Jay Bhattacharya's replication hypocrisy
The NIH director's plan to restore trust in public health
Jay Bhattacharya thinks solving the replication crisis will help restore trust in public health.
In a recent interview with Bari Weiss, “Jay Bhattacharya Was ‘Dangerous.’ Now He Leads the NIH,” he discusses the public’s lost faith in medical professionals. Never mind his involvement with the Koch-funded, anti-lockdown, pro-business treatise, the Great Barrington Declaration, which quickened the erosion. Both Weiss and Bhattacharya treat this document as sacrament, not sacrilege—certainly not the result of wealthy businessmen hellbent on jumpstarting the economy, health be damned.
Julian and I are going to cover the entire 101-minute conversation on Conspirituality this Saturday. There’s a ton to discuss given Bhattacharya’s installment as one of the top public health professionals in America. For now, I want to focus on one of his many glaring inconsistencies: the replication crisis.
Karmacoma
Bhattacharya’s main gripe with clinical trials is lack of replication. This isn’t a new issue: The New Yorker offered a deep dive into this problem back in 2013, while an early citation dates back to 2005 (ironically by Bhattacharya’s Stanford colleague and fellow anti-lockdown proponent, John Ioannidis).
The contention: clinical studies reveal something, which is then repeated as gospel, but the results aren’t independently tested again. When they are, the results sometimes don’t hold up. By that time, the initial results are taken as truth.
While the main focus of this crisis has largely been social sciences, biological sciences also face this problem. As Bhattacharya states, there isn’t a ton of incentive to replicate trials, which is partially correct. That doesn’t mean some trials aren’t put to the replication test, which I’ll get to.
Bhattacharya’s claim that public trust was eroded due to Covid measures is tangentially true, but more is revealed by what he omits: a small but vocal minority of health professionals, backed by business interests and marketed by a right-wing media ecosystem, muddied the waters so much that the public did, indeed, lose trust. Yet he puts it all on the public health establishment, which is unfair.
Yes, some experts were too excited about the development of Covid-19 vaccines. Some thought it would completely “stop the spread,” a misconception that was quickly corrected. Bhattacharya never discuss the correction. He’s smart enough to know that the heart of science lives in the humility of its practitioners. As Weiss notes, the man has written 135 or so papers in his career, some quite good—I read a few pre-Covid ones on the social determinants of health before watching this interview.
Bhattacharya knows that corrections are essential. He earned his MD from Stanford in 1997. A few years later he earned a PhD in economics, econometrics, and health economics, the focus of his career. In this light, it’s not surprising that he would promote toward business interests over public health by the time Covid-19 rolls around.
Point being, the man still knows that good science means correcting assessments when new information is presented, which is exactly what happened with the Covid vaccines. It’s understandable that the public would be angry and confused during such a stressful time, but medical experts should know that the proper protocol was honored and extend a bit of grace—something Bhattacharya, who converted to Christianity in his youth, ends the podcast with a request for when it comes to politics.
No grace is extended to those who opposed the Great Barrington Declaration, however. Bhattacharya agrees with Weiss that his ascension to a top health position is partly due to “karma.”
Then, they both share a laugh.
What’s the real crisis?
Replicating findings is important work. I’m not against more NIH money flowing into such trials, as Bhattacharya suggests. Yet he can’t even honor his own request, as evidenced in the very same interview.
Weiss is a softball interviewer. She fawns over Bhattacharya throughout the podcast. She’s infamous for leading questions that give the interviewee an out, even when she’s pressing them, which she does in the second half of this discussion around vaccines. But when the conversation finally touches upon the vaccines-autism “controversy,” Bhattacharya says:
Just take probably the most controversial example of what [RFK Jr] said, things about having to do with autism, right. He has an idea about what causes autism, but I'll tell you from a scientific point of view first there's been a tremendous increase in autism diagnosis. I look at the data, you know, you can't avoid seeing huge increases in autism diagnosis. Everyone has their pet theory for why and yet we don't know why. I as a scientist do not know the answer to that question, and so when I hear moms asking me, ‘how can I prevent my child from being becoming autistic, what should I do for my autistic child,’ it's hard to answer because now I'm back as the third-year medical student with the white coat on and I can’t pretend I know the answer when I don't. The answer in that situation is to do excellent science so that we can ask, we can find out what causes it, and then we can address it in an informed way.
A whole lot of words for a man who, just minutes before, was demanding that we need more replication of studies. Here’s the thing: the vaccine-autism link, which comes from a fraudulent study on just 12 children, has been retested many times:
More than two dozen studies have looked at the MMR vaccine and autism and not found a link. These include a massive 2019 study in the Annals of Internal Medicine, which looked at more than 600,000 children in Denmark. These studies have been done in different styles and different countries. All have reached the same conclusion.
If there’s ever been research that’s been retested and consistently not been replicated, it’s the vaccines-autism link. Instead of honoring his own request for this very thing, Bhattacharya punts. He thinks RFK Jr’s plan to “study” a vaccine-autism link, which will be led by a known anti-vaxxer, is a good idea.
Kennedy repeatedly claims the science “isn’t clear” even as it stares right at him. Bhattacharya’s interview confirms he’s going to enable Kennedy’s dangerous rhetoric, regardless of his personal feelings on the topic.
Bhattacharya later claims he would vaccinate his own children again. It’s the “other vaccines” he’s worried about—the success of Covid vaccines has also been replicated, mind you. This line of thought leads to the following mind-bending sentiment—and remember, the context is the MMR vaccine supposedly causing autism:
There is no study I've seen asking whether the Covid vaccine is linked to autism. Now it was just recently put on the childhood schedule, so it couldn't be responsible for the fact the autism that came before, but is it linked to autism going forward? There's no specific study that's looked at that. There are questions that people have about that that are not unreasonable questions.
As of September 2024, over 624 studies on Covid-19 vaccine effectiveness have been conducted across 52 countries. These include randomized controlled trials, observational studies, and meta-analyses, providing a comprehensive understanding of vaccine performance under both clinical and real-world conditions. The consensus from these studies is that Covid-19 vaccines are highly effective in reducing infection rates, disease severity, hospitalizations, and mortality.
Apparently that’s not enough replication for Bhattacharya, who would rather suggest that children not receive Covid vaccines, as he tells Weiss.
Meanwhile, Bhattacharya devotes one sentence to the “good studies” that fail to replicate Andrew Wakefield’s fraudulent propaganda while spending many discussing the distrust parents have in clinical medicine and the supposed uncertainty of vaccine science.
When Weiss asks Bhattacharya how he’ll respond when people ask him for advice as NIH director, he says they shouldn’t look to him. Rather, they should heed the advice of many sources—a “do your own research” remix.
I agree with Bhattacharya on this: people shouldn’t turn to him for medical advice. My reasoning is, obviously, wildly different.