World Mercury Project Targeted by the AAP and IAC

American consumers, particularly parents, should be asking some hard questions about why the American Academy of Pediatrics (AAP) and Immunization Action Coalition (IAC) apparently have no interest in improving vaccine safety. In the face of snowballing vaccine scandals-from fudged safety trials that use other vaccines as placebos, to persistent use of neurotoxic aluminum adjuvants, to the accelerated rollout of unproven vaccines that may be causing more problems than they solve-these and other vaccine advocacy organizations are not only turning a blind eye but are actively circling the wagons while beefing up public relations (PR) intended to stifle discussion. These PR efforts are on revealing display in an April 2017 IAC webinar on "Vaccines and the New Administration" that unsurprisingly singles out the activities of the World Mercury Project and its Chairman, Robert F. Kennedy, Jr. Expressing equal parts alarm and disdain, the AAP rhetorically asks, "Vaccine safety: here we go again...?"

Due to the well-funded medical-pharmaceutical-media apparatus that endlessly repeats the mantra that all vaccines are safe for all people all the time, it is nearly impossible to get a fair hearing for common-sense questions about vaccine safety, no matter how urgent such questions may be. The biases apparent in mainstream discussions about vaccine safety have come into even sharper focus since the changeover from one political administration to the next. In February 2017, shortly after the inauguration, several hundred national and state-based organizations rushed to sign a letter lobbying President Trump to "redouble" efforts to drive up the vaccination rate. The IAC and the AAP were two signatories of that letter, which summarily dismissed concerns about vaccine risks as "disproven."

World Mercury Project on the radar

The April webinar and the slides presented by the AAP (Figure 1) give clear insights into the efforts under way to shut down any questions regarding vaccine safety. Although the AAP also briefly considered two other perceived threats to the vaccine program-1) candidate Trump's legitimate questioning of vaccine safety and timing and 2) citizen pressures on Congress to hold hearings on vaccines-Kennedy and World Mercury Project garnered fully one third (3/9) of the AAP's slides. The three slides took note of the following events:
  • The January meeting between Kennedy and President-elect Trump to discuss a possible Commission for vaccine safety and scientific integrity;
  • The February 15 press conference convened by Kennedy and actor Robert De Niro at the National Press Club; and
  • The March 31 "Revolution for Truth" rally in Washington, DC, sponsored by World Mercury Project and four other organizations.
FIGURE 1. April 2017 IAC Webinar: AAP Presentation

In each instance, the AAP lobbyist, Patrick Johnson, used his PowerPoint to undercut the impact of the events, first, by downgrading the potential Commission from one focusing on vaccine safety and scientific integrity to one supposedly focusing "only" on autism; second, by describing the congressional briefing that followed the February 15 press conference as "sparsely attend" [sic]; and third, by stating that the March rally had "very little press coverage." Of course, Johnson did not mention the powerful role of pharmaceutical industry advertising dollars in shaping mainstream news and disincentivizing true journalistic curiosity, nor was there a nod to the influence of pharmaceutical dollars on congressional (or AAP) priorities. (To put the pharmaceutical industry's financial impact in perspective, total pharmaceutical revenues worldwide began exceeding one trillion dollars annually in 2014, with the U.S. pharmaceutical industry dominating the global market.)

The AAP's co-conspirators

In addition to the AAP, three other organizations contributed content to the IAC webinar. All four entities profess to be reliable sources of information on vaccines but share a concerted PR focus that aims to head vaccine safety concerns off at the pass. All of the organizations frame their aims in terms of cementing vaccine infrastructure and funding. The AAP's three sister organizations are:
  • The 317 Coalition: The 317 Coalition derives its name from Section 317 of the Public Health Service Act, which authorizes federal purchases of vaccines. The 317 Coalition's organizational members include vaccine manufacturers. The Coalition's "sole" focus is advocacy for increased Section 317 funding. Federal vaccine purchases currently depend on the Affordable Care Act (ACA) for over half of their funds, giving rise to Coalition worries about what might happen with an ACA modification or repeal (Figure 2). The 317 Coalition is staffed by Cornerstone Government Affairs-a PR firm based in Washington, DC, that specializes in "federal and state government relations" and "strategic communications." Mark Mioduski, one of Cornerstone's senior founding partners, presented webinar content on behalf of the Coalition.
  • Every Child by Two (ECBT): ECBT works to "share [the] value of vaccines with federal and state legislators" and generate vaccine safety "talking points" (Figure 3). The webinar presenter, Amy Pisani, is ECBT's Executive Director.
  • The Adult Vaccine Access Coalition (AVAC): AVAC focuses on "bringing necessary federal policy changes" to increase adult vaccination rates, in particular. The webinar presenter, Abby Bownas (employed by another Washington, DC-based PR company called NVG LLC), routinely lobbies policymakers in support of "legislative and regulatory solutions" to get more adults to line up for vaccines.
There are many overlapping connections between these (and similar) organizations. For example, ECBT's Amy Pisani serves on the 317 Coalition's six-member Steering Committee and on Paul Offit's Vaccine Education Center Advisory Board. Offit, in turn, sits on the ECBT Board of Directors as well as the 317 Coalition Steering Committee. The IAC's Executive Director and Chief Strategy Officer are two of the remaining members of the 317 Coalition Steering Committee.

FIGURE 3. April 2017 IAC Webinar: ECBT Presentation

section 1

Going after "vaccine hesitancy"

Vaccine proponents have handily coined a new term to describe virtually anyone who raises any questions about vaccine safety (or effectiveness). The term-which contrasts with the vaccine complacency that holds sway in public health and medical circles-is vaccine hesitancy. A highly visible vaccine hesitancy article published in Pediatrics in 2016 defined the term and sought to enhance health providers' persuasive tactics against the growing pushback from worried families.

The Pediatrics article paints vaccine-hesitant individuals with a broad brush. They are, according to the authors, "a heterogeneous group who hold varying degrees of indecision about specific vaccines or about vaccinations in general," including individuals who "accept all vaccines but remain concerned about them," "refuse or delay some vaccines but accept others," or "refuse all vaccines." The Pediatrics authors express confidence in the ability of "targeted discussion strategies" to vanquish most of these objections (particularly because "vaccine discussions continue to occupy the media and Internet"), but they also agree that "some families still will not be persuaded to vaccinate," even when a pediatrician threatens a family with dismissal from their practice "as a last resort."

It is no coincidence that Pediatrics is the official journal of the AAP, which does not think twice about using the journal to push its party line on vaccination. The IAC, too, has got vaccine hesitancy squarely in its sights. Its website conspicuously features tools (including a role-playing video and PowerPoint slide sets) intended to help health professionals deal with recalcitrant parents. The IAC's "save-the-date" newsletter about the April 2017 webinar even promoted attendance by stating that the webinar would discuss "encouragement of vaccine hesitancy by some elected officials, including the president."

Perhaps the stellar reputation of Robert F. Kennedy, Jr. in fighting for underdogs is making it tougher for these vaccine apologists to make a smear campaign stick.

That same IAC announcement also used "Robert Kennedy Jr.'s claims about a new vaccine safety commission" as a sound bite to spur webinar attendance and marshal the troops. Even though there are other nonprofits that have long advocated for a deeper look at vaccine safety, the disproportionate attention to the relatively new-on-the-scene World Mercury Project from the IAC, AAP and other members of the vaccine juggernaut is telling. Perhaps the stellar reputation of Robert F. Kennedy, Jr. in fighting for underdogs is making it tougher for these vaccine apologists to make a smear campaign stick. Regardless, members of the public should be asking themselves where the true conflicts of interest lie.

In Part Two, World Mercury Project further explores the glaring conflicts of interest that characterize the AAP and its colleague organizations.

In Part One of this analysis, we described how two highly biased non-profits-the American Academy of Pediatrics (AAP) and the Immunization Action Coalition (IAC)-have been attacking World Mercury Project and its Chairman, Robert F. Kennedy, Jr. for daring to counter false claims about vaccine safety. Yet the AAP, IAC and other non-profits such as Every Child by Two (ECBT) are among the leading actors propagating misleading assertions about vaccine safety. All three also are actively lobbying legislators to effectively jettison informed consent in favor of mandatory vaccines. (In Part One, we also discussed two vaccine advocacy coalitions: the 317 Coalition and the Adult Vaccine Access Coalition.)

In Part Two, we take a closer look at these three particular non-profits (AAP, IAC and ECBT), which were the focus of a trenchant investigationpublished in The BMJ in November 2017. The BMJ is an international peer-reviewed medical journal that takes pride in the dictum that "knowledge for healthcare professionals and patients should be independent and unbiased" [emphasis added]. The article's author is Peter Doshi, BMJassociate editor, who takes this statement to heart by dissecting the funding sources and activities of three vaccine advocacy organizations and asking whether they are "sufficiently independent."

Follow the money

Vaccine advocacy organizations like to pass themselves off as credible and independent sources of information. However, as Doshi immediately points out, the three dominant players (AAP, IAC and ECBT) all receive corporate funding from vaccine manufacturers as well as significant government funding from the Centers for Disease Control and Prevention (CDC). AAP is also intertwined with CDC through AAP's representation on the CDC-based Advisory Committee on Immunization Practices (ACIP), the influential committee that meets several times annually to formulate childhood and adult vaccine schedule recommendations.

The light that Doshi shines on the vaccine advocacy organizations' intentionally opaque finances is one of the article's most significant contributions. Doshi shows that, over the past decade, CDC has been a "steady funder" of all three non-profits. AAP has received roughly $20 million from CDC since 2009, over a third of which ($7 million) was explicitly vaccine-related. The IAC received over $2 million in CDC vaccine-related funding over the same time frame, and a third of ECBT's annual contributions comes from CDC.

By painstakingly ferreting out and perusing various online and print sources, Doshi confirmed that all three organizations receive financial support from vaccine manufacturers, but he could only obtain "spotty" information about amounts, even after contacting the organizations directly. (ECBT, for example, refused outright "to answer The BMJ's queries about how much it receives from vaccine manufacturers.") Doshi also was not able to determine "what strings, if any, come attached to the funding." The table below summarizes Doshi's main findings related to vaccine manufacturer funding for the three vaccine advocacy organizations.
Conflicts of interest-or worse?

Non-profits, regardless of their funding sources, have limits on the amounts they can spend on lobbying without losing their tax-exempt status. Nonetheless, as Doshi describes, the three vaccine organizations are not shy about engaging in major lobbying initiatives:
  • In 2015, both ECBT and the AAP actively (and successfully) lobbied in favor of California's SB277, a bill that removed the state's personal belief exemption and made children's vaccination mandatory for school attendance. Doshi notes that in response to the bill's passage, ECBT wrote to California's governor that it was "elated" at the decision. The IAC keeps tabs on vaccine mandates in every state.
  • In July 2017, the AAP published its state advocacy policy, which recommends elimination of all "state laws permitting nonmedical exemptions to school entry immunization requirements."
  • In February 2017, ECBT launched an active campaign to lobby Congress to "ensure that the funding for vaccine programs that is currently allocated through the Prevention and Public Health Fund is maintained."
  • In April 2017, all three organizations collaborated in the IAC webinarentitled "Vaccines and the New Administration" (described in Part One), which clearly includes lobbying materials for Congress.
In 2014, the Office of the Inspector General (OIG) issued a report on the extent to which Department of Health and Human Services (HHS) grant-making agencies monitor grantees' compliance with federal prohibitions on the use of grant funds for lobbying activities. The report's overall conclusion was that although the sampled grantees were aware of the lobbying prohibitions, "limited methods exist to identify noncompliance" within the HHS's 13 awarding agencies, which include CDC. In other words, the CDC is unlikely to know whether its grantees are misapplying some of their CDC funds toward lobbying activities. In the OIG survey and report, one of the respondents (a Chief Grant Management Officer) admitted that "A whistleblower or media contact would be the primary source of identifying a possible violation."

Doshi reminds readers that "US federal law prohibits the use of CDC award money for lobbying, a prohibition that 'includes grass roots lobbying efforts by award recipients that are directed at inducing members of the public to contact their elected representatives to urge support of, or opposition to, proposed or pending legislation.'" It is not possible to determine from the existing evidence whether the CDC's relationship with AAP, IAC and ECBT "crosses a [legal] line." However, it is clear that when these budget-conscious non-profits receive grant money from CDC, those grants free up other monies for lobbying purposes.

In addition, Doshi makes it clear that the three organizations are incapable of critically appraising the CDC's vaccine recommendations. A conflict of interest specialist interviewed by Doshi stated, "These groups are so strongly pro-vaccination that the public is getting a one-sided message that all vaccines are created equal...regardless of the circumstances. Reality is a little different." A watchdog journalist told Doshi that the three vaccine organizations are "certainly not financially independent, and it would appear they are also not philosophically and intellectually independent, which is just as important-if not more so."

Chinks in the safety narrative

The financial and other information uncovered by Doshi indicates that AAP, IAC and ECBT are key players in a well-funded and highly orchestrated campaign to drown out any and all dissenting voices on the topic of vaccine safety. Thus, the growing number of individuals, families, organizations and even countries expressing declining confidence in vaccine safety remains a thorn in their side. Moreover, the vaccine advocacy organizations cannot suppress the fact that the Vaccine Adverse Event Reporting System (VAERS)-actually touted by the IAC as "the nation's frontline vaccine safety surveillance system"-represents the tip of the vaccine injury iceberg, capturing as little as 1% of vaccine-related adverse events. Even with vast underreporting, the U.S. government's Vaccine Injury Compensation Program has paid out $3.7 billion dollarssince 1988 to vaccine-injured individuals who have managed to prove (against great odds) their injury claims.

In 2011, Supreme Court Justices Sonia Sotomayor and Ruth Bader Ginsburg perhaps had these billions of dollars of vaccine injury payments in mind when they wrote a dissenting opinion to a Court decision (Bruesewitz v. Wyeth LLC, 562 U.S. 223) pertaining to the 1986 National Childhood Vaccine Injury Act that created the compensation program. In their dissent, the two Justices stated,
"The majority's decision leaves a regulatory vacuum in which no one-neither the FDA nor any other federal agency, nor state and federal juries-ensures that vaccine manufacturers adequately take account of scientific and technological advancements."
The Justices further noted,
"Manufacturers, given the lack of robust competition in the vaccine market, will often have little or no incentive to improve the designs of vaccines that are already generating significant profit margins."
The Justices' prescient comments have only become more relevant in the years since the 2011 opinion. The time to open up vaccine safety to real scientific scrutiny and unbiased debate is now.