Kevin McIntyre, PhD

mRNA vaccines are a game-changer. Faster to develop, generally safer, easy to modify, huge potential for wider applications (e.g. cancer). If the vaccine has been approved, it's already been thoroughly tested in randomised controlled trials. Nobody's trying to poison anyone with these vaccines.

be wildly cost effective given how cheap they are as far as interventions go & how common & debilitating nosocomial & workplace infection is. Remember this isn't just covid, it'll work against all resp disease so it'll help with flu & colds along with the myriad of other resp diseases

So essentially it comes down to how many nosociomal/workplace infections can we prevent & how much incremebtal benefit does that provide compared to how much money do respirators incrementally cost?

To my knowledge no one has done this, but I'd hypothesize that universal respirator use would

Aside for this. Generally we are seeing the benefits being as follows: less sickness for patients & staff leading to benefits in both quality of life & $ saved. Costs being, minor discomfort, some minor communication complications & costs (someone has to pay for the masks & we'll need a lot of them)

if that patient can come home sooner. But again there is the cost of discomfort, worse communication & cost (again to the system not individuals). Now there is also going to be <100% compliance & special cases (palliative care for example) where these general strokes won't hold but let's leave those

comfortable than not wearing one, the $ (as discussed before, this should be born by the system not individual staff), & possible more difficult communication with patients. Visitors gain the benefit of being less likely to get sick visiting a loved one & an increase in their quality of life

perspective here - obviously the patient shouldn't have to pay). For staff, the main benefit includes being less likely to get sick at work, so decreased sick days & For the hospital paying less OT/being less short staffed due to absenteeism due to illness. The cost being it's probably less

Also potential complications arising/spiraling from getting such an infection (more medication, procedures, & increased probability of in-hospital death). The cost being, it's probably less comfortable than not wearing one, & masks do have some $ cost (although we'll take a health systems

Each of these groups will have different costs & benefits & there will obviously be interactions between them. For patients, the main benefit of wearing a respirator is likely reducing the probability of getting a nosocomial infection which improves quality of life & likely decreases hospital stay.

Let's think a bit more deeply on this. CEAs are essentially (incremental benefits/incremental costs). So let's think through what these all might be. First, we have essentially 3 groups of people in hospitals (we'll restrict this thought to them for ease). Patients, staff & visitors.

Maybe continuous respiratory use would be a "misuse of resources". However, just saying you think that is not evidence. Do an actual cost-effectiveness analysis. Calculate the benefits (eg fewer nosocomial infections & following outcomes) in both $ & health, & compare against the costs of masking

The irony of saying that the standard is "not supported by evidence" when they don't provide any evidence themselves. Also, their dabbling into health economics, while having no discernible expertise in that field & while claiming the authors of the standard don't have expertise really is something.

Sidekick projects may be worthy distractions for an early academic Dr. Ilya Kashnitsky is a demographer @ Statistics Denmark.

As I'm getting further from my PhD years, the reflections of that experience are becoming (hopefully) more useful to share with the ones who are just making their academic baby steps 🐾
👀 New blog post (my first not for R-bloggers) inspired by @clauswilke.com's post
🔗 ikashnitsky.phd/2025/sidekic...

So far no response that I'm aware of. Guyatt et al just published a series of articles in the BMJ pitching "core GRADE" (which to me looks very much like just recycled GRADE without any substantial improvements). In those 8 articles the word confounding was used less than 5 times by my count.

Using causal diagrams within the Grading of Recommendations, Assessment, Development and Evaluation framework to evaluate confounding adjustment in observational studies The current Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system instructs appraisers to evaluate whether individual observational studies have sufficiently adjusted for c...

My issue with EBM (specifically GRADE) is it's complete lack of modern understanding regarding confounding. EBM remains in the early 90s with regard to its understanding of epidemiologic methods which is a major weakness for a process appraising the current lit.

www.jclinepi.com/article/S089...

Doctoral Excellence Award Western University, in vibrant London, Ontario, delivers an academic and student experience second to none.

My university (@westernu.ca) is offering up to $160,000 CAD in funding to support doctoral students impacted by recent changes in higher ed in the US.

And I'm keen on supervising students who may be interested (and who conduct research in public health ethics). DM me.

grad.uwo.ca/finances/wes...

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The quote below is from Dr. Lakshmi Panagiotakopoulos, who recently resigned from CDC after co-leading the ACIP COVID work group. The new ACIP jettisoned work group experts in favor of anti-vax activists.
👉Canada's NACI is now the best source for evidence-based vax recommendations in North America

Difficult to overstate how much blood RFK and Trump will have on their hands in the coming years.

Difficult to overstate how many innocent kids will die as a result of the people who cast votes for Trump last November.

RFK Jr. says US won’t donate to global vaccine effort Kennedy ripped into Gavi, the Vaccine Alliance, in a video address at its pledging summit.

This is a travesty & a nightmare. The US was a founder of @gavi.org. It lowers global vaccine costs, has vaccinated 1B children, & averted 19M deaths. This pull out will cost 100s of thousands of children's lives a year - and RFK Jr will be personally responsible.
www.politico.com/news/2025/06...

I think a lot of people are foolishing resisting experimenting with AI out of the misguided sense that if we all just ignore it then it will go away, but we need to keep in mind our bosses aren't ignoring it.

They're furiously trying to automate our jobs away as we speak.

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What to expect from the new ACIP: new impractical hurdles for any approvals and intentionally delayed decisions. This Committee will be an immeasurably high barrier for any vaccines to be issued to Americans. They will continuously require more data and defend this based on "gold standards".

Now that RFK Jr has destroyed ACIP at the US CDC, #NACI in Canada is the place to go for non grift vaccine recommendations.

If your healthcare provider supports or endorses anything RFK. Jr has to say about public health or vaccines, your health is in grave danger. Find yourself a new healthcare provider expeditiously.
A word to the wise is sufficient.

RFK is going to be responsible for a lot of death and suffering

Remember folks: the proverbial "gold standard" for evidence was driven by our own mainstream institutional evidence based medicine movement.

A simple (read: stupid) set of rules dictating what's good (double blind RCT, meta-analysis, etc) and not (anything else).

What could possibly go wrong?

Prasad and Makary’s terrible opinion piece from 5/20 in the NEJM

Table from that Prasad and Makary article with “pregnancy and recent pregnancy” listed as an “underlying medical condition that increases a person’s risk of severe COVID-19”

HHS secretary Kennedy announcing that Covid vaccine is no longer recommended for pregnant women, including a lie that it is “good science”

Last week Prasad and Makary announced their new plan to make COVID boosters not available for those without high-risk conditions.

Even they recognized pregnancy as a high risk condition.

Today their boss said nope, no COVID vaccines for pregnant people. Another decision that will kill people