I’m so curious how someone goes from being a professor to a science denier? I simply can’t imagine that journey.
He is 100% data driven. He has no ideology behind any of his beliefs or decisions, it's all 100% data driven. He should be worshipped by HN but instead he is vilified because many people on HN are the ones motivated by ideology or politics.
The decision to block Moderna's application was simple, they were comparing their results against a lower-dosage flu shot which no one in that age range (65+) takes.
Moderna agreed to add a comparison for the higher dose for older patients and then the application was allowed through. Why is this bad?
The media framed it as if the FDA backtracked but that's a complete lie, Moderna modified their application because Prasad looked at the study and rejected it because it was purposefully giving itself easier goal posts. He did EXACTLY what we want, which is don't make it easier for drug companies to give us bullshit, and to make sure that the drugs are doing what they say they are.
The loss of Prasad is a real loss for Americans.
This wasn't the only time he stepped in and overrode experts with seemingly no justification. Just the most prominent example.
I think it's good he's gone.
Americans who are 65+ years old only use the high dose flu vaccine. Moderna only wanted to test against the low dose vaccine, so we would have no data as to the efficacy of this new vaccine for 65+ year olds vs the standard therapy. Prasad demanded that Moderna include this.
Explain to me why this is wrong? Should we let multi billion dollar drug companies do what they want? Prasad did exactly what he was supposed to do, which is use his judgement to protect Americans. And Moderna did it, and now everyone is happy.
> He did so suddenly and without warning: the FDA up to that point had not raised any concerns about Moderna's trial protocol.
This is not true. FDA previously asked Moderna to add the results of the high dose vaccine and somehow it got removed. All Prasad did was insist on this. This was not suddenly and without warning.
Yes, the treatment doesn't work and the studies show as much. But because people with Huntington's are desperate for any sort of treatment (rightfully so, it's a horrible disease), they don't want anyone to impede this therapy.
Uniqure is selling a so-called treatment to desperate patients looking for even a minuscule probability of a treatment and Prasad demanded that there be more evidence before the therapy gets more approval.
Uniqure's therapy consists of neurosurgery and injecting gene therapy deep into the brain. They claim that it slowed the disease but the same therapy compared to placebo had no better results.
Prasad was gain completely data driven, but to whoever just reads the news, they somehow believe that Prasad is against science which is complete bullshit. Everything you read about the therapy is that it doesn't work, and shouldn't be approved. He is PROTECTING us from bad drugs and therapy based on DATA.
https://augurbio.substack.com/p/unmasking-amt-130-hope-hype-...
This guy got fired for a good reason - he's an idiot.
> Moderna acknowledged that FDA scientists had previously suggested that the company use a recommended high-dose flu vaccine in trial participants 65 and older. But the agency ultimately signed off on the trial design with the uniform standard dose, calling it “acceptable.” Moderna, meanwhile, agreed to add a comparison of a high-dose vaccine to some older participants and provide the FDA with additional analysis.
FDA previously suggested to use the higher dose vaccine as comparison for 65+ but for some reason they backed off it. Who knows why, but Prasad did the right thing. And Moderna added the data and now everyone is happy.
Are you saying that multi-billion dollar drug companies should just get a rubber stamp? What Prasad demanded was spot on, which is make sure that the trials include the group of patients that need it the most against the standard, high-dose flu vaccine. Again, explain to me why this is wrong?
When did asking for better evidence, or bringing up side effects, or Absolute Risk, suddenly become things that we cannot discuss on HN?
2. There's nothing whatsoever wrong about asking questions. It becomes wrong when refusing to listen to the answers and dismissing all the ones you don't like because you don't like the person saying them. Ironically, that's ad hominem.
These people are all delusional ideologues. If reality does not match the ideology, reality must be wrong.
The very concept of merit has been destroyed and replaced with judgement calls on celebrity (necessary for leadership role) and subservience to the political whims of the last 15 minutes (and you had better switch in the next 15 minutes or you're out).
Lab leak theory was dismissed and actively suppressed. Inflated claims were made a priori about absolute vaccine efficacy that any responsible researcher who have not made.
Moreover, the trouble with trying to shut down real disinformation, eg claims that vaccines were more dangerous than the virus, is that many people will view any sort of paternalistic behavior by the government, especially around speech, with suspicion. ("Why do they care so much about what I say? They must be hiding something")
In the age of social media, I think the study of public health needs to consider more seriously the effects of viral psychology. The irrationality and stubbornness of people needs to be expected when planning public policy.
So if someone says they oppose paternalism in public health and yet supports the Trump administration's public health efforts, I'm not sure how to avoid the conclusion that they're lying.
From my perspective, it’s hysteria borne out of the difference in requirements for urban health policy vs. rural health policy, and the fact that rural people quite often travel through urban areas (e.g. airports).
Talk to anyone from Wyoming and ask what Covid was like during the worst days, and then talk to an ER doctor who worked in New York City.
Cynically, I want to blame it on the absurd lack of empathy of rural Americans and a complete lack of ability to imagine day-to-day lifestyles that do not match their own.
Were there a few scandals? For sure, I will not deny that. But I have the distinct urge to invent time travel for the hemmers, hawers, and devil’s advocates and transport them to New York Presbyterian in April of 2020.
Edit: I also have to credit rightwing media, of course, for capitalizing on the opportunity to manufacture a wedge issue that every American had an armchair opinion of. Chicken and egg, of course, but media ghouls will be media ghouls.
I would not say shutting down all discussion about a topic (lab origin) that ends up getting vindicated is a minor scandal. It's something everyone observed that erodes trust at a national level.
“Shutting down all discussion” - lol. I mean this is grossly hyperbolic. Were social media companies coordinating with the government to slow disinformation? Yes. Was it applied too broadly? Maybe. But describing it as “shutting down all discussion” is a disservice to people who don’t know as much as you and I do.
And yes, in the grand scheme of things, it is a minor scandal. Have you watched the news recently? Save your energy for issues that matter.
I don't think whataboutism is helpful here. I think the FDA was broadly well-intentioned, and this administration is not. But this article isn't about ICE.
https://www.justice.gov/opa/pr/justice-department-settles-la...
Is this not what the store owners did?
> The very concept of merit has been destroyed ...
It's the subversion of truth. I think that way of saying it is more accurate, addresses the consequences, and is less occluded by jargon: People care about truth; 'scientific expertise' may seem esoteric to most people.
I think HN is frequently part of that process: Merit - expertise, actual trials and evidence - is replaced both by sensational too-clever hot takes / takedowns, and by political/social advocacy.
Most threads begin with a takedown, a 2 minute drive-by from an amatuer, often of years of research by someone spending their life studying the matter. For some issues, we all know what side many will take before you know any facts or evidence.
These comments are normalized and given greater credibility than the OP and than valuable comments. How is that any different than the things we criticize (other than the FDA's subversion of truth [EDIT:] is far more consequential [sorry, I didn't finish that sentence!])
There are valuable comments to be found; maybe that's one difference, but I'm wonder how the signal-to-noise compares with other forums.
Very different. Decisions with enormous health implications, enormous financial implications, are made at FDA.
At HN, most people are here to learn, here to understand more.
Vinay Prasad is a fraud, completely unfit for the leadership role he was placed into, making baffling and arbitrary decisions on his own, overturning those with far more experience, knowledge and expertise.
If a HN comment gets things wrong, a few people might be misinformed, if they are credulous enough to not double check things.
When the FDA makes decisions like they have been making, thousands to millions of peoples' lives are worse off, and billions in capital is wasted.
Discussion forums of all sorts are incredibly valuable, even when they get things wrong. I have lots of complaints about the overhyping of, say, CRISPR, especially on HN, but whatever, it's a far far higher signal-to-noise than a random person I meet around town. Mention you work on drug development for big pharma to the random person and they think you're evil, at least HN is less likely to have that basic misconception.
What’s with him being allowed to continue to practice at the University of California [1]?
The fraud is in his supposed thrust towards better scientific rigor when he is so sloppy with major decisions of life and death.
Just as the comment up there says that HN comments that are critical and misinformed get a lot of attention and upvotes, Prasad has been highly critical and misinformed about scientific research, and his stint at the FDA has exposed that his critiques are much like that top-level HN comment that doesn't get things quite right.
How can one tell whether he has tenure?
The whole thing is kind of fascinating. Some of his "skeptic" fellow travelers like Cifu and Mandrola still carry water for him. Presumably he has a champion in Bob Wachter who also likes to fly the "contrarian" flag.
COVID really brought out a lot of crazies from UCSF and Stanford
I can dislike someone’s stance while at the same time recognizing that others benefit from the same protections.
If protections are reduced, the process will be weaponized.
This is a valid concern. So is moral hazard from a lack of accountability. I’m trying to figure out how those balance.
To be clear, the FDA regulates marketing claims. “Is the label accurate?”
Major decisions about life and death are between the doctor and the patient, not the FDA.
It sounds like you’re taking an expansive view of this government agency’s mandate. People will push back on this at the ballot box, even if they can’t put it to words themselves.
Such decisions, what treatments are available, are far more widespread and momentous than any individual decision between a doctor and a single patient, because they affect all conversations between doctors and patients.
> It sounds like you’re taking an expansive view of this government agency’s mandate
It sounds like you don't know what the FDA does in practice. It is not my supposed "view" it is the basic factual reality of the FDA for decades and decades. (And if you are asking for my view, I believe it has the appropriate level of control of the industry, having developed products directly under their regulation. My personal experience with the FDA, and the experience of all the people I know in similar situations, has been with a very astute and scientifically meritous institution, that worked hard to make sure that products see fair and rapid evaluation. At least, up until what I have seen under Vinay Prasad.)
In the case of vaccines, FDA's decisions can quite obviously make a difference in whether we have a rampant lethal pathogen roaring through our schools and killing our children and elderly... or not.
It's pedantic to the point of being outright false to say the FDA is not involved in major decisions of life and death. Silly take.
this is how Martin Shkreli described his work of identifying drug patents to buy that he could jack up the prices on. If that's the extent of the description you gave, I think random people would be right to first think you are doing something evil
- This baffling Moderna decision, which is so bad that many in the industry assumed it was from a failed bribe solicitation
- Linked in this article is the "truly evil" decision requiring sham brain surgery in the placebo arm for a Huntington Disease trial https://arstechnica.com/health/2026/06/truly-evil-fda-reject...
- Prasad holding a defamatory PR event about the company producing the HD candidate treatment, and only talking "on background" to hide his identity, which is sleazy and unethical "The criticism apparently struck a nerve with Prasad. The FDA held a press briefing later Thursday in which an unnamed “senior FDA official”—who identified himself as a hematology-oncologist—launched into a diatribe against UniQure, saying its “failed therapy” was supported by “distorted and manipulated” data. As for Woodcock’s comments, the official said he “expect[s] better” from her." https://arstechnica.com/health/2026/03/trumps-divisive-fda-v...
- His first ouster and reinstatement last year, over a unilateral Duchenne muscular dystrophy decision, severely lacking in scientific rigor and analysis
- Lied on his CV about being on a highly prestigious council he was not on (The Cancer Letter is not a random YouTube channel, it's high quality cancer research journalism) https://www.youtube.com/watch?v=pCASAb7J-LE&t=41
As is often the case with such contrarians and critics, their own critiques apply most aptly to themselves.
I actually think he's just grifting and the notoriety he achieved went to his head. His pre-2020 takes were better reasoned and at least worth engaging with. I could see his takes shifting with popular misinformation ideas in real time as it contributed to his success
IMO this is worse than if he were just wrong. I think he knows better, but then he talked himself into a box, and doesn't have the people and political skills to survive on a bigger stage.
You called this “minor CV fibbing” above. If he was lying about this when he applied for tenure, wouldn’t that be Cause?
In fact, he probably would have had the same decision with or without the claim which is the essence of "not material".
My own personal take is that the lying is crucial, however.
That should be their primary objective.
Yes, I started writing that and didn't finish the sentence (see my edit near the end of the GP).
But I don't let HN off the hook: The attitude I described in the GP represents and perpetrates the same outlook that politically supports or tolerates this behavior from the FDA. HN users generally legitimize that approach rather than discrediting it.
> Mention you work on drug development for big pharma to the random person and they think you're evil
I think that's paranoid: The random person won't know what that means. Few who know will also know or care about the social implications. Of those who do, only some will be knee-jerk critical of big pharma, and fewer still of research rather than the business side. It's also a victim perspective: Big Pharma has enormous power; punching up at power by questioning, criticizing, and being skeptical (or even cynical) is not at all the same thing as punching down at the vulnerable. If someone wants the power and resources and salary of Big Pharma, benefitting from its enormous power, the pushback and reputation impact comes with it (though the latter is usually positive - great resume material and credibility).
In their minds there are two classes of people, and all of politics and law is about establishing the hierarchy. For the in group, the law is meant to protect and not bind, and the out group for which the law exists to bind but not protect.
It's clear in the language about "criminals" too. Actual convictions and clear corruption in the in group politicians? That's A-OK. An immigrant that is showing up for an official hearing? Time to be whisked away and treated with cruel and unusual punishment, whether or not their bureaucratic forms were filled out perfectly. (In particular I'm thinking of the immigration raid where South Korean professionals were helping to set up a battery factory and treated with chains as if they were violent criminals)
There's a substantial "learn and understand" cohort, but there are other factions. At the start of the pandemic, there were 2 posters explicitly here to proselytize Trump style conservatism. I'm reasonably certain there was an anti-vaxx voting ring 2020-22, and I suspect there's remnant Elon fanboy and MAGA coordinated voting.
I'd love to be proved wrong on these things.
even the lead researcher of mrna vaccines before covid said she would not consider mrna vaccines safes outside of the covid emergency. and this study focus on effectiveness, not side effects.
so while turning away from science for politics is as bad as pushing it irresponsible for commercialization.
Be specific?
(I have complaints - I thought Dr. Meissner was wrongheaded about opposing allowing EUA to extend to pediatric populations. But the committee as a whole functioned well and balanced the urgency of the situation with the need for voluminous data.)
They'll just ban it again. Science got a temporary victory but I predict it won't matter.
This guy is a disaster. But really it's not just him. It's the entire organizational structure that puts him, or any other one person, in the position that they have the power to do this. There is simply no one qualified.
We need to have expert scientists to set up trials and review the design of the trials and conduct the analysis of the data. This is something that is generally objective and not able to be done without skills and experience. But then you have to make a decision based on those results. And the decision is some sort of risk reward trade off. While science can quantify what that tradeoff is, which path to take is fundamentally outside of the scope of science.
Trade offs are not objective determinations at all because they are based on subjective preferences. And therefore it makes no sense to force it into a one size fits all approval or denial by some centralized body. The only rational approach to such a trade off is to allow each individual to choose for themselves. The only person's opinion on whether the risk justifies the reward for the experimental Huntington's disease treatment is the patient's. The best we can do with science is to use it for its intended purpose to produce good data for him to make his choice.
This article has no data about why mRNA flu vaccines will improve these outcomes, and has no data about the risk/benefit ratio or how it was calculated. It doesn't even cite the "studies" it mentions. It's a remarkably bad article written for low information readers by a low information author.
Hard pass until I see some hard data.
In the first sentence, you say that flu vaccines are not and in the second you admit they are.
Maybe you meant that their coverage is not comprehensive. If so, that's what you should say.
mRNA flu vaccines have substantial potential advantages in terms of the ability to target a wider spectrum of variants and faster time to manufacture.
https://www.nejm.org/doi/full/10.1056/NEJMoa2516491
There's your hard data.