RFK Jr Wanted A Journal To Retract This Massive Study On Aluminum In Vaccines. It Refused

The study, published in July in Annals of Internal Medicine, reported the results of a long-running study of Danish children, which found no evidence for a link between aluminum compounds contained in some vaccines and chronic health problems. 

We’ll come back to the actual content of the study later, but for now, let’s take a whistlestop tour through the scientific publishing process, why Kennedy’s request was so unorthodox, and why the journal has roundly refused it. 

How to publish a paper

In order to reach the stage where a paper may be retracted, it first must get published. That sounds like stating the obvious, but it’s a much more involved process than you might think if you’ve never been through it. 

As a former managing editor of a scientific journal, I’ve had a front row seat to the whole life cycle of a paper, and I’ve seen one or two retractions in my time too. 

A typical manuscript submission process begins with the paper being assessed by an internal editor at the journal, who will judge whether the study is suitable for that journal, fits within their criteria, and whether or not it should be sent out for peer review.

We can see by looking at the Annals of Internal Medicine website that each submission to this journal is read by at least one editor and one associate editor, and that just under half of submissions (45 percent) go out for review.

Pre-publication peer review is still the most widely used method of assessing whether a scientific study is suitable for publication. Annals aims to send each paper to at least two independent reviewers.

Reviewers can recommend that a paper be rejected, published as-is, or undergo some revisions before being returned to them for another assessment. As you can imagine, this process can take several weeks or months while everyone coordinates with each other and the authors go away and revise their manuscript.

Once the reviewers and editors are happy, the authors get their acceptance letter and the manuscript can go into production. The Annals website explains that this involves copyediting, collecting information from the authors about any conflicts of interest they have, and finally scheduling and publication.

Congratulations! You just published a scientific paper. You might think the hard part is over, and it’s certainly an achievement worth celebrating, as any scientist will confirm. But that doesn’t mean you’re done.

How to retract a paper

Let’s take the Annals paper as an example. If you access the paper online, you’ll notice immediately that there’s a notice that a correction has been added. That means some kind of error was spotted and fixed after publication. In the interests of transparency, all such changes should be flagged clearly to the reader in this way (including here at IFLScience).

In this case, opening the correction notice reveals that an incorrect version of the supplementary materials was originally published with the paper, so now the right version has been added. 

That’s a straightforward error to correct – it doesn’t impact the conclusions of the paper, it doesn’t call the authors’ integrity into doubt in any way, it’s just a simple mistake. The correction notice is published, and we can all move on with our lives.

But what if a more serious problem is flagged after publication? That’s when we start getting into retraction territory. For example, if there’s a suspicion of scientific misconduct – like manipulating data – or a serious error in the experiments that might make the conclusions invalid, it may be judged that the paper should be “removed” from the scientific record.

I say “removed” in inverted commas, because it’s not considered best practice to delete studies from the literature completely – retracted papers still exist to be read, alongside the context of why they were retracted, so people can understand what went on. You can still read the infamous Wakefield paper that kicked off the utterly baseless autism/MMR scare, but you also get served information about why the conclusions of that study are not worth your time.

Issuing a retraction is a big decision, just as publishing a paper in the first place is not taken lightly. The International Committee of Medical Journal Editors (ICMJE), which issues recommendations on matters of publication ethics, suggests that retractions should ideally come with the agreement of each author, but a journal can issue a retraction itself in some circumstances.

All that to say, retractions are not issued on the basis of one random request from a politician.

RFK Jr and the Danish aluminum study

Now we understand the process a little better, let’s take a closer look at the study itself. 

Using data from over 1.2 million kids born between 1997 and 2018 – taken from a registry of every birth in Denmark – the study assessed the evidence for any link between aluminum-containing ingredients in vaccines and a huge range of health conditions. These included autoimmune diseases, allergies, and neurodevelopmental conditions like autism and ADHD.

“This work was motivated by ongoing concerns about potential harms of aluminum-adsorbed nonlive vaccines,” the authors wrote. 

Aluminum compounds are used as adjuvants in lots of inactivated vaccines, including the Tdap, which protects against diphtheria, tetanus, and pertussis (whooping cough). Because the bacteria in the Tdap vaccine are inactivated, you need an adjuvant to kick start the body’s immune system into making the antibodies that will ultimately provide protection against the disease.

Not only are they necessary, there’s already considerable evidence of the safety of aluminum adjuvants. However, as we’ve seen with other antivaccine panics, the presence of large amounts of data to the contrary often does nothing to change the views of the most ardent activists.

Kennedy has spoken publicly at length about his skepticism of various aspects of vaccine science. When the Danish study – which he described as “intensely ballyhooed” – came out, he authored an opinion piece published on Trial Site News, explaining his issues with the paper.

“The slavish, pharma-funded mainstream media, ever eager to defend industry orthodoxies, have triumphantly hailed this study as proof of aluminum’s safety without even a cursory examination of the study’s fatal deficiencies or the financial conflicts of its authors,” Kennedy wrote. “But a closer look reveals a study so deeply flawed it functions not as science but as a deceitful propaganda stunt by the pharmaceutical industry.”

He went on to directly call for the journal to retract the study. 

Now the journal has revealed, originally in an exclusive interview with Reuters, that it will not be acquiescing to this request.

“I see no reason for retraction,” said Dr Christine Laine, professor of medicine at Thomas Jefferson University and editor-in-chief of Annals. 

Senior author Dr Anders Peter Hviid also defended the work while pointing out the uniqueness of the situation: “I am used to controversy around vaccine safety studies – especially those that relate to autism, but I have not been targeted by a political figurehead in this way before.”

Meanwhile, Dr Adam Finn, a vaccine expert from the University of Bristol who was not on the study team, praised the work as being the “best available evidence” of the safety of aluminum in vaccines.

Laine told Reuters that some of Kennedy’s points mentioned legitimate limitations of the research – every study has its limitations, and this is no exception. There have been other comments from independent scientists raising these points; it’s a sign of the scientific establishment working correctly when published work sparks conversation and debates amongst peers in that field.

However, and this is a key point: Laine told Reuters that the limitations “do not invalidate what [the researchers] found, and there’s no evidence of scientific misconduct.”

Disagreeing with how a study was performed, believing that there are better methods, suggesting that further studies are needed – all perfectly valid, but not necessarily grounds for a retraction.

Moreover, this study does not stand alone in its finding that aluminum adjuvants are broadly safe. In Laine’s view, as expressed to the BBC’s Science in Action podcast, the bigger threat right now – as many other scientists have suggested – is growing antivaccine sentiment fueled by those who cast doubt on seemingly any and all research suggesting vaccines are safe. 

“The study is important, at least in the US, where there is a growing amount of vaccine skepticism and misinformation being spread about adverse effects of vaccination, which are resulting in people getting sick and even a couple of kids dying of measles.”