BMJ  2005;330:844 (9 April), doi:10.1136/bmj.330.7495.844-a

Letter

Non-specific effects of vaccination

Author's reply to Shann

The first 150 words of the full text of this article appear below.

EDITOR—Shann rightly questions the subtitle to my editorial, "Literature does not support either beneficial or detrimental effects." I did not write it and failed to note its insertion by the editor at the last moment before the article went to press—for which I apologise.

Of course, there are many well documented non-specific effects of vaccines, two of which I mentioned explicitly: "Some vaccines have effects on non-target diseases—for example, BCG protects against leprosy. Some vaccines have rare adverse reactions—for example, myopericarditis after smallpox vaccine."

The existence of some non-specific effects is not an issue—and they extend far beyond the limits of the hypothesis proposed in Shann's letter. My scepticism was, and remains, aimed at the spate of studies on the supposed "non-specific effects" (both beneficial and detrimental) of vaccines on mortality, typified by the paper by Vaugelade et al and several by Aaby et al.^{1 2 3}

These studies faced . . . [Full text of this article]

London School of Hygiene and Tropical Medicine, London WC1 7HT Paul.Fine@lshtm.ac.uk

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