Physicians for Informed Consent is a group based out of California lead by an internal medicine physician turned holistic medicine practitioner, whose main goal is, in their own words:

nonprofit organization focused on science and statistics. PIC delivers data on infectious diseases and vaccines, and unites doctors, scientists, healthcare professionals, attorneys, and families that support voluntary vaccination.

The problem with this narrative is they right off the bat, try to deceive the reader by omitting facts they don’t like. I will, in this 9 part series, debunk all their famous vaccine summary paperwork. Theoretically they support informed consent prior to vaccination, but this by definition cannot be achieved by leaving out so many holes that the information provided to the audience is like a slice of moldy Swiss cheese. This debunk will focus on their description of the COVID and influenza vaccines. To avoid accusations that I do not quote accurately, all quotes from the PIC website will be presented in the form of screenshots so nobody can tell me I took their quotes out of context. Let’s get right into it.

So when someone tries to “challenge the narrative”, I expect the person doing the challenging to exhibit a strong command of the science they are challenging, especially when it is coming from some physicians who are supposedly pro informed consent. This first assumption comes with many, many holes.

• COVID vaccines have multiple lines of evidence that they helped decrease the spread of COVID-19 back in the early days of the pandemic, but now that we have all variants and subvariants of Omicron, the COVID vaccines are less effective at preventing transmission (but not useless)
• High universal vaccine rates are in 2024, most useful at decreasing the risk of severe disease and the risk of long COVID ; they must be used in concert with other public health measures like masks to maximally decrease the risk of COVID infection
• The three facts above fail to take into account the base rate fallacy. What this means is that let’s say you have a group of 100 people, where 50 are vaccinated, and 50 are unvaccinated to start off. Lets say you persuade an additional 30 to be vaccinated, so the groups are now 80 vaccinated, 20 unvaccinated. If severe COVID occurs to 5 of the unvaccinated, and 2 of the vaccinated, the proportions respectively would be 5/20 = 25% of the unvaccinated, and 2/80 = 2.5% of the vaccinated. With this comparison, it is easy to see that more unvaccinated are getting seriously ill. However, as the populations are scaled up to realistic numbers, the amount of unvaccinated as a proportion of the entire population gets smaller and smaller, but severe disease still occurs within the vaccinated group, as immune systems are not perfect, some people just won’t mount a good protective immune response against COVID. If you want to be willfully dishonest, you can still compare the numbers of unvaccinated versus vaccinated who get severely ill, and after a certain point, the proportion of vaccinated who get severely ill slowly increases simply because the amount of unvaccinated are so small – and claim, just as Fox News did, that more “vaccinated are getting COVID”. The fact of the matter is, COVID vaccines remain excellent at preventing severe disease and so does prior infection in 2024 (however this still means it is not smart to gamble with long COVID).

This assumption is not because some guys got together with the British Monarchy and made a proclamation from atop Buckingham palace – this is based upon every epidemiological study in the world. COVID vaccines strongly decrease the risk of severe outcomes and death from COVID 19. Fact 5 commits the same error as the first assumption, where they forgot about the base rate fallacy. Fact 6 and the graph following it misleadingly show the total cumulative deaths over time rather than the death rate, which has sharply decreased since the COVID vaccine rollout and the accumulation of some degree of population immunity. The authors at PICphysicians have so little respect for their reader that they assumed they would not read the graph label, which clearly shows “total deaths” when they are trying to state their case about mortality rate, which is a different mathematical concept. Because every single month since COVID has arrived on the scene, has resulted in COVID deaths, the number of total deaths is going to accumulate over time. That’s just primary school mathematics – something called addition. If one queries an interactive dashboard that actually calculates rates, one can see that the death rates have indeed gone down over time and have smaller peaks.

The study that was referenced to make this claim committed the dishonest statistical trick of p-hacking, which is in laymans terms, rearranging the data until you get the statistical result you prefer to hear. The actual answer to this question is that the number of hospitalizations depends on the age group queried, gender, specific side effected identified, and time the study was completed. Overall, every single population level study demonstrates COVID hospitalizations were less frequent in vaccinated populations. The first two side effects of special interest that gained massive public and media attention were clots and myocarditis. Clots are now known to be associated with the viral vector vaccine, and the Astra Zeneca/ Johnson+Johnson vaccines are essentially not available due to the research into this side effect. The mRNA vaccines are known to cause myocarditis in rare instances, mostly in teen boys and young men, although the exact cause of the myocarditis is unknown (current research is leaning towards a genetic mutation in how people handle immune system responses). Myocarditis specifically has different rates in different age groups, but public health agencies are no longer recommending two vaccines spaced two months apart in large part due to this concern. COVID vaccines clearly decrease all-cause cardiac events in all ages they were tested. So overall, Physicians for Informed Consent has misstated the research multiple times here and also neglected to describe what actual researchers have done to mitigate COVID vaccine side effects.

If the reader of my blog actually digs in the articles they cited (these are the CDC meetings describing COVID vaccine side effects), one will find that they cited the title of the side effect “severe systemic reaction” for theatrical effect, rather than fully describing what happened, which is flu like symptoms that were certainly uncomfortable, but the kids got over it. Yes it is true that small kids don’t get serious COVID like the adults do, but they still land in hospitals, need oxygen, and sometimes IV fluids (which are efficiently decreased with vaccination). One of the most serious complications (which thankfully doesn’t happen all that often anymore) is multisystem inflammatory syndrome, which is efficiently decreased with COVID vaccination. This again fails to take into account that the Pfizer vaccine has less side effects, and nobody is asking people to vaccinate with two COVID vaccines doses two months apart anymore, which demonstrably decreases the rate of side effects even in historical data.

This statement indidates the PIC authors only acknowledged one clinical study of COVID vaccines in children, when in reality there have been multiple, several of which are randomized clinical trials testing COVID vaccine safety and efficacy directly in children. One could say the authors are stuck in a particular time period and can’t “open their blinders” to look at studies that occured at another time.

All the major side effects of the COVID vaccines have been identified – fever, chills, myocarditis, neuropathy, and vaccine inducted thrombotic thrombocytopenia for the viral vector vaccines (my mind is open for new, better research to show me more adjudicated side effects). There are hundreds of articles assessing fertility (reference Twitter user @VikilovesFACS) and there is no effect on fertility. While the contrarians love to reference the theoretical carcinogenicity of the COVID spike protein, they should be trying to help people not get COVID if they were being intellectually honest – however these people usually also say COVID isn’t that bad (logical fallacy much? ). In reality, the major US professional cancer societies have looked for, and not found any significant increase in cancer due to COVID vaccination. They commit the oldest antivax trick in the book – ignore all studies they don’t like.

Immunity against serious disease from COVID actually is most resilient with vaccination plus infection. While the amount of antibodies wane as they do with most viral diseases, the cells of your immune system display a remarkable ability to help against serious disease even many months after initial infection. Waning antibodies by themselves do not imply waning clinical immunity (your ability to fight off an infection). Booster shots are most critical for our most medically fragile population, but sincere efforts should be undertaken by anyone who is willing, to decrease their risk of long term cognitive deficits and risk of long COVID by masks plus vaccination. While we are no longer able to prevent every mild COVID infection unless we mask extremely carefully and consistently, using vaccination plus N95 masks together is most effective in avoiding all of COVID’s most severe consequences (in addition to getting the nice benefit of avoiding all the other respiratory viruses).

The people who understand infectious diseases the best, professional infectious disease societies (such as the IDSA in the United States), have been analyzing new treatments as they come on board, and the only antiviral that is effective for COVID is paxlovid. The studies that back up Fact 18 have multiple statistical weaknesses, mistakes, and at times, outright fraud. The best prevention is N95/ P100 masking, and vaccinations.

This is false on several levels. At the most basic level, antivaxxers don’t actually want you to care about influenza! In their world, it is not a big deal and something you can just brush off. Next off, the inquisitive reader is encouraged to read the actual source. The actual study looked at 999 kids and adults, and checked if they had respiratory viruses, including influenza, after an influenza vaccination. One part of their results is not surprising – because influenza vaccine has variable effectiveness, the vaccinated versus unvaccinated groups got approximately the same amount of influenza. This doesn’t negate the influenza vaccine’s effectiveness, because you need a bigger population to see that statistical difference. What interests PICphysicians is the second part of the study, which shows a hazard ratio of 1.65 overall for non-flu respiratory illnesses across the whole population studied.
First off, this is a small effect. Next off, while they are referring to a legitimate principle of biology, viral interference, they fail to properly link this biological concept up with what actually occurs in real humans. A bigger study reveals that viral interference is a very small to nonexistent effect in a larger population of adults. Next, the PIC authors need to work on their English comprehension skills, because the study being cited indicates the effect was found in kids but not in their adults (and their assertion misses this). Next off, even the study authors note the importance of vaccination to prevent serious outcomes of influenza. Lastly, the authors of the study being cited included both medically attended and non-medically attended respiratory illnesses, where the total absolute difference of illness was 3%. If they had done a sub-analysis of medically attended respiratory illness, that difference would have been smaller, maybe even nonexistent (consistent with most people’s real-life experience of not getting a doctor for every little sniffle).

The Joshi study they are quoting has several levels of confounding variables that are described here. The claim above is completely debunked here. What PIC physicians doesn’t want you to know is – even though scientists know the influenza vaccine isn’t as effective as the other vaccines – some people will still buy less severe influenza disease and a lower risk of hospitalization. They also don’t want you to realize that although the influenza vaccine decreases the amount of influenza disease from a small number to a smaller number, spread across the approximately 300 million people in the United States alone, that is a very large absolute number of people who had less severe disease or a lower risk of hospitalization. Lastly, they also don’t care about the well established fact that influenza vaccine researchers are in fact trying to develop the one-and-done influenza vaccine, so that we don’t have to deal with the variable effectiveness and the seasonal update anymore.

Here they are trying to play the same trick as COVID deniers played during the worst years of COVID – if a vaccine doesn’t completely stop transmission, then it’s rubbish. This is a form of the nirvana logical fallacy. As someone who actually had to study vaccines in medical training (unlike the PICphysicians), most vaccines have reasonably good efficacy in decreasing transmission, but only very few vaccines truly sharply reduce or stop transmission. All vaccines buy the user a decreased risk of severe disease and hospitalization.

I repeat what I said above: PICPhysicians also doesn’t care about the well established fact that influenza vaccine researchers realize the influenza vaccine’s variable effectiveness, and are in fact trying to develop the one-and-done influenza vaccine, so that we don’t have to deal with the variable effectiveness and the seasonal update anymore. This doesn’t mean that the currently available vaccine is meaningless. They even forget that influenza vaccines decrease the risk of heart attack.

They are referring to a concept called original antigenic sin here. As is typical, when there is controversial information in virology, the antivax ecosystem twists it to suit their message. The concept refers to the immune system recognizing a previous version of a virus via infection or vaccination, and then because it is “used” to that version, it has more difficulty recognizing the newest version of the virus. The PIC also fail to consider the carryover effect, which means that the benefits of the prior season influenza vaccine can carry over to the new season in some cases, and artificially elevate the effectiveness comparison. The CDC has specifically studied flu season vaccine effectiveness by season, and they have found that although the effectiveness changes from year to year, the effectiveness remains. Again I repeat the recurring theme – informed consent is created when the patient is given a full overview of all the facts in their appropriate context. Point number 5 above is taken out of context.

Death is most certainly uncommon, but they go off the rails when they forget that hospitalization is far more common, which is an outcome that can be mitigated by vaccination. Our youngest and our oldest are hit hardest by influenza.

The PIC group try to deceive the reader here by using the English plural of the word study, “studies”, but they only picked the studies that show the deaths aren’t decreased, and ignore all the other studies that say deaths and severe outcomes are decreased. While there is legitimate debate about the place of observational studies versus prospective cohort studies, bigger studies such as this one show the consistent message that less people get serious outcomes when they receive the influenza vaccine. It is also a rather asinine mistake to make the assertion that no influenza studies occurred after 1980, which is what you have to assume if you are only looking at a followup period from 1960-1980 (which is what the PIC group did here to make assertion #7).

The mistake in English reading comprehension, or more likely malicious omission, committed here, is that the PIC group failed to clearly spell out that they study they cited included specifically long term care facilities. It should be plainly obvious that there are other healthcare settings other than long term care facilities. There are multiple other streams of evidence other than the one they cited, from healthcare workers and from non-healthcare workers, that says when more people are vaccinated against influenza – although the relative efficacy varies from year to year – less people catch influenza. Healthcare workers themselves also benefit from vaccination. Unlike in the PIC writeup, citation 19 thoughtfully discusses relevant holes in the evidence base for healthcare worker vaccination and how public health policy could be improved to answer some unanswered questions and improve the evidence base. The PIC group cited a helpful final citation for their atrocious writeup, but failed to learn any useful lessons from it.