The Federation of State Medical Boards (FSMB) recently issued a statement about how doctors must communicate with patients about COVID-19 vaccines. The FSMB is a non-profit organization that represents the medical boards of the individual states and territories. The state boards license medical doctors, investigate complaints, and mete out disciplinary action. The statement is an astonishing bit of medical authoritarianism that should terrify patients expecting to receive informed consent and have an honest discussion with their doctors about COVID-19 (emphasis added).
Physicians who generate and spread COVID-19 vaccine misinformation or disinformation are risking disciplinary action by state medical boards, including the suspension or revocation of their medical license. Due to their specialized knowledge and training, licensed physicians possess a high degree of public trust and therefore have a powerful platform in society, whether they recognize it or not. They also have an ethical and professional responsibility to practice medicine in the best interests of their patients and must share information that is factual, scientifically grounded and consensus-driven for the betterment of public health. Spreading inaccurate COVID-19 vaccine information contradicts that responsibility, threatens to further erode public trust in the medical profession and puts all patients at risk.
Which facts? Suppose a doctor listened to the discussion about boosters and heard Doran Fink, M.D., deputy director of the clinical side of the FDA’s Division of Vaccines and Related Products Applications, discuss cardiac-related risks post-vaccination. When Dr. Arnold Monto, the acting committee chair, asked Fink if it was possible to determine at what age the side effect ceased to be a problem, Fink answered:
“If you look at the healthcare claims data, you see that there is evidence of some attributable risk at all age groups, although, the older you get, the higher the risk of complications from COVID that offset the risk of myocarditis,” he said. “So, when you look at the balances of risk versus benefit, what we really start to see is risk of myocarditis being higher [than COVID-19] in males under age 40.”
Fink also told the advisory committee that the risk of myocarditis was 1:5000 according to medical claims data. Say a doctor is counseling a 24-year-old male with healthy body weight and no pre-existing conditions. Understanding the current data, he tells his patient that the vaccine’s risk of cardiac side effects is more significant than risks related to COVID-19. Would he be putting his license at risk for misinformation? The physician would be quoting an FDA official but deviating from the narrative that everyone must be vaccinated.
Looking again at the statement, what exactly is “scientifically grounded” information? There are at least 15 studies that confirm natural immunity provides durable protection from infection with COVID-19. Suppose a doctor read the Emory study, which demonstrated broad-based, long-lasting immunity in recovered patients after eight months. He also read the Israeli population study showing a symptomatic reinfection rate of less than 1% in recovered patients without a vaccine.
Then the doctor sees a preprint indicating a small sample of recovered patients showed declining immune response six months after the Pfizer vaccine. The Emory study of unvaccinated participants did not show a similar decline. If the physician told a 35-year-old patient who recovered from COVID-19 in August of 2021 that current scientific research shows he has a strong natural immune response and a vaccine is not necessary at this point, would the state medical board mount an investigation? It is scientifically grounded but opposes the advice of the CDC and Dr. Anthony Fauci.
“Consensus-driven” is the chilling and authoritarian addition. Here’s a newsflash. Doctors disagree. Even the best doctors in the same field will have different opinions about treatment for a particular disease or disability. This reality is why getting a second opinion is part of the American medical system. Patients deserve to fully understand and agree with a course of treatment and know all of their options.
Consensus also has no place in the scientific method. It indicates that the state medical boards view science as an institution. Is Dr. Rochelle Walensky an authoritative voice simply because she holds a political appointment? It would be fair to wager that there are more capable scientists in other private and public institutions whose input and conclusions we should take at least as seriously. The genuinely alarming trend in this pandemic is treating highly regarded practitioners and researchers as heretics for dissenting from the preferred narrative.
Also, which consensus? Dr. Anthony Fauci told America that a third mRNA vaccine was the appropriate dose to provide more durable immunity against COVID-19. The FDA Vaccines and Related Biological Products Advisory Committee disagreed after reviewing data from Pfizer and Israel. The World Health Organization opposed boosters also.
The chilling effects of top-down medical authoritarianism are real. The FSMB provides no guidance on what qualifies as vaccine misinformation and leaves no room for the practice of medicine based on a doctor’s clinical experience. If this continues, the quality and safety of American healthcare will decline. Unfortunately, the authoritarians never see the errors of their ways until they are staring at the destruction of the system they governed.
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