The RFK Jr. Problem

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I recently called up my friend Safi Bakal. I wanted to see if he could correctly guess the answer to a puzzle.

First of all, before we start, I just wanted to briefly establish your bona fides for this conversation. You

have a PhD from MIT, is that correct?

Stanford. Stanford.
Stanford. And you went on

to work on the development of a number of different

drugs? Is that correct? I did. Safi ran a drug company for a long time that worked on some of the hardest problems in cancer treatment.

In preparation for our call, I sent Safi the package insert for something called Rototech. As I'm sure you've noticed, when you get a prescription drug, There's a leaflet inside the box.

I'll fold it up, tiny print. That's the package insert.
It tells you in great detail every benefit, every side effect, every clinical study associated with your medication.

The Food and Drug Administration and drug companies spend years working out the exact wording of that leaflet.

I'm assuming you've never read this before. Never read it before.
I just saw it 20 minutes ago whenever you sent it.

Rototech is a vaccine to protect babies against a very nasty intestinal bug called rotavirus. What Safi first noticed was how well it worked.

Where I go to right away that's interesting is the efficacy data,

which is post-marketing, adverse events, description, drug interactions, clinical studies, section 14.

Yeah, that's amazing. You look at table eight on page 10 or whatever.
Yep.

There was one incidence

of

any grade of diarrhea or gastroenteritis, which is what this virus is supposed to protect, and 51 on the placebo arm. Oh, wow.
So it's 50 times higher, 50 times higher. More kids will get

some

serious or moderate diarrhea or gastroenteritis

compared to those who got the vaccine. That tells me, of course, I want the vaccine for my kid.
Yeah. If I told you

you had a drug in development that had efficacy data where there was a 50x difference between treatment and control,

what word would come out of your mouth? That's absolutely astonishing. That's just jaw-dropping.
You almost never see that kind of efficacy in a therapeutic for treating active disease.

You see it once in a generation. You know, a 50x improvement is

incredible.

And now that Safiy knew what we were talking about, it was time to see if he could answer my little puzzle. A puzzle connected to the co-inventor of Rototech, a man named Paul Offutt.

I want to read to you, now that we've done this, I want to read to you from a book. I'm going to have to tell you who wrote it, but it's someone in a position of real authority in the world.

The best evidence indicates that Dr. Offutt's rotavirus vaccine causes negative net public health impacts.
In other words, Dr.

Offit's vaccine almost certainly kills and injures more children in the United States than the rotavirus disease killed and injured prior to the vaccine's introduction.

That's just complete bullshit.

I don't know what else to say. That's just, you look at this data.
This is extremely robust, careful data. You look at the statistics are published on all of the

numbers and tables here. It is just absolute nonsense.
Do you want to guess who wrote that?

Does it rhyme with Genity?

Oh, Safi, you win the prize.

My name is Malcolm Gladwell. You're listening to Revisionist History, my podcast about things overlooked and misunderstood.

This episode is the very strange story of Rototech, a vaccine that every American infant is supposed to get three times in their first eight months of life.

Or rather, the very strange campaign waged against Rototech by Robert F.

Kennedy Jr., the Secretary of Health and Human Services, the man in charge of every aspect of health, medicine, and research in the United States.

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AMU, steady through every mission. If you are the parent of small children in the developed world, in the 21st century, diarrhea is not high on your list of things you worry about.

But that was not true of your parents when you were a child, or your parents' parents, or anyone else for that matter, going back as far as human beings go.

particularly those living in the poorest parts of the world. This is what it used to be like.

There's one vivid memory that I can actually think of

is going into these pediatric wards and you had

patients, these children, literally to the point that you would actually have a diarrhea ward, a separate diarrhea ward.

because that was the quantum of cases that you would see in hospitals without exception.

This is Vishwajit Kumar, a pediatrician and public health researcher in Uttar Pradesh, one of the poorest states in India, remembering his days as an intern in the 1980s.

You have babies who come in dehydrated, severely dehydrated, and the first thing, you know, sunken eyes.

You know, you could just pull their skin and you'll find that, you know, they just don't retract because there's no turger pressure.

A small child would get sick with the rotavirus. They would run a fever.
They would start vomiting. They would develop severe diarrhea as the virus wreaked havoc in their stomach and intestines.

That's three sources of dehydration, suddenly and simultaneously. And if the child was far from a hospital and already malnourished, they were in trouble.

The best estimates at the time were that children in developing countries had between four and eight episodes of severe diarrhea in their first five years of life, each lasting from two to ten days.

For Dr. Kumar, this meant a giant room full of shrunken infants, two and sometimes three to a bed.

So you have these sweepers

whose job is to just keep cleaning the mess. Or the parents would do it, or the parents would clean it, you know.
And of the children in that ward in that era, how many would you lose?

Okay, so let's say there is a hundred of them who come in with severe and life-threatening diarrhea.

You'd lose 10% for sure. Oh, my goodness.

I mean, to lose one,

to be a doctor and lose one baby is emotionally overwhelming. You're talking about

over the course, so over the course of working in a ward, you would lose dozens of children over the course of months. Yes.
yes.

So, to give you an example, so we do these verbal autopsies because hospitals don't have good records.

And so, you essentially reconstruct that event so that then experts can sit around and say this possibly could have led to the death.

I have never been able to go through one verbal autopsy in one city.

What do you mean? It's so heartbreaking because you're like, oh,

you know,

this could have been so.

This could have been prevented. You know, it's like you look at these cases and see every newborn dies.
There is one mother who also in some ways, there is some part of it dies with her.

The battle against rotavirus took years. First, the virus itself had to be identified, separated out.
from all the other pathogens that can cause diarrhea in young children.

Then a vaccine had to be constructed from that newly identified virus, another time-consuming task.

One of the leading groups working on the problem was at the Children's Hospital of Philadelphia, at a lab run by Paul Offitt.

You helped develop the rotavirus vaccine. In what year did that

come out?

2006. 2006.
How long did you work on that? 26 years. Wow.
Why was that a hard problem to solve?

I don't think it was terribly hard to solve. It just takes a long time to solve these things.

Although the veterinarians knew this to be a cause of disease in animals since the 40s, it wasn't really described as a human pathogen until the 70s. So there wasn't a lot of information about this.

So we developed a small animal model for the disease in the early 80s.

And then we figured out and simply put which part of the virus made you sick and which part of the virus induced an immune response that was protective.

And with that information, we then combined strains that were avirulent, benign, with virulent strains

to knock out the virulent part, but include the protective part, thus summarizing 26 years of work in 40 seconds.

Offitz Group took their candidate vaccine to the drug company Merck, which spent well over a billion dollars to bring the candidate vaccine to market. The result was Rototech.

And with that, you know, the vaccine eliminated, really eliminated hospitalizations from this country.

We don't really, most pediatric residents in our hospital have never seen an inpatient with rotavirus, which is amazing because it dominated my residency. It dominated your residency.
Oh, yeah.

No, over the winter, you were just flooded with kids both in the emergency department and coming into the hospital with severe dehydration. Yeah.

And now it's gone.

And now the hospitalizations are gone. Other rotavirus vaccines followed.
A group of scientists in India developed their own in 2016.

Also, around this time, many developing countries made huge strides in sanitation, which cut down on the spread of the virus. Oral rehydration therapy became widespread.

And now the dedicated diarrhea wards that were such a big part of Kumar's training are all but gone.

It's hard to find anyone who works with children and remembers the way things were who isn't in love with the rotavirus vaccine.

And you sort of list the most important innovations that you've seen that have affected the lives of children. Where does this rank?

At the top. Amongst the top.
This is Dr. Zulfikar Bhutta, co-director for the Center of Global Child Health at Sick Kids Hospital in Toronto.
He spent years as a pediatrician in his native Pakistan.

We went down from 10 million child deaths under five in the year 2000. By 2015, to just under 6 million deaths.
Today, they are down to around 3 million deaths in children under five.

It's the fastest rate of reduction in child deaths in the history of mankind. And it hasn't just happened by happenstance.

And this is the vaccine that Robert F. Kennedy Jr.
hates.

It's the coziest time of year on Britbox. That means making piping hot tea on a chilly day, wrapping yourself in something soft on the sofa, and getting getting lost in a brilliant series.

This holiday season, Britbox has you sorted with the best of British TV. Curl up with eye-raising mysteries on the cliffy English coast in the new season of Beyond Paradise.

Escape to sweeping countryside manors where headline-making scandal is just another Tuesday in Outrageous.

Or patrol the charged streets and criminal underbellies of Belfast in the new season of the BAFTA-winning police drama Blue Lights.

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I have to confess that I knew very little about Robert F. Kennedy Jr.
before he ran for president in 2024.

But as he loomed larger and larger in the news, I realized I had his most recent book, The Real Anthony Fauci. Bill Gates, Big Pharma, and the Global War on Democracy and Public Health.

His publicist must have sent me a review copy when it came out in 2021. I found it in a big pile of books on the porch.
So I decided to read it, all 492 pages.

And it was there in chapter 3 that I discovered the particular loathing that RFK Jr. has for the rotavirus vaccines.

I couldn't make head nor tails of it, which is why I had to call my friend Safi Bakal up.

We were going over the package insert,

which you thought was clean as a whistle. Yeah.
Right.

And so I was trying to figure out why, if it was as clean as a whistle, does Kennedy have such a problem with rotatec and

rotavirus vaccines in general? And I want to read to you the key paragraph in his book,

which, and we're going to try and solve this puzzle together because I have a vague idea, but I think I'm, I can't, my ideas so reflect so poorly on him that I, part of me thinks it can't be

the right idea.

This is the key paragraph. Reported adverse reactions from Dr.
Offit's Rototech vaccine range from 953 to 1,689 per year.

These included fever, diarrhea, vomiting, irritability, intosusception, SIDS, severe combined immunity deficiency. Kennedy lists 20.

different really bad things he thinks are associated with rotatec ending with gastroenteritis pneumonia, and death.

Then he writes the paragraph that I read to Safi at the beginning of this episode: that the list of adverse reactions is so long that Rototech quote, almost certainly kills and injures more children in the United States than the rotavirus disease killed and injured prior to the vaccine's introduction.

Now, I have to say that at this point, things get deeply confusing because I couldn't figure out where that number, 953 to 1689 adverse reactions a year, comes from.

In the real Anthony Fauci, Kennedy lists as his source the package insert, but those numbers aren't in the package insert.

We hired a fact-checker with a PhD in biology, and she couldn't figure out where Kennedy's numbers come from either. Then we thought, oh, he got the numbers from VARES, the vaccine adverse event.

reporting system which is the government-run database where anyone can report a side effect that they think is associated with a vaccine. Keyword, think.

But VARES isn't Kennedy's source either. We found the numbers.

VARES only has 344 reports of side effects over 15 years for all rotavirus vaccines, of which only 32 are serious, which is like miles and miles away from the massive number of problems that Kennedy's talking about.

And even if he just made a typo, and read the numbers wrong, it still doesn't prove his case.

Because as the CDC says, quote, a report to VARS does not mean a vaccine caused an adverse event, end quote.

So just because a baby vomited after getting his rototech doesn't mean rotatec caused the vomiting. Babies vomit all the time.

To prove the vaccine was the cause of the side effect, you really have to dig into the data, look for patterns, or better yet, go back to the original clinical trial and see if there were any clues when the vaccine was first tested for side effects.

In the case of Rototech, the clinical trial trial was enormous. 12 countries, 34,000 infants were given the vaccine.
34,000 were given a placebo.

The babies were followed for a full year, and absolutely every medical event that happened to them was recorded and analyzed. 68,000 babies.

If in the course of a year, the babies who got the vaccine had more complications than the babies who got the placebo, then that would raise a red flag.

It would suggest, wait, maybe the vomiting was the result of the vaccine.

But if there was no difference in the experience of those two groups, it would suggest any associated problems were just the kind of health problems that you'd expect to see, as a matter of course, in a very large group of babies.

All of this data is laid out in the package insert.

Page five, the SAE, Serious Adverse Events.

And you would just look at that table.

and you would say no difference. The table is a comparison of side effects in in the kids who got the vaccine and the kids who didn't.
Numerically, if anything, there were more SAEs on the placebo

than the control arm, but it's insignificant. It's like the difference between eating a banana or an apple.
Yeah.

No difference. Together, we went through every one of the medical problems listed on the chart.

Gastro and I don't even know. Broncolitis, 0.6%, fever, 0.1%,

0.2% for treatment. Treatment for hemato, what's that? Placebo.
Hematachesia. Is that where we are now? We kept finding the same thing.
No difference. No difference.
And any difference?

Let's see. 0.6, 0.6.
No. No difference.

And

seizures? See, where are you? Next page. Yeah, seizures.
Yes.

Numerically, maybe a little higher, but the SAEs were exactly the same. But somehow, Kennedy reached the opposite conclusion.

In In his book, The Real Anthony Fauci, Kennedy writes, quote, since its approval, Dr. Offit's rotavirus vaccine has caused a wave of catastrophic illnesses and agonizing death.

I mean, that's just

astonishingly. It just makes, it's just astonishing.
Yeah. So wait, what's he doing?

He looked at the same thing you looked at and decided that the rotavirus vaccine was causing this enormous burden of adverse reactions. I have to say, I got completely obsessed with this.

Where is RFK Jr. getting his information? And what about the data from the clinical trial? Did he not read it? Did he read it and not understand it? Or did he read it and understand it and just say,

eh?

You have a simple chart that has two columns. One column is called placebo and one column is called treatment.
And he decided to completely ignore the column called placebo, right? Exactly.

He started to reach a conclusion about the vaccine by looking at, by

fundamentally not just misinterpreting,

he got a, he's

180 degrees wrong in his interpretation of the data.

And he had to, he had to place, it's as if he took his hand and placed it over the side of the chart that says placebo like there has to be some agency here that allows you to look at something that has two rows and only see one row

well firstly i i doubt that he actually looked at this source i'm sure he's a pretty bitty guy busy guy and you know but but sofi he writes half of an entire chapter denouncing the rotavirus vaccine it's not like this is this is not a he's not making this observation in passing he's going after at length one of the most significant public health advances of the last 25 years, right?

Something that

has saved millions of lives. This is not trivial stakes here, right? He's big game hunting here.
Yeah. Wasn't he trained as a lawyer? I don't know.

He's a lawyer, yeah. Yeah.
Yeah.

Because unless, I guess I try to err on sort of generous explanations.

And maybe you are, you go on the other side. I don't know.
But aren't lawyers trained to do that sort of thing, dig deep into facts and make a case or prove or disprove a case?

You would think that would be part of your legal training. But if you, if you were a lawyer, and made this argument in court, you would be humiliated by opposing counsel.

Yeah, I mean, it would take five seconds. You would just hold up the chart and say, oops,

I've got to the other side. Yeah.

One last question, but a very specific one, which is, If you're going to do this,

why does he link to the source that refutes

his argument?

So I can understand,

I want to completely misinterpret the clinical data on Rototech. I want to make this argument about vaccines, and I'm going to cross my fingers and hope that 95% of my readers don't notice.

But then he gives you the link to the very thing that

shows you that he's absolutely wrong. Who does this? He's not even a good liar.

What was that word that they used a few years ago? Truthiness. Yeah.
Right?

There must be an equivalent word of scienciness. My book has scienciness because it has footnotes that are science-y.
Done.

By the way, this isn't even the half of it. If you spend any time at all immersed in the words and thoughts of R.F.K.

Jr., it's pretty clear that the person who he hates above all others is Anthony Fauci. Kennedy really, really doesn't like Anthony Fauci.

He wrote a 492-page book about how much he hates Anthony Fauci. But do you know who's a close number two? Paul Offutt, the inventor of Rototech.

In the real Anthony Fauci, Kennedy spends pages on Offutt.

He writes, Offutt, quote, represents himself as an authoritative source of reliable information, but he is actually a font of wild industry ballyhoo. prevarication and outright fraud, end quote.

Tune into any of the countless podcast interviews Kennedy has given, and you'll find the same thing. After he's gone after Fauci, he goes after Offutt.

To the point where after Kennedy goes on Joe Rogan and went on one of his usual Paul Offitt rants, Offutt got death threats and hate mail.

I mean, I don't know if you listen to the whole Rogan thing, but he attacks me all the time because I committed the unpardonable sin of being the co-inventor of the rotavirus vaccine, which, by the way, saves about 165,000 lives a year in the world.

I thought that was a good thing, but apparently, according to him, I'm just the pharma show. Yeah.

I keep seeing him go after you,

and I'm trying to sort of understand, but he's never,

to your knowledge, has he ever kind of acknowledged what you guys created was of value to mankind?

Has he ever acknowledged that?

No.

165,000 people a year.

Doesn't believe it.

But did he, I mean, did he actually work through the logic of this?

not publicly. I mean, I don't know.
I don't know

how his brain works. Yeah, yeah, yeah.
Maybe it was that worm. Maybe the worm was telling him to do it.

I'm sorry to keep harping on this, but this is just bizarre.

If I was someone who really didn't like vaccines and I was writing my massive opus on the subject, I'd pick a really marginal vaccine to go after.

Something with dubious benefits, lots of side effects, something where the Vera's data was really alarming.

I don't know, an inexplicable wave of strokes or seizures or something worrisome in people who got the vaccines. But what does Kennedy do? The opposite.

He goes after maybe one of the most important public health triumphs of the last hundred years.

A vaccine with a package insert that is so immaculate that he literally has to create an objection that is transparently false.

It makes no sense.

By the way, if you're wondering why we didn't just call up RFK Jr. himself and ask him directly, oh, we tried.
Over and over again.

Calls, emails, right up to the Department of Health and Human Services. Greetings.
Thank you for calling the United States Department of Health and Human Services. Total

runaround.

Then to his lawyer and longtime confidant, Aaron Siri. who was all willing to be interviewed until I told him I wanted to talk about the rotavirus vaccine.

At which point, he put all kinds of stipulations and restrictions on how our interview would proceed, including the fact that we couldn't tape record it.

And then, when we finally did talk, Siri couldn't come up with any kind of plausible explanation for what his good friend and client was doing either. I thought, is there someone else I could call?

Was I ever going to get to the bottom of this? And then I realized, maybe I'm overthinking things. Maybe I just need to keep reading Kennedy's book.
And so I did.

And And sure enough, there it was, the answer. In chapter 9, entitled, The White Man's Burden.

One of the preeminent figures in modern medicine was the 19th century French microbiologist, Louis Pasteur. Pasteur is the pioneer of germ theory.

Infectious diseases are the result of foreign microorganisms that invade the body.

Every time you get a vaccine created specifically against a particular virus or take an antibiotic optimized to fight a specific strain of bacteria, you are following Pasteur's logic.

Germ theory is one of the foundational ideas of modern medicine. And in chapter 9 of The Real Anthony Fauci, we learn that Robert F.
Kennedy Jr. doesn't believe in germ theory.

He is, instead, a follower of Pasteur's nemesis. another 19th century French microbiologist named Antoine Bichamp.

Bichamp argued that Pasteur had it backwards. You don't get sick because you've been infected by a bug.
The bug emerges in response to the fact that your body was already sick.

The bug is a symptom, not cause. What matters is the terrain of the body, an individual's internal state of health.

It's really hard to find people who believe in Antoine Beachamp's theories. I spent hours on the internet looking before finally stumbling upon another disciple.
Maybe you'll recognize his voice.

And Pasteur believed the germ theory, obviously. That's the theory that he pushed, right? And then Betchamp believed in the terrain theory.
Now, that's what I believe.

This is the actor, Woody Harrelson, on Joe Rogan, of course.

The terrain theory,

the germ theory, obviously, a pathogen, a germ, a virus, whatever, lands in your corn flakes or on your eyeball or whatever, it gets inside you.

And then in this blank, pristine, blank slate environment, it causes damage, maybe sickness, and eventually death. To me,

I don't believe this theory as much as I do the

terrain theory, which is that your health is dependent upon your internal biological terrain and your internal filthiness or cleanliness.

And so that's what I believe is where people's immune system gets messed up from what they're consuming.

And in a nutshell, that's why I believe in Beshamp's theory as opposed to the germ theory. I should point out: guess who Woody Harrelson is good friends with? RFK Jr.

So maybe what we're looking at here is not two Beshampians who arrived at the same conclusion independently, but one Beshampian who infected another. In defiance of everything, Beschampian.

Of course, there is some truth to terrain theory. Diabetes and heart disease are the result, in part, of what Bachamp would call a disturbed terrain.

A body that because of obesity or smoking or bad nutrition or a lack of exercise has become vulnerable to chronic disease. But Kennedy doesn't stop there.
He's a radical Bachampian.

He believes that if you're otherwise healthy, the cold virus is just not going to be an issue. HIV is probably not going to give you AIDS, not if you take care of yourself.

There's a whole chapter on HIV and AIDS in his book making a version of this argument.

Early in his time as Secretary of Health and Human Services, there was a major outbreak of measles in Texas, and Kennedy's response was so lackadaisical that his press secretary quit, it seems, in disgust.

Measles? It's only a problem if you're unhealthy. The virus is the symptom, not the cause.

It took several months, two children dying, and over 500 cases, for him to finally give an interview where he said, okay,

you should get the measles shot.

Kennedy is unhappy to this day that in the 19th century battle between Louis Pasteur and Antoine Beachamp, Pasteur came out on top.

Listen, this is from the audiobook version of the real Anthony Fauci. being read by what really, really seems like AI.

For better or worse, the champions of germ theory, Louis Pasteur and Robert Koch, proved victorious in their fierce decades-long battle with their miasmist rival, Antoine Béchamp.

Just so you're aware, if you're thinking of getting the audiobook, you're in for 27 hours and 20 minutes of this.

The ubiquity of pasteurization and vaccinations are only two of the many indicators of the domineering ascendancy of germ theory as the cornerstone of contemporary public health policy.

A $1 trillion pharmaceutical industry pushing patented pills, powders, pricks, potions, and poisons, and the powerful professions of virology and vaccinology led by little Napoleon himself, Anthony Fauci, fortifies the century-old predominance of germ theory.

What doesn't RFK Jr. like?

Pills, powders, pricks, and potions, the very things that the Department of Health and Human Services brings to the world.

And of all the pills and powders and pricks within his domain, the one he hates the most is Rototech.

And why does he hate Rototech?

Because he's a Beschampian. And a Beschampian has to hate Rototech.

Because if Kennedy admits that Rototech works, then the whole edifice of 19th century pseudoscience that he has committed himself to comes tumbling down.

RFK Jr. likes to pretend that he is alarmed by vaccines that do not work.
No,

he's alarmed by vaccines that do work.

Heaven help us.

Next time on revisionist history, the plot thickens and and the virus spreads. From RFK Jr.
to Joe Rogan. And then we run into each other in Aspen.

Just random was the weirdest moment because we were both staring at each other. Yeah.
And then we almost did it like a full 360. Yeah.

Yeah.

Yeah, I noticed you walking. I'm like, that's...
Yeah, it is.

So I said, hey, what's up?

Revisionist History is produced produced by Lucy Sullivan, Nina Bird Lawrence, and Beneded Aff Haffrey. Our editor is Karen Shikurji.
Fact-checking by Kate Furby. Original scoring by Luis Guerra.

Engineering by Nina Bird Lawrence. Mixing and mastering on this episode by Marcelo Di Oliveira.
Production support from Luke Lamond. Our executive producer is Jacob Smith.

Special thanks to Sarah Nix and El Hefe, Greta Cohn.

I'm Malcolm Gladwell.

Everybody knows Shaq, but off camera, he's just a regular guy. People never believe me when I say I'm just like them.

I take out the trash, do dishes, and I struggle with moderate obstructive sleep apnea, or OSA. And a lot of adults with obesity also struggle with moderate to severe OSA.

You know those scary breathing interruptions during sleep? The loud snoring, choking, and daytime fatigue? I knew I had to talk to my doctor. Don't sleep on the symptoms.

Learn more at don't sleeponosa.com. This information is provided by Lilly, a medicine company.
Hey, what up, y'all? It's DJ Envy from the Breakfast Club. Now, picture this.

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That's B Club30. That's B C L U B 30.
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