BMJ  2006;333:1021 (11 November), doi:10.1136/bmj.39023.947037.1F

Letters

Influenza vaccination: policy versus evidence

Vested interests will always trump evidence

With reference to the article by Jefferson,¹ five years ago I asked my general practitioner what the facts were about the pros and cons of flu vaccination, and I was referred to the handouts from the Department of Health. These were long on assertion and short on facts. I embarked on a literature search and running correspondence with various civil service mandarins with the limited ambition of getting data on what actual tests—of efficacy and safety—had been done on current vaccines and with what results. After much evasive action and stalling I was informed that such information was confidential.

The Lancet published my scepticism about the extraordinary claims being made for the ability of flu vaccine to prevent not only the flu but death as well, whatever the cause.² Since then a few papers have expressed concern about the inconclusive nature of the evidence for its efficacy,^{3 4} and the public has been exhorted repeatedly to "protect themselves."

The enormous expense of this futile exercise doesn't seem to register—partly, I fear, because of payment inducements offered to general practitioners. They, perhaps, may claim they believed the recommendations of the Department of Health and carried out the vaccination programmes in good faith. This excuse—"only carrying out orders"—is of doubtful validity. There can be no excuse for the harmful public health decisions and refusal to come clean about what precisely were the reasons for them. It is too much to hope for repentance and reversal, however. The Faustian contract exemplified in the structure of the Medicines and Healthcare products Regulatory Agency will see to that.

¹ Exeter EX1 2HW h.2@which.net

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Competing interests: None declared.

References

1. Jefferson T. Influenza vaccination: policy versus evidence. BMJ 2006;333:912-5.(28 October.)[Free Full Text]
2. Hall GH. Antiflu, or antideath vaccination? Lancet 2001:357:2141.
3. Van der Wouden JC, Bueving HJ, Poole P. Preventing influenza: an overview of systematic reviews. Respir Med 2005;99:1341-9.[CrossRef][ISI][Medline]
4. Simonsen L, Reichert TA, Viboud C, Blackwelder WC, Taylor RJ, Miller MA. Impact of influenza vaccination on seasonal mortality in the US elderly population. Arch Intern Med 2005;165:265-72.[Abstract/Free Full Text]

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