Sunday, May 17, 2020

#2337: Paul Thomas

There are lot of MDs in the US, so you’re bound to find a number of loons or grifters willing to throw their lot in with the anti-science crowds among them. Paul Thomas is a pediatrician with offices (“Integrative Pediatricians”) in the Portland, Oregon area, and he has thrown his lot in with the antivaxxers. Thomas is, for instance, a founding member of the antivaccine and general quackery-promoting group Physicians for Informed Consent, and was also one of the “experts” interviewed for the antivaccine series The Truth About Vaccines – it’s of course the same small number of people with genuine credentials they use every time since there is only a very small number of people with genuine credentials willing to lend their authority to the antivaccine movement – there’s a list of them here, and it is, safe to say, a motley crew. (And of course: being an MD is not the same as being trained in medical science even if it requires some knowledge of science, a distinction easily lost on a target audience who thinks reading facebook comments and conspiracy websites counts as research anyways.) But in short: Thomas is something of a rising star in the antivaccine movement (with inept journalists like Genevieve Reaume helping him along).

The ridiculous (but dangerous) group Physicians for Informed Consent is best known for trying to spread obvious fake news about vaccines and pushing manufactroversies about vaccine safety, a typical ploy being the familiar trick of misrepresenting studies to falsely make it sound like it supports the conclusion you want it to support while relying on the audience not actually checking or being able to check whether the source actually says what you claim it says. Of course, Physicians for Informed Consent is very much opposed to informed consent (hence the Orwellian trick of putting “informed consent” in the very name); instead, they are vigorously pushing misinformation and fear-mongering and (for instance) vigorously deleting any hint of criticism by those who actually know something about the issues from their comment sections. The goal of the group is to fight any proposal to restrict the use of vaccine exemptions for kids in public schools, and Thomas has established himself as one of the leaders of the loon side of those debates.

Of course, like most antivaccine advocates, Thomas claims to be “not anti-vaccine, but pro-safe vaccine”. For one who is not antivaccine, Thomas spends a lot of time claiming that vaccines are dangerous without evidence to back up his claims. Thomas claims that he, clearly unlike most doctors, don’t “really remember really learning anything” about vaccines in medical school, and it sort of shows, for instance in his book The Vaccine-Friendly Plan, which pushes a (really antivaccine) “alternative vaccine schedule” with no basis in evidence and that ultimately, of course, really involves dropping various vaccines. Thomas, on his side, seems to suggest that the schedule is associated with lower prevalence of autism among his patients, even though he usually seems smart enough not to outright claim that vaccination leads to autism, which it demonstrably doesn’t – we don’t doubt that many of his clients believe that it does, however, and Thomas is certainly not going to disabuse them of that idea. Apparently his office has some 15,000 patients and he oversees eight doctors and nurses who share his beliefs. And ok, in his book he explicitly states that he once “realized we had poisoned a generation of children with a mercury-derived preservative called thimerosal”, which doesn’t count as a “realization”, before going on to talk about how kids are overvaccinated, and though he does, in fairness, not explicitly connect the dots to autism, he also talks about the alleged though non-existent autism epidemic, downplays the risks of vaccine-preventable diseases and claims that the polio vaccine didn’t eradicate polio in the US, which it demonstrably did and it would be utterly idiotic to try to claim otherwise. 

Unsurprisingly, Thomas likes to be portrayed as a brave, principled maverick doctor being persecuted by the establishment. In August 2019, for instance, Thomas was kicked out of the Vaccines for Children Program because he failed to stock two of the required vaccines (rotavirus and HPV) and was, according to the Oregon Health Authority, “not exercising medical judgment in accordance with accepted medical practice.” His response involved, predictably, to suggest – falsely as always – that doctors administer vaccines in part because there is a lot of money in it (there really, really isn’t – there is, however, quite a bit of money involved in writing non-medical exemptions, which, in places without restrictions, don’t cost antivaccine doctors anything, and in selling books and webinars that stoke parents’ concerns about vaccines).

The lies Thomas told in the Truth About Vaccines interview are covered here, including his attempt to scare audiences by telling them that the AAP does not investigate vaccine safety (ok, that’s technically true since the AAP is a professional organization: its members study vaccine safety, however) and his claim that doctors cause grave injury to children by vaccination, but are not interested in learning why or how. He also invokes the “science was wrong before” gambit by bringing up to the how doctors were promoting cigarettes in the 1950s, implying that vaccines are similarly waiting for studies to be done on them – a notoriously silly gambit in part because i) there are ample studies on vaccines and vaccine safety, ii) science and doctors knew quite a bit about the dangers of smoking in the 1950s, and iii) would therefore not promote cigarettes: the “doctors” in those old ads are actors, not doctors, except perhaps – ironically – for a few “brave maverick doctors” not willing to base their recommendations on accepted science but going their own ways. Of course, Thomas doesn’t really have a clear idea what the state of the science on vaccines actually is, something he amply demonstrates on the show by rambling about how doctors don’t know how to identify vaccine reactions and saying that no one has looked at whether unvaccinated kids have febrile seizures or die of SIDS (in reality, studies show that vaccines significantly reduce the risk of SIDS – Thomas would of course not be aware of that – and SIDS rates in the US are at an all-time low partially as a result.)

As his book makes clear, Thomas isn’t just worried about vaccines, however. He is also worried about Tylenol, that the chemicals in plastics are endocrine disruptors, GMOs, flame retardants, pesticides, fluoride, artificial sweeteners, chemical dyes, and all of the other “toxins” that other doctors and the CDC supposedly ignore. But does he have the science to back up his fear-mongering? Well, he does a bit of cherry-picking, and concludes that there is “a growing body of evidence,” which it certainly looks like as long as people continue to publish outliers and you refuse to look at the trends established by large, well-designed studies and the metastudies that support the opposite conclusions. It is also worth noting that many of Thomas’s patients show sensitivity to gluten. This is, of course, because Thomas uses an IgG food sensitivity test that experts say is basically worthless.

Hat-tip: RtAVM
His book is fairly and accurately reviewed here. There is another, comprehensive review here (short version: “Dr. Thomas has no relevant expertise in immunology or infectious disease to be making such recommendations, and it shows.”) Note in particular Thomas’s advice to pregnant women and new mothers, advice that are likely to cause deaths and serious harm if followed. And yes, it’s all couched in terms of one big toxins gambit with numerous appeals to chemophobia (“The Injectable Polio Vaccine (Ipol) contains formaldehyde, along with a host of other ingredients you probably wouldn’t want to inject into an infant with an immature immune system, including: human albumin, calf serum, 2-phenoxyethanol and antibiotics”).

Now, Thomas does seem to fancy himself a bit of a researcher, even if he really has no clue how scientific research works. The last few years he has been claiming to be running a study based on his own practice and “trying to get his data published,” which basically is him just registering what he wants to register about his own patients and is not a study by a long shot (here is a more detailed discussion of his “data”). His “research” partner appears to be antivaccine crank James Lyon-Weiler, with whom Thomas has also written a pretty inept “study” (no original research) demonizing aluminum adjuvants, published in the antivaccine-friendly junk journal Journal of Trace Elements in Biology and Medicine; that study is discussed here. (We will also take note of the coauthors, Grant McFarland and Elaine La Joie, neither of whom have any expertise in epidemiology, immunology, infectious disease, and epidemiology, though La Joie is at least “a certified life coach, and has a shamanic work practice”.)

Insert confirmation bias meme
Diagnosis: “Rising star in the antivaccine movement” should be diagnosis enough, shouldn’t it? 

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