Having raised the issue of Heidi Larson's intervention in the vaccine debate on the BBC last week, it is worth considering - given her global status as vaccine confidence chief - how much she actually knows, but also her lack of professional accountability. Indeed, the first time she came to the attention of Age of Autism was when she wrote an article in New Scientist helping to lobby the United Nations (successfully as it turned out) not to place a ban on mercury in vaccines under the title: "Poison pill: Not all mercury is toxic". Troubling perhaps in retrospect apart from the very poor argument is that the case was not being made by a medical doctor or toxicologist, but someone who was not professionally accountable for such an opinion. We met the same problem with her recent broadcast:
Well, I think the main thing is there most incredibly extensive safety around vaccines - the processes that go around vaccines, the reasons there is quite a while between when vaccines are developed and when children actually get them is because the system has become more and more and more robust around safety. Frankly, partly because of the public cry for this, but it has always been that way from a safety perspective because the government frankly is accountable and if it is recommending and requiring in some senses these vaccines in some senses it is not in the interest of the governments or the producer to be recommending something which is going to cause any damage.
You could say this sounds like a satirical parody of someone defending vaccine safety. It is not merely that we find ourselves in disagreement over facts, it is actually that the language is vague and she does not seem to remotely know what she is talking about. Of course, it would be much easier to advocate that vaccine are safe, carefully trialed and monitored, if you really did not know anything much about it beyond your own propaganda.
Previously, Larson has pronounced herself concerned about vaccine safety. She told Johnson & Johnson website in 2017:
Yes, there are potential risks—there will always be potential risks with any medical treatment. And we don’t talk enough about that.
Which is all very well perhaps until you accuse the people who are talking about it of the equivalent of "hate crime". Adriana Gamondes reported in these columns last month:
The corporation was so uninterested in Brabant’s adverse reaction [to a yellow fever vaccine] that even Dr. Heidi Larson—lead researcher for the Gates Foundation’s Vaccine Confidence Project—called the company’s response “inadequate” and suggested that the vaccine formulation—which has not changed since the 1960’s—is not only outdated but being given in too large a dose. Interestingly, Larson holds up Sanofi-Pasteur’s conduct in this case as an example of the damage corporations do to public confidence in vaccination.
But is it going too far to suggest that Brabant's injuries seem real to Larson because she and he had both worked for UNICEF: they are part of the same class - the rest of us can apparently go hang. And you become credible because you move in the right circles:
Dr. Heidi J. Larson is an anthropologist and Director of The Vaccine Confidence Project (VCP); Professor of Anthropology, Risk and Decision Science, Department of Infectious Disease Epidemiology, LSHTM; Associate Professor, Department of Global Health, University of Washington; and Chatham House Centre on Global Health Security Fellow. Dr. Larson previously headed Global Immunisation Communication at UNICEF, chaired GAVI’s Advocacy Task Force, and served on the WHO SAGE Working Group on vaccine hesitancy. The VCP is a WHO Centre of Excellence on addressing Vaccine Hesitancy.
Dr. Larson’s research focuses on the analysis of social and political factors that can affect uptake of health interventions and influence policies. Her particular interest is on risk and rumour management from clinical trials to delivery – and building public trust. She served on the FDA Medical Countermeasure (MCM) Emergency Communication Expert Working Group, and is Principle Investigator of the EU-funded (EBODAC) project on the deployment, acceptance and compliance of an Ebola vaccine trial in Sierra Leone.
In her job as an anthropologist Larson dreams up all sorts of reasons why people do not trust vaccines, avoiding the real reasons: the failure to trial: the failure to monitor; the failure to listen; the failure to heed; the denigration of almost anyone who speaks up. In a recent paper she and colleagues were trying to come to an academic definition of "trust". But if tens of thousands of people have simply come to the view that they or their children have been cheated of their lives they have as much right to say so as Malcolm Brabant, even if it makes her job impossible.
John Stone is UK Editor for Age of Autism.