Dr. Stock’s presentation is filled with disinformation

I have gotten a few thousand messages asking me to combat the mis-and dis-information from Dr. Stock's presentation to an Indiana School Board. My friend, who’s a brilliant biochemist, wrote a fantastic blog post about this and I couldn't have done it better myself. Go HERE to read the full rebuttal. It’s amazing.

Some high-level points:

• The speech is a classic example of verbal gish gallop: a tactic used by science denialists wherein they post a bunch of links that they claim to support their points but in reality most of the citations are unsupportive or even unrelated to their claim- but this serves the appearance of evidence. He is doing this but with words- he is making a series of incorrect arguments (that are self-contradictory) and essentially seeking to overwhelm opposition with the volume of arguments he makes.

• He starts off by saying “It’s hard to believe we are 18 months into this and still have a problem”. No, it’s not hard to believe because, first and foremost, the amount of disinformation being spread from people like himself has directly impacted our ability to effectively and efficiently respond to the pandemic. In 2020, the WHO coined this an infodemic- the overabundance of information and disinformation- that has caused confusion, anxiety, and an anti-science rhetoric. There are also a myriad of other reasons. Like, we have an increasingly globalized world. We have a chronically underfunded public health and medical health system in the United States. An increasingly polarized politics. And I could go on…

• He describes himself as a “functional family medicine physician” which, according to him “means [he] is specially trained in immunology and inflammation regulation.” That is not what a functional family medicine physician does and misrepresents his training and expertise. The U.S. medical board says that licenses can be revoked for spreading misinformation. So I’ll be curious what happens to his license. But I’m not even convinced that he has one because functional medicine is not a specialty recognized by the American Board of Medical Specialties nor the American Medical Association.

• He then argues that masks don’t work because viruses are small enough to pass through them. The problem with this reasoning is viruses do not travel as individual viral particles- they are inside the aerosols and droplets. That’s what the masks block. The IDSA has graciously compiled the multitudinous, surfeit evidence demonstrating the effectiveness of masking here which anyone is free to peruse at their leisure.

• He then states that all respiratory viruses wait for the “immune system to get sick in the winter”. The seasonality of respiratory viruses is a complex matter dependent on many factors, many of which have nothing to do directly with immunity. For instance, when it’s cold, people gather indoors for prolonged periods close together in poorly ventilated spaces. Humidity is lower which also affects virus transmission as it allows aerosols to remain suspended for longer and mucociliary clearance may be impaired. Vitamin D levels in the winter may also play a role but it’s probably not that important in higher income nations because true vitamin D deficiency is relatively rare.

• Stock then states the vaccines make your immune system become “deranged.” We have near real-time safety data on vaccines and the risks (which are themselves exceptionally rare) are: anaphylaxis 2.5-4.7 per million doses, thrombosis with thrombocytopenia syndrome (TTS) with the JJJ vaccine at 3 per million doses, Guillain-Barre syndrome at 7.8 per million doses of JJJ, and the rare cases of myocarditis whose rate is hard to define generally but goes up to ~7 per 100,000 second doses of the vaccine in younger males and is far lower for everyone else. COVID-19 patients on the other hand may have substantial immunological challenges.

• Stock then says something about the virus can’t ever go away because it has animal reservoirs (zoonotic virus). This is not the whole truth. Certainly, barring a universal coronavirus vaccine that can be given to animals and ideally one that is itself transmissible, SARS-CoV-2 is not a viable candidate for eradication because it has animal reservoirs that can keep introducing it into the population. This does not mean that vaccination cannot alleviate the public health burden of COVID-19. It does it every year for flu, which is another zoonotic disease. And COVID vaccines are far more effective. We might eventually even be able to eliminate SARS-CoV-2 country-by-country like we do for yellow fever.

• Stock then describes breakthrough cases during the summer and claims that this is proof the vaccine doesn’t work. Firstly, multiple respiratory viruses are having out of season resurgence (e.g. RSV) which significantly weakens the argument. Most probably, this is because we decided to relax every single mitigation measure against COVID which also had the side effect of reducing the spread of any infection spread by the respiratory route. He then chooses to ignore the vaccine effectiveness data we currently have.

• At this point, Stock then raises the matter of antibody-dependent enhancement, except he calls it “antibody-mediated viral enhancement.” This is irredeemable and unequivocally disinformation. Firstly, he defines ADE incorrectly by suggesting it is exclusive to vaccines. ADE does not have to be caused by a vaccine to be ADE- in Dengue which is the major infection for which it’s relevant it is almost always because of infection. We also have data on hundreds of thousands of people at this point who got convalescent plasma and it didn’t make them worse. On top of that animal studies of the vaccines demonstrated protectiveness. If the vaccines actually caused ADE it would represent a negative vaccine efficacy/effectiveness. Stop trying to make ADE happen. It’s not happening.

• Stock then brings up the Barnstable County outbreak and he gets applauded. Again ignoring context and misrepresenting data. We have no idea what the denominator here was. This is a classic example of base rate bias. Provincetown has a 95% vaccination rate. If 74% of the cases were in vaccinated people, that gives vaccines 84% effectiveness. Which is fantastic.

• Stock then claims no vaccine ever stops infection as though this is some smoking gun. Firstly, that’s not true. HPV vaccines do prevent transmission (and depending on the capsule group some pneumococcal and meningococcal vaccines are also considered to confer sterilizing immunity). Second of all no vaccine needs to stop infection for it to have massive public health benefits or stop transmission.

• Stock then references a mumps outbreak and claims that the outbreak was caused by vaccinated people shedding the mumps virus on the unvaccinated. He may be disappointed to learn that there has never been a well-documented case of secondary transmission of vaccine strain mumps in the history of its use (in this case I am referring to the Jeryl-Lynn strain used in the US). 

• Stock then claims the trifecta of vitamin D (addressed earlier), ivermectin, and zinc to treat a whole 15 COVID patients. The issue is that given any representative sample of 15 people in the US population the most probable outcome of COVID-19 is recovery so these data are not meaningful (beyond the fact that this is anecdote). Furthermore recent data has emerged to indicate that much of the positive data regarding ivermectin may be the result of fraud. I could find no data of reasonable quality on the value of zinc as a therapy in COVID-19. Stock also says that vaccination is appropriate only if there is no treatment. Vaccination is a preventive measure, not a treatment. 

• Stock then asserts very confidently again that patients who recovery from COVID-19 have no benefit from vaccination at all. This was explicitly demonstrated to be false in the recent CDC MMWR then which found the exact opposite- a significantly reduced risk of reinfection among those who got 2 doses after recovery by 2.34 times.

Hope this helps clear up some confusion. This disinformation is incredibly dangerous and directly threatens our efforts to end the pandemic.

Love, YLE and Edward Nirenberg (biochemist and author of a fantastic blog about vaccines)