Should doctors engage with “misinformation spreaders?” That’s the question Dr Jeremy Faust asked vaccine promoter Dr Paul Offit and social media personality “Dr Mike” in a “debate” hosted on Wednesday by MedPage Today.

Offit and “Dr Mike” – whose real name is Dr Mikhail Varshavski – discussed if and how they should engage with people who don’t share their pro-vaccine views.

Faust, who moderated the discussion, framed the debate this way: people like US Health Secretary Robert F. Kennedy Jr – “who really shouldn’t be” platformed – today have ways to reach a mass public. And defenders of mainstream vaccine policy have to figure out what to do about it.

“How do we fight that?” Faust asked the two doctors. Faust said misinformation comes from people like his neighbour, who hears something untrue and repeats it.

Dr Mike said the line between misinformation and disinformation has become more blurred. The “average” person can’t tell the difference between misinformation and disinformation as easily as experts like them can.

The problem is that people like Dr Mike and Offit haven’t been as successful at reaching a broad social media audience as the vaccine sceptics, he said.

Offit said he didn’t think it was a good idea to debate people like Kennedy and has declined to do so. He said Kennedy and his type use a “Gish gallop” strategy of overwhelming their opponents with false statements.

Offit said a better approach was the one he took when Democracy Now! in 2015 invited him to debate Children’s Health Defence’s (CHD) Mary Holland. Holland agreed to the conversation, but Offit wouldn’t. Instead, he asked that Holland speak first so he could then try to rebut what she said.

Holland, now CEO of CHD, has often called for dialogue. She recently asked for a conversation to “bridge that divide” between the mainstream public health establishment and those who argue that most vaccine safety claims aren’t based on scientific evidence.

Holland told The Defender that “any alleged thinker unwilling to engage in debate about science, public policy and law is a fraud.”

Dr Mike said that rather than directly engaging people who disagree with them and may “be armed with a thousand dubious studies,” defenders of mainstream vaccine policy should pick their dissenting audience and venue carefully – and make sure they send the proper representative to do the debating.

The only people worth engaging are those who may be convinced by his arguments, he said. However, he did say that he would be willing to debate Kennedy if the proper rules were in place for the debate.

The speakers admitted they’ve made some mistakes in their past public outreach.

Dr Mike said their medical community hadn’t thought enough about changing people’s minds. “We’ve had an air of superiority to our debunking, to our myth-busting. There was a time that the CDC said we shouldn’t even fight back against misinformation.”

He added: “And because we’ve carried ourselves with that approach, we’ve lost the relatability. We lost the transparency and buy-in from the general public, and therefore missed the opportunity to learn tools like social media that we could use to reach a massive audience.

“That’s why when RFK does a speech or a tweet, he gets 10 million views and the American Medical Association gets 10.”

Dr Mike also said the long-term practice of family medical physicians – including himself – of kicking out patients who refused to follow the vaccine schedule was a mistake. By kicking families out, doctors missed an opportunity to change parents’ minds, he said.

Dr Mike said it is important to look fit if one wants to reach Make America Healthy Again (MAHA) supporters.

“So every time I’m going to the gym, I actually am thinking about it as a public health service in order to be able to debate someone like RFK Jr,” he said.

Offit said his most important interventions happen through his Substack page. Through his writing he’s able to influence public health officials globally. He prefers that to debating a group of vaccine sceptics in person – as Dr Mike did recently in a Jubilee video on YouTube called “Doctor Mike vs 20 Anti-Vaxxers.”

In his YouTube “Jubilees,” Dr Mike has one-on-one debates with lay people who disagree with him in a reality-TV style competition show format where vaccine sceptics race into a circle to take the seat across from Dr Mike for debate.

The other sceptics can raise flags when they want the person debating Dr Mike to be removed from the chair. The person in the chair shares their experiences and doubts. Dr Mike responds with a brief, empathetic-sounding lecture.

Offit said talking to people like that was “my idea of hell, frankly, like one of the circles of Dante’s Inferno.”

Faust lamented the idea that Offit would ever have to feel he had to defend himself, because his work is so important – even if his mode of engagement is less likely to reach those who disagree with him.

Dr Mike said their side had to be careful to “not make it a blanket statement where we say we do not debate with people who disagree with us, because that’s how we lose the connection to the public.”

Instead, vaccine defenders need to connect emotionally to people, acknowledge their own past mistakes, and then convince sceptics of the correct position.

He said he learned how to do the Jubilees by training for boxing and learning how to use people’s aggression against them. He said he never tries to trick anyone, and he thinks it is important to have a “fair and honest communication style.”

“These aren’t evil strategies that I’ve concocted,” Dr Mike said. “I’m genuinely curious about the human sitting across from me, even if we vehemently disagree with one another.”

The commenters complained about being called shills for the pharmaceutical industry. Dr Mike said he had never taken mogoney from Big Pharma.

According to the government website OpenPayments, in 2023 alone, Dr Mike took more than $1 million in consulting fees and other compensation from Abbott Labs. Abbott is a global healthcare company with a portfolio of products that includes flu tests and a flu vaccine.

Faust said the accusation was a double standard because many vaccine sceptics make money producing and marketing supplements. Offit, co-inventor of Merck’s RotaTeq rotavirus vaccine, didn’t comment during this section of the debate.

The doctors lamented that they had not previously engaged more with people like Dr Marty Makary and Dr Vinay Prasad of the US. Food and Drug Administration, Jay Bhattacharya of the National Institutes of Health and others who now have high public health positions.

Offit said he has “little respect for them,” especially because they don’t think that healthy children should get Covid-19 vaccines.

Faust pointed out that Offit himself dissented from mainstream messaging on Covid-19 when he said that maybe children don’t need boosters after the primary series. Offit conceded that the statement “alienated some public health people who were upset that I had said that because I’d sort of gotten off the bus.”

The speakers concluded that although they made mistakes during the Covid-19 pandemic, there were no errors or blind spots in their position today as they work to “evangelise science.”

Offit said science is a powerful thing to have on their side, and he likened himself and others to Galileo, who was forced to recant his position that the earth revolved around the sun, even though it was true.

Dr Mike agreed. He said they have a messaging problem.

“We in the healthcare space need to think about our communication style, skillset, the tools that we use for it, social media being a primary one,” Dr Mike said.

He invited Kennedy to join his podcast and offered him $100,000 for the charity of his choice. After the debate, Offit and Dr Mike posted a link to their conversation on X. Commenters lambasted them.

“Translation: Should Physicians engage with people who disagree with them? It’s a convenient fortress you’re building, but it won’t last. Free speech will kill the pharmaceutical-industrial complex,” one commenter said.

“Another elite who wants to control the narrative by claiming different viewpoints are misinformation. Not working anymore, Paul,” said another. Overall, the post didn’t get very many views.

• A Tell Media report / By Brenda Baletti – A senior reporter for The Defender.