The Grand Debunk continues with chapter 6, starting with this claim and moving methodically through each subsequent false and/or deceptive claim. Let’s dig in:

1. Unvaccinated versus vaccinated studies

The core complaint in this chapter is that not enough unvaccinated versus vaccinated studies have been done to prove the worthiness and safety of the vaccine program (this doesn't even take into account the slight variability in vaccine programs across the world). If you remember only one thing from this particular essay, the antivax ecosystem will never accept a study supporting the safety of a particular vaccine. They will always move the goalposts. When a safety study is done or some other demand is met by the antivax ecosystem, they will always find something else to complain about. I will next go into great detail, with the receipts, with the multiple times they moved said goalposts.

After the DTP vaccine was retired for its side effects and replaced with DTaP in 1991, there were still widespread complaints about DTaP, trying to pass it off as the same thing as the older DTP, to attempt to continue to scare people about the newer vaccine. 

After thiomersal was removed in most standard US vaccines in 2001, multiple antivax websites, even including antivax books for sale on Amazon, still are trying to "call for the removal of mercury" from vaccines. This is also with a total absence of awareness of the difference between elemental mercury, thimerosal, ethylmercury, and methylmercury, which a chemistry major would be able to point out easily. Even in mercury containing vaccines, nobody is attempting to add mercury metal.

Read on, to see how I would refute the central point - of how there have been, vaccinated versus unvaccinated studies, and this is what they showed. 

The most basic and important refutation to the demand for vaccinated versus unvaccinated studies, is the presence of reliable outbreaks of vaccine preventable diseases every time there is a decrease in vaccination rates. For example, there is Samoa, which is no stranger to measles outbreaks. The other factor to consider is something called the base rate fallacy. If you have a larger proportion of vaccinated people, the proportion of unvaccinated people is going to be smaller, and the numbers of unvaccinated people is going to be smaller. When you compare the proportion of vaccinated people to unvaccinated, it will look like, if you just look at the absolute number, that the number of vaccinated people getting ill is bigger. This particular mathematical fallacy has been used at least thousands of times online in an attempt to fool people into thinking that the more vaccinated you are, the more likely you are to get ill, but this is just mathematically incorrect as the amount of unvaccinated people decrease as they are vaccinated. A study comparing unvaccinated versus vaccinated COVID patients is here, and the results strongly favor getting vaccinated to protect against severe disease. A similar study was done with DTaP in a large population cohort, which demonstrated undervaccinated and unvaccinated patients had greater risk of contracting pertussis. As usual, this book shows little awareness of the seriousness of actually getting vaccine preventable diseases. HPV vaccines actively prevent most types of cervical cancer in women, and oral and anogenital cancer in both men and women. Studies that the antivaxxer ecosystem like to quote on the topic frequently have statistical issues right from the start, such as using convenience samples. All in all, there are plenty of unvaccinated/ vaccinated studies if you take the time to have a look around. As usual - the antivaxxers have ignored all the studies they don't like, willfully and systematically. They don't actually ever want to admit, that a particular vaccine is generally safe and effective. This behavior would be dogma, not science.

2. Over the past 15 years, dozens of epidemiological studies have been conducted examining the association between vaccines and autism, but not a single one compared the rate of autism in fully vaccinated and fully unvaccinated children.

This is a version of the No True Scotsman fallacy, which basically refers to how a study will not fit the antivaxxer's criteria for being desirable, unless their very specific, and sometimes contradictory criteria, are all met, line by line. To put it more eloquently, if the elephant doesn't have pink trousers, a banana daiquiri, a circus troupe, and is ready to sell you a barbeque turkey sandwich, antivaxxers would not consider it to be a genuine elephant. Just hearing the word autism is extraordinarily emotionally triggering to some, which is why this emotional button is pushed, again and again. One gentle suggestion to the reader - it is important to not make a medical decision based upon an emotional trigger. Antivaxxers love their emotional buttons no matter how detached from reality they may be. There are quite a few studies comparing children with and without MMR vaccination, and they find that the rates of autism are statistically no different. In special communities that are frequently hesitant of Western medicine in general, like the American Amish, autism is indeed found in those who are unvaccinated. In people who are entirely unvaccinated, the rates of autism have actually also gone up with time just like everyone else. There is also quite a lot of distress about the lifetime medical costs of someone with autism, which are certainly substantial, but there is little distress from the antivaxxers about the cost of a single hospitalization for a vaccine preventable illness, which can easily cost upward of a million US dollars in the United States. Such a comparison completely denies the humanity of someone with autism, who with the right tools, can live a life that is just as fulling as the person next door without autism. Theoretically, after making such a detailed discussion of research pitfalls, the antivaxxer's favorite study on this subject should have impeccable research design? That's a definite no. When antivaxxers tried to design their own study, full of methodological errors, it still fell flat with nonrepresentative convenience samples, simple statistical biases, and conclusions not generalizeable to the whole population. Their convenience sample even looked at 666 children - it shouldn't be hard to ponder why the authors would chose such a number in a convenience sample.

3. Genetics vs environment in regards to Ethiopian children who were raised as expats versus in their native country

The author claims that the Ethiopians who grew up in Israel had much more autism than those who grew up in Ethiopia. Again, one can reach this conclusion if the author purposefully only reads one study in the entire ecosystem of autism research. It is better to read research written by people who are actual professionals in the field. Brain features that may imply future autism can be detected in the fetus - clearly, vaccines cannot go back in time and cause trouble before they were given (we do not give any vaccines directly to fetuses).

4. RFK and the Somali community in Minnesota

We shouldn't forget that RFK claims he cares about people's autism, but he went into a Minnesota Somali community, scared them about the MMR vaccine, and his actions actually resulted in a measles outbreak. He never has to shoulder any of the medical consequences of such an outbreak, he cares only about his brand and his financial return. If RFK actually cared about the medical safety of the Somali community, he wouldn't have done that.

5. Is there an “inconvenient truth” the medical establishment is keeping under wraps? Questions like these, when left unanswered for too long, raise doubts in parents and erode public confidence in the folks running the vaccine program.

The authors have made their point clear by this point, that no vaccine study supporting vaccine safety is acceptable to them. Again, this is not a rational position for a scientist to take. Even vaccine scientists recognize when their vaccine should be recalled (reference the old DTP vaccine for example). If the reader wishes to discuss vaccine safety in detail with their pediatrician, they should by all means go for it. Just make use of the physician messaging system (sending electronic messages) or be ready to split the visit into more than one session, because sometimes the answers and explanations necessary may require more time than what is available in a standardized pediatrician visit. Questions only remain unanswered if the antivax speakers ask questions and have no interest in hearing a rational response or just never ask in the first place. Mostly, this ecosystem really only pays attention the answers they want to hear.

6. In the absence of a study comparing the overall health of children who vaccinated according to the official schedule to that of children who received no vaccines, would you still tell parents their children are better off getting all routine vaccinations? If so, on what grounds?

The importance of not getting vaccine preventable diseases has been studied for decades, via many different types of research studies and many different research groups. The dangers of vaccine preventable diseases has similarly been studied in great detail by infectious disease physicians. A detailed explanation of most of the major risks of vaccine preventable diseases is shown here. Vaccines help you to have less of these risks - which is the biggest logical fallacy of the statement above. It is great that the vaccine preventable diseases are not as common as they once were 90 years ago, but this makes it easy for vaccines to be a victim of their own success. One only has to look at modern day disease epidemics and outbreaks to see the real risks of vaccine preventable disease.

Overall, the authors complain in this chapter about all the studies that will "never be done". 

First off, they are neglecting all the studies that actually have been done, which address their concerns directly, but have been willfully and systematically ignored. 

Next, they care little about the ethical and logistical issues of conducting all the trials that actually haven't been done (a large RCT of the entire vaccine schedule for an unvaccinated versus vaccinated cohort of kids). 

Next, they have demonstrated absolutely no interest in adhering to standardized research methodology that is specifically standardized to get reliable experimental results, protect patients, and answer clinical experimental questions. Our research methodologies aren't specifically designed to "censor the voices" of people in the antivax ecosystem - this is a pure fiction. This is an emotional button designed to rile people up rather then encourage rational, methodical scientific thinking. Again, the entry fee to research is the same for everyone - to conduct clinical research on vaccines there are guidelines specifically in place to standardize the process and the production of the results. You wouldn't intentionally use shoddy methods to build a bridge, and the same logic applies to researching vaccines. These requirements are there to produce the most generalizeable and reproducible results available. The authors of the book just quite simply don't care.