA were intentionally left out of his published genome sequence because he didn’t want to know. At that time, people with two copies of a variant of this gene were thought to have a 15-fold increased risk of Alzheimer’s, and people with one copy a 3-fold increased risk. However, recent studies have found that women are at higher risk, ApoE4 interacts with other genes in ways that affect risk; and additional ApoE4 variants have been identified. As far as I know, he never publicly reported developing Alzheimer’s and lived to age 97.
*WHAT DID YOU LEARN THAT WAS USEFUL?*
Finding that I am a slow metabolizer of antipsychotics and beta blockers. I have a slightly irregular heartbeat, and the doctor put me on beta blockers. Two put me to sleep. Now I take them once a week, so knowing I’m a slow metabolizer was a real medical benefit. It also may have explained a mystery concerning my son. He almost died of neuroleptic malignant syndrome from an antipsychotic. I now know that if I go psychotic, I will tell people I can’t take those drugs.
*WAS ANY GENOME INFORMATION NOT HELPFUL?*
They told me I had something that should have killed me, a mutation in a DNA repair gene. And so, I decided not to think about it. I didn’t go and look it up. Then they told me I was one base pair off the bad one. They also told me I was a carrier for BRCA1, so I thought I would have to phone my nieces because their mother had breast cancer. But before that I asked Mary-Claire King (who identified BRCA1 and BRCA2), and she said no, I had a harmless variant. So, I’m glad I didn’t call my nieces because then they would have paid that disgraceful sum of money to Myriad Genetics.
*WHO SHOULD HAVE THEIR GENOMES SEQUENCED?*
I’d like to see children who have mental illness sequenced with their parents. My son has schizophrenia. The moment you have a son who is not normal, you wonder if you are the cause, or if you could have done something differently. Finding a mutation would make parents see that it was just genetic injustice, not anything they did. Knowing that won’t make their child healthy, but they won’t have the double whammy of thinking they did something wrong. I think an educated society doesn’t like genetics because it is so deterministic, and they would prefer it if you could have diets so you wouldn’t have a mentally ill child.
It is my belief that about 5% of children are born with rather bleak long-term futures. They really won’t be able to take care of themselves. They might become homeless later in life, and I think making people aware of this goes back to Hermann Müller, who worried about mutational load. We should think this way again.
Evolution means mutations, and there are going to be losers who, 20,000 years ago, would not have lived very long. But now in our so-called compassionate society, we should take care of them, but we do so very badly as they age. There are some born losers. It’s not that their parents were bad. But what’s the ethical responsibility to take care of the genetic losers? Having set up the ELSI research program, I suspect that all the programs put together have yielded nothing of value. They’re talking about minor things. The major issue is, what do we do with people with mad genes? That’s never discussed.
Hermann Muller won the 1946 Nobel Prize in Physiology or Medicine for discovering that X-rays induce mutations, and, relevant to Watson’s comment, writing a seminal book on eugenics, Out of the Night: A Biologist’s View of the Future (New York: Vangard, 1935.)
ELSI stands for The Ethical, Legal and Social Implications part of the Human Genome Project.
“The unraveling of a Nobel Prize: How Hermann Muller was awarded the Nobel Prize: A front for eugenics,” by Edward J. Calabrese from the University of Massachusetts, Amherst, and Dima Yazji Shamoun of the University of Texas, Austin, published in the Journal of Occupational and Environmental Hygiene, asserts that Muller’s research attempted to legitimize eugenics. It’s possible that Muller’s coining of the phrase “genetic load” for dangerous spontaneous mutations inspired Watson’s use of the term “genetic losers (which for him, may have been a neutral statement and not a judgment).
*HAS YOUR SON INFLUENCED YOU TO HAVE YOUR GENOME SEQUENCED?*
My son would say yes, but he didn’t want to. He doesn’t want to discuss it. I would have a completely different view, that we might be able to help him and he should have no choice, but that is the sort of thing brought up at ELSI meetings. I find them counterproductive to help the people born with genetic disease.
I’m very conscious of genetic losers – other people want to deny their existence. Other people want to cure them.
*ARE YOU WORRIED ABOUT THE FLOOD OF DATA FROM SEQUENCING GENOMES?*
I’m more worried that we’ll get the flood of information, and we won’t use it because of excessive concern about privacy. Right now, I’d be pragmatic, be as free as possible with sequencing genomes, and then if disaster is the result, we’ll try to correct it. I’d hate for anyone to say ‘you can’t tell your child that he has a DNA change.’ I think parents, within limits, should have control over what their children know, and trying to regulate that would be just awful.
I’m very happy the $1000 genome exists. Genetics will help us to understand why people don’t fit in. Every time someone goes into a children’s hospital with a serious disease, it would be immoral NOT to sequence him.
ClosureAt the end of the panel discussion in 2011, I was among the crowd of mostly young people (graduate students and post-docs) with Y chromosomes who approached Dr. Watson — I’d wanted to ask him to review my soon-to-be-published gene therapy book. I was very dressed up (rare for me) and the only XX in the immediate vicinity. Dr. Watson turned on the charm and talked to me for nearly five minutes, ignoring the XY groupies.
I was embarrassed at the attention, and escaped as soon as I could politely do so. Despite his friendliness, he never responded to my follow-up request to review my book, and never acknowledged having received it when I sent him one of my personal copies.
James Watson was certainly unique, and contributed much to science. But in reading over his comments once again, here in 2025, I couldn’t help but be reminded of another older man in a position of great power who regularly blurts out offensive things that others wouldn’t even think, yet dare say out loud.
Perhaps Watson said some of the things that he did because the echo chamber of social media had yet to come along — although I suspect that wouldn’t have stopped him. Among other targets, he lampooned religious people, those with weight problems, and even scientists like himself:
“The biggest advantage to believing in God is you don’t have to understand anything, no physics, no biology. I wanted to understand.” (answer to student, date not known)
“Whenever you interview fat people, you feel bad, because you know you’re not going to hire them.” (2000, public statement on obesity)
“One could not be a successful scientist without realizing that, in contrast to the popular conception supported by newspapers and mothers of scientists, a goodly number of scientists are not only narrow-minded and dull, but also just stupid.” (The Double Helix, 1968)
But my favorite quote evokes the consequences of what he and Francis Crick accomplished:
“I never dreamed that in my lifetime my own genome would be sequenced.”
Ricki Lewis is a science writer with a PhD in genetics. She regularly contributes articles to PLOS Blogs: DNA Science. She is author of the textbook Human Genetics: Concepts and Applications and The Forever Fix: Gene Therapy and the Boy. Follow her on her website
The science is settled: biological sex is not a spectrum but a binary, and the evidence is undeniable to anyone willing to fairly consider it. So argues evolutionary biologist Colin Wright in a new peer-reviewed article simply titled Why There Are Exactly Two Sexes. Grounding his argument in Darwinian evolution—a theory universally endorsed by the science community—Wright outlines a few basic facts that no serious person disputed until just a few years ago.
In anisogamous species, including humans, sex is strictly defined by the type of gamete an organism’s reproductive system is designed to produce, small sperm for males and large ova for females. This gametic dimorphism, evolved over a billion years ago from isogamous ancestors through disruptive selection, forms the universal basis for the two sexes. “As with the fact of evolution itself,” Wright notes, “contemporary scientific debates have long moved on from questioning whether the sex binary is a fact to questions about how anisogamy evolved, why it persists, and what its evolutionary consequences are.”
Of course, challenges to this consensus are widespread today; even some major science journals have declared their opposition to the sex binary. “The idea of two sexes is simplistic,” Nature famously asserted in 2015, for example. “Biologists now think there is a wider spectrum than that.” The problem with this and similar counterarguments, Wright adds, is that they’re “seemingly driven by cultural and political debates surrounding the concept of ‘gender identity’ and transgender rights.” They don’t introduce new evidence that improves our understanding of sex, they merely try to redefine it to facilitate certain policy outcomes.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPThis biased methodology introduces an even greater problem beyond its factual mistakes: lawmakers, physicians and individuals begin making decisions that cause real harm. As Wright puts it:
Policy disputes should not be adjudicated by redefining—or defining away—the reproductive realities that make sex a useful scientific concept in the first place. When categories are blurred for nonscientific reasons, we invite downstream harms: muddled clinical protocols, compromised epidemiology, eroding and/or conflicting legal protections, and diminished public trust in scienceJoin Dr. Liza Lockwood and Cam English on this episode of Facts and Fallacies as they take a closer look at Wright’s defense of the sex binary.
Dr. Liza Lockwood is a medical toxicologist and the medical affairs lead at Bayer Crop Science. Follow her on X @DrLizaMD
Cameron J. English is the director of bio-sciences at the American Council on Science and Health. Follow him on X @camjenglish
We messaged each other with just three words: “Did you see?” We both knew what the other meant. After years of explaining to friends and family that yes, mRNA has always been in their bodies, and no, it doesn’t change your DNA, we watched as nearly half a billion dollars in research funding vanished with the stroke of a pen (rather, a ‘key’).While the cuts specifically targeted COVID and flu vaccine development, the ripple effects are devastating: the same platform technology, the same research infrastructure, and the same scientific expertise that drives all mRNA innovation are being gutted. The technology that could cure pancreatic cancer, treat cystic fibrosis, and stop the next pandemic was being dismantled based on misconceptions we’ve been fighting for years.
Despite its scientific success, mRNA has found itself at the center of controversy and public confusion since 2020. The recent funding cuts, justified by claims that contradict overwhelming scientific evidence, represent more than a policy shift; they signal a dangerous retreat from one of modern medicine’s most promising tools.
From its role in basic cellular function to its revolutionary applications in medicine, mRNA is not a threat. It’s a tool of hope. Let’s discuss…
The Role of mRNA in Cellular Function and Protein SynthesisMessenger RNA, or mRNA, is a fundamental molecule in our cells. Each cell in our body makes and uses mRNA every day to make protein. mRNA acts as a courier, carrying genetic instructions from DNA to the cell’s protein-making machinery. Every day, our cells produce mRNA to ensure the right proteins are made at the right time, essential for everything from metabolism and immunity to tissue repair.
Think of DNA as a cookbook stored in the cell’s nucleus. mRNA is like a recipe copied from that cookbook and delivered to the kitchen counter (the cytoplasm), where ribosomes (the chefs) read the instructions and cook up proteins.
This elegant process, the transcription of DNA into mRNA followed by translation into proteins, is known as the central dogma of molecular biology.
Harnessing Nature: The Rise of mRNA VaccinesUnderstanding this natural cellular process is crucial because it reveals how scientists have ingeniously harnessed our body’s own machinery for medical breakthroughs. That’s right…researchers have learned to use this natural system to develop mRNA vaccines. (If there’s one message that needs better marketing, it’s this: mRNA vaccines use your body’s natural processes—nothing artificial about it.)
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPThese vaccines teach our cells to produce a harmless piece of a pathogen, like the spike protein of SARS-CoV-2, which then triggers an immune response. This primes the immune system to recognize and fight the real virus if encountered out in ‘the wild’ (think grocery store and soccer games to schools and your place of work).
The success of mRNA vaccines against COVID-19 has ignited innovation into a new era of rapid, adaptable, and scalable vaccine development. Unlike traditional vaccines, mRNA vaccines can be designed and manufactured relatively quickly, without the need to grow pathogens (like viruses) in labs, and have revolutionized vaccine development.
mRNA Technology is a Platform for the FutureThe potential of mRNA technology goes far beyond vaccines for infectious diseases. Current research spans multiple frontiers:
Cancer ImmunotherapyResearchers are developing mRNA vaccines to treat cancers by encoding tumor-associated antigens (TAAs) or tumor-specific antigens (TSAs). These antigens train the immune system to recognize and destroy cancer cells. Clinical trials are underway for melanoma, glioblastoma, breast, prostate, and pancreatic cancers. As an example, a personalized mRNA vaccine for pancreatic cancer that uses a patient’s tumor mutations to train the immune system to prevent recurrence has shown incredibly promising results. Early results from a Phase I clinical trial exhibited immune responses linked to delayed cancer return, supporting the ongoing larger Phase II study.
Rare and Genetic DiseasesResearchers are exploring mRNA-based protein replacement therapies for conditions like cystic fibrosis and metabolic disorders. mRNA could be used to produce missing or defective proteins directly in patients’ cells. For people with cystic fibrosis (CF), a clinical trial currently underway is testing an inhaled mRNA therapy called RCT2100 for patients who have specific genetic mutations that don’t respond to current treatments. This potential therapy aims to restore the function of the cystic fibrosis transmembrane conductance regulator (CFTR) protein in the lungs, targeting the root cause of CF rather than just managing symptoms.
Autoimmune DisordersInnovative approaches using mRNA to induce a ‘do no harm’ signal, or immune tolerance, to immune cells are showing promise. For example, mRNA encoding modified myelin proteins to decrease and/or prevent autoimmune attacks to the myelin sheath surrounding neurons in the brain in multiple sclerosis are under investigation in mice with the future possibility for application in humans.
Combination VaccinesThe flexibility of mRNA technology enables scientists to develop combination vaccines that can protect against multiple diseases in a single formulation. This modular approach allows for more efficient vaccine design targeting multiple pathogens at the same time. Clinical trials have been underway for vaccines targeting flu and COVID-19 simultaneously.
mRNA is a Molecule of HopeThe explosion of mRNA research since 2020 is unprecedented. Thousands of peer-reviewed publications and numerous clinical trials now explore mRNA’s potential across medicine. The infrastructure built during the pandemic, now under threat from funding cuts, could be the foundation for conquering diseases that have plagued humanity for generations.
Isn’t it incredible how something so fundamental to our biology, mRNA, can be engineered to save lives, treat disease, and transform medicine?
Science Under FireWe began drafting this article last week, before the horrific shooting at the CDC headquarters on Friday. Officer David Rose, a father of two with another child on the way, gave his life responding to an attack that left dozens of bullet holes in the buildings where scientists work to protect public health. The National Center for Immunization and Respiratory Diseases—whose buildings took the most bullets—houses the very people who helped develop the vaccines that saved millions from COVID, were literally under fire, reportedly because of anti-vaccine beliefs.
This is where we are now. The misconceptions about mRNA that we’ve spent years trying to correct have metastasized into something deadly. The funding cuts announced Tuesday weren’t just policy decisions; they were an accelerant thrown on already dangerous flames of misinformation.
Friday’s attack targeted the very scientists whose work could one day cure your loved one’s cancer or help a child with cystic fibrosis breathe freely. These researchers have weathered years of online threats and political attacks, and now face actual violence. Yet Monday morning, they’ll walk past the boarded windows and continue their work, because the diseases they’re fighting won’t pause for politics. Something has to change.
When officials eliminate funding while claiming mRNA vaccines “fail to protect effectively,” they don’t just contradict overwhelming scientific evidence. They validate the conspiracy theories that lead to violence. They ignore that these vaccines prevented millions of deaths. They dismiss the children with cystic fibrosis who might breathe easier, the cancer patients whose tumors might disappear, and the lives that could be saved in the next pandemic.
mRNA isn’t just a molecule or a medical tool; it represents our ability to harness nature’s own processes to heal. The infrastructure built during the pandemic, now being dismantled, could have been the foundation for conquering diseases that have plagued humanity for generations.
We face a choice: Do we let fear and misinformation rob humanity of one of its greatest scientific achievements? Or do we stand with the scientists who continue their work despite bullet holes in their windows, who believe that truth and evidence still matter?
The question isn’t whether mRNA technology will transform medicine. It already has. The question is whether we’ll have the courage to defend it, to fund it, and to ensure that those working to save lives can do so without fearing for their own.
Jess Steier is a public health scientist dedicated to bridging the gap between complex scientific evidence and public understanding. Jess is the Founder of Unbiased Science, CEO of Vital Statistics Consulting, and Executive Director of The Science Literacy Lab (a 501c3 non-profit organization). Follow Jess on Substack @drjessicasteier
Aimee Pugh Bernard, PhD is an immunologist, educator, science communicator, and science advocate. Follow Aimee on TikTok @funsizeimmuninja
*A version of this article was originally posted at Unbiased Science and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find Unbiased Science on X @unbiasedscipod*
In 2021, U.S. Sen. Ted Cruz compared critical race theory — an academic subfield that examines the role of racism in American institutions, laws, and policies — to the Ku Klux Klan, the most notorious homegrown terrorist organization in U.S. history. In doing so, he opened a playbook that resembles one put into practice by Florida Gov. Ron DeSantis and others: Attack ideas that are unfriendly to a narrow view of the world, and do so by eliminating them from our school curricula and public conversation. The movement against critical race theory has now swallowed up high school Advanced Placement African American Studies in several states and threatens the teaching of basic facts about U.S. history. And this movement has devolved from pundit tough talk into authoritarian policies to ban books, modify curricula, and threaten intellectual freedom across the country (and world).
By now, many realize that these policies are a harbinger of things to come — even for fields ostensibly unrelated to African American studies, like biology. Modern breakthroughs in biology are producing a picture of life that is increasingly incompatible with authoritarian preferences for neat boxes that dictate what people are and how they should behave. Consequently, biologists must shed the naive belief that our work is apolitical and recognize that the recent attacks on how to teach U.S. history are a battle in a larger war on ideas that includes the natural sciences.
Evolutionary biology in particular is not new to political controversies. Over the past century, it has been at the center of several high-profile legal battles. Most famous are the debates about the teaching of evolution in schools (documented in Brenda Wineapple’s new book on the Scopes trial, and many others). The political tension is generated by the world view that Darwinism presents. The reasoning from evolution deniers: If public education can challenge religious explanations for how life began, then tomorrow it might question the religious basis of good and evil, man and woman, and explanations for how we all got here. And they aren’t wrong. Biology’s increasingly complicated picture of human behavior isn’t so friendly to political stances peddling the myth that one group is essentially inferior to another; and that a deity decides the boundaries around sex, sexual preference, and other dimensions.
Modern breakthroughs in biology are producing a picture of life that is increasingly incompatible with authoritarian preferences for neat boxes that dictate what people are and how they should behave.
While biological sex is a meaningful dimension for millions of species, modern biology has frustrated many classical models for what sex is and how it manifests in nature. In recent decades, evolutionary theorists have offered improvements on models that implied that females were passive actors, driven by interest and competition between males. At our most charitable, we’d call these interpretations naive and imprecise, and they highlight a long tradition of confused thinking on sex and gender that is increasingly subject to scrutiny. And when we consider the added layer of culture in the world of Homo sapiens, then hard rules and expectations regarding sex are on even shakier ground.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPConsiderations of the biology of sexual orientation follow. Evolutionary theory won’t help one argue that, for example, same-sex unions are unnatural and, by extension, immoral. The absence of evidence for a “gay gene” — a discrete genetic signature that could be used to reliably predict sexuality — is compatible with a complex model of human sexual behavior, one without a singular source that can be identified and pathologized.
Biology’s fact-driven dissolution of boxes does not stop there. They even include ones basic to the genetic structure of our species, ones we have long (erroneously) attributed to biological race. The concept of biological race has long been operating, as evolutionary biologist Joseph Thornton once highlighted, like a zombie — deceased, yet magically still ambulating. And new findings quadruple down on how undead it is. We are a species with a complicated genetic history, which includes contributions from Neanderthal, Denisovan, possibly other extinct nonhuman primates, and profound admixture resulting from our very recent history. Our patchwork genomes are a signature of historical wanderlust and widespread interbreeding, rather than simple stories of adaptation to explain why, say, Brazilians excel at soccer and the Japanese at baseball. Biology has a hard time telling us how to categorize people into nested anythings, let alone justify mistreatment based on group characteristics.
Whereas modern science isn’t so good for the racist imagination, a bevy of other forces empower the bigots. Fear, insecurity, and xenophobia are rather easy to provoke in people, and “us vs. them” is one of the oldest rallying cries in human history. This has been front and center in modern politics. The most widely shared moment in the September 2024 presidential debate between candidates Kamala Harris and Donald Trump might have been the latter’s racist account of an Ohio town supposedly overrun by immigrants, mixed in with inflammatory rhetoric about immigration in the United States.
The authoritarian’s world runs on a script resembling that of a poorly written children’s book: It insists that innate differences between groups are real and inflexible; that ideas and behaviors are essentially good or bad; and that there is a purely righteous way to live, love, govern, work, pray, and build a household. Authoritarianism requires straightforward narratives, something biology is lousy at generating. And this inability to kowtow to fairy tales is a trait it shares with the responsible study of U.S. history.
Nearly two and a half centuries ago in America, educated White men held a series of meetings to develop a set of documents that would shape everything about the world we live in. An understanding of racism’s imprint on these foundational documents and the policies that followed — such as the ones that built America’s education system, voting laws, housing laws, and many other facets of life — requires that we disabuse ourselves of a deep-cleaned version of American history. The messier narrative — one that centers stories of the poor, of women, of Indigenous people, and of enslaved Americans — is necessary for a technically sound picture of our past and present. And this is precisely why African American history was among the first targets in this modern war on thinking. The authors of this regressive movement recognize that an accurate teaching of what America is, one that requires fields like African American studies, constitutes a threat to their binary story of who belongs and who doesn’t.
Biology has a hard time telling us how to categorize people into nested anythings, let alone justify mistreatment based on group characteristics.
I propose that modern biology functions in a manner similar to U.S. history, in that the more complex story is the one we should learn to accept. Biology can reveal profound truths about what life is, and aspects of who we are as a species. But this science tells us nothing about which immigrant groups we should welcome, what biological sex has to do with household chores, or why two adults of the same sex can’t raise children together as a happy and healthy family. The modern science of biology isn’t so good at bins and boundaries, and it threatens to rain on the simple-minded parade of authoritarian politics.
Today, many are attempting to ban an understanding of how the legacy of Jim Crow segregation and associated attitudes lurk in our laws. In the near future, we should not be surprised if the same cast of characters castigates biology for the similar crime of accurately describing the world we live in.
C. Brandon Ogbunu is an assistant professor in the Department of Ecology and Evolutionary Biology at Yale University and is an external professor at the Santa Fe Institute. Find C. Brandon on X @big_data_kane
A version of this article was originally posted at Undark and is reposted here with permission. Any reposting should credit both the GLP and the original article. Find Undark on X @UndarkMag
In July 2012, a renegade American businessman, Russ George, took a ship off the coast of British Columbia and dumped 100 tons of iron sulfate dust into the Pacific Ocean. He had unilaterally, and some suggest illegally, decided to trigger an algae bloom to absorb some carbon dioxide from the atmosphere — an attempt at geoengineering, a tech-based approach to combating climate change. It was a one-off, the largest known geoengineering experiment at the time, and a harbinger for more to come.Now a startup called Stardust seeks something more ambitious: developing proprietary geoengineering technology that would help block sun rays from reaching the planet. Stardust formed in 2023 and is based in Israel, but incorporated in the United States.
Its approach is novel: Most geoengineering research today is led by scientists in the U.S. at universities and federal agencies, and the work they are doing is more or less accessible to public scrutiny. Stardust is at the forefront of an alternative path: One in which private companies drive the development, and perhaps deployment, of technologies that experts say could have profound consequences for the planet.
Geoengineering projects, even those led by climate scientists at major universities, have previously drawn the ire of environmentalists and other groups. Such a deliberate transformation of the atmosphere has never been done, and many uncertainties remain. If a geoengineering project went awry, for example, it could contribute to air pollution and ozone loss, or have dramatic effects on weather patterns, such as disrupting monsoons in populous South and East Asia.
But as global temperatures rise, public and scientific sentiments are shifting. If those temperature trends continue, governments or private entities may ultimately use geoengineering to alleviate or avoid the worst impacts of extreme weather, including deadly heat waves, firestorms, and hurricanes. And whoever deploys the technology will need to keep it up for decades while pent-up greenhouse gases gradually dissipate or are removed.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPFew outsiders have gotten a glimpse of Stardust’s plans, and the company has not publicly released details about its technology, its business model, or exactly who works at its company. But the company appears to be positioning itself to develop and sell a proprietary geoengineering technology to governments that are considering making modifications to the global climate — acting like a kind of defense contractor for climate alteration.
Stardust is moving ahead amid few national and international rules and oversight, and a recent report by the company’s former climate governance consultant, Janos Pasztor, called for the company to increase its transparency, engagement, and communication with outsiders. The report provides rare insight into the so-far reticent company. But, so far, Pasztor told Undark, the company has not met all of his requests. Stardust still needs to implement his recommendations, and “be as transparent as possible, be available proactively to respond to questions people may have, and also to engage with other actors,” he said, because they do not, or not yet, have a “social license” for geoengineering activities.
Such a deliberate transformation of the atmosphere has never been done, and many uncertainties remain.
The company is led by CEO and cofounder Yanai Yedvab, a former deputy chief scientist at the Israel Atomic Energy Commission, which oversees the country’s clandestine nuclear program. Through Eli Zupnick, a communications officer hired by the company, Yedvab never accepted Undark’s many requests for an interview. But in an emailed statement to Undark sent via Zupnick, Yedvab wrote: “Stardust is a startup focused on researching and developing technologies that may potentially stop global warming in the short term.” The company, he continued, is “studying and developing a safe, responsible, and controllable solar radiation modification” and “our goal is to enable informed and responsible decision making of the international community and governments.”
Despite Stardust’s low profile, the company rejects being referred to as “secretive.” “Publishing all the products of our research without any exception is critical,” Yedvab wrote, adding that the company is “unwaveringly committed” to publishing results “as one of the measures to gain public trust.” Stardust has not published any of its research at this time, but Yedvab stressed they will do so once “scientific validation is concluded” on all of their results.
For decades,researchers have explored a variety of approaches to hacking the climate. Today, the most common approach is a type of solar geoengineering that involves flying high-altitude aircraft or balloons to release reflective particles in the high atmosphere, well above the flight paths of commercial planes. The technique, known as stratospheric aerosol injection, requires deploying tiny, carefully- chosen particles in precise amounts. In order to work well, the particles need to be periodically replenished.
Scientists have accumulated evidence for this approach by studying natural events that have flung small particles into the atmosphere. For instance, after an eruption of Mount Pinatubo in 1991, sulfur dioxide and hydrogen sulfide hung in the atmosphere and measurably cooled the planet for more than a year.
The 1991 eruption of Mount Pinatubo, seen from Clark Air Base in the Philippines. Sulfur dioxide and hydrogen sulfide emitted during the eruption measurably cooled the planet for more than a year. Visual: Richard P. Hoblitt/USGS
Thanks to studies of that volcanic activity, some scientists argue that the environmental risks of deliberately strewing sulfates in the atmosphere are well understood. Although there are potential health risks from the approach, they say, they are small in comparison to the health risks from climate change. “We know that sulfuric acid air pollution causes mortality, and we roughly know how much. There’s more than a century of studies. We’re very unlikely to be wrong about that,” said David Keith, head of the Climate Systems Engineering initiative at the University of Chicago and an advocate of geoengineering research. In a new study, Keith and his colleagues argue that the health risks of sulfate particulates in the atmosphere are heavily outweighed by the potential impacts of not deploying geoengineering technologies.
Stardust plans a similar approach, but with a proprietary aerosol particle that’s less well understood, in Keith’s view. The company plans to distribute the particles through a machine mounted on an aircraft, according to Pasztor, a veteran climate diplomat and policy expert at the United Nations and elsewhere. According to Pasztor’s report, which he published on LinkedIn in September 2024, the company is engineering the particle and a prototype of the aircraft mount, as well as developing a system for modeling and monitoring the climatic effects. Over the coming year, Pasztor wrote, the company is planning on advancing those technologies and testing those particles in the stratosphere.
Yedvab confirmed that they are working on the technologies, saying in a statement to Undark that any such experiment would be done in a “contained, non-dispersive manner,” meaning that its particles would not be strewn over a wide area. It also committed to publishing information about any such outdoor geoengineering tests. Yedvab said that the company has not performed any such outdoor experiments yet, but it has done “a few outdoor aerial checks.” That meant that they have tested their dispersal system “under flight conditions,” but they haven’t yet scattered their aerosols in the atmosphere.
Those experimental particles do not appear to involve sulfates, meaning there is little data showing how well they might work. “It might be better in some respects, but on the other hand it’s going to be much harder to be confident about knowing what its risks are,” Keith said.
In his emailed statement, Yedvab confirmed the company is testing non-sulfate particles: “The ability to tailor particle properties to meet a broad set of requirements — safety, effectiveness, cost, and dispersibility — is a key advantage of our approach, giving it a distinct edge over sulfates and other candidate particles.”
As Stardust continues its research and development, it has drawn scrutiny, including from Pasztor. After retiring as a veteran climate diplomat, Pasztor agreed to work with Stardust in 2024 as an independent consultant. Rather than keep the remuneration for his work, he instead donated the entirety of it to the United Nations Relief and Works Agency for Palestine Refugees, or UNRWA, he told Undark.
The aim of Pasztor’s project was to highlight the need for clear international rules and oversight for geoengineering. He also wanted to make recommendations for Stardust — and for any other such geoengineering company — about how to ethically develop and deploy its technology.
Right now, there are no international rules or treaties that put obvious limits on this kind of work. As a result, an individual company or government can take dramatic gambles with the climate, in ways that could affect billions of lives, and it doesn’t have to get permission from anyone to do it.
According to Pasztor’s report, there should be rules that allow more people to be involved in that decision before it happens. Failing that, he said, Stardust should voluntarily tell the public what it’s doing and make sure it’s getting input from lots of different groups of people before it tinkers with the planetary thermostat.
“There’s one big area, transparency and outreach, to engage with the rest of the world, to the extent that the IP process allows,” he told Undark. Building trust through “a strategy of maximum transparency” should become a priority for them, he recommended in the report.
In September 2024, Stardust’s former climate governance consultant, Janos Pasztor, published his report on the company via LinkedIn. Pasztor’s report, which includes several recommendation sections like the one shown here, calls for the company to increase its transparency, engagement, and communication with outsiders.
Stardust agreed to publish a public website, including providing a copy of Pasztor’s report, and to develop a voluntary code of conduct, he said. That would publicly lay out how they intend to conduct their research and development, including agreeing not to be involved in large-scale implementation, which would instead be under the purview of government agencies. Pasztor expected Stardust to publish this information last September or soon afterward .
For a while, though, no website appeared. “They were going to publish all of that on their website. Now they are delayed,” he said during a conversation in January. “Come on guys, this is getting embarrassing.”
In early February, while Undark was reporting this article, Stardust published a bare-bones website. The site links to Pasztor’s report and lists seven principles, including “prioritizing safety and scientific integrity,” publishing “unfavorable results as well as favorable ones,” and “supporting comprehensive regulation of this emerging field.”
“Come on guys, this is getting embarrassing.”
The site doesn’t describe who works for the company, but a statement provided to Undark by Zupnick noted that Stardust has 25 physicists, chemists, and engineers on the team and listed some of the company’s leadership: Yedvab, the CEO; chief product officer Amyad Spector, a physicist and a former employee of the Israeli government’s nuclear research program; and lead scientist Eli Waxman, an astrophysicist at the Weizmann Institute of Science who formerly served as Spector’s academic supervisor.
Stardust has not yet released a code of conduct, which the company described to Undark as “guiding principles” that “represent a set of voluntary commitments we have adopted in the absence of a dedicated regulatory framework.” In an email sent to Undark by Zupnick, Yedvab stressed that the company complies with all applicable governmental and international regulations.
Some groups, however, like the Center for International Environmental Law, say that Stardust’s efforts could violate the Convention on Biological Diversity’s de facto moratorium on geoengineering activities. “By developing and planning to commercialize solar geoengineering technology, Stardust is accelerating a reckless race and potentially violating agreements of the Convention on Biological Diversity,” said CIEL’s geoengineering campaign manager, Mary Church, in a statement in February. Any deployment of the technology, Church wrote, would likely “be controlled by a handful of major powers and corporations.”
Stardust’s prospective clients seem to be governments: As countries consider geoengineering, Stardust could be poised to sell them tools to meet those goals, several experts said. In an emailed answer to questions about its business model, Yedvab described the company’s approach as “founded on the premise” that solar geoengineering “will play a critical role in addressing global warming in the coming decades.”
The company’s portfolio of technologies, Yedvab added, “could be deployed following decisions by the U.S. government and international community.”
The company is attempting to patent its geoengineering technology. “We anticipate that as U.S.-led [geoengineering] research and development programs advance, the value of Stardust’s technological portfolio will grow accordingly,” Yedvab wrote. Pasztor’s report adds that if governments decide not to pursue geoengineering, investors “risk not receiving a return on their investment.”
The prospect of proprietary, privately held geoengineering technology worries some experts. Pasztor recommends that Stardust work with its investors to explore ways to give away their intellectual property, akin to how Volvo made its patented three-point seatbelt design freely available to other manufacturers 60 years ago. Alternatively, Stardust could work with governments to purchase the full rights to the IP, who can then make the technology freely available themselves.
In any case, Pasztor argues, Stardust can only proceed in an ethical manner if they do so with full transparency and independent oversight: “They are operating in a vacuum, in the sense that there is no social license to do what they are trying to do.”
Other experts have also questioned Stardust’s conduct so far. When it comes to principles of governance, like transparency and public engagement, “they’re not adhering to any of them,” said Shuchi Talati, founder of The Alliance for Just Deliberation on Solar Geoengineering, a Washington D.C.-based nonprofit. “Pasztor’s report is the only public thing we know about them,” she added. Stardust did not do any public consultation for its outdoor field tests, nor has it released any data or other information about them, Talati said. And that lack of transparency could come with consequences for the company, she argued, as Stardust’s approach may spark conspiracy theories about what a “secret Israeli company” is doing, and down the road, it will be much harder for people to trust Stardust.
“They are operating in a vacuum, in the sense that there is no social license to do what they are trying to do.”
A better approach, Talati argued in a paper published in January, is for Stardust to be communicative and build trust as early as possible, disclosing what it’s doing and with whom it’s engaging. The company’s funders, she argued, should disclose the scope of the work they’re funding as well.
People at Friends of the Earth, an environmental group that has long dismissed geoengineering as a “dangerous distraction,” echo Talati’s concerns and go further with their critiques of Stardust. “I don’t think it’s compatible to have venture capital funding and to be committed to scientific ideals,” said Benjamin Day, FOE’s senior campaigner on geoengineering. The problem, in his view, is that Stardust’s engineers have a vested interest in finding that stratospheric geoengineering can and should be done.
If governments choose to use geoengineering, they may become heavily dependent on Stardust if they’re ahead of the competition — of which there currently is none, Day said. “There’s no private market for geoengineering technologies. They’re only going to make money if it’s deployed by governments, and at that point they’re kind of trying to hold governments hostage with technology patents.”
If any geoengineering technology goes live, it will affect the whole world. The U.S. federal government is even developing an early warning system that could detect geoengineering in the stratosphere. Furthermore, deploying geoengineering means using and monitoring it for as long as a century, while any abrupt adjustment or end of that deployment could be disruptive, with “termination shock” triggering dangerous global warming within months.
Geoengineering research has long been entangled with national defense, said Kevin Surprise, a professor of environmental studies at Mount Holyoke College who studies the economics and geopolitics of geoengineering. Some of the first geoengineering papers in the late 1990s came from institutions with Pentagon ties, like Lawrence Livermore National Lab and the Hoover Institution. High-profile geoengineering meetings with the George W. Bush administration and the Council on Foreign Relations, as well as a mention in a Department of Defense report soon followed, and the CIA reportedly funded the first geoengineering report from the National Academies of Sciences, Engineering, and Medicine.
Because of the longstanding connections between geoengineering research and development, the military, and Silicon Valley, Surprise argues, Stardust shouldn’t be viewed as a rogue actor. “This isn’t out of the blue,” he said.
Researcher Duncan McLaren suspects the company is following a standard procurement model of the defense industry, where governments get technology from a few companies that develop it mostly in secret.
In Stardust’s case, they’ve received an estimated $15 million in venture capital funding, primarily from Awz Ventures, Canadian-Israeli VC firm, in addition to a small investment from SolarEdge, an Israeli energy company. Neither company responded to Undark’s requests for comment.
Stardust said that it receives no funding from the Israeli Defense Ministry, and made clear to Pasztor that it has no connection to the Israeli government. Awz’s partners and strategic advisers have strong ties to Israeli military and intelligence agencies, including former senior directors of agencies like the Mossad, Shin Bet, and Unit 8200, as well as of the CIA and FBI, according to its website. Awz also invests in AI-based surveillance and security tech in Israel, such as through the company Corsight, which has provided facial recognition tech for Israel’s war in Gaza.
Defense scholars and security experts don’t see geoengineering technology as a potential weapon, but they do view it as something a government might use for its advantage, and as something that would disrupt international relations, said Duncan McLaren, a researcher with the Institute for Responsible Carbon Removal at American University. McLaren suspects the company is following a standard procurement model of the defense industry, where governments get military technology from a few monopolistic companies like Boeing and Lockheed Martin that develop it mostly in secret.
“That tends to be a space in which public involvement in decisions is utterly sidelined,” McLaren said, and there is “the potential for this to be a highly undemocratic process of moving us down a slippery slope to solar geoengineering.” If humanity needed this technology, he added, “I definitely want it to be controlled democratically.”
Ramin Skibba is an astrophysicist turned science writer and freelance journalist who is based in the Bay Area. Find Ramin on X @raminskibba
A version of this article was originally posted at Undark and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Undark can be found on X @undarkmag
RFK Jr. released a video addressed to the Minamata Convention on Mercury where he lied about vaccines. Again. And again. The same lies he has been spreading for over twenty years. Twenty years. This man has been lying—and causing preventable deaths—for decades, while making millions and millions of dollars from it.
As someone who has been so painfully aware of how much of a global health threat RFK Jr is, it pains me that so many media outlets, members of the public, and politicians just glossed over his career of lying about life-saving health issues.
Anyway, I digress.
He told the COP6 delegates that now that he has ensured no American have access to vaccines containing thimerosal, he was taking his plan global. This isn’t shaping policy, it’s propagating a deadly lie.
If you recall, he announced a policy earlier this year to ban all thimerosal-containing vaccines here in the US, even though thimerosal is an incredibly safe and effective antimicrobial that prevents contamination in multi-dose vaccines.
He said that “no amount of mercury should ever be injected into a child” and urged the treaty to push for a global ban on thimerosal-containing vaccines.
Thankfully, the Minamata Convention is not staffed with unqualified anti-science profiteers like RFK Jr, but this one statement alone sums up everything wrong with RFK Jr’s war on science.
Samoa was the real-world case study: when RFK Jr’s lies spread faster than the truth, children die. We know the damage this will cause. We’ve seen what happens when RFK Jr’s anti-vaccine lies target people, like in Samoa, where his lies killed more children in a month than thimerosal ever has.
His thimerosal lies will kill children, especially the most vulnerable.And though scientific experts globally (real ones, not cosplaying grifters like RFK Jr and his ACIP appointees) understand basic chemistry, the difference between thimerosal and mercury, and vaccine safety data, RFK Jr posted this on social media, which means his lies have the potential to influence public opinion and behaviors.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPLet’s get into it.
RFK Jr’s central lie: pretending all “mercury” is the same to scare peopleFor decades RFK Jr has refused to learn basic chemistry. In fact, he hasn’t changed his language even when legitimate experts have, in good faith, tried to educate him.
A note: you will continue to see me say “lies” when referring to his claims: he says falsehoods deliberately, knowing they are false. That is the definition of a lie. I don’t care about media outlets sanitizing him, sane-washing him, trying to talk out of both sides of their mouth. It is long past the time of politeness. He is killing people—and making millions of dollars at the same time.
Like with all chemophobia, his argument relies on people believing that any and all chemical compounds that include an atom or ion of mercury are 1) the same and 2) dangerous in all instances.
This is chemically, biologically, and toxicologically wrong.He’s financially and ideologically invested in being wrong — he even published a book amplifying these lies (with his anti-science grifting buddy Mark Hyman right there beside him).
But here’s the reality:
Thimerosal is not mercury. It prevents dangerous bacterial and fungal contamination in vaccines.Thimerosal keeps vaccines safe—it does not make vaccines dangerous.
Thimerosal is a chemical compound with formula C9H9HgNaO2S. The IUPAC name for thimerosal is Ethyl(2-mercaptobenzoato-(2-)-O,S) mercurate(1-) sodium.
That sure doesn’t sound like “mercury” does it?
Thimerosal was developed in the 1920s and is a very effective antimicrobial, meaning it prevents contamination with harmful bacteria and fungi.
Thimerosal is so effective only a miniscule amount is needed. It can inhibit microbial growth at concentrations of 0.001% to 0.01% w/v (weight/volume). In a vaccine vial, this would equate to 50 micrograms (µg) of thimerosal (containing 25 µg mercury ion) per 0.5 mL vaccine dose. This is why it is used to prevent bacterial contamination in multi-dose vaccines.
Thimerosal, also called Ethyl(2-mercaptobenzoato-(2-)-O,S) mercurate(1-) sodium, with the chemical formula C9H9HgNaO2S.I’m sure you can see that C9H9HgNaO2S is not the same as mercury. Chemicals are not the sum of their parts. These bonds dramatically change everything about a chemical compound. That’s why table salt, sodium chloride (NaCl), doesn’t explode when you put it in water. Sodium explodes when you put it in water, though!
- Claiming thimerosal is mercury is like saying water (formula H2O) is hydrogen gas (H2).
- Or that glucose (C6H12O6) is the same as diamonds (a lattice structure of C atoms) because it has carbon in it.
- Or that air, a mixture of gases, is nitrogen gas.
If anti-vaccine activists actually applied their own “logic,” they’d be warning people that table salt explodes in water. Funny how chemistry errors only show up when there’s profit involved.
Mercury is a pure chemical element, a metal with formula Hg⁰Yep, that’s it. A pure metal. Elemental mercury is the silver liquid metal (yes, the only metal that is liquid at room temperature and pressure) that used to fill thermometers.
Actual mercuryMercury poisoning can occur through exposure to mercury metal. Today, this risk is primarily if you inhale mercury gas (liquid mercury that has been vaporized). This potential exposure is mostly a concern for people who work in industries that use mercury metal—for example, mercury is used to catalyze chemical reactions to extract gold from ore.
Elemental mercury poisoning can be quite serious, because metal mercury can accumulate in your body and can cross the blood-brain barrier at high enough exposures. It can lead to neurological damage, kidney damage, and even death.
Elemental mercury? Never used in a vaccine, ever.
Methylmercury CH₃Hg⁺ is a mercury-containing compound with legitimate health concernsMethylmercury is also not thimerosal. Methylmercury can also cause mercury poisoning. It is an organic mercury compound created by bacteria through methylation of environmental mercury from volcanic eruptions, burning of fossil fuels and coal, and other industrial processes. Methylmercury is found in the environment ubiquitously; almost everyone has a small amount in their bodies.
It can bioaccumulate, crosses the placenta and blood-brain barrier, and in high doses can cause neurological damage.
Methylmercury? Also never used in a vaccine, ever.
Ethylmercury (C₂H₅Hg⁺) is an entirely different mercury-containing compound that’s a metabolite of thimerosalThimerosal happens to be a salt, which, in chemistry terms, means it is an ionic compound that dissociates in water into its respective positive (cation) and negative (anion) ions.
The positive ion is ethylmercury, with formula C₂H₅Hg⁺. Ethylmercury is not methylmercury. The names might sound a little similar, but the differences are vast.
Ethylmercury is a larger structure, and unlike methylmercury, is rapidly metabolized and eliminated from the body. It does not bioaccumulate. It is not associated with any neurological issues, including autism, seizures, neurodevelopmental delays, cognitive disorders, and more. It is also not linked to other symptoms associated with mercury poisoning that occurs with high exposure to elemental and methylmercury.
Ethylmercury (rather, thimerosal) is associated with making vaccines accessible and safe for billions of people globally.RFK Jr pretends that thimerosal and its ethylmercury byproduct are identical to methylmercury. This is chemically illiterate and dangerously ignorant, and even though he has been corrected on this for over two decades, he is now trying to make his grift the official position of US health leadership.
The most ridiculous part? RFK Jr is directing his demand for a global thimerosal ban at an organization that couldn’t care less about ethylmercury, underscoring how ignorant he really is.
The Minamata Convention does not care about ethylmercury or thimerosal.The Minamata Convention was adopted in 2013 to address environmental persistence of mercury. Specifically, this relates to elemental mercury and methylmercury (you know, the one that is constantly forming in the environment and bioaccumulates).
Methylmercury is why the Minamata Convention is so named.
It’s named for the Minamata Bay tragedy and Minamata disease, a condition resulting from severe methylmercury poisoning.
For those not familiar, Minamata disease was a result of widespread methylmercury poisoning through environmental exposure.
Between 1932 and 1968, industrial wastewater containing inorganic mercury (that was used to catalyze chemical reactions) was discharged into Minamata Bay, where microorganisms converted it into methylmercury — the form that bioaccumulates and causes neurological devastation.
This methylmercury accumulated in fish and shellfish in the local waters at much greater levels than what occurs naturally (from those processes noted above).
People and animals who consumed fish and shellfish from these waters experienced severe mercury poisoning. Children born to people who had mercury poisoning had congenital effects including microcephaly, brain damage, and symptoms similar to neurological disorders like cerebral palsy.
Minamata disease was first characterized in 1956 in a 5-year old girl who had difficulty walking, speaking, and presented with seizures. From there, additional cases were quickly identified in a geographic cluster. Unfortunately (and unknown to them at the time), people in these coastal villages had been exposed to high levels of methylmercury for years. In 1959, the cause was identified to be long-term exposure to high levels of methylmercury.
The efforts of the Minamata Convention are aimed at phasing out use of elemental mercury in batteries, lamps, and as a chemical catalyst.
It has zero to do with a thiosalicylate salt that is a safe and effective vaccine preservative, critically important for multi-dose vaccines where contamination is a risk. If you ban thimerosal, you don’t eliminate mercury, you eliminate vaccines.
The bigger issue?
RFK Jr’s lies about thimerosal, now directed at the Minamata Convention, undermine global vaccine efforts.In fact, the Minamata Convention explicitly exempts thimerosal-containing vaccines from their scope, because real experts understand vaccines are life-saving. There is no health concerns related to thimerosal-containing vaccines.
This will cost children their lives, even if countries ignore RFK Jr. because his lies are out there and we live in a world where fear matters more than facts.
Countless countries globally use multi-dose vaccines that contain thimerosal. Why? Because multi-dose vaccines offer substantial benefits, particularly among underserved and low income countries.
Multi-dose vaccines are more cost-effective to manufacture, about 2.5 times less costly per dose than single-dose vaccines.
Multi-dose vaccines require less cold storage volume per dose (about 50% less) which is significant in regions with inconsistent access to refrigeration.
Multi-dose vaccines reduce the cost of transport per vaccine dose—so in developing nations with infrastructure limitations, this also reduces barrier to access vaccines.
UNICEF can procure inactivated polio vaccine at $1.25 per dose for multi-dose vaccine compared to $2.80 per dose for single-dose vaccines. When you are talking about low income countries, that 124% difference in cost per dose is substantial.
I know MAHA and RFK Jr. don’t care about these people, but you should.
You should also care about what happens when infectious diseases aren’t controlled by vaccines in one country—because contrary to discourse on social media, pathogens don’t adhere to country borders. Disease anywhere becomes risk everywhere. That’s how outbreaks go global. It’s exactly why we are losing our measles-free status here in the US, only twenty-five years after we eliminated it through vaccination efforts.
Many vaccines contain thimerosal, especially formulations used in low- and middle-income countries.These include:
- Inactivated influenza vaccines
- DTP (diphtheria, tetanus, pertussis) vaccines, used in many Gavi-supported countries as it is much lower cost than the DTaP vaccine
- Tetanus toxoid (TT), DT, and Td vaccines
- Multi-dose hepatitis B vaccines
- Meningococcal vaccines, especially those used in Africa’s meningitis belt
Vaccination saves between 3-5 million lives every year. RFK Jr is deliberately undermining this.RFK Jr is trying to accelerate fear of vaccines. What do you think will happen? You already know, because it happened here in the 1990s. People will be afraid of vaccines that contain this safe and effective preservative.
If they are afraid of those vaccines, they will refuse to receive them for themselves and their children. If vaccine rates decline, that means more preventable illness and death. It also means increased spread of those preventable infectious illnesses that are transmitted person-to-person. Increased spread means more outbreaks, harder to control infections, increased demand on healthcare infrastructure, which will strain healthcare systems so badly that people with unrelated medical needs suffer too.
It also means increased chance of microbial mutation and evolution, potentially opening the door to new strains of pathogens.
Thimerosal has been studied extensively. It is not linked to any neurological issues.
If you live in a country that offers thimerosal-containing vaccines, do not be concerned: your vaccines are safe and effective. The benefits of vaccination far outweigh even a hypothetical risk of miniscule exposure to thimerosal.
If RFK Jr gets his way and countries move to “ban” thimerosal-containing vaccines, nearly 150 million children every year will lose access to life-saving medicines.For decades, RFK Jr. and his MAHA allies have worked to unravel that progress. His latest move will accelerate the damage. We cannot allow blatant falsehoods to shape science, medicine, and public policy.
RFK Jr. is a threat to global health.His personal crusade, now cemented in federal policy and amplified as the “official voice of US health agencies”, is reckless, self-serving, and deadly. Science is not the threat. His ignorance is.
Dr. Andrea Love, a microbiologist and immunologist, provides the facts (and the data!) on science and health topics. Follow Andrea on X @dr_andrealove
A version of this article was originally posted at Immunologic and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article.
US obesity rates are falling from a record high after steadily climbing since the 1960s, dropping to 37 percent this year from a peak of just under 40 percent in 2022. This downturn tightly correlates with a surge in the use of blockbuster weight-loss drugs like Ozempic and Zepbound—which have more than doubled since 2024, resulting in roughly 7.6 million fewer obese adults, according to Gallup. This positive trend underscores obesity’s responsiveness to pharmacological intervention, bolstering arguments that it behaves as a treatable medical condition rather than mere lifestyle failure.Critics aren’t convinced, however. They contend that obesity is a behavioral abnormality and a risk factor for real diseases, not a discrete pathology. Writing in the journal Nature in 2014, Dr. David Katz summed up this perspective. “Our bodies, physiologies and genes are the same as they ever were,” he argued. “What has changed while obesity has gone from rare to pandemic is not within, but all around us.” In short, an abundant food supply and marked decrease in physical labor over recent decades have turned a normal physiological response—storing excess calories for later use—into a public health threat. Humans are wired for an environment characterized by energy scarcity, where intense exertion is required to gather the calories necessary for survival, a dynamic that persisted well into the 20th century.
Proponents of the disease model of obesity, including the American Medical Association (AMA), which classified obesity as a disease in 2013, emphasize its complex etiology: genetic predispositions, hormonal dysregulation (e.g., leptin resistance) and socioeconomic barriers contribute to energy imbalance, akin to hypertension or diabetes. Advocates also say recognizing obesity as a disease destigmatizes patients, enhances insurance reimbursement for treatments and spurs research funding—vital as obesity drives comorbidities like cardiovascular disease and type 2 diabetes.
So, is obesity a disease or a harmful lifestyle choice? Are those two definitions mutually exclusive? Join Cam English on this episode of Facts and Fallacies as he examines the obesity-disease hypothesis.
Cameron J. English is the director of bio-sciences at the American Council on Science and Health. Follow him on X @camjenglish
Three hundred fifty thousand of you are predicted to die every year from heart disease caused by exposure to plastics, a new Lancet study says. But you can rest easy: the headlines don’t match the threat. You are unlikely to be in a bag, plastic, or otherwise, anytime soon. Here’s why.Lately, the press has feasted on a new Lancet article that concludes that about 350,000 of you are going to die yearly from heart disease brought about by long-term ingestion of di-2-ethylhexylphthalate (DEHP), a chemical used to soften plastics. The good news is that the study’s data are hardly convincing. Why? We need to look at the good and the bad – the numbers behind the study and how they were used.
The claim
The authors claim that in 2018 about 356,000 people, aged 55-64, died from heart disease caused by DEHP, one of many plastic-softening chemicals that belong to the class of organic chemicals called phthalates. This number represents about 13.5% of all heart disease deaths. If true, this is pretty bad. But is it? Don’t go hurling your Tupperware out the window just yet.
DEHP (and other phthalate analogs) have long been poster children of the anti-plastic/anti-chemical movements. Countless studies of phthalates, many of them junk, have been published, raising concerns that they can potentially interfere with hormones and affect metabolism (aka “endocrine disruptors”). The studies — mostly from the U.S. — have postulated links between phthalate exposure and conditions like obesity, diabetes, and heart disease.
The idea behind this new study was to estimate whether DEHP might be contributing to cardiovascular deaths globally, and if so, and if so, how much — especially in light of efforts like the Global Plastics Treaty, which aims to curb plastic pollution and its health effects. Keep the word “estimate” in mind.
For the study the researchers built a computer model and used available data on DEHP exposure levels –based on urinary metabolites– from biomonitoring studies conducted U.S., Canada, Europe, and parts of Asia and Africa, as well as published meta-analyses. Where no data existed, they estimated exposure levels using regional averages, looking for associations between average cardiovascular death rates in 55–64-year-olds and estimated DEHP exposures in the population
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPDoes this study mean anything?
This depends on whether you consider a hazard ratio (HR) of 1.10 meaningful. In English, an HR of 1.10 means that there is only a 10% difference between two groups that are being compared, a very small difference by any measure. In this case It means that there was a 10% increased risk of cardiovascular death associated with higher DEHP levels. But even this number may be overstated (or possibly understated) depending on how well the retrospective study used appropriate controls to rule out confounders – uncorrected variables that can impact the HR significantly. More on this below.
This figure wasn’t newly calculated. It came from an earlier U.S. study of about 5,300 people aged 55–64 in the NHANES database, who had their urinary phthalate levels measured and were followed over time to track mortality. The global study then applied this same 10% risk estimate across nearly 1 billion people worldwide in that age group in 2018 — regardless of country, health system, lifestyle, or environmental conditions, and came up with the number.
Positives: A very large study population
The study’s strength lies in its massive scale. It pulled together mortality and chemical exposure data from around 200 countries, helping spotlight areas — especially South Asia and the Middle East — with disproportionately high estimated exposures. This type of global modeling is useful for setting public health priorities, particularly where local data is scarce. It looks for trends, but not as good looking for specific numbers.
Negatives: Confounders and questionable assumptions
The negatives appear to badly outweigh the positives, so is the study’s estimate meaningless? No, it’s not — but it’s very far from definitive either. Here are a few issues:
- The conclusion is built on a single modest sized (~5,000) U.S.-based study with a very low HR, and applied broadly using assumptions that may not hold across diverse populations.
- For example, smoking is far more prevalent in Asia than in the US. This could result in the overstatement of the impact of DEHP in Asia because the excess deaths that are attributed to DEHP could arise from more tobacco use instead. This is probably the most important cofounder and probably the biggest weakness of the study.
- There is no correction for the differences in public health and healthcare access in the US and other parts of the world. Much higher statin use in the US compared to other countries could result in an artificially high low CV death in here, but obesity and other metabolic diseases could push the numbers in the opposite direction.
- Adding to the uncertainty, the model included a 10-year time lag between exposure and outcome — comparing DEHP levels from 2008 to cardiovascular deaths in 2018. This also introduces more room for error, since many other factors — like diet, pollution, smoking rates, and access to care — also changed during that time and weren’t accounted for.
- DEHP exposure wasn’t measured directly. Instead, researchers used four urinary metabolites as proxies, introducing individual or group metabolism as another possible confounder.
Because the model doesn’t account for these differences across countries, it may be attributing cardiovascular deaths to DEHP that are actually caused by well-known risks like smoking or poor healthcare access.
More on hazard ratios
For a typical retrospective study the rule of thumb is that an HR of 2.0 (double the risk) is likely to be meaningful, but the closer the number is to 1.0 the less valid any conclusion will be. Although the confidence interval here excludes 1.0 — making the result technically statistically significant — the effect is still marginal.
Also, the HR is reported as 1.10 (95% CI 1.03–1.19). The fact that the HR resides within the confidence interval (CI) means that the results are statistically significant but quite possibly not clinically significant. (If the HR is not within the confidence interval the results are not significant.) Even though this is not the case in this study, the fact that some of the participants had an HR of 1.03 (a 3% difference) is most likely a measuring of nothing real.
Bottom line
Don’t get me wrong. I think that there is WAY too much plastic produced and used globally and this is a serious problem if only for environmental concerns, even if there were no health concerns at all. But this does not warrant (IMO) an unnecessarily alarmist news story which will succeed only to scare consumers, many of whom are already frightened about far too much.
Josh Bloom is ACSH’s Director of Chemical and Pharmaceutical Science. Josh earned his Ph.D. in organic chemistry at the University of Virginia, followed by postdoctoral training at the University of Pennsylvania. Find Josh on X @JoshBloomACSH
A version of this article was originally posted at American Council on Science and Health and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find American Council on Science and Health on X @ACSHorg
Vitamin D supplements could help protect the caps on our chromosomes that slow ageing, sparking hopes the sunshine vitamin might keep us healthier for longer, a recent study suggests.The researchers discovered that taking 2,000 IU (international units, a standard measure for vitamins) of vitamin D daily helped maintain telomeres – the tiny structures that act like plastic caps on shoelaces, protecting our DNA from damage every time cells divide.
Telomeres sit at the end of each of our 46 chromosomes, shortening every time a cell copies itself. When they become too short, cells can no longer divide and eventually die.
Scientists have linked shorter telomeres to some of our most feared diseases of ageing, including cancer, heart disease and osteoarthritis. Smoking, chronic stress and depression all appear to speed up telomere shortening, while inflammatory processes in the body also take their toll.
Beyond strong bonesIt is well known that vitamin D is essential for bone health, helping our bodies absorb calcium. Children, teenagers and people with darker skin or limited sun exposure particularly need adequate levels to build and maintain strong bones.
But vitamin D also powers our immune system. A review of evidence found that vitamin D supplements can cut respiratory infections, especially in people who are deficient.
Early research even suggests it might help prevent autoimmune diseases like rheumatoid arthritis, lupus and multiple sclerosis, though more trials are needed.
Since inflammation damages telomeres, vitamin D’s anti-inflammatory effects could explain its protective role.
In this recent study, from Augusta University in the US, the researchers followed 1,031 people with an average age of 65 for five years, measuring their telomeres at the start, after two years, and after four years. Half took 2,000 IU of vitamin D daily, while the other half received a placebo.
The results showed that telomeres were preserved by 140 base pairs in the vitamin D group, compared with a placebo. To put this in context, previous research found that telomeres naturally shorten by about 460 base pairs over a decade, suggesting vitamin D’s protective effect could be genuinely meaningful.
This isn’t the first promising finding. Earlier studies have reported similar benefits, while the Mediterranean diet – rich in anti-inflammatory nutrients – has also been linked to longer telomeres.
Telomeres explained.The catchBut there are some important points to note. Some researchers warn that extremely long telomeres might actually increase disease risk, suggesting there’s a sweet spot we don’t yet understand.
There’s also no agreement on the right dose. The Augusta researchers used 2,000 IU daily – much higher than the current recommended intake of 600 IU for under-70s and 800 IU for older adults. Yet other research suggests just 400 IU might help prevent colds.
Experts say the optimal dose probably depends on individual factors, including existing vitamin D levels, overall nutrition and how the vitamin interacts with other nutrients.
Although these findings are exciting, it’s too early to start popping high-dose vitamin D in the hope of slowing ageing. The strongest evidence for healthy ageing still points to the basics: a balanced diet, regular exercise, quality sleep, not smoking and managing stress, all of which naturally support telomere health.
However, if you’re deficient in vitamin D or at risk of poor bone health, supplements remain a sensible choice backed by decades of research. As scientists continue unravelling the mysteries of ageing, vitamin D’s role in keeping our cellular clocks ticking may prove to be just one piece of a much larger puzzle.
Dervla Kelly is an Associate Professor of Pharmacology at the University of Limerick. Find Dervla on X @_dervla
A version of this article was originally posted at Conversation and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find Conversation on X @Conversation_US
In the months since he began serving as secretary of the Department of Health and Human Services, Robert F. Kennedy Jr. has made many public statements about vaccines that have cast doubt on their safety and on the objectivity of long-standing processes established to evaluate them.Many of these statements are factually incorrect. For example, in a newscast aired on June 12, 2025, Kennedy told Fox News viewers that 97% of federal vaccine advisers are on the take. In the same interview, he also claimed that children receive 92 mandatory shots. He has also widely claimed that only COVID-19 vaccines, not other vaccines in use by both children and adults, were ever tested against placebos and that “nobody has any idea” how safe routine immunizations are.
As an infectious disease physician who curates an open database of hundreds of controlled vaccine trials involving over 6 million participants, I am intimately familiar with the decades of research on vaccine safety. I believe it is important to correct the record – especially because these statements come from the official who now oversees the agencies charged with protecting Americans’ health.
Do children really receive 92 mandatory shots?In 1986, the childhood vaccine schedule contained about 11 doses protecting against seven diseases. Today, it includes roughly 50 injections covering 16 diseases. State school entry laws typically require 30 to 32 shots across 10 to 12 diseases. No state mandates COVID-19 vaccination. Where Kennedy’s “92 mandatory shots” figure comes from is unclear, but the actual number is significantly lower.
From a safety standpoint, the more important question is whether today’s schedule with additional vaccines might be too taxing for children’s immune systems. It isn’t, because as vaccine technology improved over the past several decades, the number of antigens in each vaccine dose is much lower than before.
Antigens are the molecules in vaccines that trigger a response from the immune system, training it to identify the specific pathogen. Some vaccines contain a minute amount of aluminum salt that serves as an adjuvant – a helper ingredient that improves the quality and staying power of the immune response, so each dose can protect with less antigen.
Those 11 doses in 1986 delivered more than 3,000 antigens and 1.5 milligrams of aluminum over 18 years. Today’s complete schedule delivers roughly 165 antigens – which is a 95% reduction – and 5-6 milligrams of aluminum in the same time frame. A single smallpox inoculation in 1900 exposed a child to more antigens than today’s complete series.
Jonas Salk, the inventor of the polio vaccine, administers a dose to a boy in 1954. Underwood Archives via Getty ImagesSince 1986, the United States has introduced vaccines against Haemophilus influenzae type b, hepatitis A and B, chickenpox, pneumococcal disease, rotavirus and human papillomavirus. Each addition represents a life-saving advance.
The incidence of Haemophilus influenzae type b, a bacterial infection that can cause pneumonia, meningitis and other severe diseases, has dropped by 99% in infants. Pediatric hepatitis infections are down more than 90%, and chickenpox hospitalizations are down about 90%. The Centers for Disease Control and Prevention estimates that vaccinating children born from 1994 to 2023 will avert 508 million illnesses and 1,129,000 premature deaths.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPPlacebo testing for vaccinesKennedy has asserted that only COVID-19 vaccines have undergone rigorous safety trials in which they were tested against placebos. This is categorically wrong.
Of the 378 controlled trials in our database, 195 compared volunteers’ response to a vaccine with their response to a placebo. Of those, 159 gave volunteers only a salt water solution or another inert substance. Another 36 gave them just the adjuvant without any viral or bacterial material, as a way to see whether there were side effects from the antigen itself or the injection. Every routine childhood vaccine antigen appears in at least one such study.
The 1954 Salk polio trial, one of the largest clinical trials in medical history, enrolled more than 600,000 children and tested the vaccine by comparing it with a salt water control. Similar trials, which used a substance that has no biological effect as a control, were used to test Haemophilus influenzae type b, pneumococcal, rotavirus, influenza and HPV vaccines.
Once an effective vaccine exists, ethics boards require new versions be compared against that licensed standard because withholding proven protection from children would be unethical.
How unknown is the safety of widely used vaccines?Kennedy has insisted on multiple occasions that “nobody has any idea” about vaccine safety profiles. Of the 378 trials in our database, the vast majority published detailed safety outcomes.
Beyond trials, the U.S. operates the Vaccine Adverse Event Reporting System, the Vaccine Safety Datalink and the PRISM network to monitor hundreds of millions of doses for rare problems. The Vaccine Adverse Event Reporting System works like an open mailbox where anyone – patients, parents, clinicians – can report a post-shot problem; the Vaccine Safety Datalink analyzes anonymized electronic health records from large health care systems to spot patterns; and PRISM scans billions of insurance claims in near-real time to confirm or rule out rare safety signals.
These systems led health officials to pull the first rotavirus vaccine in 1999 after it was linked to bowel obstruction, and to restrict the Johnson & Johnson COVID-19 vaccine in 2021 after rare clotting events. Few drug classes undergo such continuous surveillance and are subject to such swift corrective action when genuine risks emerge.
The conflicts of interest claimOn June 9, Kennedy took the unprecedented step of dissolving vetted members of the Advisory Committee on Immunization Practices, the expert body that advises the CDC on national vaccine policy. He has claimed repeatedly that the vast majority of serving members of the committee – 97% – had extensive conflicts of interest because of their entanglements with the pharmaceutical industry. Kennedy bases that number on a 2009 federal audit of conflict-of-interest paperwork, but that report looked at 17 CDC advisory committees, not specifically this vaccine committee. And it found no pervasive wrongdoing – 97% of disclosure forms only contained routine paperwork mistakes, such as information in the wrong box or a missing initial, and not hidden financial ties.
Reuters examined data from Open Payments, a government website that discloses health care providers’ relationships with industry, for all 17 voting members of the committee who were dismissed. Six received no more than US$80 from drugmakers over seven years, and four had no payments at all.
The remaining seven members accepted between $4,000 and $55,000 over seven years, mostly for modest consulting or travel. In other words, just 41% of the committee received anything more than pocket change from drugmakers. Committee members must divest vaccine company stock and recuse themselves from votes involving conflicts.
A term without a meaningKennedy has warned that vaccines cause “immune deregulation,” a term that has no basis in immunology. Vaccines train the immune system, and the diseases they prevent are the real threats to immune function.
Measles can wipe immune memory, leaving children vulnerable to other infections for years. COVID-19 can trigger multisystem inflammatory syndrome in children. Chronic hepatitis B can cause immune-mediated organ damage. Preventing these conditions protects people from immune system damage.
Today’s vaccine panel doesn’t just prevent infections; it deters doctor visits and thereby reduces unnecessary prescriptions for “just-in-case” antibiotics. It’s one of the rare places in medicine where physicians like me now do more good with less biological burden than we did 40 years ago.
The evidence is clear and publicly available: Vaccines have dramatically reduced childhood illness, disability and death on a historic scale.
Jake Scott is a Clinical Associate Professor of Infectious Diseases at Stanford University. Follow Jake on X @jakescottMD
A version of this article was originally posted at Conversation and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find Conversation on X @Conversation_US
During my neurology rotation as a medical student, one of my first patients was in the middle stage of much-dreaded Huntington’s disease (HD), a hereditary, relentlessly progressive brain disorder that strips away movement, memory, and personality. It has been described as a cruel fusion of Alzheimer’s, Parkinson’s, and motor neuron diseases. HD is hereditary, and affected families have often felt hopeless, but last month, a group of English researchers, in collaboration with biotech company uniQure reported that an experimental gene therapy has dramatically slowed the course of the illness.The Genetic and Molecular Basis of HDHD is inherited as autosomal dominant, which means that each child of an affected parent has a fifty percent chance of inheriting the mutation. The mutation, which is caused by a DNA repeat expansion in the HTT gene on chromosome 4, is an extended sequence of nucleotides (the building blocks of DNA) called CAG (cytosine-adenine-guanine). That abnormal DNA sequence expresses a toxic form of the huntingtin protein that accumulates and gradually damages and kills neurons in parts of the brain, especially in the caudate and putamen parts of the basal ganglia.
Two brain scans. The one on the left is healthy, the one on the right shows loss of brain matter (the dark areas) as neurons die in Huntington’s disease. Credit: University College London Huntington’s Disease Centre.The Symptoms of HDThe symptoms most often begin in patients between ages thirty and sixty, while juvenile HD, which begins at earlier than twenty years of age, is rarer and tends to progress faster. Average survival is about 15–20 years after the onset of motor symptoms. The downhill course is characteristically grim.
The symptoms are of three general types:
- Motor: chorea (involuntary, jerky movements), clumsiness, dystonia, impaired balance and eye movements; later, rigidity and swallowing difficulties.
- Cognitive: slowed thinking, impaired executive function, difficulty with planning and multitasking, eventual dementia.
- Psychiatric/behavioural: depression, irritability, anxiety, apathy; sometimes obsessive–compulsive features or psychosis. Sleep disruption and weight loss are common.
The diagnosis is made on the basis of a clinical examination plus genetic testing for the expanded HTT CAG repeat, which provides definitive evidence of the condition. For those at risk but without symptoms, predictive genetic testing is available, and is usually accompanied by extensive counselling.
The UK research team became emotional as they described the results of their successful clinical trial last month: The gene therapy treatment slowed the progression of the disease by 75 percent, which means that the degree of decline that would normally be expected in one year would take four years to appear after treatment. That affords patients decades of “good quality life,” Professor Sarah Tabrizi told BBC News.
The new treatment, a type of gene therapy administered during lengthy and delicate brain surgery, is a tour de force of neurosurgery and molecular biology. The latter aspect involves cutting-edge gene therapy used to interdict the functioning of an aberrant gene.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPHow, exactly, does the therapy work? In short, its goal is to reduce levels of the toxic huntingtin protein permanently, in a single treatment. It starts with a safe, genetically modified virus, AMT-130, that has been altered to contain a specially designed sequence of DNA that is the active agent. But delivering it to the right place is difficult: It requires a surgical operation during which the virus is infused deep into the brain using real-time MRI scanning to guide a microcatheter to two brain regions—the caudate nucleus and the putamen. This typically takes 12–18 hours of neurosurgery.
The virus then acts like a molecular messenger that delivers the new piece of DNA into brain cells, where the biological magic occurs: The virus carries a specially designed piece of DNA that instructs the neurons to produce RNA that prevents synthesis of the mutant protein. More specifically, the newly transformed cells begin to produce a small fragment of genetic material (microRNA) that is designed to intercept and disable the instructions (in messenger RNA) being sent from the patient’s brain cells’ DNA to synthesise mutant huntingtin protein. (Recall how proteins are synthesised: In a cell’s nucleus, DNA is transcribed into messenger RNA (mRNA), which is then transcribed into protein in the cellular cytoplasm.)
The virus is removed by the brain’s immune system in a matter of days, but the DNA is expected to remain in the patients’ neurons for the rest of their lives. This would permanently lower levels of the mutant huntingtin protein in the brain—and therein lies the magic.
The Clinical TrialResults from the trial—which involved 26 US patients—were released in a statement by uniQure, the sponsor, which said, in part:
The study met its prespecified primary endpoint, with high-dose AMT-130 demonstrating a statistically significant slowing of disease progression as measured by the composite Unified Huntington’s Disease Rating Scale (cUHDRS) at 36 months compared to a propensity score-matched external control. The study also met a key secondary endpoint by achieving statistically significant slowing of disease progression as measured by Total Functional Capacity (TFC) at 36 months compared to a propensity score-matched external control.
The pivotal finding was that three years after surgery there was an average 75 percent slowing of the disease, based on a formula that combines cognition, motor function, and the ability to manage the activities of daily living.
The results also show that the treatment preserves brain cells. Levels of neurofilaments in spinal fluid—a clear sign of brain cell death—would be expected to increase by about a third if the disease had continued to progress, but they were actually lower than at the start of the trial. This is an important complement to the finding of slowed clinical manifestations of disease progression.
“This is the result we’ve been waiting for,” said Professor Ed Wild, consultant neurologist at the National Hospital for Neurology and Neurosurgery in London, which is part of the UCLH NHS Foundation Trust. “There was every chance that we would never see a result like this, so to be living in a world where we know this is not only possible, but the actual magnitude of the effect is breathtaking, it’s very difficult to fully encapsulate the emotion.”
The treatment was considered safe, although some patients did develop inflammation from the virus that caused headaches and confusion that either resolved or needed steroid treatment. According to the statement from uniQure:
AMT-130 was generally well-tolerated, with a manageable safety profile at both doses. As of June 30, 2025 [when data collection for the current report stopped], no new drug-related serious adverse events have been observed since December 2022. The most common adverse events in the treatment groups were related to the administration procedure, which all resolved.
Approximately 75,000 people have Huntington’s disease in the US and around a further 7,000 in the UK, and 2,160 in Australia. Hundreds of thousands of additional people carry the mutation and are therefore expected to develop the disease.
The uniQure clinical trial is ongoing and enrolling new participants across the United States. The company says it will apply for approval in the US in the first quarter of 2026. Conversations with authorities in the UK and Europe are expected to start next year, but the initial focus is on America. AMT-130 has been granted Breakthrough Therapy designation and Regenerative Medicine Advanced Therapy (RMAT) designation from the US FDA.
There are some caveats, however. As noted above, the results of the trial were announced in a news release from uniQure, the company that sponsored the research, and the data have not been peer reviewed or published in an academic journal. The results in individual patients are available for only several years post-treatment, so the long-term safety and efficacy cannot yet be definitively known.
Another factor is that the drug will likely not be available for everyone due to the highly complex surgery and the anticipated cost. There is not yet an official price for the drug. Gene therapies are usually very costly, but their long-term impact on reducing healthcare expenditures means that they can still be cost-effective. In the UK, the National Health Service currently pays £2.6m (US$3.5 million) per patient for gene therapy to treat haemophilia B.
Prof Tabrizi says this gene therapy “is the beginning” and will open the gates for therapies that can reach more people. She is already working with a group of young people who know they have the gene but don’t yet have symptoms—known as “stage zero” Huntington’s—and is planning the first prevention trial to see whether the disease can be significantly delayed or even stopped completely.
It was also a landmark development for gene therapy in general. Although gene therapy treatments are in clinical trials for other genetic diseases such as cystic fibrosis, and some have already been approved by regulators for thalassaemia, the approaches to those diseases are more straightforward and simpler than the elegant studies described above.
Two aspects of the AMT-130 study constitute a departure from other gene therapy interventions: (1) the convoluted strategy through which the drug (the modified virus) transforms brain cells and causes them to produce an RNA that disrupts the host cell’s ability to code for the aberrant huntingtin protein; and (2) the unprecedentedly lengthy and delicate neurosurgical procedure required to deliver the drug, a procedure that extends over half a day or more. The result is an astonishing achievement.
The genetic alteration of the virus used to transform brain cells to neutralise the HD mutation is technically a “gain of function” (GoF) modification, because its modification confers a new property. Some commentators consider all gain-of-function research to be dangerous because—without evidence—they blame such research for the creation of SARS-CoV-2, the virus that causes COVID-19. They would like to see all such broadly defined research banned outright or regulated to an extent that would make it almost impossible to pursue. This would be misguided. Not all gain-of-function research is of concern. Many years ago, for an undergraduate research project, I mutated the harmless bacterium Bacillus subtilis and selected for mutants with an enhanced ability to digest the lactose in milk. Technically, they were what would now be defined as gain-of-function organisms, but were utterly harmless, as is AMT-130. In fact, this new development could pave the way for more effective treatment of many diseases that have so far defied human ingenuity.
Henry I. Miller, a physician and molecular biologist, is the Glenn Swogger Distinguished Fellow at the Science Literacy Project. A veteran of the NIH and FDA, he was the founding director of the FDA’s Office of Biotechnology. Find him on his website: henrymillermd.org
A version of this article was originally posted at Quillette and is reposted here with permission. Any reposting should credit both the GLP and original article. Find Quillette on X @Quillette
October 29th marks the 43rd anniversary of one of biotechnology’s most significant milestones — the approval by the Food and Drug Administration of Humulin, human insulin synthesized in genetically engineered bacteria to treat diabetes. The first “biopharmaceutical,” or drug made with molecular genetic engineering techniques, to be approved, it launched a revolutionary era in drug development.And remarkably, that approval was granted in five months, at a time when the average approval time was 31.5 months (similar to today).
Courtesy: National Museum of American HistoryInsulin is secreted in the pancreas and is essential to the metabolism of carbohydrates and fats. Insulin deficiency leads to the development of (Type 1) diabetes, requiring that patients have regular injections of insulin to maintain life and health.
As the FDA medical reviewer in 1982 and the head of the evaluation team for “Humulin,” the brand name of the human insulin, I had a front-row seat. The saga is remarkable in several ways, not least of which is that although both the drugmakers and regulators were exploring unknown territory, the development of the drug and its regulatory review progressed smoothly and rapidly.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPBefore genetically-engineered insulinInsulin in crude form was first produced a century ago, in 1922, by Canadian researchers Frederick Banting and Charles Best, which lifted the death sentence that had previously been imposed on diabetics. By the end of that year, drug company Eli Lilly and Company had devised a method for much higher purification.
But this ‘miracle drug’ was dependent on extracting the insulin from pigs and cows, using the waste products – pancreases — of the meat packing industry. According to the article in Diabetes Forecast, more than two tons of pig parts were needed to extract just eight ounces of purified insulin.
Left, pancreas glands are examined as they arrive from a meatpacking house. Right, the glands are run through grinders before the next step in the process, insulin extraction. Courtesy: National Museum of American HistoryOver the next half century, the purified insulins obtained from the pig or cow pancreases, which differ slightly in chemical composition from human insulin, were constantly improved in purity and formulated in ways that offered physicians and diabetic patients greater control over blood sugar.
The extracted insulin was, almost literally, a miracle drug. The picture below, dating to the 1920s, shows a patient before (left) and two months after (right) getting insulin.
Courtesy: Eli LillyEarly development of genetically-engineered insulinBy the early 1970s, a crisis emerged: As the supply of animal pancreases declined and the prevalence of insulin-requiring diabetes grew, there were widespread fears of possible future shortages of insulin. Fortuitously, around the same time, a new and powerful tool — recombinant DNA technology, also known as “genetic engineering” or “gene-splicing” — became available, offering the promise of unlimited amounts of insulin that, unlike the insulin from animals, was identical to the molecule produced by humans.
The seminal molecular genetic engineering experiment was reported in a 1973 research article by academic scientists Stanley Cohen, Herbert Boyer, and their collaborators. They isolated a ringlet of DNA called a “plasmid” from a bacterium, used certain enzymes to splice a gene from another bacterium into that plasmid, and then introduced the resulting “recombinant,” or chimeric, DNA into E. coli bacteria.
Professor Herbert Boyer Credit: GenentechWhen these now “recombinant” bacteria reproduced, the plasmids containing the foreign DNA were likewise propagated and produced amplified amounts of the functional recombinant DNA. And because DNA contains the genetic code that directs the synthesis of proteins, this new methodology promised the ability to induce genetically modified bacteria (or other cells) to synthesize desired proteins in large amounts.
Lilly immediately saw the promise of this technology to produce unlimited quantities of human insulin in bacteria. After obtaining the recombinant E. coli bacteria that synthesized human insulin from biotech startup Genentech, Inc., they developed processes for the large-scale cultivation of the organism (in huge fermenters like those used to make wine or beer) and for the purification and formulation of the drug.
Insulins had long been Lilly’s flagship products, and the company’s expertise was evident in the purification, laboratory testing and clinical trials of human insulin. The company’s scientists painstakingly verified that their product was extremely pure and identical to pancreatic human insulin (which differs slightly in chemical composition from beef and pork insulin).
Lilly began clinical trials of its human insulin in July 1980. The product performed superbly. There were no systematic problems with treating “naive” patients (who had never received injections of insulin) or those who switched from animal to human insulin. A small number of patients who had had adverse reactions of some kind to the animal insulins tolerated the human insulin well.
The speedy FDA speedy review processThe dossier that provided evidence of safety and efficacy was submitted in May 1982 to the FDA, where I was the medical reviewer and head of the evaluation team. Over many years the FDA had had prodigious experience with insulins and with drugs derived from various microorganisms, so it was decided that no fundamentally new regulatory paradigms were necessary to evaluate the recombinant human insulin.
In other words, recombinant DNA techniques were viewed as an extension, or refinement, of long-used and familiar methods for making drugs. That proved to be an historic, precedent-setting – and correct — decision.
Based on my FDA team’s exhaustive review of Lilly’s data, which were obtained from pre-clinical testing in animals and later in clinical trials involving thousands of diabetics, FDA granted marketing approval for human insulin in October 1982. The review and approval took only five months when the agency’s average approval time for new drugs was 30.5 months.
In retrospect, that rapid approval was particularly remarkable for a drug that was produced with a revolutionary new technology, and that after approval would be available in pharmacies nationwide to millions of American diabetics.
Credit: PharmaceuticsThe back story, however, is revealing. My team and I were ready to recommend approval after four months’ review. But when I took the packet to my supervisor, he said, “Four months? No way! If anything goes wrong with this product down the road, people will say we rushed it, and we’ll be toast.”
That’s the bureaucratic mindset. I don’t know how long he would have delayed it, but when he went on vacation a month later, I took the packet to his boss, the division director, and he signed off.
That anecdote is an example of Milton Friedman’s observation that to understand the motivation of an individual or organization, you need to “follow the self-interest.” A large part of regulators’ self-interest lies in staying out of trouble. One way to do that, my supervisor understood, is not to approve in record time a product that might experience unanticipated problems.
The Humulin approval had significant effects. A front-page New York Times article quoted my prediction that the speedy approval was a major step forward in the “scientific and commercial viability” of recombinant DNA technology. “We have now come of age,” I said, and potential investors and entrepreneurs agreed. Seeing that biopharmaceuticals would compete with other medicines on a level playing field, the “biotechnology industry” was on the fast track.
The current burdensome FDA review processUnfortunately, the rapid approval of human insulin proved to be an anomaly. Even with a toolbox of improved technologies available to both the FDA and industry, bringing a new drug to market on average now takes, on average, 10-12 years and costs, on average, more than $2.5 billion, There hasn’t been much improvement in review time from drug reviews in the pre-electronic era when New Drug Applications were submitted in paper form. (The paper pile for the review of insulin that my group performed was about three times as large as what is pictured in the FDA archive photo at the top of the piece)
Regulators are highly risk-averse, few new drugs are approved now without convening extramural advisory committees, and decisions are sometimes hijacked by political forces outside the FDA. Even so, five of the highest-revenue drugs in the U.S. in 2022 were produced by biotechnology, either with recombinant DNA or monoclonal antibody technology.
Other FDA-regulated biotech sectors have fared much worse. Regulators have made a colossal mess of the regulation of genetically engineered animals, which FDA bizarrely chose to regulate as “new animal drugs” based on their interpretation of a 1938 law. That byzantine process led to a grotesquely prolonged, 20-plus FDA year review of a faster-growing Atlantic salmon.
More disarray occurred with genetically engineered mosquitoes to control mosquitoes that carry viral diseases: Inexplicably, it took FDA more than five years to decide that, for regulatory purposes, this “gene drive” technology was a form of pesticide, and that jurisdiction belonged at the Environmental Protection Agency. As a result of this bureaucratic bungling, the entire biotech sector of genetically engineered animals is moribund.
Government regulation has not aged as gracefully as genetic engineering technology itself, which has advanced significantly over the years. Regulators are supposed to abide by the “bargain” that society has made with them: Civil servants are granted lifetime tenure and are protected from political pressure and retaliation, in return for which they are supposed to make decisions based solely on the public interest. But, often, they do not.
To get FDA-regulated products to those who need them, congressional oversight must emerge from hibernation and create a healthier, more constructive balance.
Henry I. Miller, a physician and molecular biologist, is the Glenn Swogger Distinguished Fellow at the Science Literacy Project. A veteran of the NIH and FDA, he was the founding director of the FDA’s Office of Biotechnology. Find him on his website: henrymillermd.org
RFK, Jr.’s Make America Healthy Again (MAHA) coalition has built its platform on the concept of health freedom, a belief that individuals have a right to make their own health care decisions without coercion from the public health establishment. “This growing, nonpartisan health freedom movement is pushing for bold, sweeping changes to a system that many believe is long overdue for reform,” says Josh Axe, a prominent alternative medicine advocate and MAHA supporter. “Whether you realize it or not, if you’ve ever questioned a prescription, worried about food safety, or felt unheard in a medical office, you’re already part of it.”Americans across the political spectrum embrace this rights-based rhetoric, even people who are generally hostile to Kennedy’s agenda; for instance, scientists who advocate for universal health care often frame access to medicine as a human right. Nevertheless, critics of the MAHA campaign argue that health freedom is merely a smokescreen masking an insidious agenda. Kennedy and his compatriots cloak their policy goals in the language of liberty, the argument goes, but they have no problem imposing their preferences on Americans when they can get away with it.
For example, the FDA under Kennedy’s leadership recently changed federal recommendations for COVID-19 vaccines, a move that could limit access to the shots even if people want them and could benefit from the protection they provide. And earlier in his career, RFK, Jr. was caught on camera advocating for the imprisonment of prominent businessmen he deemed proponents of climate change misinformation. The man clearly has an authoritarian streak, in other words.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPThese observations invite some important questions: is health freedom a legitimate concept that has been abused by cynical MAHA activists? Is the very idea of “health freedom” a fiction? Join Dr. Liza Lockwood and Cam English on this episode of Facts and Fallacies as they scrutinize “health freedom.”
Dr. Liza Lockwood is a medical toxicologist and the medical affairs lead at Bayer Crop Science. Follow her on X @DrLizaMD
Cameron J. English is the director of bio-sciences at the American Council on Science and Health. Follow him on X @camjenglish
We’ve been working on this article for weeks. Poring over studies on the Tylenol-autism topic. Just before we got it scheduled to post… another soundbite.At today’s Cabinet meeting, Health Secretary RFK Jr. claimed that “children who are circumcised early have double the rate of autism,” adding “it’s highly likely because they’re given Tylenol.” President Trump backed him up, saying there’s “a tremendous amount of proof or evidence, I would say as a non-doctor.”
Here’s just the tip of what’s wrong with this claim: Kennedy mentioned “two studies,” but didn’t specify which. A quick search turns up two likely candidates. One is a 2015 Danish registry study that found a modest statistical bump in autism diagnoses among circumcised boys, especially under age five. The authors themselves highlighted big limitations—such as incomplete circumcision data and the inability to prove causation. (By the way, the study never mentioned Tylenol, acetaminophen, or any pain medications. The researchers were investigating whether the circumcision procedure itself – the pain and stress – might be linked to autism.) The other is a 2013 ecological paper that used circumcision rates as a stand-in for acetaminophen exposure. Even its authors described it as “hypothesis-generating,” not proof. And just to underline how shaky the circumcision link was, a 2015 published critique of the Danish study pointed out that its autism findings rested on very small numbers and questionable assumptions.
But RFK Jr.’s real logical leap is collapsing these into one neat story: some circumcised boys get Tylenol for pain, and some are later diagnosed with autism—therefore, Tylenol causes autism. That’s like saying umbrellas cause car accidents because both are more common on rainy days. The studies don’t actually connect those dots. The Danish analysis wasn’t about Tylenol at all, and the ecological paper was little more than circumcision-as-proxy guesswork.
Kennedy’s stance? “None of this is positive, but all of it is stuff we should be paying attention to.” This immediately brought to mind that scene in Dumb and Dumber—when Lloyd Christmas hears his chances with Mary are “one out of a million” and responds: “So you’re telling me there’s a chance!”
Now, on to what we actually came here to discuss: the broader claims about Tylenol and autism that have pregnant women wondering if they really need to “tough it out”…
At a press conference on September 22, the Trump administration urged pregnant women to “tough it out” and avoid Tylenol, citing a link to autism. The claim surprised many, including the researchers whose work is being cited. Scientists say that’s not what the research shows. The strongest evidence to date shows that if there is any link, it’s not a cause-and-effect relationship.
Here’s what you should know…
For starters, acetaminophen is the active ingredient in Tylenol and many other over-the-counter medications, making this warning broader than just one brand.
The Review That Doesn’t Say What They ClaimThe centerpiece of the government’s claim is a review of 46 studies published in August. Yes, 27 studies reported some association between acetaminophen and neurodevelopmental issues. In science and public health, “association” means that two things are related or connected in some way, but it does not mean that one causes the other. A third thing might be influencing the relationship and causing both of the first two things to happen at the same time. The review’s own lead author, Dr. Didier Prada, confirmed: “We cannot answer the question about causation—that is very important to clarify.”
He even used a perfect analogy: ice cream sales and violent crime both rise in summer, but nobody thinks Rocky Road causes assault. (Association, not causation.)
They also relied on the Navigation Guide, a framework built for environmental toxins, not medications. With medications, we can measure exactly what people took and when. But with environmental toxins—think lead paint from childhood homes or industrial chemicals from old factories—researchers have to guess based on decades-old records. The Navigation Guide was designed for those messy situations. Applied to medications—where we have prescriptions and clear records—it treats weak hints like strong evidence. Medical standards like GRADE correctly start with more skepticism about observational studies; the Navigation Guide doesn’t. Small, questionable associations get inflated into findings that seem more certain than they are.
The review gave high ratings to studies with fundamental flaws—including one where every single baby had detectable acetaminophen in their cord blood, making a true unexposed comparison impossible—while penalizing a massive Swedish sibling study for not having trimester-specific timing data. Reviews like this are extremely sensitive to how studies are weighted—small changes in weighting can flip the overall conclusion from positive to negative. When the methodology lacks transparency about these crucial decisions, readers can’t evaluate whether the conclusion reflects the data or the authors’ choices.
Finally, the review leaned heavily on ‘dose-response’ as a sign of causation. If a drug is harmful, higher doses should mean higher risk. But most dose-response patterns came from small or poorly adjusted studies. In the large Swedish sibling study—our best evidence—the gradient vanished once family factors were controlled (as indicated by the purple line below). Low, medium, or high use all showed essentially the same risk which hovered around no effect (as indicated by the black dashed line at HR=1), suggesting the apparent dose-response patterns indicated in red, blue, and green came from confounding by genetics, maternal health, or the underlying condition being treated rather than the medicine itself.
Image created by Unbiased Science. Adapted from Table 2 in Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children’s risk of autism, ADHD, and intellectual disability. JAMA. 2024;331(14):1205-1214. doi:10.1001/jama.2024.3172Credibility matters, too. The senior author, Harvard Dean Andrea Baccarelli, disclosed he was a paid expert witness for plaintiffs suing acetaminophen manufacturers. When a federal judge reviewed his testimony last December, she ruled it “lacked scientific evidence“ and dismissed every case.
What The Swedish Study ShowsThe administration is overlooking the most rigorous evidence available: Sweden’s sibling study, which followed essentially every child born over two decades—2.5 million in total, including 186,000 exposed to acetaminophen during pregnancy.
Looking at the population as a whole, researchers initially saw a slight association: about a 5% increased autism risk with acetaminophen use. But when they compared siblings—one exposed, one not—the link vanished. Same parents, same household, shared genes… but different exposure. The risk dropped to zero.
If acetaminophen truly caused autism, exposed siblings would show higher rates. They didn’t. As neuroscientistSam Wang explains, that likely demonstrates the crude link was reflecting family factors—genetics, socioeconomic status, maternal illness—not the drug itself.
Critics likeNIH Director Dr. Jay Bhattacharya argue that sibling studies can “wash out” real effects by over-controlling. But that misunderstands their purpose. When siblings share genes and family environment but differ in exposure, comparing them isolates the drug’s effect. If acetaminophen truly caused autism, exposed siblings would have higher rates than unexposed siblings. When that difference vanishes, it reveals the association was driven by shared family factors, not the medication itself. Moreover, suppose sibling designs truly “washed out” real effects. In that case, we’d still see them in other well-controlled studies—but the best prospective cohorts with biomarker validation show the same null results once properly adjusted.
Out of all the studies included in the review, the Swedish study did the best job of including additional variables in its statistical analysis. These variables, especially parental diagnosis of autism, could affect acetaminophen usage and risk for autism in their children. Even after accounting for more than 25 additional variables, the study found a slight increase in risk of autism with acetaminophen use during pregnancy. However, this effect disappeared when comparing siblings to each other, which suggests that unmeasured household and genetic factors—not captured by any of the studies—are what actually drive the apparent association between acetaminophen and autism.
Follow the latest news and policy debates on sustainable agriculture, biomedicine, and other ‘disruptive’ innovations. Subscribe to our newsletter.SIGN UPThose 27 Studies: What They Actually ShowThe government continues to cite the “27 studies” that showed a positive association in the Baccarelli study. But many weren’t about autism at all, instead looking at general behavior problems. Others relied on mothers trying to remember medications years after their child was diagnosed—an obvious setup for recall bias (mothers of children with autism naturally scrutinize their pregnancy memories more intensely, potentially “remembering” more medication use). In contrast, the Swedish study recorded acetaminophen use prospectively during pregnancy and captured prescription data through pharmacy records.
Image created by Unbiased Science
This diagram illustrates recall bias in research. When studies ask about medication use years after pregnancy, the results can be skewed because memory works differently depending on context. Some parents may review their pregnancy choices in detail (e.g., those with children diagnosed with autism), while others may be less likely to do so. This natural difference in how much people have reflected on past events can create patterns in the data that don’t represent actual cause and effect. What researchers can measure through surveys (blue) may not match the real relationship they’re trying to study (black).
The authors couldn’t actually combine the studies into a traditional meta-analysis (a statistical method that pools data from multiple studies to get a clearer picture of whether there’s a real effect). The exposure and outcome measures were too different—some asked about ‘any use,’ others counted days, some split by trimester, and one measured drug metabolites in cord blood. So they fell back on vote-counting: tallying how many studies showed an association versus no association, without considering their size, strength, or reliability. That meant a Spanish cohort of 2,600 children based on parental recall was put on the same footing as Sweden’s national sibling study of 2.5 million births with genetic controls.
Patterns are telling: when mothers reported acetaminophen use prospectively, before knowing outcomes, the associations were weaker or absent. When asked years later, after a diagnosis, the associations were stronger. That’s not causation—that’s recall bias.
And even the positive findings were modest, typically 20-30 percent increased risk. At first glance, that sounds substantial. But these numbers come from observational studies, which are notoriously prone to bias. When researchers account for family genetics, maternal health, or the reasons Tylenol was taken in the first place, the apparent increase often disappears. In other words, what looks like a sizeable association on paper may actually be a mirage created by confounding and recall bias. The few stronger signals came from tiny, self-reported studies. In contrast, the largest, best-controlled evidence—the Swedish sibling study—found no effect once family factors were considered. Most crucially, none of the studies could separate the drug itself from the reason it was taken. As Yale researcherZeyan Liew points out, fever in pregnancy is a known risk factor for developmental delays.
The Real Dangers of “Toughing It Out”While the president tells women to tough it out, let’s be clear about what he’s asking them to endure. Untreated fever during early pregnancy nearly doubles the risk of neural tube defects and is linked to heart defects and oral clefts. These aren’t theoretical risks—they’re established medical facts.
Many pregnant women experience fever and pain during pregnancy. What alternatives exist? NSAIDs like ibuprofen are contraindicated in pregnancy, especially after 20 weeks. Aspirin carries bleeding risks. Opioids bring obvious concerns. As one analysis warns, creating panic about the only safe option will cause real, preventable harm.
The Timeline That Doesn’t Add UpImage created by Unbiased Science. Data sourced from https://www.cdc.gov/autism/data-research/data-table.htmlAcetaminophen (Tylenol) entered U.S. markets in 1955, more than ten years after autism was first described by Psychiatrist Leo Kanner in 1943. If acetaminophen were a major causal driver, we’d expect a surge in the 1960s–70s as use became widespread. Instead, recorded autism rose mainly in the 1990s as diagnostic criteria broadened and diagnostic substitution occurred, especially in California. (Doctors did more strongly discourage aspirin in pregnancy by the 1990s, likely nudging some women toward Tylenol, but acetaminophen was already widely used and autism rates didn’t spike then—the increase in autism diagnoses aligns with changing diagnostic criteria.)
At the press briefing, officials pointed to aCalifornia MIND Institute study claiming those diagnostic shifts couldn’t explain the rise. But the study made a basic error: it retroactively applied 2002 criteria to children from the 1980s and 90s without re-examining them. That’s like lowering the passing score on a driving test and insisting the test hasn’t gotten easier.
California’s own Department of Health laterreanalyzed the same population and found what the MIND study missed: between 1987 and 1994, autism diagnoses rose by 9.1 per 10,000 while diagnoses of intellectual disability fell by 9.3 per 10,000. The increase and decrease tracked almost exactly—classic diagnostic substitution, not a new epidemic.
The president’s claim that countries without Tylenol don’t have autism? Cuba has both acetaminophen (sold as paracetamol) and documented autism services. Lower recorded rates likely reflect underdiagnosis and reporting constraints.
The “Consensus” That Isn’tThe administration points to a 2021 statement signed by 91 scientists calling for “precautionary action.” But they recommended exactly what doctors have always said: use acetaminophen only when medically indicated, at the lowest effective dose, for the shortest time. The American College of Obstetricians and Gynecologists (ACOG) immediately responded at that time, warning against frightening women away from necessary treatment. Notably, that consensus was not based on any new research findings—it was a reinterpretation of existing observational studies that major medical organizations found unconvincing. ACOG reaffirmed in September 2025 that “acetaminophen remains the analgesic and antipyretic of choice during pregnancy” when used at the lowest effective dose for the shortest duration. Of course, the ‘lowest effective dose’ language isn’t unique to acetaminophen—it’s standard medical and legal boilerplate for virtually all medications during pregnancy. It’s good practice for everyone, pregnant or not, to take only what’s needed.
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We did take note that the Swedish study reports only 7.5% of mothers used acetaminophen versus 50-65% in the U.S. While this might partly reflect measurement issues (the study asked about ‘medications’ generally without specifically prompting about acetaminophen), the sibling analyses still found no increased risk among those identified as users. The stark difference between Swedish and American usage rates—whether real or artifactual—does raise questions about pain management during pregnancy. Are Americans quicker to reach for medication? That’s a conversation worth having about judicious use. But it’s separate from whether acetaminophen causes autism. The Swedish sibling analyses found no increased risk, suggesting the answer to that specific question is clear.
What We Can Actually Say With ConfidenceAfter examining all the evidence: If acetaminophen has any effect on autism risk—and that’s an enormous if—it would be so small we can’t detect it in millions of children. It would be one tiny factor among many in a condition that’s 80-90% heritable, with over 100 genes identified as contributors.
The government’s transformation of these uncertainties into absolute declarations isn’t just bad science—it’s dangerous. Pregnant women will suffer through treatable fevers and pain. Some will experience preventable complications. All based on a certainty that doesn’t exist in the data.
A Message to MothersIf you’re pregnant and scared, or if you’re a mother wondering if that Tylenol you took somehow “caused” your child’s autism: The premise of this entire debate—that autism is something to be prevented or blamed on someone—is fundamentally wrong.
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The best evidence shows no causal link. Can I promise with 100% certainty that acetaminophen never affects neurodevelopment? No scientist can promise that about anything.
Scientists use careful language like “no evidence of harm,” not because we haven’t studied it properly, but because we can’t ethically do the randomized experiments that would prove causation. We must rely on observational data, which is inherently less definitive. And we can’t study every possible combination of dose, timing, genetics, and environmental factors. While we can’t scientifically declare “Tylenol definitely doesn’t cause autism” (proving a negative is nearly impossible), the evidence strongly suggests that for the vast majority of people, acetaminophen use during pregnancy doesn’t meaningfully increase autism risk.
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The desperate search for environmental “causes” of autism distracts from what really matters—ensuring autistic individuals get the support, accommodation, and acceptance they need. Your child’s neurology is not your fault, not a tragedy, and not something that needs to be fixed.
The truth is less dramatic than the president’s announcement: there’s no credible evidence linking acetaminophen to autism. The real harm isn’t in taking necessary medication. It’s in the suffering that will result from transforming uncertainty into false certainty, correlation into causation, and weak associations into federal mandates—leaving pregnant women to endure treatable pain and fever based on a scientific conclusion that doesn’t exist.
Jess Steier is a public health scientist dedicated to bridging the gap between complex scientific evidence and public understanding. Jess is the Founder of Unbiased Science, CEO of Vital Statistics Consulting, and Executive Director of The Science Literacy Lab (a 501c3 non-profit organization), she has built her career on translating complex scientific concepts into accessible language while maintaining unwavering commitment to scientific integrity.
Elana Pearl BenJoseph is a physician with a focus on pediatrics, health communication, and public health. Find Elana on LinkedIn
Izzy Brandstetter Figueroa is an epidemiologist, educator, and statistics consultant for Unbiased Science. Find Izzy on LinkedIn
Paige Boklaschuk is an epidemiology student who loves to go down rabbit holes about reproductive health, nutrition, global health, and exercise science. Find Paige on LinkedIn
A version of this article was originally posted at Unbiased Science and has been reposted here with permission. Any reposting should credit the original author and provide links to both the GLP and the original article. Find Unbiased Science on X @unbiasedscipod