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I am not blaming RJK for the obesity epidemic, I'm assessing his ability to handle healthcare based on his stated beliefs. In my opinion, he is a quack. I don't believe he provides valuable solutions that can address the issue.Not a lot of disagreement from me here, more so confusion about your ire directed at people who were in no way responsible for the health problems plaguing our country while tacitly (and explicitly) aligning with those who created the mess we’re in currently.
Epidemiology has its place, I agree. That said, it is a poor and inappropriate replacement for randomized placebo control studies, particularly when trying to tease out vaccine adverse events. So what we have are health authorities who didn’t conduct the right studies before introducing a medical intervention to the entire population. Then, only when outsiders raise concerns do they look into the issue using subpar methods.
I’m very familiar with this study and their previous review. You’ll notice that Cochrane didn’t explicitly rate the quality of evidence regarding safety research in the summary you posted, and that’s becuse the majority of safety research studies are subpar (you will be hard pressed to find even one high quality MMR safety study in the Cochrane review).
A previous Cochrane review from 2012 (conducted after several high profile autism/vaccine studies were already published) noted poor study quality more explicitly:
“Authors' conclusions: The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate.”
Vaccines for measles, mumps and rubella in children - PubMed
The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. The evidence of adverse events following immunisation with the MMR vaccine cannot be separated from its role in preventing the target diseases.pubmed.ncbi.nlm.nih.gov
I don't view epidemiology as a replacement for randomised trials, it's two seperate things. It can help us ascertain a lot of things and at times infer causality, which we can then later test in some controlled studies. If it's feasible. I don't know that I understand the criticism, because the MMRV vaccines have been tested in both controlled trials and cohort studies. In regards to autism specifically, when incidence rates are so low RCT studies don't have enough power to detect differences between groups unless you include tens of thousands of participants. Cohort/epidemiological studies are more practical here and can include millions of children. Now, considering out of millions the incidence rates are identical between vaccinated and unvaccinated, I don't see how there is an argument that the vaccines cause autism.
Yes, the previous Cochrane review concluding that the reporting of safety outcomes were 'inadequate', which is one of the reasons why they updated the review almost a decade later. It's important to note here that, scientifically speaking, inedequate doesn't imply that the vaccines were unsafe only that they didn't feel the quality of evidence was strong enough. More importantly, the updated review has re-evaluated that conclusion:
Vaccines for measles, mumps, rubella, and varicella in children
Quality of the evidenceOur certainty (confidence) in the evidence is slightly limited by the design of most of the studies. Nonetheless, we judged the certainty of the evidence for the effectiveness of the MMR vaccine to be moderate, and that for the varicella vaccine to be high. Our certainty in the evidence for autism and febrile seizures was also moderate.
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