9月10日，小罗伯特·F·肯尼迪在德克萨斯州达拉斯举行的共和党全国委员会中期选举大会上走上舞台。
Robert F Kennedy Jr walks on stage during the Republican National Committee midterm convention in Dallas, Texas, on 10 September.
照片来源：Blake Fagan/AFP/Getty Images美国卫生部长呼吁将患者的医疗记录和生活方式相关数据发送给医生及人工智能系统，以帮助应对“慢性疾病流行”问题。小罗伯特·F·肯尼迪在一场由反疫苗活动人士主办的活动中，提出了关于收集、共享和分析美国健康信息的全面计划。他认为，从患者就医记录到日常锻炼情况等医疗和生活方式数据都应被政府及独立研究人员所掌握；这些数据可用于研究疫苗与健康状况（包括自闭症和死亡率）之间的潜在关联。
Photograph: Blake Fagan/AFP/Getty Images Health secretary calls for medical and lifestyle details to be sent to doctors and AI to address ‘chronic disease epidemic’ Robert F Kennedy Jr laid out an expansive vision for collecting, sharing and analyzing US health information at a Maha event hosted by a close ally and outspoken anti-vaccine activist. Medical and lifestyle data, from doctor’s visits to exercise, should be connected and shared with the government and independent researchers, where it can be searched by– including potential links between vaccines and health outcomes including autism and mortality, suggested Kennedy, the secretary of the US Department of Health and Human Services (HHS) and a longtime vaccine skeptic.
“我们需要利用美国的健康数据来查明：我们吃的食物、接触到的化学物质、接种的疫苗，以及其他环境因素和生活方式是否在某种程度上导致了慢性疾病的蔓延，”美国卫生与公共服务部（HHS）部长肯尼迪在周一的活动中表示。约有二十多人观看了这场直播。
“We need to use America’s health data to determine whether the food we eat, the chemicals we encounter, the vaccines that we’re administering, the other environmental and lifestyle exposures are contributing in one way or another to the chronic disease epidemic,” Kennedy said at an event with the Maha Institute on Monday, with about two dozen people tuning into the live stream.
该活动由马克·戈顿（Mark Gorton）主持；两周前，他曾称自己是“反疫苗运动中最敢于发声的人”。据《纽约时报》报道，该机构由托尼·莱昂斯（Tony Lyons）共同创立，其出版社通过多个基金会向肯尼迪提供了400万美元的资金，这些资金来源于政治捐款和健康相关企业。
The Maha Institute is headed by Mark Gorton, who called himself “the boldest anti-vaxxer in the anti-vax conference” two weeks ago. The institute was co-founded by Tony Lyons, whose publishing house gave $4m to Kennedy through various Maha foundations with funding from political contributions and health-related corporations, according to reporting by the New York Times.
肯尼迪负责协调他所监管的所有机构（包括美国食品药品监督管理局（FDA）、疾病控制与预防中心（CDC）以及医疗保险与医疗补助服务中心（CMS））的数据收集工作。
Kennedy has focused on pulling together data from all of the agencies he oversees, including the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the Centers for Medicare and Medicaid Services (CMS).
“无论您走到哪里，健康信息都应伴您左右，”肯尼迪说。例如，医疗服务提供方、保险公司和科技公司正在开发便携式健康记录应用，让个人更容易获取病历，也便于政府及外部机构使用这些记录。
”Your health information should follow you wherever you go,” Kennedy said. Providers, insurance and technology companies are creating apps for portable health records, for instance – making it easier for individuals to access their medical records, and also opening up the records for governmental and outside use.
“医疗补助计划（Medicaid）非常适合用于研究，因为其中涉及数亿人的生命数据，包括数千万参加该计划已有10年或20年的儿童，”肯尼迪说。他说，特朗普政府目前正在追踪医疗补助计划中的“暴露情况”、干预措施和理赔数据，而“Medicare为我们提供了有关美国老年人和残障人士的大量信息”。
“Medicaid is a really useful vehicle for studying that because there are hundreds of millions of lives in there, including tens of millions of children who’ve been in that program for 10 or 20 years,” Kennedy said. The Trump administration is now tracking “exposures”, interventions and claim data in Medicaid, and “Medicare gives us enormous amounts of information on older Americans and people with disabilities,” he said.
他说，美国食品药品监督管理局（FDA）的监测系统可以关联理赔数据和电子健康记录，“开展主动安全监测”；HealthVerity等商业平台则能够关联保险理赔、处方、实验室检查结果和电子健康记录。
FDA monitoring systems can link claims data and electronic health records “to conduct active safety surveillance”, while commercial platforms, such as HealthVerity, can link insurance claims, prescriptions, laboratory results and electronic health records, he said.
肯尼迪说，向美国疾病控制与预防中心（CDC）报送的州级数据集“无法使用”，因为这些数据集往往收集不同的数据项：“太多这样的系统仍处于孤立状态，无法向我们提供了解整体健康状况所需的实时信息。”不过，更广泛地获取各州健康数据，可以让官员和其他人员关联免疫接种记录、临床数据、实验室检查结果、药房信息和保险理赔，“从而更完整地呈现患者长期以来的健康状况，”肯尼迪说。
State-level datasets reported to the CDC are “unusable” because they often collect different data points, Kennedy said: “Too many of those systems remain siloed and cannot give us the real-time information we need to understand health at scale.”Yet wider access to state health data could allow officials and others to connect immunization records, clinical data, laboratory results, pharmacy information and insurance claims “to create a more complete picture of a patient’s health over a long period of time”, Kennedy said.
他表示，联邦官员正在利用人工智能处理数据：“过去需要数年才能完成的研究，如今真的几秒钟就能做完。你可以提出问题，立即得到答案，而我们今天正在做的正是这一点。”肯尼迪反复强调人工智能的优势。反疫苗领域的一些人甚至声称，人工智能能够揭示疫苗的危险，因此对其倍加推崇。肯尼迪说：“它可以帮助研究人员从数百万份健康记录中发现规律，而人类逐条阅读这些记录永远不可能做到这一点。”
Federal officials are using AI to process the data, he said: “Studies that used to take years, you can do them literally in seconds. You can ask questions and you can get immediate answers, and that’s what we’re doing today.”Kennedy repeatedly touted the benefits of AI, which has been embraced by some in the anti-vaccine world for purportedly showing the dangers of vaccines. “It can help researchers find patterns across millions of health histories that human beings could never find by reading those records one at a time,” Kennedy said.
肯尼迪表示，OpenAI联合创始人萨姆·奥尔特曼本周与他会面，并告诉他，美国卫生与公众服务部使用生成式人工智能的程度超过其他任何联邦机构。肯尼迪将其称为“超级智能”。最近披露的信息显示，OpenAI的智能体今年夏天曾入侵美国政府网站和澳大利亚医保网站。
OpenAI co-founder Sam Altman met with Kennedy this week and told him that HHS uses generative AI – Kennedy used the term “superintelligence” – more than any other federal agency, Kennedy said. OpenAI agents hacked US government websites and the Australian Medicare website this summer, reporting recently revealed.
“我们已经在利用所有这些数据回答一些最重要的问题。”肯尼迪说。尽管遭到广泛抗议，官员们仍建立了一个自闭症患者登记数据库。肯尼迪表示，特朗普政府还启动了一系列研究，考察饮食、电磁场、屏幕使用时间和疫苗等因素在疾病发生中的作用。
“We’re already using all of these data to answer some of our most important questions,” Kennedy said. Officials have created an autism registry despite widespread protest The Trump administration has also launched studies on the roles of such factors as diet, electromagnetic fields, screen time and vaccines in the development of illness, Kennedy said.
他反复谈到疫苗。肯尼迪说，在美国疾病控制与预防中心，官员们正利用疫苗安全数据链接系统（VSD），比较接种疫苗与未接种疫苗人群的医疗结局，同时研究铝佐剂在疫苗中的作用、婴儿期乙肝疫苗的接种时机、活疫苗与减毒疫苗的对比，以及儿童流感、新冠和HPV疫苗。
He repeatedly returned to vaccines. At the CDC, officials are using the Vaccine Safety Datalink (VSD) to compare outcomes in healthcare for vaccinated and unvaccinated people, as well as examining the role of aluminum adjuvants in vaccines; the timing of the hepatitis B vaccine in infancy; comparing live and attenuated vaccines; and studying influenza, Covid and HPV vaccines in children, Kennedy said.
利用医疗援助计划（Medicaid）和“关联的真实世界数据”，官员们还在研究孕期接种疫苗及随后的儿童健康结果。他说，美国食品药品监督管理局（FDA）的研究人员正在使用生物制品有效性和安全性（Best）系统以及联邦医疗保险（Medicare）数据，来“复制和扩展先前关于以下方面的研究”：接种疫苗与未接种疫苗的人群、铝与哮喘、以及孕妇流感疫苗与自闭症谱系障碍。
Using Medicaid and “linked real-world data”, officials are also studying vaccination during pregnancy and subsequent childhood outcomes. FDA researchers are using the Biologics Effectiveness and Safety (Best) System and Medicare data to “replicate and expand previous studies” on vaccinated and unvaccinated populations, aluminum and asthma, and maternal influenza vaccines and autism spectrum disorder, he said.
跳过新闻简报推广小肯尼迪说：“我们很快就会有答案。一个互联程度更高的健康数据系统将使这项研究更加扎实。”小肯尼迪多次重申一个长期不满的问题——在2000年代初，独立公民试图将疫苗与自闭症联系起来，却在违反保密协议后被禁止访问疫苗安全数据链（VSD）的数据。根据马里兰州行医委员会（该委员会暂停了马克·盖尔的医疗执照）的说法，马克·盖尔（Mark Geier）和大卫·盖尔（David Geier）在被暂停资格时并不隶属于任何研究机构，他们创建了自己的机构审查委员会来监督他们的工作。该委员会还指控大卫·盖尔无证行医。
skip past newsletter promotion after newsletter promotion“We will have answers soon,” Kennedy said. “A more connected health data system will make this research even stronger.”Kennedy returned repeatedly to an old grievance – how independent citizens attempting to link vaccines to autism were blocked from accessing VSD data in the early 2000s after they violated confidentiality agreements. Mark and David Geier weren’t affiliated with any research institutions at the time of their suspension, and they created their own institutional review board to oversee their work, according to the Maryland state board of physicians, which suspended Mark Geier’s medical license. The board also charged David Geier with practicing medicine without a licence.
小肯尼迪在谈到2002年之后受医疗机构保护、以维护健康隐私的VSD数据时说：“我今天无法获取这些数据。我无法获取它。”小肯尼迪称VSD是一个“行不通的系统”，并表示：“具有合理假设的合格研究人员不应需要获得把关人的许可来对其进行检验。”小肯尼迪说，特朗普政府目前的目标是使健康数据“具备研究条件，然后让数百名外部研究人员真正进来查看”。
“I cannot get access to that data today. I cannot get access to it,” Kennedy said of the VSD data after 2002, which is safeguarded by healthcare organizations for health privacy reasons. “A qualified researcher with a legitimate hypothesis should not need permission from a gatekeeper to test it,” Kennedy said, calling the VSD an “unworkable system”. The Trump administration’s goal now is to make health data “research ready, and then give access to hundreds of external researchers to actually come in and look at it”, Kennedy said.
马哈研究所主席戈顿在周一的活动发言中聚焦于开放数据。然而，就在不到两周前，在反疫苗组织“儿童健康防御”的一次会议上，戈顿将疫苗称为“公共卫生噩梦”，散布关于其成分的虚假信息，声称40%的儿童因过敏、哮喘和湿疹诊断而“受伤”于疫苗，并猛烈抨击“操控医疗体系的投毒者”。
Gorton, the Maha Institute president, focused on open data in his comments at the event on Monday. But less than two weeks earlier, at a meeting of the anti-vaccine organization Children’s Health Defense, Gorton called vaccines a “public health nightmare”, spread misinformation about their ingredients, claimed that 40% of all kids are “injured” by vaccines because of allergy, asthma and eczema diagnoses, and railed against “the poisoners running the medical system”.
疫苗接种的成功，常被誉为科学史上最伟大的成就之一，被戈顿称为“彻头彻尾的捏造”和“大规模欺诈”。他在9月17日的会议上特别针对脊髓灰质炎疫苗，声称20世纪50年代的脊髓灰质炎疫情实际上是由农药引起的。“所谓脊髓灰质炎疫苗的成功，是一场巨大的医疗欺诈和精心策划的公关骗局，”戈顿声称。
The success of vaccination, frequently called one of the greatest achievements in science, is a “complete fabrication” and “massive fraud”, Gorton said at the 17 September conference. He took particular aim at polio vaccines, claiming that an outbreak of polio in the 1950s was actually because of pesticides. “The supposed success of the polio vaccine was a massive medical fraud and a masterful PR deception,” Gorton claimed.
“是时候停止在每次发言开头都加上‘我不是反疫苗者，但是……’这样的免责声明了。疫苗是一场噩梦，只有反疫苗者才能说得足够清楚，”戈顿在那次会议上说，并补充道：“疫苗越多，自闭症越多。就是这么简单。”对马哈研究所而言，聚焦于开放健康数据是一项新举措。但戈顿周一表示，若能更便捷地获取美国健康信息，将有助于倡导者建立与其长期关注议题之间的新联系。
“The time has come to stop caveating every introduction with ‘I’m not an anti-vaxxer, but …’ Vaccines are a nightmare, and only anti-vaxxers can speak clearly enough,” Gorton said at that conference, adding: “More vaccines, more autism. It’s that simple.”Focusing on opening up health data is new for the Maha Institute. But having greater access to US health information would help advocates make new links to the issues they have long focused on, Gorton said on Monday.
包括马哈研究所在内的组织，虽然独立于政府之外，但与肯尼迪等高层领导人关系密切，能够“填补空白”并“施加政治压力”，他说。肯尼迪感谢他的老朋友戈顿提供了“难以置信的支持”。
Organizations including the Maha Institute, which exists outside the government but enjoys close ties to top leaders such as Kennedy, can “fill the gaps” and “bring political pressure”, he said. Kennedy thanked Gorton, his longtime friend, for his “incredible support”.