Better in their words…

Scott Gottlieb’s Washington Post essay is rhetorically powerful and personally moving. It is also structurally incomplete—and that incompleteness matters, because it reproduces a double standard that has distorted U.S. vaccine policy, medical practice, and research priorities for decades.

The core claim of the piece is uncontroversial: viral infections can cause devastating long-term harm in a subset of people. Epstein-Barr virus, measles, HPV, enteroviruses—these associations are real, documented, and serious. No serious critic disputes that. But Gottlieb uses this reality to imply that opposition to current vaccine policy rests on a denial of viral harm. That implication is false, and it collapses under even modest scrutiny.

The actual dispute is not whether viruses can harm people. It is whether vaccines can also harm some people, whether those harms have been systematically minimized or obscured, and whether the medical system has allowed ideological commitment to vaccination to suppress safer, complementary, or alternative approaches to prevention and treatment.

On that question, Gottlieb’s essay is silent.

That silence is not neutral.

The Missing Symmetry: Vaccine Injury Also Exists

The same logic Gottlieb applies to viral infections applies—inescapably—to vaccines. Biological interventions administered at population scale will produce heterogeneous outcomes. Some people benefit greatly. Some are unaffected. Some are harmed.

Yet when long-term harms follow vaccination, the response is categorically different. Instead of investigation, we see denial. Instead of humility, certainty. Instead of expanded research, contraction.

Post-viral syndromes are described as tragic, complex, and deserving of massive research investment. Post-vaccine syndromes are dismissed as coincidence, anxiety, misinformation, or “anti-science.” That is not science. That is ideology.

If it is valid to argue that a small fraction of EBV infections lead to lymphoma decades later, it is equally valid to ask whether a small fraction of immune-modulating interventions—administered repeatedly, early in life, and without long-term inert placebos—may also produce delayed autoimmune, neurological, or inflammatory consequences in susceptible individuals.

The refusal to apply this symmetry is the central double standard.

Conflicts of Interest Are Not a Footnote

Gottlieb writes as a survivor of cancer. He also writes as a sitting board member of Pfizer and UnitedHealth Group. That fact is disclosed—but not grappled with.

When a former FDA Commissioner who now sits on pharmaceutical boards argues that political skepticism toward vaccines threatens public health, readers deserve more than disclosure. They deserve argumentative restraint and epistemic humility proportional to the conflicts involved.

Instead, we get absolutism: dissent is framed as dismantling the “vaccine enterprise,” and policy reform is equated with recklessness. That framing conveniently aligns with the financial interests of vaccine manufacturers, insurers, and vertically integrated healthcare systems.

Scientific credibility is not strengthened by ignoring that alignment.

Suppressed Alternatives and the Narrowing of Medicine

One of the most consequential omissions in Gottlieb’s essay is the role vaccine primacy has played in suppressing other medical options.

During COVID, early outpatient treatments, repurposed drugs, risk-stratified protocols, nutritional interventions, and immune-supportive therapies were not merely debated—they were actively discouraged, censored, and in some cases professionally punished. Research pathways narrowed. Clinical discretion collapsed. Everything flowed toward vaccination as the singular solution.

That same pattern now repeats historically. When vaccines are positioned as the only acceptable preventive strategy, everything else becomes politically suspect: antivirals, immune modulation, environmental risk reduction, personalized medicine, and non-pharmaceutical prevention.

This is not how robust medicine works. It is how monocultures fail.

Measles, Memory Loss, and Selective Alarm

Gottlieb emphasizes measles-induced immune amnesia—a real phenomenon. What he does not address is whether repeated immune stimulation via other means, including certain vaccine schedules, might also alter immune calibration in ways not yet fully understood.

We are told to fear immune dysregulation when it follows infection, but to dismiss the question when it follows vaccination. That asymmetry is not evidence-based. It is policy-driven.

Science does not pre-decide which hypotheses are allowed.

The False Binary: Pro-Vaccine vs. Anti-Vaccine

The most damaging move in the essay is rhetorical, not scientific. Gottlieb collapses a wide spectrum of positions into a caricatured “anti-vaccine movement.” In reality, many critics are pro-science, pro-safety, pro-individual risk assessment, and deeply concerned about infectious disease.

What they reject is not vaccination per se, but:

• denial of vaccine injury,
• lack of long-term safety trials with true placebos,
• coercive mandates without liability reform,
• censorship of adverse-event research,
• and the subordination of clinical judgment to population-level messaging.

Calling that stance “anti-vaccine” is not argument. It is branding.

What a Serious Conversation Would Look Like

A serious public-health discussion would acknowledge all of the following simultaneously:

1. Viral infections can cause devastating long-term harm in some people.
2. Vaccines can also cause serious harm in some people.
3. Ironically, those at most risk may overlap (this is an untested hypothesis, but if risk is genetic and related to homology between human and pathogen proteins, it seems likely).
4. Genetic, immunological, and environmental susceptibility matters in both cases.
5. Suppressing research into either category undermines trust and safety.
6. Medicine advances by expanding options, not enforcing singular solutions.

Until advocates of vaccination are willing to confront all five points openly, calls to “protect the vaccine system” will sound less like science and more like institutional self-defense.

Conclusion

Scott Gottlieb is right about one thing: invisible, delayed biological harm is real—and ignoring it costs lives.

He is wrong to apply that insight in only one direction.

Vaccines are no longer the only game in town. Research on therapies matter, too.

If we are going to reckon honestly with the long-term consequences of immune system perturbation, we must do so without double standards, without financial blinders, and without silencing inconvenient patients or clinicians.

Public health does not die in darkness.

It dies when light is permitted to shine in only one place.