By Christina Waldman
April 9, 2014
Re: Who Controls the Conversation? Ethical Concerns in Dorit Rubenstein Reiss, "Compensating the Victims of Failure to Vaccinate: What are the Options?" 23 Cornell Journal of Law and Public Policy (forthcoming 2014)
Dear Mr. Monroe,
In the past year, Prof. Reiss has burst upon the blogosphere as a vigorous promoter of vaccines and public health policies favorable to vaccine interests. As advocating for vaccines in social media is not something most law professors normally do in their spare time, and to the extent that she does, some have questioned the independence of her motivation. Might she have conflicts of interest to disclose? See:
"Not Paid To Post?" Dorit Rubinstein Reiss, UC Hastings College of Law and Kaiser Permanente
Who Is Dorit Reiss?
After all, despite their arguable benefits, vaccines have become a profitable health industry, with the global vaccine market currently worth $30 billion. (“Global Vaccine Market (Human and Animal) Pipeline Analysis now Available at ReportsnReports.com, 1/26/14. ) The new version of Gardasil, if approved, is expected to net $1.9 billion.
As you know, Mr. Monroe, academicians are held to high standards of fair and objective communication. You have informed me that you are unaware of any standards for conflicts of interest specific to the Cornell Journal of Law and Public Policy. The Cornell Journal of Open Access to Law gives this standard: “All authors should disclose in their manuscripts any financial or other substantive conflict of interest that might be construed to influence the results or interpretation of their manuscript. All sources of financial support for the project should be disclosed. . . ” (under “Publication Ethics and Publication Malpractice”).
Late last year, while Merck was making application to the FDA for licensing of “V503,” the new nine-strain version of its HPV vaccine, Gardasil, a battle was going on in the comment section of the KatieCouric.com blog, “HPV Vaccine Conversation Continued,” over the safety and effectiveness of Gardasil (after Katie’s show addressed Gardasil safety concerns on Dec. 4, 2013). Prof. Reiss aggressively promoted the benefits of Gardasil in comments at this blog and elsewhere, assuring readers that Gardasil is “very, very safe” and that “There is no credible evidence” of any significant risk of serious side effects--despite the many reports of serious injuries to young girls. Katie Couric HPV Conversation; Japan HPV Adverse Event Symposium; TruthAboutGardasil.org; FierceVaccines.com - Merck Warns Of Drop in Japanese Gardasil.
In response to being asked whether she wrote all the comments with her name on them, Prof. Reiss said yes, and she claimed full responsibility for them (Dorit Reiss, 12/22/13 comment to Vince Brown). Some of them sound more like they were written by a law student than a law professor. In fact, there have been so many “Dorit Reiss” comments, at so many blogs and websites, at all hours of the day and night, sometimes posted only a minute apart, that it seems unlikely for just one person to have made them all. See, e.g., Disqus.com/DoritReiss andDisqus.com/dorit_reiss Some have wondered if there is a “bot.”
When, at the KatieCouric “HPV blog,” Prof. Reiss was asked whether she were being compensated for her voluminous commenting as a vaccine advocate, she responded: “Not really. My law school would pay me the same salary whether or not I post here.” (Dec. 8, 2013. Of note, comments at that site, including this one, had a tendency to “disappear” or get rearranged completely out of chronological order; a whole week’s worth of comments seemed to simply disappear at one point, from 12/11 to 12/27/13. By 4/4/14, only 3,849 comments remain up. According to a recent article at KevinMD.com, Global Prairie, a public relations/marketing firm, digitally captured 12,049 posts within a 22-day window. Dr. Natasha Burgert, “Analyzing the Katie Couric effect on the vaccine conversation,” 2/18/14 ).
On February 4, 2013, Prof. Reiss again responded, “….As is easy see I'm an academic in a law school. My income would not be affected by posting online in any way. And in case you missed it, I use my real name.” (Retrieved 2/27/14 8:36 p.m.) When questioned about conflicts, Prof. Reiss to my knowledge has made no conflicts disclosure other than to deny financial payment from pharmaceutical companies.
and the Center for Disease Control and Prevention (CDC) have produced limited studies affirming the [relative] safety of the HPV vaccine. The two Kaiser studies (2012) were funded by Merck, while the CDC’s study (2011) was performed by Kaiser, with the same lead researcher involved in all three studies, Kaiser Vaccine Study Center’s Dr. Nichola Klein. Kaiser Permanente’s CEO, Robert Pearl, advocates universal vaccination. (4/1/14, republished from Forbes.com).
Dr. Anne Schuchat, M.D., director of the CDC’s Center for Global Health, assured the viewing public that Gardasil was safe in a subsequent Katie Couric show, after the organized outcry that Katie’s show had been biased in favor of Gardasil victims. See (article by Tara Haelle, curiously mentioning a “widely-distributed” email she had received from the CDC giving advance notice of Dr. Schuchat’s appearance. Tara also listed Prof. Reiss’s piece in her list of articles on the subject.)
In spite of relatively low cervical cancer rates compared to the pre pap-screen era, the CDC actively promotes the HPV vaccine, Gardasil.
Government call for more HPV vaccination could boost GSK and Merck
Merck readies FDA submission for son of Gardasil
Why is the CDC Ignoring Explosion of Recorded HPV Vaccine Injuries, as Other Countries Move to Take Protective Action?
For a suggested explanation, see Gardasil: A License to Kill How A Public-Private Partnership Made the Government Merck’s Gardasil Partner
It is not clear whether Prof. Reiss ever wrote professionally about vaccines before June 24, 2013 when she jumped into the fray on the side of bioethicist Art Caplan against attorney Mary Holland. Although her article in your journal will be her first published professional piece on a vaccine issue, her law school is already touting her as a “leading expert on failure to vaccinate.”
What can be discerned from the record is that Prof. Reiss is an “Affiliated Faculty” of the University of California at San Francisco/UC Hastings Consortium on Law, Science and Health Policy, a collaborative venture of University of California Hastings College of the law with the University of California at San Francisco (UCSF), one of the world’s top medical centers and “the only UC campus devoted solely to health science.” . UCSF is the second largest employer in San Francisco, with the Bay area reportedly the third largest in the world in terms of biotechnology workforce.
The Consortium has a stated purpose of advancing “health and science through informed law and policy.” “Bridging Law and Science.” One could imagine situations in which the Consortium’s agenda might conflict with independent academic choice.
Besides benefitting from interdisciplinary graduate degree programs and internships/externships with UCSF and Kaiser Permanente , the law school faculty of the Consortium will apparently have a role in furthering the interests of the new Center for Transdisciplinary ELSI Research in Translational Genomics (CT2G), “a novel resource for ethical, legal, social and policy analysis of emerging issues in translational genomics.” When conflicts arise between ethical precepts and promoting the interests of the Center, will they be more likely to be resolved in favor of the work of the Center? Or should independent ethicists be deciding such important decisions?
While we might expect a lawyer hired as in-house counsel to a major industry to zealously advocate for its financial interests, we would not expect a law professor to function as a de facto health industry advocate without disclosing the relationship. Clearly, if Prof. Reiss’s proposed changes in tort law were adopted, vaccination rates would increase (coercively), resulting in increased sales and profits to vaccine interests. The very idea of leaving exemptions as an option (for now) but threatening lawsuits seems deceptively subversive to me. Informed consent is still a precious, individual human right, but some, it seems, would alter its protections in favor of universal vaccination. See, e.g,, Dorit Reiss,“Informed Consent and Vaccines, 1/20/14 UC Hastings Consortium member and law professor Jaime King, “Rethinking Informed Consent; the Case for Shared Medical Decision Making,”
American Journal of Law and Medicine, Vol. 32, pp. 429-501, 2006
These faculty whom Prof. Reiss thanks in her “Acknowledgements” are also “Affiliated Faculty” in the “Consortium” with her: UC Hastings law professors John Diamond, David Jung, and Rob Schwartz, as well as College Chancellor and Dean, Frank Wu, (“Where Law Schools Get their Money,” 10/13/13 in (p. 16).
The consortium receives support from several sources, including the Henry J. Kaiser Family Foundation, which disclaims any association with Kaiser Permanente or with Kaiser Industries. ). The Kaiser Family Foundation website states that-- unlike other foundations--it does not make grants, but “develops and runs its own research, journalism and communications programs, sometimes in partnership with other non-profit research organizations or major media companies. “ The Gates Foundation gave the Kaiser Foundation $20 million “to provide global health information and analyses.” (Sandi Doughton and Kristi Helm, “Does Gates funding of media taint objectivity?” p. 5, The Seattle times, 2/19/11, modified 2/23/11, stating that virtually every player in global health receives money from the Gates Foundation. In May, the Gates Foundation will have a new CEO, Susan Desmond-Hellman, current chancellor of UCSF, former head of Genentech.).
With shrinking budgets, public-private partnerships between academia, industry, government, and not-for--profits are becoming more and more common. See www.merck.com/licensing/our-partnership/Eradication-partnership.html (Merck sole industry partner with academia in AIDS research). (Merck to invest $90 million in not-for-profit research and development center in Bay area, with options). Michael Cassidy, in “What it takes for America to compete,” advocates “renewing legislation to increase federal investment in universities to generate more breakthroughs in science and technology.” (The Atlanta Business Chronicle, 1/10/14, at Georgia Research Alliance.org.) The Georgia Research Alliance is a member of the “Vaccine Dinner Club,” organized to further vaccine interests and enjoy good dinners. Its membership includes persons from higher education, industry (Georgia Research Alliance, Geovax, and Merck), government, public health (CDC, though it is also a government agency), not-for-profits, and the media. ; (article by Frank Wong, AIDS researcher, member of Vaccine Dinner club, “Blind Eye to Scientific Fraud is Dangerous,” a pro-vaccination article, 2/6/2014.)
Yet, there is frequently concern about cooptation with public-private partnerships. In 2011-2012, only 9% of UC Hastings funding came from taxpayers-- an 88% drop over the last fifteen years. Uniquely, UC Hastings is not funded by the University of California Board of Regents or, apparently, under its ethical oversight, as the ten main University of California campuses are. (Of note, the UC Hastings Institute for Innovation Law explicitly states it does not accept “gifts with strings attached.”).
In a dispute over whether a university had compromised its integrity by giving too much power to a private think tank, it was stated: “In CAUT’s [the Canadian Association of University Teachers’] view, universities that badly need money to maintain their programs cannot allow outside interests to shape what they do and whom they hire; without losing the very integrity that makes them unique and valuable.”(James L. Turk, Executive Director of the Canadian Association of University Teachers, “Academic integrity depends on independence – the case of Balsillie.” June 10, 2012, .)
While persuasion is acceptable, propaganda is not. However, with so much propaganda in the media these days, many people may need help recognizing it. One tool of propaganda is appealing strongly to the emotions, attempting to override the voice of reason. Propaganda might be defined as “a deliberate, systematic attempt to manipulate beliefs and emotions, usually through methods considered deceitful and unethical.” J. Michael Hogan, teacher of a class on propaganda. . See also, Garth S. Jowett and Victoria O’Donnell, Propaganda and Persuasion (2011).
Consider that Prof. Reiss begins this academic journal article with a scare story that tugs at the heartstrings, verified only with videos in German on the anonymous blog of “Caterina” and “Science Mom.” The emotional opening might cause a reader to overlook the fact that scientific research references were lacking, or that scientific articles easily obtainable at PubMed could counter some of Prof. Reiss’s scientific assumptions.
For example, the extremely rare disease, subacute sclerosing panencephalitis (SSPE), can derive either from wild measles infection or vaccination. The mysterious SSPE is thought to be caused by a persistent, rare, defective measles [or sometimes possibly another] virus that mutates inside the body. See, for example," Subacute sclerosing panencephalitis in immunized Thai children."Khusiwilai K, Viravan S. J Med Assoc Thai. 2011 Dec;94 Suppl 7:S198-203.PMID:22619930 (SSPE in a fully-immunized ten-year-old boy); "Measles-vaccinated Israeli boy with subacute sclerosing panencephalitis." Har-Even R, Aichenbaum S, Rabey JM, Livne A, Bistritzer T.Pediatr Neurol. 2011 Jun;44(6):467-70. doi: 10.1016/j.pediatrneurol.2011.01.011.PMID:21555060 (In reporting the case in a 16-year-old boy, the article states: “This patient illustrates that subacute sclerosing panencephalitis should be suspected among young vaccinated subjects.”) In Papua, New Guinea, there was relatively little measles or SSPE before mass measles vaccination began in 1982, but after that, SSPE became a serious problem. Charles S. Mgone et al, “Clinical presentation of subacute sclerosing panencephalitis in Papua New Guinea, Tropical Medicine and International Health 8:3, pp. 219-227, March 2003. Perhaps the science is not so clear as Prof. Reiss assumes.
There is also evidence that when measles was a common childhood disease, babies too young to be vaccinated were generally protected by maternal antibodies from infection. Now, with mass vaccination, it is babies, lacking maternal antibodies, and people whose vaccine-induced immunity has waned who are most at risk. Dr. Tetyana Obukhanych, immunologist, ebook, “Vaccine Illusions;” see “Dr. Tetyana Obukhanych Talk at Aligned Chiropractic in Kelowna, B.C.” (explaining that immunologists study how vaccines work more than they study how the natural immune system works; there is still much to learn.)
In addition to her own pro-vaccine blogs, “MomswhoVax.com and “BeforeVaccines.com,” Prof. Reiss is an active, Parent Advisory Board member of Voices for Vaccines as well as several Facebook groups that promote vaccines in social media. Voices for Vaccines, which claims to be funded only through individual donations, has ties through Task Force for Global Health to our government agency, the CDC (Foundation). Its most recent annual report lists only one donor for Voices for Vaccines. (2012) , p. 42 (Melanie Ejoifor of Queensland). For more information, see
Voices for Vaccines III: The Opinions and Silences of Dorit Reiss
Voices for Vaccines and Prof. Reiss espouse the concept, advocated by Curtis Brainard in the Columbia Journalism Review (his presentation promoted on Voices for Vaccines Facebook page, 11/5/2013), that it is “false balance” or “false equivalency” to discuss both sides of the vaccination issue, since the “pro” side is clearly the only one worth telling. As Tara Haelle who writes at the RedWineandApplesauce.com blog says: “To present “both sides” is to commit the sin of false balance, or false equivalence, defined similarly by Emily Willingham as “giving equal weight to arguments that don’t carry equal weight of evidence.” “Katie Couric Promotes Anticancer Vaccine Alarmism,” (referring again to the Curtis Brainard piece aforementioned). The problem is, who decides which arguments are worth hearing? Prof. Reiss would seemingly divide the debate into “science” and “anti-vaccination movement,” but that strikes me as a comic book analogy. Not only is a scientific outlook marked by open inquiry, but objective truth is a hypothesis always subject to challenge. In the whole grand scheme of human history, vaccination is a experiment of only a hundred years or so, whose consequences on future generations remain to be seen.
For anyone to be so completely sure that he is right that he would squelch the other’s right to be heard is anathema in a free society, where free speech and open debate are of “paramount value.” The sentiments are expressed well in the Cornell University Campus Code of Conduct, Title I, Art.3, “Responsible Speech and Expression, A2: “Within such commonly accepted limits, however, freedom of speech should be the paramount value in a university community. Because it is a special kind of community, whose purpose is the discovery of truth through the practice of free inquiry, a university has an essential dependence on a commitment to the values of unintimidated speech. . . “
Of note, Prof. Reiss recently wrote a guest piece at skepticalraptor.com exploring whether the speech of people sharing vaccine safety concerns was protected by the First Amendment, or whether they could be sued if “someone was harmed by it.” Dorit Reiss, “Anti-vaccination Claims, Misrepresentation, and Free Speech,” 3/19/2014 :, As she said in a recent commenting debate, “. . . . There are no two scientific sides to the vaccine debate. There is science, and there is anti-vaccine misrepresentation. . . .” (4/8/14 6:30 p.m.,. How do you tell if someone’s arguments can be dismissed as being in the “anti-vaccine movement?” Prof. Reiss gave eight signs, quoting “Dr. Gorski.”)
The division of the world into “them” and “us” has proved dangerous in the recent past. As Prof. David Kertzer of Brown University reminds us in his 2002 book, The Popes against the Jews: “….It is an age-old story of a powerful religion or powerful people that believes in its own divinely ordained position as sole possessor of the Truth and repository of all that is good, and, pitted against it, a despised minority, the Other, the agent of the devil. It should not have taken the Holocaust to teach us how dangerous such views of the world can be, but since the destruction of the Jewish millions, we owe it to the survivors and ourselves to learn its lesson….” David I. Kerchner, “The Popes Against the Jews,” Introduction, p. 21 (Vintage Books: NY 2002).
One of several pro-vaccination Facebook groups to which Prof. Reiss belongs is called the “Anti-Vax Wall of Shame (AVWOS).” It is a group that likes to make fun of “Anti-Vaxers,” as those who express concerns about vaccines have been labelled. Note the “Files” on the AVWOS wall which enable group members to follow “anti-vaccination” comments on the web. Note the derogatory and disrespectful way in which persons holding different beliefs on vaccine safety are described (It used to be worse; they’ve cleaned it up in the past few months. Much of the language from the old, pinned welcoming rant of Michael Simpson is too crude to print; here is one of the more tame examples: “….We give no quarter to the douchbaggery brought by the anti-vaxxers. There is no length that we will not go to show their stupidity, their arrogance, their ignorance, and their hatred of children….” This is the crowd with which Prof. Reiss associates online, a crowd comfortable with “hate speech” when it comes to those awful “anti-vaxxers.” (Facebook, Anti-Vax Wall of Shame, as it appeared in December 2013.). Many who take the time to research vaccine safety concerns and post about them on the internet are parents of vaccine-injured children.
Intriguingly, several members of this “esteemed and exclusive crowd,” in Michael Simpson’s words, are among the people Prof. Reiss thanked in her acknowledgments to this article: Michael Simpson himself (of Skeptical Raptor blog fame; blog to which Prof. Reiss refers readers often , affiliated with Kaiser Permanente; Allison Hagood, Facebook page administrator of AVWOS, Carolyn Bursle, Queensland pediatrician; Paul Offit, Merck vaccine inventor and pro-vaccine spokesperson, recently an advocate of putting journalists in jail who do not toe his line (David Kroll, “Dr. Paul Offit: ‘Journalism Jail’ For Faulty Medical Reporting,” 3/29/14, Forbes online.). Paul Offit is on the Scientific Advisory Board for Voices for Vaccines; Stacy Hillenburg, on the Voices for Vaccines Parent Advisory Board with Prof. Reiss; ; Will Robertson; Rene Najera; and Maggie Howell (Note: membership of Voices for Vaccines Facebook page is no longer open information, as it was in March 2014.).
Mr. Monroe, you have told me your Journal decided not to publish my letter because you were limiting your publication to “legal academic” works. Prof. Reiss is arguing for a change in the law that would benefit vaccine manufacturers and others financially, ostensibly in the name of the public good, by coercing parents under threat of lawsuit into vaccinating their children, despite risks which cannot be known in advance for particular children. In a free country, does health care by extortion really seem advisable? Much has been written on the morality and ethics of coercive vaccination in Louise Habakus and Mary Holland, J.D.’s book, “Vaccine Epidemic” (Skyhorse Publishing: NY 2011, 2012).
In short, not everyone shares Prof. Reiss’s starting assumptions that “the science is clear, that “vaccines are very, very safe,” or that it is acceptable to sacrifice some children to vaccine injuries for the asserted good of others. One could argue that Prof. Reiss in her “Acknowledgments” has made partial, if veiled, disclosure of affiliations which might call into question her fairness and objectivity in writing about vaccine issues and which might, arguably, be “construed to unduly influence the results or interpretation of her manuscript.” Infants and children cannot weigh risks and benefits of vaccines before consenting or refusing injections. Our duty of care towards them is of the highest nature, a sacred trust.
Thank you for considering my concerns.
Christina G. Waldman
Christina Waldman is a New York attorney and mom who shares Dr. Andrew Wakefield's concern for vaccine safety as a priority in public health. She is concerned about the health of her future grandchildren, who will be expected to receive many more vaccines than her own children did 30 years ago.