patient choice

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Spinal manipulation therapy (SMT) is widely used worldwide to treat musculoskeletal and many other conditions. The evidence that it works for any of them is weak, non-existent, or negative. What is worse, SMT can – as we have discussed so often on this blog –  cause adverse events some of which are serious, even fatal.

Spinal epidural hematoma (SEH) caused by SMT is a rare emergency that can cause neurological dysfunction. Chinese researchers recently reported three cases of SEH after SMT.

  1. The first case was a 30-year-old woman who experienced neck pain and numbness in both upper limbs immediately after SMT. Her symptoms persisted after 3 d of conservative treatment, and she was admitted to our hospital. Magnetic resonance imaging (MRI) demonstrated an SEH, extending from C6 to C7.
  2. The second case was a 55-year-old man with sudden back pain 1 d after SMT, numbness in both lower limbs, an inability to stand or walk, and difficulty urinating. MRI revealed an SEH, extending from T1 to T3.
  3. The third case was a 28-year-old man who suddenly developed symptoms of numbness in both lower limbs 4 h after SMT. He was unable to stand or walk and experienced mild back pain. MRI revealed an SEH, extending from T1 to T2.

All three patients underwent surgery after failed conservative treatment and all recovered to ASIA grade E on day 5, 1 wk, and day 10 after surgery, respectively. All patients returned to normal after 3 mo of follow-up.

The authors concluded that SEH caused by SMT is very rare, and the condition of each patient should be evaluated in full detail before operation. SEH should be diagnosed immediately and actively treated by surgery.

These cases might serve as an apt reminder of the fact that SMT (particularly SMT of the neck) is not without its dangers. The authors’ assurance that SEH is VERY RARE is a little puzzling, in my view (the paper includes a table with all 17 previously published cases). There is, as we often have mentioned, no post-marketing surveillance, surgeons only see those patients who survive such complications long enough to come to the hospital, and they publish such cases only if they feel like it. Consequently, the true incidence is anyone’s guess.

As pointed out earlier, the evidence that SMT might be effective is shaky for most indications. In view of the potential for harm, this can mean only one thing:

The risk/benefit balance for SMT is not demonstrably positive.

In turn, this leads to the conclusion that patients should think twice before having SMT and should inquire about other therapeutic options that have a more positive risk/benefit balance. Similarly, the therapists proposing SMT to a patient have the ethical and moral duty to obtain fully informed consent which includes information about the risk/benefit balance of SMT and other options.

Bernie Garrett is a professor of nursing at the University of British Columbia. He is being mentioned here because he has written a book entitled THE NEW ALCHEMISTS which deals (mostly) with so-called alternative medicine (SCAM). It is a well-written, informative, critical, and evidence-based text that I can recommend wholeheartedly. It will be available in the UK on 29 July but you can pre-order it already.

On Amazon, It is being advertised with the following words:

How to identify and see through deceptive and unethical health marketing practices Health scams come in all shapes and sizes-from the suppression of side-effects from prescription drugs to the unproven benefits of ‘traditional’ health practices-taking advantage of the human tendency to assume good intentions in others. So how do we avoid being deceived? Professor of Nursing, Bernie Garrett explores real-world examples of medical malpractice, pseudo and deceptive health science, dietary and celebrity health fads, deception in alternative medicine and problems with current healthcare regulation, ending with a simple health-scam detection kit. And he looks at how these practices and ineffective regulations affect our lives.

The book is written for the interested layperson. But I am sure that healthcare professionals will like it too, not least because it is fully referenced. Its aim is to inform and prevent consumers from being deceived and exploited by charlatans, an aim shared with this blog – while reading the book, I often got the impression that Bernie Garrett might be a regular reader of my blog.

This does not mean that I did not learn a lot from reading Bernie’s book. On the contrary, there was a lot that I did not know before and that is worth knowing. For instance, were you aware that you can earn a ‘Doctor of Naturopathic Medicine, Advanced Diploma’ or Reiki master qualification for $ 12.99 in a 6-hour online course (if you want to know where you’ll have to get Bernie’s book)?  Well, I didn’t.

Yes, I did enjoy reading this book, and I share Bernie’s views on SCAM. In his overall conclusions, he writes: “The sad truth is, many health fraudsters are highly skilled manipulators, and do not always end up being held to account for their crimes, and many continue to profit from them.” Because this is so, it is good to have another splendid book that will help us in our struggle to inform the public responsibly.

It was recently reported that about one-third of people who had been infected with COVID report suffering from long COVID:

  • Some 37% of people experienced at least one symptom lasting 12 weeks or more
  • Almost 15% said they had three or more symptoms for at least 12 weeks
  • Long-term problems were more common in women, and with increasing age
  • Higher weight, smoking, lower incomes, having a chronic illness, and having been hospitalized with Covid were linked to a higher chance of experiencing long-lasting symptoms
  • Tiredness was one of the most common symptoms, and in people who were severely ill with Covid, shortness of breath was a dominant long-lasting symptom

These are worrying figures indeed. Common symptoms of ‘long COVID’ include persistent breathlessness, fatigue, and cough; less common symptoms are chest pain, palpitations, neurological and cognitive deficits, rashes, and gastrointestinal dysfunction. Several research papers describe abnormalities confirming pathophysiological damage ranging from abnormal blood tests to organ damage seen on MRI imaging or in postmortem findings.

Yes, there are good reasons to be worried. Yet others might see this situation as an opportunity. One does not need to be clairvoyant to predict that, in so-called alternative medicine (SCAM), long-COVID will be the next big thing. Whenever there is a new, common, difficult-to-treat condition, SCAM practitioners and SCAM entrepreneurs fall over themselves claiming that their therapy is the solution. Gwyneth Paltrow’s bizarre was one of the first with her methods of easing long Covid symptoms. The Hollywood star and snake oil saleswoman said she had embarked on a “keto and plant-based” regime on the advice of an alternative medicine doctor. And, of course, it did her a world of good … Gwyneth approves of anything that is alternative.

On Medline, we already find an abundance of articles such as this one:

There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO2), was treated using manual acupuncture and Chinese herbal medicine granule formula Fuzheng Rescue Lung with Xuebijing Injection in addition to standard care. The patient’s breath rate, SpO2, heart rate, ratio of neutrophil/lymphocyte (NLR), ratio of monocyte/lymphocyte (MLR), C-reactive protein (CRP), and chest computed tomography were monitored. Acupuncture significantly improved the patient’s breathing function, increased SpO2, and decreased her heart rate. Chinese herbal medicine might make the effect of acupuncture more stable; the use of herbal medicine also seemed to accelerate the absorption of lung infection lesions when its dosage was increased. The combination of acupuncture and herbs decreased NLR from 14.14 to 5.83, MLR from 1.15 to 0.33 and CRP from 15.25 to 6.01 mg/L. These results indicate that acupuncture and Chinese herbal medicine, as adjuvants to standard care, might achieve better results in treating severe cases of COVID-19.

A telephone survey included 495 COVID patients in India. 26% of them said they had people used 161 SCAM products and home remedies during and after COVID infections. More than half of the participants (59.6%) among them had consumed Ayurvedic Kadha. Many respondents consumed more than one SCAM product or home remedy.

A recent review evaluated the effect of SCAM on COVID patients. A total of 14 studies performed on 972 COVID patients were included. The results suggested that different SCAM interventions (acupuncture, Traditional Chinese medicine [TCM], relaxation, Qigong) significantly improved various psychological symptoms (depression, anxiety, stress, sleep quality, negative emotions, quality of life) and physical symptoms (inflammatory factors, physical activity, chest pain, and respiratory function) of COVID patients. The authors concluded that various SCAM interventions have a positive effect on improving the various dimensions of coronavirus disease but since there are few studies in this regard, further studies using different CAM approaches are recommended.

This conclusion is, of course, pure wishful thinking; the available evidence is in fact more than flimsy, and claims of effectiveness are not justified. But will this stop SCAM enthusiasts to make such claims? I fear not. My prediction is that, as this homeopath already indicated, they will see COVID as an opportunity: For homeopathy, shunned during its 200 years of existence by conventional medicine, this outbreak is a key opportunity to show potentially the contribution it can make in treating COVID-19 patients. 


While working on yesterday’s post, I discovered another recent and remarkable article co-authored by Prof Harald Walach. It would surely be unforgivable not to show you the abstract:

The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and religiosity. A qualitative study was conducted interviewing ten Roman Catholic German adults who regularly practiced the Rosary prayer. As a result of using a tangible prayer cord and from the rhythmic repetition of prayers, the participants described experiencing stability, peace and a contemplative connection with the Divine, with Mary as a guide and mediator before God. Praying the Rosary was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness and devotion.

The article impressed me so much that it prompted me to design a virtual study for which I borrowed Walach’s abstract. Here it is:

The aim of this study is to explore experiences and perceived effects of train-spotting on issues around health and well-being, as well as on spirituality. A qualitative study was conducted interviewing ten British adults who regularly practiced the art of train-spotting. As a result of using a tangible train-spotter diary and from the rhythmic repetition of the passing trains, the participants described experiencing stability, peace, and a contemplative connection with the Divine, with Mary as a guide and mediator before the almighty train-spotter in the sky. Train-spotting was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness, and devotion.

These virtual results are encouraging and encourage me to propose the hypothesis that Rosary use and train-spotting might be combined to create a new wellness program generating a maximum holistic effect. We are grateful to Walach et al for the inspiration and are currently applying for research funds to test our hypothesis in a controlled clinical trial.


Prof Harald Walach is well-known to regular readers of this blog (see, for instance, here, here, and here). Those who are aware of his work will know that he is not an expert in infectious diseases, epidemiology, virology, or vaccinations. This did not stop him to publish an analysis that questions the safety and rationale of the current COVID-19 vaccination programs. Here is the abstract:

COVID-19 vaccines have had expedited reviews without sufficient safety data. We wanted to compare risks and benefits.

Method: We calculated the number needed to vaccinate (NNTV) from a large Israeli field study to prevent one death. We accessed the Adverse Drug Reactions (ADR) database of the European Medicines Agency and of the Dutch National Register ( to extract the number of cases reporting severe side effects and the number of cases
with fatal side effects.

Result: The NNTV is between 200–700 to prevent one case of COVID-19 for the mRNA vaccine marketed by Pfizer, while the NNTV to prevent one death is between 9000 and 50,000 (95% confidence interval), with 16,000 as a point estimate. The number of cases experiencing adverse reactions has been reported to be 700 per 100,000 vaccinations. Currently, we see 16 serious side effects per 100,000 vaccinations, and the number of fatal side effects is at 4.11/100,000 vaccinations. For three deaths prevented by vaccination we have to accept two inflicted by vaccination.

Conclusions: This lack of clear benefit should cause governments to rethink their vaccination policy.

I hesitate to comment because some could think that I have a personal grudge, as Walach propagated lies about me. And crucially, like he, I am not a vaccination expert. Yet, I feel I ought to point out that the data that form the basis of Walach’s calculations should not be used in this way for at least two reasons.

  1. Death after vaccination does not mean that this event was caused by the vaccine. For example, if someone had a fatal accident after vaccination, it would count as a vaccine incident according to Walach’s calculation.
  2. Vaccine effectiveness cannot be measured by calculating how many people must receive a vaccine to prevent one case of COVID-19 vaccination. Since vaccines have a protective effect on the community, this would be an outright miscalculation. The more people who receive a vaccine, the fewer people need to receive it to prevent a single case. This situation is the exact opposite of what Walach assumes in his paper.

Conclusion: amongst all his previous nonsense, Walach’s new publication stands out, I feel, as the most stupid and the most dangerous. The mistakes seem too obvious to not be deliberate. Let’s hope the journal editor in chief (who failed miserably when publishing this idiocy) has the wisdom to retract it swiftly. One of its editors already tweeted:

I have resigned from the Editorial Board of

following the publication of this article. It is grossly negligent and I can’t believe it passed peer-review. I hope it will be retracted.

And another ed-board member had this to say:

In the UK, a new post-Brexit regulatory framework is being proposed for food supplements by the government. The nutraceutical sector is estimated to be worth £275bn globally and £4bn in the UK.  A new report claims that “science is starting to point the way to a new sector of nutritional products with increasingly explicable and/or verifiable medicinal benefits, which needs to be reflected in our regulatory framework.” Tory MP George Freeman, one of the authors of the report, was quoted saying:

“We are living through an extraordinary period of technological change – not just in life science but in host of sectors: from AI to robotics to agri-tech, nutraceuticals, nanotechnology, synthetic biology, biofuels, satellites and fusion energy. The UK is indeed a ‘science superpower’. But we have traditionally been woeful at commercialising here in the UK. There are many reasons. But, in recent years, the EU’s increasingly slow, bureaucratic and ‘precautionary’ approach – copied in Whitehall – has made the EU and the UK an increasingly poor place to commercialise new technology.”

If a product like a food or a herbal remedy makes ‘medicinal’ claims, it is currently regulated by the MHRA. If a product only makes general ‘health’ claims, it is regulated by the Department of Health and Social Care in England, by the FSA in Wales and Northern Ireland, and by Food Standards Scotland in Scotland. This ‘patchwork of regulators’ is bound to change as it is deemed to create additional costs and uncertainty for businesses who would like to see the relevant functions brought together in a central regulatory body and a clearer UK landscape.

In response to the task force’s report, PM Boris Johnson stated that bold and ambitious ideas such as these are needed to encourage growth and innovation:

“The Government, through our Better Regulation Committee, is already hard at work on reform of the UK’s regulatory framework. Your bold proposals provide a valuable template for this, illustrating the sheer level of ambitious thinking needed to usher in a new golden age of growth and innovation right across the UK. So we will give your report the detailed consideration it deserves, consult widely across industry and civil society, and publish a response as soon as is practicable.”

Am I the only one who feels more than a little uneasy about all this? I honestly do not see much new science that, according to the report, points to ‘verifiable medicinal benefits’ of food supplements or nutraceuticals. What the report does however point to, I fear, is that the UK government is about to deregulate quackery with a view to making some entrepreneurs wealthy snake oil salesmen at the cost of public health and wealth.

I hope I am mistaken.

I have repeatedly reported about what has been happening with homeopathy in France. For many decades, it had a free ride. Things began to change some 10 years ago.

  • In 2014, our book was published in French. I might be fooling myself, but I do hope that it helped to start a ball rolling.
  • Subsequently, French skeptics began raising their voices against quackery in general and homeopathy in particular.
  • In 2015, Christian Boiron, boss of Boiron, stated about people opposing homeopathy that “Il y a un Ku Klux Klan contre l’homéopathie” THERE IS A KU KLUX KLAN AGAINST HOMEOPATHY”.
  • In 2018, 124 doctors published an open letter criticizing the use of so-called alternative medicine (SCAM).
  • In the same year, the Collège National des Généralistes Engseignants, the national association for teaching doctors, pointed out that there was no rational justification for the reimbursement of homeopathics nor for the teaching of homeopathy in medical schools, and they stated bluntly that it is necessary to abandon these esoteric methods, which belong in the history books.
  • Also in 2018, the University of Lille announced its decision to stop its course on homeopathy. The faculty of medicine’s dean, Didier Gosset, said: It has to be said that we teach medicine based on proof – we insist on absolute scientific rigor – and it has to be said that homeopathy has not evolved in the same direction, that it is a doctrine that has remained on the margins of the scientific movement, that studies on homeopathy are rare, that they are not very substantial. Continuing to teach it would be to endorse it.
  • In 2019, the French Academies of Medicine and Pharmacy published a document entitled ‘L’homéopathie en France : position de l’Académie nationale de médecine et de l’Académie nationale de pharmacie’. It stated that L’homéopathie a été introduite à la fin du XVIIIe siècle, par Samuel Hahnemann, postulant deux hypothèses : celle des similitudes (soigner le mal par le mal) et celle des hautes dilutions. L’état des données scientifiques ne permet de vérifier à ce jour aucune de ces hypothèses. Les méta-analyses rigoureuses n’ont pas permis de démontrer une efficacité des préparations homéopathiques. The academies concluded that no French university should offer degrees in homeopathy, and that homeopathy should no longer be funded by the public purse: “no homeopathic preparation should be reimbursed by Assurance Maladie [France’s health insurance] until the demonstration of sufficient medical benefit has been provided. No university degree in homeopathy should be issued by medical or pharmaceutical faculties … The reimbursing of these products by the social security seems aberrant at a time when, for economic reasons, we are not reimbursing many classic medicines because they are more or less considered to not work well enough …”
  • Only weeks later, the French health regulator (HAS) recommended with a large majority the discontinuation of the reimbursement of homeopathic products.
  • The health minister, Agnès Buzyn, announced “Je me tiendrai à l’avis de la Haute Autorité de santé”.
  • Consequently, the powerful French homeopathy lobby mounted political pressure, including a petition with over 1000000 signatures.
  • President Macron allegedly was hesitant and considered a range of options, including a reduction of the percentage of reimbursement.
  • Apparently, the minister stood up for science and, as rumored, even put her job on the line.
  • In July 2019, she announced the end of reimbursement and was quoted saying J’ai toujours dit que je suivrais l’avis de la Haute Autorité de santé (HAS), j’ai donc décidé d’engager la procédure de déremboursement total

Since then, homeopathy has indeed been banned from reimbursement. Here is a short update on the current situation:

After the disengagement of the French Social Security system, the world leader in homeopathy has been trying to convince complementary health insurance companies to take up the torch of large-scale reimbursement. Its seduction operation includes a third-party payment solution to boost sales.

From 1 January 2021, homeopathy is no longer reimbursed by Social Security. In March 2020, Boiron, the largest producer of homeopathics, began a restructuring that led to the loss of 560 jobs in France and the closure of one-third of its 31 production and distribution sites. On Thursday, the site of Chauray (Deux-Sèvres) closed after 33 years of activity.

… The CEO of Boiron, Valérie Lorentz-Poinsot, does not have words strong enough to describe the decision of the former Minister of Health, Agnès Buzyn, to delist homeopathy. Since the view issued in June 2019 by the French Health Authority (HAS) noting the ineffectiveness of 1,100 of these products previously reimbursed by the French health service, the reimbursement of homeopathics was reduced from 30% to 15% in 2020, then to 0% on 1 January 2021.


Oh, I almost forgot to mention: the stocks in Boiron roughly halved during the last 3 years


This study describes the use of so-called alternative medicine (SCAM) among older adults who report being hampered in daily activities due to musculoskeletal pain. Cross-sectional European Social Survey (EES) Round 7 (2014) data from 21 countries were examined for participants aged 55 years and older, who reported musculoskeletal pain that hampered daily activities in the past 12months. From a total of 35,063 individuals who took part in the ESS study, 13,016 (37%) were aged 55 or older; of which 8183 (63%) reported the presence of pain, with a further 4950 (38%) reporting that this pain hampered their daily activities in any way.

Of the 4950 older adult participants reporting musculoskeletal pain that hampered daily activities, the majority (63.5%) were from the West of Europe, reported secondary education or less (78.2%), and reported at least one other health-related problem (74.6%). In total, 1657 (33.5%) reported using at least one SCAM treatment in the previous year. Manual body-based therapies (MBBTs) were most used, including massage therapy (17.9%) and osteopathy (7.0%). Alternative medicinal systems (AMSs) were also popular with 6.5% using homeopathy and 5.3% reporting herbal treatments. A general trend of higher SCAM use in younger participants was noted.

SCAM usage was associated with

  • physiotherapy use,
  • female gender,
  • higher levels of education,
  • being in employment,
  • living in West Europe
  • having multiple health problems.

The authors concluded that a third of older Europeans with musculoskeletal pain report SCAM use in the previous
12 months. Certain subgroups with higher rates of SCAM use could be identified. Clinicians should comprehensively and routinely assess SCAM use among older adults with musculoskeletal pain.

Such studies have the advantage of large sample sizes, and therefore one is inclined to consider their findings to be reliable and informative. Yet, they resemble big fishing operations where all sorts of important and unimportant stuff is caught in the net. When studying such papers, it is wise to remember that associations do not necessarily reveal causal relationships!

Having said this, I find very little information in these already outdated results (they originate from 2014!) that I would not have expected. Perhaps the most interesting aspect is the nature of the most popular SCAMs used for musculoskeletal problems. The relatively high usage of MBBTs had to be expected; in most of the surveyed countries, massage therapy is considered to be not SCAM but mainstream. The fact that 6.5% used homeopathy to ease their musculoskeletal pain is, however, quite remarkable. I know of no good evidence to show that homeopathy is effective for such problems (in case some homeopathy fans disagree, please show me the evidence).

In my view, this indicates that, in 2014, much needed to be done in terms of informing the public about homeopathy. Many consumers mistook homeopathy for herbal medicine (which btw may well have some potential for musculoskeletal pain), and many consumers had been misguided into believing that homeopathy works. They had little inkling that homeopathy is pure placebo therapy. This means they mistreated their conditions, continued to suffer needlessly, and caused an unnecessary financial burden to themselves and/or to society.

Since 2014, much has happened (as discussed in uncounted posts on this blog), and I would therefore assume that the 6.5% figure has come down significantly … but, as you know:

I am an optimist.

I believe in progress.

An article in the Daily Mail (I know, not my favorite newspaper either) reported about a UK court case against the father of an 11-year-old daughter who objected to her being given conventional life-saving treatments for her leukemia. The man was said to be worried about possible side effects and wanted to explore homeopathic and natural therapies, while his estranged wife favored the conventional approach.

Mr Justice Hayden decided that there is ‘no basis’ for the man’s homeopathic option and that specialists can lawfully carry out the conventional treatments. But the father said he believed that previous chemotherapy had already weakened his daughter’s immune system and that the conventional treatment proposed has further side effects. He, therefore, wanted to try homeopathic and natural therapies, including ozone therapy. ‘I am not waiting for her to deteriorate and get worse,’ he told the judge. ‘Chemotherapy is not the only way. There are so many other different therapies I am hoping to try – anything as long as it doesn’t really affect her.’

A specialist treating the girl told the judge that the treatments proposed are the best option and that they know of no homeopathic options which would help. Mr Justice Hayden approved Great Ormond Street’s plan and said doctors should start the treatments as soon as possible. ‘If she receives no treatment then her life expectancy is weeks,’ he said. ‘There is no basis for the father’s homeopathic option.’

This case highlights the indirect risks of homeopathy and similar treatments in an exemplary fashion. The therapies per se might be harmless but the therapists are clearly not. There are enough homeopaths who are deluded enough to persuade their patients that homeopathy can alter the natural history of even serious conditions such as cancer. And, as we have discussed recently, these irresponsible fools are not just from the ranks of the lay-homeopaths (homeopaths who have not been to medical school) who might not know better; they also include medically trained homeopaths and even professors at leading medical schools.


A few months ago, I started contributing to a German blog. This has been fun but only moderately successful in terms of readership. This week, I posted something about a homeopath and his strange attitude towards COVID vaccinations. This post was so far read by around 20 000 people!

As it was so unusually successful (and because there is a big conference today on the subject), I decided to translate it for my non-German readers.

Here we go:

A lot of downright silly stuff is currently being written about vaccine side effects at the moment, not least on Twitter where I recently found the following comment from a medical colleague:

I’ve been a doctor for 25 years now. I have never experienced such an amount of vaccine side effects. I can’t imagine that other colleagues feel differently.

This kind of remark naturally makes you think. So let’s think a little bit about these two sentences. In particular, I would like to ask and briefly answer the following questions:

  1. How reliable is this physician’s impression?
  2. What does the reliable evidence say?
  3.  Is it conceivable that this doctor is mistaken?
  4. What might be the causes of his error?
  5. Who is the author?
  6. Why is the tweet questionable?

1. How reliable is this doctor’s impression?

A whole 25 years of professional experience! So we are dealing with a thoroughly experienced doctor. His statement about the current unusually large amount of vaccination side effects should therefore be correct. Nevertheless, one should perhaps bear in mind that the incidence of side effects cannot be determined by rough estimations, but must be precisely quantified. In addition, we also need data on the severity and duration of symptoms. For example, is it only mild pain at the injection site or venous thrombosis? Are the symptoms only temporary, long-lasting, or even permanent? In general, it must be said that the experience of a physician, while not completely insignificant, does not constitute evidence. Oscar Wilde once said, “experience is the name we give to our mistakes.”

2. What does the reliable evidence tell us?

Even if the good doctor had 100 years of professional experience and even if he could accurately characterize the side effects, his experience would be trivial compared to the hard data we have on this subject. Nearly 2 billion vaccinations have now been performed worldwide, and we are therefore in the fortunate position of having reliable statistics to guide us. And they show that side effects such as pain at the injection site, fatigue, and headaches are quite common, while serious problems are very rare.[1] A recent summary comes to the following conclusion (my translation)[2]:

The current data suggests that the currently approved mRNA-based COVID-19 vaccines are safe and effective for the vast majority of the population. Furthermore, broad-based vaccine uptake is critical for achieving herd immunity; an essential factor in decreasing future surges of COVID-19 infections. Ensuring sufficient COVID-19 vaccination adoption by the public will involve attending to the rising vaccine hesitancy among a pandemic-weary population. Evidence-based approaches at the federal, state, city, and organizational levels are necessary to improve vaccination efforts and to decrease hesitancy. Educating the general public about the safety of the current and forthcoming vaccines is of vital consequence to public health and ongoing and future large-scale vaccination initiatives.

3. Is it conceivable that this doctor is mistaken?

In answering this question, I agree with Oscar Wilde. The evidence very clearly contradicts the physician’s impression. So the doctor seems to be mistaken — at least about the incidence of side effects that are not completely normal and thus to be expected. Even if indeed ‘other colleagues feel no differently’, such a cumulative experience would still mislead us. The plural of ‘anecdote’ is ‘anecdotes’ and not ‘evidence’.

4. What might be the causes of his error?

I wonder whether our doctor perhaps did not see or did not want to see the following circumstance: It is inevitable that a physician, at a time when soon 50% of all Germans were vaccinated, also sees a lot of patients complaining about side effects. He has never seen anything like that in his 25-year career! That’s because we haven’t been hit by a pandemic in the last 25 years. For a similar reason, the colleague will treat far fewer frostbites in midsummer than during a severe winter. The only surprising thing would be not to see more patients reporting vaccine side effects during the biggest vaccination campaign ever.

5. Who is the author?

At this point, we should ask, who is actually the author and author of the above tweet? Perhaps the answer to this question will provide insight into his motivation for spreading nonsense? Dr. Thomas Quak (no, I did not invent the name) is a practicing homeopath in Fürstenfeldbruck, Germany. Like many homeopaths, this Quak probably has a somewhat disturbed relationship to vaccination. In his case, this goes as far as recommending several vaccine-critical machinations on his website and even offering ‘critical vaccination advice’ as a special service.[3]

Now we can immediately put the Quak tweet in a better perspective. Dr. Quak is a vaccination opponent or critic and wants to warn the public: for heaven’s sake, don’t get vaccinated folks; side effects are more common than ever!!!! Therefore, he also conceals the fact that the side-effects are completely normal, short-term vaccination reactions, which are ultimately of no significance.

6. Why is the tweet concerning?

Perhaps you feel that the Quak and his Quack tweet are irrelevant? What harm can a single tweet do, and who cares about a homeopath from Fürstenfeldbruck? As good as none and nobody! However, the importance does not lie in a single homeopath unsettling the population; it consists in the fact that such things currently happen every day thousandfold.

In their narrow-mindedness, vaccination opponents of all shades want to make us believe that they are concerned about our well-being because they know more than we and all the experts (who are of course bought by the pharmaceutical industry). But if you scratch just a little at the surface of their superficiality, it turns out that the exact opposite is true. They are ill-informed and only interested in spreading their hare-brained, misanthropic ideology.

And why do homeopaths do this? There are certainly several reasons. Although Hahnemann himself was impressed by the success of vaccination, which was invented in his time and hailed as a breakthrough, most of his successors soon sided with vaccination critics. Many do so by warning (like our Quak) of side effects, thinking that they are thus protecting their patients. However, they ignore two very important points:

  1. Even if the dangers of vaccinations were much greater than they actually are (no one is claiming that they are completely harmless), the benefits would still far outweigh the potential harms.
  2. If the Quaks (and all the quacks) of this world succeeded in dissuading a sizable percentage of the population from vaccinating and thus save them from the ‘oh-so-dangerous side effects’, they would still be doing a real disservice to public health. With regard to COVID-19, this would mean that the pandemic would remain with us in the long term and cost many more lives.

Whatever the motives of the homeopathic anti-vax brigade, it is certain that their attitude is a threat to our health. This has repeatedly made me state:

The homeopathic pills may be harmless, but unfortunately, the homeopaths are not!


  1. COVID-19 vaccine availability: what are the side effects? | British Journal of General Practice ( ︎
  2. Review the safety of Covid-19 mRNA vaccines: a review – PubMed ( ︎
  3. Vaccination Information ( ︎



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