Intended for healthcare professionals

Rapid response to:

Observations Body Politic

A jab in the dark

BMJ 2012; 345 doi: (Published 08 August 2012) Cite this as: BMJ 2012;345:e5313

Rapid Response:

Re: A jab in the dark

Nigel Hawkes raises some interesting questions in relation to both the proposed nasal spray influenza vaccination for school children as well as the lack of transparency and accountability of the Joint Committee on Vaccination and Immunisation. But there are some further issues he might like to look into.

For instance, the manufacturer's product information for Fluenz states [1]:

"FLUENZ should not be administered to children and adolescents with severe asthma or active wheezing because these individuals have not been adequately studied in clinical studies.

"Do not administer FLUENZ to infants and toddlers younger than 12 months. In a clinical study, an increase in hospitalisations was observed in infants and toddlers younger than 12 months after vaccination (see section 4.8).

"It is not recommended to administer FLUENZ to infants and toddlers 12-23 months of age. In a clinical study, an increased rate of wheezing was observed in infants and toddlers 12-23 months of age after vaccination (see section 4.8).

"Vaccine recipients should be informed that FLUENZ is an attenuated live virus vaccine and has the potential for transmission to immunocompromised contacts. Vaccine recipients should attempt to avoid, whenever possible, close association with severely immunocompromised individuals (e.g. bone
marrow transplant recipients requiring isolation) for 1-2 weeks following vaccination. Peak incidence of vaccine virus recovery occurred 2-3 days post-vaccination in clinical studies. In circumstances where contact with severely immunocompromised individuals is unavoidable, the potential risk of
transmission of the influenza vaccine virus should be weighed against the risk of acquiring and transmitting wild-type influenza virus."

So, in other words, the project will inevitably put at risk a great many people who cannot "benefit" directly from the vaccine including students with asthma or lowered immunity as well as infants and elderly and sick people at home, which is made doubly absurd by the poor history of anticipating the right virus strains [2] thus exposing the population en masse to an illness they most like would not otherwise have encountered. The wisdom and ethics of the committee in doing this is certainly open to question.

Secondly, the JCVI has a long and troubling history over safety issues over which it has yet to answer. In a presentation last year to the British Society of Ecological Medicine Dr Lucija Tomljenovic of British Columbia University drew shocking attention to the problem [3]:

"Here I present the documentation which appears to show that the JCVI made continuous efforts to withhold critical data on severe adverse reactions and contraindications to vaccinations to both parents and health practitioners in order to reach overall vaccination rates which they deemed were necessary for “herd immunity”, a concept which with regards to vaccination, and contrary toprevalent beliefs, does not rest on solid scientific evidence as will be explained. As a result of such vaccination policy promoted by the JCVI and the DH, many children have been vaccinated without their parents being disclosed the critical information about demonstrated risks of serious adverse reactions, one that the JCVI appeared to have been fully aware of. It would also appear that, by withholding this information, the JCVI/DH neglected the right of individuals to make an informed consent concerning vaccination. By doing so, the JCVI/DH may have violated not only InternationalGuidelines for Medical Ethics (i.e., Helsinki Declaration and the International Code of Medical Ethics) [2] but also, their own Code of Practice(

But perhaps most disturbingly of all, given the unconciliatory attitude of Professor Andrew Hall, the committee's chairman below [4], the JCVI - according to a remarkable government edict of 2009 - is no longer answerable to the government but vica versa, placing an "Obligation on the Secretary of State to ensure implementation of JCVI recommendations" [5]. While it remains constitutionally dubious whether parliament can abrogate its authority in such a way the continuing prostration of government before this body deserves public scrutiny and scepticism.


[2] Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E, 'Vaccines for preventing influenza in healthy adults.', Cochrane Database Syst Rev. 2010 Jul 7;(7):CD001269.

[3] Dr Lucija Tomljenovic, 'The vaccination policy and code of ethics of the Joint Committee on Vaccination and Immunisation: are they at odds?' BSEM March 2011

[4] Andrew J Hall 'Re: A Jab in the Dark', BMJ Rapid Responses 22 August 2012

[5] The Health Protection (Vaccination) Regulations 2009,

Competing interests: Autistic son

24 August 2012
John Stone
UK Editor
London N22