1: Dr. Vinay Prasad’s Hiring Should Have a Much Bigger Scandal Than His Firing
My first article here was a refutation of Dr. Vinay Prasad’s anti-vaccine nonsense. Along with many others, I have have been chronicling his disinformation for years, and it has taken volumes to do so. Even then, we are just scratching the surface. There’s an overwhelming amount of it. Anyone who is familiar with Dr. Prasad’s disgraceful pandemic record knows his hiring should have been more of a scandal than his firing. From COVID to RFK Jr., Dr. Prasad relentlessly sought to numb people to grave risks, all to advance his personal brand and political agenda.
Dr. Prasad was also a vulgar and unprofessional social media star who had no experience running a large organization. As Dr. Bruce Lambert said:
He is a hostile and dismissive iconoclast, especially on social media. There’s no ambiguity about why people were happy to see him leave. He had open contempt for the agency. I said when he was appointed that I thought he lacked the emotional maturity and social skill needed to lead a large organization. Nothing in his background suggested he had such skills. Managing a big bureaucracy is not easy, and just being a smart is not enough to be successful. You have to be good with people, and he is clearly not.
Though Dr. Prasad never doubted himself for a moment, he was utterly unqualified for his position, which seems to be a requirement for the Trump administration. While his decision to “spend more time with his family” was unsurprising, in a sane world, an immature disinformation agent like him never would have been near the levers of power in the first place.
2: The Leopards Came for Dr. Prasad’s Face
Donald Trump forced Dr. Prasad to resign. No matter who influenced Trump’s decision, only he had the power to send Dr. Prasad packing. Even though Trump is the kind of person who listens to vile propagandists like Laura Loomer, Dr. Prasad repeatedly endorsed Trump (Never Forget: Vinay Prasad Loved Donald Trump) and eagerly joined his administration. No one forced Dr. Prasad to do this. He chose it all.
Dr. Prasad also defended Trump’s right to fire anyone he wanted and fantasized about being able to lead mass purges himself. Dr. Prasad spent the past four years legitimizing the forces that came for his jugular. He bonded with them over COVID disinformation, and incorrectly thought that would sustain him once he joined the FDA. He never counted on these forces coming for him. However, Dr. Prasad told people to stop talking about COVID and unfortunately for him, they did. The COVID coalition shattered and the leopards came for his face too. As one person rightly said about Dr. Prasad’s downfall, “Live by the crank, die by the crank.“
3: The Circumstances Of Dr. Prasad’s Firing Were Bad and His Replacement Could be Worse
If aliens teleported Vladamir Putin and Kim Jong Un off the planet, I would not feel sad for them one bit. However, I would be very concerned that aliens were beaming away world leaders. While no one should shed a tear over Dr. Prasad’s departure, it’s not necessarily a good thing that he is gone.
Dr. Prasad made a lot of people very angry in a short amount of time, and much of that anger was sincere and understandable. Experts like Dr. Paul Offit also criticized Dr. Prasad regarding vaccines, though this played no role in his departure. No one in the Trump administration is listening to Dr. Offit, unfortunately. I urge you to listen to this interview with a mother whose child has muscular dystrophy and is thriving on a treatment Dr. Prasad briefly removed from the market. These parents felt that Dr. Prasad had not communicated with them at all.
Other actors were not so pure of heart. I don’t need to repeat the details behind Dr. Prasad’s firing, but the knives were out from all directions. Right-wing propagandists and politicians, the biotech industry, the conservative media, and advocates of right-to-try laws collaborated to sink Dr. Prasad. With COVID in the rearview mirror, they rightly saw Dr. Prasad, their former ally, as an anathema to their philosophy. The disinformation outlet the Free Press was correct when it said “the right-wing attack machine revved into action” though of course, Dr. Prasad was a key part of that attack machine for many years.
It’s unambiguously bad that these forces can manipulate Trump to take down FDA regulators. There is no question that Dr. Prasad’s firing, like his hiring, was political, and whoever replaces him will be keenly aware of this. The door is open for RFK Jr. to install a crank who will reject vaccines and approve quackery. As journalist Sarah Karlin Smith wrote:
My guess like I said last nice is this may be a sign of looser standards for cell and gene therapy space and yet conversely an even tougher environment for vaccines….
If that nightmare comes to pass, Dr. Prasad’s resignation paved the way.
4: Dr. Prasad’s Own Phony Words Took Him Down
Dr. Prasad woke-washed the pandemic, and these disingenuous performances came back to bite him. Although he parroted right-wing talking points and elevated right-wing figures, he feigned being a “progressive” to guilt liberals into believing that COVID mitigations betrayed their core values. This phoniness allowed Laura Loomer to weaponize his words against him. She absurdly portrayed Dr. Prasad as a “progressive leftist saboteur” to convince Trump that he had to go. This was the price Dr. Prasad paid for playing a character, the MAGA progressive, for the past 4 years.
5: 7-Foot Hoops Matter
While Dr. Prasad was cozying up to the forces that took him down, we here at SBM tried to sound the alarm bells about them. For example, Alysia Finely wrote an article an influential article in the WSJ titled Vinay Prasad Is a Bernie Sanders Acolyte in MAHA Drag. I had pegged her as unreliable 3 years ago in my article Science Fiction at the Wall Street Journal. Perhaps Dr. Prasad could have avoided his sad fate had he spent less time dunking on SBM and more time paying attention to our warnings about the dangers of 7-foot hoops.
6: Dr. Prasad is Not Off the Hook for RFK Jr.
In addition to fluffing Trump, Dr. Prasad relentlessly fluffed RFK Jr. To pick one example amongst many, in December 2024, he wrote to an article titled Sabotaging RFK Jr’s Confirmation Will Increase Vaccine Hesitancy that said:
The best way to curb vaccine hesitancy is to approve RFK Jr, and redirect his energies to generating more data. More data will answer the key questions that remain unanswered: which childhood immunization program is optimal. The worse thing we can do is tank his nomination. Then vaccine hesitancy will explode.
Things didn’t work out that way, and just because Dr. Prasad is no longer in power, that does not mean he is off the hook for RFK Jr.’s actions. RFK Jr. is leading the HHS in part because “respectable” doctors like Dr. Prasad vouched for him. Since taking office, RFK Jr. has predictably placed cranks like Dr. Robert Malone into positions of power. Dr. Prasad, an EBM zealot, helped unleash all the UFOers and chemtrialers on us. Dr. Prasad owns this and everything RFK Jr. else does moving forward.
Watch this video here
7: Dr. Prasad Did Not Shine in his Day Job or Impress His Co-Workers
Prior to entering the FDA, Dr. Prasad repeatedly dunked on his future employees with his typical childish profanity. That usually doesn’t end well, and it didn’t end well.
Once at the FDA, Dr. Prasad had an actual job to do, and he did not shine at it. According to an article titled Inside the Collapse of the F.D.A.:
Reports from inside the agency remained bleak. Some of the civil servants fired in February and April were now being invited back (the office of generic drugs had been reinstated), but most were not. Those who remained were being asked to volunteer for essential tasks for which there was now no dedicated staff. Scientists and technicians still did not have ready access to the scientific journals they needed to do their work. More than one drug review had been delayed, and political appointees had interfered in several others. And, ultimately, Vinay Prasad, the agency’s new chief medical and scientific officer, overrode expert recommendations on the Novavax and Moderna Covid-19 boosters slated for this fall. As expected — and perhaps as intended — many of the F.D.A.’s remaining employees were now looking for jobs outside the government.
People voted with their feet to get away from Dr. Prasad. Another article US FDA’s Biologics Center Departures Grew Before More Than 100 RIFs Exited said that the:
FDA’s biologics center reported 106 departures from Jan. 1 to June 30. These numbers do not include those who were part of the reduction-in-force. FDA sources estimate CBER lost another 100-150 due to the RIF.
I don’t know anything about the day-to-day life of FDA employees, but I imagine there are many vital but unglamorous duties. Meetings and tasks without cameras seemed to bore Dr. Prasad. According to the article titled Vinay Prasad Named Chief Medical and Science Officer at FDA:
Multiple agency employees, who requested anonymity to protect against retaliation, told STAT that Prasad seemed uninterested in the administrative work of being a center director. One CBER agency official said Prasad rarely attends center meetings with office directors, and that their questions about the budget, HR functions, and IT systems have gone unanswered. Prasad did not consult career staff before unveiling a new regulatory framework for Covid-19 vaccines with Makary in May.
Dr. Prasad also fired people himself. According to an article about Dr. Nicole Verdun titled Top Gene Therapy Regulator Forced Out at FDA:
Verdun, and her deputy, Rachael Anatol, were placed on administrative leave by Prasad, and escorted out of FDA headquarters on Wednesday, STAT reported exclusively. Verdun told staff she was not given an explanation for the firing. She declined to comment for this story.
Longtime FDA employees noted that immediately escorting employees out of the FDA is unusual, and was seen by some staffers as cruel. Multiple employees could be heard voicing outrage over the move during a call Verdun convened to tell staff of the news Wednesday, according to a recording that was obtained by STAT.
When Dr. Prasad suffered the same fate, there was no outrage. Rather his former co-workers put up this mocking photo, a technique Dr. Prasad employed himself. Whoever takes over from Dr. Prasad will find the CBER and FDA in much diminished shape compared to when he arrived in May, though at least Dr. Prasad’s departure is said to have “improved morale“.
8: Dr. Prasad Had His Chance. He Failed.
Dr. Prasad got famous regarding COVID only because he “called for” the medical establishment at the time to do many difficult things. He “called for” schools to be open and for more RCTs to be done. It turns out podcasting about doing things is easier than actually doing this. Yet, since his departure, several of his defenders have taken the attitude- Vinay Prasad cannot fail. He can only be failed.
This is false. There is no need to speak about Dr. Prasad in the conditional tense or play imaginary games about what he “would have” done in some fantasy world. He has a track record now. We don’t have to debate whether or not Dr. Prasad “would have” restored trust. He didn’t. He was given the opportunity, and he failed. Maybe he was treated horribly and unfairly and that shouldn’t have happened, but it did. Trump fired him in record time. Perhaps there is a parallel universe out there where Loomer doesn’t exist, Big Pharma is impotent, Trump is reasonable, and Dr. Prasad has a successful tenure at the FDA. But that universe isn’t ours.
Any discussion about the wonderful, amazing things Dr. Prasad “would have” done presupposes an alternate reality where powerful forces were not aligned against him or where Dr. Prasad had the savvy to contain them. That’s like saying, I would have been a major league superstar if I had been able to throw 100 MPH.
9: Propagandists are Censoring Dr. Prasad’s Pandemic Record to Rehabilitate his Image and Portray Him as a Victim
While science-based doctors were horrified at previous purges of scientists, essentially no legitimate doctor was sad to see Dr. Prasad go. I’ve seen almost no one come to his defense. However, a very small number of doctors, Dr. Prasad’s business partners and fellow misinformation superspreaders, cared only about his dismissal. They were silent when Dr. Prasad had Dr. Verdun frog marched out the FDA, and in their view, Dr. Prasad is the first fired scientist anyone should care about.
To make their case, they immediately set to censor Dr. Prasad’s pandemic record and portray him as a heroic martyr. As Dr. David Gorski discussed yesterday, Dr. Adam Cifu wrote a piece of absurd revisionist history titled Vinay Prasad is My Former Student and Friend. His Departure From FDA is a Loss for American Medicine. It said:
I do understand that he is … well … divisive. He has strong opinions, and he is not shy about sharing them. On social media, he has at times been brash, nasty, and insulting. Being opinionated and insensitive guarantees enemies, and he made them in spades. I have many colleagues who confide that they greatly respect his intelligence and productivity and agree with him on most issues, while being seriously offended by his style.
This is absurd. Dr. Prasad’s “style” is not the reason he is divisive. We Want Them Infected isn’t 400 pages of how I was “offended” by anyone’s “strong opinions”. That Dr. Prasad called people “motherfuckers” and “fucking morons” wasn’t his main problem. The main problem was that he directed this juvenile fury exclusively at vaccine-advocates.
As Dr. Cifu surely knows, Dr. Prasad’s critics, objected to his fake statistics and pro-virus/anti-vaccine disinformation. We said that his articles Should We Let Children Catch Omicron? and Sabotaging RFK Jr’s Confirmation Will Increase Vaccine Hesitancy were dangerous, and we were completely right. It’s no surprise that Dr. Cifu censored Dr. Prasad’s pandemic record. He doesn’t trust his readers with the truth and wants them to think that Dr. Prasad’s critics were just sensitive snowflakes who never made serious arguments.
Dr. Cifu also wrote:
Vinay was also guaranteed to be labeled a hypocrite. Although his views on evidentiary requirements have always been nuanced, many critics labeled him as accepting only randomized controlled studies as adequate evidence. But that’s not right. To function in his position, he would need to be open to a spectrum of evidence, as all physicians must be — and he is.
That’s totally false. “His views on evidentiary requirements have always been nuanced” is pure gaslighting. In reality, Dr. Prasad spent the past 4 years spreading doubt and rage about his predecessors precisely because they had to “open to a spectrum of evidence”. Dr. Prasad’s “many critics” didn’t “label him as accepting only randomized controlled studies as adequate evidence”. Rather, we accurately quoted Dr. Prasad, who accepted only randomized controlled studies as adequate evidence. He wrote articles titled The Scientists Who Undermine Randomized Trials and said that his motto was “RCT or STFU for all”. He was guaranteed to be labeled a hypocrite because he changed his mind about this the moment he got into office. Dr. Cifu hid this from readers, of course.
Dr. Cifu also wrote:
Vinay is absurdly smart, hardworking, kind, willing to argue points — as he and I have done many times on Sensible Medicine — and will change his mind when he is wrong.
While Dr. Prasad may be smart and hardworking, in reality he was unwilling to argue points. I wrote dozens of serious articles here and an entire book discussing the ways I disagreed his pandemic philosophy. So did many others. Neither Dr. Prasad nor Dr. Cifu ever engaged with any of it in good faith. It was impossible to have a discussion about science and data with either of them. I tried. They refused.
And Dr. Prasad was not kind about any of this. He was vicious and cruel to many people- read the article 120 Organizations, Institutions, Individuals, and Tools that UCSF’s Vinay Prasad Has Attacked. He encouraged vulgar revenge fantasies against his predecessors and other doctors, even those who needed bodyguards and received death threats. None of this bothered Dr. Cifu, however, who instead feigned concern about the “tone” of Dr. Prasad’s critics, such as myself, to discredit us and avoid the content of our criticism. My tone mattered. Dr. Prasad’s did not. Imagine the phony outrage if I made a meme like this with pictures of doctors I didn’t like.
I expect Dr. Cifu will welcome back Dr. Prasad to their monetized Substack where they share the “shocking inside story” of how he was taken down by Big Pharma. The drama, grievance, and revisionist history will continue.
10: Dr. Prasad’s Legacy is a Collapse of Trust
When it came to COVID, Dr. Prasad spent years intentionally spreading distrust about the previous medical establishment. He made videos such as You’re Right Not to Trust Public Health and wrote articles such as Trust in Doctors and Hospitals is Down; Given the Extent of the Dishonesty, It is Still Too High. He drilled this message of doubt into the public consciousness daily for years. He told people that the medical establishment lied constantly, and they believed him.
Incredibly, Dr. Prasad believed his own nonsense and thought he could fix the problem he helped create simply by with incessant discussions of rare, mild vaccine side effects. In an article about vaccine-myocarditis, he wrote:
This risk-taking approach may, in part, be responsible for widespread loss of trust in public health and medicine and growing hesitancy against all vaccination. Public trust takes decades to build, but can be forfeited in a single action. The FDA’s class SLC action on mRNA products represents one step toward rebuilding that trust.
That was never going to work. Vaccine-myocarditis was not the root cause of mistrust after all.
Yet, instead of warning Dr. Prasad that he was headed down a dangerous path, his “friends” enabled and encouraged him every step of the way. They too felt he was the perfect guy to restore trust. When Dr. Prasad was appointed to run CBER, Dr. Cifu, along with Dr. John Mandrola, wrote an article endorsing him that said:
Vinay Prasad is leaving Sensible Medicine to take a senior role at the US FDA. He has our enthusiastic support. Prasad is slated to be the incoming CBER director, where he will regulate vaccines as well as cellular and gene therapy. In our opinion, there is no better candidate…
We can’t think of anyone more qualified to lead the biologics division. Prasad’s lifelong commitment to scientific rigor will help rebuild lost trust in regulatory bodies.
Things didn’t turn out that way. However, after Prasad lost his job, Dr. Cifu claimed he always knew how this would end. He wrote:
I am also unsurprised — this administration acted exactly how I expected it would, with cowardice and short-sightedness — and angry.
While Dr. Cifu now claims he “expected it” all along, his words reveal that he while he previously believed a competent doctor could succeed in the FDA, he too has now lost trust. Dr. Mandorla feels the same way. In an article titled Prasad Being Forced Out of FDA is a Sad Day for Evidence-Based Medicine he wrote that:
But society also needs independent judges to prevent profiteering of susceptible people with serious illness. That we had one, and he was removed this easily is simply awful. Trust is shredded.
From claiming that Dr. Prasad would “rebuild lost trust” to “trust is shredded” in under 3 months is quite the medical reversal, but trust is indeed shredded after Dr. Prasad’s 3-months in office. A diverse group people, from Sensible Medicine doctors to Natural News, now view the FDA as nothing more than a pawn of right-wing influencers, politicians, and Big Pharma.
By being Loomered, Dr. Prasad unintentionally lowered trust in the FDA even further, and anyone who defends him today is conceding that his mission to restore trust was an abject failure. Do you have more confidence in the FDA than you did 3 months ago? Along with those hurt by his COVID disinformation, this collapse of trust will be Dr. Prasad’s chief legacy.
11: How Long Will Marty Makary Last in the US Surreal Soap Opera
None of this is good for Dr. Marty Makary. Not only is he without his righthand man, but he must also be sure not to displease Laura Loomer, biotech companies, or the WSJ himself. Moreover, Dr. Prasad’s defenders, Dr. Makary’s former friends and allies, are now claiming that “pharma lobbyists” are more powerful than he is when it comes to staffing at the FDA. They have a strong case.
Like Dr. Prasad, Dr. Makary specializes in numbing people to grave risks. His optimistic predictions- We’ll Have Herd Immunity– always end poorly, and today he is speaking this way about the FDA- “We’ve got tremendous leadership.” He insists that multiple news reports about Dr. Prasad’s departure are wrong. In Dr. Makary’s telling, Trump didn’t fire Dr. Prasad. Rather, Dr. Prasad left of his own volition because “the commute was brutal“. Moreover, Dr. Makary says that Dr. Prasad is welcome to return at any time. Anything else would reveal who is running the show at the FDA.
Almost no one trusts Dr. Makary now, not even his former Sensible Medicine allies, and it is not clear how he can fix this. Although his job is to restore trust, he is spending his time talking about food dyes in ice cream and spreading wild anti-vaccine anecdotes. Even anti-vaxxers are laughing at him because of that.
12: A Not-So-Fond Farewell to Vinay Prasad
Our medical leaders, past and present, have created a soap opera. So it’s possible Dr. Prasad will tire of his family and return to the FDA or makes the news in some other outrageous way. Until then, I don’t think anyone should or will care about his Substack articles or YouTube videos. I hope he returns to patient care and his family and that he finds happiness and meaning in that. However, as a public figure, he’s totally irrelevant, and he should be ignored. I wrote about Dr. Prasad many times previously because I knew that he was dangerous and influential. That’s no longer the case, and unless that changes, I see no need write about him ever again.
He was tragically ignorant about the forces he enabled, and he has nothing of value to say about them now. He’s currently a pawn in a MAGA/MAHA Civil War, and he will never be accepted into the good graces of academic medicine again. He will remain a fringe figure the rest of his career, forever tainted by his pandemic disinformation and willingness to debase himself to elevate Trump and RFK Jr. Nothing he does moving forward will erase that, and it’s good that it’s all saved on video. I am confident his Sensible Medicine buddies will do their best to deny that it ever happened.
His only usefulness is as a cautionary tale. Medical students should study his sad trajectory as a warning and strive to be his opposite in every way. Dr. Prasad had incredible potential, but he squandered it for power, fame, and paid subscribers. He surrounded himself in an echo chamber and never doubted himself or paused to consider whether any of his critics had any valid points. As Dr. Angela Rasmussen wrote in her article A Not-So-Fond Farewell to Vinay Prasad:
Prasad may have been too incompetent at enabling fascism for the fascists, but we should not forget that he volunteered to be part of that. He chose to support people who are actively annihilating the American government and attempted to prevent people from accessing lifesaving vaccines and medications. He is not a colleague. His actions at FDA demonstrate that he is a traitor to our country and we should never forget that. We should never let him forget it, either.
And while that sounds harsh, I’ve not yet heard any of Dr. Prasad’s critics speak about him this way, thankfully. Tone is important, after all.
