Belief not science is behind flu jab promotion, new report says

BMJ 2012; 345 doi: (Published 19 November 2012) Cite this as: BMJ 2012;345:e7856

Re: Belief not science is behind flu jab promotion, new report says

Drs English and Hewitt seem to misunderstand the article. They claim that I am guilty of the "perfect solution" fallacy regarding flu vaccination. I beg to differ. I cited data besides the CIDRAP report, specifically the Cochrane reviews, which reported lack of efficacy for flu vaccine in several populations.

Importantly, I pointed out that both CIDRAP and Cochrane did not find mortality benefit among the elderly, who account for over 90% of all flu deaths (most of the other deaths occur among those with multiple co-morbidities).

The modest (but hardly complete) benefit seen in healthy younger adults and lack of effect on those who need it most (the elderly) raises a quandary similar to that of prostate cancer screening and treatment described by Willet Whitmore who famously asked, “Is cure necessary in those for whom it is possible, and is cure possible in those for whom it is necessary?”

My article simply stated the facts about the known efficacy of flu vaccine - something the author of the CIDRAP report himself said has been exaggerated and even hyped at times. So I'm puzzled by the rather strong reaction it evoked by Drs English and Hewitt.

As for comments by other readers regarding drug company hype and links to autism; unfortunately, some of the "science" claimed by those who are opposed to vaccines is as bad as that of the proponents of certain vaccines. Smallpox and polio vaccines halted deadly scourges of their time. At the same time, infants and children today are given stunning numbers of vaccines by the age of 5 years, and while some are good, others leave far more room for doubt, and vaccines have indeed become big business, especially as lucrative Department of Defense and bioterrorism contracts have funded vaccine stockpiling and research.

I think what is needed to distinguish the wheat from the chaff is more sound science, not advertising or fanciful thinking disguised as science - which brings me to BMJ's commendable campaign for data transparency: something that is sorely needed if we are to learn which vaccines are necessary, which are borderline, and which we might want to forego altogether.

Jeanne Lenzer

Competing interests: author of article on flu jabs

10 December 2012
Jeanne M. Lenzer
19 Ridge St., Kingston, NY 12401 USA