Jake Scott, MD
ID doctor | Stanford Clinical Associate Professor
Science communicator. Vaccine mythbuster. Equity-driven physician & educator.
Building trust through data, clarity, and collaboration.
bradspellberg.com/vaccine-rcts
Views my own.
- Grateful to @cidrap.bsky.social & @mtosterholm.bsky.social highlighting our vaccine RCT table in this viewpoint. This kind of recognition reinforces the value of collective, evidence-based efforts to bring clarity to vaccine research. @bradspellberg.bsky.social www.cidrap.umn.edu/anti-science...
- Fresh #s from our crowd-sourced, verifiable vaccine trial dataset: bit.ly/4mbdl6U - 123 controlled trials (polio to chikungunya) - 1.9 million participants - ~80% placebo, 15% active control (used only when placebo would be unethical) Every entry links to primary source @bradspellberg.bsky.social
- Folks from around the world came together (off the clock, with no funding) not to argue, but to illuminate. Grateful to @bradspellberg.bsky.social, @abhaydhand.bsky.social, @adamlauring.bsky.social, Neal Fox, @jkeelan57.bsky.social, @alejodiaz81.bsky.social, & many other contributors bit.ly/44zoJDm
- A blunt remdesivir “immunocompromised-only” rule cut use 90% (37.7 → 4.1 %), saved ~$1.5 M, and did not raise 14- or 28-day mortality (Christensen et al., @cidjournal.bsky.social). IV therapy that drags out LOS and strains budgets should be the exception, not the reflex. bit.ly/4m9zZwo
- “No CDC childhood vaccine was ever placebo-tested.” False. Our crowd-sourced sheet lists 24 saline-placebo RCTs for 7 schedule vaccines: 1 Rotavirus (8 RCTs) 2 Hib (5) 3 Hep B (4) 4 Varicella (3) 5 Hep A (2) 6 Measles/MMR (1) 7 Influenza LAIV (1) Data 👉 bit.ly/3EuYzqI @bradspellberg.bsky.social
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- Those stand-alone measles ’65, mumps ’67, rubella ’69, and tetanus toxoid ’54 saline-placebo RCTs are priceless history that many folks have never seen. They’re all in the sheet, which is now up to 107 trials. Love seeing the continuum grow from those early studies to today’s vaccines bit.ly/3EuYzqI
- For the other schedule vaccines, trials used: - A licensed predecessor (DTaP, PCV, IPV, MenACWY, MenB) or - A adjuvant-only shot for blinding (HPV). Those designs are standard once saline would withhold protection or reveal who got the real vaccine. Every verifiable paper is linked in the sheet.
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- Thank you, my friend!
- Vaccine control types recap👇 🔹 Placebo: saline/inert when no licensed vax exists. 🔹 Active comp: Gardasil vs alum-only (blinded); PCV13 vs Prevnar. 🔹 No-intervention: early trials just observed unvaxed (pertussis ’34–38, Salk ’55). 103 trials·1.79 M pts www.bradspellberg.com/vaccine-rcts
- Addendum on active comparators: Gardasil used an alum-only shot to preserve blinding & isolate HPV antigens even though no prior HPV vax existed. When a licensed vax does exist, head-to-head studies like PCV13 vs PCV7 (Prevnar) are the template: pubmed.ncbi.nlm.nih.gov/20427630/
- Active comparator When a proven vax exists you can’t ethically withhold it. Gardasil vs alum-only maintained blinding & isolated HPV antigen effects 4/ pubmed.ncbi.nlm.nih.gov/17494926/
- @teddyrosenbluth.bsky.social @helenbranswell.bsky.social @enirenberg.bsky.social @adamjkucharski.bsky.social @aetiology.bsky.social @bradspellberg.bsky.social @angierasmussen.bsky.social @drandrealove.bsky.social
- I’ve been getting a lot of questions about what it really means for a vaccine trial to be “placebo-controlled” - and how that differs from other control groups. It’s a great question, and clarity here really matters. Let’s break it down. @bradspellberg.bsky.social @adamlauring.bsky.social #IDsky
- I’ve been getting a lot of questions about what it really means for a vaccine trial to be “placebo-controlled” - and how that differs from other control groups. It’s a great question, and clarity here really matters. Let’s break it down. @bradspellberg.bsky.social @adamlauring.bsky.social #IDsky
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View full threadNo-intervention = no control shot. Pre-1950s field trials used it when blinding norms were new, giving saline to 100k+ kids was impractical, and endpoints were hard (paralysis, death). Salk ’55 mixed no-shot & saline arms - still controlled, but higher bias risk.
- Once an effective vax exists, denying it is unethical—hence active comparators. WHO policy brief on vaccine-trial ethics (Nov 29 2021): apps.who.int/iris/handle/...
- Active comparator When a proven vax exists you can’t ethically withhold it. Gardasil vs alum-only maintained blinding & isolated HPV antigen effects 4/ pubmed.ncbi.nlm.nih.gov/17494926/
- Why alum vs saline? Gardasil contains alum adjuvant Alum mimics the local redness/soreness a real shot causes, so blinding is preserved Ethical aim: the only difference between groups is HPV antigens Alum has 90 yrs of use; 0.5 mg Al ~ < 10 % daily dietary intake - no credible neuro/autoimmune link
- What our sheet shows: 103 trials (3 duplicate tetanus rows merged) 1, 791,082 participants 77 % placebo 19 % active 4 % none 7/ Sheet: www.bradspellberg.com/vaccine-rcts
- Share this thread to counter misinformation. Crowd-sourced. No industry $. Quiet work ➡️ shared truth. Help us keep building it. docs.google.com/spreadsheets...
- No-intervention Kendrick & Eldering whole-cell pertussis, 1934–38 (TN, 5,815 kids): controlled, non-randomized, ~86 % VE - genuine “no shot.” 5/ www.jameslindlibrary.org/kendrick-p-e...
- Why it matters: Mis-labelling every control as “placebo” blurs ethics & evidence - and lets critics claim “vaccines weren’t tested against saline.” In reality, most modern trials, incl. pre-licensure COVID-19 RCTs, were classic saline-placebo studies. 6/
- 3 control types: 1. Placebo (saline/inert) 2. Active comparator (e.g., alum-only or licensed vax) 3. No-intervention (observed only) 2/
- Placebo Used when no licensed vax exists & ethics allow. Peru cholera ’99: 85 % VE vs saline 3/ pubmed.ncbi.nlm.nih.gov/10569747/
- This wasn’t built by an institution or backed by funding. It was built by clinicians, pharmacists, scientists, & anonymous contributors. No sponsors. No conflicts. Just evidence. I’d log in at midnight and see Anonymous Koala editing rows. That’s public science: open, people-powered, and shared.
- 105 controlled vaccine trials. 110 yrs. 1.8 M participants. All in one live, crowd-sourced sheet. Built by contributors worldwide to counter the myth that vaccines weren’t tested with controls. Quiet work still breaks through the noise. www.bradspellberg.com/vaccine-rcts @bradspellberg.bsky.social
- The myth that vaccines weren’t tested with controls isn’t just wrong - it’s measurably wrong. Now the data are all in one place. This is what public science looks like: transparent, crowd-sourced, open to anyone. @nytimes.com @statnews.com @kffhealthnews.org @npr.org @drandrealove.bsky.social
- 105 controlled vaccine trials. 110 yrs. 1.8 M participants. All in one live, crowd-sourced sheet. Built by contributors worldwide to counter the myth that vaccines weren’t tested with controls. Quiet work still breaks through the noise. www.bradspellberg.com/vaccine-rcts @bradspellberg.bsky.social
- 105 controlled vaccine trials. 110 yrs. 1.8 M participants. All in one live, crowd-sourced sheet. Built by contributors worldwide to counter the myth that vaccines weren’t tested with controls. Quiet work still breaks through the noise. www.bradspellberg.com/vaccine-rcts @bradspellberg.bsky.social
- 24 h of crowd power ➡️ live table of every placebo-controlled vaccine RCT - 27 trials logged so far (>2 M participants) - Control-type tag = saline vs active comparator Contribute / explore 👇 bit.ly/3EuYzqI cc @statnews.com @kffhealthnews.org
- Amazing job leading this my friend!
- Thanks so much, my friend. Means a lot coming from you. Couldn’t have done it without your vision and support.
- Thanks to @adamlauring.bsky.social for flagging two more influenza RCTs for the vaccine trial sheet - both now added. We’re now at 106 trials and 1,858,978 participants and counting. Appreciate everyone helping this become the public archive it’s turning into. www.bradspellberg.com/vaccine-rcts
- Latest tally: 102 vaccine RCTs (1914-2024) 72 SALINE/true placebo (~71 %) 26 ACTIVE comparator (~26 %) 4 NO-INTERVENTION (~4 %) Whether saline, active vax, or untreated, every trial had a control arm - contrary to the “never tested” myth. Sheet 👉 bit.ly/3EuYzqI
- Retweeting again in the hopes that members of the media can use this awesome resource when they report on vaccines and calls for "new" placebo controlled trials. @statnews.com @nytimes.com @washingtonpost.com @carlzimmer.com @apoorvanyt.bsky.social
- When an existing shot already saves lives, withholding it is unethical. Solution: use an *active comparator* control: -licensed Hib vs new Hib -Prevnar-13 vs PCV-20 -Alum-only vs HPV antigen You still get blinding & head-to-head safety/efficacy data - just no child left unprotected.
- Worried about “injected aluminum”? Aluminum hydroxide/phosphate has powered vaccines since 1926 - billions of doses Depot + innate boost ➡ stronger immunity with less antigen Shot ~0.5 mg Al (< 10 % of what we ingest daily) 90 yrs of data: no neuro/auto-immune harm; main AE = brief sore arm
- 13 days ago we started a crowd-editable Google Sheet with 7 placebo/active-controlled vaccine RCTs. It now lists 102 trials & 1.79 M participants- polio ➡️ RSV & malaria. Browse or drop a PMID 👇 bit.ly/3EuYzqI @bradspellberg.bsky.social @alejodiaz81.bsky.social Open evidence beats myths every time.
- Why licensed vaccines aren’t re-tested vs saline placebo: - Ethics: can’t deny a proven shot - Safety: post-market nets watch 10 M+ people for years - Vigilance: VAERS caught J&J clot signal in wks Active-control RCTs + continuous surveillance ≫ 1-off placebo. docs.google.com/spreadsheets/d/1bX5A…
- < 72 h from launch → 48 placebo / active-controlled vaccine RCTs logged - now including all 5 COVID trials 1.43 M participants Crowd-powered, freely accessible evidence that buries the “never placebo-tested” myth. Browse or drop a PMID 👇 bit.ly/3EuYzqI cc @bradspellberg.bsky.social
- * Quick correction to the post below: Live total is ~822 k participants across 27 trials - NOT “> 2 M.” (2 M was an early rough count before all rows were entered; more trials coming.) The sheet header now shows the real-time total. Link unchanged.
- 24 h of crowd power ➡️ live table of every placebo-controlled vaccine RCT - 27 trials logged so far (>2 M participants) - Control-type tag = saline vs active comparator Contribute / explore 👇 bit.ly/3EuYzqI cc @statnews.com @kffhealthnews.org
- 24 h of crowd power ➡️ live table of every placebo-controlled vaccine RCT - 27 trials logged so far (>2 M participants) - Control-type tag = saline vs active comparator Contribute / explore 👇 bit.ly/3EuYzqI cc @statnews.com @kffhealthnews.org
- Wow! If anyone ever doubts the power of crowd sourcing, look at the vaccine RCT table that has been built already, in under 24 h! Unbelievable work by @jakescottmd.bsky.social Dr. Abdhay Dand, @alejodiaz81.bsky.social and Dr. Ali Meza Vazquez! bradspellberg.com Vaccine RCTs | mysite
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- *Correction: live total is 822,257 participants across 27 trials - not “> 2 M.” (2 M was an early rough count of all trials we’d identified before data entry.) The sheet header now shows a real-time total. Apologies for the slip.
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- Thanks to @bradspellberg.bsky.social for kicking this off! ➡️ Sheet now tags each trial’s Control type (inert placebo vs active comparator) and has a Notes column for oddities (e.g., Salk PDF glitch). ➡️ Add PMIDs, sample sizes, links - guidelines here: bit.ly/42MPvWp Crowd input welcome. #IDsky
- The FDA plans to end most routine food safety inspections? How is this even up for discussion? Outsourcing to patchwork state/local systems isn’t oversight - it creates gaps, inconsistency, and puts poorer communities most at risk. This is how people get sick, and how trust erodes. #FoodSafety
- We're told the FDA is now making plans to end most of its routine food safety inspections That oversight work would be effectively outsourced to state and local authorities, under this plan www.cbsnews.com/news/fda-foo...
- The only thing AG1 reliably improves is revenue for Athletic Greens and its podcast affiliates. There’s zero clinical evidence it benefits actual health outcomes. Don’t waste your money.
- Juliane Bubeck Wardenburg gave a brilliant talk at #ESCMIDGlobal2025 on why S. aureus vaccine efforts have failed. With 50+ virulence factors & major immune heterogeneity, it exploits ecological & immunologic niches. Her PISA framework is a bold new path forward. pmc.ncbi.nlm.nih.gov/articles/PMC...
- From the “Weird and Unusual Infections” session at #ESCMIDGlobal2026 Wohlfahrtiimonas bacteremia in a man with alcohol use disorder, found down on a dirty floor - maggots present. Excellent presentation by Dr. Anne Engsbro. These bacteria live in flesh flies and their maggots. Bacteremia is rare.
- This is what it looks like when ideology trumps understanding. RFK Jr. has shut down tracking of maternal deaths, cancer in firefighters, HIV transmission, and drug-resistant gonorrhea. If you don’t track it, you can’t prevent it. This isn’t reform. It’s sabotage. www.politico.com/news/2025/04...
- Surveillance isn’t optional; it’s how we detect outbreaks, guide prevention, and stop transmission. Halting HIV & STI tracking means more missed cases, more spread, more suffering. This will cost lives.
- Guy Thwaites gave a brilliant talk at #ESCMID2025 on the future of TB and why the sun is finally rising. New drugs. Shorter regimens. Smarter trials. But science alone won’t end TB. Poverty, politics, and inequity remain central. And yes, the orange elephant in the room needs to go.
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View full threadIn HIV-negative TB meningitis, dexamethasone improves survival, but not for everyone. Guy Thwaites highlighted genotype-stratified data (LTA4H): - TT genotype: strong survival benefit - CC genotype: no benefit Personalized adjunctive therapy may be the future. #ESCMID2025 #TBM
- Guy Thwaites challenged the old Everest expedition model of TB trials- slow, expensive, high-income-led. He proposed a better way: agile, local, cost-effective. Like Nimsdai Purja’s rapid ascent of all 14 8000m peaks, the future of TB trials must be faster, smarter, locally led. #ESCMIDGlobal2025
- TB meningitis reminds us: it’s not just about killing bugs. Outcomes are shaped by both bacterial killing and inflammation. Guy Thwaites made the case for host-directed therapies, and even personalized approaches, as essential tools in ending TB. #ESCMID2025 #TBM
- In HIV-associated TB meningitis, CSF inflammation is high, but dexamethasone didn’t improve survival. Guy Thwaites discussed results from the Donovan et al RCT: nejm.org/doi/full/10.1056/NEJMoa2216218 ~50% had CD4 ≤50. Despite immune activation, no mortality benefit was seen. #ESCMID2025 #TBM
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- To end TB, we need to rethink how trials are done: - Support leadership from high-burden countries - Cut costs and bureaucracy - Integrate trials into national TB systems - Build local capacity, not dependency on CROs It’s not just more efficient, it’s more just. #ESCMID2025
