Author's response to influenza vaccination: policy v evidence

doi:10.1136/bmj.39045.403808.1F

BMJ 2006;333:1172 (2 December), doi:10.1136/bmj.39045.403808.1F

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Author's response to influenza vaccination: policy v evidence

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

My analysis was based on 206 studies (severalmillion observations' worth of data) included in systematicreviews spanning some 40 years. The hypotheses by Mandl do notfit some of the evidence in the elderly population.¹ He cannotexplain how in years of good matching between vaccine antigeniccontent and circulating viruses the vaccines fail to preventdeaths from all respiratory diseases in elderly community dwellers(1.32, 95% confidence interval 1.25 to 1.39, 426 668 observations)while at the same time preventing 42% (25% to 55%, 404 759 observations)of deaths from all causes,² presumably including deaths fromfalls, accidental poisoning, accidents, hypothermia, and soon.

Fedson and Nichol deride my choice of exampleof poor methodological quality of a large number of availablecohort studies.¹ The authors of the studies either did not knowsuch details or like Fedson and Nichol thought them irrelevantand would leave a reader . . . [Full text of this article]

Tom Jefferson, coordinator

¹ Cochrane Vaccines Field, Anguillara Sabazia, Roma 00061, Italy jefferson.tom@gmail.com

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Influenza vaccination: policy versus evidence: No gap between policy and evidence: David S Fedson and Kristin L Nichol
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