Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Why does flu break out as the nights draw in?
- Barry A Groves, PhD (27 October 2006)
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Shied away from Controversy or Responsibility?
- Kerry A Bailey (27 October 2006)
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Welcome, as far as it goes
- John Stone (31 October 2006)
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Denouement nears.
- Bill Welsh (31 October 2006)
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The case against Wakefield should proceed.
- Hilary Butler (1 November 2006)
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Re: The bitter end
- John P Heptonstall (2 December 2006)
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The bitter end
- John Stone (2 December 2006)
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Barry A Groves, PhD, Independent Researcher, maintains www.second-opinions.co.uk OX7 6LP
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I agree with Tom Jefferson's appraisal of the worthlessness of the flu vaccination programme. I have wondered about the worth of the influenza vaccine for some years. Surely, the vaccines available this year were made to combat last year's virus - and the influenza virus is constantly mutating. This makes it unlikely that the current vaccine would provide a worthwhile investment. A good example of the worthlessness of vaccinating against influenza is a Canadian experiment with a flu vaccine which is universally free to those vaccinated, although it has cost Ontario taxpayers more than C$200 million. The experiment began in 2000. A study published this year, after the experiment had been running for 5 years, suggested that it appeared to have done nothing to cut the spread of influenza.1 Research by the University of Ottawa, published in the journal, Vaccine, concluded that not only did the per-capita flu rates in the province not fall since the programme was introduced, the average monthly numbers of flu cases actually went up, although researchers say it is too early to say that numbers are really on the rise. Dianne Groll, the University of Ottawa professor who led the study, said ‘All we do know is rates haven’t decreased, and there has been a lot of money spent. The program was designed to reduce the incidence of flu, and this hasn’t yet happened.’ A recent study in the Lancet also concluded, ‘In elderly individuals living in the community, [influenza] vaccines were not significantly effective against influenza, influenza-like illness, or pneumonia’.2 But why did Canadians - and why do we - think that vaccination would work? Twenty years ago, Edwin Kilbourne, the grandfather of American influenza specialists had found that ‘The effect of current vaccination programs on morbidity is insignificant, and that on mortality marginal’.3 The flu virus is with us all year round. Yet, in spite of people crowding together in the streets, factories, offices, on buses, trains, airplanes, cruise ships, and in nursing homes and hospitals, an outbreak of flu in the summer months is so rare that it makes the news.4 Influenza is a disease of winter.5 Furthermore, flu epidemics happen at the same time at the same latitude around the world, both north and south of the equator.6 The evidence is overwhelming that epidemic influenza, and even some of the viruses that cause the common cold, may be prevented by adequate doses of vitamin D. So the answer is simple: We need to get out in the sun more, particularly in the middle of the day - and without a sunscreen - in the summer to build up a store of Vitamin D. It's also a good Idea to holiday in warmer climes in the winter. That is the best protection against influenza - and other infectious diseases. References 1. Groll DL, Thomson DJ. Incidence of influenza in Ontario following the Universal Influenza Immunization Campaign. Vaccine. 2006 Apr 5; [Epub ahead of print] 2. Jefferson T, Rivetti D, Rivetti A, Rudin M, Di Pietrantonj C, Demicheli V. Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review. Lancet 2005; 366: 1165-74. 3 Kilbourne E. Influenza. Plenum Press, New York, 1987, p. 291. 4. Kohn MA, et al. Three summertime outbreaks of influenza type A. J Infect Dis 1995; 172: 246–249. 5. Curwen M. Excess winter mortality in England and Wales with special reference to the effects of temperature and influenza. In: Charlton J, Murphy M, eds. The Health of Adult Britain 1841–1994. London: The Stationery Office, 1997, pp. 205–216. 6. Hope-Simpson RE. The role of season in the epidemiology of influenza. J Hyg 1981; 86: 35-47. Competing interests: None declared |
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Kerry A Bailey, SpR Public Health and GP NPHS
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It appears Ms Godlee in resisting the temptation to shy away from controversy has shied away from any responsibility to public health or the doctors she supports. It is important to publish papers such as the Tom Jeffersons(1) paper but to do so in an appropriate way. To do so in the middle of a vaccination campaign risks leaving individuals unprotected. The rise in measles she describes in her first paragraph should have been her warning. Does she see her role as helping to improve health and helping her readership to do that? or something else? The BMJ certainly achieved something- the headlines “Those flu jabs could be a waste of time, says expert’”– Telegraph (2) “Flu vaccines 'not worth the bother' says expert” Mail(3) Was there any consideration for the General Practitioners who are still completing their flu vaccinations and now face questions of its efficacy without time to assess the article? Or even the people who may decide not to have their vaccination having read these headlines? And what of the consequences? Jeffersons paper supports the Joint Committee on Vaccination and Immunisation (JCVI) policy decisions(2). It shows a decrease in influenza in healthy adults and elderly and a decrease in deaths in the elderly but she makes no reference to this. The vaccine is safe and effective but the BMJ has helped to promote the opposite message at the most sensitive time. (1)Jefferson T., Influenza Vaccine: policy versus evidence BMJ 2006;33: 912-5 (2) Telegraph 27/10/06 (3) Mail 27/10/06 (2)CMOs letter, June 2006, Department of Health Competing interests: None declared |
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John Stone, none London N22
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Having argued extensively in these columns that there were no grounds for the prosecution of Andrew Wakefield I welcome the editor's statement. The case always looked flawed and fabricated to suit public policy: it looked bad two years ago and it is shameful that threat of prosecution has remained over Wakefield's head all this time, with the GMC and its solicitors Field, Fisher, Waterhouse scratching around for anything substantive that they could bring against him, at the behest of former Health Secretary John Reid. Where I disagree with the editor is that not only is there a perception that officialdom have not taken the MMR parents' concerns seriously (except in a malign way), they live it day to day, with lack of medical and education support, while many have also suffered unpleasant fabricated illness allegations. Everything which is dysfunctional about modern government has been visited on these unfortunate families. Moreover, the way these families have been treated undermines scientific objectivity itself. That the present hue and cry should have folllowed one of the flimsiest stories that even a Sunday newspaper has ever produced speaks volumes. Another point of disagreement is with the comparison with flu vaccine. While few would doubt that unlike flu vaccine MMR is relatively effective, the unspun Cochrane review of last year surely did anything but endorse its safety. Even the six studies included which bore on the Wakefield thesis were found to have serious defects - in this regard the claim that they had not shown a link with autism and bowel disease ought not to have been considered of the greatest significance. Competing interests: Autistic son |
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Bill Welsh, Chairman Autism Treatment Trust, 26B Great King Street, Edinburgh. EH3 6QH
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Fiona Godlee is quite right in asserting that any plan by the General Medical Council (GMC) to pursue Andrew Wakefield on the grounds of “publishing flawed research” is “doomed”. The reason for the failure of such a scheme would not, however, as she claims, be due to there being a plethora of flawed studies in circulation. It would be because Wakefield’s robust and rigorous research was accurate. It has been replicated. Wakefield was and is correct; many autistic children have a novel form of bowel disease. Ms Godlee is also quite right in pointing out that there is a perception that the medical establishment “has not taken seriously the concerns of families who believe their children have been damaged by the vaccine”. This point is well illustrated by a Medical Research Council that, in almost eight years of raging debate, has refused to fund the clinical examination of even one of the thousands of children reportedly withdrawing into autism following MMR vaccination. The MRC apparently inhabits an ivory tower, unaware of the public health tragedy unfolding below. One child in a 100 in the UK now has a diagnosis of autism, a previously very rare condition. No plausible explanation for this development is being put forward by medical officialdom. As the denouement nears the GMC aspect looks more and more like a sideshow. Bill Welsh
Competing interests: Chairman of an autism treatment centre. |
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Hilary Butler, freelance journalise. home, Tuakau, New Zealand.
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Dear Sir, I disagree with Fiona Godlee that the case against Wakefield should be dropped. Her stated editorial position has always been that of an ardent MMR advocate. It seems that by proxy and belief therefore, Wakefield has been inconclusively and irrefutably proven wrong in the eyes of the whole medical profession? The reason why the case against Wakefield should proceed is that if the pro-vaccine medical literature on MMR is not also flawed, the proponents of MMR have a wonderful platform from which to convince the public that everything since 1998, said by Wakefield is a load of rubbish. Either side should be prepared to put up or shut up, not suggest that cancelling the case is a good idea, because not prosecuting will deprive Wakefield supporters of airtime. The basis of scientific accuracy and resultant public choice, should be robust debate, not "no debate and maybe the problems will go away." Fiona Godlee also says that Wakefield's work served as a reminder about flawed medical research, and "as if to prove [that]point" she rolls out Tom Jefferson's article showing lack of evidence of usefulness of the flu vaccine. Again here, I believe she is wrong. The medical evidence about the uselessness of the influenza vaccines dates from the 60's when the USA DBS (Division of Biologics Standards, now the FDA) attempted to silence their vaccine tester, Dr Anthony J Morris, who for years found that the flu vaccine was consistently useless before he was "shifted sideways". More recently, a couple of years ago, when Simonsen et al likewise found the same thing, http://www.fic.nih.gov/news/inthenews/SimonsenArchives.pdf using data from the point where Dr Morris was shifted sideways to 2004, they were later forced to recant, and pay penance by saying "...but if we vaccinate all the children then Granny won't get it." That didn't go down so well with parents, so it seems that last week, the backroom boys pulled the ultimate emotional blackmail on mothers, on the basis of one supposed study to say http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=412187&in_page_id=1&in_page_id=1&expand=true#StartComments ... that pregnant and lactating women should receive the flu vaccine on the basis that it might prevent a two-fold increase in childhood cancer. No mention that such a position is based on the erroneous assumption that the vaccine works in the first place. What does it take for the medical profession to drop something that has been pretty much useless since it first hit the market 50 plus years ago...? If Health Departments and governments can't see sense with the flu vaccine, is it any wonder that MMR's halo will be relentlessly protected, no matter what? I believe the time has come, not to say who may speak, who may not; which case should go forward or which should not; but to root out flawed research, hypocrisy, inflated egos, and lack of transparency and accountability in the medical profession, politicians and medical journals. If all that is done, then when fall-out has finished, the average person on the street might have a chance to see what the real issues are without the current, constant obfuscation by point-scoring. Sincerely, Hilary Butler. Competing interests: I chose not to have the flu vaccine, or any other vaccine. |
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John P Heptonstall, Director of the Morley Acupuncture Clinic Leeds LS27 8EG
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Sir/Madam Despite the apparent confusion in the media as to whether Wakefield is or is not to be disciplined by the GMC, and the fact that the GMC does not appear to have ever sought to clarify or quash said 'rumours', I feel justice needs to be seen to be done and the GMC should seek the requisite answers on behalf of public and profession to the enigma that is Wakefield's (and others') published scientifically-deduced findings in relation to PDDs, wild and vaccine viruses. Speculation by media correspondents' and medical journal respondents' opinions - oft overshadowed by front bench politicians' policy remarks born of Department of Health spokesperson's advice - have left the UK public suspicious of all vaccines as it is very difficult (in times of proven political deceit and spin) to automatically reject the opinion of numerous Wakefield supporting scientists merely because government 'edict' says one should! The GMC could settle this once and for all. Let us see a proper comprehensive investigation of Wakefields' scientific medical position - that must necessarily involve a proper comprehensive investigation of all disciplinary prosecution material and witness evidence that accuses Wakefield - in a properly convened tribunal at the GMC as soon as possible. Surely the GMC can commission experts, necessarily devoid of commercial and vested competing interests, sufficiently capable of analysing in great detail all the essential ingredients of both sides' evidence? I believe that the public deserves no less. Regards John H. Competing interests: None declared |
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John Stone, none London N22
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The Independent was told this summer that charges would be brought against Andrew Wakefield in the autumn [1]. While there may be the odd leaf left on the trees it is reasonable to suggest now that the autumn has come and gone. I was told by Jackie Fletcher of JABS yesterday that the hearing was presently scheduled to commence on 20 July 2007 but there are still no charges. Brian Deer reported of a court hearing in June: "The charges against Wakefield, 50, are some of the most extensive seen. Timothy Dutton QC told Mr Justice Silberman that the GMC, the body that regulates doctors, was considering 10 counts of serious professional misconduct." [2] But on the present judgement of the editor of the BMJ this looks barely credible. Are the prosecutors somewhat over-motivated? I note that the GMC's solicitors Field, Fisher, Waterhouse state on their website: "We provide advice to a large number of Government departments and agencies. "FFW's position as a prime adviser to Government was confirmed by our appointment onto two central government panels, both of which took effect from April 2003. These panel appointments have already resulted in us being instructed to advise on some major confidential projects." [3] This does not on the face of it exclude the possibility that they advise on matters connected with the Wakefield affair. [1] http://news.bbc.co.uk/1/hi/health/5070670.stm [2] http://www.timesonline.co.uk/article/0,,2087-2230936_1,00.html [3] http://www.ffw.com/Sectors/Publicsector/Centralgov.aspx Competing interests: Autistic son |
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