Citing a paper as evidence is sort of like quoting a person as evidence. Before believing anything that the paper says, you’ve got to look at the qualifications and credibility of the paper. And what that paper actually did rather than simply said. During the U.S. Senate confirmation hearings of Robert F. Kennedy Jr., as President Donald Trump’s pick as Secretary of the Department of Health and Human Services, RFK. Jr., cited a “paper” to suggest that there’s a link between vaccines and autism. But this so-called paper has got problems. Lots of them.
RFK, Jr. was responding on Day 2 of the hearing to Senator Bill Cassidy, MD, (R-Louisiana) citing a different paper: a meta analysis published in 2014 in the journal Vaccine. “The title [of the study] tells it all,” Cassidy asserted. “Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies.” Vaccine, by the way, is a long-standing peer-reviewed scientific journal that is found on PubMed and publishes, surprise, surprise, all kinds of peer-reviewed scientific studies on vaccines.
Kennedy responded with the following: “You show me those scientific studies, and you and I can meet about it. There are other studies as well, and I’d love to show those to you.” What other studies? Well, Kennedy continued by saying, “There’s a study that came out last week of 47,000 9-year-olds in the Medicaid system in Florida — I think a Louisiana scientist called Mawson — that shows the opposite. There are other studies out there. I just want to follow the science.” You can see the exchange between Cassidy, who incidentally is a physician, and Kennedy here:
The Source Of The Paper Cited By RFK Jr., Is Not Indexed On PubMed
So does this paper that Kennedy mentioned qualify as “the science” or even some science? Umm, first of all, this paper was published on January 23, 2025, in something called Science, Public Health Policy and the Law. While the word “science” may be in the name of this web site, you can’t even find such a source on the National Library of Medicine’s PubMed website, which is sort of a minimal threshold for a peer-reviewed scientific journal in health and biomedical science. Just because a journal is indexed on MEDLINE doesn’t mean that it is completely legit as some journals with somewhat bogus and predatory histories can be found there as well. But not even being on PubMed means that this Science, Public Health Policy and the Law hasn’t even gone through some kind of formal objective evaluation. Therefore, it could be the equivalent of some dude or dudette in a basement somewhere starting a website and posting something.
The Paper Cited By RFK Jr., Has Major Methodological Flaws
Secondly, it’s important to take a closer look at this “paper” that’s entitled “Vaccination and Neurodevelopmental Disorders: A Study of Nine-Year-Old Children Enrolled in Medicaid” and evaluate it scientifically. After all, you wouldn’t automatically believe someone who told you that Star Wars: The Rise of Skywalker was a great movie without actually watching it yourself, would you?
The paper used Florida Medicaid claims data to compare the frequency of neurodevelopmental disorder (NDD) diagnoses such as autism among nine-year-old children born between 1999 and 2002 between those who had ever had a health care visit with a billing code for a vaccine in their Medicaid claim records versus those who didn’t. According to the paper, 28% of those kids who had this vaccine billing code also had a diagnose of at least one NDD versus 11% who didn’t. The paper also indicated that those kids with a vaccine billing code were around 2.7 times more likely to have an autism than those who didn’t.
So what happens when you go beyond these results and take a closer look at this thing? Well, that’s what Jessica McDonald did for FactCheck.org, a project of The Annenberg Public Policy Center at the University of Pennsylvania. McDonald quoted Jeffrey S. Morris, PhD, director of the division of biostatistics and George S. Pepper Professor of Public Health and Preventative Medicine at the University of Pennsylvania’s Perelman School of Medicine, as saying, “I have read this paper carefully, and it has so many severe methodological issues, it clearly should not have passed any legitimate peer review.”
These “severe methodological issues” included the fact that the analysis “ignores all confounding factors that might influence both propensity to [be] vaccinated and propensity to be identified with a NDD, and treats the 90% of the population who were vaccinated by age 9 as equivalent in every way except vaccination to the 10% who remained unvaccinated at age 9 (according to Medicaid records),” in the words of Morris.
For example, those who are more likely to be vaccinated also are more likely to regularly interact with the healthcare system in general. And those who interact more regularly with the healthcare system are probably more likely to be diagnosed with different conditions sort of like how those who go to a bakery are more likely to like cake. But this paper didn’t really say anything about how much each group interacted with the healthcare system.
Moreover, as Morris pointed out, the paper didn’t “even check whether the NDD diagnosis occurred before or after the first vaccination record.” That’s kind of important when trying to draw some kind of cause-and-effect link because the cause is supposed to come before the effect. After all, you can’t say that opening an umbrella caused it to rain even though those who carry umbrellas are more likely to be in the rain.
Additionally, the paper did not account for the possibility that kids who didn’t have a vaccine billing code might have been vaccinated outside of the Medicaid system.
The Paper Cited By RFK Jr., Seems More Like An Opinion Piece
Third of all, the paper in a number of places reads more like an opinion piece than an objective scientific paper. It makes strong statements without providing much concrete, verifiable support for such statements. For example, the abstract of the paper states, “Preliminary studies comparing vaccinated and unvaccinated children have reported that the vaccinated are significantly more likely than the unvaccinated to be diagnosed with bacterial infections, allergies, and neurodevelopmental disorders (NDDs),” without mentioning the numerous rigorous scientific studies that have shown no link between vaccination and NDDs. It also does not admit that the papers to date that have suggested such a link have been discredited and retracted.
Who Were The Authors And Funders Of The Paper Cited By RFK Jr.?
Finally, who were the authors of this paper? Do they have longstanding records of conducting objective and rigorous scientific studies? What are their credentials? Well, both authors, Anthony Mawson and Binu Jacob, are listed as affiliated with the Chalfont Research Institute in Mississippi. A Google search for this institute doesn’t reveal a clear website, aking it difficult to assess its legitimacy. Plus, these two authors have already had another paper claiming a link between vaccination and autismretracted by not just by one journal but by two journals, according to the Retraction Watch website.
Oh, and who is listed as a funder for this paper? It’s the National Vaccine Information Center. Brandy Zadrozny, reporting for NBC News, recently described the National Vaccine Information Center as “the oldest anti-vaccine group in operation.” Just because something has the word ”information” in its title doesn’t necessarily mean that the information provided is accurate.
Despite all of these flaws, some people (and perhaps bots) have been circulating this paper widely on social media platforms such as X. I have reached out to Kennedy’s representatives for further comment and will update this article accordingly.
It’s not surprising that Kennedy’s stances on vaccination have been central to the Senate confirmation hearings. After all, vaccination has been one the greatest successes in public health. If it weren’t for vaccines, many, many more people would be still disabled and dying from diseases like smallpox, polio and measles. Life expectancy would likely be a lot shorter. “RFK, Jr.’s position on vaccines continue to be alarming and concerning,” explained Kelly Henning, MD, Lead of Bloomberg Philanthropies’ Public Health program. “It’s important to really hold RFK Jr. to a high standard. [The head of HHS] needs to make decision based on data and really have the health of the American people as the center of their positions.” In other words, science–real science, that is–needs to be injected into every decision made by the Secretary of HHS.
