Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Regardless of the evidence for political or commercial influence on the approval of 4CMenB (Bexsero), Isaacs and McVernon's concern about the balance of risks and benefits of the vaccine should not be dismissed. There were 5 cases of Kawasaki Disease in 4340 trial infants. This is 115 KD cases per 100,000 infants, about 10 times the background incidence of KD. More than a third of the infants had high fevers the day of vaccination, including 8 who had seizures, 184 seizures per 100,000 infants. This is nearly 3 times the seizure rate with the old DTwP vaccine and 5-6 times the seizure rate with DTaP/IPV/Hib vaccine. The details of these adverse effects get submerged in journal articles reporting vaccine trials (Lancet 381:785,2013. Lancet 381:825,2013. JAMA 307:573,2012). Conscientious parents with such facts in hand will probably opt out of the vaccine.